scholarly journals Surgical management of septic knee arthritis with open arthrotomy and debridement-a case report

2021 ◽  
Vol 8 (1) ◽  
pp. 98
Author(s):  
Neetin Pralhad Mahajan ◽  
Kartik Prashant Pande ◽  
Ravi Rameshbhai Dadhaniya ◽  
Pritam Talukder
Keyword(s):  
Septic Arthritis ◽  
Surgical Intervention ◽  
Symptomatic Relief ◽  
Empirical Therapy ◽  
Signs And Symptoms ◽  
Irreversible Damage ◽  
Surgical Interventions ◽  
Post Surgery ◽  
Septic Knee Arthritis ◽  
Open Arthrotomy

<p>Septic arthritis is an inflammatory destruction of the native joint following inoculation of pathogen. Most common organisms causing septic arthritis are <em>Staphylococcus</em> and <em>Streptococcus</em>. Large joints are commonly involved with hip and knee joint accounting for approximately 60% of the total cases. Diagnosis is usually straightforward with the patient presenting with obvious local signs and symptoms along with toxic constitutional symptoms owing to the aggressive nature of the disease. Medical management in form of intra-venous antibiotics forms the mainstay of treatment but it is often required for a prompt surgical intervention in order to provide acute relief from symptom and also to decrease the disease load so as to save the joint from irreversible damage. We have a 63-year-old male patient came presented to us with a right knee swelling and tenderness of 3 weeks duration with restricted ROM with severe toxic constitutional symptoms of 1 week duration. Patient was planned for open arthrotomy and debridement and drainage of the pus and was started on an empirical therapy of injection piperacillin and tazobactam combination for 3 weeks. Immediate relief from symptoms following arthrotomy with good range of motion at 4 weeks post-surgery. As is clear from our case, an early diagnosis of septic arthritis and starting of appropriate antibiotics along with appropriately aggressive surgical interventions in the form of open debridement is the key for treatment of septic arthritis in order to save the joint from irreversible inflammatory damage. Surgical intervention not only gives immediate symptomatic relief but also decreases the load over antibiotics and increases local blood supply subsequently helping in better healing.</p><p><strong> </strong></p>

scholarly journals Treatment of Ganglion Cysts

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Matthew Suen ◽  
B. Fung ◽  
C. P. Lung
Keyword(s):  
Surgical Intervention ◽  
Symptomatic Relief ◽  
Recovery Period ◽  
Surgical Excision ◽  
Primary Concern ◽  
Malignant Growth ◽  
Surgical Interventions ◽  
Cosmetic Appearance ◽  
Time Treatment ◽  
Ganglion Cysts

Ganglion cysts are soft tissue swellings occurring most commonly in the hand or wrist. Apart from swelling, most cysts are asymptomatic. Other symptoms include pain, weakness, or paraesthesia. The two main concerns patients have are the cosmetic appearance of the cysts and the fear of future malignant growth. It has been shown that 58% of cysts will resolve spontaneously over time. Treatment can be either conservative or through surgical excision. This review concluded that nonsurgical treatment is largely ineffective in treating ganglion cysts. However, it advised to patients who do not surgical treatment but would like symptomatic relief. Compared to surgery, which has a lower recurrence rate but have a higher complication rate with longer recovery period. It has been shown that surgical interventions do not provide better symptomatic relief compared to conservative treatment. If symptomatic relief is the patient’s primary concern, a conservative approach is preferred, whilst surgical intervention will decrease the likelihood of recurrence.

scholarly journals Characteristics and Treatment Outcomes of Patients with Tuberculosis Receiving Adjunctive Surgery in Uzbekistan

2021 ◽  
Vol 18 (12) ◽  
pp. 6541
Author(s):  
Anvar Riskiyev ◽  
Ana Ciobanu ◽  
Arax Hovhannesyan ◽  
Kristina Akopyan ◽  
Jamshid Gadoev ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Rural Areas ◽  
Surgical Intervention ◽  
Massive Hemoptysis ◽  
Surgical Interventions ◽  
Tb Treatment ◽  
Post Surgery ◽  
Before And After ◽  
Tuberculous Pleurisy ◽  
Scientific Practical

