scholarly journals Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Fulya YILMAZ ◽  
Koray BAS
Keyword(s):  
Demographic Data ◽  
Surgical Techniques ◽  
Hemodynamic Parameters ◽  
Safe Anesthesia ◽  
Close Cooperation ◽  
Improve Patient Management ◽  
Conventional Open Surgery ◽  
Vestibular Approach ◽  
Improve Patient ◽  
Endoscopic Parathyroidectomy

Abstract Background After thyroid diseases, hyperparathyroidism is one of the most common endocrine surgical diseases. The increasing diagnosis of thyroid pathologies in early stages and a societal emphasis on physical appearances, especially in young women, have led to the development of new surgical techniques alternative to conventional transcervical incision consistently. Here, we describe our anesthesia experience for parathyroidectomy with Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA). Patients who undergo TOEPVA at our institution between November 2018 and April 2019 were reviewed. Demographic data and hemodynamic parameters were reported. Results Seven patients were operated successfully by this technique, none of which required conversion to conventional open surgery. Two patients required atropine and one patient required ephedrine during insufflation. Conclusion After induction of anesthesia with propofol, remifentanil, and rocuronium and anesthesia managed by desflurane co-administered with continuous infusion of remifentanil provide feasible and safe anesthesia for TOEPVA. However, especially during hydrodissection and insufflation, a close cooperation between surgeon and anesthetist has a great value to improve patient management.

scholarly journals Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)

2020 ◽  
Author(s):  
Fulya YILMAZ ◽  
Koray BAS
Keyword(s):  
Demographic Data ◽  
Surgical Techniques ◽  
Training And Research ◽  
Close Cooperation ◽  
Improve Patient Management ◽  
Conventional Open Surgery ◽  
Vestibular Approach ◽  
Induction Of Anaesthesia ◽  
Improve Patient ◽  
Endoscopic Parathyroidectomy

Introduction: After thyroid diseases, hyperparathyroidism is one of the most common endocrine surgical disease. The increasing diagnosis of thyroid pathologies in early stages and a societal emphasis on physical appearances, especially in young women, have been led to development of new surgical techniques alternative to conventional transcervical incision consistently. Here, we describe our anaesthesia experience for parathyroidectomy with Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA). Material-method: Patients undergo TOEPVA at the Health Sciences University Izmir Bozyaka Training and Research Hospital between November 2018 and April 2019 were reviewed. Demographic data and hemodynamic parameters were reported. Seven patients were operated successfully by this technique none of which required conversion to conventional open surgery. Two patient required atropine and one patient required ephedrine during insufflation. Conclusion: After induction of anaesthesia with propofol, remifentanil and rocuronium; anaesthesia managed by desflurane co-administered with continous infusion of remifentanil, provide feasible and safe anaesthesia for TOEPVA. However, especially during hydrodissection and insufflation, a close cooperation between surgeon and anaesthetist have a great value to improve patient management.

scholarly journals A novel 8.7-kb mitochondrial genome deletion accurately detects endometriosis in the plasma of symptomatic women

2020 ◽  
Vol 14 (2) ◽  
pp. 97-107
Author(s):  
Andrew Harbottle ◽  
Andrea Maggrah ◽  
Robert Usher ◽  
Elise Desa ◽  
Jennifer M Creed
Keyword(s):  
Diagnostic Accuracy ◽  
Case Control ◽  
Menstrual Phase ◽  
Pcr Assay ◽  
Potential Biomarker ◽  
Significant Difference ◽  
Mtdna Deletion ◽  
Disease Subtypes ◽  
Improve Patient Management ◽  
Improve Patient

Aim: To evaluate an 8.7-kb mitochondrial DNA (mtDNA) deletion as a potential biomarker of endometriosis. Materials & methods: We tested the diagnostic accuracy of the 8.7-kb deletion real-time PCR assay using 182 prospectively collected blood samples from females presenting with symptoms of endometriosis in a case–control format. Results: The assay differentiated between endometriosis and controls (area under curve: 0.74–0.89) with a statistically significant difference (p < 0.05) in 8.7-kb deletion levels measured for all disease subtypes and stages. No correlation was seen between 8.7-kb deletion levels and participant or specimen age, hormone status or menstrual phase. Conclusion: The diagnostic accuracy of the 8.7-kb deletion for endometriosis suggests potential utility in the clinic to improve patient management.

scholarly journals Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dalal Al Hasan ◽  
Ameen Yaseen ◽  
Mohammad Al Roudan ◽  
Lee Wallis
Keyword(s):  
Severe Hypoglycaemia ◽  
Management Strategies ◽  
Severe Hypoglycemia ◽  
Inclusion Criteria ◽  
Initial Management ◽  
Scene Management ◽  
Prehospital Management ◽  
Improve Patient Management ◽  
Current Guidelines ◽  
Improve Patient

