scholarly journals Sublobectomy is a safe alternative for localized cavitary pulmonary tuberculosis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong Yang ◽  
Shaojun Zhang ◽  
Zhengwei Dong ◽  
Yong Xu ◽  
Xuefei Hu ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Surgical Complication ◽  
Lung Parenchyma ◽  
Surgical Indications ◽  
Single Institution ◽  
Safe Alternative ◽  
Cross Sectional ◽  
Satisfactory Outcome ◽  
Operative Complications

Abstract Objective Surgical resection plays an essential role in the treatment of Pulmonary Tuberculosis (PTB). There are few reports comparing lobectomy and sublobectomy for pulmonary TB with cavity. To compare the advantages between lobectomy and sublobectomy for localized cavitory PTB, we performed a single-institution cross sectional cohort study of the surgical patients. Methods We consecutively included 203 patients undergoing lobectomy or sublobectomy surgery for localized cavitary PTB. All patients were followed up, recorded and compared their surgical complication, outcome and associated characteristics. Results Both groups had similar outcomes after follow up for 13.1 ± 12.1 months, however, sublobectomy group suffered fewer intraoperative blood losses, shorter length of stay, and fewer operative complications than lobectomy group (P <  0.05). Both groups obtained satisfactory outcome with postoperatively medicated for similar period of time and few relapse (P > 0.05). Conclusion Both sublobectomy and lobectomy resection were effective ways for cavitary PTB with surgical indications. If adequate anti-TB chemotherapy had been guaranteed, sublobectomy is able to be recommended due to more lung parenchyma retain, faster recover, and fewer postoperative complications.

scholarly journals Prevalence of nutritional deficiency in patients with pulmonary tuberculosis

2013 ◽  
Vol 39 (4) ◽  
pp. 476-483 ◽  
Author(s):  
Silvana Gomes Nunes Piva ◽  
Maria da Conceicao Nascimento Costa ◽  
Florisneide Rodrigues Barreto ◽  
Susan Martins Pereira
Keyword(s):  
Pulmonary Tuberculosis ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Nutritional Deficiency ◽  
Therapeutic Interventions ◽  
Cross Sectional ◽  
End Of Treatment ◽  
Using Data

OBJECTIVE: To determine the prevalence of nutritional deficiency among patients with pulmonary tuberculosis. METHODS: This was a cross-sectional study using data obtained from the Brazilian Case Registry Database and from the medical records of patients diagnosed with pulmonary tuberculosis (15-59 years of age) residing in one of the municipalities that make up the 16th Regional Health District of the state of Bahia. We calculated the incidence, lethality, and mortality rates, as well as the prevalence of nutritional deficiency, as evaluated by body mass index. Demographic, social, clinical, and epidemiological data were collected. RESULTS: Of the 72 confirmed cases of tuberculosis, 59 (81.9%) were in males, and 21 (29.2%) of the patients were in the 40-49 year age bracket. The majority (85.3%) described themselves as Mulatto or Black; 55.2% reported using alcohol; and approximately 90% were treated as outpatients. In the district and age bracket studied, the incidence of pulmonary tuberculosis was 30.6/100,000 population. Among the 72 patients, data regarding nutritional status was available for 34. Of those, 50% and 25%, respectively, presented nutritional deficiency at the beginning and at the end of treatment. No statistically significant differences were found between normal-weight and malnourished patients regarding the characteristics studied. CONCLUSIONS: The prevalence of nutritional deficiency was high among our sample of patients with pulmonary tuberculosis. This underscores the importance of nutritional follow-up for the assessment of tuberculosis treatment in the decision-making process regarding therapeutic interventions.

