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urgent surgery

Edmond Chun Ying U, Anupkumar Shetty, Peter Richard Scott Craig, Shashank Dattatraya Chitgopkar
Background: The aim of this study was to investigate whether massive lumbar disc herniations (LDH) can be managed safely with non-operative treatment. Whilst most LDH are treated successfully with analgesia and physiotherapy, there is little literature regarding the treatment of massive LDH. Their impressive size raises the suspicion that they may cause cauda equina syndrome and are therefore often treated surgically. Methods: Patients were referred to our tertiary unit by either their general practitioner or the musculoskeletal service...
September 2018: Journal of Spine Surgery (Hong Kong)
Vanida Ann Serna, Takeshi Kurita
Uterine leiomyoma (UL) or fibroid is a benign smooth muscle tumor of the myometrium with a lifetime incidence of approximately 70%. ULs often require medical intervention due to severe symptoms such as heavy menstrual bleeding and abdominal pain. Although the most common and effective management of ULs is surgical removal, the invasive surgical procedure imposes physical and psychological burdens on the patients. Moreover, the economic burden of UL on health care system is enormous due to the high cost of surgeries...
2018: Journal of Biological Methods
Bo Yang, Tingjun Liu, Yang Qu, Hangbo Liu, Song Guo Zheng, Bin Cheng, Jianbo Sun
Head and neck cancer is the 6th most common malignancy worldwide and urgently requires novel therapy methods to change the situation of low 5-years survival rate and poor prognosis. Targeted therapy provides more precision, higher efficiency while lower adverse effects than traditional treatments like surgery, radiotherapy, and chemotherapy. Blockade of PD-1 pathway with antibodies against PD-1 or PD-L1 is such a typical targeted therapy which reconstitutes anti-tumor activity of T cell in treatments of cancers, especially those highly expressing PD-L1, including head and neck cancers...
2018: Frontiers in Oncology
Javier García-Tirado, Diego Júdez-Legaristi, Hugo Salvador Landa-Oviedo, José María Miguelena-Bobadilla
Urgent readmissions have a major impact on outcomes in patient health and healthcare costs. The associated risk factors have generally been infrequently studied. The main objective of the present work is to identify pre- and perioperative determinants of readmission; the secondary aim was to determine readmission rate, identification of readmission diagnoses, and impact of readmissions on survival rates in related analytical studies. The review was performed through a systematic search in the main bibliographic databases...
December 10, 2018: Cirugía Española
Fei Ma, Min Kang, Ye Hui Liao, Guang Zhou Lee, Qiang Tang, Chao Tang, Yin Huan Ding, De Jun Zhong
RATIONALE: Nocardial spinal epidural abscess is rare. The diagnosis is often difficult to make and, if delayed, poses a high risk of long-term disability. Nocardial spinal epidural abscess with severe lumbar disc herniation has not previously been reported. PATIENT CONCERNS: A 50-year-old man presented with progressive lumbago and leg pain for 6 weeks after receiving acupuncture therapy, and then the patient suddenly occurred urine retention after walking. DIAGNOSES: Clinical examination revealed sign of cauda equina syndrome...
December 2018: Medicine (Baltimore)
Nelly Darbois, Jean-Noël Evain, Albin Guillaud, Marc Lilot, Nicolas Pinsault
OBJECTIVES: To analyze a clip from the program ?Acupuncture, osteopathy, hypnosis: do complementary medicines have superpowers?? about acupuncture as an anesthetic for surgical procedures in China. To propose a rational explanation for the phenomena observed. To describe the processes leading a public service broadcasting channel to offer this type of content at prime time and the potential consequences in terms of public health. METHOD: Analysis using critical thinking attitudes and skills, along with a bibliographical search of Medline, Google Scholar and Cochrane Library databases...
October 22, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Theoni Kanellopoulou, Theodora Kostelidou
BACKGROUND: Perioperative therapeutic plasma exchange in patients with cardiovascular diseases poses several challenges, including alterations in intravascular volume, serum electrolytes, the coagulation cascade, and drug pharmacokinetics. METHODS: This review article summarizes different indications of plasma exchange for patients requiring cardiac surgery based on reported case reports and case series. RESULTS: The most common reported indication is plasma exchange for the management of allosensitized cardiac transplant candidate patients in combination with immunosuppressive regimens, which increases the likelihood of obtaining a cross-match-negative allograft, improving post-transplant clinical outcome...
