Clinical Research Directory

Evaluation of Postoperative Organ Injury, Risk Factors, and Short-Term Clinical Outcomes in Patients Admitted to Intensive Care After Noncardiac Surgery

This retrospective observational study examines whether troponin levels measured before surgery are associated with acute kidney injury during the first 48 hours after surgery in patients admitted to intensive care after noncardiac surgery. Troponin is a protein measured in blood that can indicate heart muscle injury. Acute kidney injury is a sudden decline in kidney function. Existing medical records from 224 patients who underwent emergency or elective surgery will be reviewed. Kidney injury will be assessed using changes in blood creatinine levels and the need for dialysis or other kidney replacement therapy. The study will also examine changes in troponin levels around surgery, length of stay, and survival during hospitalization. No additional tests or treatments are performed for this study.

Intrathoracic Sleeve Migration (Sliding Hiatal Hernia) One Year or More After Laparoscopic Sleeve Gastrectomy

Sleeve gastrectomy is the most commonly performed metabolic bariatric operation. After the operation, the upper part of the gastric sleeve can slide up through the opening in the diaphragm into the chest. This is called intrathoracic sleeve migration and is a form of sliding hiatal hernia. It may cause new reflux symptoms such as heartburn, regurgitation and vomiting, and may lead to further surgery. How often it happens is uncertain, because studies have used different definitions and tests. This single-centre observational study included adults who had a laparoscopic sleeve gastrectomy at Cairo University Hospitals between July 2024 and August 2025 and were at least one year after surgery. Each patient had a CT scan of the chest and abdomen with oral contrast to look for migration of the sleeve above the diaphragm, and completed the GERD-Q reflux questionnaire. The study measured how often intrathoracic sleeve migration occurs one year or more after sleeve gastrectomy, whether it is associated with new (de novo) reflux disease, and which patient factors may be associated with it.

ELIXIR MDTM Satisfaction Clinical Trial

This study aims to assess patient satisfaction from the use of the ELIXIR MD™ photobiomodulation (PBM) device in the perioperative period of facial and body reconstructive surgery at Cedars-Sinai Medical Center. The ELIXIR MD™ device is FDA-cleared (510(k), product code GEX) and delivers low-level, multi-wavelength light energy to targeted tissues to promote cellular repair, reduce inflammation, and enhance patient recovery. Participants undergoing elective facial or body plastic surgery will be randomized 1:1 to receive either active ELIXIR MD™ PBM treatment or sham (placebo) treatment. A total of 8 treatment sessions are scheduled: one preoperative session and sessions on POD 0, 1, 2, 3, 5, 7, and 10, each lasting 20 minutes. A final follow-up visit occurs at POD 30. Patient-reported satisfaction (a satisfaction questionnaire for facial surgery patients and the Body Metrics Questionnaire for body surgery patients), blinded edema and ecchymosis assessments via standardized photography, pain scores (VAS), and time to return to usual activities will be evaluated. The study enrolls 148 participants (74 per arm) with equal representation of facial and body surgery patients.

Biomarkers of Postoperative Complications After Cardiac Surgery

Postoperative delirium and other complications are important adverse outcomes following cardiac surgery. This study will integrate perioperative clinical information with molecular measurements to investigate factors associated with these outcomes and improve early risk assessment. Eligible patients undergoing elective coronary artery bypass grafting, cardiac valve surgery, or combined procedures will be prospectively enrolled. Data collection will include demographic characteristics, medical history, preoperative medications, laboratory findings, surgical and anesthetic characteristics, and postoperative clinical outcomes. Blood samples will be collected before surgery and approximately 24 hours after surgery, processed according to standardized procedures, and stored for subsequent analyses. Molecular investigations will include proteomic and metabolomic profiling and targeted measurement of selected biomarkers. POD will be assessed twice daily by trained research personnel during the first 7 postoperative days or until hospital discharge, whichever occurs first. Standardized, validated delirium assessment instruments will be used in the ICU and after transfer to the ward. Other postoperative complications and recovery outcomes will be recorded prospectively. Analyses will examine associations between clinical characteristics, molecular profiles, and postoperative outcomes. Causal inference methods will be used, where appropriate, to explore the potential causal relevance of candidate biomarkers under explicitly stated assumptions. Interpretable prediction models will be developed using clinical variables, molecular features, or their combination. Model performance will be assessed in terms of discrimination, calibration, and potential clinical utility. Internal validation will be performed, and temporal or external validation will be undertaken where suitable independent data are available.

