WorldWideScience

Sample records for cardiovascular surgical procedures

  1. Surgical Procedures for Vestibular Dysfunction

    Science.gov (United States)

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  2. IC Treatment: Surgical Procedures

    Science.gov (United States)

    ... surgeon fashions a tube or conduit from a short section of bowel and places the ureters (which carry urine from ... this procedure, some patients will continue to experience symptoms of ... augmented bowel segment of these newly fashioned bladders. Some patients ...

  3. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira

    2015-01-01

    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  4. Aesthetic Surgical Crown Lengthening Procedure.

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  5. Surgical Robotics Research in Cardiovascular Disease

    International Nuclear Information System (INIS)

    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy (31P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery devices

  6. Surgical Robotics Research in Cardiovascular Disease

    Energy Technology Data Exchange (ETDEWEB)

    Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

    2008-02-29

    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery

  7. Tattoo preservation during surgical procedures

    Directory of Open Access Journals (Sweden)

    Tenna S

    2014-02-01

    Full Text Available Stefania Tenna, Pietro Francesco Delle Femmine, Alfonso Luca Pendolino, Beniamino Brunetti, Paolo Persichetti Plastic Surgery Unit, University Campus Bio-Medico of Rome, University of Rome, Rome, Italy Abstract: In recent years, the number of people getting tattoos has continued to increase. Tattoos are much more than cultural fads and cosmetic complements, and nowadays often represent events that express the patient's personality without words. The presence of a tattoo in the surgical field may be a problem for both the patient and the surgeon. However, the relevant literature is mostly based on complications related to application of tattoos or methods used to remove them. To date, few reports have focused on the importance of preserving a tattoo during a surgical procedure, and no organized studies could be found. The aim of this paper is to provide an overview of the range of solutions that surgeons can use to preserve tattoos during surgery. A PubMed database search was done to assess other surgeons' experience. The terms "tattoo" in combination with "incision", "surgery", "surgical", or "operative" were used as key words. Following a review of the literature, photographs of patients presenting with a tattoo in the last 5 years at University Campus Bio-Medico of Rome were identified in order to determine the frequency of patients presenting with tattoos in our department. The patients were classified according to sex, age, type of surgery, number of tattoos, and tattoo location. Specific requests to preserve tattoos were recorded. Finally, an algorithm of treatment according to tattoo dimension and location is proposed. Knowledge of all the strategies available for saving tattoos is important for plastic and cosmetic surgeons. If a tattooed area needs to be operated on, surgeons should attempt, when possible, to avoid altering the tattoo in order to maximize the final cosmetic result. Keywords: tattoo incision, body contouring, surgery

  8. SURGICAL PROCEDURES IN SUSHRUTA SAMHITA

    Directory of Open Access Journals (Sweden)

    Singh R.K

    2011-05-01

    Full Text Available The Sushruta Samhita is an Ayurvedic text, by the legendary Sushruta, foundational to Ayurvedic medicine (Indian traditional medicine, with innovative chapters mainly on surgery. There is a general impression that Sushruta Samhita is only an ancient Indian Ayurvedic text book of surgery. Sushruta Samhita contains 184 chapters and description of 1120 illnesses, 700 medicinal plants, a detailed study on anatomy, 64 preparations from mineral sources and 57 preparations based on animal sources. It still retains the land mark position in the field of surgical texts. In addition to his worldwide known work of historical significance on plastic surgery, he also made similar unique contributions on numerous aspects of medicine, such as fracture and dislocations, urinary stones, skin diseases including leprosy, Pancha Karma (Purification procedures, toxicology, pediatrics, eye diseases, psychiatry, obstetrics and gynaecology, etc. A very limited conceptual work has been performed on the selected chapters of Sushruta Samhita. Therefore a review conceptual study has been carried out on the various surgical concepts of Sushruta Samhita. Outcome of this study shows, Sushruta Samhita is written in the aphorism form and the techniques described in it are eminently in line with technical abilities of the times. It is need of the hour to explore the hidden truth by decoding the versions of the texts.

  9. Tattoo preservation during surgical procedures

    OpenAIRE

    Tenna, Stefania; DelleFemmine,Pietro Francesco; Pendolino, Alfonso Luca; Brunetti, Beniamino; Persichetti,Paolo

    2014-01-01

    Stefania Tenna, Pietro Francesco Delle Femmine, Alfonso Luca Pendolino, Beniamino Brunetti, Paolo Persichetti Plastic Surgery Unit, University Campus Bio-Medico of Rome, University of Rome, Rome, Italy Abstract: In recent years, the number of people getting tattoos has continued to increase. Tattoos are much more than cultural fads and cosmetic complements, and nowadays often represent events that express the patient's personality without words. The presence of a tattoo in the surgic...

  10. Tattoo preservation during surgical procedures

    OpenAIRE

    Tenna S; Delle Femmine PF; Pendolino AL; Brunetti B; Persichetti P

    2014-01-01

    Stefania Tenna, Pietro Francesco Delle Femmine, Alfonso Luca Pendolino, Beniamino Brunetti, Paolo Persichetti Plastic Surgery Unit, University Campus Bio-Medico of Rome, University of Rome, Rome, Italy Abstract: In recent years, the number of people getting tattoos has continued to increase. Tattoos are much more than cultural fads and cosmetic complements, and nowadays often represent events that express the patient's personality without words. The presence of a tattoo in the surgical f...

  11. Diffusion of Innovation and the Survival of Cardiovascular Surgeons: the Impact of Atrial Fibrillation Procedures

    Directory of Open Access Journals (Sweden)

    Hebert K.

    2014-12-01

    Full Text Available As cardiovascular disease prevalence continues to decrease in the United States as does cardiovascular surgical procedures, the aging of the population brings an increase in the prevalence of heart failure and atrial fibrillation. A new hybrid procedure for the treatment of atrial fibrillation shows great promise. More randomized clinical trials are needed.

  12. Diffusion of Innovation and the Survival of Cardiovascular Surgeons: the Impact of Atrial Fibrillation Procedures

    OpenAIRE

    Hebert K.; McKinnie J.

    2014-01-01

    As cardiovascular disease prevalence continues to decrease in the United States as does cardiovascular surgical procedures, the aging of the population brings an increase in the prevalence of heart failure and atrial fibrillation. A new hybrid procedure for the treatment of atrial fibrillation shows great promise. More randomized clinical trials are needed.

  13. Surgical Procedures of Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Zinat Salem

    2013-02-01

    Full Text Available Background: Surgical intervention has been recently advocated in the treatment of morbid obesity. The objective of this study was to review surgery as an alternative in the treatment of morbidly obese adolescents. Materials and Methods: This research was conducted by searching English websites such as PubMed, Up to Date, and Google Scholar, as well as some Persian websites including SID, Iranmedex, and Magiran. Articles published from 2000 to 2010 on interventional and clinical trials were reviewed for treatment of morbid obesity in adolescents. Keywords used in internet searches include obesity; adolescence; and surgery.Results: The results obtained from the studies indicated that 4% of American adolescents suffer from morbid obesity. So far, pharmacological treatment and other approaches toward this type of obesity have been inefficient. Hence, surgery was employed as one of the new approaches to the treatment of this disorder. According to the National Health Institute criteria, in the treatment of adolescent candidates for surgery, anthropometric measurements are performed together with the measurement of other co-morbidities of obesity. Adolescents whose percentiles are ≥99 are considered as morbidly obese patients. Conclusion: The results of the studies suggested that for the extremely obese adolescents, who do not respond to other types of medical interventions within 6 months, surgery can be performed. Adolescents with BMI of ≥40 kg/m2 and skeletal maturity, or those with co morbidities of obesity, or 13-year-old girls and boys ≥15 years of age can be candidates for surgery. However, the side effects of obesity should not be neglected. Therefore, before the adolescent obesity become morbid obesity, preventive measures should be taken through changes in lifestyle.

  14. Characterization of aerosols produced by surgical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)

    1994-07-01

    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  15. Immersive Learning Experiences for Surgical Procedures.

    Science.gov (United States)

    Cha, Young-Woon; Dou, Mingsong; Chabra, Rohan; Menozzi, Federico; State, Andrei; Wallen, Eric; Fuchs, Henry

    2016-01-01

    This paper introduces a computer-based system that is designed to record a surgical procedure with multiple depth cameras and reconstruct in three dimensions the dynamic geometry of the actions and events that occur during the procedure. The resulting 3D-plus-time data takes the form of dynamic, textured geometry and can be immersively examined at a later time; equipped with a Virtual Reality headset such as Oculus Rift DK2, a user can walk around the reconstruction of the procedure room while controlling playback of the recorded surgical procedure with simple VCR-like controls (play, pause, rewind, fast forward). The reconstruction can be annotated in space and time to provide more information of the scene to users. We expect such a system to be useful in applications such as training of medical students and nurses. PMID:27046554

  16. Surgical Procedures in Predoctoral Periodontics Programs.

    Science.gov (United States)

    Radentz, William H.; Caffesse, Raul G.

    1991-01-01

    A survey of 58 dental school periodontics departments revealed the frequency of predoctoral dental students performing surgery, the frequency of specific procedures, the degree of participation or performance of students, incidence of preclinical surgical laboratories in the curricula, and materials and anesthesia used. A wide range in…

  17. [Surgical procedures for bone neoplasms in children].

    Science.gov (United States)

    Woźniak, W

    1991-01-01

    The treatment of 40 patients with bone tumors have been presented. The primary tumors were located in the following sites: femur (14), tibia (8), fibula (4), humerus (4), scapula (1), clavicle (2), pelvis (5), hand (1). Investigated group were: osteosarcoma (18), Ewing's sarcoma (14), chondrosarcoma (2), fibrosarcoma (1), synovial sarcoma (1), chondroblastoma (4). In the most frequent malignant bone tumors, osteosarcoma and Ewing's sarcoma, unified management was adapted. The treatment was initiated with multidrug chemotherapy and followed by surgery or radiotherapy (Ewing's sarcoma) of the primary site. Surgery was performed in 30 cases: 19 mutilating operations because of the broad local invasion, 11 conservative surgical procedures (limb -- salvage operations). Satisfactory oncological and functional effect can be achieved after limb-salvage surgical procedures in the cases of localized, especially semimalignant bone tumors. PMID:1369876

  18. Evaluation of surgical procedures for trigeminal neuralgia.

    OpenAIRE

    Ong, K. S.; Keng, S. B.

    2003-01-01

    Trigeminal neuralgia is a type of facial pain that is difficult to treat. The pain can be excruciating and debilitating. The wide range of treatments currently used for trigeminal neuralgia is ample evidence that there is no simple answer to how it should be managed. This review will evaluate the current surgical procedures used for the treatment of trigeminal neuralgia. A critical analysis of the evidence-based studies to date was done to evaluate and compare the efficacy of the different su...

  19. Fundamental Ethical Issues in Unnecessary Surgical Procedures.

    Science.gov (United States)

    Tayade, Motilal Chandu; Dalvi, Shashank D

    2016-04-01

    In clinical practice performing any surgical procedure is inconsistent because all surgical procedures carry definitely some degree of risk. Worldwide every year millions of patients go under knife, but many of them are enduring great pain and shelling out thousands and dollars for surgeries they don't really need. This review work was planned with an intention to focus attention towards it with reporting cited evidences of unnecessary surgical operations and discuss ethical issues concern with it. In present review the references search included standard citations Google scholar, MEDLINE and PUBMED. We also used Google search engine for screening various news concern with highlighting this topic in community and online media. For articles we go through more than 60 articles from worldwide and 12 news media views from Google search in last one year. We used following quotes for their search-unnecessary surgeries, second opinion, ethical issues in unnecessary surgeries. Geographical variations were also kept in view. Our intension was highlighting ethical issues concern with unnecessary surgical operations. Henceforth we excluded such work that does not concern with ethical issues. Unnecessary surgery is that which is medically unjustifiable when the risks and costs are more than the likely therapeutic benefits or relief to the patient based on the patient's lifestyle requirements. To avoid or minimize such interventions basic seeding of ethics in curriculum and strict laws will definitely helpful in clinical practice. In conclusion, our aim was to highlight this major issue and underline need of competency based medical bioethics education in Indian scenario. PMID:27190833

  20. Veterinary students' recollection methods for surgical procedures

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Tanggaard, Lene; Berendt, Mette

    2016-01-01

    When veterinary students face their first live animal surgeries, their level of anxiety is generally high and this can affect their ability to recall the procedure they are about to undertake. Multimodal teaching methods have previously been shown to enhance learning and facilitate recall; however......, student preferences for recollection methods when translating theory into practice have not been documented. The aim of this study was to investigate veterinary students' experience with recollection of a surgical procedure they were about to perform after using multiple methods for preparation. From...... a group of 171 veterinary students enrolled in a basic surgery course, 26 students were randomly selected to participate in semi-structured interviews. Results showed that 58% of the students used a visual, dynamic method of recollection, mentally visualizing the video they had watched as part...

  1. Finishing procedures in orthodontic-surgical cases.

    Science.gov (United States)

    Brunel, Jean-Michel

    2015-09-01

    To ensure optimal results, we must do our utmost to achieve targets based on order, symmetry and precision, our ultimate aim being to strive towards the desired harmony, planned contrast and exact proportions. Orthodontic-surgical treatments require specific finishing procedures, which most often call for multidisciplinary, or even transdisciplinary, collaboration. Finishing will involve the dental arches just as much as the orofacial environment. Above all, treatment of this kind demands a highly targeted approach in combination with well-defined and perfectly executed techniques. To finish a case satisfactorily, reasonable targets should be aimed for to ensure they are achieved. One must be ambitious and yet wise. A tight alliance of surgeon and orthodontist will nurture convincing and achievable projects and good, lifelong outcomes. Following the consolidation phase, roughly 4 to 6 weeks post-surgery, we can initiate the final orthodontic treatment, which, in effect, constitutes a mini-treatment in its own right. "Details make perfection, but perfection is not a detail" (Leonardo Da Vinci). "A lucid mind is the ante-chamber of intelligence" (Léo Ferré). In the order of life, every form of unity is always unique, and if each of us is unique, it is because everyone else is too. Ambition, wisdom, lucidity and efficiency will guarantee a successful result, the successful result. We must not be mere observers of our treatments, but the architect, project manager and site foreman at one and the same time. One could talk ad infinitum about finishing orthodontic-surgical cases because everything else leads up to the case-finishing and even the fullest description could never be exhaustive. PMID:26316452

  2. D Modelling and Rapid Prototyping for Cardiovascular Surgical Planning - Two Case Studies

    Science.gov (United States)

    Nocerino, E.; Remondino, F.; Uccheddu, F.; Gallo, M.; Gerosa, G.

    2016-06-01

    In the last years, cardiovascular diagnosis, surgical planning and intervention have taken advantages from 3D modelling and rapid prototyping techniques. The starting data for the whole process is represented by medical imagery, in particular, but not exclusively, computed tomography (CT) or multi-slice CT (MCT) and magnetic resonance imaging (MRI). On the medical imagery, regions of interest, i.e. heart chambers, valves, aorta, coronary vessels, etc., are segmented and converted into 3D models, which can be finally converted in physical replicas through 3D printing procedure. In this work, an overview on modern approaches for automatic and semiautomatic segmentation of medical imagery for 3D surface model generation is provided. The issue of accuracy check of surface models is also addressed, together with the critical aspects of converting digital models into physical replicas through 3D printing techniques. A patient-specific 3D modelling and printing procedure (Figure 1), for surgical planning in case of complex heart diseases was developed. The procedure was applied to two case studies, for which MCT scans of the chest are available. In the article, a detailed description on the implemented patient-specific modelling procedure is provided, along with a general discussion on the potentiality and future developments of personalized 3D modelling and printing for surgical planning and surgeons practice.

  3. Surgical Site Infections (SSIs) For 5 Operative Procedures, 2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — This table shows the surgical site infections (SSIs) reported by hospitals for the 5 operative procedures without risk adjusted comparisons (Heart transplant,...

  4. Tranexamic Acid in Anesthetic Management of Surgical Procedures.

    Science.gov (United States)

    Mayeux, Jessica; Alwon, Kathy; Collins, Shawn; Hewer, Ian

    2016-06-01

    Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements. In addition, this journal course addresses concerns that use of antifibrinolytics increases embolic events, reviews research that demonstrates TXA does not increase the incidence of vascular occlusive events, and describes methods of TXA use in cardiac and orthopedic surgical procedures, neurosurgery, and obstetrics. The Certified Registered Nurse Anesthetist should consider the possibility, on a case-by-case basis, of using TXA in surgical procedures to reduce blood loss with minimal adverse effects. PMID:27501656

  5. Chronic pancreatitis: A surgical disease? Role of the Frey procedure

    Institute of Scientific and Technical Information of China (English)

    Alexra; Roch; Jérome; Teyssedou; Didier; Mutter; Jacques; Marescaux; Patrick; Pessaux

    2014-01-01

    Although medical treatment and endoscopic interven-tions are primarily offered to patients with chronic pancreatitis, approximately 40% to 75% will ultimately require surgery during the course of their disease. Al-though pancreaticoduodenectomy has been considered the standard surgical procedure because of its favorable results on pain control, its high postoperative complica-tion and pancreatic exocrine or/and endocrine dysfunc-tion rates have led to a growing enthusiasm for duodenal preserving pancreatic head resection. The aim of this review is to better understand the rationale underlying of the Frey procedure in chronic pancreatitis and to ana-lyze its outcome. Because of its hybrid nature, combin-ing both resection and drainage, the Frey procedure has been conceptualized based on the pathophysiology of chronic pancreatitis. The short and long-term outcome, especially pain relief and quality of life, are better after the Frey procedure than after any other surgical proce-dure performed for chronic pancreatitis.

  6. [Antibiotic-prophylaxis in the minimally invasive pain surgical procedures].

    Science.gov (United States)

    Mastronicola, Cristina; Rocco, Marzia; Maltoni, Susanna; Marata, Annamaria; Bedini, Andrea; Sarti, Mario; Ungheri, Mirella

    2010-09-01

    The minimally invasive pain surgical procedures are more and more frequently used in the treatment and management of the chronic pain. The patients will often have recourse to a higher infection's risk during the proceedings for acquired general conditions (like enterotomy, skin ulcers, bladder catheter).The analysis literature doesn't produce specific treatment guidelines about antibiotic prophylaxis in pain therapy. This document, drawn up with multidisciplinary approach, correspond to rational, efficacy and functional guide about the choice and management of the antibiotic prophylaxis during the minimally invasive pain surgical procedures. PMID:21268371

  7. Effect of surgical procedures on prostate tumor gene expression profiles

    Institute of Scientific and Technical Information of China (English)

    Jie Li; Zhi-Hong Zhang; Chang-Jun Yin; Christian Pavlovich; Jun Luo; Robert Getzenberg; Wei Zhang

    2012-01-01

    Current surgical treatment of prostate cancer is typically accomplished by either open radical prostatectomy (ORP) or robotic-assisted laparoscopic radical prostatectomy (RALRP).Intra-operative procedural differences between the two surgical approaches may alter the molecular composition of resected surgical specimens,which are indispensable for molecular analysis and biomarker evaluation.The objective of this study is to investigate the effect of different surgical procedures on RNA quality and genome-wide expression signature.RNA integrity number (RIN) values were compared between total RNA samples extracted from consecutive LRP (n=11 ) and ORP (n=24) prostate specimens.Expression profiling was performed using the Agilent human whole-genome expression microarrays.Expression differences by surgical type were analyzed by Volcano plot analysis and gene ontology analysis.Quantitative reverse transcription (RT)-PCR was used for expression validation in an independent set of LRP (n=8) and ORP (n=8) samples.The LRP procedure did not compromise RNA integrity.Differential gene expression by surgery types was limited to a small subset of genes,the number of which was smaller than that expected by chance.Unexpectedly,this small subset of differentially expressed genes was enriched for those encoding transcription factors,oxygen transporters and other previously reported surgery-induced stress-response genes,and demonstrated unidirectional reduction in LRP specimens in comparison to ORP specimens.The effect of the LRP procedure on RNA quality and genome-wide transcript levels is negligible,supporting the suitability of LRP surgical specimens for routine molecular analysis.Blunted in vivo stress response in LRP specimens,likely mediated by CO2 insufflation but not by longer ischemia time,is manifested in the reduced expression of stress-response genes in these specimens.

  8. Characterization of aerosols produced by surgical procedures: A summary

    International Nuclear Information System (INIS)

    In many types of surgery, especially orthopedic procedures, power tools such as saws and drills are used. These tools can impart considerable energy in disrupting tissue and may produce aerosolized blood and material from bone and other tissues. Surgical lasers and electrocautery tools can also produce aerosols due to vaporization of blood and tissues. A number of studies have been reported concerning production of aerosols during surgery, and some of the aerosols produced may contain infectious materials. Health care workers have expressed concern and questions pertaining to the occupational transmission of blood-borne pathogens including the human immunodeficiency virus (HIV) and hepatitis B virus (HBV) via blood aerosols during surgery. Little or no data existed characterizing the aerosols produced performing surgical procedures. Because of this lack of data, the National Institute for Occupational Safety and Health funded a project at ITRI to assess the extent of aerosolization of blood and other tissues during surgical procedures in the laboratory and in a hospital surgical suite

  9. Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.

    Science.gov (United States)

    Dave, Omkar H; Patel, Karan A; Andersen, Clark R; Carmichael, Kelly D

    2016-01-01

    Septic arthritis of the knee is encountered on a regular basis by orthopedists and nonorthopedists. No established therapeutic algorithm exists for septic arthritis of the knee, and there is much variability in management. This study assessed the number of surgical procedures, arthroscopic or open, required to eradicate infection. The study was a retrospective analysis of 79 patients who were treated for septic knee arthritis from 1995 to 2011. Patients who were included in the study had native septic knee arthritis that had resolved with treatment consisting of irrigation and debridement, either open or arthroscopic. Logistic regression analysis was used to explore the relation between the interval between onset of symptoms and index surgery and the use of arthroscopy and the need for multiple procedures. Fifty-two patients met the inclusion criteria, and 53% were male, with average follow-up of 7.2 years (range, 1-16.2 years). Arthroscopic irrigation and debridement was performed in 70% of cases. On average, successful treatment required 1.3 procedures (SD, 0.6; range, 1-4 procedures). A significant relation (P=.012) was found between time from presentation to surgery and the need for multiple procedures. With arthroscopic irrigation and debridement, most patients with septic knee arthritis require only 1 surgical procedure to eradicate infection. The need for multiple procedures increases with time from onset of symptoms to surgery.

  10. Legal sanctity of consent for surgical procedures in India

    Directory of Open Access Journals (Sweden)

    Gauri Sharma

    2012-01-01

    Full Text Available As surgeons, we are morally committed to respecting the right of self-determination of patients, thus an informed consent is necessary before any operative intervention. Many neurosurgical patients are incapable of giving consent because of impaired consciousness. Moreover, neurosurgical procedures involve high risks and often are time sensitive; therefore obtaining consent is a challenging job. Patients and their family members need immense courage, understanding, and trust before giving consent for a surgical procedure to a doctor. Lawsuits against doctors are on the rise and it is important to understand "what is consent?" in legal parlance.

  11. Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine.

    Science.gov (United States)

    De Wijs-Meijler, Daphne P M; Stam, Kelly; van Duin, Richard W B; Verzijl, Annemarie; Reiss, Irwin K; Duncker, Dirk J; Merkus, Daphne

    2016-01-01

    This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early cardiopulmonary dysfunction is difficult to diagnose, particularly in animal models, as cardiopulmonary function is often measured invasively, requiring anesthesia. As many anesthetic agents are cardiodepressive, subtle changes in cardiovascular function may be masked. In contrast, chronic instrumentation allows for measurement of cardiopulmonary function in the awake state, so that measurements can be obtained under quiet resting conditions, without the effects of anesthesia and acute surgical trauma. Furthermore, when animals are properly trained, measurements can also be obtained during graded treadmill exercise. Flow probes are placed around the aorta or pulmonary artery for measurement of cardiac output and around the left anterior descending coronary artery for measurement of coronary blood flow. Fluid-filled catheters are implanted in the aorta, pulmonary artery, left atrium, left ventricle and right ventricle for pressure measurement and blood sampling. In addition, a 20 G catheter is positioned in the anterior interventricular vein to allow coronary venous blood sampling. After a week of recovery, swine are placed on a motor-driven treadmill, the catheters are connected to pressure and flow meters, and swine are subjected to a five-stage progressive exercise protocol, with each stage lasting 3 min. Hemodynamic signals are continuously recorded and blood samples are taken during the last 30 sec of each exercise stage. The major advantage of studying chronically instrumented animals is that it allows serial assessment of cardiopulmonary function, not only at rest but also during physical stress such as exercise. Moreover, cardiopulmonary function can be assessed repeatedly during disease development and during chronic treatment, thereby increasing statistical power and hence limiting the number of animals

  12. A novel surgical procedure for bridging of massive bone defects

    Directory of Open Access Journals (Sweden)

    Springfield Dempsey S

    2005-02-01

    Full Text Available Abstract Background Bony defects arising from tumor resection or debridement after infection, non-union or trauma present a challenging problem to orthopedic surgeons, as well as patients due to compliance issues. Current treatment options are time intensive, require more than one operation and are associated with high rate of complications. For this reason, we developed a new surgical procedure to bridge a massive long bone defect. Methods To bridge the gap, an in situ periosteal sleeve is elevated circumferentially off of healthy diaphyseal bone adjacent to the bone defect. Then, the adjacent bone is osteotomized and the transport segment is moved along an intramedullary nail, out of the periosteal sleeve and into the original diaphyseal defect, where it is docked. Vascularity is maintained through retention of the soft tissue attachments to the in situ periosteal sleeve. In addition, periosteal osteogenesis can be augmented through utilization of cancellous bone graft or in situ cortical bone adherent to the periosteal sleeve. Results The proposed procedure is novel in that it exploits the osteogenic potential of the periosteum by replacing the defect arising from resection of tissue out of a pathological area with a defect in a healthy area of tissue, through transport of the adjacent bone segment. Furthermore, the proposed procedure has several advantages over the current standard of care including ease of implementation, rapid patient mobilization, and no need for specialized implants (intramedullary nails are standard inventory for surgical oncology and trauma departments or costly orthobiologics. Conclusions The proposed procedure offers a viable and potentially preferable alternative to the current standard treatment modalities, particularly in areas of the world where few surgeons are trained for procedures such as distraction osteogenesis (e.g. the Ilizarov procedure as well as areas of the world where surgeons have little access to

  13. The versatility of spandex photographic retractor for transoral surgical procedures.

    Science.gov (United States)

    Tauro, David P; Uppada, Uday Kiran

    2016-01-01

    The trend toward transoral access, be it for pathology or facial cosmetic surgery, has become increasingly popular over the last two decades with facial incisions being used more and more sporadically than otherwise. Transoral access because of its inherent limitations, retraction of the oral and perioral tissues without inducing physical or thermal injury makes it a daunting task for the operating surgeon. The use of conventional retractors in conjunction with surgical instruments can lead to inadvertent injury to the perioral tissues resulting in untoward postoperative sequelae leading to patient discomfort and delayed recovery. This article elucidates the versatility of a simple photographic retractor (spandex) as a useful adjunctive tool in the retraction and protection of the perioral tissues for almost all transoral surgical procedures.

  14. USE OF DEXMEDETOMIDINE INFUSION WITH SUBANAESTHETIC DOSE OF KETAMINE FOR MINOR SURGICAL PROCEDURES: A STUDY

    Directory of Open Access Journals (Sweden)

    Laishram Chandralekha Singha

    2016-07-01

    Full Text Available BACKGROUND Dexmedetomidine, an α2 agonist is an approved drug for sedation and co-analgesia, but may cause hypotension and bradycardia. Ketamine, which provides profound analgesia and dissociative anaesthesia when used with dexmedetomidine may counteract the adverse haemodynamic effects as both have opposing actions on the cardiovascular system apart from providing satisfactory sedation and analgesia during minor surgical procedures. OBJECTIVE To study the sedoanalgesic efficacy and haemodynamic changes of dexmedetomidine infusion along with subanaesthetic dose of ketamine for minor surgical procedures. MATERIALS AND METHODS After Institutional Ethical Committee approval and informed patient consent, 30 ASA physical status I and II patients of age between 20-50 years planned for split skin grafting were selected and included in the study, which was done over a period of four months. The patients were given continuous infusion of loading dose of dexmedetomidine of 1 µg/kg over 10 minutes. Ketamine 0.8 mg/kg IV was given one minute before the start of the procedure and subsequently maintained with dexmedetomidine infusion @ 0.5 µg/kg/hr. Pain and sedation score, haemodynamic changes, requirement of additional dose of ketamine, and occurrence of emergence delirium were observed. RESULTS The sedation level during the procedure and the pain score in the immediate postoperative period were satisfactory. 28 patients did not have any discomfort whereas 2 patients required additional 0.8 mg/kg of IV ketamine. Hypotension occurred in 3 patients and bradycardia in 2 patients. There was nausea in 2 patients whereas emergence delirium or respiratory depression was not seen in any of the patients. CONCLUSION Dexmedetomidine infusion with subanaesthetic dose of ketamine can be used satisfactorily for minor surgical procedures.

  15. [Surgical crown lengthening procedures. Preparatory step for fixed prosthesis].

    Science.gov (United States)

    Parashis, A O; Tripodakis, A P

    1990-04-01

    Necessary restorative requirements for full coverage are adequate axial wall height of the preparation for retention as well as sufficient vertical width of sound tooth structure cervically for the crown margins. In cases where adequate healthy tooth structure does not exist coronally to the epithelial attachment due to various crown damages, the margins of the crown might traumatize the periodontal attachment and the periodontium will be jeopardized iatrogenically. Teeth with inadequate axial Reight of the clinical crown, subgingival caries, vertical or horizontal fractures will require surgical crown lengthening procedures before prosthetic treatment is performed. These procedures may either involve only the soft tissues or bone remodeling as well. Irrespective of the procedure, crown lengthening must be performed with the objective of at least 3 mm. of healthy tooth structure coronally to the bone. This width will permit the formation of a new dentinogingival junction and the existence of 1-2 m.m. of sound tooth structure coronally to the new attachment line for the construction of a biologically acceptable crown margin. The purpose of this article is to discuss the clinical problem and underline the importance of crown lengthening procedures as a preparatory step for prosthetic treatment in fixed partial dentures.

  16. Resident Exposure to Peripheral Nerve Surgical Procedures During Residency Training.

    Science.gov (United States)

    Gil, Joseph A; Daniels, Alan H; Akelman, Edward

    2016-05-01

    Background Variability in case exposures has been identified for orthopaedic surgery residents. It is not known if this variability exists for peripheral nerve procedures. Objective The objective of this study was to assess ACGME case log data for graduating orthopaedic surgery, plastic surgery, general surgery, and neurological surgery residents for peripheral nerve surgical procedures and to evaluate intraspecialty and interspecialty variability in case volume. Methods Surgical case logs from 2009 to 2014 for the 4 specialties were compared for peripheral nerve surgery experience. Peripheral nerve case volume between specialties was performed utilizing a paired t test, 95% confidence intervals were calculated, and linear regression was calculated to assess the trends. Results The average number of peripheral nerve procedures performed per graduating resident was 54.2 for orthopaedic surgery residents, 62.8 for independent plastic surgery residents, 84.6 for integrated plastic surgery residents, 22.4 for neurological surgery residents, and 0.4 for surgery residents. Intraspecialty comparison of the 10th and 90th percentile peripheral nerve case volume in 2012 revealed remarkable variability in training. There was a 3.9-fold difference within orthopaedic surgery, a 5.0-fold difference within independent plastic surgery residents, an 8.8-fold difference for residents from integrated plastic surgery programs, and a 7.0-fold difference within the neurological surgery group. Conclusions There is interspecialty and intraspecialty variability in peripheral nerve surgery volume for orthopaedic, plastic, neurological, and general surgery residents. Caseload is not the sole determinant of training quality as mentorship, didactics, case breadth, and complexity play an important role in training. PMID:27168883

  17. Exposure of the surgical team to ionizing radiation during orthopedic surgical procedures,

    Directory of Open Access Journals (Sweden)

    Evandro Pereira Palácio

    2014-06-01

    Full Text Available OBJECTIVE: the aim of this study was to assess the degree of exposure of the orthopedic surgical team to fluoroscopic ionizing radiation.METHODS: the ionizing radiation to which the orthopedic surgical team (R1, R2 and R3 was exposed was assayed using thermoluminescent dosimeters that were distributed in target anatomical regions (regions with and without protection using a lead apron. This was done during 45 hip osteosynthesis procedures to treat transtrochanteric fractures that were classified as 31-A2.1 (AO.RESULTS: the radioactive dose received by R3 was 6.33 mSv, R2 4.51 mSv and R3 1.99 mSv (p = 0.33. The thyroid region received 0.86 mSv of radiation, the thoracic region 1.24 mSv and the gonadal region 2.15 mSv (p = 0.25. There was no record of radiation at the dosimeters located below the biosafety protectors or on the team members' backs.CONCLUSIONS: the members of the surgical team who were located closest to the fluoroscope received greater radiation doses than those located further away. The anatomical regions located below the waistline were the ones that received most ionizing radiation. These results emphasize the importance of using biosafety devices, since these are effective in preventing radiation from reaching the vital organs of the medical team.

  18. Surgical procedure of Free Flap. Main nursing care

    Directory of Open Access Journals (Sweden)

    Manuel Molina López

    2010-05-01

    Full Text Available The free flap surgical technique is used to cover extensive skin loss areas and situations where no flap is available, or in axial zones. The great breackthrough in the field of reconstructive surgical techniques and the creation of new units where these complex techniques are used, means that the nursing staff who work in these hospital units are adquiring greater protagonism in caring for, and the subsequent success of this type of surgery in which the problems of collaboration in all the perioperative phases depend entirely on the nursing team.The collaborative nursing problems could be defined as real or potential health problems, where users need nursing staff to follow the treatment and control procedures prescribed by other professional, generally doctors, who control and are responsible for the final outcome.While planning collaborative objectives and activities it should be taken into account that the function of the nursing staff is twofold: on the one hand, the patient must be taken care of as prescribed by other professionals and, on the other hand, it should bring into play cognitive elements (knowledge and know-how and clinical judgment when executing these in controlling the patients evolution.In this article our intention is to give an interesting and comprehensive description of the free flap surgical technique, its pros and cons, and identify the principal collaborative problems which nursing will have to deal with in each one of the perioperative phases, the number and specific nature of such oblige nursing on many occasions, to update and/or acquire new skills.

  19. Surgical Management of Chronic Lymphedema; Introducing an Innovative Procedure

    Directory of Open Access Journals (Sweden)

    Seyed-Reza Mousavi

    2008-09-01

    Full Text Available Objective: Lymphedema is the result of impaired lymphatic drainage from the affected organ. This abnormality can be primary or secondary. Different nonoperative and operative approaches have been introduced to treat chronic lymphedema. In this study, we describe a new surgical technique and compare its results with other more commonplace methods. Methods:Fifty-nine patients with the diagnosis of chronic lower extremity lymphdema who had not responded to nonoperative management for at least 6 months, were included in the study. They were collected during 15 years between March 1987 and March 2002. Doppler ultrasonography of deep venous system to confirm its patency was routinely performed in the most of patients. Then, they underwent surgery and were followed for at least 1 year postoperatively. Findings: All the patients were operated by our new technique which is a modified form of the Homans. The outcome was excellent and 89.2% of patients were devoid of complication. A 10.8% total complication rate was inevitable. The most common complication was wound seroma. Conclusion: According to the difficulties with treatment of chronic lymphedema and variety of surgical options, our method can be an excellent and even the standard operative procedure to treat intractable forms of disease.

  20. Variation in hospital resource use and cost among surgical procedures using topical absorbable hemostats

    Directory of Open Access Journals (Sweden)

    Martyn D

    2015-11-01

    Full Text Available Derek Martyn,1 Lisa M Meckley,1 Gavin Miyasato,1 Sangtaeck Lim,2 Jerome B Riebman,3 Richard Kocharian,3 Jillian G Scaife,1 Yajing Rao,1 Mitra Corral2 1Trinity Partners, LLC, Waltham, MA, USA; 2Global Health Economics and Market Access, Ethicon, Inc., Bridgewater, NJ, USA; 3Medical Affairs, Ethicon, Inc., Bridgewater, NJ, USA Background: Adjunctive hemostats are used to assist with the control of intraoperative bleeding. The most common types are flowables, gelatins, thrombins, and oxidized regenerated celluloses (ORCs. In the US, Surgicel® products are the only US Food and Drug Administration-approved ORCs. Objective: To compare the outcomes of health care resource utilization (HRU and costs associated with using ORCs compared to other adjunctive hemostats (OAHs are defined as flowables, gelatins, and topical thrombins for surgical procedures in the US inpatient setting. Patients and methods: A retrospective, US-based cohort study was conducted using hospital inpatient discharges from the 2011–2012 calendar years in the Premier Healthcare Database. Patients with either an ORC or an OAH who underwent a cardiovascular procedure (valve surgery and/or coronary artery bypass graft surgery, carotid endarterectomy, cholecystectomy, or hysterectomy were included. Propensity score matching was used to create comparable groups of ORC and OAH patients. Clinical, economic, and HRU outcomes were compared. Results: The propensity score matching created balanced patient cohorts for cardiovascular procedure (22,718 patients, carotid endarterectomy (10,890 patients, cholecystectomy (6,090 patients, and hysterectomy (9,348 patients. In all procedures, hemostatic agent costs were 28%–56% lower for ORCs, and mean hemostat units per discharge were 16%–41% lower for ORCs compared to OAHs. Length of stay and total procedure costs for patients treated with ORCs were lower for carotid endarterectomy patients (0.3 days and US$700 and for cholecystectomy patients

  1. Requirements on surgical hand disinfection and modified procedures

    OpenAIRE

    Kramer, A; Hübner, NO; Assadian, O

    2007-01-01

    The special importance of the surgeon's hand in the multi-barrier concept to prevent surgical site infections is based on two facts: the resident flora on the hands cannot be totally eradicated and the surgical glove is no reliable barrier for micro-organisms. The aim of the pre-surgical disinfection is therefore to eliminate the transient flora and reduce the resident flora to the greatest possible amount for the duration of the surgery. New experimental evidence has led to changes in ...

  2. Requirements on surgical hand disinfection and modified procedures

    OpenAIRE

    Assadian, Ojan; Hübner, Nils-Olaf; Kramer, Axel

    2007-01-01

    The special importance of the surgeon's hand in the multi-barrier concept to prevent surgical site infections is based on two facts: the resident flora on the hands cannot be totally eradicated and the surgical glove is no reliable barrier for micro-organisms. The aim of the pre-surgical disinfection is therefore to eliminate the transient flora and reduce the resident flora to the greatest possible amount for the duration of the surgery. New experimental evidence has led to changes in the pr...

  3. Surgical procedure of Free Flap. Main nursing care

    OpenAIRE

    Manuel Molina López; Eladio J. Collado Boira; Mariano Marqués Aguilar

    2010-01-01

    The free flap surgical technique is used to cover extensive skin loss areas and situations where no flap is available, or in axial zones. The great breackthrough in the field of reconstructive surgical techniques and the creation of new units where these complex techniques are used, means that the nursing staff who work in these hospital units are adquiring greater protagonism in caring for, and the subsequent success of this type of surgery in which the problems of collaboration in all the p...

  4. Patient-specific system for prognosis of surgical treatment outcomes of human cardiovascular system

    Science.gov (United States)

    Golyadkina, Anastasiya A.; Kalinin, Aleksey A.; Kirillova, Irina V.; Kossovich, Elena L.; Kossovich, Leonid Y.; Menishova, Liyana R.; Polienko, Asel V.

    2015-03-01

    Object of study: Improvement of life quality of patients with high stroke risk ia the main goal for development of system for patient-specific modeling of cardiovascular system. This work is dedicated at increase of safety outcomes for surgical treatment of brain blood supply alterations. The objects of study are common carotid artery, internal and external carotid arteries and bulb. Methods: We estimated mechanical properties of carotid arteries tissues and patching materials utilized at angioplasty. We studied angioarchitecture features of arteries. We developed and clinically adapted computer biomechanical models, which are characterized by geometrical, physical and mechanical similarity with carotid artery in norm and with pathology (atherosclerosis, pathological tortuosity, and their combination). Results: Collaboration of practicing cardiovascular surgeons and specialists in the area of Mathematics and Mechanics allowed to successfully conduct finite-element modeling of surgical treatment taking into account various features of operation techniques and patching materials for a specific patient. Numerical experiment allowed to reveal factors leading to brain blood supply decrease and atherosclerosis development. Modeling of carotid artery reconstruction surgery for a specific patient on the basis of the constructed biomechanical model demonstrated the possibility of its application in clinical practice at approximation of numerical experiment to the real conditions.

  5. Minimal Invasive Surgical Procedure of Inducing Myocardial Infarction in Mice

    OpenAIRE

    Curaj, Adelina; Simsekyilmaz, Sakine; Staudt, Mareike; Liehn, Elisa

    2015-01-01

    Myocardial infarction still remains the main cause of death in western countries, despite considerable progress in the stent development area in the last decades. For clarification of the underlying mechanisms and the development of new therapeutic strategies, the availability of valid animal models are mandatory. Since we need new insights into pathomechanisms of cardiovascular diseases under in vivo conditions to combat myocardial infarction, the validity of the animal model is a crucial as...

  6. Non-Surgical Procedures Open Blocked Arteries to Prevent and Treat Stroke

    Science.gov (United States)

    ... Surgical Procedures Open Blocked Arteries to Prevent and Treat Stroke Stroke is a "Brain Attack" and a ... first sign of stroke, Call 911 Vascular Experts Treat Blocked Carotid Arteries Without Surgery to Prevent Stroke ...

  7. Blood pressure management in cardiovascular risk stratification : procedure, progression, process

    NARCIS (Netherlands)

    Adiyaman, A.

    2009-01-01

    In this thesis we have explored different aspects of blood pressure measurement and related it to the risk of cardiovascular disease. In the first part we showed that when the arm is positioned under heart level, for example when the arm is placed on a desk or a chair support, the blood pressure and

  8. Surgical Site Infection and Validity of Staged Surgical Procedure in Emergent/Urgent Surgery for Ulcerative Colitis

    OpenAIRE

    Uchino, Motoi; Ikeuchi, Hiroki; Matsuoka, Hiroki; Takahashi, Yoshiko; Tomita, Naohiro; Takesue, Yoshio

    2013-01-01

    Although restorative proctocolectomy is recognized as a standard procedure for ulcerative colitis, infectious complications after surgery cannot be disregarded. The aim of this study was to define predictors of surgical site infection (SSI) in urgent/emergent surgery for ulcerative colitis. We performed prospective SSI surveillance for 90 consecutive patients. Possible risk factors were analyzed by logistic regression analyses. Incidences of incisional SSI (i-SSI) and organ/space SSI were 31....

  9. Interventions to promote informed consent for patients undergoing surgical and other invasive healthcare procedures

    NARCIS (Netherlands)

    Kinnersley, P.; Phillips, K.; Savage, K.; Kelly, M.J.; Farrell, E.; Morgan, B.; Whistance, R.; Lewis, V.; Mann, M.K.; Stephens, B.L.; Blazeby, J.; Elwyn, G.; Edwards, A.G.

    2013-01-01

    BACKGROUND: Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken. However, it is a complex process which requires patients be provided with information which they can understand and retain, opportunity to consider their optio

  10. Use of Articaine in loco-regional anesthesia for day care surgical procedures

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures.

  11. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure

    Directory of Open Access Journals (Sweden)

    Kiran Kumar Ganji

    2012-01-01

    Full Text Available Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20 patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening and adjacent sites: Plaque and Gingival Indices (PI & (GI, Position of Gingival Margin from reference Stent (PGMRS, Probing depth (PD, and Biologic Width (BW. Statistical Analysis Used. Student “t” Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group and 1.95 mm (Ostectomy procedure B2 Group and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  12. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure.

    Science.gov (United States)

    Ganji, Kiran Kumar; Patil, Veena Ashok; John, Jiji

    2012-01-01

    Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW). Statistical Analysis Used. Student "t" Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  13. Expert's evaluation of innovative surgical instrument and operative procedure using haptic interface in virtual reality

    OpenAIRE

    THOMANN, Guillaume; Phan Nguyen, Duy Minh; Tonetti, Jérôme

    2013-01-01

    International audience In the domain of designing innovative products in the medical field, investigations are often oriented towards communication between actors and needs comprehension. In the DESTIN (DEsign of Surgical/Technological INnovation) project, User Centered Design methodology with concrete experiments is applied. Researchers propose experimentation in operating room for innovative products and new adapted surgical procedures co-evaluation. In this paper, they intend to evaluat...

  14. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease

    OpenAIRE

    Zhou M; Huang D; Liu C; Liu Z.; Zhang M; Qiao T; Liu CJ

    2014-01-01

    Min Zhou, Dian Huang, Chen Liu, Zhao Liu, Min Zhang, Tong Qiao, Chang-Jian Liu Department of Vascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Objective: To compare outcomes of hybrid (combined surgical and endovascular) procedures (HYBRID) with open surgical reconstructions (OPEN) in patients with multilevel infrainguinal artery occlusive diseases. Design: Case series study with retrospective analysis of pro...

  15. An adjunctive minor surgical procedure for increased rate of retraction

    Directory of Open Access Journals (Sweden)

    Prabhakar Krishnan

    2013-01-01

    Full Text Available Introduction: Orthodontic treatment is based on the principle that if prolonged pressure is applied to the tooth, tooth movement will occur as the bone around the tooth re-models. In this study osteotomy of buccal alveolar plate and undermining of interseptal bone was performed at premolar extraction site and rate of en-masse retraction and canine retraction was evaluated. Materials and Methods: Patients between the age of 18 and 25 years, requiring retraction of anterior teeth are selected for the study. Osteotomy with undermining of interseptal bone at the extraction site was performed. The procedure was performed on all four quadrants. Results: The average retraction in the maxillary arch was 0.98 mm/quadrant in 3 weeks, i.e., a total retraction of 5.89 mm in a span of 9 weeks. The average retraction in the mandibular arch was 0.96 mm/quadrant in 3 weeks, i.e., a total retraction of 5.75 mm in a span of 9 weeks. Conclusion: This method of achieving faster en masse retraction immediately after extraction definitely reduced the initial retraction time. We recommend that such procedure must be carried out with appropriate anchorage conservation methods.

  16. Prevalence of Neoplastic Diseases in Pet Birds Referred for Surgical Procedures

    Science.gov (United States)

    Castro, Patrícia F.; Fantoni, Denise T.; Miranda, Bruna C.; Matera, Julia M.

    2016-01-01

    Neoplastic disease is common in pet birds, particularly in psittacines, and treatment should be primarily aimed at tumor eradication. Nineteen cases of pet birds submitted to diagnostic and/or therapeutic surgical procedures due to neoplastic disease characterized by the presence of visible masses were retrospectively analyzed; affected species, types of neoplasms and respective locations, and outcomes of surgical procedures were determined. All birds undergoing surgery belonged to the order Psittaciformes; the Blue-fronted parrot (Amazona aestiva) was the prevalent species. Lipoma was the most frequent neoplasm in the sample studied. Most neoplasms affected the integumentary system, particularly the pericloacal area. Tumor resection was the most common surgical procedure performed, with high resolution and low recurrence rates. PMID:26981315

  17. Locally advanced rectal cancer: a cooperative surgical approach to a complex surgical procedure.

    LENUS (Irish Health Repository)

    Owens, P

    2015-01-01

    Single stage en bloc abdominoperineal resection and sacrectomy, with a myocutaneous flap closure is a relatively uncommon procedure. Our case study of a 77 year old man with a locally invasive rectal adenocarcinoma highlights the complex intraoperative management of such a patient.

  18. The evolution of surgical procedures in the management of duodenal and gastric ulcers.

    Science.gov (United States)

    Ajao, O G; Ugwu, B T

    2013-01-01

    Surgical procedures for the surgical management of duodenal ulcer had evolved through many stages, over the years. It started with gastroenterostomy alone, then followed by subtotal gastrectomy, vagotomy alone, vagotomy and gastro-jejunostomy, vagotomy and pyloroplasty, and highly selective vagotomy - all which started as open surgical procedures. Now unless there are complications the treatment is essentially medical following the work of Marshall and Warren. Currently, even when surgery is indicated, minimal invasive procedures are preferred. Four main types of pyloroplasties are well known. They are Weinberg, Heinecke-Mikulicz, Finney and Jaboulay. Vagotomy can be truncal, selective, and highly selective. Accepted surgical treatment for gastric ulcer is the distal gastric resection to include the ulcerated area, but not resecting more than 50-60% of the stomach. In the uncommon cases of Zollinger-Ellison syndrome, aggressive gastric surgery, the use of drugs, and the resection of the tumour have all been recommended in appropriate cases. With the discovery of Helicobacter pylori and its effective medical treatment, surgery has little role in the initial management of peptic ulcer disease. The place of the history of the surgical procedures employed earlier in the treatment of this disease would remain relevant.

  19. Otologic surgical procedures in an ear, nose and throat department in Subotica from 1987 to 2001

    Directory of Open Access Journals (Sweden)

    Sente Marko

    2004-01-01

    Full Text Available Introduction This paper deals with otologic surgical procedures performed in a an Ear, Nose and Throat Depertment during a 15-year period. The authors compared the number of otologic surgical procedures with the number of laryngomicroscopies and procedures performed in Waldeyer's ring. RESULTS From January 1, 1987 to December 31, 2001, 1184 patients underwent the following surgical procedures in total endotracheal anesthesia: 285 paracenteses, 473 ventilation tubes insertions, 175 antrotomies or mastoidectomies, 194 tympanoplasties, 34 radical mastoidectomies, 4 facial nerve decompressions, 5 exostoses or osteoma of the external auditory canal operations and 14 stapedectomies. DISCUsSION Otologic surgical procedures are presented in table 1. In Yugoslav literature Topolac reports approximately 700 tympanoplasties in a 10-year period (1968-1978. Radonjić and associates report 2272 ear operations in the period 1975-1985. Distribution of operations is presented in table 2, whereas in table 3 we can see that the number of operated ears is much greater than the number of operated patients. CONCLUSION We think that the number of operations is not bigger, because we operate only in critical cases. Our human and technical resources should provide advanced ear microsurgery, but only with financial and organizational support.

  20. Guidelines on the facilities required for minor surgical procedures and minimal access interventions.

    LENUS (Irish Health Repository)

    Humphreys, H

    2012-02-01

    There have been many changes in healthcare provision in recent years, including the delivery of some surgical services in primary care or in day surgery centres, which were previously provided by acute hospitals. Developments in the fields of interventional radiology and cardiology have further expanded the range and complexity of procedures undertaken in these settings. In the face of these changes there is a need to define from an infection prevention and control perspective the basic physical requirements for facilities in which such surgical procedures may be carried out. Under the auspices of the Healthcare Infection Society, we have developed the following recommendations for those designing new facilities or upgrading existing facilities. These draw upon best practice, available evidence, other guidelines where appropriate, and expert consensus to provide sensible and feasible advice. An attempt is also made to define minimal access interventions and minor surgical procedures. For minimal access interventions, including interventional radiology, new facilities should be mechanically ventilated to achieve 15 air changes per hour but natural ventilation is satisfactory for minor procedures. All procedures should involve a checklist and operators should be appropriately trained. There is also a need for prospective surveillance to accurately determine the post-procedure infection rate. Finally, there is a requirement for appropriate applied research to develop the evidence base required to support subsequent iterations of this guidance.

  1. CT appearance of common cosmetic and reconstructive surgical procedures and their complications

    International Nuclear Information System (INIS)

    In this review, we illustrate the spectrum of imaging features after plastic surgical procedures including transverse rectus abdominis myocutaneous flap, deep inferior epigastric perforators flap, latissimus dorsi flap, liposuction, abdominoplasty, and buttocks augmentation. Examples of complications, including seromas, abscesses, fat necrosis, abdominal hernia, and flap necrosis, will also be discussed.

  2. Partial fingertip necrosis following a digital surgical procedure in a patient with primary Raynaud's phenomenon.

    Science.gov (United States)

    Uygur, Safak; Tuncer, Serhan

    2014-12-01

    Raynaud's phenomenon is a common clinical disorder consisting of recurrent, long-lasting and episodic vasospasm of the fingers and toes often associated with exposure to cold. In this article, we present a case of partial fingertip necrosis following digital surgical procedure in a patient with primary Raynaud's phenomenon.

  3. Surgical procedures performed in the neonatal intensive care unit on critically ill neonates: feasibility and safety

    International Nuclear Information System (INIS)

    Transferring unstable, ill neonates to and from the operating rooms carries significant risks and can lead to morbidity. We report on our experience in performing certain procedures in critically ill neonates in the neonatal intensive care unit (NICU). We examined the feasibility and safety for such an approach. All surgical procedures performed in the NICU between January 1999 and December 2005 were analyzed in terms of demographic data, diagnosis, preoperative stability of the patient, procedures performed, complications and outcome. Operations were performed at beside in the NICU in critically ill, unstable neonates who needed emergency surgery, in neonates of low birth weight (<1000 gm) and in neonates on special equipments like higher frequency ventilators and nitrous oxide. Thirty-seven surgical procedures were performed including 12 laparotomies, bowel resection and stomies, 7 repairs of congenital diaphragmatic hernias, 4 ligations of patent ductus arteriosus and various others. Birth weights ranged between 850 gm and 3500 gm (mean 2000 gm). Gestational age ranged between 25 to 42 weeks (mean, 33 weeks). Age at surgery was between 1 to 30 days (mean, 30 days). Preoperatively, 19 patients (51.3%) were on inotropic support and all were intubated and mechanically ventilated. There was no mortality related to surgical procedures. Postoperatively, one patient developed wound infection and disruption. Performing major surgical procedures in the NICU is both feasible and safe. It is useful in very low birth weight, critically ill neonates who have definite risk attached to transfer to the operating room. No special area is needed in the NICU to perform complication-free surgery, but designing an operating room within the NICU will be ideal. (author)

  4. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in The Netherlands.

    OpenAIRE

    Manniën, Judith; Wille, Jan C; Snoeren, Ruud L M M; Hof, Susan van den

    2006-01-01

    OBJECTIVE: To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN: Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical sym...

  5. Surgical reconstruction of pressure ulcer defects: a single- or two-stage procedure?

    LENUS (Irish Health Repository)

    Laing, Tereze A

    2012-02-01

    BACKGROUND: The surgical management of pressure ulcers traditionally involved staged procedures, with initial debridement of necrotic or infected material followed by reconstruction at a later date when the wound was deemed viable and free of gross infection. However, over the past decade, it has been suggested that a single-stage procedure, combining initial debridement and definitive reconstruction, may provide advantages over staged surgery. We present our experience with the staged approach and review the current evidence for both methods. SUBJECTS AND SETTINGS: : We reviewed medical records of all patients referred to our service for pressure ulcer management between October 2001 and October 2007. The National Rehabilitation Hospital is the national center in Ireland for primary rehabilitation of adults and children suffering from spinal and brain injury, serving patients locally and from around the country. METHODS: All subjects who were managed surgically underwent a 2-stage procedure, with initial debridement and subsequent reconstruction. The main outcome measures were length of hospital stay, postoperative morbidity and mortality, and time to complete ulcer healing. RESULTS: Forty-one of 108 patients with 58 pressure ulcers were managed surgically. All patients underwent initial surgical debridement and 20 patients underwent subsequent pressure ulcer reconstruction. Postreconstructive complications occurred in 5 patients (20%). The mean time to complete ulcer healing was 17.4 weeks. Partial flap necrosis occurred in 3 patients, but there were no episodes of flap failure. CONCLUSIONS: We achieved favorable results with a 2-stage reconstruction technique and suggest that the paucity of evidence related to single-stage procedures does not support a change in surgical management.

  6. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Science.gov (United States)

    2010-10-01

    ... ASC surgical procedures performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs § 413.118 Payment for facility services related to covered ASC surgical procedures performed in hospitals on...

  7. Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in Chinese men with prostate cancer

    Directory of Open Access Journals (Sweden)

    Jeremy YC Teoh

    2015-06-01

    Full Text Available We investigated the cardiovascular thrombotic risk after surgical castration (SC versus gonadotropin-releasing hormone agonists (GnRHa in Chinese men with prostate cancer. All Chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan-Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 Chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group (75.3 ± 7.5 years was significantly higher than the GnRHa group (71.8 ± 8.3 years (P < 0.001. There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan-Meier analysis (P = 0.014. Upon multivariate Cox regression analysis, age (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04-1.11, P< 0.001, hyperlipidemia (HR 2.455, 95% CI 1.53-3.93, P< 0.001, and SC (HR 1.648, 95% CI 1.05-2.59, P= 0.031 were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.

