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Sample records for quinacrine treatment results

  1. Retrospective Study on the Efficacy and Safety of Quinacrine Sterilization

    Institute of Scientific and Technical Information of China (English)

    丁菊红; 陆卫群; 丁婉华; 朱红; 童建孙

    2000-01-01

    Objective To observe and evaluate the efficacy and safety of quinacrine sterilization.Methods A total of 572 cases of quinacrine sterilization preformed during the 4 years from 1993to 1997in Jiangsu and Guizhou Provinces were employed in this study. The efficacy and safety of quinacrine sterilization in those case were studied and evaluated, with 588 cases of surgical sterilization performed at the same time being the control group.Results Both groups were with identical demographic and gynecological characteristics. The result of multiple decrement life table analysis showed the 12th gross cumulative failure rates for quinacrine sterilization was 3. 13% and serious side effects occurred in only 2 cases accounting for O. 35%. One was ectopic pregnancy (20 months after treatment). The other was due to anaphylaxis in 10 minutes after the second insertion). No difference in the liver and nephic functions was detected and no suspected cancer cells or cancer cells were found in the two groups. 99. 6% of the 572 women interviewed accepted the quinacrine sterilization.Conclusions Quinacrine sterilization method is with high acceptability but comparatively low effectiveness. It has been proved to be a safe method of contraception in short-term. However, the safety of long-term still needs further study.

  2. Drug screen in patient cells suggests quinacrine to be repositioned for treatment of acute myeloid leukemia

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    Eriksson, Anna; Österroos, Albin; Hassan, Sadia Bashir; Gullbo, Joachim; Rickardson, Linda; Jarvius, Malin; Nygren, Peter; Fryknäs, Mårten; Höglund, Martin; Larsson, Rolf

    2015-01-01

    To find drugs suitable for repositioning for use against leukemia, samples from patients with chronic lymphocytic, acute myeloid and lymphocytic leukemias as well as peripheral blood mononuclear cells (PBMC) were tested in response to 1266 compounds from the LOPAC1280 library (Sigma). Twenty-five compounds were defined as hits with activity in all leukemia subgroups (<50% cell survival compared with control) at 10 mu M drug concentration. Only one of these compounds, quinacrine, showed low...

  3. Quinacrine impairs enterovirus 71 RNA replication by preventing binding of polypyrimidine-tract binding protein with internal ribosome entry sites.

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    Jianmin Wang

    Full Text Available Since the 1980s, epidemics of enterovirus 71 (EV71 and other enteroviruses have occurred in Asian countries and regions, causing a wide range of human diseases. No effective therapy is available for the treatment of these infections. Internal ribosome entry sites (IRESs are indispensable for the initiation of translation in enteroviruses. Several cellular factors, as well as the ribosome, are recruited to the conserved IRES during this process. Quinacrine intercalates into the RNA architecture and inhibits RNA transcription and protein synthesis, and a recent study showed that quinacrine inhibited encephalomyocarditis virus and poliovirus IRES-mediated translation in vitro without disrupting internal cellular IRES. Here, we report that quinacrine was highly active against EV71, protecting cells from EV71 infection. Replication of viral RNA, expression of viral capsid protein, and production of virus were all strongly inhibited by quinacrine. Interaction of the polypyrimidine tract-binding protein (PTB with the conserved IRES was prevented by quinacrine. Coxsackieviruses and echovirus were also inhibited by quinacrine in cultured cells. These results indicate that quinacrine may serve as a potential protective agent for use in the treatment of patients with chronic enterovirus infection.

  4. Randomized clinical study of five days apostrophe therapy with mebendazole compared to quinacrine in the treatment of symptomatic giardiasis in children

    Institute of Scientific and Technical Information of China (English)

    Roberto Ca(n)ete; Angel A Escobedo; María E González; Pedro Almirall

    2006-01-01

    AIM: To compare the efficacy and safety of five days apostrophe therapy of mebendazole (MBZ) versus quinacrine (QC) on human giardiasis in children.METHODS: A clinical trial was carried out in paediatric patients (aged 5-15 years) with confirmed symptomatic G. duodenalis mono-infection. Patients were randomly assigned to receive either MBZ [200 mg taken three times per day (TID) (n = 61)] or QC [2 mg/kg bodyweight tid (n= 61)], both for five days. Follow-up faecal samples were obtained at 3, 5 and 7 d after the end of the treatment.RESULTS: Although the frequency of cure was higher for QC (83.6%) than for MBZ (78.7%), the difference was not statistically significant (P > 0.05). Adverse events were reported more in the QC group (P < 0.05),all of them transient and self-limiting.CONCLUSION: Despite final cure rates ocurring lower than expected, the overall results of this study reconfirmed the efficacy of MBZ in giardiasis and also indicate that, although comparable to QC, at least in this setting the 5 d course of MBZ did not appear to improve the cure rates in this intestinal parasitic infection.

  5. Quinacrine acceptance spreads at NAVSFWI meet.

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    Aggarwal, A

    1996-10-30

    The 3rd World Congress and 11th Indian Conference on Family Welfare and Voluntary Sterilization and Family Welfare of India (NAVSFWI) was held at Hotel Clarks Shiraj, Agra, during September 20-22, 1996. At the conference, R.V. Bhatt, the newly elected president of NAVSFWI, expressed a need to look for alternative methods of female sterilization, such as quinacrine, because of the risks involved with surgical approaches. Dr. Bhatt added that quinacrine use as an alternative to surgical sterilization is safe, cheap, effective, and worthy of further trials, especially in rural areas, where surgery is not readily available. Dr. Elton Kessel, Secretary General of the International Federation for Family Health, stresses that no country has reduced population growth below 1% without the widespread use of both sterilization and abortion, together with other contraceptive methods. Quinacrine sterilization could satisfy much of the considerable unmet need for sterilization in India.

  6. Quinacrine promotes replication and conformational mutation of chronic wasting disease prions.

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    Bian, Jifeng; Kang, Hae-Eun; Telling, Glenn C

    2014-04-22

    Quinacrine's ability to reduce levels of pathogenic prion protein (PrP(Sc)) in mouse cells infected with experimentally adapted prions led to several unsuccessful clinical studies in patients with prion diseases, a 10-y investment to understand its mechanism of action, and the production of related compounds with expectations of greater efficacy. We show here, in stark contrast to this reported inhibitory effect, that quinacrine enhances deer and elk PrP(Sc) accumulation and promotes propagation of prions causing chronic wasting disease (CWD), a fatal, transmissible, neurodegenerative disorder of cervids of uncertain zoonotic potential. Surprisingly, despite increased prion titers in quinacrine-treated cells, transmission of the resulting prions produced prolonged incubation times and altered PrP(Sc) deposition patterns in the brains of diseased transgenic mice. This unexpected outcome is consistent with quinacrine affecting the intrinsic properties of the CWD prion. Accordingly, quinacrine-treated CWD prions were comprised of an altered PrP(Sc) conformation. Our findings provide convincing evidence for drug-induced conformational mutation of prions without the prerequisite of generating drug-resistant variants of the original strain. More specifically, they show that a drug capable of restraining prions in one species/strain setting, and consequently used to treat human prion diseases, improves replicative ability in another and therefore force reconsideration of current strategies to screen antiprion compounds.

  7. Pharmacokinetic studies on quinacrine following intrauterine administration to cynomolgus monkeys.

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    Dubin, N H; Blake, D A; DiBlasi, M C; Parmley, T H; King, T M

    1982-12-01

    Recent efforts have been made to develop a chemical oviductal occluding agent. Intrauterine quinacrine has been used in certain areas of the world with moderate success in effected tubal closure. This report presents the pharmacokinetics of a quinacrine solution (30 mg) as administered to cynomolgus monkeys via the intrauterine route, compared with intravascular injection. The data show rapid transfer of the drug from the uterine to the vascular compartment and uptake by almost all tissues examined. Although plasma concentrations disappear within 24 hours, levels can be detected in most tissues for at least 1 week following intrauterine injection. After 28 days, however, tissue levels of the drug are absent or near the limit of detection.

  8. Quinacrine and 9-amino acridine inhibit B-Z and B-H(l) form DNA conformational transitions.

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    Das, Suman; Kundu, Suprabhat; Suresh Kumar, Gopinatha

    2011-07-01

    The interaction of quinacrine and 9-amino acridine with right-handed B-form, left-handed Z-form, and left-handed protonated (H(L))-form structures of polydG-me(5)dC was investigated by circular dichroism and absorption spectral analysis. Both the compounds bind strongly to the B-form structure and convert the Z-form and H(L)-form back to the bound right-handed form. Circular dichroic data revealed that the conformation at the binding site is right-handed even though adjacent regions of the polynucleotide may have left-handed conformation. The rate and extent of B-form-to-Z-form transition were decreased in the presence of these compounds. Scatchard analysis revealed that both quinacrine and 9-amino acridine bind strongly to the polynucleotide in the B-form in a noncooperative manner, in sharp contrast to the highly cooperative binding to the Z-form and H(L)-form. Results indicated that the cooperative binding of these drugs with the Z-form and the H(L)-forms was associated with a sequential conversion of the polynucleotide from a left-handed to a bound right-handed conformation. Experimental data enabled the calculation of the number of base pairs of Z-form (7-8 with quinacrine and 9-amino acridine) and H(L)-form (4 and 25, respectively, with quinacrine and 9-amino acridine) that adopt a right-handed conformation for each bound ligand. As these compounds are known to bind preferentially to alternating guanine--cytosine sequences, which are capable of easily undergoing the B-to-Z or B-to-H(L) transition, these effects may be important in understanding their biological activities.

  9. Quinacrine pellet nonsurgical female sterilization in Wonosobo, Indonesia.

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    Suhadi, A; Soejoenoes, A

    1997-05-01

    A female sterilization regimen involving transcervical insertion of pellets containing 252 mg of quinacrine and 55.5 mg of ibuprofen in the proliferative phase of 2 consecutive menstrual cycles was found to be safe, acceptable, and effective. Subjects included 200 healthy volunteers (mean age, 33.2 years) who presented to a family planning clinic in Central Java Province, Indonesia, seeking sterilization. The insertion procedure (Kimia Farma) is similar to that for the Copper-T IUD. Only 3 women declined the second insertion. One month after insertion, side effects included lower abdominal pain (58.0%), fever (13.5%), and leukorrhea; however, these rates decreased to 0.5%, 2.0%, and 2.0%, respectively, 1 year after the second insertion and to 0.5%, 0.0%, and 1.6%, respectively, after 2 years. During the 2-year study period, 4 women became pregnant 4, 5, 14, and 18 months after the second insertion. The cumulative pregnancy rate was 1.0% 0-12 months after insertion and 2.0% in the second year. One of these women selected pregnancy termination; no malformations were noted in the 3 infants delivered. Quinacrine sterilization has the potential to meet the unmet need for female sterilization in developing countries without access to trained personnel and sophisticated surgical equipment.

  10. Beyond DNA binding - a review of the potential mechanisms mediating quinacrine's therapeutic activities in parasitic infections, inflammation, and cancers

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    Van Waes Carter

    2011-05-01

    Full Text Available Abstract This is an in-depth review of the history of quinacrine as well as its pharmacokinetic properties and established record of safety as an FDA-approved drug. The potential uses of quinacrine as an anti-cancer agent are discussed with particular attention to its actions on nuclear proteins, the arachidonic acid pathway, and multi-drug resistance, as well as its actions on signaling proteins in the cytoplasm. In particular, quinacrine's role on the NF-κB, p53, and AKT pathways are summarized.

  11. RNA targeting by DNA binding drugs: structural, conformational and energetic aspects of the binding of quinacrine and DAPI to A-form and H(L)-form of poly(rC).poly(rG).

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    Sinha, Rangana; Hossain, Maidul; Kumar, Gopinatha Suresh

    2007-12-01

    A key step in the rational design of new RNA binding small molecules necessitates a complete elucidation of the molecular aspects of the binding of existing molecules to RNA structures. This work focuses towards the understanding of the interaction of a DNA intercalator, quinacrine and a minor groove binder 4',6-diamidino-2-phenylindole (DAPI) with the right handed Watson-Crick base paired A-form and the left-handed Hoogsteen base paired H(L)-form of poly(rC).poly(rG) evaluated by multifaceted spectroscopic and viscometric techniques. The energetics of their interaction has also been elucidated by isothermal titration calorimetry. Results of this study converge to suggest that (i) quinacrine intercalates to both A-form and H(L)-form of poly(rC).poly(rG); (ii) DAPI shows both intercalative and groove-binding modes to the A-form of the RNA but binds by intercalative mode to the H(L)-form. Isothermal calorimetric patterns of quinacrine binding to both the forms of RNA and of DAPI binding to the H(L)-form are indicative of single binding while the binding of DAPI to the A-form reveals two kinds of binding. The binding of both the drugs to both conformations of RNA is exothermic; while the binding of quinacrine to both conformations and DAPI to the A-form (first site) is entropy driven, the binding of DAPI to the second site of A-form and H(L)-conformation is enthalpy driven. Temperature dependence of the binding enthalpy revealed that the RNA-ligand interaction reactions are accompanied by small heat capacity changes that are nonetheless significant. We conclude that the binding affinity characteristics and energetics of interaction of these DNA binding molecules to the RNA conformations are significantly different and may serve as data for the development of effective structure selective RNA-based antiviral drugs.

  12. Protective effects of quinacrine on lung injury induced by microwave irradiation in mice%阿的平对高功率微波辐射小鼠肺损伤的保护作用

    Institute of Scientific and Technical Information of China (English)

    吴燕; 刘淑红; 林凯; 葛学铭; 王飞; 苏振涛; 周红梅; 赵永岐; 范明

    2012-01-01

    Objective: To investigate the effect of quinacrine on lung injury induced by microwave irradiation in mice. Methods: One hundred and thirty BALB/c mice were randomly divided into four groups: normal control group ( n = 10) , radiation control group (re = 40), quinacrine low-dose group (12.6 mg/kg, re = 40) and quinacrine high-dose group (50.4 mg/kg, re = 40). Mice of the two quinacrine groups received quinacrine by gavage (20 ml/kg) 1 hour before microwave irradiation, and normal saline was given instead of quinacrine in the radiation control group. All animals, except those of normal control group, received 50 mW/cm2 microwave irradiation for 30 minutes. Pathological changes in lung were observed immediately after irradiation, and 1 day, 2 days, 7 days after irradiation in radiation control group and quinacrine groups, and 7 days after irradiation experiment in normal control group. Meanwhile, heat shock protein 70 (HSP70) protein expression in lung was analyzed using Western Blot. Results: Pathological examination showed that 50 mW/cm2 microwave irradiation for 30 minutes induced lung damages as manifested by blood stasis, alveolar epithelial cell shedding, alveolar septal thinning and fracture, and bronchial congestion in mice lungs. However, in quinacrine groups, reduction in lung septal fracture and attenuation of lung tissue congestion were found compared with radiation control group. The improvement were more markedly at 2 days after irradiation, especially in quinacrine high dose group. Microwave irradiation up-regulated the expression of HSP70 to certain degree in lung, while quinacrine pretreatment further up-regulated the expression of HSP70, especially in quinacrine high dose group. Conclusions;The mechanism of quinacrine protection on lung injury induced by microwave irradiation may be attributed to an increase of HSP70 expression.%目的:探讨阿的平对高功率微波辐射小鼠肺组织的保护作用.方法:130只BALB/c小鼠随机分为4组:

  13. Quadriceps tendon rupture - treatment results

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    Popov Iva

    2013-01-01

    Full Text Available Introduction. Quadriceps tendon rupture is a rare but rather serious injury. If this injury is not promptly recognized and early operated, it may lead to disability. This research was aimed at pointing out the results and complications of the quadriceps tendon rupture surgical treatment. Material and Methods. This retrospective multicentric study was conducted in a group of 29 patients (mostly elderly men. Lysholm knee scoring scale was used to evaluate the surgical results. The post-operative results were compared in relation to the type of tendon rupture reconstructions (acute or chronic, various surgical techniques, type of injuries (unilateral or bilateral as well as the presence or absence of comorbid risk factors in the patients. Results. The average value of a Lysholm score was 87.6. Excellent and satisfactory Lysholm score results dominated in our sample of patients. Better post-operative results were recorded in the group of patients without risk factors, in case of a bilateral injury, and in case of an acute injury. The best result was obtained after performing the reconstruction using anchors, and the worst result came after using Codivilla technique. Discussion and Conclusion. Early diagnosis and surgical treatment are an absolute imperative in management of this injury. We have not proven that a certain surgical technique has an advantage over the others. A comorbid risk factor is related to a lower Lysholm score. Despite a few cases of complications, we can conclude that the surgical treatment yields satisfactory results.

  14. Quinacrine induces apoptosis in human leukemia K562 cells via p38 MAPK-elicited BCL2 down-regulation and suppression of ERK/c-Jun-mediated BCL2L1 expression

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    Changchien, Jung-Jung; Chen, Ying-Jung; Huang, Chia-Hui [Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan (China); Cheng, Tian-Lu [Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung 807, Taiwan (China); Lin, Shinne-Ren [Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung 807, Taiwan (China); Chang, Long-Sen, E-mail: lschang@mail.nsysu.edu.tw [Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan (China); Department of Biotechnology, Kaohsiung Medical University, Kaohsiung 807, Taiwan (China)

    2015-04-01

    Although previous studies have revealed the anti-cancer activity of quinacrine, its effect on leukemia is not clearly resolved. We sought to explore the cytotoxic effect and mechanism of quinacrine action in human leukemia K562 cells. Quinacrine induced K562 cell apoptosis accompanied with ROS generation, mitochondrial depolarization, and down-regulation of BCL2L1 and BCL2. Upon exposure to quinacrine, ROS-mediated p38 MAPK activation and ERK inactivation were observed in K562 cells. Quinacrine-induced cell death and mitochondrial depolarization were suppressed by the p38MAPK inhibitor SB202190 and constitutively active MEK1 over-expression. Activation of p38 MAPK was shown to promote BCL2 degradation. Further, ERK inactivation suppressed c-Jun-mediated transcriptional expression of BCL2L1. Over-expression of BCL2L1 and BCL2 attenuated quinacrine-evoked mitochondrial depolarization and rescued the viability of quinacrine-treated cells. Taken together, our data indicate that quinacrine-induced K562 cell apoptosis is mediated through mitochondrial alterations triggered by p38 MAPK-mediated BCL2 down-regulation and suppression of ERK/c-Jun-mediated BCL2L1 expression. - Highlights: • Quinacrine induces K562 cell apoptosis via down-regulation of BCL2 and BCL2L1. • Quinacrine induces p38 MAPK activation and ERK inactivation in K562 cells. • Quinacrine elicits p38 MAPK-mediated BCL2 down-regulation. • Quinacrine suppresses ERK/c-Jun-mediated BCL2L1 expression.

  15. Calculating the contribution of different binding modes to Quinacrine - DNA complex formation from polarized fluorescence data

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    Voloshin, Igor; Karachevtsev, Victor; Zozulya, Victor

    2013-01-01

    Binding of acridine derivative quinacrine (QA) to chicken erythrocyte DNA was studied by methods of absorption and polarized fluorescent spectroscopy. Measurements were carried out in aqueous buffered solutions (pH 6.9) of different dye concentrations (QA concentration range from $10^{-6}$ till $10^{-4}$ M) and ionic strengths ($Na^{+}$ concentration rang from $10^{-3}$ till 0.15 M) in a wide range of phosphate-to-dye molar ratios ($P/D$). It is established that the minimum of fluorescent titration curve plotted as relative fluorescence intensity $vs$ $P/D$ is conditioned by the competition between the two types of QA binding to DNA which posses by different emission parameters: (i) intercalative one dominating under high $P/D$ values, and (ii) outside electrostatic binding dominating under low $P/D$ values, which is accompanied by the formation of non-fluorescent dye associates on the DNA backbone. Absorption and fluorescent characteristics of complexes formed were determined. The method of calculation of di...

  16. High affinity capture and concentration of quinacrine in polymorphonuclear neutrophils via vacuolar ATPase-mediated ion trapping: Comparison with other peripheral blood leukocytes and implications for the distribution of cationic drugs

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    Roy, Caroline; Gagné, Valérie; Fernandes, Maria J.G.; Marceau, François, E-mail: francois.marceau@crchul.ulaval.ca

    2013-07-15

    Many cationic drugs are concentrated in acidic cell compartments due to low retro-diffusion of the protonated molecule (ion trapping), with an ensuing vacuolar and autophagic cytopathology. In solid tissues, there is evidence that phagocytic cells, e.g., histiocytes, preferentially concentrate cationic drugs. We hypothesized that peripheral blood leukocytes could differentially take up a fluorescent model cation, quinacrine, depending on their phagocytic competence. Quinacrine transport parameters were determined in purified or total leukocyte suspensions at 37 °C. Purified polymorphonuclear leukocytes (PMNLs, essentially neutrophils) exhibited a quinacrine uptake velocity inferior to that of lymphocytes, but a consistently higher affinity (apparent K{sub M} 1.1 vs. 6.3 μM, respectively). However, the vacuolar (V)-ATPase inhibitor bafilomycin A1 prevented quinacrine transport or initiated its release in either cell type. PMNLs capture most of the quinacrine added at low concentrations to fresh peripheral blood leukocytes compared with lymphocytes and monocytes (cytofluorometry). Accumulation of the autophagy marker LC3-II occurred rapidly and at low drug concentrations in quinacrine-treated PMNLs (significant at ≥ 2.5 μM, ≥ 2 h). Lymphocytes contained more LAMP1 than PMNLs, suggesting that the mass of lysosomes and late endosomes is a determinant of quinacrine uptake V{sub max}. PMNLs, however, exhibited the highest capacity for pinocytosis (uptake of fluorescent dextran into endosomes). The selectivity of quinacrine distribution in peripheral blood leukocytes may be determined by the collaboration of a non-concentrating plasma membrane transport mechanism, tentatively identified as pinocytosis in PMNLs, with V-ATPase-mediated concentration. Intracellular reservoirs of cationic drugs are a potential source of toxicity (e.g., loss of lysosomal function in phagocytes). - Highlights: • Quinacrine is concentrated in acidic organelles via V-ATPase-mediated ion

  17. Treatment results evaluation using the Index of Orthodontic Treatment Need

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    Thalca Hamid

    2009-12-01

    Full Text Available Background: The use of orthodontic indices were increasingly popular in the last few years. Index of Orthodontic Treatment Need (IOTN usually was used to assess the needs and demand of orthodontic treatment, eventhough, indices can be used for more than one purpose. Purpose: To determine whether the Index of Orthodontic Treatment Need (IOTN could be able to evaluate the treatment results as well. Method: Data was obtained by evaluating each of 202 study models from 17 Orthodontic Postgraduate students. The ‘before’ and ‘after’ treatment models were assessed, using the Index of Orthodontic Treatment Need. Result: Using the Wilcoxon Signed-Rank test, the assessment of Dental Health Component (DHC and Aesthetic Component (AC, before and after orthodontic treatment showed significantly differences from each others (p : 0,000 < α : 0.05. The Null hypothesis were rejected. The grade of DHC and AC were decreasing to a better score. Conclusion: The Index of Orthodontic Treatment Need (IOTN could be used to assess the orthodontic treatment outcomes, to evaluate before and after orthodontic treatment of the patients. The results of the treatment showed good improvements of dentofacial appearance of the patients which means the successful achievement of the clinical works programs.

  18. [Preliminary results of treatment with aflibercept].

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    Blăjan, Codruta; Nicula, D; Rusu, Ioana

    2014-01-01

    The paper presents the first results concerning the Aflibercept (Eylea) treatment, the last antiVEGF approved for treatment of the age related macular degeneration (AMD), neovascular form and for macular edema due to the central retinal vein occlusion. The treatment was applied to patients presenting AMD, ME and other diseases: myopic and idiopatic choroidal neovascularisation, central serous choroidopathy (CSC) or diabetic macular edema (DME). The results were good: improvement of the visual acuity, resolution of the intraretinal fluids and macular edema. Although we did not notice major side-effects, resistance or tachyphylaxis, we noticed some recurrences.

  19. Results of the treatment for pancreatic carcinoma

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    Wakasugi, Hideyuki; Funakoshi, Akihiro; Iguchi, Haruo [National Hospital of Kyushu Cancer Center, Fukuoka (Japan)] [and others

    2000-07-01

    We evaluated results of the treatment for invasive ductal pancreatic carcinoma, which accounted for 90.6% of all pancreatic carcinomas. Three hundred thirty-six patients with this carcinoma (214 men and 122 women) were divided into two groups: one was admitted between 1978 and 1987, and the other, between 1988 and 1997. Investigation items were as follows: survival period (median), one-year survival rate, stage, diabetes, treatment. The latter group (193 cases in 1988-1997) lived slightly but significantly longer than the former group (143 cases in 1978-1987): median survival 125{yields}161.5 days, one-year survival rate 13.3{yields}18.7%. As a cause of the improvement, we obtained results that suggested the usefulness of radiotherapy: trialed cases of radiotherapy 44.0{yields}50.2%, median survival 146{yields}199.5 days, and one-year survival rate 9.5{yields}14.6%. In conclusion, results of the treatment for pancreatic carcinoma showed a slight but significant improvement. (author)

  20. [Results of the surgical treatment of thyrotoxicosis].

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    Uchikov, A; Nonchev, B; Danev, V; Murdzhev, K; Vladeva, S; Terzieva, D

    2006-01-01

    The aim of this study was to evaluate the results of the surgical treatment of patients with thyrotoxicosis in three surgical clinics in Plovdiv. PATIENTS AND MEDHOTS: We studied 90 patients, who underwent surgical treatment for thyrotoxicosis between 2000-2004. Of those 19 men (21%) and 71 women (79%); men:women = 1:3.74; mean age 38 +/- 8.3 years. The nosological distribution was as follows: Graves' disease--72 subjects (80.00%), solitary toxic adenoma--4 subjects (4.40%), toxic nodular goiter--14 subjects (15.60%). 77 subtotal thyroidectomies (85%) and 9 total thyroidectomies were performed. Patients with solitary toxic adenoma underwent lobectomy. Massive bleeding witch required revision and haemostasis was encountered in 1 patient. Transient laryngeal nerve injury occurred in 3 patients (3.33%), and temporary hypoparathyroidism in 6 subjects (6.67%), necessitating calcium supplementation. One year postoperatively, 49.35% (n = 38) of the patients who have undergone subtotal thyroidectomy were euthyroid, 45.45% (n = 35) developed hypothyroidism, and 5.2% (n = 4) relapsed. Our results indicate that surgery is safe and effective for patients with thyrotoxicosis referred for radical treatment. Because of the high rate of postoperative thyroid disfunction, assessment of the non-operative factors, witch influence the functional results, is recommended.

  1. Laser treatment of stretch marks: preliminary results

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    Longo, Leonardo; Piccinetti, A. L.; Monache, G. D.; Botta, G.; Mancini, S.

    2000-06-01

    The best treatment of these stretch mark is still unknown. Some authors proposed the treatment with flash-lamp-pumped dye laser 585 nm, with fluence over 8 J/cm2. Reviewing our experiences on no-surgical effects of lasers in the various phases of the wound healing, including the re- epithelization, we would like to apply the no-surgical laser therapy treating the stretch marks of breast, abdomen and lumbo-sacral region. The goal is to inhibit the fibrous tissue metabolism, encouraging the destruction of the collagen fibers with inflammatory mechanism, and increasing the reconstitution of the superficial dermis layers. We treated five cases of stretch marks in women 22-35 years old, since May 1999, with a cycle of applications of double lasers, 511 and 577 nm, with energy of 20 Joule for spot, respecting the maximum thermal relaxation times of the skin. We waited two weeks interval between the applications. Results obtained after five applications are very positive, and we are encouraged to continue this experimentation.

  2. Surgical Treatment Results of Acute Acromioclavicular Injuries

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    Mahmoud Jabalameli

    2010-02-01

    Full Text Available Background Different methods of surgical treatment for acromioclavicular(ACjoint injury were considered in the literature. The purpose of the study was to compare intra- articular AC repair technique with the extra-articular coracoclavicular repair technique for the patients with Rockwood type III and VAC joint injury when indicated.Methods: Nineteen consecutive patients with Rockwood type III and VAC joint injury  were treated with intra-articular (Group I - 12 cases and extra-articular (Group II - 7cases repair technique between 1380 - 1386, and the results reviewed. When the diagnosis was established, the mean age of the patients was 32.5 years (Range, 18 - 60; group I and II 31.8 years (Range, 18 - 60 and 34 years (Range, 22 - 58 respectively. The mean duration of postoperative follow - up was 24 months. The Constant shoulder scoring system was applied to obtain clinical results.   Results: Only in group I, the post-surgical complication was associated with fiber allergy, wound infection and pin site infection in two patients respectively. No pain was detected in fourteen cases. Four patients in group I had occasional mild pain during sport activity, while one case in this group reported severe pain during resting which prevented the patient from activity. Also, there was an ossification in thirteen patients particularly in group I. Clinical results showed the mean constant shoulder score was 93.4 in group I and 97.1 in group II.Conclusion: At the time of the follow - up, there was a clear difference between both groups regarding to postoperative pain and discomfort.Therefore, it seemed that potential cause of pain was due to postoperative complications. An interesting postoperative complication without interfere in the functional outcome was coracoclavicular space ossification in most cases. This was probably because of soft tissue injury during the operation.It seemed that surgical treatment of Rockwood type III and VAC joint injuries

  3. Treatment results in isolated humerus majus fractures

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    Hakan Serhat Yanık

    2012-09-01

    Full Text Available Introduction: The aim of this study is to evaluate the resultsof patients with the isolated greater tubercul fractures(GTF of humerus who conservatively or surgicallytreated.Materials and methods: 23 patients were admitted (11women, 12 men with GTF (54% dominant side of 24shoulder between 2008 and 2011. All of patient wereevaluated with MRI as preoperatively soft tissue injury.There was supraspinatus muscle tear together with GTFin 3 case and their shoulder were arthroscopically assistedrotator cuff repair. Osteosynthesis was performed in 3case with screw and fixation in 2 case with suture. GTF of16 shoulder were conservatively treated. Shoulder functionafter treatment were evaluated according to Constantscore (CS, Quick-DASH score (QDS and VAS score.Results: Three patients with screw fixation had CS 68,6points, QDS 12,8 points, VAS score 1,66. Two patientswith suture fixation had 67,5 CS points, 5,1 QDS pointsp,and 2 VAS score. Three patients with rotator cuff tear repairhad 82,6 CS points, 16,6 QDS points, and 2,33 VASscore. In patients with conservatively treated mean CSwas 63,9 points, QDS 26,1 points, VAS 2,96 points.Conclusions: In this study, conservative and surgicaltreatment results were satisfactory. In terms of pain theresults were excellent. In conclusion, GTFs are rare buttrouble-free with a good observation and sufficient rehabilitation.J Clin Exp Invest 2012; 3 (3: 378-382Key words: Humerus, fracture, greater, tubercul

  4. The Results of Surgical Treatment for Cyclotropia

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    Sibel Kocabeyoğlu

    2012-01-01

    Full Text Available Pur po se: To describe the effectiveness of oblique muscle surgery for cyclodeviations with vertical deviations. Ma te ri al and Met hod: Twenty-two eyes of 17 patients with cyclotropia were included in the study. All cases were examined pre- and postoperatively. Vertical and horizontal deviations, eye movements and oblique muscle functions were measured with prism cover test, while the degree of cyclotropia was evaluated with double Maddox rod and fundus photographs. Surgical techniques were anterior transposition of the inferior oblique muscle, inferior oblique recession, superior oblique tenotomy and superior oblique tucking. Re sults: There were 6 males and 11 females. The mean age of the patients was 17.4±9.7 years (range: 6-34 years and the mean follow-up time was 6.9±3.1 months (range: 3-12 months. Eight patients (47.1% presented with superior oblique palsy. Seven patients had a concomitant horizontal deviation; 29.4% of the patients had esotropia and 11.7% of the patients had exotropia. Eight eyes underwent anterior transposition of the inferior oblique muscle, 8 eyes underwent inferior oblique recession, 2 eyes underwent superior oblique tuck, and 4 eyes underwent superior oblique tenotomy. Anterior transposition of the inferior oblique muscle and inferior oblique recession were found as effective procedures in the treatment of vertical deviations and cyclotropia, but there was no statistically significant difference between the two procedures. Dis cus si on: Anterior transposition of the inferior oblique muscle and inferior oblique recession were found as effective procedures in the treatment of vertical deviations and cyclotropia. Anterior transposition of the inferior oblique muscle was found to be more effective than inferior oblique recession in the treatment of inferior oblique overaction. (Turk J Ophthalmol 2012; 42: 38-42

  5. Treatments for Infertility Resulting from Polycystic Ovary Syndrome (PCOS)

    Science.gov (United States)

    ... Information Clinical Trials Resources and Publications Treatments for Infertility Resulting from PCOS Skip sharing on social media ... reason for these problems. Before beginning treatment for infertility possibly related to PCOS, be sure that your ...

  6. Evaluation surgical treatment results of scoliosis in patients with neurofibromatosis

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    Hojjat Hossein-Pourfeizi

    2014-08-01

    Full Text Available Introduction: Surgical treatment of spinal deformity resulting from neurofibromatosis (NF is a major challenge for orthopedic spine surgeons. There are several problems and complications including pseudoarthrosis and cure progress despite treatment. Progressive kyphoscoliosis is the most important spinal deformity. The present study aims to evaluate surgical treatment results in severe spinal involvement cases. Methods: This analytical a-descriptive study evaluated 20 patients with NF, severe scoliosis and kyphosis (up to 50° hospitalized and treated at our center during the past 10 years. The treatment failure rate and complications were studied. Results: In this study, 20 cases with NF and kyphoscoliosis with the mean age of 13.00 ± 7.18 years were studied. These case series were consisted of 13 (65% males and 7 (35% females. Overall treatment failure was 45%. However, it was 55% of failure happened in posterior fusion alone. Failure rate was reported 36% in the combined anterior and posterior fusion and mainly seen in younger than 8-years children. Surgical complications were found in 20% with pseudoarthrosis as the most common one. There were no infections and neurological complications. Statistically, there was a significant negative relation between age and curve progression in scoliosis and kyphosis during the 2 years follow-up period. There was not any significant difference between genders considering curvature progress. Conclusion: The combined anterior and posterior fusion is probably more effective treatment, especially at early ages when more aggressive treatment is required since it reduces the treatment failure possibility.

  7. Heterochromatin in the chromosomes of the gorilla: characterization with distamycin A/DAPI, D287/170, chromomycin A3, quinacrine, and 5-azacytidine.

    Science.gov (United States)

    Schmid, M; Haaf, T; Ott, G; Scheres, J M; Wensing, J A

    1986-01-01

    The chromosomes of the gorilla were extensively studied with various staining techniques labeling the different classes of heterochromatin. The chromosomal distribution of distamycin A/DAPI-, D287/170-, quinacrine-, and chromomycin A3-positive heterochromatic regions, as well as the nucleolus organizer regions, is described and compared with the karyotypes of other hominoid species. Lymphocyte cultures were treated with low doses of 5-azacytidine during the last hours of culture. This cytidine analog induces distinct undercondensation in 37 heterochromatic regions in the 24 gorilla chromosomes. The 5-azacytidine-induced undercondensations are localized not only in most of the distamycin A/DAPI-bright heterochromatic regions but also in many telomeric C-bands of the chromosomes. Furthermore, 5-azacytidine preserves the somatic pairing between heterochromatic regions from the interphase nuclei into the metaphase stage. The homeologies and differences in the chromosomal localization of the various classes of heterochromatin, 5-azacytidine-sensitive regions, 5-methylcytosine-rich DNA sequences, and satellite DNAs in the gorilla, chimpanzee, orangutan, and man are discussed.

  8. Integrated thermal treatment system sudy: Phase 2, Results

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study, the results of which have been published as an interim report, examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 2 systems. The assumptions and methods were the same as for the Phase 1 study. The quantities, and physical and chemical compositions, of the input waste used in he Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr).

  9. Psychogenic non-epileptic seizures and psychoanalytical treatment: results

    Directory of Open Access Journals (Sweden)

    Niraldo de Oliveira Santos

    2014-12-01

    Full Text Available Background: the occurrence of psychogenic non-epileptic seizures (PNES is estimated to be between 2 to 33 cases in every 100,000 inhabitants. The number of patients with PNES reaches 19% of those treated as epileptics. Patients with PNES are treated as if they had intractable epilepsy, with unsatisfactory results even after medication treatment is used to its maximum. The aim of this study is to present the effects of individual psychoanalytical treatment in patients with PNES, assessing its impact in the evolution of the clinical picture and its association with sex, time of disease, social, psychological and professional harm, as well as going through with treatment. Methods: The case base was composed of 37 patients with PNES. The diagnosis was reached with video-EEG monitoring. Psychoanalytical treatment was carried out through 12 months of weekly sessions timed for around 50-minutes each, in a total of 48 individual sessions. Results: This study found a high rate of success in the treatment of PNES patients. 29.7% (n=11 of patients had cessation or cure of symptoms and 51.4% (n=19 had a decrease in the number of episodes. There is an association between cessation or decrease in the number of episodes and sex (p<0.01, religion (p<0.01 and concluding treatment (p<0.01. Conclusion: Individual psychoanalytical treatment applied to patients with PNES is considered effective and can be an essential form of assistance for the reduction or cessation of episodes.

  10. Anatomical and pathological changes in rat uterine cavity after blocked with quinacrine chitosan gel%喹喃克林凝胶对大鼠子宫腔堵塞后解剖及组织病理学观察

    Institute of Scientific and Technical Information of China (English)

    刘静; 杨燕; 于玲; 吴喜梅; 许观照; 李欣迎; 宋燕; 胥玉梅; 陶国振

    2013-01-01

    目的:了解喹喃克林几丁糖凝胶一次性使用对大鼠子宫腔的堵塞作用及子宫组织病理改变.方法:将不同浓度的喹喃克林几丁糖凝胶注入大鼠子宫腔内,并以宫腔注入复方苯酚糊大鼠为对照,解剖和病理切片观察大鼠子宫腔纤维化增生情况及局部和周围组织器宫反应变化.结果:大鼠子宫腔内一次性注入35%喹喃克林几丁糖凝胶,4周后宫腔完全被空泡化的基质细胞和成纤维细胞堵塞,6周后宫腔完全被肉芽组织堵塞,阻塞效果与复方苯酚糊组相同.病理解剖结果显示大鼠管腔无局部及邻近组织炎性反应.结论:一次性注入35%浓度的喹喃克林几丁糖凝胶对大鼠子宫腔有明显的阻塞作用,生殖管腔无炎性反应,可作为一种非手术绝育法继续研究.%Objective: To observe the effect of quinacrine chitosan gel ( QCG) on the blockage of rat uterine cavity and the resultant pathological changes. Methods; QCG at concentration of 35% was injected into rat uterine cavity, with phenolatabrine paste (PAP) as control. The uterine horns were collected 4 and 6 weeks later to observe the anatomical and pathological changes. Results; The rat uterine cavity was filled with vacuolated stromal cells and fibroblasts 4 weeks after an injection of QCG, and completely jammed with granulation tissue 6 weeks after the injection, which was similar to effect of PAP. No inflammatory reaction was found in the uterine cavity or the adjacent tissues. Conclusion; QCG had an obvious effect of uterine cavity blockage without any inflammatory reaction, and may be as a novel non - surgical contraceptive method for the women of reproductive age.

  11. Results of open tibial fracture treatment using external fixation

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    Golubović Ivan

    2016-01-01

    Full Text Available Introduction. Open lower leg fractures are the most common open fractures of the locomotor system and their treatment is associated with a number of complications. Objective. The aim of the paper was to present the results of the treatment of 68 patients with open lower leg fractures, as well as the complications that accompany the treatment of these fractures. Methods. In the analyzed group, there were 45 (66.18% men and 23 (33.82% women. The majority of patients - 33 (48.53% of them - were injured in motor vehicle accidents, whereas 24 (35.29% patients sustained injuries due to falls from heights. In two (2.94% patients the cause of open tibial fractures was gunshot injuries. In the analyzed group, there were 18 (26.47% type I open fractures, 21 (30.88% type II open fractures, 19 (27.94% type IIIA open fractures, seven (10.29% type IIIB open fractures, and three (4.41% type IIIC open fractures. Results. The tibial shaft fracture healed without serious complications in 50 (73.53% patients, whereas in 18 (26.47% patients we observed some complications. Nonunion was found in 10 (14.71% patients, osteitis in four (5.88, malunion in two (2.94% patients. Milder complications such as soft tissue pin tract infection developed in 13 (19.12% patients, infection of the open fracture wound soft tissue was observed in four (5.88% patients. Conclusion. Basic principles in the treatment of open lower leg fractures in this study are thorough primary open fracture wound treatment followed by the delayed wound closure, stable fracture fixation using unilateral external skeletal device, proper antibiotic treatment and tetanus prophylaxis. The results correlate with similar studies. [Projekat Ministarstva nauke Republike Srbije, br. III 41017: Virtual Human Osteoarticular System and its Application in Preclinical and Clinical Practice

  12. Results of surgical treatment of atypical endometrial hyperplasia

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    O. A. Gornykh

    2014-01-01

    Full Text Available The results of surgical treatment in 132 patients with atypical endometrial hyperplasia have been studied. Post-operative diagnosis was: en- dometrial cancer – in 19 %, atypical hyperplasia – in 35 %, simple and complex hyperplasia – in 33 %, only atrophic endometrial changes – in 13 % of patients. The tumor was within the endometrium in 5 patients, the superficial invasion of the myometrium (1–2 mm were in 8 patients, invasion to half of the myometrium – in 9 patients, invasion of more than half of the myometrium – in 3 patients. The questions of tactics of treatment of atypical endometrial hyperplasia is under discussion.

  13. Esthesioneuroblastoma: clinical course, long-term results of treatment

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    T. D. Tabolinovskaya

    2016-01-01

    Full Text Available This rare tumor from a group of neuroendocrine neoplasms was studied. The material for the study was the data of 78 patients with esthesioneuroblastoma who had been treated and followed up at the N.N. Blokhin Russian Cancer Research Center in the period 1965 to 2014. Information on hospital statistics, clinical features, methods, and treatment results were presented. The possibilities of using the TNM classification for the nasal cavity, ethmoidal sinuses, and nasopharynx were assessed to determine the anatomic extent of primary tumor. The findings contribute to the solution of problems in the diagnosis and treatment of esthesioneuroblastoma at the present stage. 

