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Topic Review
Atypical Skull-Base Osteomyelitis
Atypical skull-base osteomyelitis is a rare but fatal disease that usually involves infection of the ethmoid, sphenoid, occipital, or temporal bones that form the skull base. Unlike typical (so-called otogenic), atypical skull-base osteomyelitis has no otogenic cause. Instead, some authors call atypical skull-base osteomyelitis sinonasal, since the infection most often originates from the nose and paranasal sinuses. 
  • 1.2K
  • 09 May 2023
Topic Review
Visualization Techniques in Endoscopic Skull Base Surgery
Skull base surgery has undergone significant progress following key technological developments. From early candle-lit devices to the modern endoscope, refinements in visualization techniques have made endoscopic skull base surgery (ESBS) a standard practice for treating a variety of conditions. The endoscope has also been integrated with other technologies to enhance visualization, including fluorescence agents, intraoperative neuronavigation with augmented reality, and the exoscope. 
  • 1.2K
  • 06 May 2023
Topic Review
Vascular Access in Children with Short Bowel Syndrome
Short Bowel Syndrome and intestinal failure are chronic and severe conditions that may require life-long parenteral nutrition in children. Survival of these children relies on the correct functioning of central venous catheters; therefore, careful management, prevention, and treatment of complications is of paramount importance. Despite a growing awareness on preserving the vascular real estate, a certain number of patients still experience a progressive and life-threatening exhaustion of vascular access. 
  • 1.2K
  • 31 May 2022
Topic Review
Endoscopic Submucosal Dissection
Endoscopic submucosal dissection (ESD) is considered superior to endoscopic mucosal resection as an endoscopic resection because of its higher en bloc resection rate, but it is more difficult to perform. As ESD techniques have become more common, and the range of treatment by ESD has expanded, the number of possible complications has also increased, and endoscopists need to manage them.
  • 1.2K
  • 18 Jun 2021
Topic Review
Immunotherapy or Immuno-Chemotherapy in Non-Small Cell Lung Cancer
Surgical resections remain the gold standard for early stages non-small-cell carcinoma (NSCLC) and may be considered for locally advanced tumors. Medical treatment has changed drastically, especially for advanced stages, for which the development of immunotherapy and molecular targeted therapy significantly increased survival and quality of life. The addition of radical surgical resection following immunotherapy or immuno-chemotherapy is feasible and safe with low surgical-related mortality and morbidity in selected patients with initially unresectable NSCLC.
  • 1.2K
  • 05 May 2023
Topic Review
Chitosan-Based Materials and Devices
Chitosan is one of the most studied polysaccharides in recent decades for its biomedical application. This polymer is derived from chitin, the main component in the exoskeleton of insects and crustaceans, a homopolymer consisting of β-(1→4)-N-acetyl-D-glucosamine. The degree of deacetylation of chitosan depends on the conditions applied during the deacetylation process—such as temperature or sodium hydroxide concentration—and determines various properties of the polymer, such as pKa, solubility, and viscosity. Chitosan has been used in a broad assortment of medical materials and devices. Each system benefits from the properties that chitosan can provide for surgical applications. The shape, porosity, consistency, and size of the fabricated systems can be precisely tuned for the intended application.
  • 1.2K
  • 11 Jul 2022
Topic Review
The Association of Gut Microbiota in Gastrointestinal-Cancer Therapies
The gut microbiome of patients with gastrointestinal cancer undergoes specific changes during different therapies such as surgery, chemotherapy and radiation. Likewise, complications of these therapies are associated with specific changes in the microbiome. 
  • 1.2K
  • 02 Nov 2021
Topic Review
Adult Abdominal Tuberculosis Diagnosis
Tuberculosis is a common systemic infection with the bacteria Mycobacterium tuberculosis, which is primarily found in the lungs and causes caseous inflammation in lung tissue and other organs. Tuberculosis is an infectious disease that spreads via the air. Tuberculosis is an endemic disease in developing countries, due to the wide spread of acquired immunodeficiency syndrome (AIDS), it might represent a problem in developed countries, as well. Only around one-fifth of patients diagnosed with abdominal TB have pulmonary disease. 
  • 1.1K
  • 29 Mar 2022
Topic Review
Thrombin-Gelatin Matrix in Breast Tumor Hemostasis
Improved hemostasis during acute bleeding and a trend to prevent hematoma were observed after the TGM injection. TGM could be an alternative method to achieve better post-VABB hemostasis.
  • 1.1K
  • 02 Mar 2022
Topic Review
Preoperative Anemia in Vascular Patients
Anemia is a common condition in preoperative period of peripheral arterial disease patients. Anemia has multifactorial causes, including: iron deficiency; vitamin deficiency and inflammation; and chronic kidney disease. Some retrospective researches demonstrated, that preprocedural anemia is a predictor adverse outcomes in patients undergoing percutaneous transluminal angioplasty for vascular disease treatment. These outcomes are increase likelihood of: A) transfusion; B) amputation; C) and major adverse cardiovascular events.It is not clear if preoperative anemia optimization with iron and/or erythropoietin, reduce major adverse outcomes in patients submitted to vascular peripheral surgeries. 
  • 1.1K
  • 04 Aug 2021
Topic Review
Screw Fixation in Patients with Osteoporotic Spine
Osteoporosis is a common disease in elderly populations and is a major public health problem worldwide. It is not uncommon for spine surgeons to perform spinal instrumented fusion surgeries for osteoporotic patients. In patients with severe osteoporosis, instrumented fusion may result in screw loosening, implant failure or nonunion because of a poor bone quality and decreased pedicle screw stability as well as increased graft subsidence risk.
