scholarly journals Primary Sarcoma of Descending Aorta

Aorta ◽  
2019 ◽  
Vol 07 (06) ◽  
pp. 169-171
Author(s):  
Adele Tessitore ◽  
Alessio V. Mariolo ◽  
Domenico Galetta ◽  
Giulia Sedda ◽  
Rosa Spirito ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Medical Treatment ◽  
Poor Prognosis ◽  
High Rate ◽  
Descending Aorta ◽  
Primary Sarcoma ◽  
Intimal Sarcoma ◽  
Local Recurrences ◽  
Rare Tumors

AbstractPrimitive aortic sarcomas are rare tumors characterized by resistance to medical treatment and a poor prognosis with high metastatic rates and local recurrences. Surgery remains the mainstay treatment and is based on challenging and technically demanding resections with high rate of major intraoperative and postoperative complications. We report the case of a patient with primitive intimal sarcoma of the aorta, who underwent a descending aortic resection and reconstruction with a prosthetic tube.

scholarly journals TELD with limited foraminoplasty has potential biomechanical advantages over TELD with large annuloplasty: an in-silico study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jingchi Li ◽  
Chen Xu ◽  
Xiaoyu Zhang ◽  
Zhipeng Xi ◽  
Mengnan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Poor Prognosis ◽  
Adjacent Segment Degeneration ◽  
Iatrogenic Injury ◽  
Adjacent Segment ◽  
Fe Model ◽  
High Grade ◽  
Endoscopic Lumbar Discectomy ◽  
Adjacent Segments

Abstract Background Facetectomy, an important procedure in the in–out and out–in techniques of transforaminal endoscopic lumbar discectomy (TELD), is related to the deterioration of the postoperative biomechanical environment and poor prognosis. Facetectomy may be avoided in TELD with large annuloplasty, but iatrogenic injury of the annulus and a high grade of nucleotomy have been reported as risk factors influencing poor prognosis. These risk factors may be alleviated in TELD with limited foraminoplasty, and the grade of facetectomy in this surgery can be reduced by using an endoscopic dynamic drill. Methods An intact lumbo-sacral finite element (FE) model and the corresponding model with adjacent segment degeneration were constructed and validated to evaluate the risk of biomechanical deterioration and related postoperative complications of TELD with large annuloplasty and TELD with limited foraminoplasty. Changes in various biomechanical indicators were then computed to evaluate the risk of postoperative complications in the surgical segment. Results Compared with the intact FE models, the model of TELD with limited foraminoplasty demonstrated slight biomechanical deterioration, whereas the model of TELD with large annuloplasty revealed obvious biomechanical deterioration. Degenerative changes in adjacent segments magnified, rather than altered, the overall trends of biomechanical change. Conclusions TELD with limited foraminoplasty presents potential biomechanical advantages over TELD with large annuloplasty. Iatrogenic injury of the annulus and a high grade of nucleotomy are risk factors for postoperative biomechanical deterioration and complications of the surgical segment.

scholarly journals Cirurgia no Aspergiloma Pulmonar: Experiência Mono-Institucional

2014 ◽  
Vol 27 (4) ◽  
pp. 417
Author(s):  
Silvia Da Silva Correia ◽  
Carlos Pinto ◽  
João Bernardo
Keyword(s):  
Postoperative Complications ◽  
Surgical Resection ◽  
Surgical Procedure ◽  
Lung Resection ◽  
Previous History ◽  
Term Treatment ◽  
High Rate ◽  
Long Term Treatment ◽  
Immunosuppressed Patients ◽  
Pulmonary Aspergilloma

<strong>Introduction:</strong> Pulmonary aspergiloma or mycetoma is a saprophytic colonization of a preexisting cavity by aspergilloma. Surgical resection is the only effective long-term treatment, but remains controversial because of the high rate of complications in the perioperative and postoperative time.<br /><strong>Objectives:</strong> Analysis of the experience of a Cardiothoracic Surgery Center for the treatment of pulmonary aspergilloma and evaluation of the prognostic factors after surgery.<br /><strong>Material and Methods:</strong> Retrospective analysis including all the patients with a diagnosis of pulmonary aspergilloma submitted to surgery for a 10 years period, in a single institution (June 2001-June 2011).<br /><strong>Results:</strong> The study included 22 patients (18 men) with a mean age of 51.0 + 17.4 years. Of them, 46% were smokers, 41% were alcoholic and 50% had a previous history of tuberculosis. Most of the patients had a complex aspergilloma (73%) and 17% a simple aspergilloma. The most common presentation was hemoptysis (50%). The common surgical procedure performed was atypical lung resection in 55%, lobectomy in 27% and pneumectomy in 9%. Two patients were submitted to thoracoplasty. There was one operative death (5%). Postoperative complications occurred in 36% and the most frequent were pneumothorax (18%) and empyema (18%). The mean follow-up period was 52 months (3 - 116) and the 5 years mortality rate of 35%. Of them, 4 patients died because of non- related causes and 3 were immunosuppressed patients. The mortality was 40% in the group of complex aspergilloma and 33% in the group of complex aspergilloma.<br /><strong>Discussion:</strong> The most common surgical procedure performed was atypical lung resection. The postoperative complications rate was similar to previous studies.<br /><strong>Conclusion:</strong> Surgical resection of aspergilloma presents a low morbidity and mortality. Therefore, for patients with lung function preserved, it is the preferred treatment.<br /><strong>Keywords:</strong> Aspergillus; Pulmonary Aspergillosis/surgery.