  8. Control of bleeding in surgical procedures: critical appraisal of HEMOPATCH (Sealing Hemostat

    Directory of Open Access Journals (Sweden)

    Lewis KM

    2015-12-01

    Full Text Available Kevin Michael Lewis,1 Carl Erik Kuntze,2 Heinz Gulle3 1Preclinical Safety and Efficacy, Baxter Healthcare Corporation, Deerfield, IL, USA; 2Medical Affairs, Baxter Healthcare SA, Zurich, Switzerland; 3Surgical Sciences and Engineering, Baxter Medical Products GmbH, Vienna, Austria Abstract: The need for advanced hemostatic agents increases with the complexity of surgical procedures and use of anticoagulation and antiplatelet treatments. HEMOPATCH (Sealing Hemostat is a novel, advanced hemostatic pad that is composed of a synthetic, protein-reactive monomer and a collagen backing. The active side is covered with a protein-reactive monomer: N-hydroxysuccinimide functionalized polyethylene glycol (NHS-PEG. NHS-PEG rapidly affixes the collagen pad to tissue to promote and maintain hemostasis. The combined action of the NHS-PEG and collagen is demonstrated to have benefit relative to other hemostatic agents in surgery and preclinical surgical models. This paper reviews the published investigations and case reports of the hemostatic efficacy of HEMOPATCH, wherein HEMOPATCH is demonstrated to be an effective, easy-to-use hemostatic agent in open and minimally invasive surgery of patients with thrombin- or platelet-induced coagulopathies. Keywords: HEMOPATCH, hemostasis, surgical hemostasis, sealing, surgical sealant

  9. Traumatic Extensor Tendon Injuries to the Hand: Clinical Anatomy, Biomechanics, and Surgical Procedure Review.

    Science.gov (United States)

    Colzani, Giulia; Tos, Pierluigi; Battiston, Bruno; Merolla, Giovanni; Porcellini, Giuseppe; Artiaco, Stefano

    2016-04-01

    The extensor apparatus is a complex muscle-tendon system that requires integrity or optimal reconstruction to preserve hand function. Anatomical knowledge and the understanding of physiopathology of extensor tendons are essential for an accurate diagnosis of extensor tendon injuries (ETIs) of the hand and wrist, because these lesions are complex and commonly observed in clinical practice. A careful clinical history and assessment still remain the first step for the diagnosis, followed by US and MR to confirm the suspect of ETI or to investigate some doubtful conditions and rule out associate lesions. During last decades the evolution of surgical techniques and rehabilitative treatment protocol led to gradual improvement in clinical results of ETI treatment and surgical repair. Injury classification into anatomical zones and the evaluation of the characteristics of the lesions are considered key points to select the appropriate treatment for ETI. Both conservative and surgical management can be indicated in ETI, depending on the anatomical zone and on the characteristics of the injuries. As a general rule, an attempt of conservative treatment should be performed when the lesion is expected to have favorable result with nonoperative procedure. Many surgical techniques have been proposed over the time and with favorable results if the tendon injury is not underestimated and adequately treated. Despite recent research findings, a lack of evidence-based knowledge is still observed in surgical treatment and postoperative management of ETI. Further clinical and biomechanical investigations would be advisable to clarify this complex issue. PMID:27616821

  10. Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen.

    Science.gov (United States)

    Stulz, P; Pfeiffer, K M

    1982-03-01

    Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar. PMID:7065874

  11. The Perception of Aversiveness of Surgical Procedure Pictures Is Modulated by Personal/Occupational Relevance.

    Science.gov (United States)

    Paes, Juliana; de Oliveira, Leticia; Pereira, Mirtes Garcia; David, Isabel; Souza, Gabriela Guerra Leal; Sobral, Ana Paula; Machado-Pinheiro, Walter; Mocaiber, Izabela

    2016-01-01

    It is well established that emotions are organized around two motivational systems: the defensive and the appetitive. Individual differences are relevant factors in emotional reactions, making them more flexible and less stereotyped. There is evidence that health professionals have lower emotional reactivity when viewing scenes of situations involving pain. The objective of this study was to investigate whether the rating of pictures of surgical procedure depends on their personal/occupational relevance. Fifty-two female Nursing (health discipline) and forty-eight Social Work (social science discipline) students participated in the experiment, which consisted of the presentation of 105 images of different categories (e.g., neutral, food), including 25 images of surgical procedure. Volunteers judged each picture according to its valence (pleasantness) and arousal using the Self-Assessment Manikin scale (dimensional approach). Additionally, the participants chose the word that best described what they felt while viewing each image (discrete emotion perspective). The average valence score for surgical procedure pictures for the Nursing group (M = 4.57; SD = 1.02) was higher than the score for the Social Work group (M = 3.31; SD = 1.05), indicating that Nursing students classified those images as less unpleasant than the Social Work students did. Additionally, the majority of Nursing students (65.4%) chose "neutral" as the word that best described what they felt while viewing the pictures. In the Social Work group, disgust (54.2%) was the emotion that was most frequently chosen. The evaluation of emotional stimuli differed according to the groups' personal/occupational relevance: Nursing students judged pictures of surgical procedure as less unpleasant than the Social Work students did, possibly reflecting an emotional regulation skill or some type of habituation that is critically relevant to their future professional work. PMID:27518897

  12. Phaeochromocytoma Crisis: Two Cases of Undiagnosed Phaeochromocytoma Presenting after Elective Nonrelated Surgical Procedures

    Directory of Open Access Journals (Sweden)

    P. C. Johnston

    2013-01-01

    Full Text Available Phaeochromocytoma is a catecholamine producing tumour and an uncommon cause of hypertension. We present two cases of relatively asymptomatic individuals, in which previously undiagnosed phaeochromocytoma was unmasked by elective nonadrenal surgical procedures, manifesting as postoperative hypertensive crisis and subsequent cardiogenic shock. The initial management in intensive care is discussed, in addition to the clinical and biochemical diagnostic challenges present. Successful adrenalectomy was performed in each case.

  13. Central venous catheterization: comparison between interventional radiological procedure and blind surgical reocedure

    Energy Technology Data Exchange (ETDEWEB)

    Song, Won Gyu; Jin, Gong Yong; Han, Young Min; Yu, He Chul [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2002-11-01

    To determine the usefulness and safety of radiological placement of a central venous catheter by prospectively comparing the results of interventional radiology and blind surgery. For placement of a central venous catheter, the blind surgical method was used in 78 cases (77 patients), and the interventional radiological method in 56 cases (54 patients). The male to female ratio was 66:68, and the patients' mean age was 48 (range, 18-80) years. A tunneled central venous catheter was used in 74 cases, and a chemoport in 60. We evaluated the success and duration of the procedures, the number of punctures required, and ensuing complications, comparing the results of the two methods. The success rates of the interventional radiological and the blind surgical procedure were 100% and 94.8%, respectively. The duration of central catheterization was 3-395 (mean, 120) day, that of chemoport was 160.9 days, and that of tunneled central venous catheter was 95.1 days. The mean number of punctures of the subclavian vein was 1.2 of interventional radiology, and 2.1 for blind surgery. The mean duration of the interventional radiology and the blind surgical procedure was, respectively, 30 and 40 minutes. The postprocedure complication rate was 27.6% (37 cases). Early complications occurred in nine cases (6.7%): where interventional radiology was used, there was one case of hematoma, and blind surgery gave rise to hematoma (n=2), pneumothorax (n=2), and early deviation of the catheter (n=4). Late complications occurred in 32 cases (23.9%). Interventional radiology involved infection (n=4), venous thrombosis (n=1), catheter displacement (n=2) and catheter obstruction (n=5), while the blind surgical procedure gave rise to infection (n=5), venous thrombosis (n=3), catheter displacement (n=4) and catheter obstruction (n=8). The success rate of interventional radiological placement of a central venous catheter was high and the complication rate was low. In comparison with the blind

  14. Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures.

    Science.gov (United States)

    Park, Jin Ha; Lee, Jong Seok; Lee, Jae Hoon; Shin, Seokyung; Min, Nar Hyun; Kim, Min-Soo

    2016-03-01

    Prolonged inspiratory to expiratory (I:E) ratio ventilation has been researched to reduce lung injury and improve oxygenation in surgical patients with one-lung ventilation (OLV) or carbon dioxide (CO2) pneumoperitoneum. We aimed to confirm the efficacy of the 1:1 equal ratio ventilation (ERV) compared with the 1:2 conventional ratio ventilation (CRV) during surgical procedures. Electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched.Prospective interventional trials that assessed the effects of prolonged I:E ratio of 1:1 during surgical procedures. Adult patients undergoing OLV or CO2 pneumoperitoneum as specific interventions depending on surgical procedures. The included studies were examined with the Cochrane Collaboration's tool. The data regarding intraoperative oxygenation and respiratory mechanics were extracted, and then pooled with standardized mean difference (SMD) using the method of Hedges. Seven trials (498 total patients, 274 with ERV) were included. From overall analysis, ERV did not improve oxygenation at 20 or 30 minutes after specific interventions (SMD 0.193, 95% confidence interval (CI): -0.094 to 0.481, P = 0.188). From subgroup analyses, ERV provided significantly improved oxygenation only with laparoscopy (SMD 0.425, 95% CI: 0.167-0.682, P = 0.001). At 60 minutes after the specific interventions, ERV improved oxygenation significantly in the overall analysis (SMD 0.447, 95% CI: 0.209-0.685, P reduce the Ppeak and Pplat. PMID:27043700

  15. Evaluation of the Prevalence of Different Treatment Failure Modes after Crown Lengthening Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2016-07-01

    Full Text Available Introduction: Preservation of the health of periodontium is very important for the long-term success of restored teeth and a balance should always be created between the patients’ esthetic requirements and the periodontal health. Failures of crown lengthening procedures are classified into early and late failures. The aim of this study was to evaluate the prevalence of early failures of crown leathering surgical procedures. Materials and methods: In this descriptive/cross-sectional study, 96 patients were selected from those referring to the Department of Periodontitis, Tabriz Faculty of Dentistry, who required crown lengthening procedures. The particulars of these patients were recorded in special forms and the reasons for the failure of surgical procedures were separately determined at 2- and 6-week intervals. In addition, the frequencies of the reasons for failures were determined in percentages and absolute frequencies. Data were analyzed with descriptive statistics (frequencies and percentages using SPSS 21. Statistical significance was set at P<0.05. Results: Evaluation of patients 6 weeks after surgery showed a failure rate of 14.5% for crown lengthening procedures in patients referring to the Department of Periodontics, Tabriz Faculty of Dentistry. The most common reasons for such early failures in the 6th week, in descending order, were a lack of sufficient keratinized gingiva around in tooth in question, fracture of the tooth structure after surgery, inadequate surgery (not creating a proper distance between the healthy margin and the crest and the coronal returning of the gingival tissue on the tooth. A lack of sufficient keratinized gingiva around the tooth was the most frequent reason for the early failure of crown lengthening procedure at both study intervals. Conclusion: It can be concluded from the results of the present study that during the 6th postoperative week the crown lengthening procedures exhibited a 14.5% failure rate

  16. [A new concept in digestive surgery: the computer assisted surgical procedure, from virtual reality to telemanipulation].

    Science.gov (United States)

    Marescaux, J; Clément, J M; Nord, M; Russier, Y; Tassetti, V; Mutter, D; Cotin, S; Ayache, N

    1997-11-01

    Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reason is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which has to include five requirements: visual fidelity, interactivity, physical properties, physiological properties, sensory input and output. In this report we will describe how to get a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction. PMID:9554121

  17. [A new concept in digestive surgery: the computer assisted surgical procedure, from virtual reality to telemanipulation].

    Science.gov (United States)

    Marescaux, J; Clément, J M; Nord, M; Russier, Y; Tassetti, V; Mutter, D; Cotin, S; Ayache, N

    1997-11-01

    Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reason is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which has to include five requirements: visual fidelity, interactivity, physical properties, physiological properties, sensory input and output. In this report we will describe how to get a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction.

  18. Isokinetic muscle assessment after treatment of pectoralis major muscle rupture using surgical or non-surgical procedures

    Directory of Open Access Journals (Sweden)

    Anna Maria Fleury

    2011-01-01

    Full Text Available INTRODUCTION: Rupture of the pectoralis major muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for pectoralis major muscle rupture. METHODS: We assessed 33 pectoralis major muscle ruptures (18 treated non-surgically and 15 treated surgically. Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20% for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively. The peak torque ratio revealed that the horizontal adduction muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%. CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for pectoralis major muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of muscle strength and balance.

  19. Complications after Surgical Procedures in Patients with Cardiac Implantable Electronic Devices: Results of a Prospective Registry

    Science.gov (United States)

    da Silva, Katia Regina; Albertini, Caio Marcos de Moraes; Crevelari, Elizabeth Sartori; de Carvalho, Eduardo Infante Januzzi; Fiorelli, Alfredo Inácio; Martinelli Filho, Martino; Costa, Roberto

    2016-01-01

    Background: Complications after surgical procedures in patients with cardiac implantable electronic devices (CIED) are an emerging problem due to an increasing number of such procedures and aging of the population, which consequently increases the frequency of comorbidities. Objective: To identify the rates of postoperative complications, mortality, and hospital readmissions, and evaluate the risk factors for the occurrence of these events. Methods: Prospective and unicentric study that included all individuals undergoing CIED surgical procedures from February to August 2011. The patients were distributed by type of procedure into the following groups: initial implantations (cohort 1), generator exchange (cohort 2), and lead-related procedures (cohort 3). The outcomes were evaluated by an independent committee. Univariate and multivariate analyses assessed the risk factors, and the Kaplan-Meier method was used for survival analysis. Results: A total of 713 patients were included in the study and distributed as follows: 333 in cohort 1, 304 in cohort 2, and 76 in cohort 3. Postoperative complications were detected in 7.5%, 1.6%, and 11.8% of the patients in cohorts 1, 2, and 3, respectively (p = 0.014). During a 6-month follow-up, there were 58 (8.1%) deaths and 75 (10.5%) hospital readmissions. Predictors of hospital readmission included the use of implantable cardioverter-defibrillators (odds ratio [OR] = 4.2), functional class III­-IV (OR = 1.8), and warfarin administration (OR = 1.9). Predictors of mortality included age over 80 years (OR = 2.4), ventricular dysfunction (OR = 2.2), functional class III-IV (OR = 3.3), and warfarin administration (OR = 2.3). Conclusions: Postoperative complications, hospital readmissions, and deaths occurred frequently and were strongly related to the type of procedure performed, type of CIED, and severity of the patient's underlying heart disease. PMID:27579544

  20. Medical versus surgical termination of early pregnancy: satisfaction with care, emotional impact and acceptability of the procedure

    Directory of Open Access Journals (Sweden)

    Prasanna L. Akkenapally

    2016-09-01

    Conclusions: Satisfaction with both the methods of medical and surgical abortion is high. Acceptability of the procedure next time was more with surgical abortion. MTOP had higher emotional impact. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3158-3166

  1. Effects of surgical stress and insulin on cardiovascular function and norepinephrine kinetics

    DEFF Research Database (Denmark)

    Christensen, N J; Hilsted, J; Hegedüs, Laszlo;

    1984-01-01

    insulin-dependent diabetics show abnormalities in the regulation of cardiovascular function and sympathetic nervous activity that may be related to the lack of rise in endogenous insulin in these patients. These results suggest that insulin may be of importance for the normal function...

  2. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease

    Directory of Open Access Journals (Sweden)

    Zhou M

    2014-09-01

    Full Text Available Min Zhou, Dian Huang, Chen Liu, Zhao Liu, Min Zhang, Tong Qiao, Chang-Jian Liu Department of Vascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China Objective: To compare outcomes of hybrid (combined surgical and endovascular procedures (HYBRID with open surgical reconstructions (OPEN in patients with multilevel infrainguinal artery occlusive diseases. Design: Case series study with retrospective analysis of prospectively collected nonrandomized data.Methods: Between 2008 and 2012, 64 patients underwent OPEN and 43 underwent HYBRID. Patient characteristics, technique success, clinical improvement, and procedure-related morbidity were reviewed and compared. Patency rates and limb salvages were analyzed and compared using Kaplan–Meier life tables. Cox regression analyses were used to assess the influence of various risk factors on primary patency.Results: HYBRID patients were older and presented with worse New York Heart Association function compared with OPEN patients. The increase in the ankle-brachial index and improvement of Ruthford category after procedures were equivalent between two groups, but HYBRID patients had shorter hospital length of stay (7.6±12.0 versus 15.5±17.3; P= 0.018 and less overall perioperative morbidity (12% versus 28%; P=0.042 compared with OPEN patients. No statistically significant difference in 36-month primary (47.1%±7.1% versus 50.1%±9.4%; P=0.418, assisted primary (57.0%±7.9% versus 62.4%±9.2%; P=0.517, or secondary (82.0%±6.8% versus 83.1%±7.3%; P=0.445 patency was seen between the two groups. Limb salvage rates of HYBRID vs OPEN at 3 years were similar (76.3%±9.3% versus 80.4%±8.2%; P=0.579. Critical limb ischemia was a negative predictor of long-term patency of patients in both the HYBRID and OPEN groups (P=0.012 and P<0.001, respectively, and the presence of diabetes and renal insufficiency were another two independent predictors

  3. Implantation of temperature loggers in 100 Danish dairy calves: Surgical procedure and follow-up

    DEFF Research Database (Denmark)

    Alban, L.; Chriel, M.; Tegtmeier, C.;

    1999-01-01

    submitted for histologic examination. This paper presents 1) the surgical procedure, 2) the prevalence of tissue reaction at the post-operative visits, 3) the degree of implant recovery, 4) the results of histopathologic examinations, 5) an evaluation of age at implantation or veterinary practitioner...... because of presence of an abcess. No migration of the temperature loggers were observed. The results of a repeated measures analysis and the histopathological findings indicate that contamination during the surgery resulted in inflammation and abcess formation. It is recommended that in the presence...

  4. Automating Data Abstraction in a Quality Improvement Platform for Surgical and Interventional Procedures

    Science.gov (United States)

    Yetisgen, Meliha; Klassen, Prescott; Tarczy-Hornoch, Peter

    2014-01-01

    Objective: This paper describes a text processing system designed to automate the manual data abstraction process in a quality improvement (QI) program. The Surgical Care and Outcomes Assessment Program (SCOAP) is a clinician-led, statewide performance benchmarking QI platform for surgical and interventional procedures. The data elements abstracted as part of this program cover a wide range of clinical information from patient medical history to details of surgical interventions. Methods: Statistical and rule-based extractors were developed to automatically abstract data elements. A preprocessing pipeline was created to chunk free-text notes into its sections, sentences, and tokens. The information extracted in this preprocessing step was used by the statistical and rule-based extractors as features. Findings: Performance results for 25 extractors (14 statistical, 11 rule based) are presented. The average f1-scores for 11 rule-based extractors and 14 statistical extractors are 0.785 (min=0.576,max=0.931,std-dev=0.113) and 0.812 (min=0.571,max=0.993,std-dev=0.135) respectively. Discussion: Our error analysis revealed that most extraction errors were due either to data imbalance in the data set or the way the gold standard had been created. Conclusion: As future work, more experiments will be conducted with a more comprehensive data set from multiple institutions contributing to the QI project. PMID:25848598

  5. The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization.

    Science.gov (United States)

    Moe, Gordon W; Ezekowitz, Justin A; O'Meara, Eileen; Howlett, Jonathan G; Fremes, Steve E; Al-Hesayen, Abdul; Heckman, George A; Ducharme, Anique; Estrella-Holder, Estrellita; Grzeslo, Adam; Harkness, Karen; Lepage, Serge; McDonald, Michael; McKelvie, Robert S; Nigam, Anil; Rajda, Miroslaw; Rao, Vivek; Swiggum, Elizabeth; Virani, Sean; Van Le, Vy; Zieroth, Shelley; Arnold, J Malcolm O; Ashton, Tom; D'Astous, Michel; Dorian, Paul; Giannetti, Nadia; Haddad, Haissam; Isaac, Debra L; Kouz, Simon; Leblanc, Marie-Hélène; Liu, Peter; Ross, Heather J; Sussex, Bruce; White, Michel

    2014-03-01

    The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure.

  6. J-tube technique for double-j stent insertion during laparoscopic upper urinary tract surgical procedures.

    Science.gov (United States)

    Kim, Hyung Suk; Lee, Byung Ki; Jung, Jin-Woo; Lee, Jung Keun; Byun, Seok-Soo; Lee, Sang Eun; Jeong, Chang Wook

    2014-11-01

    Double-J stent insertion has been generally performed during laparoscopic upper urinary tract (UUT) surgical procedures to prevent transient urinary tract obstruction and postoperative flank pain from ureteral edema and blood clots. Several restrictive conditions that make this procedure difficult and time consuming, however, include the coiled distal ends of the flexible Double-J stent and the limited bending angle of the laparoscopic instruments. To overcome these limitations, we devised a Double-J stent insertion method using the new J-tube technique. Between July 2011 and May 2013, Double-J stents were inserted using the J-tube technique in 33 patients who underwent a laparoscopic UUT surgical procedure by a single surgeon. The mean stent placement time was 4.8±2.7 minutes, and there were no intraoperative complications. In conclusion, the J-tube technique is a safe and time-saving method for Double-J stent insertion during laparoscopic surgical procedures.

  7. Hospital care in severe trauma: Initial strategies and life-saving surgical procedures.

    Science.gov (United States)

    Monchal, T; Hornez, E; Prunet, B; Beaume, S; Marsaa, H; Bourgouin, S; Baudoin, Y; Bonnet, S; Morvan, J-B; Avaro, J-P; Dagain, A; Platel, J-P; Balandraud, P

    2016-08-01

    Severe trauma patients should be received at the hospital by a multidisciplinary team directed by a "trauma leader" and all institutions capable of receiving such patients should be well organized. As soon as the patient is accepted for care, the entire team should be prepared so that there is no interruption in the pre-hospital chain of care. All caregivers should thoroughly understand the pre-established protocols of diagnostic and therapeutic strategies to allow optimal management of unstable trauma victims in whom hemostasis must be obtained as soon as possible to decrease the morbid consequences of post-hemorrhagic shock. In patients with acute respiratory, circulatory or neurologic distress, several surgical procedures must be performed without delay by whichever surgeon is on call. Our goal is to describe these salvage procedures including invasive approaches to the upper respiratory tract, decompressive thoracostomy, hemostatic or resuscitative thoracotomy, hemostatic laparotomy, preperitoneal pelvic packing, external pelvic fixation by a pelvi-clamp, decompressive craniotomy. All of these procedures can be performed by all practitioners but they require polyvalent skills and training beforehand. PMID:27260640

  8. Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures

    Directory of Open Access Journals (Sweden)

    Zeba Snježana

    2007-01-01

    Full Text Available Background. Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia. Case report. We reported two males who underwent major colorectal surgery for rectal carcinoma. One patient received Aminosol 15% solution, 125 ml/h, while the other did not. The esophageal temperatures in both cases were measured every 30 minutes during the operation and 60 minutes after in Intensive Care Unit. We were monitoring blood pressure, heart rate, ECG, and shivering. Patient who received aminoacids showed ameliorated postoperative hypothermia without hypertension, arrhythmia, or shivering, while the other showed all symptoms mentioned above. Conclusion. According to literature data, as well as our findings, we can conclude that intraoperative intravenous treatment with amino acid solution ameliorates postoperative hypothermia along with its complications. .

  9. COMPARISON THE EFFICIENCY OF DIFFERENT SURGICAL PROCEDURES FOR URINARY STRESS INCONTINENCE

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To analyse the efficiency of two operations for treatment of unirary stress incontinence (USI).Methods. The clinical data of 95 USI cases or accompany USI treated by surgical procedures (Kelly operation 63 cases, Colposuspension 32 cases) was analysed retrospectively in our department.Results.The cure rates during three months after operation were 92.9% in Colposuspension group and 68.9% in Kelly operation group (P0.05). Abnormal senses rates of sexual intercouse was 3.7% in Cloposuspension and 7.3% in Kelly operation group. The length of retaining Folly catheter after Colposuspension was more than Kelly operation.Conclusion.The cure rate during three months after Colposuspension is better than Kelly operation. But the cure rates during one year after surgery are the same in two groups.

  10. COMPARISON THE EFFICIENCY OF DIFFERENT SURGICAL PROCEDURES FOR URINARY STRESS INCONTINENCE

    Institute of Scientific and Technical Information of China (English)

    朱兰; 朗景和; 刘珠凤; 黄荣丽

    2000-01-01

    Objective. To analyse the efficiency of two operations for treatment of unirary stress incontinence (USI). Methods. The clinical data of 95 USI cases or aecompeny USI treated by surgical procedures (Kelly operation 63 cases, Colpesuspemion 32 cases) was analysed retrospectively in our deparlment. Results. The cure rates during three months after operation were 92.9% in Colpesuspension group and 68.9% in Kelly operation group (P 0.05). Abnormal senses rates of sexual intercouse was 3.7 % in Clopesuspension and 7.3 % in Kelly operation group. The length of retaining Folly catheter after Colpesuspension was more than Kelly operation. Conclusion. The cure rate during three months after Colposuspension is better than Kelly operation. But the cure rates during one year after surgery are the same in two groups.

  11. A standard operating procedure for the surgical implantation of transmitters in juvenile salmonids

    Science.gov (United States)

    Liedtke, T.L.; Beeman, J.W.; Gee, L.P.

    2012-01-01

    Biotelemetry is a useful tool to monitor the movements of animals and is widely applied in fisheries research. Radio or acoustic technology can be used, depending on the study design and the environmental conditions in the study area. A broad definition of telemetry also includes the use of Passive Integrated Transponder (PIT) tags, either separately or with a radio or acoustic transmitter. To use telemetry, fish must be equipped with a transmitter. Although there are several attachment procedures available, surgical implantation of transmitters in the abdominal cavity is recognized as the best technique for long-term telemetry studies in general (Stasko and Pincock, 1977; Winter, 1996; Jepsen, 2003), and specifically for juvenile salmonids, Oncorhynchus spp. (Adams and others, 1998a, 1998b; Martinelli and others, 1998; Hall and others, 2009). Studies that use telemetry assume that the processes by which the animals are captured, handled, and tagged, as well as the act of carrying the transmitter, will have minimal effect on their behavior and performance. This assumption, commonly stated as a lack of transmitter effects, must be valid if telemetry studies are to describe accurately the movements and behavior of an entire population of interest, rather than the subset of that population that carries transmitters. This document describes a standard operating procedure (SOP) for surgical implantation of radio or acoustic transmitters in juvenile salmonids. The procedures were developed from a broad base of published information, laboratory experiments, and practical experience in tagging thousands of fish for numerous studies of juvenile salmon movements near Columbia River and Snake River hydroelectric dams. Staff from the Western Fisheries Research Center's Columbia River Research Laboratory (CRRL) frequently have used telemetry studies to evaluate new structures or operations at hydroelectric dams in the Columbia River Basin, and these evaluations typically

  12. Surgical Versus Percutaneous Femoral Access for Delivery of Large-Bore Cardiovascular Devices (from the PARTNER Trial).

    Science.gov (United States)

    McCabe, James M; Huang, Pei-Hsiu; Cohen, David J; Blackstone, Eugene H; Welt, Frederick G P; Davidson, Michael J; Kaneko, Tsuyoshi; Eng, Marvin H; Allen, Keith B; Xu, Ke; Lowry, Ashley M; Lei, Yang; Rajeswaran, Jeevanantham; Brown, David L; Mack, Michael J; Webb, John G; Smith, Craig R; Leon, Martin B; Eisenhauer, Andrew C

    2016-05-15

    It is unclear if surgical exposure confers a risk advantage compared with a percutaneous approach for patients undergoing endovascular procedures requiring large-bore femoral artery access. From the randomized controlled Placement of Aortic Transcatheter Valve trials A and B and the continued access registries, a total of 1,416 patients received transfemoral transcatheter aortic valve replacement, of which 857 underwent surgical, and 559 underwent percutaneous access. Thirty-day rates of major vascular complications and quality of life scores were assessed. Propensity matching was used to adjust for unmeasured confounders. Overall, there were 116 major vascular complications (8.2%). Complication rates decreased dramatically during the study period. In unadjusted analysis, major vascular complications were significantly less common in the percutaneous access group (35 [6.3%] vs 81 [9.5%] p = 0.032). However, among 292 propensity-matched pairs, there was no difference in major vascular complications (22 [7.5%] vs 28 [9.6%], p = 0.37). Percutaneous access was associated with fewer total in-hospital vascular complications (46 [16%] vs 66 [23%], p = 0.036), shorter median procedural duration (97 interquartile range [IQR 68 to 166] vs 121 [IQR 78 to 194] minutes, p length of stay (4 [IQR 2 to 8] vs 6 [IQR 3 to 10] days, p <0.0001). There were no significant differences in quality of life scores at 30 days. Surgical access for large-bore femoral access does not appear to confer any advantages over percutaneous access and may be associated with more minor vascular complications. PMID:27036077

  13. The changing distribution of a major surgical procedure across hospitals: were supply shifts and disequilibrium important?

    Science.gov (United States)

    Friedman, B; Elixhauser, A

    1995-01-01

    This paper describes and analyzes the changing distribution across hospitals in the U.S. of total hip replacement surgery (THR) for the period 1980-1987. THR is one of the most costly single procedures contributing to health care expenses. Also, the use of THR exhibits a particularly high degree of geographic variation. Recent research pointed to shifts in demand as one plausible economic explanation for increasing use of THR. This paper questions whether shifts in supply may have been large enough to explain changes in patient mix and the relationship of patient mix to the number of procedures performed at a particular hospital. In addition, the relationship between total use of THR and the local availability of orthopaedic surgeons as well as the average allowable Medicare fee for standardized physician services is analyzed. These relationships might yield evidence to support a scenario of induced demand beyond the optimum for patients' welfare, or evidence of supply increase within a disequilibrium scenario. This study, using data for all THR patients in a large sample of hospitals, tends to reject the formulation of a market with independent supply and demand shifts where the supply shifts were the dominant forces. Hospitals with a larger number of THRs performed did not see a higher percentage of older, sicker, and lower income patients. It was more likely that demand shifts generated increases in capacity for surgical services. Moreover, there was little evidence for a persistent disequilibrium and only weak evidence for inducement. Also, we found little evidence that hospitals responded to financial incentives inherent in the Medicare payment system after 1983 to select among THR candidates in favour of those with below average expected cost. We did observe increased concentration over time of THR procedures in facilities with high volume--suggesting plausible demand shifts towards hospitals with a priori quality and cost advantages or who obtained those

  14. Single-stage repair of adult aortic coarctation and concomitant cardiovascular pathologies: a new alternative surgical approach

    Directory of Open Access Journals (Sweden)

    Saba Davit

    2006-06-01

    Full Text Available Abstract Background Coarctation of the aorta in the adulthood is sometimes associated with additional cardiovascular pathologies that require intervention. Ideal approach in such patients is uncertain. Anatomic left-sided short aortic bypass from the arcus aorta to descending aorta via median sternotomy allows simultaneuos repair of both complex aortic coarctation and concomitant cardiac operation. Materials Four adult patients were underwent Anatomic left-sided short aortic bypass operation for complex aortic coarctation through median sternotomy using deep hypothermic circulatory arrest. Concomitant cardiac operations were Bentall procedure for annuloaortic ectasia in one patient, coronary artery bypass grafting for three vessel disease in two patient, and patch closure of ventricular septal defect in one patient. Results All patients survived the operation and were alive with patent bypass at a mean follow-up of 36 months. No graft-related complications occurred, and there were no instances of stroke or paraplegia. Conclusion We conclude that single-stage repair of adult aortic coarctation with concomitant cardiovascular lesions can be performed safely using this newest technique.

  15. The prophylactic use of C1 inhibitor in hereditary angioedema patients undergoing invasive surgical procedures: a retrospective study

    OpenAIRE

    Gavigan, Geneviève; Yang, William H; Santucci, Stephanie; Harrison, Rachel; Karsh, Jacob

    2014-01-01

    Background Hereditary Angioedema (HAE) is a rare autosomal dominant condition characterized by episodic angioedema, which may be triggered by invasive procedures and surgery. C1 inhibitor (C1 INH) was approved in the United States and Canada in 2009 and 2010, respectively, for the treatment of acute attacks. Most recently in April 2013, it was approved in Europe for short-term prophylaxis (STP), prior to medical, dental, or surgical procedures, to prevent HAE attacks in both children and adul...

  16. Utilization of surgical procedures for pelvic organ prolapse: a population-based study in Olmsted County, Minnesota, 1965–2002

    OpenAIRE

    Babalola, Ebenezer O.; Bharucha, Adil E; Melton, L. Joseph; Schleck, Cathy D.; Zinsmeister, Alan R.; Klingele, Christopher J.; Gebhart, John B.

    2008-01-01

    To describe trends in the utilization of surgical procedures for pelvic organ prolapse among women in Olmsted County, MN, we retrospectively identified all county residents undergoing pelvic organ prolapse repair from January 1, 1965 through December 31, 2002. From 1965 to 2002, 3,813 women had pelvic organ prolapse surgeries: 3,126 had hysterectomy combined with pelvic floor repair (PFR) procedures and 687 had PFR alone. The age-adjusted utilization of hysterectomy plus PFR and of PFR alone ...

  17. Smart surgical needle actuated by shape memory alloys for percutaneous procedures

    Science.gov (United States)

    Konh, Bardia

    Background: Majority of cancer interventions today are performed percutaneously using needle-based procedures, i.e. through the skin and soft tissue. Insufficient accuracy using conventional surgical needles motivated researchers to provide actuation forces to the needle's body for compensating the possible errors of surgeons/physicians. Therefore, active needles were proposed recently where actuation forces provided by shape memory alloys (SMAs) are utilized to assist the maneuverability and accuracy of surgical needles. This work also aims to introduce a novel needle insertion simulation to predict the deflection of a bevel tip needle inside the tissue. Methods: In this work first, the actuation capability of a single SMA wire was studied. The complex response of SMAs was investigated via a MATLAB implementation of the Brinson model and verified via experimental tests. The material characteristics of SMAs were simulated by defining multilinear elastic isothermal stress-strain curves. Rigorous experiments with SMA wires were performed to determine the material properties as well as to show the capability of the code to predict a stabilized SMA transformation behavior with sufficient accuracy. The isothermal stress-strain curves of SMAs were simulated and defined as a material model for the Finite Element Analysis of the active needle. In the second part of this work, a three-dimensional finite element (FE) model of the active steerable needle was developed to demonstrate the feasibility of using SMA wires as actuators to bend the surgical needle. In the FE model, birth and death method of defining boundary conditions, available in ANSYS, was used to achieve the pre-strain condition on SMA wire prior to actuation. This numerical model was validated with needle deflection experiments with developed prototypes of the active needle. The third part of this work describes the design optimization of the active using genetic algorithm aiming for its maximum flexibility

  18. Factors affecting the profitability of surgical procedures under 'Payment by Results'.

    Science.gov (United States)

    Abbott, T; White, S M; Pandit, J J

    2011-04-01

    We wished to analyse the factors influencing the potential profitability of surgical operations under the National Health Service 'Payment by Results' scheme. First, we planned to develop a generic theoretical model describing the relationships between 'profit', 'procedure duration' and 'costs'. Second, for a group of specific operations, we planned to investigate (using analysis of hypothetical lists) whether it was possible for hospitals to make a profit when lists were maximally efficient. 'Efficient' meant full utilisation of the list time, with no gaps between cases and no case cancellations. We assumed that operating theatres cost a median of £16.min(-1) (range £12-20.min(-1) or ~£7680 for an 8-h list), and we used published mean (SD) times for seven common day-case operations (varicose veins, inguinal hernia, cataract, circumcision, hydrocoele, cystoscopy, breast biopsy). We found that even when conducted perfectly efficiently, some operations (notably varicose veins) were always unprofitable. Conversely, other operations (notably cataracts) would be likely to be profitable even if conducted inefficiently. We conclude that current tariffs do not properly reward efficiency. As tariffs are based in large part on hospitals' reporting their own costs, flaws in the tariffs are likely to be due to inaccurate reporting. Even for this imperfect funding system, our theoretical model may help to develop strategies to maximise profit. Our analysis suggests alternative ways in which reimbursement systems could be designed to avoid creating perverse incentives and instead properly reward efficient practices. PMID:21401542

  19. Surgical Procedures of the Elbow: A Nationwide Cross-Sectional Observational Study in the United States

    Directory of Open Access Journals (Sweden)

    Ahmet Kinaci

    2015-01-01

    Full Text Available Background:  Elbow surgery is shared by several subspecialties. We were curious about the most common elbow surgeries and their corresponding diagnoses in the United States.   Methods:  We used the National Hospital Discharge Survey (NHDS and the National Survey of Ambulatory Surgery (NSAS data gathered in 2006-databases that together provide an estimate of all inpatient and ambulatory surgical care in the US.  Results:  An estimated 150,000 elbow surgeries were performed in the US in 2006, 75% in an outpatient setting. The most frequent diagnosis treated operative was enthesopathy (e.g. lateral epicondylitis and it was treated with several different procedures. More than three quarters of all elbow surgeries treated enthesopathy, cubital tunnel syndrome, or fracture (radial head in particular. Arthroscopy and arthroplasty accounted for less than 10% of all elbow surgeries.  Conclusions:  Elbow surgery in the United States primarily addresses enthesopathies such as tennis elbow, cubital tunnel syndrome, and trauma. It is notable that some of the most common elbow surgeries (those that address enthesopathy and radial head fracture are some of the most variably utilized and debated.

  20. Bilateral symmetry in vision and influence of ocular surgical procedures on binocular vision: A topical review.

    Science.gov (United States)

    Arba Mosquera, Samuel; Verma, Shwetabh

    2016-01-01

    We analyze the role of bilateral symmetry in enhancing binocular visual ability in human eyes, and further explore how efficiently bilateral symmetry is preserved in different ocular surgical procedures. The inclusion criterion for this review was strict relevance to the clinical questions under research. Enantiomorphism has been reported in lower order aberrations, higher order aberrations and cone directionality. When contrast differs in the two eyes, binocular acuity is better than monocular acuity of the eye that receives higher contrast. Anisometropia has an uncommon occurrence in large populations. Anisometropia seen in infancy and childhood is transitory and of little consequence for the visual acuity. Binocular summation of contrast signals declines with age, independent of inter-ocular differences. The symmetric associations between the right and left eye could be explained by the symmetry in pupil offset and visual axis which is always nasal in both eyes. Binocular summation mitigates poor visual performance under low luminance conditions and strong inter-ocular disparity detrimentally affects binocular summation. Considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK and LASIK, however the method to determine whether or not symmetry is maintained consist of comparing individual terms in a variety of ad hoc ways both before and after the refractive surgery, ignoring the fact that retinal image quality for any individual is based on the sum of all terms. The analysis of bilateral symmetry should be related to the patients' binocular vision status. The role of aberrations in monocular and binocular vision needs further investigation.

  1. Cardiovascular effects of epidural morphine or ropivacaine in isoflurane-anaesthetised pigs during surgical devascularisation of the liver

    Directory of Open Access Journals (Sweden)

    G.F. Stegmann

    2010-05-01

    Full Text Available The cardiovascular effects of non-abdominal and abdominal surgery during isoflurane anaesthesia (A-group or isoflurane anaesthesia supplemented with either epidural ropivacaine (AR-group; 0.75 % solution, 0.2 mℓ/kg or morphine (AM-group; 0.1 mg/kg diluted in saline to 0.2mℓ/kg were evaluated in 28 healthy pigs with a mean body weight of 30.3 kg SD ± 4.1 during surgical devascularisation of the liver. Anaesthesia was induced with the intramuscular injection of midazolam (0.3 mg/kg and ketamine (10 mg/kg. Anaesthesia was deepened with intravenous propofol to enable tracheal intubation and maintained with isoflurane on a circle rebreathing circuit. The vaporiser was set at 2.5% for the A-group and 1.5% for the AR- and AM-groups. Differences between treatment groups were not statistically significant (P>0.05 for any of the variables. Differences between AM- and AR-groups were marginally significant heart rate (HR (P = 0.06 and mean arterial blood pressure (MAP (P = 0.08. Within treatment groups, differences for the A-group were statistically significant (P<0.05 between non-abdominal and abdominal surgery for HR, systolic blood pressure, diastolic blood pressure (DIA and MAP. Within the AM-group differences were statistically significant (P < 0.05 for DIA and MAP, and within the AR group differences for all variables were not statistically significant (P > 0.05. It was concluded that in isoflurane-anaesthetised pigs, the epidural administration of ropivacaine decreased heart rate and improved arterial blood pressure during surgery.

  2. Fontan procedure: imaging of normal post-surgical anatomy and the spectrum of cardiac and extracardiac complications

    International Nuclear Information System (INIS)

    Univentricular congenital heart diseases include a range of entities that result in a functionally single ventricular chamber. Although the only curative therapy is cardiac transplantation, there are several palliative surgical techniques that prevent ventricular volume overload, diverting part or all the systemic venous circulation into the pulmonary arteries. The modern Fontan procedure, which consists of anastomosing both the superior (SVC) and inferior vena cava (IVC) to the right pulmonary artery (RPA), is nowadays the last step before transplantation. The importance of imaging in these entities lies not only in the understanding of the new circuit established after surgical correction, but also in the early detection of the wide spectrum of cardiac and extracardiac complications that can occur due to the new physiological condition. Due to the increased survival of these patients, long-term complications are becoming more common. The main cardiac complications are atrial enlargement, ventricular dysfunction, and stenosis or thrombosis of the conduit. Pulmonary artery stenosis, pulmonary arteriovenous fistulae (PAVF), systemic-pulmonary veno venous shunts (VVS), hepatic congestion, cardiac cirrhosis, and protein-losing enteropathy are potential extracardiac complications. - Highlights: • Fontan procedure is the main palliative surgical procedure for univentricular heart correction. • Fontan procedure entails the anastomosis of SVC and IVC to the RPA. • Complications are becoming more common due to the increased survival of patients with Fontan

  3. Creating an animation-enhanced video library of hepato-pancreato-biliary and transplantation surgical procedures.

    Science.gov (United States)

    Fung, Albert; Kelly, Paul; Tait, Gordon; Greig, Paul D; McGilvray, Ian D

    2016-01-01

    The potential for integrating real-time surgical video and state-of-the art animation techniques has not been widely applied to surgical education. This paper describes the use of new technology for creating videos of liver, pancreas and transplant surgery, annotating them with 3D animations, resulting in a freely-accessible online resource: The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery ( http://tvasurg.ca ). The atlas complements the teaching provided to trainees in the operating room, and the techniques described in this study can be readily adapted by other surgical training programmes.

  4. Management of asymptomatic carotid stenosis in patients undergoing general and vascular surgical procedures

    OpenAIRE

    Paciaroni, M; Caso, V; Acciarresi, M; Baumgartner, R.; Agnelli, G.

    2005-01-01

    Current available data do not seem to support the strategy for carotid endarterectomy prior to surgical intervention in patients with asymptomatic carotid stenosis. However, in patients with coronary artery disease, synchronous carotid endarterectomy and coronary artery bypass grafting should be considered where there is a proven surgical risk of 60% or bilateral carotid stenosis >75% on the same side as the most severe stenosis. Clarification of the optimal strategy requires an adequately po...

  5. Surgical outcome of pancreatic cancer using radical antegrade modular pancreatosplenectomy procedure

    Institute of Scientific and Technical Information of China (English)

    Ye Rim Chang; Sung-Sik Han; Sang-Jae Park; Seung Duk Lee; Tae Suk Yoo; Young-Kyu Kim; Tae Hyun Kim

    2012-01-01

    To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS)for pancreatic cancer.METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center,South Korea.Clinicopathologic data,including age,sex,operative findings,pathologic results,adjuvant therapy,postoperative clinical course and follow-up data were retrospectively collected and analyzed for this study.RESULTS:Twenty-one patients (87.5%) underwent distal pancreatectomy and 3 patients (12.5%) underwent total pancreatectomy using RAMPS.Nine patients (37.5%) underwent combined vessel resection,including 8 superior mesenteric-portal vein resections and 1 celiac axis resection.Two patients (8.3%) underwent combined resection of other organs,including the colon,stomach or duodenum.Negative tangential margins were achieved in 22 patients (91.7%).The mean tumor diameter for all patients was 4.09 ± 2.15 cm.The 2 patients with positive margins had a mean diameter of 7.25 cm.The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8%.The median survival of the 24 patients was 18.23 ± 6.02 mo.Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P =0.021).Nine patients (37.5%) had postoperative complications,but there were no postoperative mortalities.Pancreatic fistula occurred in 4 patients (16.7%):2 patients had a grade A fistula and 2 had a grade B fistula.On univariate analysis,histologic grade,positive tangential margin,pancreatic fistula and adjuvant therapy were significant prognostic factors for survival.CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.

  6. A novel set of surgical instruments facilitate the procedure of laparoscopic pyeloplasty

    Institute of Scientific and Technical Information of China (English)

    CHEN Wen-zheng; GUO Fei; LI Yun; Riccardo Autorino; LI Jin-yi; WANG Hui-qing; Fatih Altunrende; SUN Ying-hao

    2012-01-01

    Background Open pyeloplasty has been historically described as the gold standard for the surgical treatment of ureteropelvic junction obstruction (UPJO),even if new techniques have recently gained a prominent role in this field.Laparoscopic pyeloplasty (LP) is not widely prevelant because of the technically challenging nature and it represents the gold standard for UPJO only in expert hands.To overcome some difficulties and technical challenges encountered during pure laparoscopic pyeloplasty,we designed a set of new instruments and assessed them using porcine model.Methods According to the ideas from the surgeons,our medical engineer designed three new instruments,including the right angle laparoscopy scissors,the petal-shape ureter dilator and the guide tube.Four experienced laparoscopic experts were involved in a no survival porcine study to assess the help of these new instruments.Four experiments were conducted on live pigs that weighed 22 to 25 kg at the same time.After general anesthesia was administered,transperitoneal ureteroureterostomy was performed using standard laparoscopic instruments,including placing the double J stent anterograde.Then,the opposite lateral was done by the same surgeon plus these new devices for side-by-side comparative analysis.All experts were interviewed to assess these new instruments by the questionnaire based on the visual analog scale (VAS) from 1 (none) to 10 (very much).Results The procedures were all technically successful.The right angle laparoscopy scissors and the guide tube were accepted by all participants and the Help Score were 6.75 and 4.25 respectively,at the same time the New Difficulty Score 1.25 and 1.75.However,the petal-shape ureter dilator got 1.5 Help Score and 6.5 New Difficulty Score.These surgeons made a negative comment and one of surgeons recommended the stone basket was more suitable.Conclusion The right angle laparoscopy scissors and the guide tube may be helpful to minimize some difficulties in pure

  7. Is mammary reconstruction with the anatomical Becker expander a simple procedure? Complications and hidden problems leading to secondary surgical procedures: a follow-up study.

    Science.gov (United States)

    Farace, Francesco; Faenza, Mario; Bulla, Antonio; Rubino, Corrado; Campus, Gian Vittorio

    2013-06-01

    Debate over the role of Becker expander implants (BEIs) in breast reconstruction is still ongoing. There are no clear indications for BEI use. The main indications for BEI use are one-stage breast reconstruction procedure and congenital breast deformities correction, due to the postoperative ability to vary BEI volume. Recent studies showed that BEIs were removed 5 years after mammary reconstruction in 68% of operated patients. This entails a further surgical procedure. BEIs should not, therefore, be regarded as one-stage prostheses. We performed a case-series study of breast reconstructions with anatomically shaped Becker-35™ implants, in order to highlight complications and to flag unseen problems, which might entail a second surgical procedure. A total of 229 patients, reconstructed from 2005 to 2010, were enrolled in this study. Data relating to implant type, volume, mean operative time and complications were recorded. All the patients underwent the same surgical procedure. The minimum follow-up period was 18 months. During a 5-year follow-up, 99 patients required secondary surgery to correct their complications or sequelae; 46 of them underwent BEI removal within 2 years of implantation, 56 within 3 years, 65 within 4 years and 74 within 5 years. Our findings show that two different sorts of complications can arise with these devices, leading to premature implant removal, one common to any breast implant and one peculiar to BEIs. The Becker implant is a permanent expander. Surgeons must, therefore, be aware that, once positioned, the Becker expander cannot be adjusted at a later date, as in two-stage expander/prosthesis reconstructions for instance. Surgeons must have a clear understanding of possible BEI complications in order to be able to discuss these with their patients. Therefore, only surgeons experienced in breast reconstruction should use BEIs. PMID:23478009

  8. [A new concept in surgery of the digestive tract: surgical procedure assisted by computer, from virtual reality to telemanipulation].

    Science.gov (United States)

    Marescaux, J; Clément, J M; Vix, M; Russier, Y; Tassetti, V; Mutter, D; Cotin, S; Ayache, N

    1998-02-01

    Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reasons is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which must include five requirements: a) visual fidelity, b) interactivity, c) physical properties, d) physiological properties, e) sensory input and output. In this report we describe how to obtain a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction. PMID:9752550

  9. [A new concept in surgery of the digestive tract: surgical procedure assisted by computer, from virtual reality to telemanipulation].

    Science.gov (United States)

    Marescaux, J; Clément, J M; Vix, M; Russier, Y; Tassetti, V; Mutter, D; Cotin, S; Ayache, N

    1998-02-01

    Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reasons is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which must include five requirements: a) visual fidelity, b) interactivity, c) physical properties, d) physiological properties, e) sensory input and output. In this report we describe how to obtain a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction.

  10. Magnesium Lowers the Incidence of Postoperative Junctional Ectopic Tachycardia in Congenital Heart Surgical Patients: Is There a Relationship to Surgical Procedure Complexity?

    Science.gov (United States)

    He, Dingchao; Sznycer-Taub, Nathaniel; Cheng, Yao; McCarter, Robert; Jonas, Richard A; Hanumanthaiah, Sridhar; Moak, Jeffrey P

    2015-08-01

    Magnesium sulfate was given to pediatric cardiac surgical patients during cardiopulmonary bypass period in an attempt to reduce the occurrence of postoperative junctional ectopic tachycardia (PO JET). We reviewed our data to evaluate the effect of magnesium on the occurrence of JET and assess a possible relationship between PO JET and procedure complexity. A total of 1088 congenital heart surgeries (CHS), performed from 2005 to 2010, were reviewed. A total of 750 cases did not receive magnesium, and 338 cases received magnesium (25 mg/kg). All procedures were classified according to Aristotle score from 1 to 4. Overall, there was a statistically significant decrease in PO JET occurrence between the two groups regardless of the Aristotle score, 15.3 % (115/750) in non-magnesium group versus 7.1 % (24/338) in magnesium group, P < 0.001. In the absence of magnesium, the risk of JET increased with increasing Aristotle score, P = 0.01. Following magnesium administration and controlling for body weight, surgical and aortic cross-clamp times in the analyses, reduction in adjusted risk of JET was significantly greater with increasing Aristotle level of complexity (JET in non-magnesium vs. magnesium group, Aristotle level 1: 9.8 vs. 14.3 %, level 4: 11.5 vs. 3.2 %; odds ratio 0.54, 95 % CI 0.31-0.94, P = 0.028). Our data confirmed that intra-operative usage of magnesium reduced the occurrence of PO JET in a larger number and more diverse group of CHS patients than has previously been reported. Further, our data suggest that magnesium's effect on PO JET occurrence seemed more effective in CHS with higher levels of Aristotle complexity.

  11. Cost-effectiveness analyses of elective orthopaedic surgical procedures in patients with inflammatory arthropathies

    DEFF Research Database (Denmark)

    Osnes-Ringen, H.; Kvamme, M. K.; Sønbø Kristiansen, Ivar;

    2011-01-01

    (SD 13) years, 77% female] with inflammatory arthropathies underwent orthopaedic surgical treatment and responded to mail surveys at baseline and during follow-up (3, 6, 9, and 12 months). Questionnaires included the quality-of-life EuroQol-5D (EQ-5D) and Short Form-6D (SF-6D) utility scores. The...

  12. Changes in hospitalisation and surgical procedures among the oldest-old

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Jeune, Bernard; Juel, Knud;

    2013-01-01

    with more active treatment of the recent cohorts of old-aged persons and reduced age inequalities in the Danish healthcare system. No increase in post-operative mortality suggests that the selection of older patients eligible for a surgical treatment is likely to be based on the health status of old...

  13. Nuss procedure for surgical stabilization of flail chest with horizontal sternal body fracture and multiple bilateral rib fractures.

    Science.gov (United States)

    Lee, Sung Kwang; Kang, Do Kyun

    2016-06-01

    Flail chest is a life-threatening situation that paradoxical movement of the thoracic cage was caused by multiply fractured ribs in two different planes, or a sternal fracture, or a combination of the two. The methods to achieve stability of the chest wall are controversy between surgical fixation and mechanical ventilation. We report a case of a 33-year-old man who fell from a high place with fail chest due to multiple rib fractures bilaterally and horizontal sternal fracture. The conventional surgical stabilization using metal plates by access to the front of the sternum could not provide stability of the flail segment because the fracture surface was obliquely upward and there were multiple bilateral rib fractures adjacent the sternum. The Nuss procedure was performed for supporting the flail segment from the back. Flail chest was resolved immediately after the surgery. The patient was weaned from the mechanical ventilation on third postoperative day successfully and was ultimately discharged without any complications.

  14. Comprehensive evaluation of occupational radiation exposure to intraoperative and perioperative personnel from 18F-FDG radioguided surgical procedures

    International Nuclear Information System (INIS)

    The purpose of the current study was to comprehensively evaluate occupational radiation exposure to all intraoperative and perioperative personnel involved in radioguided surgical procedures utilizing 18F-fluorodeoxyglucose (18F-FDG). Radiation exposure to surgeon, anesthetist, scrub technologist, circulating nurse, preoperative nurse, and postoperative nurse, using aluminum oxide dosimeters read by optically stimulated luminescence technology, was evaluated during ten actual radioguided surgical procedures involving administration of 18F-FDG. Mean patient dosage of 18F-FDG was 699 ± 181 MBq (range 451-984). Mean time from 18F-FDG injection to initial exposure of personnel to the patient was shortest for the preoperative nurse (75 ± 63 min, range 0-182) followed by the circulating nurse, anesthetist, scrub technologist, surgeon, and postoperative nurse. Mean total time of exposure of the personnel to the patient was longest for the anesthetist (250 ± 128 min, range 69-492) followed by the circulating nurse, scrub technologist, surgeon, postoperative nurse, and preoperative nurse. Largest deep dose equivalent per case was received by the surgeon (164 ± 135 μSv, range 10-580) followed by the anesthetist, scrub technologist, postoperative nurse, circulating nurse, and preoperative nurse. Largest deep dose equivalent per hour of exposure was received by the preoperative nurse (83 ± 134 μSv/h, range 0-400) followed by the surgeon, anesthetist, postoperative nurse, scrub technologist, and circulating nurse. On a per case basis, occupational radiation exposure to intraoperative and perioperative personnel involved in 18F-FDG radioguided surgical procedures is relatively small. Development of guidelines for monitoring occupational radiation exposure in 18F-FDG cases will provide reassurance and afford a safe work environment for such personnel. (orig.)

  15. Who are the Pioneers? A Critical Analysis of Innovation and Expertise in Cutaneous Noninvasive and Minimally Invasive Cosmetic and Surgical Procedures

    OpenAIRE

    Bangash, HK; Eisen, DB; Armstrong, AW; Nelson, AA; Jalian, HR; Alam, M.; Avram, MM; Ibrahimi, OA

    2016-01-01

    Few studies illustrate the contributions made by various specialties in pioneering commonly performed noninvasive and minimally invasive cosmetic and surgical procedures.To evaluate the contributions made by various specialties in pioneering noninvasive and minimally invasive cosmetic and surgical procedures.Key words using the Medical Search Headings Database were used to query in the Thomson Reuters Web of Science Database. The 25 most highly cited studies were sorted according to the citat...

