scholarly journals Role of Surgery in Management of Osteo-Articular Tuberculosis of the Foot and Ankle

2017 ◽  
Vol 11 (1) ◽  
pp. 633-650 ◽  
Author(s):  
Mandeep Singh Dhillon ◽  
Vikas Agashe ◽  
Sampat Dumbre Patil
Keyword(s):  
Surgical Intervention ◽  
Joint Destruction ◽  
External Fixators ◽  
Foot And Ankle ◽  
Surgical Interventions ◽  
Immunosuppressed Patients ◽  
Surgical Options ◽  
Minimally Invasive Methods ◽  
Active Disease

Background: Tuberculosis of the foot and ankle still remains to be a significant problem, especially in the developing countries, and with an increase in incidence in immunosuppressed patients. Treatment is mainly medical using multidrug chemotherapy; surgical interventions range from biopsy, synovectomy and debridement, to joint preserving procedures like distraction in early cases, and arthrodesis of hindfoot joints and the ankle in advanced disease with joint destruction. Surgical Options: All procedures should be done after initiating appropriate medical management. The ankle is the commonest joint needing intervention, followed by the subtalar and talo-navicular joint. Forefoot TB limited to the bone rarely needs surgical intervention except when the infective focus is threatening to invade a joint. Articular disease can spread rapidly, so early diagnosis and treatment can influence the outcome. Surgical interventions may need to be modified in the presence of sinuses and active disease; fusions need compression, and implants have to be chosen wisely. External fixators are the commonest devices used for compression in active disease, but intramedullary nails better stabilize pantalar arthrodesis. Arthroscopy has become a valuable tool for visualizing the ankle and hindfoot joints, and is an excellent adjunct for arthrodesis by minimally invasive methods. Conclusion: Although Osteoarticular Tb involving the foot and ankle is largely managed with chemotherapy, specific indications for surgical intervention exist. Timely done procedures could limit joint destruction, or prevent spread to adjacent joints. Fusions are the commonest procedure for sequelae of disease or for correcting residual deformity.

En Coup de Sabre Scleroderma and Parry-Romberg Syndrome in Adolescents: Surgical Options and Patient-related Outcomes

2010 ◽  
Vol 37 (10) ◽  
pp. 2174-2179 ◽  
Author(s):  
MARIA LOURDES H. PALMERO ◽  
YOSEF UZIEL ◽  
RONALD M. LAXER ◽  
CHRISTOPHER R. FORREST ◽  
ELENA POPE
Keyword(s):  
Surgical Intervention ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Facial Asymmetry ◽  
Localized Scleroderma ◽  
Psychosocial Effects ◽  
Surgical Interventions ◽  
Pediatric Age Group ◽  
Surgical Options ◽  
Parry Romberg Syndrome

Objective.There is little information regarding surgical options and outcomes in patients with facial localized scleroderma. We evaluated the surgical outcomes of procedures performed for linear scleroderma of the face in the pediatric age group; and assessed psychosocial effects of surgical interventions on the affected children.Methods.A retrospective chart review was performed of children with en coup de sabre scleroderma (ECDS) and Parry-Romberg syndrome (PRS) who underwent surgical intervention; this included demographic data, clinical features, and type of surgical interventions. A questionnaire of 13 questions covering 4 domains (physical, emotional, social, and symptoms) was sent to patients who consented to take part in the survey. Surgical treatments and outcomes were analyzed retrospectively.Results.Seventeen patients underwent surgical intervention (autologous fat injections, Medpor implants, bone paste cranioplasty, and free groin flap) to correct facial asymmetry. Ten patients answered the questionnaire (58.8% response rate). Unhappiness with their appearance, loss of confidence, and bullying were cited as reasons for surgery. The appearance subscale of the survey demonstrated the lowest standardized scores and greatest negative effect on the patients’ quality of life compared to the 3 other subscales. All subjects would consider another surgery and would recommend surgery to other patients with ECDS and PRS.Conclusion.Surgical treatment is a potential useful intervention in children with facial disfigurement. Prospective data are needed.

Management of Laparoscopic Sleeve Gastrectomy Staple-Line Leak

2018 ◽  
Author(s):  
Jorge A. Huaco ◽  
Emanuele Lo Menzo ◽  
Samuel Szomstein ◽  
Raul J. Rosenthal
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Proximal Gastrectomy ◽  
Hemodynamic Instability ◽  
Intraluminal Pressure ◽  
Complication Rates ◽  
Surgical Options

Laparoscopic sleeve gastrectomy (LSG) has rapidly become the preferred procedure in bariatric surgery. Because of the increased intraluminal pressure and the presence of an intact pylorus, leaks after LSG have a tendency to perpetuate and become chronic. The management of leaks depends primarily on the clinical presentation of the patient, but a leak’s location and chronicity also play a significant role in management. In general, patients with hemodynamic instability need to be treated aggressively and expeditiously with surgical intervention, whereas more stable patients can undergo less-invasive interventions, such as percutaneous drainage and an endoscopic approach. However, once the leak becomes chronic, the role of endoscopic and percutaneous approaches is uncertain, and often more radical surgical intervention is required. Among the surgical options for chronic leaks, Roux-en-Y mucosa-to-mucosa anastomosis and proximal gastrectomy with Roux-en-Y reconstruction have delivered durable results, with acceptable complication rates.

scholarly journals Surgical interventions for primary central nervous system lymphoma