scholarly journals Targeting Signaling Pathways in Inflammatory Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2479
Author(s):  
Xiaoping Wang ◽  
Takashi Semba ◽  
Lan Thi Hanh Phi ◽  
Sudpreeda Chainitikun ◽  
Toshiaki Iwase ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Signaling Pathways ◽  
Inflammatory Breast Cancer ◽  
Poor Prognosis ◽  
High Rate ◽  
Novel Therapies ◽  
Biological Functions ◽  
Novel Targets ◽  
Preclinical And Clinical Studies ◽  
Related Mortality

Inflammatory breast cancer (IBC), although rare, is the most aggressive type of breast cancer. Only 2–4% of breast cancer cases are classified as IBC, but—owing to its high rate of metastasis and poor prognosis—8% to 10% of breast cancer-related mortality occur in patients with IBC. Currently, IBC-specific targeted therapies are not available, and there is a critical need for novel therapies derived via understanding novel targets. In this review, we summarize the biological functions of critical signaling pathways in the progression of IBC and the preclinical and clinical studies of targeting these pathways in IBC. We also discuss studies of crosstalk between several signaling pathways and the IBC tumor microenvironment.

scholarly journals Factors Affecting the Outcomes of Tibiotalocalcaneal Fusion

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0038
Author(s):  
Charles C. Pitts ◽  
Bradley Alexander ◽  
Joshua L. Washington ◽  
Hannah M. Barranco ◽  
Romil K. Patel ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Postoperative Complications ◽  
Kidney Disease ◽  
Bone Graft ◽  
Postoperative Infection ◽  
High Rate ◽  
Diabetic Patients ◽  
Charcot Arthropathy ◽  
Infection Rates ◽  
Increased Risk

Category: Hindfoot; Ankle; Ankle Arthritis Introduction/Purpose: Tibiotalocalcaneal (TTC) fusion is used to treat a variety of conditions affecting the ankle and subtalar joint, including osteoarthritis (OA), Charcot arthropathy, avascular necrosis (AVN) of the talus, failed total ankle arthroplasty, and severe deformity. The prevalence of postoperative complications remains high due to the complexity of hindfoot disease seen in these patients. The aim of this study was to analyze the relationship between preoperative conditions and postoperative complications in order to predict the outcome following primary TTC fusion. Methods: We retrospectively reviewed the medical records of 101 patients who underwent TTC fusion at the same institution between 2011 and 2019. Risk ratios (RRs) associated with age, sex, diabetes, cardiovascular disease, smoking, preoperative ankle deformity, and the use of bone graft during surgery were related to the postoperative complications. We determined from these data which pre- and perioperative factors significantly affected the outcome. Results: Patients with a preoperative diagnosis of Charcot arthropathy and non-traumatic OA had significantly higher nonunion rates of 44.4% (12 patients) and 39.1% (18 patients) (p = 0.016) and infection rates of 29.6% (eight patients) and 37% (17 patients) compared to patients with traumatic arthritis, respectively (p = 0.002). There was a significantly increased rate of nonunion in diabetic patients (RR 2.22; p = 0.010). Patients with chronic kidney disease were 2.37-times more likely to have a nonunion (p = 0.006). Patients aged over 60 years had more than a three-fold increase in the rate of postoperative infection (RR 3.60; p = 0.006). The use of bone graft appeared to be significantly protective against postoperative infection (p = 0.019). Conclusion: We were able to confirm, in the largest series of TTC ankle fusions currently in the literature, that there remains a high rate of complications following this procedure. Those with diabetes, chronic kidney disease, or aged over 60 years had an increased risk of nonunion. These findings help to confirm those of previous studies. Additionally, our study adds to the literature by showing that autologous bone graft may help in decreasing infection rates. This helps surgeons further understand which patients are at a higher risk for postoperative complications when undergoing TTC fusion. [Table: see text]

scholarly journals Aberrant MicroRNAs in Pancreatic Cancer: Researches and Clinical Implications