  16. The meniscus tear: state of the art of rehabilitation protocols related to surgical procedures

    Science.gov (United States)

    Frizziero, Antonio; Ferrari, Raffaello; Giannotti, Erika; Ferroni, Costanza; Poli, Patrizia; Masiero, Stefano

    2012-01-01

    Summary Meniscal injuries represent one of the most frequent lesions in sport practicing and in particular in soccer players and skiers. Pain, functional limitation and swelling are typical symptoms associated with meniscal tears. Epidemiological studies showed that all meniscal lesions, in different sports athletes, involves 24% of medial meniscus, while 8% of lateral meniscus and about 20–30% of meniscal lesions are associated with other ligament injuries. Meniscal tears can be treated conservatively or surgically. Surgery leads in many cases to complete resolution of symptoms and allows the return to sport activity. However many studies show that this treatment can induce more frequently the development of degenerative conditions if not correctly associated to a specific rehabilitation protocol. The aim of this article is to compare different timing in specific rehabilitation programs related to the most actual surgical options. PMID:23738313

  17. The meniscus tear. State of the art of rehabilitation protocols related to surgical procedures.

    Science.gov (United States)

    Frizziero, Antonio; Ferrari, Raffaello; Giannotti, Erika; Ferroni, Costanza; Poli, Patrizia; Masiero, Stefano

    2012-10-01

    Meniscal injuries represent one of the most frequent lesions in sport practicing and in particular in soccer players and skiers. Pain, functional limitation and swelling are typical symptoms associated with meniscal tears. Epidemiological studies showed that all meniscal lesions, in different sports athletes, involves 24% of medial meniscus, while 8% of lateral meniscus and about 20-30% of meniscal lesions are associated with other ligament injuries. Meniscal tears can be treated conservatively or surgically. Surgery leads in many cases to complete resolution of symptoms and allows the return to sport activity. However many studies show that this treatment can induce more frequently the development of degenerative conditions if not correctly associated to a specific rehabilitation protocol. The aim of this article is to compare different timing in specific rehabilitation programs related to the most actual surgical options. PMID:23738313

  18. 肝癌手术治疗进展%Progress in surgical procedures of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    樊嘉; 史颖弘

    2009-01-01

    The incidence of hepatocellular carcinoma (HCC) has increased worldwide over the past two decades. Surgical resection and liver transplantation have been demonstrated as potentially curative treatment options, which could be considered in 30% -40% of HCC patients. Recent advancements of surgical treatment have focused not only on the surgical techpiques, but also the hepatic functional reserve evaluation, resectability assessment and the effects of biological characteristics of tumor on prognosis. There is no single variable to evaluate the hepatic functional reserve accurately. Combined Child-Pugh classification, ICGI5, portal vein pressure detection and remanent liver volume measurement are required prior to liver resection. The 5-year survival rate after liver resection for HCC is about 50%. The results are acceptable for some selected patients that underwent tumor resection with thrombectomy, including HCC with portal vein tumor thrombus or bile duct thrombosis. The choice of local resection or regular hepatectomy is still controversial although the former is commonly performed to treat HCC with cirrhosis, and the latter is applied to HCC patients without liver cirrhosis. The results of liver transplanta-tion for HCC are better than liver resection, and the Milan criteria is generally accepted. Any attempts to expand the selection criteria should be cautious because of organ shortage. Salvage transplantation for intrabepatic recurrence after liver resection may be a good choice in some resectable HCC. The recurrence and metastasis after surgical treatment are the main obstacles to achieve better results. Identification of predictive factors could be helpful to develop prevention strategies. Due to the importance of biological characteristics in tumor recurrence and metastasis, a molecular classification to predict prognosis of HCC patients will lead to a more personalized medicine. Targeting key molecules of biological pathways could optimize the therapeutic

  19. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    Science.gov (United States)

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    2016-01-01

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool. PMID:27568126

  20. Teaching Surgical Procedures with Movies: Tips for High-quality Video Clips

    Science.gov (United States)

    Jacquemart, Mathieu; Bouletreau, Pierre; Breton, Pierre; Mojallal, Ali

    2016-01-01

    Summary: Video must now be considered as a precious tool for learning surgery. However, the medium does present production challenges, and currently, quality movies are not always accessible. We developed a series of 7 surgical videos and made them available on a publicly accessible internet website. Our videos have been viewed by thousands of people worldwide. High-quality educational movies must respect strategic and technical points to be reliable.

  1. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    Science.gov (United States)

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    2016-01-01

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool.

  2. Temporomandibular joint ankylosis: Case-series of two different surgical procedures

    Directory of Open Access Journals (Sweden)

    Gholamreza Shirani

    2014-01-01

    Full Text Available Introducation: The long-term outcome and clinical results of gaparthroplasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared. The purpose of this study was to compare the effect of gap arthroplasty and costochondral graft methods on reankylosis, a mount of mouth opening and growth. Materials and Methods: A non-randomized, retrospective clinical study of l0 cases (5-12 years old of condylar ankylosis of the mandible, surgically treated during a 10 year period from 2002 to 2012 was performed. Four patients were treated by condylectomy and interpositional flap, whereas six were treated by condylectomy and immediate costachondral rib grafts. The first group underwent long-term postoperative therapy using removable activator appliances. Casts, radiographs, photographs, and computed tomography (CT were used post surgically to evaluate rib graft, condylar growth and function, occlusion, facial, and condylar symmetry. Data were analyzed by SPSS 16 statistical software using Mann-Whitney, Paired T-test and Chi-square tests. Results: Children with long-standing condylar ankylosis of the mandible treated by condylectomy and interpositional flap showed more favorably when activators were used post-surgically. Conclusions: Gaparthroplasty with functional activator post-operatively can be considering for TMJ ankylosis.

  3. Arthroscopically assisted Latarjet procedure: A new surgical approach for accurate coracoid graft placement and compression

    Directory of Open Access Journals (Sweden)

    Ettore Taverna

    2013-01-01

    Full Text Available The Latarjet procedure is a confirmed method for the treatment of shoulder instability in the presence of bone loss. It is a challenging procedure for which a key point is the correct placement of the coracoid graft onto the glenoid neck. We here present our technique for an athroscopically assisted Latarjet procedure with a new drill guide, permitting an accurate and reproducible positioning of the coracoid graft, with optimal compression of the graft onto the glenoid neck due to the perfect position of the screws: perpendicular to the graft and the glenoid neck and parallel between them.

  4. Arthroscopically assisted Latarjet procedure: A new surgical approach for accurate coracoid graft placement and compression.

    Science.gov (United States)

    Taverna, Ettore; Ufenast, Henri; Broffoni, Laura; Garavaglia, Guido

    2013-07-01

    The Latarjet procedure is a confirmed method for the treatment of shoulder instability in the presence of bone loss. It is a challenging procedure for which a key point is the correct placement of the coracoid graft onto the glenoid neck. We here present our technique for an athroscopically assisted Latarjet procedure with a new drill guide, permitting an accurate and reproducible positioning of the coracoid graft, with optimal compression of the graft onto the glenoid neck due to the perfect position of the screws: perpendicular to the graft and the glenoid neck and parallel between them.

  5. Multiscale modelling as a tool to prescribe realistic boundary conditions for the study of surgical procedures.

    Science.gov (United States)

    Laganà, K; Dubini, G; Migliavacca, F; Pietrabissa, R; Pennati, G; Veneziani, A; Quarteroni, A

    2002-01-01

    This work was motivated by the problems of analysing detailed 3D models of vascular districts with complex anatomy. It suggests an approach to prescribing realistic boundary conditions to use in order to obtain information on local as well as global haemodynamics. A method was developed which simultaneously solves Navier-Stokes equations for local information and a non-linear system of ordinary differential equations for global information. This is based on the principle that an anatomically detailed 3D model of a cardiovascular district can be achieved by using the finite element method. In turn the finite element method requires a specific boundary condition set. The approach outlined in this work is to include the system of ordinary differential equations in the boundary condition set. Such a multiscale approach was first applied to two controls: (i) a 3D model of a straight tube in a simple hydraulic network and (ii) a 3D model of a straight coronary vessel in a lumped-parameter model of the cardiovascular system. The results obtained are very close to the solutions available for the pipe geometry. This paper also presents preliminary results from the application of the methodology to a particular haemodynamic problem: namely the fluid dynamics of a systemic-to-pulmonary shunt in paediatric cardiac surgery.

  6. Surgical Procedures for Breast Cancer - Mastectomy and Breast Conserving Therapy (Beyond the Basics)

    Science.gov (United States)

    ... performed BCT procedure in the United States and Canada. (See "Breast conserving therapy" .) Radiation therapy Invasive breast ... breast cancer The following organizations also provide reliable health ... and undertakings, oral or written, are hereby expressly superseded and canceled. ...

  7. The Venetian blind technique: modification of the Pi procedure for the surgical correction of sagittal synostosis.

    Science.gov (United States)

    Wexler, Andrew; Cahan, Leslie

    2012-11-01

    Numerous methods of surgical repair for scaphocephaly (sagittal synostosis) have been reported in the literature, from strip craniectomies to more complex methods of calvarial vault remodeling. While good cosmesis and restoration of a normal anteroposterior diameter may be obtained with these methods, a more rounded contour of the biparietal areas is often more difficult to achieve. We describe a modification of the Pi technique, described by Jane in 1976, that results in a more rounded contour of the biparietal areas. We report our experience on cranial vault remodeling for the correction of scaphocephaly in 51 patients from 1998 to 2011. PMID:23154346

  8. Update on dexmedetomidine: use in nonintubated patients requiring sedation for surgical procedures

    Directory of Open Access Journals (Sweden)

    Mohanad Shukry

    2010-03-01

    Full Text Available Mohanad Shukry, Jeffrey A MillerUniversity of Oklahoma Health Sciences Center, Department of Anesthesiology, Children’s Hospital of Oklahoma, Oklahoma City, OK, USAAbstract: Dexmedetomidine was introduced two decades ago as a sedative and supplement to sedation in the intensive care unit for patients whose trachea was intubated. However, since that time dexmedetomidine has been commonly used as a sedative and hypnotic for patients undergoing procedures without the need for tracheal intubation. This review focuses on the application of dexmedetomidine as a sedative and/or total anesthetic in patients undergoing procedures without the need for tracheal intubation. Dexmedetomidine was used for sedation in monitored anesthesia care (MAC, airway procedures including fiberoptic bronchoscopy, dental procedures, ophthalmological procedures, head and neck procedures, neurosurgery, and vascular surgery. Additionally, dexmedetomidine was used for the sedation of pediatric patients undergoing different type of procedures such as cardiac catheterization and magnetic resonance imaging. Dexmedetomidine loading dose ranged from 0.5 to 5 μg kg-1, and infusion dose ranged from 0.2 to 10 μg kg-1 h-1. Dexmedetomidine was administered in conjunction with local anesthesia and/or other sedatives. Ketamine was administered with dexmedetomidine and opposed its bradycardiac effects. Dexmedetomidine may by useful in patients needing sedation without tracheal intubation. The literature suggests potential use of dexmedetomidine solely or as an adjunctive agent to other sedation agents. Dexmedetomidine was especially useful when spontaneous breathing was essential such as in procedures on the airway, or when sudden awakening from sedation was required such as for cooperative clinical examination during craniotomies.Keywords: dexmedetomidine, sedation, nonintubated patients

  9. A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2014-01-01

    Full Text Available Background: The impact of early mobilization on perioperative comorbidities and length of stay (LOS has shown benefits in other medical/surgical subspecialties. However, few spinal series have specifically focused on the "pros" of early mobilization for spinal surgery, other than in acute spinal cord injury. Here we reviewed how early mobilization and other adjunctive measures reduced morbidity and LOS in both medical and/or surgical series, and focused on how their treatment strategies could be applied to spinal patients. Methods: We reviewed studies citing protocols for early mobilization of hospitalized patients (day of surgery, first postoperative day/other in various subspecialties, and correlated these with patients′ perioperative morbidity and LOS. As anticipated, multiple comorbid factors (e.g. hypertension, high cholesterol, diabetes, hypothyroidism, obesity/elevated body mass index hypothyroidism, osteoporosis, chronic obstructive pulmonary disease, coronary artery disease and other factors contribute to the risks and complications of immobilization for any medical/surgical patient, including those undergoing spinal procedures. Some studies additionally offered useful suggestions specific for spinal patients, including prehabilitation (e.g. rehabilitation that starts prior to surgery, preoperative and postoperative high protein supplements/drinks, better preoperative pain control, and early tracheostomy, while others cited more generalized recommendations. Results: In many studies, early mobilization protocols reduced the rate of complications/morbidity (e.g. respiratory decompensation/pneumonias, deep venous thrombosis/pulmonary embolism, urinary tract infections, sepsis or infection, along with the average LOS. Conclusions: A review of multiple medical/surgical protocols promoting early mobilization of hospitalized patients including those undergoing spinal surgery reduced morbidity and LOS.

  10. Quantifying the Diversity and Similarity of Surgical Procedures Among Hospitals and Anesthesia Providers.

    Science.gov (United States)

    Dexter, Franklin; Ledolter, Johannes; Hindman, Bradley J

    2016-01-01

    In this Statistical Grand Rounds, we review methods for the analysis of the diversity of procedures among hospitals, the activities among anesthesia providers, etc. We apply multiple methods and consider their relative reliability and usefulness for perioperative applications, including calculations of SEs. We also review methods for comparing the similarity of procedures among hospitals, activities among anesthesia providers, etc. We again apply multiple methods and consider their relative reliability and usefulness for perioperative applications. The applications include strategic analyses (e.g., hospital marketing) and human resource analytics (e.g., comparisons among providers). Measures of diversity of procedures and activities (e.g., Herfindahl and Gini-Simpson index) are used for quantification of each facility (hospital) or anesthesia provider, one at a time. Diversity can be thought of as a summary measure. Thus, if the diversity of procedures for 48 hospitals is studied, the diversity (and its SE) is being calculated for each hospital. Likewise, the effective numbers of common procedures at each hospital can be calculated (e.g., by using the exponential of the Shannon index). Measures of similarity are pairwise assessments. Thus, if quantifying the similarity of procedures among cases with a break or handoff versus cases without a break or handoff, a similarity index represents a correlation coefficient. There are several different measures of similarity, and we compare their features and applicability for perioperative data. We rely extensively on sensitivity analyses to interpret observed values of the similarity index. PMID:26678472

  11. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2005-11-01

    Full Text Available Introduction: In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy which could serve as a basis for coverage decisions, has been published in Germany. Objective: Against this background the aim of the following assessment is: * Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. * To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. * If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc

  12. Evaluation of propofol as a general anesthetic agent for minor oral surgical procedure.

    Science.gov (United States)

    Jaggi, Nitin; Kalra, Amit; Baghla, Gunpreet Kaur; Medsinge, Sonali V; Purohit, Nikhil

    2013-01-01

    Nausea and vomiting following anesthesia is a distressing problem for the patient as it increases the recovery time, intensity of nursing care and delays discharge. The aim of randomized controlled single blind study is to evaluate the efficacy and safety of subhypnotic doses of propofol for the prevention of postoperative nausea and vomiting (PONV) in day care management of cases in oral and maxillofacial surgeries. Twenty-five patient of ASA-1 with age ranging from 12 to 40 years were scheduled for various maxillofacial surgical cases like fracture, cyst enucleation, surgical removal of 3rd molar, etc. were given propofol at the dose of 2 to 2.5 mg/kg as induction dose and sedation was maintained with the dose 5 to 10 mg/min. There was no significant effect on heart rate, systolic and diastolic blood pressure, respiratory rate and oxygen saturation intraoperatively. In conclusion, a subhypnotic dose of propofol is fast acting, safe and easily controllable, short acting general anesthetic agent with rapid recovery. The study found that the PONV was significantly reduced in the patient with propofol, no hemodynamic derangements were noted in the postoperative period. PMID:24309336

  13. Anaplastic carcinoma of the pancreas: Is there a role for palliative surgical procedure?

    Directory of Open Access Journals (Sweden)

    Rajan Vaithianathan

    2014-01-01

    Full Text Available Anaplastic carcinoma (AC or undifferentiated carcinoma of the pancreas is a rare variant among the malignant pancreatic neoplasms. These tumors have a poor prognosis with survival measured in months. The role of surgical palliation to improve the quality of life is not well defined in these patients. We report a case of AC of pancreas in a 65-year-old male patient. Patient had upper abdominal pain with frequent bilious vomiting. Computed tomography scan of the abdomen showed a mass in the body of pancreas with possible infiltration of duodenojejunal flexure (DJF. Laparotomy revealed an inoperable mass with posterior fixity and involvement of the DJF. Patient underwent a palliative duodenojejunostomy. Tissue biopsy from the tumor showed pleomorphic type AC with giant cells. Patient had good symptomatic relief from profuse vomiting and progressed well at follow up. AC of pancreas is a rare and aggressive malignancy with dismal outlook. If obstructive symptoms are present due to duodenal involvement, a palliative bypass may be a worthwhile surgical option in selected cases.

  14. Surgical Procedures for External Auditory Canal Carcinoma and the Preservation of Postoperative Hearing

    Directory of Open Access Journals (Sweden)

    Hiroshi Hoshikawa

    2012-01-01

    Full Text Available Carcinoma of the external auditory canal (EAC is an unusual head and neck malignancy. The pathophysiology of these tumors is different from other skin lesions because of their anatomical and functional characteristics. Early-stage carcinoma of the EAC can be generally cured by surgical treatment, and reconstruction of the EAC with a tympanoplasty can help to retain hearing, thus improving the patients’ quality of life. In this study, we present two cases of early-stage carcinoma of the EAC treated by canal reconstruction using skin grafts after lateral temporal bone resection. A rolled-up skin graft with a temporal muscle flap was useful for keeping the form and maintaining the postoperative hearing. An adequate size of the skin graft and blood supply to the graft bed are important for achieving a successful operation.

  15. Residual and Recurrent Acoustic Neuroma in Hearing Preservation Procedures: Neuroradiologic and Surgical Findings

    OpenAIRE

    Mazzoni, Antonio; Calabrese, Vincenzo; Moschini, Luca

    1996-01-01

    Magnetic resonance imaging with gadolinium DTPA is currently the most accurate method for detecting small intracanalicular yestibular schwannomas. This imaging modality is not nearly as clear in diagnosis of a small residual or recurrent neuroma after a hearing preservation procedure. This study looked for gadolinium-enhanced MRI images mimicking recurrent lesions in 104 consecutive cases of unilateral acoustic neuroma removed with a hearing preservation technique by the retrosigmoid transmea...

  16. Short-term survival and effects of transmitter implantation into western grebes using a modified surgical procedure

    Science.gov (United States)

    Gaydos, Joseph K.; Massey, J. Gregory; Mulcahy, Daniel M.; Gaskins, Lori A.; Nysewander, David; Evenson, Joseph; Siegel, Paul B.; Ziccardi, Michael H.

    2011-01-01

    Two pilot trials and one study in a closely related grebe species suggest that Western grebes (Aechmophorus occidentalis) will not tolerate intracoelomic transmitter implantation with percutaneous antennae and often die within days of surgery. Wild Western grebes (n = 21) were captured to evaluate a modified surgical technique. Seven birds were surgically implanted with intracoelomic transmitters with percutaneous antennae by using the modified technique (transmitter group), 7 received the same surgery without transmitter implantation (celiotomy group), and 7 served as controls (only undergoing anesthesia). Modifications included laterally offsetting the body wall incision from the skin incision, application of absorbable cyanoacrylate tissue glue to the subcutaneous space between the body wall and skin incisions, application of a waterproof sealant to the skin incision after suture closure, and application of a piece of porcine small intestine submucosa to the antenna egress. Survival did not differ among the 3 groups with 7 of 7 control, 6 of 7 celiotomy, and 6 of 7 transmitter birds surviving the 9-day study. Experimental birds were euthanized at the end of the study, and postmortem findings indicated normal healing. Significant differences in plasma chemistry or immune function were not detected among the 3 groups, and only minor differences were detected in red blood cell indices and plasma proteins. After surgery, the birds in the transmitter group spent more time preening tail feathers than those in the control and celiotomy groups. These results demonstrate that, in a captive situation, celiotomy and intracoelomic transmitter implantation caused minimal detectable homeostatic disturbance in this species and that Western grebes can survive implantation of intracoelomic transmitters with percutaneous antennae. It remains to be determined what potential this modified surgical procedure has to improve postoperative survival of Western grebes that are

  17. Clinical evaluation of the biological width following surgical crown-lengthening procedure: A prospective study

    Directory of Open Access Journals (Sweden)

    Shobha K

    2010-01-01

    Full Text Available Background and Objectives: The purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown-lengthening in human subjects. Materials and Methods: A clinical trial study involving 15 patients was carried out for a period of 6 months. Sites were divided into 3 groups: treated (TT sites, adjacent (AD sites and nonadjacent (NAD sites. Free gingival margin [FGM], attachment level, pocket depth, bone level, biological width [BW] were recorded at baseline, 1, 3 and 6 months. Direct bone level after flap reflection was recorded before and after osseous resection at baseline only. Level of osseous crest was lowered based on BW, and supracrestal tooth structure needed using a combination of rotary and hand instruments. Statistical Analysis: Student t test and ANOVA were used. Results: Overall, apical displacement of FGM at TT, AD and NAD sites was statistically significant compared to baseline. The apical displacement of FGM at TT site was more when compared to that at AD and NAD sites at 3 and 6 months. The BW at the TT site was smaller at 1, 3 and 6 months compared to that at baseline. However, at all sites, BW was reestablished to the baseline value at the end of 6 months. Interpretation and Conclusion: The BW at TT sites was reestablished to its original vertical dimension by 6 months. In addition, a consistent 2-mm gain of coronal tooth structure was observed at the 1, 3 and 6-month examinations.

  18. Patient-Specific Surgical Planning, Where Do We Stand? The Example of the Fontan Procedure.

    Science.gov (United States)

    de Zélicourt, Diane A; Kurtcuoglu, Vartan

    2016-01-01

    The Fontan surgery for single ventricle heart defects is a typical example of a clinical intervention in which patient-specific computational modeling can improve patient outcome: with the functional heterogeneity of the presenting patients, which precludes generic solutions, and the clear influence of the surgically-created Fontan connection on hemodynamics, it is acknowledged that individualized computational optimization of the post-operative hemodynamics can be of clinical value. A large body of literature has thus emerged seeking to provide clinically relevant answers and innovative solutions, with an increasing emphasis on patient-specific approaches. In this review we discuss the benefits and challenges of patient-specific simulations for the Fontan surgery, reviewing state of the art solutions and avenues for future development. We first discuss the clinical impact of patient-specific simulations, notably how they have contributed to our understanding of the link between Fontan hemodynamics and patient outcome. This is followed by a survey of methodologies for capturing patient-specific hemodynamics, with an emphasis on the challenges of defining patient-specific boundary conditions and their extension for prediction of post-operative outcome. We conclude with insights into potential future directions, noting that one of the most pressing issues might be the validation of the predictive capabilities of the developed framework. PMID:26183962

  19. [Middle ear cholesteatoma in children. Criteria for surgical procedure in 57 cases].

    Science.gov (United States)

    Lerosey, Y; Andrieu-Guitrancourt, J; Marie, J P; Dehesdin, D

    1998-10-01

    Fifty five children with 57 cholesteatomas (2 bilateral cholesteatomas) were operated on by the same surgeon. The median period of follow-up was 87 months. Fifteen cases were lost to follow-up (26%). An ossicular erosion was present in 76% of cases. In the first stage, an "intact canal wall technique" (ICWT) was carried out in 44% and a "canal wall down technique" (CWDT) in 56%. A planned second stage was carried out in 76% of ICWT and 56% of CWDT. The incidence of residual cholesteatoma was 29% and the incidence of recurrent cholesteatoma was 11%. A third stage was carried out in 6 cases (11%) without residual or recurrent cholesteatoma. Finally a CWDT was performed in 65% and a ICWT in 35%. The hearing results were significantly better with ICWT but this was due to a better preoperative hearing level. Whatever the surgical technique, the hearing results were better in the presence of an intact stapes. The surgery was individualized. Although ICWT is our priority technique, it was feasible, in our experience, only in a minority of cases because of difficult ablation, insufficient eustachian tube function and very advanced sigmoid sinus or very low lying tegmen plate. Minimal postoperative cavity problems were encountered, even in children where in our experience the mastoidal pneumatisation is limited. PMID:9827188

  20. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    Science.gov (United States)

    2011-01-01

    Background Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient. PMID:21995682

  1. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    Directory of Open Access Journals (Sweden)

    Hintermann Beat

    2011-10-01

    Full Text Available Abstract Background Simultaneous osteoarthritis (OA of the ankle joint complicates primary total knee arthroplasty (TKA. In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week and hospital stay (12 days of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient.

  2. Use of high-magnification loupes or surgical operating microscope when performing prophylaxes, scaling or root planing procedures.

    Science.gov (United States)

    Mamoun, John

    2013-01-01

    The use of high-level magnification (6-8x loupes magnification, or higher degrees of magnification provided by the surgical operating microscope), combined with head-mounted, coaxial lighting, may improve the ability of a dentist or dental hygienist to perform prophylaxis or scaling and root planing procedures, compared to the performance of these tasks using unaided vision or entry-level (2.5x) magnification, combined with overhead operatory lighting. A magnified view of the supragingival contours of a tooth surface facilitates visualizing the dimensions and curvature of the unseen sub-gingival tooth surfaces, which facilitates detection and removal of calculus that is located on these subgingival surfaces. Improved calculus removal ability may lead to better periodontal disease outcomes. PMID:24245463

  3. Retention of laparoscopic procedural skills acquired on a virtual-reality surgical trainer

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Sørensen, J L; Oestergaard, Jeanett;

    2011-01-01

    and 18 months after an initial training course. METHODS AND MATERIALS: The investigation was designed as a 6- and 18-month follow-up on a cohort of participants who earlier participated in a skills training programme on the LapSim VR. The follow-up cohort consisted of trainees and senior consultants...... allocated to two groups: (1) novices (experience 200 procedures during the past 3 years, n = 10). Each participant performed ten sessions. Assessment of skills was based on time, economy of movement and the error parameter "bleeding". The novice group...

  4. Surgical Efficiencies and Quality in the Performance of Voluntary Medical Male Circumcision (VMMC) Procedures in Kenya, South Africa, Tanzania, and Zimbabwe

    OpenAIRE

    Dino Rech; Bertrand, Jane T; Nicholas Thomas; Margaret Farrell; Jason Reed; Sasha Frade; Christopher Samkange; Walter Obiero; Kawango Agot; Hally Mahler; Delivette Castor; Emmanuel Njeuhmeli

    2014-01-01

    INTRODUCTION: This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC), quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC) and total elapsed operating time (TEOT). METHODS: Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Afri...

  5. ProSeal laryngeal mask airway: An alternative to endotracheal intubation in paediatric patients for short duration surgical procedures

    Directory of Open Access Journals (Sweden)

    Jaya Lalwani

    2010-01-01

    Full Text Available The laryngeal mask airway (LMA is a supraglottic airway management device. The LMA is preferred for airway management in paediatric patients for short duration surgical procedures. The recently introduced ProSeal (PLMA, a modification of Classic LMA, has a gastric drainage tube placed lateral to main airway tube which allows the regurgitated gastric contents to bypass the glottis and prevents the pulmonary aspiration. This study was done to compare the efficacy of ProSeal LMA with an endotracheal tube in paediatric patients with respect to number of attempts for placement of devices, haemodynamic responses and perioperative respiratory complications. Sixty children, ASA I and II, weighing 10-20 kg between 2 and 8 years of age group of either sex undergoing elective ophthalmological and lower abdominal surgeries of 30-60 min duration, randomly divided into two groups of 30 patients each were studied. The number of attempts for endotracheal intubation was less than the placement of PLMA. Haemodynamic responses were significantly higher (P<0.05 after endotracheal intubation as compared to the placement of PLMA. There were no significant differences in mean SpO 2 (% and EtCO 2 levels recorded at different time intervals between the two groups. The incidence of post-operative respiratory complications cough and bronchospasm was higher after extubation than after removal of PLMA. The incidence of soft tissue trauma was noted to be higher for PLMA after its removal. There were no incidences of aspiration and hoarseness/sore throat in either group. It is concluded that ProSeal LMA can be safely considered as a suitable and effective alternative to endotracheal intubation in paediatric patients for short duration surgical procedures.

  6. Less Invasive Surgical Procedures Using Narrow-Diameter Implants: A Prospective Study in 20 Consecutive Patients.

    Science.gov (United States)

    Lambert, France Emmanuelle; Lecloux, Geoffrey; Grenade, Charlotte; Bouhy, Alice; Lamy, Marc; Rompen, Eric Henri

    2015-12-01

    Narrow-diameter implants (NDIs) are increasingly produced and used in implant dentistry, especially since the introduction of new, more resistant materials. The objective of the present study was to evaluate the clinical performance of NDIs (3.3 mm) placed in thin alveolar crests. Twenty consecutive patients needing implant-supported fixed partial dentures and presenting an alveolar thickness ≤6 mm were treated with 1 or several NDIs. The surgical protocol was chosen according to the clinical situation: (1) flapless, (2) mini-cervical flap, (3) wide flap, (4) wide flap + guided bone regeneration (GBR). Implants were immediately loaded if the primary stability was higher than 20 Ncm. Implant survival and success, prosthodontic success rates, and patient-centered outcomes were evaluated after a follow-up period of 1 year. A total of 39 implants were placed in 20 patients, 12 and 27 implants in the anterior regions and in the posterior mandible, respectively. All but 1 implant reached an insertion torque higher than 20 Ncm and were loaded within 48 hours. The implant survival and success rates both reached 94.7%. The need for GBR was avoided in 60% of the implant sites. The mean peri-implant bone remodeling after a follow-up period of 1 year was -0.35 mm at the implant level. Peri-implant bone remodeling was higher in the posterior region, when the alveolar crest was thinner than 4 mm and GBR was required in addition. In conclusion, use of NDIs to restore partial edentation in sites with limited horizontal thickness seems to be an effective treatment option that prevented GBR in the majority of the present cases. Immediate provisionalization of NDIs does not seem to impair the results. PMID:24766161

  7. PROCEDIMIENTO EN CIRUGÍA: TORACOSTOMÍA CERRADA Surgical procedures: closed thoracostomy

    Directory of Open Access Journals (Sweden)

    Juan de Dios Díaz-Rosales

    2010-12-01

    Full Text Available La toracostomía consiste en la introducción de un tubo en la cavidad pleural, para drenar aire, sangre, bilis, pus u otros líquidos. Este artículo detalla paso por paso la técnica para la colocación del tubo pleural. También mencionamos las indicaciones, contraindicaciones y las posibles complicaciones asociadas a este procedimientoThoracostomy is the insertion of a tube into the pleural cavity to drain air, blood, bile, pus, or other fluids. This paper provides one approach step-by-step to insertion of chest tube and offers a rationale for practice. It also discusses indications, contraindications and potential complications associated with the procedure

  8. High condylectomy procedure: a valuable resource for surgical management of the mandibular condylar hyperplasia.

    Science.gov (United States)

    Pereira-Santos, Darklilson; De Melo, Willian Morais; Souza, Francisley Avila; de Moura, Walter Leal; Cravinhos, Julio César de Paulo

    2013-07-01

    Condylar hyperplasia is an overdevelopment of the condyle, which may manifest unilaterally or bilaterally. This pathological condition can lead to facial asymmetry, malocclusion, and dysfunction of the temporomandibular joint. The etiology and pathogenesis of condylar hyperplasia remain uncertain, but it has been suggested that its etiology may be associated with hormonal factors, trauma, and hereditary hypervascularity, affecting both genders. The diagnosis is made by clinical examination, and radiological imaging, and additionally, bone scintigraphy, is a fundamental resource for determining whether the affected condyle shows active growth. Patients with active condylar hyperplasia management have better results when they are subjected to the high condylectomy procedure. The authors report a case in a 20-year-old female subject with unilateral active condylar hyperplasia who was treated by high condylectomy. The patient has been followed up for 4 years without signs of recurrence and with good functional stability of the occlusion. PMID:23851829

  9. A Fluidic Cell Embedded Electromagnetic Wave Sensor for Online Indication of Neurological Impairment during Surgical Procedures

    International Nuclear Information System (INIS)

    Lactate is known to be an indicator of neurological impairment during aortic aneurysm surgery. It is suggested that cerebrospinal fluid removed during such surgery could provide useful information in this regard. Medical professionals find the prospect of online detection of such analytes exciting, as current practice is time consuming and leads to multiple invasive procedures. Advancing from the current laboratory based analysis techniques to online methods could provide the basis for improved treatment regimes, better quality of care, and enhanced resource efficiency within hospitals. Accordingly, this article considers the use of a low power fluidic system with embedded electromagnetic wave sensor to detect varying lactate concentrations. Results are promising over the physiological range of 0 − 20 mmol/L with a calibration curve demonstrating an R2 value > 0.98.

  10. Feasibility and safety of combined interventional procedures in elderly patients with complex cardiovascular diseases:experience of a single medical center

    Institute of Scientific and Technical Information of China (English)

    Caiyi LU; Haiyun WU; Shiwen WANG; Xinli WU; Qiao XUE; Taohong HU; Muyang YAN; Rui CHEN; Zhongren ZHAO

    2005-01-01

    Objectives:To report the clinical experience of combined interventional procedures in the treatment of elderly patients with coexisting two or more cardiovascular diseases in our medical center, and to assess the feasibility, safety and therapeutic efficacy of this management strategy. Methods : Patients were selected to the study if: 1) age >65 years; 2) with coexistence of two or more cardiovascular diseases which are indications for interventional therapy; 3) patients' general condition and organ functions allow the performance of combined multiple procedures; 4) the predicted procedure time is within 150 min; 5) the predicted contrast medium dosage is within 300 ml. The criteria we analyzed included procedural type, rocedural time, fluoroscopy time, dosage of contrast medium, success rates of the procedures, complications and in-hospital mortality. All patients were followed up for 30.4 ± 9.3 months,to determine the all-cause mortality, recurrence rates and adverse cardiac events. Results : From January 2000 to December 2004,combined interventional procedures were performed on 136 patients, with 2 procedures on 134 patients and 3 procedures on 2 patients.The mean procedure time was 115.4±11.6 min, the mean fluoroscopy time was 35.7±9.3 min, and the mean dosage of contrast medium used was 183.6±19.4 ml. Procedural success rate was 100%, no procedure related death or major complications occurred.Conclusion: Performed by a competent team, combined interventional procedures in elderly patients with multiple cardiovascular diseases were feasible and relatively safe.

  11. MANAGEMENT OF PATIENTS ON ANTICOAGULANT THERAPY UNDERGOING DENTAL SURGICAL PROCEDURES. Review Article.

    Directory of Open Access Journals (Sweden)

    Atanaska Dinkova

    2013-07-01

    Full Text Available Dental treatment performed in patients receiving oral anticoagulant drug therapy is becoming increasingly common in dental offices.The aim of oral anticoagulant therapy is to reduce blood coagulability to an optimal therapeutic range within which the patient is provided some degree of protection from thromboembolic events. This is achieved at the cost of a minor risk of haemorrhage. Frequently raised questions concern the safety and efficacy of the various anticoagulation regimens and their accompanying thromboembolic and bleeding risks relative to invasive dental procedures.The aim of this literature review is to evaluate the available evidence on the impact of anticoagulant medications on dental treatment and highlight certain patient management issues closely interrelated to various aspects of dental treatment. For that purpose literature search in the electronic database of Medscape, Pubmed-Medline, Science Direct, and EBSCO host, in the data base of Medical University Plovdiv and specialised published books in general medicine and dentistry was made.A total of 33 publications between 1995 and 2013 were identified: 12 review articles, 11 randomized controlled and non-randomised studies, 6 guidelines and practical guides, 1 meta-analysis and 3 specialised books.

  12. Surgical procedure for limbal dermoid and palpebral coloboma-dermoid in English bulldog puppy

    Directory of Open Access Journals (Sweden)

    Božinović Stanko

    2009-01-01

    Full Text Available A dermoid is a malformation, a congenital choristoma, in fact an ectopic part of the skin. This malformation can be located on the eyelids (palpebral, on the palpebral or bulbar part of the conjunctive, on the third eyelid or on the cornea, the limbus edge of the eyelid. Ocular dermoids consist of a cornified squamous-stratified epithelium that can be pigmented to various degrees, located on irregular dermis in which there are hair follicles, sweat and fat glands, and, in rare cases, cartilage and bone can also be observed. Corneal dermoids can be classified into three types: limbal or epibulbar dermoid, a dermoid which covers the greater part or the entire cornea, a dermoid that covers the entire front segment of the eye. Coloboma presents a congenital malformation that is characterized by the absence of an eyelid and it can be located on the upper or on the lower lid. This paper presents the case of an English bulldog puppy in which a limbal dermoid and a palpebral coloboma-dermoid were observed at the same time. In this case, superficial keratectomy was selected for the treatment of the limbal dermoid, while the palpebral colobomadermoid was treated using excision with a plastic reconstruction procedure. A microscopic examination of sample tissue of the corneal demoid showed, on the surface, cornified squamous-stratified epithelium lying on the dermis. The dermis was observed to contain hair follicles, as well as sweat and fat glands.

  13. The influence of a eutectic mixture of lidocaine and prilocaine on minor surgical procedures: a randomized controlled double-blind trial.

    LENUS (Irish Health Repository)

    Shaikh, Faisal M

    2012-01-31

    BACKGROUND: A eutectic mixture of lidocaine and prilocaine (EMLA) has been shown to be effective in reducing pain from needle sticks, including those associated with blood sampling and intravenous insertion. OBJECTIVE: To evaluate the effectiveness of EMLA cream applied before needle puncture for local anesthetic administration before minor surgical procedures in this double-blind, randomized, controlled, parallel-group study. MATERIALS AND METHODS: Patients were randomly assigned to receive EMLA or placebo cream (Aqueous) applied under an occlusive dressing. After the procedure, patients were asked to rate the needle prick and procedure pain on a visual analog scale (0=no pain; 10=maximum pain). RESULTS: A total of 94 minor surgical procedures (49 in EMLA and 45 in control) were performed. The mean needle-stick pain score in the EMLA group was significantly lower than in the control group (2.7 vs. 5.7, p<.001, Mann-Whitney U-test). There was also significantly lower procedure pain in the EMLA group than in the control group (0.83 vs. 1.86, p=.009). There were no complications associated with the use of EMLA. CONCLUSION: EMLA effectively reduces the preprocedural needle-stick pain and procedural pain associated with minor surgical procedures.

  14. Surgical efficiencies and quality in the performance of voluntary medical male circumcision (VMMC procedures in Kenya, South Africa, Tanzania, and Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Dino Rech

    Full Text Available INTRODUCTION: This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC, quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC and total elapsed operating time (TEOT. METHODS: Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23-25 minutes and 6-15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized. After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT. CONCLUSIONS: SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume

  15. Rapid attachment of adipose stromal cells on resorbable polymeric scaffolds facilitates the one-step surgical procedure for cartilage and bone tissue engineering purposes

    NARCIS (Netherlands)

    W.J. Jurgens; R.J. Kroeze; R.A. Bank; M.J.P.F. Ritt; M.N. Helder

    2011-01-01

    The stromal vascular fraction (SVF) of adipose tissue provides an abundant source of mesenchymal stem cells. For clinical application, it would be beneficial to establish treatments in which SVF is obtained, seeded onto a scaffold, and returned into the patient within a single surgical procedure. In

  16. Rapid Attachment of Adipose Stromal Cells on Resorbable Polymeric Scaffolds Facilitates the One-Step Surgical Procedure for Cartilage and Bone Tissue Engineering Purposes

    NARCIS (Netherlands)

    Jurgens, Wouter J.; Kroeze, Robert Jan; Bank, Ruud A.; Ritt, Marco J. P. F.; Helder, Marco N.

    2011-01-01

    The stromal vascular fraction (SVF) of adipose tissue provides an abundant source of mesenchymal stem cells. For clinical application, it would be beneficial to establish treatments in which SVF is obtained, seeded onto a scaffold, and returned into the patient within a single surgical procedure. In

  17. Determination of doses and cancer risk to paediatric and young adult patients undergoing plain radiographic and fluoroscopic guided surgical procedures

    International Nuclear Information System (INIS)

    Fifty paediatric and young adult patients who underwent plain radiographic and fluoroscopic procedures in the operating theatres of a selected orthopaedic hospital were investigated. Radiation Dose was measured using single chip TLD (LiF) held at the skin surface at the beam entrance site for scoliotic, kyphotic and kyphoscoliotic patients undergoing Posterior Spinal Fusion (single stage), Posterior Spinal Fusion (two stage), Growing Rod and Revision Posterior Spinal Fusion as well as patients undergoing Intramedullary Nailing of the Femur and Osteotomy of the lower Extremity. The radiographic equipment were working at self-consistencies. The readings from the TLD, with patient data and other relevant information from the equipment console were used in Monte Carlo program software (PCMXC 2.0) to estimate organ and effective doses as well as assess cancer risk. Mean effective dose from Posterior Spinal Fusion (single stage), Posterior Spinal Fusion (two stage), Growing Rod, Revision Posterior Spinal Fusion, Nailing of the Femur and Osteotomy of the lower Extremity were found to be 7.62 ± 0.84 mSv, 7.48 ± 1.0, 6.82 ± 0.99 mSv, 2.50 ± 0.27 mSv, 0.18 ± 0.09 mSv and 0.001 ± 0.6E4 mSv respectively. The ribs recorded the highest bony organ tissue whiles the breast recorded the highest soft tissue organ dose with Posterior Spinal Fusion (single stage) recording the highest of 25.55±2.81 mGy and 11.49±1.22 mGy. Comparison of paediatric and young adult effective dose showed a higher effective dose in paediatric. Risk of radiation exposure induced cancer death from any cancer were considered for all the procedures and growing rod recorded the highest with 0.0954 % for females and 0.0500% for males. Risk of lung cancer was prevalent in all surgical procedures considered for the study followed by other cancers. However risk of breast cancer was high in females and risk of colon cancer for males. Paediatric and young adult patients exposure records were recommended to be

  18. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe

    Science.gov (United States)

    Tshimanga, Mufuta; Mangwiro, Tonderayi; Mugurungi, Owen; Xaba, Sinokuthemba; Murwira, Munyaradzi; Kasprzyk, Danuta; Montaño, Daniel E.; Nyamukapa, Daisy; Tambashe, Basile; Chatikobo, Pesanai; Gundidza, Patricia; Gwinji, Gerald

    2016-01-01

    Background The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost) of the PrePex device compared to forceps-guided surgical circumcision. Methods and Findings This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160) or surgical arm (n = 80). Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE) data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; pcircumcision. The PrePex device has great potential for use in overburdened health systems and in resource-limited settings and is recommended for use in rapid scale-up of adult MC in Zimbabwe. Trial Registration ClinicalTrials.gov NCT01956370 PMID:27227679

  19. CHANGES OF INTERLEUKIN-6 AND RELATED FACTORS AS WELL AS GASTRIC INTRAMUCOSAL Ph DURING COLORECTAL AND ORTHOPAEDIC SURGICAL PROCEDURES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the changes of perioperative serum levels of interleukin-6 ( IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation. Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol, pHi and plasma lactate were also measured at the same time points. Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation. CRP was not detectable until the first day after operation. Peak concentration of IL-6 had positive relationship with CRP. These variables changed more significantly in colorectal group than that in orthopaedic group (P < 0. 05). pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group ( P < 0. 05 ).Conclusion IL-6 may reflect tissue damage more sensitively than CRP. Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.

  20. Mastectomy -- The Surgical Procedure

    Science.gov (United States)

    ... de sus senos:Consejos útiles para mujeres El Cancer de Mama y el Medio Ambiente: Preguntas y Respuestas Guía de herramientas de educación sobre el cancer de seno para comunidades hispanas/Latinas About Us ...

  1. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Mufuta Tshimanga

    Full Text Available The World Health Organization (WHO and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost of the PrePex device compared to forceps-guided surgical circumcision.This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160 or surgical arm (n = 80. Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; p<0.00001. There were 2 AEs for 2 participants (rate of 1.3%, 95% Confidence Interval: 0.0025-4.53%, which were resolved with simple intervention. The AEs were device related, including 1 case of pain leading to device removal and 1 case of removal of the device.The trial supports previous studies' conclusions that the PrePex procedure is safe, quick, easy to apply, and effective in terms of procedure time as an alternative to traditional surgical circumcision. The PrePex device has great potential for use in overburdened health systems and in resource-limited settings and is

  2. Preliminary Development of a Workstation for Craniomaxillofacial Surgical Procedures: Introducing a Computer-Assisted Planning and Execution System

    Science.gov (United States)

    Gordon, Chad R.; Murphy, Ryan J.; Coon, Devin; Basafa, Ehsan; Otake, Yoshito; Al Rakan, Mohammed; Rada, Erin; Susarla, Sriniras; Swanson, Edward; Fishman, Elliot; Santiago, Gabriel; Brandacher, Gerald; Liacouras, Peter; Grant, Gerald; Armand, Mehran

    2014-01-01

    Introduction Facial transplantation represents one of the most complicated scenarios in craniofacial surgery because of skeletal, aesthetic, and dental discrepancies between donor and recipient. However, standard off-the-shelf vendor computer-assisted surgery systems may not provide custom features to mitigate the increased complexity of this particular procedure. We propose to develop a computer-assisted surgery solution customized for preoperative planning, intraoperative navigation including cutting guides, and dynamic, instantaneous feedback of cephalometric measurements/angles as needed for facial transplantation. Methods We developed the Computer-Assisted Planning and Execution (CAPE) workstation to assist with planning and execution of facial transplantation. Preoperative maxillofacial computed tomography (CT) scans were obtained on 4 size-mismatched miniature swine encompassing 2 live face-jaw-teeth transplants. The system was tested in a laboratory setting using plastic models of mismatched swine, after which the system was used in 2 live swine transplants. Postoperative CT imaging was obtained and compared with the preoperative plan and intraoperative measures from the CAPE workstation for both transplants. Results Plastic model tests familiarized the team with the CAPE workstation and identified several defects in the workflow. Live swine surgeries demonstrated utility of the CAPE system in the operating room, showing submillimeter registration error of 0.6 ± 0.24 mm and promising qualitative comparisons between intraoperative data and postoperative CT imaging. Conclusions The initial development of the CAPE workstation demonstrated integration of computer planning and intraoperative navigation for facial transplantation are possible with submillimeter accuracy. This approach can potentially improve preoperative planning, allowing ideal donor-recipient matching despite significant size mismatch, and accurate surgical execution. PMID:24406592

  3. Lasers in Cardiovascular Surgery—Current Status

    OpenAIRE

    Hunter, John G.; Dixon, John A.

    1985-01-01

    The argon, carbon dioxide and neodymium-YAG lasers have been proposed as effective instruments for surgical procedures of the intact cardiovascular system. While argon and CO2 lasers cause superficial (0 to 1 mm) thermal injury, the Nd:YAG laser is better suited for effecting deep thermal necrosis (3 to 4 mm). Microsurgical vessel anastomoses can be done by “tissue welding” with any of the three clinical lasers. Myocardial revascularization may be accomplished by drilling “neocapillaries” in ...

  4. [Esthetic and social indications for the "redressement forcé" technic and the hazards of this surgical procedure].

    Science.gov (United States)

    Roykó, A; Razouk, G; Dénes, J

    1995-11-01

    The authors report on-, and evaluate the type of operation known as "redressement force" for the correction of retained upper canines. The risk of the surgical intervention is extremely high, but there are good reasons for the indications, too.

  5. Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Maarouf A Hoteit; Amaar H Ghazale; Andrew J Bain; Eli S Rosenberg; Kirk A Easley; Frank A Anania; Robin E Rutherford

    2008-01-01

    AIM: To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) score to predict that outcome.METHODS: We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period. The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint.RESULTS: Patients who reached the endpoint had a higher MELD score, a higher CTP score and were more likely to have undergone an urgent procedure. Among patients undergoing elective surgical procedures, no statistically significant difference was noted in the mean MELD (12.8 ± 3.9 vs 12.6 ± 4.7, P = 0.9) or in the mean CTP (7.6 ± 1.2 vs 7.7 ± 1.7, P = 0.8) between patients who reached the endpoint and those who did not. Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures (MELD: 22.4 ± 8.7 vs 15.2 ± 6.4, P = 0.0007; CTP: 9.9 ± 1.8 vs 8.5 ± 1.8, P = 0.008). The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair, without a significant difference between them (AUC = 0.755 ± 0.066 for MELD vs AUC = 0.696 ± 0.070 for CTP, P = 0.3).CONCLUSION: The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.

  6. Abortion - surgical - aftercare

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    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  7. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... be used for urogynecologic procedures, including repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). It is ... associated with surgical mesh for transvaginal repair of pelvic organ prolapse 513(e) Proposed Order for Reclassification of Surgical ...

  8. Update on bariatric surgical procedures and an introduction to the implantable weight loss device: the Maestro Rechargeable System

    Directory of Open Access Journals (Sweden)

    Hwang SS

    2016-08-01

    Full Text Available Stephanie S Hwang,1 Mark C Takata,1 Ken Fujioka,2 William Fuller1 1Division of General/Bariatric Surgery, Scripps Clinic Weight Management, 2Division of Diabetes and Endocrinology, Scripps Clinic, La Jolla, CA, USA Abstract: There are many different methods of treating obesity, ranging from various medical options to several surgical therapies. This paper briefly summarizes current surgical options for weight loss with a focus on one of the newest US Food and Drug Administration-approved devices for surgical weight loss therapy, the Maestro Rechargeable System. Also known as the vagal blocking for obesity control implantable device, this tool blocks vagal nerve activity to induce weight loss. Keywords: VBLOC device, vagal, vagus, obesity

  9. Immediate prostheses on one-piece trans-mucosal implants in flapless surgical procedures Case Series Report. Part I: full arch rehabilitations

    Directory of Open Access Journals (Sweden)

    Aris Petros Tripodakis

    2012-06-01

    Full Text Available Aim: The aim of the present case series report is to illustrate a clinical technique and present the application of onepiece transmucosal implants in flapless surgical procedures, supporting full arch immediate prostheses. Materials and methods: A total of 294 implants (Xive TG, Friadent, Germany have been used to support full arch immediate prostheses, over the last six years and have been in function for at least one year. The surgical placement of five or more implants per case involved immediate extraction and intrasocket flapless placement, combined with minimal flap elevation in the areas of healed extraction sites (43 mandibular and 7 maxillary arches. In all cases immediate provisionalization followed. Detailed three-dimensional cone-beam localized volumetric tomography preceeded the surgical procedures. The delivery of the final ceramo-metal prostheses was accomplished within a 20 day period. Materials and methods: Results Six implants failed to osseointegrate. All other implants are still successfully bearing the final prosthesis for the time that they have been followed. Soft tissue reaction was favorable from both the biologic and esthetic point of view. Conclusion: The flapless placement of one piece implants into edentulous healed sites is a predictable procedure in the presence of abundance of supporting bone as confirmed by 3-D imaging. On the other hand, immediate extraction placement of one piece implants allows the engagement of sound bone located deeper into the socket and provides adequate mechanical support of the soft tissue architecture that is preserved predictably. In all cases the prosthetic procedures are accomplished without disturbing the hardsoft tissue interface as the abutment-prosthesis interface is coronally elevated by the virtual design of the implant.

  10. The tent pole splint: a bone-supported stereolithographic surgical splint for the soft tissue matrix expansion graft procedure.

    Science.gov (United States)

    Cillo, Joseph E; Theodotou, Nicholas; Samuels, Marc; Krajekian, Joseph

    2010-06-01

    This report details the use of computer-aided planning and intraoperative stereolithographic direct-bone-contact surgical splints for the accurate extraoral placement of dental implants in the soft tissue matrix expansion (tent pole) graft of the severely resorbed mandible. PMID:20231048

  11. Effects of live music therapy sessions on quality of life indicators, medications administered and hospital length of stay for patients undergoing elective surgical procedures for brain.

    Science.gov (United States)

    Walworth, Darcy; Rumana, Christopher S; Nguyen, Judy; Jarred, Jennifer

    2008-01-01

    The physiological and psychological stress that brain tumor patients undergo during the entire surgical experience can considerably affect several aspects of their hospitalization. The purpose of this study was to examine the effects of live music therapy on quality of life indicators, amount of medications administered and length of stay for persons receiving elective surgical procedures of the brain. Subjects (N = 27) were patients admitted for some type of surgical procedure of the brain. Subjects were randomly assigned to either the control group receiving no music intervention (n = 13) or the experimental group receiving pre and postoperative live music therapy sessions (n = 14). Anxiety, mood, pain, perception of hospitalization or procedure, relaxation, and stress were measured using a self-report Visual Analog Scale (VAS) for each of the variables. The documented administration of postoperative pain medications; the frequency, dosage, type, and how it was given was also compared between groups. Experimental subjects live and interactive music therapy sessions, including a pre-operative session and continuing with daily sessions until the patient was discharged home. Control subjects received routine hospital care without any music therapy intervention. Differences in experimental pretest and posttest scores were analyzed using a Wilcoxon Matched-Pairs Signed-Rank test. Results indicated statistically significant differences for 4 of the 6 quality of life measures: anxiety (p = .03), perception of hospitalization (p = .03), relaxation (p = .001), and stress (p = .001). No statistically significant differences were found for mood (p > .05) or pain (p > .05) levels. Administration amounts of nausea and pain medications were compared with a Two-Way ANOVA with One Repeated Measure resulting in no significant differences between groups and medications, F(1, 51) = 0.03; p > .05. Results indicate no significant differences between groups for length of stay (t = .97

  12. Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database

    Directory of Open Access Journals (Sweden)

    Yasunaga Hideo

    2012-05-01

    Full Text Available Abstract Background Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. Methods We analyzed 131,394 patients undergoing lung lobectomy, esophagectomy, gastrectomy, colorectal surgery, hepatectomy or pancreatectomy for cancer between July and December, 2007–2008, using the Japanese Diagnosis Procedure Combination database linked to the Survey of Medical Institutions data. Physician-to-bed ratio (PBR and nurse-to-bed ratio (NBR were determined for each hospital. Hospital volume was categorized into low, medium and high for each of six cancer surgeries. Failure to rescue (FTR was defined as a proportion of inhospital deaths among those with postoperative complications. Multi-level logistic regression analysis was performed to examine the association between physician/nurse staffing and FTR, adjusting for patient characteristics and hospital volume. Results Overall inhospital mortality was 1.8%, postoperative complication rate was 15.2%, and FTR rate was 11.9%. After adjustment for hospital volume, FTR rate in the group with high PBR (≥19.7 physicians per 100 beds and high NBR (≥77.0 nurses per 100 beds was significantly lower than that in the group with low PBR ( Conclusions Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.

  13. Surgical procedures for papillary thyroid carcinoma located in the thyroid isthmus: an intention-to-treat analysis

    Science.gov (United States)

    Lei, Jianyong; Zhu, Jinqiang; Li, Zhihui; Gong, Rixiang; Wei, Tao

    2016-01-01

    Objective We sought to evaluate and compare the outcomes of different surgical protocols for papillary thyroid cancer (PTC) located in the isthmus in a retrospective intention-to-treat analysis. Patients and methods The data of 3,068 patients who received thyroidectomy due to thyroid cancer in our center were reviewed. Of these, 103 patients had a dominant carcinoma located in the isthmus. Various baseline and tumor characteristics and surgical outcomes were evaluated and compared with respect to the different surgical protocols (85 cases with total thyroidectomy and 18 cases with less-than-total thyroidectomy). Univariate and multivariate analyses were performed to identify resected patients who developed recurrence with isthmic PTC. Results The postoperative complication rates were comparable between the two groups (17.6% versus 11.1%, P=0.500). Although the total thyroidectomy group showed a much higher rate (P=0.004) and number (P0.05). Tumor recurrence was observed in five patients, including two patients in the total thyroidectomy group and three patients in the less-than-total thyroidectomy group; the tumor recurrence rate in the total thyroidectomy group was significantly lower than that in the less-than-total thyroidectomy group (P=0.040). Univariate and multivariate analyses indicated less-than-total thyroidectomy as a risk factor for tumor recurrence in PTC cases with tumors located at the isthmus (hazard ratio: 1.870, 95% confidence interval: 1.320–2.218, P<0.001). Conclusion Our findings indicate that total thyroidectomy is an appropriate initial surgical protocol for isthmic PTC due to the lower recurrence rate, comparable postoperative complication rate, and parathyroid function recovery. PMID:27578987

  14. Combined HLA matched limbal stem cells allograft with amniotic membrane transplantation as a prophylactic surgical procedure to prevent corneal graft rejection after penetrating keratoplasty: case report

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    Paolo Capozzi

    2014-09-01

    Full Text Available Purpose. To determine if the use of combined HLA matched limbal stem cells allograft with amniotic membrane transplantation (AMT is a safe and effective prophylactic surgical procedure to prevent corneal graft after penetrating keratoplasty (PK. Methods. We report the case of a 17 years old patient with a history of congenital glaucoma, trabeculectomy and multiple corneal graft rejections, presenting total limbal cell deficiency. To reduce the possibility of graft rejection in the left eye after a new PK, a two step procedure was performed. At first the patient underwent a combined HLA matched limbal stem cells allograft (LAT and AMT and then, 10 months later, a new PK. Results. During 12 months of follow-up, the corneal graft remained stable and smooth, with no sign of graft rejection. Conclusions. In our patient, the prophylactic use of LAT from HLA-matched donors and AMT before PK, may result in a better prognosis of corneal graft survival.