Abstract Background The objective of this study was to describe the epidemiology of severe hypoglycaemia in Kuwait, aiming to provide a preliminary background to update the current guidelines and improve patient management. Method This was a prospective analysis of severe hypoglycaemia cases retrieved from emergency medical services (EMS) archived data between 1 January and 30 June 2020. The severe hypoglycaemia cases were then sub-grouped based on EMS personal initial management and compared in terms of scene time, transportation rate, complications and outcomes. The primary outcomes were GCS within 10–30 min and normal random blood glucose (RBS) within 10–30 min. Results A total of 167 cases met the inclusion criteria. The incidence of severe hypoglycaemia in the national EMS was 11 per 100,000. Intramuscular glucagon was used on scene in 89% of the hypoglycaemic events. Most of the severe hypoglycaemia patients regained normal GCS on scene (76.5%). When we compared the two scene management strategies for severe hypoglycaemia cases, parenteral glucose administration prolonged the on-scene time (P = .002) but was associated with more favourable scene outcomes than intramuscular glucagon, with normal GCS within 10–30 min (P = .05) and normal RBS within 10–30 min (P = .006). Conclusion: Severe hypoglycaemia is not uncommon during EMS calls. Appropriate management by EMS personals is fruitful, resulting in favourable scene outcomes and reducing the hospital transportation rate. More research should be invested in improving and structuring the prehospital management of severe hypoglycaemia. One goal is to clarify the superiority of parenteral glucose over intramuscular glucagon in the prehospital setting.

scholarly journals Necrotizing fasciitis with prior leprosy: a case report

2020 ◽  
Vol 6 (6) ◽  
pp. 788
Author(s):  
Vannia C. Teng ◽  
Prima K. Esti ◽  
Sweety Pribadi
Keyword(s):  
Case Report ◽  
Necrotizing Fasciitis ◽  
Limited Resource ◽  
Masking Effect ◽  
Risk Indicator ◽  
Broad Spectrum Antibiotic ◽  
Life Threatening ◽  
Lrinec Score ◽  
Improve Patient Management ◽  
Improve Patient

<p class="abstract">Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with a high misdiagnosis rate. Here, we present the case of NF with hypoesthesia due to prior leprosy in a limited resource area. Laboratory risk indicator for NF (LRINEC) score was used to determine the diagnosis of NF. Resuscitation and broad-spectrum antibiotic were initiated, followed by surgical debridement due to lack of wound improvement and skin graft to cover the wound was done. This case report highlights the usage of LRINEC score to reduce misdiagnosis, ensure early diagnosis, and improve patient management in NF with masking effect.</p>

Hyperprogressive disease: recognizing a novel pattern to improve patient management

2018 ◽  
Vol 15 (12) ◽  
pp. 748-762 ◽  
Author(s):  
Stéphane Champiat ◽  
Roberto Ferrara ◽  
Christophe Massard ◽  
Benjamin Besse ◽  
Aurélien Marabelle ◽  
...  
Keyword(s):  
Patient Management ◽  
Hyperprogressive Disease ◽  
Improve Patient Management ◽  
Improve Patient

Transoral Endoscopic Parathyroidectomy Vestibular Approach (TOEPVA)—Choosing the Right Patient

2019 ◽  
Vol 7 (3) ◽  
pp. 232-236
Author(s):  
Rohit Ranganath ◽  
Jonathon O. Russell ◽  
Vaninder K. Dhillon ◽  
Ralph P. Tufano
Keyword(s):  
The Right ◽  
Vestibular Approach ◽  
Endoscopic Parathyroidectomy

Post-Traumatic Headache: From Classification Challenges to Biological Underpinnings

Cephalalgia ◽  
2008 ◽  
Vol 28 (1_suppl) ◽  
pp. 12-15 ◽  
Author(s):  
ME Lenaerts
Keyword(s):  
Patient Management ◽  
Primary Headache ◽  
Biological Data ◽  
Traumatic Head Injury ◽  
Management Quality ◽  
Clinical Consequences ◽  
Traumatic Head ◽  
Post Traumatic ◽  
Improve Patient Management ◽  
Improve Patient

The ICHD-II criteria for post-traumatic headache (PTH) are strictly outlined. PTH can be subdivided into an acute and a chronic forms, the former likely nociceptive in nature, the latter likely neuropathic. The time of transition between the acute and the chronic forms is artificial and in the future should be better based on clear clinical or rather biological data. Chronic PTH often presents as one of the primary headache syndromes, e.g. migraine or tensiontype headache. Its biology is poorly understood and whether it merely represents the expression of the primary headache or it has a distinct pathogenesis remains unclear. The frontal lobe is often affected in traumatic head injury. Its dysfunction can cause an array of clinical consequences that have an impact on the patient's symptomatology and therapeutic outcome. Its recognition is likely to improve patient management quality.

Real-time PCR versus shell vial culture on urine of patients with suspected congenital cytomegalovirus infection

2019 ◽  
Vol 14 (9) ◽  
pp. 585-591
Author(s):  
Luana Coltella ◽  
Stefania Ranno ◽  
Giuseppe Pizzichemi ◽  
Livia Piccioni ◽  
Stefano Chiavelli ◽  
...  
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Congenital Infection ◽  
Urine Samples ◽  
Congenital Cytomegalovirus ◽  
Shell Vial ◽  
Congenital Cmv Infection ◽  
Polymerase Chain ◽  
Improve Patient Management ◽  
Improve Patient

Aims: Cytomegalovirus (CMV) is the most common cause of congenital infection. Aim of this study is to support quantitative real-time polymerase chain reaction (PCR) versus shell vials culture for CMV screening in urine samples. Patients & methods: A retrospective study was conducted on 255 urine samples belonging to patients admitted to Bambino Gesù Pediatric Hospital, Rome, Italy, with suspected congenital CMV infection. Results & conclusion: Quantitative real-time PCR resulted more standardized, faster, less operator-dependent, less laborious and most of all cost saving and more sensitive than shell vial culture. Since a negative result for CMV in urine means no congenital infection, a more sensitive tool for detection of CMV DNA is essential to improve patient management and to reduce healthcare costs associated to a late diagnosis.

Sign in / Sign up

Export Citation Format

Share Document