Thoracoscopic diaphragm plication

2020 ◽  
Keyword(s):  
Quality Of Life ◽  
Surgical Approaches ◽  
Minimally Invasive Techniques ◽  
Respiratory Compromise ◽  
Video Tutorial ◽  
The Past ◽  
Huge Impact ◽  
Invasive Techniques ◽  
Thoracoscopic Technique

Diaphragmatic paralysis with subsequent eventration and respiratory compromise has a huge impact on the quality of life of affected patients. Many different surgical approaches for correcting this problem have been described in the past, using both transabdominal and transthoracic pathways. Either way, since the procedure in general requires suturing of the diaphragm, minimally invasive techniques have only been adopted very slowly and most thoracic surgeons nowadays still use a minithoracotomy, even when adopting a video-assisted approach. We have developed a safe and simple completely thoracoscopic technique for diaphragmatic plication, and in this video tutorial we demonstrate our technique.

Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

2019 ◽  
Vol 18 (6) ◽  
pp. 606-613
Author(s):  
Rafael A Vega ◽  
Jeffrey I Traylor ◽  
Ahmed Habib ◽  
Laurence D Rhines ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Minimally Invasive ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Thoracic Vertebrae ◽  
Minimally Invasive Techniques ◽  
Invasive Approach ◽  
Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

scholarly journals Advances in the Endoscopic Management of Obesity

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Jason Behary ◽  
Vivek Kumbhari
Keyword(s):  
Bariatric Surgery ◽  
Minimally Invasive ◽  
Mortality Rates ◽  
Endoscopic Management ◽  
Obese Patients ◽  
Minimally Invasive Techniques ◽  
Substantial Cost ◽  
The Past ◽  
Invasive Techniques

Obesity has become a worldwide epidemic with significant impact on quality of life, morbidity, and mortality rates. Over the past two decades, bariatric surgery has established itself as the most effective and durable treatment for patients with obesity and its associated comorbidities. However, despite the use of minimally invasive techniques, bariatric surgery is associated with complications in approximately 15% of patients, has a substantial cost, and is used by only 1% of patients who are eligible. Therefore, there is a need for effective minimally invasive therapies, which will be utilized by the large proportion of obese patients who are in desperate need of treatment but are not receiving any. Endoscopic approaches to the management of obesity have been developed, with the aim of delivering more effective, durable, and safer methods of weight reduction. In this paper, we review currently available and future endoscopic therapies that will likely join the armamentarium used in the management of obesity.

Chronic Pain After Cardiac Surgery

2019 ◽  
pp. 166-171
Author(s):  
Jennette D. Hansen ◽  
Mark A. Chaney
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Cardiac Surgery ◽  
Acute Pain ◽  
Multimodal Analgesia ◽  
Minimally Invasive Techniques ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Invasive Techniques

Chronic pain after cardiac surgery can impair quality of life and rehabilitation. Chronic pain is difficult to study, and depending on how patients are questioned, the incidence of chronic pain after sternotomy is between 17% and 56%, and chronic pain after thoracotomy is between 15% and 80%. Several risk factors are independent predictors for the development of chronic pain. In recent years, minimally invasive techniques have been utilized in cardiac surgery patients to potentially minimize pain and to decrease length of stay in the hospital. At this point in time, no single regimen has been proven superior at preventing chronic pain. An aim to treat acute pain without delaying extubation has been the recent focus of pain management, with research in neuraxial and peripheral nerve blocks. In addition, multimodal analgesia is key for treatment of acute pain to allow patients to deep breathe, cough, and ambulate comfortably without respiratory depression. Some believe treatment of acute pain leads to less development of chronic pain; however, this has not yet been definitively proven.

scholarly journals Avaliação da eficácia da microabrasão no tratamento de manchas de fluorose: revisão de literatura

2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Pedro Paulo Aguiar Santos Cavalcanti ◽  
Maria Eduarda Arruda de Lucena ◽  
Hian Carvalho Souza ◽  
Eloiza Leonardo de Melo ◽  
Jéssica Meirinhos Miranda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Dental Fluorosis ◽  
Minimally Invasive Techniques ◽  
Health Related Quality ◽  
Porto Alegre ◽  
Related Quality ◽  
Health Related ◽  
Belo Horizonte ◽  
Invasive Techniques

