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[PMID]:29362796
[Au] Autor:Bouillon K; Bertrand M; Bader G; Lucot JP; Dray-Spira R; Zureik M
[Ad] Endereço:Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France.
[Ti] Título:Association of Hysteroscopic vs Laparoscopic Sterilization With Procedural, Gynecological, and Medical Outcomes.
[So] Source:JAMA;319(4):375-387, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Safety of hysteroscopic sterilization has been recently questioned following reports of general symptoms such as allergy, tiredness, and depression in addition to associated gynecological results such as pelvic pain, perforation of fallopian tubes or uterus, and unwanted pregnancy. Objective: To compare the risk of reported adverse events between hysteroscopic and laparoscopic sterilization. Design, Setting, and Participants: French nationwide cohort study using the national hospital discharge database linked to the health insurance claims database. Women aged 30 to 54 years receiving a first hysteroscopic or laparoscopic sterilization between 2010 and 2014 were included and were followed up through December 2015. Exposures: Hysteroscopic sterilization vs laparoscopic sterilization. Main Outcomes and Measures: Risks of procedural complications (surgical and medical) and of gynecological (sterilization failure that includes salpingectomy, second sterilization procedure, or pregnancy; pregnancy; reoperation) and medical outcomes (all types of allergy; autoimmune diseases; thyroid disorder; use of analgesics, antimigraines, antidepressants, benzodiazepines; outpatient visits; sickness absence; suicide attempts; death) that occurred within 1 and 3 years after sterilization were compared using inverse probability of treatment-weighted Cox models. Results: Of the 105 357 women included (95.5% of eligible participants; mean age, 41.3 years [SD, 3.7 years]), 71 303 (67.7% ) underwent hysteroscopic sterilization, and 34 054 (32.3%) underwent laparoscopic sterilization. During the hospitalization for sterilization, risk of surgical complications for hysteroscopic sterilization was lower: 0.13% for hysteroscopic sterilization vs 0.78% for laparoscopic sterilization (adjusted risk difference [RD], -0.64; 95% CI, -0.67 to -0.60) and was lower for medical complications: 0.06% vs 0.11% (adjusted RD, -0.05; 95% CI, -0.08 to -0.01). During the first year after sterilization, 4.83% of women who underwent hysteroscopic sterilization had a higher risk of sterilization failure than the 0.69% who underwent laparoscopic sterilization (adjusted hazard ratio [HR], 7.11; 95% CI, 5.92 to 8.54; adjusted RD, 4.23 per 100 person-years; 95% CI, 3.40 to 5.22). Additionally, 5.65% of women who underwent hysteroscopic sterilization required gynecological reoperation vs 1.76% of women who underwent laparoscopic sterilization (adjusted HR, 3.26; 95% CI, 2.90 to 3.67; adjusted RD, 4.63 per 100 person-years; 95% CI, 3.38 to 4.75); these differences persisted after 3 years, although attenuated. Hysteroscopic sterilization was associated with a lower risk of pregnancy within the first year of the procedure but was not significantly associated with a difference in risk of pregnancy by the third year (adjusted HR, 1.04; 95% CI, 0.83-1.30; adjusted RD, 0.01 per 100 person-years; 95% CI, -0.04 to 0.07). Risks of medical outcomes were not significantly increased with hysteroscopic sterilization compared with laparoscopic sterilization. Conclusions and Relevance: Among women undergoing first sterilization, the use of hysteroscopic sterilization was significantly associated with higher risk of gynecological complications over 1 year and over 3 years than was laparoscopic sterilization. Risk of medical outcomes was not significantly increased over 1 year or over 3 years. These findings do not support increased medical risks associated with hysteroscopic sterilization.
[Mh] Termos MeSH primário: Histeroscopia/efeitos adversos
Laparoscopia/efeitos adversos
Complicações Pós-Operatórias/etiologia
Esterilização Tubária/métodos
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
França
Seres Humanos
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Gravidez
Gravidez não Planejada
Reoperação/estatística & dados numéricos
Esterilização Tubária/efeitos adversos
Falha de Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21269


