Glomus tumors derive from the glomus cell around arteriovenous anastomosis. These are rare tumors and when found are most common in the deep dermis of the extremities. In rarer cases still they have been reported to b...Glomus tumors derive from the glomus cell around arteriovenous anastomosis. These are rare tumors and when found are most common in the deep dermis of the extremities. In rarer cases still they have been reported to be found in the lung. These are most commonly incidental findings of solitary lesions of the lung with a pre-operative differential diagnosis of non-small cell carcinomas and carcinoids. Due to the rare nature of these tumors, they are rarely considered in the differential diagnosis and are also often misdiagnosed at the time of frozen section. We present three cases of glomus tumors of the lung with emphasis on the consideration of the method of diagnosis, histological findings and management.展开更多
Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objecti...Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objective: To compare the outcome of amiodarone prophylaxis in diabetics and non-diabetics. Design: Subgroup analysis within a randomized, controlled, double-blinded trial. Results: Development of atrial fibrillation was equally frequent among diabetics (18.2%) and non-diabetics (20.5%) (p = 1.00). Atrial fibrillation occurred in 7.1% of prophylactic diabetics and in 9.3% of prophylactic non-diabetics, while 37.5% non-prophylactic diabetics and 31.3% non-prophylactic non-diabetics experienced atrial fibrillation (p = 0.31). Prophylactic amiodarone was equally effective in diabetics as in non-diabetics with a relative risk of 3.5 (1.8 - 67.0) and the number need to treat of 4.4 (3.3 - 8.3) (p = 0.31). The length of in-hospital stay for diabetics was equal to non-diabetics with an average stay of 7.1 versus 8 days at Aarhus University Hospital (p = 0.61) with similar stays at intermediary and intensive care unit as well as total in-hospital stay of 8.9 versus 10 days (p = 0.60). Conclusions: Diabetics have the same risk of atrial fibrillation and the same benefits from prophylactic amiodarone as non-diabetics after surgery for lung cancer. Furthermore, diabetics have the same length of stay as non-diabetics. No severe adverse effects were found in either group.展开更多
Approximately 5% of goitres extend below the thoracic inlet and can potentially become life threatening due to compression of the airway and major vessels. Approximately 7% of these goitres which require surgical rese...Approximately 5% of goitres extend below the thoracic inlet and can potentially become life threatening due to compression of the airway and major vessels. Approximately 7% of these goitres which require surgical resection will need an additional sternotomy to deliver the intra-thoracic component. Massive retrosternal toxic goitres presenting acutely are rare and are described infrequently in literature. We hereby present two cases of massive retrosternal thyrotoxic goitres presenting with acute respiratory failure, requiring non-invasive ventilation, as well as significant head and neck venous compression. Surgery on the thyrotoxic patient with a goitre, even if not significantly enlarged, is associated with a high peri-operative mortality due to cardiac instability and hemorrhage. We discuss the challenges of surgical intervention in these patients with particular emphasis on the timing of surgery to relieve compressive symptoms and the time needed to achieve a euthyroid state. We also emphasize the need for meticulous hemostasis, use of a cell-saver, transfusion protocols, adjuncts to hemostasis, as well as careful monitoring and continuous adjustments to the coagulation profile.展开更多
文摘Glomus tumors derive from the glomus cell around arteriovenous anastomosis. These are rare tumors and when found are most common in the deep dermis of the extremities. In rarer cases still they have been reported to be found in the lung. These are most commonly incidental findings of solitary lesions of the lung with a pre-operative differential diagnosis of non-small cell carcinomas and carcinoids. Due to the rare nature of these tumors, they are rarely considered in the differential diagnosis and are also often misdiagnosed at the time of frozen section. We present three cases of glomus tumors of the lung with emphasis on the consideration of the method of diagnosis, histological findings and management.
文摘Background: To evaluate if the risk for developing atrial fibrillation after lung surgery is higher for diabetics than non-diabetic patients and whether diabetic status prolongs the length of in-hospital stay. Objective: To compare the outcome of amiodarone prophylaxis in diabetics and non-diabetics. Design: Subgroup analysis within a randomized, controlled, double-blinded trial. Results: Development of atrial fibrillation was equally frequent among diabetics (18.2%) and non-diabetics (20.5%) (p = 1.00). Atrial fibrillation occurred in 7.1% of prophylactic diabetics and in 9.3% of prophylactic non-diabetics, while 37.5% non-prophylactic diabetics and 31.3% non-prophylactic non-diabetics experienced atrial fibrillation (p = 0.31). Prophylactic amiodarone was equally effective in diabetics as in non-diabetics with a relative risk of 3.5 (1.8 - 67.0) and the number need to treat of 4.4 (3.3 - 8.3) (p = 0.31). The length of in-hospital stay for diabetics was equal to non-diabetics with an average stay of 7.1 versus 8 days at Aarhus University Hospital (p = 0.61) with similar stays at intermediary and intensive care unit as well as total in-hospital stay of 8.9 versus 10 days (p = 0.60). Conclusions: Diabetics have the same risk of atrial fibrillation and the same benefits from prophylactic amiodarone as non-diabetics after surgery for lung cancer. Furthermore, diabetics have the same length of stay as non-diabetics. No severe adverse effects were found in either group.
文摘Approximately 5% of goitres extend below the thoracic inlet and can potentially become life threatening due to compression of the airway and major vessels. Approximately 7% of these goitres which require surgical resection will need an additional sternotomy to deliver the intra-thoracic component. Massive retrosternal toxic goitres presenting acutely are rare and are described infrequently in literature. We hereby present two cases of massive retrosternal thyrotoxic goitres presenting with acute respiratory failure, requiring non-invasive ventilation, as well as significant head and neck venous compression. Surgery on the thyrotoxic patient with a goitre, even if not significantly enlarged, is associated with a high peri-operative mortality due to cardiac instability and hemorrhage. We discuss the challenges of surgical intervention in these patients with particular emphasis on the timing of surgery to relieve compressive symptoms and the time needed to achieve a euthyroid state. We also emphasize the need for meticulous hemostasis, use of a cell-saver, transfusion protocols, adjuncts to hemostasis, as well as careful monitoring and continuous adjustments to the coagulation profile.
