Callahanfry9327
Cardiovascular-related death remains the major cause of mortality in Iran despite significant improvements in its care. In the present study, we report the in-hospital mortality, hospitalization length, and treatment methods for patients with ST-elevation myocardial infarction (STEMI) in Tehran Heart Center (THC).
Records pertaining to patients with STEMI from March 2006 to March 2017 were extracted from the databases of THC. Besides a description of temporal trends, multivariable regression analysis was used to find factors associated with in-hospital mortality.
During the study period, 8,295 patients were admitted with STEMI with a mean age of 60.4 ± 12.5 years. Men accounted for 77.5% of the study population. Hospitalization length declined from 8.4 to 5.2 days, and in-hospital mortality was reduced from 8.0% to 3.9% (both P values < 0.001). In a multivariable model adjusted for age, sex, conventional cardiac risk factors, prior cardiac history, and indices of event severity, primary percutaneous coronary intervention (PCI) (OR 0.280, 95% CI 0.186 to 0.512; P<0.001), coronary artery bypass graft (CABG) surgery (OR 0.482, 95% CI 0.220 to 0.903; P=0.025), and rescue or facilitated PCI (OR 0.420, 95% CI 0.071 to 0.812; P=0.001) were all associated with reduced in-hospital mortality in comparison with medical treatment. Furthermore, primary PCI was a crucial protective factor against prolonged length of hospital stay (OR 0.307, 95% CI 0.266 to 0.594; P<0.001).
In-hospital mortality and hospitalization length were almost halved during the study period, and primary PCI has now replaced thrombolysis in the management of STEMI.
In-hospital mortality and hospitalization length were almost halved during the study period, and primary PCI has now replaced thrombolysis in the management of STEMI.
Miniinvasive approaches are a long-term trend in surgery. Maximum possible quality of life after treatment of rectal cancer is a long-term goal. Adequate radicality of surgery is a long-term necessity. It is sometimes very difficult to fulfill all the above-mentioned requirements in low-level rectal cancer. By applying a multidisciplinary approach in the treatment of mildly advanced stages of low-seated malignant rectal tumor, a treatment procedure resulting in continence preserving can be offered to a selected group of patients meeting the strict indication criteria. We document our results with respect to a small number of patients in several interesting case reports.
We are following up one patient after ideal treatment course achieving downstaging after neoadjuvant treatment, with uncomplicated operation and after operation period and with a long-term complete remission. One patient achieved dehiscence of the rectum suture. After secondary healing we observed a long-term remission. In one patient a res that the manuscript met the ICMJE recommendation for biomedical papers.
According to the worldwide data available, the combination of neoadjuvant chemoradiotherapy and local excision by means of an operative rectoscope is a safe alternative to a resection surgery with total mesorectal excision in T2N0 rectal cancer. However, there is a need of other studies with more patients included, optimally randomized and prospective ones, which will support these claims. Supported by MH CR - DRO (MOÚ, 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. click here The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Carcinoids have been classified according to their embryonic origin in the past and are now categorized and classified as neuroendocrine tumors, including low malignant typical carcinoids, moderate malignant atypical carcinoids, and highly malignant large cell neuroendocrine and small cell carcinomas. A typical carcinoid is a previously used term for the current designation of a grade I neuroendocrine tumor, well differentiated, belonging to a group of rare tumors with a good prognosis with metastasis of less than 15% with a five-year survival of more than 90%, rarely producing serotonin. Even this bio-logically favorable tumor with a relatively low degree of metastasis cannot be underestimated. Case The following section summarizes the classification of neuroendocrine tumors, their dia-gnosis and treatment, and the second section presents a specific case of a patient with multiple metastases of an original lung carcinoid (histology at the time of surgery 2012, at the time of using this older version of neuroendocrine tumors) describing its further treatment. Conclusion In well differentiated neuroendocrine tumors, there is a significant risk of metastasis despite their radical surgery; their dispensarization is therefore necessary. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Ultrasound-guided pectoral nerve block type II is a recently proposed technique for postoperative analgesia after breast cancer surgery. The thoracic paravertebral block is widely used for this purpose by decades. The presented study compares the efficacy of these two techniques for postoperative analgesia.
Sixty adult women were undergoing unilateral radical mastectomy or quadrantectomy with axillary dissection. The patients were randomized to receive either pectoral nerve block with 30ml ropivacaine 0.375% (Pecs group) or thoracic paravertebral block with 20ml ropivacaine 0.5% (TPVB group). The evaluated variables included pain intensity by the numerical rating scale at 0, 2, 4, 6, 12, 18 and the 24 hours, 24-hour postoperative opioid (promedol) and nonopioid (ketoprofen) consumption and the time to first rescue analgesia.
There were no statistically significant differences between both groups in the pain intensity after surgery. Ten (33%) patients from Pecs group and nine (30%) patients from TPVB group did not require any analgesia within the first 24 hours (P = 0.793). The mean postoperative ketoprofen consumption was lower in Pecs group 63.3 (± 66.87) mg vs. 90.0 (± 84.49) mg (Р = 0.283). The number of patients who required promedol was 6 (20%) vs. 8 (27%) in Pecs and TPVB groups, respectively (Р = 0.542). The time to first analgesic request was longer in Pecs group, 550 (400.0-600.0) min vs. 510 (360.0-600.0) min (Р = 0.506) in TPVB group.
In breast cancer surgery, the pectoral nerve block type II with ropivacaine 0.375% can provide postoperative analgesia that is comparable to the single-level thoracic paravertebral block.
In breast cancer surgery, the pectoral nerve block type II with ropivacaine 0.375% can provide postoperative analgesia that is comparable to the single-level thoracic paravertebral block.