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[PMID]:29499664
[Au] Autor:Kim WJ; Kim MM
[Ad] Endereço:Department of Ophthalmology, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, 42415, South Korea.
[Ti] Título:The fast exodrift after the first surgical treatment of exotropia and its correlation with surgical outcome of second surgery.
[So] Source:BMC Ophthalmol;18(1):67, 2018 Mar 02.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To compare the rate of exodrift after a second surgery for recurrent exotropia, in patients grouped to fast versus slow exodrift after their first surgery. To determine whether there is a correlation with surgical outcome, and to evaluate the factors associated with fast exodrift. METHODS: Patients with recurrent intermittent exotropia, who underwent contralateral lateral rectus recession and medial rectus resection as the second surgery and were followed up for 24 months postoperatively between January 1991 and January 2013, were reviewed retrospectively. The patients were divided into two groups according to the rate of exodrift after the first surgery: Group F, patients exhibiting fast exodrift after the first surgery (> 10 prism diopters [PD] before postoperative month 6); and Group S, patients exhibiting slow exodrift after the first surgery (≤10 PD before postoperative month 6). The difference in the clinical course over the 24 months after the second surgery between the two groups and factors associated with fast exodrift were analyzed. RESULTS: In total, 106 patients with recurrent exotropia were enrolled in this study. Of these, 68 (64.2%) and 38 (35.8%) patients were included in group F and S, respectively. Group F showed more exodrift compared with groups S over the 24-month postoperative period; however, there was no significant difference in the clinical course between the two groups during that time (p = 0.54, repeated-measure ANOVA). In logistic analysis, immediate postoperative deviation after the first surgery was associated with fast exodrift (p <  0.001). CONCLUSION: Although patients with recurrent exotropia had shown fast exodrift after the first surgery, no significant difference in the surgical outcome was observed after the second surgery according to the rate of exodrift after the first surgery.
[Mh] Termos MeSH primário: Exotropia/cirurgia
Músculos Oculomotores/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Exotropia/diagnóstico
Exotropia/fisiopatologia
Movimentos Oculares/fisiologia
Feminino
Seguimentos
Seres Humanos
Masculino
Músculos Oculomotores/fisiopatologia
Procedimentos Cirúrgicos Oftalmológicos
Prognóstico
Recidiva
Reoperação
Estudos Retrospectivos
Visão Binocular/fisiologia
Acuidade Visual
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180304
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0722-5


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[PMID]:29384600
[Au] Autor:Kondov S; Siepe M; Beyersdorf F; von Samson-Himmelstjern P; Czerny M
[Ad] Endereço:Department of Cardiovascular Surgery, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Germany.
[Ti] Título:Thoracoabdominal aortic replacement with a bovine pericardial tube graft for aortobronchial fistulation 10 years after TEVAR.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Dec 20.
[Is] ISSN:1813-9175
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Aortobronchial fistula after thoracic endovascular aortic repair is usually a late complication. It is associated with high mortality and its surgical management is technically challenging. This tutorial illustrates the steps involved in removing an infected stent graft and replacing it with a bovine pericardial tube graft.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Doenças da Aorta/cirurgia
Implante de Prótese Vascular/efeitos adversos
Fístula Brônquica/cirurgia
Infecções Relacionadas à Prótese/cirurgia
Fístula Vascular/cirurgia
[Mh] Termos MeSH secundário: Animais
Doenças da Aorta/etiologia
Bioprótese
Prótese Vascular/efeitos adversos
Fístula Brônquica/etiologia
Bovinos
Remoção de Dispositivo
Procedimentos Endovasculares/efeitos adversos
Seres Humanos
Pericárdio/transplante
Infecções Relacionadas à Prótese/etiologia
Reoperação
Stents/efeitos adversos
Fístula Vascular/etiologia
[Pt] Tipo de publicação:VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.027


