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.

scholarly journals The impact of surgical intervention on renal function in cystinuria

2018 ◽  
Vol 40 (3) ◽  
pp. 256-260 ◽  
Author(s):  
Serra Sürmeli Döven ◽  
Ali Delibaş ◽  
Hakan Taşkınlar ◽  
Ali Naycı
Keyword(s):  
Renal Function ◽  
Radionuclide Imaging ◽  
Surgical Intervention ◽  
Renal Scarring ◽  
Urinary Stones ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

ABSTRACT Introduction: Cystinuria is an autosomal recessive disorder due to intestinal and renal transport defects in cystine and dibasic amino acids, which result in recurrent urolithiasis and surgical interventions. This study aimed to assess the impact of surgical interventions on renal function by analyzing estimated glomerular filtration rates. Methods: Thirteen pediatric patients with cystinuria, who were followed-up in a single tertiary institution between 2004 and 2016, were included in the study. Medical records were reviewed to collect data on clinical presentation of patients, urine parameters, stone formation, medical treatment, surgical intervention, stone recurrence after surgical procedure, stone analysis, ultrasonography, 99m-technetium dimercaptosuccinic acid (99mTc-DMSA) radionuclide imaging results, and follow-up time. Creatinine clearances estimated by modified Schwartz (eGFR) formula before and after surgery were used to assess renal function and compared statistically. Results: Nine patients (69.2%) had renal scarring which were detected with 99mTc-DMSA radionuclide imaging. In ten patients (76.9%), open surgical intervention for stones were needed during follow-up. Significant difference was not detected between eGFR before and after surgical intervention (mean 92 versus 106, p = 0.36). Nine of the patients (69.2%) were stone free in the last ultrasonographic examination. Relapses of stone after surgery were seen in 66.6% of patients who underwent surgical intervention. Conclusions: Surgical interventions for urinary stones are commonly required in patients with cystinuria. Renal scarring is a prevalent finding in cystinuric patients. Surgical interventions have no negative impact on eGFR in patients with cystinuria according to the present study.

scholarly journals Ongoing transmission of HCV: Should cesarean section be justified? Data mining discovery

2017 ◽  
Vol 5 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Abd Elrazek ◽  
Samy Saab ◽  
Mahmoud Foad ◽  
Elsayed A. Elgohary ◽  
Mohammad M. Sallam ◽  
...  
Keyword(s):  
Data Mining ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Rural Areas ◽  
Surgical Intervention ◽  
Genotype 4 ◽  
Surgical Interventions ◽  
Positive Mother ◽  
Hcv Transmission

Abstract Background and Objectives Over the past few decades, cesarean section (CS) rates are steadily increasing in most of the middle- and high-income countries. However, most of the pregnant women (particularly undergoing CS) are not screened for hepatitis C virus (HCV); hence, neonates born to HCV-positive mother could be a source of future HCV infection. In this study, the role of the CS and other surgical interventions in HCV transmission in Egypt, the highest endemic country of HCV-4, was investigated. Methods From January to June 2016, a prospective cohort study was conducted among 3,836 pregnant women in both urban and rural areas across Egypt for HCV screening in both mothers and neonates born to HCV-positive mother. All pregnant women were screened during third trimester or just before delivery, neonates born to HCV-positive mothers were evaluated within 24-h postdelivery to record vertical transmission cases. Data mining (DM)-driven computational analysis was used to quantify the findings. Results Among 3,836 randomized pregnant women, HCV genotype 4 was identified in 80 women (2.08%). Out of 80 HCV-infected women, 18 have experienced surgical intervention (22.5%) and 62 CS (77.5%). HCV vertical transmission was identified in 10 neonates, 10/80 (12.5%). Conclusion Screening women who had experienced surgical intervention or CS during child bearing period and before pregnancy might prevent HCV mother-to-child transmission (MTCT). CS should be ethically justified to decrease global HCV transmission.

