scholarly journals RARE-03. CNS GERMINOMA WITH SYNCHRONOUS LESIONS IN THE SELLAR AND PINEAL REGIONS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi221-vi222
Author(s):  
Armen Simonyan ◽  
Anna Mikhaylova ◽  
Levan Lepsveridze ◽  
Maksim Semenov
Keyword(s):  
Clinical Case ◽  
Surgical Intervention ◽  
Symptomatic Treatment ◽  
Tumor Biopsy ◽  
Histological Changes ◽  
Difficult Situation ◽  
Surgical Interventions ◽  
Lack Of Information ◽  
Occlusive Hydrocephalus ◽  
Cns Malignancies

Abstract Germinomas comprise approximately 2–5% of all CNS malignancies, and have a favourable prognosis. Bad outcomes are relatively rare. Synchronous lesions occurs in 5–10% of cases. We report a case of 28 years old male, presented with motor aphasia, visual impairment and dysphagia. In period of last 15 months patient underwent 3 surgical interventions due to occlusive hydrocephalus. MRI revealed volume formations of the pineal and sellar regions. Taking into account the severity of the patient’s condition, consilium decided to refrain from surgical intervention and adjuvant therapy. Patient was transferred to the palliative unit. He died after 3 months. According to the results of the autopsy, the histological changes in tumors of the pineal and infundibular regions, corresponds to the germinoma. Due to the lack of information about patient’s treatment, carried out until hospitalization in our center, we don’t undertake to judge whether there was diagnostic omission, or incorrect treatment in this clinical case. But in our opinion, in case of suspected CNS germinoma, it is necessary to conduct more “aggressive treatment” (Tumor biopsy, followed by radiotherapy and chemotherapy). Symptomatic treatment should be used in cases, where the treatment of main disease is impossible. We hope that this sad clinical case will help Neurosurgeons in making decisions in a difficult situation.

scholarly journals Bowel obstruction in obturator hernia: a challenging diagnosis

2021 ◽  
Vol 8 (7) ◽  
pp. 2212
Author(s):  
Nimisha Ramachandran Chemmangattuvalappil ◽  
Babu John Pulluvelil ◽  
Ravindran Chirukandath ◽  
Santosh Vijayan Thekoot ◽  
Bobby Sebastian
Keyword(s):  
Bowel Obstruction ◽  
Clinical Case ◽  
Surgical Intervention ◽  
Exploratory Laparotomy ◽  
Obturator Hernia ◽  
Rare Type ◽  
Obturator Foramen ◽  
Surgical Interventions ◽  
Emergency Surgical Intervention ◽  
Specific Symptoms

The obturator hernia is a rare pelvic hernia that presents as bowel obstruction caused by the presence of an intestinal segment, more often ileum passing through obturator foramen. This type of hernia accounts for 0.5-1.4% of all hernias. We reported the clinical case of a 74 year old woman with no previous surgical interventions, presented to ER with abdominal pain and distension, features of intestinal obstruction, which she had experienced for previous three days. A CT scan revealed a right jejunal, obstructed obturator hernia. The patient underwent an emergency surgical intervention with emergency exploratory laparotomy and repair. This case was presented as obturator hernia was a rare type of hernia due to its diagnosis, which is often unclear with non-specific pain radiating to legs mimicking neurological symptoms. A prompt suspect based for the non-specific symptoms is crucial for the diagnosis. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology.

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

Do People Trust in Robot-Assisted Surgery? Evidence from Europe (Preprint)

2020 ◽  
Author(s):  
Joan Torrent-Sellens ◽  
Ana Jiménez-Zarco ◽  
Francesc Saigí-Rubió
Keyword(s):  
Technology Acceptance ◽  
Surgical Intervention ◽  
Negative Relationship ◽  
Predictor Variable ◽  
Major Change ◽  
Ease Of Use ◽  
The European Union ◽  
Robot Assisted ◽  
Surgical Interventions ◽  
Robot Assisted Surgery

