scholarly journals Incidence of Horner syndrome associated with neuroblastic disease

2020 ◽  
Author(s):  
Katarzyna Kuchalska ◽  
Monika Barełkowska ◽  
Katarzyna Derwich ◽  
Katarzyna Jończyk-Potoczna ◽  
Anna Gotz-Więckowska
Keyword(s):  
Adrenal Gland ◽  
Retrospective Analysis ◽  
Surgical Procedures ◽  
Pediatric Oncology ◽  
Surgical Procedure ◽  
Pediatric Patients ◽  
Study Group ◽  
Horner Syndrome ◽  
Neuroblastic Tumor ◽  
Frequent Localization

Abstract Purpose Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur in pediatric patients as a result of tumors, especially neuroblastoma (NBL). The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL. Methods A retrospective analysis of data collected at the Department of Pediatric Oncology, Hematology, and Transplantology from 2004 to 2019 was performed. The study group included 119 patients younger than 18 years old, with 62 girls and 57 boys. All of them were diagnosed with a neuroblastic tumor. Results Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. Three of these patients presented to the clinic with HS, whereas HS developed after the surgical procedure to remove the tumor in four patients. The adrenal gland was the most frequent localization of the tumor. However, HS occurred more frequently in patients with mediastinum tumors. As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. All of the patients with HS were younger than 2 years old. Conclusion Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment.

Which Kind of Vascular Access for Hemodialysis in Pediatric Patients?

2003 ◽  
Vol 4 (2) ◽  
pp. 68-72 ◽  
Author(s):  
O. Manca ◽  
G.F. Pili ◽  
M.G. Murgia ◽  
A. Martorana ◽  
C. Setzu ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Surgical Procedures ◽  
Vascular Access ◽  
Surgical Procedure ◽  
Pediatric Patients ◽  
Small Diameter ◽  
Clinical Criteria ◽  
Arteriovenous Fistulas ◽  
First Choice

The choice of vascular access in hemodialysis pediatric patients can be challenging, due to the small diameter of vessels. In the last 19 years, 38 arteriovenous fistulas (AVF) for hemodialysis have been created on 21 patients; 25 of them were radio-cephalic AVF. The evaluation of the vessels was, in the majority of cases, done by clinical criteria. A local anesthesia was used in all surgical procedures. The percentage of early AVF failure was 24%. Long-term AVF survival was 97%, 65% and 55% at respectively 1, 3 and 5 years. Our data indicate that even in pediatric patients the radio-cephalic fistula is the first choice surgical procedure.

scholarly journals Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

2021 ◽  
pp. 112067212110024
Author(s):  
Roberto dell’Omo ◽  
Mariaelena Filippelli ◽  
Gianni Virgili ◽  
Francesco Bandello ◽  
Giuseppe Querques ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Retinal Detachment ◽  
Retrospective Analysis ◽  
Surgical Procedures ◽  
Public Transportation ◽  
Rhegmatogenous Retinal Detachment ◽  
Intravitreal Injections ◽  
P Value ◽  
Academic Hospitals ◽  
Rate Ratios

Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

scholarly journals Prognostic Nutritional Index Considering Resection Range Is Useful for Predicting Postoperative Morbidity of Hepatectomy

2021 ◽  
Author(s):  
Shigeyuki Nagata ◽  
Shohei Maeda ◽  
Satoko Nagamatsu ◽  
Seiichiro Kai ◽  
Yasuro Fukuyama ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Procedures ◽  
Predictive Value ◽  
Surgical Procedure ◽  
Major Hepatectomy ◽  
Prognostic Nutritional Index ◽  
Complication Rates ◽  
Immunological Status ◽  
Grade Ii ◽  
Prognostic Nutrition Index

Abstract Background Poor preoperative nutritional and immunological status are major risk factors for postoperative complications in patients with various malignancies. Lower preoperative prognostic nutrition index (PNI) is associated with higher rates of postoperative complications and poorer prognosis in those patients. The aim of this study was to analyze the predictive value of the PNI for post-hepatectomy complications in patients with hepatocellular carcinoma (HCC), and evaluate its utility in the surgical procedure. Methods This retrospective study included 510 patients who underwent open hepatectomies for HCC. The predictive value of the preoperative nutritional and immunological status for postoperative complications was assessed using the PNI. Postoperative complications were defined as grade II or higher per the Clavien-Dindo classification. Postoperative complication rates were compared according to surgical procedure (major hepatectomy vs minor hepatectomy). Results Patients with postoperative complications had significantly lower PNIs than those without (43.1 ± 5.5 vs 47.0 ± 5.7, P < 0.001). In the multivariate analysis, low preoperative PNI (< 45) was an independent risk factor for postoperative complications after hepatectomy (hazard ratio, 3.85). When patients were classified per their PNI (high vs low) and extent of surgical procedures (major vs minor), there were more complications among patients with low PNI than those with high PNI, regardless of the extent of surgical procedures. Specifically, the group of patients with low PNI who underwent major hepatectomy had significantly higher rates of postoperative complications than the other groups. Conclusions Adding the resection range to the PNI is useful for predicting the postoperative morbidities of hepatectomy patients.

