scholarly journals Role of laparoscopic appendicectomy in management of early appendicular mass

2020 ◽  
Vol 7 (7) ◽  
pp. 2337
Author(s):  
Kota Ramesh ◽  
Khyati Kiran Janapareddy
Keyword(s):  
Intraoperative Complications ◽  
Laparoscopic Approach ◽  
Operative Management ◽  
Diagnostic Value ◽  
Laparoscopic Appendicectomy ◽  
Group 13 ◽  
Surgical Department ◽  
Male Patients ◽  
Appendicular Mass

Background: Appendicular mass consists of matted loops of bowel and omentum adherent to the adjacent inflamed appendix. Laparoscopic approach adds diagnostic value and allows visualization of entire abdominal viscera facilitating better and safer dissection.Methods: This is an observational prospective study done in patients presenting to Gandhi Hospital’s surgical department with incidentally detected appendicular mass on laparoscopy from August 2016 to August 2018.Results: Maximum cases belong to adolescent age group (13 out of 30). Majority of cases are male patients (24 out of 30). Each surgery took around 1 hour. No intraoperative complications occurred in 23 patients. Difficult adhesiolysis experienced in 5 patients. Serosal bowel injury occurred in 1 patient. Orals were delayed where intraoperative dissection was prolonged or difficult. Majority of patients were discharged after 3 days.Conclusions: With immediate operative management of appendicular mass presenting in early stages of inflammation, dissection can be safely proceeded with and appendicectomy can be safely performed eliminating the need for second hospitalization and risk of recurrence. The incidence of intra-operative and post-operative complications is low making laparoscopic appendicectomy in early appendicular mass a safe and feasible treatment option. 

scholarly journals Planning of methods of surgical correction of soft tissues of the face and neck

2021 ◽  
Vol 25 (4) ◽  
pp. 47-52
Author(s):  
S. M. Alimova ◽  
V. I. Sharobaro ◽  
A. V. Telnova ◽  
E. E. Stepanyan
Keyword(s):  
Soft Tissues ◽  
Ultrasound Examination ◽  
Diagnostic Value ◽  
Surgical Correction ◽  
Age Related ◽  
The Face ◽  
Male Patients ◽  
The Mean ◽  
Degree Of Participation

Objective. Role of ultrasound examination in planning surgical correction of age-related changes of the face and neck soft tissues.Methods. A prospective analysis of the study and treatment of 80 patients with involutive changes in the soft tissues of the face and neck who were carried out from 2018 to 2020 in the Mositalmed Clinic. The age of the patients ranged from 24 to 60 years. The mean age was 42 ± 6.89 years (± SE standard deviation mean). There were 67 female patients (83.7%), male patients – 13 (16.3%).Results. The diagnostic value of ultrasound examination in involutional changes in the soft tissues of the face and neck for determining the causes of contour deformities is noted.Conclusion. Ultrasound imaging in an upright position of the patient makes it possible to determine the degree of participation of each tissue in the formation of deformity, which is extremely important for planning various techniques for rejuvenating the face and neck.

scholarly journals Gender-Specific Differences in Presentation and Management of Spinal Infection: A Single-Center Retrospective Study of 159 Cases

2020 ◽  
pp. 219256822090580
Author(s):  
Sara Lener ◽  
Christoph Wipplinger ◽  
Sebastian Hartmann ◽  
Andreas Rietzler ◽  
Claudius Thomé ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Operative Management ◽  
Spinal Infection ◽  
Single Center ◽  
Male And Female ◽  
Female Patients ◽  
Threatening Condition ◽  
Erythrocyte Concentrates ◽  
Male Patients ◽  
Underlying Mechanisms

Study Design: A retrospective single-center analysis of 159 cases. Objective: To investigate differences between male and female patients, as spinal infection (SI) represents a life-threatening condition and numerous factors may facilitate the course and outcome of SI, including patients’ age and comorbidities, as well as gender. To date, no comparative data investigating sex differences in SI is available. Thus, the purpose of the present retrospective trial was to investigate differences between male and female patients. Methods: A total of 159 patients who were treated for a spinal infection between 2010 and 2016 at our department were included in the analysis. The patients were categorized into 2 groups based on gender. Evaluation included magnetic resonance imaging, laboratory values, clinical outcome, and conservative/operative management. Results: Male patients suffered from SI significantly more often than female patients (n = 101, 63.5% vs n = 58, 36.5%, P = .001). However, female patients were initially affected more severely, as infection parameters were significantly higher ( P = .032) and vertebral destruction was more serious ( P = .018). Furthermore, women suffered from intraoperative complications more often ( P = .024) and received erythrocyte concentrates more frequently ( P = .01). Nevertheless, mortality rates and outcome were comparable. Pain scales were significantly higher in female patients at 12-month follow-up ( P = .042). Conclusion: Although male patients show a higher incidence for SI, the course of disease and the management is more challenging in female patients. Nevertheless, outcome after 12 months is comparably good. Underlying mechanisms may include a better immune response and dissimilar effects of antibiotic treatment in women. Pain management in female patients is still unsatisfactory after 12 months.

