Effect of Thymectomy in Rats and Calves Dissertation
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Atrial Fibrillation and Splenic Infarction Presenting with Unexplained Fever and Persistent Abdominal Pain - a Case Report and Review of the Literature
Case ReportSplenic Infarction Presenting with Unexplained Fever and Persistent Acta Abdominal Cardiol SinPain 2012;28:157-160 Atrial Fibrillation and Splenic Infarction Presenting with Unexplained Fever and Persistent Abdominal Pain - A Case Report and Review of the Literature Cheng-Chun Wei1 and Chiung-Zuan Chiu1,2 Atrial fibrillation is a common clinical problem and may be complicated with events of thromboembolism, especially in patients with valvular heart disease. Splenic infarction is a rare manifestation of the reported cases. The symptoms may vary from asymptomatic to severe peritonitis, though early diagnosis may lessen the probability of severe complications and lead to a good prognosis. We report a 79-year-old man with multiple cardioembolic risk factors who presented with fever and left upper quadrant abdominal pain. To diagnose splenic infarction is challenging for clinicians and requires substantial effort. Early resumption of the anti-coagulation component avoids complications and operation. Key Words: Atrial fibrillation · Splenic infarction · Thromboembolism event · Valvular heart disease INTRODUCTION the patient suffered from severe acute abdominal pain due to splenic infarction. Fortunately, early diagnosis Splenic infarction is a rare cause of an acute abdo- and anticoagulation therapy helped the patient to avoid men. According to a sizeable autopsy series, only 10% emergency surgery and a possible negative outcome. of splenic infarctions had been diagnosed antemortem.1-3 It can occur in a multitude of conditions, with general or local manifestations, and was often a clinical “blind CASE REPORT spot” during the process of diagnosis. However, splenic infarction must be considered in patients with hema- The patient was a 79-year-old man with degenera- tologic diseases or thromboembolic conditions. -
Asplenia Vaccination Guide
Stanford Health Care Vaccination Subcommitee Revision date 11/308/2018 Functional or Anatomical Asplenia Vaccine Guide I. PURPOSE To outline appropriate vaccines targeting encapsulated bacteria for functionally or anatomically asplenic patients. Routine vaccines that may also be indicated but not addressed here include influenza, Tdap, herpes zoster, HPV, MMR, and varicella.1,2,3 II. Background Functionally or anatomically asplenic patients should be vaccinated to decrease the risk of sepsis due to organisms such as Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis. Guidelines are based on CDC recommendations. For additional information, see https://www.cdc.gov/vaccines/schedules/hcp/imz/adult-conditions.html. III. Procedures/Guidelines1,2,3,6,7,8 The regimen consists of 4 vaccines initially, followed by repeat doses as specified: 1. Haemophilus b conjugate (Hib) vaccine (ACTHIB®) IM once if they have not previously received Hib vaccine 2. Pneumococcal conjugate 13-valent (PCV13) vaccine (PREVNAR 13®) IM once • 2nd dose: Pneumococcal polysaccharide 23-valent (PPSV23) vaccine (PNEUMOVAX 23®) SQ/IM once given ≥ 8 weeks later, then 3rd dose as PPSV23 > 5 years later.4 Note: The above is valid for those who have not received any pneumococcal vaccines previously, or those with unknown vaccination history. If already received prior doses of PPSV23: give PCV13 at least 1 year after last PPSV23 dose. 3. Meningococcal conjugate vaccine (MenACWY-CRM, MENVEO®) IM (repeat in ≥ 8 weeks, then every 5 years thereafter) 4. Meningococcal serogroup B vaccine (MenB, BEXSERO®) IM (repeat in ≥ 4 weeks) Timing of vaccination relative to splenectomy: 1. Should be given at least 14 days before splenectomy, if possible. -
Peripheral Blood Cells Changes After Two Groups of Splenectomy And
