scholarly journals Basics in clinical nutrition: Surgical access – Gastrostomy, needle catheter jejunostomy

2009 ◽  
Vol 4 (5) ◽  
pp. e221-e222 ◽  
Author(s):  
Remy Meier ◽  
Laszlo Harsanyi
Keyword(s):  
Clinical Nutrition ◽  
Surgical Access ◽  
Catheter Jejunostomy

Holmes tremor: a delayed complication after resection of brainstem cavernomas

2020 ◽  
pp. 1-11
Author(s):  
Marco Cenzato ◽  
Davide Colistra ◽  
Giorgia Iacopino ◽  
Christian Raftopoulos ◽  
Ulrich Sure ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Neurophysiological Monitoring ◽  
Strict Adherence ◽  
Surgical Access ◽  
Holmes Tremor ◽  
Neurophysiological Studies ◽  
Metropolitan Hospital ◽  
Delayed Complication ◽  
Brainstem Cavernoma ◽  
Predicting Factor

OBJECTIVEIn this paper, the authors aimed to illustrate how Holmes tremor (HT) can occur as a delayed complication after brainstem cavernoma resection despite strict adherence to the safe entry zones (SEZs).METHODSAfter operating on 2 patients with brainstem cavernoma at the Great Metropolitan Hospital Niguarda in Milan and noticing a similar pathological pattern postoperatively, the authors asked 10 different neurosurgery centers around the world to identify similar cases, and a total of 20 were gathered from among 1274 cases of brainstem cavernomas. They evaluated the tremor, cavernoma location, surgical approach, and SEZ for every case. For the 2 cases at their center, they also performed electromyographic and accelerometric recordings of the tremor and evaluated the postoperative tractographic representation of the neuronal pathways involved in the tremorigenesis. After gathering data on all 1274 brainstem cavernomas, they performed a statistical analysis to determine if the location of the cavernoma is a potential predicting factor for the onset of HT.RESULTSFrom the analysis of all 20 cases with HT, it emerged that this highly debilitating tremor can occur as a delayed complication in patients whose postoperative clinical course has been excellent and in whom surgical access has strictly adhered to the SEZs. Three of the patients were subsequently effectively treated with deep brain stimulation (DBS), which resulted in complete or almost complete tremor regression. From the statistical analysis of all 1274 brainstem cavernomas, it was determined that a cavernoma location in the midbrain was significantly associated with the onset of HT (p < 0.0005).CONCLUSIONSDespite strict adherence to SEZs, the use of intraoperative neurophysiological monitoring, and the immediate success of a resective surgery, HT, a severe neurological disorder, can occur as a delayed complication after resection of brainstem cavernomas. A cavernoma location in the midbrain is a significant predictive factor for the onset of HT. Further anatomical and neurophysiological studies will be necessary to find clues to prevent this complication.

Improvement of surgical access in autogenous infrainguinal reconstruction by the method «in situ»

2018 ◽  
Vol 16 (7(part 2)) ◽  
pp. 81-85
Author(s):  
M. V. Plotnikov ◽  
◽  
A. V. Maksimov ◽  
Keyword(s):  
Surgical Access

SIMULTANEOUS ESOPHAGO-GASTRECTOMY WITH COLONIC INTERPOSITION AS A METHOD OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER WITH HIGH INVOLVEMENT OF THE ESOPHAGUS

2017 ◽  
Vol 63 (1) ◽  
pp. 146-152
Author(s):  
Mikhail Ter-ovanesov ◽  
Aleksandr Levitskiy ◽  
E. Lesnidze ◽  
Aram Gaboyan ◽  
Mariya Kukosh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Esophageal Reconstruction ◽  
Gastroesophageal Cancer ◽  
Colonic Interposition ◽  
Simultaneous Application ◽  
High Involvement ◽  
Surgical Access ◽  
Critical Overview

In the current oncological practice surgical treatment of gastroesophageal cancer with high involvement of the esophagus can extend to total esophago-gastrectomy with colonic interposition as the main method of radical treatment. However the technical complexity and high risk of the intervention are factors in determining the divergent views on the operation itself, testimony for the criteria of patient’s selection, choice of surgical access and the formation of a colonic graft in conjunction with method of esophageal reconstruction. The long-term results of operative intervention depend primarily on the extent of tumor process but obviously higher than after conservative treatment. This article presents a brief critical overview of the main aspects of the simultaneous application of esophago-gastrectomy in surgery of gastroesophageal cancer with high esophageal involvement and our clinical case of successful surgical treatment of a woman with pregnancy-associated gastroesophageal cancer.