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[PMID]:27773869
[Au] Autor:Doose C; Kütting M; Egron S; Farhadi Ghalati P; Schmitz C; Utzenrath M; Sedaghat A; Fujita B; Schmitz-Rode T; Ensminger S; Steinseifer U
[Ad] Endereço:Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz-Institute Aachen, RWTH Aachen University, Aachen, Germany.
[Ti] Título:Valve-in-valve outcome: design impact of a pre-existing bioprosthesis on the hydrodynamics of an Edwards Sapien XT valve.
[So] Source:Eur J Cardiothorac Surg;51(3):562-570, 2017 03 01.
[Is] ISSN:1873-734X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Objectives: Bioprosthetic aortic heart valves are increasingly implanted in younger patients. Therefore, a strategy for potential valve failure should be developed before implanting the 'first valve'. The goal of this in vitro study was to provide insight into the effects of the design of a bioprosthesis on a valve-in-valve implanted Sapien XT valve. Methods: The hydrodynamic performance of a 23-mm Sapien XT valve implanted in Vascutek Aspire, Edwards Perimount, Medtronic Mosaic and St. Jude Medical Trifecta heart valves was investigated in a left heart simulator. In addition to the hydrodynamic results, the leaflet dynamics were analysed in high-speed video recordings of the tests. Results: All valve-in-valve combinations in this study fulfilled the minimum acceptance criteria defined by relevant approval standards (e.g. ISO 5840) but displayed significant differences in their performances. Small inner diameters of the bioprostheses were associated with increased mean pressure gradients, decreased effective orifice areas and geometric opening areas as well as with pin-wheeling and uneven leaflet motion. In addition, implantation in bioprostheses with internally mounted leaflets was associated with lower paravalvular leakage. Conclusions: The results of this study suggest that a surgical bioprosthesis with a large inner diameter and internally mounted leaflets improves the heamodynamics and potentially the durability of a valve-in-valve combination. These results should give the attending physicians critical information to consider when deciding on a bioprosthesis for younger patients.
[Mh] Termos MeSH primário: Valva Aórtica/cirurgia
Bioprótese
Implante de Prótese de Valva Cardíaca/métodos
Próteses Valvulares Cardíacas
[Mh] Termos MeSH secundário: Valva Aórtica/fisiopatologia
Seres Humanos
Hidrodinâmica
Desenho de Prótese
Falha de Prótese
Reoperação/instrumentação
Reoperação/métodos
Resultado do Tratamento
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1093/ejcts/ezw317


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[PMID]:29486746
[Au] Autor:Rosentreter A; Lappas A; Widder RA; Alnawaiseh M; Dietlein TS
[Ad] Endereço:Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. andre.rosentreter@googlemail.com.
[Ti] Título:Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices.
[So] Source:BMC Ophthalmol;18(1):60, 2018 Feb 27.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. RESULT: Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. CONCLUSIONS: Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.
[Mh] Termos MeSH primário: Colágeno/uso terapêutico
Túnica Conjuntiva/lesões
Túnica Conjuntiva/cirurgia
Implantes para Drenagem de Glaucoma/efeitos adversos
Glaucoma/cirurgia
Glicosaminoglicanos/uso terapêutico
Procedimentos Cirúrgicos Oftalmológicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Feminino
Seres Humanos
Pressão Intraocular
Masculino
Meia-Idade
Complicações Pós-Operatórias/cirurgia
Reoperação
Estudos Retrospectivos
Esclera/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycosaminoglycans); 9007-34-5 (Collagen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0721-6


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[PMID]:29403334
[Au] Autor:Clark J; Randolph J; Sokol JA; Moore NA; Lee HBH; Nunery WR
[Ad] Endereço:Department of Ophthalmology and Visual Sciences, Kentucky Lions Eye Center, University of Louisville, Louisville, Kentucky.
[Ti] Título:Surgical approach to limiting skin contracture following protractor myectomy for essential blepharospasm.
[So] Source:Digit J Ophthalmol;23(4):8-12, 2017.
[Is] ISSN:1542-8958
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To report our experience with protractor myectomy in patients with benign essential blepharospasm who did not respond to serial botulinum toxin injection, and to describe intra- and postoperative techniques that limited skin contracture while also providing excellent functional and cosmetic results. Methods: The medical records of patients with isolated, benign, essential blepharospasm who underwent protractor myectomy from 2005 to 2008 by a single surgeon were reviewed retrospectively. The technique entailed operating on a single eyelid during each procedure, using a complete en bloc resection of all orbicularis tissue, leaving all eyelid skin intact at the time of surgery, and placing the lid under stretch with Frost suture and applying a pressure dressing for 5-7 days. Results: Data from 28 eyelids in 7 patients were included. Average follow-up was 21.5 months (range, 4-76 months). Of the 28 eyelids, 20 (71.4%) showed postoperative resolution of spasm, with no further need for botulinum toxin injections. In the 8 eyelids requiring further injections, the average time to injection after surgery was 194 days (range, 78-323 days), and the average number of injections was 12 (range, 2-23 injections). All but one eyelid had excellent cosmetic results, without signs of contracture; one eyelid developed postoperative skin contracture following premature removal of the Frost suture and pressure dressing because of concerns over increased intraocular pressure. Conclusions: In our patient cohort, this modified technique resulted in excellent cosmetic and functional results and limited postoperative skin contracture.
[Mh] Termos MeSH primário: Blefarospasmo/cirurgia
Contratura/cirurgia
Pálpebras/cirurgia
Músculos Oculomotores/cirurgia
Procedimentos Cirúrgicos Oftalmológicos/métodos
Complicações Pós-Operatórias/cirurgia
Dermatopatias/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Contratura/diagnóstico
Contratura/etiologia
Pálpebras/patologia
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Reoperação
Estudos Retrospectivos
Pele/patologia
Dermatopatias/diagnóstico
Dermatopatias/etiologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE
[do] DOI:10.5693/djo.01.2016.11.001


