scholarly journals On the issue of surgical intervention for hydronephrosis

2020 ◽  
Vol 8 (4) ◽  
pp. 321-356
Author(s):  
A. Dranitsyn
Keyword(s):  
Abdominal Surgery ◽  
Operative Treatment ◽  
Surgical Intervention ◽  
Clinical History ◽  
Genital Area ◽  
Differential Methods

Despite the fact that the clinical history and operative treatment of hydronephrosis belong to the so-called brilliant period of abdominal surgery, which came from the time of the introduction of antiseptics and asepsis, however, no indication or differential methods of diagnostics in perfection, which we see, for example, with the treatment of brushes and other tumors of the genital area.

scholarly journals Change in Functional Impairment, Disability, and Quality of Life Following Operative Treatment for Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 53S-69S ◽  
Author(s):  
Michael G. Fehlings ◽  
Lindsay A. Tetreault ◽  
Shekar Kurpad ◽  
Darrel S. Brodke ◽  
Jefferson R. Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Functional Impairment ◽  
Cervical Myelopathy ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Duration Of Symptoms ◽  
Degenerative Cervical Myelopathy ◽  
The Impact

Study Design: Systematic review. Objectives: The primary objective of this systematic review was to define the change in impairment, disability, and pain following surgical intervention in patients with degenerative cervical myelopathy (DCM). Secondary objectives included to assess the impact of preoperative disease severity and duration of symptoms on outcomes and to summarize complications associated with surgery. Methods: A systematic literature search was conducted to identify prospective studies evaluating the effectiveness and safety of operative treatment in patients with DCM. Outcomes of interest were functional status, disability, pain, and complications. The quality of each study was evaluated using the Newcastle-Ottawa Scale, and the strength of the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Results: Of the 385 retrieved citations, 32 met inclusion criteria and are summarized in this review. Based on our results, pooled standard mean differences showed a large effect for improvement in Japanese Orthopaedic Association or modified Japanese Orthopaedic Association score from baseline at short-, medium-, and long-term follow-up: 6 to 12 months (1.92; 95% confidence interval [CI] = 1.41 to 2.43), 13 to 36 months (1.40; 95% CI = 1.12 to 1.67), and ≥36 months (1.92; 95% CI = 1.14 to 2.69) (moderate evidence). Surgery also resulted in significant improvements in Nurick, Neck Disability Index, and Visual Analogue Scale scores (low to very low evidence). The cumulative incidence of complications was low (14.1%; 95% CI = 10.1% to 18.2%). Conclusion: Surgical intervention for DCM results in significant improvements in functional impairment, disability, and pain and is associated with an acceptably low rate of complications.

scholarly journals Inicijalna dijagnostika intraabdominalnog krvavljenja uzrokovano izolovanom povredom slezine kod tupe abdominalne traume

2003 ◽  
Vol 50 (4) ◽  
pp. 129-133
Author(s):  
Srdjan Dikic ◽  
Dragoljub Bilanovic ◽  
Tomislav Randjelovic ◽  
D. Radovanovic ◽  
Miroslav Granic ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Surgical Intervention ◽  
Bleeding Control ◽  
Bleeding Source ◽  
Intraabdominal Bleeding ◽  
Bleeding Area ◽  
Conservative Attitude

Diagnosis of intraabdominal bleeding caused by spleen injury must be performed in the shortest possible period of time, with little risk for the patient, and with high preciseness. By its simple performance, high preciseness and little risk for the patient, DPL imposes as the predominant method in initial diagnostic of intraabdominal bleeding. Control and monitoring of lavage may duly signalize degree of bleeding. Preciseness of this diagnostic in our series ranges up to 93.3%. DPL method is especially important in a combined neurotrauma. Ultrasonography is a sovereign method in diagnostic of bleeding source as well as in monitoring of bleeding that from the very beginning does not require urgent surgical intervention. Its importance is in monitoring both intrasplenic and subcapsulary hematomas. It is not appliable in disturbed and haemodynamically unstable patients. It is in particular important in children where a maximum conservative attitude with respect to operative treatment has been assumed. CT takes the leading place with respect to preciseness of bleeding area, and the combined thoracoabdominal trauma. Preciseness of CT in our series comes up to 96.6%, but can be applied only in haemodynamically stable patients. Same as US of abdomen so the CT of abdomen represents a prominent method in monitoring of both intrasplenic and subcapsular hematomas, which do not require urgent surgical intervention.

Why do a cardiopulmonary exercise test?

