Use of Perioperative Steroids with Microvascular Decompression Operations

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 353-357 ◽  
Author(s):  
Donald W. Marion ◽  
Peter J. Jannetta
Keyword(s):  
Postoperative Complications ◽  
Microvascular Decompression ◽  
Cranial Nerves ◽  
Wound Infections ◽  
Related Complication ◽  
Deep Wound ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Single Blind

Abstract Complications associated with the use of perioperative steroids in elective craniotomies were evaluated in a single-blind prospective study of 222 consecutive microvascular decompression operations. Patients were randomized into one of three groups: Group A received steroids preoperatively and for 4 days postoperatively, Group B received steroids preand postoperatively for 1 day, and Group C received no steroids. There were 17 complications in Group A; 12 of these were wound-related. There were significantly fewer complications in Groups B and C (P < 0.01). Group B had 3 complications, Group C had 4, and there was only 1 wound-related complication in Group C. There were no deaths, deep wound infections, or life-threatening complications. Severe postoperative headaches, a symptom that steroids were intended to minimize, occurred in 38% of patients in Group A, 42% of patients in Group B, and 25% of patients in Group C. The use of perioperative steroids did not reduce the length of postoperative hospitalization. Duration of the operation had no significant effect on the incidence of postoperative complications or the length of postoperative hospitalization. We conclude that there is no indication for the routine perioperative use of steroids with microvascular decompression operations of the posterior fossa cranial nerves and that such use leads to a higher incidence of postoperative complications. (Neurosurgery 22:353-357, 1988)

Comprehensive Nursing can Relieve the Negative Emotions of Patients undergoing Breast Cancer Resection and Reduce Postoperative

2021 ◽  
Vol 7 (5) ◽  
pp. 4234-4243
Author(s):  
Xiaoxia Lv ◽  
Lihua Wang ◽  
Yan Zhai
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Quality Score ◽  
Cancer Resection ◽  
Upper Limb Function ◽  
Sf 36 ◽  
Group A ◽  
Group B ◽  
Nursing Quality

To explore the effect of comprehensive nursing on adverse emotions and postoperative complications of breast cancer patients undergoing mastectomy. Altogether 180 patients who received treatment in our hospital from May 2017 to May 2019 were selected as the research participants and divided into group A and group B. Among them, 100 cases in group A received comprehensive nursing, 80 cases in group B received routine nursing. The surgical indications, upper limb function, serum NGF, TK1 and CA15-3 expression level, VAS score, SAS, SDS score, quality of life SF-36 score were detected, and the incidence rate of postoperative complications and nursing quality score were compared. Compared with group B, group A had less postoperative bed time, intraoperative blood loss, length of hospital stay, better recovery of upper limb function, lower expression levels of serum NGF, TK1 and CA15-3, lower VAS score, SAS and SDS score, higher quality of life SF-36 score, lower incidence of postoperative complications and higher nursing quality score. Comprehensive nursing can relieve the negative emotions of patients undergoing breast cancer resection and reduce the incidence of postoperative complications.

scholarly journals Efficacy of High-Power Laser in Alleviating Pain and Improving Function of Patients With Patellofemoral Pain Syndrome: A Single-Blind Randomized Controlled Trial

2018 ◽  
Vol 10 (1) ◽  
pp. 37-43
Author(s):  
Farshad Nouri ◽  
Seyed Ahmad Raeissadat ◽  
Dariush Eliaspour ◽  
Seyed Mansoor Rayegani ◽  
Maryam Sadat Rahimi ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Pain Syndrome ◽  
The Other ◽  
Short Term ◽  
Randomized Controlled ◽  
Group A ◽  
Laser Group ◽  
Group B ◽  
Single Blind ◽  
Post Therapy