Surgical interventions are performed as an adjunct to pharmacological treatment in Uzbekistan in 10–12% of diagnosed tuberculosis (TB) patients. In this study among patients with respiratory TB who had surgical interventions in Republican Specialized Scientific-Practical Medical Centre of Phthisiology and Pulmonology of Uzbekistan (RSSPMCPP) from January to May 2017, we describe (i) reasons and types of surgical intervention, (ii) post-surgical complications, (iii) histological diagnosis before and after surgery, and (iv) treatment outcomes. There were 101 patients included in the analysis (mean age 36 years; 51% male; 71% lived in rural areas). The main indications for surgical intervention included pulmonary tuberculoma (40%), fibrocavitary, or cavernous pulmonary TB (23%) and massive hemoptysis (20%). Pulmonary resections were the most frequent surgical procedures: segmentectomy (41%), lobectomy or bilobectomy (19%), and combined resection (17%). Ten patients (9%) suffered post-surgery complications. According to histological examination after surgery, TB was confirmed in 81 (80%) patients. For the other 20 patients, the confirmed diagnoses were: lung cancer (n = 6), echinococcosis (n = 5), post-TB fibrosis (n = 5), non-tuberculous pleurisy (n = 2), hamartoma (n = 1), and pneumonia (n = 1). The majority of patients (94%), who underwent surgery, were considered successfully treated. In conclusion, adjunctive surgical therapy can be an option for TB treatment, especially in cases of complicated TB.

In-Hospital Complications following Arthrotomy versus Arthroscopy for Septic Knee Arthritis: A Cohort-Matched Comparison

2019 ◽  
Vol 34 (01) ◽  
pp. 074-079 ◽  
Author(s):  
Yehuda E. Kerbel ◽  
Alexander M. Lieber ◽  
Gregory J. Kirchner ◽  
Natalie N. Stump ◽  
John P. Prodromo ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Surgical Site Infection ◽  
Hospital Cost ◽  
Perioperative Complications ◽  
Site Infection ◽  
Knee Arthritis ◽  
Inpatient Hospital ◽  
Major Complications ◽  
Septic Knee Arthritis ◽  
Open Arthrotomy

AbstractThere is a paucity of literature comparing the relative merits of open arthrotomy versus arthroscopy for the surgical treatment of septic knee arthritis. The primary goal of this study is to compare the risk of perioperative complications between these two surgical techniques. To this end, 560 patients treated for septic arthritis of the native knee with arthroscopy were statistically matched 1:1 with 560 patients treated with open arthrotomy. The outcome measures included major complications, minor complications, mortality, inpatient hospital charges, and length of stay (LOS). Major complications were defined as myocardial infarction, cardiac arrest, stroke, deep vein thrombosis, pulmonary embolism, pneumonia, postoperative shock, unplanned ventilation, deep surgical site infection, wound dehiscence, infected postoperative seroma, hospital acquired urinary tract infection, and retained surgical item. Minor complications included phlebitis and thrombophlebitis, postprocedural emphysema, minor surgical site infection, peripheral nerve complication, and intraoperative hemorrhage. Mortality data were extracted from the database using the Uniform Bill patient disposition. Complications were analyzed using univariate and multivariate logistic regression models, whereas mean costs and LOS were compared using the Kruskal–Wallis H-test. Major complications occurred in 3.8% of the patients in the arthroscopy cohort and 5.4% of the patients in the arthrotomy cohort (p = 0.20). Too few patients in our sample died to report based on National (Nationwide) Impatient Sample (NIS) minimum reporting standards. Rates of minor complications were similar for the arthroscopy and arthrotomy cohorts (12.5 vs. 13.9%; p = 0.48). Multivariate analysis did not reveal any greater risk of minor or major complication between the two procedures. Inpatient hospital cost was similar for arthroscopy (  = $15,917; standard deviation [SD] = 14,424) and arthrotomy (  = $16,020; SD = 18,665; p = 0.42). LOS was also similar for both arthrotomy (6.78 days, SD = 6.75) and arthroscopy (6.24 days, SD = 5.95; p = 0.23). Patients undergoing arthroscopic treatment of septic arthritis of the knee showed no difference in relative risk of perioperative complications, LOS, or hospital cost compared with patients who underwent open arthrotomy.

