scholarly journals Considerations on cervical anastomoses in postcaustic esophageal reconstruction

2015 ◽  
Vol 5 (20) ◽  
pp. 215-223
Author(s):  
Irina Predescu ◽  
Dragos Predescu ◽  
Codrut Sarafoleanu ◽  
Silviu Constantinoiu

Abstract Background. The increased incidence of accidental or non-accidental ingestion of corrosive substances or drug compounds leading to postcaustic esophagitis represents a major public health issue. The treatment of postcaustic esophagitides is difficult and long lasting, calling for a complex team trained in this borderline pathology: gastroenterologist, general surgeon, otorhinolaryngologist, anesthesiologist, psychiatrist. In cases when preventive treatment has failed, the only effective therapy remains the surgical one. Material and methods. Our study involved an analysis of the cases treated and/or operated in the Department of General and Esophageal Surgery of the “Sfanta Maria” Hospital in Bucharest, between 1981-2014; respectively 195 patients who benefited from reconstructive esophageal interventions. Of the selected patients, 191 were operated for corrosive pathology produced by ingestion of caustic soda and only four cases by ingestion of acids. The lesion balance showed that, besides the esophagus, the oropharynx (28 patients), the larynx (7 patients) and the stomach (31 patients) had been affected by the corrosion process, requiring particular surgical solutions. The bypass reconstruction (preserving the esophagus) was the standard treatment, esophagectomy having been performed in only 4 patients. Results. The main remote postoperative complaint was feeding inability, a consequence of various causes: cervical anastomosis stenosis, motor dysfunctions of the graft or of the laryngopharyngeal complex, over-time alteration of the graft, technical vices or the degradation of intra-abdominal assemblies, traumatic injuries of the presternal substituent. Conclusion. One of the most important moments during the esophageal reconstruction surgery remains the duration of the cervical anastomosis, since the postoperative complication rate and the remote functional outcome depend on it. Minimizing postoperative risks and complications requires a complete mastery of surgical methods, of the small technical “artifices” and of the necessary therapeutic refinements adapted to each individual case.

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Rodolfo Castro ◽  
Hugo Perazzo ◽  
Beatriz Grinsztejn ◽  
Valdilea G. Veloso ◽  
Chris Hyde

Chronic hepatitis C remains one of the main causes of chronic liver disease worldwide and presents a variable natural history ranging from minimal changes to advanced fibrosis and cirrhosis and its complications, such as development of hepatocellular carcinoma. Approximately, 1.45 million people are estimated to be infected by HCV in Brazil representing a major public health issue. The aim of this paper was to review the epidemiology and management of chronic hepatitis C from a Brazilian perspective. The management of chronic hepatitis C has been challenged by the use of noninvasive methods to stage liver fibrosis as an alternative to liver biopsy and the high cost of new interferon-free antiviral treatments. Moreover, the need of cost-effectiveness analysis in hepatitis C and the recent changes in treatment protocols were discussed.


2021 ◽  
Author(s):  
Bader Y Alhatlani ◽  
Waleed A Aljabr ◽  
Mohammed S Almarzouqi ◽  
Sami M Alhatlani ◽  
Rayan N Alzunaydi ◽  
...  

Aim: Hepatitis E virus (HEV) transmission through blood transfusion is a major public health issue worldwide. We aimed to determine the seroprevalence of HEV in blood donors in the Qassim region of Saudi Arabia. Materials & methods: Serum samples (n = 1078) were collected from volunteer blood donors and tested for the presence of anti-HEV IgG and IgM by indirect ELISA. Results: The seroprevalence of anti-HEV IgG among the blood donors was 5.7% overall. Anti-HEV IgG and IgM seropositivity were significantly higher in non-Saudi donors than in Saudi donors (22.1 vs 3 and 7.8 vs 0.2% for anti-HEV IgG and IgM, respectively). Conclusion: The seroprevalence of HEV among blood donors in the Qassim region was lower than previous estimates for other regions of the country and neighboring countries.


2016 ◽  
Vol 14 (4) ◽  
Author(s):  
Yuan Yuh Leong ◽  
Louis Tong

Dry eye, a visually disabling disease that has been reported to be a major public health issue in many countries, is known to induce a significant decrease in quality of life. In this report, we aim to compile information on the investigators of dry eye that published most frequently in peer reviewed scientific journals and the publications in Asia and Europe.


2006 ◽  
Vol 63 (10) ◽  
pp. 897-901 ◽  
Author(s):  
Novak Milovic ◽  
Vladimir Bancevic ◽  
Olivera Jakovljevic ◽  
Zoran Paunic

Background: Renal injuries are most often caused by traumatic injuries, but they can also be induced iatrogenically, during renal biopsy, percutaneous nephrostomy or lithotripsy. Vascular renal injuries may be treated by embolization, nonsurgical or surgical methods. Case report. In this paper we presented a high-risk patient with poor outcome of an open surgery threatment and a prior attempt of embolization, with gross haematuria caused by traumatic renal arterio-venous (AV) fistula and pyelocalical injury who was managed by supraselective embolization of the irrigating arterial vessel. Conclusion. Supraselective embolization is a first choice method for the treatment of low grade renal vessel injuries. Even patients with the most severe renovascular lesions and major renal destruction (a grade IV injury) can be treated nonsurgically with supraselective embolization, with an excellent chance to preserve the maximal amount of functional renal parenchyma. This method is rapid, effective, tissue preserving, and likely to reduce morbidity and mortality.


2021 ◽  
Vol 13 (8) ◽  
pp. 1-18
Author(s):  
Matthew Thomas ◽  
Laura Brady ◽  
Monika Wozniak ◽  
Elizabeth Terranova ◽  
Cheryll Moore ◽  
...  

Background: Opioid use is a major public health issue and opioid overdose requires rapid response with naloxone. Aims: This study assesses the impact of a training session on the knowledge and attitudes of first responders and members of the community regarding opioid overdose recognition and naloxone use. Methods: A training session was delivered to 2327 participants between July 2019 and March 2020. The study used a paired, pre-/post-analysis to quantify changes. Findings: Nearly all (99.7%) participants completed a survey before and after training. Statistically significant improvements were observed in nearly all attitude and knowledge items. Conclusion: An education session delivered to an educationally and professionally diverse group can improve trainees' knowledge and attitudes. There were some significant differences between sub-groups, particularly regarding their professional and educational background, and whether the location was urban or rural. Further study is needed to examine whether trainees would benefit from a course tailored toward their education and professional experience.


Author(s):  
Sukhwinder Sahota ◽  
Tahir Mahmood

Obesity is a complex multifactorial disorder, which has reached epidemic proportions worldwide. It affects all aspects of an individual’s life: physical, social, emotional, and psychological. Although it is largely preventable, obesity is now a major public health issue and has a significant impact on the health and well-being of an individual throughout their lifespan. Obesity is associated with multiple adverse outcomes not only during the reproductive phase of a woman’s life but during the post-reproductive era as well. Obesity also increases risks for non-obstetrical and gynaecological illnesses such as diabetes mellitus, hypertension, metabolic syndrome, cardiovascular disease, and non-gynaecological cancers. Obesity thus is a cause of major societal economic burden.


Sign in / Sign up

Export Citation Format

Share Document