The treatment of choice between coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) has remained unclear. Considering quality of life (QOL) increases life expectancy, we believe QOL should be important in determining the optimum treatment. Thus the objective of this review was to illustrate the comparative effects of CABG and PCI on postprocedural QOL. Methods. We searched PubMed (Medline) and Embase from inception of the databases to May 2014 using “PCI versus CABG quality of life”, “Percutaneous Coronary intervention versus Coronary artery bypass graft surgery Quality of life”, “PCI versus CABG health status”, “Angioplasty versus CABG”, “Percutaneous coronary intervention versus coronary artery bypass surgery health status”, and different combinations of the above terms. 447 articles were found. After applying strict exclusion criteria, we included 13 studies in this review. Results. From the 9 studies that compared QOL scores at 6 months after procedure, 5 studies reported CABG to be superior. From the 10 studies that compared QOL among patients at 1 year after procedure, 9 reported CABG to be superior. Conclusion. It can be established that CABG is superior to PCI in improving patient's QOL with respect to all scales used to determine quality of life.
Incidence of acute pancreatitis seems to be increasing in the Western countries and has been associated with significantly increased morbidity. Nearly 80% of the patients with acute pancreatitis undergo resolution; some develop complications including pancreatic necrosis. Infection of pancreatic necrosis is the leading cause of death in these patients. A significant portion of these patients needs surgical interventions. Traditionally, the “gold standard” procedure has been the open surgical necrosectomy, which is now being completed by the relatively lesser invasive interventions. Minimally invasive surgical (MIS) procedures include endoscopic drainage, percutaneous image-guided catheter drainage, and retroperitoneal drainage. This review article discusses the open and MIS interventions for pancreatic necrosis with each having its own respective benefits and disadvantages are covered.
Musculoskeletal tuberculosis accounts for 1%-3% of all cases of tuberculosis (TB) worldwide with elbow involvement being even less common. The most cases of tuberculous arthritis occur in patients born in and emigrated from endemic regions, especially in patients who are co-infected with human immunodeficiency virus (HIV). We present a rare case of tuberculous septic arthritis of the elbow joint in a 78-year-old African-American female from the United States, with no history of travel abroad. Her presenting symptoms included pain, swelling, and decreased range of motion of the right elbow for six months. She underwent incision and debridement of the elbow joint and was started on empiric intravenous antibiotic therapy for suspected pyogenic septic arthritis. Several weeks later, surgical cultures demonstrated acid-fast bacilli, identified as Mycobacterium tuberculosis (M. tuberculosis) and a four-drug anti-tuberculosis regimen was initiated. Based upon culture results, additional imaging evaluation was undertaken. She did not have any symptoms of a pulmonary disease but was found to be positive for Mycobacterium tuberculosis in sputum cultures and bronchoalveolar lavage. We emphasize the importance of considering a tuberculosis infection in the differential diagnosis of monoarticular arthritis, especially in elderly patients with immune deficient states since early recognition and treatment result in good functional outcomes.
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