Extended applications of the endoscopic modified Lothrop procedure

2016 ◽  
Vol 130 (9) ◽  
pp. 827-832 ◽  
Author(s):  
N Choudhury ◽  
A Hariri ◽  
H Saleh
Keyword(s):  
Frontal Sinus ◽  
Ossifying Fibroma ◽  
Outcome Parameter ◽  
Surgical Indications ◽  
Silent Sinus Syndrome ◽  
Operative Complications ◽  
Extended Range ◽  
Cerebrospinal Fluid Leaks ◽  
The Mean

AbstractObjective:The endoscopic modified Lothrop procedure is mainly used for refractory frontal sinusitis. However, we have used it as an access procedure to facilitate treatment for an extended range of additional frontal sinus pathologies.Methods:A retrospective review of patients who underwent the endoscopic modified Lothrop procedure for ‘alternative’ frontal sinus pathologies was conducted. Patient data were reviewed. The main outcome parameter measured was signs of recurrence.Results:Twelve patients (6 males, 6 females) from a 7-year study period, with a mean age of 45.2 years (range, 16–78 years), were analysed. The surgical indications included frontoethmoidal mucoceles, cerebrospinal fluid leaks within the frontal sinus, cystic fibrosis, frontal sinus osteoma, frontal sinus ossifying fibroma and frontal silent sinus syndrome. The mean follow-up period was 33.3 months. There were no known recurrences.Conclusion:We have used the endoscopic modified Lothrop procedure for a range of frontal sinus pathologies, safely and effectively, with no peri-operative complications.

scholarly journals Tuberculosis in elderly: The Indian perspective

2018 ◽  
Vol 5 (4) ◽  
pp. 983
Author(s):  
Nehal . ◽  
Supriya Tiwari ◽  
Shyamala Krishnaswamy Kothandapani ◽  
Usha . ◽  
Khena .
Keyword(s):  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Hospital ◽  
Cross Sectional ◽  
Loss To Follow Up ◽  
Adherence To Medication ◽  
Study Population

Background: Tuberculosis, the leading infectious cause of morbidity, mortality worldwide. Elderly Tuberculosis accounts for a major proportion of these cases and are often neglected due to associated comorbidities and overlapping clinical features. This study aimed to estimate the prevalence of tuberculosis among elderly and medication adherence.Methods: A cross-sectional, retrospective study in patients with Tuberculosis ≥50 years registered under RNTCP, at a tertiary care hospital, South India, from January 2017 to December 2017. Clinical data collected, and medication adherence was assessed.Results: Out of the total 187 study population, 35 subjects were found to be ≥50 years with a prevalence of 18.7%. Pulmonary Tuberculosis was more common (82.8%). Majority of the subjects were sputum positive (77.14%). Comorbidities highest in patients >70years. Diabetes was the most significant comorbidity in all the age groups (48.57%) and patients with pulmonary Tuberculosis (p=0.04). Pulmonary Tuberculosis observed highest among smokers whereas extra pulmonary Tuberculosis found higher among alcoholics (33.3%). Treatment outcome was better in patients with hypertension compared to other comorbidities (p=0.014). Loss to follow-up was highest among smokers and in patients with bronchial asthma (40%). Present study showed moderate to low adherence to medication in elderly.Conclusions: There is high prevalence of Tuberculosis among elderly. Diabetes was the commonest comorbidity. Pulmonary Tuberculosis was significantly associated with smokers. Low adherence and loss to follow-up was high among elderly. We recommend comprehensive screening, treatment and follow-up especially in elderly with comorbidities for early diagnosis and better treatment outcome.  

scholarly journals Post-operative Advantages of Transanal Endo-rectal Pull Through (TERPT) over Swenson's Procedure in Terms of General Surgical Complications

2009 ◽  
Vol 12 (Number 1) ◽  
pp. 10-13
Author(s):  
A S Md. Waliullah ◽  
S Alam ◽  
M A Aziz ◽  
A R Khan ◽  
M T H Siddiqui
Keyword(s):  
Gold Standard ◽  
Voiding Dysfunction ◽  
Surgical Complication ◽  
Wound Sepsis ◽  
Operative Complications ◽  
Group A ◽  
In Trans ◽  
Pull Through ◽  
Group B