Introduction: In this study, a single-blind and randomized controlled trial (RCT) for assessing the effectiveness of high-power (up to 12 W) laser therapy (HPLT) on patients with patellofemoral pain syndrome (PFPS) was carried out. Methods: Forty-four patients were randomly assigned to two treatment groups by generating random numbers with MATLAB 2014b software, where odd and even numbers were attributed to sham laser group (group A) and actual laser group (group B), respectively. Group B patients underwent HPLT with total dose of 300 J/session for 5 consecutive sessions separated by a 2-day interval. On the other hand, sham laser was applied to group A patients. Both groups had the same exercise therapy programs during the study period (3 months). The exercise therapy program included isometric knee exercise for 3 sets per day and 10 times in each set, with duration of 10 seconds per time and straight leg raise for 15 seconds 10 times a day. The group codes of patients were not revealed to subjects and data analyzer until completion of the study. Kujala, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) questionnaires were chosen as outcome measures. These questionnaires were completed at three points during the study; at the beginning of the study to obtain the pre-therapy conditions and one month and three months after the start of the study to evaluate post-therapy conditions. Results: Two main analyses were conducted: within-group and between-group analyses. Withingroup analyses indicated significant improvements in respect to all measurements where pretherapy and post-therapy comparisons were conducted in both groups (P < 0.05). On the other hand, between-group comparisons did not reveal any statistically significant functional difference between group A and group B regarding the evaluative criteria (P > 0.05) except for pain VAS (P < 0.05). Conclusion: This study indicated that short-term HPLT accompanied by appropriate exercise regimen significantly decreased pain in patients with PFPS. But it was not recommended as an efficient modality in functional improvement. Also, it was observed that, in the short-term period of study, HPLT was a safe modality.

scholarly journals Palmoplantar psoriasis: a comparative therapeutic study

2019 ◽  
Vol 5 (4) ◽  
pp. 779
Author(s):  
Sathya Narayanan Rajendran ◽  
Sukanya Mathupal Gurusamy
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Simple Random Sampling ◽  
Inflammatory Dermatosis ◽  
Duration Of Illness ◽  
Erythrodermic Psoriasis ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Therapeutic Study

<p class="abstract"><strong>Background:</strong> Psoriasis is an immunologically mediated inflammatory dermatosis presenting with extremely variable clinical manifestations ranging from indolent lesions to life threatening forms of pustular and erythrodermic psoriasis. Palmoplantar psoriasis present as hyperkeratotic scaly plaques with fissures and can be managed with different treatment forms. This study was done to compare the efficacy between topical and systemic treatment options.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in a tertiary level teaching hospital after ethical committee clearance. Fifty patients with palmoplantar psoriasis were allocated into the two groups using simple random sampling. PPPASI scoring was calculated to assess the extent of involvement. Patients in Group A were prescribed calcipotriol with clobetasol propionate ointment. Group B patients were given tablet methotrexate.<strong></strong></p><p class="abstract"><strong>Results:</strong> Twenty eight patients were males M: F of 1.27: 1. Mean age was 36. Mean duration of illness was eleven months. Most of these patients were manual laborers. 32 patients had lesions over both palms and soles, 9 over palms alone and 9 involving soles alone. Mean PASI reduction at 16 weeks was seen maximum with methotrexate. Compliance was comparatively good with methotrexate than topical. Though mean PASI reduction and compliance was good, relapse rates were higher with methotrexate in our study.</p><p class="abstract"><strong>Conclusions:</strong> There was no significant change in clinico-epidemiology and presentation of palmoplantar psoriasis. Methotrexate was observed to be the more efficacious modality in treating palmoplantar psoriasis.</p>

scholarly journals Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11534
Author(s):  
Stefano Sartini ◽  
Laura Massobrio ◽  
Ombretta Cutuli ◽  
Paola Campodonico ◽  
Cristina Bernini ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Adverse Outcome ◽  
University Hospital ◽  
Rt Pcr ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

scholarly journals Ablating Aspiration Needle Tract Prior to Microwave Ablation Can Improve Therapeutic Outcomes for Predominantly Cystic Thyroid Nodules

2021 ◽  
Vol 12 ◽  
Author(s):  
Haizhen Yang ◽  
Yanwei Chen ◽  
Baoding Chen ◽  
Shuangshuang Zhao ◽  
Zheng Zhang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Cyst Fluid ◽  
Cystic Fluid ◽  
Needle Tract ◽  
Intracystic Hemorrhage ◽  
Group A ◽  
Hospital Stays ◽  
Group B