Introdução: A fluorose dentária é uma patologia que afeta os elementos dentários sendo desencadeada pela presença em excesso de fluoreto, e manifestando-se ao nível do esmalte dentário na forma de manchas e/ou defeitos anatómicos. Objetivo: Avaliar a eficácia da microabrasão no tratamento da fluorose e verificar a aplicabilidade desta técnica nos dias atuais, ratificando a importância da microabrasão como um tratamento estético minimamente invasivo. Materiais e Métodos: Foram realizadas buscas nas bases de dados Google Acadêmico, Scielo e PubMed/MEDLINE através da inserção dos termos “Enamel Microabrasion AND Fluorosis Dental”. Os critérios de inclusão foram: Casos clínicos, publicados de 2015 à 2019, escritos na língua portuguesa, espanhola e inglesa. Os critérios de exclusão foram os artigos que não estavam nas bases de dados pré-definidas, artigos que não possuíam textos disponibilizados na íntegra e artigos em outras línguas das que foram definidas. Os dados foram extraídos e tabelados e posteriormente foi realizada a análise qualitativa dos dados. Resultados: Foram identificados 1.411 artigos nas bases de dados, sendo 1330 na base Google Acadêmico, 2 na base scielo, 79 na base PubMed/MEDLINE e foram excluídos 946 artigos de acordo com os critérios de inclusão e exclusão. Conclusão: Apesar de diminuir a espessura do esmalte, a microabrasão como técnica para o tratamento permite a resolução de problemas estéticos de maneira minimamente invasiva, com alto grau de satisfação pelos pacientes e pelos profissionais e ainda com baixo custo. Além disso, favorece os pacientes por trazer resultados imediatos e permanentes com mínima e imperceptível perda de esmalte.Descritores: Fluorose Dentária; Microabrasão do Esmalte; Esmalte Dentário.ReferênciasHermes SR. Microabrasão do esmalte dental para tratamento de fluorose. RGO Rev gaúch odontol. 2013; 61(supl 1):427-33.Prado Júnior RR, Ribeiro RC, Brito AC, Lopes TSP. Microabrasão como tratamento de esmalte fluorótico. RGO Porto Alegre. 2008;56(2):21-6.Chankanka O, Levy SM, Warren JJ, Chalmers JM. A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol. 2010; 38(2):97-109.Calixto LR, Galafassi G, Alves MR, Mandarino F. Tratamento de manchas dentais: Clareamento e Microabrasão. Caderno Científico, Estética. 2007:20-2.Agostini M. Fluorose Dentária: uma revisão de literatura [monografia]. Belo Horizonte: Universidade Federal de Minas Gerais, Curso de Especialização em Atenção Básica em Saúde da Família; 2011.Bağlar S, Çolak H, Hamidi MM · Novel microabrasion paste. J Esthet Restor Dent. 2015; 27(5):258-66.Di Giovanni T, Eliades T, Papageorgiou SN. Interventions for dental fluorosis: A systematic review. J Esthet Restor Dent. 2018;30(6):502-8.Gupta A, Dhingra R, Chaudhuri P, Gupta A. A comparison of various minimally invasive techniques for the removal of dental fluorosis stains in children. J Indian Soc Pedod Prev Dent. 2017;35(3):260-68.Meireles SS, Goettems ML, Castro KS, Sampaio FC, Demarco FF. Dental fluorosis treatment can improve the individuals’ OHRQoL? Results from a randomized clinical trial. Braz Dent J. 2018;29(2):109-16.Oliveira LMX, Novaes Junior JB, Barreiros ID, Paiva SM, Martins CC. Tratamento de fluorose dentária moderada com a técnica de microabrasão de esmalte com ácido clorídrico 6% e carbeto de silício: relato de caso clínico. Arq Odontol. 2014;50(3):142-48.Pini NI, Sundfeld-Neto D, Aguiar FH, Sundfeld  RH, Martins LRM, Lovadino JR et al. Enamel microabrasion: An overview of clinical and scientific considerations. World J Clin Cases. 2015;3(1):34-41.Pinto MM, Guedes CC, Motta LJ, Bussadori SK. Alternativa estética para manchas de fluoroseempregando técnicas de microabrasão e clareamento em adolescents. Rev assoc paul cir dent. 2009;63(2):130-33.Mendonça AAM, Ponciano ACR, Fregonesi F, Porto CLA, Campos EA. Microabrasão como alternativa estética – relato de caso clínico. JBC j. bras. clin. odontol. Integr. 2006;10(54):200-3.Sundfeld RH, Komatsu J, Russo M, Holland Junior C, Castro MAM, Quintella LPAS et al. Remoção de manchas no esmalte dental: estudo clínico e microscópico. Rev bras odontol. 1990;47(3):29-34.

