scholarly journals Surgical Management of Bronchiectasis

2020 ◽  
Author(s):  
Yasser Ali Kamal
Keyword(s):  
Computed Tomography ◽  
Antibiotic Therapy ◽  
Medical Treatment ◽  
Chronic Cough ◽  
Preoperative Evaluation ◽  
Postoperative Outcomes ◽  
Mortality And Morbidity ◽  
Sputum Production ◽  
Localized Disease ◽  
Bronchial Dilatation

Bronchiectasis is a chronic clinicopathological disease of the lung characterized by chronic cough, sputum production, recurrent pulmonary infection, and persistent bronchial dilatation on computed tomography. For many years, bronchiectasis associated with high mortality and morbidity particularly before the advent of antibiotics. The medical treatment of bronchiectasis includes antibiotic therapy, airway clearance, bronchodilators, and anti-inflammatory agents. Surgery is mainly performed for localized disease after failure of the medical treatment, including: segmentectomy, lobectomy, and pneumonectomy. This chapter highlights the current surgical considerations for treatment of bronchiectasis, regarding indications of surgery, preoperative evaluation and preparation, available operative procedures, postoperative outcomes, and other important surgical issues.

Imaging study of the anatomical variations and the maxillary sinus pathology in patients with missing lateral teeth for the application of dental implants

ORL ro ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 6-12
Author(s):  
Iulian Damian ◽  
Gheorghe-Ionel Comșa
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Preoperative Evaluation ◽  
Anatomical Variations ◽  
Accurate Information ◽  
Maxillary Artery ◽  
Lateral Sinus ◽  
Sinus Wall ◽  
Increased Risk

Preoperative evaluation of maxillary sinus anatomy is very important to avoid surgical complications due to close anatomical relations between the sinus and the posterior maxillary teeth and/or edentulous alveolar ridge. Posterior superior alveolar artery is a branch of the maxillary artery and provides the vascularization of the lateral sinus wall and underlying mucosa. Maxillary artery branches should be taken into consideration during sinus lifting procedures and bone augmentation due to increased risk of bleeding by damaging the artery during the osteotomy. Computed tomography (CT) explores three-dimensional anatomic structures and provides complex and accurate information about them. Cone Beam Computed Tomography (CBCT) offers an accurate view of the teeth and surrounding structures at high resolution, despite low-dose radiation used. In this study, the incidence of anatomical variations and sinus pathology were assessed using CBCT. The aim is to evaluate the presence of sinus pathology (sinus mucosal thickening, oro-antral communications, sinus tumors, cysts, polyps), presence and position of the posterior superior alveolar artery. These issues are important because they are about the limits of the dental implants in the posterior maxillary area. The presence of sinus pathology and anatomical variations may predispose to complications and even failures of implantation therapy.  

scholarly journals Serial computed tomography findings of Coronavirus disease 2019 (COVID-19) pneumonia treated with favipiravir and steroid therapy: report of 11 cases

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Naoki Irizato ◽  
Hiroshi Matsuura ◽  
Atsuya Okada ◽  
Ken Ueda ◽  
Hitoshi Yamamura
Keyword(s):  
Computed Tomography ◽  
Mechanical Ventilation ◽  
Steroid Therapy ◽  
Time Course ◽  
Ground Glass ◽  
Time Points ◽  
Ct Findings ◽  
Mixed Pattern ◽  
Bronchial Dilatation

Abstract Background This study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy. Results Eleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015). Conclusions At 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.

scholarly journals A case of chronic cough due to sarcoidosis

2021 ◽  
pp. 201010582110190
Author(s):  
Qin Jian Low ◽  
Mohd Nadzri Bin Misni ◽  
Seng Wee Cheo ◽  
Khai Lip Ng ◽  
Noorul Afidza Muhammad
Keyword(s):  
Computed Tomography ◽  
Chronic Cough ◽  
Pulmonary Sarcoidosis ◽  
Granulomatous Disease ◽  
Unknown Aetiology ◽  
Caseous Necrosis ◽  
Night Sweats ◽  
Histopathological Lesion ◽  
Treatment Of Sarcoidosis ◽  
Steroid Sparing