  15. Robotic technology in cardiovascular medicine.

    Science.gov (United States)

    Bonatti, Johannes; Vetrovec, George; Riga, Celia; Wazni, Oussama; Stadler, Petr

    2014-05-01

    Robotic technology has been used in cardiovascular medicine since the late 1990s. Interventional cardiology, electrophysiology, endovascular surgery, minimally invasive cardiac surgery, and laparoscopic vascular surgery are all fields of application. Robotic devices enable endoscopic reconstructive surgery in narrow spaces and fast, very precise placement of catheters and devices in catheter-based interventions. In all robotic systems, the operator manipulates the robotic arms from a control station or console. In the field of cardiac surgery, mitral valve repair, CABG surgery, atrial septal defect repair, and myxoma resection can be achieved using robotic technology. Furthermore, vascular surgeons can perform a variety of robotically assisted operations to treat aortic, visceral, and peripheral artery disease. In electrophysiology, ablation procedures for atrial fibrillation can be carried out with robotic support. In the past few years, robotically assisted percutaneous coronary intervention and abdominal aortic endovascular surgery techniques have been developed. The basic feasibility and safety of robotic approaches in cardiovascular medicine has been demonstrated, but learning curves and the high costs associated with this technology have limited its widespread use. Nonetheless, increased procedural speed, accuracy, and reduced exposure to radiation and contrast agent in robotically assisted catheter-based interventions, as well as reduced surgical trauma and shortened patient recovery times after robotic cardiovascular surgery are promising achievements in the field. PMID:24663088

  16. [Surgical-orthodontic correction of unerupted upper canine teeth and motivation for the procedure from the patient's viewpoint].

    Science.gov (United States)

    Razouk, G; Roykó, A; Dénes, J

    1995-10-01

    The surgical correction of the retention of upper canines is made easier by the direct bonding method, furthermore it increases the chances of successful treatment. At the same time at teen-age the treatment is usually missing, since the persistent milk-teeth in the place of impacted canines are ensuring the aesthetic effect. The late treatment is motivated by aesthetic aspects also by loosing the milk-canines. Thus the indication of the treatment is a cure only from the orthodontist's aspect, from the patient's view it's only the aesthetics.

  17. COMPARISON OF GLYCEMIC EFFECT OF ADRENALIN CONTAINING LOCAL ANESTHETIC IN DIABETIC AND NON-DIABETIC PATIENTS UNDERGOING MINOR ORAL SURGICAL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Pradeep

    2015-12-01

    Full Text Available AIM To compare the changes in blood glucose level associated with administration of adrenaline containing local anesthetic in diabetic and non-diabetic patients undergoing minor oral surgical procedures. METHODS AND MATERIAL The study included 150 well controlled diabetic patients and 150 non-diabetic healthy patients in age group of 40-60 years who underwent minor oral surgical procedures (trans alveolar extractions, alveoplasty and flap surgeries. Patients in both the group were administered 1.8ml of local anesthetic agent containing 1:100,000 adrenaline for inferior alveolar nerve block and 0.2 ml of anesthetic agent for long buccal nerve block. Blood glucose levels were assessed and compared during pre-operative and one hour post-operative period. STATISTICAL ANALYSIS The comparison of the random blood sugar levels preop and postop in both the groups were compared using paired t test and RBS levels between two groups were analysed using unpaired t test. P value less than 0.05 was considered statistically significant. RESULTS No statistically significant change in post-operative blood glucose level was noted between the diabetic and non-diabetic patients. CONCLUSION The study concluded that it is safe to administer local anesthetic containing 1:100,000 adrenaline in smaller volumes to well controlled diabetic patients.

  18. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  19. Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program.

    Science.gov (United States)

    Sherrod, Brandon A; Johnston, James M; Rocque, Brandon G

    2016-09-01

    OBJECTIVE Hospital readmission rate is increasingly used as a quality outcome measure after surgery. The purpose of this study was to establish, using a national database, the baseline readmission rates and risk factors for patient readmission after pediatric neurosurgical procedures. METHODS The American College of Surgeons National Surgical Quality Improvement Program-Pediatric database was queried for pediatric patients treated by a neurosurgeon between 2012 and 2013. Procedures were categorized by current procedural terminology (CPT) code. Patient demographics, comorbidities, preoperative laboratory values, operative variables, and postoperative complications were analyzed via univariate and multivariate techniques to find associations with unplanned readmissions within 30 days of the primary procedure. RESULTS A total of 9799 cases met the inclusion criteria, 1098 (11.2%) of which had an unplanned readmission within 30 days. Readmission occurred 14.0 ± 7.7 days postoperatively (mean ± standard deviation). The 4 procedures with the highest unplanned readmission rates were CSF shunt revision (17.3%; CPT codes 62225 and 62230), repair of myelomeningocele > 5 cm in diameter (15.4%), CSF shunt creation (14.1%), and craniectomy for infratentorial tumor excision (13.9%). The lowest unplanned readmission rates were for spine (6.5%), craniotomy for craniosynostosis (2.1%), and skin lesion (1.0%) procedures. On multivariate regression analysis, the odds of readmission were greatest in patients experiencing postoperative surgical site infection (SSI; deep, organ/space, superficial SSI, and wound disruption: OR > 12 and p 10 days (OR 1.411, p = 0.010), oxygen supplementation (OR 1.645, p = 0.010), nutritional support (OR 1.403, p = 0.009), seizure disorder (OR 1.250, p = 0.021), and longer operative time (per hour increase, OR 1.059, p = 0.029). CONCLUSIONS This study may aid in identifying patients at risk for unplanned readmission following pediatric neurosurgery

  20. The. Thoma Ionescu - Victor Gomoiu Procedure: Cervicothoracic Sympathectomy for Angina Pectoris. The First Surgical Attempt to Treat the Coronary Heart Disease.

    Science.gov (United States)

    Vasilescu, Cătălin; Salmen, Monica; Bobocea, Andrei

    2016-01-01

    Cervicothoracic Sympathectomy is a common indication in the treatment of Raynaud Syndrome, Palmer Hyperhidrosis or Acute Ischemia of the superior limb. Nonetheless, almost a century ago it represented one of the first innovative attempts in curing coronary heart disease. Nowadays, this indication is no more than a footnote in a volume on the History of Medicine, and a trivia fact for medical history enthusiasts. The operation's history is rather conflicting. A young Romaninan surgeon, Victor Gomoiu seems to have come up with the idea, in the early 20th century. However, his contribution remains unknown, after his successful collaboration with the famous surgeon and anatomist, Thoma Ionescu unfortunately turns into a dispute. This procedure was once thought cutting-edge. Furthermore it is the starting point for cardiovascular surgery. Whoever sparked the idea, gains an important place in the hall of fame of international surgery, that is why it is important to know its creator. PMID:27544937

  1. An evaluation of a periodontal plastic surgical procedure for the reconstruction of interdental papillae in maxillary anterior region: A clinical study

    Directory of Open Access Journals (Sweden)

    Madhuri Lokhande Sawai

    2012-01-01

    Full Text Available Background: In today′s world, people are very much aware about their looks and personality. They are getting more concerned about the esthetics and thus are not ready to compromise the appearance of black holes, especially in the anterior region of the mouth. Various techniques like orthodontic correction, prosthetic veneers and various periodontal surgical methods have been used to cover these unaesthetic open embrasures. In the present study, a variant technique given by Beagle in 1992 was used to cover these open gingival embrasures. The technique uses a gingival flap from the labial aspect to close the open gingival embrasures thus solving the problem of black holes. Aims and Objectives: This clinical study was aimed to reconstruct the lost or blunted interdental papillae with gingival tissue for esthetic purpose and for maintaining oral health with the objective to determine the extent to which the procedure can revert the maxillary esthetics. Materials and Methods: The patients selected were those who were having a complaint of at least one black hole in the maxillary anterior region with grade ′0′ or ′1′ type of contour of interdental tissues. A total of 39 open embrasures were surgically closed using this technique. Various indices were taken pre-surgically and then again post surgically. Results: Plaque index and gingival index showed an initial increase in the scores at the end of 1 week. Later, there was a gradual fall till the end of the study. Bleeding index significantly increased at the end of 12 weeks ( P<0.001 but reduced to insignificant levels at the end of 24 weeks ( P<0.09. The sulcus depth increased by about 1.19 mm. There was improvement in the contour of interdental tissues in 51% of cases and in 38.46% the interdental papillae completely obliterated the open embrasures. Conclusion: The surgical technique used here for reconstruction of interdental papilla was fairly successful. However, use of bone grafts or

  2. Change of Cardiovascular Variability During a Stepwise Paced Breathing Procedure%渐进性引导呼吸下的心血管变异性分析

    Institute of Scientific and Technical Information of China (English)

    张政波; 王步青; 柴晓珂; 郑捷文; 王卫东; 吴昊; 李开元; 刘洪运

    2014-01-01

    研究了引导呼吸下心血管参数变化情况,观察引导呼吸对心血管系统的累积作用效果。采用了呼吸率由高到低渐进性变化的呼吸运动模板,同步观察了心率变异性、血压和脉搏波传导时间的变化规律。实验结果表明,在渐进性引导呼吸过程中,随着呼吸率的降低,呼吸运动对心率、血压和脉搏波传导时间的幅度调制作用显著增强(p<0.05),同时脉搏波传导时间延长,血压下降。该引导呼吸模式具有显著降低血压的作用效果(p<0.05),脉搏波传导时间基线可作为一个有效的指标来表征引导呼吸的作用效果。%To investigate the effect of paced breathing on cardiovascular system, the cardiovascular variables of heart rate, blood pressure and pulse transit time (PTT) were measured during a stepwise paced breathing procedure (six different breathing rates at [14, 12.5, 11, 9.5, 8, 7]BPM). Respiratory sinus arrhythmia (RSA) was estimated by using autoregressive (AR) model based power spectral analysis. The ensemble empirical mode decomposition (EEMD) was applied to PTT to decompose the signal into different intrinsic mode function, and respiration-derived oscillation and trend component (baseline) in PTT were extracted for further analysis. The results clearly indicate that the stepwise paced breathing procedure can induce increased oscillations in RSA, blood pressure and PTT, meanwhile, reduce blood pressure and lengthen PTT baseline. It was demonstrated that this stepwise paced breathing procedure can lead to blood pressure reduction significantly (p<0.05), and PTT can be used as a maker for the effect of paced breathing on cardiovascular system.

  3. Relationship Between Periodontics and Restorative Procedures: Surgical Treatment of the Restorative Alveolar Interface (Rai)––Case Series

    OpenAIRE

    Almeida, A. L. P. F.; Esper, L. A.; Sbrana, M. C.; Cunha, M. J. S.; Greghi, S. L. A.; Carrilho, G. P. B.; Pegoraro, L. F.

    2012-01-01

    Maintenance of a healthy periodontium is fundamental for the long term success of prosthetic restorations. Thus, prosthetic procedures with subgingival margins may affect the periodontal health if the distances between the junctional epithelium and supracrestal connective tissue attachment aren’t respected, or if there is insufficient space to maintain the health of the interproximal tissues, leading to gingival inflammation, connective tissue attachment loss and bone resorption. The restorat...

  4. Patient-specific modeling of human cardiovascular system elements

    Science.gov (United States)

    Kossovich, Leonid Yu.; Kirillova, Irina V.; Golyadkina, Anastasiya A.; Polienko, Asel V.; Chelnokova, Natalia O.; Ivanov, Dmitriy V.; Murylev, Vladimir V.

    2016-03-01

    Object of study: The research is aimed at development of personalized medical treatment. Algorithm was developed for patient-specific surgical interventions of the cardiovascular system pathologies. Methods: Geometrical models of the biological objects and initial and boundary conditions were realized by medical diagnostic data of the specific patient. Mechanical and histomorphological parameters were obtained with the help mechanical experiments on universal testing machine. Computer modeling of the studied processes was conducted with the help of the finite element method. Results: Results of the numerical simulation allowed evaluating the physiological processes in the studied object in normal state, in presence of different pathologies and after different types of surgical procedures.

  5. 心血管病医院外科ICU护士分层管理体验的质性研究%A qualitative research on the experience of nurse stratified management in surgical intensive care unit in cardiovascular hospital

    Institute of Scientific and Technical Information of China (English)

    薛梅; 李庆印; 石丽; 贾艳; 杨戎

    2013-01-01

    目的 探讨医护人员对外科ICU护士分层管理的体验.方法 采用定性研究方法,对8名从事外科ICU工作的护士长、主任及临床医生进行访谈,并运用Claizzi分析程序进行资料分析.结果 外科ICU护士分层使用模式发挥了管理效能,护理组长任职条件更全面,此模式基本合理,但在普通病区仍不成熟.结论 护士分层使用适用于心血管外科ICU,有利于不同层级护士管理职能的发挥.%Objective To explore the experience of nurse stratified management in surgical intensive care unit (ICU). Methods The qualitative research method was adopted,and 8 experts engaged in surgical ICU,including head nurses,directors and clinical doctors were interviewed. The Claizzi analysis method was employed to analyze the data. Results The nurse stratified model played the management efficiency in surgical ICU. Qualifications of team leaders were more comprehensive. This model was basically reasonable in ICU,but the general ward was still not mature. Conclusion The nurse stratified using is suitable for cardiovascular surgical ICU and in favor of the management functions of nurses in different levels.

  6. Lumbosubarachnoid-lumboepidural shunting in patients with idiopathic normal-pressure hydrocephalus: surgical procedures and follow-up study of five cases.

    Science.gov (United States)

    Takeuchi, Totaro; Fukushima, Shintaro; Misaki, Daigoro; Shibata, Satoshi

    2013-01-01

    The objective of the study is to introduce the surgical procedure of the lumbosubarachnoid-lumboepidural (L-L) shunting performed as treatment for idiopathic normal-pressure hydrocephalus (iNPH) and its follow-up. The subjects were five patients with probable iNPH (aged 78-85 years; mean age 81 years; four males and one female) who were judged to be at high risk from general or lumbar anesthesia due to their systemic complications and age. The L-L shunt operation was performed for all the patients under local anesthesia using Codman-Hakim Programmable Valve(®) (Codman & Shurtleff, Inc., Raynham, Massachusetts, USA). The initial pressure for all patients was set at 8 cmH2O. The evaluation of shunt efficacy and the lumbar epidural space cerebrospinal fluid (CSF) absorption test (injection of contrast media into epidural space) were performed both on the operation day and during follow-up period (9-12 months). The shunt operation was judged to be effective in four out of five patients (regarded as shunt responders), whereas no improvement in symptoms was seen in one patient (regarded as shunt nonresponder) where the shunting had no effect after the initial pressure was changed to 4 cmH2O. The lumbar epidural space CSF absorption test both on the operation day and during the follow-up period confirmed absorption in all patients. The L-L shunting is useful for patients with probable iNPH who are at high risk from general or lumbar anesthesia due to their systemic complications and age. CSF was continuously absorbed in the lumbar epidural space during postoperative follow-up period. A longer follow-up is required to establish this surgical procedure.

  7. Lung Volume Reduction in Chronic Obstructive Pulmonary Disease (COPD AND#8211; An Updated Review of Surgical and Endoscopic Procedures

    Directory of Open Access Journals (Sweden)

    Ramakant Dixit

    2012-08-01

    Full Text Available The conventional medical management of emphysema using bronchodilators and anti-inflammatory agents has a limited benefit in patients having advanced hyperinflation of lungs due to destruction of elastic tissue. The natural course of Chronic Obstructive Pulmonary Disease (COPD has been shown to be altered by only smoking cessation and oxygen therapy so far. The lung volume reduction surgery is viewed as another modality to change the natural history of emphysema in recent years. For patients with more generalized emphysema, resection of lung parenchyma improves elastic recoil and chest wall mechanics. An extensive literature search has demonstrated that carefully selected patients of emphysema (i.e. upper lobe predominant disease, low exercise capacity and Forced Expiratory Volume in First Second (FEV1 and DLco and #8804; 20% of predicted receive benefits in terms of symptomatic improvement and physiologic response following Lung Volume Reduction Surgery (LVRS. The resurgent interest in LVRS and National Emphysema Treatment Trial findings for emphysema have stimulated a range of innovative methods, to improve the outcome and reduce complications associated with current LVRS techniques. These novel approaches include surgical resection with compression/banding devices, endobronchial blockers, sealants, obstructing devices and valves and endobronchial bronchial bypass approaches. Experimental data and preliminary results are becoming available for some of these approaches. Most of the published studies so far have been uncontrolled and unblinded. Overall, extensive research in the near future will help to determine the potential clinical applicability of these new approaches to the treatment of emphysema symptoms. [Arch Clin Exp Surg 2012; 1(4.000: 249-257

  8. Recombinant activated factor VII in the treatment of intractable non-surgical bleeding following major vascular procedures

    Directory of Open Access Journals (Sweden)

    Končar Igor B.

    2008-01-01

    Full Text Available INTRODUCTION A recombinant form of activated factor VII (rFVIIa is a haemostatic drug that is approved for use in haemophiliacs with antibodies to factor VIII or factor IX. Most recent studies and clinical experience have shown that rFVIIa (NovoSeven ®, Novo Nordisk A/S, Denmark gives extreme haemostatic effect in patients with severe "non-haemophilic" bleeding produced after trauma and major surgery. OBJECTIVE We present our preliminary experience of the use of rFVIIa in vascular surgery when conventional haemostatic measures are inadequate. METHOD There were 32 patients divided into five groups: Group I - 14 patients with ruptured abdominal aortic aneurysms; Group II - 10 patients with thoracoabdominal aortic aneurysms; Group III - 5 patients with retroperitoneal tumors involving great abdominal vessels; Group IV - 2 patients with portal hypertension and Group V - one patient with iatrogenic injury of brachial artery and vein during fibrinolytic treatment, because of myocardial infarction. RESULTS Clinical improvement was detected following treatment in 29 patients. Bleeding was successfully controlled as evidenced by improved haemodynamic parameters and decreased inotropic and transfusion requirements. CONCLUSION In vascular patients more liberal use of rFVIIa is limited, because no randomized controlled trial has proved its efficacy and safety in such patients; while also keeping in mind that the price of a 4.8 mg of rFVIIa is $4,080. We recommend the use of rFVIIa in vascular surgery only during and after operative treatment of thoracoabdominal aortic aneurysms, ruptured abdominal aortic aneurysms, retroperitoneal tumors involving the aorta and/or inferior vena cava, as well as portal hypertension, when non-surgical massive uncontrolled bleeding are present.

  9. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría

    2014-10-01

    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  10. Improving Surveillance for Surgical Site Infections Following Total Hip and Knee Arthroplasty Using Diagnosis and Procedure Codes in a Provincial Surveillance Network.

    Science.gov (United States)

    Rusk, Alysha; Bush, Kathryn; Brandt, Marlene; Smith, Christopher; Howatt, Andrea; Chow, Blanda; Henderson, Elizabeth

    2016-06-01

    OBJECTIVE To evaluate hospital administrative data to identify potential surgical site infections (SSIs) following primary elective total hip or knee arthroplasty. DESIGN Retrospective cohort study. SETTING All acute care facilities in Alberta, Canada. METHODS Diagnosis and procedure codes for 6 months following total hip or knee arthroplasty were used to identify potential SSI cases. Medical charts of patients with potential SSIs were reviewed by an infection control professional at the acute care facility where the patient was identified with a diagnosis or procedure code. For SSI decision, infection control professionals used the National Healthcare Safety Network SSI definition. The performance of traditional surveillance methods and administrative data-triggered medical chart review was assessed. RESULTS Of the 162 patients identified by diagnosis or procedure code, 46 (28%) were confirmed as an SSI by an infection control professional. More SSIs were identified following total hip vs total knee arthroplasty (42% vs16%). Of 46 confirmed SSI cases, 20 (43%) were identified at an acute care facility different than their procedure facility. Administrative data-triggered medical chart review with infection control professional confirmation resulted in a 1.1- to 1.7-fold increase in SSI rate compared with traditional surveillance. SSIs identified by administrative data resulted in sensitivity of 90% and specificity of 99%. CONCLUSION Medical chart review for cases identified through administrative data is an efficient supplemental SSI surveillance strategy. It improves case-finding by increasing SSI identification and making identification consistent across facilities, and in a provincial surveillance network it identifies SSIs presenting at nonprocedure facilities. Infect Control Hosp Epidemiol 2016;37:699-703. PMID:27018968

  11. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  12. Increasing incidence of statin treatmentamong the elderly and those withoutprevious cardiovascular conditions. A nationwide register study

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach; Andersen, Morten

    with discharge diagnoses and surgical procedures performed during 1977-2005. The disease status for all cohort members was assigned by means of disease markers for seven cardiovascular conditions, corresponding to a hierarchy of broad indications for statin therapy. Using the indication hierarchy, we computed...... disease markers, presumably related to increasing use of the risk score scheme.      ...

  13. Quality of life in Chinese women treated surgically for breast cancer with one of three different procedures

    Institute of Scientific and Technical Information of China (English)

    任敏

    2015-01-01

    Objective To determine the quality of life of patients treated with one of three different types of surgery for breast cancer.Methods This was a cross-sectional study using a questionnaire survey completed by Chinese patients without active disease after at least 2 years of follow-up after breast cancer surgery.Results This study totally included 139 breast cancer patients:44 ( 31.6%) had undergone modified radical mastectomy with reconstruction, 41(29.5%)had a quadrantectomy with axillary lymph node dissection, and 54(38.9%)had a modified radical mastectomy without reconstruction.The EORTC QLQ-C30 and EORTC QLQ-BR23 question-naires were used;their reliability was>0.82.Global health status(94.30 ±12.04, P=0.028)and role functio-ning(85.16 ±17.23, P=0.138)were highest in the quadrantectomy group.Pain score was highest in the modi-fied radical mastectomy with reconstruction group(26.13 ±30.15, P =0.042).The breast symptom score (22.56 ±22.30, P=0.009)and body image perception(85.56 ±19.72, P=0.025)were highest in the conser-vative treatment group.The overall health of patients given modified radical mastectomy without reconstruction was lower(72.61 ±20.89, P=0.014) in women older than 50 years compared with younger women.Conclu-sions The quadrantectomy with axillary lymph node dissection procedure had better acceptance, but the overall health status did not differ between groups.Overall health status is lower in women older than 50 years receiving a modified radical mastectomy without reconstruction.

  14. Deformidade de Sprengel: tratamento cirúrgico pela técnica de green modificada Sprengel's deformity: surgical correction by a modified green procedure

    Directory of Open Access Journals (Sweden)

    Sandro da Silva Reginaldo

    2009-06-01

    Full Text Available OBJETIVO: Demonstrar os resultados estéticos e funcionais de pacientes submetidos à correção cirúrgica de escápula alta congênita - deformidade de Sprengel - por uma modificação da técnica de Green, bem como avaliar o grau de satisfação dos pacientes e as complicações da técnica utilizada. MÉTODOS: Foram avaliados nove pacientes operados pela técnica de Green modificada, no período de setembro de 1993 a abril de 2008. Como modificação da técnica original foram realizados descolamento muscular subperiosteal, ressecção apenas da porção súpero-medial da escápula e, em vez da utilização de tração esquelética, optou-se pela fixação com fio de aço subcutâneo da porção medial da espinha da escápula à crista ilíaca posterior contralateral. A idade média dos pacientes foi de sete anos e três meses. O seguimento pós-operatório médio foi de três anos e sete meses. RESULTADOS: Houve incremento médio na elevação de cerca de 39º (variando de 0º a 80º . Segundo a classificação de Cavendish, obteve-se a melhora estética de dois graus em oito casos e de três graus em um. Todos os pacientes ficaram satisfeitos com o resultado. CONCLUSÕES: Os pacientes com deformidade de Sprengel submetidos a tratamento cirúrgico por meio de uma modificação da técnica de Green, com fixação da escápula na crista ilíaca posterior contralateral em vez de se utilizar tração esquelética, apresentaram melhora tanto funcional como estética; todos os pacientes e/ou familiares ficaram satisfeitos e as complicações relacionadas com a técnica cirúrgica não interferiram no resultado final.OBJECTIVE: To evaluate the cosmetic and functional results of patients submitted to surgical correction of Congenital High Scapula (Sprengel's Deformity using modified Green's Procedure, as well as patients' satisfaction and complications. METHODS: Nine patients submitted to surgical treatment from September 1993 to April 2008 have

  15. Tratamiento periodontal quirúrgico: Revisión. Conceptos. Consideraciones. Procedimientos. Técnicas Periodontal surgical therapy: Review. Concepts. Considerations. Procedures. Techniques

    Directory of Open Access Journals (Sweden)

    R. Matos Cruz

    2011-12-01

    considered as an adjunct to cause-related periodontal therapy. The kind of surgery performed, the number of sites included and the moment at which it should performed is decided after evaluating for the initial cause-related therapy results. The ultimate objective of periodontal surgical treatment is the long term preservation of the periodontium. Periodontal surgery can contribute to this end creating accessibility for an adequate scaling and root planning therefore restoring the gingival morphology which facilitates the automatic plaque control of the patient. Developed surgical techniques must be evaluated on the basis of their potential to facilitate the elimination of subgingival deposits, as well as facilitate plaque control and thus improve the long term preservation of the periodontium. In the present article the authors review the basis of surgical periodontal treatment as well as related concepts and considerations, objectives, indications and contraindications, procedures and factors that determine the selection of one or the other surgical technique.

  16. SURGICAL OUTCOME OF TRIPLE PROCEDURE AS PENETRATING KERATOPLASTY WITH EXTRACAPSULAR CATARACT EXTRACTION WITH POSTERIOR CHAMBER INTRAOCULAR LENS IMPLANTATION IN PATIENTS WITH BOTH CENTRAL CORNEAL OPACITY AND ADVANCED CATARACT AT RURAL SET UP

    OpenAIRE

    Shubhangi Nigwekar, Kishor Badhe, Neeta Misra, Surekha Bangal

    2015-01-01

    Purpose: To study the surgical outcome of triple procedure as penetrating keratoplasty (PKP) with conventional extra capsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation in patients with both central corneal opacity and advanced cataract at rural set up. Introduction: When corneal opacity and cataract present together then well-established and effective triple procedure is indicated. Prognosis for a clear graft is good in triple, as graft endothe...

  17. Modified surgical procedures in rat scoliosis model%双足鼠脊柱侧凸模型手术方法改良

    Institute of Scientific and Technical Information of China (English)

    王储; 郝东升; 段圆慧; 吴志宏; 邱贵兴

    2009-01-01

    目的 双足鼠脊柱侧凸模型是一种理想的脊柱侧凸动物模型.目前建模手术方法死亡率较高.本研究拟从手术方法上探究提高建模手术成功率的方法.方法 在15只1个月龄大鼠中,采用双上肢去神经和右侧肋骨栓系(4-0无创缝线)法建模,术中不分离脊旁肌.观察死亡率.结果 术中肋骨栓系时,所有大鼠膈肌活动良好,未出现气胸或大血管损伤.无大鼠在手术中或术后一周内死亡.结论 建模术中不分离脊旁肌、右侧肋骨栓系和栓系用4-0无创缝线,成功使得建模手术死亡率降为零,是一种较好的手术方法.%Objective Bipedal rat is an ideal animal model in researching scoliosis. However, high mortality remained in current surgical procedures leading to a high rate of failure. Methods Fifteen rats were subjected to the operation of denervation in upper limbs and tethering ribs on the right side using 4-0 non-invasive stitch, and the erector muscle of spine was reserved during the operation. One-week mortality was calculated. Results No complications were observed in the surgical procedures, and no rat died during or after the operation. Conclusion Reservation of the erector muscle of spine and tethering ribs on the right side using 4-0 non-invasive stitch can make the mortality of the operation decline to zero.

  18. Cardiovascular Magnetic Resonance in Marfan syndrome

    OpenAIRE

    Dormand, Helen; Mohiaddin, Raad H

    2013-01-01

    This review provides an overview of Marfan syndrome with an emphasis on cardiovascular complications and cardiovascular imaging. Both pre- and post-operative imaging is addressed with an explanation of surgical management. All relevant imaging modalities are discussed with a particular focus on cardiovascular MR.

  19. MULTILEVEL SOFT TISSUE WITH BONY CORRECTIVE SURGERY IN LOWER LIMB DEFORMITIES AS ONE SITTING PROCEDURE IN SPASTIC CEREBRAL PALSY: AN EXPERIENCE FROM FREE DISABLED SURGICAL CAMPS

    Directory of Open Access Journals (Sweden)

    Antony R

    2015-06-01

    Full Text Available The study was intended to assess the results of multilevel soft tissue with bony corrective surgery as one sitting procedure on static deformities and contractures in lower limbs with patients of spastic cerebral palsy at free disabled surgical camps at Chhattisgarh state. In our study 30 patients were included with sixty percent male and forty percent female , within 4 - 16 years age group. Almost all patients had diplegia and only few patients had quadriplegia with grade 3 power in both upper limbs. Improvement in functional ability and locomotion of all operated patients were asse ssed by gross motor functional classification scale and with physical examination. Almost all patients who were operated in our study showed significant improvement in functional abilities and locomotion after surgery. All patients were maintaining functional abilities at follow up duration of 2 years (24 months, with 70%. excellent cases gait of patient were normal or mild spastic but they were walking without support , with 20% good cases gait of patients were spastic but patients comfortably walk with short knee braces and with 10% fair cases gait of patients were scissors but patients walked comfortably with long knee braces . Our study shows that, promising results can be obtained in spastic cerebral palsy patients with static deformities and cont ractures of joints in lower limbs with multilevel soft tissue and bony corrective surgery. We believe that it’s a team effort of the surgeon , paramedical and rehabilitation staff in postoperative period for the achievement of better results.

  20. 不同术式治疗尿道下裂48例体会%Different surgical procedures for hypospadia:a report of 48 cases

    Institute of Scientific and Technical Information of China (English)

    王胜利; 杨大强; 张端卫; 孙毅伦

    2011-01-01

    Objective: To observe and summarize the therapeutic effects and complications of different surgical procedures for treatment of hypospadia so as to provide basis for patients to choose a suitable pattern. Methods:Different surgical procedures were applied to 48 patients with hypospadia. Duckett was adopted by 23 cases, Denis-Browne 3 cases, Duplay 10 cases, MAGPI 1 case,Duckett + Duplay 3 cases, scrotal septal vascular pediclen flap 3 cases and Hodgson 5 cases. The success rate and the complication of each procedure were analyzed retrospectively. Results:Of the 23 cases treated by Duckett, one-stage success was achieved in 18 cases,urinary fistula occurred in 3 cases, anastomotic stricture in one case and skin edge necrosis in one case; of the 3 cases treated by DenisBrowne ,2 cases achieved successful results and 1 developed urethral stricture; of the 10 cases adopting Duplay, one-stage success was achieved in 7 cases and urinary fistula occurred in 3 cases;the operation was successful in the one case treated by MAGP;of the 3 cases adopting Duckett + Duplay, the operation was successful in 1 case, urinary fistula occurred in lcase and anastomotic stricture in 1 case;of the 3 cases treated by scrotal septal vascular pediclenflap, successful result was achieved in 2 cases and urinary fistula occurred in one case;of the 5 cases adopting Hodgson,4 cases achieved good results and urinary fistula occurred in 1 case. Conclusions:Different surgical procedures should be applied to different types of hypespadia. To most patients receiving the therapy for the first time, Duckett and Hodgson procedures should be taken as the first choice; patients receiving the penis diorthosis surgery for the second time may choose Duplay or Denis-Browne; patients having experienced failed operations or lacking external genital organ skin source should consider using dissociation substitution tissues( cheek mucous membrane, tongue mucous membrane and so on).%目的:总结不同术式治疗

  1. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. Noninflammatory degenerative diseases - nomenclature and diagnostic criteria.

    Science.gov (United States)

    Halushka, Marc K; Angelini, Annalisa; Bartoloni, Giovanni; Basso, Cristina; Batoroeva, Lubov; Bruneval, Patrick; Buja, L Maximilian; Butany, Jagdish; d'Amati, Giulia; Fallon, John T; Gallagher, Patrick J; Gittenberger-de Groot, Adriana C; Gouveia, Rosa H; Kholova, Ivana; Kelly, Karen L; Leone, Ornella; Litovsky, Silvio H; Maleszewski, Joseph J; Miller, Dylan V; Mitchell, Richard N; Preston, Stephen D; Pucci, Angela; Radio, Stanley J; Rodriguez, E Rene; Sheppard, Mary N; Stone, James R; Suvarna, S Kim; Tan, Carmela D; Thiene, Gaetano; Veinot, John P; van der Wal, Allard C

    2016-01-01

    Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syndrome, etc.), and vasculopathic aging processes involved in vascular injury can cause both distinct and nonspecific histopathologic changes with degeneration of the media as a common denominator. Terminology for these changes has varied over time leading to confusion and inconsistencies. This consensus document has established a revised, unified nomenclature for the variety of noninflammatory degenerative aortic histopathologies seen in such specimens. Older terms such as cystic medial necrosis and medionecrosis are replaced by more technically accurate terms such as mucoid extracellular matrix accumulation (MEMA), elastic fiber fragmentation and/or loss, and smooth muscle cell nuclei loss. A straightforward system of grading is presented to gauge the extent of medial degeneration and synoptic reporting tables are provided. Herein we present a standardized nomenclature that is accessible to general pathologists and useful for future publications describing these entities. PMID:27031798

  2. 心血管外科医护一体化伤口治疗管理模式探讨%Investigation on the wound caring mode in the department of surgical cardiovascular

    Institute of Scientific and Technical Information of China (English)

    白阳静; 陈佳丽; 李梅; 陈红

    2012-01-01

    目的 探讨心血管外科医护一体化伤口治疗管理模式.方法 构建心血管外科医护一体化伤口治疗管理模式,对心血管外科伤口治疗进行规范化流程管理,实施12个月后,对比实施前246名患者和实施后271名患者的伤口愈合情况、平均住院日,同时单纯随机抽取60名患者进行模式实施前后的满意度调查,应用秩和检验、t检验进行模式实施前后效果比较.结果 应用医护一体化的伤口治疗管理模式12个月后,患者满意度及伤口愈合情况明显改善,患者平均住院日缩短,差异有统计学意义(P<0.05).结论 医护一体化伤口治疗管理模式有利于提高伤口治疗效果、促进医护合作,取得良好的社会效益.%OBJECTIVE To explore the implementation and effects of the Doctor-Nurse Integration Wound Caring Mode in the caring of surgical cardiovascular wound. METHODS We established the Doctor-Nurse Integration Wound Caring Mode in the surgical Cardiovascular wound caring for 12 months. The effects of this mode were evaluated by wound healing and patient satisfaction about wound care. Rank sura test was used to analyze data to compare the effect of the implementation of the Doctor-Nurse Integration Wound Caring Mode. 246 patients before implementation and 271 patients after implementation were compared to assess the effect of wound healing rate. Random sampling method was used to select 60 patients to assess patient satisfaction. RESULTS After implementation of the Doctor-Nurse Integration Wound Caring Mode for 12 months, the patients' satisfaction and the wound healing were statistically significantly improved (P< 0.05) , and the average inpalient day was significantly decreased (P< 0.05). CONCLUSION The Doctor-Nurse Integration Wound Caring Mode is useful to improve effectiveness of wound caring, patient satisfaction and efficiency of society.

  3. 某院妇科手术部位感染目标性监测及干预%Targeted monitor and intervention strategies on surgical site infection following gynecological surgical procedure

    Institute of Scientific and Technical Information of China (English)

    张亚军; 孙庆芬; 顾彩霞; 李曼

    2013-01-01

    Objective To realize surgical site infection (SSI) following gynecological surgical procedure, analyze the possible risk factors, and explore effective measures on reducing the incidence of SSI. Methods From January 1 to December 31 ,2011 , patients receiving abdominal hysterectomy, vaginal hysterectomy, and laparoscopic hysterectomy in two gynecological departments of a hospital were monitored, SSI rates before intervention(from January 1 to June 30,2011 , control group) and after intervention (from July 1 to December 31 ,2011 , intervention group) were analyzed and compared. Results A total of 1 120 patients were in control group, including 648 cases of abdominal hysterectomy, SSI rate was 4. 94%; 212 vaginal hysterectomy, SSI rate was 9. 43%; 260 laparoscopic hysterectomy, there was no SSI; the average SSI rate in two departments was 4. 64% (52/1 120), SSI rate between two departments was not significantly different(5. 38% vs 4. 00%, x2 = 1. 206, P>0. 05), the average SSI rate in intervention group was significantly lower than control group (1. 57%[20/1 272] vs 4. 64% ,x2 = 19. 23,P<0. 001). Conclusion Through targeted monitor, risk factors are analyzed, intervention measures are performed,and SSI can be reduced.%目的 了解某院妇科手术部位感染(SSI)现状,分析可能的危险因素,探讨降低SSI发病率的有效措施.方法 2011年1月1日-12月31日,对该院两个妇科病区行剖腹子宫切除术、阴式子宫切除术、腹腔镜下子宫切除术的所有患者进行监测,定期汇总分析,比较采取干预措施前(2011年1月1日-6月30日监测的病例,设为对照组)和干预措施落实后(2011年7月1日-12月31日监测的病例,设为干预组)的SSI率.结果 对照组共1 120例患者,其中剖腹子宫切除术648例,SSI率为4.94%;阴式子宫切除术212例,SSI率为9.43%;腹腔镜下子宫切除术260例,未发生SSI.干预前妇科病区平均SSI率为4.64%(52/1 120),两个妇科病区平均SSI率( 5.38% vs 4

  4. Comparison of 50 vertebral compression fractures treated with surgical (kyphoplasty) or non surgical approach

    Science.gov (United States)

    Giannotti, Stefano; Carmassi, Fabio; Bottai, Vanna; Dell’Osso, Giacomo; Gazzarri, Francesco; Guido, Giulio

    2012-01-01

    Summary The presence of a vertebral fracture increases the risk of a new fracture within a year by at least five times and the risk further increases in case of recurrent fractures (domino effect). The pain and fracture kyphosis can compromise respiratory function. Many patients sustain serious cardiovascular, musculoskeletal, metabolic, and immune complications related to immobility and bedrest. This study is a clinical and radiological assessment of a consecutive cohort of 50 patients with vertebral fractures. We made comparison of 25 vertebral compression fractures treated with surgical (kyphoplasty) or non surgical approach. Systematic reviews of this procedure have shown significantly improved back pain and quality of life compared to conservative therapy. When performed by a well-trained practitioner in appropriately selected patients, kyphoplasty is a safe and effective treatment for fresh vertebral compression fractures. PMID:23289035

  5. Optimization and surgical design for applications in pediatric cardiology

    Science.gov (United States)

    Marsden, Alison; Bernstein, Adam; Taylor, Charles; Feinstein, Jeffrey

    2007-11-01

    The coupling of shape optimization to cardiovascular blood flow simulations has potential to improve the design of current surgeries and to eventually allow for optimization of surgical designs for individual patients. This is particularly true in pediatric cardiology, where geometries vary dramatically between patients, and unusual geometries can lead to unfavorable hemodynamic conditions. Interfacing shape optimization to three-dimensional, time-dependent fluid mechanics problems is particularly challenging because of the large computational cost and the difficulty in computing objective function gradients. In this work a derivative-free optimization algorithm is coupled to a three-dimensional Navier-Stokes solver that has been tailored for cardiovascular applications. The optimization code employs mesh adaptive direct search in conjunction with a Kriging surrogate. This framework is successfully demonstrated on several geometries representative of cardiovascular surgical applications. We will discuss issues of cost function choice for surgical applications, including energy loss and wall shear stress distribution. In particular, we will discuss the creation of new designs for the Fontan procedure, a surgery done in pediatric cardiology to treat single ventricle heart defects.

  6. Câncer do reto médio: avaliação do procedimento cirúrgico Cancer of the middle rectum: surgical procedure assessment

    Directory of Open Access Journals (Sweden)

    José Hyppólito da Silva

    1999-02-01

    úrgica.The surgical treatment of cancer of the middle rectum is still controversial. Several surgical procedures were retrospectively assessed in 90 patients operated from February 1990 to June 1997. Of these, 43 (47.7% patients were females and 47 (52.3% males. Age ranged from 20 to 90 years (mean,60.2 years. The main symptoms were tenesmus and straining, passage of blood and lost of weight. The time between the begining of the symptoms and the diagnosis ranged from two to 24 months (mean, 7.5 months. Abdominoperineal resection was done in 17 patients and the main complication was perineal dehiscence occuring in 47% of cases. One patient was submmited to total proctocolectomy. Hartmann procedure was done in 26 patients with 7.6% morbidity and 7.6% mortality caused by clinical complications. Twenty six patients had resection followed by anastomosis. 1n ten cases hand anastomosis had normal course without complications. In others 16, mechanical anastomosis was done with three dehiscences and one death related to clinical complications. Pull-through operation with coloanal anastomosis was done in eight patients with 50% complications, due to necrosis and retraction of the colon stump. One death occurred related to surgical complication. In 12 cases tumor resection was not done because the precarious condition of these patients. We conclude that the best procedure in cancer of the middle rectum depends of efficient evaluation considering the cell differentiation degree. the metastasis existence, the local condition of the tumor the clinical state of the patient and the experience of the surgeon.

  7. 复杂性肾结石不同手术治疗方法的疗效分析%Different surgical procedures for complex renal calculi

    Institute of Scientific and Technical Information of China (English)

    刘永昌; 陈志雄; 潘翔

    2013-01-01

    Objective To compare the clinical efficacy of mini-invasive percutaneous nephrolithotomy (MPCNL) with that of open surgery for the treatment of complex renal calculi.Methods 82 patients with complex renal calculi who had undergone surgical treatment during the period of April 2006 to April 2011 were assigned to MPCNL group (41 patients) and open-surgery group (41 patients) based on the type of procedures.Surgical duration,intraoperative bleeding volume,rate of complications,postoperative length of hospital stay,total medical cost,and rate of calculi clearance were compared between the two groups.Results Surgical duration and length of hospital stay were shorter,intraoperative bleeding volume was less,rate of complications was lower,medical cost was greater,and rate of calculi clearance was higher in MPCNL group than in open-surgery group [(110 ± 21)min vs.(178 ± 33)min,(7.31 ± 0.94)days vs.(13.32 ± 2.84)days,(96.25 ± 12.34)ml vs.(176.56 ± 11.35)ml,12.2% (5/41) vs.29.3% (12/41),(12 636.6 ± 672.37) yuans vs.(8532.20 ± 350.56) yuans,and 80.49% (33/41) vs.65.85% (27/41); P<0.05].Conclusions As compared with open surgery,mini-invasive percutaneous nephrolithotomy has shorter surgical duration and postoperative hospital stay,higher rate of calculi clearance,quicker recovery,less blood loss,and fewer complications,though it has higher total medical cost.It is a safe,effective way to treat complex renal calculi.%目的 比较、分析微创经皮肾镜取石术与开放手术治疗复杂性肾结石的临床疗效.方法 选择2006年3月至2011年3月于我院接受手术治疗的82例复杂性肾结石患者,按治疗方法分为微创经皮肾镜取石组41例和开放手术组41例.比较两组在手术时间、术中出血量、并发症发生率、术后住院时间、总治疗费用及结石清除率方面的差异.结果 微创经皮肾镜取石组手术时间[(110±21) min vs.(178±33) min]、术中出血量[(96.25±12.34) ml vs.(176.56±11

  8. Cardiovascular surgery in the elderly: an update

    Institute of Scientific and Technical Information of China (English)

    Song WAN; Ahmed A. ARIFI; Calvin S. H. NG; Anthony P. C. YIM

    2005-01-01

    The aging of the population and improvements in outcomes after cardiovascular surgery have resulted in a worldwide growing demand of complex surgical intervention for elderly patients. We briefly review the up-to-date English-language literature with particular focus on cardiovascular surgery in elderly patients. With earlier referral, careful preoperative evaluation, strategic planning, and the continuing efforts in optimizing surgical techniques, operative mortality and morbidity following primary or reoperative coronary artery bypass grafting and valvular interventions are expected to fall in this high-risk patient subset. Importantly,accumulating evidence indicates that elderly patients may benefit from improved functional status and quality of life after cardiovascular surgical therapy

  9. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  10. Crown lengthening: a surgical flap approach.

    Science.gov (United States)

    Lundergan, W; Hughes, W R

    1996-09-01

    In many instances it is not possible to place a restoration margin without encroaching on the periodontal attachment apparatus. A surgical crown-lengthening procedure can provide a good solution to this common clinical problem. This article discusses indication and contraindication for surgical crown-lengthening procedures and presents an appropriate surgical technique.

  11. Extending boundaries in minimally invasive procedures with simultaneous bilateral video endoscopic inguinal lymphadenectomy (veil for penile cancer: initial Denver health medical center and ABC school of medicine experience and surgical considerations

    Directory of Open Access Journals (Sweden)

    Alexandre Pompeo

    2013-07-01

    Full Text Available Purpose To report the surgical technique, procedural outcomes, and feasibility of simultaneous bilateral Video Endoscopic Inguinal Lymphadenectomy (VEIL in the management of patients with indication for inguinal lymphadenectomy. Surgical Technique: VEIL was applied in all patients using the oncological landmarks (the adductor longus muscle medially, the sartorius muscle laterally and the inguinal ligament superiorly. A 1.5 cm incision was made 2 cm distally to the lower vertex of the femoral triangle. A second incision was made 2 cm proximally and 6 cm medially. Two 10 mm Hasson trocars were inserted in these incisions and the working space was insufflated with CO2 at 5-15 mmHg. The final trocar was placed 2 cm proximally and 6 cm laterally from the first port. Results: A total of 5 VEIL procedures in 3 patients were performed. Two patients underwent simultaneous bilateral VEIL while another underwent simultaneous bilateral surgery with VEIL on the right and open lymphadenectomy on the left side due to an enlarged node. All laparoscopic procedures were successfully performed without conversion and maintained the oncological templates. One lymphocele occurred in the patient who underwent the open procedure. None of the patients presented with skin necrosis after the procedure. Mean number of nodes retrieved was 6 from each side and 2 patients presented with positive inguinal nodes. After one year of follow-up no recurrences were observed. Conclusion: Simultaneous lymphadenectomy procedures are feasible. Improvement in operative and anesthesia time could decrease the morbidity associated with inguinal lymphadenectomy while maintaining the oncological principles.

  12. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS: First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS: The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION: 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  13. SURGICAL OUTCOME OF TRIPLE PROCEDURE AS PENETRATING KERATOPLASTY WITH EXTRACAPSULAR CATARACT EXTRACTION WITH POSTERIOR CHAMBER INTRAOCULAR LENS IMPLANTATION IN PATIENTS WITH BOTH CENTRAL CORNEAL OPACITY AND ADVANCED CATARACT AT RURAL SET UP

    Directory of Open Access Journals (Sweden)

    Shubhangi Nigwekar, Kishor Badhe, Neeta Misra, Surekha Bangal

    2015-10-01

    Full Text Available Purpose: To study the surgical outcome of triple procedure as penetrating keratoplasty (PKP with conventional extra capsular cataract extraction (ECCE with posterior chamber intraocular lens (PCIOL implantation in patients with both central corneal opacity and advanced cataract at rural set up. Introduction: When corneal opacity and cataract present together then well-established and effective triple procedure is indicated. Prognosis for a clear graft is good in triple, as graft endothelium does not touch the hard nucleus which may occur in two steps or sequential surgery. It provides faster visual rehabilitation. Being single step procedure it reduces patient’s hospital stay, postoperative care and follows up visits. Methodology: In this hospital based observational , three years longitudinal study, we studied the surgical outcome of relatively rare one step triple procedure as PKP with conventional ECCE with PCIOL implantation in sulcus or in bag, in patients with both central corneal opacity and advanced cataract at rural set up. The outcome measures included graft clarity on slit lamp, postoperative unaided visual acuity with Snellen’s chart and the occurrence of postoperative complications after taking IEC permission and informed written consent in local language from study patients. Results: Out of 13 study patients mean age was 61.15yrs (Range50-80yrs. Follow up range was 9-34 months. At final follow up 9 patients (69.23% had clear grafts and 61.52% patients gained visual acuity >6/24. Graft failure was the most common post operative complication in 30.76% followed by Posterior capsular opacification (PCO in 15.38% patients which was treated well with YAG laser capsulotomy. Conclusion: Triple procedure gives good results in respect to graft clarity, unaided vision, and faster rehabilitation.

  14. High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England.

    Science.gov (United States)

    Møller, Henrik; Riaz, Sharma P; Holmberg, Lars; Jakobsen, Erik; Lagergren, Jesper; Page, Richard; Peake, Michael D; Pearce, Neil; Purushotham, Arnie; Sullivan, Richard; Vedsted, Peter; Luchtenborg, Margreet

    2016-09-01

    It is debated whether treating cancer patients in high-volume surgical centres can lead to improvement in outcomes, such as shorter length of hospital stay, decreased frequency and severity of post-operative complications, decreased re-admission, and decreased mortality. The dataset for this analysis was based on cancer registration and hospital discharge data and comprised information on 15,738 non-small-cell lung cancer patients resident and diagnosed in England in 2006-2010 and treated by surgical resection. The number of lung cancer resections was computed for each hospital in each calendar year, and patients were assigned to a hospital volume quintile on the basis of the volume of their hospital. Hospitals with large lung cancer surgical resection volumes were less restrictive in their selection of patients for surgical management and provided a higher resection rate to their geographical population. Higher volume hospitals had shorter length of stay and the odds of re-admission were 15% lower in the highest hospital volume quintile compared with the lowest quintile. Mortality risks were 1% after 30 d and 3% after 90 d. Patients from hospitals in the highest volume quintile had about half the odds of death within 30 d than patients from the lowest quintile. Variations in outcomes were generally small, but in the same direction, with consistently better outcomes in the larger hospitals. This gives support to the ongoing trend towards centralisation of clinical services, but service re-organisation needs to take account of not only the size of hospitals but also referral routes and patient access. PMID:27328450

  15. 国际脊髓损伤:脊柱干预及手术操作基础数据集%International Spinal Cord Injury:Spinal Interventions and Surgical Procedures Basic Data Set

    Institute of Scientific and Technical Information of China (English)

    MF Dvorak; 刘根林(译); 郑樱(译); 张缨(译); 郝春霞(译); 卫波(译); 王一吉(译); 逯晓蕾(译); 袁媛(译); E Itshayek; MG Felings; AR Vaccaro; PCWing; F Biering-Sorensen; VK Noonan; 康海琼(译); 周红俊(译)

    2015-01-01

    Study design Survey of expert opinion, feedback and final consensus. Objective To describe the development and the vari-ables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set. Setting Internation-al working group. Methods A committee of experts was established to select and define data elements. The data set was then disseminated to the appropriate committees and organizations for comments. All suggested revisions were considered and both the International Spinal Cord Society and the American Spinal Injury Association endorsed the final version. Results The data set consists of nine variables:(1) In-tervention/Procedure Date and start time (2) Non-surgical bed rest and external immobilization, (3) Spinal intervention-closed manipulation and/or reduction of spinal elements, (4) Surgical procedure-approach, (5) Date and time of the completion of the intervention or surgical clo-sure;(6) Surgical procedure-open reduction, (7) Surgical procedure-direct decompression of neural elements, and (8 and 9) Surgical proce-dure-stabilization and fusion (spinal segment number and level). All variables are coded using numbers or characters. Each spinal interven-tion and procedure is coded (variables 1 through 7) and the spinal segment level is described (variables 8 and 9). Sample clinical cases were developed to illustrate how to complete it. Conclusion The International SCI Spinal Interventions and Surgical Procedures Basic Data Set was developed to facilitate comparisons of spinal interventions and surgical procedures among studies, centers and countries.%研究设计调查专家意见、反馈及共识。目的描述国际脊髓损伤(SCI)脊柱干预及手术操作基础数据集的开发及其中包含的变量。设置国际工作组。方法成立专家委员会以选择及确定数据项目。将数据集送至相关的委员会及组织征求意见。考虑所有的建议后,国际脊髓协会及美国

  16. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.  ...

  17. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  18. Return hospital visits and morbidity within 60 days after day surgery: a retrospective study of 18,736 day surgical procedures

    DEFF Research Database (Denmark)

    Engbaek, J; Bartholdy, J; Hjortsø, Carsten Nico Portefée

    2006-01-01

    As day surgery includes more extensive procedures focus should be put on late outcome. The frequency of day surgery-related return visits and the associated morbidity were examined to identify suitable indicators of quality.......As day surgery includes more extensive procedures focus should be put on late outcome. The frequency of day surgery-related return visits and the associated morbidity were examined to identify suitable indicators of quality....

  19. Intravenous infusion of ketamine-propofol can be an alternative to intravenous infusion of fentanyl-propofol for deep sedation and analgesia in paediatric patients undergoing emergency short surgical procedures

    Directory of Open Access Journals (Sweden)

    Samit Kumar Khutia

    2012-01-01

    Full Text Available Background: Paediatric patients often present with different painful conditions that require immediate surgical interventions. Despite a plethora of articles on the ketamine-propofol combination, comprehensive evidence regarding the suitable sedoanalgesia regime is lacking due to heterogeneity in study designs. Methods: This prospective, randomized, double-blind, active-controlled trial was conducted in 100 children, of age 3-14 years, American Society of Anesthesiologist physical status IE-IIE, posted for emergency short surgical procedures. Patients were randomly allocated to receive either 2 mL of normal saline (pre-induction plus calculated volume of drug from the 11 mL of ketamine-propofol solution for induction (group PK, n=50 or fentanyl 1.5 μg/kg diluted to 2 mL with normal saline (pre-induction plus calculated volume of drug from the 11 mL of propofol solution for induction (group PF, n=50. In both the groups, the initial bolus propofol 1 mg/kg i.v. (assuming the syringes contained only propofol, for simplicity was followed by adjusted infusion to achieve a Ramsay Sedation Scale score of six. Mean arterial pressure (MAP was the primary outcome measurement. Results: Data from 48 patients in group PK and 44 patients in group PF were available for analysis. Hypotension was found in seven patients (14.6% in group PK compared with 17 (38.6% patients in group PF (P=0.009. Intraoperative MAP was significantly lower in group PF than group PK when compared with baseline. Conclusion: The combination of low-dose ketamine and propofol is more effective and a safer sedoanalgesia regimen than the propofol-fentanyl combination in paediatric emergency short surgical procedures in terms of haemodynamic stability and lesser incidence of apnoea.

  20. Surgical Assisting

    Science.gov (United States)

    ... specific training over and above a degree in science, nursing, physician assisting, or another health profession. Prerequisites . Recommended eligibility requirements for admission into a surgical assisting program are: Bachelor of Science degree (or higher) Associate degree in an allied ...

  1. Fighting surgical site infections in small animals

    DEFF Research Database (Denmark)

    Verwilghen, Denis; Singh, Ameet

    2015-01-01

    A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs. ...

  2. Research on the development of database for the monitoring of radiation dose in cardiovascular interventional procedures%心血管介入手术剂量监测系统数据库的研制

    Institute of Scientific and Technical Information of China (English)

    张继勉; 田源; 丁艳秋

    2014-01-01

    Objective:A database was designed and developed for effective utilization monitoring data of radiation dose to patients and occupational operators in cardiovascular interventional procedures. Methods:To complete a command reception of the client program, data display and other functions, compiled database software using MS Visual Basic level programming language. Using MS Access database completed data storage, management and maintenance. Results:The database was designed according to technological indicator acknowledged;the relevant help file was set up. The database includes two sub-libraries professional database and patient database. Professionals and patients can be recorded separately input, record view and record query. Conclusion:The data platform for monitoring data of radiation dose in cardiovascular interventional procedures was provided, which can provide basic data for constituting normalization and technical standard of dose limited of radiation dose to patients and occupational operators in cardiovascular interventional procedures.%目的:为了更好地保存和利用心血管介入治疗中职业人员和患者剂量监测的数据,编制剂量监测系统数据库。方法:应用MS Visual Basic高级编程语言编制数据库软件,完成前台客户端程序的命令接收和数据显示等功能,使用MS Access数据库完成数据的存贮、管理和维护。结果:根据国际公认的技术指标,设计完成本数据库,并撰写数据库的编制说明。数据库包括职业人员和患者两个分库,分别进行记录输入、记录浏览和记录查询。结论:剂量监测系统数据库的建立,提供了心血管介入手术累计剂量监测数据的平台,为国家制订介入手术职业人员与患者辐射剂量控制标准与技术规范提供基础数据。

  3. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA

    2012-09-01

    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  4. Observation of surgical procedure and urine storage function of orthotopic neobladder after radical cystectomy%膀胱全切术后原位膀胱形态与储尿功能的相关性研究

    Institute of Scientific and Technical Information of China (English)

    史东民; 王赫; 牛颜良; 李彦龙; 张明刚; 史沛清; 李学东; 孙长华; 黄永刚

    2013-01-01

    Objective To identify the best surgical procedure for orthotopic neobladder by evaluating the morphology and the urine storage function of the neobladder in comparison of the four surgical procedures.Methods From Jan.1991 to Mar.2011,there were 117 cases radical cystectomies in our institute performed.Of these cases,there were 28 cases using W ileal orthotopic bladder,14 cases using VIP in situ bladder,50 cases using detenial sigmoid colon bladder,25 cases using sigmoid colon bladder.Results 69 cases were followed up for 1-3 years,among them 35 cases were followed up more than 3 years.All the cases with different surgical procedures after 1 year were with stable urine storage function of the urinary bladder and were close to normal urine storage function.The ileum bladder shape was like a ball.After comparison,the VIP in situ bladder was the best choice for in situ bladder and urine storage function.Conclusions For different neobladder,there is no obvious difference in long-term urine storage function;Neobladder morphology and urine storage capacity is related with the length of bowel loops.%目的 探讨膀胱全切术后原位膀胱形态和储尿功能的相关性. 方法 1991年1月至2011年3月行膀胱全切原位膀胱术患者117例,男104例,女13例.年龄38~70岁,平均56岁.采用W形回肠原位膀胱28例,VIP原位膀胱14例,去带乙状结肠膀胱50例,去管乙状结肠膀胱25例. 结果 术后随访1~3年34例,>3年35例.所有患者术后1年储尿功能稳定,均接近正常膀胱储尿功能.回肠膀胱形态似球形,以VIP原位膀胱形态和储尿功能为优. 结论 采用去管化原位膀胱远期储尿功能满意;同类相同长度肠管成形的膀胱形态与储尿容量相关.