Exercise Capacity in Chronic Heart Failure

2012 ◽  
Vol 9 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Gina G Mentzer ◽  
Alex J Auseon
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Exercise Capacity ◽  
Positive Impact ◽  
Pharmacologic Therapy ◽  
The Past ◽  
Diagnosis And Prognosis ◽  
Future Therapy

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

scholarly journals Family reported outcomes, an unmet need in the management of a patient's disease: appraisal of the literature

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
R. Shah ◽  
F. M. Ali ◽  
A. Y. Finlay ◽  
M. S. Salek
Keyword(s):  
Quality Of Life ◽  
Family Members ◽  
Unmet Need ◽  
Reliability And Validity ◽  
Chronic Health Condition ◽  
Family Quality Of Life ◽  
Good Reliability ◽  
Huge Impact ◽  
The Impact

Abstract Background A person’s chronic health condition or disability can have a huge impact on the quality of life (QoL) of the whole family, but this important impact is often ignored. This literature review aims to understand the impact of patients' disease on family members across all medical specialities, and appraise existing generic and disease-specific family quality of life (QoL) measures. Methods The databases Medline, EMBASE, CINHAL, ASSIA, PsycINFO and Scopus were searched for original articles in English measuring the impact of health conditions on patients' family members/partner using a valid instrument. Results Of 114 articles screened, 86 met the inclusion criteria. They explored the impact of a relative's disease on 14,661 family members, mostly 'parents' or 'mothers', using 50 different instruments across 18 specialities including neurology, oncology and dermatology, in 33 countries including the USA, China and Australia. These studies revealed a huge impact of patients' illness on family members. An appraisal of family QoL instruments identified 48 instruments, 42 disease/speciality specific and six generic measures. Five of the six generics are aimed at carers of children, people with disability or restricted to chronic disease. The only generic instrument that measures the impact of any condition on family members across all specialities is the Family Reported Outcome Measure (FROM-16). Although most instruments demonstrated good reliability and validity, only 11 reported responsiveness and only one reported the minimal clinically important difference. Conclusions Family members' QoL is greatly impacted by a relative's condition. To support family members, there is a need for a generic tool that offers flexibility and brevity for use in clinical settings across all areas of medicine. FROM-16 could be the tool of choice, provided its robustness is demonstrated with further validation of its psychometric properties.

Different Types of Auricular Keloids and Treatment by Intralesional Cryosurgery: Best Practice for Obtaining Long-Lasting Clinical Results

Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Yaron Har-Shai ◽  
Lior Har-Shai ◽  
Viktor A. Zouboulis ◽  
Christos C. Zouboulis
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Recurrence Rate ◽  
Best Practice ◽  
Clinical Results ◽  
Psychosocial Impact ◽  
Aesthetic Outcome ◽  
The Past ◽  
Different Types

<b><i>Background:</i></b> Auricular keloids belong to the most perplexing medical conditions, which have significant psychosocial impact on the patient’s body image and quality of life. <b><i>Summary:</i></b> The article is purposed to provide dermatologists and plastic surgeons with the best proven practice using intralesional cryosurgery for the treatment of the different auricular keloid types in order to obtain superior clinical results by minimizing the probability of recurrence. In the past 20 years, the authors have developed novel procedures in order to increase the effectiveness of intralesional cryosurgery on auricular keloids, including hydrodissection, warm gauze technique, and excision of dangling skin. Long-lasting clinical results with a low recurrence rate and a satisfactory aesthetic outcome are achieved with no deformation of the ear framework.

FC 113UTILITY OF A SINGLE ITCH-RELATED QUESTION AND THE SKINDEX-10 QUESTIONNAIRE FOR ASSESSING PRURITUS AND PREDICTING HEALTH RELATED QUALITY OF LIFE IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Marcelo Lopes ◽  
Angelo Karaboyas ◽  
Kazuhiko Tsuruya ◽  
Issa Al Salmi ◽  
Nidhi Sukul ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Predictive Power ◽  
Related Question ◽  
Health Related Quality ◽  
The Past ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
Single Question