Resistance vs Aerobic Prehabilitation Before Colorectal Cancer Surgery

The goal of this clinical trial is to learn which type of exercise before surgery best reduces complications after colorectal surgery in adults with colorectal cancer or precancerous lesions. The main questions it aims to answer are: * Does resistance (strength) training, aerobic (endurance) training, or a combination of both before surgery lower the rate and severity of complications in the first 30 days after surgery, compared with no exercise program? * Which factors influence how well patients follow a prehabilitation program, and does following the program affect surgical outcomes? Researchers will compare three exercise groups with a control group that receives standard care without an exercise program. Participants will: * Be randomly assigned to one of four groups: resistance training, aerobic training, combined training, or no exercise program (control) * Do the assigned home exercise program for 4 to 6 weeks before surgery, with weekly physiotherapy check-ups in person or by phone * Receive nutritional counseling, breathing exercises, and psychological support if needed, regardless of group * Keep a daily exercise diary and record their pulse daily * Undergo physical fitness tests (walking test, sit-to-stand test, handgrip strength) and quality-of-life questionnaires before surgery and 8 weeks after surgery

Low-Dose Norepinephrine With Conservative Fluid Therapy in Hepatobiliary Surgery

This prospective randomized controlled study aims to compare the effect of low-dose norepinephrine combined with conservative goal-directed fluid therapy versus conventional fluid therapy on postoperative pulmonary complications assessed by lung ultrasound score in patients undergoing major hepatobiliary surgery.

Site of Tracheal Extubation and Operating Room Efficiency During Robot-assisted Surgery

This study aims to evaluate the impact of different extubation strategy on the occupancy time of operating room (OR) and the incidence of adverse events and quality of recovery after robotic-assisted surgery. The investigators hypothesize that extubation in the post-anesthesia care unit (PACU) may reduce OR occupancy time without increasing adverse events or worsening quality of recovery early after robotic-assisted surgery. This strategy may enhance perioperative efficiency while maintaining clinical safety.

Preoperative Optimisation of Modifiable Risk Factors in Surgery of the Pancreas

The goal of this stepped-wedge randomized controlled trial is to investigate whether implementation of a best practice program for preoperative optimisation (prehabilitation program) with a focus on screening, assessment, and intervention of 8 potentially (partly) modifiable risk factors in patients with (suspected) pancreatic cancer will improve outcome. The main questions it will aim to answer are: 1. Does a prehabilitation program improve the time to functional recovery after pancreatic surgery? 2. Does a prehabilitation program lead to a reduction in the Comprehensive Complication Index after pancreatic surgery?

Perioperative Personalized Blood Pressure Management: IMPROVE-multi

Rates of major complications and mortality in the first weeks after surgery remain very high: postoperative mortality is still around 2% in central Europe and the United States. Postoperative deaths are a consequence of postoperative complications. Postoperative complications that are most strongly associated with postoperative death include acute kidney injury and acute myocardial injury. To avoid postoperative complications it is thus crucial to identify and address modifiable risk factors for complications. One of these modifiable risk factors may be intraoperative hypotension. Intraoperative hypotension is associated with major postoperative complications including acute kidney injury, acute myocardial injury, and death. It remains unknown which blood pressure value should be targeted in the individual patient during surgery to avoid physiologically important intraoperative hypotension. In current clinical practice, an absolute mean arterial pressure threshold of 65mmHg is used as a lower "one-size-fits-all" intervention threshold. This "population harm threshold" is based on the results of retrospective studies. However, using this population harm threshold for all patients ignores the obvious fact that blood pressure varies considerably among individuals. In contrast to current "one-size-fits-all" perioperative blood pressure management, the investigators propose the concept of personalized perioperative blood pressure management. Specifically, the investigators propose to test the hypothesis that personalized perioperative blood pressure management reduces the incidence of a composite outcome of acute kidney injury, acute myocardial injury, non-fatal cardiac arrest, and death within 7 days after surgery compared to routine blood pressure management in high-risk patients having major abdominal surgery. The investigators will perform preoperative automated blood pressure monitoring for one night to define individual intraoperative blood pressure targets. Automated blood pressure monitoring is the clinical reference method to assess blood pressure profiles. The mission of the trial is to reduce postoperative morbidity and mortality after major surgery. The vision is to achieve this improvement in patient outcome by using the innovative concept of personalized perioperative blood pressure management. This trial is expected to change and improve current clinical practice and will have a direct impact on perioperative blood pressure management guidelines.

