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Managing Renal Cell Carcinoma Associated Paraneoplastic Syndrome With Nephron-Sparing Surgery In A Patient With Von Hippel-Lindau., John M DiBianco, Julie Y An, Sally Tanakchi, Zachary Stanik, Aidan McGowan, Mahir Maruf, Abhinav Sidana, Amit Lodha Jain, Akhil Muthigi, Arvin K George, Christopher Bayne, W Marston Linehan, Shawna L Boyle, Adam R Metwalli 2017 George Washington University

Managing Renal Cell Carcinoma Associated Paraneoplastic Syndrome With Nephron-Sparing Surgery In A Patient With Von Hippel-Lindau., John M Dibianco, Julie Y An, Sally Tanakchi, Zachary Stanik, Aidan Mcgowan, Mahir Maruf, Abhinav Sidana, Amit Lodha Jain, Akhil Muthigi, Arvin K George, Christopher Bayne, W Marston Linehan, Shawna L Boyle, Adam R Metwalli

Urology Faculty Publications

A patient with germline von Hippel-Lindau (VHL) gene alteration and history of multiple tumors present with classical paraneoplastic syndrome (PNS) associated with renal cell carcinoma (RCC). She underwent open nephron sparing surgery with resolution of symptoms. She remained without recurrence of RCC for the initial 2 years of her follow-up. To the best of our knowledge, this case represents the first in which PNS was specifically resolved using a partial nephrectomy in a patient with VHL. This case report provides initial evidence for the potential role of nephron sparing surgery in the management of paraneoplastic symptoms associated with hereditary RCC.


Arteriovenous Fistula Patency In The 3 Years Following Vonapanitase And Placebo Treatment, Eric K. Peden, Timothy P. O'Connor, Barry J. Browne, Bradley S. Dixon, Andres Schanzer, Stephen C. Jensik, Albert D. Sam 2nd, Steven K. Burke 2017 Houston Methodist Hospital

Arteriovenous Fistula Patency In The 3 Years Following Vonapanitase And Placebo Treatment, Eric K. Peden, Timothy P. O'Connor, Barry J. Browne, Bradley S. Dixon, Andres Schanzer, Stephen C. Jensik, Albert D. Sam 2nd, Steven K. Burke

Andres Schanzer

OBJECTIVE: This study explored the long-term outcomes of arteriovenous fistulas treated with vonapanitase (recombinant human elastase) at the time of surgical creation.

METHODS: This was a randomized, double-blind, placebo-controlled trial of 151 patients undergoing radiocephalic or brachiocephalic arteriovenous fistula creation who were randomized equally to placebo, vonapanitase 10 mug, or vonapanitase 30 mug. The results after 1 year of follow-up were previously reported. The current analysis occurred when the last patient treated was observed for 3 years. For the current analysis, the primary end point was primary patency; the secondary end points included secondary patency, use of the fistula for ...


Decreasing Cost In The Gi Endoscopy Suite By Utilizing Best Sedation Practices, Casey Brianne Mancini 2017 University of Southern Mississippi

Decreasing Cost In The Gi Endoscopy Suite By Utilizing Best Sedation Practices, Casey Brianne Mancini

Doctoral Nursing Capstone Projects

Colorectal cancer is a leading cause of cancer death in the United States (Mandel, Tanner, Lichtenstein, Metz, Katzka, Ginsberg, & Kochman, 2008; Siegel, DeSantis, & Jemal, 2014). Because this lethal disease claims lives of many people every year, more patients are undergoing screening colonoscopies, which have greatly aided in decreasing the number of colorectal cancer deaths (Siegel et al., 2014). The most common form of sedation for colonoscopies is moderate sedation with a benzodiazepine and an opioid (Cohen, Hightower, Wood, Miller, & Aisenberg, 2004; Lera dos Santos, et. al., 2013). However, sedation by anesthesia providers using propofol is becoming more common and may aid in reducing recovery and discharge times from the postoperative anesthesia care unit (PACU) as well as reducing overall costs. A retrospective chart review (N=176; 88 in propofol group and 88 in benzodiazepine and opioid group) was performed to determine if propofol sedation did reduce discharge times and decrease overall costs for the patient. Patients included in this study ...