Abstract Background and Aims Chronic kidney disease-associated pruritus (CKD-aP) has been linked with comorbid conditions, and poorer mental and physical health-related quality-of-life (HR-QOL) in hemodialysis (HD) patients. The Skindex-10 questionnaire and a single itch-related question from the KDQOL-36 have been used to evaluate the impact of pruritus in HD patients. In this analysis, we investigated the performance of the single question and the Skindex-10 as predictors of HR-QOL in HD patients. Method We analyzed data from 4940 HD patients from 17 countries enrolled during year 2 of phase 5 of the Dialysis Outcomes and Practice Patterns Study (DOPPS, 2013): Belgium, Canada, Germany, the Gulf Cooperation Council (GCC) (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates), Italy, Japan, Russia, Spain, Sweden, Turkey, the UK, and the US. The Skindex-10 scores were calculated as per Mathur et al. (2010): responses to each of the 10 questions (0-6 scale), pertaining to how often patients were bothered by itchy skin in the past week, were summed to create a total summary score (range 0-60, with 0 indicating not at all bothered) and 3 subdomain scores [i.e., itching (disease) and its impact on mood/emotional and social functioning]. The itch-related single question from the KDQOL-36 asked: “During the past 4 weeks, to what extent were you bothered by itchy skin?” with response options including “not at all, somewhat, moderately, very much, extremely”. Itch-related measures were collected concurrently with HR-QOL measures: Physical (PCS) and Mental (MCS) Component Summary scores, derived from the SF-12. We calculated the Spearman correlation coefficient between the Skindex-10 (total score and for each of its 3 domains) and the single question. We used separate linear regression models to evaluate the predictive power of 1) the Skindex-10 score, 2) the single itch question, and 3) both, on PCS and MCS outcomes, based on R-squared values. Results Skindex-10 scores varied across countries; the proportion of patients with a very high Skindex-10 score (≥50) ranged from 12% in the GCC to only 2% in Italy, Russia and Sweden. Across all countries, 55% had a Skindex-10 score=0. For the single pruritus question, 37% answered that they were not at all bothered while 16% were very much or extremely bothered by itchy skin. The correlation between the single question and Skindex-10 was 0.71 overall, 0.72 for the disease domain, 0.62 for the social domain, and 0.70 for the emotional domain. Patient characteristics were similar across categories of both pruritus measures. Regression analyses showed that every 10 points higher in the Skindex-10 score was associated with 1.2 point lower PCS (95% CI: -1.4, -0.9) and 1.5 point lower MCS (95% CI: -1.7, -1.3) scores. Similarly, the single question showed increasingly poorer PCS and MCS scores with a greater degree of being bothered by pruritus: compared with patients not at all bothered by itchy skin, patients who were moderately bothered had 4.8 point lower PCS (-5.7, -3.9) and 4.3 point lower MCS (-5.3, -3.3) scores. The R-squared for PCS was 0.065 when using the single question and only 0.033 when using the Skindex-10 as the predictor. R-squared was also higher for MCS when using the single question (0.056) vs. Skindex-10 (0.052). When including both pruritus measures, the predictive power for PCS did not improve compared to the single question (R2=0.065), while increasing only slightly (R2=0.063) for MCS. Conclusion The single KDQOL-36 question about the extent bothered by itchy skin over the past 4 weeks was highly correlated with the Skindex-10 score and at least as predictive – if not more – of key HR-QOL measures as the Skindex-10. In daily clinical practice, utilizing 1 simple question about the extent patients are bothered by itchy skin can be a feasible and efficient way for routine assessment of pruritus to better identify HD patients with not only CKD-aP but also poorer HR-QoL.

scholarly journals Total Joint Replacement in the Past Does Not Relate to a Deteriorated Functional Level and Health Status in the Oldest Old

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Wiebe Chr. Verra ◽  
Anton J. M. de Craen ◽  
Coen C. M. M. Jaspars ◽  
Jacobijn Gussekloo ◽  
Gerard Jan Blauw ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Daily Living ◽  
Total Joint Replacement ◽  
Oldest Old ◽  
Hip Pain ◽  
Joint Function ◽  
Joint Replacements ◽  
The Past ◽  
Health Related

Total hip or knee replacement is effective in improving joint function, quality of life, and pain reduction. The oldest old population with joint replacements (TJR) is underrepresented in current literature. We compared health-related and functional characteristics of oldest olds with and without TJR. Participants (aged 85 years) were divided into a group with and without TJR. Comorbidity, physical and joint functioning, daily living activities, quality of life, and mortality were recorded. Thirty-eight of 599 participants (6.3%) received a TJR in the past. Participants with a TJR had slightly less comorbidities, walked slower (P=0.006), and complained more about hip-pain (P=0.007). Mortality of those with a TJR was lower during the first 8-year followup (P=0.04). All other characteristics were comparable between groups. We conclude that subjects with a TJR performed equally well, besides showing a lower gait speed and a higher frequency of hip-pain. Except for the lower gaitspeed, having a TJR is not associated with poorer health.

Sign in / Sign up

Export Citation Format

Share Document