The Effect of Perioperative Nutritional Care on Recovery After Knee and Hip Replacement Surgery

This prospective observational study will assess the impact of standardized perioperative nutritional care on postoperative outcomes in patients undergoing elective total hip (THA) or knee arthroplasty (TKA) at the First Department of Orthopaedic Surgery, St. Anne's University Hospital in Brno. The protocol includes preoperative patient education, nutritional risk screening, and carbohydrate loading up to two hours before anesthesia, followed by early postoperative refeeding. Data collection will include demographic and surgical variables, nutritional status, carbohydrate intake, and the occurrence of intra- and postoperative complications, including infection and delayed wound healing. As perioperative nutritional care is part of routine clinical practice, the study requires no additional interventions or resources. Results will provide evidence on the effectiveness of structured nutritional support in enhancing recovery and reducing complications after joint replacement surgery.

Predictive Value of Frailty Scores and Admission Laboratory Markers for Postoperative ICU Mortality

This prospective observational study aims to evaluate the predictive value of the Clinical Frailty Scale (CFS), the Katz Activities of Daily Living (ADL) scale, and admission laboratory markers for postoperative mortality among geriatric patients admitted to the intensive care unit (ICU) after surgery. Frailty assessment and functional status are increasingly recognized as determinants of outcomes in older adults, yet their combined predictive power with routine laboratory parameters at ICU admission remains unclear. By systematically collecting clinical scores and laboratory data at the time of ICU admission, this study seeks to identify early predictors of mortality and support risk-stratification in geriatric postoperative patients.

Epigenetic Susceptibility to Inflammatory Complications After Cardiac Surgery

This study aims to better understand 3 crucial questions: 1. Why do some patients experience more severe complications after heart surgery than others? 2. Are there markers on our genetic makeup (called epigenetic modifications) that can predict complications after major surgery? 3. How do epigenetic modifications lead to overactive inflammation that causes harm to patients after heart surgery? Over 270,000 patients undergo major surgery in Scotland each year. Major surgery is associated with increased risk of complications, particularly in older patients with multiple health conditions. Complications are a leading cause of death, delayed recovery, long-term illness and increased healthcare cost to the NHS. Significant complications occur in up to 57% of patients after heart surgery. In response to major surgery, the body stimulates an inflammatory response as part of a complex repair mechanism, however, in some cases inflammation can become exaggerated, becoming harmful and contributing to the development of complications. The investigators believe that a patient's risk of overactive inflammation, which can lead to complications after surgery, is heavily influenced by a patient-specific system of biological markers, layered upon their DNA; a scientific field known as epigenetics. Where a patient's DNA (their 'genetics') may be considered as an instruction manual for each cell's molecular processes, these 'epigenetic' markers work as if someone has highlighted sections of the manual to be read (and actioned). The pattern of these markers on immune system cells can therefore dictate the extent of the inflammatory response, especially after a major insult such as surgery. While the DNA itself cannot be modified, epigenetic markers can be modified, through strategies including diet, exercise, and medication. The aim of this study is to evaluate whether the modifiable epigenetic code of key immune-system cells dictates the extent of post-operative inflammation, contributing to organ damage and complications. With patients' permission, the investigators will: 1. Obtain blood samples before and after major heart surgery, to test for epigenetic markers and inflammation. 2. Observe patients after surgery and collect routine data from laboratory tests and patient observations which assess for organ dysfunction and inflammation. 3. Conduct patient questionnaires before and after surgery to assess physical fitness and patient-centred quality of life measures. 4. Analyse patterns between patients who have severe organ dysfunction after surgery and those patients who have minimal organ dysfunction after similar surgery, to better understand which patients are at greatest risk, according to their epigenetic makeup. This study may improve understanding of which patients are likely to suffer organ damage and complications after major surgery, and which patients may have a protective epigenetic makeup which reduces complications. With this knowledge, the investigators aim is that future patients could receive personalised treatment plans before surgery, to modify their epigenetic makeup, reduce harm from complications and improve outcomes for patients. The investigators are not testing any new treatments in this study.