Comparison Of Enteral Versus Intravenous Potassium Supplementation In Hypokalaemia In Paediatric Patients In Intensive Care Post Cardiac Surgery: Open-Label Randomised Equivalence Trial (Eips), Naveed ur Rehman Siddiqu, Quratulain Merchant, Babar Hasan, Arjumand Rizvi, Muneer M Amanullah, Amina Rehmat,, Anwarul Haque 2017 Aga Khan University

Comparison Of Enteral Versus Intravenous Potassium Supplementation In Hypokalaemia In Paediatric Patients In Intensive Care Post Cardiac Surgery: Open-Label Randomised Equivalence Trial (Eips), Naveed Ur Rehman Siddiqu, Quratulain Merchant, Babar Hasan, Arjumand Rizvi, Muneer M Amanullah, Amina Rehmat,, Anwarul Haque

Department of Surgery

Abstract

OBJECTIVES:

The primary objective was to compare the efficacy of enteral potassium replacement (EPR) and intravenous potassium replacement (IVPR) as first-line therapy. Secondary objectives included comparison of adverse effects and number of doses required to resolve the episode of hypokalaemia.

TRIAL DESIGN:

The EIPS trial is designed as a randomised, equivalence trial between two treatment arms.

STUDY SETTING:

The study was conducted at the paediatric cardiac intensive care unit (PCICU) at Aga Khan University Hospital, Karachi.

PARTICIPANTS:

41 patients (aged 1 month to 15 years) who were admitted to PCICU post cardiac surgery were recruited (23 IVPR arm and ...


Comparison Of Enteral Versus Intravenous Potassium Supplementation In Hypokalaemia In Paediatric Patients In Intensive Care Post Cardiac Surgery: Open-Label Randomised Equivalence Trial (Eips)., Naveed ur Rehman Siddiqu, Quratulain Merchant, Babar Hasan, Arjumand Rizvi, Muneer M Amanullah, Amina Rehmat, Anwarul Haque 2017 Aga Khan University

Comparison Of Enteral Versus Intravenous Potassium Supplementation In Hypokalaemia In Paediatric Patients In Intensive Care Post Cardiac Surgery: Open-Label Randomised Equivalence Trial (Eips)., Naveed Ur Rehman Siddiqu, Quratulain Merchant, Babar Hasan, Arjumand Rizvi, Muneer M Amanullah, Amina Rehmat, Anwarul Haque

Department of Surgery

Abstract

OBJECTIVES:

The primary objective was to compare the efficacy of enteral potassium replacement (EPR) and intravenous potassium replacement (IVPR) as first-line therapy. Secondary objectives included comparison of adverse effects and number of doses required to resolve the episode of hypokalaemia.

TRIAL DESIGN:

The EIPS trial is designed as a randomised, equivalence trial between two treatment arms.

STUDY SETTING:

The study was conducted at the paediatric cardiac intensive care unit (PCICU) at Aga Khan University Hospital, Karachi.

PARTICIPANTS:

41 patients (aged 1 month to 15 years) who were admitted to PCICU post cardiac surgery were recruited (23 IVPR arm and ...


Angiosarcoma Of The Lower Extremity Presenting As Bilateral Pneumothoraces, Mark H. Cooper 2017 Marshall University, Huntington, WV

Angiosarcoma Of The Lower Extremity Presenting As Bilateral Pneumothoraces, Mark H. Cooper

Marshall Journal of Medicine

Abstract

Spontaneous pneumothorax usually presents as unilateral disease. Bilateral spontaneous pneumothoraces are less common and are more likely to be secondary than primary. We describe a case of bilateral spontaneous pneumothoraces that were resistant to conventional treatment, and found ultimately to be secondary to angiosarcoma of the lower extremity. A previously well 49 year old white female was referred to our institution in London with bilateral pneumothoraces. A left video assisted thoracoscopic procedure was undertaken, and the wedge resection of the lung specimen contained an area of metastatic tumor. Talc was placed into the left pleural cavity; talc was also ...


Generation Of Crispr Knockout Of Idh1 In Pancreatic Ductal Adenocarcinoma Cell Line: An Optimal Model To Study Pancreatic Cancer Metabolic Reprogramming, Katerina Dukleska, MD, Mahsa Zarei, PhD, Ali Vaziri-Gohar, PhD, Charles J. Yeo, MD, Jonathan Brody, MD, Jordan M. Winter, MD 2017 Thomas Jefferson University

Generation Of Crispr Knockout Of Idh1 In Pancreatic Ductal Adenocarcinoma Cell Line: An Optimal Model To Study Pancreatic Cancer Metabolic Reprogramming, Katerina Dukleska, Md, Mahsa Zarei, Phd, Ali Vaziri-Gohar, Phd, Charles J. Yeo, Md, Jonathan Brody, Md, Jordan M. Winter, Md

Department of Surgery Posters

Introduction

• Pancreatic ductal adenocarcinoma (PDA) is the third leading cause of cancer-related death in the US.

