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Experimental and Therapeutic Medicine Aug 2024The incidence of eye metastasis from primary malignant tumors is low. Predominantly, these primary malignant tumors consist of breast and lung carcinoma. Ocular...
The incidence of eye metastasis from primary malignant tumors is low. Predominantly, these primary malignant tumors consist of breast and lung carcinoma. Ocular metastatic carcinoma is often clinically overlooked. In clinical practice, it is rare for small-cell lung carcinoma (SCLC) to metastasize to the right eye. Early detection and treatment via the monitoring of clinical symptoms and auxiliary examinations of the eye are of great significance in preserving the patient's vision and improving their quality of life. Such treatments include radiotherapy or enucleation of the eyeball. A 54-year-old male patient with SCLC experienced a decline in vision and blurred vision during his systemic treatment using combined enverolumab and etoposide and cisplatin. Upon examination, including fundus photography, ocular B-scan and magnetic resonance imaging, a right eye metastasis was suspected. Within a short period of time, the patient experienced significant pain and blindness in the right eye, which required surgical removal of the right eyeball. Postoperative pathology confirmed metastasis. After six cycles of treatment, the primary lesion in the lung reduced in size. By reporting this case of SCLC metastasis to the right eye, we aim to provide a reference for the clinical diagnosis and treatment of ocular metastatic carcinoma.
PubMed: 38939177
DOI: 10.3892/etm.2024.12607 -
Przeglad Gastroenterologiczny 2024Haemorrhoidal disease is one of the most common nowadays. It is often associated with a sedentary lifestyle. The leading cause of its development is also a functional...
INTRODUCTION
Haemorrhoidal disease is one of the most common nowadays. It is often associated with a sedentary lifestyle. The leading cause of its development is also a functional disorder of the intestine and chronic constipation. To date, there is a steady growth rate of this disease, leading to its "rejuvenation". The current stage of development indicates the need for further improvement of surgical treatment and optimisation of patient management methods and the creation of uniform standards of care for this contingent of patients.
AIM
To evaluate the clinical effectiveness of the use of platelet-rich plasma therapy and the biologically active substance "ozoyl" in the treatment of haemorrhoidal disease.
MATERIAL AND METHODS
The main group included 100 patients with chronic haemorrhoids who were operated on in the period from March 2021 to March 2022. For this group, autoplasma was used during surgery, and an ozoyl-based drug in the postoperative period. The remaining 100 participants of this study, assigned to the control group, underwent a conventional haemorrhoidectomy operation and standard patient management using a hydrophilic ointment based on chloramphenicol.
RESULTS
After the conducted clinical studies, it was established that in the main group, the pain syndrome decreased by about 30%, considering the period from the first day of the postoperative period compared to the control group. The postoperative wound healed in the main group in the third week after the operation, unlike the control group, in which this event was noted in the fourth week. The patients did not complain during the examination 3 months later.
CONCLUSIONS
This study is of practical significance because haemorrhoidal disease today has a high prevalence, and an integrated approach is required for the treatment of such patients. Ozoyl is a powerful cell and tissue repairer.
PubMed: 38939058
DOI: 10.5114/pg.2024.139517 -
Cureus Jun 2024Solid organ transplant recipients are prone to developing a wide range of complications associated with the procedure itself, as well as with immunosuppressants....
Solid organ transplant recipients are prone to developing a wide range of complications associated with the procedure itself, as well as with immunosuppressants. Guillain-Barré syndrome, which is part of the spectrum of inflammatory neuropathies, is not expected to occur early after organ transplant when immunosuppression is at its highest point. We describe the clinical case of a patient who underwent an urgent liver transplant due to acute liver failure secondary to drug-induced liver injury and developed Guillain-Barré syndrome early after the transplant.
PubMed: 38938905
DOI: 10.7759/cureus.63304 -
Open Veterinary Journal May 2024Fractures with large bone defects and non-unions are a great challenge for veterinary orthopaedists. In small dog breeds, this complication is commonly encountered in...