  • 1.1K
  • 30 May 2022
Topic Review
Perioperative Medication Therapy
Drug-related problems (DRPs) are common among surgical patients, especially older patients with polypharmacy and underlying diseases. DRPs can potentially lead to morbidity, mortality, and increased treatment costs. The enhanced recovery after surgery (ERAS) system has shown great advantages in managing surgical patients. Medication therapy management for surgical patients is an important part of the ERAS system. Improper medication therapy management can lead to serious consequences and even death.
  • 1.1K
  • 02 Feb 2023
Topic Review
Augmented Reality in Surgery
Augmented reality (AR) is an innovative system that enhances the real world by superimposing virtual objects on reality. The application of AR in image-guided surgery (IGS) can be an increasingly important opportunity for the treatment of patients. In particular, AR allows one to see 3D images projected directly onto patients thanks to the use of special displays.
  • 1.1K
  • 09 Aug 2022
Topic Review
Regenerative strategies in Cleft Palate
Cleft lip and/or palate (CLP) is a craniofacial malformation with a prevalence in newborns of 14 per 10,000 live births worldwide. 
  • 1.1K
  • 01 Jul 2021
Topic Review
Treatment of Rectal Cancer
Rectal cancer poses a substantial healthcare challenge, emphasizing the critical need for effective treatment strategies. Among the various approaches available, surgical intervention, notably total mesorectal excision (TME), stands as the gold standard for rectal cancer management, consistently delivering exceptional oncological results. In certain instances of early-stage disease, endoscopic treatments and transanal resection techniques may be viable options, offering a more conservative approach. Additionally, for cases characterized by locally advanced tumors, radiotherapy has demonstrated significant benefits in augmenting the overall treatment efficacy.
  • 1.1K
  • 04 Sep 2023
Topic Review
Abdominal Compartment Syndrome
Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion. The sudden increase in pressure inside these spaces requires rapid decompression by means of surgical intervention. In the case of abdominal compartment syndrome (ACS), surgical decompression consists of a laparostomy. 
  • 1.1K
  • 10 Jan 2022
Topic Review
Hyperbaric Oxygen Therapy in Treating Surgical Site Infections
Hyperbaric oxygen therapy (HBOT) can result in rapid healing and epithelialization of various wounds and has potential beneficial effects in the treatment of surgical site infections (SSIs) or other similar infections following cardiac, neuromuscular scoliosis, coronary artery bypass, and urogenital surgeries. Moreover, it was a safe therapeutic procedure in most cases. The mechanisms related to the antimicrobial activity of HBOT include direct bactericidal effects through the formation of reactive oxygen species (ROS), the immunomodulatory effect of HBOT that increase the antimicrobial effects of the immune system, and the synergistic effects of HBOT with antibiotics. 
  • 1.1K
  • 08 May 2023
Topic Review
Percutaneous Endoscopic Necrosectomy
The Percutaneous Endoscopic Necrosectomy (PEN) technique consists of percutaneous puncture of the pancreatic necrotic collection from retroperitoneal, or less frequently, transperitoneal access, under ultrasound or CT guidance. Next, a fully-coated, self-expandable esophageal stent is inserted across the puncture, with its distal end reaching the necrotic collection lumen and its proximal end located outside the patient’s body. During PEN, a flexible endoscope (usually a gastroscope) is inserted along the esophageal stent lumen and necrosectomy (mechanical evaluation of necrotic debris from the cavity) is performed using various endoscopic instruments. During the procedure, the cavity is extensively flushed, usually with physiological saline, and the contents are aspirated. If subsequent PEN procedures are required, the esophageal stent is retained in the percutaneous location, with the introduction of plastic endoprostheses or drainage tubes along its lumen for passive or active post-procedural drainage of the necrotic collection, respectively. After the completion of endoscopic treatment using percutaneous access, the esophageal stent is removed and the site is secured with an ostomy pouch to collect the residual contents of the necrotic cavity.
  • 1.1K
  • 20 Jul 2022
Topic Review
Effect of Sodium Fluorescein on High-Grade Gliomas
High-grade gliomas (HGG) are the most common primary malignant brain cancer in adults. Complete surgical removal of HGG is known to increase the overall survival and progression-free survival. Fluorescence-guided surgery with 5-aminolevulinic acid (5-ALA) increases gross total resection considerably compared to white light surgery (65% vs. 36%). Recently, an off-label fluorophore, sodium fluorescein (SF), has become popular in fluorescence-guided surgery due to numerous utility benefits compared to 5-ALA, including lower cost, non-toxicity, easy administration during surgery and a wide indication for other CNS tumors.
  • 1.1K
  • 28 Feb 2022
Topic Review
The Challenge of Perihilar Cholangiocarcinoma
Perihilar cholangiocarcinomas (pCCA) are rare yet aggressive tumors originating from the bile ducts. While surgery remains the mainstay of treatment, only a minority of patients are amenable to curative resection, and the prognosis of unresectable patients is dismal. The introduction of liver transplantation (LT) after neoadjuvant chemoradiation for unresectable pCCA in 1993 represented a major breakthrough, and it has been associated with 5-year survival rates consistently >50%. Despite these encouraging results, pCCA has remained a niche indication for LT, which is most likely due to the need for stringent candidate selection and the challenges in preoperative and surgical management.
  • 1.1K
  • 27 Mar 2023
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