  5. 肝硬化门静脉高压症外科治疗程序%Surgical therapy procedure in cirrhosis with portal hypertension

    Institute of Scientific and Technical Information of China (English)

    吴志勇; 陈炜

    2011-01-01

    肝硬化门静脉高压症的传统外科治疗主要是针对其最严重的并发症--食管胃底静脉曲张破裂出血.目前达成的共识是急性大出血以非手术治疗为主,如药物、内镜和三腔二囊管等;出血无法控制如果肝功能Child-Pugh分级A/B级者则可急诊手术,只要病人存在门静脉向肝血流,术式以断流术为主,如果Child-Pugh分级C级者可行经颈内静脉肝内门体分流术(TIPS)治疗.病人首次出血控制后预防再出血大多需要外科治疗.术前需明确病因,评估肝脏储备功能、门静脉高压症程度、肝脏和门静脉系统血流动力学状况等.传统外科手术方式主要为断流术、分流术和联合手术等.我们强调术式选择须依据门静脉系统血流动力学状况,各种术式均有明确的血流动力学状况的适应证.门静脉高压症出血病人中只有肝功能Child-Pugh分级C级经内科治疗无法改善者(终末期肝病)适合行肝移植.%Bleeding from esophagogastric varices is the most life-threatening complication of portal hypertension, which is the main target of traditional surgical therapy. It has been reached a consensus that non-operative therapy is primary during the period of acute variceal bleeding, such as pharmacotherapy, endoscopic therapy, triplelumen tube balloon tamponade and so on. In the case of refractory bleeding, emergency operation is suitable in patients provided that the liver dysfunction is not too severe ( Child- Pugh class A or B ). Devascularization is the most suitable choice in emergency operation so long as there is hepatopetal blood flow in the portal vein. Transjugular intrahepatic portosystem shunt (TIPS) is suitable for the patients of Child-Pugh class C who are in emergency state. Most patients who survive a first variceal hemorrhage episode should receive surgical treatment to prevent recurrent episodes. The etiological factor(s) should be defined before operation, and it also should be

  6. Evaluation of medical residents exposed to X-ray during surgical procedures; Avaliacao dos medicos residentes expostos aos raios-X durante procedimentos cirurgicos

    Energy Technology Data Exchange (ETDEWEB)

    Alabarse, F.G.; Leal, R.; Amador, G.B.; Bacelar, A. [Hospital de Clinicas de Porto Alegre, RS (Brazil). Fisica Medica. Servico de Engenharia Biomedica; Westphal, M.; Furtado, A.P.A. [Hospital de Clinicas de Porto Alegre, RS (Brazil). Fisica Medica. Servico de Radiologia]. E-mail: abacelar@hcpa.ufrgs.br

    2001-07-01

    This work present some evaluations in relation to the Medical Resident that work with X-rays during surgery procedures. The objective is discovery what the staff that make more use of this kind of radiation during their procedures and evaluate the relation with their respective doses. The information was toke during the activities that make some use of X-rays. This information was connected with the respective dose of Medical Resident. The results is that the worker of Medical Resident is the worker that are most in exposure in a surgery unit. The staff that use X-rays with more frequency and have the biggest time in exposure is Orthopedy and Traumathology. The highest dose that they received were of 22,72 mSv, in a Resident of the Urology group. (author)

  7. How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Stina Öberg

    2016-01-01

    Full Text Available A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh for slender patients. The aim of this study was to illustrate an easy procedure that alleviates/removes the pain. A male patient had persistent pain six months after the Onstep operation and therefore had a ring removal operation. The procedure is presented as a video and a protocol. At the eleven-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated in a video.

  8. How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair.

    Science.gov (United States)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

    2016-01-01

    A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh for slender patients. The aim of this study was to illustrate an easy procedure that alleviates/removes the pain. A male patient had persistent pain six months after the Onstep operation and therefore had a ring removal operation. The procedure is presented as a video and a protocol. At the eleven-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated in a video. PMID:27298748

  9. Cardiovascular and interventional radiology

    International Nuclear Information System (INIS)

    This year's cardiovascular section demonstrates a continued growth in the number of digests on cardivascular and general interventional topics and continued progress in MRI studies. The reader will also notice fewer digests on DSA and percutaneous stone removal compared with the 1985 and 1986 Year Books. While newer technology, such as extracorporeal shock wave lithotripsy, has significantly reduced the number of percutaneous procedures for renal calculi, other interventional procedures, such as those involving fibrinolysis, are increasing by leaps and bounds. A number of digests on benign and malignant bile duct strictures continue to shed light on the management of these difficult cases. While abscess drainage is growing and well accepted by most surgeons, articles on esophageal dilatations seem to be declining in the radiology literature, probably on the basis of fewer operations being performed by us and more being performed by endoscopists. Digests on MRI in the cardiovascular system continue to report excellent images of the aorta and of congenital heart disease

  10. Case report of surgical treatment of abnormal atrial flutter (incisional atrial tachycardia in the patient after mitral valve replacement and radiofrequency modification of Maze procedure

    Directory of Open Access Journals (Sweden)

    Revishvili А. Sh.

    2012-12-01

    Conclusion. This type of tachycardia following after an atrial fibrillation surgery may be considered as a failing transmural myocardial damage during the procedure. The catheter method can be used succesfully unless there are no effects of antiarrhythmic therapy. The catheter method enables not only to verify the disconnection between the left atrial pulmonary veins and left atrium myocardium but also to perform the ablation in zones of the atrial myocardium that are anatomic substrates of post surgery tachyarrhythmias.

  11. Evaluation of Changes in Tumor Shadows and Microcalcifications on Mammography Following KORTUC II, a New Radiosensitization Treatment without any Surgical Procedure for Elderly Patients with Stage I and II Breast Cancer

    Science.gov (United States)

    Tsuzuki, Akira; Ogawa, Yasuhiro; Kubota, Kei; Tokuhiro, Shiho; Akima, Ryo; Yaogawa, Shin; Itoh, Kenji; Yamada, Yoko; Sasaki, Toshikazu; Onogawa, Masahide; Yamanishi, Tomoaki; Kariya, Shinji; Nogami, Munenobu; Nishioka, Akihito; Miyamura, Mitsuhiko

    2011-01-01

    We introduced non-surgical therapy with a novel enzyme-targeting radiosensitization treatment, Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II) into early stages breast cancer treatment. The purpose of this study was to examine changes in tumor shadows and microcalcifications on mammography (MMG) following KORTUC II for elderly patients with breast cancer. We also sought to determine whether MMG was useful in evaluating the therapeutic effect of KORTUC II. In addition to MMG, positron emission tomography-computed tomography (PET-CT) was performed to detect both metastasis and local recurrence. In all 10 patients, tumor shadows on MMG completely disappeared in several months following the KORTUC II treatment. The concomitant microcalcifications also disappeared or markedly decreased in number. Disappearance of the tumors was also confirmed by the profile curve of tumor density on MMG following KORTUC II treatment; density fell and eventually approached that of the peripheral mammary tissue. These 10 patients have so far have also shown neither local recurrence nor distant metastasis on PET-CT with a mean follow-up period of approximately 27 months at the end of September, 2010. We conclude that breast-conservation treatment using KORTUC II, followed by aromatase inhibitor, is a promising therapeutic method for elderly patients with breast cancer, in terms of avoiding any surgical procedure. Moreover, MMG is considered to be useful for evaluating the efficacy of KORTUC II. PMID:24212965

  12. Evaluation of Changes in Tumor Shadows and Microcalcifications on Mammography Following KORTUC II, a New Radiosensitization Treatment without any Surgical Procedure for Elderly Patients with Stage I and II Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tsuzuki, Akira; Ogawa, Yasuhiro, E-mail: ogaway@kochi-u.ac.jp; Kubota, Kei; Tokuhiro, Shiho; Akima, Ryo; Yaogawa, Shin; Itoh, Kenji; Yamada, Yoko; Sasaki, Toshikazu [Department of Diagnostic Radiology & Radiation Oncology, Medical school, Kochi University Nankoku, Kochi 783-8505 (Japan); Onogawa, Masahide [Department of Pharmacy, Medical School, Kochi University, Nankoku, Kochi 783-8505 (Japan); Yamanishi, Tomoaki; Kariya, Shinji; Nogami, Munenobu; Nishioka, Akihito [Department of Diagnostic Radiology & Radiation Oncology, Medical school, Kochi University Nankoku, Kochi 783-8505 (Japan); Miyamura, Mitsuhiko [Department of Pharmacy, Medical School, Kochi University, Nankoku, Kochi 783-8505 (Japan)

    2011-09-09

    We introduced non-surgical therapy with a novel enzyme-targeting radiosensitization treatment, Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II) into early stages breast cancer treatment. The purpose of this study was to examine changes in tumor shadows and microcalcifications on mammography (MMG) following KORTUC II for elderly patients with breast cancer. We also sought to determine whether MMG was useful in evaluating the therapeutic effect of KORTUC II. In addition to MMG, positron emission tomography-computed tomography (PET-CT) was performed to detect both metastasis and local recurrence. In all 10 patients, tumor shadows on MMG completely disappeared in several months following the KORTUC II treatment. The concomitant microcalcifications also disappeared or markedly decreased in number. Disappearance of the tumors was also confirmed by the profile curve of tumor density on MMG following KORTUC II treatment; density fell and eventually approached that of the peripheral mammary tissue. These 10 patients have so far have also shown neither local recurrence nor distant metastasis on PET-CT with a mean follow-up period of approximately 27 months at the end of September, 2010. We conclude that breast-conservation treatment using KORTUC II, followed by aromatase inhibitor, is a promising therapeutic method for elderly patients with breast cancer, in terms of avoiding any surgical procedure. Moreover, MMG is considered to be useful for evaluating the efficacy of KORTUC II.

  13. Evaluation of Changes in Tumor Shadows and Microcalcifications on Mammography Following KORTUC II, a New Radiosensitization Treatment without any Surgical Procedure for Elderly Patients with Stage I and II Breast Cancer

    Directory of Open Access Journals (Sweden)

    Akihito Nishioka

    2011-09-01

    Full Text Available We introduced non-surgical therapy with a novel enzyme-targeting radiosensitization treatment, Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II into early stages breast cancer treatment. The purpose of this study was to examine changes in tumor shadows and microcalcifications on mammography (MMG following KORTUC II for elderly patients with breast cancer. We also sought to determine whether MMG was useful in evaluating the therapeutic effect of KORTUC II. In addition to MMG, positron emission tomography-computed tomography (PET-CT was performed to detect both metastasis and local recurrence. In all 10 patients, tumor shadows on MMG completely disappeared in several months following the KORTUC II treatment. The concomitant microcalcifications also disappeared or markedly decreased in number. Disappearance of the tumors was also confirmed by the profile curve of tumor density on MMG following KORTUC II treatment; density fell and eventually approached that of the peripheral mammary tissue. These 10 patients have so far have also shown neither local recurrence nor distant metastasis on PET-CT with a mean follow-up period of approximately 27 months at the end of September, 2010. We conclude that breast-conservation treatment using KORTUC II, followed by aromatase inhibitor, is a promising therapeutic method for elderly patients with breast cancer, in terms of avoiding any surgical procedure. Moreover, MMG is considered to be useful for evaluating the efficacy of KORTUC II.

  14. Incisão periauricular para operações da glândula parótida Periauricular incision for surgical procedures on the parotid gland

    Directory of Open Access Journals (Sweden)

    Andy Petroianu

    2010-12-01

    Full Text Available RACIONAL: As incisões mais comuns para parotidectomia consistem em abertura pré ou periauricular prolongadas para a região submandibular ou cervical. Elas podem acompanhar-se de cicatrizes imperfeitas, provocando deformidades cutâneas locais. OBJETIVO: Avaliar o tratamento de afecções cirúrgicas parotídeas através de incisão periauricular apenas. MÉTODO: Foram estudados 39 pacientes consecutivos com moléstias da parótida. Adenoma pleomórfico (20 casos foi a afecção mais encontrada, seguida por outros tumores benignos (9 casos, carcinomas (5 casos, cisto parotídeo (3 casos e parotidite crônica (2 casos. Todas as parotidectomias foram realizadas através de incisão periauricular. Em presença de carcinoma, a linfadenectomia cervical foi conduzida por meio de incisão cervical transversa supra-hióidea homolateral. RESULTADO: A remoção da afecção parotídea foi possível em todos os casos sem incisão cutânea complementar. Todas as cicatrizes tiveram bom resultado estético e, após seis meses, elas estavam quase imperceptíveis. Os pacientes revelaram satisfação com o resultado da operação. Fraqueza facial temporária ocorreu em 28 operações. Desconforto auricular transitório foi registrado em 22 pacientes. Todos tiveram hipoestesia da região operada, que perdurou por até seis meses. As complicações encontradas neste trabalho estão descritas na literatura como esperadas em parotidectomia, independentemente do tipo de incisão. CONCLUSÃO: A incisão periauricular é opção boa e estética para abordagem cirúrgica da glândula parótida.BACKGROUND: The most common incisions for parotidectomy consist of opening or pre periauricular extended to the submandibular or cervical region. They can accompany themselves ragged scars, causing local skin deformities. AIM: The purpose of this study was to evaluate the treatment of parotid surgical diseases using periauricular incision. METHOD: Thirty nine patients with

  15. Surgical Simulation and Competency.

    Science.gov (United States)

    Kim-Fine, Shunaha; Brennand, Erin A

    2016-09-01

    Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy. PMID:27521885

  16. Neurosurgical procedures in patients with liver cirrhosis: A review

    Institute of Scientific and Technical Information of China (English)

    Ching-Chang; Chen; Yin-Cheng; Huang; Chun-Nan; Yeh

    2015-01-01

    Liver cirrhosis, a devastating liver fibrosis caused by hepatitis/inflammation or tumors, is a major comorbid factor in known surgery fields, such as cardiovascular and abdominal surgeries. It is important to review possible comorbid results in neurosurgical procedures in cirrhotic patients. In the reviewed literature, ChildPugh and model for end-stage liver disease scores are commonly used in the assessment of surgical risks for cirrhotic patients undergoing abdominal, cardiovascular or neurosurgical procedures. The major categories of neurosurgery are traumatic brain injury(TBI), spontaneous intracranial hemorrhage(SICH), brain tumors, and spinal instrumentation procedures. TBI was reported with surgical mortality as high as 34.5% and a complication rate of 87.2%. For SICH, mortality ranged from 22.7% to 47.0%, while complications were reported to be 43.2%. Less is discussed in brain tumor patients; still the postoperative hemorrhage rate approached 26.7%. In spinal fusion instrumentation procedures, the complication rate was as high as 41.0%. Preoperative assessment and correction could possibly decrease complications such as hemorrhage, wound infection and other cirrhosis-related complications(renal, pulmonary, ascites and encephalopathy). In this study, we reviewed the neurosurgical-related literature with regard to liver cirrhosis as a prognostic factor influencing neurosurgical outcomes.

  17. The Maxillary Sinus Membrane Elevation Procedure: Augmentation of Bone around Dental Implants without Grafts—A Review of a Surgical Technique

    Directory of Open Access Journals (Sweden)

    Christopher Riben

    2012-01-01

    Full Text Available Background. Long-term edentulism may in many cases result in resorption of the alveolar process. The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. The method is over 30 years old, and initially autogenous bone grafts were used and later also different bone substitutes. Since 1997, a limited number of studies have explored the possibility of a graftless procedure where the void under the sinus membrane is filled with a blood clot that enables bone formation. Aim. To describe the evolution of the sinus-lift technique and to review the literature related to the technique with a focus on long-term studies related to the graft-less technique. Methods. The electronic database PubMed was searched, and a systematic review was conducted regarding relevant articles. Results. A relatively few long-term studies using the described technique were found. However, the technique was described as reliable considering the outcome of the existing studies. Conclusion. All investigated studies show high implant survival rates for the graftless technique. The technique is considered to be cost-effective, less time-consuming, and related to lower morbidity since no bone harvesting is needed.

  18. 外科手术过程中护理风险因素分析及护理对策%The Surgical Procedures Care Risk Factors and Nursing Strategy

    Institute of Scientific and Technical Information of China (English)

    朱俊峰

    2015-01-01

    Objective To investigate the surgical nursing risk control measures. Methods A retrospective analysis of our hospital in January 2012-June 2014 1532 surgical procedures in patients with clinical data, summarize the main risk factors for nursing. Results The surgical risk factors for primary care:(1) care management system is not perfect;(2) nursing care system is not strictly enforced;(3)nurses can not provide continuity of service;(4) nurses legal consciousness;(5) care responsibilities are not clear. Conclusion Nursing sound management system, establish a long-term communication mechanism between nurses and patients, to improve clinical nursing skil s and other measures can effectively reduce the surgical care risk factors and improve the efficiency and quality of care.%目的:探讨外科手术护理风险控制对策。方法回顾性分析我院2012年1月~2014年6月1532例外科手术患者临床资料,总结主要护理风险因素。结果外科手术主要护理风险因素为:(1)护理管理制度不健全;(2)护理人员未严格执行护理工作制度;(3)护理人员不能提供连续性服务;(4)护理人员法律意识淡薄;(5)护理责任不明确。结论通过健全护理管理制度、建立护患长效沟通机制、提高临床护理人员专业技能等措施,可切实减少外科手术护理风险因素,提高护理效率和质量。

  19. Surgical treatment for liver cancer

    Institute of Scientific and Technical Information of China (English)

    Nicole; C; Tsim; Adam; E; Frampton; Nagy; A; Habib; Long; R; Jiao

    2010-01-01

    Primary liver cancer is amongst the commonest tumors worldwide,particularly in parts of the developing world,and is increasing in incidence. Over the past three decades,surgical hepatic resection has evolved from a high risk,resource intensive procedure with limited application,to a safe and commonly performed operation with a range of indications. This article reviews the approach to surgical resection for malignancies such as hepatocellular cancer,metastatic liver de-posits and neuroendocrine tumors. Surv...

  20. Blepharoplasty and periorbital surgical rejuvenation

    OpenAIRE

    Milind Naik

    2013-01-01

    The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects ...

  1. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke

    2011-01-01

    Effective acquisition of a skill requires practise. Therefore it is of great importance to provide veterinary students with opportunities to practice their surgical skills before carrying out surgical procedures on live patients. Some veterinary schools let students perform entire surgical...... procedures on research animals, in order to learn the basic skills along the way. From an ethical point of view it is questionable however to use live research animals for the sole purpose of practising surgery, and also, research animals are very costly. It is therefore necessary to identify alternative...... teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...

  2. [Treatment with inhibitors of new oral direct anticoagulants in patients with severe bleedings or urgent surgical procedures. The new dabigatran antidote: the place of idarucizumab in clinical practice].

    Science.gov (United States)

    Boda, Zoltán

    2016-03-20

    Only vitamin K antagonists could be applied as oral anticoagulants over the past six decades. Coumarols have narrow therapeutic range, and unpredictable anticoagulant effects are resulted by multiple drug interactions. Therefore, regular routine monitoring of the international normalized ratio is necessary. There are two groups of factor-specific anticoagulants: molecules with anti-FIIa (dabigatran) and anti-FXa (rivaroxaban, apixaban and edoxaban) effect. Author summarizes the most important clinical features of the new oral anticoagulants, their indications and the possibilities of laboratory controls. Bleedings are the most important side effects of anticoagulants. This review summarizes the current published evidences for new oral anticoagulants reversal (non-specific and specific) agents, especially in cases with severe acute bleedings or urgent surgery procedures. It reports on how to use inhibitors, the recommended doses and the most important clinical results. The review focuses on idarucizumab - already approved by the U.S. Food and Drug Administration and the European Medicines Agency - which has a key role as the first specific inhibitor of dabigatran.

  3. PROCEDIMIENTOS EN CIRUGÍA: COLOCACIÓN DE CATÉTER SUBCLAVIO, ABORDAJE INFRACLAVICULAR Surgical procedures: placement of subclavian catheter, infraclavicular approach

    Directory of Open Access Journals (Sweden)

    Juan de Dios Díaz-Rosales

    2008-12-01

    Full Text Available La cateterización venosa central constituye un procedimiento frecuente en el servicio de cirugía general del Hospital General de Ciudad Juárez, que puede ser tanto diagnóstico como terapéutico. Su fin es introducir catéteres en los grandes vasos venosos colocando su punta distal en la vena cava superior, en la aurícula derecha o en la vena cava inferior, esto depende de las preferencias del médico que inserta el catéter. En el presente artículo se describe en forma didáctica la técnica de inserción infraclavicular.Central venous catheterization is a frequent procedure in our Hospital (Juarez City-Mexico, with diagnostic and therapeutic goals. Its goal is introduce catheters in great veins, placing its tip portion at superior cava vein, right auricle or inferior cava vein. In this paper we describe the technique of sublavian catheterization by infraclavicular approach.

  4. Sepsis of the hip due to pressure sore in spinal cord injured patients: advocacy for a one-stage surgical procedure.

    Science.gov (United States)

    Le Fort, M; Rome-Saulnier, J; Lejeune, F; Bellier-Waast, F; Touchais, S; Kieny, P; Duteille, F; Perrouin-Verbe, B

    2014-11-04

    Study design:Retrospective study reporting characteristics and management of septic arthritis of the hip due to pressure sores in spinal cord-injured patients.Objectives:To describe clinical and biological data of septic arthritis of the hip and its treating management.Setting:The database of the regional SCI referral center, Nantes, France.Methods:We retrospectively collected data from 33 cases of septic arthritis of the hip in the medical files of 26 patients.Results:We analyzed 33 cases of septic arthritis of the hip treated in one French referent center for spinal cord-injured patients from January 1988 to December 2009. Most patients had a thoracic complete paraplegia and nearly two-third (17 out of 26) had no systematic follow-up. In 25 out of 33 cases, the septic arthritis of the hip was due to a trochanteric pressure sore. The causal pressure sore was most frequently associated with a persistent drainage. The standard radiological examination led to the diagnosis in 30 cases and, in 7 questionable cases, magnetic resonance imaging was more contributory. Surgery always consisted of a wide carcinological-like excision and of a subtrochanteric proximal femoral resection including both greater and lesser trochanters. A musculocutaneous flap was realized for all cases and the choice of the muscle depended on the localization of the causal pressure sore but also of the remaining choices, as most of the patients had already undergone a prior surgery. An antibiotic treatment was adapted to multiple samples during surgery.Conclusion:We do advocate for a one-stage procedure including a subtrochanteric proximal femoral resection and a musculocutaneous flap.Spinal Cord advance online publication, 4 November 2014; doi:10.1038/sc.2014.170.

  5. Gene transfer during surgical procedures with molecular surgical suture

    Directory of Open Access Journals (Sweden)

    Dan Huang

    2009-06-01

    Full Text Available Over the last decades, there has been an explosion of interest in plasmid DNA for gene therapy with reports of their efficacy in the fight against cancer, vascular diseases, and inherited diseases caused by specific gene defects (Srivastava, 2003. DNA plasmids present several advantages over the use of recombinant viruses concerning their production and safety issues. Plasmid DNA vectors can be constructed easily and economically, and they are free of size constraints imposed by viral packaging, obviating the need for an infectious vector and lessening the likelihood of toxicity and immunogenicity (Davis, 1993. Plasmids have a relative low cost, long shelf life and allow repetitive administration of the therapeutic gene without generating an immune response against the delivery vector (Donnelly, 2003. Finally, plasmids can be injected directly into tissues, such as heart (Sarkar, 2002, muscle (Neumeister, 2001, Dan, 2000 and tumors (De Marco, 2003, Sasaki, 2002.

  6. Advances in the surgical management of prolapse.

    Science.gov (United States)

    Slack, Alex; Jackson, Simon

    2007-03-01

    Prolapse is an extremely common condition, for which 11% of women will have a surgical procedure at some point in their lives. The recurrence rate after most of the traditional surgical procedures is high and upto 29% of women who have had surgery for prolapse will require a further operation. In order to improve the surgical outcome, there is currently much interest in the use of grafts to augment traditional repairs and new procedures have been developed using specifically developed grafts. These have been combined with minimally invasive surgical techniques in an attempt to reduce surgical morbidity. These procedures may improve the outcome of surgery for prolapse. However, there is currently a lack of long-term data from randomized trials to demonstrate their effectiveness and safety. PMID:17448267

  7. The retained surgical sponge.

    Science.gov (United States)

    Kaiser, C W; Friedman, S; Spurling, K P; Slowick, T; Kaiser, H A

    1996-01-01

    OBJECTIVE. A review was performed to investigate the frequency of occurrence and outcome of patients who have retained surgical sponges. METHODS. Closed case records from the files of the Medical Professional Mutual Insurance Company (ProMutual, Boston, MA) involving a claim of retained surgical sponges were reviewed for a 7-year period. RESULTS. Retained sponges occurred in 40 patients, comprising 48% of all closed claims for retained foreign bodies. A falsely correct sponge count after an abdominal procedure was documented in 76% of these claims. Ten percent of claims involved vaginal deliveries and minor non-body cavity procedures, for which no sponge count was performed. Total indemnity payments were $2,072,319, and defense costs were $572,079. In three cases, the surgeon was deemed responsible by the court despite the nursing staff's admitting liability and evidence presented that the surgeon complied completely with the standard of care. A wide range of indemnity payments was made despite a remarkable similarity of outcome in the patients studied. CONCLUSIONS. Despite the rarity of the reporting of a retained surgical sponge, this occurrence appears to be encountered more commonly than generally is appreciated. Operating teams should ensure that sponges be counted for all vaginal and any incisional procedures at risk for retaining a sponge. In addition, the surgeon should not unquestioningly accept correct count reports, but should develop the habit of performing a brief but thorough routine postprocedure wound/body cavity exploration before wound closure. The strikingly similar outcome for most patients would argue for a standardized indemnity payment being made without the need for adversarial legal procedures. PMID:8678622

  8. Surgical management of ectopic pregnancy.

    Science.gov (United States)

    Stock, Laura; Milad, Magdy

    2012-06-01

    Surgery remains an acceptable, and sometimes necessary, modality for the treatment of ectopic pregnancy. Laparoscopy is the preferred method of access, yet controversy remains regarding the optimal procedure and postoperative management. Generally, salpingostomy is employed with the goal of maintaining fertility, although data to support this tenet are lacking. In most cases, the decision to perform conservative versus radical surgery is on the basis of the patient's history, her desire for future fertility, and surgical findings. The procedures of salpingostomy and salpingectomy, techniques to prevent and control blood loss at the time of surgery, and surgical options for nontubal ectopic pregnancies are reviewed. PMID:22510627

  9. 呼吸放松引导在手术患者静脉穿刺中的应用%Application of Breathing and Relaxation Guiding Method in Surgical Patients Undergoing Invasive Procedures

    Institute of Scientific and Technical Information of China (English)

    杜福兰; 马菊芳; 张德惠

    2013-01-01

      目的:探讨呼吸放松引导在手术患者静脉穿刺中的应用效果。方法:将50例拟实施手术患者随机分为呼吸放松引导组(A组)和对照组(B组),每组25例;A组患者在呼吸放松引导后实施静脉穿刺,B组患者常规心理疏导后实施静脉穿刺。观察两组患者在呼吸放松前、呼吸放松5分钟后、实施静脉穿刺时的心率、血压变化和疼痛不适程度。结果:A组患者心率、血压在呼吸放松干预前后及静脉穿刺时有明显差异(P<0.05),其疼痛不适程度亦明显减轻(P<0.05);B组患者心率、血压前后无明显差异,患者疼痛不适程度明显增高(P<0.05)。结论:正确的呼吸放松引导可使手术患者在静脉穿刺时心率减慢、血压降低,同时明显减轻患者的疼痛不适感。%Objective:To investigate the effect of breathing and relaxation guiding method in surgical patients undergoing invasive procedures. Methods:Fifty patients undergoing elective surgery were enrolled in the study.All patients were randomly divided into two groups(group A,group B).Invasive procedures were done in groupApatients after the breathing and relaxation guiding was completed,and in group B patients after conventional psychological counseling was completed. Heart rate,blood pressure,discomfort and pain were observed at several time points:before breathing and relaxation guiding,five minutes after the breathing relaxation guiding,implementation of invasive procedures. Results:Heart rate and blood pressure in group A patients were higher before invasive procedures than that after the procedures were done (P<0.05).Discomfort and pain were significantly reduced before invasive procedures than that after the procedures were done (P<0.05).Heart rate and blood pressure in group B patients were not significantly changed,but discomfort and pain were significantly higher after the procedures were done (P<0.05). Conclusion:The correct breathing and

  10. Surgical treatments for osteoarthritis.

    Science.gov (United States)

    de l'Escalopier, Nicolas; Anract, Philippe; Biau, David

    2016-06-01

    There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance. Osteoarthritis symptoms are usually the consequence of an imbalance between the load applied to a joint and the surface available to support that load. Therefore, conservative treatments will either tend to decrease the load exerted on the joint, such as in a tibial valgus osteotomy for instance, or to improve the articular surface supporting that load. Sometimes, both can be provided at the same time; the peri-acetabular osteotomy for hip dysplasia is an example of such a procedure. Conservative treatments are usually offered to young patients in order to delay, if not avoid, the need for a joint prosthesis. They are usually performed before osteoarthritis appears or at an early stage. Joint arthroplasties have overwhelmingly excellent functional results and today's research is directed towards providing rapid recovery, very long-term stability, and the assurance of a good functionality in extreme conditions. However, complications with joint arthroplasties can be serious with little, if any, reasonable salvage solution. Therefore, these procedures are offered to patients who have failed adequate medical treatment measures. PMID:27185463

  11. Common swine models of cardiovascular disease for research and training.

    Science.gov (United States)

    Crisóstomo, Verónica; Sun, Fei; Maynar, Manuel; Báez-Díaz, Claudia; Blanco, Virginia; Garcia-Lindo, Monica; Usón-Gargallo, Jesús; Sánchez-Margallo, Francisco Miguel

    2016-02-01

    Cardiovascular diseases are a major health concern and therefore an important topic in biomedical research. Large animal models allow researchers to assess the safety and efficacy of new cardiovascular procedures in systems that resemble human anatomy; additionally, they can be used to emulate scenarios for training purposes. Among the many biomedical models that are described in published literature, it is important that researchers understand and select those that are best suited to achieve the aims of their research, that facilitate the humane care and management of their research animals and that best promote the high ethical standards required of animal research. In this resource the authors describe some common swine models that can be easily incorporated into regular practices of research and training at biomedical institutions. These models use both native and altered vascular anatomy of swine to carry out research protocols, such as testing biological reactions to implanted materials, surgically creating aneurysms using autologous tissue and inducing myocardial infarction through closed-chest procedures. Such models can also be used for training, where native and altered vascular anatomy allow medical professionals to learn and practice challenging techniques in anatomy that closely simulates human systems. PMID:26814353

  12. The effect of antibiotic irrigation of surgical Incisions in prevention of Surgical Site Infection

    Directory of Open Access Journals (Sweden)

    Mirsharifi S R

    2008-05-01

    Full Text Available Background: surgical site infection is one of the most common post operative complications alongside with sepsis, cardiovascular, pulmonary and thromboembolic complications. The development of surgical site infection is related to three factors: the degree of microbial contamination of the wound during surgery, the duration of the procedure, and host factors such as diabetes, malnutrition, obesity, immune suppression, and a number of other underlying disease states. The purpose of this study was to evaluate the effects of topical cephazolin in controlling infection of the site of surgery after non-laparoscopic cholecystecomy.Methods: One hundred and two of patients referred to the outpatient clinic of Imam Khomeini Hospital from fall 2005 to fall 2006 non- laparoscopic cholecystectomy enrolled in a randomized clinical trial. All patients underwent the same procedure of anesthesia and surgery and they were randomly assigned into two groups of cases with irrigation of the site of surgery with 1g of topical Cephazolin prior to the termination of the operation- and controls. Cephazolin is a first generation cephalosporin which binds penicillin binding protein and is a potent cell wall synthesis inhibitor. The patients were followed up for six weeks for symptoms and signs of infection including discharge of the wound; and presence of pain, warmness, swelling and erythema of the wound.Results: There were no significant differences between two study groups regarding mean age, duration of operation, and sex. There was no significant difference in the incidence of infection of the site of surgery (11.8% in both groups with p=0.99 between two groups.Conclusion: Analyzing the collected data confirms that prophylactic use of topical cephazolin was unable to decrease the risk of infection of the site of surgery in patients undergoing non- laparascopic cheolecystectomy.

  13. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Josué Viana Neto, E-mail: jvcn@uol.com.br [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Melo, Emanuel Carvalho; Silva, Juliana Fernandes [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Rebouças, Leonardo Lemos; Corrêa, Larissa Chagas; Germano, Amanda de Queiroz [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Machado, João José Aquino [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil)

    2014-03-15

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology.

  14. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    International Nuclear Information System (INIS)

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology

  15. Interventional cardiovascular magnetic resonance: still tantalizing

    OpenAIRE

    Saikus Christina E; Kocaturk Ozgur; Guttman Michael A; Faranesh Anthony Z; Ratnayaka Kanishka; Lederman Robert J

    2008-01-01

    Abstract The often touted advantages of MR guidance remain largely unrealized for cardiovascular interventional procedures in patients. Many procedures have been simulated in animal models. We argue these opportunities for clinical interventional MR will be met in the near future. This paper reviews technical and clinical considerations and offers advice on how to implement a clinical-grade interventional cardiovascular MR (iCMR) laboratory. We caution that this reflects our personal view of ...

  16. Surgical management of chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Stavros Gourgiotis; Stylianos Germanos; Marco Pericoli Ridolifni

    2007-01-01

    BACKGROUND:Treatment of chronic pancreatitis (CP) is a challenging condition for surgeons. During the last decades, increasing knowledge about pathophysiology of CP, improved results of major pancreatic resections, and integration of sophisticated diagnostic methods in clinical practice have resulted in signiifcant changes in surgery for CP. DATA SOURCES:To detail the indications for CP surgery, the surgical procedures, and outcome, a Pubmed database search was performed. The abstracts of searched articles about surgical management of CP were reviewed. The articles could be identiifed and further scrutinized. Further references were extracted by cross-referencing. RESULTS: Main indications of CP for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The goal of surgical treatment is to improve the quality of life of patients. The surgical approach to CP should be individualized according to pancreatic anatomy, pain characteristics, baseline exocrine and endocrine function, and medical co-morbidity. The approach usually involves pancreatic duct drainage and resection including longitudinal pancreatojejunostomy, pancreatoduodenectomy (Whipple's procedure), pylorus-preserving pancreatoduodenectomy, distal pancreatectomy, total pancreatectomy, duodenum-preserving pancreatic head resection (Beger's procedure), and local resection of the pancreatic head with longitudinal pancreatojejunostomy (Frey's procedure). Non-pancreatic and endoscopic management of pain has also been advocated. CONCLUSIONS:Surgical procedures provide long-term pain relief, a good postoperative quality of life with preservation of endocrine and exocrine pancreatic function, and are associated with low early and late mortality and morbidity. In addition to available results from randomized controlled trials, new studies are needed to determine which procedure is the most effective for the management of patients with CP.

  17. Non-cardiovascular findings in clinical cardiovascular magnetic resonance imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Ghadimi Mahani, Maryam [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Morani, Ajaykumar C. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Lu, Jimmy C.; Dorfman, Adam L. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, Ann Arbor, MI (United States); Fazeli Dehkordy, Soudabeh [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Providence Hospital and Medical Centers, Department of Graduate Medical Education, Southfield, MI (United States); Jeph, Sunil [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Geisinger Medical Center, Department of Radiology, Danville, PA (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)

    2016-04-15

    With increasing use of pediatric cardiovascular MRI, it is important for all imagers to become familiar with the spectrum of non-cardiovascular imaging findings that can be encountered. This study aims to ascertain the prevalence and nature of these findings in pediatric cardiovascular MRIs performed at our institution. We retrospectively evaluated reports of all cardiovascular MRI studies performed at our institute from January 2008 to October 2012 in patients younger than18 years. Most studies (98%) were jointly interpreted by a pediatric cardiologist and a radiologist. We reviewed the electronic medical records of all cases with non-cardiovascular findings, defined as any imaging finding outside the cardiovascular system. Non-cardiovascular findings were classified into significant and non-significant, based on whether they were known at the time of imaging or they required additional workup or a change in management. In 849 consecutive studies (mean age 9.7 ± 6.3 years), 145 non-cardiovascular findings were found in 140 studies (16.5% of total studies). Overall, 51.0% (74/145) of non-cardiovascular findings were in the abdomen, 30.3% (44/145) were in the chest, and 18.6% (27/145) were in the spine. A total of 19 significant non-cardiovascular findings were observed in 19 studies in individual patients (2.2% of total studies, 47% male, mean age 5.9 ± 6.7 years). Significant non-cardiovascular findings included hepatic adenoma, arterially enhancing focal liver lesions, asplenia, solitary kidney, pelvicaliectasis, renal cystic diseases, gastric distention, adrenal hemorrhage, lung hypoplasia, air space disease, bronchial narrowing, pneumomediastinum and retained surgical sponge. Non-cardiovascular findings were seen in 16.5% of cardiovascular MRI studies in children, of which 2.2% were clinically significant findings. Prevalence and nature of these non-cardiovascular findings are different from those reported in adults. Attention to these findings is important

  18. Transferring a Classic Dog Laboratory To Videodisc: Cardiovascular Physiology

    Science.gov (United States)

    Terpstra, J.K.; Harris, T.M.

    1989-01-01

    This demonstration presents the development process and intended uses of the Classic Laboratory Experiments in Basic Health Sciences: Cardiovascular Physiology videodisc containing over thirty experiments. This interactive videodisc is designed to teach the physiological effects of procedures and drugs on the cardiovascular system. The Cardiovascular Physiology program is the first in a series of classic dog laboratory videodiscs to be developed.

  19. Virtual occlusion in planning orthognathic surgical procedures.

    NARCIS (Netherlands)

    Nadjmi, N.; Mollemans, W.; Daelemans, A.; Hemelen, G. Van; Schutyser, F.A.C.; Berge, S.J.

    2010-01-01

    Accurate preoperative planning is mandatory for orthognathic surgery. One of the most important aims of this planning process is obtaining good postoperative dental occlusion. Recently, 3D image-based planning systems have been introduced that enable a surgeon to define different osteotomy planes pr

  20. Virtual occlusion in planning orthognathic surgical procedures.

    Science.gov (United States)

    Nadjmi, N; Mollemans, W; Daelemans, A; Van Hemelen, G; Schutyser, F; Bergé, S

    2010-05-01

    Accurate preoperative planning is mandatory for orthognathic surgery. One of the most important aims of this planning process is obtaining good postoperative dental occlusion. Recently, 3D image-based planning systems have been introduced that enable a surgeon to define different osteotomy planes preoperatively and to assess the result of moving different bone fragments in a 3D virtual environment, even for soft tissue simulation of the face. Although the use of these systems is becoming more accepted in orthognathic surgery, few solutions have been proposed for determining optimal occlusion in the 3D planning process. In this study, a 3D virtual occlusion tool is presented that calculates a realistic interaction between upper and lower dentitions. It enables the surgeon to obtain an optimal and physically possible occlusion easily. A validation study, including 11 patient data sets, demonstrates that the differences between manually and virtually defined occlusions are small, therefore the presented system can be used in clinical practice.

  1. SURGICAL NUTRITION

    Directory of Open Access Journals (Sweden)

    Danny Kurniawan Darianto

    2015-07-01

    Full Text Available A patient undergoing surgery faces great physiologic and psychologic stress. so nutritional demands are greatly increased during this period and deficiencies can easily develop. If these deficiencies are allowed to develop and are not in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met, complications are less likely developing. Natural resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutition, burns, and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders, and use of supplements can hasten wound healing and shorten recovery times.

  2. Thoracoscopy: a collaborative surgical approach.

    Science.gov (United States)

    Brand, A F

    1995-07-01

    Perioperative nurses, surgeons, anesthesiologists, certified registered nurse anesthetists, and pharmacists are meeting the challenge of decreasing thoracic surgical patients' length of hospital stay with thoracoscopy. This innovative alternative to traditional thoracotomy procedures has been achieved through an attentive team approach using the fundamental perioperative skills of assessment, positioning, safety, and sharing of knowledge. PMID:7647761

  3. Open surgical management of pediatric urolithiasis: A developing country perspective

    OpenAIRE

    Rizvi, Syed A; Sultan, Sajid; Ijaz, Hussain; Mirza, Zafar N.; Ahmed, Bashir; Saulat, Sherjeel; Umar, Sadaf Aba; Naqvi, Syed A.

    2010-01-01

    Objectives To describe decision factors and outcome of open surgical procedures in the management of children with stone. Materials and Methods Between January 2004 and December 2008, 3969 surgical procedures were performed in 3053 children with stone disease. Procedures employed included minimally invasive techniques shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS), perurethral cystolithotripsy (PUCL), percutaneous cystolithotripsy (PCCL), and open sur...

  4. Improving Surgical Access in Rural Africa through a Surgical Camp Model.

    Science.gov (United States)

    Galukande, M; Kituuka, O; Elobu, E; Jombwe, J; Sekabira, J; Butler, Elissa; Faulal, J

    2016-01-01

    Introduction. Surgical camps are preplanned activities where volunteer surgical teams congregate at specified place(s) and perform a wide range of mostly elective procedures for a limited period of time. This is usually at no cost to the patients, who belong to vulnerable (poor and hard to reach) communities. We describe a surgical camp model and its challenges as a means of improving access to surgical services. Methods. A cross-sectional descriptive study. Data from a recent Association of Surgeons of Uganda surgical camp were collected and analyzed for demographics, costs, procedure types, and rates and, in addition, challenges encountered and solutions. Personnel that participated in this exercise included specialist surgeons, surgical residents, medical officers, clinical officers, anesthetists, and theater nurses (a total of 121 staff). Results. In total, 551 procedures were performed during a four-day-long camp. Mean age was 35 years (SD 23), M : F ratio was 2 : 1. Herniorrhaphy, skin lump excision, hydrocelectomy, and thyroidectomy formed 81% of all the procedures. Average cost per procedure was $73 USD. Conclusion. Surgical camps offer increased access to surgical services to vulnerable populations. Hernias and goiters were most common. Surgical camps should become an integral part of the Health Service delivery in low-resourced environments. PMID:27413775

  5. Surgical management of pancreatic neuroendocrine tumors

    NARCIS (Netherlands)

    A.P.J. Jilesen

    2015-01-01

    This thesis gives an overview of the surgical management and prognosis of patients with pancreatic neuroendocrine tumors (pNET). A systematic review including 2600 studies, was performed on complications and survival after different surgical procedures for pNETs. The overall pancreatic fistula rate

  6. Non-surgical embryo transfer in pigs

    NARCIS (Netherlands)

    Hazeleger, W.

    1999-01-01

    Embryo transfer in pigs has been performed surgically for a long time. However, a less invasive, non-surgical, procedure of embryo transfer could be a valuable tool for research (to study embryo survival and embryo-uterus interactions) and practical applications (export, prevention of disease transm

  7. Cardiovascular Glossary

    Science.gov (United States)

    ... not close naturally, as it should, after birth. Percutaneous coronary intervention (PCI) - Any of the noninvasive procedures usually performed ... catheterization laboratory. Angioplasty is an example of a percutaneous coronary ... a transcatheter intervention. Percutaneous transluminal coronary ...

  8. Surgical versus non-surgical treatment of congenital hyperinsulinism.

    Science.gov (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David

    2009-03-01

    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  9. Surgical treatment of pathological obesity

    International Nuclear Information System (INIS)

    The obesity is the chronic non-communicable disease with a higher rate of growth in past 20 years. It is a risk factor for type 2 diabetes mellitus, high blood pressure, cardiovascular and respiratory affections, infertility, sexual and functional impotence, metabolic syndrome, load joint disorders and some types of cancer (breast, colon, prostate). The metabolic bariatric surgery is the surgical treatment more effective for the morbid obesity at long -and medium- term and not the pharmacologic treatment and the isolated diets. The aim of present historical review of the international literature on the evolution of surgical techniques of the bariatric surgery (malabsorption techniques, gastric restrictive techniques and mixed techniques), is to make available to those interested in this subject, a valuable therapeutic tool to be rationally used. (author)

  10. Surgical tools and medical devices

    CERN Document Server

    Jackson, Mark

    2016-01-01

    This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

  11. Guideline Implementation: Prevention of Retained Surgical Items.

    Science.gov (United States)

    Fencl, Jennifer L

    2016-07-01

    A surgical item unintentionally retained in a patient after an operative or other invasive procedure is a serious, preventable medical error with the potential to cause the patient great harm. Perioperative RNs play a key role in preventing retained surgical items (RSIs). The updated AORN "Guideline for prevention of retained surgical items" provides guidance for implementing a consistent, multidisciplinary approach to RSI prevention; accounting for surgical items; preventing retention of device fragments; reconciling count discrepancies; and using adjunct technologies to supplement manual count procedures. This article focuses on key points of the guideline to help perioperative personnel provide optimal care during a procedure. Key points addressed include taking responsibility for RSI prevention as a team; minimizing distractions, noise, and interruptions during counts; using consistent counting methods; reconciling discrepancies; and participating in performance-improvement activities. Perioperative RNs should review the complete guideline for additional information and for guidance in writing and updating policies and procedures. PMID:27350354

  12. 永久性心房颤动外科双极射频消融术的效果%Outcomes of Maze Procedure Using Bipolar Radiofrequency Ablation for Surgical Treatment of Permanent Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    杨嵩; 张希; 唐白云; 殷胜利

    2012-01-01

    Objective To summarize the clinical outcomes of maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for the surgical treatment of permanent atrial fibrillation (AF) and rheumatic valve diseases. Methods A total of 124 patients with permanent AF and rheumatic valves diseases undergoing surgical treatment from March 2006 to October 2010 in the First Affiliated Hospital of Sun Yat-sen University were randomly divided into ablation group and control group using coin method with 62 patients in each group. The mean atrial fibrillation duration was (56.1+47.1) months in ablation group, and patients in this group underwent maze procedure using bipolar radiofrequency ablation and valve replacement. The mean atrial fibrillation duration was (43. 8+25.6) months in control group, and patients in this group underwent only valve replacement. Demographic characteristics, cardiopulmonary bypass (CPB) time, aortic cross-clamping (ACC) time, mechanical ventilation time, intensive care unit (ICU) length of stay, postoperative complications and follow-up outcomes were compared between the two groups. Results The demographic characteristics of the two groups were not statistically different (P > 0.05). The CPB time and ACC time between the two groups were not statistically different (P > 0.05). The postoperative hospital stay of ablation group was significantly longer than that of control group (15.8+6.1 d vs. 12.9+3.1 d, P=0.001). No patient needed permanent pacemaker implantation in either group. Postoperative ejection fraction of ablation group was significantly higher than that of control group (59.6%±9.2% vs. 55.5%±5.4%, P < 0.01). The rate of sinus rhythm maintenance at 6 months, 12 months, 18 months, 24 months during follow-up in ablation group were 88.5%, 87.5%, 87.1% and 82.4% respectively, 3. 3%, 2.2%, 0.0%, and 0.0% in control group respectively, which was statistically different between the two groups (P < 0.05). Conclusion Maze

  13. Pesquisa de Micobactérias Ambientais em água de torneira, luvas e soluções utilizadas em procedimentos cirúrgicos no Hospital Universitário Getúlio Vargas - Manaus/AM Investigation of Environmental Mycobacteria in tap water, surgical gloves and antiseptic solutions used in surgical procedures at the Getúlio Vargas University Hospital, Manaus-AM/Brazil

    Directory of Open Access Journals (Sweden)

    Adriana Vallejo Restrepo

    2009-01-01

    Full Text Available Investigou-se por métodos bacteriológicos (cultivo e moleculares (PCR - Restriction Enzyme Analysis, PRA, a presença de micobactérias ambientais em águas de torneira, soluções e luvas cirúrgicas, utilizadas nas etapas dos procedimentos cirúrgicos executados no centro cirúrgico do Hospital Universitário Getulio Vargas (HUGV, na cidade de Manaus-Amazonas/Brasil. Foram colhidas e analisadas 105 amostras sendo: 24 de águas (colhidas das 2 torneiras existentes no centro cirúrgico, 8 de solução de Povidine e 7 de solução de Clorhexidina, que servem para a higienização das mãos dos cirurgiões; 39 de luvas cirúrgicas (superfícies internas e externas; e 27 de soluções que foram efetivamente utilizadas durante o ato cirúrgico. Por método bacteriológico obteve-se 41 isolados micobacterianos apenas de águas das torneiras. Pelo PRA obteve-se a detecção de DNA micobacteriano somente na amostra de água que forneceu acima de 100 colônias de micobactérias por tubo semeado. Os isolados foram identificados como sendo Mycobacterium celatum perfil 2, M. gordonae perfil 3, M. gordonae perfil 6, M. intracellulare perfil 1, M. lentiflavum perfil 3 e M. mucogenicum perfil 1. O encontro de M. mucogenicum, espécie já incriminada em surtos pós-cirúrgicos, indica que devem ser efetuados procedimentos de limpeza e monitoramento em todos os pontos de distribuição de águas, visando à prevenção de surtos de micobacterioses nosocomiais induzidos pelo uso das águas nas diferentes atividades de manuseio ou higienização dos pacientes submetidos a procedimentos invasivos.Using bacteriological (culture and molecular (PCR - Restriction Enzyme Analysis, PRA methods, we investigated the presence of environmental mycobacteria in tap water, antiseptic solutions and surgical gloves, used in carrying out surgical procedures at the Getúlio Vargas University Hospital Surgical Center, in Manaus -Amazonas/Brazil. Samples (105 were collected and

  14. How to Choose the Best Metabolic Procedure?

    Science.gov (United States)

    Castagneto Gissey, Lidia; Casella Mariolo, James Rossario; Mingrone, Geltrude

    2016-07-01

    Bariatric/metabolic surgery has proven to be effective in inducing and maintaining diabetes remission-although with a percentage of patients undergoing hyperglycemia relapse-weight loss, and improvement of the cardiovascular risk. It is, however, associated with mortality, although low, and early and late complications. In particular, metabolic complications are related to vitamin deficiency due to the erratic absorption of the supplemented vitamins and to the unpredictable compliance of patients to vitamin and trace element supplementation. In addition, often, the general practitioners and even the specialists are unaware of the clinical effects of metabolic dysfunction following malabsorptive surgery. The choice of the surgical procedure should be the balance between benefits and risks. Our review addresses this important question trying to give some suggestions. PMID:27229936

  15. Synthesis and Simulation of Surgical Process Models.

    Science.gov (United States)

    Claude, Guillaume; Gouranton, Valérie; Caillaud, Benoit; Gibaud, Bernard; Arnaldi, Bruno; Jannin, Pierre

    2016-01-01

    Virtual Reality for surgical training is mainly focused on technical surgical skills. We work on providing a novel approach to the use of Virtual Reality focusing on the procedural aspects. Our system relies on a specific work-flow generating a model of the procedure from real case surgery observation in the operating room. This article presents the different technologies created in the context of our project and their relations as other components of our workflow. PMID:27046555

  16. Cardiovascular group

    Science.gov (United States)

    Blomqvist, Gunnar

    1989-01-01

    As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.

  17. Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Cheung Angela

    2004-08-01

    Full Text Available Abstract Health Issue Cardiovascular disease (CVD is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men. Key Findings In 1998, 78,964 Canadians died from CVD, almost half (39,197 were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women. Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women. Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension. Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men. Data Gaps and Recommendations CVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure. Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status.

  18. Selection of surgical procedures for different clinical shapes of vocal cord polyps%不同临床形态声带息肉手术方式的选择

    Institute of Scientific and Technical Information of China (English)

    徐志鸿; 何锦添; 钟景良

    2013-01-01

    Objective To discuss the selection of surgical procedures for treating different clinical shapes of vocal cord polyps. Methods The clinical data of 346 patients with vocal cord polyps were analyzed retrospectively. The vocal cord polyps were classified into 5 types according to the clinical shape of vocal cord polyps and their pathological features: edematous type in 124 cases, vascular type in 65 cases, fibrous type in 88 cases, hemorrhagic or thrombotic type in 38 cases, and amyloid type in 31 cases. The therapeutic effects of surgical procedure with electronic laryngoscope and suspension laryngoscope on different shapes of vocal cord polyps were compared. Results For vocal cord polyps of edematous type, vascular type and hemorrhagic type, there were no significant differences in clinical effects with electronic laryngoscope and suspension laryngoscope operation (P>0.05). For vocal cord polyps of fibrous type and amyloid type, the effect of suspension laryngoscopic surgery group was significnaly better than that in electronic laryngoscopic surgery group (P<0.05). There were 21 complications in suspension laryngoscopic surgery group, without any complications in electronic laryngoscopic surgery group. Conclusion For vocal cord polyps of edematous type, vascular type and hemorrhagic type, it is safe and effective to complete the operation with electronic laryngoscope, but for the vocal cord polyps of fibrous type and amyloid type, suspension laryngoscopic surgery should be applied.%目的 探讨不同临床形态声带息肉手术方式的选择.方法 回顾性分析我科声带息肉手术患者346例,根据喉镜图片及病理结果将其分为5型:水肿型124例、血管扩张型65例、纤维型88例、出血型和出血血栓型38例、淀粉样变性型31例.比较不同类型采用电子喉镜和支撑喉镜手术的疗效.结果 水肿型、血管扩张型、出血型和出血血栓型采用电子喉镜及支撑喉镜手术的疗效比

  19. Relationship between surgical procedure and outcome for patients with grade I chondrosarcomas Evolução dos pacientes com condrossarcoma grau I em relação ao tipo de tratamento cirúrgico

    Directory of Open Access Journals (Sweden)

    Maurício Etchebehere

    2005-04-01

    Full Text Available PURPOSE: To evaluate the oncological outcome of patients with grade I chondrosarcomas according to the type of surgical treatment performed, since there is still controversy regarding the need for aggressive resections to reach a successful outcome. MATERIALS AND METHODS: The records of 23 patients with grade I chondrosarcomas were reviewed. The mean age was 38.4 years, ranging from 11 to 70 years; 52% were men and 48% were women. The femur was the site of 13 tumors. The tumors were staged as IA (17, 74% and IB (6, 26%. Regarding tumor location, 74% (17 were medullary, 22% (5 were peripheral, and 4% (1 was indeterminate. Tumor size ranged from 2 to 25 cm, mean 7.9 cm. Regarding the surgical procedure, 11 patients underwent intralesional resection, 9 patients underwent wide resection, and 3 underwent radical resection. The follow-up period ranged from 24 to 192 months. RESULTS: None of the patients developed local recurrence or metastases; 7 patients had other general complications. CONCLUSIONS: This data supports the use of less aggressive procedures for treatment of low-grade chondrosarcomas.OBJETIVO: Avaliar a evolução oncológica de portadores de condrossarcomas grau I de acordo com o tipo de tratamento cirúrgico efetuado. Existe controvérsia em relação à necessidade de ressecções agressivas para obtenção de uma evolução clínica favorável. MATERIAIS E MÉTODOS: Os prontuários de 23 portadores de condrossarcoma grau I foram analisados. A idade dos pacientes variou de 11 a 70 anos com média de 38,4 anos, 52% eram homens e 48% mulheres. O local mais acometido foi o fêmur com 13 pacientes. Dezessete lesões (74% foram classificadas como IA e seis (26% como IB. Setenta e quatro por cento dos tumores eram medulares, 22% eram periféricas e uma lesão indeterminada. O tamanho dos tumores variou de 2 a 25 cm, média de 7,9 cm. Onze pacientes foram submetidos a ressecção intralesional, nove a ressecção ampla e três a ressec

  20. Laser therapy in cardiovascular disease

    Science.gov (United States)

    Rindge, David

    2009-02-01

    Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

  1. Evolution of surgical skills training

    Institute of Scientific and Technical Information of China (English)

    Kurt E Roberts; Robert L Bell; Andrew J Duffy

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced,virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery.An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training,ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

  2. Blepharoplasty and periorbital surgical rejuvenation

    Directory of Open Access Journals (Sweden)

    Milind Naik

    2013-01-01

    Full Text Available The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects of commonly performed periocular injections are discussed from the dermatologist′s point of view.