550 Laryngomalacia and obstructive sleep apnea in infants with PWS

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A218-A218
Author(s):  
Weston Powell ◽  
Joanna Wrede ◽  
Parisa Salehi
Keyword(s):  
Growth Hormone ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Surgical Intervention ◽  
Comorbid Condition ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Surgical Interventions ◽  
Obstructive Sleep ◽  
Before And After

Abstract Introduction Growth hormone (GH) improves tone, body composition, development, and growth in infants with Prader-Willi Syndrome (PWS). Concerns about sudden death following GH initiation and worsening obstructive sleep apnea (OSA) in children with PWS resulted in guidelines for polysomnography (PSG) evaluation before and after starting GH. We review novel evidence of laryngomalacia as a mechanism for this worsening of OSA and describe the incidence of laryngomalacia in this patient population. Methods A retrospective review of infants and children seen at the Seattle Children’s PWS clinic between October 2014 and May 2020 who had undergone polysomnography (PSG) before and after growth hormone initiation was performed. Findings on otolaryngology evaluation via flexible fiberoptic laryngoscopy (FFL) or drug-induced sleep endoscopy were reviewed to characterize obstruction, diagnosis of laryngomalacia, and response to surgical intervention. Results A total of 28 cases were identified. 12 (41%) were evaluated with FFL between ages 4 and 21 months old (median 5) for noisy breathing, worsening or persistent OSA, or dysphagia. Out of these, 9 (75% of FFL, 31% of total) were diagnosed with laryngomalacia. Children with laryngomalacia were more likely to have worsening of OSA after GH initiation. Surgical interventions including supraglottoplasty or adenotonsillectomy led to improvement in OSA in 86% of children who had worsening after GH initiation. Conclusion Worsening OSA after GH initiation is seen in 38% of patients with PWS. Laryngomalacia is a common comorbid condition and more frequent in those with worsening OSA after GH initiation that is amenable to targeted surgical intervention. Support (if any):

scholarly journals Primary healthcare centers engagement in tuberculosis treatment in Ukraine

2019 ◽  
Vol 13 (07.1) ◽  
pp. 83S-88S
Author(s):  
Evgenia Geliukh ◽  
Dilyara Nabirova ◽  
Karapet Davtyan ◽  
Svetlana Yesypenko ◽  
Rony Zachariah
Keyword(s):  
Treatment Outcomes ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Facilities ◽  
Adjusted Risk ◽  
Tb Treatment ◽  
Adjusted Risk Ratio ◽  
Binomial Regression ◽  
Primary Healthcare Centers

Introduction: We assessed the influence of a result-based financing (RBF) model, which included incentives for Primary Healthcare facilities on TB treatment outcomes. Methodology: We compared TB patients > 17 years and their treatment outcomes among those who did and did not benefit from RBF-model in 14 districts of Odeska oblast, Ukraine in 2017. Log-binomial regression was used to examine factors associated with being included in RBF-model. Results: Of 2,269 reported TB patients, 308 (14%) were included in RBF-model. Most patients in the RBF-model were from rural areas 229 (74%), unemployed 218 (71%), and HIV-infected 131 (43%). Individuals from urban areas (Adjusted risk ratio, ARR =0.9, 95% Confidence Interval, CI:0.89-0.94), having drug-resistant TB (ARR = 0.3, 95% CI: 0.18-0.45), and relapse TB (ARR = 0.6, 95% CI:0.40-0.83) were less likely to be included in RBF-model. Favorable outcomes in new/relapse cases with RBF-model was 89% compared with 41% (p < 0.001) without RBF. Similarly, for other retreatment this was 83% versus 40% (p < 0.001). Failures in the no-RBF group was 29% for new and relapse cases while for other retreatment cases, it was 26% (significantly higher than in the RBF-model). Conclusion: RBF-model is effective in achieving high levels of favorable TB treatment outcomes. Almost three-in-ten TB patients in non-RBF category failed TB treatment despite having drug-susceptible TB. Efforts are now needed to include it within ongoing public health reforms and assess the feasibility of scaling-up this intervention through implementation research and dedicated funding.

Repair of Bronchial Anastomosis Following Lung Transplantation

2021 ◽  
Author(s):  
Themistokles Chamogeorgakis ◽  
Kenneth Moquin ◽  
Michael Simoff ◽  
Hassan Nemeh
Keyword(s):  
Lung Transplantation ◽  
Surgical Intervention ◽  
Primary Repair ◽  
Massive Hemoptysis ◽  
Air Leak ◽  
Surgical Interventions ◽  
Bronchial Anastomosis ◽  
Anastomotic Complications ◽  
Aortic Homograft ◽  
Bilateral Lung