  14. Endovascular treatment of penetrating aortic ulcers: mid-term results.

    Science.gov (United States)

    Dalainas, I; Nano, G; Medda, M; Bianchi, P; Casana, R; Ramponi, F; Stegher, S; Malacrida, G; Inglese, L; Tealdi, D G

    2007-07-01

    The aim of this study was to evaluate mid-term results of endovascular treatment of penetrating aortic ulcers. Between February 2000 and November 2006, 18 consecutive patients underwent endovascular treatment of the descending thoracic aorta (N=16) and abdominal infrarenal aorta (N=2) for penetrating aortic ulcer, in a single University Hospital. Data were prospectively collected and retrospectively analyzed. Mean follow-up was 41 months (range 4 to 77 months). Technical success was achieved in all patients. No perioperative deaths occurred. No conversion to open repair or secondary procedures were required. Two patients died in the follow-up period for reasons not related to penetrating aortic ulcers. One type II endoleak was observed. It was still present, unchanged, twelve months after the procedure. Endovascular treatment of penetrating aortic ulcers of the descending thoracic and infrarenal aorta were safe and effective in the mid-term in this small series of patients.

  15. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: turkmenciftci@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: akincid@hotmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey)

    2016-03-15

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  16. Results of the dental treatment in children with bruxism

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    Kirenia Pieri Silva

    2015-02-01

    Full Text Available Background: bruxism is a habit associated to stress and to occlusal disturbances which can be solved applying an odontological treatment. Objective: to evaluate the effectiveness of the odotological treatment in students from 5 to 11 years with bruxism. Methods: a study of cuasiexperimental intervention design of type before and after in all the children with bruxim (52, with ages of 5 to 11 elderly years, belonging to Health Area II. Cienfuegos. An oral exam to each child was made; parents and teachers were interviewed as well. Studied variables were: Age, sex, the bruxism's grade of affectation, psychological diagnosis and symptoms and the bruxism's signs. The results present itself in draw of numbers and percentages. Results: the bigger affectation predominated in the female sex from 6 to 11 elderly years and the psychological diagnosis of severe disorders. When examining the signs and symptoms of bruxism before the intervention, the more frequent were the dental squeaking and the dental squeezing. After applying the treatment, more than the half of the children improved his symptomatology in relation to the initial status, and an improvement of over the 70 % in the event of the muscular pain was achieved. Conclusion: the effectiveness of the dental treatment in the improvement of the signs and symptoms of the bruxism was demonstrated.

  17. Clinical Results of Hypomethylating Agents in AML Treatment

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    Marjan Cruijsen

    2014-12-01

    Full Text Available Epigenetic changes play an important role in the development of acute myeloid leukemia (AML. Unlike gene mutations, epigenetic changes are potentially reversible, which makes them attractive for therapeutic intervention. Agents that affect epigenetics are the DNA methyltransferase inhibitors, azacitidine and decitabine. Because of their relatively mild side effects, azacitidine and decitabine are particularly feasible for the treatment of older patients and patients with co-morbidities. Both drugs have remarkable activity against AML blasts with unfavorable cytogenetic characteristics. Recent phase 3 trials have shown the superiority of azacitidine and decitabine compared with conventional care for older AML patients (not eligible for intensive treatment. Results of treatment with modifications of the standard azacitidine (seven days 75 mg/m2 SC; every four weeks and decitabine (five days 20 mg/m2 IV; every four weeks schedules have been reported. Particularly, the results of the 10-day decitabine schedule are promising, revealing complete remission (CR rates around 45% (CR + CRi (i.e., CR with incomplete blood count recovery around 64% almost comparable with intensive chemotherapy. Application of hypomethylating agents to control AML at the cost of minimal toxicity is a very promising strategy to “bridge” older patients with co-morbidities to the potential curative treatment of allogeneic hematopoietic cell transplantation. In this article, we discuss the role of DNA methyltransferase inhibitors in AML.

  18. RESULTS OF SURGICAL TREATMENT OF HAGLUND’S DESEASE

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    A. A. Kardanov

    2013-01-01

    Full Text Available Objectives. The article presents the results assessment of open calcaneal excision compared to percutaneous excision of patients with Haglund’s disease. Materials and methods. Twenty-one patients (26 feet underwent the surgical treatment during the period from 2010 to 2012. The clinical diagnosis was confirmed by axial load radiography estimated with “Fowler-Philip” and “posterior pitch lines” methods. Eight feet were treated with open calcaneal excision and 18 feet - with percutaneous procedure. The mean duration of follow-up was 21,8 months. Clinical evaluation criteria were deformity and/or bursitis recurrence, tenderness, pain by wearing shoes, return to the sport training, patient satisfaction, presence/absence of major complications. Results. Good results were reported for 21 patients; fair results - for 4 patients; and poor results - for one patient. No significant differences in results depending on the method of intervention have been identified.

  19. Pirfenidone treatment in idiopathic pulmonary fibrosis: nationwide Danish results

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    Goran Nadir Salih

    2016-09-01

    Full Text Available Background: Pirfenidone was approved by the European Medicines Agency and introduced in most European countries in 2011 for treatment of idiopathic pulmonary fibrosis (IPF. Objective: To describe the national Danish experiences of pirfenidone treatment for IPF during 30 months with respect to target population, safety, adherence to the treatment and effect analysis in a well-characterised IPF population in a real-life setting. Methods: Retrospective data collection from medical records of all patients in Denmark with IPF from 2011 to 2014. Data included baseline demographics, high-resolution computed tomography (HRCT, histopathology, forced vital capacity (FVC and 6-min walk test (6MWT. Longitudinal data on FVC, walk test, adherence to the treatment and vital status were also collected. Results: Pirfenidone treatment was initiated in 113 patients. Mean age was 69.6±8.1 years (±SD, and 71% were male. Definite IPF diagnosis required thoracoscopic lung biopsy in 45 patients (39.8%. The remaining 68 cases had a definite (64 patients or possible usual interstitial pneumonia (four patients pattern on HRCT. Patients were followed for 0.1–33.8 months (median 9.4 months. Fifty-one patients (45.2% needed dose adjustment, 18 (16% patients discontinued therapy and 13 patients (11.5% died. The annual mean decline in FVC was 164 ml (SE 33.2. The decline in 6MWT was 18.2 m (SE 11.2. Nausea (44.2%, fatigue (38.9% and skin reactions (32.7% were frequent adverse events. Conclusion: Patients with IPF treated with pirfenidone experienced tolerable adverse events. Patients were maintained on treatment due to a careful follow-up and dose adjustment programme. The annual decline in physiological parameters and mortality rate was comparable to previous randomised controlled trials.

  20. Pirfenidone treatment in idiopathic pulmonary fibrosis: nationwide Danish results

    Science.gov (United States)

    Salih, Goran Nadir; Shaker, Saher Burhan; Madsen, Helle Dall; Bendstrup, Elisabeth

    2016-01-01

    Background Pirfenidone was approved by the European Medicines Agency and introduced in most European countries in 2011 for treatment of idiopathic pulmonary fibrosis (IPF). Objective To describe the national Danish experiences of pirfenidone treatment for IPF during 30 months with respect to target population, safety, adherence to the treatment and effect analysis in a well-characterised IPF population in a real-life setting. Methods Retrospective data collection from medical records of all patients in Denmark with IPF from 2011 to 2014. Data included baseline demographics, high-resolution computed tomography (HRCT), histopathology, forced vital capacity (FVC) and 6-min walk test (6MWT). Longitudinal data on FVC, walk test, adherence to the treatment and vital status were also collected. Results Pirfenidone treatment was initiated in 113 patients. Mean age was 69.6±8.1 years (±SD), and 71% were male. Definite IPF diagnosis required thoracoscopic lung biopsy in 45 patients (39.8%). The remaining 68 cases had a definite (64 patients) or possible usual interstitial pneumonia (four patients) pattern on HRCT. Patients were followed for 0.1–33.8 months (median 9.4 months). Fifty-one patients (45.2%) needed dose adjustment, 18 (16%) patients discontinued therapy and 13 patients (11.5%) died. The annual mean decline in FVC was 164 ml (SE 33.2). The decline in 6MWT was 18.2 m (SE 11.2). Nausea (44.2%), fatigue (38.9%) and skin reactions (32.7%) were frequent adverse events. Conclusion Patients with IPF treated with pirfenidone experienced tolerable adverse events. Patients were maintained on treatment due to a careful follow-up and dose adjustment programme. The annual decline in physiological parameters and mortality rate was comparable to previous randomised controlled trials. PMID:27616539

  1. Conservative treatment of the anal carcinoma. Retrospective results - radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dobrowsky, W.

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  2. [Conservative treatment of anal cancer. Retrospective results--radiotherapy].

    Science.gov (United States)

    Dobrowsky, W

    1987-09-01

    The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected: 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function-preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy.

  3. Chordoma. Report on treatment results in eighteen cases

    Energy Technology Data Exchange (ETDEWEB)

    Lybeert, M.L.M.; Meerwaldt, J.H.

    1986-01-15

    Eighteen patients with a proven histologic diagnosis of chordoma were treated between 1949 and 1982. Four patients received only surgery, 4 patients only radiation therapy, and 10 patients received surgery and postoperative radiation therapy to a varying dose. The results suggest that a higher radiation dose gives longer recurrence-free survival, and that the best long term results can be achieved by combining surgery - as radically as possible - with radiation therapy to a dose level of 60 to 65 Gy. In view of the number of marginal recurrences (2 out of the 14 patients who received radiation therapy), the importance of choosing the right treatment volume is stressed.

  4. THE RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH ADRENAL TUMORS

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    A. A. Kostin

    2016-01-01

    Full Text Available Malignant adrenal tumors such as adrenocortical cancer (ACC and malignant pheochromocytoma (MPCC have a particularly aggressive course, leading to higher mortality in these patients, especially in the later stages of the disease. In this regard, there is a statistically significant difference in survival of patients, depending on the time of detection and initiation of treatment.Purpose. Analysis of the results of surgical treatment of patients with adrenal tumors.Patients and methods. 55 patients aged from 17 to 75 years (median 50 ± 13 years with primary tumor neoplasms of the adrenal gland underwent surgical treatment in the period from 1999 to 2014 in the Department of Onco-urology, P. Hertsen MORI. 18 adrenalectomy (32,7% completed laparoscopy, 36 (65,5% – open access, 1 (1,8% – videoassistance. Among them, retroperitoneal lymph node dissection with ipsilateral hand made in 14 (25.5%, combined operations with resection of adjacent organs – 7 (12,7%, thrombectomy with resection of the inferior Vena cava – 3 (5,5% cases. The median time was 100 ± 73 minutes in open surgical procedures – 183 ± 55 minutes, laparoscopic – 60 ± 30 minutes. The volume of blood loss – 300 ± 1136 ml. According to the routine morphological studies, 24 (43,6% patients the tumor were benign, the remaining 31 (56,4% – malignant.Results. Long-term results have been traced in 84% of patients in group with ACC. The observation time for patients varied from 2 to 167 months, with a median of 64.5 (IQR 22–111 months. Median survival without progression and 5-year overall and tumor survival was: I stage – 93 months and 67 ± 13%, II stage – 30 months and 75 ± 21%, III stage– 18 months and 67 ± 27%, IV stage – 10 months and 25 ± 21%. The observation time for patients with MPCC varies from 12 to 102 months, with a median of 60 (IQR 18–102 months. Median survival without progression was 26 (IQR 15 to 38 months, 5-year overall and tumor survival

  5. Upper cervical injuries: Clinical results using a new treatment algorithm

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    Andrei F Joaquim

    2015-01-01

    Full Text Available Introduction: Upper cervical injuries (UCI have a wide range of radiological and clinical presentation due to the unique complex bony, ligamentous and vascular anatomy. We recently proposed a rational approach in an attempt to unify prior classification system and guide treatment. In this paper, we evaluate the clinical results of our algorithm for UCI treatment. Materials and Methods: A prospective cohort series of patients with UCI was performed. The primary outcome was the AIS. Surgical treatment was proposed based on our protocol: Ligamentous injuries (abnormal misalignment, facet perched or locked, increase atlanto-dens interval were treated surgically. Bone fractures without ligamentous injuries were treated with a rigid cervical orthosis, with exception of fractures in the dens base with risk factors for non-union. Results: Twenty-three patients treated initially conservatively had some follow-up (mean of 171 days, range from 60 to 436 days. All of them were neurologically intact. None of the patients developed a new neurological deficit. Fifteen patients were initially surgically treated (mean of 140 days of follow-up, ranging from 60 to 270 days. In the surgical group, preoperatively, 11 (73.3% patients were AIS E, 2 (13.3% AIS C and 2 (13.3% AIS D. At the final follow-up, the American Spine Injury Association (ASIA score was: 13 (86.6% AIS E and 2 (13.3% AIS D. None of the patients had neurological worsening during the follow-up. Conclusions: This prospective cohort suggested that our UCI treatment algorithm can be safely used. Further prospective studies with longer follow-up are necessary to further establish its clinical validity and safety.

  6. Floating knee injuries: Results of treatment and outcomes

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    Mohammad Hadi Nouraei

    2013-01-01

    Full Text Available Background: Floating knee, referred to as ipsilateral fractures of the femur and tibia, is usually associated with several complications and mortality. This study was designed to present our experience with treatment of this injury throughout; age, sex, mechanism of injury, associated injuries, method and results of treatment, and complications of floating knee are discussed. Materials and Methods: This retrospective study was performed between January 2006 and December 2011. All patients with floating knee injuries who were admitted to the referral educational hospitals were included. The information about the 238 cases of floating knee injuries were gathered through the 254,620 trauma files and after excluding 18 patients who died within 6 months, the remaining files were studied and the target information was recorded. Results: The most frequent age group was 20-29 years (44.5%. The floating knee injuries were more common in males (85.5%. Type (D according to "the classification of Letts and Vincent" was observed in 38.9% cases. The most frequent mechanism of injury was car to motorcycles accidents (48.2%. The most common associated injury was pelvic fractures (86.8%. Open reduction and internal fixation was the common type of treatment (70%. The most common early and late complications were knee hemarthrosis in 31 cases (14% and knee osteoarthritis in 30 cases (13.6%, respectively. Death during the 5 years follow up was due to circulatory disruption, followed by deep vein thrombosis (61%. There was a significant relation between the age and outcomes as it worsens with age (P-value < 0.05. Conclusion: This study revealed that the complication rate associated with floating knee injuries remained high, regardless of the used treatment regimen and surgeons should focus on reducing complications while treating it.

  7. The results of surgical and nonsurgical treatment of mallet finger

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    Starčević Branislav

    2006-01-01

    Full Text Available Introduction: The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer finger. Objective Our paper had several research Objectives: presentation of the existing Results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors’ Results. Method: The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months. An average follow up was 28.7 months. The Objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by χ2-test and Student’s t-test. The confidence interval was p=0.05. Results: A total range of motion was 51.9±6.6 for nonsurgically treated patients, and 48.2±4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5±3.3 for nonsurgical and 10.0±3.2 for operated patients. Conclusion: The Results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical Method of treating the same deformity.

  8. Toxicity of solid residues resulting from wastewater treatment with nanomaterials.

    Science.gov (United States)

    Nogueira, Verónica; Lopes, Isabel; Rocha-Santos, Teresa; Gonçalves, Fernando; Pereira, Ruth

    2015-08-01

    Nanomaterials (NMs) are widely recommended for wastewater treatments due to their unique properties. Several studies report the different advantages of nanotechnology in the remediation of wastewaters, but limited research has been directed toward the fate and potential impacts of the solid residues (SRs) produced after the application of such technologies. The present work aimed at investigating the ecotoxicity of SRs resulting from the treatment of three effluents (OOMW, kraft pulp mill, and mining drainage) with two NMs (TiO2 and Fe2O3). The invertebrate Chironomus riparius was selected as test organism and exposed to the residues. The effect on percentage of survival and growth was assessed. Results showed that the SRs from the treatments nano-TiO2(1.0gL(-1))/H2O2(0.5M) and nano-Fe2O3(1.0gL(-1))/H2O2(1.0M) from OOMW and nano-Fe2O3(0.75gL(-1))/H2O2(0.01M) from kraft pulp mill effluent exhibited lethal toxicity to C. riparius. Only the exposure to SRs resulting from the treatment with nano-Fe2O3(0.75gL(-1))/H2O2(0.01M) applied to the kraft pulp mill effluent significantly affected the growth rate based on the head capsule width. In terms of growth rate, based on the body length, it decreased significantly after exposure to the SRs from the treatments nano-TiO2 (1.0gL(-1)) and nano-Fe2O3(0.75gL(-1))/H2O2(0.01M) of kraft paper mill effluent and nano-Fe2O3(1.0gL(-1))/H2O2(1.0M) of OOMW. According to our study the SRs can promote negative effects on C. riparius. However, the effects are dependent on the type of effluent treated as well as on the organic and inorganic compounds attached to the NMs. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Lamivudine treatment for decompensated cirrhosis resulting from chronic hepatitis B.

    Science.gov (United States)

    Villeneuve, J P; Condreay, L D; Willems, B; Pomier-Layrargues, G; Fenyves, D; Bilodeau, M; Leduc, R; Peltekian, K; Wong, F; Margulies, M; Heathcote, E J

    2000-01-01

    The prognosis of decompensated cirrhosis resulting from chronic hepatitis B is poor, and the benefits of treatment with interferon are outweighed by serious side effects and by the risk of fatal exacerbation of disease activity. Lamivudine rapidly reduces hepatitis B virus (HBV)-DNA in serum to undetectable levels. We have treated 35 patients with chronic hepatitis B and decompensated cirrhosis with lamivudine 100 mg or 150 mg orally once daily. Pretreatment, all were positive for HBV-DNA in serum. Ten had Child-Pugh class B and 25 had Child-Pugh class C liver disease. Seven patients underwent liver transplantation within 6 months of treatment initiation, 5 patients died within 6 months, and 23 patients were treated for at least 6 months (mean = 19 months). In a majority of these 23 cases, there was a slow but marked improvement in liver function, which was most apparent after 9 months of treatment, with a decrease in serum bilirubin from 67 +/- 13 to 30 +/- 4 micromol/L (P decompensated HBV cirrhosis, but the long-term benefits remain uncertain.

  10. Our Treatment Results of Circumscribed and Diffuse Choroidal Hemangiomas

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    Esra Savku

    2013-08-01

    Full Text Available Purpose: To discuss our treatment results of choroidal hemangiomas. Material and Method: The records of 39 cases of choroidal hemangioma followed up at our clinic between July 1999–October 2012 were reviewed retrospectively. Asymptomatic cases were followed up. Symptomatic cases with subretinal fluid and impaired vision received treatment. Results: Mean age of the 39 patients was 44 (12-80 years. Thirty-five of 39 cases had circumscribed choroidal hemangioma, and 4 cases had diffuse choroidal hemangioma. Sturge-Weber syndrome was present in 3 cases with diffuse choroidal hemangioma. Cases with circumscribed choroidal hemangioma and minimal subretinal fluid were treated with TTT in 11 cases, PDT in 12 cases, and PDT+TTT in 1 case. Cases with circumscribed choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy in 1 case, Ru-106 plaque radiotherapy+TTT in 1 case, EBRT in 3 cases, and TTT+EBRT in 1 case. One painful blind eye with neovascular glaucoma and complicated cataract was enucleated. Cases with diffuse choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy+TTT in 1 case and EBRT in 1 case. Ahmed glaucoma valve implantation and FAKO emulsification were applied to a case with neovascular glaucoma and complicated cataract. Complete resorption of subretinal fluid was achieved in 23 (72% of treated 32 cases. When mean initial tumor thickness was 2.6 mm (0.5-6, mean final tumor thickness was 1.4 mm (0-6. When mean initial visual acuity (LogMAR was 1.5 (0-3, mean final visual acuity was 1.1 (0-3. No recurrence was observed. Discussion: The amount of the subretinal fluid determines the method of treatment in circumscribed choroidal hemangioma. While TTT and PDT are effective treatment modalities for minimal subretinal fluid, plaque radiotherapy and EBRT are applied in cases with excessive subretinal fluid. Combination therapies may be necessary according to the

  11. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo;

    2016-01-01

    Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...... generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli.Results: Simulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency...... frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes....

  12. Varfarin in the complex treatment of antiphospholipid syndrome: preliminary results

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    T M Reshetnyak

    2003-01-01

    Full Text Available Objective. To assess efficacy and tolerance of varfarin in prophylaxis and therapy of thrombotic complications in patients with antiphospholipid syndrome (APS. Methods. 20 pts with APS (5 male and 15 female received varfarin during a year. 8 of them had primary APS (PAPS and 12 -systemic lupus erythematosus with APS (SLE+APS. 2 other pts (I with SLE+APS and I with PAPS received varfarin during the last 4 years. Nobody from 9 pts with PAPS received corticosteroids (CS. In SLE+APS pts CS dose varied from 4 to 20 mg/day and was not increased during follow up. During the study prothrombine time (PT was examined with thromboplastin ( manufactured by Renam having international sensitivity index 1,2 and international normalization relation (INR. Depending on treatment scheme APS pts were divided into 3 groups. Group 1 included 8 pts with INR<2,0, Group 2-7 with INR >3,0, group 3 - 7 pts with INR<2,0 receiving as additional treatment thrombo ASS 100 mg/day and vasonit from 600 to 1200 mg/day. Results. Two pts with INR = 1,8 had thrombosis recurrence (due to leg thrombophlebitis. There were no recurrences in other groups. 2 from 22 pts had "large" bleedings. "Small" bleedings episodes were noted in 7 from 22 pts. Largely that were subcutaneous bleedings (in 4 pts no more than 5 cm of size. Two pts receiving varfarin with INR 1,8 and 2,4 had renal colic. Conclusion. Our preliminary results prove the necessity of inclusion of varfarin in the treatment of pts with APS and thrombosis but intensive anticoagulant effect is not always desired.

  13. Comparison of Roth appliance and standard edgewise appliance treatment results.

    Science.gov (United States)

    Kattner, P F; Schneider, B J

    1993-01-01

    A retrospective comparison of Roth appliance and standard edgewise appliance treatment results was made using two indices. The first, the ideal tooth relationship index (ITRI), scored dental casts for the presence of ideal tooth contacts. The second judged posttreatment dental casts on the basis of criteria established by Andrews in his "Six Keys to Normal Occlusion." The sample consisted of 120 orthodontically treated cases completed by two practitioners who have used both the Roth and standard edgewise appliances. Thirty cases of each appliance type were collected from each practitioner. The overall posttreatment ITRI percentage scores showed no significant differences between the appliances. Practitioner differences existed for the anterior intraarch, anterior interarch, and posterior buccal interarch relationships. These differences were related to both treatment time and finishing arch wire size. The results of the Six Keys Analysis showed that the angulation and inclination of the maxillary posterior teeth were better with the Roth appliance. However, success in achieving some components of the six keys did not translate into an increased percentage of ideal tooth contacts as measured by the ITRI. Despite using the Roth appliance, experienced clinicians still found it difficult to achieve all six keys to normal occlusion.

  14. Results of Entecavir treatment in patients with chronic hepatitis B

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    Şükran Köse

    2013-12-01

    Full Text Available Objective: This study was designed to determine the efficacy and safety of Entecavir (ETV after 96 weeks treatment in patients with chronic viral hepatitis B (CHB. Methods: Thirty-eight patients were included into the study. The criteria for starting ETV treatment were as follows: elevated ALT levels >upper limit of normal (ULN two times, with HBV-DNA levels ≥5 log10 copies/ml (≥20000 IU/mL, in HBe Ag positive patients, ≥4log10 copies/ml (≥2000IU/mL in HBe Ag negative patients and liver damage was confirmed by histopathology (Knodell HAI ≥4 or fibrosis ≥1. Patients were followed up every 12 weeks by virological and biochemical tests. Results: Twenty-four of 38 patients (63.2% were male. Mean age of patients were 38.6 years, 14 of them were HBeAg positive (36.8%. At baseline, median ALT level was detected as 106.7 IU/ml, median HBV DNA levels were 4.8 x 107 copy/ml, and mean Knodell HAI score was nine. Eleven of 14 HBe Ag positive patients (78.6% were treatment-naïve. No resistance mutation was determined during treatment. Biochemical responses (BR at 48 th and 96th week were 100% and virologic response (VR were 57.1%, and 50%, respectively. Serological response (SR at 48th and 96 th weeks were 35.7% and 42.8% respectively. Fifteen (62.5% of 24 HBe Ag negative patients were treatment-naïve; two patients were detected to have lamivudine resistance mutation. At 48 th and 96 th week, BR was 95.8%, and 100%, respectively; and VR were 83.3% both. Conclusion:In our study, virologic response was significantly high after two years of therapy with Entecavir in HBe Ag negative patients. J Microbiol Infect Dis 2013;3(4: 176-180

  15. Treatment utilization and barriers to treatment: Results of a survey of dependent methamphetamine users

    Directory of Open Access Journals (Sweden)

    Lee Nicole K

    2011-02-01

    Full Text Available Abstract Background Australia has one of the highest rates of methamphetamine use in the world; however, treatment access for methamphetamine is comparatively low. This descriptive study aimed to identify patterns of treatment utilization and perceived barriers to accessing treatment among dependent methamphetamine users in the hope that such information will enable services to more appropriately respond to this group. Methods One hundred and twenty-six methamphetamine users who had a current or past history of methamphetamine dependence were interviewed about their experiences of, and perceived barriers to, treatment. Results Treatment utilization among methamphetamine users was reportedly low. One of the main reasons cited for not accessing treatment was that methamphetamine users did not perceive their drug use to be a problem (despite apparent levels of dependence. Self-detoxification with the use of other licit and illicit drugs was high among this group. Participants identified a lack of confidence in the ability of treatment services to address methamphetamine dependence and the 'opiate-centric' nature of treatment services as significant blocks to treatment entry. Suggestions for improvement by participants included operating specialist services for methamphetamine users, placing an emphasis on responsiveness and routinely involving case management services for this group. Discussion and Conclusions To improve service delivery, treatment services should reorient their services to better address the needs of methamphetamine users by making small changes such as specific opening times for methamphetamine users or using a dedicated space for methamphetamine treatment. Alternative options such as online treatments and specialist methamphetamine clinics should be considered for methamphetamine users.

  16. Results of the surgical treatment of calcaneo-navicular coalito.

    Science.gov (United States)

    Jerosch, J; Lindner, N; Finnen, D A

    1997-01-01

    We present the results after surgical treatment in 15 patients who suffered from calcaneo-navicular coalitio. A total of 20 operations were performed on 19 feet (3 T-arthrodesis, 5 simple resections, 9 resections with fat interposition, 3 resections with muscle interposition). At the time of follow-up, the patients were examined clinically and radiologically. In addition, different functional tests were performed (heel-tip test, balance test, single-leg high jump, single-leg jumping course). Ten of 17 patients who underwent radiographic study at the follow-up had a successful result. Patients who had a coalitio showed a tibial rotation (heel-tip test) of 11.5 degrees, and those patients without a coalitio had a tibia rotation of 20.3 degrees. Concerning the functional outcome, 12 of 17 patients had a successful result. The range of motion of the subtalar joint did not correlate with the functional capacity of the ankle. Seven of 20 patients subjectively judged the outcome as a failure. The worst results were found in patients with pre-existing degenerative changes at the time of resection.

  17. Treatment results of incomplete chemoradiotherapy in locally advanced cervical cancer

    Directory of Open Access Journals (Sweden)

    Gao Y

    2013-04-01

    Full Text Available Ying Gao,1,* Fei Gao,2,* Zi Liu,1 Li-ping Song1 1Department of Radiotherapy Oncology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Second Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China *These authors contributed equally to this work Objective: Regimens that combine chemotherapy and radiotherapy increase toxicity and compromise a patient’s ability to adhere to the treatment plan. We evaluated the efficacy and safety of a partially completed chemoradiation regimen prescribed for locally advanced carcinoma of the cervix. Methods: Medical records of 156 patients with locally advanced cervical cancer stage IIB–IVA who received chemoradiation with cisplatin (40 mg/m2 and 5-fluorouracil (500 mg/m2 from October 2006 to October 2008 were collected. The treatment protocol called for two cycles of chemotherapy. External beam radiation therapy was administered using a 10-MeV electron beam. Local control, disease free survival, overall survival, and toxicities were evaluated. Results: With a median follow-up of 37.5 months, 89 patients (57% completed the planned protocol. Sixty seven patients (43% completed fewer than two cycles. The 3-year local control rate was significantly better in the patient group that completed the prescribed plan (92.1% compared to 80.6%; P = 0.033. No statistical significance was observed between the groups that completed or did not complete the two cycle protocol with regard to disease free survival (80.9% and 73.2%, respectively; P = 0.250, overall survival (84.3% and 79.1%; P = 0.405, and progression survival (3.4% and 3.0%; P = 0.892. Differences in acute hematologic toxicity and subcutaneous toxicity were observed between the two groups. Conclusions: Completion of two cycles of 5-fluorouracil and cisplatin with radiotherapy was effective, safe, and responsible for better local control

  18. Thermal plasma treatment of cell-phone waste : preliminary result

    Energy Technology Data Exchange (ETDEWEB)

    Ruj, B. [Central Mechanical Engineering Research Inst., Durgapur (India). Thermal Engineering Group; Chang, J.S.; Li, O.L. [McMaster Univ., Hamilton, ON (Canada). Dept. of Engineering Physics; Pietsch, G. [RWTH Aachen Univ., Aachen (Germany)

    2010-07-01

    The cell phone is an indispensable service facilitator, however, the disposal and recycling of cell phones is a major problem. While the potential life span of a mobile phone, excluding batteries, is over 10 years, most of the users upgrade their phones approximately four times during this period. Cell phone waste is significantly more hazardous than many other municipal wastes as it contains thousands of components made of toxic chemicals and metals like lead, cadmium, chromium, mercury, polyvinyl chlorides (PVC), brominated flame retardants, beryllium, antimony and phthalates. Cell phones also use many expensive rare metals. Since cell phones are made up of plastics, metals, ceramics, and trace other substances, primitive recycling or disposal of cell phone waste to landfills and incinerators creates irreversible environmental damage by polluting water and soil, and contaminating air. In order to minimize releases into the environment and threat to human health, the disposal of cell phones needs to be managed in an environmentally friendly way. This paper discussed a safer method of reducing the generation of syngas and hydrocarbons and metal recovery through the treatment of cell phone wastes by a thermal plasma. The presentation discussed the experiment, with particular reference to sample preparation; experimental set-up; and results four samples with different experimental conditions. It was concluded that the plasma treatment of cell phone waste in reduced condition generates gaseous components such as hydrogen, carbon monoxide, and hydrocarbons which are combustible. Therefore, this system is an energy recovery system that contributes to resource conservation and reduction of climate change gases. 5 refs., 2 tabs., 2 figs.

  19. Treatment strategies for extensive chronic SFA occlusions: indications and results.

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Reijnen, M.M.P.J.; Wallis de Vries, B.M.; Zeebregts, C.J.A.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  20. Treatment strategies for extensive chronic SFA occlusions : indications and results

    NARCIS (Netherlands)

    Lensvelt, M. M. A.; Reijnen, M. M. P. J.; De Vries, B. M. Wallis; Zeebregts, C. J.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  1. [Intermittent thrombolytic treatment. Results during severe, chronic arterial diseases].

    Science.gov (United States)

    Fiessinger, J N; Aiach, M; Lagneau, P; Cormier, J M; Housset, E

    1975-04-20

    38 patients with severe chronic arteritis of the lower limbs were treated with streptokinase intermittently. All had been refused for surgical operation. One patient died, 4 others had early interruption of treatment. Eleven of the 38 patients had efficient thrombolysis confirmed by arteriography. The facts confirm the possibility of thrombolysis during chronic arterial disease. The fact that the aggravation was recent was favourable factor in prognosis. The eleven patients improved, had severe aggravation of symptomes for less than 2 months. Thus thrombolytic treatment has a place of choice in the treatment of severe arterial disease where surgery is impossible, or dangerous, owing to the uncertain state of the vascular bed below the lesion. Efficacious, it permits reconstructive surgery in cases where it had been at first refused. The use of intermittent treatment, apart from advantages of confort and cost, seems to increase the efficacy of treatment.

  2. Endovascular treatment of popliteal artery aneurysm. Early and midterm results

    Directory of Open Access Journals (Sweden)

    Rodrigo Borges Domingues

    2015-02-01

    Full Text Available OBJECTIVE: to evaluate the efficacy of endovascular repair of popliteal artery aneurysms on maintaining patency of the stent in the short and medium term. METHODS: this was a retrospective, descriptive and analytical study, conducted at the Integrated Vascular Surgery Service at the Hospital da Beneficência Portuguesa de São Paulo. We followed-up 15 patients with popliteal aneurysm, totaling 18 limbs, treated with stent from May 2008 to December 2012. RESULTS: the mean follow-up was 14.8 months. During this period, 61.1% of the stents were patent. The average aneurysm diameter was 2.5cm, ranging from 1.1 to 4.5cm. The average length was 5cm, ranging from 1.5 to 10 cm. In eight cases (47.1%, the lesion crossed the joint line, and in four of these occlusion of the prosthesis occurred. In 66.7% of cases, treatment was elective and only 33.3% were symptomatic patients treated on an emergency basis. The stents used were Viabahn (Gore in 12 cases (66.7%, Fluency (Bard in three cases (16.7%, Multilayer (Cardiatis in two cases (11.1% and Hemobahn (Gore in one case (5.6%. In three cases, there was early occlusion (16.6%. During follow-up, 88.2% of patients maintained antiplatelet therapy. There was no leakage at ultrasound (endoleak. No fracture was observed in the stents. CONCLUSION: the results of this study are similar to other published series. Probably, with the development of new devices that support the mechanical characteristics found on the thighs, there will be improved performance and prognosis of endovascular restoration.

  3. Superficial urinary bladder tumors treatment results: A 10-year experience

    Directory of Open Access Journals (Sweden)

    Stanković Jablan

    2007-01-01

    Full Text Available Background/Aim. The most common urinary bladder tumors are superficial tumors. Due to their tension to relapse and progress towards deeper layers after surgical therapy, an adequate therapy significantly contributed to the improvement of the results of urinary bladder tumors treatment. Staging and gradus of the tumor, presence of the carcinoma in situ (CIS or relapses significantly influenced the choice of the therapy. The aim of this study was to ascertain the effectiveness of the intravesicelly applied BCG (Bacille Colmette - Guerin vaccine or chemiotherapy in the prevention of the relapses and further progression of superficial urinary bladder tumors. Methods. All of the diagnosed superficial tumors of bladder were removed by transurethral resection (TUR. After receiving the patohistological finding they were subjected to adjuvant therapy, immune BCG vaccine or chemiotherapy (epirubicin, doxorubicin, mitomycin-C. The third group did not accept adjuvant therapy, but had regularly scheduled cystoscopic controls. The appearance of relapses, progression of stage and grades of the tumor, as well as possible unwanted effects of adjuvant therapy were registered. Results. The applied immunotherapy (BCG influenced decreased tumor relapses (7% and statistically important difference between patients who had taken adjuvant chemotherapy (relapses 18.4% and those without this therapy was acknowledged. Grades of tumor did not show statistically significant difference on tumor relapse. A significantly longer period of time in the appearance of tumor relapse after BCG (29.33 months, had significant importance comparing to chemio (9.44 months or non-taken adjuvant therapy (9.84 months. Very small number of unwanted effects suggested an obligatory undertaking adjuvant therapy after TUR of superficial tumors. Conclusion. A significant decrease of relapses as well as avoidance of further progression of urinary bladder tumors, has introduced adjuvant therapy in

  4. Specialized treatment for Avoidant personality disorder (AvPD): Treatment rationales and preliminary results

    DEFF Research Database (Denmark)

    Simonsen, Sebastian

    and preliminary results from a specialized psychotherapy program developed for patients with AvPD treated at Stolpegaard Psychotherapy Centre, Capital Region of Denmark. Methods: Treatment consists of individual therapy based on Metacognitive Interpersonal Therapy (MIT) while group therapy is a modified form...

  5. Surgical treatment of cervical spine trauma: Our experience and results

    Science.gov (United States)

    Dobran, Mauro; Iacoangeli, Maurizio; Nocchi, Niccolò; Di Rienzo, Alessandro; di Somma, Lucia Giovanna Maria; Nasi, Davide; Colasanti, Roberto; Al-Fay, Mohuammad; Scerrati, Massimo

    2015-01-01

    Objective and Background: The objective of this study is to evaluate how the neurological outcome in patients operated for cervical spinal cord injury (SCI) is influenced by surgical timing, admission American Spinal Injury Association (ASIA) grading system, and age. Materials and Methods: From January 2004 to December 2011, we operated 110 patients with cervical SCI. Fifty-seven of them (44 males and 13 females) with preoperative neurological deficit, were included in this study with a complete follow-up. Age, sex, associated comorbidities (evaluated with Charlson comorbidity index [CCI]), mechanism of trauma, preoperative and follow-up ASIA score, time elapsed from injury to surgical treatment, preoperative cervical computed tomography scan or magnetic resonance imaging, type of fractures, and surgical procedure were evaluated for each patient. The patient population was divided into two groups related to the timing of surgery: Ultra-early surgery group (within 12 h from the trauma, 27 patients) and early surgery (within 12–72 h from the trauma, 30 patients). Statistical Analysis Used: The univariate analysis of data was carried out by the Chi-square test for discrete variables, the t-test for the continuous ones. Logistic regression was used for the multivariate analysis. Results: Neurological outcome was statistically better in ultra-early surgery group (<12 h) than in patient underwent surgery within 12–72 h (82.14% vs. 31%, multivariate analysis P = 0.005). The neurological improvement was also correlated with the age and the ASIA grade at admission in the univariate analysis (P = 0.006 and P = 0.017 respectively) and in the multivariate 1 (P = 0.037 and P = 0.006 respectively) while the CCI was correlated with the improvement only in the univariate analysis (P = 0.007). Conclusion: Nowadays, in patients with cervical SCI early surgery could be associated with improved outcome, most in case of young people with mild neurological impairment. PMID:26396608

  6. Integrated thermal treatment system study -- Phase 2 results. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 1 systems. The alternatives evaluated were: rotary kiln, slagging kiln, plasma furnace, plasma gasification, molten salt oxidation, molten metal waste destruction, steam gasification, Joule-heated vitrification, thermal desorption and mediated electrochemical oxidation, and thermal desorption and supercritical water oxidation. The quantities, and physical and chemical compositions, of the input waste used in the Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr). 28 refs., 88 figs., 41 tabs.

  7. Results of surgical treatment for juvenile myasthenia gravis.

    Science.gov (United States)

    Vázquez-Roque, F J; Hernández-Oliver, M O; Medrano Plana, Y; Castillo Vitlloch, A; Fuentes Herrera, L; Rivero-Valerón, D

    2017-04-01

    Radical or extended thymectomy is an effective treatment for myasthenia gravis in the adult population. There are few reports to demonstrate the effectiveness of this treatment in patients with juvenile myasthenia gravis. The main objective of this study was to show that extended transsternal thymectomy is a valid option for treating this disease in paediatric patients. Twenty-three patients with juvenile myasthenia gravis underwent this surgical treatment in the period between April 2003 and April 2014; mean age was 12.13 years and the sample was predominantly female. The main indication for surgery, in 22 patients, was the generalised form of the disease (Osserman stage II) together with no response to 6 months of medical treatment. The histological diagnosis was thymic hyperplasia in 22 patients and thymoma in one patient. There were no deaths and no major complications in the postoperative period. After a mean follow-up period of 58.87 months, 22 patients are taking no medication or need less medication to manage myasthenic symptoms. Extended (radical) transsternal thymectomy is a safe and effective surgical treatment for juvenile myasthenia gravis. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Stem cells show promising results for lymphoedema treatment

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Quaade, Marlene Louise; Sheikh, Søren Paludan

    2015-01-01

    Abstract Lymphoedema is a debilitating condition, manifesting in excess lymphatic fluid and swelling of subcutaneous tissues. Lymphoedema is as of yet still an incurable condition and current treatment modalities are not satisfactory. The capacity of mesenchymal stem cells to promote angiogenesis......, secrete growth factors, regulate the inflammatory process, and differentiate into multiple cell types make them a potential ideal therapy for lymphoedema. Adipose tissue is the richest and most accessible source of mesenchymal stem cells and they can be harvested, isolated, and used for therapy...... in a single stage procedure as an autologous treatment. The aim of this paper was to review all studies using mesenchymal stem cells for lymphoedema treatment with a special focus on the potential use of adipose-derived stem cells. A systematic search was performed and five preclinical and two clinical...

  9. Distal end radius fractures: evaluation of results of various treatments and assessment of treatment choice

    Directory of Open Access Journals (Sweden)

    Vargaonkar Gauresh

    2014-07-01

    Full Text Available 【Abstract】Objective:The rapid expansion of knowledge regarding the functional anatomy of hand and wrist, increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restoration of distal radius fractures has generated a renewed interest in addressing these fractures in a more precise manner. The purpose of our study was to evaluate the difference in patients function among those treated by 1 closed reduction and Plaster of Paris cast, 2 distractor application, or 3 open reduction and internal fixation with a volar plate, and to assess the treatment choice for each particular fracture type. Methods: A prospective study was carried out on 60 patients with fractures of the distal end radius. Fractures were classified according to the AO classification into type A (extra-articular, type B (partial articular and type C (complete articular. After initial evaluation patients were taken up for either conservative or operative treatment and were followed up for two years. Results: Anatomical results were evaluated according to the Sarmiento’s modification of Lindstrom Criteria, which showed that excellent results were more frequent with open reduction and internal fixation using the plating technique. Clinical and functional results were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification, which was revealed to relate with the type of treatment techniques. Conclusion: There is no customized solution for all the fractures of the distal radius. The choice of treatment should be based on the fracture type, the patient’s characteristics, the patient’s demands and the treating surgeon’s experience and preference. Key words: Distal end radius fractures; Volar plate; Radial orthofix

  10. Distal end radius fractures: evaluation of results of various treatments and assessment of treatment choice

    Institute of Scientific and Technical Information of China (English)

    Vargaonkar Gauresh

    2014-01-01

    Objective:The rapid expansion of knowledge regarding the functional anatomy of hand and wrist,increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restoration of distal radius fractures has generated a renewed interest in addressing these fractures in a more precise manner.The purpose of our study was to evaluate the difference in patients function among those treated by 1) closed reduction and Plaster of Paris cast,2) distractor application,or 3) open reduction and internal fixation with a volar plate,and to assess the treatment choice for each particular fracture type.Methods:A prospective study was carried out on 60 patients with fractures of the distal end radius.Fractures were classified according to the AO classification into type A (extra-articular),type B (partial articular) and type C (complete articular).After initial evaluation patients were taken up for either conservative or operative treatment and were followed up for two years.Results:Anatomical results were evaluated according to the Sarmiento's modification of Lindstrom Criteria,which showed that excellent results were more frequent with open reduction and internal fixation using the plating technique.Clinical and functional results were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification,which was revealed to relate with the type of treatment techniques.Conclusion:There is no customized solution for all the fractures of the distal radius.The choice of treatment should be based on the fracture type,the patient's characteristics,the patient's demands and the treating surgeon's experience and preference.