ns erte ion p : O y p H e f Yunfu et al., J Hypertens (Los Angel) 2018, 7:1 n o l A a DOI: 10.4172/2167-1095.1000249 c c n r e u s o s J Journal of Hypertension: Open Access ISSN: 2167-1095 Research Article Open Access Peripheral Blood Cells Changes After Two Groups of Splenectomy and Prevention and Treatment of Postoperative Complication Yunfu Lv1*, Xiaoguang Gong1, XiaoYu Han1, Jie Deng1 and Yejuan Li2 1Department of General Surgery, Hainan Provincial People's Hospital, Haikou, China 2Department of Reproductive, Maternal and Child Care of Hainan Province, Haikou, China *Corresponding author: Yunfu Lv, Department of General Surgery, Hainan Provincial People's Hospital, Haikou 570311, China, Tel: 86-898-66528115; E-mail: [email protected] Received Date: January 31, 2018; Accepted Date: March 12, 2018; Published Date: March 15, 2018 Copyright: © 2018 Lv Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Objective: This study aimed to investigate the changes in peripheral blood cells after two groups of splenectomy in patients with traumatic rupture of the spleen and portal hypertension group, as well as causes and prevention and treatment of splenectomy related portal vein thrombosis. Methods: Clinical data from 109 patients with traumatic rupture of the spleen who underwent splenectomy in our hospital from January 2001 to August 2015 were retrospectively analyzed, and compared with those from 240 patients with splenomegaly due to cirrhotic portal hypertension who underwent splenectomy over the same period. -
Pseudoischemic Electrocardiogram in Myasthenia Gravis with Thymoma Published Online in Wiley Interscience
Address for correspondence: Nicola Mumoli, MD CaseShort Communication Livorno Hospital Department of Internal Medicine Viale Alfieri 36 Pseudoischemic Electrocardiogram in 57100 Livorno, Italy Myasthenia Gravis with Thymoma: [email protected] Reversibility After Thymectomy Patrizio Chiavistelli, MD, Marco Cei, MD, Giovanni Carmignani, MD, Carlo Bartolomei, MD Nicola Mumoli, MD Department of Internal Medicine, Livorno Hospital, Livorno, Italy Abnormal ST T-wave changes can be found at presentation in various noncoronary disorders; misinterpretation of these patterns as ischemic heart disease can lead to erroneous diagnosis and treatment. Here we present a case of myasthenia gravis (MG) with thymoma, in which the resting electrocardiogram (ECG) led to a misleading diagnosis of myocardial ischemia. After thymectomy, the ECG resumed a normal pattern. Myasthenia gravis is not usually considered in the differential diagnosis of conditions associated with an abnormal ECG. The combination of dysphagia, dyspnoea, ECG changes, and creatine kinase (CK) elevations may easily bring to mind an erroneous and possibly deleterious diagnosis of myocardial ischemia. Introduction did not seek medical attention. At the beginning of the The resting 12-lead electrocardiogram (ECG) remains at current year, he reported a flu-like illness, with spontaneous the center of the diagnostic pathways of acute coronary recovery, but shortly afterward he experienced dyspnea, syndromes (ACSs), either with1 or without ST segment dysphagia, and weight loss (37 kg). One month before elevation,2 because it serves as an invaluable tool for admission, he underwent fiberoptic endoscopy of the nose, both diagnosis and risk stratification. Nevertheless, as is pharynx, and larynx because of dysphonia, without any universally accepted, the predictive value of any diagnostic evidence of an active disease. -
Open Splenectomy Scott F
Open Splenectomy Scott F. Gallagher, Larry C. Carey, Michel M. Murr Indications and Contraindications Indications ■ Trauma ■ Blood dyscrasias, e.g., idiopathic thrombocytopenic purpura ■ Symptomatic relief, e.g., Gaucher’s disease, chronic myeloid or lymphatic leukemia ■ Splenic cysts and tumors Contraindications ■ No absolute contraindications for splenectomy ■ Limited life expectancy and prohibitive operative risk Contraindications to ■ Previous open upper abdominal surgery Laparoscopic Splenectomy ■ Uncontrolled coagulation disorder ■ Very low platelet count (<20,000/100ml) ■ Massive splenic enlargement, i.e., spleen greater four times normal size or larger ■ Portal hypertension Preoperative Investigation and Preparation ■ Imaging studies to estimate the size of the spleen or extent of splenic injury and other abdominal injuries in trauma cases ■ Interpretation of bone marrow biopsy, peripheral blood smear, and ferrokinetics in coordination with a hematologist ■ Discontinue anticoagulants (such as aspirin, warfarin, clopidogrel and vitamin E) ■ Patients routinely given polyvalent pneumococcal vaccine, Haemophilus influenzae b conjugate vaccines and meningococcal vaccines on the same day at least 10–14days prior to splenectomy (given postoperatively in trauma cases) ■ Prophylactic antibiotics (cefazolin or cefotetan) ■ Perioperative DVT prophylaxis ■ Perioperative steroids should be administered to patients on long-term steroid therapy 954 SECTION 7 Spleen Procedure STEP 1 The standard supine position is employed with an optional small roll/bump under the left flank. The patient should be well secured to the operating table should it become necessary to tilt the table to improve visualization of the operative field. Mechanical retractors greatly enhance exposure and the primary surgeon should stand on the right side of the patient; the first assistant opposite the surgeon on the left side of the patient. -
Studies of Thymic Function with Emphasis on the Role of the Thymus in Oncogenesist
[CANCER RESEARCH 26 Part I, 551-574, April 1966] Studies of Thymic Function with Emphasis on the Role of the Thymus in Oncogenesist LLOYDW. LAW National Cancer Institute, Bethesda, Maryland This presentation will be concerned with 2 general topics: organ to other sites occurs with a selective seeding in spleen (a) our present knowledge of thymic structure and function, lymph nodes, and other lymphoid organs. but particularly the latter, as revealed by the results of recent For a more detailed discussion of the ontogeny of the thymus experiments in several species of animals following early thymic and its microscopic anatomy, the reader is referred to the studies ablation, and (b) consideration of the precise role of the thymus in of Smith (97) and of Ruth et al. (92). the initiation and suppression of neoplastic growths. Pertaining to Thymic Structure and Function Origin and Early Structure of the Thymus In most species the thymus is located in the upper anterior The thymus is a compound organ consisting of 3 quite different part of the chest. Exceptions are the chicken and guinea pig. cell systems: (a) lymphoid cells, (b) reticulum cells, and (c) The absolute size varies from species to species but the absolute e[)ithehal cells. The latter 2 may be referred to as the epithelial size of thymic lobules appears to be remarkably uniform in the reticulum cell complex. The thymus in mammals arises as various species, suggesting that there may be a critical limit for paired structures from the endoderm of the 3rd and 4th branchial the size of a thymic lobule. -
Analysis of the Role of Thyroidectomy and Thymectomy in the Surgical Treatment of Secondary Hyperparathyroidism
Am J Otolaryngol 40 (2019) 67–69 Contents lists available at ScienceDirect Am J Otolaryngol journal homepage: www.elsevier.com/locate/amjoto Analysis of the role of thyroidectomy and thymectomy in the surgical ☆ treatment of secondary hyperparathyroidism T Mateus R. Soares, Graziela V. Cavalcanti, Ricardo Iwakura, Leandro J. Lucca, Elen A. Romão, ⁎ Luiz C. Conti de Freitas Division of Head and Neck Surgery, Department of Ophthalmology, Otolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil ARTICLE INFO ABSTRACT Keywords: Purpose: Parathyroidectomy can be subtotal or total with an autograft for the treatment of renal hyperpar- Parathyroidectomy athyroidism. In both cases, it may be extended with bilateral thymectomy and total or partial thyroidectomy. Hyperparathyroidism Thymectomy may be recommended in combination with parathyroidectomy in order to prevent mediastinal Thymectomy recurrence. Also, the occurrence of thyroid disease observed in patients with hyperparathyroidism is poorly Thyroidectomy understood and the incidence of cancer is controversial. The aim of the present study was to report the ex- perience of a single center in the surgical treatment of renal hyperparathyroidism and to analyse the role of thyroid and thymus surgery in association with parathyroidectomy. Materials and methods: We analysed parathyroid surgery data, considering patient demographics, such as age and gender, and surgical procedure data, such as type of hyperparathyroidism, associated thyroid or thymus surgery, surgical duration and mediastinal recurrence. Histopathological results of thyroid and thymus samples were also analysed. Results: Medical records of 109 patients who underwent parathyroidectomy for secondary hyperparathyroidism were reviewed. On average, thymectomy did not have impact on time of parathyroidectomy (p = 0.62) even when thyroidectomy was included (p = 0.91). -
