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Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Neuropathic disorders due to nutritional deficiency or toxicity. Patients at risk include those with impaired gastrointestinal absorption (status-post gastric bypass surgery or partial gastrectomy or with autoimmune malabsorption) or decreased nutritional intake (alcoholics, chronic illness, extreme diets, or anorexia).
Vascular Surgery
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
If a patient has not had satisfactory improvement from an exercise programme, then they can be referred to vascular surgery for consideration of surgical intervention. Options include: AngioplastyBypass surgery
Vascular Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Yiu-Che Chan, John Wang, Julian Wong, Edward Choke, Tjun Tang
Peripheral bypass: A trial25 randomised patients with critical limb ischaemia to bypasssurgery-first or balloon angioplasty-first revascularisation strategies. No significant differences in amputation-free survival or overall survival were found between the two groups overall. However, for patients who survived for at least 2 years, the bypass surgery-first strategy was associated with significant increase in subsequent overall survival.
Long-term effects of physical activity prescription after bariatric surgery: A randomized controlled trial
Published in Physiotherapy Theory and Practice, 2022
Monika Fagevik Olsén, Malin Wiklund, Erica Sandberg, Stefan Lundqvist, Elizabeth Dean
Bariatric surgery with commensurate weight loss has been reported to improve patients’ self-reported physical function including less back and knee pain, increased walking speed, and improved ability to climb stairs and navigate obstacles (Gill et al., 2016; King et al., 2016; Morrow et al., 2020; Vincent et al., 2012). Patients’ physical activity before and after surgery has been investigated in several trials. In 2016, one review reported on 26 articles evaluating changes in PA after bariatric surgery (Herring et al., 2016). The investigators reported a shift toward more active time but with less intensity, within the first 6 months postoperatively. This was demonstrated by a reduction in intensity of PA and an increase in step count. In a trial of 2458 participants, 76.5% who completed baseline and follow-up assessments improved their physical function beyond a clinically meaningful difference (King et al., 2016). Patients who have undergone laparoscopic surgery reported being more active than those undergoing open procedures in both the short (i.e. 2 weeks) and long-term (i.e. 3 months) (Evans et al., 2004). Other studies such as one by Berglind et al. (2015) have not reported differences between pre – and post-surgery differences in PA or sedentary behavior. With respect to the perspectives of patients, investigators have reported that although being physically active and exercising is easier for patients after bypass surgery, modifying exercise and identifying the optimal parameters of exercise remain challenging for them (Wiklund, Olsén, and Willén, 2011).
Is the revascularisation strategy and outcome different in patients with acute coronary syndrome in COVID-19 pandemic era: a tertiary centre experience
Published in Acta Cardiologica, 2022
İbrahim Faruk Aktürk, Cennet Yıldız, Dilay Karabulut, Ersan Oflar, Alparslan Şahin, Abdulcelil Sait Ertuğrul, Atilla Koyuncu, Veli Polat, Aysun Karahan, Feridun Koşar, İlayda Bostancı Alp, Kudret Keskin, Fatma Nihan Turhan Çağlar
In our study, there was a significant difference between groups in the bypass surgery group. At the pre-pandemic period, 27 patients underwent bypass surgery, whereas in the pandemic group, only eight patients underwent bypass surgery. During the pandemic period, all elective surgeries were postponed, in addition our cardiovascular surgery intensive care unit was occupied by intubated COVID-19 patients during that time. Although bypass surgery reduces long-term mortality in multivessel disease patients, it may increase in-hospital mortality as well [37]. This may explain higher but statistically nonsignificant in hospital mortality during the pre-pandemic period. Interestingly, during the pre-pandemic period, we had four patients with cardiac arrest under cardiopulmonary resuscitation, but in the pandemic group, we had one patient like this. Although statistically nonsignificant, this situation may have an effect on in hospital mortality difference between groups.
Numerical study of hemodynamics in a complete coronary bypass with venous and arterial grafts and different degrees of stenosis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Shila Alizadehghobadi, Hasan Biglari, Hanieh Niroomand-Oscuii, Meisam H. Matin
One of the most prevalent cardiovascular diseases is coronary artery disease which is the leading cause of death all over the world (Wong 2014). The stenosis or blockage of the artery brings about a reduction of blood flow to the heart muscle and therefore causes problems for blood supply to the heart. One of the main treatments for the coronary artery blockage is bypass surgery in which an alternative graft is used to compensate for the blood flow reduction through the coronary artery (Arima et al. 2005; Deb et al. 2013). This graft is connected to the aorta from upstream and to the coronary artery from downstream. Internal thoracic artery (ITA) and small saphenous vein are the commonly used vessels in bypass. The main issue encountered after the bypass surgery is stenosis or partial blockage of the graft which occurs due to the variations in the hemodynamic conditions leading to the failure of the grafting. The hemodynamic conditions strongly depends on the mechanical properties of the artery tissues. Since the accurate experimental evaluation of the parameters is almost elusive due to the challenges associated with the ultrasonic velocity measurement, numerical simulations can examine the flow conditions and hemodynamics conveniently but with some limitations. Owida et al. (2012) provided an overview on numerical simulations of the flow pattern and wall shear stress in the occluded coronary arteries.