  11. CONGENITAL ABSENCE OF THE VAGINA - RESULTS OF CONSERVATIVE TREATMENT

    NARCIS (Netherlands)

    LAPPOHN, RE

    1995-01-01

    Objective: To assess the efficacy of a combination of Frank's mold therapy with intercourse as a treatment for congenital vaginal aplasia. Study design: From 1973-1993, thirty-three patients with congenital aplasia of vagina and uterus were seen by one gynecologist. Patients with a partner were inst

  12. Good result after surgical treatment of Pellegrini-Stieda syndrome.

    Science.gov (United States)

    Theivendran, Kanthan; Lever, Caroline J; Hart, William J

    2009-10-01

    Ossification of the femoral attachment of the medial collateral ligament (MCL) of the knee with associated pain and restricted movements is rare and is characteristic of the Pellegrini-Stieda (PS) syndrome. Although in mild cases conservative treatment is often successful, patients with more significant bone formation and persistent symptoms require surgical excision. We describe a case of PS syndrome with a description of the surgical technique consisting of excision of the bony lesion and reconstruction of the MCL by using the adductor magnus tendon.

  13. [The Helkimo index for assessing treatment results after mandibular fractures].

    Science.gov (United States)

    Härtel, J; Hellmuth, M; Hellmuth, K O

    1991-01-01

    Based on the Helkimo index we assessed the success of conservative and conservative-surgical forms of treatment for mandibular fractures in a total of 166 patients. The control group consisted of 50 probands. The Helkimo dysfunction index, which is based on various criteria, showed dysfunction in 81.9% of the patients with only slight functional impairment in 57.2% of these cases. 18.1% of the patients were clinically symptom-free. A comparison with the probands revealed no major differences in dysfunction between the two groups. Significant differences were observed only in the case of 2 isolated criteria (maximum mandibular protrusion, muscle pain). Severe dysfunction, however, was more common in the fracture patients. Based on the Helkimo occlusion index disorder were noted in 91.7% of the patients, while severe occlusion disorder were observed particularly in patients with combined mandibular body and condyle fractures (40.0%). In the control group a more favorable occlusion index was found to be due mainly to the greater number of present and/or occluding teeth. The Helkimo index, particularly the dysfunctionindex, is a very useful instrument for assessing the success of treatment measures in mandibular fracture cases. It should be more commonly used to improve the possibilites of objective comparisons between patients from different hospitals.

  14. Medulloblastoma in childhood: long-term results of treatment

    Energy Technology Data Exchange (ETDEWEB)

    Broadbent, V.A.; Barnes, N.D.; Wheeler, T.K.

    1981-07-01

    Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth, with shortening of the spine in relation to the limbs, in all the children. The height centile was lower than expected from parental height in four and one was severely dwarfed. Growth hormone secretion in response to exercise was, however, normal in five of six patients tested. Three children also showed failure of growth of the jaw sufficiently severe to be a cosmetic problem. Frank mental retardation was present in three children. A raised resting TSH level was found in two children, one of whom had a multinodular goiter. Of the three children with severe problems, two had been treated when under two years of age. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes in very young children.

  15. Favorable results with syringosubarachnoid shunts for treatment of syringomyelia.

    Science.gov (United States)

    Tator, C H; Meguro, K; Rowed, D W

    1982-04-01

    From 1969 to 1979, 20 patients with syringomyelia were treated with a syringosubarachnoid shunt. The principal indications for this procedure were: significant progressive neurological deterioration and absent or minimal tonsillar ectopia. There were 15 patients with idiopathic syringomyelia, four with posttraumatic syringomyelia, and one with syringomyelia secondary to spinal arachnoiditis. The operations were performed with an operating microscope, and attention was directed to preserving thearachnoid membrane to ensure proper placement of the distal end of the shunt in an intact subarachnoid space. In all cases, a silicone rubber ventricular catheter was inserted into the syrinx through a posterior midline myelotomy. The average follow-up period was 5 years. A favorable result was obtained in 15 of the 20 patients (75%), including an excellent result with improvement of neurological deficit in 11 patients and a good result with cessation of progression in four patients. In the remaining five patients the result was poor with further progression of neurological deficit. A short duration of preoperative symptoms was usually a favorable prognostic feature. Four patients with a history of less than 6 months all had excellent results. Thirteen patients had a syringosubarachnoid shunt only, and all had good or excellent results. Seven patients had other surgical procedures, before, accompanying, or after shunt placement, and two had favorable results. Thus, the syringosubarachnoid shunt is an effective therapeutic modality for many patients with syringomyelia, particularly if there is little or no tonsillar herniation.

  16. Results achieved in the treatment of patients with vestibular schwannoma.

    Science.gov (United States)

    Freigang, Bernd; Rudolf, Jan

    2004-01-01

    Personal experience gathered with the treatment of 264 vestibular schwannoma (VS) at the Magdeburg University ENT Hospital is analysed. ABR Audiometry is useful as a screening, even though it yielded false-negative values in 12.7% (n = 33) for intrameatal VS and 16.9% for all VS, despite accurate evaluation. Latency increases of Waves I, III and V and their intraaural comparison exhibited a statistically significant difference for the VS levels proposed by TOS. The mean of intrameatal VS too was found to have longer latencies compared with the normal-hearing ears of the patients. In the individual case, with threshold hearing normal, anamnestic findings as well as otoneurological evidence provide an early indication for enhanced MRI, CISS imaging, or individual 3D reconstruction of the pontocerebellar cisterna. Adopting intraoperative monitoring of the facial nerve and the cochlea as well as the Pars acustica by means of far-field and near-field electrodes, a good facial 'mobility' was achieved in 95.3%, and a useful audition (AAO-HNS Types A and B) in 60%. Monitoring is beneficial as it enhances the reliability and improves the subtle preparation during surgery. The power of hearing improved postoperatively within six months and remained at a good level over two years. From our perspective, otorhinolaryngologists are the right specialists to attend to VS.

  17. RESULTS OF SURGICAL TREATMENT IN THE CRANIOCERVICAL JUNCTION IN MUCOPOLYSACCHARIDOSIS

    Directory of Open Access Journals (Sweden)

    Luís Eduardo Carelli Teixeira da Silva

    2016-03-01

    Full Text Available ABSTRACT Objective: Evaluate the results after decompression and stabilization of craniocervical junction in patients with mucopolysaccharidosis (MPS. Method: Retrospective study of 10 patients with MPS through the analysis of medical records and additional tests. Result: All patients with mid-term and long-term follow-up achieved consolidation of the arthrodesis and 87.5% had neurological improvement of Nurick score. Conclusion: Early diagnosis and intervention in cases of stenosis and/or craniocervical instability of patients with MPS provide patients a good recovery of neurological function, despite the great technical difficulty and risk of complications.

  18. [Cranial acupuncture in the treatment of spasticity. Clinical results].

    Science.gov (United States)

    Gomirato, G; Grimaldi, L; Perfetti, C; Roccia, L

    1976-06-09

    Hospitals in communist China perfected a new acupuncture technique about 3 yrs ago, whereby needles are placed in the scalp to stimulate the cortical centres below. This method is particularly indicated in subjects with neurological damage. Results observed in 45 subjects with cerebral vasculopathy at the neurological clinic of Pisa University and the reflexotherapy service of the University of Turin were encouraging and suggest that clinical experimentation should be attempted on a wider scale.

  19. [Long term results after invasive treatment of critical limb ischemia].

    Science.gov (United States)

    Ruzsa, Zoltán; Kuti, Ferenc; Berta, Balázs; Tóth, Károly; Bánsághi, Zoltán; Vámosi, Zoltán; Hüttl, Kálmán

    2017-03-01

    Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register. The aim of the revascularization was to achieve a straight inline flow to the wound with balloon angioplasty. Stent implantation was done in the case of recoil and flow limiting dissection. Primary end points were clinical success (relief of resting pain, healing of ulceration, limb survival) and major adverse events (death, myocardial infarction, major unplanned amputation, need for surgical revascularization, or major bleeding). Secondary end points were the angiographic result of the intervention, procedural data and consumption of angioplasty equipment. The impact of diabetic leg syndrome and the result of the angioplasty on the limb salvage was also investigated. We have analysed the impact of major amputation on long term mortality. Mean age of patients was 72.5 ± 10.6 years and the follow-up period was 40.8 ± 9.7 months. Technical success was reached in 255 (90.7%) of the patient's: 255 limbs straight inline flow with good angiographic result was restored to at least one tibial vessel. Balloon angioplasty, stent implantation and rotational atherectomy was performed in 278 (98.9%), 74 (26.3%) and 2 patients (0.7%). From clinical end points the rest pain was ceased in 56.6%, the ulcer and the gangrena was healed in 73.5% and 46.5%. The long term limb survival was 73.5%; 65.8% in diabetic and 89.6% in non-diabetic leg syndrome (p = 0.001). The major adverse events at long-term follow-up occured in 122 (43

  20. The Immediate Results of Surgical Treatment of Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Alexei L. Charyshkin

    2016-06-01

    Full Text Available The objective of this study was to evaluate the immediate results of the use of ureterointestinal anastomosis according to the Bricker technique at radical cystectomy (RC for bladder cancer (BC. Materials and Results: The study included 96 patients (11.5% women and 88.5% men with bladder cancer (BC, aged from 31 to 74 years (mean age 63.8±7.2, who underwent RC in the Lipetsk Regional Oncology Center, in the period from 2005 to 2014. Among the early postoperative complications, we identified dynamic ileus (16.7%, inflammatory complications of the surgical wound (12.5%, acute pyelonephritis (10.4%, and failure of ureterointestinal anastomosis (4.2%. The frequency of postoperative acute pyelonephritis corresponded to the findings of other authors. Two (2.1% patients died from early postoperative complications because of concomitant diseases (ischemic heart disease, myocardial infarction; thus, postoperative mortality in the early postoperative period was 4.2%. Chronic pyelonephritis with chronic renal failure detected in 15(15.6% patients after one year after surgery was the most frequent late postoperative complication. The stricture of ureterointestinal anastomosis in 9(9.4% patients has been eliminated through relaparotomy and resection of anastomosis. The development of urolithiasis in 12(12.5% patients after one year after surgery has required the implementation of contact lithotripsy and litholytic therapy.

  1. [Surgical treatment results of 52 cases of temporomandibular ankylosis].

    Science.gov (United States)

    Kimura-Fujikami, Takao

    2003-01-01

    We courried out a retrospective study of 52 surgical cases of temporomandibular joint ankylosis, fibrous types I and II in 19 patients (36.4%) and osseous type III-IV in 33 patients (63.6%). Forty two children and teenagers at the Hospital de Pediatria (1983-1985/1989-1998) and Hospital General La Raza (1985-1989) were included also, 10 adults including those operated on at the Hospital de Especialidades, CMN Siglo XXI (IMSS) from 1998 to 2001 were included. We used Dunn modified method en 37 cases (67%) and 17 patients were with Risdon operated on technique (33%). Etiology of ankylosis were direct trauma to jaw, which affected temporomandibular joint mainly in children, while in adults causes were more varied and included as osteomyelitis, middle ear infection, sequels of hemifacial microsomy, and trauma results were considered as good upon obtaining mouth opening of 35 mm without neo-ankylosis during 1-year postoperative control.

  2. Latest Results for Anti-Angiogenic Drugs in Cancer Treatment

    DEFF Research Database (Denmark)

    Frandsen, Sofie; Kopp, Sascha; Wehland, Markus;

    2016-01-01

    BACKGROUND: Angiogenesis is a mechanism, which tumors use to recruit oxygen and nutrients in order to maintain growth. The vascular endothelial growth factor family is the primary mediator of this process. For the last couple of decades, inhibition of angiogenesis has been the subject of extensiv...... mechanisms are necessary. Moreover, biomarker studies in future clinical investigations are important for the development of the next generation of anti-angiogenic drugs....... research, but so far anti-angiogenic drugs have only shown a modest effect. METHODS: This paper reviews four relevant anti-angiogenic drugs: bevacizumab, ramucirumab, nintedanib and sunitinib. The primary focus will be recent trials investigating the effects of the drugs in lung, breast...... and gastrointestinal cancers. Furthermore, there will be a discussion of unsolved problems, such as lack of biomarkers, drug resistance, and adverse events, for which a solution is necessary in order to improve the benefit of anti-angiogenic drugs in the future. RESULTS: Anti-angiogenic therapy is extensively used...

  3. [Pramipexole in Parkinson disease. Results of a treatment observation].

    Science.gov (United States)

    Reichmann, H; Brecht, H M; Kraus, P H; Lemke, M R

    2002-08-01

    Pramipexole is a novel, internationally available selective nonergot D2 dopamine agonist. The effectiveness, tolerability, and safety of pramipexole have been extensively proven in controlled trials in patients in the early and advanced stage of Parkinson's disease as monotherapy and in combination with L dopa. These trials indicated specific activity against tremor, anhedonia, and depression. Therefore, the present prospective, multicenter postmarketing surveillance study evaluated for the first time to what extent the results from the controlled pramipexole trials could be replicated under routine conditions in neurological practice and clinics. Modern scales were applied for the assessment of tremor and mood, i.e., the Short Parkinson's Evaluation Scale (SPES), the Tremor Impact Scale (TIS), and the German version of the Snaith-Hamilton Pleasure Scale (SHAPS-D). In 298 German Centers, 657 Parkinson's patients (365 men, 292 women) in advanced disease stages were treated with pramipexole in combination with levodopa. The average ages (+/- SD) were 67 (+/- 8.9) years for men and 69 (+/- 9.4) years for females. Motor functioning, especially tremor, motor complications, depression, and activities of daily living improved highly significantly (P pramipexole prescribed was 1.05 mg and thus was definitely lower than the average daily dosages of 2.35-2.66 mg used in controlled trials. This signifies that the option to adjust dosage according to effectiveness and tolerability under routine conditions yields a considerably lower incidence of adverse effects.

  4. [Morton metatarsalgia. Results of surgical treatment in 54 cases].

    Science.gov (United States)

    Assmus, H

    1994-04-01

    This syndrome, which involves nerve compression, is probably often overlooked and is, therefore, more frequent than supposed. It is characterized by pain of the forefoot, especially the 3rd and 4th toe, and is induced by pressure of the intermetatarsal space, or extension of the metatarsophalangeal joints. Results of the present study suggest that it can be successfully treated by surgery. Fifty-four patients--mostly women in midlife--had undergone operation by dorsal excision of the "neuroma" which had been performed under local anaesthesia in a bloodless field. Forty of the patients (74.1%) had recovered completely within an observation period of 1-6 years. Four (7.4%) demonstrated significant, and another 4, only slight improvement. In 6 cases (11.1%), surgery failed. The 6 unsuccessful cases had not exhibited any preoperative disturbance to the sensibility of the 4th toe. They showed, rather, symptoms of conversion disorder with depressive features, e.g. increased nocturnal suffering which is atypical for Morton's metatarsalgia. It is concluded that the accuracy of diagnosis according to strict criteria is decisive for surgical outcome.

  5. [Tendinosis calcarea--results of treatment with needling].

    Science.gov (United States)

    Gärtner, J

    1993-01-01

    In a prospective study, 33 patients with calcifying tendinitis had a needling in local anaesthesia performed under control of an image converter. There was at least a one year follow-up period. Resorption of the hydroxyapatite deposits was seen in 23 instances; 75% of all patients were free of symptoms or had considerably improved (Table 3). For better assessment of these results we embarked on an additional retrospective study observing the spontaneous evolution of 235 hydroxyapatite deposits for 3 years on average. On the x-ray, these deposits had a characteristic appearance and could be classified into one of three types: either sharply outlined and densely structured (type I), or with cloudy limitations and transparent in structure (type III). In addition we saw deposits combining the features of both of the above named types (type II) (Table 5, Fig. 6). Based on this classification, a clear correlation was revealed to exist between initial x-ray findings and the frequency of resorption after needling: with type I, complete resorption was seen in 33% of the cases, with type II in 71%, and with type III in 85% of the cases (Table 6). With type II, however, only half of the patients were free of symptoms. Surgical removal of the hydroxyapatite deposits became necessary in 3 patients because of persisting heavy pains. As complication we observed intraoperatively an incomplete tear of the rotator cuff, the relation of which to the needling remained unsure. In this context, the question is discussed whether calcifying tendinitis and rupture of the rotator cuff may represent two disease entities of identical origin.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Antiresorptive Treatment for Spaceflight Induced Bone Atrophy - Preliminary Results

    Science.gov (United States)

    LeBlanc, Adrian; Matsumoto, toshio; Jones, Jeff; Shapiro, Jay; Lang, Thomas; Shackelford, Linda C.; Smith, Scott M.; Evans, Harlan J.; Spector, Elisabeth R.; Ploutz-Snyder, Robert; Sibonga, Jean; Nakamura, Toshitaka; Kohri, Kenjiro; Ohshima, Hiroshi

    2011-01-01

    Detailed measurements from the Mir and ISS long duration missions have documented losses in bone mineral density (BMD) from critical skeletal sub-regions. The most important BMD losses are from the femoral hip, averaging about -1.6%/mo integral to -2.3%/mo trabecular. Importantly these studies have documented the wide range in individual BMD loss from -0.5 to -5%/mo. Associated elevated urinary Ca increases the risk of renal stone formation during flight, a serious impact to mission success. To date, countermeasures have not been satisfactory. The purpose of this study is to determine if the combined effect of anti-resorptive drugs plus the standard in-flight exercise regimen will have a measurable effect on preventing space flight induced bone loss (mass and strength) and reducing renal stone risk. To date, 4 crewmembers have completed the flight portion of the protocol in which crewmembers take a 70-mg alendronate tablet once a week before and during flight, starting 17 days before launch. Compared to previous ISS crewmembers (n=14) not taking alendronate, DXA measurements of the spine, femur neck and total hip were significantly improved from -0.8 +/- 0.5%/mo to 1.0 +/- 1.1%/mo, -1.1 +/- 0.5%/mo to -0.2 +/- 0.3%/mo, -1.1 +/- 0.5%/mo to 0.04 +/- 0.3%/mo respectively. QCT-determined trabecular BMD of the femur neck, trochanter and total hip were significantly improved from -2.7 +/- 1.9%/mo to -0.2 +/- 0.8%/mo, -2.2 +/- 0.9%/mo to -0.3 +/- 1.9%/mo and -2.3 +/- 1.0%/mo to -0.2 +/- 1.8%/mo respectively. Significance was calculated from a one-tailed t test. Resorption markers were unchanged, in contrast to measurements from previous ISS crewmembers that showed typical increases of 50-100% above baseline. Urinary Ca showed no increase compared to baseline levels, also distinct from the elevated levels of 50% or greater in previous crews. While these results are encouraging, the current n (4) is small, and the large SDs indicate that, while the means are improved, there

  7. Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD.

    Science.gov (United States)

    Jiamsakul, Awachana; Kerr, Stephen J; Ng, Oon Tek; Lee, Man Po; Chaiwarith, Romanee; Yunihastuti, Evy; Van Nguyen, Kinh; Pham, Thuy Thanh; Kiertiburanakul, Sasisopin; Ditangco, Rossana; Saphonn, Vonthanak; Sim, Benedict L H; Merati, Tuti Parwati; Wong, Wingwai; Kantipong, Pacharee; Zhang, Fujie; Choi, Jun Yong; Pujari, Sanjay; Kamarulzaman, Adeeba; Oka, Shinichi; Mustafa, Mahiran; Ratanasuwan, Winai; Petersen, Boondarika; Law, Matthew; Kumarasamy, Nagalingeswaran

    2016-05-01

    Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P 30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P < 0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (P = 0.158). Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. © 2016 John Wiley & Sons Ltd.

  8. Coping and Self-Efficacy in Marijuana Treatment: Results from the Marijuana Treatment Project

    Science.gov (United States)

    Litt, Mark D.; Kadden, Ronald M.; Stephens, Robert S.

    2005-01-01

    This study examined whether a coping-skills-based treatment for marijuana dependence operated by encouraging the use of coping skills or via other mechanisms. Participants were 450 men and women treated in the multisite Marijuana Treatment Project who were randomly assigned to motivational enhancement therapy plus cognitive-behavioral (MET-CB)…

  9. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2016-01-01

    Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...... frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes....... the sensitive fraction of the commensal flora.Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were...

  10. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo;

    2016-01-01

    considered combination treatments. The current study modeled bacterial growth in the intestine of pigs after intramuscular combination treatment (i.e. using two antibiotics simultaneously) and sequential treatments (i.e. alternating between two antibiotics) in order to identify the factors that favor...... the sensitive fraction of the commensal flora.Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were...

  11. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Medical treatment for injuries resulting from an... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention....

  12. Behavioural treatment of trichotillomania : two-year follow-up results : predictors of treatment outcome

    NARCIS (Netherlands)

    Keijsers, G.P.J.; Minnen, A. van; Hoogduin, C.A.L.; Klaassen, B.N.W.; Hendriks, G.J.; Tanis-Jacobs, J.

    2006-01-01

    Post-treatment evaluation studies of behaviour therapy (BT) for trichotillomania (TTM) have shown that BT is successful in reducing symptoms in this impulse-control disorder. The present study was aimed at investigating gain maintenance at long-term follow-up. TTM-related symptoms and other symptom

  13. Study Finds Ebola Treatment ZMapp Holds Promise, Although Results Not Definitive

    Science.gov (United States)

    ... News Release Thursday, October 13, 2016 Study finds Ebola treatment ZMapp holds promise, although results not definitive ... emergency. A clinical trial to evaluate the experimental Ebola treatment ZMapp found it to be safe and ...

  14. The frequency of missed test results and associated treatment delays in a highly computerized health system

    OpenAIRE

    2007-01-01

    Abstract Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results") are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA). Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary ca...

  15. Treatment results and long-term stability of anterior open bite malocclusion.

    NARCIS (Netherlands)

    Remmers, D.; Hullenaar, RW Van't; Bronkhorst, E.M.; Berge, S.J.; Katsaros, C.

    2008-01-01

    OBJECTIVES: To evaluate treatment results and long-term stability of anterior open bite malocclusion and to identify predictive factors for both treatment results and their stability. DESIGN: Retrospective study. SETTING AND SAMPLE POPULATION: The Department of Orthodontics and Oral Biology at the R

  16. An evaluation of culture results during treatment for tuberculosis as surrogate endpoints for treatment failure and relapse.

    Directory of Open Access Journals (Sweden)

    Patrick P J Phillips

    Full Text Available It is widely acknowledged that new regimens are urgently needed for the treatment of tuberculosis. The primary endpoint in the Phase III trials is a composite outcome of failure at the end of treatment or relapse after stopping treatment. Such trials are usually both long and expensive. Valid surrogate endpoints measured during or at the end of treatment could dramatically reduce both the time and cost of assessing the effectiveness of new regimens. The objective of this study was to evaluate sputum culture results on solid media during treatment as surrogate endpoints for poor outcome. Data were obtained from twelve randomised controlled trials conducted by the British Medical Research Council in the 1970s and 80s in East Africa and East Asia, consisting of 6974 participants and 49 different treatment regimens. The month two culture result was shown to be a poor surrogate in East Africa but a good surrogate in Hong Kong. In contrast, the month three culture was a good surrogate in trials conducted in East Africa but not in Hong Kong. As well as differences in location, ethnicity and probable strain of Mycobacteria tuberculosis, Hong Kong trials more often evaluated regimens with rifampicin throughout and intermittent regimens, and patients in East African trials more often presented with extensive cavitation and were slower to convert to culture negative during treatment. An endpoint that is a summary measure of the longitudinal profile of culture results over time or that is able to detect the presence of M. tuberculosis later in treatment is more likely to be a better endpoint for a phase II trial than a culture result at a single time point and may prove to be an acceptable surrogate. More data are needed before any endpoint can be used as a surrogate in a confirmatory phase III trial.

  17. The results of conservative and surgical treatments of styloiditis radii de Quervain

    OpenAIRE

    2004-01-01

    Though styloiditis radii de Quervain is a little disease condition, it sometimes necessitates surgery. in this research we examined the result of 147 patients who was admitted to the Department of Orthopaedics of Ev. Krankenhaus retrospectively. We compared corticosteroid which mentionted injection with conservative treatment. We prefer conservative methods instead of corticosteroid treatment which mentionted in the literature. Conservative treatment was necessary in 78,91% of cases. 31 of ou...

  18. Severe root resorption resulting from orthodontic treatment: Prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Caroline Pelagio Raick Maués

    2015-02-01

    Full Text Available OBJECTIVE: To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. METHODS: A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular, treatment with or without extractions, treatment duration, root apex stage (open or closed, root shape, as well as overjet and overbite at treatment onset. RESULTS: Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9% presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. CONCLUSION: This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset.

  19. Severe root resorption resulting from orthodontic treatment: Prevalence and risk factors

    Science.gov (United States)

    Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos

    2015-01-01

    OBJECTIVE: To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. METHODS: A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. RESULTS: Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. CONCLUSION: This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset. PMID:25741825

  20. Results of Surgical Treatment of Chronic Patellar Tendinosis (Jumper's Knee): A Systematic Review of the Literature.

    Science.gov (United States)

    Brockmeyer, Matthias; Diehl, Nora; Schmitt, Cornelia; Kohn, Dieter M; Lorbach, Olaf

    2015-12-01

    To review the literature concerning surgical treatment options for chronic patellar tendinosis (jumper's knee), a common problem among athletes. When conservative treatment fails, surgical treatment is required. Systematic review of the literature concerning the results of current surgical treatment options for chronic patellar tendinosis. All articles of studies with an evidence level ≥IV from January 2000 until February 2015 presenting the surgical outcome after arthroscopic as well as open treatment of chronic patellar tendinosis were included. The literature research of the PubMed database was performed using the following key words: "patellar" and "tendinitis," "tendonitis," "tendinosis" or "tendinopathy"; "inferior patellar pole"; "jumper's knee"; "surgical treatment" and "open" or "arthroscopic patellar tenotomy." A systematic review of the literature was performed especially to point out the effectiveness of arthroscopic treatment of chronic patellar tendinosis. The results revealed good clinical results for arthroscopic as well as open treatment of chronic patellar tendinosis that is refractory to conservative treatment in athletes. An average success rate of 87% was found for the open treatment group and of 91% for the arthroscopic treatment group. However, after open surgery, the mean time of return to the preinjury level of activity is 8 to 12 months, with a certain number of patients/athletes who cannot return to the preinjury level of activity. Minimally invasive, arthroscopically assisted or all-arthroscopic procedures may lead to a significantly faster return to sporting activities and may, therefore, be the preferred method of surgical treatment. Level IV, systematic review of Level I-IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  1. The extremely resorbed mandible : A comparative prospective study of 2-year results with 3 treatment strategies

    NARCIS (Netherlands)

    Stellingsma, Kees; Raghoebar, Gerry M.; Meijer, Henny J.A.; Stegenga, Boudewijn

    2004-01-01

    Purpose: The aim of this prospective clinical study was to compare the clinical and radiographic results of 3 modes of implant treatment in combination with an overdenture in patients with extremely resorbed mandibles. The 3 treatment strategies used were a transmandibular implant, augmentation of t

  2. Barriers to Mental Health Treatment: Results from the WHO World Mental Health (WMH) Surveys

    Science.gov (United States)

    Andrade, L. H.; Alonso, J.; Mneimneh, Z.; Wells, J. E.; Al-Hamzawi, A.; Borges, G.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; de Graaf, R.; Florescu, S.; Gureje, O.; Hinkov, H. R.; Hu, C.; Huang, Y.; Hwang, I.; Jin, R.; Karam, E. G.; Kovess-Masfety, V.; Levinson, D.; Matschinger, H.; O’Neill, S.; Posada-Villa, J.; Sagar, R.; Sampson, N. A.; Sasu, C.; Stein, D.; Takeshima, T.; Viana, M. C.; Xavier, M.; Kessler, R. C.

    2014-01-01

    Background To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. Methods Data are from the WHO World Mental Health (WMH) Surveys. Representative household samples were interviewed face-to-face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n= 63,678) and analyzed at different levels of clinical severity. Results Among those with a DSM-IV disorder in the past twelve months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. Desire to handle the problem on one’s own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers both to initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment dropout (39.3%) followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). Conclusions Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide. PMID:23931656

  3. [Remote results of surgical treatment of aging ptosis of face and neck tissues].

    Science.gov (United States)

    Ezrokhin, V M; Pavlovich, V A

    2008-01-01

    Remote results of surgical treatment of patients with aging ptosis of face and neck tissues during 15 years are presented. Results were good there where suggested incisions marking was carried out and for those face and neck skin regions which should be corrected. Unsatisfactory results were received in the cases when wounds edges were sewn by uninterrupted blanket sutures without skin deeper layers fixing.

  4. Interim results of the Ph-negative acute lymphoblastic leukemia treatment in adult patients (results of Russian research group of ALL treatment (RALL

    Directory of Open Access Journals (Sweden)

    E. N. Parovichnikova

    2015-01-01

    Full Text Available An interim analysis of long-term treatment results for 202 patients with acute lymphoblastic leukemia (ALL, aged 15–60 years, received therapy according protocol ALL-2009 was shown. The basic principle of ALL-2009 was non-aggressive, but continued cytostatic exposure, as well as the reproducibility in a regional hematology centers. Long-term treatment results of ALL-2009 are 2 times higher than the previously obtained in adult ALL patients within the Russian clinical multicenter studies of adult ALL. The 5‑year overall survival of patients younger than 30 years was 73.6 %, relapse-free survival (RFS – 71.5 %, compared with 52.7 % and 61.8 % in patients aged 30 years and older, respectively. In patients with B-precursor ALL with normal karyotype of blast cells significantly higher 5‑year RFS (82.1 % compared to patients with abnormal karyotype (58.8 % was registered. For T-ALL cytogenetic characteristics of blast cells had no prognostic significance. For patients with T-ALL important to perform autologous stem cell transplantation as a later consolidation, as this significantly reducerelapse rate (from 33 to 0 %.

  5. Interim results of the Ph-negative acute lymphoblastic leukemia treatment in adult patients (results of Russian research group of ALL treatment (RALL

    Directory of Open Access Journals (Sweden)

    E. N. Parovichnikova

    2014-01-01

    Full Text Available An interim analysis of long-term treatment results for 202 patients with acute lymphoblastic leukemia (ALL, aged 15–60 years, received therapy according protocol ALL-2009 was shown. The basic principle of ALL-2009 was non-aggressive, but continued cytostatic exposure, as well as the reproducibility in a regional hematology centers. Long-term treatment results of ALL-2009 are 2 times higher than the previously obtained in adult ALL patients within the Russian clinical multicenter studies of adult ALL. The 5‑year overall survival of patients younger than 30 years was 73.6 %, relapse-free survival (RFS – 71.5 %, compared with 52.7 % and 61.8 % in patients aged 30 years and older, respectively. In patients with B-precursor ALL with normal karyotype of blast cells significantly higher 5‑year RFS (82.1 % compared to patients with abnormal karyotype (58.8 % was registered. For T-ALL cytogenetic characteristics of blast cells had no prognostic significance. For patients with T-ALL important to perform autologous stem cell transplantation as a later consolidation, as this significantly reducerelapse rate (from 33 to 0 %.

  6. The comparative analysis of results of surgical treatment of myasthenia in the remote periods of disease

    Directory of Open Access Journals (Sweden)

    L. Zaslavsky

    2016-01-01

    Full Text Available Based on long-term follow-up to perform comparative analysis of long-term results of surgical treatment of myasthenia. A retrospective analysis of long-term results of surgical treatment of 146 patients with myasthenia has been carried out. We used the modified Keynes classification to estimate the severity of myasthenia and to summarize the data relating to therapy volume and treatment results. In dependence on the type of thymus lesion patients were divided into two groups. Thymus hyperplasia was verified at — 106 (72.6 % patients, tumor lesion of the thymus gland (thymoma — at 40 (27.4 % ones. The results were estimated in the following periods after thymectomy: 1—2 years, 3—4 years, 5—6 years, 7 — 9 years, 10—14 years, and over 15 years. Short- and longterm results of surgical treatment of myasthenia for the patients without tumor lesions of the thymus gland were significantly better. Positive effects of surgical treatment of myasthenia in patients with hyperplasia are observed after 1 year of surgery (p = 0.0023, and the best results are observed after 5 — 6 year of the disease, then after 7 — 9 year one notes some deterioration of state (p = 0.026. In the myasthenia patients with thymoma one notes the similar trends in dynamics of state, but in general, the results are significantly (p = 0.042 badly than in the group of the patients with hyperplasia. Starting from the first year after operation treatment the patients with myasthenia with thymus hyperplasia have statistically significant (p = 0.048 decrease of average doses of glucocorticoids, and anticholinesterase drugs. The statistically best treatment results were noted for the patients operated at the first year of the disease. Positive result of surgical treatment of myasthenia is noted both in the short- and long-term period and at thymomas. In the group of patients with thymoma one has noted significantly badly results in comparison with group of hyperplasia. It is

  7. The frequency of missed test results and associated treatment delays in a highly computerized health system

    Science.gov (United States)

    Wahls, Terry L; Cram, Peter M

    2007-01-01

    Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results") are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA). Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary care providers in VA clinics. Methods: An anonymous on-line survey of primary care providers was conducted as part of the health systems ongoing quality improvement programs. We collected information from providers concerning their clinical effort (e.g., number of clinic sessions, number of patient visits per session), number of patients with missed abnormal test results, and the number and types of treatment delays providers encountered during the two week period prior to administration of our survey. Results: The survey was completed by 106 out of 198 providers (54 percent response rate). Respondents saw and average of 86 patients per 2 week period. Providers encountered 64 patients with missed results during the two week period leading up to the study and 52 patients with treatment delays. The most common missed results included imaging studies (29 percent), clinical laboratory (22 percent), anatomic pathology (9 percent), and other (40 percent). The most common diagnostic delays were cancer (34 percent), endocrine problems (26 percent), cardiac problems (16 percent), and others (24 percent). Conclusion: Missed results leading to clinically important treatment delays are an important and likely underappreciated source of diagnostic error. PMID:17519017

  8. The frequency of missed test results and associated treatment delays in a highly computerized health system

    Directory of Open Access Journals (Sweden)

    Wahls Terry L

    2007-05-01

    Full Text Available Abstract Background: Diagnostic errors associated with the failure to follow up on abnormal diagnostic studies ("missed results" are a potential cause of treatment delay and a threat to patient safety. Few data exist concerning the frequency of missed results and associated treatment delays within the Veterans Health Administration (VA. Objective: The primary objective of the current study was to assess the frequency of missed results and resulting treatment delays encountered by primary care providers in VA clinics. Methods: An anonymous on-line survey of primary care providers was conducted as part of the health systems ongoing quality improvement programs. We collected information from providers concerning their clinical effort (e.g., number of clinic sessions, number of patient visits per session, number of patients with missed abnormal test results, and the number and types of treatment delays providers encountered during the two week period prior to administration of our survey. Results: The survey was completed by 106 out of 198 providers (54 percent response rate. Respondents saw and average of 86 patients per 2 week period. Providers encountered 64 patients with missed results during the two week period leading up to the study and 52 patients with treatment delays. The most common missed results included imaging studies (29 percent, clinical laboratory (22 percent, anatomic pathology (9 percent, and other (40 percent. The most common diagnostic delays were cancer (34 percent, endocrine problems (26 percent, cardiac problems (16 percent, and others (24 percent. Conclusion: Missed results leading to clinically important treatment delays are an important and likely underappreciated source of diagnostic error.

  9. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Science.gov (United States)

    Matthews, Alicia K.; Li, Chien-Ching; Kuhns, Lisa M.; Tasker, Timothy B.; Cesario, John A.

    2013-01-01

    Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT) people's response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N = 198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association's “Freedom from Smoking Program” (ALA-FFS) and were tailored to LGBT smokers' needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5) were mostly White (70.4%) and male (60.5%) and had at least a college degree (58.4%). Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions). Higher educational attainment and use of nicotine replacement therapy (NRT) were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45), use of NRT (OR = 4.24), and lower nicotine dependency (OR = 0.73) were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake. PMID:23840237

  10. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Directory of Open Access Journals (Sweden)

    Alicia K. Matthews

    2013-01-01

    Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.

  11. Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.

    Science.gov (United States)

    Cloitre, Marylene; Courtois, Christine A; Charuvastra, Anthony; Carapezza, Richard; Stolbach, Bradley C; Green, Bonnie L

    2011-12-01

    This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects. Copyright © 2011 International Society for Traumatic Stress Studies.

  12. [Results of surgical treatment for acromioclavicular dislocation using a modified Mitchell method].

    Science.gov (United States)

    Król, M; Jarco, K; Sleczkowski, M; Delimat, J; Szot, J

    2000-01-01

    The paper presents the results of surgical treatment in acromioclavicular dislocation (grade III according to Tossy) in 53 patients. Joint reconstruction was performed using Mitchell's modified method--acromioclavicular reconstruction was achieved by applying a with Dallos poliester fiber prosthesis. Clinically in 90.5% of the cases a good or excellent result was achieved.

  13. MASTICATION, PHONETICS AND ESTHETICS AS A FINAL RESULT OF PARTIAL OR COMPLETE DENTURE TREATMENT.

    Directory of Open Access Journals (Sweden)

    Kalina Georgieva

    2015-08-01

    Full Text Available Three target groups- dentists/ dental students, dental technicians and patients were asked to fill in an anonymous questionnaire about their satisfaction of the final results after prosthetic treatment with removable dentures using a scale from 1 to 5 (1- completely dissatisfied, 2-dissatisfied, 3-indifferent, 4-satisfied, 5-completely satisfied. The mean results (including colour, shape and size of artificial teeth, arrangement of front teeth, colour of artificial gums, phonetics, mastication, natural smile, enough space for tongue for all three groups of respondents were compared. Dental technicians (4,34 are more satisfied than dentists/dental students (3,62 and patients (3,53. A successful outcome of prosthetic treatment depends on one hand on the professional approach of the dental team and on the other hand on the patient’s motivation and cooperation. The predictive final results and realistic expectations lead to satisfaction of all participants in the treatment process.

  14. Clinical results after different operative treatment methods of radial head and neck fractures

    DEFF Research Database (Denmark)

    Zwingmann, J; Welzel, M; Dovi-Akue, D

    2013-01-01

    was placed on extracting data describing clinical efficacy and outcome by using the Mason classification and including elbow function scores. A total of 841 clinical studies were identified describing in total the clinical follow-up of 1264 patients. RESULTS: For type II radial head and neck fractures....... If a prosthesis was implanted, the primary implantation seems to be associated with a better outcome after type III (87%) and IV (82%) fractures compared to the results after a secondary implantation. DISCUSSION: Recommendations for surgical treatment of radial head and neck fractures according to the Mason...... the significant best treatment option seems to be ORIF with an overall success rate of 98% by using screws or biodegradable (polylactide) pins. ORIF with a success rate of 92% shows the best results in the treatment of type III fractures and seem to be better than resection and implantation of a prosthesis...

  15. Preemptive Treatment of Nausea and Vomiting of Pregnancy: Results of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Caroline Maltepe

    2013-01-01

    Full Text Available Objectives. To determine whether the initiation of treatment (preemptive treatment before the symptoms of nausea and vomiting of pregnancy (NVP versus when the symptoms begin can improve the outcome in patients at a high risk for recurrence of severe NVP. Study Design. Prospective, randomized controlled trial. Results. Preemptive therapy conferred a significant reduction in HG as compared to the previous pregnancy (P=0.047. In the preemptive arm, there were 2.5-fold fewer cases of moderate-severe cases of NVP than those in the control group (15.4% versus 39.13% in the first 3 weeks of NVP (P=0.05. In the preemptive group, significantly more women had their NVP resolved before giving birth (78.2% versus 50% (P<0.002. Conclusions. Preemptive treatment with antiemetics is superior to the treatment that starts only when the symptoms have already occurred in decreasing the risk of severe forms of NVP.

  16. Results of Shipboard Approval Tests of Ballast Water Treatment Systems in Freshwater

    Science.gov (United States)

    2014-11-01

    Results of Shipboard Approval Tests of Ballast Water Treatment Systems in Freshwater Distribution Statement A: Approved for public release...distribution is unlimited. November 2014 Report No. CG-D-05-15 Results of Shipboard Approval Tests of BWT Systems in Freshwater ii...London, CT 06320 Results of Shipboard Approval Tests of BWT Systems in Freshwater iii UNCLAS//Public | CG-926 R&DC | Cangelosi, et al

  17. [Remote results of the surgical treatment of dystopia of the kidneys in children].

    Science.gov (United States)

    Bairov, G A; Osipov, I Iu; Koval'chuk, V S; Kurbanov, T A

    1988-10-01

    An analysis of results of the surgical treatment of 61 patients aged from 1 to 14 years has been made. Follow-up examinations from 1 to 18 years after treatment was performed in 53 of the 61 patients. In sacral and iliac dystopia of the kidney good outcomes were obtained after combined reconstructive plastic operations consisting of nephropexy associated with ureterolysis, resection of accessory vessels, plasty of the pyeloureteral segment and resection of the kidney pole with abnormal blood supply. With pelvic and crossed dystopia nephrureterectomy is indicated. With the only dystopic kidney good remote results were obtained after a one-step radical correcting operation.

  18. Gout in a rheumatology clinic: results of EULAR/ACR guidelines-compliant treatment.

    Science.gov (United States)

    Slot, O

    2017-09-11

    Surveys of treatment results of gout in primary care have shown that less than 25% of patients reach the recommended treatment target (serum urate EULAR/ACR) guidelines-based treatment of gout in a rheumatology clinic. Data from consecutive new crystal-proven gout patients were analysed in a prospective observational study. The study included 100 patients: 88 males aged 62.1 ± 13.1 years (mean ± sd) and 12 females aged 74.1 ± 6.9 years. Disease duration was 8.6 ± 6.9 years, and the disease pattern was monoarticular, oligoarticular, polyarticular, and tophaceous in 18, 37, 25, and 20 patients, respectively. Overall, 42% had tried urate-lowering treatment (ULT) ever and 15% were on ULT at entry. ULT was initiated or intensified in a treat-to-target (T2T) approach in 93 patients, with flare prophylactic colchicine treatment in 90 patients. T2T was successfully reached in 85 patients after 4.7 ± 3.9 months and 82 patients reached a state of well-controlled disease (T2T reached for 3 months and no flares or anti-inflammatory treatment for 1 month) after 10.4 ± 5.6 months. Ten patients did not reach T2T owing to low compliance and five patients did not reach T2T owing to adverse effects or nephropathy. EULAR/ACR guidelines-compliant treatment in a rheumatology clinic with verified diagnosis, patient education, T2T with ULT, and flare prophylaxis led to successful treatment results in 85% of patients.

