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A Novel Method for Managing Water and Electrolyte Balance after Transsphenoidal Surgery: Preliminary Study of Moderate Water Intake RestrictionWAKABAYASHI, TOSHIHIKO, OKUMURA, ERIKO, NAGATANI, TETSUYA, TAKEUCHI, KAZUHITO 02 1900 (has links)
No description available.
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Impact of Intraoperative 3-Tesla MRI on Endonasal Endoscopic Pituitary Adenoma Resection and a Proposed New Scoring System for Predicting the Utility of Intraoperative MRI / 経鼻内視鏡下垂体腫瘍摘出術における術中3テスラMRIの効果と、術中MRIの有用性を予測する新規スコアリングシステムの提唱Tanji, Masahiro 24 May 2021 (has links)
京都大学 / 新制・論文博士 / 博士(医学) / 乙第13419号 / 論医博第2227号 / 新制||医||1052(附属図書館) / 京都大学大学院医学研究科脳統御医科学系専攻 / (主査)教授 高橋 淳, 教授 中本 裕士, 教授 大森 孝一 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM
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Risk factors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic reviewAcosta, Michael A. 17 June 2016 (has links)
BACKGROUND: Delayed symptomatic hyponatremia (DSH) is among the most common reasons for readmission following transsphenoidal surgery. Patients can present with a large range of symptoms, requiring immediate attention and prolonging hospital stay. In rare and severe cases, DSH can result in death. While various risk factors for DSH have been investigated, there is still a need for better understanding in order to identify patients who are at risk. Clinicians can then take preventative measures to improve patient outcomes. A systematic review was performed to determine both predictors and rates of DSH after both endoscopic (eTSS) and microscopic transsphenoidal surgery (mTSS).
METHODS: We conducted a systematic search through databases MEDLINE/PUBMED, MEBASE, and The Cochrane Library. Included studies were selected with the following criteria: (i) case series with at least 10 cases reported, (ii) adult patients who underwent eTSS or mTSS for pituitary adenomas, and (iii) reported occurrence of DSH (hyponatremia defined as blood sodium level <135 mEq/L) three days post-operatively. Data were analyzed using CMA V.3 Statistical Software (2014).
RESULTS: We identified 10 case series that satisfied the inclusion criteria consisting of 2,947 patients with pituitary adenomas. The following were investigated as potential predictors of DSH: age, CSF leak, gender, and tumor size. Rates of DSH were found to be between 4 and 12 percent for both mTSS and eTSS.
CONCLUSIONS: Age, gender, tumor size, rate of blood sodium level decline between post-operative day (POD) 4 and 7, and Cushing’s disease are potential predictors of DSH. A better understanding of these predictors can help clinicians identify patients at risk for DSH so preventative measures can be taken to reduce the deleterious effects of hyponatremia after transsphenoidal surgery.
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