Relationship between Clinical and Biologic Variables and Chloramphenicol Pharmacokinetic Parameters in Pediatric Patients with Sepsis

2000 ◽  
Vol 34 (3) ◽  
pp. 393-397 ◽  
Author(s):  
Gustavo Lugo Goytia ◽  
Ismael Lares-Asseff ◽  
María Gabriela Pérez Guillé ◽  
Adrián Guillé Pérez ◽  
Cynthia Larios Mejía
Keyword(s):  
Population Model ◽  
Pediatric Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Pharmacokinetic Parameters ◽  
Pharmacokinetic Data ◽  
Study Group ◽  
Validation Group ◽  
Wbc Count ◽  
Biologic Factors

OBJECTIVE: To evaluate the influence of several clinical and biologic factors on the disposition kinetics of oral chloramphenicol in pediatric patients and to determine the usefulness of this information to predict chloramphenicol serum concentrations. STUDY DESIGN: The clinical, biologic, and pharmacokinetic data of 30 consecutive pediatric patients diagnosed with sepsis and admitted to a tertiary care center were analyzed retrospectively. The patients were randomly assigned to a study group and a validation group. The model was developed by a three-step approach involving Bayesian estimation of pharmacokinetic parameters, selection of covariates by principal component analysis, and final selection by stepwise multiple linear regression. The model was tested in the study group and compared with a general population model using a prediction error analysis. RESULTS: Regression analysis revealed that weight, albumin, and white blood cell (WBC) count were the most important determinants for chloramphenicol distribution volume, whereas age, WBC count, and serum creatinine were the most important determinants for chloramphenicol clearance. The performance of the constructed population model improved significantly in terms of both bias and precision compared with the general model when tested in the validation group. CONCLUSIONS: Clinical and biologic factors may significantly influence chloramphenicol's disposition in pediatric patients with sepsis and therefore should be considered in programming dosage regimens.

VOLUME MANIPULATION FOR SIMULATING FACIAL CONTOURING SURGERY

2014 ◽  
Vol 26 (01) ◽  
pp. 1450016 ◽  
Author(s):  
Ming-Dar Tsai ◽  
Feng-Chou Tsai ◽  
Chih-Lung Lin ◽  
Ming-Shium Hsieh
Keyword(s):  
Wound Healing ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Tissue Deformation ◽  
Bone Morphology ◽  
Facial Bone ◽  
High Quality ◽  
3D Images ◽  
Case Examples ◽  
The Face

In facial contouring surgery, surgeons operate the facial bone to correct bone morphology and thus achieve esthetic feminine face. To evaluate the face appearance after surgery and rehearse every surgical procedure in facial contouring surgery, simulations for tissue peeling, incising and suturing on the face together with bone burring and grafting on the facial bone are required. This paper presents a method that transforms respective tissue vertices to simulate tissue peeling. The transformation is based on specified incisions and clamps as in real facial contouring surgery. This paper also uses an auxiliary structure to represent and record tissue boundary changes inside the face. The elastic, partially plastic and plastic tissue deformation and wound formation during an incision can be simulated by manipulating these boundary changes. The incised wound recorded in the auxiliary structure is also manipulated to simulate tissue generation in wound healing during a suture. This volume manipulation method is combined with the reported method for bone burring and grafting simulations so that high-quality 3D images for illustrating surgical procedures both on the face and facial bone can be achieved. Simulations of two case examples including tissue peeling, incising and suturing procedures, and three modalities of facial contouring surgery demonstrate the effectiveness of the proposed method and system.

scholarly journals A Survey of Competency-Based Training of Senior House Officers in Performing Minor Surgical Procedures

2006 ◽  
Vol 88 (6) ◽  
pp. 576-578 ◽  
Author(s):  
Samuel CL Leong ◽  
Alison J Waghorn
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Perianal Abscess ◽  
Incision And Drainage ◽  
Minor Surgical Procedures ◽  
Surgical Trainees ◽  
Competency Based ◽  
A Minor ◽  
Second Procedure ◽  
And Training

INTRODUCTION The aim of this survey was to ascertain the level of competency and training of basic surgical trainees (SHOs) in performing incision and drainage of a perianal abscess (a minor surgical procedure). MATERIALS AND METHODS Questionnaires were sent to SHOs enquiring about preferred methods of incision and drainage and the teaching received to perform this procedure. RESULTS Of respondent SHOs, 10% did not receive teaching when performing their first incision and drainage and over half did not received any feedback from their trainers. A mere 65% received practical supervision. Use of the curette and de-roofing of the abscess are not routine methods used. In addition, 13% reported inadequate incision and drainage, which required a second procedure. CONCLUSIONS Competency-based training in minor surgical procedures benefits not only from didactic teaching, immediate supervision and appraisal but also from frequent practise. This was found to be lacking for incision and drainage of perianal abscesses by basic surgical trainees surveyed in the study.

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