Clinical and Paraclinical Considerations Regarding Acute Cholecystitis

AbstractThe gallbladder represents a vast pathological subject, vastly disputed because of the many diseases and conditions that can develop. One of the diseases of the bladder is acute cholecystitis, a pathological entity that is induced by the acute inflammation of the gallbladder. It is of particular interest to the patients that present gallstones, with a prevalence of 10 to 25% of the total surgical interventions regarding the gallbladder diseases.The objective of this article is to analyze the diagnosis and treatment of acute cholecystitis and highlight the importance of diet in this pathology.The incriminating factor of acute cholecystitis is the biliary stasis, along with bacterial infections that also intervene and the possible ischemia of the bladder wall. In about 90 to 95% cases the biliary stasis is a follow up to the calculous obstruction of the cystic duct, context in which patients are diagnosed with acute lithiasic cholecystitisUnder antibiotic therapy clinical improvement occurs rarely, most often a stationary phase of acute cholecystitis settles in. The unfavorable evolutions refer to patients who develop complications. Bile peritonitis which may be generalized or localized, most often a localized peritonitis occurs, which will develop a plastron in a few days that acts as an armor, is even to touch and presents a dull percussionConclusions. Acute cholecystitis is a common disease in clinical practice, and most often it represents a surgical emergency. The quality of life of a patient that suffers from gallbladder diseases may be affected, as they must follow a certain diet.

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Surgical Interventions Are Effective for Treating Unruptured Sinus of Valsalva Aneurysms

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.707147 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juntao Qiu ◽

Enzehua Xie ◽

Yuetang Wang ◽

Wei Wang ◽

Cuntao Yu ◽

...

Keyword(s):

Quality Of Life ◽

Coronary Sinus ◽

Surgical Repair ◽

Heart Function ◽

Early Death ◽

Sinus Of Valsalva ◽

Surgical Interventions ◽

The Right

Background: This study investigates the optimal management for unruptured sinus of Valsalva aneurysms (USVAs) combined with other cardiovascular lesions.Methods: This retrospective study examined 33 USVA patients who underwent surgical repair from February 1, 2007 to January 31, 2012. We analyzed the surgical procedures and the patients' quality of life after surgery. Additionally, echocardiography follow-up was performed before and after the operation.Results: Most USVAs (87.8%) originated in the right coronary sinus. Aside from one patient who was preoperatively misdiagnosed as having a ruptured sinus of Valsalva aneurysm (SVA). USVAs of the right coronary sinus were addressed by reinforcing this sinus with a Dacron patch through the right ventricle. USVAs were corrected by aortotomy using an autogenous pericardium patch when they originated in the non-coronary or left coronary sinus. Thirty patients (90.9%) were followed up for 22–119 months. No early death, residual fistula or SVA recurrence were found during the follow-up period. They all had a good quality of life and good heart function (New York Heart Association class I–II).Conclusions: Active surgical repair of an USVA can be achieved with satisfactory results in patients combined with other cardiovascular lesions.

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Choice of combined treatment of lung cancer and aortic valve pathologies

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2013-4-51-53 ◽

2015 ◽

Vol 17 (2) ◽

pp. 51

Author(s):

A. M. Karaskov ◽

O. Yu. Anikeeva ◽

O. A. Pashkovskaya ◽

A. B. Open

Keyword(s):

Aortic Valve ◽

Treatment Approach ◽

Combined Treatment ◽

Left Lung ◽

Patient Specific ◽

Surgical Interventions ◽

Specific Complex ◽

Hypofractionated Radiation

We present a clinical case of step-by-step treatment of a patient with a tumor of the left lung upper lobe and a pronounced aortic valvular disease. The combination of concurrent pathologies always requires a thorough selection of the treatment approach. The risks of simultaneous surgical interventions are associated with high intraoperative and early postoperative complications. The selected approach of the stepwise treatment of aortic valve replacement followed by stereotactic hypofractionated radiation therapy has demonstrated the outcomes comparable to those of radical surgery. The compensation of hemodynamic parameters and a full local response during 18-month follow-up has confirmed the appropriateness of a patient-specific complex treatment approach, with a high quality of life maintained.

