Surgery

OBJECTIVE: We investigated the semiology of focal onset bilateral motor (convulsive) seizure (FBMS) in patients with intractable focal epilepsy who underwent epilepsy surgery to understand its value in localizing the origin of the seizure. METHODS: The study included 20 patients who underwent resective surgery after intracranial video-EEG monitoring (iEEG) with a favorable seizure outcome (Engel class I), and had at least one FBMS during iEEG. The diagnosis was mesial temporal lobe epilepsy (MTLE) for 7 patients and neocortical epilepsy (NE) for 13 patients (lateral temporal lobe, 3; posterior cortex, 6; frontal lobe, 3; perirolandic, 1)...

BACKGROUND: Type 3c diabetes mellitus (T3cDM) is diabetes secondary to other pancreatic diseases such as chronic pancreatitis, pancreatic resection, cystic fibrosis, and pancreatic ductal adenocarcinoma (PDA). Clinically, it may easily be confused with conventional type 2 diabetes mellitus (T2DM). A delay in pancreatic cancer diagnosis and treatment leads to a worse outcome. Therefore, early recognition of PDA-associated T3cDM and distinction from conventional T2DM represents an opportunity improve survival in patients with PDA...

Acquired middle ear cholesteatoma leads to hearing loss, ear discharge, ear pain, and more serious intracranial complications. However, there is still no effective treatment other than surgery. TFIIB-related factor 2 (BRF2) acted as a redox sensor overexpressing in oxidative stress which linked endoplasmic reticulum (ER) stress, while glucose-regulated protein 78 (GRP78) was a biomarker of ER stress in cancer, atherosclerosis and inflammation. In our study, we investigated the roles of BRF2 and GRP78 in acquired middle ear cholesteatoma...

BACKGROUND: Between October 2019 and February 2020, massive crowds protested in Lebanon against economic collapse. Various less than lethal weapons including riot control agents and rubber bullets were used by law enforcement, which led to several traumatic and chemical injuries among victims. This study describes the clinical presentation, management, outcome, and healthcare costs of injuries. METHODS: A retrospective review of the hospital records of all the casualties presenting to the Emergency Department of the American University of Beirut Medical Center between October 17th, 2019, and February 29th, 2020, was conducted...

BACKGROUND: Osteochondral defects of the talus (OCD) are a well-established pathology within the ankle. They are most commonly associated with ankle trauma and whilst many are asymptomatic, they can have a significant negative impact on the patient, most notably with regards pain and mobility. Treatment of these lesions remains variable across the diverse cohort of these patients. AIMS: Evaluating the incidence of talus OCDs. Evaluating anatomic and morphologic data of the lesions against previous studies...

INTRODUCTION AND AIMS: COVID-19 has had a significant impact on orthopaedic surgery globally. This paper aims to evaluate the impact of COVID-19 on foot and ankle trauma in a major trauma centre. METHODS: A retrospective observational study of prospectively collected data was performed. All foot and ankle trauma patients over a 33 week period (1st December 2019-16th July 2020) were analysed. All patients with trauma classified by the AO/OTA as occurring at locations 43 and 81-88 were included...

BACKGROUND: Ankle fractures are a common orthopedic injury that frequently involves associated cartilage lesions, soft tissue damage, and a significant inflammatory burden. Despite studies revealing intra-articular pathology in up to 79% of ankle fractures, only 1% of open reduction and internal fixation (ORIF) procedures undergo arthroscopic evaluation. The primary purpose of this study was to determine the cost effectiveness of ankle arthroscopy performed at time of ORIF for ankle fracture...

PURPOSE: We aimed to conduct a systematic review to evaluate the personality changes in adult patients with drug-resistant epilepsy following surgical treatment. METHODS: A systematic review was conducted using the Preferred Reporting Items of Systematic Reviews and MetaAnalyses (PRISMA) statement. We searched PubMed, Medline databases, and the Cochrane Controlled Trials Register, with search terms 'personality', 'epilepsy', and 'surgery'. RESULTS: Eleven studies were selected...

OBJECTIVE: The aim of the study was to assess safety and long term efficacy as well as short and long term complications of vaginal prolapse mesh repair using single incision trocar-less system while preserving the uterus. STUDY DESIGN: A single-center, retrospective cohort study including all patients who underwent vaginal prolapse mesh repaier surgery with EndoFast Reliant™ kit between October 2010 and January 2015. Outcomes included anatomical changes (POP-Q), overactive bladder symptoms (OAB) stress urinary incontinence (SUI), sexual function and constipation as well as the rate of surgical failure, immediate and long-term complications...

OBJECTIVE: We aimed to evaluate the impact of the sentinel lymph node (SLN) biopsy on adjuvant therapy, recurrence and survival in early endometrial cancer (EC). STUDY DESIGN: We retrospectively included all patients who underwent SLN biopsy for EC between February 2007 and March 2018. RESULTS: Of the 249 EC patients included, the overall SLN detection rate was 91 %. SLNs were positive in 36 (14.4 %) cases. Nine of the 13 preoperative low-risk patients with positive SLNs were re-operated and 22 % presented positive non-SLNs...