PurposeTo investigate whether ablating the aspiration needle tract could improve the safety and efficacy of ultrasound-guided microwave ablation (MWA) for predominantly cystic thyroid nodules.Materials and MethodsThis retrospective study evaluated 41 predominantly cystic thyroid nodules that underwent MWA between June 2017 and August 2019. The nodules were stratified by different procedures into two groups: the aspiration needle tract was ablated before cyst fluid aspiration and MWA when treating 26 nodules in Group A, while the other 15 nodules in Group B underwent MWA directly after cyst fluid aspiration. Baseline characteristics, intervention time, hospital stays, nodules with intraoperative intracystic hemorrhage, and postoperative complications were compared between the two groups. Volume, volume reduction rate (VRR), compressive score (CS), and aesthetic score (AS) were evaluated during follow-up.ResultsBoth groups achieved decreases in volume, CS, and AS, as well as an increase in VRR. The volumes and VRRs in Group A at 1, 3, 6, and 12 months were significantly smaller and greater than those in Group B (p &lt; 0.001). The incidence of intraoperative intracystic hemorrhage in Group A was significantly lower than that in Group B (p=0.035). Compared to Group B, hospital stays were much shorter in Group A (p=0.040). There were no significant differences in intervention time, cystic fluid volume or postoperative complications.ConclusionAspiration needle tract ablation dramatically reduces the incidence of intraoperative intracystic hemorrhage and markedly improves the efficacy of MWA for predominantly cystic thyroid nodules.

Postoperative Complication Assessments of Different Reconstruction Procedures after Total Pharyngolaryngoesophagectomy: Tubular Gastric Pull-Up versus Whole Gastric Pull-Up

2018 ◽  
Vol 84 (12) ◽  
pp. 1927-1931
Author(s):  
Zhenbo Dai ◽  
Qinghua He ◽  
Boyu Pan ◽  
Liren Liu ◽  
Dejun Zhou
Keyword(s):  
Postoperative Complications ◽  
Hypopharyngeal Cancer ◽  
Reconstruction Method ◽  
Observation Study ◽  
Reconstruction Procedure ◽  
Intrathoracic Stomach ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Gastric Pull Up

Hypopharynx carcinoma tends to be diagnosed at advanced stage and usually has a poor prognosis because of the high incidence of submucosal spreading and lymphatic metastasis. Total pharyngolaryngoesophagectomy (PLE) is mostly used as a curative intervention for this deadly disease, and a commonly used reconstruction method after PLE is gastric pull-up, which could be further divided into tubular gastric pull-up and whole gastric pull-up procedures. Aiming to achieve a precise guidance on optimal reconstruction method after PLE, the present study evaluated the postoperative complications involving in different gastric pull-up procedures in patients with hypopharynx cancer. A total of 52 consecutive patients with hypopharyngeal cancer who underwent total PLE with gastric pull-up reconstruction in Tianjin Medical University Cancer Institute and Hospital between 1996 and 2014 were analyzed in this study. Of these patients, 28 underwent tubular gastric pull-up reconstruction procedure (Group A), whereas 24 underwent whole gastric pull-up reconstruction procedure (Group B). We compared the postoperative complications between these two groups retrospectively. Postoperative anastomotic fistulas occurred in three patients in Group A (3/28) versus eight patients in Group B (8/24), leading to an incidence rate of 10.71 and 33.33 per cent, respectively. The incidence of intrathoracic stomach syndrome was 21.43 per cent in Group A (6/28) versus 58.33 per cent in Group B (14/24), and the incidence of reflux was 35.71 per cent in Group A (10/28) versus 66.67 per cent in Group B (16/24). All of the above postoperative complications exhibited statistical differences between two groups ( P ≤ 0.05). This retrospective observation study suggests that compared with whole gastric pull-up, tubular gastric pull-up is a better reconstruction procedure of choice after PLE, evidenced by reduced incidences of postoperative anastomotic fistula, intrathoracic stomach syndrome, and reflux.

