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Manual Il fu Mattia Pascal (eNewton Classici) (Italian Edition)
Parietal surgery had no significant complication and had shorter LOS p Surgical infectious cases had longer LOS p surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates.
Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations. No commercial use is permitted unless otherwise expressly granted. Outcome after surgical treatment of chronic thromboembolic pulmonary hypertension: In patients with a pulmonary vascular resistance PVR higher than dynes s cm -5 , this procedure is linked with an increased perioperative risk. We compare the outcomes of patients with moderate to severe versus extremely elevated PVR.
A thousand broken pieces
All patient data were entered in a prospective database. We performed a retrospective analysis of our total patient collective and of subgroups defined by: The median duration of surgery was min, cardiopulmonary bypass min, aortic cross-clamp time min and circulatory arrest 34 min. In total, there were 14 in-hospital deaths 6.
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Bleeding, stroke, sepsis and pneumonia led to death in 1 patient each. The 1-year survival rate was Despite the increased perioperative risk and mortality, PEA should not be denied to patients with extremely elevated PVR but clear indication for surgery. Achalasia comes from a Greek word that means "failure to relax. This report addresses esophageal achalasia--its history, diagnosis, pathophysiology, and treatment options.
We report our experience in treating this disorder surgically using modified Heller myotomy combined or not with partial gastric fundoplication. These features make it reasonable to reasses the relative indications for surgery and nonsurgical therapy in achalasia of the esophagus.
Rhabdomyolysis in Critically Ill Surgical Patients. Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication. Descriptive statistical methods were used to analyze the collected data.
Out of totally patients hospitalized in the ICU, 93 were diagnosed with rhabdomyolysis during the course of one year. Regular monitoring and early detection of elevated serum CK and myoglobin levels in critically ill surgical and trauma patients is recommended in order to recognize and treat rhabdomyolysis in timely manner and thus prevent development of AKI. Surgical treatment of traumatic tricuspid insufficiency: Traumatic tricuspid insufficiency TTI is uncommon and surgical experience is limited.
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We report our surgical experience with TTI in 13 patients. From January through March , we operated on 13 patients with TTI 10 men 3 women; mean age, The intervals from trauma to diagnosis and from trauma to surgery averaged At operation, the mechanism of TTI was due to anterior chordal rupture in 8, anterior papillary muscle rupture in 3, rupture of anterior papillary muscle and chordae in 1, and anterior leaflet defect in 1.
In 7 patients the annulus was dilated. Valve repair was successful in 13 patients.
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No early or late deaths occurred. Severe hemolysis occurred in 1 patient after tricuspid and mitral valve repairs. At follow-up extending to 9. Transthoracic echocardiography demonstrated no or trivial residual regurgitation in 7 patients , mild regurgitation in 4, and mild-to-moderate regurgitation in 2. A significant decrease of the right ventricular end-diastolic dimension Satisfactory early and midterm outcomes can be achieved for TTI by tricuspid valve repair.
Early surgical intervention should be emphasized to achieve good functional results and preserve the right ventricular function.
When and why is surgical revascularization indicated for the treatment of moyamoya syndrome in patients with RASopathies? A systematic review of the literature and a single institute experience. Moyamoya disease MMD is a cerebrovascular disorder characterized by the progressive occlusion of the supraclinoid internal carotid artery ICA , resulting in the formation of an abnormal cerebral vascular network.
When MMD occurs in association with an underlying medical condition, including some distinctive genetic disorders, it is named moyamoya syndrome MMS. Similarly to patients suffering from MMD, patients with MMS generally become symptomatic because of ischemic complications, which lead to hemiparesis, transient ischemic events, seizures, and sensory symptoms. We retrospectively reviewed 18 RASopathy patients with MMS treated at our institution from to 16 neurofibromatosis type 1, 1 Costello syndrome, and 1 Schimmelpenning syndrome. Here, we report clinical data, performed surgical procedures, and clinic-radiological outcome of these patients.
Most of them received both indirect revascularization and medical therapy. At the moment, there are no univocal recommendations on which of these two treatment strategies is the treatment of choice in patients with RASopathies and MMS. We suggest that patients with a good overall prognosis primarily depending on the distinctive underlying genetic disorder and initial cerebrovascular disease could benefit from a prophylactic surgical revascularization, in order to prevent the cognitive impairment due to the progression of the vasculopathy.
Little is known about the scope of practice and outcomes in pediatric surgery performed by humanitarian organizations in resource-poor settings and conflict zones. This study provides the largest report to date detailing such data for a major nongovernmental organization providing humanitarian surgical relief support in these settings. To characterize pediatric surgical care provision by a major nongovernmental organization in specialized humanitarian settings and conflict zones.
Surgical interventions were primarily for general surgical , traumatic, and obstetric emergencies and were categorized by mechanism, type of intervention, American Society of Anesthesia risk classification, and urgency of intervention.