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Tao Sun ◽  
Xiangyu Kong ◽  
Yiqi Du ◽  
Zhaoshen Li
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Poor Prognosis ◽  
Vital Role ◽  
High Rate ◽  
Ductal Adenocarcinoma ◽  
Clinical Implications ◽  
Circulating Mirnas ◽  
Current Review ◽  
Wide Range

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with a high rate of mortality and poor prognosis. Numerous studies have proved that microRNA (miRNA) may play a vital role in a wide range of malignancies, including PDAC, and dysregulated miRNAs, including circulating miRNAs, are associated with PDAC proliferation, invasion, chemosensitivity, and radiosensitivity, as well as prognosis. Greater understanding of the roles of miRNAs in PDAC could provide insights into this disease and identify potential diagnostic markers and therapeutic targets. The current review focuses on recent advances with respect to the roles of miRNAs in PDAC and their practical value.

scholarly journals The Role of Hypoxia and SRC Tyrosine Kinase in Glioblastoma Invasiveness and Radioresistance

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2860 ◽  
Author(s):  
Filippo Torrisi ◽  
Nunzio Vicario ◽  
Federica M. Spitale ◽  
Francesco P. Cammarata ◽  
Luigi Minafra ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Receptor Tyrosine Kinase ◽  
Poor Prognosis ◽  
High Rate ◽  
Crucial Importance ◽  
Src Tyrosine Kinase ◽  
Complete Surgical Resection ◽  
Radiation Induced ◽  
Proliferation And Invasion

Advances in functional imaging are supporting neurosurgery and radiotherapy for glioblastoma, which still remains the most aggressive brain tumor with poor prognosis. The typical infiltration pattern of glioblastoma, which impedes a complete surgical resection, is coupled with a high rate of invasiveness and radioresistance, thus further limiting efficient therapy, leading to inevitable and fatal recurrences. Hypoxia is of crucial importance in gliomagenesis and, besides reducing radiotherapy efficacy, also induces cellular and molecular mediators that foster proliferation and invasion. In this review, we aimed at analyzing the biological mechanism of glioblastoma invasiveness and radioresistance in hypoxic niches of glioblastoma. We also discussed the link between hypoxia and radiation-induced radioresistance with activation of SRC proto-oncogene non-receptor tyrosine kinase, prospecting potential strategies to overcome the current limitation in glioblastoma treatment.

scholarly journals Prognostic Risk Factors for Complications Associated with Below the Knee Amputations

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0037
Author(s):  
Jason Ni ◽  
Eric Lukosius ◽  
Kaitlin Saloky ◽  
Kempland Walley ◽  
Leanne Ludwick ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Charlson Comorbidity Index ◽  
High Rate ◽  
Tourniquet Time ◽  
Ambulatory Status ◽  
Asa Classification ◽  
Below The Knee ◽  
Comorbidity Index ◽  
Prognostic Risk Factors

Category: Other Introduction/Purpose: Below the knee amputation (BKA) is an effective surgical procedure for individuals with severe injury or infection to their lower extremities. However, patients who receive these procedures are subject to significant morbidity and a high rate of postoperative complications due to the presence of multiple concomitant comorbidities. Despite the wide practice of this intervention, prognostic risk factors aiding in predicting surgical outcomes in these patients are poorly understood. The purpose of this study is to evaluate risk factors that may contribute to the outcomes of BKA procedures. Methods: The clinical and radiographic outcomes for 89 patients ages 19-90 who underwent BKA were retrospectively evaluated from 2012-2017. Postoperative complications of mortality, infection, and reoperation were evaluated with patient and surgical variables. Patient variables included: age, ambulatory status, obesity, diabetes, HbA1C2 levels, neuropathy, smoking, Charlson Comorbidity Index (CCI), and American Society of Anesthesiologists (ASA) classification. Surgical variables evaluated included: presence of pre-op infection, pre-op ambulatory status, tourniquet time, tourniquet pressure, and usage of prophylactic antibiotics. Results: Of the patients evaluated there was an overall complication rate of 49% (44/89) and a mortality rate of 19% (17/89). Patients with diabetes (p=.035), a greater score on the Charlson Comorbidity Index (p=.001), and an ASA classification =3 (p=.005) were associated with a greater risk of mortality. Operative values (i.e. tourniquet time, tourniquet pressure etc.) did not affect patient mortality rates in a significant way, but there was a higher incidence of complications (i.e. mortality, post-op infections, and reoperations) with patients with pre-operative infections. Conclusion: Diabetes, a higher CCI score and a greater ASA value were found to be significant predictors of patient mortality after BKA (p<0.05). Future perioperative optimization in these patients identified as high risk may improve patient outcomes in the future.