  3. [Orthognathic surgery: surgical failures and complications].

    Science.gov (United States)

    Guyot, Laurent

    2016-03-01

    Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure.

  4. [Intraoperative anaphylaxis caused by latex surgical gloves].

    Science.gov (United States)

    Tomita, S; Sugawara, K; Tamakawa, S; Saitoh, Y

    1998-02-01

    A 17-year-old male encountered anaphylaxis caused by latex surgical gloves during emergency surgery under general anesthesia. He had undergone multiple surgical procedures, bladder catheterization and was suffering from atopic dermatitis. The patient developed bronchospasm and circulatory collapse 20 minutes after the start of surgery. Administration of dopamine, aminophylline and methylprednisolone helped to normalize airway pressure and blood pressure. Latex allergy occurs in persons considered at high risk including patient with spina bifida, urogenital abnormalities, atopic dermatitis, health care workers and rubber industry workers. These persons may develop hypersensitivity to latex products. If patients who are suspected to be latex allergy undergo surgical procedures, anesthesiologist should check past history and sensitivity to rubber in detail. In patients known to be allergic to latex, we must avoid latex products, such as surgical gloves, or anesthetic and surgical equipments. PMID:9513338

  5. Cardiovascular Magnetic Resonance Imaging

    Science.gov (United States)

    Pelc, Norbert

    2000-03-01

    Cardiovascular diseases are a major source of morbidity and mortality in the United States. Early detection of disease can often be used to improved outcomes, either through direct interventions (e.g. surgical corrections) or by causing the patient to modify his or her behavior (e.g. smoking cessation or dietary changes). Ideally, the detection process should be noninvasive (i.e. it should not be associated with significant risk). Magnetic Resonance Imaging (MRI) refers to the formation of images by localizing NMR signals, typically from protons in the body. As in other applications of NMR, a homogeneous static magnetic field ( ~0.5 to 4 T) is used to create ``longitudinal" magnetization. A magnetic field rotating at the Larmor frequency (proportional to the static field) excites spins, converting longitudinal magnetization to ``transverse" magnetization and generating a signal. Localization is performed using pulsed gradients in the static field. MRI can produce images of 2-D slices, 3-D volumes, time-resolved images of pseudo-periodic phenomena such as heart function, and even real-time imaging. It is also possible to acquire spatially localized NMR spectra. MRI has a number of advantages, but perhaps the most fundamental is the richness of the contrast mechanisms. Tissues can be differentiated by differences in proton density, NMR properties, and even flow or motion. We also have the ability to introduce substances that alter NMR signals. These contrast agents can be used to enhance vascular structures and measure perfusion. Cardiovascular MRI allows the reliable diagnosis of important conditions. It is possible to image the blood vessel tree, quantitate flow and perfusion, and image cardiac contraction. Fundamentally, the power of MRI as a diagnostic tool stems from the richness of the contrast mechanisms and the flexibility in control of imaging parameters.

  6. A new approach to simplify surgical colpotomy in laparoscopic hysterectomy

    NARCIS (Netherlands)

    Van den Haak, L.; Rhemrev, J.P.; Bikkendaal, M.D.; Luteijn, A.C.; Van den Dobbelsteen, J.J.; Driessen, S.R.; Jansen, F.W.

    2016-01-01

    New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and d

  7. 几种不同手术方式在甲状腺手术中的的应用%Different Surgical Procedures in the Application of the Thyroid Surgery

    Institute of Scientific and Technical Information of China (English)

    姚骏; 张雪; 孙延平; 项洪刚; 胡国柱

    2011-01-01

    目的:探讨几种不同手术方式在甲状腺切除术中的的应用及其相应的临床疗效.方法:选取我院120 例具有手术指征且需择期行甲状腺切除术患者,随机分为超声刀开放手术组(Ⅰ组)、经腔镜手术组(Ⅱ组)、和常规开放手术组(Ⅲ组),各40 例.比较3组手术方式的可行性、安全性及其临床疗效.结果:3 组甲状腺切除术均获成功,Ⅰ组选择胸骨切迹上小切口,具有较好的美容效果、而Ⅱ组美容效果最好;Ⅰ组手术所需时间显著短于Ⅱ组和Ⅲ组;Ⅰ组、Ⅱ组的术中出血量和术后切口引流量均显著少于Ⅲ组;其中Ⅱ组有8例转为开放性切口完成手术,术后随访6个月,Ⅱ组和Ⅲ组均各有1例复发.3组均未发生术后大出血,喉上神经、喉返神经及甲状旁腺等周围组织损伤等并发症.Ⅰ组手术效果显著优于Ⅱ组和Ⅲ组.结论:超声刀小切口甲状腺开放手术改良了以往开放式和腔镜下甲状腺手术的不足,简单易行、创伤小、止血确切、出血少、手术野清晰,术后引流量少、并发症危险低、时间短,不影响患者美容效果.%Objective: To several different ways in the thyroid surgery for the application and the corresponding clinical curative effect.Methods:Select from 120 cases of surgical indications and need to do for patients with thyroid elective, randomly divided into ultrasound knife open scores ( group I), the chamber lens ( group Ⅱ), and the conventional open scores (group Ⅲ ), each 40 cases.All three groups the feasibility of the surgical procedure, safety and its clinical curative effect .Results: Three groups are successful, thyroid resection group I choose sternum position of small incision cut, and has a good hairdressing effect, and group Ⅱ hairdressing effect is the best; group I operation needs time was significantly less than group Ⅱ and group Ⅲ; I group, group Ⅱ of peri-operative bleeding and postoperative incision lead

  8. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi

    2010-03-01

    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  9. Surgical treatment of facial paralysis.

    Science.gov (United States)

    Mehta, Ritvik P

    2009-03-01

    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.

  10. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  11. Therapeutic Effects between Surgical Procedures with Direct Laryngoscope and Electronic Laryngoscope on Epiglottis Cyst%直接喉镜与电子喉镜下手术治疗会厌囊肿疗效比较

    Institute of Scientific and Technical Information of China (English)

    姜俊芝; 郭淑霞; 王静; 刘飞; 刘华顶; 侯德法; 赵毓宝

    2012-01-01

    Objective:To investigate the advantages and disadvantages between the surgical procedures with direct laryngoscope and electronic laryngoscope on epiglottis cyst. Methods:72 patients with epiglottis cyst were randomly divided into two groups, 38 cases in the treatment group were treated with electronic laryngoscope surgery and 34 cases in the control group were treated with direct laryngoscope surgery . Both groups were checked by electronic laryngoscopic before the operation and 1 month, 5 months after operation. The effects of two groups were compared. Results:Patients were followed up for 1 ~3 years after operation. The cure rate of control group was 64.7% (22 cases) , 6 cases got better and 6 cases was uncured. The cure rate was 89.4% (34cases) in the treatment group, 2 cases got better and 2 cases were uncured. The chi - square test was statistically significant between cure rate of two groups ( P < 0.01). Conclusions: Electronic laryngoscope on epiglottis cyst is a minimally invasive operation. This method can be easily operated with the advantages of less pain and desirable effect, thus worth popularizing in clinical otolaryngology.%目的:探讨直接喉镜和电子喉镜下会厌囊肿摘除术的手术方法及各自的优缺点.方法:会厌囊肿患者72例,随机分为两组,治疗组38例行电子喉镜下手术,对照组34例行直接喉镜下手术.两组患者均在术前及术后1个月、5个月行电子喉镜检查,观察并比较两组术后疗效.结果:术后随访1~3 a,治疗组治愈34例、好转2例、未愈2例,治愈率89.4%;对照组治愈23例、好转6例,未愈6例,治愈率64.7%.两组患者治愈率比较,差异有统计学意义(P<0.01).结论:电子喉镜下会厌囊肿摘除属微创手术,具有视野清晰、操作准确、创伤小、痛苦少、花费少等优点,值得临床推广.

  12. Electronic surgical record management.

    Science.gov (United States)

    Rockman, Justin

    2010-01-01

    This paper explores the challenges surgical practices face in coordinating surgeries and how the electronic surgical record management (ESRM) approach to surgical coordination can solve these problems and improve efficiency. Surgical practices continue to experience costly inefficiencies when managing surgical coordination. Application software like practice management and electronic health record systems have enabled practices to "go digital" for their administrative, financial, and clinical data. However, surgical coordination is still a manual and labor-intensive process. Surgical practices need to create a central and secure record of their surgeries. When surgical data are inputted once only and stored in a central repository, the data are transformed into active information that can be outputted to any form, letter, calendar, or report. ESRM is a new approach to surgical coordination. It enables surgical practices to automate and streamline their processes, reduce costs, and ensure that patients receive the best possible care. PMID:20480775

  13. Measures of surgical quality: what will patients know by 2005?

    OpenAIRE

    Michael S. Broder; Payne-Simon, L; Brook, R H

    2005-01-01

    Rationale, aims and objectives Many objective measures rating quality of doctors, hospitals, and medical groups are publicly reported. Surgical patients may have more opportunity to use quality measures than other types of patients to guide their choice of provider. If surgical patients are able to choose higher quality providers, overall surgical quality might increase. Objective To determine what procedure-specific measures of surgical quality are available to consumers facing surgery in Ca...

  14. Surgical implantation and functional assessment of an invasive telemetric system to measure autonomic responses in domestic pigs.

    Science.gov (United States)

    Krause, A; Zebunke, M; Bellmann, O; Mohr, E; Langbein, J; Puppe, B

    2016-01-01

    The first aim of this study was to establish a surgical procedure to implant a new telemetric device for the continuous recording of electrocardiogram (ECG) and blood pressure (BP) in freely moving pigs. A second aim was the functional assessment of cardiovascular parameters, including heart rate variability (HRV) and blood pressure variability (BPV), so that these data could be used as the basis for the objective evaluation of autonomic activity and balance in different behavioural contexts. Eleven domestic pigs (German Landrace) underwent surgery for the placement of a telemetric device. At day 15 after surgery, 512 consecutive inter-beat intervals and pressure waves were analysed using different detection methods (automatic and manually corrected) while the animals were resting or feeding, respectively. HRV and BPV were calculated. Incomplete datasets were found in four pigs due to missing ECG or BP signals. Technical and surgical issues concerning catheterisation and detachment of the negative ECG lead were continuously improved. In the remaining pigs, excellent signal quality (manually corrected data of 1%) was obtained during resting and acceptable signal quality (ECG recordings. Sympathetic arousal with accompanying vagal withdrawal during feeding was documented. The established surgical implantation and functional assessment of the telemetric system with the reliable registration of cardiovascular parameters in freely moving pigs could serve as a basis for future studies of autonomic regulation in context of stress and animal welfare. PMID:26626089

  15. Surgical treatment of perforated gastric ulcer

    Directory of Open Access Journals (Sweden)

    Korica Milan

    2002-01-01

    Full Text Available Introduction Peptic ulcer perforation is a complication of ulcer disease which requires urgent surgical treatment. The aim of this paper was to point out our experience in surgical treatment of perforated peptic ulcer. Material and methods This retrospective study analyzes results of surgical treatment in 365 patients with perforated peptic ulcer during the period January 1996 to December 2000. Results During the last 5-year period 365 patients were treated following peptic ulcer perforation. The average age was 43.53±8.26, with the span from 18 to 86. The most frequent surgical procedures in treatment of peptic ulcer perforation were: simple closure with biopsy (55.88%, excision of the ulcer with a pyloroplasty and vagotomy (35.29% as nonresection surgical procedures and stomach resection after Billroth II (8.83%. The postoperative mortality was 4.41%. Conclusions The methods of choice in surgical treatment of gastric ulcer perforation are nonresection surgical procedures with drug therapy and eradication of Helicobacter pylori, if present.

  16. 脊柱融合术后邻近节段退变再手术治疗的临床研究%Clinical study on the second surgical procedure of adjacent segment degeneration after the first time spinal fusion

    Institute of Scientific and Technical Information of China (English)

    曾云; 熊敏; 陈森; 余化龙; 何宁; 王志勇; 刘志刚; 韩珩

    2011-01-01

    Objective To discuss the effectiveness of the second surgical procedure of adjacent segment degeneration after the first spinal fusion.Method 35 patients who had been performed spinal fusion in our hospital or had symptoms recurred or aggravated after 12 ~ 114 (42 ±35) months of the prior surgery were enrolled in this study.A second surgery was performed and intraoperative the intradiscal pressure of adjacent segments of degeneration and normal segments was measured.The VAS score systems were compared among prior surgery,3 months later and 2 years after the second surgery.Result The intradiscal pressure of adjacent segments after the cervical vertebra and lumbar vertebra fusion were [ (15 ± 4.6)cmH2O,(23 ±5.2)cmH2O],much higher than normal segments [ (3 ±2.3)cmH2O,(8 ±4.1)cmH2O](P <0.01).The VAS score systems of 3 months later and 2 years after the second surgery were [ (2.9 ±0.7),(2.0 ± 0.6) ],which were dramatically lower than the prior (7.8 ± 1.2) (P < 0.01).In 12 ~ 46(31 ± 12) months of follow-up after the second procedure,X-ray and MRI showed that fusion segments reached nearly bone fusion,well decompressed and without nerve compression or other complications.Conclusion If recurrence of symptoms after spinal fusion were caused by adjacent segment degeneration,reoperation would guarantee good clinical outcome.%目的 探讨脊柱融合术后邻近节段退变再手术治疗的疗效.方法 85例既往在本院行脊柱融合术的患者,术后12~114(42±35)个月症状复发或加重.对所有患者进行再手术治疗及术中测量邻近退变节段与正常节段椎间盘内压,比较再次手术前、术后3月及2年的视觉模拟评分.结果 颈椎、腰椎融合术后邻近退变节段的椎间盘内压[(15±4.6)cmH2O、(23±5.2)cmH2O]显著高于正常节段[(3±2.3)cmH2O、(8±4.1)cmH2O](P<0.01).术后3个月、2年视觉模拟评分(2.9±0.7)、(2.0±0.6)较再次手术前(7.8±1.2)明显降低(P<0.01).再手术后经12~46

  17. Surgical innovation as sui generis surgical research.

    Science.gov (United States)

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  18. Pressão arterial do anestesiologista durante o ato anestésico-cirúrgico no período matutino Presión arterial del anestesista durante el acto anestésico-quirúrgico en el período matutino Anesthesiologists’ blood pressure during surgical anesthetic procedures in the morning

    Directory of Open Access Journals (Sweden)

    Pedro Wanderley de Aragão

    2002-09-01

    estudio fue verificar si la práctica de la anestesia es factor desencadenante de la variación de la presión arterial en el anestesista durante el acto anestésico quirúrgico. MÉTODO: Participaron del estudio diez anestesistas, cada un realizando diez anestesias raquidianas para parto cesariano. Fueron registradas cinco medidas de la presión arterial en cinco momentos diferentes, en el total de 50 afericiones por anestesista. La primera, realizada después de descanso previo de cinco minutos de la llegada del anestesista al centro quirúrgico, denominado M1. La segunda, antes de la realización de la punción lumbar, M2. La tercera, luego después de la retirada de la aguja del local de la punción donde fue realizado el bloqueo, M3. La cuarta, inmediatamente después de la retirada del feto, M4. Y la última aferición, al término de la sutura de la piel. M5. RESULTADOS: Ocurrió elevación en la presión arterial del anestesista nos momentos M3 y M4. CONCLUSIONES: La práctica anestésica realizada es responsable por la alteración significativa de la presión arterial del anestesista y está directamente relacionada con los momentos de mayor riesgo para el paciente durante el acto anestésico quirúrgico.BACKGROUND AND OBJECTIVES: Systemic arterial hypertension affects approximately 20% of the world population, depending on the interaction between genetic predisposition and environmental factors. Stresses inherent to the anesthesiologist’s work might reflect in the cardiovascular system, influencing professional’s blood pressure. This study aimed at verifying whether the practice of anesthesia is a triggering factor for anesthesiologists’ blood pressure changes during surgical anesthetic procedures. METHODS: Participated in these study 10 anesthesiologists, each one inducing 10 spinal anesthesias for cesarean section. Blood pressure was measured in five different moments, in a total of 50 readings one each anesthesiologist. The first measure was recorded

  19. The effectiveness of surgical face masks in the operating room : a systematic review / Nontsokolo Sylvia Makeleni.

    OpenAIRE

    Makeleni, Nontsokolo Sylvia

    2012-01-01

    Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical ...

  20. Preduodenal superior mesenteric vein and Whipple procedure with vascular reconstruction—A case report

    Directory of Open Access Journals (Sweden)

    Kristina Höing

    2015-01-01

    Conclusion: Extended surgical procedures like a pancreaticoduodenectomy are realisable in patients with PV disorders, but require awareness, adequate radiological interpretation and specific surgical experience for secure treatment.

  1. Neonatal cardiovascular physiology.

    Science.gov (United States)

    Hines, Michael H

    2013-11-01

    The pediatric surgeon deals with a large number and variety of congenital defects in neonates that frequently involve early surgical intervention and care. Because the neonatal cardiac physiology is unique, starting with the transition from fetal circulation and including differences in calcium metabolism and myocardial microscopic structure and function, it serves the pediatric surgeon well to have a sound understanding of these principles and how they directly and indirectly affect their plans and treatments. In addition, many patients will have associated congenital heart disease that can also dramatically influence not only the surgical and anesthetic care but also the timing and planning of procedures. Finally, the pediatric surgeon is often called upon to treat conditions and complications associated with complex congenital heart disease such as feeding difficulties, bowel perforations, and malrotation in heterotaxy syndromes. In this article, we will review several unique aspects of neonatal cardiac physiology along with the basic physiology of the major groups of congenital heart disease to better prepare the training and practicing pediatric surgeon for care of these complex and often fragile patients.

  2. A porcine model for teaching surgical cricothyridootomy

    Directory of Open Access Journals (Sweden)

    Fernando Antonio Campelo Spencer Netto

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the acceptability of an educational project using A porcine model of airway for teaching surgical cricothyroidotomy to medical students and medical residents at a university hospital in southern Brazil.METHODS: we developed a teaching project using a porcine model for training in surgical cricothyroidotomy. Medical students and residents received lectures about this surgical technique and then held practical training with the model. After the procedure, all participants filled out a form about the importance of training in airway handling and the model used.RESULTS: There were 63 participants. The overall quality of the porcine model was estimated at 8.8, while the anatomical correlation between the model and the human anatomy received a mean score of 8.5. The model was unanimously approved and considered useful in teaching the procedure.CONCLUSION: the training of surgical cricothyroidotomy with a porcine model showed good acceptance among medical students and residents of this institution.

  3. 慢性中耳乳突炎性疾病不同手术方式的疗效分析%Curative Effects of Different Surgical Procedures for Chronic Middle Ear and Mastoid Inflammatory Lesions

    Institute of Scientific and Technical Information of China (English)

    阿依恒·曲库尔汗; 王远强; 木拉提·阿地力; 冯娟

    2015-01-01

    Objective To study the curative effects of microscopic surgery for inflammatory lesions in the middle ear and mastoid by using different surgical procedures . Methods There were 110 cases of inflammatory lesions in the middle ear and mastoid from January 2009 to October 2013, including middle ear cholesteatoma and chronic suppurative otitis media .According to the scope of the lesions , either canal wall up mastoidectomy with or without tympanoplasty or open mastoidotympanectomy was carried out . Postoperative ear recovery , complications , recurrence , and hearing improvement were observed . Results The canal wall up mastoidectomy was performed in 51 cases, 46 of which received tympanoplasty simultaneously and 6 of which underwent a secondary artificial prosthesis implantation .Two patients with middle ear cholesteatoma experienced recurrence 1 year after surgery , and were given a secondary open operation .Postoperatively, hearing improvement was achieved >25 dB in 27 cases, >15 dB in 16 cases, and hearing loss was seen in 1 case.There were 59 cases of open mastoidectomy , including 31 cases of small tympanic cavity plasty .After open surgery, dry ear was not achieved in 1 case, which was cured after 2 months of dressing changes .The dry ear was achieved in all the remaining cases, with hearing improvement >15 dB in 3 cases and hearing loss in 3 cases. Conclusion According to different lesions in the middle ear and mastoid , different operative methods can be used to obtain satisfactory clinical curative effects .%目的:探讨慢性中耳乳突炎性疾病的不同显微手术方式的疗效。方法2009年1月~2013年10对110例慢性中耳乳突炎性病变,包括中耳胆脂瘤和慢性化脓性中耳炎,根据病变范围显微镜下分别施行完壁式乳突根治或同时鼓室成形术和开放式乳突根治术,观察术后干耳恢复情况、并发症、复发以及术后听力改善程度等。结果完壁式乳突根治术51例,其中46

  4. Combined treatment with urea injection and surgical procedure for the scrotal vein malformation in teenagers%尿素注射联合手术治疗青少年阴囊静脉血管畸形

    Institute of Scientific and Technical Information of China (English)

    乔军波; 李金; 马玉春; 郭晓楠; 朱晓爽; 董长宪

    2012-01-01

    Objective To discuss the treatment of the scrotal vein malformation in teenagers and clinical efficacy.Methods 32 cases with the local and diffuse scrotal vein malformation were retrospectively analyzed.31 cases underwent local injection with 40% urea before resection.The urea was injected locally into tumor through multi-points within 30 seconds,2-6 ml every time,one time a day.The injection was performed for 5-12 days.The treatment was refused in one case.The therapeutic effect and cosmetic result were recorded.Results The tumors were removed radicaly in 28 cases including one operation in 25 cases and secondary operation in 3 cases.The patients were followed up for 1-3 years with no recurrence.Cosmetic result with bilaterally symmetric scrotum was satisfactory.The tumors in 3 severe cases were partially resected with improvement.Conclusions Combined treatment with urea injection and surgical procedure can effectively treat the scrotal vein malformation with satisfactory result.%目的 探讨青少年阴囊静脉血管畸形的治疗方法,评价手术治疗的临床效果.方法 回顾性分析2001年1月至2010年12月诊治的32例青少年阴囊静脉血管畸形的病例资料,从单纯性局部病变到弥漫性广泛病变,其中31例术前先行瘤体内局部多点注射40%尿素溶液治疗,每日1次,每次半分钟以内,注射量为2~6 ml,连续注射治疗5~12d;然后分一期或二期手术切除瘤体.1例放弃治疗.结果 31例中手术根治性切除共28例,25例一期完整切除,3例二期完全切除,术后随访1~3年,无复发,术后阴囊双侧对称,外观满意;3例严重病例进行分期手术,仅行部分切除,术后外观较前改善.结论尿素联合手术切除瘤体的方法,可以有效地治疗青少年阴囊静脉血管畸形,并能满足美容学要求.

  5. Cardiovascular Disease and Diabetes

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Cardiovascular Disease & Diabetes Updated:Mar 23,2016 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  6. Cardiovascular manifestations of phaeochromocytoma

    NARCIS (Netherlands)

    Prejbisz, A.; Lenders, J.W.M.; Eisenhofer, G.; Januszewicz, A.

    2011-01-01

    Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma,

  7. Percutaneous implantation of the CoreValve aortic valve prosthesis in patients at high risk or rejected for surgical valve replacement: Clinical evaluation and feasibility of the procedure in the first 30 patients in the AMC-UvA

    NARCIS (Netherlands)

    J. Baan; Z.Y. Yong; K.T. Koch; J.P.S. Henriques; B.J. Bouma; S.G. de Hert; J. van der Meulen; J.G.P. Tijssen; J.J. Piek; B.A.J.M. de Mol

    2010-01-01

    Objective. To report the feasibility, safety and efficacy of percutaneous aortic valve implantation (PAVI) with the CoreValve self-expanding aortic valve bioprosthesis in elderly patients with aortic valve stenosis who are rejected for surgery or have a high surgical risk.Methods. PAVI using the Cor

  8. A new concept for surgical hand disinfection

    OpenAIRE

    Hübner, NO; Below, H.; Kramer, A.

    2006-01-01

    This paper presents the development of and justification for a different procedure in surgical hand disinfection based on results of our own studies and data from the literature. An overview of the importance of hand disinfection, outstanding persons who substantially contributed to its development, and fundamentals of its implementation are also presented. Focussing on the resident flora as the target of surgical hand disinfection, the microflora of the hand is addressed. Consequences for di...

  9. A new concept for surgical hand disinfection

    OpenAIRE

    Kramer, Axel; Below, Harald; Hübner, Nils-Olaf

    2006-01-01

    This paper presents the development of and justification for a different procedure in surgical hand disinfection based on results of our own studies and data from the literature. An overview of the importance of hand disinfection, outstanding persons who substantially contributed to its development, and fundamentals of its implementation are also presented.Focussing on the resident flora as the target of surgical hand disinfection, the microflora of the hand is addressed. Consequences for dis...

  10. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  11. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique

    Science.gov (United States)

    Vilá y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo

    2016-01-01

    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores. PMID:27073783

  12. Surgical treatments for vaginal apical prolapse.

    Science.gov (United States)

    Kong, Mi Kyung; Bai, Sang Wook

    2016-07-01

    Pelvic organ prolapse is a common condition, occurring in up to 11% of women in the United States. Often, pelvic organ prolapse recurs after surgery; when it recurs after hysterectomy, it frequently presents as vaginal apical prolapse. There are many different surgical treatments for vaginal apical prolapse; among them, abdominal sacral colpopexy is considered the gold standard. However, recent data reveal that other surgical procedures also result in good outcome. This review discusses the various surgical treatments for vaginal apical prolapse including their risks and benefits. PMID:27462591

  13. Modified Youngswick procedure for hallux limitus.

    Science.gov (United States)

    Radovic, Philip; Yadav-Shah, Ekta; Choe, Ki

    2007-01-01

    Multiple surgical procedures have been described for the correction of hallux limitus deformity. We describe a new modification of the Youngswick procedure for the surgical treatment of hallux limitus. Other procedures for hallux limitus correction are also discussed. This modified Youngswick procedure will provide a new approach to treating hallux limitus secondary to metatarsus primus elevatus when shortening of the first metatarsal is not indicated. PMID:17901350

  14. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin

    2016-07-01

    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  15. The delivery of general paediatric surgery in Ireland: a survey of higher surgical trainees.

    LENUS (Irish Health Repository)

    Boyle, E

    2012-12-01

    The delivery of general paediatric surgery is changing in Ireland. Fewer paediatric surgical procedures are being performed by newly appointed consultant general surgeons, resulting in increased referrals to the specialist paediatric surgeons of uncomplicated general paediatric surgical problems. We surveyed current higher surgical trainees about their views on provision of paediatric surgical services.

  16. Cardiovascular magnetic resonance of quinticuspid aortic valve with aortic regurgitation and dilated ascending aorta

    OpenAIRE

    Zhang Zhaoqi; Zhang Lijun; Meng Yanfeng; Wang Yongmei; Yang Xiaoming

    2009-01-01

    Abstract We report a rare case of a quinticuspid aortic valve associated with regurgitation and dilation of the ascending aorta, which was diagnosed and post-surgically followed up by cardiovascular magnetic resonance and dual source computed tomography.

  17. Should surgical outcomes be published?

    Science.gov (United States)

    Chou, Evelyn; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

    2015-04-01

    Despite publishing surgical outcomes being a positive step forwards in the progression of England's healthcare system, it has no doubt been faced with criticism and reservations. This review article aims to discuss the pros and cons of publishing individual surgical outcomes, as well as the challenges faced. Publishing outcomes requires data from a number of sources such as national clinical audits, hospital episode statistics, patient-reported outcomes, registers and information from revalidation. As yet, eight surgical specialties have begun publishing their data, including cardiac (coronary artery bypass graft, valve and aortic surgery), endocrine (thyroidectomy, lobectomy, isthmusectomy), orthopaedic (hip and knee replacement), urological (full and partial nephrectomies, nephroureterectomy), colorectal (bowel tumour removal), upper gastrointestinal (stomach cancer and oesophageal cancer removal, bariatric surgery), ear, nose and throat surgery (larynx, oral cavity, oropharynx, hypopharynx and salivary gland cancer removal), as well as vascular surgery (abdominal aortic aneurysm, carotid endarterectomy). However, not all procedures have been addressed. Despite the controversy surrounding the topic of publishing surgical outcomes, the advantages of reporting outcomes outweigh the disadvantages, and these challenges can be overcome, to create a more reliable, trustworthy and transparent NHS. Perhaps one of the main challenges has been the difficulty in collecting large amounts of clinically significant data able to quantify the performance of surgeons.

  18. Ethical issues in surgical innovation.

    Science.gov (United States)

    Miller, Megan E; Siegler, Mark; Angelos, Peter

    2014-07-01

    Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new approach will be beneficial to patients, not all innovations are successful or result in improved patient care. The ethical dilemma of surgical innovation lies in the uncertainty of whether a particular innovation will prove to be a "good thing." This uncertainty creates challenges for surgeons, patients, and the healthcare system. By its very nature, innovation introduces a potential risk to patient safety, a risk that may not be fully known, and it simultaneously fosters an optimism bias. These factors increase the complexity of informed consent and shared decision making for the surgeon and the patient. Innovative procedures and their associated technology raise issues of cost and resource distribution in the contemporary, financially conscious, healthcare environment. Surgeons and institutions must identify and address conflicts of interest created by the development and application of an innovation, always preserving the best interest of the patient above the academic or financial rewards of success. Potential strategies to address the challenges inherent in surgical innovation include collecting and reporting objective outcomes data, enhancing the informed consent process, and adhering to the principles of disclosure and professionalism. As surgeons, we must encourage creativity and innovation while maintaining our ethical awareness and responsibility to patients.

  19. [Cardiovascular safety of antidiabetics].

    Science.gov (United States)

    Aline Roth, Pressl-Wenger; Jornayvaz, François R

    2016-06-01

    Type 2 diabetes is characterized by a high risk of micro- and macro-vascular complications. Cardiovascular diseases are the leading cause of death of diabetic patients. In this context, the search for molecules decreasing cardiovascular mortality makes sense. Until the EMPA-REG OUTCOME study published late 2015, showing a reduction of cardiovascular mortality of patients treated with empagliflozin, an SGLT2 inhibitor, there was no molecule known to decrease cardiovascular mortality. The purpose of this article is to review the various existing antidiabetic molecules and their impact (positive/neutral/negative) on cardiovascular mortality. PMID:27487675

  20. Do changes in surgical procedures for breast cancer have consequences for hospital mean length of stay? A study of women operated on for breast cancer in Sweden, 1980-95

    DEFF Research Database (Denmark)

    Lindqvist, Rikard; Möller, Torgil R; Stenbeck, Magnus;

    2002-01-01

    BACKGROUND: Between 1986 and 1996, the overall mean overnight length of stay for all diagnoses in Sweden decreased from 20.8 to 7.1 days. OBJECTIVES: The study describes changes in surgical technique, from mastectomy to breast-conserving surgery, in treatment of female breast cancer and the paral......BACKGROUND: Between 1986 and 1996, the overall mean overnight length of stay for all diagnoses in Sweden decreased from 20.8 to 7.1 days. OBJECTIVES: The study describes changes in surgical technique, from mastectomy to breast-conserving surgery, in treatment of female breast cancer...... and the parallel change in average length of hospital stay, and discusses the possible link between the trends. RESEARCH DESIGN: The study was performed as a descriptive register study on hospital admission data from the Swedish Hospital Discharge Register over a 16-year period (1980-95). RESULTS: During the study...

  1. [Surgical treatment of type 2 diabetes mellitus].

    Science.gov (United States)

    Carrillo-Esper, Raúl; Muciño-Bermejo, María Jimena

    2014-01-01

    Sustained remission of type 2 diabetes mellitus and significantly improved hyperlipidemia and arterial hypertension, control has been achieves in both lean and obese patient after bariatric surgery procedures or other gastrointestinal surgical procedures. It has been demonstrated that the metabolic effects of bariatric surgery in these patients derives not only in reducing weight and caloric intake, but also endocrine changes resulting from surgical manifestation gastrointestinal tract. In this article we review the clinical outcomes of such interventions (collectively called "metabolic surgery") and the perspectives on the role that these surgeries play in the treatment of patients with type 2 diabetes mellitus.

  2. Minimally invasive cardiac surgery in the adult: surgical instruments, equipment, and techniques.

    Science.gov (United States)

    Kitamura, M; Uwabe, K; Hirota, J; Kawai, A; Endo, M; Koyanagi, H

    1998-09-01

    To clarify the special instruments and equipment used for minimally invasive cardiac surgery (MICS), we examined the initial experiences with MICS operations with ministernotomy or minithoracotomy at our institution. Fifty adult patients with congenital, valvular, and/or ischemic heart diseases underwent MICS operations, and all surgical procedures were completed without conversion to full sternotomy. The length of the skin incision was about 10 cm or less in all patients. Postoperative recovery was favorable, and the majority of the patients were discharged from the hospital around the end of the second postoperative week. In this series of patients, an oscillating bone saw, lifting type retractor, 2 blade spreader, cannula with a balloon, and right-angled aortic clamp among other items, were very useful for successfully performing various operations with MICS approaches and techniques. The associated results suggest that MICS with ministernotomy or minithoracotomy was feasible using special instruments and equipment and could be encouraged for adult patients with various cardiovascular diseases.

  3. Clinical presentation and surgical treatment of scoliosis in Marfan syndrome

    Institute of Scientific and Technical Information of China (English)

    LI Qi-yi; QIU Gui-xing; WANG Yi-peng; ZHANG Jian-guo; SHEN Jian-xiong; WENG Xi-sheng; Wang Ting; LEE Chia-I; YU Sheng-ji

    2005-01-01

    @@ Marfan syndrome (MFS) as an autosomal dominant connective tissue disease is characterized by ocular,cardiovascular,and skeletal deformities including scoliosis.1,2 A group of 12 patients with Marfan syndrome associated with scoliosis were surgically treated at our hospital from January 1990 to January 2004.

  4. Lysophosphatidic acid metabolism and elimination in cardiovascular disease

    Science.gov (United States)

    Salous, Abdelghaffar Kamal

    The bioactive lipids lysophosphatidic acid (LPA) and sphingosine 1-phosphate (S1P) are present in human and mouse plasma at a concentration of ~0.1-1 microM and regulate physiological and pathophysiological processes in the cardiovascular system including atherothrombosis, intimal hyperplasia, and immune function, edema formation, and permeability. PPAP2B, the gene encoding LPP3, a broad activity integral membrane enzyme that terminates LPA actions in the vasculature, has a single nucleotide polymorphism that been recently associated with coronary artery disease risk. The synthesis and signaling of LPA and S1P in the cardiovascular system have been extensively studied but the mechanisms responsible for their elimination are less well understood. The broad goal of this research was to examine the role of LPP3 in the termination of LPA signaling in models of cardiovascular disease involving vascular wall cells, investigate the role of LPP3 in the elimination of plasma LPA, and further characterize the elimination of plasma LPA. The central hypothesis is that LPP3 plays an important role in attenuating the pathological responses to LPA signaling and that it mediates the elimination of exogenously applied bioactive lipids from the plasma. These hypotheses were tested using molecular biological approaches, in vitro studies, synthetic lysophospholipid mimetics, modified surgical procedures, and mass spectrometry assays. My results indicated that LPP3 played a critical role in attenuating LPA signaling mediating the pathological processes of intimal hyperplasia and vascular leak in mouse models of disease. Additionally, enzymatic inactivation of lysophospholipids by LPP and PLA enzymes in the plasma was not a primary mechanism for the rapid elimination of plasma LPA and S1P. Instead, evidence strongly suggested a transcellular uptake mechanism by hepatic non-parenchymal cells as the predominant mechanism for elimination of these molecules. These results support a model in

  5. 中国达芬奇手术机器人临床应用%Clinical Application of Da Vinci Surgical System in China

    Institute of Scientific and Technical Information of China (English)

    金振宇

    2014-01-01

    Da Vinci robotic surgical system leads the development of minimally invasive surgical techniques. By using Da Vinci surgical robot for minimal y invasive surgery, it brings a lot of advantages to the surgeons. Since 2008, Da Vinci surgeries have been performed in 14 hospitals in domestic cities such as Beijing and Shanghai. Until the end of 2012, 3 551 cases of Da Vinci robotic surgery have been performed, covering various procedures of various surgical departments including the department of general surgery, urology, cardiovascular surgery, thoracic surgery, gynecology, and etc. Robotic surgical technique has made remarkable achievements.%达芬奇手术机器人引领着微创外科技术的发展,使用达芬奇手术机器人进行微创手术给医生带来诸多优势。我国自2008年起,先后由北京、上海等地14家医院逐步开展达芬奇机器人手术,至2012年底已经累计完成达芬奇机器人手术3551例,涵盖普外科、泌尿外科、心血管外科、胸外科、妇产科、五官科等各学科多种手术术式,取得了瞩目的成就。

  6. Surgical Residents are Excluded From Robot-assisted Surgery

    DEFF Research Database (Denmark)

    Broholm, Malene; Rosenberg, Jacob

    2015-01-01

    PURPOSE: Implementation of a robotic system may influence surgical training. The aim was to report the charge of the operating surgeon and the bedside assistant at robot-assisted procedures in urology, gynecology, and colorectal surgery. MATERIALS AND METHODS: A review of hospital charts from...... performed. In 10 (1.3%) of these procedures, a resident attended as bedside assistant and never as operating surgeon in the console. CONCLUSIONS: Our results demonstrate a severe problem with surgical education. Robot-assisted surgery is increasingly used; however, robotic surgical training during residency...... surgical procedures during a 1-year period from October 2013 to October 2014. All robot-assisted urologic, gynecologic, and colorectal procedures were identified. Charge of both operating surgeon in the console and bedside assistant were registered. RESULTS: A total of 774 robot-assisted procedures were...

  7. Three dimensional model for surgical planning in resection of thoracic tumors

    Directory of Open Access Journals (Sweden)

    Min P. Kim

    2015-01-01

    Conclusion: Three-dimensional printed model provide better visualization of complex thoracic tumors, aid in counseling the patient about the surgical procedure and assisted in surgical resection of thoracic malignancy.

  8. Standardising fast-track surgical nursing care in Denmark

    DEFF Research Database (Denmark)

    Hjort Jakobsen, Dorthe; Rud, Kirsten; Kehlet, Henrik;

    2014-01-01

    Considerable variations in procedures, hospital stay and rates of recovery have been recorded within specific surgical procedures at Danish hospitals. The aim of this paper is to report on a national initiative in Denmark to improve the quality of surgical care by implementation of clinical......) in 2004. The unit was responsible for guideline construction and implementation using the 'workshop practice method': establishing a website, creating a knowledge centre, coordinating implementation agents, and arranging national workshops and conferences. The UPN has promoted implementation of fast......-track regimes in all surgical departments in Denmark. We recommend the workshop-practice method for implementation of new procedures in other areas of patient care....

  9. 预见性护理程序在预防眼科门诊手术患者晕厥中的应用效果%Foresee sex nursing procedure at prevent ophthalmology out-patient service from surgical operation dizzy Jue of sufferer in of applied effect

    Institute of Scientific and Technical Information of China (English)

    岳利莹; 马冬萍; 姜培英

    2014-01-01

    Objective The investigation foresees sex nursing procedure at prevent ophthalmology out-patient service from surgical operation dizzy Jue of sufferer in of applied effect. Methods The sufferer who random selects by examinations my hospital to carry on surgical operation at my ophthalmology out-patient service in the hospital from November, 2011 to November, 2012 is 222, is divided into its nursing set and matched control.Foresee sex nursing procedure to sufferer’s adoption of nursing set, adopt normal regulations nursing procedure to the sufferer of matched control.Compare two sets of sufferers the mental state before doing surgical operations, the blood pressure variety in the surgical operation process, mindset variety still has after the surgical operation ends whether appear a dizzy Jue phenomenon. Results Nursing set sufferer of of the blood pressure value, mental condition still has already appeared dizzy Jue all the rate once was good friends with a matched control, and the its difference has statistics to learn meaning. Conclusion To ophthalmology out-patient service surgical operation the sufferer carry on foresee sex nursing intervention can improve a sufferer of mindset, ease the nervous feeling of the sufferer to the surgical operation, effectively lower a sufferer to take place dizzy Jue of all rate.%目的:探究预见性护理程序在预防眼科门诊手术患者晕厥中的应用效果。方法:随机选取我院2011年11月到2012年11月在我院眼科门诊进行手术的患者222例,将其分为护理组和对照组。对护理组的患者采用预见性护理程序,对对照组患者采用常规护理程序。比较两组患者在执行手术前的精神状态,手术过程中的血压变化、心态变化还有在手术结束后是否出现晕厥现象。结果:护理组患者的的血压值、心理状况还有出现晕厥的概率要好过对照组,且其差异性具有统计学意义。结论:对眼科门诊手术患者

  10. Foresee sex nursing procedure at prevent ophthalmology out-patient service from surgical operation dizzy Jue of sufferer in of applied effect%预见性护理程序在预防眼科门诊手术患者晕厥中的应用效果

    Institute of Scientific and Technical Information of China (English)

    岳利莹; 马冬萍; 姜培英

    2014-01-01

    Objective The investigation foresees sex nursing procedure at prevent ophthalmology out-patient service from surgical operation dizzy Jue of sufferer in of applied effect. Methods The sufferer who random selects by examinations my hospital to carry on surgical operation at my ophthalmology out-patient service in the hospital from November, 2011 to November, 2012 is 222, is divided into its nursing set and matched control.Foresee sex nursing procedure to sufferer’s adoption of nursing set, adopt normal regulations nursing procedure to the sufferer of matched control.Compare two sets of sufferers the mental state before doing surgical operations, the blood pressure variety in the surgical operation process, mindset variety still has after the surgical operation ends whether appear a dizzy Jue phenomenon. Results Nursing set sufferer of of the blood pressure value, mental condition still has already appeared dizzy Jue all the rate once was good friends with a matched control, and the its difference has statistics to learn meaning. Conclusion To ophthalmology out-patient service surgical operation the sufferer carry on foresee sex nursing intervention can improve a sufferer of mindset, ease the nervous feeling of the sufferer to the surgical operation, effectively lower a sufferer to take place dizzy Jue of all rate.%目的:探究预见性护理程序在预防眼科门诊手术患者晕厥中的应用效果。方法:随机选取我院2011年11月到2012年11月在我院眼科门诊进行手术的患者222例,将其分为护理组和对照组。对护理组的患者采用预见性护理程序,对对照组患者采用常规护理程序。比较两组患者在执行手术前的精神状态,手术过程中的血压变化、心态变化还有在手术结束后是否出现晕厥现象。结果:护理组患者的的血压值、心理状况还有出现晕厥的概率要好过对照组,且其差异性具有统计学意义。结论:对眼科门诊手术患者

  11. [Surgical treatment of chiasmal gliomas in children].

    Science.gov (United States)

    Helcl, F

    1997-03-01

    Chiasmal gliomas are rare brain tumors occurring especially in children. Their proper treatment is still controversial and consists of surgery, radiotherapy and chemotherapy. Surgical removal of these tumors can usually be only partial or subtotal and radiotherapy frequently follows. There are supporters of surgical approach, as well as its enemies. The author has been engaged in problems of optimal treatment of this entity for more than 10 years. He is offering a review of knowledge from the literature concerning surgical treatment of this disease in children. The great majority of articles in the literature are dealing with retrospective analysis of relatively small series of patients usually treated in single neurosurgical department and the surgical treatment is enclosed like a part of combined therapy. Articles dealing only with surgical treatment of chiasmal gliomas are few and reviews determining the contemporary role of surgery of this entity are also lacking. This was the main impulse for writing this compilation. The short history of surgical therapy is reviewed. Some new trends of this therapy are also mentioned (microsurgery, Cavitron Ultrasonic Surgical Aspirator and peroperative use of visual evoked potentials). Up to date criteria for surgical treatment of chiasmal gliomas in children are given-exploration of chiasmal region and performing a biopsy in all cases, radical surgery only in extrinsic gliomas of the chiasmal region and conservative surgical approach to intrinsic chiasmal gliomas. It is emphasized that the significance of obstructive hydrocephalus in this entity has not been fully estimated till now, as well as the role of shunting procedures. Surgical treatment remains, nevertheless, an important armamentarium in the management of chiasmal gliomas in children. (Ref. 20.)

  12. Surgical Ablation of Atrial Fibrillation.

    Science.gov (United States)

    Ramlawi, Basel; Abu Saleh, Walid K

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality. The Cox-Maze IV is the most currently accepted iteration. It achieves the same lesion set of the Cox- maze III but uses alternative energy sources to create the transmural lesions, potentially in a minimally invasive approach on the beating heart. High-frequency ultrasound, microwave, and laser energy have all been used with varying success in the past. Today, bipolar radiofrequency heat or cryotherapy cooling are the most accepted sources for creating linear lesions with consistent safety and transmurality. The robust and reliable nature of these energy delivery methods has yielded a success rate reaching 90% freedom from atrial fibrillation at 12 months. Such approaches offer a significant long-term advantage over catheter-based ablation, especially in patients having longstanding, persistent atrial fibrillation with characteristics such as dilated left atrial dimensions, poor ejection fraction, and failed catheter ablation. Based on these improved results, there currently is significant interest in developing a hybrid ablation strategy that incorporates the superior transmural robust lesions of surgical ablation, the reliable stroke prevention potential of epicardial left atrial appendage exclusion, and sophisticated mapping and confirmatory catheter-based ablation technology. Such a minimally invasive hybrid strategy for ablation may lead to the development of multidisciplinary "Afib teams" to

  13. Current surgical strategies for malignant pleural mesothelioma.

    Science.gov (United States)

    Takuwa, Teruhisa; Hasegawa, Seiki

    2016-08-01

    Malignant pleural mesothelioma (MPM) is associated with a poor prognosis. The main components of multimodality treatment include surgery, chemotherapy, and radiation therapy. Surgery remains controversial. Two procedures are currently offered: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). The recent scientific literature suggests that P/D is a well-tolerated procedure, with the potential of becoming a default procedure in multimodality regimens. However, the precise treatment schemes and surgical procedures are yet to be established. In our study, we review the advantages and disadvantages of EPP and P/D, summarize the post-EPP and post-P/D observations (including mortality, morbidity, and median survival time), and discuss the choice of surgical technique (EPP vs. P/D). Moreover, we highlight the aspects of the multimodality treatments that are offered to MPM patients, including chemotherapy, radiotherapy, intensity-modulated radiation therapy, and other types of therapy. PMID:26590581

  14. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza

    2016-01-01

    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  15. Surgical navigation in oral implantology.

    Science.gov (United States)

    Miller, Robert J; Bier, Jurgen

    2006-03-01

    The ability to generate 3-dimensional volumetric images of the maxillofacial area has allowed surgeons to evaluate anatomy before surgery and plan for the placement of implants in ideal positions. However, the ability to transfer that information to surgical reality has been the most challenging part of implant dentistry. With the advent of computer-assisted surgery, the surgeon may now navigate through the entire implant procedure with extremely high accuracy. A new portable laptop navigated system for oral implantology is discussed as an adjunct for complex implant cases. PMID:16569960

  16. SURGICAL TREATMENT OF METASTATIC SPINAL TUMOR

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 王以朋; 邱贵兴; 叶启彬; 张嘉

    2002-01-01

    Objectives. To evaluate the effect of surgical treatment on metastatic spinal tumor. Methods. The results of surgical intervention for metastatic spinal tumor of 31 consecutive patients since October 1985 were reviewed. Results. The average survival time was 17.6 months (range from 3 months to 9 years), and 4 patients are still alive with an average survival time of 24.6 months (range, 14~ 84 months). No postoperative complication was noted. The preoperative symptoms were partially relieved and neurological functions were improved after surgery. Conclusions. Surgical treatment for metastatic spinal tumor could improve the life quality, but should be adopted cautiously. The surgical procedures such as decompression and internal fixation should be involved only when neurological deficits occurred. The surgery with postoperative complementary therapy may not only improve the life quality , but also extend the patients' life span.

  17. Unique surgical tool as an iatromagic charm.

    Science.gov (United States)

    Somma, Alfredo Musajo; Somma, Laura Musajo

    2010-12-01

    Papyri are writings made on special sheets made out of reeds grown on the banks of the river Nile. The Authors comment on the relationship between a ritual text and surgical therapy with an exploration of an ancient charm as recorded in a Greek written papyrus stored in the Medicea Laurenziana Library papyri collection. This charm was presumably intended to act apotropaically, rendering harmless the aggressive surgical tool by means of still keeping its therapeutic value and thereby affording healing protection. This ritual charm acts as a "therapeutic medium" to help the surgical procedure useful to cut or to excise the uvula. The surgical power of stafillotomos is linked to the protective power of the iatromagic charm, giving the chance to analyze ancient data and to suggest a possible shape of the original scalpel. PMID:21657101

  18. SURGICAL TREATMENT OF METASTATIC SPINAL TUMOR

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 王以朋; 等

    2002-01-01

    Objective:To evaluate the effect of surgical treatment on metastatic spinal tumor.Methods:The results of surgical intervention for metastatic spinal tumor of 31 consecutive patients since October 1985 were reviewed.Results:The average survival time was 17.6 months (range from 3 months to 9 years),and 4 patients are still alive with an average survival time of 24.6 months(range,14-84 months).No postoperative complication was noted.The preoperative symptoms were partially relieved and neurological functions were improved after surgery.Conclusions:Surgical treatment for metastatic spinal tumor could improve the life quality,but should be adopted cautiously.The surgical procedures such as decompression and internal fixation should be involved only when neurological deficits occurred.The surgery with postoperative complementary therapy may not only improve the life quality,but also extend the patients' life span.

  19. Autophagy in cardiovascular biology

    OpenAIRE

    Lavandero, Sergio; Chiong, Mario; Rothermel, Beverly A.; Hill, Joseph A.

    2015-01-01

    Cardiovascular disease is the leading cause of death worldwide. As such, there is great interest in identifying novel mechanisms that govern the cardiovascular response to disease-related stress. First described in failing hearts, autophagy within the cardiovascular system has been widely characterized in cardiomyocytes, cardiac fibroblasts, endothelial cells, vascular smooth muscle cells, and macrophages. In all cases, a window of optimal autophagic activity appears to be critical to the mai...

  20. Cardiovascular molecular MR imaging

    OpenAIRE

    Lamb, H J; van der Meer, R. W.; Roos, A. (Anna); Bax, J J

    2007-01-01

    Introduction Cardiovascular molecular imaging is a rapidly evolving field of research, aiming to image and quantify molecular and cellular targets in vivo. MR imaging has some inherent properties that make it very suitable for cardiovascular molecular imaging. Until now, only a limited number of studies have been published on cardiovascular molecular imaging using MR imaging. Review In the current review, MR techniques that have already shown potential are discussed. Metabolic MR imaging can ...

  1. Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial

    OpenAIRE

    Pape-Koehler, Carolina; Immenroth, Marc; Sauerland, Stefan; Lefering, Rolf; Lindlohr, Cornelia; Toaspern, Jens; Heiss, Markus

    2013-01-01

    Background Surgical procedures are complex motion sequences that require a high level of preparation, training, and concentration. In recent years, Internet platforms providing surgical content have been established. Used as a surgical training method, the effect of multimedia-based training on practical surgical skills has not yet been evaluated. This study aimed to evaluate the effect of multimedia-based training on surgical performance. Methods A 2 × 2 factorial, randomized controlled tria...

  2. [Surgical facial reanimation after persisting facial paralysis].

    Science.gov (United States)

    Pasche, Philippe

    2011-10-01

    Facial reanimation following persistent facial paralysis can be managed with surgical procedures of varying complexity. The choice of the technique is mainly determined by the cause of facial paralysis, the age and desires of the patient. The techniques most commonly used are the nerve grafts (VII-VII, XII-VII, cross facial graft), dynamic muscle transfers (temporal myoplasty, free muscle transfert) and static suspensions. An intensive rehabilitation through specific exercises after all procedures is essential to archieve good results.

  3. Totally laparoscopic versus conventional ileoanal pouch procedure – design of a single-centre, expertise based randomised controlled trial to compare the laparoscopic and conventional surgical approach in patients undergoing primary elective restorative proctocolectomy- LapConPouch-Trial

    Directory of Open Access Journals (Sweden)

    Weitz Jürgen

    2006-11-01

    Full Text Available Abstract Background Restorative proctocolectomy is increasingly being performed minimal invasively but a totally laparoscopic technique has not yet been compared to the standard open technique in a randomized study. Methods/design This is a two armed, single centre, expertise based, preoperatively randomized, patient blinded study. It is designed as a two-group parallel superiority study. Power calculation revealed 80 patients per group in order to recruit the 65 patients to be analysed for the primary endpoint. The primary objective is to investigate intra-operative blood loss and the need for blood transfusions. We hypothesise that intra-operative blood loss and the need for peri-operative blood transfusions are significantly higher in the conventional group. Additionally a set of surgical and non-surgical parameters related to the operation will be analysed as secondary objectives. These will include operative time, complications, postoperative pain, lung function, postoperative length of hospital stay, a cosmetic score and pre-and postoperative quality of life. Discussion The trial will answer the question whether there is indeed an advantage in the laparoscopic group in regard to blood loss and the need for blood transfusions. Moreover, it will generate data on the safety and potential advantages and disadvantages of the minimally invasive approach. Trial registration : ISCRTN61411448

  4. Immediate implant post-surgical complications.

    Science.gov (United States)

    Ibbott, C G; Oles, R D

    1995-03-01

    Immediate surgical implants provide a convenient means of replacing missing teeth without requiring hard tissue reduction of restoration-free potential fixed partial denture abutments. Although the procedure is described as "predictable," complications and failures do occur. This report presents four cases of immediate implant complications and their management, and discusses possible causes of the untoward results. Careful pre-operative planning, adequate surgical technique and post-surgical management, timely and suitable loading, and meticulous hygiene maintenance can serve to minimize implant complications and failures. The prospective immediate implant patient must be provided with sufficient information to allow informed consent to be given. Minimal requirements are a description of the procedures in terms the patient can understand, an explanation of potential risks and complications, and adequate disclosure of information about alternative therapies. PMID:7773849

  5. [Surgical treatment of chronic idiopathic constipation].

    Science.gov (United States)

    Menguy, R; Chey, W

    We review current experience with surgical treatment of severe constipation due to primary inertia of the colon. Over the last 10 years, we have operated 18 patients (14 females and 4 males) with severe constipation. The surgical procedure was either nearly total colonectomy with ascending colon/rectum anastomosis (8 cases) or total colonectomy with ileorectal anastomosis (9 cases). In one patient, coloproctectomy was performed with an ileoanal anastomosi. Indications for surgery were based on results of barium emena and functional evaluation of defecation. Results were satisfactory in all patients. In several patients however, we noted that the motility of other levels of the digestive tract was also impaired. Colonectomy was introduced as a treatment for chronic constipation nearly a century ago and although very few indications have been retained in the recent this procedure has now become an acceptable surgical approach in a limited number of well-though-out cases. PMID:7729199

  6. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz

    2015-01-01

    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  7. 腹腔镜后入路胰十二指肠切除术的应用解剖学研究%Anatomic study on surgical procedure of posterior approach laparoscopic pancreaticoduode=nectomy

    Institute of Scientific and Technical Information of China (English)

    周锐; 林浩铭; 李国林; 何海; 杨晓飞; 丁自海; 闵军

    2014-01-01

    Objective To invesgate regional anatomy features of related vessels and surgical planes in posterior approach laparoscopic pancreaticoduodenectomy (paLPD). Methods In order to distinguish related vessels in paLPD accurately , we explored anatomy symbols , exposure methods and search for safe surgical planes under laparoscopic visions by means of analysis from 25 patients surgery videos and observing anatomy features of 15 adult specimens. Results Four regions are identified as important surgical planes in paLPD ,including the avascular region between posterior pancreas duodenum and prerenal fascia ,the avascular region between posterior pancreatic neck and superior mesenteric vein , the region between pancreatic uncinate process and mesenteric vessels , and the celiac trunk and hepatoduodenal ligament regions ,and they cover all related vessels in paLPD. Operating along accurate surgical planes ,we can not only reduce vessels injury risks ,but also improve surgery efficiency and follow the “en bloc” principle better. Conclusion paPLD is a safety and feasible way in LPD,and we can improve surgery safety and efficiency by mastering the features of related vessels under laparoscopic visions and operating along accurate surgical planes.%目的:探讨腹腔镜后入路胰十二指肠切除术(paLPD)切除过程中相关血管和外科平面的局部解剖学特点。方法通过对我院25例接受 paLPD 患者手术过程的回顾以及15具尸体标本进行解剖学观察,总结有助于在腹腔镜视野下对paLPD 切除过程中相关血管进行准确定位的解剖标志和显露方法,并寻找安全的外科平面。结果胰十二指肠后方与肾前筋膜的无血管间隙、胰颈后方与肠系膜上静脉前面之间的无血管间隙、胰腺钩突与肠系膜血管之间、腹腔干和肝十二指肠韧带区域是paLPD 切除过程中重要的四个外科平面,手术相关血管全部涵盖在这四个外科平面内。 paLPD 中循

  8. EMERGENCY SURGICAL ABDOMINAL PATHOLOGY IN REPUBLIC OF MOLDOVA

    OpenAIRE

    E. Maloman, ,; Gh. Ghidirim; V. Cazacov

    2007-01-01

    The aim of this paper is to study the abdominal surgical emergencies. Methods: We made a retrospective study during 1982 – 2004. We encountered 586 patients. From these, 98 patients had acute surgical pathology with peritonitis and were admitted into the hospital in the first 24 hours from the debut. We studied the type of diagnosis and the surgical procedure. Results: The incidence of some of the acute abdominal pathology is encreasing: intestinal obstruction with 49.3%, the haemorrhagic com...