Compliance-Guided Abdominal Wall Closure Strategy in Large Ventral Hernia Repair

People undergoing repair of large ventral hernias can develop breathing problems after surgery, especially around the time when the abdominal wall is closed. During closure, pressure inside the abdomen may increase and lung mechanics can worsen. This study will evaluate a structured intraoperative decision approach that uses standard anesthesia measurements of static respiratory system compliance at predefined timepoints to support the choice of abdominal wall closure technique. The main goal is to assess the rate of early postoperative respiratory failure within 72 hours after surgery.

Remifentanil vs Fentanyl in Children 7-12 After Urologic Surgery: Emergence Delirium and Recovery Quality

Emergence delirium (agitation) is a common complication in children recovering from general anesthesia, especially after sevoflurane. Affected children wake in a dissociative state - restless, crying, inconsolable, unaware of their surroundings - with a reported incidence of 25-80%. It raises the risk of self-injury, accidental catheter removal, vomiting, and maladaptive behavior persisting for weeks, and prolongs hospital stay. Short-acting opioids such as fentanyl and remifentanil are widely used in pediatric anesthesia for sedation and analgesia and to blunt the hemodynamic response to surgical stimulation and airway instrumentation. Both have been proposed to reduce emergence agitation after sevoflurane anesthesia, but findings for remifentanil are inconsistent: some studies report a reduction, others an increase. Clinicians therefore lack clear guidance on opioid selection for maintenance. This trial compares intraoperative remifentanil with intraoperative fentanyl maintenance on the occurrence of emergence delirium in children undergoing urologic surgery under general anesthesia. Secondary aims are postoperative recovery, duration of surgery, and intraoperative hemodynamics. Design: single-center randomized controlled trial. 176 children aged 7-12 years, ASA I-II, scheduled for elective pediatric urologic surgery, randomized 1:1 (88 per group). All participants receive the same background technique: intravenous midazolam 0.05 mg/kg five minutes before entering the operating room; standard monitoring (ECG, pulse oximetry, non-invasive blood pressure, capnography); induction with propofol 3-5 mg/kg; laryngeal mask airway (LMA); sevoflurane titrated to 1 MAC; and preemptive intravenous paracetamol and ketamine 0.3 mg/kg after induction. The fentanyl group receives fentanyl 1 mcg/kg after loss of consciousness, then 1 mcg/kg every 30 minutes until the end of surgery. The remifentanil group receives remifentanil 0.5 mcg/kg, then an infusion of 1 mcg/kg/min. In both groups the LMA is inserted 90 seconds after the bolus. At the end of surgery sevoflurane is discontinued and the LMA removed once the child breathes regularly and moves purposefully without stimulation. Emergence delirium is assessed in the post-anesthesia care unit with the Pediatric Anesthesia Emergence Delirium (PAED) scale (0-20). Additional measurements include time from sevoflurane discontinuation to LMA removal, time to eye opening on verbal stimulus, and readiness for discharge.