The role of clomiphene citrate in the resolution of hypogonadism in male patients with prolactinomas under cabergoline therapy

2018 ◽  
Author(s):  
Lucio Vilar ◽  
Clarice Vilar ◽  
Ruy Lyra ◽  
Ana Carolina The ◽  
Erik Trovao ◽  
...  
Keyword(s):  
Clomiphene Citrate ◽  
Male Patients

scholarly journals Sex-Specific Differences in Glioblastoma

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1783
Author(s):  
Anna Carrano ◽  
Juan Jose Juarez ◽  
Diego Incontri ◽  
Antonio Ibarra ◽  
Hugo Guerrero Cazares
Keyword(s):  
Sex Differences ◽  
Immune System ◽  
Molecular Level ◽  
Deep Understanding ◽  
Protective Role ◽  
Men And Women ◽  
Individualized Approach ◽  
Male Patients ◽  
Outcome Differences

Sex differences have been well identified in many brain tumors. Even though glioblastoma (GBM) is the most common primary malignant brain tumor in adults and has the worst outcome, well-established differences between men and women are limited to incidence and outcome. Little is known about sex differences in GBM at the disease phenotype and genetical/molecular level. This review focuses on a deep understanding of the pathophysiology of GBM, including hormones, metabolic pathways, the immune system, and molecular changes, along with differences between men and women and how these dimorphisms affect disease outcome. The information analyzed in this review shows a greater incidence and worse outcome in male patients with GBM compared with female patients. We highlight the protective role of estrogen and the upregulation of androgen receptors and testosterone having detrimental effects on GBM. Moreover, hormones and the immune system work in synergy to directly affect the GBM microenvironment. Genetic and molecular differences have also recently been identified. Specific genes and molecular pathways, either upregulated or downregulated depending on sex, could potentially directly dictate GBM outcome differences. It appears that sexual dimorphism in GBM affects patient outcome and requires an individualized approach to management considering the sex of the patient, especially in relation to differences at the molecular level.

scholarly journals POS1388 ULTRASOUND FOR PANNICULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 977.1-977
Author(s):  
A. Potapova ◽  
O. Egorova ◽  
O. Alekseeva ◽  
A. Volkov ◽  
S. Radenska-Lopovok
Keyword(s):  
Dynamic Range ◽  
Subcutaneous Fat ◽  
Diagnostic Value ◽  
High Energy ◽  
Contralateral Side ◽  
Imaging Method ◽  
Non Invasive ◽  
M 12

Background:Ultrasound (US) is a non-invasive and safe imaging method that allows in vivo differentiation of the morphological structures of subcutaneous fat (SCF) tissue in in normal and pathology.Objectives:Reveal features of ultrasound changes in SCF in panniculitis (Pn).Methods:57 patients (f – 45, m - 12) aged 18 - 67 years with an initial diagnosis of erythema nodosum and a disease duration of 3.6 ± 1.4 years were examined. In addition to the general clinical examination, a computed tomography of the chest organs and a pathomorphological examination of a skin biopsy from the site of the node were performed. Ultrasound was performed on a MyLabTwice apparatus (ESAOTE, Italy) using a multi-frequency linear transducer (10-18 MHz) with the PD technique, the parameters of which were adapted for recording low-speed flows (PRF 300-600 Hz, low filter, dynamic range - 20-40 dB), the presence of vascularization was assessed not only in the affected area, but also on the contralateral side using high-energy Doppler.Results:33 patients were diagnosed with septal Pn (SPn), 24 - lobular Pn (LPn). In all cases, the diagnosis was verified by histological examination. Ultrasound made it possible to assess the thickness, echoicity and vascularization of the SCF. In 35 patients, significant thickening of the SCF was revealed (as compared to the contralateral side), of which in 14 cases with SPn, in 21 - with LPn. Significant diffuse thickening of the SCF with the contralateral side was observed in 18 patients, incl. in 12 (66%) patients with LPn. Limited thickening was more typical for SPn (73%). A significant increase in the echoicity of the SCF was noted in all forms of Pn. A “lobular” echo pattern with an anechogenic environment was observed in 25 patients, of which 18 (72%) had LPn. An increase in vascularization compared to the contralateral side was recorded in 30 cases (SPn-17, LPn-13).Conclusion:The obtained preliminary results indicate the important role of ultrasound in assessing the depth and prevalence of the inflammatory process at Pn. To clarify the diagnostic value of this method, further studies are needed on a larger sample of patients.Disclosure of Interests:None declared

The Role of Angioembolization in Hepatic Trauma

2020 ◽  
pp. 000313482097372
Author(s):  
Ali Cadili ◽  
Jonathan Gates
Keyword(s):  
Gold Standard ◽  
Management Strategy ◽  
Operative Management ◽  
Hepatic Trauma ◽  
Anatomy And Physiology ◽  
Liver Injuries ◽  
Hepatic Injuries ◽  
Non Operative Management ◽  
Type Of Injury