  9. A prototype surgical manipulator for robotic intraocular micro surgery.

    Science.gov (United States)

    Mulgaonkar, Amit P; Hubschman, Jean-Pierre; Bourges, Jean-Louis; Jordan, Brett L; Cham, Christopher; Wilson, Jason T; Tsao, Tsu-Chin; Culjat, Martin O

    2009-01-01

    A prototype manipulator system was developed for ophthalmologic microsurgery. The system, consisting of two parallel X-Y stages, can mechanically maintain a fixed-point of rotation at the surface of the eye, potentially reducing trauma during surgical procedures. The initial prototype was designed to function in concert with the da Vinci Surgical System for gross positioning. Robotic tests demonstrated the mechanical fitness of the prototype while an in vitro surgical sclerectomy was performed to demonstrate functionality of the approach. PMID:19377152

  10. Development of a Cognitive Robotic System for Simple Surgical Tasks

    OpenAIRE

    Yantaç, Asım Evren; Muradore, Riccardo; Fiorini, Paolo; Fiorini, Paolo; Barkana, Duygun Erol; Bonfe, Marcello; Borierol, Fabrizio; Caprara, Andrea; De Rossi, Giacomo; Dodi, Riccardo; Elle, Ole Jakob; Ferraguti, Federica; Gasperottil, Lorenza; Gassert, Roger; Mathiassen, Kim; Handini, Dilla; Lambercy, Olivier; Lil, Lin; Kruusmaal, Maarja; Manurung, Auralius Oberman; Meruzzi, Giovanni; Ho Quoc Phuong Nguyen; Freda, Nicola; Riolfo, Gianluca; Ristolainen, Asko; Sanna, Alberto; Secchi, Cristian; Torsello, Marco

    2015-01-01

    The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded pr...

  11. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan

    2015-01-01

    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  12. Graft infections after surgical aortic reconstructions

    NARCIS (Netherlands)

    Berger, P.

    2015-01-01

    Prosthetic vascular grafts are frequently used to reconstruct (part) of the aorta. Every surgical procedure caries a certain risk for infection and when a prosthetic aortic graft is implanted, this may lead to an aortic graft infection (AGI). Endovascular techniques have gradually replaced open surg

  13. Surgical treatment of lumbar stenosis in achondroplasia

    NARCIS (Netherlands)

    Thomeer, RTWM; Van Dijk, JMC

    2002-01-01

    Object. The authors conducted a study to evaluate the results of a unique surgical procedure for treating primary lumbar stenosis in patients with achondroplasia, based on its distorted anatomical dimensions. Methods. A consecutive single-center series of 36 achondroplastic dwarfs with symptomatic l

  14. Surgical Site Infection Surveillance Following Ambulatory Surgery

    OpenAIRE

    Rhee, Chanu; Huang, Susan S.; Berríos-Torres, Sandra I.; Kaganov, Rebecca; Bruce, Christina; Lankiewicz, Julie; Platt, Richard; Yokoe, Deborah S.

    2015-01-01

    We assessed 4045 ambulatory surgery patients for surgical site infection (SSI) using claims-based triggers for medical chart review. Of 98 patients flagged by codes suggestive of SSI, 35 had confirmed SSIs. SSI rates ranged from 0 to 3.2% for common procedures. Claims may be useful for SSI surveillance following ambulatory surgery.

  15. Surgical smoke and ultrafine particles

    Directory of Open Access Journals (Sweden)

    Nowak Dennis

    2008-12-01

    Full Text Available Abstract Background Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine ( Methods To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc. was applied. Results Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3 of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes. Conclusion Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

  16. Surgical treatment for pulmonary emphysema.

    Science.gov (United States)

    Delarue, N C; Woolf, C R; Sanders, D E; Pearson, F G; Henderson, R D; Cooper, J D; Nelems, J M

    1977-05-01

    Three in-vivo observations stimulated interest in surgical treatment for emphysema: (a) the destructive changes are rarely generalized, (b) the central portions of the lungs are frequently less seriously affected, and (c) marginal folding produces obstructive change in the more normal lung tissue. If destroyed avascular space-occupying areas can be removed, the compressed lung tissue may be stretched to fill pleural space in a functionally effective fashion. Residual elastic tissue will them maintain patency of terminal bronchioles. Preoperatively the extent of the destructive change can be defined most accurately by pulmonary angiography, and zones of functioning capilary circulation can be identified. Forty-seven patients with multifocal space-occupying emphysematous change have been treated surgically. The postoperative mortality was 21% but worthwhile long-term improvement has been obtained in 45% of patients presenting with disabling dyspnea. In these patients, surgical treatment warrants consideration if significant space occupation accompanies the bullous disease, provided alveolar vascularization can be demonstrated in the compressed adjacent normal lung tissue. Limited resections that preserve all vascularized and potentially functioning lung tissue are preferable. It is essential that obliteration of the hemithorax be obtained promptly in view of the high incidence of postoperative complications requiring secondary operative procedures, if 'leaks' and residual spaces are allowed to persist. Postoperative care in a respiratory intensive care unit is mandatory. PMID:870155

  17. Evidence-based surgical techniques for caesarean section

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Secher, Niels Jørgen; Krebs, Lone

    2014-01-01

    Caesarean section (CS) is a common surgical procedure, and in Denmark 21% of deliveries is by CS. There is an increasing amount of scientific evidence to support the different surgical techniques used at CS. This article reviews the literature regarding CS techniques. There is still a lack of evi...

  18. German Heart Surgery Report 2015: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery.

    Science.gov (United States)

    Beckmann, Andreas; Funkat, Anne-Katrin; Lewandowski, Jana; Frie, Michael; Ernst, Markus; Hekmat, Khosro; Schiller, Wolfgang; Gummert, Jan F; Welz, Armin

    2016-09-01

    On the basis of a long-standing voluntary registry, which was founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all heart, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during 2015 are analyzed. In 2015, a total of 103,967 heart surgery procedures (implantable cardioverter defibrillator, pacemaker, and extracardiac procedures without ECC excluded) were submitted to the database. Approximately 14.8% of the patients were at least 80 years old, resulting in an increase of 0.6% compared with the data of 2014. For 38,601 isolated coronary artery bypass grafting procedures (relationship on-/off-pump: 5:1), the unadjusted inhospital mortality was 2.7%. Concerning the 32,346 isolated heart valve procedures (including 10,606 catheter-based implantations) an unadjusted inhospital mortality of 4.4% was observed.This annual updated registry of the GSTCVS represents voluntary public reporting by accumulating actual information for nearly all heart surgical procedures in Germany, demonstrates advancements in heart medicine, and enables internal/external quality assurance for all participants. In addition, the registry demonstrates that the provision of heart surgery in Germany is appropriate and patients are treated nationwide in a round-the-clock service.

  19. Effect of postoperative epidural analgesia on surgical outcome

    DEFF Research Database (Denmark)

    Holte, K; Holte, Kathrine

    2002-01-01

    Pain relief allowing sufficient mobilization after major surgical procedures can only be achieved by continuous epidural analgesia with local anesthetics, which also reduces the stress response to surgery. However, the role of postoperative epidural analgesia on postoperative morbidity is controv...

  20. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... to you by Intuitive Surgical. During the program, it’s easy for you to learn about the procedure. ... of the cervix and the anterior vagina and it invading into the posterior bladder. To make matters ...

  1. Arsenic and cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Bianchi F.

    2013-04-01

    Full Text Available A growing body of epidemiologic, experimental and clinical evidence shows that arsenic may exert relevant cardiovascular effects with early damage such as endothelial dysfunction. Early biomarkers of cardiovascular damage together with markers of exposure, genetic and epigenetic effects, DNA damage, apoptosis, oxidative stress remain unexplored and a study is ongoing in Italy.

  2. Cardiovascular manifestations in hyperthyroidism

    OpenAIRE

    Vairamani Kandan; Sathyamurthy P; Rajkumar M; Lavanya Narayanan

    2016-01-01

    Background: It is well known that thyroid hormone directly affects the heart and peripheral vascular system. In hyperthyroidism, cardiovascular manifestations are frequent findings. Atrial arrhythmias, limitations in exercise tolerance, and congestive heart failure were reported to occur more common in older patients as a result of hyperthyroidism. Cardiovascular signs of hyperthyroidism include tachycardia, widened pulse pressure, marked increase in cardiac output with impaired cardiovascula...

  3. Lifestyle in Cardiovascular Disease

    NARCIS (Netherlands)

    J.O. Younge (John)

    2015-01-01

    markdownabstract__Abstract__ Globally, the burden of cardiovascular disease (CVD) is still increasing. However, in recent decades, better treatment modalities have led to less cardiovascular related deaths. After years of research, we now generally accept that lifestyle factors are the most importa

  4. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  5. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  6. Colorectal Anastomoses: Surgical outcome and prevention of anastomotic leakage

    OpenAIRE

    Bakker, Ilsalien

    2016-01-01

    Colorectal surgery is a frequently performed procedure with more than 10.000 annual resections in the Netherlands. The majority of resections are performed for colorectal cancer. The first part of this thesis focused on outcome of colorectal cancer surgery in the Netherlands based on the nationwide data of the Dutch Surgical Colorectal Audit. Surgical resection with creation of bowel continuance is the primary goal in uncomplicated procedures. An anastomosis however, bears the risk of anastom...

  7. Modified method of analysis for surgical correction of facial asymmetry

    OpenAIRE

    Christou, Terpsithea; Kau, Chung How; Waite, Peter D.; Kheir, Nadia Abou; Mouritsen, David

    2013-01-01

    Introduction: The aim of this article was to present a new method of analysis using a three dimensional (3D) model of an actual patient with facial asymmetry, for the assessment of her facial changes and the quantification of the deformity. This patient underwent orthodontic and surgical treatment to correct a severe facial asymmetry. Materials and Methods: The surgical procedure was complex and the case was challenging. The treatment procedure required an orthodontic approach followed by Le ...

  8. Tissue Engineering: Creating Living Cardiovascular Grafts

    NARCIS (Netherlands)

    Muylaert, D.E.P.

    2016-01-01

    When heart valves or coronary arteries fail, the surgical implantation of a replacement structure can be a life-saving operation. Right now, replacement vessels for bypass grafting are harvested from the leg or chest of the patient, which is an additional and invasive procedure. Similarly, heart val

  9. Surgical treatment of radiation enteritis

    International Nuclear Information System (INIS)

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting

  10. Surgical simulation in orthopaedic skills training.

    Science.gov (United States)

    Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

    2012-07-01

    Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated. PMID:22751160

  11. Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model

    Directory of Open Access Journals (Sweden)

    M. Erol Demirseren

    2012-01-01

    Full Text Available Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating rooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient population, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training. There are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and the evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures is an easily obtainable real human tissue which could be used as a training model in plastic surgery.

  12. Cardiovascular comorbiditiy in psoriasis

    Directory of Open Access Journals (Sweden)

    Gurcharan Singh

    2011-01-01

    Full Text Available The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatologists treating psoriasis need to approach the disease as a potentially multisystem disorder and must alert these patients to the potentially negative effects of their disease.

  13. The effects of local nitroglycerin on the surgical delay procedure in prefabricated flaps by vascular implant in rats Efeitos da nitroglicerina tópica na autonomização de retalhos pré-fabricados por implante vascular em ratos

    Directory of Open Access Journals (Sweden)

    Jairo Zacchê de Sá

    2012-12-01

    Full Text Available PURPOSE: To evaluate the effect of local nitroglycerin on the viable area of a prefabricated flap for vascular implant in rats, and to investigate the surgical delay procedure. METHODS: A femoral pedicle was implanted under the skin of the abdominal wall in forty Wistar rats. The animals were divided into four groups of ten: group 1 - without surgical delay procedure and local nitroglycerin; group 2 - with surgical delay procedure, but without local nitroglycerin; group 3 - without surgical delay procedure, but with local nitroglycerin; and group 4 - with simultaneous surgical delay procedure and local nitroglycerin. The percentages of the viable areas, in relation to the total flap, were calculated using AutoCAD R 14. RESULTS: The mean percentage value of the viable area was 8.9% in the group 1. 49.4% in the group 2; 8.4% in the group 3 and 1.1% in the group 4. There was significant difference between groups 1 and 2 (p=0.005, 1 and 4 (p=0.024, 2 and 3 (p=0.003, 2 and 4 (p=0.001. These results support the hypothesis that the closure of the arterial venous channels is responsible for the phenomenon of surgical delay procedure. CONCLUSION: Local nitroglycerin did not cause an increase in the prefabricated viable flap area by vascular implantation and decreased the viable flap area that underwent delay procedures.OBJETIVO: Avaliar o efeito da nitroglicerina tópica sobre a área viável de um modelo de retalho pré-fabricado por implante vascular em ratos e analisar o mecanismo de autonomização cirúrgica aplicada a retalhos pré-fabricados. MÉTODOS: Foram utilizados 40 ratos Wistar. No primeiro tempo cirúrgico - 20 ratos foram submetidos a implante do pedículo femoral na região subdérmica da parede abdominal, e 20 submetidos à autonomização cirúrgica de retalho cutâneo de parede abdominal e, simultaneamente, implante do pedículo femoral na região subdérmica deste retalho. No segundo tempo - após três semanas e em todos os animais

  14. Incidence of secondary surgical procedures after cervical disc arthroplasty compared to fusion: a meta-analysis%颈椎人工椎间盘置换术与前路减压融合固定术再手术率的Meta分析

    Institute of Scientific and Technical Information of China (English)

    姜东杰; 顾庆国; 王占超; 王新伟; 袁文

    2015-01-01

    目的 比较颈椎人工椎间盘置换术与前路减压融合固定术治疗单节段颈椎病术后相邻节段和手术节段再手术的发生率.方法 计算机检索Pubmed、Medline、Ovid、Embase、Cochrane Library和中国生物医学文献数据库、万方、维普等数据库,英文检索词为"cervical"、"replacement OR arthroplasty OR prosthesis’,、"fusion OR arthrodesis","reoperation ORsecondary surgical procedure",中文检索词为"颈椎"、"间盘置换"、"融合"、"再手术".由2名评价者严格按照纳入及排除标准进行文献筛选,收集关于颈椎人工椎间盘置换术与前路减压融合固定术再手术发生率的前瞻性随机对照研究.根据Cochrane Reviews Handbook 5.1.0的RCT偏倚风险评价标准对纳入文献的偏倚风险进行独立评价,并采用Review Manager5.2软件进行统计分析相邻节段和手术节段的再手术发生率.结果12篇文献纳入研究,短期(2年)随机对照研究6篇,中远期(4~8.8年)随机对照研究6篇.4篇为低偏倚风险,7篇为中偏倚风险,1篇为高偏倚风险.Meta分析显示,短期随访结果 中两种术式在相邻节段的再手术发生率无明显差异,而中远期随访结果显示非融合组术后相邻节段再手术率低于融合组;非融合组手术节段再手术率均低于融合组.短期随访中两组患者采用Removal翻修方法的例数无差别;中远期随访中融合组患者采用该翻修方法进行翻修的人数多于非融合组.结论 非融合术式能在一定程度上降低相邻节段再手术的发生率,但是在短期(2年)内对降低邻近节段再手术的发生率效果并不明显.减少融合术后假关节形成是降低融合术式手术节段再手术率的有效方法.%Objective To compare the incidence of secondary surgical procedures after cervical disc arthroplasty vs anterior cervical discectomy with fusion in patients treated for symptomatic single level cervical spondylosis.Methods An online

  15. Ambulatory Surgical Measures - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  16. Ambulatory Surgical Measures - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  17. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  18. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  19. [Cardiovascular prevention - 2016].

    Science.gov (United States)

    Vértes, András; Szabados, Eszter

    2016-09-01

    Cardiovascular diseases are the main causes of premature death worldwide despite the fact that cardiovascular mortality decreased significantly in the last few decades in financially developed countries. This reduction is partly due to the modern medical and revascularisation treatments, and partly because of the effectiveness of prevention strategies such as lowering blood pressure and cholesterol level, as well as successful strategies against smoking. However, this positive trend is undermined by the striking growth in obesity and in type 2 diabetes mellitus, which could also be successfully controlled by lifestyle changes. This summary is based on an overview of the recent (2016) European Guideline for the Prevention of Cardiovascular Diseases. Here the authors describe preventive strategies and goals to be achieved, the most important lifestyle suggestions, and the secondary prevention medical treatment for patients with already established cardiovascular disease. Orv. Hetil., 2016, 157(38), 1526-1531. PMID:27640620

  20. Depression and cardiovascular disease.

    Science.gov (United States)

    Bradley, Steven M; Rumsfeld, John S

    2015-10-01

    There is a wealth of evidence linking depression to increased risk for cardiovascular disease (CVD) and worse outcomes among patients with known CVD. In addition, there are safe and effective treatments for depression. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with CVD. In this review, we first summarize the evidence linking depression to increased risk of CVD and worse patient outcomes. We then review the mechanisms by which depression may contribute to cardiovascular risk and poor cardiovascular outcomes. We then summarize prior studies of depression treatment on cardiovascular outcomes. Finally, we offer guidance in the identification and management of depression among CVD populations. Given that 1 in 4 CVD patients has concurrent depression, application of these best-practices will assist providers in achieving optimal outcomes for their CVD patients. PMID:25850976

  1. Testosterone and Cardiovascular Disease.

    Science.gov (United States)

    Kloner, Robert A; Carson, Culley; Dobs, Adrian; Kopecky, Stephen; Mohler, Emile R

    2016-02-01

    Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in treating heart failure, angina, and myocardial ischemia. A large, prospective, long-term study of T replacement, with a primary endpoint of a composite of adverse cardiovascular events including myocardial infarction, stroke, and/or cardiovascular death, is needed. The Food and Drug Administration recently put additional restrictions on T replacement therapy labeling and called for additional studies to determine its cardiac safety. PMID:26846952

  2. Cardiovascular modeling and diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Kangas, L.J.; Keller, P.E.; Hashem, S.; Kouzes, R.T. [Pacific Northwest Lab., Richland, WA (United States)

    1995-12-31

    In this paper, a novel approach to modeling and diagnosing the cardiovascular system is introduced. A model exhibits a subset of the dynamics of the cardiovascular behavior of an individual by using a recurrent artificial neural network. Potentially, a model will be incorporated into a cardiovascular diagnostic system. This approach is unique in that each cardiovascular model is developed from physiological measurements of an individual. Any differences between the modeled variables and the variables of an individual at a given time are used for diagnosis. This approach also exploits sensor fusion to optimize the utilization of biomedical sensors. The advantage of sensor fusion has been demonstrated in applications including control and diagnostics of mechanical and chemical processes.

  3. Eponymous cardiovascular surgeries for congenital heart diseases--imaging review and historical perspectives.

    Science.gov (United States)

    Buethe, Ji; Ashwath, Ravi C; Rajiah, Prabhakar

    2015-01-01

    Advances in pediatric cardiology and cardiac surgical techniques over the past few decades have revolutionized the management of the patients with congenital heart disease, and many now survive into adulthood. Several eponymous surgical procedures performed for congenital heart disease have been named after eminent surgeons. In this article, we provide a short biography of the surgeons associated with these eponymous surgical procedures along with their other important scientific contributions. This is followed by a review of these surgical procedures and their most common complications. Imaging appearances of these surgical procedures along with common complications are described and illustrated, with particular emphasis on magnetic resonance imaging. The surgical procedures described in this review include Blalock-Taussig, Potts, Waterston, Glenn, Fontan, Kawashima, Norwood, Sano, Damus-Kaye-Stansel, Mustard, Senning, Jatene, LeCompte, Rastelli, Rashkind, Ross, and Waldenhausen.

  4. [Surgical renal biopsies: technique, effectiveness and complications].

    Science.gov (United States)

    Pinsach Elías, L; Blasco Casares, F J; Ibarz Servió, L; Valero Milián, J; Areal Calama, J; Bucar Terrades, S; Saladié Roig, J M

    1991-01-01

    Retrospective study made on 140 renal surgical biopsies (RSB) performed throughout the past 4 years in our Unit. The technique's effectiveness and morbidity are emphasized and the surgical technique and type of anaesthesia described. The sample obtained was enough to perform an essay in 100% cases, and a diagnosis was reached in 98.5%. Thirty-nine patients (27.8%) presented complications, 13 (9.2%) of which were directly related to the surgical technique. No case required blood transfusion and no deaths were reported. The type of anaesthesia used was: local plus sedation in 104 (74.2%) cases, rachianaesthesia in 10 (7.1%) and general in 26 (18.5%). The same approach was used in all patients: minimal subcostal lumbotomy, using Wilde's forceps to obtain the samples. It is believed that RSB is a highly effective, low mortality procedure, easy and quick to perform, and suitable for selected patients. PMID:1927642

  5. Approach to Pediatric Patients during Surgical Interventions

    Directory of Open Access Journals (Sweden)

    Seher Ünver

    2013-12-01

    Full Text Available A child’s surgical period usually contains unpleasant and difficult experiences, for the child and the parents. The child in this period experiences greater anxiety and distress. On the other hand, pediatric patients have complex states that directly effects their perioperative care during. Because their perioperative care includes not only the knowledge of general surgical procedure and care of a patient in the operating room. It also includes the specific understanding of a child’s airway, anatomy and physiology, the understanding of child development and care of the child and family. This review is prepared to present these differences of the pediatric surgical patients and the care during their perioperative period. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2013; 11: 128-33

  6. Surgical treatment of acute pulmonary embolism--a 12-year retrospective analysis

    DEFF Research Database (Denmark)

    Lehnert, Per; Møller, Christian H; Carlsen, Jørn;

    2012-01-01

    Surgical embolectomy for acute pulmonary embolism (PE) is considered to be a high risk procedure and therefore a last treatment option. We wanted to evaluate the procedures role in modern treatment of acute PE....

  7. Surgical stent for dental implant using cone beam CT images

    International Nuclear Information System (INIS)

    The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

  8. Giant choledochal calculosis: Surgical treatment

    Directory of Open Access Journals (Sweden)

    Hasan Bektas

    2014-01-01

    Full Text Available Context: Gallstone disease is one of the most common surgical pathologies. Choledocholithiasis may occur in some of these cases and require surgical intervention. Although there are relatively non-invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP, this technique is usually unsuccessful in patients with stones larger than 10 mm. In our case, we aimed to report a giant choledochal stone (15 cm × 4.5 cm, which is rare in surgical practice and our treatment with open surgery. Case Report: The patient was a 59-year-old woman. Magnetic resonance cholangiopancreatography (MRCP had showed a hydropic gallbladder with an excessively dilated CBD and a 110 mm × 41 mm stone. In the operation, an excessively dilated CBD was seen and after choledochotomy and a very large calculus that filled CBD completely. Choledochotomy incision was carried forward and a T-tube choledochostomy with choledochoduodenostomy (CD was performed. The patient was discharged without any complications on postoperative 8 th day. Conclusion: Benign gallstone disease is a multifactorial process, with risk factors such as obesity, hemolytic diseases, diabetes mellitus, and pregnancy. Risk factors for choledocholithiasis are similar to those for gallstone disease. MRCP is a non-invasive technique in detecting choledocholithiasis. The gold standard intervention for CBD stones is ERCP. Stones in CBD may reach very considerable dimensions without causing serious symptoms. The most common symptom is jaundice. During preoperative radiological examination, giant stones may be interfered with malignancies. Surgeons should obey conventional algorithms in diagnosis and open surgery must be kept in mind in earlier stages without being too insistent on endoscopic interventions.

  9. Local anesthesia and minilaparotomy: a safe procedure for tubal occlusion in women with severe health problems.

    Science.gov (United States)

    Díaz-Sánchez, V; Bonilla, C; Reyes, A; Valero, A; Domenzáin, M; Pérez-Palacios, G

    1987-08-01

    From 1982 to 1986, 79 women with severe health problems underwent tubal occlusion by minilaparotomy using local anesthesia and intravenous sedation as a permanent method of fertility regulation. All the patients reported herein were classified as "high risk" population for a surgical procedure due to the following medical reasons: cardiovascular (30.2%); diabetes mellitus (25.3%); thyroid disease (18.9%); adrenal dysfunction (11.3%); kidney transplantation (6.3%); severe hypertension (3.7%); and pulmonary problems (3.7%). The procedure morbidity was 3.7% and the mortality 0%. The follow-up rate at 1 year was 86% and no pregnancies or complications of the primary disease due to the surgical procedure have been reported. It was concluded that tubal ligation by minilaparotomy performed by well-trained staff and with back-up hospital services on an out-patient basis is a safe and effective method of family planning in patients considered as a "high risk" population. Post-doctoral research fellows in Reproductive Biology. PMID:3427966

  10. SurgiCal Obesity Treatment Study (SCOTS): protocol for a national prospective cohort study of patients undergoing bariatric surgery in Scotland

    Science.gov (United States)

    Logue, Jennifer; Stewart, Sally; Munro, Jane; Grieve, Eleanor; Lean, Mike; Lindsay, Robert S; Bruce, Duff; Ali, Abdulmajid; Briggs, Andrew; Sattar, Naveed; Ford, Ian

    2015-01-01

    Introduction The efficacy of bariatric surgery for large-scale, long-term weight loss is well established. However, many questions remain over the continual benefits and cost-effectiveness of that weight loss for overall health, particularly when accounting for potential complications and adverse events of surgery. Health research institutes in the UK and the USA have called for high-quality longitudinal cohort studies of patients undergoing bariatric surgery, assessing outcomes such as surgical complications, mortality, diabetes remission, microvascular complications, cardiovascular events, mental health, cost and healthcare use. Methods and analysis SurgiCal Obesity Treatment Study (SCOTS) is a national, prospective, observational, cohort study of patients undergoing primary bariatric surgical procedures in Scotland. This study aims to recruit 2000 patients and conduct a follow-up for 10 years postbariatric surgery using multiple data collection methods: surgeon-recorded data, electronic health record linkage, and patient-reported outcome measures. Outcomes measured will include: mortality, weight change, diabetes, surgical, cardiovascular, cancer, behavioural, reproductive/urological and nutritional variables. Healthcare utilisation and economic productivity will be collected to inform cost-effectiveness analysis. Ethics and dissemination The study has received a favourable ethical opinion from the West of Scotland Research Ethics committee. All publications arising from this cohort study will be published in open-access peer-reviewed journals. All SCOTS investigators (all members of the research team at every recruiting site) will have the ability to propose research suggestions and potential publications using SCOTS data; a publications committee will approve all requests for use of SCOTS data and propose writing committees and timelines. Lay-person summaries of all research findings will be published simultaneously on the SCOTS website (http

  11. Intraoperative OCT in Surgical Oncology

    Science.gov (United States)

    South, Fredrick A.; Marjanovic, Marina; Boppart, Stephen A.

    The global incidence of cancer is rising, putting an increasingly heavy burden upon health care. The need to effectively detect and treat cancer is one of the most significant problems faced in health care today. Effective cancer treatment typically depends upon early detection and, for most solid tumors, successful removal of the cancerous tumor tissue via surgical procedures. Difficulties arise when attempting to differentiate between normal and tumor tissue during surgery. Unaided visual examination of the tissue provides only superficial, low-resolution information and often with little visual contrast. Many imaging modalities widely used for cancer screening and diagnostics are of limited use in the operating room due to low spatial resolution. OCT provides cellular resolution allowing for more precise localization of the tumor tissue. It is also relatively inexpensive and highly portable, making it well suited for intraoperative applications.

  12. Surgical hand hygiene: scrub or rub?

    Science.gov (United States)

    Widmer, A F

    2013-02-01

    Surgical hand hygiene is standard care prior to any surgical procedure. Per-operative glove punctures are observed in almost 30% of all interventions, and a risk factor for postoperative infections. In the past, washing hands with antimicrobial soap and water (surgical scrub) was the norm, mainly with chlorhexidine or iodine. More recently, alcohol-based hand rub has been successfully introduced, showing greater effectiveness, less irritation to the hands, and requiring less time than washing hands. All products should have a remnant effect that delays microbial growth under the gloved hand. Some of the alcohol-based compounds are effective (as determined by the European Norm EN 12791) within 90 s whereas others require 3-5 min, similar to the scrub. The short procedure relies heavily on proper technique and timing, since lowering the exposure time to bacterial killing. Today, surgical hand hygiene should meet EN 12791 in Europe, or other standards, such as the US Food and Drug Administration tentative final monograph norm in the USA. It is best performed by using an alcohol-based hand rub, but a scrub with chlorhexidine-containing soap also meets these standards. PMID:23453175

  13. 3D Rotational X-Ray guidance for surgical interventions

    NARCIS (Netherlands)

    Kraats, Everine Brenda van de

    2005-01-01

    The research described in this thesis is aimed at increasing the accuracy and decreasing the invasiveness of surgical procedures, with a focus on spine procedures, by using a combination of multi-modality images, computer-assisted navigation, intraoperative 3D rotational X-ray (3DRX) imaging, and mi

  14. Monitorando o cancelamento de procedimentos cirúrgicos: indicador de desempenho organizacional Monitoreando el cancelamiento de procedimientos quirúrgicos: indicador del desempeño organizacional Monitoring cancellations of surgical procedures: an indicator of organizational performance

    Directory of Open Access Journals (Sweden)

    Márcia Galan Perroca

    2007-03-01

    ón de recursos materiales y equipamientos (1,6%.This descriptive and exploratory study aims at investigating the occurrence and causes for the cancellations of scheduled surgeries in the Surgical Center unit of a large school hospital in the interior of the State of São Paulo. Data were collected during three consecutive months in 2004 using institutional documents and forms elaborated by the researchers. In the period of study, 4,870 surgeries were scheduled in the investigated unit, of which 249 were suspended, an average of 5.1%. The main causes for the cancellations concerned the patients (57.8%, such as his/her absence (56.3% and his/her unfavorable clinical conditions (34.7%; the unit's organization (22.1%, due to the lack of available beds for hospitalization (29.1% and the occurrence of emergency surgeries (25.5%; and the allocation of human resources (17.7% or of material resources and equipment (1.6%.

  15. Surgical treatment for complex acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    LIU Qiang; WU Dou; LI Ping; HAN Shu-feng

    2006-01-01

    Objective: To explore the effect of surgical treatment on complex acetabular fractures.Methods: The data of 46 patients (38 males and 8 females, aged 16-75 years, mean = 38. 5 years ) with complex acetabular fractures, who were admitted to our hospital from January 1998 to December 2005, were analyzed retrospectively in this study. According to Letournel rules, posterior wall and posterior column fractures were found in 11 patients, transverse and posterior wall fractures in 13, T-type fracture in 4, both columns fracture in 10, and anterior column and posterior transverse fracture in 8. The choice of surgical approach was based on the individual fractures, which included ilioinguinal approach in 5 patients, Kocher-Langenbech approach in 7, combined approach in 26, and extended iliofemoral approach in 8.Results: All the patients were followed up for 3.5 years averagely. The clinical outcomes were analyzed with Harris hip score and radiography. In 36 patients (78.3%), the surgical procedure was successful (Harris hip score > 80 points). The rate of excellent and good was about 86 %.Conclusions: The keys to increase the effectiveness of surgical treatment on acetabular fractures are correct preoperative classification of factures and choices of appropriate surgical approach and time.

  16. Surgical Treatment of Pediatric Epileptic Encephalopathies

    Directory of Open Access Journals (Sweden)

    J. Fridley

    2013-01-01

    Full Text Available Pediatric epileptiform encephalopathies are a group of neurologically devastating disorders related to uncontrolled ictal and interictal epileptic activity, with a poor prognosis. Despite the number of pharmacological options for treatment of epilepsy, many of these patients are drug resistant. For these patients with uncontrolled epilepsy, motor and/or neuropsychological deterioration is common. To prevent these secondary consequences, surgery is often considered as either a curative or a palliative option. Magnetic resonance imaging to look for epileptic lesions that may be surgically treated is an essential part of the workup for these patients. Many surgical procedures for the treatment of epileptiform encephalopathies have been reported in the literature. In this paper the evidence for these procedures for the treatment of pediatric epileptiform encephalopathies is reviewed.

  17. Personalized Guides for Registration in Surgical Navigation.

    Science.gov (United States)

    Dickinson, Andrew W L; Rasquinha, Brian J; Rudan, John F; Ellis, Randy E

    2016-01-01

    Personalized guides are increasingly used in orthopedic procedures but do not provide for intraoperative re-planning. This work presents a tracked guide that used physical registration to provide an anatomy-to-tracking coordinate frame transformation for surgical navigation. In a study using seven femoral models derived from clinical CT scans used for hip resurfacing, a guide characterization FRE of 0.4°±0.2°, drill-path drill-path angular TRE of 0.9°±0.4° and a positional TRE of 1.2mm±0.4mm were found; these values are comparable to conventional optical tracking accuracy. This novel use of a tracked guide may be particularly applicable to procedures that require a small surgical exposure, or when operating on anatomical regions with small bones that are difficult to track or reliably register. PMID:27046560

  18. Surgically assisted rapid maxillary expansion in adults.

    Science.gov (United States)

    Pogrel, M A; Kaban, L B; Vargervik, K; Baumrind, S

    1992-01-01

    Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes.

  19. SURGICAL ORTHODONTICS: LITERATURE REVIEW AND CASE REPORT

    Directory of Open Access Journals (Sweden)

    Piyush HEDA

    2013-03-01

    Full Text Available Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed intense interest for the treatment of facial deformities, being widely practiced throughout the world. Orthognathic surgery has become an acceptable treatment plan for patients with various maxillofacial deformities, giving pleasing results. The present study reports the successful treatment method of Class II division 1 malocclusion through orthognathic surgery.

  20. Marathon run: cardiovascular adaptation and cardiovascular risk.

    Science.gov (United States)

    Predel, Hans-Georg

    2014-11-21

    The first marathon run as an athletic event took place in the context of the Olympic Games in 1896 in Athens, Greece. Today, participation in a 'marathon run' has become a global phenomenon attracting young professional athletes as well as millions of mainly middle-aged amateur athletes worldwide each year. One of the main motives for these amateur marathon runners is the expectation that endurance exercise (EE) delivers profound beneficial health effects. However, with respect to the cardiovascular system, a controversial debate has emerged whether the marathon run itself is healthy or potentially harmful to the cardiovascular system, especially in middle-aged non-elite male amateur runners. In this cohort, exercise-induced increases in cardiac biomarkers-troponin and brain natriuretic peptide-and acute functional cardiac alterations have been observed and interpreted as potential cardiac damage. Furthermore, in the cohort of 40- to 65-year-old males engaged in intensive EE, a significant risk for the development of atrial fibrillation has been identified. Fortunately, recent studies demonstrated a normalization of the cardiac biomarkers and the functional alterations within a short time frame. Therefore, these alterations may be perceived as physiological myocardial reactions to the strenuous exercise and the term 'cardiac fatigue' has been coined. This interpretation is supported by a recent analysis of 10.9 million marathon runners demonstrating that there was no significantly increased overall risk of cardiac arrest during long-distance running races. In conclusion, intensive and long-lasting EE, e.g. running a full-distance Marathon, results in high cardiovascular strain whose clinical relevance especially for middle-aged and older athletes is unclear and remains a matter of controversy. Furthermore, there is a need for evidence-based recommendations with respect to medical screening and training strategies especially in male amateur runners over the age of

  1. Surgical sperm retrieval: Techniques and their indications

    OpenAIRE

    Shah, Rupin

    2011-01-01

    Men with azoospermia can father a child through intra-cytoplasmic sperm injection if sperm can be retrieved from their epididymis or testis. Several percutaneous and open surgical procedures have been described to retrieve sperm. The various techniques and their merits are discussed in this review. In men with obstructive azoospermia, epididymal sperm can usually be retrieved by percutaneous epididymal sperm aspiration (PESA). If PESA fails then testicular sperm are obtained by needle aspirat...

  2. Characteristics of Pseudoaneurysms in Southern India; Risk Analysis, Clinical Profile, Surgical Management and Outcome

    Directory of Open Access Journals (Sweden)

    Hafeezulla Lone

    2015-04-01

    Full Text Available Objective: To determine the risk factors, clinical characteristics, surgical management and outcome of pseudoaneurysm secondary to iatrogenic or traumatic vascular injury. Methods: This was a cross-sectional study being performed in department of cardiovascular and thoracic surgery skims soura during a 4-year period. We included all the patients referring to our center with primary diagnosis of pseudoaneurysm. The pseudoaneurysm was diagnosed with angiography and color Doppler sonography. The clinical and demographic characteristics were recorded and the risk factors were identified accordingly. Patients with small swelling (less than 5-cm and without any complication were managed conservatively. They were followed for progression and development of complications in relation to swelling. Others underwent surgical repair and excision. The outcome of the patients was also recorded. Results: Overall we included 20 patients with pseudoaneurysm. The mean age of the patients was 42.1±0.6 years. Among them there were 11 (55% men and 9 (45% women. Nine (45% patients with end stage renal disease developed pseudoaneurysm after inadvertent femoral artery puncture for hemodialysis; two patients after interventional cardiology procedure; one after femoral embolectomy; one developed after fire arm splinter injury and one formed femoral artery related pseudoaneurysm after drainage of right inguinal abscess. The most common site of pseudoaneurysm was femoral artery followed by brachial artery. Overall surgical intervention was performed in 17 (85% patients and 3 (15% were managed conservatively. Conclusion: End stage renal disease is a major risk factor for pseudoaneurysm formation. Coagulopathy, either therapeutic or pathological is also an important risk factor. Patients with these risk factors need cannulation of venous structures for hemodialysis under ultrasound guide to prevent inadvertent arterial injury. Patients with end stage renal disease who

  3. Surgical crown lengthening for function and esthetics.

    Science.gov (United States)

    Allen, E P

    1993-04-01

    Clinical crown lengthening is a useful procedure to provide tooth length for proper restoration of a tooth without compromising the periodontium or the retentive qualities of the restoration. It is also useful for enhancing maxillary anterior esthetics. Crown lengthening may be as simple as a limited removal of soft tissue or as complex as orthodontic extrusion followed by flap with osseous surgery on a tooth requiring endodontic therapy. Total treatment could thus involve endodontic, orthodontic, periodontic, and restorative procedures. Careful evaluation, case selection, treatment planning, and surgical treatment following the principles outlined in this article can achieve results that meet the functional and esthetic challenges of current dental practice.

  4. Preventing surgical site infection. Where now?

    LENUS (Irish Health Repository)

    Humphreys, H

    2009-12-01

    Surgical site infection (SSI) is increasingly recognised as a measure of the quality of patient care by surgeons, infection control practitioners, health planners and the public. There is increasing pressure to compare SSI rates between surgeons, institutions and countries. For this to be meaningful, data must be standardised and must include post-discharge surveillance (PDS) as many superficial SSIs do not present to the original institution. Further work is required to determine the best method of conducting PDS. In 2008 two important documents on SSI were published from the Society for Healthcare Epidemiology of America\\/The Infectious Disease Society of America and the National Institute for Health and Clincal Excellence, UK. Both emphasise key aspects during the preoperative, operative and postoperative phases of patient care. In addition to effective interventions known to be important for some time, e.g. not shaving the surgical site until the day of the procedure, there is increasing emphasis on physiological parameters, e.g. blood glucose concentrations, oxygen tensions and body temperature. Laparoscopic procedures are increasingly associated with reduced SSI rates, and the screening and decontamination of meticillin-resistant Staphylococcus aureus carriers is effective for certain surgical procedures but has to be balanced by cost and the risk of mupirocin resistance. Finally, there is a need to convert theory into practice by the rigorous application of SSI healthcare bundles. Recent studies suggest that, with a multidisciplinary approach, simple measures can be effective in reducing SSI rates.

  5. [Cardiovascular disease in pregnancy].

    Science.gov (United States)

    Hilfiker-Kleiner, Denise; Bauersachs, Johann

    2016-01-01

    Cardiovascular diseases are among the most frequent complications in pregnancies. Among them preexisting heart diseases including congenital heart disease, genetic cardiomyopathies, myocardial infarction and chemotherapy-induced cardiomyopathies display a special challenge for the mother and her physicians. Moreover, the incidence of cardiovascular disease induced by or associated with pregnancy, i.e. hypertensive disorders and peripartum cardiomyopathies, has increased over the past decades. In the present overview we explain why pregnancy is a stress model for the maternal heart and summarize the current knowledge on the influence of pregnancy on preexisting cardiomyopathies. We highlight recent advances in research with regard to hypertensive complications in pregnancy and peripartum cardiomyopathy (PPCM). Moreover, we summarize etiologies, risk factors, pathomechanisms, diagnosis, treatment, management and prognosis. Finally, interdisciplinarity between different clinical fields and basic science is a key requirement to avoid longterm damage to the cardiovascular system induced by pregnancy associated impacts and with this improve women's health in general. PMID:26800071

  6. Triglycerides and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Varbo, Anette

    2014-01-01

    After the introduction of statins, clinical emphasis first focussed on LDL cholesterol-lowering, then on the potential for raising HDL cholesterol, with less focus on lowering triglycerides. However, the understanding from genetic studies and negative results from randomised trials that low HDL...... cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride......-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk...

  7. 心血管介入手术辐射防护设施与措施防护效果的监测与评价%The monitoring and evaluation of protection effect of radiation protective facility and measure in cardiovascular interventional procedures

    Institute of Scientific and Technical Information of China (English)

    张继勉; 丁艳秋; 张文艺; 焦玲; 张晓东; 张良安

    2014-01-01

    Objective: To monitor and analyze the protection effect of protective appliance to operators in Cardiovascular Interventional Procedures and to provide a basis data for radiation protection of operators. Methods:TLD dosimeters were used to measure the protection effect of lead rubber apron of the first operator, the second operator and nurse in cardiovascular interventional procedures. The protection effect of lead screen and lead curtain also was measured. Results:The dose of outer lead rubber apron was obviously higher than inner. The attenuation ratio of lead rubber apron for the first operator was 91.1%;the attenuation ratio of lead rubber apron for the second operator was 88.6%;the shielding efficiency of lead rubber apron was obvious. The attenuation ratio of lead screen on the treatment couch was 96.0%. The attenuation ratio of lead curtain beside the treatment couch was 97.0%. Conclusion:The radiation protective facility and measure was effective in Cardiovascular Interventional Procedures.%目的:对心血管介入手术中操作者辐射剂量控制措施与设施防护效果进行监测与评价,获取对心血管介入手术辐射防护设计有意义的数据。方法:将热释光剂量计(TLD)元件分别放置于第一术者、第二术者和护理人员的铅衣内侧以及铅衣外侧,对铅衣屏蔽效果进行测量;通过在诊疗床上铅屏内侧以及外侧、床侧铅帘内侧以及外侧放置TLD元件,对其诊疗床铅屏、铅帘的防护效果进行测量。结果:第一术者与第二术者胸部铅衣外侧的剂量大于内侧,说明铅衣发挥了屏蔽散射X射线的作用。第一术者铅衣对射线的衰减率为91.1%,第二术者为88.6%。固定防护设施床上铅屏对射线的衰减率为96.0%,床侧铅帘对射线的衰减率为97.0%。结论:心血管介入手术现场的辐射防护措施与设施是有效的。

  8. A comparative study of the systemic inflammatory response syndrome after the laparoscopic exploration of common bile duct versus open surgical procedure%腹腔镜与开腹胆道探查术后全身炎症反应综合征情况对比研究

    Institute of Scientific and Technical Information of China (English)

    汪新天; 吴金术; 陈晨; 蒋波

    2012-01-01

    目的 探讨腹腔镜与开腹胆总管探查手术创伤与术后全身炎症反应综合征(SIRS)发生的关系.方法 收集腹腔镜胆总管探查术患者(腔镜组,n=32)和开腹胆总管探查术患者(开腹组,n=43)临床资料,分析不同手术方式与患者术后SIRS发生率的关系.结果 与开腹组相比,腔镜组患者术后SIRS发生率明显降低、SIRS持续时间缩短(P<0.05),术后住院时间缩短(P<0.01).两组患者手术时间、麻醉时间及失血量差异无显著性(P>0.05).结论 腹腔镜胆总管探查术患者术后SIRS发生率低,手术创伤小.%[Objective] To compare the influence of the laparoscopic exploration of common bile duct and open surgical procedure on the systemic inflammatory response syndrome. [Methods] 75 cases with cholecystolithiasis and choledocholithiasis were divided into laparoscopic group (32 cases) and open surgery group (43 cases). The clinical data of the two groups were compared and analyzed retrospectively. [ Results ] The incidence rate and persistence time of SIRS were lower on the laparoseopic group. The postoperative hospital stay was longer in the open group than that in the laparoscopic group. [Conclusion] The patient who performed LCBDE have lesser surgical trauma and lower incidence of SIRS.

  9. Pharmacogenomics and cardiovascular disease

    DEFF Research Database (Denmark)

    Weeke, Peter; Roden, Dan M

    2013-01-01

    Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established...... resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described...

  10. Clocks and cardiovascular function

    Science.gov (United States)

    McLoughlin, Sarah C.; Haines, Philip; FitzGerald, Garret A.

    2016-01-01

    Circadian clocks in central and peripheral tissues enable the temporal synchronization and organization of molecular and physiological processes of rhythmic animals, allowing optimum functioning of cells and organisms at the most appropriate time of day. Disruption of circadian rhythms, from external or internal forces, leads to widespread biological disruption and is postulated to underlie many human conditions, such as the incidence and timing of cardiovascular disease. Here, we describe in vivo and in vitro methodology relevant to studying the role of circadian rhythms in cardiovascular function and dysfunction PMID:25707279

  11. Advancing cardiovascular tissue engineering

    Science.gov (United States)

    Truskey, George A.

    2016-01-01

    Cardiovascular tissue engineering offers the promise of biologically based repair of injured and damaged blood vessels, valves, and cardiac tissue. Major advances in cardiovascular tissue engineering over the past few years involve improved methods to promote the establishment and differentiation of induced pluripotent stem cells (iPSCs), scaffolds from decellularized tissue that may produce more highly differentiated tissues and advance clinical translation, improved methods to promote vascularization, and novel in vitro microphysiological systems to model normal and diseased tissue function. iPSC technology holds great promise, but robust methods are needed to further promote differentiation. Differentiation can be further enhanced with chemical, electrical, or mechanical stimuli. PMID:27303643

  12. [Cardiovascular complications of diabetes].

    Science.gov (United States)

    Nishio, Yoshihiko

    2015-12-01

    Several lines of epidemical evidence have shown that type 2 diabetes is the most important risk factor for cardiovascular diseases (CVD). It has been shown that the risk of primary prevention of CVD in patients with diabetes is equal to that of the secondary prevention in general population. In this manuscript, recent reports on the cardiac tests to detect the cardiovascular lesions will be reviewed. The data suggest that MDCT is a promising test even in the patients with diabetes. Furthermore, recent evidence of the treatment of diabetes with insulin or the drugs available recently such as DPP-4 inhibitors and SGLT-2 inhibitors will be reviewed. PMID:26666152

  13. Research in cardiovascular care

    DEFF Research Database (Denmark)

    Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna;

    2014-01-01

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....

  14. Development of a Cognitive Robotic System for Simple Surgical Tasks

    Directory of Open Access Journals (Sweden)

    Riccardo Muradore

    2015-04-01

    Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

  15. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff;

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... Skills); both courses were offered in multiple classes (with a total of 171 students in 2009 and 156 students in 2010). All classes in 2009 participated in the SSL stage of the Basic Surgical Skills course before performing live-animal surgery, and one class (28 students) in 2010 did not. Two validated...

  16. Iatrogenic intrapericardial diaphragmatic hernia diagnosed by cardiovascular magnetic resonance

    OpenAIRE

    Entrikin Daniel W; Chughtai Haroon L; Drafts Brandon C

    2010-01-01

    Abstract Intrapericardial diaphragmatic hernias are very uncommon and are most typically caused by high-force blunt trauma. Other iatrogenic causes such as prior surgical formation of a pericardial window have been described, but are exceedingly rare. We present a case of an intrapericardial diaphragmatic hernia in a patient with a prior pericardial window in which the diagnosis was unclear using conventional imaging modalities, but was established using cardiovascular magnetic resonance.

  17. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S;

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious extra...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  18. Surgical wound care

    Science.gov (United States)

    ... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...

  19. Ancient Egyptian surgical heritage.

    Science.gov (United States)

    Saber, Aly

    2010-12-01

    Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

  20. 3种微创手术治疗复杂性输尿管上段结石212例比较%A comparison of three surgical procedures of complicated upper ureteral calculi for 212 cases

    Institute of Scientific and Technical Information of China (English)

    李旭明; 程洪林; 郭闯; 程宗勇; 李锋; 张力; 李元仲

    2011-01-01

    Objective To compare the efficacy of three procedures, ureteroscopic litripsy(URL), minimally invasive percutaneous nephrolithotomy(MPCNL) ,and retroperitoneal laparoscopic ureterolithomy(RLU), for the treatment of complicated upper ureteral calculi. Methods Two hundred and thirteen cases of complicated upper ureteral calculi were treated in this hospital from February 2002 to February 2010,including fifty-two cases of URL, one hundred and seven cases of MPCNL, and fifty-four cases of RLU. Results The stone free rate seven days after operation:URL was 36.5%(19/52),MPCNL was 75.7%(81/107),RLU was 90.6% (48/53); the stone free rate one months after operation: URL was 71. 1% (38/52), MPCNL was 95. 3% (102/107), RLU was 96.2%(51/53); the stone-free rate three months after operation:URL was 82.7%(43/52),MPCNL was 98. 1%(105/107),RLU was 98.1%(52/53). There was significantly difference between URL and MPCNL(P<0.05) ,URL and RLU (P<0.05). There was also significantly difference between MPCNL and RLU in the near future(P<0. 05) ,but had no difference in long term. Conclusion High stone free rate can be obtained with RLU and MPCNL for impacted upper ureteral calculi. The stone-free rate is less satisfactory with URL.%目的 比较输尿管镜碎石(URL)、微创经皮肾镜取石(MPCNL)、后腹腔镜下输尿管切开取石(RLU)治疗复杂性输尿管上段结石的疗效.方法 回顾分析2002年2月至2010年2月复杂性输尿管上段结石212例,其中URL治疗52例,MPCNL治疗107例,RLU治疗54例.比较分析3种手术的治疗效果.结果 术后7 d结石清除率:URL组36.5%(19/52),MPCNL组75.7%(81/107),RLU组90.6%(48/53).术后1个月结石清除率:URL组73.1%(38/52),MPCNL组95.3%(102/107),RLU组96.2%(51/53).术后3个月结石清除率:URL组82.7%(43/52),MPCNL组98.1%(105/107),RLU组98.1%(52/53).URL组分别与MPCNL组、RLU组比较差异有统计学意义(P<0.05),MPCNL、RLU组之间比较近期差异有统计学意义(P<0.05),

  1. Cardiovascular tissues contain independent circadian clocks

    Science.gov (United States)

    Davidson, A. J.; London, B.; Block, G. D.; Menaker, M.

    2005-01-01

    Acute cardiovascular events exhibit a circadian rhythm in the frequency of occurrence. The mechanisms underlying these phenomena are not yet fully understood, but they may be due to rhythmicity inherent in the cardiovascular system. We have begun to characterize rhythmicity of the clock gene mPer1 in the rat cardiovascular system. Luciferase activity driven by the mPer1 gene promoter is rhythmic in vitro in heart tissue explants and a wide variety of veins and arteries cultured from the transgenic Per1-luc rat. The tissues showed between 3 and 12 circadian cycles of gene expression in vitro before damping. Whereas peak per1-driven bioluminescence consistently occurred during the late night in the heart and all arteries sampled, the phases of the rhythms in veins varied significantly by anatomical location. Varying the time of the culture procedure relative to the donor animal's light:dark cycle revealed that, unlike some other rat tissues such as liver, the phases of in vitro rhythms of arteries, veins, and heart explants were affected by culture time. However, phase relationships among tissues were consistent across culture times; this suggests diversity in circadian regulation among components of the cardiovascular system.

  2. HARTMANN'S PROCEDURE – RESCUE OPERATIONS

    Directory of Open Access Journals (Sweden)

    A. Vasilescu

    2010-05-01

    Full Text Available Hartmann's procedure is the surgical resection of the superior rectum, rectosigmoid jonction and sigmoid colon with closure of the rectal stump and colostomy. It is is an alternative to Dixon procedure and it was used to treat complicated distal colon cancer (obstruction and peritonitis or diverticulitis (Hinchey stage III-IV. These days the indication to this procedure are limited to emergency surgery when immediate anastomosis is not possible, palliative surgery in colorectal cancer. During this procedure, the lesion is removed, the distal bowel closed intraperitoneally, and the proximal colon is brought to the stoma. It can be done by both open and laparoscopic approach. We describe a surgical technique and the problems that can occur. Hartmann's procedure has been reported to have a morbidity with rates ranging from 23% to 69% and a mortality rate ranging from 1% to 28%. Laparoscopic Hartmann’s procedure are technically feasible procedures with reasonable outcomes. Today Hartmann's procedure is still considered a valid alternative to localized or generalized peritonitis caused by perforation of the bowel secondary to the cancer or diverticulitis and in cases with viable but injured proximal bowel that precludes safe anastomosis.

  3. Remoción de terceros molares mandibulares con asistencia endoscópica: Nota técnica de un nuevo procedimiento quirúrgico para prevenir lesiones del NAI y formación de defectos óseos Removal of mandibular third molars with endoscopic approach: Technical note of a new surgical procedure to avoid IAN damage and bone defect formation

    Directory of Open Access Journals (Sweden)

    R Fuentes

    2012-08-01

    Full Text Available La variada posición anatómica de los terceros molares mandibulares presenta importantes desafíos asociados a su profundidad y grado de inclinación. Las complicaciones más habituales del procedimiento quirúrgico convencional de extracción se relacionan con la extensa osteotomía y poca visualización del sitio quirúrgico, que pueden generar consecuencias post-quirúrgicas como inflamación, dolor, trismus, lesiones reversibles e irreversibles del nervio alveolar inferior (NAI o nervio lingual, riesgo de fractura y formación de defectos periodontales del segundo molar. La implementación de soportes rígidos en la óptica endoscópica ha permitido utilizar esta tecnología para realizar abordajes mínimamente invasivos para remover terceros molares mediante accesos flapless con una mínima osteotomía de la zona oclusal, conservando la pared bucal y lingual a través de la visualización directa y magnificada del sitio quirúrgico, adaptable a los movimientos del paciente durante la intervención. En este reporte se presenta un nuevo procedimiento quirúrgico mínimamente invasivo a través de asistencia endoscópica para la conservación ósea en la remoción de terceros molares mandibulares con riesgo de lesión del nervio alveolar inferior.Anatomic variability of the position of mandibular third molars represents significant challenges associated with its depth and angulation. The most common complications of conventional surgical procedure are related to extensive osteotomy and poor visualization, which can cause postsurgical effects such as inflammation, pain, trismus, reversible and irreversible lesions of the inferior alveolar nerve (IAN or lingual nerve, fracture risk and formation of a deep periodontal defect on the distal aspect of the second molar. The implementation of rigid endoscopy in optics has allowed to use this technology via a minimally invasive approach to remove third molars by a minimally occlusal flapless ostectomy

  4. Cardiovascular involvement in patients affected by acromegaly: an appraisal.

    Science.gov (United States)

    Mosca, Susanna; Paolillo, Stefania; Colao, Annamaria; Bossone, Eduardo; Cittadini, Antonio; Iudice, Francesco Lo; Parente, Antonio; Conte, Sirio; Rengo, Giuseppe; Leosco, Dario; Trimarco, Bruno; Filardi, Pasquale Perrone

    2013-09-01

    Cardiovascular complications are frequent in acromegalic patients. Several studies reported increased prevalence of traditional cardiovascular risk factors and early development of endothelial dysfunction and of structural vascular alterations, with subsequent increased risk of coronary artery disease. Furthermore, chronic exposure to high levels of GH and IGF-I leads to the development of the so called "acromegalic cardiomyopathy", characterized by concentric biventricular hypertrophy, diastolic dysfunction and, additionally, by progressive impairment of systolic performance leading to overt heart failure. Cardiac valvulopathies and arrhythmias have also been documented and may concur to the deterioration of cardiac function. Together with strict control of cardiovascular risk factors, early control of GH and IGF-I excess, by surgical or pharmacological therapy, has been reported to ameliorate cardiac and metabolic abnormalities, leading to a significant reduction of left ventricular hypertrophy and to a consistent improvement of cardiac performance.