scholarly journals Surgical Treatment of Pathological Developmental Dysplasia of the Hip: A 12-Year Study

2021 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Avascular Necrosis ◽  
Surgical Intervention ◽  
Operative Procedure ◽  
Developmental Dysplasia ◽  
Surgical Interventions ◽  
Radiographic Outcomes ◽  
Post Surgery ◽  
Age Of Diagnosis ◽  
A Prospective Study ◽  
Dysplasia Of The Hip

Aim: We aimed to assess outcomes of a 12-year longitudinal observational study of developmental dysplasia of the hip (DDH) requiring surgical intervention. Method: We conducted a prospective study from 2004 to 2015 of all cases of DDH undergoing surgical intervention. In addition to clinical examination, Tönnis acetabular index (AI) method and International Hip Dysplasia Institute (IHDI) grading used. Avascular necrosis of the femoral head (AVN) was assessed by the Kalamchi method. Results & Discussion: There were 81 hips in 72 patients (12 male, 60 female). Mean age of the first operative procedure was 16.4 months (95% CI, 13.66 to 19.14). Mean follow up was 47.6 months (95% CI, 41.8 to 53.4). 31 children underwent closed reductions, 48 required open reduction; 17 femoral and 39 pelvic osteotomies were performed during the course of the study. Overall, post-surgery 96.3 % were noted to have an acceptable AI (< 2 SD of the mean). Five hips were considered to have poor results due to residual subluxation/ dislocation (6.2%). Evidence of avascular necrosis was present in 16 of the 81 hips (19.8%).Higher grades of hip pathology were generally associated with a later age of diagnosis and likely to require more extensive surgical interventions. Conclusion: Operative intervention for DDH results in acceptable clinical and radiographic outcomes in the vast majority of children. Keywords: DDH, Developmental Dysplasia of the hip, Surgery.

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

Rhinosinusitis in the Pediatric Patient with Cystic Fibrosis

2014 ◽  
Vol 10 (3) ◽  
pp. 198-201 ◽  
Author(s):  
Christopher Fundakowski ◽  
Rosemary Ojo ◽  
Ramzi Younis
Keyword(s):  
Cystic Fibrosis ◽  
Autosomal Recessive ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Chronic Sinusitis ◽  
Genetic Disorder ◽  
Symptomatic Relief ◽  
Recurrence Rates ◽  
Polyp Recurrence ◽  
Sinonasal Polyposis

Cystic fibrosis (CF) is a common autosomal recessive genetic disorder where a deletion mutation and subsequent downstream alteration in transmembrane regulator proteins results in increased mucus viscosity. CF manifests clinically with chronic multisystem inflammation and recurrent infections. Nearly all children with CF have chronic sinusitis, and a large majority will have concurrent sinonasal polyposis. Chronic sinusitis and sinonasal polyposis in pediatric patients with CF can be managed conservatively initially, though most will fail medical management and require surgical intervention. Unfortunately, symptom resolution is marginal and polyp recurrence rates are high. Currently, no cure exists for CF and the mainstay of treatment is to provide symptomatic relief, and minimize disease morbidity.