• PDA is resistant to conventional chemotherapy; however, mechanisms that contribute to this chemoresistance are not well-described.

• The tumor microenvironment in PDA has a dense stromal reaction, which is thought to result in low oxygen and low nutrient conditions (Feig, C., et al. 2012).

• Isocitrate Dehydrogenase 1 (IDH1) has been identified as an enzyme that plays an important role in chemoresistance in PDA (Zarei, M., et al. In progress).

• We sought to establish an IDH1 knockout cell line to further study its role in PDA ...


S100Β As A Serum Marker In Endocrine Resistant Breast Cancer., Sara Charmsaz, Éamon Hughes, Fiona T. Bane, Paul Tibbitts, Marie McIlroy, Christopher Byrne, Sinéad Cocchiglia, Jean McBryan, Bryan T Hennessy, Róisín M. Dwyer, Michael J. Kerin, Arnold DK Hill, Leonie S. Young 2017 Royal College of Surgeons in Ireland

S100Β As A Serum Marker In Endocrine Resistant Breast Cancer., Sara Charmsaz, Éamon Hughes, Fiona T. Bane, Paul Tibbitts, Marie Mcilroy, Christopher Byrne, Sinéad Cocchiglia, Jean Mcbryan, Bryan T Hennessy, Róisín M. Dwyer, Michael J. Kerin, Arnold Dk Hill, Leonie S. Young

Surgery Articles

BACKGROUND: Endocrine therapy is standard treatment for estrogen receptor (ER)-positive breast cancer. However, its efficacy is limited by intrinsic and acquired resistance. Here the potential of S100β as a biomarker and inhibition of its signaling network as a therapeutic strategy in endocrine treated patients was investigated.

METHODS: The expression of S100β in tissue and serum was assessed by immunohistochemistry and an enzyme-linked immunosorbent assay, respectively. The S100β signaling network was investigated in cell line models of endocrine resistance by western blot, PCR, immunoprecipitation, and chromatin-immunoprecipitation. Endocrine resistant xenografts and tumor explants from patients with resistant tumors were treated with ...


Comparing Mid Lumbar Interbody Fusion (Midlf) With Traditional Posterior Lumbar Interbody Fusion (Plif), Joel T. Phillips 2017 The University of Western Ontario

Comparing Mid Lumbar Interbody Fusion (Midlf) With Traditional Posterior Lumbar Interbody Fusion (Plif), Joel T. Phillips

Electronic Thesis and Dissertation Repository

Mid-lumbar interbody fusion (MIDLF) uses a novel cortical bone trajectory (CBT) screw that provides robust fixation that is less dependent on cancellous bone quality than a traditional pedicle screw. MIDLF also allows for decompression and instrumentation through a smaller central surgical window. The aim of this study is to compare MIDLF with posterior lumbar interbody fusion (PLIF) with regards to perioperative complications, operative time, blood loss, length in hospital, radiographic outcomes and post-operative patient functional scores. A retrospective review of our institutional database was performed of patients undergoing MIDLF. Matched PLIF controls were then selected from the same database for ...


Therapeutic Application Of Carbon Monoxide In Acute Limb Compartment Syndrome, Aurelia Bihari 2017 The University of Western Ontario

Therapeutic Application Of Carbon Monoxide In Acute Limb Compartment Syndrome, Aurelia Bihari

Electronic Thesis and Dissertation Repository

Acute limb compartment syndrome (CS), a devastating complication of musculoskeletal trauma, develops in response to elevation of the pressure within a closed osseofascial compartment, producing muscle- and limb-threatening ischemia. Full decompression of all involved compartments by fasciotomy is the current gold-standard therapy, but it must be performed within a surgical window of 6-8 hours, before tissue damage becomes permanent.

Carbon monoxide (CO), a byproduct of heme metabolism, has been shown protective in ischemia. While inhalation of CO leads to elevation of carboxyhemoglobin (COHb), recent development of transitional metal carbonyls, CO-releasing molecules (CO-RMs), particularly the water-soluble CORM-3, delivers CO in a ...


