Interventional Procedures Reducing the Needs for Conventional Surgery

2021 ◽  
pp. 487-496
Author(s):  
Gökhan Kahraman ◽  
Özgür Özen ◽  
Ali Harman
Keyword(s):  
Interventional Procedures ◽  
Conventional Surgery

A Cost-effectiveness Analysis of Aspirin versus Oral Anticoagulants after Acute Myocardial Infarction in Italy

1998 ◽  
Vol 80 (12) ◽  
pp. 887-893 ◽  
Author(s):  
Jacopo Gianetti ◽  
Gianfranco Gensini ◽  
Raffaele De Caterina
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Cost Effectiveness ◽  
Interventional Procedures ◽  
Cost Allocation ◽  
Oral Anticoagulants ◽  
The United States ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Artery Disease

SummaryAims. The recent publication of two large trials of secondary prevention of coronary artery disease with oral anticoagulants (WARIS and ASPECT) has caused a revival of the interest for this antithrombotic therapy in a clinical setting where the use of aspirin is common medical practice. Despite this, the preferential use of aspirin has been supported by an American cost-effectiveness analysis (JAMA 1995; 273: 965). Methods and Results. Using the same parameters used in that analysis and incidence of events from the Antiplatelet Trialists Collaboration and the ASPECT study, we re-evaluated the economic odds in favor of aspirin or oral anticoagulants in the Italian Health System, which differs significantly in cost allocation from the United States system and is, conversely, similar to other European settings. Recalculated costs associated with each therapy were 2,150 ECU/ patient/year for oral anticoagulants and 2,187 ECU/patient/year for aspirin. In our analysis, the higher costs of oral anticoagulants versus aspirin due to a moderate excess of bleeding (about 10 ECU/ patient/year) and the monitoring of therapy (168 ECU/ patient/year) are more than offset by an alleged savings for recurrent ischemic syndromes and interventional procedures (249 ECU/ patient/year). Conclusions. Preference of aspirin vs. oral anticoagulants in a pharmaco-economical perspective is highly dependent on the geographical situation whereupon calculations are based. On a pure cost-effectiveness basis, and in the absence of data of direct comparisons between aspirin alone versus I.N.R.-adjusted oral anticoagulants, the latter are not more expensive than aspirin in Italy and, by cost comparisons, in other European countries in the setting of post-myocardial infarction.

Surgical ASD closure in the era of interventional procedures

2005 ◽  
Vol 53 (S 01) ◽  
Author(s):  
A Böning ◽  
N Gerken ◽  
J Scheewe ◽  
G Fischer ◽  
H Kramer ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Asd Closure

Association between Socioeconomic Factors and Postoperative Complications of Cholecystectomy

2021 ◽  
pp. 1-13
Author(s):  
Herman Romero Ramírez ◽  
Norma Muñoz Albán ◽  
Consuelo Albán Meneses ◽  
Alicia Escobar Torres
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Socioeconomic Factors ◽  
Control Variable ◽  
Laparoscopic Technique ◽  
Safe Operation ◽  
Conventional Surgery ◽  
Socioeconomic Characteristics ◽  
Dependent Variables ◽  
Education Levels

The article´s goal isto determine if socioeconomic factors influence the postoperative complications of cholecystectomy. For this, the observational study was defined, analytical and quantitative study was conducted in 100 patients who underwent cholecystectomy. A logistic regression model was applied in which risk factors, socioeconomic characteristics, along with a control variable, were incorporated as variables. Three models were run with alternative dependent variables that are delimited by the type of postoperative complication recorded. The results found showed that women show a higher risk of presenting complications after cholecystectomy, the same occurs in older patients. Likewise, the risk is much lower in people with higher education levels and in patients who underwent laparoscopic cholecystectomy, they only have a 5% risk of presenting complications. Postoperative complications after cholecystectomy are minimized by using the laparoscopic technique and socioeconomic factors would influence the risk of suffering postoperative complications after said surgery, which makes laparoscopic cholecystectomy a safe operation with many other benefits and advantages over traditional or conventional surgery.

LAPAROSCOPIC REPAIR OF PERFORATED DUODENAL ULCER PATCH VERSUS CONVENTIONAL SURGERY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Anil Kumar Saxena ◽  
Dr. Devi Das Verma
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Wound Dehiscence ◽  
Duodenal Perforation ◽  
Perforated Duodenal Ulcer ◽  
Conventional Surgery ◽  
Duodenal Ulcers ◽  
Duration Of Operation ◽  
Repair Group

