Predicting Successful Laparoendoscopic Transhiatal Esophagectomy (THE) by Mediastinal Height Measurement

2020 ◽  
Vol 86 (8) ◽  
pp. 1032-1035
Author(s):  
Shane Wylie Monnett ◽  
Jonathon Yu-Lin Tsai ◽  
Jeffrey Daniel Austin ◽  
Cameron Martin Harmon ◽  
Jacob Ian Shapiro ◽  
...  
Keyword(s):  
Medical Records ◽  
Preoperative Staging ◽  
Transhiatal Esophagectomy ◽  
Chest Ct ◽  
Thoracic Vertebrae ◽  
Inclusion Criteria ◽  
Height Measurement ◽  
Tertiary Referral Center ◽  
The Mean ◽  
Mini Laparotomy

Background Laparoendoscopic transhiatal esophagectomy (THE) provides advantages over traditional THE by not only avoiding laparotomy but by also allowing more precise esophageal mobilization. Occasionally, the length of the gastric conduit is insufficient to allow delivery into the neck after laparoscopic mobilization and requires laparotomy to complete the procedure. We hypothesize that the need for laparotomy will correlate with the measurement of mediastinal height (distance from thoracic vertebrae T1-T12) on chest CT. Methods Medical records of all patients who underwent attempted laparoendoscopic-assisted THE at a tertiary referral center between March 1, 2003 and January 31, 2019 were reviewed. Patients’ mediastinal height was measured using computed tomography (CT) imaging of the chest by investigators and analyzed for correlation between mediastinal height and successful completion of a totally laparoendoscopic procedure. Results A total of 21 cases met inclusion criteria: 9 successful laparoendoscopic THE procedures and 12 failed laparoendoscopic THE procedures (those requiring addition of a mini-laparotomy or thoracotomy). The mean mediastinal length for successful laparoendoscopic surgery was 23.5 cm, whereas the mean mediastinal length for failed laparoscopic surgeries was 24.8 cm (P = .03). Patient’s overall height was not found to correlate with the need for conversion. Conclusions Shorter mediastinal length is associated with successful laparoendoscopic or laparoscopic THE. This information is readily available to clinicians from routine preoperative staging studies (chest CT) and may be used to potentially predict the success rate of a totally laparoendoscopic approach and aid in patient selection. Further prospective evaluation of these findings is warranted.

scholarly journals Amiodarone-induced pulmonary toxicity

2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Junichi Ochi ◽  
Minoru Ohkouchi ◽  
Yoshikazu Tsukada ◽  
Shinichiro Tominaga ◽  
Satoshi Takayama ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Medical Records ◽  
Lung Biopsy ◽  
Pulmonary Toxicity ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Chest Computed Tomography ◽  
Ct Findings ◽  
The Mean ◽  
Foamy Macrophages

Amiodarone-induced pulmonary toxicity is a critical and potentially fatal side effect of amiodarone. Our study was designed to reveal its clinical features, including KL-6, as an interstitial marker. The medical records of eight patients (five men and three women) with amiodarone-induced pulmonary toxicity, who had been referred to our hospital, were examined. The mean age at the initiation of amiodarone was 48 years (range, 54-87 years) and mean duration of medication prior to the development of pulmonary toxicity was 18 months (range, 7-33 months). Serum KL-6 was elevated in six of the eight patients with a range of 525-2915 U/mL. Chest computed tomography (CT) findings showed non-segmental consolidation and/or ground glass opacity. Foamy macrophages were found in bronchoalveolar lavage (BAL) fluids of all examined patients and in transbronchial lung biopsy (TBLB) specimens in half of the examined patients. We concluded that serum KL-6, chest CT findings, and foamy macrophages in BAL fluids and TBLB specimens will be helpful for the diagnosis of amiodarone-induced pulmonary toxicity.

scholarly journals Prevalence of Dermatological Presentations of Canine Leishmaniasis in a Nonendemic Area: A Retrospective Study of 100 Dogs

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Roberta Perego ◽  
Daniela Proverbio ◽  
Giada Bagnagatti De Giorgi ◽  
Eva Spada
Keyword(s):  
Immune System ◽  
Retrospective Study ◽  
Medical Records ◽  
Canine Leishmaniasis ◽  
Inclusion Criteria ◽  
Continuous Stimulation ◽  
Exfoliative Dermatitis ◽  
The Mean ◽  
Endemic Areas ◽  
Stimulation Of