Free Fluid Detection With Telementored eFAST

This feasibility study will evaluate the accuracy of telementored eFAST (Extended Focused Assessment with Sonography in Trauma) in detecting abdominal free fluid in patients who have recently undergone liver surgery. The primary goal is to determine how well the remote-guided ultrasound can identify fluid accumulation compared to conventional ultrasound performed by a radiologist. Participants in this study will be examined with ultrasound, supported in real-time by a remote expert, to assess its accuracy and other relevant performance metrics.

Efficacy of Intraoperative Use of 20% Albumin Combined With Ringer Lactate Versus Ringer Lactate During Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

Introduction Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is considered as the standard of care for the treatment of peritoneal metastases. Cytoreductive surgery with HIPEC is characterized by large intra operative fluid shift secondary to surgical resection, peritoneal inflammation and capillary shifts, requesting high volume of intra operative fluid therapy. Previous studies found a strong association between intra operative hypovolemia or volume overload with post operative outcomes. Albumin as an intravenous fluid has been widely studied in critical ill patients, but evaluation of its efficacy during major surgery on post operative clinical outcomes are lacking. We hypothesize that a reduction of intra operative crystalloid volume infusion by using 20% albumin during CRS with HIPEC could improve patients' prognosis. The aim of this study will be to assess the efficacy of 20% albumin combined with Ringer Lactate versus Ringer Lactate for fluid therapy during CRS with HIPEC on post operative outcome at 28 day. Methods and analysis The study protocol has been designed and written in accordance with the Prospective randomised, comparative, controlled, prospective, open-label, with parallel group and multicentre clinical trial. Recruitment, randomisation and allocation Information on the study and screening of patients will be conducted during the consultation of anaesthesia (= selection visit), 2 months at 3 days before the surgery. Information notice and consent form will be delivered. The day before the surgery, anaesthesiologist who will conduct the pre anaesthetic visit will be able to include patients in the study (=inclusion visit). Randomisation will be done at the inclusion visit after information and signature of consent form of voluntary patients. A randomization number will be assigned. The 1:1 randomisation will be centralized via an online interface ensuring secret group assignment, and based on predefined randomisation lists with variable-size permutation blocks, stratified by center. Randomisation will be accomplished using a computer-generated random sequence. Randomized Open, Blinded endpoint (PROBE) design. This study is a randomised, comparative, controlled, prospective, open-label, with parallel group and multicentre clinical trial. Intervention * 20% Albumin + Ringer Lactate group (intervention group) Per-operative fluid therapy consisting in Ringer Lactate combined with 20% albumin. Patients will receive a bolus of 3 mL/kg on one hour of 20% albumin from anaesthetic induction. Then, infusion of 20% albumin (100 mL, 20g) will be administered for each 1200 mL of vascular filling by Ringer Lactate. Dosage of intra operative albuminemia will be realized 2 hours after the end of the bolus or infusion to ensure albuminemia is within the target concentrations (35-45 g/L). Use of 20% albumin will be realized for the entire duration of the surgery and stopped at the end of the surgery. * Control group Ringer Lactate for intra operative fluid management based on the latest scientific recommendations. As the the study is an open labelled randomized clinical trial, placebo use is not planned. Outcome measures The primary outcome will be the Comprehensive Complication Index (CCI score) at day 28 after CRS with HIPEC. Secondary outcomes are mortality at day 28, CCI score at day 7, volume of intra operative and post operative (48h) post operative fluid therapy, cumulated incidence of surgical post operative complications, cumulated incidence of medical post operative complications, need for mechanical ventilation, renal replacement therapy between surgery and day 28, SOFA score variation between pre operative period and 48h after surgery, number of days alive out of intensive care unit and out of hospital until day 28 Sample size calculation To ensure a power of 80%, a number of patients 130 (65 patients by group) will be necessary with a reduction of 13.6 (SD 24) points of the CCI score at day 28 in the intervention group. Because of a risk of neoplastic evolution between anaesthetic consultation and randomisation (10% of early cancellation), a total of 146 patients (73 by group) will be included in the study. Discussion In summary, ALBUCHIP study will be the first randomized clinical trial assessing efficacy of intraoperative use of 20% albumin combined with Ringer Lactate versus Ringer Lactate during CRS with HIPEC. Results yielded from this study will be helpful for vascular filling during CRS with HIPEC but, thanks to ancillary studies, to improve pathophysiological understanding of this surgery.