Abstract Background Bronchial anastomotic complications are reported in 2 to 18% of patients after lung transplantation. The majority of complications can be managed with bronchoscopic intervention. When extensive dehiscence is present, surgical intervention can be entertained. Materials and Methods Between March 1, 2006, and December 31, 2019, our program performed 244 lung transplantations. We conducted a retrospective review of our patient cohort and identified patients who suffered from significant anastomotic complications that required surgical interventions. Results Twenty-eight and 216 patients underwent single and bilateral lung transplantations, respectively. Eighteen patients developed airway complications (7.4%). The incidence of anastomotic complications was 5.2% (24 complications for a total of 460 bronchial anastomoses). Four patients were managed conservatively. The majority of the bronchial anastomotic complications were managed endoscopically (eight patients). Four patients with associated massive air leak underwent repair of the bronchial anastomosis and two patients were retransplanted because they developed severe distal airway stenosis. Conclusion Bronchial anastomotic complications are a major cause of morbidity in lung transplantation. The majority of cases can be managed bronchoscopically. In more severe cases associated with massive air leak or imminent massive hemoptysis from bronchopulmonary arterial fistula, surgical intervention is necessary. Aortic homograft interposition along with vascularized pedicle wrapping may be a viable option to re-establish airway continuity when tension-free bronchial anastomotic revision is not possible. In cases with smaller bronchial defects, primary repair with utilization of a vascularized flap can be effective as treatment option.

scholarly journals The Informed Patient

2016 ◽  
Vol 11 (1) ◽  
pp. 147-153 ◽  
Author(s):  
Haidar Abdul-Muhsin ◽  
Mark Tyson ◽  
Santanam Raghu ◽  
Mitchell Humphreys
Keyword(s):  
Information Seeking ◽  
Surgical Intervention ◽  
Third Party ◽  
Accurate Information ◽  
Sources Of Information ◽  
Surgical Interventions ◽  
Before And After ◽  
Information Seeking Behaviors ◽  
The Relationship ◽  
Informed Patient

The Internet has placed considerable information at the disposal of patients, but the sources for credible and accurate information may be difficult for a layperson to discern. Benign prostatic hyperplasia (BPH) in elderly men can be treated with different surgical interventions. The purpose of this research was to determine information seeking behaviors (ISB) of BPH patients before and after each type of surgery. All patients who underwent surgical intervention for BPH at a tertiary training center between January 2007 and January 2013 were included in this study. A comprehensive questionnaire regarding their ISB was sent through a third-party survey center. The following areas were examined: (1) the patient’s opinion regarding information sources of BPH and its treatment, (2) the extent of ISB for each patient and its relation to the type of surgical intervention he eventually underwent, and (3) the relationship between the extent of ISB and the patient’s final satisfaction. The results indicated that the majority of patients felt that it is relatively easy to find information about BPH and its treatment. Most of the patient started with either general online search engines or used the hospital website. Patients who explored more sources of information ended up choosing a more specific and sophisticated procedure. Generally, patients used fewer sources postoperatively regardless of the procedure they underwent. There was no correlation between the extent of ISB and overall satisfaction ( r = −0.0719, p = .1610) and regret ( r = −0.0436, p = .3945).

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.

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>

DUAL-ENERGY CT WITH XENON IN PATIENTS WITH LUNG PATHOLOGY. FIRST DATA

2018 ◽  
pp. 47-51
Author(s):  
O. E. Karpov ◽  
O. Yu. Bronov ◽  
V. M. Kitaev ◽  
P. S. Vetshev ◽  
D. A. Pikhuta ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Lung Ventilation ◽  
Dual Energy ◽  
Diagnostic Methods ◽  
Dual Energy Ct ◽  
Lung Pathology ◽  
Preoperative Preparation ◽  
Before And After ◽  
Pulmonary Pathology ◽  
Postoperative Lung Function

Routine diagnostic methods have limitations in terms of predicting the ventilation function of the lungs before and after surgery. It was decided to investigate the possibilities of dual-energy CT (DECT) using xenon in assessment of lung ventilation function.Objective: to master the methods of examination of patients with pulmonary pathology, evaluate the possibility of justifying the volume of operative intervention and prediction of postoperative lung function based on the hybrid images.Materials and methods. For the study, 12 patients with different pulmonary pathologies were selected (COPD – 5, lung cancer – 4, bronchiectasis – 3). Results. It was found that the use of DECT with xenon reflects the functional state of lung tissue.Conclusions. DECT with xenon have potential for planning surgical intervention and introducing the method into modern protocols of preoperative preparation.

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

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