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[PMID]:27779562
[Au] Autor:Dumon T; Wegner I; Sperling N; Grolman W
[Ad] Endereço:*Jean Causse Ear Clinic, Colombiers, France †Department of Otorhinolaryngology-Head and Neck Surgery ‡Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands §Department of Clinical Otolaryngology, Weill Cornell Medical College, New York, New York.
[Ti] Título:Implantation of Bone-Anchored Hearing Devices Through a Minimal Skin Punch Incision Versus the Epidermal Flap Technique.
[So] Source:Otol Neurotol;38(1):89-96, 2017 01.
[Is] ISSN:1537-4505
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the minimal skin punch incision without additional skin incision or soft tissue reduction with the epidermal flap technique and soft tissue reduction, for the implantation of percutaneous bone-anchored hearing devices. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary care referral center. SUBJECTS AND METHODS: Two hundred seventeen patients underwent 220 implantations. Sixty five cases underwent implantation by means of a skin punch resection without soft tissue reduction (punch group) and 155 cases underwent epidermal flap and soft tissue reduction (dermatome group). Main outcome measures were duration of surgery, perioperative adverse events, skin tolerance, and revision surgery. RESULTS: The duration of surgery was shorter in the punch group (p < 0.001). The percentage of normal to moderate skin reactions, by Holgers classification, was higher in the punch group (90%) than in the dermatome group (84%). No severe reactions occurred in the punch group, but did occur in 7% in the dermatome group. These differences, although clinically important, did not reach statistical significance (p = 0.071). The rate of revision surgeries was not significantly different between the two groups. The indication for revision was different: mainly for skin issues in the dermatome group, against implant dislocation in the punch group. CONCLUSION: The implantation of the currently available percutaneous bone-anchored hearing implants with a minimal skin punch resection shortened duration of surgery and improved postoperative appearance, while preserving a good skin tolerance. In the punch group, there were less skin issues leading to revision surgery, however we did observe more implant dislocations needing revision surgery.
[Mh] Termos MeSH primário: Auxiliares de Audição
Procedimentos Cirúrgicos Otológicos/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Período Pós-Operatório
Estudos Prospectivos
Reoperação
Retalhos Cirúrgicos
Âncoras de Sutura
Centros de Atenção Terciária
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29480862
[Au] Autor:Yao BZ; Li L; Jiang M; Wang J; Zhang J
[Ti] Título:Refractory chyle leakage after laparoscopic cholecystectomy for gallstone disease: A case report and literature review.
[So] Source:Medicine (Baltimore);97(2):e9604, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Gallstone disease is commonly worldwide and safely treated by laparoscopic cholecystectomy. Chylous ascites is a rare but serious complication of many abdominal operations. PATIENT CONCERNS: We present a rare case of refractory chyle leakage post-LC for acute cholecystitis that is successfully treated in a 40-year-old man, and review current literature on the prevalence, diagnosis, and management of this complication. DIAGNOSES: Refractory chyle leakage post-LC, a rare but serious complication after laparoscopic cholecystectomy. INTERVENTIONS: Conservative treatment was given initially; however, the outcome was frustrating. Surgical intervention was given without further delay. OUTCOMES: After the reoperation, conservative treatment was still maintained. After nearly 8 months of treatment, the patient recovered and then was discharged. LESSONS: This case represents a previously unreported complication of refractory and high flow chyle leakage after laparoscopic cholecystectomy, which did not improve alter conservative management with dietary changes and other measures. So we suggest that surgical intervention should be given for refractory cases without further delay. It can not only shorten the disease progression, but also alleviate the sufferings of the patient.
[Mh] Termos MeSH primário: Colecistectomia Laparoscópica/efeitos adversos
Colecistite Aguda/cirurgia
Quilo
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Adulto
Tratamento Conservador
Drenagem
Cálculos Biliares/cirurgia
Seres Humanos
Masculino
Reoperação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009604