  19. Hand Robotics Rehabilitation: Feasibility and Preliminary Results of a Robotic Treatment in Patients with Hemiparesis

    Directory of Open Access Journals (Sweden)

    Patrizio Sale

    2012-01-01

    Full Text Available Background. No strongly clinical evidence about the use of hand robot-assisted therapy in stroke patients was demonstrated. This preliminary observer study was aimed at evaluating the efficacy of intensive robot-assisted therapy in hand function recovery, in the early phase after a stroke onset. Methods. Seven acute ischemic stroke patients at their first-ever stroke were enrolled. Treatment was performed using Amadeo robotic system (Tyromotion GmbH Graz, Austria. Each participant received, in addition to inpatients standard rehabilitative treatment, 20 sessions of robotic treatment for 4 consecutive weeks (5 days/week. Each session lasted for 40 minutes. The exercises were carried out as follows: passive modality (5 minutes, passive/plus modality (5 minutes, assisted therapy (10 minutes, and balloon (10 minutes. The following impairment and functional evaluations, Fugl-Meyer Scale (FM, Medical Research Council Scale for Muscle Strength (hand flexor and extensor muscles (MRC, Motricity Index (MI, and modified Ashworth Scale for wrist and hand muscles (AS, were performed at the beginning (T0, after 10 sessions (T1, and at the end of the treatment (T2. The strength hand flexion and extension performed by Robot were assessed at T0 and T2. The Barthel Index and COMP (performance and satisfaction subscale were assessed at T0 and T2. Results. Clinical improvements were found in all patients. No dropouts were recorded during the treatment and all subjects fulfilled the protocol. Evidence of a significant improvement was demonstrated by the Friedman test for the MRC (P<0.0123. Evidence of an improvement was demonstrated for AS, FM, and MI. Conclusions. This original rehabilitation treatment could contribute to increase the hand motor recovery in acute stroke patients. The simplicity of the treatment, the lack of side effects, and the first positive results in acute stroke patients support the recommendations to extend the clinical trial of this

  20. Results of the conservative treatment in clubfoot using the French method

    Directory of Open Access Journals (Sweden)

    Dana VASILESCU

    2014-03-01

    Full Text Available The idiopathic clubfoot represents a congenital deformation incorporating four distinct alterations: the equinus, varus, cavus and adduction of the forefoot to the hindfoot. The meaning given to the conservative treatment of clubfoot by French method is that of mobilization-manipulation and serial plaster immobilizations. We followed the results of the early conservative orthopedic treatment in the congenital clubfoot in 52 patients (74 feet under the age of 1 year. These cases were treated in the Department of Pediatric Orthopedics of the Rehabilitation Clinical Hospital of Cluj-Napoca for a period of 5 years. The degree of deformation used DiMeglio’s clinical criteria. The conservative treatment began since the presentation of the cases with mobilizations – manipulations and continued up to the age of one month. After the age of one month, serial plaster immobilizations followed. When the conservative treatment failed consecutive to five or six successive plasters, the correction already obtained was followed by surgery. The percentage of the favorable results after the conservative treatment can reach 82.44 %. The results are not so good in cases of arthrogryposis multiplex congenita, myelomeningocele etc.

  1. Primary care providers’ knowledge, beliefs and treatment practices for gout: results of a physician questionnaire

    Science.gov (United States)

    Mazor, Kathleen M.; Negron, Amarie; Ogarek, Jessica; Firneno, Cassandra; Yood, Robert A.

    2013-01-01

    Objective. We sought to examine primary care providers’ gout knowledge and reported treatment patterns in comparison with current treatment recommendations. Methods. We conducted a national survey of a random sample of US primary care physicians to assess their treatment of acute, intercritical and tophaceous gout using published European and American gout treatment recommendations and guidelines as a gold standard. Results. There were 838 respondents (response rate of 41%), most of whom worked in private practice (63%) with >16 years experience (52%). Inappropriate dosing of medications in the setting of renal disease and lack of prophylaxis when initiating urate-lowering therapy (ULT) accounted for much of the lack of compliance with treatment recommendations. Specifically for acute podagra, 53% reported avoidance of anti-inflammatory drugs in the setting of renal insufficiency, use of colchicine at a dose of ≤2.4 mg/day and no initiation of a ULT during an acute attack. For intercritical gout in the setting of renal disease, 3% would provide care consistent with the recommendations, including initiating a ULT at the appropriate dose with dosing titration to a serum urate level of ≤6 mg/dl and providing prophylaxis. For tophaceous gout, 17% reported care consistent with the recommendations, including ULT use with dosing titration to a serum urate level of ≤6 mg/dl and prophylaxis. Conclusion. Only half of primary care providers reported optimal treatment practices for the management of acute gout and gout, suggesting that care deficiencies are common. PMID:23620554

  2. Non-lethal heat treatment of cells results in reduction of tumor initiation and metastatic potential

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo-Shin; Lee, Tae Hoon; O' Neill, Brian E., E-mail: BEOneill@houstonmethodist.org

    2015-08-14

    Non-lethal hyperthermia is used clinically as adjuvant treatment to radiation, with mixed results. Denaturation of protein during hyperthermia treatment is expected to synergize with radiation damage to cause cell cycle arrest and apoptosis. Alternatively, hyperthermia is known to cause tissue level changes in blood flow, increasing the oxygenation and radiosensitivity of often hypoxic tumors. In this study, we elucidate a third possibility, that hyperthermia alters cellular adhesion and mechanotransduction, with particular impact on the cancer stem cell population. We demonstrate that cell heating results in a robust but temporary loss of cancer cell aggressiveness and metastatic potential in mouse models. In vitro, this heating results in a temporary loss in cell mobility, adhesion, and proliferation. Our hypothesis is that the loss of cellular adhesion results in suppression of cancer stem cells and loss of tumor virulence and metastatic potential. Our study suggests that the metastatic potential of cancer is particularly reduced by the effects of heat on cellular adhesion and mechanotransduction. If true, this could help explain both the successes and failures of clinical hyperthermia, and suggest ways to target treatments to those who would most benefit. - Highlights: • Non-lethal hyperthermia treatment of cancer cells is shown to cause a reduction in rates of tumor initiation and metastasis. • Dynamic imaging of cells during heat treatment shows temporary changes in cell shape, cell migration, and cell proliferation. • Loss of adhesion may lead to the observed effect, which may disproportionately impact the tumor initiating cell fraction. • Loss or suppression of the tumor initiating cell fraction results in the observed loss of metastatic potential in vivo. • This result may lead to new approaches to synergizing hyperthermia with surgery, radiation, and chemotherapy.

  3. Radiotherapy and hyperthermia for treatment of primary locally advanced cervix cancer: results in 378 patients.

    NARCIS (Netherlands)

    Franckena, M.; Lutgens, L.C.; Koper, P.C.; Kleynen, C.E.; Steen-Banasik, E.M. van der; Jobsen, J.J.; Leer, J.W.H.; Creutzberg, C.L.; Dielwart, M.F.; Norden, Y. Van; Canters, R.A.; Rhoon, G.C. van; Zee, J. van der

    2009-01-01

    PURPOSE: To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series. METHODS AND MATERIALS: From 1996 to

  4. Acceptable results using plug for the treatment of complex anal fistulas

    DEFF Research Database (Denmark)

    Kleif, Jakob; Hagen, Kikke; Wille-Jørgensen, Peer

    2011-01-01

    The management of complex fistula-in-ano remains a surgical challenge. Previously published studies on the treatment of fistula-in-ano with the anal fistula plug (AFP) have reported a success rate reaching 35-87%. The aim of this study was to assess the results of the AFP procedure in a group...

  5. Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion

    Directory of Open Access Journals (Sweden)

    Uhlmann Carmen

    2016-12-01

    Full Text Available Background. Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.

  6. Long-term Results of the Posteromedial Release in the Treatment of Idiopathic Clubfoot

    NARCIS (Netherlands)

    van Gelder, Janke H.; van Ruiten, Alward G. P.; Visser, Jan D.; Maathuis, Patrick G. M.

    2010-01-01

    Background: Short-term follow-up studies show good results in foot function, after surgical treatment of idiopathic clubfeet. Long-term follow-up studies are rare and probably represent a mixture of experience of different treating orthopedic surgeons. The purpose of this study is to present the

  7. [Results of surgical treatment of cholelithiasis by laparotomic and minimally invasive accesses].

    Science.gov (United States)

    Aliev, Iu G; Chinikov, M A; Panteleeva, I S; Kurbanov, F S; Popovich, V K; Sushko, A N

    2014-01-01

    The article presents the results of surgical treatment of 1038 patients with cholelithiasis, acute and chronic calculous cholecystitis and complicated forms of the disease. Operations were performed with traditional laparotomic and minimally invasive approaches. Indications for choosing access, as well as the advantages and disadvantages of various options of surgery in patients with cholelithiasis are discussed.

  8. Treatment of simple bone cysts by topical infiltrations of methylprednisolone acetate: Technique and results

    Energy Technology Data Exchange (ETDEWEB)

    Carrata, A.; Garbagna, P.; Mapelli, S.; Zucchi, V.

    1983-02-01

    The authors report their experience in the percutaneous treatment of simple bone cysts by intra-cystic local infiltrations of methylprednisolone acetate. In particular, the method adopted, the evolution of the radiologic picture and the results, achieved are described. Sixty patients were successfully treated without complications or surgery.

  9. Long-term results and complications after treatment of bilateral fractures of the mandibular condyle

    NARCIS (Netherlands)

    Forouzanfar, T.; Lobbezoo, F.; Overgaauw, M.; de Groot, A.; Kommers, S.; van Selms, M.; van den Bergh, B.

    2013-01-01

    The purpose of this study was to investigate the long-term results of conservative treatment of bilateral condylar fractures and to study the influence of possible functional impairment on intensity of pain and associated disability. We studied 71 patients (mean (SD) age 33 (14) years) with conserva

  10. Treatment and follow up results of patients with monosymptomatic enuresis nocturna

    Directory of Open Access Journals (Sweden)

    Mehmet Sezai Oğraş

    2013-09-01

    Full Text Available Objective: To evaluate the treatment results of patientswith monosymptomatic enuresis nocturna.Methods: 97 patients with monosymptomatic enuresisnocturna were included. First, motivation and behavioraltreatment have been applied to the patients for 3 months.60-120 mcg desmopressin has been applied to 79 patientswho did not want to continue to the motivation andbehavioral treatment or who did not have benefit from motivationand behavioral treatment or whose disease haverelapsed. It is accepted as “full response” if the numberof wetting decreases 90-100%, “middle response” decreases50-90%, “failed response” decreases less than50%. Treatment and relapse rates were evaluated basedon the response to therapy at the time of controls.Results: Mean age of the patients was 7.75±1.96 (5-12years. 20 of 97 (21% patients who have taken motivationand behavioral treatment have been cured. Two (%10of these patients’ diseases have relapsed. Desmopressinhas been applied to79 patients who did not have benefitfrom motivation and behavioral treatment or whosediseases have relapsed. Full dryness has been providedin 36 (46% patients who have taken desmopressin andcame to the control visit. “Middle response” has been obtainedin 22 (28% patients. “Failed response” has beenobtained in 21 (26% patients. Relapse has been seen incase of quitting desmopressin in 35 (60% patients whohave benefit from desmopressin.Conclusion: Although, Desmopressin is the most preferredmethod in monosymptomatic enuresis nocturna,because of easy usage and fast response, relapse ratio ishigh following discontinuation of the drug.Key words: Monosymptomatic enuresis nocturna, desmopressin,treatment

  11. Endovascular Treatment of Malignant Superior Vena Cava Syndrome: Results and Predictive Factors of Clinical Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Fagedet, Dorothee, E-mail: DFagedet@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de medecine interne, Pole Pluridisciplinaire de Medecine (France); Thony, Frederic, E-mail: FThony@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Timsit, Jean-Francois, E-mail: JFTimsit@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de reanimation, Pole Medecine Aiguee Communautaire (France); Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Monnin-Bares, Valerie, E-mail: v-monnin@chu-montpellier.fr [CHRU Arnaud de Villeneuve, Imagerie Medicale Thoracique Cardiovasculaire (France); Ferretti, Gilbert R., E-mail: GFerretti@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Vesin, Aurelien; Moro-Sibilot, Denis, E-mail: DMoro.pneumo@chu-grenoble.fr [University Grenoble 1 e Albert Bonniot Institute, Inserm U823 (France)

    2013-02-15

    To demonstrate the effectiveness of endovascular treatment (EVT) with self-expandable bare stents for malignant superior vena cava syndrome (SVCS) and to analyze predictive factors of EVT efficacy. Retrospective review of the 164 patients with malignant SVCS treated with EVT in our hospital from August 1992 to December 2007 and followed until February 2009. Endovascular treatment includes angioplasty before and after stent placement. We used self-expandable bare stents. We studied results of this treatment and looked for predictive factors of clinical efficacy, recurrence, and complications by statistical analysis. Endovascular treatment was clinically successful in 95% of cases, with an acceptable rate of early mortality (2.4%). Thrombosis of the superior vena cava was the only independent factor for EVT failure. The use of stents over 16 mm in diameter was a predictive factor for complications (P = 0.008). Twenty-one complications (12.8%) occurred during the follow-up period. Relapse occurred in 36 patients (21.9%), with effective restenting in 75% of cases. Recurrence of SVCS was significantly increased in cases of occlusion (P = 0.01), initial associated thrombosis (P = 0.006), or use of steel stents (P = 0.004). Long-term anticoagulant therapy did not influence the risk of recurrence or complications. In malignancy, EVT with self-expandable bare stents is an effective SVCS therapy. These results prompt us to propose treatment with stents earlier in the clinical course of patients with SVCS and to avoid dilatation greater than 16 mm.

  12. Preoperative lanreotide treatment improves outcome in patients with acromegaly resulting from invasive pituitary macroadenoma.

    Science.gov (United States)

    Li, Z-Q; Quan, Z; Tian, H-L; Cheng, M

    2012-01-01

    To investigate whether 3 months' preoperative treatment with lanreotide improved outcome in newly diagnosed patients with acromegaly resulting from invasive pituitary macroadenoma. After baseline evaluation, untreated patients were randomized to undergo direct transsphenoidal surgery or lanreotide treatment (30 mg via intramuscular injection every 2 weeks, increased to 30 mg/week at week 8 if growth hormone nadir > 2.5 μg/l), for 3 months prior to surgery. Tumour shrinkage following lanreotide treatment was analysed. Cure was evaluated at 3 months postsurgery by measuring growth hormone and insulinlike growth factor-1 (IGF-1) levels. Preoperative lanreotide treatment significantly reduced mean tumour size. Growth hormone and IGF-1 levels were lower in the pretreatment group than in the direct surgery group at 3 months postsurgery. According to combined growth hormone and IGF-1 levels, significantly more patients were cured by trans-sphenoidal surgery in the pretreatment group compared with the direct surgery group (11 of 24 and five of 25 patients, respectively). Lanreotide treatment for 3 months before trans-sphenoidal surgery effectively reduced tumour size, and improved surgical cure rate, in newly diagnosed patients with acromegaly resulting from invasive pituitary macroadenoma.

  13. Acceptable results using plug for the treatment of complex anal fistulas

    DEFF Research Database (Denmark)

    Kleif, Jakob; Hagen, Kikke; Wille-Jørgensen, Peer

    2011-01-01

    The management of complex fistula-in-ano remains a surgical challenge. Previously published studies on the treatment of fistula-in-ano with the anal fistula plug (AFP) have reported a success rate reaching 35-87%. The aim of this study was to assess the results of the AFP procedure in a group...... of Danish patients with complex fistulas, and to analyse if the results were compatible with previous international findings....

  14. [Results of the surgical treatment of acute thrombosis of the major arteries of the limbs].

    Science.gov (United States)

    Ovchinnikov, V A; Vereshchagin, N A; Shavin, V V; Parakhoniak, N V

    1984-08-01

    An analysis of the surgical treatment of acute arterial trombosis of the extremities in 86 patients is presented. The causes of thrombosis were mainly obliterating atherosclerosis, artery trauma and postembolic occlusion. Best results of reconstructive operations were obtained in patients with postembolic occlusion of the arteries and their posttraumatic trombosis, worst results - in obliterating atherosclerosis. Thrombendarterectomy and autovenous shunts and prostheses were found to be the mos effective reconstructive operations.

  15. Managing appearance changes resulting from cancer treatment: resilience in adolescent females.

    Science.gov (United States)

    Wallace, Melissa L; Harcourt, Diana; Rumsey, Nichola; Foot, Annabel

    2007-11-01

    Typically, adolescence is marked by cognitive and physical developments impacting on self-esteem, independence and sexual awareness, often resulting in increased appearance awareness and dissatisfaction. Adolescents with cancer have the additional burden of illness, treatments and resultant appearance changes. This study aimed to explore the impact of these changes on adolescents who have had cancer. In depth, semi-structured interviews were conducted with six females between 14 and 19 years who had completed treatment within the previous two years, and analysed using Interpretative Phenomenological Analysis (IPA). Concerns around an altered appearance were significant during treatment, serving as a constant reminder of 'difference' and a marker of illness. However, since treatment, participants expressed an apparent shift in views and expectations of their appearance, as well as the value placed on it -- expressing increased satisfaction with their own appearance and a decrease in its importance. While important to acknowledge the distress and challenges experienced by participants, results highlight the need for research and care to focus on positive experiences of patients, rather than simply maladjustment. Explanations for the findings are explored, including the temporary nature of many appearance changes and the life-threatening nature of cancer.

  16. Results of thrombolytic treatment with recombinant streptokinase in elderly and non elderly patients.

    Directory of Open Access Journals (Sweden)

    René Tomás Manso Fernández

    2005-04-01

    Full Text Available Fundament: The great advances of modern medicine in the last 30 years, have deepened on the treatment of acute myocardial infarct dynamically and efficiently, allowing at present to show good results not only in the decrease of the mortality rate but also in the improvement of the patientâ?Ts quality of life. Objective: To offer the precise results with recombinant sterptokinase in elder and non-elder patients with an acute myocardial infarct. Method: prospective observational study of 325 patients admitted with a diagnosis of an acute myocardial infarct at the ¨Dr. Gustavo Aldereguia Lima¨ Hospital. These patients received thrombolitic treatment with recombinant strptokinase (Heberkinase i a dose of 1 500 000 units, and treatment with 325 mg of acetil salicilic acid too. Results: The presence of the infarct was more frequent in males (68,31% mainly associated to the smoking habit, Hypertension, and cholesterolemia in patients less than 74 years of age and in those patients aged 75 or more, the infarct was associated to Hypertension and Diabetes. The most affected side of the heart was the anterior part(44,6%, and the thrombolitic treatment was developd in an average of 211, 76 minutes. Deaths increased with age. The most significant variables associated to mortality in the infarcted patients were the fact of being hemodinamically classified into a Killip-Kimball (K-K Grade III-IV and having had arrhythmia and cardiac rupture.

  17. Midterm results of endovascular treatment of iliac artery lesions: analysis of 59 cases

    Directory of Open Access Journals (Sweden)

    Leonardo Ghizoni Bez

    2013-06-01

    Full Text Available BACKGROUND: Endovascular treatment of peripheral arterial occlusive disease has become increasingly frequent in the past few years. Because it is a less invasive procedure, lower morbidity and mortality rates are associated with this form of treatment. OBJECTIVES: To describe the endovascular procedures performed in iliac arteries for the treatment of peripheral arterial occlusive disease. METHODS: This retrospective study assesses 59 cases of iliac artery angioplasty performed according to a specific protocol from January 2004 to February 2010. RESULTS: Mean age of patients was 62 years (minimum: 42, maximum: 89. Thirty seven were male (62.72% and 22 female (37.28%. The main indications for treatment were moderate to severe intermittent claudication in 30 cases (50.84% and rest pain or trophic lesions (critical ischemia in 29 cases (49.15%. Postoperative follow-up included ankle-brachial index measurements and a duplex ultrasound at 30 days, 3 months, 6 months, 12 months, and every 6 months thereafter. Minimum follow-up time was 3 months, and maximum, 72 months (6 years, with primary and secondary patency rates of 91.37 and 94.82%, respectively. CONCLUSIONS: The results of this case series, combined with literature review results, allow to conclude that the endovascular approach is an effective and safe option to treat peripheral arterial occlusive disease in iliac arteries.

  18. Using 'payment by results' to fund the treatment of dependent drug users--proceed with care!

    Science.gov (United States)

    Maynard, Alan; Street, Andrew; Hunter, Rachael

    2011-10-01

    The UK government is changing its system of payment for drug treatment services in order to reward the achievement of better patient outcomes. This is a model that may be taken up internationally. This 'payment by results' funding system will reward providers for achieving good outcomes in terms of whether clients are drug free, employed and/or not convicted of a criminal offence. Providers will also receive a payment based on health and wellbeing outcome measurement. The definition and measurement of success in achieving these outcomes is complex and challenging, as is the need to bridge treatment costs during the period in which outcomes are pursued. This experiment requires careful evaluation if the delivery of drug treatment is not to be jeopardized or fragmented.

  19. Result from arthroscopic surgical treatment of renewed tearing of the rotator cuff of the shoulder

    Directory of Open Access Journals (Sweden)

    Glaydson Gomes Godinho

    2015-02-01

    Full Text Available OBJECTIVES: To evaluate function among patients with postoperative recurrence of rotator cuff injuries that was treated arthroscopically (case series and compare this with function in patients without recurrence (control group; and to compare function among patients with recurrence of rotator cuff injuries that were greater than and smaller than 3 cm.METHODS: This was a retrospective evaluation of patients who underwent arthroscopic revision of rotator cuff injuries using the ASES, Constant & Murley and UCLA scores and a visual analog pain scale, in comparison with patients in a control group who underwent primary rotator cuff repair.RESULTS: The size of the rotator cuff injury recurrence had a statistically significant influence on the result from the arthroscopic surgical treatment. The functional scores showed worse results than those from the first procedure.CONCLUSION: Arthroscopic surgical treatment of renewed tearing of rotator cuff injuries showed worse functional scores than those from primary repair of the injury.

  20. [Short and long-term results of endovascular treatment of bifurcational coronary stenosis].

    Science.gov (United States)

    Shugushev, Z Kh; Movsesiants, M Iu; Maksimkin, D A; Baranovich, V Iu; Faĭbushevich, A G; Stefanov, S A; Tarichko, Iu V

    2010-01-01

    Short and long-term results of endovascular treatment of true bifurcational coronary stenosis were analyzed in 229 patients. 68 patients received a "provisional-T" stenting on the first stage of the study. On the next stage 40 patients received the same "provisional-T" stenting, a total bifurcational stenting was conducted in 37 patients. Only coated stents were used. Independent risk factors of "provisional-T" stenting conversion to total bifurcational stenting were revealed. There were no differences between "provisional-T" and total bifurcational stenting considering the short-term treatment results. Long-term results (12-18 months) were analyzed in 70 patients. There were no restenosis of the main artery, whereas restenosis of the lateral branch was noticed in 5.5 and 2.94%, respectively, in the groups of "provisional-T" and total bifurcational stenting. Late thrombosis was registered in 1 case from the group of total bifurcational stenting.

  1. FUNCTIONAL RESULTS OF SURGICAL TREATMENT FOR ISTHMIC SPONDYLOLISTHESIS USING ANTERIOR AND POSTERIOR EXPOSURES

    Directory of Open Access Journals (Sweden)

    V. V. Rudenko

    2013-01-01

    Full Text Available Objective - to compare results of spondylolisthesis treatment using different surgical technologies. Material and methods: 84 patients (aged from 19 till 67 with spondylolisthesis of 1-3 degree (H.W Meyerding were operated. Two methods of surgical exposures were used for decompression and stabilization. Anterior decompression and stabilization exposures from retroperitoneal access were used for the first group of patients. The second group was operated using posteriolateral interbody fusion with transpedicular screw fixation. The following results were estimated after operation: the level of patients’ postoperative adaptation period and the rate of neurological and orthopedic rehabilitation during the postoperative period. Conclusions. The obtained functional results show no difference for both groups where posterior and anterior exposures were used for spondylolisthesis surgical treatment of 1-3 degree.

  2. Desmoplastic small round cell tumor: Extra abdominal and abdominal presentations and the results of treatment

    Directory of Open Access Journals (Sweden)

    Biswas G

    2005-01-01

    Full Text Available BACKGROUND: Desmoplastic small round cell tumor (DSRCT is a rare malignant neoplasm of adolescent males. Current multimodality treatment prolongs life and rarely achieves cure. Aim: To review the presenting features, histopathology and outcome of 18 patients with DSRCT treated at a single institution. Setting and Design: This is a retrospective observational study of patients with DSRCT who presented at the Tata Memorial Hospital between January 1994 to January 2005. Materials and Methods: Eighteen patients of DSRCT seen during this period were evaluated for their clinical presentation, response to chemotherapy and other multimodality treatment and overall survival. The cohort of 18 patients included 11 males (61% and 7 females (39% with a mean age of 16 years (Range 1½ - 30 years. Majority (83% presented with abdomino-pelvic disease. The others, involving chest wall and extremities. There were 6 patients (33% with metastatic disease at presentation. Results:The treatment primarily included a multimodality approach using a combination of multiagent chemotherapy with adjuvant surgery and radiotherapy as applicable. A response rate of 39% (CR-1, PR-6, with chemotherapy was observed. The overall response rate after multimodality treatment was 39% (CR-5, PR-2. The overall survival was poor except in patients who had complete excision of the tumor. Conclusion: Abdomino-pelvic site was the commonest presentation, the disease can occur at other non-serosal surfaces also. Despite aggressive treatment the outcome was poor. However, complete surgical excision seems to provide a better survival.

  3. Characteristics and Treatment Results of 5 Patients with Fibrous Dysplasia and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Nilufer Ozdemir Kutbay

    2015-01-01

    Full Text Available Aim. Fibrous dysplasia is a rare bone disease caused by missense mutation leading to abnormal fibroblast and osteoblast proliferation and increased bone resorption. FD can present in monostotic or polyostotic forms. About 3% of FD could be in association with McCune-Albright syndrome (MAS. Because FD is a rare disease, there is limited data in the literature about characteristics of disease and response to treatment. Methods. We present our five cases of FD with general properties and their responses to medical treatment. Results. Two of our patients had polyostotic and three had monostotic FD. One of the polyostotic patients had MAS. One of our patients had surgery for femur fractures, facial asymmetry, and findings of compression. Four patients were given pamidronate; one was given zoledronic acid as bisphosphonate treatment. Bone pain was relieved in all patients with medical treatment. Conclusion. There was a decrease in bone turnover markers to some degree with medical treatment but no radiological improvement was observed.

  4. Long-term Results of Treatment of Patients with Non-proliferative Diabetic Retinopathy Angioprotectors

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyeva

    2017-01-01

    Full Text Available Purpose: Optimization of approaches to the treatment of early stages diabetic retinopathy based on modern diagnosis and monitoring of patients with type 2 diabetes.Patients and methods: It was examined 90 patients (180 eyes with type 2 diabetes with DR: women (74.4% and men (25.6%, age 63,7±2,3 years. All groups matched by sex and age: Group 1 — control (healthy individuals without diabetes; Group 2 — Patients with DR0 (30 patients, 60 eyes with type 2 diabetes without DR; 3 group — patients with DR I without DMO with type 2 diabetes (30 patients, 60 eyes. Patients 2 and 3 groups was treated with conservative treatment angioprotectors drug-Doxi-Hem® registered in Russia. The drug was administered in a dose of 500 mg three times a day for six months. Monitor patients for six months of receiving Doxi-Hem® preparation consisted of monthly conventional ophthalmic examination, including further analysis of BCVA (BCVA, light sensitivity of the macula (SM as a result of fundusmikroperimetrii MAIA, central retinal thickness (PZT based on the results of the optical coherence tomography (OCT. We take into account the compensation of diabetes on the level of glycated hemoglobin (HbA1C blood.Results: When monitoring patients with type 2 diabetes to optimize the treatment of established efficacy and safety of drug therapy Doxi-Hem® in the prevention and treatment of pre-clinical and early manifestations of DR (DR0, DR1, which is confirmed by reliable positive dynamics of visual functions (BCVA, p <0.05, before treatment 0,8±0,02, after treatment increased to 0,92±0,02, morphological reduction in retinal thickness (PZT, p <0.05; before treatment 272,3±5,8 mm, after treatment 241.5±15.8 um, increased sensitivity of the macula (CM, p <0.05, before treatment 22.2±1.5 dB, after treatment 27.0±3.2 dB. Required control the severity of type 2 diabetes on the target level of blood glycosylated hemoglobin (HbA1C.Conclusion: Optimization approaches to

  5. Hypopharyngeal squamous cell carcinoma--treatment results in 138 consecutively admitted patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Danish Cancer Society, Aarhus (Denmark). Dept. of Experimental Clinical Oncology

    2000-07-01

    The aim of this study was to evaluate the results of the initial and salvage treatment for hypopharyngeal carcinoma. The study was conducted in 1963 to 1991 and included 138 patients (38 females and 100 males). Most of the tumours originated in the piriform sinus (86%). Tumour stage distribution was T1: 20%, T2: 27%, T3: 37% and T4: 17% and nodal stage distribution was N0: 45%, N1: 25%, N2: 10%, and N3: 20%. Primary treatment was delivered with curative intent in 124 out of 138 cases. Treatment failure was noted in 98 patients, with 55% recurrence in T-position, 39% in N-position, and 14% at distant metastases sites. Salvage surgery was successful in 9 out of 32 patients. The overall 5-year locoregional tumour control, cause-specific and overall survival rates were 20%, 25% and 19%, respectively. Univariate actuarial analysis showed that T- and N-stage, clinical stage, tumour size and well-differentiated tumours were significant prognostic parameters. A Cox multivariate analysis showed that only the T- and N-stages were independent prognostic factors. In conclusion, the prognosis for advanced hypopharyngeal carcinoma is extremely poor and the meagre results with conventional radiotherapy alone indicate that other treatment modalities should be introduced in the management of this disease.

  6. Self-perception of people who stutter regarding their experiences and results of stuttering treatments.

    Science.gov (United States)

    Andrade, Claudia Regina Furquim de; Cunha, Maria Claudia; Juste, Fabiola Staróbole; Ritto, Ana Paula; Almeida, Beatriz Paiva Bueno de

    2014-01-01

    To investigate the opinion about stuttering treatments in people who stutter, based on their answers to two open questions. The participants were 40 adults of both genders, with self-reported stuttering. During the first phase of the research, we contacted two Brazilian nongovernmental organizations: the Brazilian Stuttering Association (ABRAGAGUEIRA) and the Brazilian Fluency Institute (IBF). These associations agreed to participate and were responsible for sending the research questions to their members via electronic mail. The first contact with the participants elucidated the purpose and method of our research and, after obtaining informed consent from participants, the two questions were sent. The research questions involved their opinion about cure, treatments to which the participants had been submitted, and their outcome. After analysis, the answers obtained indicated that people who stutter believe in a cure for stuttering; that the ideal therapy would be the one that led to the disappearance of the symptoms; and the most frequently reported professional to treat the disorder is the speech-language pathologist. The results also indicated that although most of the participants had undergone speech-language treatment for stuttering, neither significant improvements were observed nor satisfaction was positive. The results indicate that the answers presented by the participants were not based on scientific knowledge about the disorder but on their wish that "something could happen" to make stuttering "disappear." Although in this study we did not investigate the type of treatment to which the patients were submitted, the results suggest that the factors that contribute to an effective treatment are contentious.

  7. Mid- and Long-Term Results of Endovascular Treatment in Thoracic Aorta Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Luigi Irace

    2012-01-01

    Full Text Available Study Aim. Evaluation of results in blunt injury of the thoracic aorta (BAI endovascular treatment. Materials and Methods. Sixteen patients were treated for BAI. Thirteen patients had associated polytrauma, 4 of these had a serious hypotensive status and 4 had an hemothorax. In the remaining 3, two had a post-traumatic false aneurysm of the isthmus and 1 had a segmental dissection. In those 13 patients a periaortic hematoma was associated to hemothorax in 4. All patients were submitted to an endovascular treatment, in two cases the subclavian artery ostium was intentionally covered. Results. One patient died for disseminated intravascular coagulation. No paraplegia was recorded. No ischemic complications were observed. A type I endoleak was treated by an adjunctive cuff. During the followup (1–9 years 3 patients were lost. A good patency and no endoleaks were observed in all cases. One infolding and 1 migration of the endografts were corrected by an adjunctive cuff. Conclusion. The medium and long term results of the endovascular treatment of BAI are encouraging with a low incidence rate of mortality and complications. More suitable endo-suite and endografts could be a crucial point for the further improvement of these results.

  8. CLINICAL RESULTS FROM THE TREATMENT OF CHRONIC SKIN WOUNDS WITH PLATELET RICH PLASMA (PRP

    Directory of Open Access Journals (Sweden)

    Pencho Kossev

    2015-12-01

    Full Text Available PURPOSE: To show platelet rich plasma (PRP application of chronic skin wounds and to evaluate the results from the treatment. MATERIAL AND METHODS: A total of 14 patients with problematic skin wounds had been treated at the clinic for a period of five years (from May 2009 to December 2014 with the following patient sex ratio: male patients - 5 and female patients - 9. Average age - 48,5 (30-76. Patients with Type 2 Diabetes - 4, with decubitus ulcers - 6, traumatic - 8, with infection - 5. Based on a scheme developed by us, all cases were treated by administering platelet-rich plasma, derived by PRGF Endoret system. Follow-up period was within 4 - 6 months (4,5 on average. RESULTS: The results have been evaluated based on the following functional scoring systems - Total wound score, Total anatomic score and Total score (20. The baseline values at the very beginning of the follow-up period were as follows: Total wound score - 12 p.; Total anatomic score - 10 p., Total score - 17 p. By the end of the treatment period the score was 0 p., which means excellent results, i.e. complete healing of the wounds. CONCLUSION: We believe that the application of PRP may become optimal therapy in the treatment of difficult to heal wounds around joints, bone, subject tendons, plantar surface of the foot, etc., as it opens new perspectives in the field of human tissue regeneration.

  9. Prior doctor shopping resulting from differential treatment correlates with differences in current patient-provider relationships.

    Science.gov (United States)

    Gudzune, Kimberly A; Bennett, Wendy L; Cooper, Lisa A; Clark, Jeanne M; Bleich, Sara N

    2014-09-01

    To determine the prevalence of doctor shopping resulting from differential treatment and to examine associations between this shopping and current primary care relationships. In 2012, a national internet-based survey of 600 adults receiving primary care in the past year with a BMI ≥ 25 kg/m(2) was conducted. Our independent variable was "switching doctors because I felt treated differently because of my weight." Logistic regression models to examine the association of prior doctor shopping with characteristics of current primary care relationships: duration, trust in primary care provider (PCP), and perceived PCP weight-related judgment, adjusted for patient factors were used. Overall, 13% of adults with overweight/obesity reported previously doctor shopping resulting from differential treatment. Prior shoppers were more likely to report shorter durations of their current relationships [73% vs. 52%; p = 0.01] or perceive that their current PCP judged them because of their weight [74% vs. 11%; p shop resulting from perceived differential treatment. These prior negative experiences have no association with trust in current relationships, but our results suggest that patients may remain sensitive to provider weight bias. © 2014 The Obesity Society.

  10. Intravitreal bevacizumab treatment for choroidal neovascularization in pathologic myopia: 12-month results.

    Science.gov (United States)

    Gharbiya, Magda; Allievi, Francesca; Mazzeo, Luigi; Gabrieli, Corrado Balacco

    2009-01-01

    To evaluate the short-term efficacy and safety of intravitreal bevacizumab for the treatment of myopic choroidal neovascularization (CNV). Prospective, nonrandomized, interventional case series. Twenty eyes from 20 patients with CNV secondary to pathologic myopia participated in this prospective nonrandomized interventional case series. All patients were scheduled for three monthly intravitreal bevacizumab 1.25 mg injections. Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), foveal center thickness (FCT) on optical coherence tomography (OCT), and fluorescein angiographic findings were examined before and after treatment. Patients were followed up for 12 months. The mean BCVA (+/- standard deviation [SD]) at baseline was 24.8 (+/- 11.86) letters (Snellen equivalent: 20/80). At 12 months after treatment, the mean BCVA (+/- SD) improved significantly (P = .000001) to 43 (+/- 12.38) letters (Snellen equivalent: 20/35). At 12 month follow-up, BCVA improved 10 letters or more in 18 (90%) out of 20 treated eyes and improved 15 letters or more in 14 (70%) out of 20 treated eyes. No treated eyes experienced a worsening of BCVA from baseline. The mean FCT (+/- SD) at baseline was 223 (+/- 47.43) microns. At 12 months after treatment, the mean FCT (+/- SD) reduced to 206 (+/- 50.87) microns. This reduction in FCT after treatment was not statistically significant (P = .11). At 12 months follow-up, absence of fluorescein leakage from the CNV was demonstrated in 19 (95%) out of 20 treated eyes and persistent leakage in one eye (5%). None of the 19 eyes that had CNV closure experienced recurrence at 12-month follow-up. No ocular or systemic adverse effects from treatment were encountered. These results of intravitreal bevacizumab in myopic CNV are very promising with no apparent short-term safety concerns. At 12 months, treated eyes had a significant improvement in visual acuity (VA). OCT findings, as well, showed a trend consistent with the

  11. [Treatment of parasitic liver diseases].

    Science.gov (United States)

    Lecuna, V

    1989-01-01

    Most of primary and secondary parasitic liver diseases, at present can be property treated with drugs. Venezuelan pharmaceutic market has some peculiarities that have determined the disappearance from the market of many drugs such as emetine, thiabendazole, quinacrine and niclosamide. Diloxanide never appeared. Venezuela has no commercial international treatises that protect international patents in the pharmaceutical area. In addition, government regulation of cost of drugs is very strict. This is particularly true with old drugs (such as emetine or quinacrine) which had such a low price that is non-commercial for the maker of the drug, usually a large transnational, and is withdrawn from the market. Flexibility of prices is quite easy for new antibiotics which are very expensive. Frequently small national companies import the drug from Italy and Japan which sell the drug independently from international treats. Such companies frequently produce the drug for the government social system, but are unreliable and also frequently they withdraw the drug a variable period of time. The government, through the Ministry of Public Health administer free treatment with drugs for malaria, tuberculosis and leprosy. The severe economic crisis of the country has severely impaired the preventive programs and there is an increase of malaria due to gold mining in the south of the country and falciparum chloroquine resistance and an increase of schistosomiasis in a previous free area. Also administration of drugs for malaria has been severely impaired, mainly for economic reasons. The establishment of a National Government Laboratory is an old (as far as 1946) political goal, but has remained in the political intention.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Intravitreal bevacizumab as primary treatment for retinal angiomatous proliferation: twelve-month results.

    Science.gov (United States)

    Gharbiya, Magda; Allievi, Francesca; Recupero, Vincenzo; Martini, Delia; Mazzeo, Luigi; Gabrieli, Corrado Balacco

    2009-06-01

    To evaluate the short-term efficacy and safety of intravitreal bevacizumab for the treatment of retinal angiomatous proliferation. Seventeen eyes from 16 patients with newly diagnosed retinal angiomatous proliferation underwent intravitreal injections of bevacizumab, 1.25 mg. The patients were scheduled for three monthly bevacizumab injections. Early Treatment of Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, central macular thickness on optical coherence tomography, and fluorescein angiographic findings were examined before and after treatment. Patients were followed-up for 12 months. The mean best-corrected visual acuity (+/- standard deviation [SD]) at baseline was 39.53 (+/-10.40) letters (Snellen equivalent: 20/42). At 12 months after treatment the mean best-corrected visual acuity (+/-SD) improved significantly (P = 0.0000001) to 47.88 (+/-11.78) letters (Snellen equivalent: 20/28). Best-corrected visual acuity improved 3 ETDRS lines or more in 3 (17.65%) of 17 treated eyes, 14 (82.35%) eyes were stable, and 15 (88.23%) eyes gained 1 or more ETDRS lines. The mean central macular thickness (+/-SD) at baseline was 297 (+/-60.72) microm. At 12 months after treatment, the mean central macular thickness (+/-SD) reduced significantly (P = 0.00001) to 237 (+/-28.80) microm. At the 12-month follow-up, absence of fluorescein leakage was demonstrated in 14 (82%) of 17 treated eyes. No ocular or systemic adverse effects from treatment were encountered. The 12-month results of intravitreal bevacizumab for retinal angiomatous proliferation are very promising with no apparent short-term safety concerns. Treated eyes had a significant functional and anatomical improvement. Further studies will be needed to better determine long-term efficacy and safety.

  13. The Results of Intraosseous Drilling and Decompression in the Treatment of Chronic Anterior Knee Pain

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    Saberi S

    2012-01-01

    Full Text Available Background: Anterior knee pain is one of the most common complaints of patients in orthopedic clinics. The first step in the treatment of this problem is conservative treatment which includes administration of anti-inflammatory drugs, exercise and changes in life style. Many patients respond well to these measures in about six months, but a small number of patients may not respond to the conservative treatment; therefore, surgical procedures such as Maquet osteotomy or lateral retinacular release may be needed in these cases. The aim of this study was to determine the efficacy of intraosseous drilling and decompression of patella in the treatment of chronic anterior knee pain.Methods : This study was performed as a case series on ten patients with chronic anterior knee pain attending the Orthopedic Clinic of Imam Khomeini Hospital, in Tehran, Iran in 2009-2010. Eight of the patients were male and the rest were female. The patients met the inclusion criteria and were followed up for at least 12 months after the surgery. Results : The mean age of the patients was 27.8±4.66 yr and their mean BMI was 22.5±1.71 kg/m2. The mean pain severity before the interventions was 8.2±0.78 based on VAS but it decreased to 2.5±1.26 post-surgically. An average reduction of 5.7 scores were noticed in pain severity depicting a significant reduction of pain (P<0.0001.Conclusion: It may be concluded that intraosseous drilling and decompression of patella is a safe and effective method in the treatment of chronic anterior knee pain not responding to conservative treatment.

  14. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Experimental Clinical Oncology

    2001-01-01

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment.

