Changes in Hemoglobin Levels in Patients with Hiatal Hernia and Anemia Demonstrates a Durable Resolution When Surgery Utilized

2021 ◽  
pp. 263451612110252
Author(s):  
Anne Sophie Laliberte ◽  
John J. Brandabur ◽  
Shu-Ching Chang ◽  
Peter U. Baik ◽  
Anee Sophia Jackson ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Medical Management ◽  
Surgical Repair ◽  
Short Term ◽  
Iron Supplements ◽  
H2 Blockers ◽  
Predominantly Female ◽  
Medical Guidelines ◽  
Type 3

Objective: To describe the patterns of care of patients presenting with anemia and a hiatal hernia and to document hemoglobin levels at each stage of care. Background data: Anemia may be associated with hiatal hernia. Current medical guidelines recommend iron supplements and proton pump inhibitors (PPIs) as initial steps, but not surgical repair is not routinely recommended despite evidence of cure. Methods: Retrospective review of patients with anemia and hiatal hernia who underwent surgical repair. Hemoglobin, PPI use, and symptoms were assessed at diagnosis, preoperatively, and postoperatively. Results: We identified 116 predominantly female patients with type 3 hernias with 52.6% (n = 61) having Cameron ulcers. At baseline, 24.1% (n = 28) were transfused, 52% (n = 60) started on iron supplements, 72% (n = 84) on PPIs, and 10% (n = 12) on H2-blockers. Referral to surgery occurred 454 days (IQR: 129-1332) after anemia diagnosis. The mean Hgb at diagnosis was 9.79 (range: 4.8-12.7) in females and 10.9 (range: 7.7-12.9) in males, increasing to 11.1 (range: 5.4-15) and 11.4 (range: 5.8-15.9) with medical management. After laparoscopic repair, it increased to 12.3 (range: 8.1-14.8) and 13.4 (range: 8.9-16.8) at short term follow up. This was sustained at 12.8 (range: 8.8-17.7) and 14.2 (8.1-17) long term. Medical management normalized Hgb in 36% (n = 40/111); whereas surgery normalized Hgb in 62% (n = 64/104) short term and 74% (n = 69/93) long term. Cameron’s ulcers were associated with normalization in 85% (38/45) but only 62% (n = 21/34) when not present. Conclusion: Anemia associated with a hiatal hernia improves with medication, but the addition of surgery normalizes Hgb, appears durable, allows cessation of medication, and improves quality of life.

scholarly journals Type VIII Slap Repair: Patient-Reported Outcomes Of 34 Patients With Minimum 4-year Follow-up

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0017
Author(s):  
Justin W. Arner ◽  
Mitchell Stephen Fourman ◽  
Steven Bayer ◽  
Darren L. De SA ◽  
Dharmesh Vyas ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Surgical Repair ◽  
Return To Sport ◽  
Functional Score ◽  
Short Term ◽  
Type Viii ◽  
Slap Repair ◽  
Patient Reported

Objectives: Type VIII superior labrum anterior posterior (SLAP) tears - described as SLAP II injuries with posterior extension of the labral tear to the 6 o’clock aspect of the glenoid - have been shown in short-term outcome work to be a source of noted shoulder instability, pain, and reduced function/range of motion in both throwing and non-throwing athletes. Limiting our evaluation and effective treatment of these injuries in both the professional athlete and weekend warrior is our lack of mid- and long-term post-operative outcomes after surgical repair. It is hypothesized that Type VIII SLAP repairs would fare poorly, particularly in the throwing cohort, at mid- to long-term follow-up. Methods: With a minimum 4-year follow-up after Type VIII SLAP repair by a single surgeon, return to sport, KJOC, ASES, stability, range of motion, and pain were compared between throwers, contact, and non-contact athletes. Results: With an average follow-up of 6.2 years, 34 athletes (19 throwers, 5 contact athletes, 10 non-contact athletes), with a mean age of 24.4 years were evaluated. Significant (p < .0001) improvements were observed between pre- and post-operative pain, range of motion, and ASES total and functional scores in throwers and non-throwers. Stability improved but was not significant (Table 1). There were no post-operative differences between throwers and non-throwers (Table 2). Pre-operative ASES functional score was significantly lower in contact athletes than in throwers and non-contact athletes (p < .01), but post-operatively improved significantly with no difference between groups (Table 3, 4). Overall, there was no difference in return to sport between groups as 73.7% of throwers and 93.3% of non-throwers returned (Table 4) and 62.5% of throwers and 57.9% of non-throwers (p = .73) returned to the same level. Further, 89.5% of throwers and 100% of non-throwers (p = .49) said that their surgery was worthwhile. Conclusion: Given the paucity of literature, current surgical outcomes of athletes who have undergone Type VIII SLAP repairs is limited, particularly in mid- and long-term function and return to sport. The current findings suggest that surgical repair of Type VIII SLAP lesions contributes to significant improvements in pain, function, and shoulder range of motion that persists >4 years after repair. However, stability changes after injury appear more chronic in nature. Further, thrower and non-throwers appear to have similar outcomes, which has not previously been seen in short term studies. [Table: see text][Table: see text][Table: see text][Table: see text]

