Articles: cations.
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Internal disc disruption is a common cause of disabling low back pain in a substantial number of young, healthy adults. A clinical diagnosis of internal disruption, in absence of objective clinical findings, is convincingly established only by means of provocation discography. Intradiscal electrothermal therapy has been shown to be effective in managing chronic disabling discogenic pain. ⋯ Further, the assessment of functional status showed significant improvement with standing and walking, whereas sitting also demonstrated significant improvement in 62% of the patients, though it was not statistically significant. No complications were noted in the perioperative period or during the follow-up period. In conclusion, intradiscal electrothermal therapy is a safe and effective procedure in patients suffering with chronic functionally limiting discogenic pain who fail to respond to aggressive conservative modalities of treatments as well as interventional therapy with injections.
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To review the strategies for identification and subsequent management of high-risk patients that have been proposed to reduce perioperative morbidity and mortality. ⋯ In patients who are about to undergo major intra-abdominal surgery, preoperative cardiopulmonary exercise testing is an excellent predictor of risk in the postoperative period. No other test is able to offer such a comprehensive preoperative risk evaluation for an operative patient.
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Introduction. Intra-Arterial Hepatic Chemotherapy (IAHC) based on floxuridine (FUdR) infusion is an effective treatment for hepatic metastases from colorectal cancer. A percutaneously implanted intra-arterial device may overcome the surgical stress of the laparotomic placement allowing an increase in the number of patients treated by IAHC. ⋯ Conclusions. Surgically implanted indwelling catheters for IAHC present lower incidence of device-related complications than percutaneous transaxillary implanted catheters. In spite of its irreversibility and significant biological costs, surgical implant is still advised when laparotomy has to be performed for other contextual procedures, such as colorectal or hepatic resection, while percutaneous transaxillary catheter placement is indicated for palliative or neoadjuvant IAHC.
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Sympathetic blocks in the cervical and upper thoracic region are commonly used techniques for a variety of diagnostic, therapeutic and prognostic purposes. Stellate ganglion block is the common nomenclature utilized, however, stellate ganglion is present in only 80% of the population, thus, either lower cervical sympathetic block or upper thoracic sympathetic block is an appropriate term. The cervical sympathetic ganglia are identified as the superior, middle, intermediate and the inferior cervical sympathetic ganglion. ⋯ Complications of stellate ganglion block include complications related to the technique, infection, and pharmacological complications related to the drugs utilized. Cervical sympathetic or stellate ganglion block is a very commonly performed procedure. If performed correctly, this can provide good therapeutic, prognostic, and diagnostic values.