The efficacy and safety of the Amplatzer ductal occluder in young children and infants

2005 ◽  
Vol 15 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Jameel Al-Ata ◽  
Amin M. Arfi ◽  
Arif Hussain ◽  
Amjad A. Kouatli ◽  
M. Omar Jalal
Keyword(s):  
Young Children ◽  
Pulmonary Arteries ◽  
Major Complication ◽  
High Rate ◽  
Excessive Bleeding ◽  
Descending Aorta ◽  
Complete Occlusion ◽  
Transcatheter Occlusion ◽  
Occluder Device ◽  
Aortic Obstruction

Background: We have used the Amplatzer ductal occluder for transcatheter closure of large persistently patent arterial ducts, and used our experience to assess the safety and efficacy of the device in young children and infants. Methods and patients: We used the Amplatzer ductal occluder prospectively in 43 patients with large patent arterial ducts, reviewing our experience to identify any problems or complications. Results: The procedure proved successful in 42 of the patients. We achieved complete occlusion of the duct in 33 (78.5 per cent) of the patients on the day of insertion. In 6 additional patients, complete occlusion occurred 1 week to 6 months after the procedure. Trivial leaks persisted in 2 patients, while one had a significant residual leak. Problems were encountered in 7 patients. The procedure failed in one, a device was wasted in 2, pulled through in 3, while we experienced kinking of the long Mullins sheath, being unable to retrieve the device, in one patient. Minor complications occurred in 6 patients, finding flow at a peak velocity of 2.2 metres per second in the descending aorta in 2 patients, and at 2.5 metres per second in 2 further patients, and flow at 2.5 metres per second in the pulmonary arteries of two patients. One patient experienced a major complication due to excessive bleeding. Out of the 14 patients suffering adverse events, 13 weighed less than 10 kilograms. This rate of problems and complication in these patients weighing less than 10 kilograms was significantly higher than in the patients weighing more than 10 kilograms. Conclusion: Transcatheter occlusion of moderate to large patent arterial ducts with the Amplatzer ductal occluder device is safe and effective, with a high rate of complete occlusion. Problems and minor complications may be encountered in children weighing less than 10 kilograms. If the device is to be deployed completely in the ductal ampulla, and to avoid descending aortic obstruction, the size of the retention flanges of the occluder should not exceed the largest diameter of the patent arterial duct.

scholarly journals Effects of Medical Drugs According to Sweating Localization in Primary Hyperhidrosis

2021 ◽  
pp. 22-25
Author(s):  
Bayrakçi Onur
Keyword(s):  
Thoracic Surgery ◽  
Medical Treatment ◽  
Complete Response ◽  
The Body ◽  
High Rate ◽  
Chi Square ◽  
Excessive Sweating ◽  
Chi Square Test ◽  
Primary Hyperhidrosis ◽  
Palmar Sweating

Background: Primary hyperhidrosis is excessive sweating localized to different parts of the body, mostly on the hands. It is exact cause  unknown, negatively affects the psychosocial structure of the person and a clinically important health problem. Aims: In the study, it was aimed to examine the effects of drugs used on primary hyperhidrosis. Study Design: The drugs used by the patients who applied to the thoracic surgery clinic with the complaint of sweating and their effects were analyzed retrospectively. Ersin Arslan Training and Research Hospital Thoracic Surgery Clinic between January 1, 2015, and September 30, 2021 (outcomes of seven years). Methodology: A total of 120 patients(45 female, 75 male and age range 8-67) with sweating complaints were identified. Age, gender, sweating localization and drugs used were examined. Statistically, data were analyzed with 95% confidence interval(CI) and Chi Square test. Results: A total of 120 patients were analyzed. 37.5% were female and 62.5% male.The mean age was 27.1±1.54 years.Patients were use 23.4% Aluminum hydrochloride cream),20.8% Bornaprine hydrochloride, 20% Hyoscine-N-butylbromide.According to sweating localizations;42.6% palmar only, 18.7% palmar and axilla, 18.7% palmar and craniofacial, 7.8% palmar and plantar, 5.9% diffuse, 4.5% cranial, 1.8% palmar and abdomen.It is more often between ages of 21-30 and in male.According to the complaints of patients with a history of using medical treatment; there were 34.5% partial response and 20.2% complete response, and no response to medical treatment in 45.3%. Conclusion: In the study; according to the localization of sweating;Aluminum hydrochloride cream reduces sweating on the palmar, and Hyoscine-N-butylbromide reduces axillary and palmar sweating. Bornaprine hydrochloride reduces sweating on all localizations except craniofacial and abdomen, and is related with a complete response on palmar sweating.According to sweating localizations; although there are localizations where all three drugs used are effective, it has been concluded that these drugs used in primary hyperhidrosis do not respond fully at a high rate.

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