BACKGROUND
Fractures with large bone defects and non-unions are a great challenge for veterinary orthopaedists. In small dog breeds, this complication is commonly encountered in fractures of the radius and ulna due to poorer vascularisation of the distal antebrachium region.
CASE DESCRIPTION
A case of radius/ulnar non-union in a 1.5-year-old Pinscher occurring after trauma and two successive unsuccessful osteosyntheses is described. During the operative revision, after the removal of existing bone implants, the bone defect was filled with cortical autologous bone graft. Autocancellous bone mixed with erythropoietin was applied proximally and distally to the cortical autograft for stimulation of bone healing. The post-operative period was without complications. As early as the 9th post-operative week, the animal was able to bear weight on the limb, without signs of lameness, pain, and swelling. Radiologically, a very good bridging of the graft was observed. Fifteen weeks after the operative revision, the fracture was completely healed with excellent clinical outcome.
CONCLUSION
The application of autogenous cortical bone graft and cancellous autograft mixed with erythropoietin demonstrated an excellent therapeutic effect and resulted in complete regeneration of the large bone defect over a 15-week period.
Topics: Animals; Dogs; Erythropoietin; Bone Transplantation; Fractures, Ununited; Dog Diseases; Ulna Fractures; Male; Radius Fractures; Female
PubMed: 38938442
DOI: 10.5455/OVJ.2024.v14.i5.25 -
Clinical Implant Dentistry and Related... Jun 2024The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume...
INTRODUCTION
The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect.
MATERIALS AND METHODS
Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery.
RESULTS
A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm) in VCMX and (186.38 ± 57.52) (mm) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups.
CONCLUSION
The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.
PubMed: 38938060
DOI: 10.1111/cid.13353 -
Clinical & Experimental Ophthalmology Jun 2024To evaluate the results of corneal allogenic intrastromal ring segment (CAIRS) implantation in keratoconus.
BACKGROUND
To evaluate the results of corneal allogenic intrastromal ring segment (CAIRS) implantation in keratoconus.
METHODS
The medical records of patients with keratoconus who underwent CAIRS implantation were reviewed. The CAIRS, prepared by trephination from the donor cornea, was implanted into a tunnel created using the femtosecond laser. The depth of the tunnel was 200 μ; the inner diameter of the tunnel was 4.5 mm; and the outer diameter was 7 mm. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry, minimum corneal thickness (CT), endothelial cell density (ECD), and high order aberration values were recorded preoperatively and at the 1st, 3rd, and 6th months postoperatively.
RESULTS
A total of 23 eyes of 23 patients were included in the study. Preoperative UCVA (0.08 ± 0.01) and BCVA (0.25 ± 0. 11) values improved postoperatively and reached 0.40 ± 0.05 and 0.68 ± 0.09, respectively, at the end of the 6-month follow-up period (p < 0.001, p = 0.016; respectively). A statistically significant flattening of all keratometric values was observed in the postoperative period compared to preoperatively (p < 0.001 for all). There were no statistical differences between CT and ECC values at the preoperative and postoperative visits (p = 0.654, p = 0.769; respectively). In addition, coma aberration values were lower than the preoperative values at all postoperative visits (p < 0.05 for all).
CONCLUSIONS
These results suggest that CAIRS implantation is a safe treatment option with good visual and keratometric outcomes for suitable patients with keratoconus.
PubMed: 38938058
DOI: 10.1111/ceo.14411 -
Liver Transplantation : Official... May 2024This study aims to investigate the effects of neuromuscular electrical stimulation (NMES) in addition to conventional early mobilization in the early postoperative...