December 8, 2018: Journal of Clinical Apheresis
Thierry Vuilliomenet, Caroline Gebhard, Chiara Bizzozero, Salome Glauser, Steffen Blum, Andreas Buser, Daniel Bolliger, Martin T R Grapow, Martin Siegemund
OBJECTIVES: Our goal was to evaluate the impact of the discontinuation times of dual antiplatelet therapy with clopidogrel, prasugrel or ticagrelor on postoperative bleeding rates and the use of blood products in patients undergoing isolated urgent coronary artery bypass grafting (CABG). METHODS: We retrospectively analysed 334 patients with acute coronary syndrome undergoing urgent CABG at the University Hospital Basel. A total of 262 patients continued to take dual antiplatelet therapy during the surgery (72 received clopidogrel; 68, prasugrel; and 122, ticagrelor)...
December 6, 2018: Interactive Cardiovascular and Thoracic Surgery
Bo Huang, Lei Tan, Xiangmei Liu, Jun Li, Shuilin Wu
Bone-implant materials are important for bone repairing and orthopedics surgery, which include bone plates and bone nails. These materials need to be designed not only considering its biostability and biocompatibility, but also their by-products induced infection after therapy or long-time treatment in vivo . Thus, the development of novel implant materials is quite urgent. Red phosphorus has great biocompatibility and exhibits efficient photothermal ability. Herein, a red phosphorus/IR780/arginine-glycine-asparticacid-cysteine (RGDC) coating on titanium bone-implant was prepared...
March 2019: Bioactive Materials
Sandeep Kumar Vishwakarma, Chandrakala Lakkireddy, Avinash Bardia, Syed Ameer Basha Paspala, Chaturvedula Tripura, Md Aejaz Habeeb, Aleem Ahmed Khan
End stage liver diseases (ESLD) represent a major, neglected global public health crisis which requires an urgent action towards finding a proper cure. Orthotropic liver transplantation has been the only definitive treatment modality for ESLD. However, shortage of donor organs, timely unavailability, post-surgery related complications and financial burden on the patients limits the number of patients receiving the transplants. Since last two decades cell-based therapies have revolutionized the field of organ/tissue regeneration...
November 27, 2018: World Journal of Hepatology
Maximillian A Rogers, Elena Aikawa
Cardiovascular calcification is a health disorder with increasing prevalence and high morbidity and mortality. The only available therapeutic options for calcific vascular and valvular heart disease are invasive transcatheter procedures or surgeries that do not fully address the wide spectrum of these conditions; therefore, an urgent need exists for medical options. Cardiovascular calcification is an active process, which provides a potential opportunity for effective therapeutic targeting. Numerous biological processes are involved in calcific disease, including matrix remodelling, transcriptional regulation, mitochondrial dysfunction, oxidative stress, calcium and phosphate signalling, endoplasmic reticulum stress, lipid and mineral metabolism, autophagy, inflammation, apoptosis, loss of mineralization inhibition, impaired mineral resorption, cellular senescence and extracellular vesicles that act as precursors of microcalcification...
December 10, 2018: Nature Reviews. Cardiology
K V Kochkina, A V Sidorenko, A V Myznikov, G A Usik, A A Shtark, T A Kochkina, A V Pustovoitov, A V Protopopov
A ruptured thoracoabdominal aortic aneurysm is an urgent situation requiring emergency surgery during which it is necessary to decrease the scope of the intervention in a patient at an extremely high surgical risk. A combination of surgical and endovascular techniques makes it possible to minimize surgical injury, blood loss, to shorten the duration of internal organs ischaemia, to reduce the risk of paraplegia. Presented herein are the results of emergency hybrid intervention for a ruptured thoracoabdominal aortic aneurysm, accompanied and followed by description of the technical aspects of performing the surgical and endovascular stages...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
N V Lebedev, A E Klimov, O N Cherepanova, A A Barkhudarov
For today, it is necessary to recognize, that treatment of patients with abdominal sepsis remains the basic problem in urgent surgery due to the invariably high mortality. Early diagnostics and targeted therapy are the key points for improving of sepsis outcome. At present, researchers around the world have proposed a large number of biological markers for diagnosing sepsis and predicting mortality. Ideally, doctors can use biomarkers for risk stratification, diagnosing, monitoring of treatment effectiveness and outcome prediction...
