Both the NLR and PLR, as well as C-reactive protein, predicted mortality in this critically ill population. The PLR and NLR are easy-to-measure, inexpensive markers. Physicians should be aware of elevations in PLR and NLR in patient care in ICUs.
Bu çalışmada perkütan subklaviyen ven yoluyla tamamen implante edilebilir venöz erişim portu yerleştirilen hastaların klinik özellikleri, periprosedürel sonuçları, erken ve geç komplikasyonları ve tedavi stratejileri sunuldu.Ça lış mapla nı:Mart 2012 -Haziran 2018 tarihleri arasında perkütan landmark yöntemi ile subklaviyen ven yoluyla 2000 kanser hastasına (1066 erkek, 934 kadın; ort. yaş: 58.4±12.7 yıl; dağılım, 18-88 yıl) toplam 2084 port cihazı yerleştirildi. Demografik özellikler, primer tanı, teknik başarı, işlem süresi, cihazın kalma süresi, cihazın çıkarılma nedenleri ve erken ve geç komplikasyonlar dahil olmak üzere tıbbi veriler retrospektif olarak incelendi.
Bul gu lar:En sık görülen kanser türü erkeklerde kolon kanseri, kadınlarda meme kanseri idi. İşlemin teknik başarı oranı %98.5 idi. Hastaların çoğunda (%92.4) sağ subklaviyen ven üzerinden erişim sağlandı. Arteriyel ponksiyon, kateter malpozisyonu, yüzeyel hematom ve pnömotoraks gibi erken komplikasyonlar 143 hastada (%6.9) gözlenir iken, 118 hastada (%5.7) enfeksiyon, kateter tıkanması, venöz tromboz, yara problemleri, kateter göçü ve embolizasyonu ve pinch-off sendromu gibi geç komplikasyonlar gelişti. En sık erken komplikasyon 63 hastada (%3) hatalı arteriyel ponksiyon iken, 44 hastada (%2.1) enfeksiyon en sık görülen geç komplikasyondu. Kemoterapinin tamamlanması veya komplikasyon gelişmesi nedeniyle toplam 192 port cihazı çıkarıldı.So nuç: Çalışmamız yüksek teknik başarı ve düşük komplikasyon oranları ile perkütan subklavyen ven yoluyla tamamen implante edilebilir venöz erişim portu yerleştirilmesinin güvenliğini ve tolerabilitesini doğrulamıştır.Anah tar söz cük ler: Komplikasyon, perkütan, port kateter, subklavyen ven, tamamen implante edilebilir venöz erişim cihazı.
ObjectiveWe aimed to present clinical features, surgical approaches, importance of surgical
technique and long-term outcomes of our patients with cardiac myxoma who underwent
surgery.MethodsWe retrospectively collected data of patients with cardiac myxoma who underwent
surgical resection between February 1990 and November 2014. Biatrial approach is the
preferred surgical method in a large proportion of patients that are operated due to
left atrial myxoma because it provides wider exposure than the uniatrial approach. To
prevent recurrence during surgical resection, a large excision is made so as to include
at least 5 mm of normal area from clean tissue around the tumor. Moreover, special
attention is paid to the excision that is made as a whole, without digesting the
fragment of tumor with gentle dissections.ResultsForty-three patients (20 males, mean age of 51.7±8.8 years) were included. Most
common symptom was dyspnea (48.8%). Tumor was located in the left atrium in 37 (86%)
patients. Resections were achieved via biatrial approach in 34 patients, uniatrial
approach in 8 patients, and right atriotomy with right ventriculotomy in 1 patient. One
patient died due to low cardiac output syndrome in the early postoperative period. Mean
follow-up time was 102.3±66.5 months. Actuarial survival rates were 95%, 92% and
78% at five, 10 and 15 years, respectively. Recurrence was observed in none of the
patients during follow-up.ConclusionAlthough myxomas are benign tumors, due to embolic complications and obstructive signs,
they should be treated surgically as soon as possible after diagnosis. To prevent
recurrence, especially in cardiac myxomas which are located in left atrium, preferred
biatrial approach is suggested for wide resection of the tumor and to avoid residual
tumor.
The most important measure is careful sternal retraction and use of the hands-up position for the low incidence and benign course of brachial plexus problems. Inappropriate sternal retraction during preparation of internal mammary artery should be avoided.
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