A Review Of Pain Control In Pediatric Cardiac Bypass Surgery, Pranathi Ari, Andrew T. Waberski, Nina Deutsch 2017 George Washington University

A Review Of Pain Control In Pediatric Cardiac Bypass Surgery, Pranathi Ari, Andrew T. Waberski, Nina Deutsch

GW Research Days 2016 - Present

Background: Children undergoing cardiac surgery with cardiopulmonary bypass receive high dose opioids for analgesia and to reduce the neurohormonal stress response. While opioids have excellent pharmacodynamics profiles adverse effects include: respiratory depression, bradycardia, nausea, vomiting, and tolerance. Additionally, opioids with short half-lives like fentanyl require several boluses to be administered during surgery causing fluctuating levels analgesia. Several strategies to advance pain control incorporate regional and neuraxial anesthetic techniques, however anticoagulation preclude its routine use. Alternatively using opioids with longer half-lives for analgesia may improve pain control and reduce adverse effects.

Objective: The objective of this study is to quantify postoperative ...


Arteriovenous Fistula Patency In The 3 Years Following Vonapanitase And Placebo Treatment, Eric K. Peden, Timothy P. O'Connor, Barry J. Browne, Bradley S. Dixon, Andres Schanzer, Stephen C. Jensik, Albert D. Sam 2nd, Steven K. Burke 2017 Houston Methodist Hospital

Arteriovenous Fistula Patency In The 3 Years Following Vonapanitase And Placebo Treatment, Eric K. Peden, Timothy P. O'Connor, Barry J. Browne, Bradley S. Dixon, Andres Schanzer, Stephen C. Jensik, Albert D. Sam 2nd, Steven K. Burke

Open Access Articles

OBJECTIVE: This study explored the long-term outcomes of arteriovenous fistulas treated with vonapanitase (recombinant human elastase) at the time of surgical creation.

METHODS: This was a randomized, double-blind, placebo-controlled trial of 151 patients undergoing radiocephalic or brachiocephalic arteriovenous fistula creation who were randomized equally to placebo, vonapanitase 10 mug, or vonapanitase 30 mug. The results after 1 year of follow-up were previously reported. The current analysis occurred when the last patient treated was observed for 3 years. For the current analysis, the primary end point was primary patency; the secondary end points included secondary patency, use of the fistula for ...


Unmet Need For Surgery In South Asia., Sanjay Nagral, Maharra Hussain, Sarder A Nayeem, Ranjan Dias, S. Ather Enam 2017 Jaslok Hospital and Research Centre

Unmet Need For Surgery In South Asia., Sanjay Nagral, Maharra Hussain, Sarder A Nayeem, Ranjan Dias, S. Ather Enam

Department of Surgery

No abstract provided.


Effectiveness Of Plain X-Ray In Detection Of Fish And Chicken Bone Foreign Body In Upper Aerodigestive Tract, Talha Ahmed Qureshi, Mohammad Sohail Awan, Muntazir Hussain, Muhammad Wasif 2017 Aga Khan University

Effectiveness Of Plain X-Ray In Detection Of Fish And Chicken Bone Foreign Body In Upper Aerodigestive Tract, Talha Ahmed Qureshi, Mohammad Sohail Awan, Muntazir Hussain, Muhammad Wasif

Department of Surgery

Abstract

OBJECTIVE:

To assess the use of plain film radiology in the detection of fish and chicken bones in the upper aerodigestive tract.

METHODS:

This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised medical charts of patients who had undergone oesophagoscopy for removal of fish and chicken bone from 1990 to 2015.SPSS 19 was used for data analysis.

RESULTS:

Of the 24 patients, foreign body was detected on X-ray in 7(29.2%) and through fibre optic laryngoscopy in 13(54.2%).All the patients underwent surgical intervention for removal of the foreign ...


Extensive Mediastinal Aspergillosis Presenting With Dyspnoea And Cardiac Tamponade Symptoms, Syed F Mustafa, Hamza AR Khan, Saulat H. Fatimi 2017 Aga Khan University

Extensive Mediastinal Aspergillosis Presenting With Dyspnoea And Cardiac Tamponade Symptoms, Syed F Mustafa, Hamza Ar Khan, Saulat H. Fatimi

Department of Surgery

No abstract provided.


Bomb Blast In A Tertiary Care Hospital, The Challenges Faced During Management Of Victims In A Resource Limited Country, Rizwan Sultan, Hasnain Zafar, Umar B, Khabir Ahmed 2017 Aga Khan University

Bomb Blast In A Tertiary Care Hospital, The Challenges Faced During Management Of Victims In A Resource Limited Country, Rizwan Sultan, Hasnain Zafar, Umar B, Khabir Ahmed

Department of Surgery

Abstract Introduction: A bomb blast in a hospital results in a many fold increase in the casualties. The affected health care in the region is the next challenge faced by the administration of the city. We discuss the challenges faced after a bomb blast in the civil hospital of Quetta, Pakistan on 8 August 2016. Methods: A retrospective review of the medical records of patients who were transferred by air to the Aga Khan University Hospital Karachi over a period of 86 h after the blast in Quetta. Results: Seventy-five patients were received in three separate waves; those received in ...