Anaesthesia for Hip and Knee Arthroplasty (SPIGA)

Beneficial and harmful effects of spinal versus general anaesthesia in patients undergoing hip and knee arthroplasty.

Renoprotective Effects of Dexmedetomidine Preconditioning in CABG Surgery

Acute kidney injury (AKI) is one of the most frequent complications of coronary artery bypass graft (CABG) surgery performed with cardiopulmonary bypass (CPB). Even small postoperative rises in serum creatinine are associated with longer intensive care stay and higher mortality. Ischemia-reperfusion injury, the systemic inflammatory response elicited by contact of blood with the bypass circuit, and heightened perioperative sympathetic activity are believed to contribute to its development. Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist used as a sedative and anesthetic adjunct. It attenuates sympathetic outflow and has shown anti-inflammatory and organ-protective properties in experimental models and in some cardiac surgical populations, but whether it reduces AKI after on-pump CABG surgery has not been established. This is a prospective, randomized, double-blind, placebo-controlled, single-center trial in adults undergoing elective CABG surgery with CPB. One hundred patients aged 18-80 years, ASA physical status II or III, with a preoperative serum creatinine below 1.5 mg/dL are allocated 1:1 to a dexmedetomidine group (n=50) or a control group (n=50). Patients in the dexmedetomidine group receive a loading dose of 1 microgram/kg over 15 minutes after central venous catheterization, followed by a maintenance infusion of 0.5 microgram/kg/h until the start of CPB. Patients in the control group receive an equal volume of 0.9% sodium chloride over the same period and with the same infusion scheme. In both groups the infusion is stopped when CPB begins; no study drug is given during bypass or postoperatively. Anesthesia, surgery, CPB conduct, fluid and vasoactive therapy, and postoperative intensive care follow a standardized protocol with identical numerical thresholds in both groups, applied by clinicians unaware of group allocation. The primary outcome is the incidence of postoperative AKI within the first 72 hours, staged according to the serum creatinine criteria of the KDIGO 2012 classification. Secondary outcomes are systemic inflammatory markers (white blood cell count, neutrophils, lymphocytes, neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin), vasoactive drug requirement quantified by the vasoactive-inotropic score, need for renal replacement therapy, time to extubation, intensive care unit and hospital length of stay, and 30-day and 90-day mortality. All patients are followed until postoperative day 90. All variables assessed in the study are parameters obtained as part of routine clinical care in this patient population; no additional intervention or additional laboratory test is performed for study purposes.

Implementation and Assessment of the BE-FIT Program

Lengthy hospitalization and immobility can lead to muscle loss resulting in reduced recovery rates and prolonged hospital stay or readmission. Older adults discharged from hospitals are at an increased risk for functional decline, falls and disability. Daily exercise and physical activities have proven to enhance the recovery and discharge process for older patients from the hospital and ultimately save vast amounts of dollars each year. The aim of this study is to initiate early mobilization and decrease the rate of functional decline in post-surgical older adults' patients in the acute care hospital setting in Alberta, Canada. The investigators are implementing a BE-FIT (BEdside reconditioning for Functional ImprovemenTs) a quality improvement, evidence-based exercise program that focuses on early mobilization and recovery by minimizing bed rest, promoting functional tasks, and encouraging self-management. Patients enrolled in the program will receive a bedside exercise plan to be completed independently throughout their stay in the hospital. Control patients will receive usual care without the added exercise plan. Patient mobility during their hospital stay will be assessed pre and post BE-FIT initiation according to a predetermined mobility scoring system. Secondary outcomes will include: time-to-mobility, length of stay, complication incidence and hospitalization costs.

