ABSTRACT
BACKGROUND AND AIMS: The effect of surgical treatment for spontaneous intracerebral hemorrhage (ICH) remains uncertain. We conducted an observational retrospective cohort study on supra-centimeter spontaneous ICH treated with either neurosurgical or conservative management. The baseline demographics and risk factors were correlated with in-hospital mortality and 3 and 6-month survival rates stratified by management. METHODS: We included all patients with evidence of spontaneous ICH > 1 cm detected by CT and admitted between august 2020 and march 2021 to the "SMM" Hospital in Perugia. RESULTS: Onehundredandtwentytwo patients were included in the study, and 45% (n.55) were surgically treated. The mean age was 71.9 ± 15.3, and 61% (n.75) were males. Intra-hospital mortality ended up being 31% (n.38), 3 months-survival was 63% (n.77) and 6 months-survival was 60% (n.73). From the multivariate analysis of the surgical patients versus medical patient, we observed that the surgical patients were younger (67.5 ± 14.9 vs 75.5 ± 14.7 y; OR 0.87; Cl 95% 0.85-0.94; p 0.001), with greater ICH volume at the onset (61 ± 39.4 cc vs 51 ± 64 cc; OR 1.03; Cl 95% 1.005-1.07; p 0.05), more midline shift (7.61 ± 5.54 mm vs 4.09 ± 5.88 mm; OR 1.37; Cl 95% 1.045-1.79; p 0.023), and a higher ICH score (3 vs 2 mean ICH score; OR 21.12; Cl 95% 2.6-170.6; p 0.004). Intra-hospital mortality in the surgical group and in the conservative treatment group was respectively 33% vs 30%, 3 month-survival was 64% vs 63% and 6 month- survival were 60% in both groups. CONCLUSIONS: Our patient cohort shows no overall benefit from surgery over conservative treatment, but surgical patients were younger and had larger ICH volume.
Subject(s)
Cerebral Hemorrhage , Male , Humans , Middle Aged , Aged , Aged, 80 and over , Female , Retrospective Studies , Treatment Outcome , Cerebral Hemorrhage/surgeryABSTRACT
AIM: The literature about pediatric robotic-assisted laparoscopic dismembered pyeloplasty (RALDP) is poor and limited to few series. This article reports the initial pediatric experience comparing it with the major series. METHODS: Between January 2006 and January 2007 at Umberto Parini Hospital in Aosta three patients were treated for left RALDP by a single senior surgeon. RESULTS: Mean age of the patients was 16.1 years (range 14.9-17.0). Mean body mass index was 21.6 kg/m2 (range 18.7-26.9). All patients were treated for left RALDP. Mean operative time (OT) was 160 minutes (range 120-185). Blood loss was null in all procedures and no interventions were converted to open. Mean postoperative hospitalization was 6.3 days (range 5-8). No intra- or postoperative complications occurred. CONCLUSIONS: This short series demonstrates that RALDP is feasible in adolescents as well and in a peripheral Centre high skilled in adult robotic urology. The OT is excellent in comparison with other series. A preliminary experience in adult robotic surgery and an initial collaboration with urologists for adults are strongly recommended.
Subject(s)
Kidney Pelvis/surgery , Laparoscopy/methods , Nephrectomy/methods , Robotics , Adolescent , Female , Humans , Italy , MaleSubject(s)
Kidney Transplantation , Medical Informatics/methods , Registries , Renal Dialysis , Databases, Factual , Humans , SoftwareABSTRACT
The effects of cis-2-hydroxy-2-phenylcyclohexanecarboxilic acid (cicloxilic acid) on the liver damage produced by a choline-free, high-fat low-protein diet (Handler's diet) were studied in rats. Treatment with cicloxilic acid significantly counteracted the increase in liver weight, hepatic lipids, serum transaminase and ornithine carbamoyl transferase activities, caused by the unbalanced and deficient diet. Histological examination of the liver showed a near-normal structure of the hepatic cells in the cicloxilic acid-treated animals. Other antihepatotoxic and choleretic drugs, with which cicloxilic acid was compared, showed either much less protective activity or none at all. Furthermore, while cicloxilic acid (which exhibits choleretic activity) did not alter the hepatic glycogen content, another choleretic drug, 1-phenyl-1-hydroxypentane (PC 1), caused marked depletion. It is concluded that the protective activity exerted by cicloxilic acid on the liver is separable from its choleretic activity.
Subject(s)
Choline Deficiency/complications , Cyclohexanecarboxylic Acids/therapeutic use , Dietary Fats/pharmacology , Liver Diseases/drug therapy , Protein Deficiency/complications , Animals , Diet , Lipid Metabolism , Liver/pathology , Liver Diseases/etiology , Liver Diseases/pathology , Liver Function Tests , Male , Organ Size/drug effects , RatsABSTRACT
The effects of cis-2-hydroxy-2-phenyl-cyclohexanecarboxilic acid (cicloxilic acid) on the liver injury produced by carbon tetrachloride poisoning were studied in rats. It was found that oral treatment counteracts the CCl4-induced increase in liver weight, rise of liver triglycerides, fall of plasma triglycerides and rise of serum transaminase and ornithine carbamoyl transferase activities. Further, cicloxilic acid, when administered alone, altered none of the parameters studied. Cicloxilic acid was found to be more effective at the lowest doses than any of the other antihepatotoxic and choleretic drugs used. When cicloxilic acid was administered at the highest doses, the plasma triglyceride level of the intoxicated animals was not significantly different from that of the controls. To find out whether cicloxilic acid was effective in maintaining a normal lipoprotein secretion after CCl4 poisoning, experiments were carried out with Triton WR-1339. The results indicate that cicloxilic acid maintains the output of triglycerides from the liver to the plasma compartment at near-normal level in CCl4 poisoned rats. Possible mechanisms for the effects of cicloxilic acid on the CCl4-induced liver damage are discussed.