Perioperative Steroids For Lumbar Disc Surgery: A Meta-Analysis Of Randomized Controlled Trials., Muhammad Waqas, Hussain Shallwani,, Muhammad Shahzad Shamim, Khabir Ahmed 2017 Aga Khan University

Perioperative Steroids For Lumbar Disc Surgery: A Meta-Analysis Of Randomized Controlled Trials., Muhammad Waqas, Hussain Shallwani,, Muhammad Shahzad Shamim, Khabir Ahmed

Department of Surgery

Abstract

BACKGROUND:

Our review question was "Does perioperative steroids administration, in comparison with other treatments or placebo, improve either postoperative pain control, length of hospital stay, or return to work in patients undergoing lumbar disc surgery?"

METHODS:

We searched PubMed, CINAHL PLUS, and Cochrane databases for randomized control trials (RCTs) studying the role of steroids for lumbar disc surgery. Studies that compared perioperative steroids with other treatments or placebo were included. Study outcomes included postoperative back pain, leg pain, length of hospital stay, and return to work. Data was extracted through a proforma. Means and mean differences were calculated for ...


The Many Guises Of Primary Hyperparathyroidism… An Unchanged Scenario, Tasnim Ahsan, Uzma Erum, K. M. Inam Pal, Rukhshanda Jabeen, Saima Ghaus Qureeshi, Urooj Lal Rehman, Zeenat Banu 2017 Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

The Many Guises Of Primary Hyperparathyroidism… An Unchanged Scenario, Tasnim Ahsan, Uzma Erum, K. M. Inam Pal, Rukhshanda Jabeen, Saima Ghaus Qureeshi, Urooj Lal Rehman, Zeenat Banu

Department of Surgery

Abstract

OBJECTIVE:

To study the causes, characteristics and outcome of treatment of patients with primary hyperparathyroidism.

METHODS:

This retrospective cohort analysis was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with primary hyperparathyroidism between 2004 and 2014. .SPSS 17 was used for data analysis.

RESULTS:

Of the 25 patients,1(4%)was male and 24(96%) were female. The overall mean age was 41.72±15.9 years, with a mean duration of symptoms of 4.1±3.3 years. The mean pre-operative parathyroid hormone level was 879.48±793.51 pg/ml. Skeletal manifestations ...


Appendicular Mass – A Rare Form Of Tuberculosis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mircea Bratucu, Teodora Vladescu, Cristian Balalau 2017 Carol Davila University, Department of Surgery, Bucharest, Romania

Appendicular Mass – A Rare Form Of Tuberculosis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mircea Bratucu, Teodora Vladescu, Cristian Balalau

Journal of Mind and Medical Sciences

Tuberculosis is in the top 10 causes of death worldwide, being one of the most deadly infectious diseases. It is estimated that one of three people from the entire earth population has a latent infection with M tuberculosis. This aerobic bacterium possesses the ability to persist in host tissues for years and to begin replication once immunity declines.

The lungs are most frequent site of infection as the Mycobacterium tuberculosis is carried by aerosol droplets and is commonly transmitted by respiratory route. The second way of transmission is by contaminated food.

Intestinal contamination coexists with pulmonary tuberculosis and only 10 ...


The Prevalence Of High Dysplastic Colonic Adenomatous Polyps In A 3 Year Endoscopic Retrospective Study From A Single Clinical Center, Alexandru C. Septimiu, Cosmin A. Moldovan, Florin D. Ungureanu 2017 Witting Clinical Hospital of Bucharest, Department of surgery

The Prevalence Of High Dysplastic Colonic Adenomatous Polyps In A 3 Year Endoscopic Retrospective Study From A Single Clinical Center, Alexandru C. Septimiu, Cosmin A. Moldovan, Florin D. Ungureanu

Journal of Mind and Medical Sciences

Introduction: Many colon neoplastic tumors come from the malignancy of adenomatous polyps (70%-90%) that were not timely diagnosed in order to be resected. Materials and Methods: We conducted a retrospective study regarding the incidence of adenomatous polyps during 1.000 consecutive colonoscopies performed in our Upper and Lower Digestive Endoscopy Laboratory during a three-year period. Results: During these colonoscopies, some targeted polyps were biopsied or completely removed and the samples had been sent to a complete anatomopathological examination. Taking into consideration the results, the polyps were classified after the histological type and the form of dysplasia, in order to ...


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