2006 ◽  
Vol 21 (5) ◽  
pp. 1-8 ◽  
Author(s):  
James B. Elder ◽  
Thomas C. Chen
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Surgical Intervention ◽  
Central Nervous System Lymphoma ◽  
Intrathecal Chemotherapy ◽  
Surgical Decompression ◽  
Surgical Interventions ◽  
Leptomeningeal Involvement ◽  
Neurological Presentation

✓ Early diagnosis is central to proper management of primary central nervous system lymphomas (PCNSLs). Surgical intervention hinges on initial entertainment of a diagnosis of a PCNSL, based on acute neurological presentation and neuroimaging findings. Unless there is an urgent need for surgical decompression, a biopsy to obtain a diagnosis of PCNSL is the first step in surgical management. Repeated biopsy may be necessary in patients who have received pre-operative steroid therapy. Patients with PCNSL may also present with leptomeningeal involvement, resulting in the need for an Ommaya reservoir for intrathecal chemotherapy. In cases in which hydrocephalus develops, placement of a ventriculoperitoneal shunt may be necessary. Two case studies are presented to highlight the role of surgical intervention in PCNSL.

The Role of Podiatry in the Prevention of Falls in Older People

2013 ◽  
Vol 103 (6) ◽  
pp. 452-456 ◽  
Author(s):  
Bijan Najafi ◽  
Eling D. de Bruin ◽  
Neil D. Reeves ◽  
David G. Armstrong ◽  
Hylton B. Menz
Keyword(s):  
Older Adults ◽  
Surgical Intervention ◽  
Fear Of Falling ◽  
Falls Prevention ◽  
Foot And Ankle ◽  
Special Issue ◽  
Age Related ◽  
Risk Of Falls ◽  
Foot Problems

Given the age-related decline in foot strength and flexibility, and the emerging evidence that foot problems increase the risk of falls, established guidelines for falls prevention recommend that older adults have their feet examined by a podiatrist as a precautionary measure. However, these guidelines do not specify which intervention activities might be performed. Published in this special issue of JAPMA are nine high-quality articles, including seven original studies and two basic science reviews, focusing on the benefit and impact of footwear and foot and ankle interventions in reducing the risk of falling. The selected studies discuss various relevant questions related to podiatric intervention, including adherence to intervention; preference and perception of older adults in selecting footwear; benefit of insoles, footwear, and nonslip socks in preventing falls; fear of falling related to foot problems; benefit of podiatric surgical intervention; and benefit of foot and ankle exercise in preventing falls. (J Am Podiatr Med Assoc 103(6): 452–456, 2013)

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

Immunoregulatory Role of Interleukin-37 in Rheumatoid Arthritis; Relation to Disease Activity and Joint Destruction

2018 ◽  
Vol 86 (September) ◽  
pp. 3341-3348
Author(s):  
DALIA B. EL-BOHOTY, M.Sc.; DOAA S. AL-ASHKAR, M.D. ◽  
MAALY M. MABROUK, M.D.; HALA M. NAGY, M.D.
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Joint Destruction

The Role of Synovial Fibroblasts in Mediating Joint Destruction in Rheumatoid Arthritis

2005 ◽  
Vol 11 (5) ◽  
pp. 563-568 ◽  
Author(s):  
Ingmar Meinecke ◽  
Edita Rutkauskaite ◽  
Steffen Gay ◽  
Thomas Pap
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Destruction ◽  
Synovial Fibroblasts

Hybrid Imaging in Evaluation of Abdominal Sarcoidosis

2018 ◽  
Vol 15 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Isidora Grozdic Milojevic ◽  
Dragana Sobic-Saranovic ◽  
Nebojsa Petrovic ◽  
Slobodanka Beatovic ◽  
Marijana Tadic ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Therapy Response ◽  
Ct Examination ◽  
Abdominal Disease ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Total Remission ◽  
Active Disease

Objective: To determine the prevalence of abdominal involvement, distribution pattern and evaluate role of hybrid molecular imaging in patients with abdominal sarcoidosis. Methods: Between January 2010 and December 2011, 98 patients with chronic sarcoidosis and presence of prolonged symptoms or other findings suggestive of active disease were referred to FDG PET/CT examination. Active disease was found in 82 patients, and they all were screened for the presence of abdominal sarcoidosis on FDG PET/CT. All patients also underwent MDCT and assessment of serum ACE level. Follow up FDG PET/CT examination was done 12.3±5.4 months after the baseline. Results: Abdominal sarcoidosis was present in 31/82 patients with active sarcoidosis. FDG uptake was present in: retroperitoneal lymph nodes (77%), liver (26%), spleen (23%), adrenal gland (3%). Majority of patients had more than two locations of disease. Usually thoracic disease was spread into the extrathoracic localizations, while isolated abdominal sarcoidosis was present in 10% of patients. After first FDG PET/CT examination therapy was changed in all patients. Eleven patients came to the follow up examination where SUVmax significantly decreased in the majority of them. Three patients had total remission, three had absence of abdominal disease but discrete findings in thorax and others had less spread disease. ACE levels did not correlate with SUVmax level. Conclusion: FDG PET/CT can be a useful tool for detection of abdominal sarcoidosis and in the evaluation of therapy response in these patients. Awareness of the presence of intra-abdominal sarcoidosis is important in order to prevent long-standing unrecognized disease.

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.

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