Public Use Data File Documentation
Public Use Data File Documentation Part III - Medical Coding Manual and Short Index National Health Interview Survey, 1995 From the CENTERSFOR DISEASECONTROL AND PREVENTION/NationalCenter for Health Statistics U.S. DEPARTMENTOF HEALTHAND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics CDCCENTERS FOR DlSEASE CONTROL AND PREVENTlON Public Use Data File Documentation Part Ill - Medical Coding Manual and Short Index National Health Interview Survey, 1995 U.S. DEPARTMENT OF HEALTHAND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics Hyattsville, Maryland October 1997 TABLE OF CONTENTS Page SECTION I. INTRODUCTION AND ORIENTATION GUIDES A. Brief Description of the Health Interview Survey ............. .............. 1 B. Importance of the Medical Coding ...................... .............. 1 C. Codes Used (described briefly) ......................... .............. 2 D. Appendix III ...................................... .............. 2 E, The Short Index .................................... .............. 2 F. Abbreviations and References ......................... .............. 3 G. Training Preliminary to Coding ......................... .............. 4 SECTION II. CLASSES OF CHRONIC AND ACUTE CONDITIONS A. General Rules ................................................... 6 B. When to Assign “1” (Chronic) ........................................ 6 C. Selected Conditions Coded ” 1” Regardless of Onset ......................... 7 D. When to Assign -
Splenectomy for Splenomegaly and Secondary Hypersplenism
World J. Surg. 9, 437--443, 1985 1985 by the Soci~t~ lnternationale de Chirurgie Splenectomy for Splenomegaly and Secondary Hypersplenism William W. Coon, M.D. Department of Surgery, The University of Michigan Hospitals, Ann Arbor, Michigan, U.S.A. Splenomegaly and secondary hypersplenism may be associ- The separation of hypersplenism into primary ated with acute and chronic infections, autoimmune states, and secondary categories is also imprecise. The portal hypertension or splenic vein thrombosis, and a diseases usually included under "primary" hyper- number of infiltrative and neoplastic conditions involving splenism are those in which the fundamental defect the spleen. Our experience and that of others with these is thought to be related to a congenital or acquired various conditions demonstrates that the decision to per- alteration in cell membrane or structure of form splenectomy should be based on well-defined and hematopoietic cells (idiopathic thrombocytopenic often strictly limited indications. Except for idiopathic purpura, acquired hemolytic anemia, some of the splenomegaly, the presence and severity of secondary congenital hemolytic anemias, etc.). hypersplenism or severely symptomatic splenomegaly This discussion will be confined to selected enti- should be well documented. In each case, the potential for ties usually considered to be associated with "sec- palliation and known mean duration of expected response ondary" hypersplenism in which splenomegaly and must be weighed against the increased morbidity and altered splenic -
Cellular and Humoral Immune Alterations in Thymectomized Patients for Thymoma