Introduction: For many surgeries for duodenal ulcer Laparoscopic repair has become gold standard for many elective procedures such as ant reflux procedures, laparoscopic cholecystectomy and in colorectal surgery. Although in the emergency setting such as in the management of perforated duodenal ulcer Laparoscopic repair has been slow and limited. Since 1990, for the treatment of perforated peptic ulcer Laparoscopic repair has been used which has been widely accepted as an effective method. Duodenal ulcer is defined as a peptic ulcer which develops in the first part of the small intestine called duodenum and usually present as a perforation of acute abdomen. In perforated duodenal symptoms as severe and sudden onset abdominal pain that is worse in right upper quadrant and epigastrium and usually followed by nausea and vomiting. In this situation there is rapid generalization of pain and in examination shows peritonitis with lack of bowel sounds. Aim: The main objective of this study is to evaluate outcome of laparoscopic surgery in comparison with conventional surgery. Material and methods: All the patients with clinically diagnosed with perforated duodenal ulcers presenting within 24 hours of symptoms and undergoing surgery were included during the study period. Total 50 patients were included with age group 15-65 years. All the patients with perforated duodenal ulcers were included which go through either conventional open or laparoscopic without omental patch repair. Result: Total 50 patients were included in these studies which were divided into two group with 25 patients in each group as laparoscopic duodenal perforation repair group and conventional open repair group. Mean duration of operation (in minutes) was 105.4±10.4 in laparoscopic duodenal perforation repair group whereas mean duration of operation (in minutes) was 67.3±8.6 in conventional open repair group. Mean duration of number of doses of analgesics required in laparoscopic group and conventional open group as 9.5±1.7 and 17.2± 3.1 respectively. Out of 25 patients in each group of laparoscopic duodenal perforation repair group and the conventional open repair group the outcome were noted with their post operative complication as shown in table no 5 below.   In Post-operative complications 21(84%) patients in laparoscopic duodenal perforation repair group and 14(56%) patients in conventional open repair group had no complications. 4 (16%) patients in the laparoscopic duodenal perforation repair group and 2(8%) patients in conventional open repair group showed Post-operative complications as chest infection. In the conventional open repair group  patients present with wound dehiscence and wound infection and Wound dehiscence and chest infection were 4(16%) and 5(20%) respectively whereas nil in Laparoscopic duodenal perforation repair group. Conclusion: Duodenal ulcer perforation is a life-threatening emergency which required urgent management for the patients. Due to the advance in duodenal ulcer perforation closure by laparoscopy it becomes popular and favorite choice. With certain criteria, laparoscopic closure of perforated duodenal ulcer is safe and effective though it was associated with longer operating time and had no impact on the outcome. Hence laparoscopic closure was better in comparison to open repair for the earlier returns to normal daily activities. Keywords:  Duodenal ulcer, Laparoscopic repair, Post-operative analgesia, conventional surgery

Cardiological Biopharmaceuticals in the Conception of Drug Targeting Delivery: Practical Results and Research Perspectives

Acta Naturae ◽  
2012 ◽  
Vol 4 (3) ◽  
pp. 72-81 ◽  
Author(s):  
A. V. Maksimenko
Keyword(s):  
Cell Adhesion Molecules ◽  
Drug Targeting ◽  
Interventional Procedures ◽  
Target Localization ◽  
Clinical Use ◽  
Protein Conjugates ◽  
Research Perspectives ◽  
Significant Interest ◽  
Targeting Delivery ◽  
Molecular Sizes

The results of the clinical use of thrombolytic and antithrombotic preparations developed on the basis of protein conjugates obtained within the framework of the conception of drug targeting delivery in the organism are considered. A decrease has been noted in the number of biomedical projects focused on these derivatives as a result of various factors: the significant depletion of financial and organizational funds, the saturation of the pharmaceutical market with preparations of this kind, and the appearance of original means for interventional procedures. Factors that actively facilitate the conspicuous potentiation of the efficacy of bioconjugates were revealed: the biomedical testing of protein domains and their selected combinations, the optimization of molecular sizes for the bioconjugates obtained, the density of target localization, the application of cell adhesion molecules as targets, and the application of connected enzyme activities. Enzyme antioxidants and the opportunity for further elaboration of the drug delivery conception via the elucidation and formation of therapeutic targets for effective drug reactions by means of pharmacological pre- and postconditioning of myocardium arouse significant interest.

The Expanding Role of Echocardiography in Interventional Cardiology

2010 ◽  
Vol 6 (2) ◽  
pp. 71 ◽  
Author(s):  
Lindsay A Smith ◽  
Amit Bhan ◽  
Mark J Monaghan ◽  
◽  
◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Imaging Modality ◽  
Interventional Cardiology ◽  
Design And Technology ◽  
Team Approach ◽  
Medical Problems ◽  
Multidisciplinary Team Approach ◽  
Case Selection ◽  
Optimal Imaging

Echocardiography provides excellent realtime imaging of the heart, making it the imaging modality of choice immediately before, during and after cardiac interventional procedures. It helps to guide case selection and execution of the intervention, evaluates the effects of the intervention and enables early detection of complications. Advances in the design and technology of medical devices and delivery systems, coupled with demand for alternative non-surgical therapies for common medical problems, have led to an increase in the volume, variety and complexity of non-coronary cardiac interventional procedures performed. Many of these procedures require a multidisciplinary team approach and demand optimal imaging to ensure successful outcomes. The aim of this article is to review the expanding role of echocardiography in non-coronary interventional cardiology in adults.

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