Dalargin for Prevention of Organ Disfunction in High-Risk Abdominal Surgery

Major abdominal surgeries (e.g., gastrectomy, pancreatectomy, colectomy) carry a high risk of life-threatening postoperative complications, including multiorgan disfunction syndrome (MODS), acute kidney injur (AKI), miocardial injury after non-cardiac surgery (MINS) and severe infections. These complications are driven by ischemia-reperfusion injury, leading to oxidative stress and a systemic inflammatory response. Despite advances in surgical and anesthetic techniques, there are no effective pharmacological strategies for personalized prevention of these events, which adversely affect recovery and survival. In this context, opioid receptor agonist, particularly senthetic analogs of Leu-enkephalin such as Dalargin, have emerged as promising agents for pharmacologica preconditioning. Preclinical evidence suggests their ability to mitigate oxidative stress and inflammation by moduating key signaling pathways . The potential for these peptides to protect andothelial function and reduce organ damage presents a novel therapeutic avenue. This study aims to clinically test the hypothesis that perioperative intravenous infusion of Dalargin reduce the incidence and severity of postoperative organ dysfunction. Patients undergoing high-risk abdominal surgery will be randomized to receive either a 72-hour continuous of Dalargin (following a defined dosage regimen) or an identical placebo infusion. the study will also integrate an assessment of genetic polymorphism ( e.g., in NRF2, OLR1, TLR9 genes) to explore personalized approaches to risk stratification and prevention.

Tolerability Comparison of Flarex to Lotemax SM

This study compared the ocular tolerability of fluorometholone acetate ophthalmic suspension 0.1% (FLAREX) to loteprednol etabonate ophthalmic gel 0.38% (Lotemax SM) in adult subjects. Each subject received one drop of each product, one in each eye, in a randomized, double-masked design. Comfort, impact on vision, and palpebral conjunctival injection were evaluated at 30 seconds, 5 minutes, and 10 minutes after instillation.

Postoperative Hypocalcemia After Thyroidectomy

This retrospective cohort study investigates predictors of postoperative hypocalcemia following thyroidectomy procedures at Minia University Hospital over a 10-year period (2014-2024). Postthyroidectomy hypocalcemia is one of the most common complications of thyroid surgery, affecting 20-50% of patients. The study aims to identify demographic, clinical, laboratory, and surgical factors associated with the development of both transient and permanent hypocalcemia. Results will inform risk stratification, patient counseling, and perioperative management strategies.

Bioelectrical Response to Preoperative Hydration in Colorectal Surgery

This single-center study will evaluate whether short-term changes in bioelectrical impedance measurements after a standardized preoperative intravenous fluid infusion can help predict complications following elective colon or rectal surgery. The prospective group will include 120 consecutive adults. After emptying the bladder, participants will be weighed and assessed barefoot on a standing multifrequency bioelectrical impedance device. They will then receive Ionolyte, a balanced isotonic crystalloid, at 15 mL/kg based on the lower of actual and ideal body weight, up to 1,000 mL, over exactly 40 minutes. Participants will empty the bladder again and undergo repeat measurement 60 minutes after infusion start. The main predictor is the continuous change in phase angle, and the main outcome is at least one Clavien-Dindo grade II-V complication within 30 days. A supportive analysis will compare clinical outcomes with 240 consecutive historical controls using existing hospital records. The historical controls do not receive the study procedure and are not included in the prospective enrollment.

Infectious Complications After Esophagectomy

Infectious complications represent the most common postoperative adverse events following esophagectomy for cancer, such as pneumonia (15% of cases). These complications increase immediate risks, lengthen hospital stays, and worsen patient quality of life. The population includes patients admitted to intensive care after esophagectomy for cancer between January 1, 2017, and December 31, 2024. The study focuses on this population due to the increasing incidence of esophageal cancer, the increased use of surgery for these indications, and the importance of postoperative infections in these complex procedures, despite their understudied nature in the current literature. Identifying modifiable risk factors could lead to corrective measures and thus improve the prognosis of postoperative patients. The research focuses primarily on the incidence, types, factors, and prognosis associated with the occurrence of infections after esophagectomy for cancer. It also includes an analysis of the pathogens involved, their resistance profiles, and the antibiotic therapies used in first-line probabilistic treatment.