scholarly journals Validity of the macroscopic identification of neovascularization at the saphenofemoral junction by the operating surgeon

2005 ◽  
Vol 41 (1) ◽  
pp. 64-68 ◽  
Author(s):  
Bruno Geier ◽  
Sara Olbrich ◽  
Letterio Barbera ◽  
Markus Stücker ◽  
Achim Mumme
Keyword(s):  
Saphenofemoral Junction ◽  
Operating Surgeon ◽  
Macroscopic Identification

Intraoperative monitoring of brain-stem auditory evoked potentials

1982 ◽  
Vol 57 (3) ◽  
pp. 341-348 ◽  
Author(s):  
Peter A. Raudzens ◽  
Andrew G. Shetter
Keyword(s):  
Evoked Potentials ◽  
Brain Stem ◽  
Auditory Evoked Potentials ◽  
Neurological Deficits ◽  
Additional Patient ◽  
Content Type ◽  
Intracranial Surgery ◽  
Surgical Measures ◽  
Evoked Potential Monitoring ◽  
Operating Surgeon

✓ Intraoperative brain-stem auditory evoked potentials (BAEP's) were monitored in 46 patients undergoing intracranial surgery for a variety of pathological conditions to determine whether this technique was capable of providing useful information to the operating surgeon. Intraoperative BAEP's were unchanged throughout surgery in 34 patients (74%), and these individuals had no postoperative hearing deficits. Four patients (9%) developed an abrupt ipsilateral loss of all waveform components beyond Wave I and had postoperative evidence of a pronounced hearing loss in the affected ear. An additional patient demonstrated BAEP loss contralateral to the side of surgery, and this was associated with subsequent signs of severe brain-stem dysfunction. Seven patients (15%) developed intraoperative delays of BAEP waveform latency values, but maintained recognizable waveforms beyond Wave I. Postoperatively, their hearing was either normal or mildly impaired, and there were no indications of other brain-stem abnormalities. This group represents the individuals who may have been benefited by evoked potential monitoring, since corrective surgical measures were taken when latency delays were observed. Intraoperative BAEP's can be reliably and routinely recorded in an operating room environment. They provide a good predictor of postoperative auditory status, and may have prevented permanent neurological deficits in a small segment of patients by alerting the surgeon to potentially reversible abnormalities.

scholarly journals Acute pancreatitis in a patient with COVID-19

2021 ◽  
Vol 14 (2) ◽  
pp. e239656
Author(s):  
Rawan A Rahman AlHarmi ◽  
Tahera Fateel ◽  
Jalila Sayed Adnan ◽  
Kamel AlAwadhi
Keyword(s):  
Acute Pancreatitis ◽  
Pulmonary Disease ◽  
Invasive Procedure ◽  
Pancreatic Injury ◽  
History Taking ◽  
Complicated Course ◽  
Operating Surgeon

COVID-19 mainly causes pulmonary disease. Involvement of gastrointestinal and hepatobiliary systems, among other systems, has been reported. We report a case of acute pancreatitis in a patient with resolving COVID-19 pneumonia. History taking and investigations excluded other causes of pancreatitis. This case demonstrates the possibility of pancreatic injury in patients with COVID-19, in line with previously reported similar cases. We believe that it is imperative to screen patients presenting with acute pancreatitis for SARS-CoV-2. It is also important to take into consideration that patients with a complicated course who require an invasive procedure such as drainage might pose a risk of transmission to the operating surgeon or interventionist.

scholarly journals 950 Experience of Inguinal Mesh Hernioplasty Under Local Anaesthesia: A 3-Year Experience in A Teaching Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hashmi ◽  
R Ahmed ◽  
T Zafar ◽  
M Ahmed ◽  
N Yousaf ◽  
...  
Keyword(s):  
Local Anaesthesia ◽  
Groin Pain ◽  
Clinical Judgement ◽  
Chronic Groin Pain ◽  
Day Case ◽  
Post Operative Pain ◽  
The Mean ◽  
Mesh Hernioplasty ◽  
Operating Surgeon

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.

