Laparoscopic selective esophagogastric devascularization and splenectomy for patients with cirrhotic portal hypertension.
Conclusions: The LSEGDS is a safe and effective procedure for management of cirrhotic portal hypertension, especially in patients with visible paraesophageal veins. PMID: 31118982 [PubMed]
A 50-year-old female with a history of infected left total hip arthroplasty underwent left total hip prosthesis reimplantation. The patient developed massive bleeding intraoperatively, and an emergent angiogram was requested. Pelvic arteriography demonstrated multiple areas of active hemorrhage arising from branches of the left gluteal artery and profunda femoris treated with Gelfoam (Pfizer, Washington, DC) and coil embolization. Despite embolization, the patient remained hemodynamically unstable, requiring a massive transfusion protocol.
A 62-year-old woman with persistent chronic thromboembolic pulmonary hypertension (CTEPH) status after pulmonary thromboendarterectomy presented with worsening exercise capacity and continued dyspnea requiring 3 L O2 at home. Ventilation perfusion scan (Fig 1) demonstrated A high probability of pulmonary embolism. Pulmonary angiography (Fig 2) revealed multifocal subsegmental arterial occlusions and stenoses consistent with CTEPH. Her medications included macitentan, riociguat, and selexipag for CTEPH.
Authors: Niewiński G, Graczyńska A, Morawiec S, Raszeja-Wyszomirska J, Wójcicki M, Zieniewicz K, Główczyńska R, Grąt M Abstract BACKGROUND Orthotopic liver transplantation (OLT) is the standard of care for end-stage liver disease. The Charlson Comorbidity Index (CCI) was originally created to assess the survival rate of patients with chronic diseases, although it was modified and adopted in OLT recipients as CCI-OLT. MATERIAL AND METHODS In total of 248 consecutive liver transplant recipients with viral cirrhosis in 98 (39.5%) patients were included. CCI-OLT was calculated assigning a weight of 3...
Conclusions: The mFI-5 is an independent predictor of postoperative morbidity and mortality in elderly patients undergoing surgery for hip fractures. This clinical tool can be used by hospitals and surgeons to identify high-risk patients, accurately council patients and families with transparency, and guide perioperative care to optimize patient outcomes. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Learn more about the risk factors for thrombosis in patients with SLE and the treatment options for these complications.Rheumatology
CONCLUSION: The combination of temporary balloon occlusion and uterine artery embolization does not seem to promote better hemorrhage control than each procedure performed individually does.
CONCLUSION: Major lung resection has benefited from minimally invasive approaches and fast track to surgery. However, it is important to note the occurrence of new and specific complications related to those news surgical access. PMID: 31208887 [PubMed - as supplied by publisher]
IntroductionAnticoagulant therapy in individuals with cirrhosis is challenging, as their risk of hemorrhage is significant due to concomitant alterations in primary hemostasis, secondary hemostasis and fibrinolysis. For many years, warfarin and heparin (including low molecular weight heparin) were the only treatment options for patients with thrombosis. Since 2010, novel, direct-acting oral anticoagulants (DOAC) that inhibit either thrombin (dabigatran) or factor Xa (e.g., rivaroxaban, apixaban, edoxaban, and betrixaban) are available. These direct-acting oral anticoagulants do not require laboratory monitoring and have mi...