Articles: postoperative.
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Lung Cancer Posters IISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Review the characteristics and outcomes of patients in our series ⋯ The following authors have nothing to disclose: Daniel Valdivia, Lucas Hoyos, Lidia Macias, David Gomez, Andres VarelaNo Product/Research Disclosure Information.
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Cardiovascular Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: We present a case of progressive hypoxemia with platypnea-orthodeoxia developing after lung resection surgery for lung cancer. ⋯ Symptoms of hypoxemia with platypnea-orthodeoxia are concerning for shunt physiology. The differential diagnosis includes sources of intracardiac (ASD, PFO) and intrapulmonary shunting. He had a prior intracardiac shunt on an earlier echo but not on the post-operative study. He had no evidence of other cardiac causes such as pericardial effusion, constrictive pericarditis or aortic aneurysm. He had an interstitial lung disease by CT scan but this was unchanged radiographically. There was no evidence of other pulmonary causes such as COPD, thromboembolic disease or an intrapulmonary shunt (arteriovenous malformation). He had no history of liver disease with shunt from cirrhosis or history of kyphoscoliosis. Platypnea-orthodeoxia was first described in 1949 and major causes are intracardiac shunts and intrapulmonary shunts. The intracardiac shunts are right-to-left and most often include atrial septal defect, patent foramen ovale or fenestrated atrial aneurysm. Other causes include pericardial effusion, lobectomy, pneumonectomy or upper abdominal surgery. This occurs from preferential blood flow towards the atrial septum that is accentuated by altered intracardiac anatomy, compliances of the right and left heart, pulmonary vascular resistance and transient right to left pressure gradients associated with respiratory and positional changes. This is generally not associated with pulmonary hypertension and atrial right-to-left shunting has been reported despite normal right-sided pressures. A right-to-left shunt is more likely to appear after a right-sided lung resection with most patients having symptoms develop a month to several months afterwards. Noncardiac causes can include intrapulmonary shunting, such as thromboembolic disease and AVMs, or cirrhosis and kyphoscolisoss. The key to diagnosis is clinical suspicion of symptoms of dyspnea and hypoxemia, induced or worsened by an upright posture. In conclusion, interatrial shunting through a PFO or ASD is a rare but clinically significant condition after thoracic surgery. There are several underlying etiologies and can occur in the immediate postoperative period or can be more delayed.Reference #1: Interatrial Shunting After Major Thoracic Surgery: A Rare but Clinically Significant Event. Ann Thorac Surg 2012;93:1647-51Reference #2: Dyspnoea and hypoxaemia after lung surgery: the role of interatrial right-to-left shunt. Eur Respir J 2006; 28: 174-181Reference #3: Platypnoea-orthodeoxia syndrome. Heart 2000;83:221-223DISCLOSURE: The following authors have nothing to disclose: Nitin Bhatt, Ulysses MagalangNo Product/Research Disclosure Information.
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Cancer Case Report Posters ISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: A solitary fibrous tumor (SFT) is a rare pleural neoplasm, and tumor-to-tumor metastases are unusual phenomena. ⋯ We present an unusual case of tumor-to-tumor metastasis involving (PET)-negative breast cancer as donor to a recipient SFT 6 years after treatment for primary breast cancer and synchronous with contralateral primary lung cancer.Reference #1: Petraki et al, International Journal of Surgical Pathology 11(2):127-135, 2003DISCLOSURE: Eric Toloza: Other: Honoraria from Intuitive Surgical Inc. for proctoring & observation site The following authors have nothing to disclose: Frank Velez-Cubian, Robert Gabordi, Prudence Smith, Shohreh Dickinson, Carla Moodie, Joseph GarrettNo Product/Research Disclosure Information.
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PediatricsSESSION TYPE: Slide PresentationsPRESENTED ON: Sunday, March 23, 2014 at 12:15 PM - 01:15 PMPURPOSE: Necrotizing Pneumonia is a rare complication of bacterial pulmonary infection in children that has become more prevalent since the introduction of antibiotics. The treatment with appropriate antibiotics resolve the clinical course of necrotizing pneumonia in children, nevertheless, a small number of patients might need surgical treatment. The objective of this study is to present the results of the conservative surgical approach: Lung Necrosectomy, in children with necrotizing pneumonia. ⋯ The following authors have nothing to disclose: Francina Bolaños, Patricio Santillán Doherty, Luis Marcelo Argote Greene, Maria Elena Aguilar, Santibañez Sandoval José alfredo, Maria del Socorro Ortiz GeaNo Product/Research Disclosure Information.
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OSA PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Obstructive apneas can be a serious perioperative complication. Every anesthesiologist should be aware of the influence of anesthetic medications on the occurrence of such apneas. We studied the effect of an oral premedication with 0.5 mg alprazolam in patients scheduled for day-care colonoscopy. ⋯ The following authors have nothing to disclose: Eric Deflandre, Anne-Catherine Courtois, Stephanie Degey, Jean-Francois Brichant, Pol Hans, Robert Poirrier, Vincent BonhommeNo Product/Research Disclosure Information.