Cellular senescence at the saphenofemoral junction in patients with healthy, primary varicose and recurrent varicose veins – A pilot study

Vascular ◽  
2021 ◽  
pp. 170853812110128
Author(s):  
Dominic Mühlberger ◽  
Anne-Katrin Zumholz ◽  
Erich Brenner ◽  
Achim Mumme ◽  
Markus Stücker ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cellular Senescence ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Common Finding ◽  
Venous Disease ◽  
Venous Reflux ◽  
Recurrent Varicose Veins ◽  
Primary Varicose Veins ◽  
Saphenofemoral Junction

Objectives Cellular senescence could play a role in the development of venous disease. Superficial venous reflux at the saphenofemoral junction is a common finding in patients with primary varicose veins. Furthermore, reflux in this essential area is associated with higher clinical stages of the disease and recurrent varicose veins. Therefore, this pilot study aimed to investigate cellular senescence in the immediate area of the saphenofemoral junction in patients with healthy veins, primary varicose veins and additionally in patients with recurrent varicose veins due to a left venous stump. Methods We analyzed vein specimens of the great saphenous vein immediately at the saphenofemoral junction. Healthy veins were collected from patients who underwent arterial bypass reconstructions. Samples with superficial venous reflux derived from patients who received high ligation and stripping or redo-surgery at the groin, respectively. Sections were stained for p53, p21, and p16 as markers for cellular senescence and Ki67 as a proliferation marker. Results A total of 30 samples were examined (10 healthy, 10 primary varicose, and 10 recurrent varicose veins). We detected 2.10% p53+ nuclei in the healthy vein group, 3.12% in the primary varicose vein group and 1.53% in the recurrent varicose vein group, respectively. These differences were statistically significant ( p = 0.021). In the healthy vein group, we found 0.43% p16+ nuclei. In the primary varicose vein group, we found 0.34% p16+ nuclei, and in the recurrent varicose vein group, we found 0.74% p16+ nuclei. At the p < 0.05 level, the three groups tended to be significant without reaching statistical significance ( p = 0.085). There was no difference in respect of p21 and Ki67. Conclusion We found significantly higher expression rates of p53 in primary varicose veins at the saphenofemoral junction than in healthy veins. p16 expression tended to be increased in the recurrent varicose vein group. These preliminary findings indicate that cellular senescence may have an impact in the development of varicose veins or recurrence. Further studies addressing this issue are necessary.

scholarly journals Hydatid Disease Simulating Acute Abdomen: A Case Report and Brief Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Georgios Lianos ◽  
Georgios Baltogiannis ◽  
Avrilios Lazaros ◽  
Konstantinos Vlachos
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Hydatid Disease ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
The Body ◽  
Parasitic Disease ◽  
Review Of The Literature ◽  
Diffuse Abdominal Pain ◽  
Operating Surgeon

Introduction. Hydatid disease is caused by the tapewormEchinococcus granulosusand is still a matter of public health in many regions of the world, where it is an endemic parasitic disease. Although the liver is the most involved organ, hydatidosis can be found anywhere in the human body. Rare forms of location may lead to diagnostic and therapeutic dilemmas.Case Report. Herein we report a rare case of acute abdominal pain and progressively increasing abdominal distension due to abdominal and multiple splenic echinococcosis in a 72-year-old Caucasian male. We also provide a brief review of the literature.Conclusion. Although hydatid disease is found most often in the liver and lungs, rarely any organ of the body can be involved by this zoonosis. Though rare, the possibility of unusual location of echinococcosis must always be considered by the operating surgeon, when dealing with diffuse abdominal pain in endemic areas, because any misinterpretation may result in unfavorable outcomes.

Comparison between different techniques for management of renal stones in horseshoe kidneys

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Abdel Fattah Mohammed Aggour ◽  
Mohamed Kotb Ahmed Tolba ◽  
Abdelrahman nazmy abbas hatata
Keyword(s):  
Horseshoe Kidney ◽  
Renal Stones ◽  
Operative Management ◽  
Flexible Ureteroscopy ◽  
Stone Clearance ◽  
Stone Burden ◽  
Laparoscopic Pyelolithotomy ◽  
Almost All ◽  
Laparoscopic Assisted ◽  
Operating Surgeon

Abstract Objective To report the operative management , intra and post operative complications and subsequent stone-free rates of patients with urolithiasis in a horseshoe kidneys. Materials and Methods We retrospectively reviewed all patients presenting to our centre with a horseshoe kidney and urolithiasis over a 20-year period. The stone burden, surgical management, complications and stone clearance rates were recorded. Results In all, 80 patients with urolithiasis in horseshoe kidney were treated. Percutaneous nephrolithotomy (PCNL) was used in 28 patients. 12 patients had laparoscopic assisted PCNL , 8 had flexible ureteroscopy and 18 had laparoscopic pyelolithotomy . PCNL was used for large stones = (mean digitized surface area= 614.32 mm 2 ) and required one to four stages to achieve an overall stone clearance rate of 88%. Stones were cleared at one sitting in 77% of PCNL procedures. only 33% of patients treated with flexible ureteroscopy was cleared from stones in one session and surprisingly, 89% of patients treated with laparoscopic pyelolithotomy was stone free after one session Complications were minimal, with 15% minor and 3% major complications in the PCNL group only.. Conclusions Appropriate management of urolithiasis within the horseshoe kidney depends not only on stone burden, but also on stone location, calyceal configuration and malrotation. Stones can be cleared successfully in almost all patients providing that all techniques are available to the operating surgeon.