2018: Khirurgiia
F I Ibragimov
AIM: To decrease disability and mortality in patients with severe combined pelvic and abdominal trauma via applications of new progressive treatment tactics. MATERIAL AND METHODS: Retrospective and prospective analysis included 1033 patients with severe combined traumas (SCT) who were treated at the Clinical Hospital #3 in 2009-2015. Patients were divided into 2 groups - control (2009-2010) and main (2011-2015) group. Treatment in control group was similar to conventional approaches...
2018: Khirurgiia
H M Haug, E Johnson, T Mala, D T Førland, T T Søvik, H O Johannessen
INTRODUCTION: About 1% of paraesophageal hernias (PEH) require emergency surgery due to obstruction or gangrene. We present two complicated cases of incarcerated PEH. Presentation of cases: A patient aged 18 with trisomy 21 was admitted after four days of vomiting and epigastric pain. CT scan revealed a large PEH. The stomach was massively dilated with compression of adjacent viscera and the celiac trunk. The stomach was repositioned laparoscopically and deflated by endoscopy in an attempt to avoid resection...
November 30, 2018: International Journal of Surgery Case Reports
T Ajithkumar, R Taylor, R D Kortmann
Paediatric low-grade (World Health Organization grade I-II) gliomas (LGGs) represent a spectrum of primary central nervous system tumours. Local tumour control is the cornerstone in the general management of childhood gliomas. Surgery is the primary treatment of choice in the majority. Non-surgical treatments are recommended for progressive or symptomatic inoperable disease. Although chemotherapy is increasingly used as first non-surgical treatment, radiotherapy remains standard as salvage treatment or as primary treatment in selected cases in which surrounding normal tissue can be optimally preserved...
December 6, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Simone Mahfouda, Julia K Moore, Aris Siafarikas, Timothy Hewitt, Uma Ganti, Ashleigh Lin, Florian Daniel Zepf
The Endocrine Society Clinical Practice Guidelines on the treatment of gender incongruent people recommend the use of gender-affirming cross-sex hormone (CSH) interventions in transgender children and adolescents who request this treatment, who have undergone psychiatric assessment, and have maintained a persistent transgender identity. The intervention can help to affirm gender identity by inducing masculine or feminine physical characteristics that are congruent with an individual's gender expression, while aiming to improve mental health and quality-of-life outcomes...
December 6, 2018: Lancet Diabetes & Endocrinology
Sara Abu Ghanem, Attapon Junlapan, Shu Wei Tsai, Liang-Chun Shih, Chih-Kwang Sung, Edward J Damrose
AIM: Steps for assessment and successful management of bilateral vocal fold motion impairment (VFMI) are (1) recognition of its presence, (2) identifying the etiology and factors restricting vocal fold motion, (3) evaluation of airway patency, and (4) establishing a management plan. No large series documenting the course and outcome of adult idiopathic bilateral VFMI has been published within the past 15 years. METHODS: Retrospective chart review of adult patients with idiopathic bilateral VFMI at a tertiary academic center...
December 4, 2018: Journal of Voice: Official Journal of the Voice Foundation
Aleksander Hoxha, Sokol Shehu, Rezar Deveja, Thoma Qirjazi
Background: Excessive bleeding impairs outcome after coronary artery bypass grafting (CABG). Clopidogrel in combination with aspirin, given before percutaneous coronary intervention, have become the standard for stent thrombosis prevention. Some premedicated patients, however, are found to need surgical treatment, thus platelet inhibition caused by clopidogrel becomes a concern for post operation major bleeding. Aims: This study was designed to evaluate the impact of preoperative clopidogrel on bleeding and outcomes after coronary artery bypass graft surgery (CABG)...
November 2018: Medical Archives
Ekta A Patel, Michael D Perloff
Back pain is a top primary and urgent care complaint; radicular pain can be caused by herniation of the nucleus pulposus (intervertebral disc), spinal stenosis, or degenerative changes to the vertebrae. The focus of this clinical review will be the clinical approach and treatment of lumbar radicular pain, cervical radicular pain, and spinal stenosis. Usually localized through neurological history, exam, and imaging, specific signs and symptoms for lumbar radicular, spinal stenosis, and cervical radicular pain can help determine etiology...
December 2018: Seminars in Neurology
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