This study aims to investigate the effects of neuromuscular electrical stimulation (NMES) in addition to conventional early mobilization in the early postoperative period after living donor liver transplantation (LTx) on body composition and physical function. This was a retrospective single-center cohort study. Adult subjects who were admitted for living donor LTx from 2018 to 2023 were included in the analysis. After April 2020, patients underwent 4 weeks of NMES in addition to conventional rehabilitation. The skeletal muscle mass index, body cell mass, and physical function, including the 6-minute walking distance, were assessed before surgery and at discharge, and changes in these outcomes were compared before and after the introduction of NMES. Sixty-one patients were in the NMES group, and 53 patients before the introduction of NMES were in the control group. ANCOVA with etiology, obstructive ventilatory impairment, Child-Pugh classification, and initial body composition value as covariates demonstrated that there was a significantly smaller decline of body cell mass (-2.9±2.7 kg vs. -4.4±2.7 kg, p = 0.01), as well as of the skeletal muscle mass index (-0.78±0.73 kg/m2 vs. -1.29±1.21 kg/m2, p = 0.04), from baseline to discharge in the NMES group than in the control group; thus, the decline after surgery was suppressed in the NMES group. Four weeks of NMES, in addition to conventional rehabilitation in the early period after LTx, may attenuate the deterioration of muscle mass. It is suggested that NMES is an option for developing optimized rehabilitation programs in the acute postoperative period after LTx.
PubMed: 38937941
DOI: 10.1097/LVT.0000000000000408 -
BMC Women's Health Jun 2024Peutz-Jeghers syndrome (PJS) is characterized by the presence of hamartomatous polyps in the gastrointestinal tract and mucocutaneous pigmentation on the lips, oral... (Review)
Review
BACKGROUND
Peutz-Jeghers syndrome (PJS) is characterized by the presence of hamartomatous polyps in the gastrointestinal tract and mucocutaneous pigmentation on the lips, oral mucosa, nose, fingers, and toes. Synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT) refers to the occurrence of multifocal mucinous lesions in at least two sites, including the cervix, uterus, fallopian tubes, and ovaries, in the female genital tract. SMMN-FGT and PJS are rare diseases with a very low incidence, especially when occurring simultaneously.
CASE PRESENTATION
We report a case in which a woman with a large mass on the left ovary underwent a gynecological surgery and was diagnosed with cervical gastric-type adenocarcinoma and mucinous lesions in the endometrium, bilateral fallopian tubes, and ovary, i.e., SMMN-FGT, by postoperative paraffin pathology. The patient sought medical attention for abdominal distension and enlargement. A gynecological ultrasound revealed a multilocular cystic mass in the pelvis, while serum tumor markers were within normal limits, with mildly elevated carbohydrate antigen 199 and carbohydrate antigen 125 levels. Cervical thin-prep cytology test result was negative. The patient had a family history of PJS with black spots on her skin and mucous membranes since the age of 8 years. She underwent multiple partial small bowel resections and gastrointestinal polypectomy owing to intestinal obstruction and intussusception. She underwent left adnexectomy, hysterectomy, right salpingectomy, greater omental resection, appendectomy and right ovary biopsy, and received six courses of adjuvant chemotherapy with Lopressor plus Carboplatin. Genetic testing revealed a heterozygous serine threonine kinase 11 germline mutation and there were no signs of recurrence during the 18-month follow-up period after treatment.
CONCLUSIONS
This is a rare case in which PJS was complicated by SMMN-FGT. Owing to its extreme rarity, there are no guidelines, but reported cases appear to indicate a poor prognosis. We retrospectively reviewed all cases of collisions between PJS and SMMN-FGT and explored the clinical features, pathological characteristics, diagnosis, treatment methods, and prognosis when the two diseases coexisted. The aim is to deepen the clinicians' understanding of this disease for early detection, diagnosis and treatment.
Topics: Humans; Female; Peutz-Jeghers Syndrome; Metaplasia; Genital Neoplasms, Female; Adenocarcinoma, Mucinous; Ovarian Neoplasms; Adult; Uterine Cervical Neoplasms; Neoplasms, Multiple Primary
PubMed: 38937781
DOI: 10.1186/s12905-024-03184-y -
British Journal of Cancer Jun 2024Pancreatoduodenectomy is the only cure for cancers of the pancreas and the periampullary region but has considerable operative complications and uncertain prognosis. Our...
BACKGROUND
Pancreatoduodenectomy is the only cure for cancers of the pancreas and the periampullary region but has considerable operative complications and uncertain prognosis. Our goal was to analyse temporal improvements and provide contemporary population-based benchmarks for outcomes following pancreatoduodenectomy.