Surgical management of synchronous colorectal liver metastases: Simultaneous versus staged resections.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 616-616
Author(s):  
Igor Shchepotin ◽  
Andrii Lukashenko ◽  
Olena Kolesnik ◽  
Anton Burlaka
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Liver Metastases ◽  
Metastatic Cancer ◽  
Economic Effect ◽  
Hepatic Metastases ◽  
Group A ◽  
Bed Days ◽  
Group B

616 Background: Surgical treatment of metastatic colorectal cancer remains the only method that improves overall 5-year survival. This study aimed to compare the surgical outcome and survival benefit between synchronous and staged resection of liver metastases from colorectal cancer. Methods: Clinicopathologic data, treatments, and postoperative outcomes from 110 patients who underwent simultaneous (48 patients, group A) or staged (62 patients, group B) colorectal and hepatic resections at clinic of National cancer institute in period of 2008-2013 were reviewed. Results: Postoperative complications in patients with simultaneous resections (group A) were observed in 13 cases (27.1%), including 5, 1, 4, 2, 0, and 1 of grades I, II, IIIa, IIIb, IV, and V, respectively. Similar results have been reported in group B after staged resections, where overall postoperative complications registered in 16 patients (25.8 %), including 4, 3, 6, 3, 0 of grades I, II, IIIa, IIIb, and IV respectively. Overall level of post-operative complications in the groups A and B after surgical stages finishing did not differ statistically (p=0.96). Shorter operative intervention duration was registered in the group A – (311±10.1) min, whereas in the group B it was (496.6±16.2) min (р<0.001). Patients after staged resection stayed in clinic for a longer time – 23.9±0.8 bed-days, when simultaneous resections provided with shorter recovery terms in post-operative period – 9.8±0.5 bed-days (p<0.001). Overall 3-year survival in the group of patients with simultaneous resections (group А) was 42 % and in the group B 55 % (р=0.22). Conclusions: Analysis of our research indicated necessity of the development of differentiated approach in management of synchronous colorectal liver metastatic cancer. Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected patients. Subsequent research should be directed towards study of prognosis factors and criteria for patients’ selection for surgical treatment groups, assessment of economic effect, and patients life quality.

Use of Nanotechnology-Designed Footsock in the Management of Preulcerative Conditions in the Diabetic Foot: Results of a Single, Blind Randomized Study

2008 ◽  
Vol 7 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Banchellini Elisa ◽  
Macchiarini Silvia ◽  
Dini Valentina ◽  
Rizzo Loredana ◽  
Tedeschi Anna ◽  
...  
Keyword(s):  
Treatment Group ◽  
Adverse Events ◽  
Water Loss ◽  
Diabetic Foot ◽  
Randomized Study ◽  
Clinical Score ◽  
Transepidermal Water Loss ◽  
Group A ◽  
Group B ◽  
Single Blind

The Difoprev system constituted by a sock loaded with nanocapsules containing a hydrating agent in the diabetic foot is tested. A total of 30 neuropathic outpatients with foot anhydrosis were randomized into group A, treated with the application of the sock with the nanocapsules, and group B wearing only the socks without the nanocapsules. Patients were blindly evaluated with a clinical score, hygrometry, transepidermal water loss, skin temperature, and skin hardness at baseline and after 6 weeks. No difference between the groups emerged at baseline. Although group B showed no changes at the end of the treatment, group A significantly ( P < .05) improved in all the parameters evaluated. No adverse events were recorded in both groups during the study. The use of hydrating agents carried by nanocapsules-loaded socks is safe and effective for the neuropathic diabetic foot.