BACKGROUND: The prognosis of complex primary total knee arthroplasty (TKA) with severe deformity and ligament deficiency is not clear. There is a paucity of evidence in the current literature on treatment outcomes of the rotating hinge knee implants in primary TKA. The aim of this study was to determine the mid-term clinical, radiographic, and health-related quality of life (HRQoL) outcomes in patients who had undergone complex primary TKA using single hinged knee replacement. METHODS: In total, 106 complex primary TKAs (101 patients) were performed using the single rotating hinged knee (RHK) implant design at our institution between January 2004 and December 2013...

BACKGROUND: The study intended to determine the presence of lower limb arterial calcification (LLAC) in lower extremity color Doppler ultrasonography (CDUS) before primary total knee arthroplasty (TKA) and its relation with cardiovascular events (CVE) during knee arthroplasty and the postoperative period, as well as to investigate its effect on surgical risk estimation. METHODS: We designed this study as a retrospective cohort study. The study comprised 467 patients who met the inclusion criteria and had surgery for a primary gonarthrosis diagnosis between January 2005 and December 2015 were included...

AIM: Conformational forms of the epidermal growth factor receptor (EGFR) are pro-tumorigenic. The prevalence and impact of conformational forms of EGFR in malignant mesothelioma (MM) is unknown. We investigated expression of EGFR and conformational forms of EGFR by immunohistochemistry using EGFR-targeting monoclonal antibodies (mAb). In addition, EGFR gene amplification was investigated by fluorescent in-situ hybridization (FISH). Findings were correlated with survival. METHODS: Patients treated between 1988 and 2014 were identified from the thoracic surgery database of the Austin Hospital, Melbourne, Australia...

INTRODUCTION AND IMPORTANCE: Nonoperative management of adhesive SBO is well established but remains a challenge in patients without prior abdominal surgery. We aim to report a case of successful nonoperative management with the use of enteral hypertonic water-soluble contrast administration in a patient with virgin abdomen. CASE PRESENTATION: A healthy 24-year old man with no previous surgery presented to the emergency room with one day of abdominal pain. A CT abdomen and pelvis was consistent with SBO without clear anatomic etiology...

INTRODUCTION: Myxoid liposarcoma of the bladder is a rare mesenchymal tumor which is difficult to diagnose and carries a poor prognosis. The primary treatment is complete surgical resection which is usually followed by adjuvant chemotherapy. PRESENTATION OF CASE: We report a case of 26 years female who presented with a large abdominal mass and was initially misdiagnosed to be arising from ovaries and subsequently discovered to be a mesenchymal tumor arising from the bladder...

INTRODUCTION: Gastric volvulus are rare. Complications can be life threatening, including necrosis and perforation. Assessment of mucosal viability is essential, and urgent surgical intervention is mandatory in case of vascular compromise. PRESENTATION OF CASE: An 72-year-old female known for a paraesophageal hiatal hernia was admitted at our emergency department with acute abdominal pain. Blood count demonstrated leukocytosis and increased C-reactive protein. Abdominal computed tomography showed a mesenteroaxial gastric volvulus...

INTRODUCTION: Disclosure of damage related to care is a difficult area of communication due to the physician's feeling of guilt or the fear of liability. The aim of this study was to develop, and to evaluate the impact of an inter-disciplinary simulation program on communication of damage related to care. METHODS: Residents in gynecology/obstetrics and anesthesiology participated in role-playing scenarios of communication of damage related to care. We assessed verbal, non-verbal communication skills and inter-disciplinary relations with a modified SPIKES protocol and with a video analysis with predefined indicators...

Many surgical options have been proposed for the treatment of first carpometacarpal (CMC1) osteoarthritis. Conventional techniques are invasive, so we wanted to develop an arthroscopic technique. Partial trapeziectomy combined with various interpositions and ligament reconstruction is a long-standing intervention. As in total trapeziectomy, the combination with ligament reconstruction remains controversial. The aim of this study was to demonstrate the benefits of adding an abductor pollicis longus (APL) ligament reconstruction to partial trapeziectomy performed under arthroscopy...

INTRODUCTION: Central venous occlusive disease is a common cause of upper extremity, arteriovenous (AV) access dysfunction in hemodialysis patients. When refractory to balloon angioplasty, treatment options include central venous stenting and the Hemodialysis Reliable Outflow (HeRO) graft. The purpose of this study is to evaluate the outcomes of these options. METHODS: A retrospective review was performed of patients who underwent central venous stenting or HeRO placement for central venous obstruction between December 2008 and March 2018...

OBJECTIVES: Venous leg ulcers (CEAP 6) represent the severest form of chronic venous insufficiency. As closure techniques for superficial venous reflux evolve, direct outcome comparisons of treatments are integral as many studies have already demonstrated early endovenous intervention improves wound healing. This study aims to compare rates of venous wound healing between two techniques of superficial vein closure: ClosureFastTM radiofrequency ablation (RFA) and adhesive closure (VenaSealTM )...