BACKGROUND Increasingly intelligent and autonomous robots are destined to have a huge impact on our society. Their adoption, however, represents a major change to the healthcare sector’s traditional practices, which, in turn, poses certain challenges. To what extent is it possible to foresee a near-future scenario in which minor routine surgery is directed by robots? And what are the patients’ or general public’s perceptions of having surgical procedures performed on them by robots, be it totally or partially? A patient’s trust in robots and AI may facilitate the spread and use of such technologies. OBJECTIVE The goal of our study was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. METHODS We used data from a 2017 Flash Eurobarometer (number 460) of European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. The research designs and tests a technology acceptance model (TAM). Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, robots using experience and sociodemographic independent variables. RESULTS The negative relationship between most of the predictors of ease of use, expected benefits and attitude towards robots, and confidence in robot-assisted surgery was contrasted. The only non-sociodemographic predictor variable that has a positive relationship with trust in robots participating in a surgical intervention is previous experience in the use of robots. In this context, we analyze the confidence predictors for three different levels of robot use experience (zero use, average use, and high use). The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude and perception of robots become more negative. Research results also determined that variables of a sociodemographic nature played an important predictive role. It was confirmed that the effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. CONCLUSIONS Despite the considerable benefits for the patient that the use of robots can bring in a surgical intervention, the results obtained show that trust in robots goes beyond rational decision-making. By contrasting the reasons that generate trust and mistrust in robots, especially by highlighting the experience of use as a key element, the research makes a new contribution to the state of the art and draws practical implications of the use of robots for health policy and practice.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

scholarly journals Safety and effectiveness of surgical fixation versus non-surgical methods for the treatment of flail chest in adult populations: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Ayobobola A. Apampa ◽  
Ayesha Ali ◽  
Bryar Kadir ◽  
Zubair Ahmed
Keyword(s):  
Systematic Review ◽  
Surgical Intervention ◽  
Meta Analysis ◽  
Adult Population ◽  
Flail Chest ◽  
Surgical Interventions ◽  
Surgical Methods ◽  
Surgical Fixation ◽  
Randomised Controlled ◽  
Pulmonary Status

Abstract Purpose The objective of this systematic review is to compare the safety and efficacy of surgical fixation of rib fractures against non-surgical interventions for the treatment of flail chest in the adult population. Methods A search was performed on the 22nd of July 2020 to identify articles comparing surgical fixation versus clinical management for flail chest in adults, with a description of the outcome parameters (resource utility, mortality, adverse effects of the intervention and adverse progression in pulmonary status). Relevant randomised controlled trials were selected, their risk of bias assessed, and the data then extracted and analysed. Results 157 patients were included from four studies in the analyses, with 79 and 78 patients in the surgical and non-surgical groups, respectively. The pooled effects of all outcomes tended towards favouring surgical intervention. Surgical intervention was associated with lower rates of pneumonia (I2 = 46%, Tau2 = 0.16, p = 0.16), significantly lower rates of tracheostomy (I2 = 76%, Tau2 = 0.67, p = 0.02), and a significantly lower duration of mechanical ventilation (I2 = 88%, Tau2 = 33.7, p < 0.01) in comparison to the non-surgical management methods. Conclusion Our results suggest that surgical intervention reduces the need for tracheostomy, reduces the time spent in the intensive care unit following a traumatic flail chest injury and could reduce the risk of acquiring pneumonia after such an event. There is a need for further well-designed studies with sufficient sample sizes to confirm the results of this study and also detect other possible effects of surgical intervention in the treatment of traumatic flail chest in adults.

scholarly journals Idiopathic Multifocal Osteolysis: Case of Surgical Treatment

2015 ◽  
Vol 22 (3) ◽  
pp. 78-83
Author(s):  
A. P Pozdeev ◽  
E. A Zakhar’yan ◽  
D. S Buklaev ◽  
I. N Krasnogorskiy ◽  
T. F Zubairov
Keyword(s):  
Clinical Case ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Lymphatic Vessels ◽  
Bisphosphonate Therapy ◽  
Surgical Interventions ◽  
Massive Osteolysis ◽  
Thin Walls ◽  
Idiopathic Osteolysis ◽  
Tubular Bones

Idiopathic osteolysis is a rare disorder characterized by spontaneous, massive and progressive resorption of bone tissue. Massive osteolysis results from proliferation of blood and lymphatic vessels with thin walls, resembling capillaries, in the bone and surrounding soft tissues. Literature review on this problem and clinical case of a patient successfully operated on using the technique elaborated at our clinic are presented. Surgical interventions enabled to achieve the restoration of tubular bones integrity and ensured conditions for independent patient’s movement. Possibility of the performance of reconstructive surgical interventions for the restoration of limb weight bearing ability that is reasonable to combine with bisphosphonate therapy.

scholarly journals CASE OF OCULAR MANIFESTATIONS HYDROXYCHLOROQUINS TOXIC EFFECT

2011 ◽  
Vol 2 (2) ◽  
pp. 12-21 ◽  
Author(s):  
A A Kazaryan ◽  
E Nikolaevna Ponomareva
Keyword(s):  
American Academy ◽  
Clinical Case ◽  
Difficult Problem ◽  
Diabetes Type ◽  
Diabetes Type 1 ◽  
Effective Screening ◽  
Ocular Manifestations ◽  
Lack Of Information ◽  
Uncommon Disease