  15. Results of Treatment with 2-Chlorodeoxyadenosine (2-CDA in Multiple Reactivations or Refractory Langerhans Cell Histiocytosis

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    Ghasem Miri-Aliabad

    2014-01-01

    Full Text Available Background: Langerhans cell histiocytosis (LCH is the most common type of histiocytosis and characterized by abnormal proliferation and excess accumulation of inflammatory and langerhans cells at various tissue sites. Clinical manifestations are variable, ranging from spontaneously regressing single bone lesion to multisystem disease, life-threatening and refractory to treatment. Conventional chemotherapy has been shown to be effective in treatment of majority of patients with LCH. However, treatment of refractory disease or multiple reactivations is difficult. The aim of this study is to assess the efficacy of 2-CDA in relapsed or refractory LCH. Materials and methods: Four patients with relapsed or refractory LCH that were treated with 2-chlorodeoxyadenosin (2-CDA enrolled in this study. All patients had received at least one prior chemotherapy regimen. The dose and schedule of 2-CDA was 6 mg/m²/day for 5 days every 3-4 weeks. Results: Median age at the time of treatment with 2-CDA was 9.7 years. Three patients had multisystem disease and one had multifocal bone lesions. All patients had multifocal bone lesions. None of them had risk organ involvement. Mean course of treatment with 2-CDA was 9.5. Radiologic evaluations revealed complete resolution of bone lesions in two (50% patients. In one (25% patient lesions regressed (partial response and in another (25% the disease remained stable. Drug related side effects were minimal. At the present time all patients are alive. Conclusion: Our study demonstrates that 2-CDA as a single agent is efficacious in treatment of multiple reactivations or refractory LCH and well-tolerated in children.

  16. Nonsurgical transurethral radiofrequency collagen denaturation: results at three years after treatment.

    Science.gov (United States)

    Elser, Denise M; Mitchell, Gretchen K; Miklos, John R; Nickell, Kevin G; Cline, Kevin; Winkler, Harvey; Wells, W Glen

    2011-01-01

    Objective. To assess treatment efficacy and quality of life in women with stress urinary incontinence 3 years after treatment with nonsurgical transurethral radiofrequency collagen denaturation. Methods. This prospective study included 139 women with stress urinary incontinence due to bladder outlet hypermobility. Radiofrequency collagen denaturation was performed using local anesthesia in an office setting. Assessments included incontinence quality of life (I-QOL) and urogenital distress inventory (UDI-6) instruments. Results. In total, 139 women were enrolled and 136 women were treated (mean age, 47 years). At 36 months, intent-to-treat analysis (n = 139) revealed significant improvements in quality of life. Mean I-QOL score improved 17 points from baseline (P = .0004), while mean UDI-6 score improved (decreased) 19 points (P = .0005). Conclusions. Transurethral collagen denaturation is a low-risk, office-based procedure that results in durable quality-of-life improvements in a significant proportion of women for as long as 3 years.

  17. Nonsurgical Transurethral Radiofrequency Collagen Denaturation: Results at Three Years after Treatment

    Directory of Open Access Journals (Sweden)

    Denise M. Elser

    2011-01-01

    Full Text Available Objective. To assess treatment efficacy and quality of life in women with stress urinary incontinence 3 years after treatment with nonsurgical transurethral radiofrequency collagen denaturation. Methods. This prospective study included 139 women with stress urinary incontinence due to bladder outlet hypermobility. Radiofrequency collagen denaturation was performed using local anesthesia in an office setting. Assessments included incontinence quality of life (I-QOL and urogenital distress inventory (UDI-6 instruments. Results. In total, 139 women were enrolled and 136 women were treated (mean age, 47 years. At 36 months, intent-to-treat analysis (n=139 revealed significant improvements in quality of life. Mean I-QOL score improved 17 points from baseline (P=.0004, while mean UDI-6 score improved (decreased 19 points (P=.0005. Conclusions. Transurethral collagen denaturation is a low-risk, office-based procedure that results in durable quality-of-life improvements in a significant proportion of women for as long as 3 years.

  18. DEWATERING TREATMENT SCALE-UP TESTING RESULTS OF HANFORD TANK WASTES

    Energy Technology Data Exchange (ETDEWEB)

    TEDESCHI AR

    2008-01-23

    This report documents CH2M HILL Hanford Group Inc. (CH2M HILL) 2007 dryer testing results in Richland, WA at the AMEC Nuclear Ltd., GeoMelt Division (AMEC) Horn Rapids Test Site. It provides a discussion of scope and results to qualify the dryer system as a viable unit-operation in the continuing evaluation of the bulk vitrification process. A 10,000 liter (L) dryer/mixer was tested for supplemental treatment of Hanford tank low-activity wastes, drying and mixing a simulated non-radioactive salt solution with glass forming minerals. Testing validated the full scale equipment for producing dried product similar to smaller scale tests, and qualified the dryer system for a subsequent integrated dryer/vitrification test using the same simulant and glass formers. The dryer system is planned for installation at the Hanford tank farms to dry/mix radioactive waste for final treatment evaluation of the supplemental bulk vitrification process.

  19. Monteggia-like lesions – treatment strategies and one-year results

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    Laun, Reinhold

    2015-12-01

    Full Text Available Introduction: The eponym “Monteggia fracture” includes various patterns of complex fracture-dislocations of the proximal ulna and radius, which are not well defined yet. They are frequently described as Monteggia-like lesions or Monteggia equivalent injuries. Until today, these injury patterns have been reported rarely. The objective of this retrospective study was to better define patterns of injury and to document the short-term results of treatment with current fixation techniques.Methods: Ten patients with a Monteggia-like lesion were included in this study and clinical and radiological follow-up examinations at an average of 12.3 months after the trauma were performed. For clinical follow-up the Mayo Modified Wrist Score, the Mayo Elbow Performance Score, the functional rating index of Broberg and Morrey, and the DASH score were utilized.Results: Osteosynthesis of the ulna was performed using a proximally contoured or precontoured LCP (locking compression plate in all patients. All patients had a fracture of the radial head. All patients with a Mason type III radial head fracture received a cemented bipolar radial head prosthesis. All Mason type II fractures were treated with open reduction and internal fixation using mini screws. In all Mason type I fractures the treatment of the radial head dislocation was by closed reduction. Associated coronoid fractures were stabilized with lag screws through the ulnar plate or with independent lag screws after reduction of the fracture. According to the aforementioned scoring systems good to excellent results could be achieved.Conclusions: Our findings demonstrate that good or excellent short-term results can be obtained if the injury is classified correctly and a standardized surgical treatment of all components of the injury is achieved. Further studies with larger patient populations and longer follow up periods are needed to evaluate long-term effectiveness of this treatment concept.

  20. Effects of Antibiotic Treatment on the Results of Nested PCRs for Scrub Typhus▿

    OpenAIRE

    Kim, Dong-Min; Byun, Joo Nam

    2008-01-01

    In order to determine the effects of antibiotic treatment on the results of nested PCRs for scrub typhus, we investigated the frequency of positive outcomes at various times after antibiotic administration in patients with scrub typhus. The rate of detection by nested PCR with blood buffy coat before antibiotic administration was 90.5%. However, this decreased to 60.5% within 3 days after administration of antibiotics such as doxycycline and rifampin and to 10% by the fourth day following ant...

  1. Surgery versus prolonged conservative treatment for sciatica: 5-year results of a randomised controlled trial

    OpenAIRE

    Lequin, Michiel B.; Verbaan, Dagmar; Jacobs, Wilco C. H.; Brand, Ronald; Gerrit J. Bouma; Vandertop, William P.; Peul, Wilco C; ,

    2013-01-01

    Objective This study describes the 5 years’ results of the Sciatica trial focused on pain, disability, (un)satisfactory recovery and predictors for unsatisfactory recovery. Design A randomised controlled trial. Setting Nine Dutch hospitals. Participants Five years’ follow-up data from 231 of 283 patients (82%) were collected. Intervention Early surgery or an intended 6 months of conservative treatment. Main outcome measures Scores from Roland disability questionnaire, visual analogue scale (V...

  2. Results of the spine-to-rib-cage distraction in the treatment of early onset scoliosis

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    Teli Marco

    2010-01-01

    Full Text Available Background: Growing rod systems have been used in the last 30 years for the treatment of early onset scoliosis (EOS with variable success rates. We report the results of treatment of EOS with a newly developed hybrid rod distraction system applied to the rib cage and spine with a nonfusion technique in a prospective multicenter clinical trial. Materials and Methods: A total of 22 patients affected by progressive EOS resistant to cast and/or brace treatment were enrolled from 2004 to 2005 after informed consent into a trial of surgical treatment with a single spine-to-rib growing rod instrumentation growing spine profiler (GSP. Curves> 60° Cobb in the frontal plane or bending < 50% were addressed with staged anterior annulotomy and fusion and posterior implantation of a GSP rod. Less severe and rigid curves were treated with posterior implantation of GSP only. The elongation of GSP was planned according to spinal growth. Patients were kept in a brace between elongations. Results: A total of 20 patients were available to follow-up with complete data. The mean follow up is 4.1 years. Mean age at time of initial surgery was 5 years (3-8. Nine patients had staged antero-posterior surgeries, 11 posterior only surgeries. Mean spinal growth was 1.9 cm (1.5-2.3 or 0.5 cm per year. Mean coronal Cobb′s angle correction was from 56° to 45°. Major complications affected 40% of patients and included rod failure in 6/20 and crankshaft in 5/20 (all in the anteroposterior surgery group. Conclusion: Treatment of EOS with spine-to-rib growing rod in the present form provides similar correction and complication rates to those published in the series considering traditional single or dual growing rod systems. Based on this, the authors recommend revision of the GSP design and a new clinical trial to test safety and efficacy.

  3. Biochemical changes in grape rootstocks resulted from humic acid treatments in relation to nematode infection

    Institute of Scientific and Technical Information of China (English)

    Hosny H Kesba; Hossam S El-Beltagi

    2012-01-01

    Objective: To investigate the effect of humic acid on nematode infected, resistant and susceptible grapes in relation to lipid peroxidation and antioxidant mechanisms on selected biochemical parameters known as proactive substances. Methods: The grape rootstocks, superior, superior/freedom and freedom were reacted differently to Meloidogyne incognita and Rotylenchulus reniformis according to rootstock progenitor. Two weeks after inoculation, two commercial products of humic acid were applied at the rate of (2, 4 mL or grams/plant) as soil drench. After 4 months, nematode soil populations were extracted and counted. A subsample of roots from each plant was stained and gall numbers, embedded stages per root were calculated, final population, nematode build up (Pf/Pi), average of eggs/eggmass were estimated. Subsamples of fresh root of each treatment were chemically analyzed. Results: Freedom reduced significantly the nematode criteria and build up. Humic acid granules appeared to be more suppressive to nematode build up on superior and the higher dose on superior/freedom than liquid treatments. On freedom, all treatments reduced significantly the nematode build up regardless to the material nature. The higher dose was more effective than the lower one. As a result of humic acid applications, the malondialdehyde (MDA) and H2O2 contents were significantly reduced after humic acid treatments while the antioxidant compounds glutathione (GSH), ascorbic acid (ASA) and total phenol contents were significantly increased when compared with check. Antioxidant defense enzymes ascorbate peroxidase (APX), superoxide dismutase (SOD), catalase (CAT) and polyphenol oxidase (PPO) showed significant increase in their specific activities in treated plants compared with nematode treated check. Conclusions: Humic acid treatments improve the yield of grape by increasing the contents of antioxidant compounds and the specific activities of antioxidant enzymes.

  4. Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results

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    Velluti Claudio

    2007-07-01

    Full Text Available Abstract Background No controlled trials have evaluated the long term efficacy of exercise activity to improve the treatment of patients with Major Depressive Disorders. The aim of the present study was to confirm the efficacy of the adjunctive physical activity in the treatment of major depressive disorders, with a long term follow up (8 months. Methods Trial with randomized naturalistic control. Patients selected from the clinical activity registries of the Psychiatric Unit of the University of Cagliari, Italy. Inclusion criteria: female, between 40 and 60 years, diagnosis of Major Depressive Disorders (DSM-IV TR resistant to the ongoing treatment. Exclusion criteria: diagnosis of psychotic disorders; any contraindications to physical activity. 30 patients (71.4% of the eligible participated to the study. Cases: 10 randomized patients undergoing pharmacological treatment plus physical activity. Controls: 20 patients undergoing only pharmacological therapy. The following tools were collected from each patient by two different psychiatric physicians at baseline and 8 month after the beginning of exercise program: SCID-I, HAM-D, CGI (Clinical Global Impression, GAF. Results The patients that made physical activity had their HAM-D, GAF and CGI score improved from T0 to T8, all differences were statistically significant. In the control group HAM-D, GAF and CGI scores do not show any statistically significant differences between T0 and T8. Limits Small sample size limited to female in adult age; control group was not subject to any structured rehabilitation activity or placebo so it was impossible to evaluate if the improvement was due to a non specific therapeutic effect associated with taking part in a social activity. Conclusion Physical activity seems a good adjunctive treatment in the long term management of patients with MDD. Randomized placebo controlled trials are needed to confirm the results.

  5. Clinical Findings, Follow-up and Treatment Results in Patients with Ocular Rosacea

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    İlkay Kılıç Müftüoğlu

    2016-02-01

    Full Text Available Objectives: To report the clinical features, treatment options and complications in patients with ocular rosacea. Materials and Methods: The records of 48 eyes of 24 patients with ocular rosacea were retrospectively reviewed. Patients’ ocular signs and symptoms were scored between 1 and 4 points according to disease severity; tear film break-up time (BUT and Schirmer’s test results were recorded before and after the treatment. Preservative-free artificial tears, topical antibiotic eye drops/ointments, short-term topical corticosteroids, topical 0.05% cyclosporine and oral doxycycline treatment were applied as a standard therapy to all patients. Additional treatments were given as needed. Complications were recorded. Results: Twenty-four patients with a mean age of 48.5±35.4 (32-54 years were followed for a mean 15±9.4 (8-36 months. Ocular findings included meibomitis in 100% of cases, anterior blepharitis in 83% (40 eyes, punctate keratopathy in 67% (32 eyes, chalazia in 50% (24 eyes, corneal neovascularization in 50% (24 eyes and subepithelial infiltrates in 16.6% (8 eyes. Significant improvement of symptoms and clinical findings were achieved in all patients with treatment. The increases in Schirmer’s test and BUT were 3.3±1.5 and 4.5±2.8, respectively (p<0.05. Descemetocele and small corneal perforation occurred in 2 eyes; re-epithelialization was achieved in both eyes with tissue adhesive application (1 eye and additional amniotic membrane transplantation (1 eye. Four eyes of three patients showed significant regression of corneal neovascularization with topical bevacizumab therapy. Conclusion: Ocular rosacea may present with a variety of ophthalmic signs. It is possible to control the ophthalmic disease with appropriate therapeutic modalities including topical corticosteroids, topical cyclosporine and systemic doxycycline.

  6. Longterm results and their prognosis in surgical treatment of Grave's disease

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    I V Makarov

    2013-06-01

    Full Text Available This study focuses on improving the results of surgical treatment of patients with diffuse toxic goiter way jus tify the selection of thyroid residue and thyroid status in predicting longterm periods. The basis of the study is the immediate and longterm results of surgical treatment of 138 patients suffering from diffuse toxic goi ter. As a result of the research, with a modern point of clinical and statistical analysis proved the effective ness of fascial subtotal resection of the thyroid gland in patients with diffuse toxic goiter (Graves' disease. The dependence of disorders of the thyroid is remainded of its volume, autoimmune changes and limitations of the operation. The quality of life of patients in the late postoperative period is studied. The tactics of sur gical treatment of patients with diffuse toxic goiter, aimed at the prevention of postoperative recurrence of hyperthyroidism and hypothyroidism on the basis of prediction of the functional state of the thyroid residue in the longterm period, is proposed. Detected optimal sizes of thyroid balance after subtotal resection of the thyroid gland in patients with diffuse toxic goiter permit to objectify the technique of intervention.

  7. Sequential Salinomycin Treatment Results in Resistance Formation through Clonal Selection of Epithelial-Like Tumor Cells

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    Florian Kopp

    2014-12-01

    Full Text Available Acquiring therapy resistance is one of the major obstacles in the treatment of patients with cancer. The discovery of the cancer stem cell (CSC–specific drug salinomycin raised hope for improved treatment options by targeting therapy-refractory CSCs and mesenchymal cancer cells. However, the occurrence of an acquired salinomycin resistance in tumor cells remains elusive. To study the formation of salinomycin resistance, mesenchymal breast cancer cells were sequentially treated with salinomycin in an in vitro cell culture assay, and the resulting differences in gene expression and salinomycin susceptibility were analyzed. We demonstrated that long-term salinomycin treatment of mesenchymal cancer cells resulted in salinomycin-resistant cells with elevated levels of epithelial markers, such as E-cadherin and miR-200c, a decreased migratory capability, and a higher susceptibility to the classic chemotherapeutic drug doxorubicin. The formation of salinomycin resistance through the acquisition of epithelial traits was further validated by inducing mesenchymal-epithelial transition through an overexpression of miR-200c. The transition from a mesenchymal to a more epithelial-like phenotype of salinomycin-treated tumor cells was moreover confirmed in vivo, using syngeneic and, for the first time, transgenic mouse tumor models. These results suggest that the acquisition of salinomycin resistance through the clonal selection of epithelial-like cancer cells could become exploited for improved cancer therapies by antagonizing the tumor-progressive effects of epithelial-mesenchymal transition.

  8. Sequential Salinomycin Treatment Results in Resistance Formation through Clonal Selection of Epithelial-Like Tumor Cells.

    Science.gov (United States)

    Kopp, Florian; Hermawan, Adam; Oak, Prajakta Shirish; Ulaganathan, Vijay Kumar; Herrmann, Annika; Elnikhely, Nefertiti; Thakur, Chitra; Xiao, Zhiguang; Knyazev, Pjotr; Ataseven, Beyhan; Savai, Rajkumar; Wagner, Ernst; Roidl, Andreas

    2014-12-01

    Acquiring therapy resistance is one of the major obstacles in the treatment of patients with cancer. The discovery of the cancer stem cell (CSC)-specific drug salinomycin raised hope for improved treatment options by targeting therapy-refractory CSCs and mesenchymal cancer cells. However, the occurrence of an acquired salinomycin resistance in tumor cells remains elusive. To study the formation of salinomycin resistance, mesenchymal breast cancer cells were sequentially treated with salinomycin in an in vitro cell culture assay, and the resulting differences in gene expression and salinomycin susceptibility were analyzed. We demonstrated that long-term salinomycin treatment of mesenchymal cancer cells resulted in salinomycin-resistant cells with elevated levels of epithelial markers, such as E-cadherin and miR-200c, a decreased migratory capability, and a higher susceptibility to the classic chemotherapeutic drug doxorubicin. The formation of salinomycin resistance through the acquisition of epithelial traits was further validated by inducing mesenchymal-epithelial transition through an overexpression of miR-200c. The transition from a mesenchymal to a more epithelial-like phenotype of salinomycin-treated tumor cells was moreover confirmed in vivo, using syngeneic and, for the first time, transgenic mouse tumor models. These results suggest that the acquisition of salinomycin resistance through the clonal selection of epithelial-like cancer cells could become exploited for improved cancer therapies by antagonizing the tumor-progressive effects of epithelial-mesenchymal transition.

  9. Analysis of the results of treatment of patients with malignant tumors of the salivary glands

    Directory of Open Access Journals (Sweden)

    V. T. Vayradyan

    2016-01-01

    Full Text Available Objective: improve results of the treatment of patients with malignant salivary gland neoplasm (MSGN.Materials and methods. Analysis of 417 patients suffering from MSGN treated in the Federal State Budgetary Institution “N.N. Blokhin Russian Cancer Research Center” from 1988 to 2014. All the subjects were divided into 4 main groups according to the treatment assigned: group of the surgical treatment – 27.3 % (n = 114, group of the combined treatment (surgery and radiotherapy (RT – 54.0 % (n = 225, group of the complex treatment (surgery, radiotherapy and chemotherapy – 10.5 % (n = 44, group of conservative treatment (radiotherapy and/or chemotherapy – 8.2 % (n = 34.Results. Best 5-year disease-free survival (DFS was observed in patients with localization of the tumor process in the minor salivary glands (MSG, mucosal tunic (MT of mouth (73.2 ± 5.5% and parotid gland (62.3 ± 3.3 %, while the lowest survival rate was observed in tumors of sublingual salivary gland (0% (median was not achieved, p = 0.07. Depending on the morphological variants the best 5-year DFS was observed in groups of myoepithelial carcinoma, and acinar cell carcinoma: 81.3 ± 9.8 and 79.1 ± 8.4 %, respectively (median was not reached, p > 0.05; the worst survival rate was observed in patients with squamous cell carcinoma, carcinoma of the salivary ducts and adenocarcinoma: 45.7 ± 15.5; 50.3 ± 12.7 and 53.0 ± 5.5 %, respectively (median was not reached. In poorly differentiated tumors (G3 5-year DFS was lowest and was equal to 32.7 ± 4.1 %, while in G1 tumors – 83.6 ± 3.1% (p = 0.000001. In G3 tumors addition of radiotherapy to the surgery significantly reduces the incidence of local recurrence - from 51.4 % (surgical treatment alone down to 33.8 % (combined treatment (p = 0.08. There was a significant decrease in 5-year disease-free survival rate from 74.2 ± 2.6 % without any adverse pathological signs down to 37.9 ± 5.4% in the presence of these signs

  10. Cancer of the breast. Staging methods, primary treatment options and end results.

    Science.gov (United States)

    Donegan, W L

    1979-01-01

    A totally satisfying concept of treatment is not easy to formulate from the complex and often conflicting results of local therapeutic interventions for breast cancer. It seems evident that clinically occult cancer is often beyond the pale of both resection and irradiation at primary treatment, particularly when cancer is found in regional lymph nodes. Despite all combinations of local treatment, the ultimate risk of failure correlates more closely with the stage of the disease at the time of treatment than with the particular form of treatment. Thus the extent of disease must be considered the major, perhaps the ultimate determinant of prognosis. Because, under controlled conditions, several therapeutic alternatives have appeared to provide virtually identical end results in terms of survival and ultimate dissemination of the disease, the adequacy of control within the field of treatment may, in fact, be the most meaningful end result of local treatment. The experience that has accumulated with treatment of breast cancer supports the thesis that removal of the breast accomplishes all that can be achieved in terms of curing the disease, and wider treatment with surgery or irradiation serves only to improve the prospects for local control. Halsted demonstrated this principle with his radical mastectomy and it still seems to be the case. This fact provides further impetus for detecting and treating cancer while it is still localized to the breast. With these generalizations in mind some empirical observations can be added. An anatomic fact is that multiple microscopic foci of cancer that are not evident clinically are often present in the mammary parenchyma. Undisturbed, at least some, and perhaps eventually all, of these foci of cancer progress to become clinical cancers. Thorough removal of the entire breast (the entire mammary parenchyma) eliminates this particular hazard and, one may presume, terminates the disease if it is still limited to the breast. Removal of

  11. Results of Operative and Nonoperative Treatment of Rockwood Types III and V Acromioclavicular Joint Dislocation

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    Joukainen, Antti; Kröger, Heikki; Niemitukia, Lea; Mäkelä, E. Antero; Väätäinen, Urho

    2014-01-01

    Background: The optimal treatment of acute, complete dislocation of the acromioclavicular joint (ACJ) is still unresolved. Purpose: To determine the difference between operative and nonoperative treatment in acute Rockwood types III and V ACJ dislocation. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In the operative treatment group, the ACJ was reduced and fixed with 2 transarticular Kirschner wires and ACJ ligament suturing. The Kirschner wires were extracted after 6 weeks. Nonoperatively treated patients received a reduction splint for 4 weeks. At the 18- to 20-year follow-up, the Constant, University of California at Los Angeles Shoulder Rating Scale (UCLA), Larsen, and Simple Shoulder Test (SST) scores were obtained, and clinical and radiographic examinations of both shoulders were performed. Results: Twenty-five of 35 potential patients were examined at the 18- to 20-year follow-up. There were 11 patients with Rockwood type III and 14 with type V dislocations. Delayed surgical treatment for ACJ was used in 2 patients during follow-up: 1 in the operatively treated group and 1 in the nonoperatively treated group. Clinically, ACJs were statistically significantly less prominent or unstable in the operative group than in the nonoperative group (normal/prominent/unstable: 9/4/3 and 0/6/3, respectively; P = .02) and in the operative type III (P = .03) but not type V dislocation groups. In operatively and nonoperatively treated patients, the mean Constant scores were 83 and 85, UCLA scores 25 and 27, Larsen scores 11 and 11, and SST scores 11 and 12 at follow-up, respectively. There were no statistically significant differences in type III and type V dislocations. In the radiographic analysis, the ACJ was wider in the nonoperative than the operative group (8.3 vs 3.4 mm; P = .004), and in the type V dislocations (nonoperative vs operative: 8.5 vs 2.4 mm; P = .007). There was no statistically significant difference between study groups in

  12. Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

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    Rodrigo Arnold Tisot

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.METHODS: A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.RESULTS: There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047 compared to those surgically treated (p=0.335. The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.CONCLUSION: The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.

  13. Analysis of structural transformation in wool fiber resulting from oxygen plasma treatment using vibrational spectroscopy

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    Barani, Hossein; Haji, Aminoddin

    2015-01-01

    The aim of this study was to investigate the influence of oxygen plasma procedure at different time treatments on wool fiber using the micro-Raman spectroscopy as a non-destructive vibrational spectroscopic technique and Fourier transform infrared spectroscopy. The amide I and III regions, Csbnd C skeletal vibration region, and Ssbnd S and Csbnd S bonds vibration regions were analyzed with the Raman microscope. The Fourier transform infrared spectroscope analysis was employed to find out the effect of oxygen plasma treatment on the cysteic acid residues content of the wool fiber sample. The results indicated that the α-helix structure was the highest component content of wool fiber. Moreover, the protein secondary structure of wool fibers was transformed from α-helical arrangement to the β-pleated sheet configuration during the oxygen plasma treatment. Also, the disulphide bonds content in the treated wool fiber reduced because they were fractured and oxidized during oxygen plasma treatment. The oxygen plasma treated samples presented higher cysteic acid compared to the untreated wool samples due to produce more cleavage of disulfide linkages.

  14. How does the inclusion of twins conceived via fertility treatments influence the results of twin studies?

    Science.gov (United States)

    Burt, S Alexandra; Klump, Kelly L

    2012-12-01

    Rates of twinning have risen dramatically over the last 30 years, from 1 in 53 births in 1980 to 1 in 30 births in 2009 (Martin et al. (January 2012). Three decades of twin births in the United States, 1980-2009. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Health Statistics). This increase is largely attributable to increases in the use of fertility treatments (i.e., ovulation induction and in vitro fertilization) combined with delays in parenthood. Although this increase means that more twins are available for recruitment into twin studies, it also has potential consequences for the heritability estimates obtained in these studies. This study sought to evaluate this possibility, making use of the ongoing Michigan Twins Project (N = 7,261 families with twins aged 3-17 years), an arm of the Michigan State University Twin Registry. Results revealed that, on average, twins conceived via fertility treatments had lower rates of behavior problems than those conceived naturally, although these behavioral differences could be explained largely by demographic and socio-economic differences across the two types of twin families. Twin similarity did not meaningfully differ across fertility treatment status. We thus conclude that estimates of genetic and environmental influences obtained from twin studies over the last 10-15 years are more or less unaffected by the inclusion of twins conceived via fertility treatments in their samples.

  15. Internal structure changes in bleached black human hair resulting from chemical treatments: A Raman spectroscopic investigation

    Science.gov (United States)

    Kuzuhara, Akio

    2014-11-01

    In order to investigate in detail the influence of chemical treatments (reduction, hydrolyzed eggwhite protein (HEWP) treatment, and oxidation) on damaged hair keratin fibers, the structure of cross-sections at various depths of excessively bleached (damaged) black human hair resulting from a permanent waving process was directly analyzed using Raman spectroscopy. It was found that L-cysteine (CYS) largely reacted with the gauche-gauche-gauche (GGG) conformation of disulfide (-SS-) groups (while CYS did not react with the trans-gauche-trans (TGT) conformation). In particular, not only the GGG content, but also the cysteic acid content existing throughout the cortex region of the excessively bleached human hair remarkably decreased by performing the oxidation process after reduction. On the other hand, the GGG content of the excessively bleached black human hair increased, while the TGT content decreased by performing the oxidation process after reduction and then HEWP treatment processes. From these experiments, the authors concluded that some of the keratin associated protein (KAP), which has a rich -SS- content and cysteic acid content was eluted from the cortex region along with the disconnection of -SS- groups, thereby leading to the remarkable reduction in the reconnection of -SS- groups of the excessively bleached black human hair after the permanent waving process (the reduction and oxidation processes). Also, the authors concluded that the HEWP treatment process in the permanent waving process caused the reconstruction of the KAP, thereby contributing to the acceleration of the reconnection of -SS- groups during the oxidation process.

  16. Yttrium-90 radioembolization for the treatment of unresectable liver cancer: Results of a single center

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    Özhan Özgür

    2014-03-01

    Full Text Available Objective: To determine the effects of yttrium-90 (Y-90 resin microsphere radioembolization therapy on patients with unresectable liver cancer who do not benefit from chemotherapy. Methods: Fifty-five patients underwent radioembolization therapy included in the study whose had unresectable primary or metastatic liver cancer originating from the gastrointestinal tract. Three were excluded from the study after pre-evaluation angiography. Thirteen (23.6% of the remaining 52 patients had hepatocellular carcinoma and 39 (76.4% had metastatic liver cancer. Fifty-two patients underwent Y-90 radioembolization treatment. Each patient's response to the administered treatment was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST and the overall probability of survival was displayed graphically by the Kaplan-Meier method. Results: After Y-90 therapy, 47 patients were follow-up. While 57% of the patients responded to treatment as clinical benefit, the disease progressed in 43%. The median hepatic progression-free survival time of the patients was 3.4 months (95% confidence interval (ci:1.4-5.3 and the overall survival time was 11.3 months (95%, CI:8.7-14.03. Conclusion: This study emphasizes that Y-90 resin microsphere radioembolization treatment is effective in patients with unresectable liver cancer.

  17. Results of surgical treatment of developmental dysplasia of hip considering child’s age

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    Milašinović Sonja

    2011-01-01

    Full Text Available Introduction. Developmental dysplasia of the hip (DDH represents one of common diseases of the locomotor system. Late discovery and inadequate healing of this defect leads to serious disability in the best years of human life. Objective. The aim of this study was to analyze the quality of functional and anatomic restitution of the diseased hip, depending on the age of the patient at the time of surgery. Methods. Our retrospective study was developed on 78 children surgically treated for DDH. The examiners were distributed in three groups according to age in which they had been operated. The data were produced on the basis of full-scale medical documents for each patient. Results. We analyzed and compared anatomic and functional results of surgeries treating DDH in the group of examiners. On examination, we got data that the most prevalent were distorted gait, inequality of the legs and positive Trendelendburg’s sign in the group of children who had been operated in the oldest age. The patients who were surgically treated in older age had worse postoperative results in aspect value angle of flexion and abduction in treated hip, higher frequency in manifesting pain and asymmetric gait. Better corrective results on aspect of dimension of the colodiaphyseal and Hilgenrainer’s angle will be obtained if DDH treatment is conducted in younger age of patients. In 94.95%, the patients were treated with Salter innominate osteotomy of pelvis with osteotomy of the femur involving its shortening and reverse rotation. Preoperative treatment with Pavliks harness was provided in 44.02% children, with abduction of Hilgenrainer’s apparatus in 2.6%, with abductions “Niva” slips in 2.6% and preoperative extension in 28.2%. Conclusion. The surgical treatment of DDH in the observed patients done at the earlier age of growth resulted in the evidently better anatomical and functional results at postoperative observation.

  18. Short-term results of carotid stenting for the treatment of extracranial carotid occlusive disease

    Institute of Scientific and Technical Information of China (English)

    FU Wei-guo; ZHU Ting; CHEN Bin; JIANG Jun-hao; YANG Jue; SHI Zhen-yu

    2006-01-01

    @@ Carotid artery angioplasty and stenting (CAS) has been performed with increasing frequency for the treatment of extracranial carotid occlusive diseases (ECOD) in recent years. Its feasibility and safety are supported by the Stenting and Angioplasty with Protection in Patient at High Risk for Endarterectomy (SAPPHIRE) trial,1 which revealed a lower incidence of death, stroke and myocardial infarction compared with carotid endarterectomy (CEA) in high-risk patients. However, it is a pity that up to now, initial results of this endovascular procedure have yet been infrequently documented in China. This retrospective study was to analyze the short-term results of CAS to treat ECOD in a single medical center.

  19. RESULTS OF POSTERIOR MYECTOMY FOR THE TREATMENT OF CHILDREN WITH CHRONIC CONSTIPATION

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    Mehran PEYVASTEH

    2015-12-01

    Full Text Available Background and Objectives - The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Methods - Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA. Results - Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months. Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months. Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant ( P <0.001. Of all cases, 52% continued treatment of constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Conclusion - Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment.

  20. Clinical Features, Presence of Human Herpesvirus-8 and Treatment Results in Classic Kaposi Sarcoma

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    Özlem Su

    2008-12-01

    Full Text Available Background and Design: Classic Kaposi sarcoma (KS occurs predominantly among the elderly, with Jews, Italians and Greeks. Classic KS has been seen relatively frequently in Turkey. Our aim was to evaluate the demographic, clinical features of Kaposi sarcoma and etiopathological role of human herpesvirus-8 (HHV-8. Treatment results of 18 classic Kaposi’s sarcoma were also concluded.Material and Method: Eighteen cases of classic Kaposi sarcoma diagnosed as clinically and histopathologically between January 2001 and August 2008 in our dermatology department were taken to this study. Demographic, clinical features and treatment results were reviewed retrospectively in all patients. HHV-8 was investigated in the lesional skin of 7 patients.Results: A male/female ratio of 2/1 was found. Mean age at diagnosis was 67.2 (37-94 years. Bilaterally lower extremities were involved in 15 patients (83.3%, the trunk was involved in 3 patients (16.6%. Plaques and nodules were the common type of lesions (66.6% and 55.5%. Nine patients had no symptoms (50%. Edema was the most common symptom (38.8%. A second primary malignancy was found in 2 patients (11.1%. HHV-8 was detected in 6 of the 7 patients(85.7%. Majority of the patients were treated with interferon alfa (subcutaneously and cryotherapy as a monotherapy or a combination therapy. Imiquimod was the second agent in combined treatment (27.7%. Conclusion: We suggest that interferon alfa and imiquimod can be used as first line therapy agents with their antiviral and immunmodulatuar features in the treatment of KKS. (Turkderm 2008; 42: 122-6

  1. Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study.

    Science.gov (United States)

    Pierot, Laurent; Costalat, Vincent; Moret, Jacques; Szikora, Istvan; Klisch, Joachim; Herbreteau, Denis; Holtmannspötter, Markus; Weber, Werner; Januel, Anne-Christine; Liebig, Thomas; Sychra, Vojtech; Strasilla, Christoph; Cognard, Christophe; Bonafé, Alain; Molyneux, Andrew; Byrne, James V; Spelle, Laurent

    2016-05-01

    OBJECT WEB is an innovative intrasaccular treatment for intracranial aneurysms. Preliminary series have shown good safety and efficacy. The WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) trial is a prospective European trial evaluating the safety and efficacy of WEB in wide-neck bifurcation aneurysms. METHODS Patients with wide-neck bifurcation aneurysms for which WEB treatment was indicated were included in this multicentergood clinical practices study. Clinical data including adverse events and clinical status at 1 and 6 months were collected and independently analyzed by a medical monitor. Six-month follow-up digital subtraction angiography was also performed and independently analyzed by a core laboratory. Success was defined at 6 months as complete occlusion or stable neck remnant, no worsening in angiographic appearance from postprocedure, and no retreatment performed or planned. RESULTS Ten European neurointerventional centers enrolled 51 patients with 51 aneurysms. Treatment with WEB was achieved in 48 of 51 aneurysms (94.1%). Adjunctive implants (coils/stents) were used in 4 of 48 aneurysms (8.3%). Thromboembolic events were observed in 9 of 51 patients (17.6%), resulting in a permanent deficit (modified Rankin Scale [mRS] Score 1) in 1 patient (2.0%). Intraoperative rupture was not observed. Morbidity (mRS score > 2) and mortality were 2.0% (1 of 51 patients, related to rupture status on entry to study) and 0.0% at 1 month, respectively. Success was achieved at 6 months in 85.4% of patients treated with WEB: 23 of 41 patients (56.1%) had complete occlusion, 12 of 41 (29.3%) had a neck remnant, and 6 of 41 (14.6%) had an aneurysm remnant. CONCLUSIONS The WEBCAST study showed good procedural and short-term safety of aneurysm treatment with WEB and good 6-month anatomical results.

  2. Evaluation of the results from non-arthroplastic treatment (arthroscopy for shoulder arthrosis

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    Alberto Naoki Miyazaki

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients' epidemiological profile, surgical technique used, possible complications and postoperative protocol. METHODS: Between 1998 and 2011, 31 patients (32 shoulders with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch. RESULTS: There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation ( p< 0.001 and there was a tendency ( p= 0.057 toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed. CONCLUSION: Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor

  3. Results of surgical treatment of massive localized lymphedema in severely obese patients

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    Wilson Cintra Júnior

    2014-01-01

    Full Text Available OBJECTIVE: to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL in the severely obese. METHODS: in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life. RESULTS: all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias. CONCLUSION: surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.

  4. THE CLINICAL COURSE AND TREATMENT RESULTS OF LUNG METASTASES FROM BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    Xu Binghe; Zhou Jichang; Zhou Aiping; Wang Yan; Feng Fengyi; Sun yan

    1998-01-01

    Objective:To analyze the clinical course and treatment result of lung metastases from breast cancer. Method:122 cases with lung metastases from breast cancer were treated with chemotherapy or chemotherapy plus endocrine therapy, response was assessed according to WHO criteria and survival rate estimated using the life Table. Results: The median time from initial treatment of primary tumor to lung metastases was 22 months. Sites of common consecutive metastases were lung, liver and bone. The overall response rate was 48% with a CR rate of 15%. Compared to non- DDP- encompassing regimen, the CR rate was higher in DDP-based chemotherapy (7%versus 21%, P<0.05) with a longer median survival time (MST). The PR rate was higher in regimens containing anthracycline (48%) than in those without anthracycline (20%, P<0.01). The response rate was similar between chemotherapy and chemotherapy plus endocrine therapy (P>0.05). No difference in MST was observed between patients receiving anthracycline-and non-anthracyclineencompassing regimens. The 1-, 3-, 5-, and 10-year survival rate was 77%, 22 %, 11%, and 10%, respectively.Conclusion: Size of primary tumor, the length of diseasefree interval, the number of lung metastases may provide additional information for predicting patients survival after treatment of lung metastases. Combination chemotherapy, especially DDP-based chemotherapy may prolong survival time of patients with lung metastases from breast cancer.

  5. Results of kyphoplasty in the minimally invasive treatment of vertebral metastasis

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    Carlos Fernando Pereira da Silva Herrero

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the clinical and radiological outcome of minimally invasive surgical treatment of vertebral metastases using the technique of kyphoplasty. METHODS: This was a prospective observational study of patients with the diagnosis of spinal metastasis who underwent minimally invasive surgical treatment by filling the vertebral body with balloon kyphoplasty technique. Clinical evaluation included patient age at surgery, diagnosis of the tumor, biopsy results, data of the surgical procedure performed, visual pain scale (VAS and complications related to surgery. Radiological evaluation involved the study of radiographic procedures in the anteroposterior and lateral incidences, with the analysis of vertebral body kyphosis and the occurrence of extravasation of cement. RESULTS: 22 patients with spinal metastases who were treated by balloon kyphoplasty, 8 (36% males and 14 (64% females were studied. The average age was 56.05 years and the mean follow-up was 8.5 months. The mean preoperative VAS was 8.73, 1.73 in the initial postoperative period, and 1.92 in the late postoperative period. CONCLUSION: Kyphoplasty proved to be a safe and effective technique for symptomatic treatment of vertebral metastases.

  6. Factors that influence the urodynamic results of botulinum toxin in the treatment of neurogenic hyperactivity.

    Science.gov (United States)

    Gutiérrez-Martín, P; Vírseda-Chamorro, M; Salinas Casado, J; Gómez-Rodríguez, A; Esteban-Fuertes, M

    2015-05-01

    To determine the urodynamic efficacy and factors that influence the urodynamic results of treatment of neurogenic detrusor hyperactivity with intradetrusor injection of botulinum toxin type A (BTX-A) in patients with spinal cord injury (SCI). A retrospective study was conducted with a cohort of 70 patients composed of 40 men and 30 women with stable SCI (mean age, 39 ± 13.3 years) who underwent an intradetrusor injection of 300 IUs of BTX-A. A urodynamic study was conducted prior to the injection and 6 ± 4.3 months after the treatment. New urodynamic studies were subsequently performed up to an interval of 16 ± 12.2 months. The BTX-A significantly increased (p lesion age showed no influence in terms of the increase in bladder capacity. The indwelling urinary catheter (IUC) was the only statistically significant negative factor. The urodynamic effect of BTX-A is maintained for a considerable time interval. The IUC negatively influences the result of the treatment. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Experience with cinacalcet in primary hyperparathyroidism: results after 1 year of treatment

    Science.gov (United States)

    García-Martín, Antonia; Luque-Pazos, Alessandra

    2013-01-01

    Objectives: To assess the characteristics of patients with primary hyperparathyroidism (PHPT) treated with cinacalcet and to evaluate its efficacy in reducing serum calcium and parathyroid hormone (PTH) concentrations after 1 year of treatment. Methods: The study included 20 patients with PHPT who had completed at least 12 months of treatment with cinacalcet (eight patients for refusal of parathyroidectomy, three for surgery not possible due to comorbidities and nine for progressive hypercalcemia prior to surgery). We recorded clinical and biochemical data at baseline, and after 3, 6 and 12 months of treatment. We also monitored adverse events. Cinacalcet was administered in increasing doses until normal serum calcium was reached or side effects preventing a further increase occurred. Results: After 3 months of treatment, serum calcium significantly decreased (11.73 ± 0.85 versus 10.71 ± 1.63 mg/dl, p < 0.001) and serum phosphorus significantly increased (2.41 ± 0.48 versus 2.63 ± 0.70 mg/dl, p = 0.004) while no significant change occurred in PTH (181.91 ± 102.37 versus 195.47 ± 111.71 pg/ml, p = 0.695). No further variation was observed after 6 months compared with 3 months of follow up. However, after 12 months of treatment, there was a significant decrease in PTH concentrations compared with baseline (181.91 ± 102.37 versus 152.47± 70.16 pg/ml, p = 0.028) as well as serum calcium (11.73 ± 0.85 versus 10.20± 0.95 mg/dl, p < 0.001); serum phosphorus significantly increased (2.41 ± 0.48 versus 2.71 ± 0.43 mg/dl, p = 0.01). Normocalcemia (S-Ca < 10.2 mg/dl) was achieved in 55% of patients. The medication was usually well tolerated (83.4%). Most common adverse events were nausea and vomiting, especially at the beginning of therapy. Conclusion: Cinacalcet rapidly reduced serum calcium in patients with PHPT and this reduction remained stable after 1 year of treatment. We also observed a decrease in PTH. Cinacalcet is an effective alternative in nonsurgical

  8. Nucleic Acids in Human Glioma Treatment: Innovative Approaches and Recent Results

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    S. Catuogno

    2012-01-01

    Full Text Available Gliomas are the most common primary central nervous system tumors with a dismal prognosis. Despite recent advances in surgery, radiotherapy, and chemotherapy, current treatment regimens have a modest survival benefit. A crucial challenge is to deliver drugs effectively to invasive glioma cells residing in a sanctuary within the central nervous system. New therapies are essential, and oligonucleotide-based approaches, including antisense, microRNAs, small interfering RNAs, and nucleic acid aptamers, may provide a viable strategy. Thanks to their unique characteristics (low size, good affinity for the target, no immunogenicity, chemical structures that can be easily modified to improve their in vivo applications, these molecules may represent a valid alternative to antibodies particularly to overcome challenges presented by the blood-brain barrier. Here we will discuss recent results on the use of oligonucleotides that will hopefully provide new effective treatment for gliomas.

