Definitive treatment of premalignant lesions of the breast with “double crown”: An innovative percutaneous technique

Total colonic aganglionosis (TCA) extended to the ileum is seen quite rare among infants with Hirschsprung's disease. Type and timing of definitive surgery in these patients are controversial. This report was presented to discuss the management of two siblings with TCA. Case 1: A two-day-old girl was operated for partial intestinal obstruction. During laparotomy, serial frozen biopsies proved TCA extended to the terminal ileum and a loop ileostomy was performed. At five months of age, a modified Duhamel-Martin procedure without protective ileostomy was performed. An endo-GIA stapler was transanally used for colo-ileal anastomosis. She is doing well for the last five years. Case 2: A one-day-old boy admitted to the hospital with similar findings to his sister. Frozen biopsies during first laparotomy proved that majority of ileum and entire colon was aganglionic and a proximal ileostomy was performed. At 10 months of age, he underwent a similar Duhamel-Martin operation. He is in a good condition for the last four years. Conclusion: In infants, our modification on Duhamel-Martin procedure, which is based on the use of an endo-GIA stapler transanally for colo-ileal anastomosis without protective ileostomy, may be utilized as an alternative method in the definitive treatment of patients with TCA.

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Study the Anatomy and Physiology of Body's Urinary System and Fibromyalgia Syndrome (FMS) for the Design an Intelligent Alarm System for Monitoring of FMS

Journal of Clinical and Translational Urology ◽

10.33702/jctu.2019.1.1.4 ◽

2019 ◽

Vol 1 (1) ◽

pp. 72-81

Author(s):

Hamidreza Shirzadfar ◽

Narsis Gordoghli

Keyword(s):

Chronic Pain ◽

International Association ◽

Continuous Process ◽

Well Being ◽

Chronic Illnesses ◽

World Health ◽

Definitive Treatment ◽

Psychological Consequences ◽

Medical Problems ◽

Health Organization

In recent years, chronic medical problems have become increasingly prevalent. Chronic ‎illnesses challenge the view of life as a regular and continuous process, a challenge that has ‎important psychological consequences. The long duration of people suffering from these ‎diseases, the long process of treatment and the fact that there is no proper and definitive ‎treatment for most of these diseases and their associated complications have made chronic ‎diseases a detrimental factor in public health. According to the World Health Organization ‎‎(2006), the prevalence of chronic and non-communicable diseases is increasing in all countries, ‎especially developing countries, so that the major challenge for the health system in the present ‎century, is not living people, but better adapted to chronic illnesses and maintaining their ‎mental and social health and well-being Ed's life-threatening chronic physical illness.‎ Chronic pain is a pain that lasts longer than usual, and according to the criteria of the ‎International Association of Pain, this time is defined as at least 3 months to 6 months. Chronic ‎pain is such that not only faced the sick person whit the pressure of the pain but also with many ‎other pressure that affect different parts of her life. Fibromyalgia is one of the most rheumatologic disorders and one of the most resistant chronic ‎pain syndromes. Fibromyalgia is one of the most common musculoskeletal disorders in adults ‎and chronic pain is one of the most common complaints in this group of patients.

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Premalignant and Malignant Lesions of the Heterotopic Pancreas in the Esophagus: a Case Report and Review of the Literature

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.242.uly ◽

2015 ◽

Vol 24 (2) ◽

pp. 235-239 ◽

Cited By ~ 9

Author(s):

Jan Ulrych ◽

Vladimir Fryba ◽

Helena Skalova ◽

Zdenek Krska ◽

Tomas Krechler ◽

...

Keyword(s):

Case Report ◽

Gastrointestinal Tract ◽

Unusual Case ◽

Accurate Diagnosis ◽

Heterotopic Pancreas ◽

Premalignant Lesions ◽

Resected Specimen ◽

Review Of The Literature ◽

Severe Dysphagia ◽

Malignant Lesions

Heterotopic pancreas is a congenital pathology of the gastrointestinal tract, particularly rare in the esophagus. Both symptomatology and findings during preoperative examinations are non-specific and therefore do not often lead to an accurate diagnosis, which is usually revealed only by histopathological assessment of a resected specimen. We report an unusual case of a patient suffering from severe dysphagia caused by heterotopic pancreas in the distal esophagus with chronic inflammation and foci of premalignant changes. This article also reviews 14 adult cases of heterotopic pancreas in the esophagus previously reported in the literature, with the aim of determining the clinical features of this disease and possible complications including rare premalignant lesions and malignant transformation. Especially with regard to those complications, we suggest that both symptomatic and incidentally found asymptomatic lesions should be resected.

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Chronic Mechanical Circulatory Support for Patients with End-stage Heart Failure as a Definitive Treatment Option

European Cardiology Review ◽

10.15420/ecr.2010.8.2.22 ◽

2010 ◽

Vol 6 (4) ◽

pp. 22

Author(s):

Patrycja Ganslmeier ◽

Christof Schmid ◽

◽

Keyword(s):

Heart Failure ◽

Mechanical Circulatory Support ◽

Definitive Treatment ◽

Circulatory Support ◽

Randomized Evaluation ◽

Fda Approval ◽

Cerebrovascular Events ◽

Device Placement ◽

End Stage Heart Failure ◽

End Stage

Mechanical circulatory support for end-stage heart failure has become routine and is now increasingly used as definitive treatment. Several small devices qualify for this purpose, but only a few have gained US Food and Drug Administration (FDA) approval as yet. Several studies, including the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study, the Investigation of Non-transplant-Eligible Patients Who Are Inotrope Dependent (INTrEPID) and the HeartMate (HM) II trial have confirmed a significantly improved quality of life and functional capacity after device placement. However, cerebrovascular events, infection and device malfunction still pose a considerable risk to patients and hinder widespread use.