Application of Diet-derived Taste Active Components for Clinical Nutrition: Perspectives from Ancient AyurvedicMedical Science, Space Medicine, and Modern Clinical Nutrition

2014 ◽  
Vol 20 (16) ◽  
pp. 2791-2796 ◽  
Author(s):  
Anil Kulkarni ◽  
Alamelu Sundaresan ◽  
Muhammad Rashid ◽  
Shigeru Yamamoto ◽  
Francisco Karkow
Keyword(s):  
Clinical Nutrition ◽  
Space Medicine ◽  
Active Components

scholarly journals Challenges in Clinical Nutrition during the COVID-19 Pandemic

2020 ◽  
Vol 1 (1) ◽  
pp. 13-15
Author(s):  
Christina N.  Katsagoni
Keyword(s):  
Artificial Ventilation ◽  
Clinical Nutrition ◽  
Tube Insertion ◽  
Nutritional Screening ◽  
Nutrition Management ◽  
Muscle Catabolism ◽  
Key Aspects ◽  
Inflammatory Syndrome ◽  
Nutrition Practice ◽  
Nasogastric Tube Insertion

The viral epidemic caused by the new Coronavirus SARS-CoV-2 is responsible for the new Coronavirus disease-2019 (Covid-19). Fifteen percent of the Covid-19 patients will require hospital stay, and 10% of them will need urgent respiratory and hemodynamic support in the intensive care unit (ICU). Covid-19 is an infectious disease characterized by inflammatory syndrome, itself leading to reduced food intake and increased muscle catabolism. Therefore Covid-19 patients are at high risk of being malnourished, making the prevention of malnutrition and the nutritional management key aspects of care. Urgent, brutal and massive arrivals of patients needing urgent respiratory care and artificial ventilation lead to the necessity to reorganize hospital care, wards and staff. In that context, nutritional screening and care may not be considered a priority. Moreover, at the start of the epidemic, due to mask and other protecting material shortage, the risk of healthcare givers contamination have led to not using enteral nutrition, although indicated, because nasogastric tube insertion is an aerosol-generating procedure. Clinical nutrition practice based on the international guidelines should therefore adapt and the use of degraded procedures could unfortunately be the only way. Based on the experience from the first weeks of the epidemic in France, we emphasize ten challenges for clinical nutrition practice. The objective is to bring objective answers to the most frequently met issues to help the clinical nutrition caregivers to promote nutritional care in the hospitalized Covid-19 patient. We propose a flow chart for optimizing the nutrition management of the Covid-19 patients in the non-ICU wards.

scholarly journals The Impact of the COVID-19 Pandemic on Breast Reconstruction: A Canadian Perspective

2021 ◽  
pp. 229255032110300
Author(s):  
Caroline F. Illmann ◽  
Christopher Doherty ◽  
Margaret Wheelock ◽  
Joshua Vorstenbosch ◽  
Joan E. Lipa ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Care Delivery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Reconstructive Procedures ◽  
Surgical Access ◽  
Canadian Perspective ◽  
Canadian Provinces ◽  
The Impact

Background: The COVID-19 pandemic has led to unprecedented challenges and restrictions in surgical access across Canada, including for breast reconstructive services which are an integral component of comprehensive breast cancer care. We sought to determine how breast reconstructive services are being restricted, and what strategies may be employed to optimize the provision of breast reconstruction through a pan-Canadian evaluation from the providers’ perspective. Methods: This was a cross-sectional survey of Canadian plastic and reconstructive surgeons who perform breast reconstruction. The 33-item web-based questionnaire was developed by a pan-Canadian working group of breast reconstruction experts and disseminated via email to members of the Canadian Society of Plastic Surgery. The questionnaire queried respondents on the impact of the COVID-19 pandemic and associated restrictions on surgeons’ breast reconstruction practice patterns and opinions on strategies for resource utilization. Results: Responses were received from 49 surgeons, who reported practicing in 8 of 10 Canadian provinces. Restrictions on the provision of breast reconstructive procedures were most limited during the First Wave of the COVID-19 pandemic, where all respondents reported at least some reduction in capacity and more than a quarter reporting complete cessation. Average reported reduction in capacity ranged from 31% to 78% across all 3 waves. Autologous, delayed, and prophylactic reconstructions were most commonly restricted. Conclusion: This study provides a pan-Canadian impact assessment on breast reconstructive services during the COVID-19 pandemic from the providers’ perspective. To uphold the standards of patient-centred care, a unified approach to strategically reorganize health care delivery now and in the future is needed.

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