Based on experience and analysis of a few articles, devoted to this topic, the authors diagnose and describe the clinical case of the rare symptoms' group, associated with taking of hydroxychloroquine by the patient with sarcoidosis and diabetes type 1. The diagnostics of this lesion is difficult problem in the regular ophthalmologic practice, because of the uncommon disease, the lack of information and continuity between specialists, especially rheumatologists and pulmonologists. The recommendations of American Academy of Ophthalmology for effective screening of patients undergoing hydroxychloroquine therapy are given in this report.

scholarly journals ADVANTAGES OF INTRATHECAL BUPIVACAINE AND DEXMEDETOMIDINE COMBINATION OVER BUPIVACAINE AND CLONIDINE: A COMPARATIVE ANALYSIS IN GYNAECOLOGICAL INTERVENTIONS

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Aruna Mahanta ◽  
Keshav Saran Agrawal
Keyword(s):  
Regional Anaesthesia ◽  
Motor Block ◽  
Surgical Intervention ◽  
Average Duration ◽  
Sensory Block ◽  
Lower Side ◽  
Regional Analgesia ◽  
Surgical Interventions ◽  
Group I ◽  
Group Ii

Background: most of the gynaecological interventions are generally done under regional anaesthesia. Currently dexmedetomidine came out as a beneficial adjunct for regional analgesia as well as anaesthesia. It is a highly selective α-2 agonist. Aims & objectives: to compare the effects & behavior of dexmedetomidine with clonidine when both are used with bupivacaine for spinal analgesia. Material and Methods: 100 cases of ASA grade 1 & 2 who were undergoing elective gynaecological surgical intervention were studied. They were divided into two groups (50 each). Group I received combination of bupivacaine & clonidine while group II received combination of bupivacaine + dexmedetomidine. Results: Average duration of onset of sensory block was earlier in group II. Arrival of motor block in Group I was slightly on lower side than Group II. Ten cases in Group I and eighteen cases from group II had notable bradycardia and hypotension. Discussion: Our study concludes that dexmedetomidine when used in combination with bupivacaine is very effective in gynaecological surgical interventions that demand longer duration & have comparatively lesser side effects. Keywords: dexmedetomidine, clonidine, Bupivacaine, gynaecological procedures.

scholarly journals Perforation of the jejunum diverticulum: the role of CT examination

2019 ◽  
pp. 66-76
Author(s):  
I. V. Platitsyn ◽  
A. V. Kondratyev ◽  
A. V. Panin ◽  
E. M. Shubarkina ◽  
A. L. Maslov
Keyword(s):  
Small Intestine ◽  
Acute Abdomen ◽  
Research Methods ◽  
Clinical Case ◽  
Laparoscopic Resection ◽  
Surgical Intervention ◽  
Everyday Practice ◽  
Correct Interpretation ◽  
Common Causes

Uncomplicated diverticula of the small intestine are asymptomatic, extremely rare in everyday practice and, most often, are detected already with the development of complications such as perforation and abscess formation. Diagnosis of complicated diverticula of the small intestine is difficult due to many other, more common causes of acute abdomen, insufficient use of the capabilities of the methods of radiation diagnosis, the lack of application and correct interpretation of the results of instrumental and special research methods. The article presents a clinical case of perforation of the jejunum diverticulum. The results of effective MDCT diagnosis and successful surgical intervention are presented: laparoscopic resection of the jejunum with the formation of the primary hardware intracorporeal enteroentero-anastomosis side by side. 

scholarly journals The use of 3D modeling to determine the parameters of surgical intervention for pulmonary tuberculosis

2020 ◽  
Vol 98 (6) ◽  
pp. 47-51
Author(s):  
E. A. Borodulinа ◽  
A. V. Kolsаnov ◽  
P. V. Rogozhkin ◽  
A. A. Mаnukyan
Keyword(s):  
Computed Tomography ◽  
Pulmonary Tuberculosis ◽  
3D Modeling ◽  
3D Model ◽  
Surgical Intervention ◽  
Bronchial Tree ◽  
Surgical Interventions ◽  
Color Mapping ◽  
Vascular Structures ◽  
Tomography Data

The clinical experience demonstrates the importance of 3D modeling when planning surgical intervention in patients with pulmonary tuberculosis. The 3D model was built up based computed tomography data using Avtoplan software with plug-ins for segmentation of the lung, pathological foci, vascular structures, and bronchial tree. The data obtained during 3D modeling allowed us to plan surgery and the data were fully confirmed during the operation. The 3D model with color mapping reveals syntopy, which is extremely difficult to determine using standard computed tomography and allows the wider use of minimally invasive endoscopic surgical interventions.

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