Sarcoidosis is a multisystemic, chronic granulomatous disease of unknown aetiology that often affects the lungs. Diagnosis and treatment of sarcoidosis can be strenuous. Patients may be asymptomatic or experience cough, dyspnoea, fatigue, unintentional weight loss or night sweats. Computed tomography is valuable in the diagnosis of sarcoidosis. The typical histopathological lesion of sarcoidosis is granuloma without caseous necrosis in the involved organs. As tuberculosis is endemic in our region, clinicians should not forget this great mimicker. The cornerstone of treatment of sarcoidosis is corticosteroids but newer agents such as steroid-sparing agents and biological agents are available. We report a case of pulmonary sarcoidosis presenting with chronic cough.

scholarly journals Smartphone-Based Prediction Model for Postoperative Cardiac Surgery Outcomes Using Preoperative Gait and Posture Measures

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1704
Author(s):  
Rahul Soangra ◽  
Thurmon Lockhart
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Cardiac Surgery ◽  
Regression Model ◽  
Mobile Phone ◽  
Gait Speed ◽  
Adverse Outcomes ◽  
Postoperative Outcomes ◽  
Mortality And Morbidity ◽  
Prediction Of Mortality

Gait speed assessment increases the predictive value of mortality and morbidity following older adults’ cardiac surgery. The purpose of this study was to improve clinical assessment and prediction of mortality and morbidity among older patients undergoing cardiac surgery through the identification of the relationships between preoperative gait and postural stability characteristics utilizing a noninvasive-wearable mobile phone device and postoperative cardiac surgical outcomes. This research was a prospective study of ambulatory patients aged over 70 years undergoing non-emergent cardiac surgery. Sixteen older adults with cardiovascular disease (Age 76.1 ± 3.6 years) scheduled for cardiac surgery within the next 24 h were recruited for this study. As per the Society of Thoracic Surgeons (STS) recommendation guidelines, eight of the cardiovascular disease (CVD) patients were classified as frail (prone to adverse outcomes with gait speed ≤ 0.833 m/s) and the remaining eight patients as non-frail (gait speed > 0.833 m/s). Treating physicians and patients were blinded to gait and posture assessment results not to influence the decision to proceed with surgery or postoperative management. Follow-ups regarding patient outcomes were continued until patients were discharged or transferred from the hospital, at which time data regarding outcomes were extracted from the records. In the preoperative setting, patients performed the 5-m walk and stand still for 30 s in the clinic while wearing a mobile phone with a customized app “Lockhart Monitor” available at iOS App Store. Systematic evaluations of different gait and posture measures identified a subset of smartphone measures most sensitive to differences in two groups (frail versus non-frail) with adverse postoperative outcomes (morbidity/mortality). A regression model based on these smartphone measures tested positive on five CVD patients. Thus, clinical settings can readily utilize mobile technology, and the proposed regression model can predict adverse postoperative outcomes such as morbidity or mortality events.

scholarly journals Is it possible to estimate the need for surgical management in patients with a tubo-ovarian abscess at admission? A retrospective long-term analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Murat Gözüküçük ◽  
Esra Gülen Yıldız
Keyword(s):  
Surgical Treatment ◽  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Medical Treatment ◽  
Length Of Hospital Stay ◽  
Treatment Modalities ◽  
Laboratory Findings ◽  
Factors Affecting ◽  
Laboratory Infection ◽  
Major Factors