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Role of implantable loop recorder in the clinical diagnosis of syncope: Results of the introduction of an effective diagnostic tool

Orvosi Hetilap ◽

10.1556/oh.2015.30124 ◽

2015 ◽

Vol 156 (15) ◽

pp. 609-613

Author(s):

Miklós Somlói ◽

Emil Toldy-Schedel ◽

Zoltán Nényei ◽

Róbert Böszörményi ◽

János Tomcsányi

Keyword(s):

Clinical Practice ◽

Diagnostic Yield ◽

Diagnostic Algorithm ◽

Definitive Treatment ◽

Implantable Loop Recorder ◽

Everyday Clinical Practice ◽

Loop Recorder ◽

Early Application ◽

Electrocardiographic Monitoring ◽

The Everyday

Introduction: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. Aim: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. Method: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. Results: There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. Conclusions: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope. Orv. Hetil., 2015, 156(15), 609–613.

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TUMOR GANAS OVARIUM RESIDIF METASTASIS KARSINOMA MUSIN KE UMBILIKUS, PERITONEUM, DAN CAIRAN ASITES TANPA DITEMUKAN TANDA KEGANASAN PADA PEMERIKSAAN HISTOPATOLOGIS PASCA OPERATIF SEBELUMNYA

JOURNAL OBGIN EMAS ◽

10.25077/aoj.3.2.130-136.2019 ◽

2019 ◽

Vol 3 (2) ◽

pp. 130-136

Author(s):

Arif Fadillah ◽

Andi Friadi

Keyword(s):

Ovarian Carcinoma ◽

Ovarian Tumor ◽

Malignant Tumors ◽

Histopathological Examination ◽

Ovarian Tumors ◽

Postoperative Chemotherapy ◽

Definitive Treatment ◽

Malignant Ovarian Tumor ◽

Patient Will ◽

Optimal Debulking

Background : Malignant ovarian tumor are still the number one cause of death and the second most of incidents for gynecological malignant tumors. The principles of management of ovarian cancer are the same as the principles of handling other malignant diseases, for the treatment of primary lesions operatively and the handling of potential sites of tumor metastases with chemotherapy. Histopathological examination is still considered a gold standard for diagnosis and definitive treatment of malignant ovarian tumors. If histopathologic results are obtained, then the patient will be planned to undergo postoperative chemotherapy. The mismatch between the preoperative and intraoperative clinical features, and the results of postoperative histopathological examination is a problem in managing cases of ovarian malignant tumors.Objective : Report a case of residive ovarian carcinoma with no appearance of malignancy marker in the previous postoperative histopathological examination.Method : Case reportCase : We report the case of a 45-year-old woman with a history of two previous laparotomy. The first operation was carried out in February 2014 on the indication of an extra ovarian cyst, resulting in the impression of a "Follicular Cysts" based on histopathological examination. The second operation was performed in March 2015, performed surgical staging tumors with an indication of malignant ovarian tumors with clinical metastases, but from histopathological examination it was found that "Cystadenoma Ovarii Muscinosum Multiloculare" and "no visible signs of malignancy", so the patient was not managed with postoperative chemotherapy. In April 2019 patients came with complaints of new mass growth, from CT-Scan and USG investigations there was a suspicious impression of a residive ovarian tumor with metastases into the omentum and massive ascites. On May 16, 2019 an optimal debulking was performed with the findings of residive mass, ascites, and mass metastases in the intra operative peritoneum. From the results of histopathological examination, it was found that "Muscinous Carcinoma with metastases to the umbilicus, peritoneum, and ascitic fluidKeywords: Malignant residive ovarian tumor, mucinous ovarian carcinoma

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Early experience of laparoscopic cholecystectomy in acutely inflamed gallbladder

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9ispl1.1283 ◽

2018 ◽

Vol 9 (SPL1) ◽

Author(s):

Ali Abdul Hussein Handoz ◽

Ahmed Kh Alsagban

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Gall Stone ◽

The Elderly ◽

Stone Disease ◽

Definitive Treatment ◽

Adjacent Structures ◽

Common Causes ◽

Gall Stone Disease ◽

Male To Female

Gallstones are now among the most important disease in the era of surgery. Definitive treatment of gall stone disease remains cholecystectomy. One of the common causes of emergency surgical referral is acute cholecystitis of which 50-70% cases are seen in the elderly patients.50 patients were treated with laparoscopic cholecystectomy from October 2013 to October 2015. The patient’s age was from 20 to 65 years old with a mean age of 34 ±3 years old. The patients received in the emergency unit and their attack not more than 72 hrs of acute gall stone inflammation were included in this study.From the 50 patients,15 were males (34%) and females were 35 (74%) so the ratio of 1:2of male to female. Problems and complications that facing in this study at time of laparoscopy were mainly adhesions to the adjacent structures like stomach, colon, and omentum. Adhesion into CBD also considered.Early intervention for acute cholecystitis of calculus type by laparoscopy now regarding safe and gold standard approach that should be kept in mind when dealing with such cases.

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