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Inclusion of pregnant women in clinical trials of COVID-19 therapies: what have we learned?

2020

Analysis and review of the perioperative management of COVID-19 patients in thoracic surgery.

2021

Resumen Debido a la grave situacion de pandemia que vivimos causada por el COVID-19, la Seccion de Anestesia Cardiaca, Vascular y Toracica de la SEDAR pretende dar informacion de los aspectos mas relevantes a considerar en pacientes con sospecha o infeccion confirmada por coronavirus que van a ser sometidos a cirugia toracica. Creemos que es esencial mantener una optima transmision de informacion para llevar a cabo maniobras seguras, tanto para los pacientes como para el personal sanitario. La estrategia de manejo debe basarse en una organizacion exquisita del trabajo, definiendo quien, como y cuando va a realizar cada tarea y procedimiento. Las recomendaciones que se proponen, tras valorar…

Mirizzi syndrome type V complicated with both cholecystobiliary and cholecystocolic fistula: a case report

2021

Abstract Mirizzi syndrome (MS) is a common bile duct (CBD) obstruction caused by extrinsic compression from an impacted stone in the cystic duct or infundibulum of the gallbladder. Patients affected by MS may present abdominal pain and jaundice. A 37-year-old male with neurologic residuals post-encephalitis arrived at the emergency department reporting abdominal pain, jaundice and fever. An ultrasound of the abdomen identified cholecystolithiasis with a dilated CBD. He did not undergo CT or MRI due to poor compliance and parents’ disagreement. Eventually, they accepted to perform endoscopic retrograde cholangiopancreatography, which diagnosed MS with both cholecystobiliary and cholecystocol…

Surgical Treatment of Coledochal Cyst Associated with an Aberrant Posterior Hepatic Duct: Report of a Case and Brief Literature Review

2011

Choledochal cysts (CCs) are rare congenital cystic or fusiform dilatations of the biliary tree that can involve the extrahepatic and/or intrahepatic biliary tree. We report a case of huge type I CC associated with an aberrant posterior hepatic duct. A 52-year-old man presented with a 3-week history of upper right abdominal pain and jaundice and serologic sign of obstructive jaundice. Ultrasonography (US), magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography were performed with the diagnosis of CC type I according to the classification of Alonso-Lej and Todani-Watanabe. The indication for surgical resection was posed. The cyst was completely resected…

Endoscopic Resection of a Large Colonic Lipoma: Case Report and Review of Literature

2010

Colonic lipomas are uncommon, benign, submucosal adipose tumors that are usually asymptomatic. Large lipomas can cause symptoms such as constipation, abdominal pain, rectal bleeding and intussusception. We report the case of a 60-year-old man with a history of lower abdominal pain and pseudoobstructive symptoms. Colonoscopy revealed a large polypoid sessile lesion in the sigma. We used a standardized technique of polypectomy, preceded by submucosal injection of dilute 5 ml polygelin with epinephrine 1:10,000 solution, to fully resect large colonic lipomas. The lipoma size was 3.5 cm. No bleeding or perforation developed. Histology showed the polyp to be a submucosul lipoma. On follow-up, th…

The Evolution of Hemophilia Care: Clinical and Laboratory Advances, Opportunities, and Challenges

2020

AbstractHemophilia A (HA) and B (HB) are X-linked bleeding disorders caused by mutations in the F8 or F9 gene that result in the absence, or reduced activity, of the corresponding clotting factor. The severity of bleeding and related complications is proportional to the amount of residual circulating functional factor. The development of a safe and effective hemophilia treatment lasted several decades and has been mainly based on clotting factor replacement. Advances in the engineering and manufacturing of clotting concentrates have led to the widespread availability of extended half-life products that reduced the number of intravenous infusions needed to achieve adequate trough levels. The…

Cytomegalovirus and inflammatory bowel disease: Is there a link?

2006

The objective of this report is to give an overall view of the epidemiological, clinical, diagnostic and therapeutic features of Cytomegalovirus (CMV) infection in inflammatory bowel disease (IBD). A review of published reports on this topic was carried out, with particular attention paid to the selection of patients included in studies and the diagnostic methods employed. CMV is frequently associated with IBD. In some cases, CMV infection is associated with a poor outcome but it is not clear which patients are more likely to be affected and in which stage of the disease. The use of anti-viral therapy in IBD is controversial and an empirical study with controls is needed. The natural histor…

Postoperative education concerning the use of the upper limb, and exercise and treatment of the upper limb: cross-sectional survey of 105 breast canc…

2003

In this retrospective survey we investigated the recall of breast cancer patients (n=105) 6 months after the operation concerning postoperative instructions on exercises for shoulder mobility, and instructions for oedema prevention and treatment, upper limb strength training and the use of the upper limb in daily activities. Patients also described the content in their own words and ranked the instructors who had mostly given this education. Operation type and length of hospital stay did not have any effect on the education recalled, but the age of the respondent had some effect (r=−0.23, p<0.05). The Wilcoxon signed ranks test showed that the most commonly reported item was instructions on…

Predicting mortality with cardiac troponins: recent insights from meta-analyses.

2019

Abstract The introduction of cardiac troponin (cTn) testing in clinical practice has been one of the most important breakthroughs that have occurred in the recent history of laboratory medicine. Although it is now uncontestable that cTn values are essential for diagnosing acute coronary syndrome (ACS), solid evidence is also emerging that assessment of either cardiac troponin I (cTnI) or T (cTnT) may provide valuable prognostic information in the general healthy population, as well as in patients with a vast array of cardiac and extra-cardiac diseases. We have hence performed a critical review of the scientific literature for identifying meta-analyses which have investigated the potential c…

The effect of off-pump coronary artery bypass on mortality after acute coronary syndrome: A meta-analysis

2012

Background Patients requiring surgical revascularisation for acute coronary syndrome (ACS) form a clinically heterogeneous group ranging from haemodynamic stability to cardiogenic shock. Whilst 'off-pump' revascularisation (OPCAB) is often considered, patient selection and operative timing remain controversial. This study aims to identify whether OPCAB may confer a mortality benefit over ONCAB in revascularisation for ACS. Secondly, we review the impact of OPCAB on completeness of revascularisation (CR) and long-term re-intervention. Methods A systematic literature review identified 9 studies (1 randomised controlled trial) of which 8 fulfilled criteria for meta-analysis. Outcomes for a tot…