Introduction: Safety of treatment with mammalian target of rapamycin inhibitors (mTORi) in the postoperative period after heart transplantation (HT) is controversial.
Methods: We evaluated the incidence of postoperative complications (pericardial, pleural, and surgical wound complications) among nine de novo heart transplant recipients treated with mTORi compared with 19 patients who did not receive them during the same period (control group).
Results: No significant differences were observed between the two groups regarding sex, age, body mass index, pretransplant diagnosis, history of diabetes mellitus, prior cardiac surgery, or baseline renal function. The main laboratory parameters at 1 month were also similar. During the first 2 months after HT, four patients (44%) in the mTORi group developed severe pericardial effusions requiring drainage, compared to 1 (5%) in the control group (P = .026). All patients presenting this complication in the mTORi group received everolimus. In addition, two cases of sternal dehiscence were observed in the mTORi group, compared to none in the control group (P = .09); one patient on everolimus required sternal reopening and debridement for clinically suspected mediastinitis. Duration of chest tube drainage, quantity of collected pleural fluid, and need for thoracentesis were similar in both groups.
Conclusions: In our series, patients receiving mTORi-particularly everolimus-during the postoperative period after HT showed a higher incidence of severe pericardial effusion requiring drainage, as well as a trend toward a higher incidence of sternal dehiscence, as compared to a group not receiving mTORi. The use of mTORi during the early postcardiac transplant period should be individualized.
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http://dx.doi.org/10.1016/j.transproceed.2008.09.021 | DOI Listing |
A A Pract
January 2025
Department of Psychology, Neuropsychology Lab, CarlVon Ossietzky Universität, Oldenburg, Germany.
An elderly patient with renal cell carcinoma underwent a robotic nephrectomy. After an uneventful intraoperative period, soon after extubation she developed generalized seizures and was diagnosed with posterior reversible encephalopathy syndrome (PRES) on neuroimaging. Management included antiepileptic and antihypertensive therapies, necessitating intensive care and neurorehabilitation.
View Article and Find Full Text PDFFoot Ankle Int
January 2025
Sirindhorn Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand.
Background: To determine whether a combined endoscopic suprafascial and infrafascial approach with medial and lateral portals is a safe and effective technique for the endoscopic treatment of chronic plantar fasciitis with plantar heel spur pain.
Methods: An interventional, prospective study was conducted. A total of 61 patients with plantar fasciitis with plantar heel spur pain underwent an endoscopic plantar fasciotomy with plantar heel spur resection, using a combined suprafascial and infrafascial approach between January 2018 and August 2022.
Br J Hosp Med (Lond)
December 2024
Department of Ophthalmology and Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China.
By addressing patients' physical, psychological, social, cultural, and environmental comfort needs holistically, Kolcaba's Comfort Theory raises the standard of care and increases patient satisfaction. This study explored the combined application of these nursing models during the perioperative period for patients undergoing nasal deformity correction surgery. 92 patients undergoing nasal deformity correction at the Seventh Affiliated Hospital of Sun Yat-sen University were randomly divided into two groups: the conventional group (46 patients), which received standard perioperative nursing care, and the experimental group (46 patients), which received concept map thinking nursing combined with Kolcaba's comfort nursing intervention during the perioperative period.
View Article and Find Full Text PDFSpine (Phila Pa 1976)
January 2025
Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Study Design: Prospective cohort study.
Objective: This study aimed to investigate the durability of postural stability after ASD correction surgery and its' association with clinical outcomes.
Summary Of Background Data: The prevalence of symptomatic adult spinal deformity (ASD) necessitates surgical intervention, aiming to correct global spinal balance and spinopelvic parameters.
Spine (Phila Pa 1976)
January 2025
Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Study Design: Systematic review and meta-analysis.
Objective: To investigate evidence on the prevalence and timeline of RTW after lumbar microdiskectomy.
Summary Of Background Data: While lumbar microdiskectomy is a widely used and well-studied procedure, there is lack of evidence on the postoperative prevalence and schedule of return to work after this type of surgery.
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