scholarly journals Comparison of medical and/or surgical management of 23 cats with intracranial empyema or abscessation

2018 ◽  
Vol 21 (6) ◽  
pp. 566-574 ◽  
Author(s):  
Sophie Martin ◽  
Randi Drees ◽  
Balazs Szladovits ◽  
Elsa Beltran
Keyword(s):  
Surgical Management ◽  
Medical Management ◽  
Statistical Significance ◽  
Imaging Findings ◽  
Short Term ◽  
Term Outcome ◽  
Term Survival ◽  
Treatment Protocols ◽  
Long Term Survival

Objectives Feline intracranial abscessation or empyema is infrequently reported in the veterinary literature. To date, the largest study is based on a population of 19 cats with otogenic infection. The aim of this study was to review a larger population of cats with intracranial empyema from multiple aetiologies and document their signalment, imaging findings, treatment protocols (including medical and/or surgical management) and to compare outcomes. Methods Cases presenting to a single referral centre over a 10 year period with compatible history, neurological signs and imaging findings consistent with intracranial abscessation and empyema were reviewed retrospectively. Results Twenty-three cats met the inclusion criteria. Advanced imaging (CT and/or MRI) was performed in 22/23 cats; one case was diagnosed via ultrasound. Ten cases underwent medical and surgical management combined, 10 underwent solely medical management and three were euthanased at the time of diagnosis. Short-term outcome showed that 90% of surgically managed and 80% of medically managed cats were alive at 48 h post-diagnosis. Long-term survival showed that surgically managed cases and medically managed cases had a median survival time of 730 days (range 1–3802 days) and 183 days (range 1–1216 days), respectively. No statistical significance in short- or long-term survival ( P >0.05) was found between medically and surgically managed groups. Conclusions and relevance Feline intracranial abscessation and empyema are uncommon conditions that have historically been treated with combined surgical and medical management. This study documents that, in some cases, intracranial abscessation and empyema can also be successfully treated with medical management alone.

scholarly journals Hiatal hernia repair with Toupet fundoplication in surgical treatment of hiatal hernia, complicated by gastroesophageal reflux disease

2019 ◽  
Vol 10 (3) ◽  
pp. 5-12
Author(s):  
A. G. Grintcov ◽  
R. V. Ishenko ◽  
Igor V. Sovpel ◽  
O. V. Sovpel ◽  
Ju. A. Shapovalova
Keyword(s):  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Reflux Disease ◽  
Hiatal Hernia Repair ◽  
Toupet Fundoplication ◽  
Short Term

Introduction. Hiatal hernia occupies a third place in the structure of the gastrointestinal tract pathology. The association of hiatal hernia with gastroesophageal reflux disease can lead to severe complications and requires a surgical treatment. Objective. To analyze short-term and long-term results of a surgical treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease (GERD). Methods. A retrospective analysis of the short-term and long-term treatment results of 62 patients suffering from hiatal hernia complicated by gastroesophageal reflux disease was performed. All the patients underwent a laparoscopic hiatal hernia repair supplemented by Toupet fundoplication. Results. The hospital stay duration was 7.21.6 days. The postoperative complication rate was 6.5%. Mild functional dysphagia was noted in 8(12.9%). Persistent long-term dysphagia in the late postoperative period was observed in 2(3.2%) patients. The recurrences of hiatal hernia or GERD were noted in 15(24.2%) patients in 5 years after the surgery. The total GERD-HRQL questionnaire score 5 years after the surgery was 5.73.9. Сonclusion. Laparoscopic interventions are safe, less traumatic, provide the possibility of early rehabilitation of patients, can achieve positive functional results in 85% of patients and should be used in the treatment of patients suffering from hiatal hernia complicated by GERD.

scholarly journals Sustainable Development of the Steppe in the Region of El Bayadh, Approach to a New Fattening System