2021 ◽  
pp. 3-6
Author(s):  
William J.M. Kinnear ◽  
James H. Hull
Keyword(s):  
Exercise Capacity ◽  
Clinical Examination ◽  
Exercise Test ◽  
Physical Training ◽  
Surgical Intervention ◽  
Clinical History ◽  
Cardiopulmonary Exercise Test ◽  
Cardiopulmonary Exercise ◽  
Operative Care ◽  
Care Performance

This chapter describes how a maximal cardiopulmonary exercise test (CPET) assesses the exercise capacity of an individual. It identifies whether exercise is limited by the heart or lungs, or by another factor. The test can be used to elucidate the cause of symptoms such as breathlessness. By quantifying exercise capacity, a CPET can be used as a tool to plan physical training. Information from a CPET helps quantify the risk of a surgical intervention and is used in planning post-operative care. Performance in a CPET is a predictor of subsequent mortality. A CPET should be preceded by a full clinical history and a thorough clinical examination. The test is best interpreted alongside the results of simple preliminary investigations.

Suppurative Thrombophlebitis: Correlation Between Pathogen and Underlying Disease

1986 ◽  
Vol 7 (12) ◽  
pp. 582-585 ◽  
Author(s):  
Capt Robert A. Johnson ◽  
Capt Robert A. Zajac ◽  
Maj Martin E. Evans
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Nosocomial Infection ◽  
Abdominal Surgery ◽  
General Hospital ◽  
Inflammatory Process ◽  
Surgical Intervention ◽  
Underlying Disease ◽  
Streptococcus Faecalis ◽  
Apparent Association

AbstractWe identified 29 episodes of suppurative thrombophlebitis in 27 patients admitted to a large general hospital between May 1980 and May 1984. In 25 patients, the intravenous cannulae had been in place for more than 3 days. Streptococcus faecalis, Pseudomonas aeruginosa or one of the Enterobacteriaceae were implicated in 14 patients. All these patients had recently undergone abdominal surgery or had a major intraabdominal inflammatory process at the time they developed thrombophlebitis. The remaining 13 patients were infected with Staphylococcus aureus, other grampositive cocci or Candida species. Only two of these had an active abdominal process at the time of their infection (x2 = 16.08, P<0.001). There is an apparent association between phlebitis caused by enteric organisms and active intra-abdominal pathology. There were two deaths related to delayed or deferred surgery. Suppurative thrombophlebitis is a lethal, preventable nosocomial infection that requires urgent surgical intervention.

Tibial Neuropathy—Tarsal Tunnel Syndrome

2018 ◽  
Author(s):  
Daniel A. Lyons ◽  
David L. Brown
Keyword(s):  
Physical Examination ◽  
Surgical Intervention ◽  
Tibial Nerve ◽  
Clinical History ◽  
Surgical Decompression ◽  
Tarsal Tunnel ◽  
Success Rates ◽  
Tarsal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Space Occupying Lesion

Tarsal tunnel syndrome (TTS) is caused by compression of the tibial nerve and its branches within the tarsal tunnel at the ankle. The diagnosis of TTS is often made clinically, but imaging and electrodiagnostic studies should be considered when the diagnosis cannot be ascertained from the clinical history and physical examination. Surgical decompression of the tarsal tunnels should be pursued only after conservative measures have failed or when a space-occupying lesion or point of tibial nerve compression has been identified. Surgical intervention requires complete release of the flexor retinaculum at the medial ankle, as well as release of the three distinct tunnels enveloping the medial and lateral plantar nerves and the calcaneal branch. Success rates for tibial nerve decompression vary widely in the literature, ranging from 44% to 96%.

Entrapment Neuropathies

2017 ◽  
Author(s):  
James W. Teener
Keyword(s):  
Surgical Intervention ◽  
Clinical History ◽  
Axonal Loss ◽  
Entrapment Neuropathies ◽  
Single Nerve

Entrapment neuropathies are a subset of compression neuropathies caused by chronic impingement upon a nerve by nearby structures. The resulting pathology depends upon the duration and severity of entrapment, and ranges from demyelination if entrapment is mild or brief to axonal loss in more severe cases. Entrapment neuropathies typically cause symptoms referable to a single nerve distribution, but sensory symptoms may appear to extend beyond the typical dermatome of the entrapped nerve. Diagnosis is based upon clinical history and examination, and is supported by electrodiagnostic studies and imaging. A variety of supportive therapies may result in improvement of symptoms, but in cases of severe entrapment, surgical intervention to release the nerve is often necessary, and even then recovery is often incomplete.

