Search results for "EPA"
showing 10 items of 8995 documents
Current state of critically ill patients sedation with volatile anesthetics. Its role in renal and hepatic toxicity
2013
Summary The anesthetic-conserving device (AnaConDa™) facilitated, from a technical viewpoint, the routine use of volatile anesthetics in intensive care patients using ICU ventilators. To date, its use is currently time-limited by clinicians due to the potential renal and hepatic toxicity associated with the production of plasma fluoride after its metabolism, despite its advantages. We reviewed the available human and animal studies literature examining the use of volatile anesthetics as sedative agents and its role in renal and/or hepatic toxicity. We have very few studies concerning the prolonged administration of sevoflurane through the AnaConDa™ and its effect on renal and hepatic functi…
Management of Antiaggregated and Anticoagulated Patients Scheduled for Thoracic Surgery: Recommendations for Venous Thromboprophylaxis
2017
The management of patients under the effect of antiplatelet or anticoagulant agents is a common challenge in thoracic surgery. Their temporary interruption or continuation needs a balanced assessment between the risk of thrombosis (interruption) and bleeding (continuation). Moreover, most patients must receive an anticoagulant for thromboprophylaxis (mainly a low-molecular-weight heparin). So, it is important to have in mind all surgical and anaesthetic implications of these drugs to take the optimal decision in each case.
Anticoagulation in a Neurosurgical Patient with Heparin-Induced Thrombocytopenia Type II with Argatroban and Fondaparinux after Clipping of an Intrac…
2009
Background: Therapeutic anticoagulation in patients after a major neurosurgical procedure remains critical because of the risk of a major intracranial bleed. Novel drugs could play
Einfluss von Typ-II-Endoleaks auf die Größenänderung und Hämodynamik experimenteller Aortenaneurysmen nach endovaskulärer Therapie
2003
PURPOSE To evaluate the aneurysm volume and the intra-aneurysmatic pressure and maximal pressure pulse (dp/dtmax) in completely excluded aneurysms and cases with endoleaks. MATERIALS AND METHODS In 36 mongrel dogs, experimental autologous aneurysms were treated with stent-grafts. All aortic side branches were ligated in 18 cases (group I) but were preserved in group II (n = 18). Aneurysm volumes were calculated from CT scans before and after intervention, and from follow-up CT scans at 1 week, 6 weeks and 6 months. Finally, for hemodynamic measurements, manometer-tipped catheters were introduced into the excluded aneurysm sac (group I and II), selectively in endoleaks (group II), and intral…
Skin-nipple-sparing mastectomy: The first approach in primary myxoid chondrosarcoma of the breast
2017
Abstract The primary mammary chondrosarcoma corresponds to less than 0,5% of the mammary malignancies. For the period ranging from 1967 to 2014, only 18 cases were reported in the literature. A 41 year old woman found a hard nodule on her external right superior quadrant/axillary prolongation through breast self-examination. The vacuum-assisted core biopsy (VACB) revealed “high grade extra-skeletal myxoid chondrosarcoma”. A skin-nipple-sparing mastectomy with the insertion of a mammary expander was performed. A protocol of adjuvant radiotherapy was also indicated. Until 2013, the gold standard was the radical mastectomy. By 2014, there were two cases of conservative approach to quadrantecto…
Kryotherapie primärer und sekundärer Lebertumoren
2002
AIMS We assessed the morbidity, mortality and efficacy of cryotherapy for primary and secondary malignant liver tumours in a prospective case control study. METHODS Since 1996 we performed 77 cryosurgical procedures on 71 patients. 6 patients had hepatocellular carcinoma, the remainders metastases, mainly of colorectal origin (n = 49). Cryotherapy was used when a complete tumour resection was not feasible, but complete tumour destruction by cryotherapy seemed possible. Mean follow-up was 21 months. RESULTS The mean number of lesions per patient was 2.6 (1-10) with a mean maximum diameter of 3.7 cm (1-11). In 36 of 71 patients cryotherapy was used in combination with liver resection. Morbidi…
Management of Small Bowel Perforation by a Bizarre Foreign Body in a 55-Year-Old Woman
2018
Introduction. Ingestion of foreign bodies including dentures, fishbone, screw, and/or surgical devices can be a cause of morbidity, and it rarely could be fatal. Presentation of Case. We present the first hitherto reported case of mussel shell ingestion, which caused acute abdominal pain in a 55-year-old woman. The shell pierced ileal loops, and it was found in the abdominal cavity. Discussion. The accidental or voluntary ingestion of a foreign body is an uncommon event compared to the other causes of bowel perforation. It is fundamental to immediately remove the intestinal fluid, repair the tear, and prevent sepsis, because each delay in diagnosis can lead to a worst outcome. Conclusion. I…
Current Strategies to Identify Patients That Will Benefit from TACE Treatment and Future Directions a Practical Step-by-Step Guide
2021
Abstract Treatment of hepatocellular carcinoma (HCC) depends on the stage of disease. In the Western Hemisphere, the Barcelona Clinic Liver Cancer classification (BCLC) is the preferred staging system. Approximately one-third of patients initially present with intermediate-stage disease. For these patients, transarterial chemoembolization (TACE) is the treatment of choice. However, the intermediate-stage comprises a heterogeneous subgroup of patients with considerable differences in tumor burden and liver function. In addition, differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, com…
Aulogous fibrin sealant (Vivostat(®)) in the neurosurgical practice: Part II: Vertebro-spinal procedures.
2015
Background Epidural hematomas, cerebrospinal fluid fistula, and spinal infections are challenging postoperative complications following vertebro-spinal procedures. We report our preliminary results using autologous fibrin sealant as both fibrin glue and a hemostatic during these operations. Methods Prospectively, between January 2013 and March 2015, 68 patients received an autologous fibrin sealant prepared with the Vivostat(®) system applied epidurally to provide hemostasis and to seal the dura. The surgical technique, time to bleeding control, and associated complications were recorded. Results Spinal procedures were performed in 68 patients utilizing autologous fibrin glue/Vivostat(®) to…
The Addition of Transarterial Chemoembolization to Palliative Chemotherapy Extends Survival in Intrahepatic Cholangiocarcinoma
2021
Incidence and mortality of intrahepatic cholangiocarcinoma (iCCA) have been increasing continuously. Recent studies suggest that the combination of palliative chemotherapy (pCTX) and transarterial chemoembolization (TACE) improves overall survival (OS). This study aimed to evaluate the outcome of patients treated with TACE and pCTX in unresectable iCCA at our tertiary care center. A group of 14 patients was treated with both pCTX and TACE. The non-randomized control group of 59 patients received pCTX alone. Patients received a median of two pCTX lines in both groups. Those treated with TACE underwent a median number of 3.5 sessions. Median OS from the time of unresectability was 26.2 months…