Standardizing Laryngeal Cleft Evaluations: Reliability of the Interarytenoid Assessment Protocol

2018 ◽  
Vol 160 (3) ◽  
pp. 533-539 ◽  
Author(s):  
Steven Coppess ◽  
Reema Padia ◽  
David Horn ◽  
Sanjay R. Parikh ◽  
Andrew Inglis ◽  
...  
Keyword(s):  
Completion Time ◽  
Intrarater Reliability ◽  
Substantial Agreement ◽  
Anatomic Landmarks ◽  
Assessment Protocol ◽  
Academic Center ◽  
Endoscopic Videos ◽  
Completion Times ◽  
Operating Surgeon

Objective While the Benjamin-Inglis classification system is widely used to categorize laryngeal clefts, it does not clearly differentiate a type 1 cleft from normal anatomy, and there is no widely accepted or validated protocol for systematically evaluating interarytenoid mucosal height. We sought to propose the interarytenoid assessment protocol as a method to standardize the description of the interarytenoid anatomy and to test its reliability. Study Design Retrospective review of endoscopic videos. Setting Pediatric academic center. Subjects and Methods The interarytenoid assessment protocol comprises 4 steps for evaluation of the interarytenoid region relative to known anatomic landmarks in the supraglottis, glottis, and subglottis. Thirty consecutively selected videos of the protocol were reviewed by 4 otolaryngologists. The raters were blinded to identifying information, and the video order was randomized for each review. We assessed protocol completion times and calculated Cohen’s linear-weighted κ coefficient between blinded expert raters and with the operating surgeon to evaluate interrater/intrarater reliability. Results Median age was 4.9 years (59 months; range, 1 month to 20 years). Median completion time was 144 seconds. Interrater and intrarater reliability showed substantial agreement (interrater κ = 0.71 [95% confidence interval (CI), 0.55-0.87]; intrarater mean κ = 0.70 [95% CI, 0.59-0.92/rater 1, 0.47-0.85/rater 2]; P < .001). Comparing raters to the operating surgeon demonstrated substantial agreement (mean κ = 0.62; 95% CI, 0.31-0.79/rater 1, 0.48-0.89/rater 2; P < .001). Conclusion The interarytenoid assessment protocol appears reliable in describing interarytenoid anatomy. Rapid completion times and substantial interrater/intrarater reliability were demonstrated. Incorporation of this protocol may provide important steps toward improved standardization in the anatomic description of the interarytenoid region in pediatric dysphagia.

scholarly journals Sutureless 25-Gauge Pars Plana Vitrectomy Combined with Retropupillary Fixation of an Iris-Claw Intraocular Lens

2016 ◽  
Vol 7 (3) ◽  
pp. 433-439
Author(s):  
Spyridon E. Chalkiadakis ◽  
Efstratios A. Parikakis ◽  
Simon R.J. Taylor
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Visual Rehabilitation ◽  
Aesthetic Result ◽  
Viable Solution ◽  
Pars Plana ◽  
Real Challenge ◽  
Operating Surgeon ◽  
Iris Claw

Background: The surgical case of a dropped intraocular lens inside the vitreous cavity constitutes a real challenge for the operating surgeon. Herein, we describe a case series where an alternative optical rehabilitation technique for late intraocular lens-bag complex dislocation has been used. Methods: A modern vitrectomy device was used to remove the capsule with the dropped intraocular lens using sutureless 25-gauge pars plana vitrectomy. To ensure a better aesthetic result, with faster patient recovery and a reduced number of operations, the whole procedure was performed during the same operating session; an iris-claw intraocular lens for aphakia was selected for implantation. The implant was passed behind the constricted iris with the concave surface facing it. The lens was grasped with the manufacturer’s holding forceps and fixed onto the posterior surface of the iris using the special enclavation needles. Results: We have operated 12 eyes in two different clinical centres successfully, with minimal intra- and/or postoperative complications. Conclusion: We believe that this is a viable solution for the visual rehabilitation of patients, who would otherwise need more than one operation for a lens exchange.

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