Cellular and humoral immune alterations in thymectomized patients for thymoma Maurizio Lalle, Mauro Minellli, Paola Tarantini, Mirella Marino, Virna Cerasoli, Francesco Facciolo, Cesare Iani, Mauro Antimi To cite this version: Maurizio Lalle, Mauro Minellli, Paola Tarantini, Mirella Marino, Virna Cerasoli, et al.. Cellular and humoral immune alterations in thymectomized patients for thymoma. Annals of Hematology, Springer Verlag, 2009, 88 (9), pp.847-853. 10.1007/s00277-008-0693-3. hal-00535026 HAL Id: hal-00535026 https://hal.archives-ouvertes.fr/hal-00535026 Submitted on 11 Nov 2010 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Ann Hematol (2009) 88:847–853 DOI 10.1007/s00277-008-0693-3 ORIGINAL ARTICLE Cellular and humoral immune alterations in thymectomized patients for thymoma Maurizio Lalle & Mauro Minellli & Paola Tarantini & Mirella Marino & Virna Cerasoli & Francesco Facciolo & Cesare Iani & Mauro Antimi Received: 1 September 2008 /Accepted: 23 December 2008 /Published online: 23 January 2009 # Springer-Verlag 2009 Abstract The aim of this study was to analyze the impact studies, a longer surveillance and a cooperative approach, of thymectomy on kinetics of the immune reconstitution in due to the rarity of the disease, are necessary to define thymoma patients. -
Psi Technical Specs V31.Pdf
AHRQ Quality Indicators Patient Safety Indicators: Technical Specifications Department of Health and Human Services Agency for Healthcare Research and Quality http://www.qualityindicators.ahrq.gov March 2003 Version 3.1 (March 12, 2007) AHRQ Quality Indicators Web Site: http://www.qualityindicators.ahrq.gov Table of Contents About the Patient Safety Indicators ............................................................................................................... 1 Patient Safety Indicators – Detailed Definitions ............................................................................................ 3 Complications of Anesthesia (PSI 1) ............................................................................................................ 3 Death in Low-Mortality DRGs (PSI 2) ........................................................................................................... 5 Decubitus Ulcer (PSI 3) ................................................................................................................................. 7 Failure to Rescue (PSI 4) .............................................................................................................................. 9 Foreign Body Left during Procedure, Secondary Diagnosis Field (PSI 5 and 21)...................................... 17 Iatrogenic Pneumothorax, Secondary Diagnosis Field (PSI 6 and 22)....................................................... 18 Selected Infections Due to Medical Care, Secondary Diagnosis Field (PSI 7 and 23) ............................. -
Comparison of Different Methods of Splenic Hilar Lymph Node Dissection
Ji et al. BMC Cancer (2016) 16:765 DOI 10.1186/s12885-016-2814-z RESEARCH ARTICLE Open Access Comparison of different methods of splenic hilar lymph node dissection for advanced upper- and/or middle-third gastric cancer Xin Ji†, Tao Fu†, Zhao-De Bu, Ji Zhang, Xiao-Jiang Wu, Xiang-Long Zong, Zi-Yu Jia, Biao Fan, Yi-Nan Zhang and Jia-Fu Ji* Abstract Background: Surgery for advanced gastric cancer (AGC) often includes dissection of splenic hilar lymph nodes (SHLNs). This study compared the safety and effectiveness of different approaches to SHLN dissection for upper- and/or middle-third AGC. Methods: We retrospectively compared and analyzed clinicopathologic and follow-up data from a prospectively collected database at the Peking University Cancer Hospital. Patients were divided into three groups: in situ spleen- preserved, ex situ spleen-preserved and splenectomy. Results: We analyzed 217 patients with upper- and/or middle-third AGC who underwent R0 total or proximal gastrectomy with splenic hilar lymphadenectomy from January 2006 to December 2011, of whom 15.2 % (33/ 217) had metastatic SHLNs, and from whom 11.4 % (53/466) of the dissected SHLNs were metastatic. The number of harvested SHLNs per patient was higher in the ex situ group than in the in situ group (P = 0.017). Length of postoperative hospital stay was longer in the splenectomy group than in the in situ group (P =0.002)ortheex situ group (P < 0.001). The splenectomy group also lost more blood volume (P = 0.007) and had a higher postoperative complication rate (P = 0.005) than the ex situ group.