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Results of Prompt Surgical Intervention in Hemodialysis Radiocephalic Fistula Secondary Dysfunction

International Surgery ◽

10.9738/intsurg-d-15-00152.1 ◽

2019 ◽

Vol 104 (5-6) ◽

pp. 217-225

Author(s):

Iyad Fansa ◽

Mesut Kösem ◽

Celalettin Karatepe ◽

Adem Sezen ◽

Hilal Kuşcu Karatepe ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Intervention ◽

Catheter Placement ◽

Proximal Anastomosis ◽

Common Procedure ◽

Surgical Interventions ◽

Mean Time ◽

Early Surgical Intervention

Radiocephalic fistula (RCF) dysfunction is a common problem due to low maturation and patency rates of these fistulas. The most common procedure in such cases is to place a temporary catheter for the dialysis. Temporary catheter placement and undergoing dialysis with this catheter cause complications, reduce the chance for fistula, and deteriorate the quality of life. The aim of this study was to demonstrate that immediate intervention in RCF dysfunctions can increase fistula success for the patient and can reduce the need for a catheter. Furthermore, the hemodialysis treatment can continue without affecting the quality of life. A total of 295 patients who were admitted for RCF dysfunction and who underwent early surgical intervention without any catheter placement were evaluated for postoperative complications, patency rates, and rates and durations of temporary catheter use over a mean time of 47 months of follow-up (range: 4–79 months). Of the patients, 77.2% (n = 228) underwent new proximal anastomosis (NEO; the radial artery and cephalic vein were reached with an incision created proximal to the previous anastomosis), 14.2% (n = 42) underwent brachiocephalic arteriovenous fistula (AVF), 8.4% (n = 25) underwent side-to-side brachiobasilic AVF + superficialization of the basilic vein. In 88.8% (n = 262) of the patients, successful cannulations were performed within the first 24 to 48 hours without any catheter requirement or complications. Temporary catheter was used for 15.1 ± 10.7 days in 11.2% (n = 33) of the patients. In RCF dysfunctions, early surgical interventions performed in the forearm and elbow provide early cannulation and thus decrease the catheter requirement, also prevent the complications of temporary catheters (infection, decreasing the fistula success, vascular injuries, etc.), increase the autogenous fistula success, and allow for the continuation of dialysis without disturbing the quality of life.

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Impact of Angioplasty and Arterial Reconstructive Surgery on the Quality of Life of Claudicants

Scottish Medical Journal ◽

10.1177/003693309704200207 ◽

1997 ◽

Vol 42 (2) ◽

pp. 47-48 ◽

Cited By ~ 15

Author(s):

J.P. Pell ◽

A.J. Lee

Keyword(s):

Quality Of Life ◽

Percutaneous Transluminal Angioplasty ◽

Transluminal Angioplasty ◽

Case Mix ◽

Arterial Reconstruction ◽

Surgical Interventions ◽

The Impact ◽

Percutaneous Transluminal

Claudicants usually die from concomitant conditions. Therefore, surgical interventions are aimed at improving quality of life, rather than survival. This study compared the impact of percutaneous transluminal angioplasty (PTA), arterial reconstruction and conservative management on quality of life. SF36 questionnaires were completed by 201 newly referred claudicants prior to treatment andsix months later. Multiple regression was used to compare the quality of life scores following the three treatments after adjustment for baseline scores, age, sex, site of disease and disease severity. Follow-up data were available on 81% of the 195 patients alive. Nineteen (10%) of these had undergone PTA and 19 (10%) reconstruction. All aspects of quality of lif e deteriorated following conservative treatment. PTA and arterial reconstruction produced significant improvements in both pain and physical functioning after adjustment for case-mix. Although unlikely to improve survival, PTA and arterial reconstruction are associated with significant improvements in quality of life.