  9. [The results of wet AMD treatment by intravitreal injections--preliminary report].

    Science.gov (United States)

    Okruszko, Anna; Borucka, Anna I; Ulińska, Magdalena; Szaflik, Jerzy

    2007-01-01

    Age-related macular degeneration (AMD) is the leading cause of irreversible, severe loss of vision in the developed countries. One of the modern methods of treatment in neovascular form of AMD are repeated intravitreal injections of ranibizumab (Lucentis). Ranibizumab is a recombinant, humanized, monoclonal antibody that neutralizes all biologically active forms of vascular endothelial growth factor A (VEGF-A). The aim of the study was to analyze the results of intravitreal ranibizumab injections in wet AMD patients. There were 57 patients enrolled in the study. 87% of them avoided any loss of visual acuity and 47.3% gained at least one line at visual acuity chart. Authors conclude that treatment with repeated intravitreal injections of ranibizumab is effective in neovascular form of AMD.

  10. Does occasional cannabis use impact anxiety and depression treatment outcomes?: Results from a randomized effectiveness trial.

    Science.gov (United States)

    Bricker, Jonathan B; Russo, Joan; Stein, Murray B; Sherbourne, Cathy; Craske, Michelle; Schraufnagel, Trevor J; Roy-Byrne, Peter

    2007-01-01

    This study investigated the extent to which occasional cannabis use moderated anxiety and depression outcomes in the Collaborative Care for Anxiety and Panic (CCAP) study, a combined cognitive-behavioral therapy (CBT) and pharmacotherapy randomized effectiveness trial. Participants were 232 adults from six university-based primary care outpatient clinics in three West Coast cities randomized to receive either the CCAP intervention or the usual care condition. Results showed significant (Pcannabis use status (monthly vs. less than monthly) for depressive symptoms, but not for panic disorder or social phobia symptoms (all P>.05). Monthly cannabis users' depressive symptoms improved in the CCAP intervention just as much as those who used cannabis less than monthly, whereas monthly users receiving usual care had significantly more depressive symptoms than those using less than monthly. A combined CBT and medication treatment intervention may be a promising approach for the treatment of depression among occasional cannabis users. (c) 2006 Wiley-Liss, Inc.

  11. RESULTS OF TREATMENT OF CERVICAL DISCOPATHY WITH PEEK INTERBODY CAGES AT THREE LEVELS WITHOUT PLATE FIXATION

    Directory of Open Access Journals (Sweden)

    Amado González Moga

    Full Text Available ABSTRACT Objective: To present the results of treatment of patients with cervical discopathy by anterior cervical approach, discectomy and placement of a PEEK interbody cage without anterior plate fixation. Methods: Retrospective, cross-sectional study from March 2013 to March 2015. Sixteen patients with radiculopathy or clinical signs of myelopathy were included; all patients underwent cervical surgery through anterior approach, discectomy, and placement of PEEK cages on three levels. Decompression levels were determined according to the correlation between preoperative radiological and clinical findings. Results: Sixteen patients predominantly male were included, with mean age of 50 years at the onset of the condition. Ten patients had involvement of C4-C5, C5-C6, C6-C7 levels, and six patients C3-C4, C4-C5 and C5-C6. Fourteen patients had cervicobrachialgia and two myelopathy. The preoperative visual analog scale average was 8/10 and the average postoperative value at 6 months was 3/10. At 6 months, there was no radiological evidence of recurrence. One patient had non-fatal complications. Conclusions: The treatment of cervical discopathy by anterior approach with interbody fusion with PEEK cage on three levels, with no plate fixation seemed to be safe and effective with better long-term results in terms of pain and myelopathy. The clinical results compare favorably with other similar series and, most importantly, the complications associated with anterior fixation plate are avoided.

  12. Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

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    Bruno Dutra Roos

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. METHODS: Between January 2011 and March 2012, 49 patients (50 hips underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS, the Non-Arthritic Hip score (NAHS and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. RESULTS: Out of the 41 hips treated, 31 (75.6% presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4° for the internal rotation of the hip ( p< 0.001. Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9° and mean increase of 0.10, respectively ( p< 0.001. CONCLUSION: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

  13. Treatment for liver metastases from breast cancer: Results and prognostic factors

    Institute of Scientific and Technical Information of China (English)

    Xiao-Ping Li; Zhi-Qiang Meng; Wei-Jian Guo; Jie Li

    2005-01-01

    AIM: Liver metastases from breast cancer (BCLM) are associated with poor prognosis. Cytotoxic chemotherapy can result in regression of tumor lesions and a decrease in symptoms. Available data, in the literature, also suggest a subgroup of patients rraay berefit from surgery, but few talked about transcatheter arterial chemoembolization (TACE).We report the results of TACE and systemic chemotherapy for patients with liver metastases from breast cancer and evaluate the prognostic factors. METHODS: Forty-eight patients with liver metastases, from proved breast primary cancer were treated with TACEor systemic chemotherapy between January 1995 and December 2000. Treatment results were assessed according to WHO criteria, along with analysis of prognostic factors for survival using Cox regression model.RESULTS: The median follow-up was 28 mo (1-72 mo). Response rates were calculated for the TACE group and chemotherapy group, being 35.7% and 7.1%,respectively. The difference was significant. The one-, two- and three-year Survival rates for the TACE group were 63.04%, 30.35%, and 13.01%, and those for the systemic chemotherapy group were 33.88%, 11.29%, and 0%. According to univariate analysis, variables significantly associated with survival were the lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight. Other factors such as age, the intervals between the primary to the metastases, the maximal diameter of the liver metastases, the number of liver metastases, extrahepatic metastasis showed no prognostic significances. These factors mentioned above such as the lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight were also independent factors in multivariate analysis.CONCLUSION: TACE treatment of liver metastases from breast cancer may prolong survival in certain patients. This approach offers new promise for the curative treatment of the patients

  14. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    Science.gov (United States)

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  15. Ethics on the dental treatment of patients with mental disability: results of a Netherlands - Belgium survey.

    Science.gov (United States)

    Marks, Luc; Adler, Naomi; Blom-Reukers, Helen; Elhorst, Jan H; Kraaijenhagen-Oostinga, Annelies; Vanobbergen, Jacques

    2012-11-01

    This study evaluates several ethical dilemmas of by dental practitioners treating persons with mental disabilities (PMD) by dentists in the Netherlands and Belgium. Ethical dental care for PMD is a hot topic. Worldwide different treatment strategies are used in the dental treatment of this patient group. In addition, cultural aspect seems to play an important role in the choices made. The latter can explain the difficulty in creating European and worldwide guidelines on this issue. A questionnaire was sent to dental practitioners interested in treating PMD persons both in the Netherlands and in Belgium including questions on the use of behaviour management techniques, use and attitude towards sedation and physical fixation and the cooperation with other health care personal. Behaviour management techniques and sedation are frequently used. Dentist of the Netherlands and Belgium in general reject the restraint of PMD persons. However, limited use of manual restraint in accordance with the carers and the close surrounding of the patient seems to be accepted. Dental practitioners are sometimes confronted with an emotional dilemma in treating PMD and the majority feels that it is a continuous challenge to obtain optimal result of the dental treatment.

  16. Metaplastic carcinoma of the breast: Treatment, results and prognostic factors based on international literature.

    Science.gov (United States)

    Sanguinetti, Alessandro; Lucchini, Roberta; Santoprete, Stefano; Farabi, Raffaele; Fioriti, Lorella; Bistoni, Giovanni; Triola, Roberta; Avenia, Nicola

    2014-01-01

    Metaplastic carcinoma of the breast (MCB) is a rare form of cancer containing mixture of epithelial and mesenchymal elements in variable combinations. Few and conflicting clinical data are available in the literature addressing optimal treatment modalities, prognosis and outcome. A retrospective study was conducted to review all patients with MCB diagnosed and treated at Breast Unit of Azienda Ospedaliera "Santa Maria" Terni - Italy between 2001/2010. The aim is to describe patient's clinic pathologic features and to analyze treatment results. Six female patients were studied. The median age was 48 years (range 14/58). The median tumor size was 9 cm. (range 3/18 cm.). Two cases (33%) were identified as purely epithelial and 4 (67%) as mixed epithelial and mesenchymal metaplasia. Hormone receptors were positive in only 2 patients. Modified radical mastectomy performed in 3 patients and 5 underwent axillary node dissection. Adjuvant chemotherapy was given to all patients and postoperative radiotherapy to 4. Four patients relapsed with median time of relapse of 12 months. MCB is an aggressive form of breast cancer associated with poor outcome, high incidence of local recurrence and pulmonary metastases. The disease tends to be estrogen/progesterone receptor negative. Tumor size has an important impact on outcome. The best treatment approach is yet to be defined.

  17. Preliminary results with a strip ionization chamber used as beam monitor for hadrontherapy treatments

    Science.gov (United States)

    Boriano, A.; Bourhaleb, F.; Cirio, R.; Cirrone, G. A. P.; Cuttone, G.; Donetti, M.; Garelli, E.; Giordanengo, S.; Luparia, A.; Marchette, F.; Peroni, C.; Raffaele, L.; Sabini, M. G.; Valastro, L.

    2006-01-01

    Preliminary results are presented from a test of a parallel plate ionization chamber with the anode segmented in strips (MOPI) to be used as a beam monitor for therapeutical treatments on the 62 MeV proton beam line of the INFN-LNS Superconducting Cyclotron. Ocular pathologies have been treated at the Catana facility since March 2002. The detector, placed downstream of the patient collimator, will allow the measurement of the relevant beam diagnostic parameters during treatment such as integrated beam fluence, for dose determination; the beam baricentre, width and asymmetry will be obtained from the fluence profile sampled with a resolution of about 100 Urn at a rate up to 1 kHz with no dead time. In this test, carried out at LNS, the detector has been exposed to different beam shapes and the integrated fluence derived by the measured beam profiles has been compared with that obtained with other dosimeters normally used for treatment. The skewness of the beam profile has been measured and shown to be suitable to on-line check variations of the beam shape.

  18. Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.

    Science.gov (United States)

    Gray, Meeghan E; Cameron, Elissa Z

    2010-01-01

    The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species.

  19. [Diagnosis and treatment of varicose veins: part 2: therapeutic procedures and results].

    Science.gov (United States)

    Nüllen, H; Noppeney, T

    2010-12-01

    This is the second of two articles on the diagnosis and treatment of varicose veins. Primary varicosis is a congenital degenerative disease of the peripheral venous system of the lower extremities. Treatment is carried out according to an individualized concept which takes the incurability and progression of the disease into consideration. Conservative treatment with compression bandages is an option for all forms of varicosis and the accompanying complications. Veins can be specifically ablated by sclerotherapy of varices. In addition to high ligation and stripping mini-phlebectomy and subfascial endoscopic perforator surgery (SEPS) can also be performed. The indications in cases of SEPS should be extremely limited because of possible severe complications. Radiofrequency ablation (RFO) and endovenous laser therapy (ELT) are also available as endovenous therapy options. Information in the literature on recurrence rates of the various procedures is extremely variable and the reasons for recurrent varicosis are the subject of controversy. The data relating to the results of RFO and ELT are relatively good and both procedures show a significant improvement in quality of life and the venous clinical severity score (VCSS).

  20. Results of surgical treatment versus chemoradiation therapy in oropharyngeal early tumors

    Directory of Open Access Journals (Sweden)

    Chedid, Helma Maria

    2009-03-01

    Full Text Available Introduction: The epidermoid carcinoma of the upper aerodigestive tract is diagnosed in approximately 40% of the cases of advanced clinical stages. Objective: To evaluate the disease-free interval in patients with clinical stages I and II epidermoid carcinoma who were submitted to surgery or chemoradiation. Method: Retrospective study of the records of 139 patients treated for oropharyngeal epidermoid carcinoma submitted to treatment with curative intent. Among those patients, 38 were classified with early tumors clinical stages I and II. Twenty-seven (71.1% underwent surgical treatment whereas eleven (28.9% were treated with chemoradiation. The mean age was 56.4 years; 31 cases (81.6% were in men and seven (18.4% were in women. Results: Among the eleven patients who were submitted to chemoradiation, 72.7% obtained locoregional control of the disease and their disease-free survival was of 42%. Among the 27 patients operated, 19 remained in Clinical Stages I and II in the histological report and six underwent postoperative radiation therapy. The disease-free interval for two years was of 70%. Conclusion: The patients submitted to the surgery had a better disease-free interval as compared to those submitted to chemoradiation treatment.

  1. Treatment Result in the Initial Stage of Kanazawa Mobile Embolectomy Team for Acute Ischemic Stroke

    Science.gov (United States)

    UCHIYAMA, Naoyuki; MISAKI, Kouichi; MOHRI, Masanao; KAMIDE, Tomoya; HIROTA, Yuichi; HIGASHI, Ryo; MINAMIDE, Hisato; KOHDA, Yukihiko; ASAHI, Takashi; SHOIN, Katsuo; IWATO, Masayuki; KITA, Daisuke; HAMADA, Yoshitaka; YOSHIDA, Yuya; NAKADA, Mitsutoshi

    2016-01-01

    Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy. In this article, we report early treatment outcomes and validate the effectiveness of a network between affiliated hospitals and KMET. Between January 2014 and December 2015, 48 patients, aged 45–92 years (mean: 73.0 years), underwent acute reperfusion therapy provided by KMET in 10 affiliated hospitals of Kanazawa University Hospital. The pre-treatment NIHSS scores ranged from 5 to 39 (mean: 19.1). ASPECTS+W ranged from 1 to 11 (mean: 7.3). Successful revascularization, defined as thrombolysis in cerebral infarction (TICI) 2b or 3, was achieved in 38/48 cases (80%), and a good outcome, defined as modified Rankin Scale (mRS) score from 0 to 2 at 90 days after the treatment, was achieved in 24/48 cases (50%). There were two cases of intracranial bleeding (4%). Mean time from onset to recanalization was 297 min. These results, which are similar to those of five previous RCTs, suggest that a collaborative network between affiliated hospitals and KMET is effective for acute reperfusion therapy in local areas wherein experienced neuroendovascular specialists are insufficient. PMID:27725522

  2. Radiofrequency ablation of hepatic metastasis: Results of treatment in forty patients

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    Rath G

    2008-01-01

    Full Text Available Aim: To evaluate the local control of hepatic metastasis with radiofrequency ablation treatment. Materials and Methods: We did a retrospective analysis in 40 patients treated with radiofrequency ablation for hepatic metastasis. The tumors ablated included up to two metastatic liver lesions, with primaries in breast, gastrointestinal tract, cervix, etc. Radiofrequency ablation was performed under general anesthesia in all cases, using ultrasound guidance. Radionics Cool-Tip RF System was used to deliver the treatment. Results: The median age of patients treated was 49 years. There were 13 female and 27 male patients. The median tumor size ablated was 1.5 cm (0.75-4.0 cm. A total of 52 radiofrequency ablation cycles were delivered. Successful ablation was achieved in all patients with hepatic metastasis less than 3 cm in size. Pain was the most common complication seen (75%. One patients developed skin burns. At 2-year follow-up 7.5% of patients had locally recurrent disease. Conclusions: Radiofrequency ablation is a minimally invasive treatment modality. It can be useful in a select group of patients with solitary liver metastasis of less than 3 cm size.

  3. Treatment results of combined platelet-rich plasma and fat injection in patients with velopharyngeal insufficiency

    Directory of Open Access Journals (Sweden)

    Hamid Reza Fathi

    2013-10-01

    Full Text Available Background: Velopharyngeal insufficiency causes hypernasal vocal quality and can also result in audible nasal air emission and difficulty in producing pressure consonants. The resulting speech is often socially unacceptable and can be difficult to understand. Platelet-rich plasma is an autologous derivative of whole blood. Today, the importance of clinical use of Platelet-rich plasma in the plastic surgery is considered. This study was designed to evaluate the effectiveness of combined Platelet-rich plasma and fat injection in the treatment of velopharyngeal insufficiency. Methods: In this prospective clinicaltrial study, of 15 patients including 9 males and 6 females and aged 15-20 years with mild/ moderate velopharyngeal insufficiency who were injected with 5 mL of combined Platelet-rich plasma (1 mL and fat (4 mL in the front volume in the posterior pharyngeal wall in the pre-vertebral fascia under sedation. Speech samples were recorded by nasoendoscopy before the injection, and at 6 weeks and 6 months after the injection. Assessment of pathologic speech was done by speech therapist. Results: Velar displacement showed significantly increased at 6 weeks after the injection (P=0.049. Velopharyngeal gap disappeared in 60% of patients at 6 weeks after the injection (P=0.019. Lateral pharyngeal wall movement showed significantly increased in 73.3% of the patients at 6 months after the injection (P=0.04. After the treatment, aerodynamic assessment showed significantly decreased in nasal air escape during phonation and repeat the words (P<0.05. Assessment speech therapist showed significantly improve quality of phonation in these patients (P<0.05. Conclusion: It seems that, combined Platelet-rich plasma and fat injection lead to improve voice resonance and reduce nasal air escape in all treated cases. It can be a promising alternative to major procedures, such as velopharyngoplasties, for the treatment of mild/ moderate velopharyngeal insufficiency.

  4. Femtosecond laser for glaucoma treatment: the comparison between simulation and experimentation results on ocular tissue removal

    Science.gov (United States)

    Hou, Dong Xia; Ngoi, Bryan K. A.; Hoh, Sek Tien; Koh, Lee Huat K.; Deng, Yuan Zi

    2005-04-01

    In ophthalmology, the use of femtosecond lasers is receiving more attention than ever due to its extremely high intensity and ultra short pulse duration. It opens the highly beneficial possibilities for minimized side effects during surgery process, and one of the specific areas is laser surgery in glaucoma treatment. However, the sophisticated femtosecond laser-ocular tissue interaction mechanism hampers the clinical application of femtosecond laser to treat glaucoma. The potential contribution in this work lies in the fact, that this is the first time a modified moving breakdown theory is applied, which is appropriate for femtosecond time scale, to analyze femtosecond laser-ocular tissue interaction mechanism. Based on this theory, energy deposition and corresponding thermal increase are studied by both simulation and experimentation. A simulation model was developed using Matlab software, and the simulation result was validated through in-vitro laser-tissue interaction experiment using pig iris. By comparing the theoretical and experimental results, it is shown that femtosecond laser can obtain determined ocular tissue removal, and the thermal damage is evidently reduced. This result provides a promising potential for femtosecond laser in glaucoma treatment.

  5. Result of arthroscopic treatment of pigmented villonodular synovitis of the knee.

    Science.gov (United States)

    De Ponti, Alessandro; Sansone, Valerio; Malcherè, Marco

    2003-01-01

    We report 10 years' experience in arthroscopic treatment of pigmented villonodular synovitis (PVNS) of the knee in a series of patients affected by the localized or diffuse form of the disease. The purpose of the study is to critically examine the results of arthroscopic synovectomy in the knee affected by PVNS, to determine the safety and effectiveness of the procedure. Retrospective case analysis. The study population consists of 19 patients, with an average follow-up of 60 months (minimum, 12; maximum, 128). All patients underwent knee arthroscopy. The 3 standard portals were used; posteromedial and posterolateral portals were added if required. Four patients were affected by localized PVNS and were subject to partial synovectomy with excision of the pathologic tissue. The remaining 15 patients presented a diffuse form of PVNS; 7 of them underwent extended arthroscopic synovectomy and 8 underwent partial synovectomy. The diagnosis was confirmed by synovial biopsy. In the group affected by the localized form of PVNS, the arthroscopic local excision resulted in a complete and persistent regression of the pathology. Among the patients affected by the diffuse form of PVNS, clinical results were better and the recurrence rate was lower in the group treated with extended synovectomy. No relevant complications were encountered. In particular, no cases of infection, stiffness, or neurovascular lesions were seen. Arthroscopic synovectomy is an appropriate treatment for knee PVNS. Extended synovectomy must be performed in all cases of diffuse PVNS.

  6. RESULTS OF SURGICAL TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURES OF LONG BONES USING INTRAMEDULLARY ELASTIC NAIL

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-12-01

    Full Text Available BACKGROUND Among the various methods of treating the long bone fractures in children less than 5yrs (POP cast and adolescents 16yrs (IMN, flexible intramedullary nail has gained importance because of its stability, not violating the physis and less complications and early rehabilitation. Irrespective of mode of treatment, goal shall be to achieve union at fracture site, control length and alignment, minimize the morbidity and complications for patient and their family. MATERIALS AND METHODS A prospective study was conducted on children of both sexes, between the age group of 5-15yrs with diaphyseal fractures of long bones, meeting the inclusion and exclusion criteria during the study period at RRMCH (September 2012 to September 2014. Totally, 30 cases were evaluated clinically and radiologically and followed up at 3, 6, 12, 24 weeks after surgery. Final outcome was assessed using Flynn’s criteria for Tens Scoring System. RESULTS Results of entire, 30 patients were followed up for an average of 6 months, was excellent in 19(63% cases and satisfactory in 11(37% cases and no poor outcome. CONCLUSION Based on this study and result, we found that intramedullary elastic nailing technique is an ideal method for treatment of pediatric femoral and tibial diaphyseal fractures.

  7. CLINICAL RESULTS FROM THE TREATMENT OF CHRONIC SKIN WOUNDS WITH PLATELET RICH PLASMA (PRP)

    OpenAIRE

    2015-01-01

    PURPOSE: To show platelet rich plasma (PRP) application of chronic skin wounds and to evaluate the results from the treatment. MATERIAL AND METHODS: A total of 14 patients with problematic skin wounds had been treated at the clinic for a period of five years (from May 2009 to December 2014) with the following patient sex ratio: male patients - 5 and female patients - 9. Average age - 48,5 (30-76). Patients with Type 2 Diabetes - 4, with decubitus ulcers - 6, traumatic - 8, with infection -...

  8. The Structural and Strength Changes Resulting from Modification of Heat Treatment of High Carbon Steel

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    Grygier D.

    2016-06-01

    Full Text Available Pearlitic steels containing from some 0,8 to 0,95% C belong to the group of unalloyed steels intended for cold drawing or rolling. One of the problems discussed in literature is cracking of pearlitic steel subjected to plastic working, caused by high brittleness of the lamellar precipitations of hard cementite. This issue is extremely important because it affects significantly reduce fatigue strength. The paper presents proposals to modify the process of heat treatment, results in getting a steel with spheroidal structure characterized by better plastic properties, in order to eliminate this problem.

  9. Results of treatment of acute liver failure patients with use of the prometheus FPSA system.

    Science.gov (United States)

    Grodzicki, M; Kotulski, M; Leonowicz, D; Zieniewicz, K; Krawczyk, M

    2009-10-01

    Herein we have presented the results of treatment of acute liver failure (ALF) patients with the use of the Prometheus FPSA dialysis system. To January 2009, we performed 278 FPSA procedures in 114 patients, including 52 experience and ALF. The patients who underwent the FPSA procedure consisted of 32 women and 20 men of overall mean age of 33 +/- 12 years. The causes of ALF were: Wilson's disease (n = 15), unknown origin ALF (n = 11), amanita phalloides intoxication (n = 7), paracetamol intoxication (n = 8), acute hepatitis B virus (HBV)/hepatitis C virus (HCV) infection (n = 7), liver insufficiency after parenchymal resection (n = 2) drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome (n = 1), rabdomyolysis (n = 1), or primary nonfunction (PNF) after orthotopic liver transplantation (OLT) (n = 1). All procedures were performed using the Prometheus 4008H Fresenius Medical Care liver support system. The average number of treatments per patient was 2.41 and the average time for each FPSA treatment was 6.3 hours. The average heparin dose used during the procedure was 750 IU/h. After the whole treatment regimen, we observed significant improvements in the biochemical results. The average concentrations improved: serum ammonia (before 249.2 mug/dL versus after 109.7 mug/dL); serum bilirubin (before 21.53 mg/dL versus after 8.81 mg/dL), serum aspartate aminotransferase (AST; before 2456.4 U/L versus after 1068.8 U/L); serum alanine aminotransferase (ALT; before 2958.2 U/L versus after 1595.8 U/L); serum urea (before 58.5 mg/dL versus after 21.1 mg/dL); serum creatinine (before 2.9 mg/dL versus after 1.7 mg/dL); and pH value (before 7.11 versus after 7.32). After Prometheus treatment OLT was performed in 33 patients. Among the 28 who survived (53.8%), 22 underwent OLT and 6 did not have OLT. Among the 24 patients who died (46.2%), 13 were before OLT and 11 after OLT. The Prometheus 4008H Fresenius Medical Care Liver support system was useful method of

  10. Chronic antidepressant treatments resulted in altered expression of genes involved in inflammation in the rat hypothalamus.

    Science.gov (United States)

    Alboni, Silvia; Benatti, Cristina; Montanari, Claudia; Tascedda, Fabio; Brunello, Nicoletta

    2013-12-05

    To gain insight into the possible immune targets of antidepressant, we evaluated the expression of several inflammatory mediators in the hypothalamus of rats chronically (28 days) treated with the serotonin selective reuptake inhibitor fluoxetine (5mg/kg, i.p.) or the tricyclic compound imipramine (15 mg/kg, i.p.). We focused our attention on the hypothalamus as it plays a key role in determining many of the somatic symptoms experienced by depressed patients. This brain region, critical also for expression of motivated behaviours, participates in the control of the hypothalamic-pituitary-adrenal axis activity and in stress response as well as coordinates physiological functions such as sleep and food intake that have been found altered in a high percentage of depressed patients. Notably, hypothalamus is a key structure for brain cytokine expression and function as it integrates signals from the neuro, immune, endocrine systems. By means of quantitative Real Time PCR experiments we demonstrated that a chronic treatment with either fluoxetine or imipramine resulted in a reduction of IL-6 and IFN-γ mRNAs and increased IL-4 mRNA expression in the rat hypothalamus. Moreover, we demonstrated that hypothalamic expression of members of IL-18 system was differentially affected by chronic antidepressant treatments. Chronically administered fluoxetine decreased IL-8 and CX3CL1 hypothalamic expression, while a chronic treatment with imipramine decreased p11 mRNA. Our data suggest that a shift in the balance of the inflammation toward an anti-inflammatory state in the hypothalamus may represent a common mechanism of action of both the chronic treatments with fluoxetine and imipramine. © 2013 Published by Elsevier B.V.

  11. Results of the treatment of keratocystic odontogenic tumours using enucleation and treatment of the residual bony defect with Carnoy's solution.

    Science.gov (United States)

    Leung, Y Y; Lau, S L; Tsoi, K Y Y; Ma, H L; Ng, C L

    2016-09-01

    This retrospective study aimed to investigate the recurrence rate of keratocystic odontogenic tumours (KCOTs) treated by enucleation and the application of Carnoy's solution, and to assess the surgical morbidities associated with this treatment. KCOTs treated using a standard protocol of enucleation and the application of Carnoy's solution between 1990 and 2013 were evaluated. One hundred and five KCOTS in 105 patients (54 male, 51 female) were analysed. The mean follow-up period was 86.6 months (range 24-313 months). The recurrence rate was 11.4%. A postoperative inferior alveolar nerve neurosensory deficit occurred in 30.1% of the mandibular cases, with 16% of these being permanent. The postoperative infection and fracture rates were 1.9% and 0.9%, respectively. Younger age, multilocular KCOTs, larger tumour size, and longer antero-posterior lesion length on the radiograph were found to be risk factors for recurrence. It is concluded that enucleation and the application of Carnoy's solution to treat KCOTs results in a relatively low recurrence rate and a low rate of surgical morbidities.

  12. Treatment results of adjuvant radiotherapy and chemotherapy in breast cancer patients with positive axillary nodes

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyun Soo [College of Medicine, Pochon CHA Univ, Sungnam (Korea, Republic of); Suh, Chang Ok [College of Medicine, Yonsei Univ, Seoul (Korea, Republic of)

    2000-12-01

    Between January 1983 and December 1988, 218 female patients with known breast cancer and positive axillary nodes were treated with adjuvant radiotherapy and chemotherapy following radical mastectomy. Treatment results were retrospectively analysed at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University of College of Medicine. The patients were classified into 3 groups; group 1 included 80 patients treated with adjuvant chemotherapy alone; in group 2, 52 patients treated with radiotherapy alone; and in group 3, 86 patients treated with combined chemo-radiotherapy. The mean age was 44 years and ranged from 27 to 70. The median follow-up time was 51 months. Seven-year relapse free and overall survival rates were 56% and 67%; in group 1, 50% and 56%; in group 2, 51% and 65%; and in group 3, 62% and 75% respectively. This difference was not statistically significant(p<0.05). The loco-regional failure rates were 13% and distant failure rates were 33%. There was less risk of loco-regional failure in group 2 and 3 which included radiotherapy (.0<0.05). But there was no significant y difference in the rates of distant failure(p>0.05). By univariate analysis, the only significant prognostic factor affecting relapse-free survival was the percentage of positive axillary nodes; and the overall survival significantly correlated with the primary tumor size, the number or percentage of positive axillary nodes, and stage. But in multivariate analysis, the only significant prognostic factor was treatment modality. By univariate analysis of prognostic factors affecting the rates of overall failure and distant failure, the significant prognostic factors was the percentage of positive axillary nodes; and the risk of the loco-regional failure significantly correlated with the treatment modality. In conclusion, these results suggest a potential for decreasing the risk of loco-regional failure with the addition of postoperative radiotherapy to chemotherapy in the

  13. Long-term results of surgical treatment of pigmented villonodular synovitis of the knee.

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    Akinci, Orhan; Akalin, Yavuz; İncesu, Mustafa; Eren, Ahmet

    2011-01-01

    The aim of this study was to evaluate the long-term results of total synovectomy in pigmented villonodular synovitis of the knee (PVNS). Open total synovectomy was performed for 19 patients (9 men, 10 women; mean age: 42.8 years) with PVNS. Of these patients, 15 had diffuse and 4 localized PVNS. The patients were followed for an average of 80.2 months and the average time between the onset of complaints and surgery was 23 months. In 4 patients, PVNS was identified during total knee replacement (TKR) performed due to gonarthrosis. Radiotherapy was performed as an adjuvant treatment in one patient with recurrence. Puncture was performed in 11 patients due to effusion and 8 to 70 cc of fluid was aspirated. Diagnosis was made during the exposure for TKR in 4 patients, by a biopsy in 2 and based on joint puncture and MRI findings in the rest. Recurrence occurred in 5 patients. A second total synovectomy was performed in 4 patients. Radiotherapy was used for the remaining one patient. Two patients were operated three times. During the follow-up, TKR was performed in 7 of the 19 patients. None of the patients developed infection and hemarthrosis requiring puncture nor required amputation or arthrodesis. Three patients had a postoperative knee joint stiffness of 10 to 25 degrees. The patients were evaluated according to the Knee Society Score and 8 (42.2%) had perfect, 9 (47.3%) good and 2 (10.5%) bad results. PVNS is a disease with a high risk of recurrence. No individual or combined treatment method can offer a definitive solution. Open or arthroscopic radical synovectomy is still considered as the gold standard. If necessary, adjuvant intraarticular or extraarticular radiotherapy can be added to the treatment.

  14. First-year treatment costs among new initiators of topical prostaglandin analogs: pooled results

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    Jordana K Schmier

    2010-05-01

    Full Text Available Jordana K Schmier1, David W Covert21Managing Scientist, Exponent Inc., Alexandria, VA, USA; 2Associate Director, Health Economics, Alcon Research Ltd., Ft. Worth, TX, USAObjective: To estimate first-year treatment costs among new initiators of topical prostaglandin analogs in a managed care population.Research design and methods: A model was developed to estimate first-year medical costs. Model inputs were based on weighted results from three previous studies. Treatment patterns were derived from a claims database analysis. Published studies were used to estimate visit-related resource use. Costs were obtained from standard sources.Results: Across studies, 27,809 patients met study criteria, 44.2% of whom remained on their index therapy for 12 months. Adjunctive therapy was needed in 22.5%, 18.5%, and 11.9% of bimatoprost, latanoprost, and benzalkonium chloride (BAK-free travoprost patients, respectively. Median days to initiating adjunctive therapy were 64, 67, and 127 for bimatoprost, latanoprost, and BAK-free travoprost patients. Estimated first-year medical costs were $1,945, $1,803, and $1,730 for patients initiating therapy with bimatoprost, latanoprost, and BAK-free travoprost. Findings were consistent through sensitivity analysis.Conclusions: A BAK-free prostaglandin analog may permit longer duration of monotherapy and be associated with lower first-year treatment costs. Use of a claims database and the selection of new initiators of prostaglandin analogs limit the ability to project findings to all glaucoma patients.Keywords: costs and cost analysis, drug therapy, combination, glaucoma, prostaglandin analogs

  15. Systematic Review of Results of Kissing Stents in the Treatment of Aortoiliac Occlusive Disease.

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    Groot Jebbink, Erik; Holewijn, Suzanne; Slump, Cornelis H; Lardenoije, Jan-Willem; Reijnen, Michel M P J

    2017-07-01

    Endovascular treatment of aortoiliac occlusive disease (AIOD) involving the aortic bifurcation is challenging. The gold standard is open surgery with patency rates up to 90% at 5 years, but has considerable morbidity and mortality. The kissing stent (KS) technique was introduced as an alternative. The goal of this review is to give an overview of the current results and role of the KS technique in AIOD treatment. The Cochrane guidelines were used to assure a systematic method. A search query designed in the Scopus search interface was used to identify relevant studies. Abstracts from the search were screened against the inclusion and exclusion criteria. During full-text reading, methodological quality was scored using a critical review list tailored to the topic of AIOD. Thereafter, study data were extracted and pooled for further analysis. In total, 143 abstracts were retrieved using Scopus, 116 were rejected and 7 more were rejected after full-text screening. One study was included after cross referencing. Twenty-one studies presented 1,390 patients. Rutherford classification 1/2/3 was the indication in 76.2% of patients, and 48.4% of the lesions were classified as Trans-Atlantic Inter-Society Consensus C or D. The technical success rate was 98.7%, and the complication rate was 10.8%. Clinical improvement at 30 days was achieved in 89.9%. Primary patency at 12, 24, and 60 months was 89.3%, 78.6%, and 69.0%, respectively. KS treatment of AIOD yields acceptable mid-term results, with high technical success rates and mostly minor complications occur. The long-term patency cannot yet match that of open surgery, underlining the need for further research that provides insight into factors related to reocclusion. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. [Treatment results of neuroblastoma in children in the Republic of Belarus].

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    Proleskovskaia, I V; Savich, T V; Mareĭko, Iu E; Savva, N N; Aleĭnikova, O V

    2009-01-01

    Our investigation was concerned with effectiveness of infantile neuroblastoma treatment in Belarus and dependence of prognosis on extent of radical surgery. The study involved 115 patients with morphologically confirmed diagnosis of primary tumor who were treated at the Center (1997-2007). Ten-year overall and relapse-free survival rates for favorable prognosis, stage I, II, III, were 1.00 and 0.94 +/- 0.04, respectively. They were significantly higher than those for intermediate (0.70 +/- 0.09 and 0.61 +/- 0.09) or high risk (0.32 +/- 0.08 and 0.27 +/- 0.08), respectively, (p < or = 0.01). The results for radical local surgery were better: 5-year relapse-free survival--0.82 +/- 0.09 as compared with subtotal excision (0.62 +/- 0.12) and biopsy (0.5 +/- 0.25) among patients older than 12 months. Autologous stem cell transplantation (ASCT) was followed by significant improvement: 6-year overall and relapse-free survival (stage IV) (0.5 +/- 0.12 and 0.38 +/- 0.12, respectively) as compared those without ASCT (0.12 +/- 0.08 and 0.1 +/- 0.08), respectively, (p < or = 0.01). The main cause of death after ASCT was relapse. Poor results following post-ASCT treatment of stage IV tumor should be improved by more effective detection and removal of tumor cell harvest.

  17. Photodynamic therapy with green light for the treatment of vulvar lichen sclerosus - Preliminary results.

    Science.gov (United States)

    Osiecka, B J; Jurczyszyn, K; Nockowski, P; Murawski, M; Ziółkowski, P

    2017-03-01

    The standard treatment for lichen sclerosus (LS) is symptomatic and is primarily based on the chronic use of corticosteroids, sometimes resulting in unsatisfactory effects. Therefore, other non-pharmacological methods are being sought, which are less aggravating for the patient. LS can be treated topically by using photodynamic therapy (PDT) based on 5-aminolevulinic acid (5-ALA). Unfortunately, therapy with the red light is often connected with severe local pain during the illumination. Green light can also be characterised by its ability to turn on photodynamic reactions in cells. The aim of this study was an evaluation into the efficacy and tolerance of 5-ALA-PDT with a green light (540nm±15nm) in 11 patients with chronic LS that were characterised by severe itching. The disease lasted from 1.5 to 4 years. All the patients were treated with three sessions of PDT. Following treatment with PDT, a significant improvement of local status, as well as a reduction of the main symptom (pruritus), were observed. No patient complained of severe pain during the sessions that would have required an interruption of irradiation or local application of analgesics. Our preliminary results of using green light in PDT for superficial skin non-oncological lesions are very promising but require further studies. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

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    Hassan BOUSSAKRI

    2016-03-01

    Full Text Available This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4 of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP, as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%. 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.

  19. Results of operative treatment for recalcitrant retrocalcaneal bursitis and midportion Achilles tendinopathy in athletes.

    Science.gov (United States)

    Lohrer, Heinz; Nauck, Tanja

    2014-08-01

    The results of operative treatment for recalcitrant midportion Achilles tendinopathy and recalcitrant retrocalcaneal bursitis were evaluated using the patient administered, disease specific, and validated VISA-A-G questionnaire. A cohort of 89 patients was prospectively followed. These patients underwent operations for sport induced midportion Achilles tendinopathy (39 procedures) or retrocalcaneal bursitis (55 procedures). Depending on the individual intraoperative findings the patients of either disease were treated with two respective operative modifications (tendon repair or no tendon repair). Preoperative and follow-up status (3, 6, and 12 months) were investigated using the VISA-A-G questionnaire. Preoperatively, the four groups scored from 37.0 ± 17.6 to 45.9 ± 15.2 (p = 0.376-0.993) on the VISA-A-G questionnaire. Six and 12 months postoperatively, the VISA-A-G scores improved significantly (p bursitis and midportion Achilles tendinopathy responded equally well to operative treatment. When repaired, additional tendon lesions did not influence this result. We demand to differentiate not only between midportion Achilles tendinopathy and retrocalcaneal bursitis but also to identify additional Achilles tendon lesions to specifically address these lesions during operative procedures.

  20. RESULTS OF THE USE OF PEEK CAGES IN THE TREATMENT OF BASILAR INVAGINATION BY GOEL TECHNIQUE

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    Luís Eduardo Carelli Teixeira da Silva

    2016-03-01

    Full Text Available ABSTRACT Objective: Analysis of the use of polyetheretherketone (PEEK cages for atlantoaxial facet realignment and distraction for treatment of basilar invagination by Goel technique. Method: Retrospective descriptive statistical analysis of the neurological status, pain, presence of subsidence and bone fusion with the use of PEEK cages in 8 atlantoaxial joints of 4 patients with basilar invagination. All patients were treated with atlantoaxial facet distraction and realignment and subsequent arthrodesis C1-C2 by the technique of Goel modified by the use of PEEK cage. Results: All patients showed improvement in Nurick neurological assessment scale and Visual Analogue Scale (VAS of pain. There were no cases of subsidence, migration, or damage to the vertebral artery during the insertion of the cage. All joints evolved with bone fusion, assessed by dynamic radiographs, and computed tomography. Two patients developed neuropathic pain in dermatome of C2 and one patient had unilateral vertebral artery injury during C2 instrumentation treated with insertion of pedicle screw to control the bleeding. Conclusion: The results of the treatment of basilar invagination by the Goel technique with the use of PEEK cages shown to be effective and safe although further studies are needed to confirm this use.

  1. Traumatic Cataract, Results of Surgical Treatment. Sancti Spíritus. 2005-2009.

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    Alina Abella Bonachea

    2012-04-01

    Full Text Available The traumatic cataract constitutes a challenge for the surgeon of the previous segment. It can be presented as a consequence of any type of ocular trauma or -penetrating traumatism with bigger frequency correlated to corneal injuries that they can implicate the iris. It was made a descriptive retrospective observacional study of all of the patients with this diagnosis who went to Oftalmology's consultation during the period of 1ro of January 2005 to September 30, 2009 at Sancti Spíritus's Hospital General, with the objective to describe the surgical treatment results of it with the implantation of intraocular lens and the most frequent complications of traumatic cataract. The population and sample was: 14 patients, totality. Datas were processed in tables and inferential statistics. In 85.7 % of patients were implanted intraocular lens, and it was used Blumenthal's surgical technique. The more frequent trans-operative complication was the losses of vitreous and the more frequent postoperative complications were the moderate corneal edema and the ocular hypertension. The election treatment is the surgical one, obtaining similar results than conventional surgery of cataract if the posterior segment is undamaged, in these cases the visual prognostic is very favorable.

  2. Treatment results in women with clinical stage I and pathologic stage II endometrial carcinoma.

    Science.gov (United States)

    Jobsen, J J; Schutter, E M; Meerwaldt, J H; Van Der Palen, J; Van Der Sijde, R; Ten Cate, L N

    2001-01-01

    The aim of this study is to report survival and results of therapy and possible prognostic factors in women with pathologic stage II endometrial carcinoma. Forty-two patients with pathologic stage II endometrial carcinoma were treated at the department of Radiation Oncology of the Medisch Spectrum Twente between 1987 and 1998. All patients received external radiotherapy following standard surgical procedures and no adjuvant systemic therapy was given. From the 42 patients 21 had a pathologic stage IIA and 21 stage IIB. The median follow-up was 62 months. The overall recurrence rate was 21.5% (9/42). Seven patients had distant metastasis, of which three also had locoregional recurrence, vaginal vault and/or pelvic. The presence of myometrial invasion (> (1/2)) and/or lymph-angioinvasion showed a significant relation with distant metastasis (P = 0.017). Stage IIB showed more recurrences, 33% (7/21). There was a significant different 5-year disease specific survival for stage IIA and IIB, respectively, 95% and 74% (P = 0.0311). Patients with a differentiation grade 3 and stage IIB showed a significantly poorer (P = 0.003) 5-year survival of 48.6% (P = 0.003). Results obtained in the present series of patients are in accordance with the literature. The present treatment policy seems justified, except for patients with pathologic stage IIB and grade 3, in which a more aggressive treatment should be considered.