The liver is one of the most commonly injured solid organs in blunt abdominal trauma. Non-operative management is considered to be the gold standard for the care of most blunt liver injuries. Angioembolization has emerged as an important adjunct that is vital to the success of the non-operative management strategy for blunt hepatic injuries. This procedure, however, is fraught with some possible serious complications. The success, as well as rate of complications of this procedure, is determined by degree and type of injury, hepatic anatomy and physiology, and embolization strategy among other factors. In this review, we discuss these important considerations to help shed further light on the contribution and impact of angioembolization with regards to complex hepatic injuries.

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

Early versus delayed operative management of appendicular mass

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hassan sayed Tantawy ◽  
Amr Mohamed El Hefny ◽  
Ahmed Yasser Abd El Halim ◽  
Mohammed Ali Abdel Ghaffar Nasr
Keyword(s):  
Retrospective Study ◽  
Acute Abdomen ◽  
Defense Mechanisms ◽  
Operative Management ◽  
University Hospital ◽  
Greater Omentum ◽  
Abdominal Ultrasonography ◽  
Military Hospitals ◽  
Group I ◽  
Appendicular Mass

Abstract Background Acute appendicitis is one of the most common causes of acute abdomen. It may be either complicated or uncomplicated. Sometimes the acute inflammation of the appendix may be enclosed by the patient’s own defense mechanisms to form inflammatory phlegmon. Complicated appendicitis is a palpable appendiceal mass, phlegmon, or a localized abscess. A phlegmon is an inflammatory tumor consisting of the inflamed appendix, with the greater omentum and adjacent viscera. Aim of the Work To determine the preferred approach taken to the management of the appendicular mass, to compare between acute appendectomy and delayed surgical intervention for appendicular mass, and to determine patient outcome following appendectomy for appendicular mass. Material and Methods: Study A retrospective study. Study Setting The study has been conducted in Ain Shams University Hospital (El-Demerdash) and military hospitals in Cairo and Alexandria under supervision of thesis supervisors. Study Period The study retrospectively analyze data of patients diagnosed as appendicular mass between January 2017 and December 2017. Study Population: Inclusion Criteria Patients with acute abdomen, diagnosed as appendicular mass by clinical examination and imaging (US and CT). Exclusion Criteria Females with right ovarian problems. Cases with right ureteric stones. Cases of recurrence. Abdominal ultrasonography and CT did not confirm the mass. Results The present study was a descriptive, retrospective, study that included 20 patients diagnosed with appendicular mass attended to surgery clinics at El-Demerdash and Military hospitals between January 2017 and December 2017. The patients were divided into two groups: Group I including 10 patients started conservative treatment then received delayed appendectomy. Group II including 10 patients received early appendectomy. Conclusion In conclusion, early appendicectomy is a safe and superior option in patients with appendicular mass compared to delayed appendicectomy. The results indicate that early appendicectomy leads to shorter hospital stay and return to normal activities than delayed appendicectomy. Moreover, postoperative difficulties and complications were less following early appendicectomy. The early appendectomy appears to achieve more favorable outcomes in patients with more severe symptoms, high fever, and high inflammatory markers. Nonetheless, more studies are necessary to confirm our findings.

scholarly journals Serum YKL-40 Levels in Patients with Gastric Cancer

2011 ◽  
Vol 3 ◽  
pp. BIC.S7154 ◽  
Author(s):  
Veyis Itik ◽  
Ozgur Kemik ◽  
Ahu Kemik ◽  
A. Cumhur Dulger ◽  
Aziz Sümer ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Colorectal Cancers ◽  
Healthy Population ◽  
Serum Samples ◽  
Future Studies ◽  
Male Patients

Aims and background YKL-40 is secreted by several types of tumors. Increased serum YKL-40 levels have been reported in prostate, glioblastoma, breast and colorectal cancers. Determination of YKL-40 levels may serve as a valuable biomarker for the diagnosis and treatment of gastric cancer. The purpose of this study was to determine the serum YKL-40 levels expressed in gastric carcinomas. Methods Between 2009 and 2011, we retrospectively reviewed 100 patients with gastric cancer and compared their serum samples to 75 healthy volunteers. YKL-40 levels were determined by an enzyme-linked immunosorbent assay (ELISA). Results We found significantly higher serum levels of YKL-40 in patients with gastric cancer compared to the healthy population ( P < 0.0001). We also found significant differences in serum YKL-40 levels between female and male patients with gastric cancer ( P < 0.01). Conclusions YKL-40 is over-expressed in gastric cancer, suggesting a more aggressive phenotype. YKL-40 may be a useful serum biomarker for gastric cancer identification, and future studies should focus on the role of YKL-40 in the tumorigenesis of gastric cancer and responsiveness toward treatment.

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