Popular Swenson's pull through is still the most commonly practiced • Gold Standard' of operative treannem for rectosigmoid Hirschspnare's disease. Bm minimally invasive renowital endo-rectal pull through (TERPT) is now being increasingly practiced workhrede for its treatment of many centres. Here e.rperiences at Dhaka Shish', Hospital regarding the post-operative advantages of TERPT over Swenson's procedure are compared in terms of three general surgical complication., namely, unary voiding dysfituction. wound sepsis sod anadontoric stenosis. is is a prospecthe study during January 2000 to December 2001 on 32 rege. bock weight, 'erected rectosigmaid length and follow-up duration matched) biopsy confirmed patients of rectosigmoid Hirschspnare's disease. The patients were divided into tire Groups: Group A (a a !E)and Group B pn = 16) who under went TERPT and Swenson's pull through respectively. k; (with Votes correction) test was used for statistical analysis. ln Group A (TERPT) the post-operative urinary voiding dysfunction (retentioreincontinence). wound sepsis and anastomotic stenosis were significantly lesser than the Group B (Swenson' s). Through this short tear post-operative comparative study. TERPT was found to be more advantageous than the Sanson's pull through procedure in trans 4 three general mimic& post-operative complications.

scholarly journals Hyperbaric oxygen therapy for the treatment of Steinberg I and II avascular necrosis of the femoral head: a report of fifteen cases and literature review

2021 ◽  
Author(s):  
Motasem Salameh ◽  
Isam S. Moghamis ◽  
Osama Kokash ◽  
Ghalib O. Ahmed
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Hyperbaric Oxygen ◽  
Case Series ◽  
Safe Alternative ◽  
Pain Scores ◽  
Satisfactory Outcome ◽  
Oxford Hip Score ◽  
Complications Rate

Abstract Purpose This article aimed to report a case series of pre-collapse avascular necrosis of the femoral head treated with hyperbaric oxygen and review the most recent literature on the topic. Methods The data from a prospectively followed registry of 15 patients with Steinberg I and II avascular necrosis of the femoral head was collected. Functional outcome, pain scores, and radiographic changes at an average follow-up of 22 months were analyzed and reported. Results Thirteen patients had satisfactory outcome at final follow-up with an average Oxford hip score of 37.3, pain scores were significantly improved at final follow-up (P < 0.001), and 26.7% of hips progressed to collapse on follow-up radiographs with no complications reported in all patients. Conclusion Hyperbaric oxygen treatment for pre-collapse avascular necrosis of the femoral head is considered a safe alternative with satisfactory clinical and radiological outcomes and low complications rate.

scholarly journals Delorme’s operation for internal rectal prolapse in an outpatient hospital

2016 ◽  
Vol 63 (1) ◽  
pp. 111-116
Author(s):  
Èrt Jamsek ◽  
Sojar Kosorok ◽  
Matic Buniè ◽  
Pavle Kosorok
Keyword(s):  
Rectal Prolapse ◽  
Obstructed Defecation ◽  
Outpatient Setting ◽  
Anaerobic Infection ◽  
Best Interest ◽  
Single Institution ◽  
Internal Rectal Prolapse ◽  
Satisfactory Outcome ◽  
Operation Results

Purpose: Internal rectal prolapse frequently occurs in older, sometimes polymorbid patients. Trans-abdominal operation is therefore not always in the patient?s best interest. The aim of this retrospective study was to demonstrate that the Delorme?s procedure is feasible and safe to be performed in an outpatient setting. Methods: This study is a retrospective review of a single-institution experience. Fifty-one patients (age 64.7 ? 12.5, range 35 to 90 years) with internal rectal prolapse were treated with Delorme?s procedure during 6-year period. Patients were assessed at follow-up 1 and 6 weeks after the surgery and phone interview was performed after 51.4 ? 16.5 months after operation. Results: All 51 patients were operated under spinal anesthesia and observed for approximately 6 hours before discharge. Six patients needed referral to inpatient hospital for safety observation after the procedure. There were no mortalities in our study. One patient developed anaerobic infection and needed a colostomy. Out of 34 presenting with sensation of incomplete evacuation, 28 (82.4%) reported improvement after procedure, 13 out of 15 (86.7%) reported improvement in obstructed defecation symptoms and 4 out of 7 patients (57.1%) reported improvement in incontinence. Average sick leave was 16.0 ? 4.3 days. Seven patients suffered from postoperative stenosis. Recurrence was seen in 5 cases (9.8%). Majority of the patients (73,3%) would recommend this procedure for problems similar to their own. Conclusion: Our study shows that the Delorme?s procedure is feasible in an outpatient setting, with reasonable complications and satisfactory outcome.