This retrospective study determined the prevalence of dermatological lesions associated with canine leishmaniasis (CanL) in a nonendemic area in Italy. The medical records of 131 dogs with CanL were reviewed and, of these, 115/131 dogs (88%) had dermatological manifestations of which 100/131 dogs (76%) met the inclusion criteria. Sixty-two percent of dogs were male and 38% were female and the mean age was 6.4 years. Thirty-two percent of dogs were mixed breeds; the remainder represented a variety of pure breeds. In 79% of dogs dermatological signs occurred in association with systemic signs of CanL, whilst 21% of dogs had only dermatological manifestations. The most common dermatological manifestation was exfoliative dermatitis (74%), followed by ulcerative (18%) and nodular (11%) lesions. In 51% of dogs the lesions were localized mainly on the pinnae, head, and pressure points; in the remaining 49% lesions were generalized. The only statistically significant association was between Retriever breed and animals with only dermatological signs (P=0.0034, OD 5.97, CI 0.996–37.933). In this study dermatological manifestations of CanL were very commonly reported, and their prevalence is similar to previous studies in endemic areas despite the fact that dogs living in nonendemic areas are not exposed to repeated infectious bites and continuous stimulation of the dermal immune system.

scholarly journals Outcome of Inferonasal Conjunctival Autograft in Pterygium Surgery

2021 ◽  
Vol 23 (4) ◽  
pp. 319-323
Author(s):  
Pragati Gautam Adhikari ◽  
Sagun Narayan Joshi
Keyword(s):  
Medical Records ◽  
Demographic Variables ◽  
Inclusion Criteria ◽  
Conjunctival Autograft ◽  
Donor Area ◽  
Mean Size ◽  
Pterygium Surgery ◽  
The Mean ◽  
Pterygium Excision

This study was done to evaluate the outcome of pterygium excision with inferonasal conjunctival autograft at a tertiary eye care centre. Retrospective analysis of medical records of primary pterygia patients operated by a single surgeon between 2017 to 2020 were analyzed. A total of 43 patients who met the inclusion criteria were included in the study. The demographic variables, along with size of pterygium and recurrence over a period of six month follow up was noted. The mean age of patients was 46.97 years (29-74 years). The mean size of pterygium was 3.17 mm. Recurrence was seen in 3 eyes over a period of 6 months. Graft edema was observed in 11 patients and graft hemorrhage along with congestion was seen in 8 cases which resolved over a 3 weeks follow up period. Mild conjunctival scarring was seen over donor area in 5 of the eyes. Pterygium excision with inferior conjunctival autograft is an effective alternative technique to superotemporal autograft technique.

scholarly journals The use of folic acid in dengue: has it any value?

2019 ◽  
Vol 49 (2) ◽  
pp. 85-87 ◽  
Author(s):  
Ahsan Ali Syed ◽  
Saad Bin Zafar ◽  
Asif Ali Shah ◽  
Safia Awan
Keyword(s):  
Folic Acid ◽  
Medical Records ◽  
Dengue Infection ◽  
Inclusion Criteria ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time

Folic acid is used in dengue patients. Our study aims to compare the duration of recovery of thrombocytopenia in patients with dengue infection who received folic acid and those who did not. We retrospectively reviewed the medical records of adult patients admitted over six years with a diagnosis of dengue. Of 2216 patients, 1464 fulfilled the inclusion criteria. Group A were those patients who received folic acid and group B were those who did not. A total of 1322 (90.3%) patients received folic acid. The mean time period required for platelets to double the nadir was 1.7 (±2.2) days in both groups A and B ( P = 0.89). In conclusion, there is no significant difference in the recovery of thrombocytopenia in patients with dengue fever who received folic and those who did not receive folic acid.

scholarly journals Early Hydroxychloroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study

2020 ◽  
Author(s):  
Francisco Javier Membrillo ◽  
Germán Ramírez-Olivencia ◽  
Miriam Estébanez ◽  
Begoña de Dios ◽  
María Dolores Herrero ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Evidence ◽  
Patient Survival ◽  
Specific Treatment ◽  
Immunomodulatory Activity ◽  
Loading Dose ◽  
Clinical Use ◽  
Inclusion Criteria ◽  
The Mean

Background: Although no specific treatment for COVID 19 has been proven effective yet, some drugs with in vitro potential against SARS-CoV-2 virus have been proposed for clinical use. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness on the outcome of the disease. Methods: We enrolled all 18-85 years old inpatients from Central Defense Hospital, Madrid, Spain, who were hospitalised due to COVID-19 and had a definitive outcome (either dead or discharged). We used a statistical survival analysis. Results: We analysed 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, versus 22% in the group of hydroxychloroquine (p=0,002). According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group. Conclusions: in a cohort of 166 patients between 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with an initial loading dose of 800mg improved patient survival when admitted in early stages of the disease. There was a non-statistically significant trend towards survival in all groups, which will need to be clarified in subsequent studies.

