1,721,109 research outputs found
Replication Data for: "Foreign Debt, Capital Controls, and Secondary Markets: Theory and Evidence from Nazi Germany"
No full textThis is the replication package for "Foreign Debt, Capital Controls, and Secondary Markets: Theory and Evidence from Nazi Germany," accepted in 2023 by the Journal of Political Economy.</i
The impact of obesity on surgery in gynecological oncology: a review.
No full textSurgery represents a mainstay in the treatment of gynecological cancers. It is a
common belief that operating on obese patients causes more peri- and
postoperative complications than operating on nonobese patients. The surgical
outcome in gynecological oncology can be evaluated by comparing intra- and
postoperative complications, extent of lymphadenectomy, negativity of the
specimens' margins, and percentage of optimal debulking between obese and
nonobese patients affected by malignancies at the same stage. In this review, we
analyze how obesity affects the feasibility of a correct oncologic procedure in
case of cervical, endometrial, and ovarian cancer. We also describe the
techniques that have been suggested in the literature to improve the surgical
outcome on obese patients
Extended field-of-view and three-dimensional ultrasound imaging of siliconebreast implant lesions.
No full textUterine sarcoma occurring in a premenopausal patient after uterine arteryembolization: a case report and review of the literature.
No full textObjective: We report a case of uterine leiomyosarcoma occurring after uterine artery embolization and review the previously published cases. We estimate the incidence of sarcoma after UAE, the mean diagnostic delay in young women undergoing this procedure and review the potential and limits of preoperative procedures in diagnosing uterine sarcomas. Case report: A 35-year-old woman had an early failure after UAE. She underwent surgery 13 months after the procedure. Final pathologic report was consistent with uterine leiomyosarcoma. Conclusion: Incidence of uterine sarcomas after UAE is low, probably similar to that of misdiagnosed leiomyosarcomas in women undergoing surgery for presumed symptomatic leiomyomas. Therefore a relation between the procedure and the malignancy seems to be very unlikely. Diagnostic delay in menstruated women younger than 50 undergoing UAE for presumed symptomatic leiomyoma ranges between 13 and 15 months. The safest procedure for women who fail the conservative management of leiomyoma with UAE is surgical, allowing for definitive pathologic exclusion of malignancy
Extensive fever workup produces low yield in determining infectious etiology.
No full textOBJECTIVE: The study was undertaken to evaluate the use of a fever workup in
women undergoing benign gynecologic procedures.
STUDY DESIGN: A retrospective chart review was performed at Jackson Memorial
Hospital between 1994 and 2000. Information was abstracted from hospital and
clinic records. Fever criteria was defined as 1 temperature equal to or greater
than 101.5, or 2 equal to or greater than 100.4, at least 4 hours apart within a
24-hour period. Patients undergoing additional intraoperative procedures leading
to increased febrile morbidity were excluded. Data abstracted included patient
demographics, procedure, complications, antibiotic use, and extent of fever
workup. Statistical analysis used was 2-sample t tests, Wilcoxon rank test, chi2
test, and multivariate logistic regression. Alpha level = .05.
RESULTS: The charts of 505 patients were reviewed, and 147 patients met fever
criteria. All patients underwent surgery for benign conditions, abdominal
hysterectomy being the most common (90%). The study population was divided into 2
groups: the noninfectious group and infectious group. These groups were
determined by wound infection, pelvic abscess, blood or urine culture,
ultrasound, and chest roentgen. Both groups were found to be similar with respect
to demographics, surgical procedures, and postoperative complications, with the
exception of body mass index (28.4 vs 31.7) and length of hospital stay (3.9 vs
5.3). Results from fever workups included positive results blood cultures (9.7%),
urine culture (18.8%), and chest roentgens (14%) in this study population. We
found no association between positive urine analysis and urine culture. When
comparing both groups, a statistically significant difference was found with
regard to maximum temperature elevation, number of days febrile, and
postoperative day of maximum temperature (P < .05).
CONCLUSION: The extensive fever workup was not frequently positive in this study
population. Its use and cost-effectiveness should be questioned. Therefore, the
fever workup should be tailored to the individual patient
Laparoscopic pelvic and paraaortic lymphadenectomy in gynecologic oncology.
No full textIn the early 1990s, different authors independently developed techniques for
pelvic and paraaortic lymph node sampling. Since then, laparoscopic
lymphadenectomy has been demonstrated to yield the same number of nodes when
compared with the laparotomic approach. Only one microscopically involved lymph
node was lost at laparoscopic lymphadenectomy when a laparotomic control followed
immediately after. It seems bleeding, which is the most serious perioperative
complication, is more common during laparoscopic lymphadenectomy than during
laparotomy; however, the incidence will decrease with experience of the surgeon.
The laparoscopic procedure does not seem to influence negatively the survival of
patients with early stage endometrial and cervical cancer. There does not seem to
be a significant reduction in overall hospital charges for laparoscopic surgery
in oncology, but patients who undergo laparoscopic surgery recover significantly
sooner than those who undergo laparotomy
Sentinel lymph node mapping in endometrial cancer: comparison of fluorescence dye with traditional radiocolloid and blue
Full text linkSentinel lymph node (SLN) mapping in endometrial cancer (EMCA) is rapidly gaining acceptance in the clinical community. As compared to a full lymphadenectomy in every patient, to a selective lymphadenectomy after frozen section of uterus in selected patients with intrauterine risk factors or to a strategy in which a lymphadenectomy is always omitted, SLN mapping seems to be a reasonable and oncologically safe middle ground. Various protocols can be used when applying an SLN mapping. In this manuscript we review the characteristics, toxicity and clinical impact of technetium-99m radiocolloid (Tc-99m), of the blue dyes (methylene blue, isosulfan blue and patent blue) and of indocyanine green (ICG). ICG has an excellent toxicity profile, has higher overall and bilateral detection rates as compared to blue dyes and higher bilateral detection rates as compared to a combination of Tc-99m and blue dye. The detrimental effect of BMI on the detection rates is attenuated when ICG is used as a tracer. The ease of use of the ICG SLN mapping is perceived by the patients as a better quality of care delivered. Whenever possible, ICG should be favored over the other tracers for SLN mapping in EMCA patients
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