To improve the quality of life of patients suffering from spinal cord injury, "Catheterizable cecostomy" operation have recently been carried out. In the procedure, cathetelizable stoma is opened and patients are able to control the excretion by injecting enema solution through the stoma. Although operations are usually performed under general anesthesia with tracheal intubation, special considerations sometimes need to be taken for airway management. In such cases, we select spinal anesthesia. Because the surgery is achieved on a fixed charge, efficiency of pre-operative assessment should be done for the cost-cutting with shortening of perioperative period. Diseases including hypertension, diabetes mellitus, etc., must be controlled before admission to the hospital. With these considerations, proper pre-operative assessment can be made.
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J Clin Med
December 2024
Section Cochlear Implantation, Department of Otorhinolaryngology, University Hospital of Munich (LMU), 81377 Munich, Germany.
: Before a cochlear implant is considered, patients undergo various audiological tests to assess their suitability. One key test measures the auditory brainstem response (ABR) to acoustic stimuli. However, in some cases, even with maximum sound stimulation, no response is detected.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan 33382, Taiwan.
Contrast-enhanced mammography (CEM) uses intermittent dual-energy (low- and high-energy) exposures to produce low-energy mammograms and recombine enhanced images after the administration of iodized contrast medium, which provides more detailed information to detect breast cancers by using the features of morphology and abnormal uptake. In this article, we reviewed the literature to clarify the clinical applications of CEM, including (1) the fundamentals of CEM: the technique, radiation exposure, and image interpretation; (2) its clinical uses for cancer diagnosis, including problem-solving, palpable mass, suspicious microcalcification, architecture distortion, screening, and CEM-guided biopsy; and (3) the concerns of surgical oncology in pre-operative and neoadjuvant chemotherapy assessments. CEM undoubtedly plays an important role in clinical practice.
View Article and Find Full Text PDFJ Pediatr (Rio J)
January 2025
Department of General Surgery and Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China. Electronic address:
Objective: This study aimed to develop a predictive model using a random forest algorithm to determine the likelihood of postoperative adhesive small bowel obstruction (ASBO) in infants under 3 months with intestinal malrotation.
Methods: A machine learning model was used to predict postoperative adhesive small bowel obstruction using comprehensive clinical data extracted from 107 patients with a follow-up of at least 24 months. The Boruta algorithm was used for selecting clinical features, and nested cross-validation tuned and selected hyper-parameters for the random forest model.
Anaesthesia
January 2025
Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Bron, France.
Introduction: The diagnostic accuracy of gastric ultrasound in children has not been assessed thoroughly. We aimed to determine the sensitivity and specificity in children of a qualitative ultrasound examination of the gastric antrum in the supine 45° semi-recumbent position and a clinical algorithm for detecting a gastric fluid volume > 1.25 ml.
View Article and Find Full Text PDFLancet Reg Health Am
December 2024
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Background: Over the last decade, numerous efforts have been made to combat the opioid crisis globally. The impact of these strategies has not been adequately measured and may differ across populations depending on baseline risk. We compared changes in long-term prescription opioid use following surgery within a national US cohort, between 2017 and 2022.
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