METHODS
We empanelled a cohort comprising all patients in Sweden with pancreatic or periampullary cancer treated with pancreatoduodenectomy from 1964 to 2016 and achieved complete follow-up through 2016. We analysed postoperative deaths and disease-specific net survival.
RESULTS
We analysed 5923 patients with cancer of the pancreas (3876), duodenum (444), bile duct (504), or duodenal papilla (963) who underwent classic (3332) or modified (1652) Whipple's procedure or total pancreatectomy (803). Postoperative deaths declined from 17.2% in the 1960s to 1.6% in the contemporary time period (2010-2016). For all four cancer types, median, 1-year and 5-year survival improved substantially over time. Among patients operated between 2010 and 2016, 5-year survival was 29.0% (95% confidence interval (CI): 25.5, 33.0) for pancreatic cancer, 71.2% (95% CI: 62.9, 80.5) for duodenal cancer, 30.8% (95% CI: 23.0, 41.3) for bile duct cancer, and 62.7% (95% CI: 55.5, 70.8) for duodenal papilla cancer.
CONCLUSION
There is a continuous and substantial improvement in the benefit-harm ratio after pancreatoduodenectomy for cancer.
PubMed: 38937622
DOI: 10.1038/s41416-024-02757-w -
European Spine Journal : Official... Jun 2024Parkinson's Disease (PD) patients represent challenging spinal surgery candidates due to associated frailty and deformity. This study consolidates the literature... (Review)
Review
BACKGROUND
Parkinson's Disease (PD) patients represent challenging spinal surgery candidates due to associated frailty and deformity. This study consolidates the literature concerning spinal surgery outcomes in PD versus non-PD patients, to evaluate if PD predisposes patients to worse post-operative outcomes, so that treatment protocols can be optimised.
METHODS
A systematic review and meta-analysis was conducted of PubMed/Medline, Embase, and Google Scholar databases per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies of interest included comparative (PD versus non-PD) cohorts undergoing spinal instrumented fusions. Post-operative clinical outcomes were collated and compared for significance between cohorts. Further analysis was made on outcomes based on the different surgical procedures performed (Anterior Cervical Discectomy and Fusion (ACDF), Thoracolumbar or Lumbar fusions, Thoracolumbar or Lumbar fusions without Osteoporotic Vertebral Compression fracture (OVCF) patients). All statistical analysis was performed using The R Project for Statistical Computing (version 4.1.2), with a p-value of < 0.05 deemed statistically significant.
RESULTS
In total, 2,323,650 patients were included across 16 studies. Of those, 2,308,949 (99.37%) were patients without PD (non-PD), while 14,701 (0.63%) patients had PD at time of surgery. The collective mean age was 68.23 years (PD: 70.14 years vs non-PD: 64.86 years). Comparatively, there were 844,641 males (PD: 4,574; non-PD: 840,067) and 959,908 females (PD: 3,213; non-PD: 956,695). Overall, there were more post-operative complications in the PD cohort. Specifically, PD patients experienced significantly more surgical site infections (p = 0.01), increased rates of revision surgeries (p = 0.04) and increased venous thromboembolic events (p = 0.02) versus the non-PD cohort. In thoracolumbar/lumbar spinal fusions without OVCF patients, the PD cohort had increased rates of revision surgeries (p < 0.01) in comparison to the non-PD cohort. However, when including OVCF patients in thoracolumbar/lumbar spinal fusions, the PD cohort had significantly higher amounts of postoperative complications (p = 0.01), pneumonia (p = 0.02), and revision surgeries (p < 0.01) when compared to the non-PD cohort.
CONCLUSION
Although more robust prospective studies are needed, the results of this study highlight the need for advanced wound care management in the postoperative period, both in-hospital and in the community, in addition to comprehensive multidisciplinary care from allied health professionals, with potential for the use of Enhanced Recovery After Surgery (ERAS) protocols in PD patients undergoing spinal instrumented fusions.
PubMed: 38937352
DOI: 10.1007/s00586-024-08307-5