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Dealing with Ebstein's anomaly

Cardiology in the Young ◽

10.1017/s1047951113001169 ◽

2013 ◽

Vol 24 (2) ◽

pp. 191-200 ◽

Cited By ~ 11

Author(s):

Lianne M. Geerdink ◽

Livia Kapusta

Keyword(s):

Diagnostic Methods ◽

Ebstein’S Anomaly ◽

Common Disease ◽

Surgical Interventions ◽

Ebstein's Anomaly ◽

Current Classification ◽

History Of ◽

Surgical Options ◽

Symptoms And Signs

AbstractEbstein's anomaly is a complex congenital disorder of the tricuspid valve. Presentation in neonatal life and (early) childhood is common. Disease severity and clinical features vary widely and require a patient-tailored treatment. In this review, we describe the natural history of children and adolescents with Ebstein's anomaly, including symptoms and signs presenting at diagnosis. Current classification strategies of Ebstein's anomaly are discussed. We report on diagnostic methods for establishing the severity of disease that might enhance decision on the timing of surgical intervention. Furthermore, we describe different surgical options for severely ill neonates and multiple surgical interventions after infancy. Only with ample knowledge and understanding of the above, this complex and diverse group of patients can be correctly treated in order to improve not only duration, but also quality of life.

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Use of fluconazole in women of reproductive age with vulvovaginal candidiasis

Medical Council ◽

10.21518/2079-701x-2018-13-96-102 ◽

2018 ◽

pp. 96-102

Author(s):

E. A. Mezhevitinova ◽

P. R. Abakarova ◽

Sh. M. Pogosyan

Keyword(s):

Quality Of Life ◽

Vulvovaginal Candidiasis ◽

Reproductive Age ◽

Common Disease ◽

Women Of Reproductive Age ◽

Recurrent Vulvovaginal Candidiasis ◽

Group I ◽

Relapse Therapy

Topicality: vulvovaginal candidiasis (VVC) is a common disease caused by the infectious damage of the vulva and vagina by yeast-like fungi from Candida genus. According to the literature, a VVC episode occurs in 75% of women, and 5-8% of them get a recurring course of the disease. Frequent recurrences of the disease may result in the psychosexual disorder and reduce the women’s quality of life and recurrent vulvovaginal candidiasis (VVC) therapy is still a very difficult task.Purpose of the study: evaluate the efficacy of fluconazole (150 mg) in acute and recurrent vulvovaginal candidiasis.Materials and methods:A total of 89 women of reproductive age with acute and recurrent HCV were enrolled in the study, which were subdivided into 2 groups: the first group included women with acute vulvovaginal candidiasis (AVVC) (n = 51), and the second group - women with recurrent vulvovaginal candidiasis (RVVC) (n = 38). The Group I (AVVC) received fluconazole 150 mg once. Depending on the prescribed therapy, the second group (RVVC) was subdivided into two subgroups: patients in the IIa subgroup received fluconazole 150 mg intravenously, three times, at intervals of 2 days, and women in the IIb subgroup received fluconazole 150 mg for a period of 6 months in addition to the three-fold intake of fluconazole weekly. The follow-up period was 6 months after the end of therapy, during which the frequency of VVC recurrence and the effectiveness of the therapy was evaluated.Results of the study: our data showed that all patients with acute VVC had a discontinuation of symptoms of the disease and a normalization of laboratory parameters after treatment with fluconazole, and after the anti-relapse therapy course the incidence of VVC recurrences was significantly lower compared to the period before anti-relapse therapy (p = 0.038). It was shown that all the investigated strains of C. albicans (100%) were sensitive to fluconazole, and resistance was detected only in 1 strain of C. glabrata and 1 strain of C. krusei.