2020 ◽  
pp. 30-37
Author(s):  
Mekhloufi Moulay Brahim ◽  
Mohamed Khader ◽  
Tayeb Nouri ◽  
Mahari Latifa
Keyword(s):  
Sampling Method ◽  
Farming Systems ◽  
Breeding Systems ◽  
Short Term ◽  
Land Use Patterns ◽  
Use Patterns ◽  
Type 3

The objective of this research is to follow the evolution and sustainability of the natural resource management systems adopted by different breeders found in the Al Bayadh region in Algeria. Using a stratified sampling method, 52 farms were surveyed between 2010 and 2015 to capture the diversity of farming systems and identify changes in land use patterns. The findings of the research reveal a predominance of sedentary and semi-transhumant farming systems with a sharp decline in nomadism. This study enabled us to identify three types of breeding: sedentary breeding systems with short-term fattening (type 1), semi-sedentary systems with medium-term fattening (type 2), and transhumant/nomadic systems with long-term fattening (type 3) that therefore reflect a diversity of actions in the management of the risk that threaten livestock production.

Outcomes of infants and children undergoing surgical repair of ventricular septal defect: a review of the literature and implications for research with an emphasis on pulmonary artery hypertension

2020 ◽  
Vol 30 (6) ◽  
pp. 799-806
Author(s):  
Anna G. Palladino-Davis ◽  
Christopher S. Davis
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Medical Management ◽  
Septal Defect ◽  
Surgical Repair ◽  
Pulmonary Artery Hypertension ◽  
Ventricular Septal Defects ◽  
Septal Defects ◽  
Defect Repair

AbstractBackground:Pulmonary vascular disease resulting from CHDs may be the most preventable cause of pulmonary artery hypertension worldwide. Many children in developing countries still do not have access to early closure of clinically significant defects, and the long-term outcomes after corrective surgery remain unclear. Focused on long-term results after isolated ventricular septal defect repair, our review sought to determine the most effective medical therapy for the pre-operative management of elevated left-to-right shunts in patients with an isolated ventricular septal defect.Methods:We identified articles specific to the surgical repair of isolated ventricular septal defects. Specific parameters included the pathophysiology and pre-operative medical management of pulmonary over-circulation and outcomes.Results:Studies most commonly focused on histologic changes to the pulmonary vasculature and levels of thromboxanes, prostaglandins, nitric oxide, endothelin, and matrix metalloproteinases. Only 2/44 studies mentioned targeted pharmacologic management to any of these systems related to ventricular septal defect repair; no study offered evidence-based guidelines to manage pulmonary over-circulation with ventricular septal defects. Most studies with long-term data indicated a measurable frequency of pulmonary artery hypertension or diminished exercise capacity late after ventricular septal defect repair.Conclusion:Long-term pulmonary vascular and respiratory changes can occur in children after ventricular septal defect repair. Research should be directed at providing an evidenced-based approach to the medical management of infants and children with ventricular septal defects (and naturally all CHDs) to minimise consequences of pulmonary artery hypertension, particularly as defect repair may occur late in underprivileged societies.

scholarly journals Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs

2017 ◽  
Vol 181 (23) ◽  
pp. 625-625 ◽  
Author(s):  
Tana Borlace ◽  
Rodrigo Gutierrez-Quintana ◽  
Frances Ellen Taylor-Brown ◽  
Steven De Decker
Keyword(s):  
Surgical Treatment ◽  
Nucleus Pulposus ◽  
Medical Management ◽  
Clinical Presentation ◽  
Imaging Findings ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Successful Outcomes

Although successful outcomes have been reported after medical and surgical treatment for dogs with cervical hydrated nucleus pulposus extrusion (HNPE), it is unknown which treatment option is preferred. Thirty-four dogs treated medically (n=18) or surgically (n=16) for cervical HNPE were retrospectively identified. Signalment, clinical presentation and imaging findings were compared between medically and surgically treated dogs. Medical management consisted of restricted exercise in combination with physiotherapy. Surgical treatment consisted of a ventral slot procedure. Short-term follow-up information was retrieved from re-examination visits. Long-term outcome was obtained via telephone interviews. More dogs in the surgical group demonstrated cervical hyperaesthesia on initial clinical presentation (P=0.045), otherwise there was no significant difference in signalment, clinical presentation or imaging findings between both groups. Two dogs in the medically managed group underwent surgical decompression due to an unsatisfactory response to medical management. All cases for which long-term information was available (n=30) were neurologically normal at the time of data collection. There were no significant differences for any of the short-term or long-term outcome variables between both treatment groups. This study demonstrated successful outcomes after medical or surgical treatment and suggests that both treatment modalities can be considered for dogs with cervical HNPE.

