Surgery today
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Case Reports
Significant improvement of chronic pain by Pregabalin after thoracotomy: report of four cases.
Unfortunately, many patients may have persistent pain lasting for many months, or even years, following thoracic surgery. No effective treatment has so far been established for chronic pain after thoracotomy. There are no reports of treatment involving Pregabalin for pain after thoracic surgery. This study reports four cases that showed significant improvement with Pregabalin in late-onset (notified during an office visit after discharge) nocturnal insomnia and in stress-induced ulcers caused by intercostal neuralgia after thoracotomy.
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Gastro-duodenal content reflux from gastro-esophageal reflux disease (GERD) induces the inflammation-metaplasia-dysplasia-adenocarcinoma sequence. Proton pump inhibitors (PPIs) are potent blockers of gastric acid secretion, which are widely used for treating GERD and peptic ulcer-associated acid-secreting diseases. The effect of PPI therapy on esophageal carcinogenesis remains unclear. ⋯ Recent studies have revealed that PPIs can exert anti-inflammatory effects such as anti-oxidant properties and immunomodulatory effects through their interactions with neutrophils, monocytes, endothelial and epithelial cells. In addition, PPIs have the ability to prevent adhesion molecule binding in malignant cells and suppress metastasis. This article reviews the role of PPIs in esophageal carcinogenesis and their use as antitumor agents.
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Achieving pain relief and improving the quality of life are the main targets of treatment for patients with chronic pancreatitis. The use of total pancreatectomy to treat chronic pancreatitis is a radical and in some ways ideal strategy. ⋯ With islet autotransplantation, patients with chronic pancreatitis receive their own islet cells and therefore do not require immunosuppressive therapy. In the future, total pancreatectomy with islet autotransplantation may be considered a treatment option for chronic pancreatitis patients.
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Tracheobronchial rupture is an uncommon but potentially serious complication of endotracheal intubation. In this study, the diagnosis and treatment strategies of a specific group of ruptures caused by double-lumen tube intubation are herein presented. ⋯ Thoracic surgeons must be alerted to the possibility for tracheobronchial rupture in patients intubated with double-lumen tubes, a procedure commonly used in thoracic surgery. Immediate repair must be performed for any laceration diagnosed intraoperatively.