  5. Cardiovascular magnetic resonance imaging of hypoplastic left heart syndrome in children

    International Nuclear Information System (INIS)

    Cardiovascular magnetic resonance imaging (CMR) plays an important complementary role to echocardiography and conventional angiography in the evaluation of hypoplastic left heart syndrome. This imaging modality is particularly useful for assessing cardiovascular postsurgical changes, extracardiac vascular anatomy, ventricular and valvular function, and a variety of complications. The purpose of this article is to provide a contemporary review of the role of CMR in the management of untreated and surgically palliated hypoplastic left heart syndrome in children. (orig.)

  6. [Recent advances in medical and surgical treatment of ulcerative colitis].

    Science.gov (United States)

    Sugita, Akira; Koganei, Kazutaka; Tatsumi, Kenji; Futatsuki, Ryo; Kuroki, Hirosuke; Yamada, Kyoko; Arai, Katsuhiko; Fukushima, Tsuneo

    2015-03-01

    Recent advances in both medical and surgical treatment of ulcerative colitis have been remarkable. Changes in medical treatment are mainly good results of therapy with the anti-TNF-α antibody, tacrolimus, and those in surgical treatment are an expansion of the surgical indications to include patients with intractable disease, such as treatment refractoriness and chronic corticosteroid dependence, by a better postoperative clinical course after pouch surgery, improred selection of surgical procedures and the timing of surgery in elderly patients. To offer the optimal treatment for patients with ulcerative colitis, new medical therapies should be analyzed from the standpoint of the efficacy and limitations of effect. Long postoperative clinical course of surgical patients including colitic cancer, prevention of postoperative complications should be also analyzed.

  7. Cardiovascular Disease Prevention Strategies

    NARCIS (Netherlands)

    R.L. Nijhuis (Rogier)

    2004-01-01

    textabstractWhereas secondary prevention of cardiovascular events through risk factor modification in patients with known coronary and carotid artery disease is recognised as cost-effective, CVD prevention by drug therapy in asymptomatic individuals has shown only modest benefits and to be relativel

  8. Gender and Cardiovascular Disease

    NARCIS (Netherlands)

    Den Ruijter, Hester M.; Pasterkamp, Gerard

    2015-01-01

    More women than men die of cardiovascular disease (CVD) each year in every major developed country and most emerging economies. Nonetheless, CVD has often been considered as men’s disease due to the higher rates of coronary artery disease (CAD) of men at younger age. This has led to the underestimat

  9. Cardiovascular effects of gliptins.

    Science.gov (United States)

    Scheen, André J

    2013-02-01

    Dipeptidyl peptidase 4 (DPP-4) inhibitors (commonly referred to as gliptins) are a novel class of oral antihyperglycaemic agents with demonstrated efficacy in the treatment of type 2 diabetes mellitus (T2DM). Preclinical data and mechanistic studies have indicated a possible beneficial action on blood vessels and the heart, via both glucagon-like peptide 1 (GLP-1)-dependent and GLP-1-independent effects. DPP-4 inhibition increases the concentration of many peptides with potential vasoactive and cardioprotective effects. Clinically, DPP-4 inhibitors improve several risk factors in patients with T2DM. They improve blood glucose control (mainly by reducing postprandial glycaemia), are weight neutral (or even induce modest weight loss), lower blood pressure, improve postprandial lipaemia, reduce inflammatory markers, diminish oxidative stress, and improve endothelial function. Some positive effects on the heart have also been described in patients with ischaemic heart disease or congestive heart failure, although their clinical relevance requires further investigation. Post-hoc analyses of phase II-III, controlled trials suggest a possible cardioprotective effect with a trend for a lower incidence of major cardiovascular events with gliptins than with placebo or active agents. However, the actual relationship between DPP-4 inhibition and cardiovascular outcomes remains to be proven. Major prospective clinical trials with predefined cardiovascular outcomes and involving various DPP-4 inhibitors are now underway in patients with T2DM and a high-risk cardiovascular profile.

  10. Neuropeptides in cardiovascular control.

    Science.gov (United States)

    Ganong, W F

    1984-12-01

    Neuropeptides can affect cardiovascular function in various ways. They can serve as cotransmitters in the autonomic nervous system; for example, vasoactive intestinal peptide (VIP) is released with acetylcholine and neuropeptide Y with norepinephrine from postganglionic neurons. Substance P and, presumably, other peptides can can affect cardiovascular function when released near blood vessels by antidromically conducted impulses in branches of stimulated sensory neurons. In the central nervous system, many different neuropeptides appear to function as transmitters or contransmittes in the neural pathways that regulate the cardiovascular system. In addition neuropeptides such as vasopressin and angiotensin II also circulate as hormones that are involved in cardiovascular control. Large doses of exogenous vasopressin are required to increase blood pressure in normal animals because the increase in total peripheral resistance produced by the hormones is accompanied by a decrease in cardiac output. However, studies with synthetic peptides that selectively antagonize the vasopressor action of vasopressin indicate that circulating vasopressin is important in maintaining blood pressure when animals are hypovolemic due to dehydration, haemorrhage or adrenocortical insufficiency. VIP dilates blood vessels and stimulates renin secretion by a direct action on the juxtaglomerular cells. Renin secretion is stimulated when the concentration of VIP in plasma exceeds 75 pmol/litre, and higher values are seen in a number of conditions. Neostigmine, a drug which increases the secretion of endogenous VIP, also increases renin secretion, and this increase is not blocked by renal denervation or propranolol. Thus, VIP may be a physiologically significant renin stimulating hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Epigenetics and cardiovascular disease

    Science.gov (United States)

    Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only...

  12. Current management of surgical oncologic emergencies.

    Directory of Open Access Journals (Sweden)

    Marianne R F Bosscher

    Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  13. Quality of life in patients with ulcerative colitis treated surgically

    OpenAIRE

    Kozłowska, Katarzyna A.; Bączyk, Grażyna; Krokowicz, Piotr

    2014-01-01

    Introduction Ulcerative colitis belongs to the group of inflammatory bowel diseases. The specific symptoms and chronic nature of the disease significantly affect the quality of patients’ lives. Quality-of-life assessment helps to define its determining factors as well as the efficiency of surgical procedures. Aim Quality-of-life evaluation of patients with ulcerative colitis treated surgically. Material and methods A retrospective review was carried out on 35 patients with ulcerative colitis,...

  14. SURGICAL INTERVENTION OF SYMPTOMATIC PINEAL CYST : CASE REPORT

    OpenAIRE

    Hashimoto, Hiroyuki; Yonezawa, Taiji; Iida, Junichi; Masui, Katsuya; Sakaki, Toshisuke

    1996-01-01

    We report a rare case of symptomatic pineal cyst detected by magnetic resonance imaging. This patient presented with intermittent headache and gaze paresis. Subtotal resection of the pineal cyst was performed by the occipital transtentorial approach. It was proved histologically that the surgical specimen was composed of reactive glial tissue and normal tissue of the pineal gland with calcification. The procedure completely relieved the patient of refractory symptoms. Surgical management shou...

  15. Surgical site infection prevention: the operating room environment.

    Science.gov (United States)

    Clyburn, Terry A; Evans, Richard P; Moucha, Calin S; Prokuski, Laura

    2011-01-01

    Surgical site infections can complicate orthopaedic procedures and contribute to morbidity, mortality, and health care costs. Extensive literature has been published on this topic; however, the quality of data using standards of evidence-based medicine is variable with a lack of well-controlled studies. A review of the literature concerning measures to prevent surgical site infections in the operating room environment may be helpful in preventing such infections.

  16. A prospective study on geriatric abdominal surgical emergencies

    OpenAIRE

    Deepak R. Chavan; Shailesh Kannur; B. B. Metan; Girish Kullolli

    2014-01-01

    Background: Geriatric population is a special subgroup of population undergoing emergency abdominal surgeries. Both higher age group and emergency surgical procedure are considered as high risk factors. In this study, we study the most common cause for geriatric population to undergo an emergency abdominal surgery and the therapeutic outcomes. Methods: All the patients aged more than 60 years coming to surgical department, BLDEU's hospital with acute abdominal conditions. Study period was ...

  17. Imaging in Lung Transplantation: Surgical Considerations of Donor and Recipient.

    Science.gov (United States)

    Backhus, Leah M; Mulligan, Michael S; Ha, Richard; Shriki, Jabi E; Mohammed, Tan-Lucien H

    2016-03-01

    Modifications in recipient and donor criteria and innovations in donor management hold promise for increasing rates of lung transplantation, yet availability of donors remains a limiting resource. Imaging is critical in the work-up of donor and recipient including identification of conditions that may portend to poor posttransplant outcomes or necessitate modifications in surgical technique. This article describes the radiologic principles that guide selection of patients and surgical procedures in lung transplantation.

  18. Clinical experience of surgical intervention for severe acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Xu Yuan; Shao Qinshu; Yang Jin; Yu Xiaojun; Xu Ji

    2014-01-01

    Background The controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century.Even now surgical procedures play a decisive role in the treatment of SAP,especially in managing the related complications,but the rational indications,timing,and approaches of surgical intervention for SAP are still inconclusive.Methods Clinical data of 308 SAP patients recruited during January 2000-January 2013,including 96 conservatively treated cases plus 212 surgically intervened cases,were comparatively analyzed.Based on the initial surgical intervention time,the surgical intervention group was split into two:early intervention group (within 2 weeks) 103 cases,and late intervention group (after 2 weeks) 109 cases.Results In the conservative treatment group,the cure rate was 82.29% (79/96),the death rate was 13.54% (13/96),and 4 cases self-discharged,while in the surgical intervention group,the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged.The difference was of no statistical significance between these two groups (P >0.05).In surgical intervention group,the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109),and the difference was statistically significant (P <0.05).Conclusions Both conservative treatment and surgical intervention play important roles in the treatment of SAP,and the indication,timing,and procedure should be strictly followed.Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications,such as multiple organ failure,which does not improve despite active treatment,and in those who develop abdominal compartment syndrome.

  19. Practical pearls for oral procedures.

    Science.gov (United States)

    Davari, Parastoo; Fazel, Nasim

    2016-01-01

    We provide an overview of clinically relevant principles of oral surgical procedures required in the workup and management of oral mucosal diseases. An understanding of the fundamental concepts of how to perform safely and effectively minor oral procedures is important to the practicing dermatologist and can minimize the need for patient referrals. This chapter reviews the principles of minor oral procedures, including incisional, excisional, and punch biopsies, as well as minor salivary gland excision. Pre- and postoperative patient care is also discussed. PMID:27343958

  20. Hypertriglyceridemia and Cardiovascular Diseases: Revisited

    OpenAIRE

    Han, Seung Hwan; Stephen J Nicholls; Sakuma, Ichiro; Zhao, Dong; Koh, Kwang Kon

    2016-01-01

    Residual cardiovascular risk and failure of high density lipoprotein cholesterol raising treatment have refocused interest on targeting hypertriglyceridemia. Hypertriglyceridemia, triglyceride-rich lipoproteins, and remnant cholesterol have demonstrated to be important risk factors for cardiovascular disease; this has been demonstrated in experimental, genetic, and epidemiological studies. Fibrates can reduce cardiovascular event rates with or without statins. High dose omega-3 fatty acids co...

  1. Nonfasting hyperlipidemia and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, B G; Langsted, A; Freiberg, J J

    2009-01-01

    , total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A1 all associate with increased risk of cardiovascular disease. These new data open the possibility that nonfasting rather than fasting lipid profiles can be used for cardiovascular risk prediction. If implemented, this would...... of cardiovascular disease and early death....

  2. Advances in the surgical treatment of breast cancer.

    Science.gov (United States)

    Xing, Lei; He, Qiang; Wang, Yuan-Yuan; Li, Hong-Yuan; Ren, Guo-Sheng

    2016-06-01

    Breast cancer has become the top malignant neoplasm in Chinese women with an increasing risk of morbidity and mortality. As a crucial part of comprehensive treatment of breast cancer, breast surgical technique is ceaselessly ameliorating and enriching its features. With the purpose of achieving minimal surgical intervention and satisfactory cosmetic results, the trend of mammary surgery is focusing on minimally invasive treatment and aesthetics in the 21st century. This article gives an overview of the most representative surgical procedures, such as breast conservative surgery, sentinel lymph node dissection, oncoplastic technique and breast reconstructive surgery. PMID:27265302

  3. [Substantiation of active surgical tactics for patients with puerperal endometritis].

    Science.gov (United States)

    Nikonov, A P; Ankirskaia, A S

    1991-01-01

    An active surgical tactics for managing patients (uterine wash and its cavity content vacuum aspiration) was applied in 34 patients with postnatal endometritis. Echography and hysteroscopy demonstrated that in 28 of 34 patients, the endometritis developed in the presence of pathological involvements into the uterine cavity, which made the use of surgical endometrial treatment justifiable. In addition, the surgical treatment substantially decreased the bacterial dissemination of the content in the uterine cavity. The proposed procedure enabled uterine extirpation to be avoided in 5 of 6 patients with partial suture inadequacy. PMID:2042714

  4. Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas Postoperative mediastinitis in cardiovascular surgery postoperation: analysis of 1038 consecutive surgeries

    Directory of Open Access Journals (Sweden)

    Michel Pompeu Barros de Oliveira Sá

    2010-03-01

    Full Text Available OBJETIVO: Relatar a incidência de mediastinite no pós-operatório de cirurgia cardiovascular. MÉTODOS: Foram analisados os prontuários de 1038 pacientes submetidos à cirurgia cardiovascular entre maio/ 2007 e junho/2009. Todas as operações foram realizadas na Divisão de Cirurgia Cardiovascular do Pronto Socorro Cardiológico de Pernambuco - PROCAPE. RESULTADOS: A mediastinite ocorreu, em média, 13 dias após a cirurgia, num total de 25 (2,4% casos, com taxa de letalidade 32,0% (n=8. Vários fatores de risco foram identificados: 56% diabéticos, 56% tabagistas, 20% obesos, 16% portadores de doença pulmonar obstrutiva crônica e 8% com insuficiência renal crônica. A maioria (n=21; 84,0% dos casos foi observada em pacientes submetidos à revascularização do miocárdio, sendo esta associada a maior risco de desenvolvimento da infecção (IC 3.44-8.30, P=0,0001. Observou-se alto índice de complicações: insuficiência respiratória (44%, acidente vascular cerebral (16%, choque cardiogênico (12%, insuficiência renal aguda (28%, infecção pulmonar (36%, falência de múltiplos órgãos (16% e deiscência de esterno (48%. A cultura do exsudato foi positiva em 84% dos casos, sendo o Staphylococcus aureus o patógeno mais observado (28,8%. CONCLUSÕES: A mediastinite continua como complicação cirúrgica bastante grave e de difícil manuseio no pós-operatório de cirurgia cardiovascular. A doença permanece como de baixa incidência, entretanto, ainda com alta letalidade. A cirurgia de revascularização está associada a maior risco de desenvolvimento da infecção.OBJECTIVE: To report the incidence of mediastinitis in cardiovascular surgery postoperation. METHODS: The records of all 1038 patients who underwent cardiovascular surgical procedures between May/2007 and June/2009 were reviewed. All operations were performed in Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE. RESULTS: The

  5. [Cardiovascular alterations associated with doping].

    Science.gov (United States)

    Thieme, D; Büttner, A

    2015-05-01

    Doping -the abuse of anabolic-androgenic steroids in particular- is widespread in amateur and recreational sports and does not solely represent a problem of professional sports. Excessive overdose of anabolic steroids is well documented in bodybuilding or powerlifting leading to significant side effects. Cardiovascular damages are most relevant next to adverse endocrine effects.Clinical cases as well as forensic investigations of fatalities or steroid consumption in connection with trafficking of doping agents provide only anecdotal evidence of correlations between side effects and substance abuse. Analytical verification and self-declarations of steroid users have repeatedly confirmed the presumption of weekly dosages between 300 and 2000 mg, extra to the fact that co-administration of therapeutics to treat side-effects represent a routine procedure. Beside the most frequent use of medications used to treat erectile dysfunction or estrogenic side-effects, a substantial number of antihypertensive drugs of various classes, i.e. beta-blockers, diuretics, angiotensin II receptor antagonists, calcium channel blockers, as well as ACE inhibitors were recently confiscated in relevant doping cases. The presumptive correlation between misuse of anabolic steroids and self-treatment of cardiovascular side effects was explicitly confirmed by detailed user statements.Two representative fatalities of bodybuilders were introduced to outline characteristic, often lethal side effects of excessive steroid abuse. Moreover, illustrative autopsy findings of steroid acne, thrombotic occlusion of Ramus interventricularis anterior and signs of cardiac infarctions are presented.A potential steroid abuse should be carefully considered in cases of medical consultations of patients exhibiting apparent constitutional modifications and corresponding adverse effects. Moreover, common self-medications -as frequently applied by steroid consumers- should be taken into therapeutic considerations

  6. Una técnica para la extirpación de los órganos vomeronasales en el armadillo Chaetophractus villosus. Abordaje desde la cavidad bucal - A surgical procedure for the ablation of the Vomeronasal Organs in the armadillo Chaetophractus villosus. Approach from oral cavity

    Directory of Open Access Journals (Sweden)

    Iodice, O. H.

    2010-03-01

    Full Text Available ResumenSe describen los pasos de un procedimiento quirúrgico para la extirpación bilateral de los órganos vomeronasales del armadillo Chaetophractus villosus (Mammalia, Xenarthra. Cada órgano está ubicado en el piso de la cavidad nasal, adosado a cada lado del tabique nasal. Los órganos se abordan a través de unaabertura practicada en el techo de la cavidad bucal. Este procedimiento se realiza bajo lupa estereoscópica y permite una visualización directa de los órganos Los mismos se destruyen por medio de una fresa accionada por un torno. De este modo se tiene la certeza de una ablación total. La posterior verificación por mediode cortes histológicos no es por lo tanto necesaria. Esto representa una ventaja importante puesto que las características físicas del hueso de estos animales requieren períodos largos de ablandamiento (generalmente alrededor tres meses. SummaryA surgical procedure for the bilateral ablation of the vomeronasal organs of the armadillo Chaetophractus villosus (Mammalia, Xenarthra is described. The organs are approached from the roof of the oral cavity through a longitudinal slit performed with a dental drill. This procedure is performed under magnifying stereoscopic lens and permits the direct visualization of the organs. Those structures are then destroyed with the dental drill. This provides certainty of totalablation. As a consequence, verification by means of histological sections is not needed. This represents an important advantage since the physical characteristics of the bone of these animals require long periods of softening (usually around three months.

  7. EXPERIENCE ON SURGICAL MANAGEMENT OF RUPTURE OF ABDOMINAL AORTIC ANEURYSM

    Institute of Scientific and Technical Information of China (English)

    管珩; 郑月宏; 李拥军; 刘昌伟; 刘暴; 叶炜

    2003-01-01

    Objective. To describe our surgical experience on rupture of abdominal aortic aneurysm .Methods. Two cases of ruptured aortic aneurysms with severe complication were analyzed. Aorta re-construction procedures were performed using bifurcated e-PTFE grafts during emergency operation. Diag-nosis, preoperative resuscitation, emergency surgical intervention, and postoperative complications of thesepatients were summarized and discussed.Results. Rupture of aortic aneurysm in both patients presented as a huge retroperitoneum haematomaby computed tomography scan. They were successfully saved by prompt body fluid compensation, emer-gency procedure, intraoperative resuscitation, and postoperative intensive care.Conclusions. Correct diagnosis, prompt surgical management, immediate intraoperative proximal aortaclamping during procedure, and effective management of postoperative complications were the key pointsto successful treatment of ruptured aortic aneurysm.

  8. Influence of surgical sutures on wound healing

    Directory of Open Access Journals (Sweden)

    Mirković Siniša

    2010-01-01

    Full Text Available Historical data on closing and suturing of surgical wounds describe a wide range of various suture materials. The choice of the surgical catgut, i.e. the type and diameter, depends on the locality, characteristics and condition of the tissue to be treated. From the standpoint of oral-surgical practice the following clinical parameters are of outstanding importance with respect to the selection of suture material: accumulation of soft deposits on the sutures, score of the adjacent soft tissues and dehiscence of the operative wound. Our prospective clinical study included 150 patients distributed into three groups of 50 subjects. The surgical procedure performed on each patient involved resection (apicotomy of the tooth root end in the intercanine sector of the upper jaw. The following suture materials were applied: Black Silc 5-0, Nylon 5-0 and Vicryl 5-0. The effects of the selected sutures were evaluated according to the wound dehiscence. The effects of the applied sutures were recorded on Days 2, 5 and 7 after the surgery. The comparison of cited parameters of the investigated materials after suturing the oral mucosa revealed that none of the used material was ideal; however, a certain advantage might be given to the synthetic monofilament suture materials.

  9. Surgical Treatment of Atrial Fibrillation: A Review

    Directory of Open Access Journals (Sweden)

    Nadine Hiari

    2011-01-01

    Full Text Available Atrial fibrillation is the most commonly sustained arrhythmia in man. While it affects millions of patients worldwide, its incidence will markedly increase with an aging population. Primary goals of AF therapy are to (1 reduce embolic complications, particularly stroke, (2 alleviate symptoms, and (3 prevent long-term heart remodelling. These have been proven to be a challenge as there are major limitations in our knowledge of the pathological and electrophysiological mechanisms underlying AF. Although advances continue to be made in the medical management of this condition, pharmacotherapy is often unsuccessful. Because of the high recurrence rate of AF despite antiarrhythmic drug therapy for maintenance of sinus rhythm and the adverse effects of these drugs, there has been growing interest in nonpharmacological strategies. Surgery for treatment of AF has been around for some time. The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation and has more than 90% success in eliminating atrial fibrillation. Although the cut and sew maze is very effective, it has been superseded by newer operations that rely on alternate energy sources to create lines of conduction block. In addition, the evolution of improved ablation technology and instrumentation has facilitated the development of minimally invasive approaches. In this paper, the rationale for surgical ablation for atrial fibrillation and the different surgical techniques that were developed will be explored. In addition, it will detail the new approaches to surgical ablation of atrial fibrillation that employ alternate energy sources.

  10. Hepatic surgical anatomy.

    Science.gov (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  11. Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics.

    Science.gov (United States)

    Gandedkar, Narayan H; Chng, Chai Kiat; Yeow, Vincent Kok Leng

    2016-01-01

    Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery) are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the "paper surgery" to establish "surgical-plan." Furthermore, the "paper surgery" is emulated in "model surgery" such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing "paper surgery" and an occlusion is set up during "model surgery" for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from "treatment planning" to "execution" for successful management of aforementioned dentofacial deformity. PMID:27630506

  12. Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics

    Directory of Open Access Journals (Sweden)

    Narayan H Gandedkar

    2016-01-01

    Full Text Available Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the "paper surgery" to establish "surgical-plan." Furthermore, the "paper surgery" is emulated in "model surgery" such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing "paper surgery" and an occlusion is set up during "model surgery" for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from "treatment planning" to "execution" for successful management of aforementioned dentofacial deformity.

  13. Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics.

    Science.gov (United States)

    Gandedkar, Narayan H; Chng, Chai Kiat; Yeow, Vincent Kok Leng

    2016-01-01

    Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery) are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the "paper surgery" to establish "surgical-plan." Furthermore, the "paper surgery" is emulated in "model surgery" such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing "paper surgery" and an occlusion is set up during "model surgery" for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from "treatment planning" to "execution" for successful management of aforementioned dentofacial deformity.

  14. Louis Pasteur surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  15. Surgical implantation of transmitters into fish.

    Science.gov (United States)

    Mulcahy, Daniel M

    2003-01-01

    Although the Animal Welfare Act does not cover poikilotherms, individual institutions and policies and legal requirements other than the Animal Welfare Act (e.g., the US Public Health Service and the Interagency Research Animal Committee's Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training) require the review of projects involving fish by institutional animal care and use committees (IACUCs). IACUCs may, however, lack the knowledge and experience to evaluate fish projects judiciously, especially when the projects are in field settings. Surgeries involving implantation of transmitters and other instruments into the coelom, which now comprise a very common research tool in the study of free-ranging fishes, are examples of surgeries that use a broad spectrum of surgical and anesthetic techniques, some of which would not be considered acceptable for similar work on mammals. IACUCs should apply the standards they would expect to be used for surgeries on homeotherms to surgeries on fish. Surgeons should be carefully trained and experienced. Surgical instruments and transmitters should be sterile. Regulations and laws on the use of drugs in animals should be followed, particularly those concerned with anesthetics and antibiotics used on free-ranging fish. Exceptions to surgical procedures should be made only when circumstances are extreme enough to warrant the use of less than optimal procedures. PMID:13130160

  16. Slow breathing and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Ashish Chaddha

    2015-01-01

    Full Text Available Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  17. Slow breathing and cardiovascular disease.

    Science.gov (United States)

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine. PMID:26170595

  18. Prodrugs in Cardiovascular Therapy

    Directory of Open Access Journals (Sweden)

    Maryam Tabrizian

    2008-05-01

    Full Text Available Prodrugs are biologically inactive derivatives of an active drug intended to solve certain problems of the parent drug such as toxicity, instability, minimal solubility and non-targeting capabilities. The majority of drugs for cardiovascular diseases undergo firstpass metabolism, resulting in drug inactivation and generation of toxic metabolites, which makes them appealing targets for prodrug design. Since prodrugs undergo a chemical reaction to form the parent drug once inside the body, this makes them very effective in controlling the release of a variety of compounds to the targeted site. This review will provide the reader with an insight on the latest developments of prodrugs that are available for treating a variety of cardiovascular diseases. In addition, we will focus on several drug delivery methodologies that have merged with the prodrug approach to provide enhanced target specificity and controlled drug release with minimal side effects.

  19. Migraine and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Marcelo E. Bigal

    2011-02-01

    Full Text Available Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis.

  20. Cardiovascular Molecular Imaging

    OpenAIRE

    Khanicheh, Elham

    2009-01-01

    Although there have been significant improvements in the treatment of cardiovascular diseases they still remain the main cause of morbidity and mortality globally. Currently available diagnostic approaches may not be adequate to detect pathologic changes during the early disease stages, which may be valuable for risk stratification and also to assess a response to a therapy. Therefore molecular imaging techniques such as Contrast Enhanced Ultrasound (CEU) molecular imaging to noninvasively i...

  1. Cocoa and cardiovascular health

    OpenAIRE

    R. Corti; Flammer, A J; Hollenberg, N K; Lüscher, T F

    2009-01-01

    Epidemiological data demonstrate that regular dietary intake of plant-derived foods and beverages reduces the risk of coronary heart disease and stroke. Among many ingredients, cocoa might be an important mediator. Indeed, recent research demonstrates a beneficial effect of cocoa on blood pressure, insulin resistance, and vascular and platelet function. Although still debated, a range of potential mechanisms through which cocoa might exert its benefits on cardiovascular health have been propo...

  2. Modelling cardiovascular disease prevention

    OpenAIRE

    Alimadad, Azadeh

    2012-01-01

    According to the World Health Organization (WHO), cardiovascular disease (CVD), which sits under the chronic disease umbrella, is the number one cause of death globally. Over time, we have witnessed different trends that have influenced the prevalence of CVD. One of the ways of decreasing CVD and its social costs and global fatalities is through influencing preventable CVD risk factors. Though many risk factors such as age and gender are not preventable, there are several effective behaviours...

  3. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    2015-10-01

    Full Text Available AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7% had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

  4. Surgical virtual reality - highlights in developing a high performance surgical haptic device.

    Science.gov (United States)

    Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

    2013-01-01

    Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices. PMID:24331310

  5. Surgical virtual reality - highlights in developing a high performance surgical haptic device.

    Science.gov (United States)

    Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

    2013-01-01

    Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices.

  6. Stimulation of antibody synthesis induced by surgical trauma in rats.

    Science.gov (United States)

    Kinnaert, P; Mahieu, A; Van Geertruyden, N

    1978-01-01

    The effect of a standard laparatomy on antibody synthesis was studied in Wistar R/A rats recieving an intravenous injection of 10(9) sheep red blood cells (SRBC) during the surgical procedure. Anti-SRBC antibody titres were significantly higher in operated animals than in controls. When SRBC were given 2 hr after the surgical procedure, stimulation of antibody synthesis still persisted, but when the antigen was administered 24 hr after laparotomy, no significant difference could be detected between the operated animals and controls. Surgery also enhances the secondary humoral response. PMID:668200

  7. [The development of strategic management of high-tech surgical medical care].

    Science.gov (United States)

    Nechaev, V S; Krasnov, A V

    2013-01-01

    The high-tech surgical medical care is one of the most effective types of medical care in Russia. However high-tech surgical treatment very often is inaccessible for patients. The development of basics of strategic management of high-tech surgical care makes it possible to enhance availability of this type of care and to shorten the gap between volumes of rendered care and population needs. This approach can be resulted in decrease of disability and mortality of the most prevalent diseases of cardio-vascular diseases, malignant neoplasms, etc. The prerequisites can be developed to enhance life quality and increase longevity of population.

  8. [The development of strategic management of high-tech surgical medical care].

    Science.gov (United States)

    Nechaev, V S; Krasnov, A V

    2013-01-01

    The high-tech surgical medical care is one of the most effective types of medical care in Russia. However high-tech surgical treatment very often is inaccessible for patients. The development of basics of strategic management of high-tech surgical care makes it possible to enhance availability of this type of care and to shorten the gap between volumes of rendered care and population needs. This approach can be resulted in decrease of disability and mortality of the most prevalent diseases of cardio-vascular diseases, malignant neoplasms, etc. The prerequisites can be developed to enhance life quality and increase longevity of population. PMID:24175384

  9. Surgical procedures in emphysema: any impact on dynamic hyperinflation?

    Directory of Open Access Journals (Sweden)

    M. I. Polkey

    2006-12-01

    Full Text Available Bullectomy, lung volume reduction surgery and transplantation can palliate dyspnoea in emphysema. The available data suggest that their mode of action, at least with regard to pulmonary mechanics, includes beneficial effects on dynamic hyperinflation. In single lung transplant recipients, this may be asymmetric, causing native lung hyperinflation.

  10. Surgical procedures in emphysema: any impact on dynamic hyperinflation?

    OpenAIRE

    Polkey, M. I.

    2006-01-01

    Bullectomy, lung volume reduction surgery and transplantation can palliate dyspnoea in emphysema. The available data suggest that their mode of action, at least with regard to pulmonary mechanics, includes beneficial effects on dynamic hyperinflation. In single lung transplant recipients, this may be asymmetric, causing native lung hyperinflation.

  11. Surgical Site Infections (SSIs) For 24 Operative Procedures, 2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — This table shows the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) risk adjusted standardized infection ratios (SIR) for...

  12. Surgical removal of infected pacemaker leads without cardiopulmonary bypass after failed extraction using the Excimer Laser Sheath Extraction System.

    Science.gov (United States)

    Tokunaga, Chiho; Enomoto, Yoshiharu; Sato, Fujio; Kanemoto, Shinya; Matsushita, Shonosuke; Hiramatsu, Yuji; Aonuma, Kazutaka; Sakakibara, Yuzuru

    2012-03-01

    With the growing number of cardiac pacemakers and internal cardioverter defibrillator implantations, problems with endocardial lead infection have been increasing. The newly developed Excimer Laser Sheath Lead Extraction System has been recognized as being highly useful for removing chronic infected leads. However, serious bleeding complications are a concern when this system is used. Here we report our experience with a 67-year-old man who was diagnosed with pacemaker endocarditis. Initially, lead removal was attempted using the Excimer Laser Sheath Extraction System, though this was abandoned because of severe adhesion of the leads and the junction of the supra vena cava (SVC) with the right atrium. Surgical removal of the leads was performed without using cardiopulmonary bypass and the leads were removed without any complications. During surgery, we found there was a silent perforation of the innominate vein brought about by the Excimer Laser Sheath System. Also, the junction of the SVC with the right atrium was thought to be an area potentially at high risk of perforation, because of a lack of surrounding tissue. It is our opinion that those who carry out procedures with the Excimer Laser Sheath System should understand the potential risk of perforation based on cardiac anatomy and should be prepared for lethal bleeding complications. Also, for emergent situations, we believe that close backup by a cardiovascular surgical team should be considered essential for performing the Excimer Laser Sheath Lead Extraction safely.

  13. Surgical versus non-surgical management for primary patellar dislocations: an up-to-date meta-analysis.

    Science.gov (United States)

    Zheng, Xiaozuo; Kang, Kai; Li, Tong; Lu, Bo; Dong, Jiangtao; Gao, Shijun

    2014-12-01

    The aim of this up-to-date meta-analysis was to compare the effects of surgical versus non-surgical treatment of patients following primary patellar dislocation and to provide the best evidence currently available. A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane Registry of Clinical Trials. All databases were searched from the earliest records to May 2013. Eligible studies were selected, and data were extracted by two independent investigators. The primary outcome variable was the frequency of recurrent patellar dislocation. The other outcomes included knee function scores, patient-rated outcomes, and radiographic examination. If appropriate, meta-analysis of these variables was performed. Nine independent trials were found to match the inclusion criteria. The pooled results demonstrated that the incidence of recurrent patellar dislocation and Hughston visual analog scale was significantly lower in the surgical treatment group than that in the non-surgical treatment group (P 0.05). This up-to-date meta-analysis indicates that surgical treatment was associated with a lower risk of recurrent patellar dislocation, but a lower Hughston VAS than non-surgical treatment for primary patellar dislocation. More large high-quality trials and further studies are needed to overcome the limitations of small sample sizes, and varieties of different surgical procedures or non-surgical management strategies adopted in the included trials.

  14. Surgical repair of partial atrioventricular defect.

    Science.gov (United States)

    El-Rassi, Issam; Charafedine, Fatimah; Majdalani, Mariane; Arabi, Mariam; Khater, Daniele; Bitar, Fadi

    2015-01-01

    Long-term survival rate of patients operated for partial atrioventricular (AV) canal is lower than that of the general population, and late complications are relatively significant: between 10 and 30% of operated patients present with left AV valve regurgitation, and up to 25% have to be reoperated for valve repair or replacement, left ventricular outflow tract obstruction or residual atrial septal defect. Because the left AV valve regurgitation is the most common complication following surgery, technical details in the surgical management of the mitral valve are the most important aspects of this procedure; for example, the decision to close the cleft and to perform an annuloplasty. The presence of mitral valve anomalies in 7-28% of the cases complicates further the surgical management of these valves. This article will describe in detail the operative technique of partial AV canal repair, and review the relevant literature. PMID:26685152

  15. Groin hernia: anatomical and surgical history.

    Science.gov (United States)

    McClusky, David A; Mirilas, Petros; Zoras, Odysseas; Skandalakis, Panagiotis N; Skandalakis, John E

    2006-10-01

    The history of surgical repair of groin hernia is a lengthy record of assorted techniques in search of a cure for an ailment that comes in many sizes and shapes and that has plagued humanity for thousands of years. Although improvements are still being sought and found, for several decades surgeons have had the means to relieve most hernia sufferers. A remaining issue is whether the wide array of surgical procedures can or should be whittled down to a few "standard" operations that are safe, effective, and cost-efficient. The history of the anatomy of groin hernia shows how much there was to learn and how much remains to be learned. It also shows how important it is for the surgeon to know and understand both the anatomy of the area and the formation of groin hernia.

  16. Surgical ablation devices for atrial fibrillation.

    Science.gov (United States)

    Lall, Shelly C; Damiano, Ralph J

    2007-12-01

    The introduction of ablation technology has revolutionized the surgical treatment of atrial fibrillation (AF). It has greatly simplified surgical approaches and has significantly increased the number of procedures being performed. Various energy sources have been used clinically, including cryoablation, radiofrequency, microwave, laser, and high-frequency ultrasound. The goal of these devices is to create conduction block to either block activation wavefronts or to isolate the triggers of AF. All present devices have been shown to have clinical efficacy in some patients. The devices each have their unique advantages and disadvantages. It is important that surgeons develop accurate dose-response curves for new devices in clinically relevant models on both the arrested and beating heart. This will allow the appropriate use of technology to facilitate AF surgery. PMID:18175210

  17. Fighting Global Disparities in Cancer Care: A Surgical Oncology View.

    Science.gov (United States)

    Hoekstra, Harald J; Wobbes, Theo; Heineman, Erik; Haryono, Samuel; Aryandono, Teguh; Balch, Charles M

    2016-07-01

    Cancer is the second leading cause of death globally after cardiovascular disease. Long-term cancer survival has improved in the Western world due to early detection and the use of effective combined treatment modalities, as well as the development of effective immunotherapy and drug-targeted therapy. Surgery is still the mainstay for most solid tumors; however, low- and middle-income countries are facing an increasing lack of primary surgical care for easily treatable conditions, including breast, colon, and head and neck cancers. In this paper, a surgical oncology view is presented to elaborate how the Western surgical oncologist can take part in the 'surgical fight' against global disparities in cancer care, and a plea is made to strive for structural solutions, such as a partnership in surgical oncology training. The pros and cons of the use of eHealth and mHealth technologies and education programs for schools and the community are discussed as these create an opportunity to reach a large portion of the population in these countries, at low cost and with high impact. PMID:27038459

  18. Guideline implementation: surgical instrument cleaning.

    Science.gov (United States)

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-05-01

    Cleaning, decontaminating, and handling instructions for instruments vary widely based on the type of instrument and the manufacturer. Processing instruments in accordance with the manufacturer's instructions can help prevent damage and keep devices in good working order. Most importantly, proper cleaning and disinfection may prevent transmission of pathogenic organisms from a contaminated device to a patient or health care worker. The updated AORN "Guideline for cleaning and care of surgical instruments" provides guidance on cleaning, decontaminating, transporting, inspecting, and storing instruments. This article focuses on key points of the guideline to help perioperative personnel implement appropriate instrument care protocols in their practice settings. The key points address timely cleaning and decontamination of instruments after use; appropriate heating, ventilation, and air conditioning parameters for the decontamination area; processing of ophthalmic instruments and laryngoscopes; and precautions to take with instruments used in cases of suspected prion disease. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:25946180

  19. Surgical Treatment for Pulmonary Hamartomas

    Directory of Open Access Journals (Sweden)

    Funda Ižncekara

    2015-11-01

    Full Text Available Aim: In this study, we evaluated the patients operated for hamartoma and treated endobronchially and the diagnostic value of this approach has been examined. Material and Method: 59 patients (24 females, 35 males; mean age 53 years, range 28-78 years which were operated and endobronchial treated for hamartoma in our clinic between January 2003 - January 2013 were analyzed retrospectively. Patient age, sex, symptoms, histopathological, surgical procedures and treatment outcomes were evaluated. Results: The most common complaint was shortness of breath, while 25 patients were asymptomatic. Thoracotomy and mass enucleation in 29 patients (%49,15, thoracotomy and wedge resection in 18 patients (%30.5, VATS and wedge resection in 4 patients (%6.77, thoracotomy and upper lobectomy in 4 patients (%6.77, thoracotomy and lower lobectomy in 2 patients (%3.38 and left upper lobe segmentectomy in 1 patient (%1.69 and right upper bronchial sleeve resection in 1 patient were performed. The postoperative pathology of lesions examined and diagnosis were chondroid hamartoma in 28 , pulmonary hamartoma in 20 , hamartoma chondrolypomatous in 11 and the bronchial hamartoma in 2 . No mortality was observed intraoperatively. Discussion: Although hamartomas are benign , diagnosis should be made because it can be confused with lung cancer. Definitive diagnosis and treatment can be performed successfully through VATS in primarily appropriate cases with minimal morbidity or thoracotomy or endobronchial treatment.

  20. Clinical practice guideline: tonsillitis II. Surgical management.

    Science.gov (United States)

    Windfuhr, Jochen P; Toepfner, Nicole; Steffen, Gregor; Waldfahrer, Frank; Berner, Reinhard

    2016-04-01

    In 2013, a total of 84,332 patients had undergone extracapsular tonsillectomies (TE) and 11,493 a tonsillotomy (TT) procedure in Germany. While the latter is increasingly performed, the number of the former is continually decreasing. However, a constant number of approximately 12,000 surgical procedures in terms of abscess-tonsillectomies or incision and drainage are annually performed in Germany to treat patients with a peritonsillar abscess. The purpose of this part of the clinical guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through the surgical treatment options to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical treatment options encompass intracapsular as well as extracapsular tonsil surgery and are related to three distinct entities: recurrent episodes of (1) acute tonsillitis, (2) peritonsillar abscess and (3) infectious mononucleosis. Conservative management of these entities is subject of part I of this guideline. (1) The quality of evidence for TE to resolve recurrent episodes of tonsillitis is moderate for children and low for adults. Conclusions concerning the efficacy of TE on the number of sore throat episodes per year are limited to 12 postoperative months in children and 5-6 months in adults. The impact of TE on the number of sore throat episodes per year in children is modest. Due to the heterogeneity of data, no firm conclusions on the effectiveness of TE in adults can be drawn. There is still an urgent need for further research to reliably estimate the value of TE compared to non-surgical therapy of tonsillitis/tonsillo-pharyngitis. The impact of TE on quality of life is considered as being positive, but further research is mandatory to establish appropriate inventories and standardized evaluation procedures, especially in children. In contrast to TE, TT or comparable procedures are characterized by a substantially lower postoperative

  1. Three different surgical techniques of crown lengthening: A comparative study

    Directory of Open Access Journals (Sweden)

    Ramya Nethravathy

    2013-01-01

    Full Text Available Introduction: A short clinical crown may lead to poor retention form thereby leading to improper tooth preparation. Surgical crown lengthening procedure is done to increase the clinical crown length without violating the biologic width. Several techniques have been proposed for clinical crown lengthening which includes gingivectomy, apically displaced flap with or without resective osseous surgery, and surgical extrusion using periotome. Objective: The aim of this paper is to compare clinically the three different surgical techniques of crown lengthening procedures. Materials and Methods: Fifteen patients who reported to the department of Periodontology, were included in the study. Patients were randomly divided into three groups, which include patients who underwent gingivectomy (Group A, apically repositioned flap (Group B and surgical extrusion using periotome (Group C. Clinical measurements such as clinical crown length, gingival zenith, interdental papilla height were taken at baseline and at 3 rd month post-operatively. Results: Clinical and radiographic evaluation at 3 rd month suggest that surgical extrusion technique offers several advantages over the other conventional surgical techniques such as preservation of the interproximal papilla, gingival margin position and no marginal bone loss. Conclusions: This technique can be used to successfully treat a grossly damaged crown structure as a result of tooth fracture, dental caries and iatrogenic factors especially in the anterior region, where esthetics is of great concern.

  2. Bacterial migration through punctured surgical gloves under real surgical conditions

    OpenAIRE

    Heidecke Claus-Dieter; Assadian Ojan; Stanislawski Natalie; Goerdt Anna-Maria; Hübner Nils-Olaf; Kramer Axel; Partecke Lars

    2010-01-01

    Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag met...

  3. Cardiovascular physiology and sleep.

    Science.gov (United States)

    Murali, Narayana S; Svatikova, Anna; Somers, Virend K

    2003-05-01

    Sleep is a natural periodic suspension of consciousness during which processes of rest and restoration occur. The cognitive, reparative and regenerative accompaniments of sleep appear to be essential for maintenance of health and homeostasis. This brief overview will examine the cardiovascular responses to normal and disordered sleep, and their physiologic and pathologic implications. In the past, sleep was believed to be a passive state. The tableau of sleep as it unfolds is anything but a passive process. The brain's activity is as complex as wakefulness, never "resting" during sleep. Following the demise of the 'passive theory of sleep' (the reticular activating system is fatigued during the waking day and hence becomes inactive), there arose the 'active theory of sleep' (sleep is due to an active general inhibition of the brain) (1). Hess demonstrated the active nature of sleep in cats, inducing "physiological sleep" with electrical stimulation of the diencephalon (2). Classical experiments of transection of the cat brainstem (3) at midpontine level inhibited sleep completely, implying that centers below this level were involved in the induction of sleep (1, 4). For the first time, measurement of sleep depth without awakening the sleeper using the electroencephalogram (EEG) was demonstrated in animals by Caton and in humans, by Berger (1). This was soon followed by discovery of the rapid eye movement sleep periods (REM) by Aserinski and Kleitman (5), demonstration of periodical sleep cycles and their association with REM sleep (6, 7). Multiple studies and steady discoveries (4) made polysomnography, with its ability to perform simultaneous whole night recordings of EEG, electromyogram (EMG), and electrooculogram (EOC), a major diagnostic tool in study of sleep disorders. This facility has been of further critical importance in allowing evaluation of the interaction between sleep and changes in hemodynamics and autonomic cardiovascular control. Consequently the

  4. Optimising surgical training: use of feedback to reduce errors during a simulated surgical procedure.

    LENUS (Irish Health Repository)

    Boyle, Emily

    2011-08-01

    To assess the effect of proximate or immediate feedback during an intensive training session. The authors hypothesised that provision of feedback during a training session would improve performance and learning curves.

  5. YOGA IMPROVES CARDIOVASCULAR PARAMETERS

    Directory of Open Access Journals (Sweden)

    Pramod P. Kadu

    2016-06-01

    Full Text Available ABSTRACT Yoga in ancient technique practices by sage for a desirable and healthy life. Yogic exercise and Pranayam may modulate cardiovascular function. To assess the cardiovascular parameter in control and study group. We selected 90 healthy volunteers between age group 35 – 50 years and divided into two groups. i Study group – 45 ii Control group – 45. Control group was not doing any type of exercise or yoga during 1 yr of period whereas yoga group did yogic exercise for 1 yr under supervision of yoga expert. In both the group heart rate SBP and DBP evaluate at 0, 6 and 12 month period. In control group heart rate, SBP, and DBP showed no significant change at 0, 6, and 12 month reading, whereas study group (yoga 81.96±5.65 showed significant decreased heart rate From 81.96 ±5.65 to 75.60 ± 3.44 at 6 month and 73.75 ± 11.36 at 12 month (p<0.001 SBP decreased from 128 ± 7.66 to 120.97 ± 4.21 at 6 month and 120.48± 3.86 at 12 months (p<0.001. DBP showed significant decreased from 88.44 ± 5.25 to 80.53 ± 3.44 at 6 months and 80.53 ± 2.53 at 12months (p<0.001. Yogic exercise and Pranayam done regularly at long term improve cardiovascular efficiency.

  6. Ortho-surgical management of condylar hyperplasia: Rare case reports.

    Science.gov (United States)

    Singh, Virendra; Verma, Ajay; Attresh, Gyanander; Batra, Jitender

    2014-01-01

    Condylar hyperplasia of the mandible is a clinical condition of over-development and growth because of excessive cellular growth of one condylar part of the mandible leading to facial asymmetry, mandibular deviation and enlargement of condyle. The elongation of the condylar neck in turn leads to malocclusion and articular dysfunction. In the past the interceptive and corrective procedures of growth and deformity in condylar hyperplasia were either condylectomy or high condylotomy. However, the deformity ceases after growth is completed. Therefore, other surgical procedures have to be undertaken to correct the manifested deformity of condylar hyperplasia. Further it has to be stressed that no single procedure can completely correct the deformity. So in addition to condylectomy, other orthognathic surgical procedures both on body and ramus and also on maxilla can be undertaken to correct the canting of occlusion. Two rare cases of unilateral hyperplasia encountered in our hospital are presented which required different lines of treatment. PMID:25298720

  7. Traffic noise and cardiovascular disease

    OpenAIRE

    Selander, Jenny

    2010-01-01

    Traffic noise is an increasing problem in urban areas worldwide, but health effects in relation to traffic noise exposure are not well understood. Several studies show that noise may give rise to acute stress reactions, possibly leading to cardiovascular effects, but the evidence is limited on cardiovascular risks associated with traffic noise exposure. Cardiovascular effects have been indicated for other environmental stressors such as occupational noise exposure and job ...

  8. Fetal cardiovascular physiology.

    Science.gov (United States)

    Rychik, J

    2004-01-01

    The cardiovascular system of the fetus is physiologically different than the adult, mature system. Unique characteristics of the myocardium and specific channels of blood flow differentitate the physiology of the fetus from the newborn. Conditions of increased preload and afterload in the fetus, such as sacrococcygeal teratoma and twin-twin transfusion syndrome, result in unique and complex pathophysiological states. Echocardiography has improved our understanding of human fetal cadiovasvular physiology in the normal and diseased states, and has expanded our capability to more effectively treat these disease processes.

  9. Cardiovascular hypertensive emergencies.

    Science.gov (United States)

    Papadopoulos, D P; Sanidas, E A; Viniou, N A; Gennimata, V; Chantziara, V; Barbetseas, I; Makris, T K

    2015-02-01

    Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes.

  10. Periodontitis and cardiovascular disease.

    Science.gov (United States)

    Jeftha, A; Holmes, H

    2013-03-01

    Periodontal medicine has been studied and reviewed extensively since its introduction to the dental fraternity. The association of periodontal disease with and its effects on the cardiovascular system are amongst the many topics explored. A summary of the research into these associations and the possible mechanisms of any relationship is presented. Although a link between these two chronic inflammatory diseases is evident, the very heterogeneity of the relevant studies has not provided evidence sufficient to support an actual causal relationship. More stringent epidemiologic and intervention studies are required. PMID:23951765

  11. Semilunar vestibular technique: A novel procedure for multiple recession coverage (a report of two cases)

    OpenAIRE

    Nymphea Pandit; Inder Kumar Pandit; Deepika Bali; Shaifi Jindal

    2015-01-01

    The procedures for root coverage have been greatly refined over the past few decades. Still as compared to the other periodontal surgical procedures, predictability of mucogingival procedures remains uncertain which is more in patients who present with multiple recessions or recession complicated with periodontal involvement. Techniques which claim success almost always involve a second surgical site. A novel technique avoiding second surgical site and good predictability for multiple recessi...

  12. LAPAROSCOPIC SURGICAL TRAINING. A THREE STAGES MODE

    Directory of Open Access Journals (Sweden)

    R. Moldovanu

    2013-03-01

    Full Text Available The classic “Halstedian” apprenticeship model for surgical training takes place into the operating theater under the strict coordination of a senior surgeon. The development of minimally invasive surgery (MIS rapidly revealed that this apprenticeship model is insufficient to successful fulfill the well known three stages of training of Rasmussen model – skill-based behavior (SBB, rule-based behavior (RBB and knowledge-based behavior (KBB – due to ethical, medico-legal and economic considerations and a specific training using different methods (theoretical and hands-on courses using simulators, animal models and web resources is mandatory. However it isn’t a worldwide accepted laparoscopic training curriculum. We present our experience with different types of teaching methods; in this way we retrospectively reviewed our experience in laparoscopic education, presenting data using Rasmussen model, as a dynamic three stages model: 1 first stage (the beginning, from 1993 until 1995, our staff acquired SBB, RBB and KBB for basic MIS procedures: cholecystectomy, appendectomy, surgical ablation of ovarian cysts; 2 the second stage, from 1996 until 1999, characterized by continuous training of our surgical staff until the achievement of the KBB level for basic MIS procedures and training for other operations (laparoscopic treatment of the groin hernias, eso-gastric and bariatric surgery and the teaching of the residents and the surgeons from Moldova region to achieve SBB and RBB for basic MIS procedures; 3 the third stage, from 2000 until present characterized by a continuous improvement of the surgical teams’ laparoscopic skills for different procedures, and developing a modern curricula for laparoscopic education. CONCLUSIONS: There is no universal method for laparoscopic training. Our experience demonstrates good results using a combination of training methods which allowed acquiring: SBB (Basic skills using virtual reality (VR simulators

  13. Radiological and surgical management of thyroid neoplasms.

    Science.gov (United States)

    Takami, H; Ikeda, Y; Miyabe, R; Okinaga, H; Kameyama, K; Fukunari, N

    2004-01-01

    Recent advances in the radiological diagnosis in thyroid neoplasms have been achieved by high-resolution ultrasonography and color-Doppler, and the ultrasound-guided fine-needle aspiration biopsy and ultrasound-guided percutaneous ethanol injection therapy have been developed on the basis of these modalities. Ultrasonography and ultrasound-guided fine-needle aspiration biopsy have made minimally invasive thyroid surgery possible. The surgical procedures are classified into three main categories according to the approach, and each approach has its own advantages and disadvantages. Surgeons have to select the most suitable approach from one of these categories of approaches for each patient with a thyroid neoplasm. PMID:15271417

  14. [Surgical treatment of temporomandibular joint ankylosis].

    Science.gov (United States)

    Worsaae, N; Hjørting-Hansen, E; Jensen, B; Seidler, B; Praetorius, F

    1992-09-14

    Surgical treatment of temporo-mandibular joint (TMJ) ankylosis may be a particularly difficult procedure due to unfavourable anatomic configurations and the proximity of vital structures. Postoperatively, it is followed by an often long and painful period of physiotherapy. The results of treatment of eight patients with TMJ ankylosis are reported. Different methods were used according to age of the patient and the extent of the ankylotic changes. The importance of early treatment is emphasized. This results in less extensive surgery and reduces secondary growth anomalies of the jaws.

  15. Improving Surgical Care in Low- and Middle-Income Countries: A Pivotal Role for the World Health Organization

    OpenAIRE

    Bickler, Stephen W.; Spiegel, David

    2010-01-01

    In response to increasing evidence that surgical conditions are an important global public health problem, and data suggesting that essential surgical services can be delivered in a cost-effective manner in low- and middle-income countries, the World Health Organization (WHO) has expanded its interest in surgical care. In 2004, WHO established a Clinical Procedures Unit within the Department of Essential Health Technologies. This unit has developed the Emergency and Essential Surgical Project...

  16. Oxidative Stress in Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Gábor Csányi

    2014-04-01

    Full Text Available In the special issue “Oxidative Stress in Cardiovascular Disease” authors were invited to submit papers that investigate key questions in the field of cardiovascular free radical biology. The original research articles included in this issue provide important information regarding novel aspects of reactive oxygen species (ROS-mediated signaling, which have important implications in physiological and pathophysiological cardiovascular processes. The issue also included a number of review articles that highlight areas of intense research in the fields of free radical biology and cardiovascular medicine.

  17. Module based training improves and sustains surgical skills

    DEFF Research Database (Denmark)

    Carlsen, C G; Lindorff-Larsen, K; Funch-Jensen, P;

    2015-01-01

    PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills. METHODS: A...... randomised controlled trial concerning supervised hernia repair in eight training hospitals in Denmark was performed. The participants were 18 registrars [Post graduate year (PGY) 3 or more] in their first year of surgical specialist training. The intervention consisted of different modules with a skills......-lab course followed by 20 supervised Lichtenstein hernia repairs. Operative performance was video recorded and blindly rated by two consultants using a previously validated skills rating scale (8-40 points). Outcome measures were change in the ratings of operative skills and operative time. RESULTS: In the...

  18. Current Approaches for the Prevention of Surgical Site Infections

    Directory of Open Access Journals (Sweden)

    Sander Florman

    2007-01-01

    Full Text Available Surgical site infections (SSIs are the most common type of nosocomial infection among surgical patients and are commonly caused by the patients’ own microbial flora. The prevalence of SSI is a major concern because of the associated increase in the incidence of morbidity and mortality, length of hospitalization and cost of care for postoperative patients. Key factors that determine whether patients are at risk for developing SSI include the inherent potential contamination of the surgical site, the duration of the operation and the individual patient susceptibility. Preventive preoperative measures that can reduce the risk of SSIs include administration of antimicrobial prophylaxis, proper utilization of skin antiseptic agents for both the patient and the surgical team, proper patient preoperative hair removal and the policy of canceling elective procedures when remote skin, urinary or pulmonary infections occur. This paper will review the efficacy and safety of available antiseptic agents, as well as discuss patient-specific prevention strategies.

  19. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  20. Surgical Management of Patients with Chiari I Malformation

    Directory of Open Access Journals (Sweden)

    John Siasios

    2012-01-01

    Full Text Available Chiari malformations (CMs constitute a variety of four mainly syndromes (I, II, III, and IV, which describe the protrusion of brain tissue into the spinal canal through the foramen magnum. These malformations frequently occur in combination with other pathological entities such as myelomeningocele, hydrocephalus, and/or hydrosyringomyelia. The recent improvement of imaging techniques has increased not only the rate of CM diagnosis but also the necessity for its early treatment. Several different surgical techniques have been employed in the treatment of patients with symptomatic CM-I. In our current study, a systematic and critical review of the pertinent literature was made for identifying the most commonly employed surgical procedures in the management of these patients. Emphasis was given in outlining the advantages and disadvantages of each surgical approach. Moreover, an attempt was made for defining those parameters that may be prognostic factors for their surgical outcome. There is a consensus that surgical treatment is reserved only for symptomatic patients with CM-I. It has also been postulated that early surgically intervention is usually associated with better outcome. Despite the large number of previously published clinical series, further clinical research with large-scale studies is necessary for defining surgical treatment guidelines in these patients.