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Topic Review
Post-Discectomy Infection
Postoperative discitis (POD) accounts for 20% to 30% of all cases of pyogenic spondylodiscitis, while POD may be mis-or-under-diagnosed, due to the vague related symptomatology and the non-specific imaging findings. Most studies report infection rate of less than 1%, which increases with the addition of non-instrumented fusion to 2.4% to 6.2%. The onset of POD symptoms usually occurs at 2–4 weeks after an apparently uneventful operation. Back pain and muscle spasms are usually refractory to bed rest and analgesics. Magnetic Resonance Imaging (MRI) is the most sensitive and specific imaging diagnostic technique. Antimicrobial therapy depends on the results of tissue cultures, and along with bracing represents the mainstay of management. Surgical intervention is necessary in patients failing conservative treatment. For the majority of cases, extensive surgical debridement, antibiotic therapy, and orthosis immobilization are effective in eliminating the infection.
  • 453
  • 12 Mar 2024
Topic Review
Management of Hepatocellular Carcinoma Associated with NAFLD
Non-alcoholic fatty liver disease (NAFLD) has gained attention due to its increasing prevalence worldwide becoming a global epidemic. The increasing incidence of NAFLD and the concurrent increase in the number of hepatocellular carcinoma (HCC) cases at a global level is a matter of concern. HCC has several risk factors, of which NAFLD and its associated metabolic disturbances—type 2 diabetes mellitus, obesity, and dyslipidemia—are of great interest due to their accelerating rise in incidence worldwide. There is a high amount of data derived from basic and clinical studies that reveal the molecular pathways that drive NAFLD-associated HCC. Based on these findings, new prevention, surveillance, and treatment strategies are emerging. 
  • 452
  • 17 Oct 2023
Topic Review
Cytokine Adsorption in Lung Transplantation and Heart Transplantation
Cytokine adsorption can resolve different complications characteristic of transplantation medicine, such as cytokine storm activation and blood ABO and immune incompatibilities. Cytokine adsorption is also performed for the treatment of various life-threatening conditions, such as endotoxic septic shock, acute respiratory distress syndrome, and cardiogenic shock, all potentially leading to adverse clinical outcomes during transplantation. After surgery, dysmetabolism and stress response limit successful graft survival and can lead to primary or secondary graft dysfunction. In this clinical context, and given that a major problem in transplant medicine is that the demand for organs far exceeds the supply, a technological innovation such as a hemoadsorption system could greatly contribute to increasing the number of usable organ donors.
  • 442
  • 22 Jan 2024
Topic Review
Traumatic Brain Injury on Brain Region
The following concerns and measures of neurotrauma are discussed here: It expands more on the protection role that the skull encompasses regarding the encephalon together with a detailed explanation of the effects of head injuries and their implications, which may include coma or death as a result of fractures or dysfunctions. The text gives descriptions of the incidence, especially in car-related accidents, and details about TBI such as the symptoms and the issues likely to occur as a result of the injury. The paper also draws attention to certain dangerous behaviors; such as; non-utilization of seat belts, driving when drunk, no helmet usage, and inadequate supervision to eliminate traumatic brain injury. Among the changes in management of the TBIs whether surgical or through medication, the text lastly highlights the fact that more emphasis has been placed on preventing this condition than on finding a cure for it.
  • 430
  • 26 Jan 2025
Topic Review
Postoperative Delirium and Cognitive Dysfunction after Anesthesia
Perioperative disorders of neurocognitive function are a set of heterogeneous conditions, which include transient post-operative delirium (POD) and more prolonged post-operative cognitive dysfunction (POCD). 
  • 426
  • 19 Oct 2023
Topic Review
Conservative Axillary Surgery in Breast Cancer
Axillary lymph node dissection (ALND) has traditionally been performed to assess nodal status, prevent axillary recurrence, and possibly improve survival. However, the procedure has been associated with postoperative morbidities, including arm lymphedema, shoulder dysfunction, and paresthesia. Sentinel lymph node (SLN) biopsy was introduced as an alternative approach to assess axillary nodal status and potentially eliminate the need for ALND in patients with clinically node-negative (cN0) breast cancer. Despite this progress, eliminating ALND for all breast cancer patients still seems premature at this time. Various forms of conservative axillary surgery have been developed to replace or supplement conventional ALND. Conservative axillary surgery may be promising in reducing the incidence of arm lymphedema without increasing the risk of axillary recurrence.
  • 397
  • 17 Nov 2023
Topic Review
Inferior Mesenteric Artery Ligation Level in Rectal-Cancer Surgery
Within the intricate field of rectal cancer surgery, the contentious debate over the optimal level of ligation of the inferior mesenteric artery (IMA) persists as an ongoing discussion, influencing surgical approaches and patient outcomes.
  • 397
  • 08 Jan 2024
Topic Review
Adjuvant Radiotherapy in Autologous Breast Reconstruction
In autologous breast reconstruction, a sufficient flap volume is fundamental to restore breast shape and ensure an aesthetic outcome. After mastectomy, postoperative irradiation is regularly indicated in the oncological treatment algorithm. When administering radiation therapy after autologous reconstruction, the tissue transferred is inherently irradiated. Although there is evidence that points to a reduction in flap volume after adjuvant radiotherapy, the data have been contradicting and inconclusive. 
  • 348
  • 10 Jan 2024
Topic Review Peer Reviewed
Postoperative Fever in the Digestive Oncology Patient
Fever above 38 °C is a common phenomenon in the first few days after any major surgery. In many cases, it is caused by the inflammatory response triggered by surgical aggression, which subsides spontaneously. However, fever can also be indicative of a complication. The differential diagnosis should include infectious and non-infectious conditions. In patients in the postoperative period following oncologic surgery, the tumor process itself may also cause the onset of fever.
  • 345
  • 25 Jul 2025
Topic Review Peer Reviewed
Gynecomastia Surgery in the Early Ottoman Period: An Evaluation of Şerefeddin Sabuncuoğlu’s Contributions
Şerefeddin Sabuncuoğlu (c. 1385–1470) was one of the most prominent surgeons of the early Ottoman period, particularly noted for his systematic and visually documented surgical approaches to breast tissue. His principal work, Cerrahiyyetü’l-Hâniyye, is based on the 30th volume of the Andalusian physician al-Zahrawi’s Kitab al-Tasrif, yet it goes well beyond a translation by incorporating Sabuncuoğlu’s clinical observations, experiential knowledge, and original surgical explanations. The text provides detailed descriptions of breast pathologies, including gynecomastia, and outlines diagnostic procedures, therapeutic strategies, surgical drainage methods, local wound-cleansing practices, and the definitions and uses of numerous surgical instruments, many of which are illustrated via miniatures. His second major work, Mücerrebnâme, is equally significant from a pharmacotherapeutic perspective, containing experiential prescriptions for swelling, inflammation, and painful breast lesions and reflecting the empirical reasoning he applied to drug-based treatments. Together, these two works portray Sabuncuoğlu as a versatile physician who combined operative techniques with pharmacological knowledge, offering a comprehensive view of medical practice in the early Ottoman period. His detailed account of gynecomastia surgery, supported by observations on pre- and postoperative care, represents an important source for understanding both medieval surgical practice and the development of anatomical and therapeutic knowledge in the Islamic medical tradition.
  • 33
  • 29 Dec 2025
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