Results of non-operative treatment following hip fracture compared to surgical intervention

Injury ◽  
2009 ◽  
Vol 40 (4) ◽  
pp. 418-421 ◽  
Author(s):  
M. Hossain ◽  
V. Neelapala ◽  
J.G. Andrew
Keyword(s):  
Hip Fracture ◽  
Operative Treatment ◽  
Surgical Intervention

scholarly journals Radiographic predictors of deterioration in patients with lumbosacral lipomas

2016 ◽  
Vol 18 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Albert Tu ◽  
Alexander R. Hengel ◽  
D. Douglas Cochrane
Keyword(s):  
Retrospective Review ◽  
Surgical Intervention ◽  
Clinical History ◽  
Motor Dysfunction ◽  
Clinical Deterioration ◽  
Prophylactic Surgery ◽  
Motor Deficits ◽  
Imaging Results ◽  
Early Surgical Intervention ◽  
Over Time

OBJECTIVE Although patients with lumbosacral lipomas may be asymptomatic at presentation, most develop neurological symptoms over time. Given the challenges in examining infants, the authors sought to determine whether MRI would be helpful in identifying patients who are more likely to deteriorate early in life and who would potentially benefit from early surgical intervention. METHODS A retrospective review of all patients with lumbosacral lipomas who were seen at the authors' institution between 1997 and 2013 and who were managed without prophylactic surgery was performed. The clinical history and imaging results for each patient were reviewed in detail and then correlated to the pattern of and age at clinical deterioration. RESULTS Twenty-four patients were identified. Nine worsened within the first 18 months of life (early deterioration), and 15 patients deteriorated or remained stable after 30 months (late deterioration/stable). No patients worsened between 18 and 30 months of age. Patients who deteriorated early were more likely to have large intradural lipomas that filled the canal, increased during the 1st year of life, and compressed neurological structures. Some had a syrinx extending above the neural-lipoma interface. Syrinxes in patients with early deterioration were large and expanded in infancy. Patients with early deterioration had motor deficits at the time of deterioration, whereas patients with late deterioration developed mixed urological and motor dysfunction. CONCLUSIONS Patients with large lipomas displacing the cord and an enlarging syrinx have a propensity for early clinical deterioration. Given this, their families may be counseled that 1) the risk of deterioration in infancy may be higher than in infants without these features, and 2) they require more diligent observation. Intervention before deterioration in these infants should also be considered. Patients without these features may be safely observed to a lesser extent.

scholarly journals Auricular Perichondritis in a Tertiary Rural Hospital

2013 ◽  
Vol 28 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Gautam Dhar ◽  
Bijan Basak ◽  
Ganesh Chandra Gayen ◽  
Ritam Ray
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Surgical Intervention ◽  
Motor Vehicle ◽  
Wound Care ◽  
Clinical History ◽  
Predisposing Factors ◽  
Total Study Population ◽  
Early Management ◽  
Male Predominance ◽  
Ear Piercing

Objective:  Auricular perichondritis refers to inflammation involving the perichondrium of the external ear. It is a very serious disease which may lead to permanent deformity of the pinna. We describe the predisposing factors, pathogenic organisms, interventions and residual deformities in a prospective consecutive sample of patients. Methods: Design:           Prospective Cohort Study Setting:           Tertiary Rural Government Teaching Hospital Participants: All patients presenting with auricular perichondritis for a period of one year, between March 2011 and February 2012 were consecutively enrolled, and a clinical history and demographic details were obtained. Routine hematologic, blood biochemical examinations and culture / sensitivity of discharge from the pinna were conducted, and empiric intravenous ciprofloxacin was administered and continued if confirmed by culture and sensitivity. Those sensitive to co-amoxiclav, ceftazidime or amikacin were shifted to those medications. Medications were shifted to oral forms when available and indicated by resolution of acute inflammation, wound healing and no growth on cultures. Parenteral medications were maintained until the same parameters were achieved. Surgical incision and drainage was also performed when indicated, followed by a standardized wound care regimen. Follow up was for six months ending with assessment of pinna deformity. Results: Of the total study population of 50, 76% were male and 24% were female; 15-75 years of age (range 60 years) displaying male predominance and clustering in the fourth decade of life. The most common predisposing factors were trauma from motor vehicle accidents (30%) followed by high ear piercing (22%). Pseudomonas aeruginosa (48%) followed by Staphylococcus aureus (20%) were the most common organisms isolated. All were managed with intravenous antibiotics, but 76% also required surgical intervention.  Sixty-eight percent developed residual deformities of the pinna, with 50% being total and 18% being partial.   Conclusion: Auricular perichondritis is a frightening disease which requires early management.  As  Pseudomonas aeruginosa  is  the  commonest  organism,  antipseudomonal  antibiotics  should  be started  as  early  as  possible. Despite medical and surgical intervention, residual deformities may ensue.   Keywords:  auricular perichondritis, pinna, trauma, Pseudomonas aeruginosa

scholarly journals A STUDY OF INTESTINAL OBSTRUCTION CONSERVTIVE VERSUS SURGICAL MANAGEMENT

2020 ◽  
Vol 1 (2) ◽  
pp. 10-16
Author(s):  
MA Oyinlola ◽  
OA Omisakin
Keyword(s):  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Exploratory Laparotomy ◽  
Related Factors ◽  
Previous Abdominal Surgery ◽  
Intestinal Contents ◽  
History Of ◽  
Obstructed Hernia

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.

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