Evolution of cranial epilepsy surgery complication rates: a 32-year systematic review and meta-analysis

2014 ◽  
Vol 120 (6) ◽  
pp. 1415-1427 ◽  
Author(s):  
Collin C. Tebo ◽  
Alexander I. Evins ◽  
Paul J. Christos ◽  
Jennifer Kwon ◽  
Theodore H. Schwartz
Keyword(s):  
Systematic Review ◽  
Epilepsy Surgery ◽  
Meta Analysis ◽  
Temporal Lobectomy ◽  
Neurological Deficits ◽  
Complication Rates ◽  
Wound Infections ◽  
Group A ◽  
Time Periods ◽  
Group B

Object Surgical interventions for medically refractory epilepsy are effective in selected patients, but they are underutilized. There remains a lack of pooled data on complication rates and their changes over a period of multiple decades. The authors performed a systematic review and meta-analysis of reported complications from intracranial epilepsy surgery from 1980 to 2012. Methods A literature search was performed to find articles published between 1980 and 2012 that contained at least 2 patients. Patients were divided into 3 groups depending on the procedure they underwent: A) temporal lobectomy with or without amygdalohippocampectomy, B) extratemporal lobar or multilobar resections, or C) invasive electrode placement. Articles were divided into 2 time periods, 1980–1995 and 1996–2012. Results Sixty-one articles with a total of 5623 patients met the study's eligibility criteria. Based on the 2 time periods, neurological deficits decreased dramatically from 41.8% to 5.2% in Group A and from 30.2% to 19.5% in Group B. Persistent neurological deficits in these 2 groups decreased from 9.7% to 0.8% and from 9.0% to 3.2%, respectively. Wound infections/meningitis decreased from 2.5% to 1.1% in Group A and from 5.3% to 1.9% in Group B. Persistent neurological deficits were uncommon in Group C, although wound infections/meningitis and hemorrhage/hematoma increased over time from 2.3% to 4.3% and from 1.9% to 4.2%, respectively. These complication rates are additive in patients undergoing implantation followed by resection. Conclusions Complication rates have decreased dramatically over the last 30 years, particularly for temporal lobectomy, but they remain an unavoidable consequence of epilepsy surgery. Permanent neurological deficits are rare following epilepsy surgery compared with the long-term risks of intractable epilepsy.

scholarly journals Evaluation of the “50-50 criteria” of post-hepatectomy liver failure as mortality predictor after resection of liver tumors

2019 ◽  
Vol 6 (3) ◽  
pp. 648
Author(s):  
Ashraf M. El-Badry ◽  
Ahmed E. Ahmed
Keyword(s):  
Liver Resection ◽  
Postoperative Complications ◽  
Liver Failure ◽  
Prothrombin Time ◽  
Total Bilirubin ◽  
Serum Total Bilirubin ◽  
Complication Rates ◽  
Group A ◽  
Cirrhotic Patients ◽  
Group B

Background: Post-hepatectomy liver failure (PHLF) represents a serious complication of liver resection. A standardized definition of PHLF based on serum total bilirubin (TB) level and prothrombin time (PT) reduction at the fifth postoperative day (POD-5) gained wide popularity.Methods: Medical records of consecutive adult patients who underwent elective liver resection for hepatic neoplasms from May 2015 to April 2018 were prospectively collected. PHLF was defined as serum total bilirubin (TB) level >50 mmol and prothrombin time (PT) reduction <50% on the fifth postoperative day (POD-5). Patients with PHLF were identified as group A and compared with group B (without PHLF) regarding postoperative complications and mortality.Results: Fifty-one patients were enrolled, forty-three with malignant (primary and secondary) neoplasms and eight with benign liver masses. Group A comprised eight patients who fulfilled the criteria of PHLF whereas 43 patients were included in group B. The mean age, gender ratio and mean number of resected liver segments were not significantly different between both groups. Patients in group A exhibited significantly increased complication rates compared with group B. Postoperative mortality occurred exclusively in group A where five among eight patients (62.5%) died postoperatively. The mortality rate was remarkably higher (100%) in cirrhotic patients who developed PHLF compared with 40% in non-cirrhotic with PHLF.Conclusions: PHLF is associated with increased severity of postoperative complications and mortality. Development of PHLF prompts intensive treatment protocol, particularly in cirrhotic patients.

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