Conceptual short-term memory (CSTM) supports core claims of Christiansen and Chater

2016 ◽  
Vol 39 ◽  
Author(s):  
Mary C. Potter
Keyword(s):  
Working Memory ◽  
Rapid Serial Visual Presentation ◽  
Language Comprehension ◽  
Short Term Memory ◽  
Visual Presentation ◽  
Long Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Use Of Knowledge

AbstractRapid serial visual presentation (RSVP) of words or pictured scenes provides evidence for a large-capacity conceptual short-term memory (CSTM) that momentarily provides rich associated material from long-term memory, permitting rapid chunking (Potter 1993; 2009; 2012). In perception of scenes as well as language comprehension, we make use of knowledge that briefly exceeds the supposed limits of working memory.

Ultrastructural investigations of MDL 19,660-induced effects on the canine platelet and megakaryocyte

1990 ◽  
Vol 48 (3) ◽  
pp. 374-375
Author(s):  
D.E. Loudy ◽  
J. Sprinkle-Cavallo ◽  
J.T. Yarrington ◽  
F.Y. Thompson ◽  
J.P. Gibson
Keyword(s):  
Antidepressant Drug ◽  
Beagle Dogs ◽  
Long Term Effects ◽  
Short Term ◽  
Platelet Counts ◽  
Toxicological Studies ◽  
Induced Aggregation ◽  
Internal Architecture

Previous short term toxicological studies of one to two weeks duration have demonstrated that MDL 19,660 (5-(4-chlorophenyl)-2,4-dihydro-2,4-dimethyl-3Hl, 2,4-triazole-3-thione), an antidepressant drug, causes a dose-related thrombocytopenia in dogs. Platelet counts started to decline after two days of dosing with 30 mg/kg/day and continued to decrease to their lowest levels by 5-7 days. The loss in platelets was primarily of the small discoid subpopulation. In vitro studies have also indicated that MDL 19,660: does not spontaneously aggregate canine platelets and has moderate antiaggregating properties by inhibiting ADP-induced aggregation. The objectives of the present investigation of MDL 19,660 were to evaluate ultrastructurally long term effects on platelet internal architecture and changes in subpopulations of platelets and megakaryocytes.Nine male and nine female beagle dogs were divided equally into three groups and were administered orally 0, 15, or 30 mg/kg/day of MDL 19,660 for three months. Compared to a control platelet range of 353,000- 452,000/μl, a doserelated thrombocytopenia reached a maximum severity of an average of 135,000/μl for the 15 mg/kg/day dogs after two weeks and 81,000/μl for the 30 mg/kg/day dogs after one week.

Comparison of Auditory, Language, Memory, and Attention Abilities in Children With and Without Listening Difficulties

2020 ◽  
Vol 29 (4) ◽  
pp. 710-727
Author(s):  
Beula M. Magimairaj ◽  
Naveen K. Nagaraj ◽  
Alexander V. Sergeev ◽  
Natalie J. Benafield
Keyword(s):  
Auditory Processing ◽  
Short Term Memory ◽  
Group Differences ◽  
Long Term Memory ◽  
Short Term ◽  
Significant Group ◽  
Term Memory ◽  
Memory And Attention ◽  
Speed And Accuracy

Objectives School-age children with and without parent-reported listening difficulties (LiD) were compared on auditory processing, language, memory, and attention abilities. The objective was to extend what is known so far in the literature about children with LiD by using multiple measures and selective novel measures across the above areas. Design Twenty-six children who were reported by their parents as having LiD and 26 age-matched typically developing children completed clinical tests of auditory processing and multiple measures of language, attention, and memory. All children had normal-range pure-tone hearing thresholds bilaterally. Group differences were examined. Results In addition to significantly poorer speech-perception-in-noise scores, children with LiD had reduced speed and accuracy of word retrieval from long-term memory, poorer short-term memory, sentence recall, and inferencing ability. Statistically significant group differences were of moderate effect size; however, standard test scores of children with LiD were not clinically poor. No statistically significant group differences were observed in attention, working memory capacity, vocabulary, and nonverbal IQ. Conclusions Mild signal-to-noise ratio loss, as reflected by the group mean of children with LiD, supported the children's functional listening problems. In addition, children's relative weakness in select areas of language performance, short-term memory, and long-term memory lexical retrieval speed and accuracy added to previous research on evidence-based areas that need to be evaluated in children with LiD who almost always have heterogenous profiles. Importantly, the functional difficulties faced by children with LiD in relation to their test results indicated, to some extent, that commonly used assessments may not be adequately capturing the children's listening challenges. Supplemental Material https://doi.org/10.23641/asha.12808607

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