  3. Surgical and conservative treatment of patients with congenital scoliosis: α search for long-term results

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    Weiss Hans-Rudolf

    2011-06-01

    Full Text Available Abstract Background In view of the limited data available on the conservative treatment of patients with congenital scoliosis (CS, early surgery is suggested in mild cases with formation failures. Patients with segmentation failures will not benefit from conservative treatment. The purpose of this review is to identify the mid- or long-term results of spinal fusion surgery in patients with congenital scoliosis. Methods Retrospective and prospective studies were included, reporting on the outcome of surgery in patients with congenital scoliosis. Studies concerning a small numbers of cases treated conservatively were included too. We analyzed mid-term (5 to 7 years and long-term results (7 years or more, both as regards the maintenance of the correction of scoliosis and the safety of instrumentation, the early and late complications of surgery and their effect on quality of life. Results A small number of studies of surgically treated patients were found, contained follow-up periods of 4-6 years that in the most cases, skeletal maturity was not yet reached, and few with follow-up of 36-44 years. The results of bracing in children with congenital scoliosis, mainly in cases with failure of formation, were also studied. Discussion Spinal surgery in patients with congenital scoliosis is regarded in short as a safe procedure and should be performed. On the other hand, early and late complications are also described, concerning not only intraoperative and immediate postoperative problems, but also the safety and efficacy of the spinal instrumentation and the possibility of developing neurological disorders and the long-term effect these may have on both lung function and the quality of life of children. Conclusions Few cases indicate the long-term results of surgical techniques, in the natural progression of scoliosis. Similarly, few cases have been reported on the influence of conservative treatment. In conclusion, patients with segmentation failures

  4. Surgical and conservative treatment of patients with congenital scoliosis: α search for long-term results

    Science.gov (United States)

    2011-01-01

    Background In view of the limited data available on the conservative treatment of patients with congenital scoliosis (CS), early surgery is suggested in mild cases with formation failures. Patients with segmentation failures will not benefit from conservative treatment. The purpose of this review is to identify the mid- or long-term results of spinal fusion surgery in patients with congenital scoliosis. Methods Retrospective and prospective studies were included, reporting on the outcome of surgery in patients with congenital scoliosis. Studies concerning a small numbers of cases treated conservatively were included too. We analyzed mid-term (5 to 7 years) and long-term results (7 years or more), both as regards the maintenance of the correction of scoliosis and the safety of instrumentation, the early and late complications of surgery and their effect on quality of life. Results A small number of studies of surgically treated patients were found, contained follow-up periods of 4-6 years that in the most cases, skeletal maturity was not yet reached, and few with follow-up of 36-44 years. The results of bracing in children with congenital scoliosis, mainly in cases with failure of formation, were also studied. Discussion Spinal surgery in patients with congenital scoliosis is regarded in short as a safe procedure and should be performed. On the other hand, early and late complications are also described, concerning not only intraoperative and immediate postoperative problems, but also the safety and efficacy of the spinal instrumentation and the possibility of developing neurological disorders and the long-term effect these may have on both lung function and the quality of life of children. Conclusions Few cases indicate the long-term results of surgical techniques, in the natural progression of scoliosis. Similarly, few cases have been reported on the influence of conservative treatment. In conclusion, patients with segmentation failures should be treated

  5. Changes in somatic disease incidents during opioid maintenance treatment: results from a Norwegian cohort study

    Science.gov (United States)

    Brekke, Mette; Gossop, Michael; Lindbaek, Morten; Reinertsen, Even; Thoresen, Magne; Waal, Helge

    2011-01-01

    Objectives To examine the effect of opioid maintenance treatment (OMT) on somatic morbidity in a cohort of OMT patients. Design Retrospective cohort study. Setting OMT programme in two Norwegian counties. Participants 200 OMT patients, participation rate 71.2%. Main outcome measures Incidence rates (IR) before, during and after OMT for acute/subacute hospital-treated somatic disease incidents (drug-related, non-drug-related, injuries) and rates for inpatient days and outpatient treatment contacts. Results IR for drug-related hospital treatment episodes were 76% lower during compared to before OMT (before versus during incidence rate ratio (IRR) 4.2 (95% CI 2.9 to 6.2), pOMT (after versus during IRR 11.1 (6.6 to 18.5), pOMT (before versus during IRR 0.7 (0.6 to 1.0), p=0.02) and 32% higher after compared to during OMT (IRR 1.4 (0.9 to 2.2), p=0.15), while injuries showed little change according to OMT status. Although patients with on-going drug-taking during OMT showed less reduction in drug-related hospital-treated incidents during treatment than patients not using illicit drugs, the quartile with most drug-taking showed a significant reduction (before versus during IRR 3.6 (2.4 to 5.3)). Patients who had experienced cessation of OMT showed a significant reduction in drug-related treatment episodes during OMT (before versus during IRR 1.7 (1.0 to 2.9)), although less than patients without OMT interruptions (before versus during IRR 6.1 (3.6 to 10.6)), and a significant increase after OMT cessation compared with during OMT (IRR 5.4 (3.0 to 9.7)). Conclusion Acute/subacute drug-related somatic morbidity is reduced during compared to before OMT. This was also found for patients with on-going drug-taking during OMT. However, acute drug-related health problems show an increase after OMT cessation, and this is a matter of concern. Further studies on somatic morbidity after OMT cessation should be carried out. PMID:22021771

  6. Results of surgical treatment of cervical cancer patients of childbearing age

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    V. S. Navruzova

    2015-01-01

    Full Text Available The world marked increase in the incidence of cervical cancer in young women, especially from 29 to 45 years old. Analysis showed that in patients with preserved ovarian function, not only the effectiveness of the treatment, but also the quality of life. It is associated with the acceleration, earlier puberty and the onset of sexual activity. In recent years more and more widely used radical surgery with preservation of the ovaries and the abduction of the radiation castration and preservation of reproductive function. In the National Cancer Research Centre of the Ministry of Health of the Republic of Uzbekistan analyzed the results of surgical treatment of 204 patients with cervical cancer younger. Age of patients from 23 to 45 years, that is, in the most hard-working, reproductive period. In our study patients met principally with exophytic – 82 (40.2 % and 68 (33.3 % еndophytic growth cervical tumors. Histological in 197 (96.6 % patients with squamous cervical cancer patients with 7 (3.4%. Adenocarcinoma of cervical cancer. Handard examination of the patient are further adapted to determine the level of sex hormones (estradiol, progesterone, determination of the tumor marter CA-125 levels of calcium and phosphate in the blood. 112 patients from the main group and the combined complex therapy surgical treatment with organ-component (conservation and ovarian transposition. The first group included 112 (55.1 % patients, who as part of combination therapy was performed and complex surgical treatment of ovarian transposition. The second group included 92 (44.9% patients who as part of combination therapy and complex surgery performed without ovarian transposition. Each group was divided into 3 subgroup included patients with stage process T1b–2aN0M0. Which performs the combined radiotherapy. The second subgroups included patients with stage process that runs systemic chemotherapy, surgery, combined radiotherapy. The third group included

  7. [CRITERIA OF ESTIMATION AND RESULTS OF TREATMENT OF IATROGENIC INJURIES OF URETERS IN ONCOLOGICAL PATIENTS].

    Science.gov (United States)

    Kononenko, O A; Stakhovskiy, E O; Vukalovych, P S; Voylenko, O A; Stakhovskiy, O E; Vitruk, Yu V; Chepurnatiy, M V

    2015-11-01

    Clinical analysis was conducted in 74 oncological patients, in whom 103 iatrogenic injuries of ureter (IIU) were revealed and for which they were treated in Scientific-nvestigative Department of Plastic and Reconstructive Oncourology. Restoration of renal and ureteric function were noted in terms up to 6 mo, in these terms were revealed all complications, caused by recurrence of obstruction. Late follow-up results of III were positive in 95.2% patients, unsatisfactory result was revealed in 3 (4.8%) patients, what have demanded conduction of surgical secondary correction of urodynamics. Quality of life after restoration operative treatment have improved in 31.70%patients in comparison of such before the operation.

  8. RESULTS OF TREATMENT OF ACUTE LUMBAR DISC HERNIATION WITH TRANSFORAMINAL NERVE ROOT BLOCK

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    EMILIANO NEVES VIALLE

    Full Text Available ABSTRACT Objective: To determine the efficacy of anesthetic transforaminal nerve root block in patients with sciatica secondary to lumbar disc herniation through a prospective observational study. Methods: The study included 176 patients from a private clinic undergoing transforaminal injection performed by a single spinal surgeon. The patients were assessed after two weeks, three months and six months regarding to the improvement of the pain radiating to the lower limbs. In case of persistent symptoms, patients could choose to perform a new nerve root block and maintenance of physical therapy or be submitted to conventional microdiscectomy. Results: By the end of six-month follow-up of the 176 patients, 116 had a favorable outcome (95 after one block and 21 after two blocks, and only 43 required surgery. Conclusion: The results of our study suggest a positive effect of transforaminal block for the treatment of sciatica in patients with lumbar disc herniation.

  9. Radiological assessment of surgical treatment results in children and adolescents with pectus excavatum: medium-term results of 75 cases

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    Sh.K. Khakimov

    2014-09-01

    Full Text Available Objective — Minimally invasive repair of pectus excavatum (PE has been established as the preferred technique for the repair of PE. Modified techniques of repair based on D. Nuss method for PE are promoted to improve the safety of the procedures. Purpose of this work was to analyzing the operative results with accounting of the toracometric parameters of pectus excavatum in children and adolescents. Methods — Toracometric parameters were the followings, as: sternum rotation, cardiac and pulmonary vein rotation angles, Haller and asymmetry indices in children and adolescents with PE. 48 (64% patients are operated by D. Nuss procedure and 27 (36% with modifications, due to severity of diagnostic parameters, which were exhibited the significance difference between pre- and postoperative indices, mainly, in patients who has a severe degree changes preoperatively. Results — The sternum rotation degree (in 75 patients was decreased till 0.4±0.02° (P=0.01, whereas was 20.7±0.46° preoperatively (P=0.001. Preoperatively, the mean of cardiac rotation angle significantly reduced, preoperative was 56.0±2.9° (P=0.001 (in 75 patients and after operative intervention made up 47.0±2.7° (P=0.001. Haller index also is decreased till 2.3±0.2, whereas was 3.9±0.2 preoperatively (P=0.002. The angle of the pulmonary vein rotation was preoperatively 51.0±3.4° (P=0.001 and after operation was increased till 53.0±1.8° (P=0.01. Conclusions — It has necessity apply the computer tomography investigation in patients with PE deformity. Also, it cannot miss the stage of the sterno-costal complex strength, its pliability and the gravity of the sternum rotation, which may lead to raise the share of good and excellent results.

  10. A prospective study of reversible dementias: Frequency, causes, clinical profile and results of treatment

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    Srikanth S

    2005-01-01

    Full Text Available Background: Dementia due to potentially reversible etiologies is an important group of dementias to be identified not only because of the number of such Patients encountered but also due to the potential for substantial improvement with treatment. Aims : To prospectively investigate the frequency and causes of dementias with potentially reversible etiologies; to examine the clinical features of this subgroup with a view to identifying a signature profile and to determine if this potential reversibility translates into actual reversibility with appropriate treatment. Setting and design : A prospective longitudinal study of patients with dementia presenting to the outpatient services of a tertiary referral hospital. Methods : All Patients above 40 years referred for evaluation of cognitive complaints were serially enrolled and underwent clinical examination, various laboratory tests and neuroimaging. Patients were followed-up for one year. Statistical analysis : One way analysis of variance for continuous variables followed by post hoc comparisons using Scheffe′s procedure. Results: A total of 129 patients met Diagnostic and Statistical Manual of Mental Disorders edition 4 (DSM IV criteria for dementia and qualified for inclusion into the study. Twenty-four patients (18%, all with moderately severe cognitive [mean mini mental state examination (MMSE score ± SD = 17.9 ± 4.8] and neuropsychiatric [mean neuropsychiatric inventory (NPI score ± SD = 30.7 ± 8.7] dysfunction were diagnosed to have reversible causes - neuroinfections in 11 patients, normal pressure hydrocephalus in 8 patients and vitamin B12 deficiency in 5 patients. The majority of these patients had gait and urinary dysfunction reminiscent of subcortical dementias. These reversible causes were clinically suspected in only 58% of patients. In 20/24 patients in whom follow up was possible mean MMSE score had improved to 22.2 and mean NPI score had improved to 8.0, following 6 months

  11. H02 WETLAND TREATMENT SYSTEM WATER CHEMISTRY SAMPLING AND RESULTS REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Bach, M; Michael Serrato, M; Eric Nelson, E

    2008-02-15

    inorganic chemistry influence on pH. In addition, alternative methods to alleviate or mitigate the pH increase were evaluated. This study documents the results of sampling activities undertaken and conveys the analytical results along with suggestions for operation of the H-02 Wetland Treatment System. The water samples collected and the water quality data generated from this activity are for analytical purposes only, and as such, were not collected in support of compliance activities.

  12. Oncological results after surgical treatment of squamous cell cancer of the lateral wall of the oropharynx.

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    Díaz-Molina, Juan P; Rodrigo, Juan P; Alvarez-Marcos, Cesar; Llorente, José L; Costales, María; Suárez, Carlos

    2011-07-01

    The gold standard of treatment of cancer of the lateral wall of the oropharynx continues to be unclear, especially in advanced stages. In this study, we report our experience with surgical treatment of these cancers and describe the functional and oncological results of the procedures. Retrospective review. A total of 155 previously untreated patients with squamous cell carcinoma of the lateral wall of the oropharynx who underwent a surgical resection of the lesion at our department from January 1990 to January 2008 were included. Sixty-seven percent of these patients received postoperative radiotherapy. The records of these patients were reviewed to obtain measures such as local and regional control, disease-specific survival, and speech and swallowing function. Six patients had a stage I disease, 15 had a stage II disease, 31 had a stage III disease, 86 had a stage IVA, and 17 had stage IVB disease. The overall recurrence rate was 60%, and the local recurrence rate was 40%. The 5-year overall survival and disease-specific survival rates were 33% and 43%, respectively. Five-year disease-specific survival rates by stage were as follows: 100%, 59%, 57%, 31%, and 33% for stages I to IVB, respectively. Multivariate analysis showed two parameters that were independent predictors of a reduced disease-specific survival: cervical lymph node metastases pN2-3 (P = .027) and primary tumor classified as pT3-4 (P = .029). In 122 patients, a tracheotomy was performed, and it couldn't be sealed in 23% of them. Oral alimentation was successfully recovered in 93% of the patients. Surgical treatment of cancer of the lateral wall of the oropharynx provides acceptable oncological and functional results, especially in early and moderately advanced stages (stages I-III). In advanced stages (stage IV), we obtained good functional preservation rates but poor oncological outcomes. Consequently, these groups of patients could be considered for another treatment modality, such as

  13. Impact of smear microscopy results and observed therapy on tuberculosis treatment in Mombasa, Kenya.

    Science.gov (United States)

    Arentz, M; Narita, M; Sangaré, L; Kah, J F; Low, D; Mandaliya, K; Amukoye, E; Sitienei, J; Walson, J L

    2011-12-01

    Tuberculosis (TB) treatment center at Coast Provincial General Hospital in Mombasa, Kenya. To describe TB management practices in a facility in coastal Kenya and identify factors associated with poor treatment outcomes. Retrospective review of patient treatment records from January 2008 to June 2009. Treatment outcomes of patients were classified as treatment success (cure or treatment completion) or poor treatment outcome (treatment failure, death or default). Relative risk regression was used to determine the association between exposures of interest and poor treatment outcomes. Records were obtained from a total of 183 patients: 142 (78%) had pulmonary TB, 68 (37%) were human immunodeficiency virus (HIV) infected and 81 (44%) had acid-fast bacilli (AFB) positive smear micros- copy. Most treated individuals (86%) achieved a successful treatment outcome as defined by the World Health Organization. Of those with poor treatment outcomes, 64% defaulted, 32% died, and 4% failed treatment. Initial negative AFB smear and HIV co-infection were associated with poor treatment outcomes (RR 3.32, 95%CI 1.22-8.99 and RR 4.61, 95%CI 1.69- 12.59, respectively). Strategies to accelerate accurate diagnosis of smear-negative TB and increase patient retention during treatment, especially in HIV co-infected individuals, are needed to reduce poor treatment outcomes in Kenya.

  14. Treatment of intracranial aneurysms by flow diverter devices: Long-term results from a single center

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, Francesco, E-mail: frabriga@unina.it [Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Napoli, Manuela, E-mail: napoli.manuela@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Leone, Giuseppe, E-mail: g.leonemd@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Marseglia, Mariano, E-mail: mariano-marseglia@libero.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Mariniello, Giuseppe, E-mail: giuseppe.mariniello@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Caranci, Ferdinando, E-mail: ferdinando.caranci@unina.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Tortora, Fabio, E-mail: fabiotor@libero.it [Chair of Neuroradiology, “Magrassi Lanzara” Clinical-Surgical Department, Second University of Naples, Viale Colli Aminei 21, 80131 Naples (Italy); Maiuri, Francesco, E-mail: frmaiuri@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy)

    2014-09-15

    Highlights: • We report the long-term results (2–4 years) with Flow Diverter Devices (FDD) from a single-center. • We recommend the use of FDD for large-neck aneurysms of the ICA syphon. • We think that more sophisticate FDD will reduce the incidence of technical adverse events. - Abstract: Objectives: Flow-Diverter Devices (FDD) are a new generation stents designed for the treatment of the intracranial aneurysms. This article reports the long-term results (2–4 years) of this treatment from a single-center. Methods: From November 2008 to January 2012, 35 patients (29 females and 6 males; mean age 53.9 y) with 39 intracranial aneurysms were treated by FDD. Five patients (14.3%) had ruptured aneurysms and 30 (85.7%) had no previous hemorrhage. The procedures were performed in 5 patients (14.3%) with SILK and in 30 (85.7%) with PED. In 3 patients FDDs were used as a second treatment after failure of previous coiling (2 cases) or stenting (one case). The 39 aneurysms were in supraclinoid ICA in 26 (66.7%), cavernous ICA in 2 (5.1%), PCoA in 4 (10.2%), MCA in 5 (12.9%), SCA in 1 (2.6%) and PICA in 1 (2.6%). The aneurysms were small (<10 mm) in 32 cases (82%), large (11–25 mm) in 6 (15.3%) and giant in 1 (2.6%). The occlusion rate according to the aneurysm location, size and neck and the complications were evaluated. Results: Peri-procedural complications included transient dysarthria (2 patients), vasospasm with acute intra-stent aggregation (one), microwire rupture (one) and failure of the stent opening (one). The follow-up was made between 24 and 62 months (mean 41 months); clinical examination and CTA were performed at 1, 3, 6 and 12 months after the procedure. The complete occlusion was confirmed by CTA and DSA. MRI with angiographic-studies was taken every year. Complete occlusion was obtained in 35 aneurysms (92.1%) and subtotal in 3 (7.9%). Complete occlusion occurred at 3 months in 24 cases (68.6%), within 3 and 6 months in 9 (25.7%). The rate and

  15. Intensity-modulated radiation therapy for T4 nasopharyngeal carcinoma. Treatment results and locoregional

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.L.Y.; Tsai, C.L.; Chen, W.Y.; Wang, C.W. [National Taiwan Univ. Hospital, Taipei (China). Div. of Radiation Oncology; Huang, Y.S.; Chen, Y.F. [National Taiwan Univ. Hospital, Taipei (China). Dept. of Medical Imaging; Kuo, S.H. [National Taiwan Univ. Hospital, Taipei (China). Div. of Radiation Oncology; National Taiwan Univ. College of Medicine, Taipei (China). Graduate Inst. of Clinical Medicine; Hong, R.L. [National Taiwan Univ. Hospital, Taipei (China). Div. of Medical Oncology; Ko, J.Y.; Lou, P.J. [National Taiwan Univ. Hospital, Taipei (China). Dept. of Otolaryngology

    2013-12-15

    Purpose: The purpose of this work was to examine outcomes in patients with T4 nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Methods and materials: Between 2007 and 2010, 154 patients with nonmetastatic T4 NPC were treated with IMRT to a total dose of 70 Gy in 33-35 fractions. In addition, 97 % of patients received concurrent platinum-based chemotherapy. The median follow-up time was 52.8 months. Results: The rates of 5-year actuarial locoregional control, distant metastasis-free survival, progression free-survival, and overall survival (OS) were 81.2, 72.2, 61.9, and 78.1 %, respectively. A total of 27 patients had locoregional recurrence: 85.2 % in-field failures, 11.1 % marginal failures, and 3.7 % out-of-field failures. Fourteen patients with locoregional recurrence received aggressive treatments, including nasopharyngectomy, neck dissection, or re-irradiation, and the 5-year OS rate tended to be better (61.9 %) compared to those receiving conservative treatment (32.0 %, p = 0.051). In patients treated with 1 course of radiotherapy, grade {>=} 3 toxicities of ototoxicity, neck fibrosis, xerostomia, epistaxis, and radiographic temporal lobe necrosis occurred in 18.2, 9.8, 6.3, 2.1, and 5.6 % of patients, respectively. Increased ototoxicity, osteonecrosis, severe nasal bleeding, and temporal necrosis were observed in patients treated by re-irradiation. Conclusion: IMRT offers good locoregional control in patients with T4 NPC. For patients with locoregional recurrence after definitive radiotherapy, aggressive local treatment may be considered for a better outcome. (orig.)

  16. Antegrade scrotal sclerotherapy of internal spermatic veins for varicocele treatment: technique, complications, and results

    Directory of Open Access Journals (Sweden)

    Alessandro Crestani

    2016-01-01

    Full Text Available Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy (ASS represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min (range 9 to 50 min. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 (7.2% patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 (5.9% cases. In 32/40 (80% cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 × 10 6 to 21 × 10 6 ml−1 (P < 0.001. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% (P < 0.001. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure (P < 0.001. In the subgroup of the 168 infertile patients, 52 (31% fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.

  17. Posatirelin for the treatment of degenerative and vascular dementia: results of explanatory and pragmatic efficacy analyses.

    Science.gov (United States)

    Gasbarrini, G; Stefanini, G; Addolorato, G; Foschi, F; Ricci, C; Bertolotti, P; Voltolini, G; Bonavita, E; Bertoncelli, R; Renzi, G; Bianchini, G; Bonaiuto, S; Giannandrea, E; Cavassini, G; Mazzini, V; Chioma, V; Marzara, G; D'Addetta, G; Totaro, G; Dalmonte, E; Tassini, D; Giungi, F; De Nitto, C; Di Fazio, G; Tessitore, A; Guadagnino, M; Tessitore, E; Spina, P; Luppi, M; Bignamini, A; Peracino, L; Fiorentino, M; Beun-Garbe, D; Poli, A; Ambrosoli, L; Girardello, R

    1998-01-01

    In order to confirm the efficacy and safety of posatirelin (L-pyro-2-aminoadipyl-L-leucyl-L-prolinamide), a synthetic peptide having cholinergic, catecholaminergic and neurotrophic activities, a multicentre, double-blind, controlled study versus placebo was planned in elderly patients suffering from Alzheimer's disease and vascular dementia, according to National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) and National Institute of Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria, respectively. The trial consisted of a 2-week run-in phase with placebo administered once a day orally, followed by a double-blind period of 3 months, with posatirelin or placebo administered once a day intramuscularly. Efficacy was assessed using the Gottfries-Bråne-Steen (GBS) Rating Scale (primary variable) and the Rey Memory Test (secondary variable). Laboratory tests, vital signs and adverse events were monitored. A total of 360 patients were randomized, the intent-to-treat sample (ITT) being made up of 357 patients and the per protocol sample (PP) of 260 patients. Both pragmatic and explanatory analyses showed significant differences between treatment groups in the GBS Rating Scale and the Rey Memory Test, with no difference in the two types of dementia. No difference between treatments was observed in safety variables, the incidence of adverse events in the posatirelin group being 7.3%. The study confirms previous results showing that treatment with posatirelin can improve cognitive and functional abilities of patients suffering from degenerative or vascular dementia.

  18. Our results in surgical treatment of laryngotracheal stenosis, ten years experience

    Directory of Open Access Journals (Sweden)

    Jović Rajko M.

    2006-01-01

    Full Text Available Introduction. There are numerous techniques for the treatment of laryngotracheal stenosis. The aim of this paper was to present surgical techniques and results of treatment of laryngeal and laryngotracheal stenosis in a ten-year period by retrospective analysis. Material and methods. Medical records of 34 patients (17 male and 17 female surgically treated for laryngeal or laryngotracheal stenosis between 1995 and 2004 were analyzed. 19 (55.9% patients had previous surgical procedures, whereas fifteen patients (44.1 % were diagnosed and treated for the first time. Results. 5 patients had a glottic-subglottic stenosis, 11 patients had a subglottic stenosis, 16 patients had subglottic-tracheal stenosis and 2 patients had a glottic-subglottic-tracheal stenosis. 21 patients had normal vocal cord motion, 8 patients showed unilateral vocal cord fixation, and 5 had bilateral vocal cord fixation. Laryngotracheoplasty with anterior-posterior costal cartilage graft was performed in 24 patients, while single stage segmental laryngotracheal resection of the stenotic part was performed in 8 patients. One patient was operated in direct laryngomicroscopy and one with dilatation of the stenotic segment with T tube insertion. The most common complication was the development of granulation due to use of the Montgomery T-tube which was removed in direct laryngomicroscopy. Except for one patient, 33(97% patients were decannulated. There was no perioperative mortality. Conclusion. Although laiyngotracheoplasty with anterior-posterior costal cartilage graft placement cannot be used in all cases of laryngotracheal stenosis, it was the method of choice in previously operated patients with segmental resection of the stenotic segment. This method requires use of Montgomery T-tube or anesthesiological tube, which is very hard to keep clean. Better recovery, short hospitalization and excellent results were obtained with the cricotracheal segmental resection. .

  19. Leksell Gamma Knife treatment for pilocytic astrocytomas: long-term results.

    Science.gov (United States)

    Simonova, Gabriela; Kozubikova, Petra; Liscak, Roman; Novotny, Josef

    2016-07-01

    OBJECTIVE The purpose of this study was to evaluate long-term treatment results, radiation-related toxicity, and prognostic factors for the progression-free survival (PFS) of patients with pilocytic astrocytomas treated by means of stereotactic radiosurgery with a Leksell Gamma Knife. METHODS A total of 25 patients with pilocytic astrocytomas underwent Gamma Knife surgery during the period 1992-2002. The median target volume was 2700 mm(3) (range 205-25,000 mm(3)). The 18 patients treated with 5 daily fractions received a median minimum target dose of 25 Gy. Doses for the 2 patients treated with 10 fractions over 5 days (2 fractions delivered on the same day at least 6 hours apart) were 23 and 28 Gy. For the 5 patients treated with a single fraction, the minimum target dose ranged from 13 to 20 Gy (median 16 Gy). RESULTS Complete regression occurred in 10 patients (40%) and partial regression in 10 patients (40%). The 10-year overall survival rate was 96% and the 10-year PFS rate was 80%. Target volume appeared to be a significant prognostic factor for PFS (p = 0.037). Temporary Grade 3 toxicity appeared in 2 patients (8%), and these patients were treated with corticosteroids for 2 months. Permanent Grade 4 toxicity appeared in 2 patients (8%) and was associated with neurocognitive dysfunction. In these 2 individuals, the neurocognitive dysfunction was also felt to be in part the result of the additional therapeutic interventions (4 in one case and 6 in the other) required to achieve durable control of their tumors. CONCLUSIONS Radiosurgery represents an alternative treatment modality for small residual or recurrent volumes of pilocytic astrocytomas and provides long-term local control. Target volume appears to be the most important factor affecting PFS.

  20. Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

    Science.gov (United States)

    Lee, Hyun-Joo; Kim, Poong-Taek; Deslivia, Maria Florencia; Lee, Suk-Joong; Nam, Sang-Jin

    2015-01-01

    Background Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results. PMID:26330961

  1. [Periprosthetic Femoral Fractures after Total Hip Replacement: Our Results and Treatment Complications].

    Science.gov (United States)

    Pavelka, T; Salášek, M; Weisová, D

    2017-01-01

    PURPOSE OF THE STUDY The study consists of a retroactive evaluation of results of surgical treatment in patients with periprosthetic femoral fracture after total hip replacement and a comparison with results reported in the literature. MATERIAL AND METHODS In the period from 2003 to 2013, a total of 83 patients with periprosthetic femoral fracture after total hip replacement were treated at our clinic, namely 69 women and 14 men. The mean age in the cohort was 74 years (range 47-87). The Vancouver classification was used to grade the fractures. The cohort included 31 patients with type B1 fracture, 25 patients with type B2 fracture, 8 patients with type B3 fracture, and 19 patients with type C fracture. Altogether 80 patients underwent a surgery, 3 patients with non-displaced type B1 fracture were treated conservatively. The mechanism of injury was a simple fall in 75 % of primary endoprostheses and in 56% of revision endoprostheses. The average time to fracture was 7.6 years in primary implant and 3.6 years in revision endoprosthesis. In fractures with a well-fixed stem (type B1 and C) plate osteosynthesis was used. In case of a comminution zone, osteosynthesis was followed by spongioplasty. In patients with a loose stem (type B2 and B3), the fracture was treated with a revision uncemented stem. In two cases a combination of a revision stem and a massive corticocancellous bone graft was used. The evaluation was performed using the Harris Hip Score and the minimum follow-up from the surgery was 3 years. RESULTS In the group of patients with type B1 fracture, 28 patients were treated surgically. An excellent result was achieved in 22 patients (84%), in 4 patients (16%) the result was very good. The remaining 2 patients failed to meet the requirement of the minimum follow-up of 3 years. In the group of patients with type B2 fractures, composed of 25 patients, the femoral component was replaced with a revision uncemented stem with cerclage wires or titanium tapes or

  2. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES.

    Science.gov (United States)

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2012-01-01

    To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

  3. Long-term treatment of postmenopausal osteoporosis with strontium ranelate: results at 8 years.

    Science.gov (United States)

    Reginster, J Y; Bruyère, O; Sawicki, A; Roces-Varela, A; Fardellone, P; Roberts, A; Devogelaer, J P

    2009-12-01

    Strontium ranelate 2 g/day has proven efficacy against vertebral and nonvertebral fracture over 5 years in postmenopausal osteoporosis, though many women require longer-term treatment. This article describes the efficacy, safety, and tolerability of this agent over 8 years. Postmenopausal osteoporotic women having participated in the 5-year efficacy trials SOTI and TROPOS were invited to enter a 3-year open-label extension study. The results presented here focus on patients who received strontium ranelate for 8 years. At the extension baseline, the population treated for 8 years (n=879; 79.1+/-5.6 years) had femoral neck T-score of -2.61+/-0.71. The cumulative incidences of new vertebral and nonvertebral fractures (13.7% and 12.0%, respectively) over years 6 to 8 were non-statistically different from the cumulative incidences in the first 3 years of the original studies (11.5% and 9.6%). Lumbar spine, femoral neck, and total hip bone mineral density (BMD) increased throughout the 8-year period. Annual relative change in BMD was significant at every visit, except the 8-year visit for femoral neck and total hip BMD. Strontium ranelate was safe and well tolerated over 8 years. Long-term treatment with strontium ranelate 2 g/day in postmenopausal osteoporotic women leads to continued increases in BMD at all sites. The data also provide some evidence for a sustained antifracture efficacy.

  4. THE STUDY OF RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH VERTEBRAL-SPINAL TRAUMA

    Directory of Open Access Journals (Sweden)

    B. Sh. Minasov

    2010-01-01

    Full Text Available A study of the efficacy of medical rehabilitation of 170 patients with spinal-cord injury through the application of modern rehabilitation and surgical technologies was conducted. Patients of I (control group received standard set of conservative treatment and rehabilitation. Patients of II (main group the rehabilitation was supplemented with therapeutic exercises with the use of loop complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. Patient of III (control group surgical treatment and the conventional range of rehabilitation were performed. Patients of IV (main group the rehabilitation was completed with early activation using espandernogo complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. It is proved that the developed complex rehabilitation of patients with spinal-cord injury using an early stable functional osteosynthesis with the minimum extent necessary, the use of complex «Hope» can improve the functional results at the expense of early motor activation, preventing the formation of contractures and muscle atrophy. The use of adaptation to the stress of hypoxia in the late period of vertebro-spinal cord injury improves overall health, reduces the severity of autonomic reactions, emotional stress, can cut pain syndromes.

  5. Laser surface treatment and the resultant hierarchical topography of Ti grade 2 for biomedical application

    Science.gov (United States)

    Kuczyńska, Donata; Kwaśniak, Piotr; Marczak, Jan; Bonarski, Jan; Smolik, Jerzy; Garbacz, Halina

    2016-12-01

    Modern prosthesis often have a complex structure, where parts of an implant have different functional properties. This gradient of functional properties means that local surface modifications are required. Method presented in this study was develop to functionalize prefabricated elements with original roughness obtained by conventional treatments used to homogenize and clean surface of titanium implants. Demonstrated methodology results in multimodal, periodic grooved topography with roughness in a range from nano- to micrometers. The modified surfaces were characterized in terms of shape, roughness, wettability, surface energy and chemical composition. For this purpose, the following methods were used: scanning electron microscopy, optical profilometry, atomic force microscopy, contact angle measurements and X-ray photoelectron spectroscopy. Protein adsorption studies were conducted to determine the potential biomedical application of proposed method. In order to estimate the intensity and way of the protein adsorption process on different titanium surfaces, XPS studies and AFM measurements were performed. The systematic comparison of surface states and their osseointegration tendency will be useful to evaluate suitability of presented method as an single step treatment for local surface functionalization of currently produced implantable devices.

  6. WE-F-304-00: Outcomes of Hypofractionated Treatments - Results of the WGSBRT

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    in explaining the results of hypofractionated RT Describe the dose/volume metrics that are considered safe in SBRT treatment of tumors near the optic structures. Discuss the efficacy of hypofractionation and dosing schedules used in treating vestibular schwannomas Identify some difficulties in modeling TCP and NTCP for cranial tumors treated with hypofractionation. One moderator, Dr. Grimm, designed and holds intellectual property rights to the DVH Evaluator software tool which is an FDA-cleared product in commercial use, and can analyze some of this data. No others have relevant conflicts of interest.

  7. RESULTS OF A PILOT CLINICAL TRIAL OF DENDRITICCELL BASED VACCINES FOR TREATMENT OF RECURRENT HERPESVIRUS INFECTION

    Directory of Open Access Journals (Sweden)

    O. Yu. Leplina

    2016-01-01

    Full Text Available Chronic recurrent infections caused by herpes simplex virus (HSV types 1 and 2 represent a serious medical and social challenge. Given an important role of immune system in surveillance of viral infections, an induced enhancement of antigen-specific immune response seems to be a promising approach to treatment of recurrent HSV infections, in particular, using dendritic cell (DCs vaccines. The present paper contains results of an open pilot study evaluating efficacy and safety of dendritic-cell vaccines in the patients with recurrent HSV infections. Twenty-nine patients including 14 persons with labial herpes, and 15, with genital herpes have been enrolled in this study. DCs were generated in presence of GM-CSF and IFNα and then loaded with recombinant viral proteins (HSV1gD or HSV2gD. These cells were applied in 2 rounds of vaccination performed within 9 months. Immunotherapy with DCs did not induce sufficient side effects, and was accompanied by more than two-fold decrease in relapse rate and increased length of remissions during the 9-month period of treatment. Later on, we revealed a reduced frequency of relapses, and a 3-fold increase in remission duration over the subsequent 6-month follow up. The clinical effect during the treatment and at later terms (a half-year observation was noted with both labial and genital herpes, as registered in the majority of patients, being associated with induction of antigen-specific proliferative response and normalization of reduced mitogenic responsiveness of mononuclear cells towards ConA. The patients’ survey at longer terms (more than 24 months has shown that the beneficial effect of immunotherapy, in terms of reduced relapse rates, was maintained in 77.8% of the respondents by 48 months (a median follow-up term. At this time, the antigen specific proliferative response was maintained in 66.7% of patients. The data obtained suggest that the dendritic-cell vaccines may be a promising approach to the

  8. TU-A-BRD-01: Outcomes of Hypofractionated Treatments - Initial Results of the WGSBRT

    Energy Technology Data Exchange (ETDEWEB)

    Li, X [Medical College of Wisconsin, Milwaukee, WI (United States); Lee, P [UCLA, Los Angeles, CA (United States); Ohri, N [Albert Einstein College of Medicine, Bronx, NY (United States); Joiner, M [Wayne State University, Detroit, MI (United States); Kong, F [Georgia Regents University, Augusta, GA (Georgia); Jackson, A [Mem Sloan-Kettering Cancer Ctr, New York, NY (United States)

    2014-06-15

    Stereotactic Body Radiation Therapy (SBRT) has emerged in recent decades as a treatment paradigm that is becoming increasingly important in clinical practice. Clinical outcomes data are rapidly accumulating. Although published relations between outcomes and dose distributions are still sparse, the field has progressed to the point where evidence-based normal tissue dose-volume constraints, prescription strategies, and Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) models can be developed. The Working Group on SBRT (WGSBRT), under the Biological Effects Subcommittee of AAPM, is a group of physicists and physicians working in the area of SBRT. It is currently performing critical literature reviews to extract and synthesize usable data and to develop guidelines and models to aid with safe and effective treatment. The group is investigating clinically relevant findings from SBRT in six anatomical regions: Cranial, Head and Neck, Thoracic, Abdominal, Pelvic, and Spinal. In this session of AAPM 2014, interim results are presented on TCP for lung and liver, NTCP for thoracic organs, and radiobiological foundations:• Lung TCP: Detailed modeling of TCP data from 118 published studies on early stage lung SBRT investigates dose response and hypothesized mechanisms to explain the improved outcomes of SBRT. This is presented from the perspective of a physicist, a physician, and a radiobiologist.• Liver TCP: For primary and metastatic liver tumors, individual patient data were extracted from published reports to examine the effects of biologically effective dose on local control.• Thoracic NTCP: Clinically significant SBRT toxicity of lung, rib / chest wall and other structures are evaluated and compared among published clinical data, in terms of risk, risk factors, and safe practice.• Improving the clinical utility of published toxicity reports from SBRT and Hypofractionated treatments. What do we want, and how do we get it? Methods

  9. Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

    Directory of Open Access Journals (Sweden)

    Didier Dequanter

    2010-06-01

    Full Text Available Didier Dequanter, Mohammad Shahla, Pascal Paulus, Phillippe LothaireDepartment of Head and Neck Surgery, CHU Charleroi, Montigny le Tilleul, BelgiumIntroduction: The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas.Methods: A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT. Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN were eligible.Results: There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old. Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months. A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died.Conclusion: Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems

  10. Early results of the Ponseti method for the treatment of clubfoot associated with myelomeningocele.

    Science.gov (United States)

    Gerlach, David J; Gurnett, Christina A; Limpaphayom, Noppachart; Alaee, Farhang; Zhang, Zhongli; Porter, Kristina; Kirchhofer, Melissa; Smyth, Matthew D; Dobbs, Matthew B

    2009-06-01

    Myelomeningocele is a common birth defect that is often accompanied by clubfoot deformity. Treatment of clubfoot associated with myelomeningocele traditionally has consisted of extensive soft-tissue release operations, which are associated with many complications. The purpose of the present study was to evaluate the early results of the Ponseti method for the treatment of clubfoot associated with myelomeningocele. Sixteen consecutive patients with myelomeningocele (twenty-eight clubfeet) and twenty consecutive patients with idiopathic clubfeet (thirty-five clubfeet) were followed prospectively while being managed with the Ponseti method. The average duration of follow-up was thirty-four months for the myelomeningocele group and thirty-seven months for the idiopathic group. Clubfoot severity was graded at the time of presentation with use of the Diméglio system. The initial correction that was achieved, casting and/or bracing difficulties, recurrences, and subsequent treatments were evaluated and compared between the two cohorts by means of appropriate statistical analysis. Eleven (39%) of the twenty-eight clubfeet in the myelomeningocele group were graded as Diméglio grade IV, compared with only four (11%) of the thirty-five clubfeet in the idiopathic group (p = 0.014). Initial correction was achieved in thirty-five clubfeet (100%) in the idiopathic group and in twenty-seven clubfeet (96.4%) in the myelomeningocele group (p = 0.16). Relapse of deformity was detected in 68% of the feet in the myelomeningocele group, compared with 26% of the feet in the idiopathic group (p = 0.001). Relapses were treated successfully without the need for extensive soft-tissue release surgery for all but four of the clubfeet in the myelomeningocele group and for all but one of the clubfeet in the idiopathic group (p = 0.16). Our data support the use of the Ponseti method for the initial treatment of clubfoot deformity associated with myelomeningocele, although attention to detail is

  11. Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo [Chonbuk National University Hospital, Jeonju (Korea, Republic of); Lee, Heui Kwan [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Soo Geon [Jesushospital, Jeonju (Korea, Republic of)

    2008-06-15

    We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

  12. Pyrolysis process for the treatment of scrap tyres: preliminary experimental results.

    Science.gov (United States)

    Galvagno, S; Casu, S; Casabianca, T; Calabrese, A; Cornacchia, G

    2002-01-01

    The aim of this work is the evaluation, on a pilot scale, of scrap tyre pyrolysis process performance and the characteristics of the products under different process parameters, such as temperature, residence time, pressure, etc. In this frame, a series of tests were carried out at varying process temperatures between 550 and 680 degrees C, other parameters being equal. Pyrolysis plant process data are collected by an acquisition system; scrap tyre samples used for the treatment, solid and liquid by-products and produced syngas were analysed through both on-line monitoring (for gas) and laboratory analyses. Results show that process temperature, in the explored range, does not seem to seriously influence the volatilisation reaction yield, at least from a quantitative point of view, while it observably influences the distribution of the volatile fraction (liquid and gas) and by-products characteristics.

