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Mortality rates are lower in SIAD,than in hypervolaemic or hypovolaemic hyponatraemia: Results of a prospective observational study 下载免费PDF全文
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Sanjeev Singh Himanshu Pratap Saket Agarwal Aditya Singh Deepak Kumar Satsangi 《Indian Journal of Thoracic and Cardiovascular Surgery》2011,27(2):76-82
Background
The decision to preserve the pulmonary valve during intracardiac repair of Tetralogy of Fallot [TOF] is traditionally based on the intra-operative measurement of pulmonary annulus by a Hegar dilator as per Rowlatt’s table. We sought to evaluate if there can be flexibility in not using a transannular patch repair in Indian population with mildly hypoplastic pulmonary annulus. 相似文献5.
Neuroendocrine tumors (NETs) of the gastrointestinal tract and pancreas are slow-growing but commonly advanced malignancies
with increasing incidence and prevalence. While locoregional disease can be effectively managed with resection, treatment
of recurrent, progressive or metastatic disease has until recently been limited to palliative embolization and cytoreducitve
surgery, with cytotoxic chemotherapeutic agents being the last resort. However, novel molecular targeted therapies inhibiting
malignant cell proliferation and neoangiogenesis, as well as new cytotoxic chemotherapy drugs and somatostatin analogues,
are all being investigated for their potential use in advanced neuroendocrine tumors. Long-acting release forms of octreotide
have been shown to not only improve symptoms in carcinoid syndrome but to also delay progression of gastrointestinal NETs.
On the other hand, phase III trials have demonstrated everolimus (with octreotide) and sunitinib to increase progression-free
survival in pancreatic NETs. Use of bevacizumab has also shown promise in a phase II study, and results of an ongoing phase
III trial comparing it to interferon are eagerly expected. Use of radiolabeled somatostatin analogues is still under investigation,
though several phase II studies are encouraging. New cytotoxic agents, most notably temozolomide and capecitabine, are already
in use, but their relative effectiveness compared to streptozocin in pancreatic NETs is yet to be determined. 相似文献
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We describe a new technique wherein we have used the Ionescu Ross Wooler stent for housing the pulmonary autograft. We believe that this technique is easy and reproducible and offers many advantages over the previously described techniques. 相似文献
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Mohit Girotra Vivek Kumar Javaid M. Khan Pamela Damisse Rtika R. Abraham Vikas Aggarwal Sudhir K. Dutta 《Saudi Journal Of Gastroenterology》2012,18(2):133-139
Background/Aim:
Clostridium difficile infection (CDI) can affect up to 8% of hospitalized patients. Twenty-five percent CDI patients may develop C. difficile associated diarrhea (CDAD) and 1–3% may progress to fulminant C. difficile colitis (FCDC). Once developed, FCDC has higher rates of complications and mortality.Patients and Methods:
A 10-year retrospective review of FCDC patients who underwent colectomy was performed and compared with randomly selected age- and sex-matched non-fulminant CDAD patients at our institution. FCDC (n=18) and CDAD (n=49) groups were defined clinically, radiologically, and pathologically. Univariate analysis was performed using Chi-square and Student''s t test followed by multivariate logistic regression to compute independent predictors.Results:
FCDC patients were significantly older (77 ± 13 years), presented with triad of abdominal pain (89%), diarrhea (72%), and distention (39%); 28% had prior CDI and had greater hemodynamic instability. In contrast, CDAD patients were comparatively younger (65 ± 20 years), presented with only 1 or 2 of these 3 symptoms and only 5% had prior CDI. No significant difference was noted between the 2 groups in terms of comorbid conditions, use of antibiotics, or proton pump inhibitor. Leukocytosis was significantly higher in FCDC patients (18.6 ± 15.8/mm3 vs 10.7 ± 5.2/mm3; P=0.04) and further increased until the point of surgery. Use of antiperistaltic medications was higher in FCDC than CDAD group (56% vs 22%; P=0.01).Conclusions:
Our data suggest several clinical and laboratory features in CDI patients, which may be indicative of FCDC. These include old age (>70 years), prior CDI, clinical triad of increasing abdominal pain, distention and diarrhea, profound leukocytosis (>18,000/mm3), hemodynamic instability, and use of antiperistaltic medications. 相似文献8.
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Saket Singh MS MCh Julia F. Chen MD Roland Assi MD Naiem Nassiri MD Prashanth Vallabhajosyula MD MS 《Journal of cardiac surgery》2020,35(12):3578-3580
We report an emergent complex hybrid repair of a type A intramural hematoma with a tear of the aortic arch at the site of Kommerell's diverticulum and an aberrant right subclavian artery. We identified a type IA endoleak intraoperatively, which was managed immediately with proximal extension. Performing this operation in the hybrid operating room facilitated optimal surgical management. 相似文献