Perbandingan Nilai Risk Malignancy Index Kanker Ovarium Tipe Serosum dan Musinosum RSUP Dr. M. Djamil Padang pada Tahun 2017

2020 ◽  
Vol 4 (1) ◽  
pp. 87-94
Author(s):  
Frita Dwi Luhuria ◽  
Defrin Defrin ◽  
Andi Friadi
Keyword(s):  
Ovarian Cancer ◽  
Medical Records ◽  
Age Distribution ◽  
Mean Value ◽  
Common Type ◽  
Ca 125 ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Serous Ovarian Carcinoma ◽  
The Mean

The Risk Malignancy Index (RMI) is one of the simplest assessments that can assist in diagnosing and determining the prognosis of benign and malignant adnexa masses. Epithelial carcinoma is the most common type of about 90% of ovarian cancers.  As many as 35-40% of the epithelial type are serous and 6-10% are musinosum.This study aims to compare the picture of RMI value on the incidence of ovarian cancer serosum and musinosum type. This study was cross sectinal comparative study from medical records of ovarian cancer patients at obstetrics and gynecology section in DR M Djamil Hospital Padang from January 1st, 2017 until December 31st, 2017. The population was found one hundred and forty of patients with ovarian cancer and only one hundred and twenty nine of patients met the inclusion criteria and there were no exclusion criteria. Next RMI value is calculated based on RMI 1 formula, result is described in tabular form and data processing with SPSS program. Conclucion of this study is there were no differences in age distribution, ascites occurrence and age of menopause in serous and musinosum ovarian cancer. There is a difference in Ca, 125 levels in serous with musinosum ovarian cancer which also contribute to the high value of RMI. The mean value of patients‘s RMI in serous type ovarian cancer is higher than the mean value of RMI in patients with type Musinosum ovarian cancer. Keywords: index of risk malignancy, menopause, ultrasonography, anatomic pathology, serous ovarian carcinoma

scholarly journals Gambaran Komplikasi Transurethral Resection of the Prostate pada Pasien Benign Prostatic Hyperplasia

2017 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Zuhirman Zuhirman ◽  
Desby Juananda ◽  
Putry Lestari
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Gold Standard ◽  
Medical Records ◽  
Benign Tumor ◽  
Descriptive Study ◽  
Prostatic Hyperplasia ◽  
Inclusion Criteria ◽  
The Mean ◽  
Age Range

Benign prostatic hyperplasia (BPH) is a benign tumor that most common, a serious problem and may affect thequality of life. Transurethral resection of the prostate (TURP) is the gold standard for BPH management. The aim ofthis study was to describe the complications of TURP in patients with BPH. This was a descriptive study by reviewingthe medical records of BPH patients underwent TURPs at RSUD Arifin Achmad, Riau Province in 2011-2015. Therewere 280 medical records fulfilled the inclusion criteria in which showed 93 patients who experienced complicationsof TURP. The most age range was 60-69 years old (12,9%), the mean of the resection duration was 30(10-80) minutesand the mean of weight of the resected prostatic tissue was 30 (10-50)grams. The most common complications wasbleeding (42,9%), urinary retention (27,6%).In the research, we conclude the complications were higher than theones in the literatures.

scholarly journals Early Hydroxychloroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study

2020 ◽  
Author(s):  
Francisco Javier Membrillo de Novales ◽  
Germán Ramírez-Olivencia ◽  
Miriam Estébanez ◽  
Begoña de Dios ◽  
María Dolores Herrero ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Medical Records ◽  
Clinical Evidence ◽  
Hospital Death ◽  
Immunomodulatory Activity ◽  
Loading Dose ◽  
Inclusion Criteria ◽  
Cumulative Survival ◽  
The Mean