Abstract Background This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission. Materials and methods Between January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic presentation, pelvic inflammatory risk factors, antibiotic therapy, applied surgical treatment, laboratory infection parameters, and length of hospital stay were recorded. Results The records of 115 patients hospitalized with a prediagnosis of TOA were reviewed for the current study. After hospitalization, TOA was ruled out in 19 patients, and data regarding 96 patients was included for analysis. Twenty-eight (29.2%) patients underwent surgical treatment due to failed antibiotic therapy. Sixty-eight (70.8%) were successfully treated with parenteral antibiotics. Medical treatment failure and need for surgery were more common in patients with a large abscess (volume, > 40 cm3, or diameter, > 5 cm). The group treated by surgical intervention was statistically older than the patients receiving medical treatment (p < 0.05). Conclusions Although the treatment in TOA may vary according to clinical, sonographic, and laboratory findings; age of patients, the abscess size, and volume were seen as the major factors affecting medical treatment failure. Moreover, TOA treatment should be planned on a more individual basis.

scholarly journals Trends in Hysterectomy for Genital Prolapse: Rural Experience

2013 ◽  
Vol 7 ◽  
pp. CMRH.S10804 ◽  
Author(s):  
Shakuntala Chhabra ◽  
Manjiri Ramteke ◽  
Sonali Mehta ◽  
Nisha Bhole ◽  
Yojna Yadav
Keyword(s):  
Coming Out ◽  
Vaginal Hysterectomy ◽  
Preoperative Evaluation ◽  
Genital Prolapse ◽  
Uterovaginal Prolapse ◽  
Preoperative Treatment ◽  
Genital Tract Infection ◽  
Surgical Morbidity ◽  
Mortality And Morbidity ◽  
Abnormal Vaginal Bleeding

The present study was conducted to investigate the trends of vaginal hysterectomy for genital prolapse in last 20 years by analyzing case records of affected women. During the analysis period, 4831 women underwent hysterectomy; records of 4223 (87.5%) were available. Of these, 911 (21.6%), 2.7% of 34,080 gynecological admissions, had vaginal hysterectomy for genital prolapse (study subjects). Eighty percent women who had vaginal hysterectomy for genital prolapse were over 40 years of age; however, most of these women had had the disorder for years before they presented. Only 4 (0.4%) women had not given birth, 874 (96%) women had had two or more births, and 383 (42%) had had 5 or more births. Having given birth was the major factor responsible for genital prolapse. In all, 94.2% of women presented with something coming out of the vagina.” Some women presented with abnormal vaginal bleeding or pain in abdomen as the chief complaint although they had had uterovaginal prolapse for years. There was no mortality and morbidity decreased over the years. There has been no change in the rate of vaginal hysterectomy for genital prolapse over the years. Surgical morbidity decreased trend, possibly because of the preoperative, intraoperative, and postoperative precautions taken, especially preoperative treatment of urinary and genital tract infection. Attempts need to be made to have safe births and a healthy life style so as to prevent genital prolapse and in case it occurs, therapy to prevent progression so that major interventions like hysterectomy are averted. Meticulous preoperative evaluation and planned therapy help in reducing surgical morbidity, if surgery becomes essential.

Computed tomography for preoperative evaluation of need for sternotomy in surgery for retrosternal goitre

2015 ◽  
Vol 400 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Per Malvemyr ◽  
Nils Liljeberg ◽  
Mikael Hellström ◽  
Andreas Muth
Keyword(s):  
Computed Tomography ◽  
Preoperative Evaluation

scholarly journals Chronic cough and sputum production are associated with worse clinical outcomes in stable asthma

2013 ◽  
Vol 107 (10) ◽  
pp. 1501-1508 ◽  
Author(s):  
Neil C. Thomson ◽  
Rekha Chaudhuri ◽  
C. Martina Messow ◽  
Mark Spears ◽  
William MacNee ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Cough ◽  
Sputum Production

64 Multidetector-Row Computed Tomography for Preoperative Evaluation of Gastric Cancer

2007 ◽  
Vol 31 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Dal Mo Yang ◽  
Hyun Cheol Kim ◽  
Wook Jin ◽  
Chang Woo Ryu ◽  
Jee Hee Kang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Preoperative Evaluation ◽  
Multidetector Row Computed Tomography ◽  
Multidetector Row
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