43 research outputs found
Perioperative outcome of left atrial appendage amputation in coronary artery bypass grafting.
No full textGercek M, Skuljevic T, Borgermann J, Gummert J, Gercek M. Perioperative outcome of left atrial appendage amputation in coronary artery bypass grafting. Clinical research in cardiology : official journal of the German Cardiac Society. 2024.BACKGROUND: Left atrial appendage (LAA) amputation performed alongside cardiac surgery has become an increasingly established procedure to reduce stroke risk in patients with atrial fibrillation. As the recommendation levels for LAA amputation continue to rise, ample evidence assessing its perioperative safety and risk factors is of utmost interest.; METHODS: All patients who underwent isolated coronary artery bypass grafting (CABG) between 2018 and 2021 at two high-volume centers were retrospectively included in the study. Patients were divided into two groups-the CABG and CABG+LAA groups-based on whether they underwent concomitant LAA amputation. Propensity score matching (PS matching) was applied to ensure comparability between the groups. The primary endpoint was defined as a composite outcome comprising of all-cause mortality, stroke, and reoperation. Secondary endpoints included the components of the primary endpoint, perioperative outcome parameters, transfusion rates, and laboratory parameters.; RESULTS: A total of 3904 patients were included with 3038 and 866 in the CABG and CABG+LAA group, respectively. After PS matching each group consisted of 856 patients. The primary endpoint showed no significant differences between the CABG and CABG+LAA group (7.0% vs. 6.5% (OR 0.9 95% CI [0.64; 1.35], p=0.70)). Similarly, there were no notable differences in the individual components of the composite endpoint: all-cause mortality (p=0.84), stroke (p=0.74), and reoperation (p=0.50). Subgroup results did not show any relevant dissimilarity.; CONCLUSION: The concomitant performance of LAA amputation is not associated with worse in-hospital outcomes, as measured by the composite endpoint of all-cause mortality, stroke, and reoperation. © 2024. The Author(s)
Determination of Skin Cancer Types with Deep Learning Methods and Patient Management
No full textNot Availabl
Acute Dependency Reaction to Meperidine: A case report
No full textPostoperative discitis is a rare and painful complication that may emerge following spine procedures. We present a 34-year-old male patient with postoperative discitis who had been addicted to meperidine during pain relief. Three weeks after routine lumbar discectomy, this patient presented with clinical findings and radiographic imaging consistent with discitis. Meperidine, rate of administration was 1 mg/kg three times a day, was prescribed for his low back pain. After two weeks of opioid therapy an iatrogenic meperidine addiction occurred. Opioid analgesics are helpful for excessive painful conditions as a discitis. Although this case showed us we should be careful when we prescribe opioids
Percutaneous endoscopic gastrostomy in the neurosurgical intensive care unit: Complications and outcome
No full textBackground: Even with a functioning gastrointestinal tract, it is not always easy to initiate oral feeding in some neurosurgical patients because of their persistently depressed neurologic status or severe lower cranial nerve palsies. Percutaneous endoscopic gastrostomy (PEG) may be required for long-term feeding in these patients. The purpose of the present study is to report our experience with PEG chosen for establishing an enteral route in patients of neurosurgical intensive care unit (ICU). Methods: The outcome and complications of PEG in neurosurgical ICU patients of Marmara University Institute of Neurological Science between January 2001 and November 2006 were retrospectively evaluated. Results: Thirty-one patients, with the median age of 51 years (range, 14-78 years) underwent PEG placement. PEG was placed before the craniotomy in 2 patients and after in 29. Indications for PEG were absent gag reflex in 10 patients and low Glasgow Coma Scale score in 2 1. Before the PEG tube insertion, 18 patients had enteral nutrition by a nasogastric tube and 10 had parenteral nutrition (PN), with a median duration of 14.5 (range, 4-60) and 12 (range, 7-25) days, respectively. Two patients accidentally pulled out the gastrostomy tubes 10 and 11 days after insertion. Buried bumper syndrome developed in 1 patient. Two patients died 8 and 34 days after the procedure in the neurosurgical ICU. Twenty-nine patients were discharged from the hospital while being fed via the PEG tubes. In 11 patients who were able to resume oral feeding, the tube was removed, with a median interval of 62 (range, 25-150) days. Procedure-related mortality, 30-day mortality, and overall mortality of the patients were 0%, 6.4%, and 45%, respectively. Conclusion: PEG is a safe and well-tolerated gastrostomy method for neurosurgical ICU patients with depressed neurologic state or severe lower cranial nerve palsies
Outcomes for combined anterior and posterior surgical approaches for patients with multisegmental cervical spondylotic myelopathy
No full textCorpectomy is widely used to treat cervical spondylotic myelopathy (CSM). However, when this technique alone is performed at 1 or 2 levels for a multisegmental involvement (3 or more vertebrae), the incidence of post-operative complications is high. The optimal treatment for multisegmental CSM is still debatable. The aim of this study was to assess clinical and radiological outcomes for patients with multisegmental CSM who underwent combined anterior and posterior (AP) surgical approaches. Forty adults (17 women and 23 men; age range, 41-76 y) treated at our center between 2004 and 2007 were reviewed retrospectively. Their neurological function was assessed at different times using the Nurick classification (Grades 0 [root symptoms only] to 5 [wheelchair- or bed-bound]). Patients' satisfaction with the surgery was evaluated using Odom's criteria (poor, fair, good, or excellent). Pre-operatively, 20% of patients were assessed as Nurick Grade 0, 60% as Grade 1, and 20% as Grade 2. At the 1-year follow-up, only 10% of patients were assessed as Grade 1. At 1 year after surgery, 85% of patients rated their satisfaction with the operation as excellent and 15% rated it as good. These outcomes suggest that, when surgery is indicated and patients with multisegmental CSM are carefully selected, the combined AP approach yields symptom relief comparable to that of corpectomy alone and a lower incidence of post-operative complications. Crown Copyright (C) 2008 Published by Elsevier Ltd. All rights reserved
Komünist Çin Dönemi Uygur Şiiri Üzerine
No full textCağdas Uygur Siiri, Cağdas Uygur Edebiyatının onemli bir bolumunu teskil etmektedir.
XX. yuz yılın baslarında cağdas Uygur siiri, Uygur halkının mucadelesini,
isyanını ve arzu isteklerini konu ederek, gercek hayatın aynası olmustur. Bu
donemde siir, en cok yazılan edebi tur olma ozelliği tasır. Komunist parti yonetimi
devrinde ve Kultur Devrimi sırasında, bu ozellik devam eder. Fakat farklı
donemde islenen konu, farklılık gostermektedir. 1980 sonrası ise cağdas Uygur siirine
genc yetenekler katılmıs, siirlerin seviyesinde, anlatım tarzında, sekillerinde
ve konusunda buyuk gelisme yasanmıstır. Bu makalede Cin komunist donemi
Uygur siirinin kayda değer ozellikleri, orneklerle acıklanmıstı
Tumoral Calcinosis and Epidural Lipomatosis of the Lumbar Spine
No full textLumbar spinal tumoral calcinosis and spinal epidural lipomatosis are rare conditions. We present a 70-year-old female patient with serology negative spondyloarthropathy who developed paresis due to tumoral calcinosis in the left facet joint between L5 and S1 levels and spinal epidural lipomatosis at L5 and Si levels. Surgery was performed to excise the lesions en bloc. Neural decompression was provided. Neurological symptoms improved after surgery. Here, we report the first serology negative spondyloarthropathy case that had concomitant development of tumoral calcinosis and spinal epidural lipomatosis