Background: There is no treatment proven effective against COVID-19. Several drugs with in vitro potential against SARS-CoV-2 virus have been proposed. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness changing the outcome of the disease. Methods: We enrolled all 18-85 years old inpatients from Central Defense Hospital “Gómez Ulla”, Madrid, Spain, who were hospitalised for COVID-19 and had a definitive outcome (dead or discharged). We used a statistical survival analysis to detect treatment differences associated with in-hospital death. Results: We analysed first 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, 22% of those treated with hydroxychloroquine (p=0,002). According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group. Conclusions: in a cohort of 166 patients from 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with 800mg added loading dose increased survival when patients were admitted in early stages of the disease. There was a non-statistically significant trend towards survival in all groups, which will have to be clarified in subsequent studies.

scholarly journals Characteristics of Patients with Accommodative Esotropia Who Need Glasses for Stable Alignment after Myopic Shift

2021 ◽  
Vol 62 (8) ◽  
pp. 1116-1122
Author(s):  
Min Woo Kim ◽  
Donghun Lee ◽  
Myung Mi Kim
Keyword(s):  
Medical Records ◽  
Initial Visit ◽  
Inclusion Criteria ◽  
Clinical Factors ◽  
Stable Group ◽  
Factors Associated ◽  
Myopic Shift ◽  
The Mean ◽  
Accommodative Esotropia

Purpose: We analyzed the characteristics of patients with refractive accommodative esotropia (RAET) who required glasses for stable alignment after a myopic shift.Methods: We retrospectively analyzed the medical records of patients diagnosed with RAET at the initial visit, and who had developed a myopic shift in both eyes over the 5-year follow-up period. To evaluate clinical factors associated with the persistence of esotropia after myopia, the enrolled patients were divided into two groups; patients with RAET who needed glasses for stable alignment after a myopic shift (unstable group) and patients with RAET whose esotropia resolved after a myopic shift (stable group).Results: A total of 55 patients met the inclusion criteria. The mean follow-up period was 13.8 ± 5.7 years (5-27 years). Spherical equivalent (SE) refractive errors at the initial visit were +3.1 ± 1.6 diopters (D) (+1.00 to +7.25 D) and -1.5 ± 0.9 D (-4.38 to -0.5 D) at the last visit. Of the 55 RAET patients, 24 were included in the unstable group and 31 were included in the stable group. No significant differences in gender, age at diagnosis, SE refractive error, or angle of esotropia with glasses were observed between the two groups. However, significantly more patients failed the Lang I test or had anisometropia over 1.5 D at the last visit, and the duration between the onset of esotropia and prescribing glasses was significantly longer in the unstable group than in the stable group.Conclusions: Glasses may be needed for stable alignment even after a myopic shift in RAET patients with long durations of misalignment, poor stereopsis, and anisometropia.

Comparison of transhiatal esophagectomy using a mediastinoscope with transhiatal esophagectomy by the classic method

2020 ◽  
pp. 021849232096397
Author(s):  
Reza Rezaei ◽  
Seyed Hossein Fattahi Masuom ◽  
Navid Soroush ◽  
Vahid Zehi
Keyword(s):  
Operative Time ◽  
Group Versus ◽  
Transhiatal Esophagectomy ◽  
Thoracic Esophagus ◽  
Mediastinal Lymph Nodes ◽  
Inclusion Criteria ◽  
Early Postoperative Complications ◽  
Significant Difference ◽  
Cardiopulmonary Complications ◽  
The Mean

Background This study aimed to evaluate the results of transhiatal esophagectomy using a mediastinoscope in comparison with conventional transhiatal esophagectomy. Methods Sixty-two esophageal cancer patients who were referred to our thoracic surgery clinic between April 2015 and March 2017, and met the inclusion criteria, were randomly divided into two groups of 31 each. In the first group, patients were operated on by conventional transhiatal esophagectomy. In the second group, only release of the thoracic esophagus through a neck incision (mediastinal esophagolysis) was performed using a mediastinoscope. The other surgical procedures were similar to those in the first group. Results The mean age of the patients was almost the same in both groups (57.7 years in the first group versus 56.7 years in the second group). There was no significant difference in sex ratio. The mean volume of blood loss during the operation, mean operative time, and intensive care unit stay as well as cardiopulmonary complications and early postoperative complications were lower in the group that had esophagectomy using a mediastinoscope, and the number of resected mediastinal lymph nodes was greater. Conclusion Based on the results of this study, it can be expected that use of a video mediastinoscope for esophagolysis of the thoracic esophagus in a transhiatal esophagectomy procedure is safe and it will reduce the morbidity and mortality in these patients.

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