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Cost of persistent asthma in Italy

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2016.350 ◽

2016 ◽

Vol 11 ◽

Author(s):

Roberto W. Dal Negro ◽

Chiara Distante ◽

Luca Bonadiman ◽

Paola Turco ◽

Sergio Iannazzo

Keyword(s):

Quality Of Life ◽

Social Impact ◽

Persistent Asthma ◽

Forced Expiratory Volume ◽

Total Annual Cost ◽

Common Disease ◽

Healthcare Resources ◽

The Impact

Background: Asthma is a common disease of the airways with a significant burden for the society and for patients’ quality of life. The Social Impact of Respiratory Integrated Outcomes (SIRIO) study estimated a mean cost of 1,177.40 € per patient/year in Italy, in 2007. The aim of the present study was to update the cost of persistent asthma patients in Italy. Methods: An observational, retrospective, bottom-up analysis was carried out starting from the data base operating in the Lung Unit of the Specialist Medical Centre (CEMS), Verona (Italy), over the period June 2013-December 2015. Patients’ data were recorded over the 12 ± 2 months before the enrollment and during 12 ± 2 months of follow-up. The prospective was the Italian National Health Service and the broad Italian society. Clinical data were measured in terms of forced expiratory volume in 1 s (FEV1%) and number of relapses. Healthcare resources (namely; number of hospitalizations and/or ER admissions; number of visits; drug use and duration, and indirect costs) were recorded. Results: The cohort consisted of 817 patients with persistent asthma of different severity. They had a 42.96% male prevalence; a mean (±SE) age of 49.06 (±0.64) years; a mean 87.47% (±0.81) FEV1% pred. in baseline, and 69.16% of subjects had comorbidities. The mean (±SE) number of relapses was 0.91 (±0.09) per patient/year before the enrolment. After 12 months, FEV1% significantly improved by +6.31% (±0.45) from the corresponding baseline value (p < 0.001). The number of relapses decreased of −0.46 (±0.09) (p < 0.001). The estimated total annual cost per asthmatic patient was 1,183.14 € (±65.79 €) during the 12 months before the enrolment, and 1,290.89 € (±68.74 €) throughout the follow-up. The increase was mostly due to the significantly increased duration of therapeutic strategies. The costs of hospitalization, general practitioner and rescue medications were significantly decreased. Conclusions: The periodic update of cost analysis is a key to monitor the trend of main asthma outcomes and related expenditure over time. It allows to plan the most convenient actions in terms of prevention strategies and effective interventions, with the aim of optimizing the healthcare resources consumption and maximizing the impact on clinical outcomes and patients’ quality of life. The role of an appropriate pharmacological strategy still proves crucial in minimizing asthma morbidity and the corresponding socio-economic impact.

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Minicraniotomy versus bur holes for evacuation of chronic subdural collections in infants—a preliminary single-institution experience

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.8.peds1131 ◽

2011 ◽

Vol 8 (5) ◽

pp. 423-429 ◽

Cited By ~ 8

Author(s):

Paul Klimo ◽

Anne Matthews ◽

Sean M. Lew ◽

Marike Zwienenberg-Lee ◽

Bruce A. Kaufman

Keyword(s):

Treatment Failure ◽

Imaging Study ◽

Late Complications ◽

Single Institution ◽

Radiographic Findings ◽

Surgical Interventions ◽

Subdural Drain ◽

The Many

Object Various surgical interventions have been described to evacuate chronic subdural collections (CSCs) of infancy. These include transfontanel percutaneous aspiration, subdural drains, placement of bur hole(s) with or without a subdural drain, and shunting. Shunt placement typically provides good long-term success (resolution of the subdural fluid), but comes with well-known early and late complications. Recently, the authors have used a mini–osteoplastic craniotomy technique with the goal of definitively treating these children with a single surgery while avoiding the many issues associated with a shunt. They describe their procedure and compare it with the traditional bur hole technique. Methods In this single-institution retrospective study, the authors evaluated 26 cases involving patients who underwent treatment for CSC. Preoperative, intraoperative, and postoperative data were reviewed, including radiographic findings (density of the subdural fluid and ventricular and subarachnoid space size), neurological examination findings, and intraoperative fluid description. The primary outcome was treatment failure, defined as the patient requiring any subsequent surgical intervention after the index procedure (minicraniotomy or bur hole placement). Results Fifteen patients (10 male and 5 female; median age 5.1 months) collectively underwent 27 minicraniotomy procedures (each procedure representing a hemisphere that was treated). In the bur hole group, there were 11 patients (6 male and 5 female; median age 4.6 months) with 18 hemispheres treated. Both groups had subdural drains placed. The average follow-up for each treatment group was just over 7 months. Treatment failure occurred in 2 patients (13%) in the minicraniotomy group compared with 5 patients (45%) in the bur hole group (p = 0.09). Furthermore, the 2 patients who had treatment failure in the minicraniotomy group required 1 subsequent surgery each, whereas the 5 in the bur hole group needed a total of 9 subsequent surgeries. Eventually, 80% of the patients in the minicraniotomy group and 70% of those in the bur hole group had resolution of the subdural collections on the last imaging study. Conclusions The minicraniotomy technique may be a superior technique for the treatment of CSCs in infants compared with bur hole evacuation. The minicraniotomy provides greater visualization of the subdural space and allows more aggressive evacuation of the fluid, better irrigation of the space, the ability to fenestrate any accessible membranes safely, and continued egress of fluid into the subgaleal space. Although this preliminary report has obvious limitations, evaluation of this technique may be worthy of a prospective, multiinstitutional collaborative effort.