Ayurvedic management of Retinitis Pigmentosa (Doshandha) - A Case Study

2017 ◽  
Vol 2 (05) ◽  
Author(s):  
Anju D. ◽  
Pushpa Raj Poudel ◽  
Ajoy Viswam ◽  
Ashwini M. J.
Keyword(s):  
Retinitis Pigmentosa ◽  
Low Vision ◽  
Symptomatic Relief ◽  
Retinal Dystrophy ◽  
Treatment Protocol ◽  
Signs And Symptoms ◽  
Photoreceptor Cells ◽  
Rod Photoreceptor ◽  
Night Time ◽  
Initial Symptoms

Retinitis pigmentosa (RP) is an inherited, degenerative eye disease that causes severe vision impairment due to the progressive degeneration of rod photoreceptor cells in retina. This form of retinal dystrophy manifests initial symptoms independentof age; thus, RP diagnosis occurs anywhere from early infancy to late adulthood. This primary pigmentary retinal dystrophy is a hereditary disorder predominantly affecting the rods more than the cones. The main classical triads of retinitis pigmentosa are arteriolar attenuation, Retinal bone spicule pigmentation and Waxy disc pallor. The main treatment of retinitis pigmentosa is by using Low vision aids (LVA) and Genetic counseling. As such a complete cure for retinitis pigmentosa is not present. So a treatment protocol has to be adopted that helps in at least the symptomatic relief. In Ayurveda, the signs and symptoms of this can be compared with the Lakshanas of Doshandha which is one among the Dristigata Roga. It is considered as a diseased condition in which sunset will obliterate the Dristi Mandala and makes the person blind at night time. During morning hours the rising sunrays will disperse the accumulated Dosas from Dristi to clear vision. This disease resembles Kaphajatimira in its pathogenesis, but the night blindness is the special feature. Since the disease is purely Kaphaja, a treatment attempt is planned in Kaphara and Brimhana line. The present paper discusses a case of retinitis pigmentosa and it’s Ayurvedic Treatment.

Do People Trust in Robot-Assisted Surgery? Evidence from Europe (Preprint)

2020 ◽  
Author(s):  
Joan Torrent-Sellens ◽  
Ana Jiménez-Zarco ◽  
Francesc Saigí-Rubió
Keyword(s):  
Technology Acceptance ◽  
Surgical Intervention ◽  
Negative Relationship ◽  
Predictor Variable ◽  
Major Change ◽  
Ease Of Use ◽  
The European Union ◽  
Robot Assisted ◽  
Surgical Interventions ◽  
Robot Assisted Surgery

BACKGROUND Increasingly intelligent and autonomous robots are destined to have a huge impact on our society. Their adoption, however, represents a major change to the healthcare sector’s traditional practices, which, in turn, poses certain challenges. To what extent is it possible to foresee a near-future scenario in which minor routine surgery is directed by robots? And what are the patients’ or general public’s perceptions of having surgical procedures performed on them by robots, be it totally or partially? A patient’s trust in robots and AI may facilitate the spread and use of such technologies. OBJECTIVE The goal of our study was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. METHODS We used data from a 2017 Flash Eurobarometer (number 460) of European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. The research designs and tests a technology acceptance model (TAM). Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, robots using experience and sociodemographic independent variables. RESULTS The negative relationship between most of the predictors of ease of use, expected benefits and attitude towards robots, and confidence in robot-assisted surgery was contrasted. The only non-sociodemographic predictor variable that has a positive relationship with trust in robots participating in a surgical intervention is previous experience in the use of robots. In this context, we analyze the confidence predictors for three different levels of robot use experience (zero use, average use, and high use). The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude and perception of robots become more negative. Research results also determined that variables of a sociodemographic nature played an important predictive role. It was confirmed that the effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. CONCLUSIONS Despite the considerable benefits for the patient that the use of robots can bring in a surgical intervention, the results obtained show that trust in robots goes beyond rational decision-making. By contrasting the reasons that generate trust and mistrust in robots, especially by highlighting the experience of use as a key element, the research makes a new contribution to the state of the art and draws practical implications of the use of robots for health policy and practice.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

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