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[PMID]:29310612
[Au] Autor:Song YJ; Kim S; Yoon GJ
[Ad] Endereço:Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea.
[Ti] Título:Impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment: a case report.
[So] Source:BMC Ophthalmol;18(1):4, 2018 Jan 08.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To report a case of impending extrusion of Ex-PRESS shunt treated by shunt-position adjustment. CASE PRESENTATION: A 56-year-old Asian woman presented with impending extrusion and malposition of Ex-PRESS shunt in her left eye. The bleb of the left eye was shallow and diffuse. In the past, the patient was treated by Ex-PRESS shunt implantation under the scleral flap in both eyes. There had been no Ex-PRESS shunt-related complication in her right eye, and she reported no history of left-eye trauma. Based on these findings, we hypothesized that the source of the left-eye problem was a loosely fixed Ex-PRESS shunt spur. It was thought, furthermore, that this inadequate scleral resistance during the Ex-PRESS shunt implantation was due to the low scleral rigidity resulting from high myopia and insufficient maintenance of the anterior chamber. We proceeded to make an incision in the area adjacent to the Ex-PRESS shunt using a super sharp blade. The shunt was then pushed into the anterior chamber with forceps, and the spur was fixed firmly. Pushing the shunt to the anterior chamber was found to have been sufficient to fix it firmly. In fact, when the sclera was palpated with a sponge, aqueous outflow was observed with no shunt displacement. Postoperative intraocular pressure (IOP) was managed well, and the bleb had formed with diffuse, prominent shapes. The Ex-PRESS shunt was well sustained with good positioning. CONCLUSIONS: When an Ex-PRESS shunt operation is performed on a patient who shows a tendency for low scleral rigidity, shunt implantation should be accomplished carefully and with force adequate for firm spur fixation.
[Mh] Termos MeSH primário: Implantes para Drenagem de Glaucoma/efeitos adversos
Glaucoma/cirurgia
Pressão Intraocular/fisiologia
Esclera/cirurgia
Retalhos Cirúrgicos
Trabeculectomia/métodos
[Mh] Termos MeSH secundário: Câmara Anterior
Feminino
Glaucoma/fisiopatologia
Seres Humanos
Meia-Idade
Período Pós-Operatório
Falha de Prótese
Reoperação
Tonometria Ocular
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-017-0665-2


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[PMID]:29300074
[Au] Autor:Schneider A; Klautz RJM; Hazekamp M
[Ad] Endereço:Department of Cardiothoracic Surgery Leiden University Medical Center Leiden, The Netherlands.
[Ti] Título:The Ross reimplantation technique.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Sep 25.
[Is] ISSN:1813-9175
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Pulmonary autograft replacement of a diseased aortic valve (the Ross procedure) is effective in children, where growth is essential, and in young patients for whom a biological solution is preferred. Long-term outcomes are generally good. However eventual autograft dilatation may necessitate reoperation. In order to diminish the risk of autograft dilatation, several 'wrapping' techniques have been developed. Here, we present our technique of choice: the reimplantation of the pulmonary autograft in a vascular tube graft, scalloping the sinuses of Valsalva. This leaves no bulky tissue inside the vascular tube graft and makes autograft dilatation impossible.
[Mh] Termos MeSH primário: Valva Aórtica/cirurgia
Implante de Prótese de Valva Cardíaca/métodos
[Mh] Termos MeSH secundário: Bioprótese
Implante de Prótese Vascular
Seres Humanos
Reoperação
Reimplante
Seio Aórtico/cirurgia
Transplante Autólogo
[Pt] Tipo de publicação:VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.019



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