scholarly journals Epilepsy surgery for low-grade epilepsy-associated neuroepithelial tumor of temporal lobe: a single-institution experience of 61 patients

2021 ◽  
Author(s):  
Zhe Zheng ◽  
Hongjie Jiang ◽  
Hemmings Wu ◽  
Yao Ding ◽  
Shuang Wang ◽  
...  
Keyword(s):  
Surgical Strategy ◽  
Seizure Outcome ◽  
Low Grade ◽  
Extended Resection ◽  
Single Institution ◽  
Presurgical Evaluation ◽  
Satisfactory Outcome ◽  
Electrocorticogram Ecog ◽  
Surgical Extent

Abstract Background Low-grade epilepsy-associated neuroepithelial tumor (LEAT) is highly responsive to surgery in general. The appropriate surgical strategy remains controversial in temporal LEAT. The aim of this study is to analyze the surgical seizure outcome of temporal LEAT, focusing on the aspects of surgical strategy. Methods Sixty-one patients from a single epilepsy center with temporal LEAT underwent surgery. The surgical strategy was according to the multidisciplinary presurgical evaluation. Electrocorticogram (ECoG)-assisted resection was utilized. Surgical extent including lesionectomy and extended resection was described in detail. Seizure outcome was classified as satisfactory (Engel class I) and unsatisfactory (Engel classes II–IV). Results After a median follow-up of 36.0 (30.0) months, 83.6% of patients achieved satisfactory outcome, including 72.1% with Engel class Ia. There was 39.3% (24/61) of patients with antiepileptic drug (AED) withdrawal. Use of ECoG (χ2 = 0.000, P > 0.1), preresection spike (χ2 = 0.000, P = 0.763), or spike residue (P = 0.545) was not correlated with the seizure outcome. For lateral temporal LEAT, outcome from lesionectomy was comparable to extended resection (χ2 = 0.499, P > 0.1). For mesial temporal LEAT, 94.7% (18/19) of patients who underwent additional hippocampectomy were satisfactory, whereas only 25% (1/4) of patients who underwent lesionectomy were satisfactory (P = 0.009). Conclusion Surgical treatment was highly effective for temporal LEAT. ECoG may not influence the seizure outcome. For lateral temporal LEAT, lesionectomy with or without cortectomy was sufficient in most patients. For mesial temporal LEAT, extended resection was recommended.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Theoretical and Methodological Problems of a 10-Year Follow-Up Program Evaluation Study

2002 ◽  
Vol 18 (3) ◽  
pp. 229-241 ◽  
Author(s):  
Kurt A. Heller ◽  
Ralph Reimann
Keyword(s):  
Program Evaluation ◽  
Evaluation Studies ◽  
Evaluation Study ◽  
Control Groups ◽  
Cross Sectional ◽  
Long Term Study ◽  
Partial Inclusion ◽  
Methodological Problems

Summary In this paper, conceptual and methodological problems of school program evaluation are discussed. The data were collected in conjunction with a 10 year cross-sectional/longitudinal investigation with partial inclusion of control groups. The experiences and conclusions resulting from this long-term study are revealing not only from the vantage point of the scientific evaluation of new scholastic models, but are also valuable for program evaluation studies in general, particularly in the field of gifted education.

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