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THREE-COLUMN OSTEOTOMY OF THE SPINE DURING REVISION SURGERY IN A PATIENT WITH CONGENITAL ANGULAR THORACOLUMBAR KYPHOSCOLIOSIS

Hirurgiâ pozvonočnika ◽

10.14531/ss2018.3.30-38 ◽

2018 ◽

Vol 15 (3) ◽

pp. 30-38

Author(s):

A. A. Panteleyev ◽

M. L. Sazhnev ◽

D. S. Gorbatyuk ◽

A. I. Kazmin ◽

V. S. Pereverzev ◽

...

Keyword(s):

Infectious Complications ◽

Female Adolescent ◽

Review Of The Literature ◽

Surgical Interventions ◽

Patient Reports ◽

Pelvic Organs ◽

Significant Correction ◽

Last Stage

A clinical case of surgical treatment of a female adolescent patient with multiple malformations, congenital thoracolumbar kyphoscoliosis, severe lower paraparesis and impaired functions of pelvic organs is presented with a review of the literature on the problem under consideration. During the course of treatment over several years, the patient underwent repeated revision surgical interventions because of implant instability and infectious complications. The last stage of treatment included a three-column osteotomy of the spine at the deformity apex with posterior instrumented fixation. A significant correction of the deformity was achieved. Based on the results of 18-month follow-up, the correction is maintained, the implant is stable. The patient reports a significant improvement in the quality of life.

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SPIES optical biopsies in laryngeal papillomatosis. The 4 waves sign

ROMANIAN BIOTECHNOLOGICAL LETTERS ◽

10.25083/rbl/26.1/2318.2322 ◽

2021 ◽

Vol 26 (1) ◽

pp. 2318-2322

Author(s):

VIOREL ZAINEA ◽

IRINA GABRIELA IONITA ◽

SILVIU PITURU ◽

CATALINA PIETROSANU ◽

ANDREEA RUSESCU ◽

...

Keyword(s):

Accurate Diagnosis ◽

Viral Etiology ◽

Laryngeal Papillomatosis ◽

Surgical Interventions ◽

Endoscopic Method ◽

Systemic Side Effects ◽

Epithelial Lesions ◽

Made In

Laryngeal papillomatosis represents a challenging disease for the ENT surgeon. It has a recurrent pattern, with lesions that tend to be more and more extensive and affect the quality of life of the patient. Due to it’s viral etiology, multiple medical therapies have been attempted for these patients. Their results are still somewhat controversial, taking into account the local and systemic side effects. Diabetes mellitus (DM) patients are considered to be relatively immunocompromised and the laryngeal papillomatosis is more severe. The lesions occur at an epithelial level. The earlier the diagnosis, the better the outcome of the patient. The advancements made in the field of medical technologies made possible ample surgical interventions that maintain the natural airway. Out of these, the most used today is the CO2 LASER, with good results when correctly managed. The purpose of this paper is to present the use of an endoscopic method of examination, that uses SPIES filters, for a more accurate diagnosis of the epithelial lesions, which allows a better evaluation and more thorough follow-up of our patients. We believe attention should be paid to this topic due to the surgical, epidemiological and biological reasons.

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