  13. How you evaluate treatment results in low back pain patients depends on who the patient is

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    2008-01-01

    How you evaluate treatment results in low back pain patients depends on who the patient is Lauridsen, HH 1*, Hartvigsen, J1,2, Manniche, C1,3, Korsholm, L1,4, Grunnet-Nilsson, N1 1.    Clinical Locomotion Science, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark...... of an evaluative instrument in back pain patients is complicated because of lack of head-to-head comparisons of clinimetric properties of the various instruments. In addition, little is known about instrument behaviour in clinical subgroups. The objective of this study was to concurrently compare responsiveness...... and minimal clinically important differences (MCID) for commonly used pain scales and functional instruments in four subpopulations of LBP patients. Methods The Danish versions of the Oswestry Disability Index (ODI), the 23-item Roland Morris Disability Questionnaire (RMQ), the physical function and bodily...

  14. Breast-conserving treatment of early breast cancer; Results in a common trial

    Energy Technology Data Exchange (ETDEWEB)

    Pirtoli, L. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Bellezza, A. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Pepi, F. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Tucci, E. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Crociani, M. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Crastolla, A.M. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Farzad, M. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Bindi, M. (Siena Univ. (Italy). Unita Operativa di Radioterapia)

    1993-01-01

    Results of large prospective trials, often based on selected series and optimal treatment techniques, indicate that breast conserving therapy is appropriate for most patients with early breast cancer. Questions remain regarding the therapeutic outcome in common practice. We report on a series of 206 consecutive, unselected patients treated with current radiotherapy procedures. The Kaplan-Meier evaluation showed 5- and 8-year survival rates (93%, 91%), distant disease-free survival rates (87%, 85%) and local relapse-free survival rates (90%, 88%) that were comparable to those of the conservative arms in reported randomised trials and to the data from retrospective studies reported by authoritative institutions. However, subanalysis according to prognostic factors such as menopausal status, age and axillary nodal status was of limited value, due to the small number of cases. (orig.).

  15. Patients age and results of treatment in discogenic cauda equina syndrome.

    Science.gov (United States)

    Sulla, I

    1994-03-01

    Cauda equina syndrome is a feared complication of lumbar disc disease. Despite of early surgery it frequently leaves persistent effects. Localisation, type, and duration of spinal nerve roots compression are quoted as the most important factors influencing the results of treatment. Statistical evaluation of data acquired by examinations of 58 persons operated on for this disease et the Department of Neurosurgery in Kosice within the period from January 1st, 1982 to December 31st, 1991 has shown that the further important facts are ageing of tissues and impairment of microcirculation. In patients over the age of 45 the recovery of motor and sexual functions, as well as the voluntary control of rectal sphincters, and the working ability were significantly worse. It is suggested thereby that in elderly persons with a proven intervertebral disc disease an early surgical intervention is indicated. (Tab. 7, Ref. 23.)

  16. Exome sequencing results in successful riboflavin treatment of a rapidly progressive neurological condition

    Science.gov (United States)

    Petrovski, Slavé; Shashi, Vandana; Petrou, Steven; Schoch, Kelly; McSweeney, Keisha Melodi; Dhindsa, Ryan S.; Krueger, Brian; Crimian, Rebecca; Case, Laura E.; Khalid, Roha; El-Dairi, Maysantoine A.; Jiang, Yong-Hui; Mikati, Mohamad A.; Goldstein, David B.

    2015-01-01

    Genetically targeted therapies for rare Mendelian conditions are improving patient outcomes. Here, we present the case of a 20-mo-old female suffering from a rapidly progressing neurological disorder. Although diagnosed initially with a possible autoimmune condition, analysis of the child's exome resulted in a diagnosis of Brown–Vialetto–Van Laere syndrome 2 (BVVLS2). This new diagnosis led to a change in the therapy plan from steroids and precautionary chemotherapy to high-dose riboflavin. Improvements were reported quickly, including in motor strength after 1 mo. In this case, the correct diagnosis and appropriate treatment would have been unlikely in the absence of exome sequencing and careful interpretation. This experience adds to a growing list of examples that emphasize the importance of early genome-wide diagnostics. PMID:27148561

  17. Cystic Dilation of Extrahepatic Bile Ducts in Adulthood: Diagnosis, Surgical Treatment and Long. Term Results

    Directory of Open Access Journals (Sweden)

    G. Belli

    1998-01-01

    Full Text Available To evaluate the long-term results of surgery for choledohal cyst in adulthood, a series of 13 patients over the age of 16 operated on for choledochal cyst during a period of six years and followed-up for a minimum of 3 years was analyzed. Patients with type I and IVa cysts underwent extrahepatic cyst resection and Roux-en-Y hepatico-jejunostomy. Choledochoceles (type III were managed endoscopically. No operative mortality or morbidity occurred. Type I and III cysts showed almost ideal follow-up with no sign of stricture on HIDA scan. One type IVa cyst patients developed recurrent cholangitis due to anastomotic stricture, managed percutaneously. Whenever possible, complete cyst resection and Roux-en-Y reconstruction is the treatment of choice for all extrahepatic biliary cysts. Intra- and extrahepatic dilatations are adequately treated by extrahepatic resection and careful endoscopic or radiologic surveillance. Small choledochoceles can be safely managed by endoscopic sphincterotomy.

  18. Pranayam for Treatment of Chronic Obstructive Pulmonary Disease: Results From a Randomized, Controlled Trial

    Science.gov (United States)

    Gupta, Anupama; Gupta, Rajesh; Sood, Sushma; Arkham, Mohammad

    2014-01-01

    Context Existing medications for chronic obstructive pulmonary disease (COPD) do not modify the long-term decline in lung functions. The increasing prevalence of COPD requires the development of interventions beyond the usual medical treatment, with a specific focus on rehabilitation. Controlled breathing (pranayam) is a specific set of respiratory exercises within yoga that has been shown to improve the resting respiratory rate, vital capacity, maximum voluntary ventilation, breath-holding time, and maximal inspiratory and expiratory pressures. Objective In this study, pranayam was analyzed as an adjunct treatment for medically stable individuals with moderate to severe COPD. Design The research team carried out a case control study. Setting This study took place at a tertiary care institution, with the participation of the departments of Physiology, Yoga and Naturopathy, and Pulmonary Medicine at Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences in Rohtak, Haryana, India. Participants Participants were 50 medically stable individuals with moderate to severe COPD. Intervention Twenty-five participants in the intervention arm (IA) were trained to practice pranayam for 30 min 2 ×/d and also received the usual medical treatment. The control group also included 25 participants, and they received the usual medical treatment only, without pranayam. Outcome Measures The COPD assessment test (CAT) score and the body-mass index, obstruction, dyspnea, exercise (BODE) capacity index were assessed at baseline and at 3 mo. The results were expressed using standard statistical methods. Results For the IA, a significant improvement occurred in the CAT score (21.2 ± 2.6–17.4 ± 2.5, P 20) to medium (10–20) after 3 mo of practicing pranayam. The control arm (CA) showed no significant improvement in the CAT score (21.6 ± 2.7–21.4 ± 2.7). Although the IA showed a significant improvement in a 6-min walk test (6MWT) when compared to the CA, (1) the IA

  19. Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years

    Science.gov (United States)

    Filardo, Giuseppe; Kon, Elizaveta; Di Matteo, Berardo; Di Martino, Alessandro; Tesei, Giulia; Pelotti, Patrizia; Cenacchi, Annarita; Marcacci, Maurilio

    2014-01-01

    Background Chronic Achilles tendinopathy is responsible for a severe reduction in physical performance and persistent pain. There is currently a number of therapeutic options and the local administration of growth factors is an emerging treatment strategy. In particular, platelet-rich plasma (PRP) is a widely used way to provide a local regenerative stimulus for tendon healing. The aim of this study was to document the mid-term results obtained after treating recalcitrant Achilles tendinopathy with injections of high concentrate, leucocyte-rich PRP. Materials and methods Twenty-seven patients (mean age: 44.6 years; 22 men and 5 women) affected by chronic mid-portion Achilles tendinopathy (7 bilateral, for a total of 34 tendons), refractory to previous treatments, were enrolled. Patients were treated with three ultrasound-guided intra-tendinous injections of PRP at 2-week intervals. Patients were prospectively evaluated at baseline, and then at 2, 6, and up to a mean of 54.1 months of follow-up (minimum 30 months), using the following tools: Blanzina, VISA-A, EQ-VAS for general health, and Tegner scores. Results The VISA-A score showed a significant improvement: the baseline score of 49.9±18.1 increased to 62.9±19.8 at 2 months (p=0.002), with a further improvement at 6 months (84.3±17.1, ptendinopathy with a stable outcome up to a medium-term follow-up. Longer symptom duration was related with a more difficult return to sporting activity. PMID:24960641

  20. Analysis of the results of treatment of patients with destructive forms of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    N. V. Chubchenko

    2013-08-01

    Full Text Available In Ukraine the incidence of acute pancreatitis is 102 per 100 000 population. In recent years researches in the field of the methods of diagnostics of disease severity showed that one of the most promising is determination of the concentration of procalcitonin in blood. The experience of application hemodiafiltration was described In the literature. The purpose of the research: to analyze the results of treatment of patients with destructive forms of acute pancreatitis with the use of modern methods of diagnostics and treatment. Materials and methods. The study included 15 patients with destructive forms of acute pancreatitis. The severity of the patient's condition was evaluated by the scale APACHE II, the degree of multiple organ failure (MOF by the scale SOFA, the degree of endogenous intoxication by assess of the leukocyte index of intoxication (LII and concentration of procalcitonin. Results. Only 11 patients recovered, five had purulent-septic complications, which in one case led to a lethal outcome. Three patients admitted in the extremely pore condition of the disease with lethal outcome in connection with the development of shock and multiple organ failure. The highest values of procalcitonin corresponded to the maximum values of APACHE II and SOFA. Three patients received prolonged venous-venous hemodiafiltration and in two of them positive dynamics was got: decreased number of points by APACHE II ≤6,SOFA≤3, decreased LII ≤7 and concentration of procalcitonin, one became death. Conclusions. For the assessment of severity of disease it is necessary to determine the concentration of procalcitonin. In the complex intensive therapy the prolonged venous-venous hemodiafiltration use is justified.

  1. Results of radiotherapy and vitamin E in the treatment of Peyronie's disease.

    Science.gov (United States)

    Rodrigues, C I; Njo, K H; Karim, A B

    1995-02-01

    A retrospective analysis of 38 patients with Peyronie's disease treated with primary radiotherapy in the period of 1975-1993. Important complaints were curvature of the penis during erection for 92% of the patients, painful erection for 68%, and problems with sexual intercourse for 37.5%. Average size of all indurated plaques was 2.5 cm. The average pretreatment duration of symptoms was 9.5 months. All 38 patients were irradiated with orthovoltage radiotherapy (200 and 250 kV photons) with a total dose of 9 Gy in 5 alternating days (regimen A). Because of minimal response, 16 patients were irradiated again with another 9 Gy in 5 days and finally received 18 Gy (regimen B). With regimen A, a satisfying improvement was achieved for the majority of the patients: 65% experienced less penile pain during erection, 40% reported less curvature of the penis, and 47% experienced an improvement of their sex life. With the higher dose of regimen B there was an additional improvement for a minority of the patients: 25% reported less pain during erection, 21% had less curvature, and 29% experienced an improved sex life. With regimen A, pain improvement was statistically significantly superior when compared to regimen B. For all other improvements (curvature, sexual intercourse, and induration) no dose-response relation could be demonstrated between regimen A and the higher dose regimen B. No patient experienced any radiation-induced morbidity. After evaluating regimen A and regimen B, the overall result was that 76% experienced less pain, 60% reported an improved sex life, and 48% had a diminished curvature during erection. From this analysis it can be concluded that the distressing symptoms of Peyronie's disease can be treated successfully with radiotherapy. Radiotherapy proves to be a safe, noninvasive treatment method without causing morbidity. Low-dose radiotherapy with only a few fractions is recommended for an effective treatment result.

  2. Obstructive pyelonephritis as a result of urolithiasis in Japan: diagnosis, treatment and prognosis.

    Science.gov (United States)

    Hamasuna, Ryoichi; Takahashi, Satoshi; Nagae, Hiroshi; Kubo, Tatsuhiko; Yamamoto, Shingo; Arakawa, Soichi; Matsumoto, Tetsuro

    2015-03-01

    To study the current scenario of diagnosis, treatment and mortality of obstructive pyelonephritis secondary to urolithiasis in Japan. The study was a retrospective and multicenter survey for hospitalized patients with obstructive pyelonephritis as a result of urolithiasis in educational facilities for specialists by the Japanese Urological Association. Patients' characteristics including physical or laboratory examinations, treatment and prognosis were recorded, and the risk factors for disease death were analyzed. A total of 1363 patients from 208 hospitals were analyzed. The median age of patients was 68 years, and there were 2.2-fold more female patients than male patients. From 844 patients, 891 species of bacteria or fungi were isolated, and Gram-negative rods accounted for 76.5% of cases. The mortality of patients was 2.3%. The risk factors related to disease death by univariate analysis were identified as older age, solitary kidney, ambulance use to visit hospital, disturbance of consciousness, severe appetite loss, higher performance status, disseminated intravascular coagulation status or systemic inflammatory response syndrome, vasopressors and anti-disseminated intravascular coagulation therapies, increased pulse rates, lower hemoglobin, lower serum albumin, and high blood urea nitrogen values. The predictive risk factors for disease death of patients' status at hospitalization were age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness and solitary kidney by multivariate analysis. Obstructive pyelonephritis as a result of urolithiasis represents an emergent disease in the urological field with relatively high mortality. Patients with older age or poor conditions should be hospitalized, and intervention by a urology specialist is likely to be required. © 2014 The Japanese Urological Association.

  3. Positive EtG findings in hair as a result of a cosmetic treatment.

    Science.gov (United States)

    Sporkert, Frank; Kharbouche, Hicham; Augsburger, Marc P; Klemm, Clementine; Baumgartner, Markus R

    2012-05-10

    In a case of a driving ability assessment, hair analysis for ethyl glucuronide (EtG) was requested by the authorities. The person concerned denied alcohol consumption and did not present any clinical sign of alcoholism. However, EtG was found in concentrations of up to 910pg/mg in hair from different sampling dates suggesting an excessive drinking behavior. The person declared to use a hair lotion on a regularly base. To evaluate a possible effect of the hair lotion, prospective blood and urine controls as well as hair sampling of scalp and pubic hair were performed. The traditional clinical biomarkers of ethanol consumption, CDT and GGT, were inconspicuous in three blood samples taken. EtG was not detected in all collected urine samples. The hair lotion was transmitted to our laboratory. The ethanol concentration in this lotion was determined with 35g/L. The EtG immunoassay gave a positive result indicating EtG, which could be confirmed by GC-MS/MS-NCI. In a follow-up experiment the lotion was applied to the hair of a volunteer over a period of six weeks. After this treatment, EtG could be measured in the hair at a concentration of 72pg/mg suggesting chronic and excessive alcohol consumption. Overnight incubation of EtG free hair in the lotion yielded an EtG concentration of 140pg/mg. In the present case, the positive EtG hair findings could be interpreted as the result of an EtG containing hair care product. To our knowledge, the existence of such a product has not yet been reported, and it is exceptionally unusual to find EtG in cosmetics. Therefore, external sources for hair contamination should always be taken into account when unusual cosmetic treatment is mentioned. In those cases, it is recommended to analyze the hair product for a possible contamination with EtG. The analysis of body hair can help to reveal problems occurring from cosmetic treatment of head hair. As a consequence, the assessment of drinking behavior should be based on more than one

  4. Long-term results after Boston brace treatment in adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Steen Harald

    2009-08-01

    Full Text Available Abstract Background Few studies have evaluated long-term outcome after bracing using validated health related quality of life outcome measures. The aim of the present study was to evaluate the long-term outcome in adolescent idiopathic scoliosis (AIS 12 years or more after treatment with the Boston brace. Methods 109 (80% of 135 patients (7 men with AIS treated with the Boston brace at a mean of 19.2 (range 12–28 years previously responded to long-term follow-up examination. All patients (n = 109 answered a standardised questionnaire including demographics, work status, treatment, Global Back Disability Question, Oswestry Disability Index (ODI (100-worst possible, General Function Score (GFS (100 – worst possible, EuroQol (EQ-5D (1 – best possible, EQ-VAS (100 – best possible and Scoliosis Research Society -22 (SRS – 22 (5 – best possible. Clinical and radiological examination was obtained in 86 patients. Results The magnitude of the primary prebrace major curve was in average 33.4° (range 20 – 52. At weaning and at the last follow-up the corresponding values were 28.3° (9–56 and 34.2° (8 – 87, respectively. The mean age at follow-up was 35 (27 – 46 years. Work status was: full time (80%, on sick-leave (3%, on rehabilitation (4%, disability pension (4%, homemaker (7%, students (2%, 7% had changed their job because of back pain. 88% had had delivered a baby, 55% of them had pain in pregnancy. Global back status was excellent or good in 81%. The mean (standard deviation ODI was 6.4 (9.8, GFS 5.4 (10.5, EQ-5D 0.84 (0.2, SRS-22: pain 4.2 (0.8, mental health 4.2 (0.7, self-image 3.9 (0.7, function 4.1 (0.6, satisfaction with treatment 3.7 (1.0. 28% had taken physiotherapy for back pain the last year and 12% had visited a doctor. Conclusion Long-term results were satisfactory in most patients with AIS treated with the Boston brace.

  5. Pregabalin for the treatment of postoperative pain: results from three controlled trials using different surgical models

    Directory of Open Access Journals (Sweden)

    Singla NK

    2014-12-01

    Full Text Available Neil K Singla,1 Jacques E Chelly,2 David R Lionberger,3 Joseph Gimbel,4 Luis Sanin,5 Jonathan Sporn,5 Ruoyong Yang,5 Raymond Cheung,5 Lloyd Knapp,6 Bruce Parsons5 1Lotus Clinical Research, Pasadena, CA, USA; 2Division of Acute Interventional Perioperative Pain, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA; 4Arizona Research Center, Phoenix, AZ, USA; 5Pfizer Inc., New York, NY, USA; 6Pfizer Inc., New London, CT, USA Purpose: To evaluate the efficacy and safety of pregabalin (150 or 300 mg/d as an adjunctive therapy for the treatment of postoperative pain. Patients and methods: This study reports findings from three separate, multicenter, randomized, double-blind, placebo-controlled trials of adjunctive pregabalin for the treatment of postoperative pain. Patients underwent one of three categories of surgical procedures (one procedure per study: elective inguinal hernia repair (post-IHR; elective total knee arthroplasty (post-TKA; or total abdominal hysterectomy (posthysterectomy. The primary endpoint in each trial, mean worst pain over the past 24 hours, was assessed 24 hours post-IHR and posthysterectomy, and 48 hours post-TKA. Patients rated their pain on a scale from 0 to 10, with higher scores indicating greater pain severity. Results: In total, 425 (post-IHR, 307 (post-TKA, and 501 (posthysterectomy patients were randomized to treatment. There were no statistically significant differences between the pregabalin and placebo groups with respect to the primary endpoint in any of the three trials. The least squares mean difference in worst pain, between 300 mg/d pregabalin and placebo, was -0.7 (95% confidence interval [CI] =-1.4, -0.1; Hochberg adjusted P=0.067 post-IHR; -0.34 (95% CI =-1.07, 0.39; P=0.362 post-TKA; and -0.2 (95% CI =-0.66, 0.31; P=0.471 posthysterectomy. Conclusion: There were no significant differences

  6. Treatment

    National Research Council Canada - National Science Library

    Safaa M. Raghab; Ahmed M. Abd El Meguid; Hala A. Hegazi

    2013-01-01

    .... This paper presents the results of the analyses of leachate treatment from the solid waste landfill located in Borg El Arab landfill in Alexandria using an aerobic treatment process which was applied...

  7. Arthroscopic treatment of acute acromioclavicular dislocations using a double button device: Clinical and MRI results.

    Science.gov (United States)

    Loriaut, P; Casabianca, L; Alkhaili, J; Dallaudière, B; Desportes, E; Rousseau, R; Massin, P; Boyer, P

    2015-12-01

    Arthroscopic treatment of acute grade 3 and 4 acromioclavicular dislocation is controversial, due to the risk of recurrence and of postoperative reduction defect. The purpose of the present study was to investigate whether the healing of the acromioclavicular (AC) and coracoclavicular (CC) ligaments and the accurate 3D positioning parameters of the AC joint using MRI were correlated with satisfactory functional outcome. Thirty-nine patients were enrolled from 2009 to 2011 and managed arthroscopically by CC lacing using a double-button device. Clinical assessment included the Shoulder and Hand (QuickDash) score, Constant-Murley score and visual analog scale (VAS) for residual pain. Time and rate to return to work and return to sport were assessed according to type of sport and work. Postoperative complications were recorded. Radiological examination consisted of anteroposterior clavicle and lateral axillary radiographs. AC ligament healing and 3D joint congruency were assessed on MRI and correlated to the clinical results. Mean patient age was 35.7 years (range, 20-55). Mean follow-up was 42.3±10.6 months (range, 24-60). At final follow-up, mean QuickDash score, Constant score and VAS were respectively 1.7±4 (range, 0-11), 94.7±7.3 (range, 82-100) and 0.5±1.4 (range, 0-2). Thirty-five (90%) patients were able to resume work, including heavy manual labor, and sport. Radiology found accurate 3D joint congruency in 34 patients (87%) and CC and AC ligament healing in 36 (93%). Complications included reduction loss at 6 weeks in 3 patients, requiring surgical stabilization. Satisfactory functional results were associated with accurate AC joint congruency in the coronal and axial planes (P<0.05) and good AC and CC ligament healing (P<0.04). An initial 25% reduction defect in the coronal plane was not associated with poor functional results (P=0.07). Arthroscopic treatment by CC lacing satisfactorily restored ligament and joint anatomy in the present series. These

  8. Symptoms of cutaneous sensitivity pre-treatment and post-treatment: results from the rizatriptan TAME studies.

    Science.gov (United States)

    Cady, R; Martin, V; Mauskop, A; Rodgers, A; Hustad, C M; Ramsey, K E; Skobieranda, F

    2007-09-01

    The presence of cutaneous allodynia may predict response to triptans. Identical randomized double-blind studies were conducted comparing the efficacy of rizatriptan 10 mg or placebo administered within 1 h of headache onset, while pain was mild. The primary endpoint was freedom from pain at 2 h. Presence of symptoms suggesting cutaneous sensitivity (SCS) at baseline and at 2 h post-treatment was recorded. Before treatment, 29% of rizatriptan patients and 22% of placebo patients reported SCS. At 2 h, the percentage of patients with SCS was significantly decreased with rizatriptan. The presence of SCS pre-treatment was not predictive of response to rizatriptan. Most patients with SCS at 2 h were non-responders. Early treatment with rizatriptan significantly reduced the percentage of patients with SCS at 2 h. The presence of SCS at baseline did not predict pain-free response, but presence of SCS at 2 h correlated with lack of a 2-h pain-free response.

  9. [Decitabine treatment in myelodysplastic syndromes--results of a compassionate patient program in Israel].

    Science.gov (United States)

    Klepfish, Abraham; Silbershatz, Itay; Lugassy, Gilles; Shimoni, Avichai; Mittelman, Moshe

    2013-10-01

    Hypermethylation of tumor suppressor genes (TSG) has been recognized as an important factor in the pathogenesis of malignancies, including myelodysplastic syndromes (MDS). Decitabine (trade name Dacogen; 5-aza-2'-deoxycytidine) is a cytosine analog which inhibits the enzyme DNA methyltransferase (DNMT), inducing hypomethylation and activates TSG, leading to tumor cell growth inhibition. In clinical trials with hypomethylating agents in advanced MDS, a total response rate of 30-73% has been observed, with a complete response (CR) of 9-37%, partial response (PR] of similar rate and a hematologic improvement (HI] in 20-48% of the patients. We report the results of a national Israeli compassionate program of decitabine administration to patients with advanced MDS. From July 2007 through August 2008, under the joint sponsorship of The Israel Society of Hematology and Blood Transfusions and Janssen, Israel, a compassionate program was conducted. Decitabine was administered to patients with advanced MDS who were not candidates for any other anti-MDS treatment, except for supportive care. The selected regimen was a 5-day intravenous administration of 20 mg/m/d, every 28 days. After the program had been completed, an approval of the institutional Helsinki committees was obtained, and the data were collected in an attempt to evaluate the results of this novel treatment. The standard response criteria, i.e. total response, CR, PR and HI were applied. Toxicity, survival and leukemic transformation rate were also analyzed. Twenty-four patients with advanced MDS participated in the program but evaluable information could be collected only on 17 patients. The median number of therapeutic cycles was two per patient. Twelve patients were transfusion-dependent at program onset, of whom 7 either benefited from reduced transfusion requirements or became transfusion-free. The overall response rate was 26%, with 23% PR and 13% HI. Two patients (13%) demonstrated leukemic transformation

  10. Current treatment for venom-induced consumption coagulopathy resulting from snakebite.

    Directory of Open Access Journals (Sweden)

    Kalana Maduwage

    2014-10-01

    Full Text Available Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest important systemic clinical syndromes and can be complicated by serious and life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC is the commonest coagulopathy resulting from snakebite and occurs in envenoming by Viperid snakes, certain elapids, including Australian elapids, and a few Colubrid (rear fang snakes. Procoagulant toxins activate the clotting pathway, causing a broad range of factor deficiencies depending on the particular procoagulant toxin in the snake venom. Diagnosis and monitoring of coagulopathy is problematic, particularly in resource-poor countries where further research is required to develop more reliable, cheap clotting tests. MEDLINE and EMBASE up to September 2013 were searched to identify clinical studies of snake envenoming with VICC. The UniPort database was searched for coagulant snake toxins. Despite preclinical studies demonstrating antivenom binding toxins (efficacy, there was less evidence to support clinical effectiveness of antivenom for VICC. There were no placebo-controlled trials of antivenom for VICC. There were 25 randomised comparative trials of antivenom for VICC, which compared two different antivenoms (ten studies, three different antivenoms (four, two or three different doses or repeat doses of antivenom (five, heparin treatment and antivenom (five, and intravenous immunoglobulin treatment and antivenom (one. There were 13 studies that compared two groups in which there was no randomisation, including studies with historical controls. There have been numerous observational studies of antivenom in VICC but with no comparison group. Most of the controlled trials were small, did not use the same method for assessing coagulopathy, varied the dose of antivenom, and did not provide complete details of the study design (primary outcomes

  11. Intraprostatic injection of alcohol gel for the treatment of benign prostatic hyperplasia: preliminary clinical results.

    Science.gov (United States)

    Larson, Benjamin T; Netto, Nelson; Huidobro, Christian; de Lima, Marcelo Lopez; Matheus, Wagner; Acevedo, Cristian; Larson, Thayne R

    2006-09-06

    Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH. A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20-30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months. The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment. This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an

  12. Enhanced Fidelity to a Psychosocial Treatment for Bipolar Disorder: Results from a Randomized Controlled Implementation Trial

    Science.gov (United States)

    Waxmonsky, Jeanette; Kilbourne, Amy M.; Goodrich, David E.; Nord, Kristina M.; Laird, Christina; Lai, Zongshan; Clogston, Julia; Kim, Hyungjin Myra; Miller, Christopher J.; Bauer, Mark S.

    2014-01-01

    Background We determined whether application of a novel implementation intervention (Enhanced Replicating Effective Programs-REP) versus its standard, dissemination-focused version (REP) improved fidelity to bipolar disorder treatment (Life Goals Collaborative Care- LGCC). Methods Five community practices from Michigan and Colorado were randomized to receive LGCC using Enhanced or standard REP. One provider at each practice implemented LGCC which included patient self-management support (4 group sessions focused on symptoms and behavior goals), guideline dissemination to providers, and ongoing phone care management focused on maintaining behavior goals and provider engagement. Standard REP included intervention packaging (i.e., translation of LGCC core components into user-friendly language), training, and as-needed technical assistance. Enhanced REP added customization of LGCC and ongoing, proactive technical assistance through an internal and external facilitator that focused on enhancing provider buy-in and uptake. Multiple and logistic regression analyses determined the impact on patient-level LGCC fidelity between Enhanced versus standard REP. Results Participants (N=384; mean age = 42 years, 67% women, 29% nonwhite) averaged 3.0 out of 4 LGCC group sessions and had 4.0 care management contacts. Enhanced REP implementation was associated with 2.6 (p<.001) greater total number of sessions/contacts than standard REP, which was driven by 2.5 (p<.01) more care management contacts, after adjusting for patient factors. Women and those with a history of homelessness received fewer sessions. Conclusions Enhanced REP implementation was associated with improved LGCC fidelity, primarily for care management contacts. Additional customization of interventions such as LGCC may be needed to ensure adequate treatment fidelity for key vulnerable populations. PMID:24129806

  13. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study

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    Roseboom MG

    2011-02-01

    Full Text Available Abstract Background Probiotics are increasingly used in the treatment of functional gastrointestinal disorders. Studies in constipated adults with a Bifidus yoghurt (containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus showed a significant increase in defecation frequency. The aim of this pilot study was to determine if Bifidobacterium breve is effective in the treatment of childhood constipation. Methods Children, 3 to 16 years of age, with functional constipation according to the Rome III criteria were eligible for this study. During 4 weeks, children received one sachet of powder daily, containing 108- 1010 CFU Bifidobacterium breve. Furthermore, children were instructed to try to defecate on the toilet for 5-10 minutes after each meal and to complete a standardized bowel diary daily. The primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency using the Bristol stool scale frequency of episodes of faecal incontinence, pain during defecation, frequency of abdominal pain, frequency of adverse effects (nausea, diarrhoea and bad taste, and frequency of intake of bisacodyl. Results Twenty children (75% male, mean age 7.4 were included in this pilot study. The defecation frequency per week significantly increased from 0.9 (0-2 at baseline to 4.9 (0-21 in week 4 (p Conclusion Bifidobacterium breve is effective in increasing stool frequency in children with functional constipation. Furthermore it has a positive effect with respect to stool consistency, decreasing the number of faecal incontinence episodes and in diminishing abdominal pain. A randomized placebo controlled trial is required to confirm these data.

  14. Treatment results of glioblastoma during the last 30 years in a single institute.

    Science.gov (United States)

    Kumabe, Toshihiro; Saito, Ryuta; Kanamori, Masayuki; Chonan, Masashi; Mano, Yui; Shibahara, Ichiyo; Kawaguchi, Tomohiro; Kato, Hideaki; Yamashita, Yoji; Sonoda, Yukihiko; Kawagishi, Jun; Jokura, Hidefumi; Watanabe, Mika; Katakura, Ryuichi; Kayama, Takamasa; Tominaga, Teiji

    2013-01-01

    Treatment results of glioblastoma (GB) during the last 30 years in Tohoku University were analyzed to identify any improvements in patient outcome in all 332 histologically proven cases of newly diagnosed GB treated consecutively in our department between 1982 and 2011. These 30 years was divided into 5 treatment eras, Group 1 (1982-1988, without preoperative evaluation by magnetic resonance [MR] imaging, n = 46), Group 2 (1989-1996, with preoperative MR imaging, n = 41), Group 3 (1997-1999, additionally underwent intraoperative functional brain mapping and neuronavigation system, n = 38), Group 4 (2000-August 2006, underwent 30 Gy of whole brain radiation followed by 30 Gy of extended local accelerated hyperfractionated radiation therapy, n = 96), and Group 5 (September 2006-2011, adjuvant usage of temozolomide [TMZ], n = 111). Overall survival (OS) was calculated from the date of surgery to the death from any cause. The median survival time/2-year OS/5-year OS of Groups 1 to 5 were 10.7 months/10.9%/0%, 17.3 months/26.2%/6.9%, 15.9 months/23.7%/5.3%, 20.1 months/34.8%/15.5%, and 20.9 months/45.5%/19.7%. The prognosis for patients with GB improved significantly after the introduction of MR imaging. Younger GB, defined as patients aged below 60 years, or total tumor resection with all ages in Group 5 had 5-year 0S of 31.0% and 30.1%, respectively. The prognosis of GB was improved significantly after the introduction of TMZ for elderly GB, recursive partitioning analysis class 5, or totally resected GB. Introduction of MR imaging and TMZ, and total resection of the tumor were important in the improvement of outcome for patients with GB.

  15. Soil biodiversity in artificial black pine stands after selective silvicultural treatments: preliminary results

    Science.gov (United States)

    Mocali, Stefano; Fabiani, Arturo; Butti, Fabrizio; De Meo, Isabella; Bianchetto, Elisa; Landi, Silvia; Montini, Piergiuseppe; Samaden, Stefano; Cantiani, Paolo

    2016-04-01

    The decay of forest cover and soil erosion is a consequence of continual intensive forest exploitation, such as grazing and wildfires over the centuries. From the end of the eighteenth century up to the mid-1900s, black pine plantations were established throughout the Apennines' range in Italy, to improve forest soil quality. The main aim of this reafforestation was to re-establish the pine as a first cover, pioneer species. A series of thinning activities were therefore planned by foresters when these plantations were designed. The project Selpibiolife (LIFE13 BIO/IT/000282) has the main objective to demonstrate the potential of an innovative silvicultural treatment to enhance soil biodiversity under black pine stands. The monitoring will be carried out by comparing selective and traditional thinning methods (selecting trees from below leaving well-spaced, highest-quality trees) to areas without any silvicultural treatments (e.g. weeding, cleaning, liberation cutting). The monitoring survey was carried out in Pratomagno and Amiata Val D'Orcia areas on the Appennines (Italy) and involved different biotic levels: microorganisms, mesofauna, nematodes and macrofauna (Coleoptera). The results displayed a significant difference between the overall biodiversity of the two areas. In particular, microbial diversity assessed by both biochemical (microbial biomass, microbial respiration, metabolic quotient) and molecular (PCR-DGGE) approaches highlighted different a composition and activity of microbial communities within the two areas before thinning. Furthermore, little but significant differences were observed for mesofauna and nematode community as well which displayed a higher diversity level in Amiata areas compared to Pratomagno. In contrast, Coleoptera showed higher richness values in Pratomagno, where the wood degrader Nebria tibialis specie dominated, compared to Amiata. As expected, a general degraded biodiversity was observed in both areas before thinning.

  16. Neurological results of the modified treatment of epilepsy by stimulation of the vagus nerve.

    Science.gov (United States)

    Vaiman, Michael; Heyman, Eli; Lotan, Gad

    2017-07-08

    The vagus nerve stimulation (VNS) is used for treatment of drug-resistant epilepsy but laryngeal side effects are common. We tried to improve VNS by modifying the implantation procedure. The aim was to reduce the rate of side effects that have prevented using VNS to its full capacity. We operated on 74 pediatric patients for VNS device implantation using a modified surgical protocol incorporating lower neck incision for electrode placement and 36 patients who were operated by standard technique were used for control group. We retrospectively analyzed reduction in frequency of seizures, reduction in severity of seizures (assessed by the shortened Ictal/post-ictal subscale of the Liverpool Seizure Severity Scale that included falling to the ground, postictal headache and sleepiness, incontinence, tongue biting, and injury during attack). Using the new implantation technique, side effects related directly to VNS therapy occurred in six cases (8.1%) showing statistically sound improvement over the standard implantation technique (p ˂ 0.05). To achieve good results, the maximum stimulation (3.5 mA) was used in 24 patients (32.4%), with no laryngeal side effects detected. Twelve patients (16.2%) were seizure-free after the first year of VNS treatment. 74.3% of patients experienced a 50% reduction in seizure frequency and improved ictal or postictal activity. To minimize laryngeal complications in implantation surgery for VNS devices, the surgical technique may be modified, and lower neck incision could be used. A low rate of laryngeal side effects allows using the VNS device to its full electrical capacity.

  17. Preliminary results of video-assisted anal fistula treatment (VAAFT) in children.

    Science.gov (United States)

    Pini Prato, A; Zanaboni, C; Mosconi, M; Mazzola, C; Muller, L; Meinero, P C; Faticato, M G; Leonelli, L; Montobbio, G; Disma, N; Mattioli, G

    2016-05-01

    Anal fistula is a common acquired anorectal disorder in children. Treatment methods that have been used are associated with inconsistent results and possible serious complications. In 2011 a minimally invasive approach, video-assisted anal fistula treatment (VAAFT) was described for adult patients. The aim of the present study was to assess the first series of pediatric patients treated with VAAFT. All patients who underwent VAAFT between August 2013 and May 2015 were included. Demographics, clinical features, preoperative imaging, surgical details, outcome, and medium-term data were prospectively collected for each patient. Thirteen procedures were performed in nine patients. The male to female ratio was 8:1, and the median age was 9.6 years. Five fistulas were idiopathic, three iatrogenic, and one associated with Crohn's disease. Eight complete VAAFT procedures were performed. The remaining five procedures were either fistuloscopy and cutting seton placement or fistuloscopy and electrocoagulation, both without mucosal sleeve. The median length of surgery was 41 min. The median hospital stay was 24 h, and the median length of follow-up was 10 months. Resolution of the fistula was observed in all patients who underwent a complete VAAFT. In four out of five patients who underwent an incomplete procedure (without mucosal sleeve), the fistula recurred. No incontinence or soiling was reported in the medium term. VAAFT proved to be feasible and safe in children. It also proved to be versatile as it could be applied to fistulas of different etiologies. The key to success seems to be an adequate mucosal sleeve. Older children and adolescents benefit most from VAAFT which is a valid alternative to available surgical procedures.

  18. Treatment results of breast cancer patients with locoregional recurrence after mastectomy

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yuri; Gong, Gyun Gyub; Lee, Hee Jin [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2013-09-15

    To analyze the results of locoregional and systemic therapy in the breast cancer patients with locoregional recurrence (LRR) after mastectomy. Seventy-one patients who received radiotherapy for isolated LRR after mastectomy between January 1999 and December 2009 were retrospectively reviewed. Among the 71 patients, 59 (83.1%) underwent wide excision and radiotherapy and 12 (16.9%) received radiotherapy alone. Adjuvant hormonal therapy was given to 45 patients (63.4%). Oncologic outcomes including locoregional recurrence-free survival, disease-free survival (DFS), and overall survival (OS) and prognostic factors were analyzed. Median follow-up time was 49.2 months. Of the 71 patients, 5 (7%) experienced second isolated LRR, and 40 (56%) underwent distant metastasis (DM). The median DFS was 35.6 months, and the 3- and 5-year DFS were 49.1% and 28.6%, respectively. The median OS was 86.7 months, and the 5-year OS was 62.3%. Patients who received hormone therapy together showed better 5-year DFS and OS than the patients treated with locoregional therapy only (31.6% vs. 22.1%, p = 0.036; 66.5% vs. 55.2%, p = 0.022). In multivariate analysis, higher N stage at recurrence was a significant prognostic factor for DFS and OS. Disease free interval (≤ 30 months vs. >30 months) from mastectomy to LRR was also significant for OS. The patients who received hormone therapy showed superior DFS and showed trend to better OS. DM was a major pattern of failure after the treatment of LRR after mastectomy. The role of systemic treatment for LRR after mastectomy should be investigated at prospective trials.

  19. Vismodegib for the treatment of basal cell carcinoma: results and implications of the ERIVANCE BCC trial.

    Science.gov (United States)

    Dessinioti, Clio; Plaka, Michaela; Stratigos, Alexander J

    2014-05-01

    The need for effective treatment of patients with locally advanced or metastatic basal cell carcinoma (BCC), in conjunction with major advances in the elucidation of the molecular basis of this tumor has led to the advent of new targeted therapies - namely, hedgehog inhibitors. The rationale for their use in patients with advanced BCC is based on their inhibitory effect on the hedgehog pathway, which is aberrantly activated in BCCs due to mutations of its primary components, PTCH1 and SMO genes. Vismodegib (GDC-0449) is an orally bioavailable hedgehog pathway inhibitor that selectively inhibits SMO. The ERIVANCE BCC study is a Phase II, international, multicenter clinical trial evaluating the efficacy and safety of vismodegib 150 mg once daily in patients with locally advanced or metastatic BCC. Vismodegib has been approved for the treatment of adult patients with metastatic BCC, or with locally advanced BCC that has recurred following surgery or who are not candidates for surgery or radiation therapy. This article will outline the rationale, design and available results from the ERIVANCE BCC study and discuss the clinical implications of vismodegib in the management of patients with BCC. Challenges regarding vismodegib use include the recurrence of BCC after drug discontinuation, the development of acquired resistance, the dramatic efficacy in patients with Gorlin syndrome, and class-related drug toxicity. Ongoing clinical trials aim to explore the role of vismodegib in the neoadjuvant setting prior to surgery, the potential use of alternate dosing regimens in order to limit chronic adverse events, as well as the identification of patients with BCC that are more likely to respond to this targeted therapy based on genotypic and/or phenotypic characteristics.

  20. Surgical treatment of subcostal incisional hernia with polypropylene mesh - analysis of late results

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Oliveira Peres

    Full Text Available OBJECTIVE: To evaluate the results of subcostal incisional hernia repair using polypropylene mesh, the technical aspects of musculo-aponeurotic reconstruction, routine fixation of supra-aponeurotic mesh and follow-up for five years.METHODS: We conducted a retrospective study that assessed 24 patients undergoing subcostal incisional hernia repair with use of polypropylene mesh; 15 patients (62.5% were female; ages ranged from 33 to 82, and 79.1% had comorbidities.RESULTS: Early complications: three cases (12.5% of wound infection, three cases (12.5% of seroma, one case (4.1% of hematoma; and one case (4.1% of wound dehiscence. Late complications occurred in one case (4.1% of hernia recurrence attributed to technical failure in the fixation of the mesh and in one case (4.1% of chronic pain. There were no cases of exposure or rejection of the mesh.CONCLUSION: The subcostal incisional hernia, though not very relevant, requires adequate surgical treatment. Its surgical correction involves rebuilding the muscle-aponeurotic defect, supra-aponeurotic fixation of polypropylene mesh, with less complexity and lower rates of complications and recurrences.

  1. Treatment results of chemoradiation for T1 esophageal cancer with lymph node metastases

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Yoshiyuki [Nishio Municipal Hospital, Aichi (Japan); Fuwa, Nobukazu; Matsumoto, Akira; Asano, Akiko; Sasaoka, Masahiro

    2000-04-01

    We clinically evaluated 12 patients with advanced superficial esophageal cancer who had undergone chemoradiotherapy. A retrospective analysis was performed between October 1992 and December 1998 on 12 patients with M1 metastasis in lymph nodes or direct invasion of enlarged lymph nodes (A3) to adjacent structures. Combined treatment with radiotherapy and chemotherapy was applied to all patients. High-dose cisplatin (CDDP) and 5-fluorouracil (5FU) were administered to five patients, low-dose CDDP and 5-FU to five patients, and others to two patients. Ten patients were treated by external irradiation alone, and two patients were treated by external and intracavitary irradiation. Of the 12 patients, the response of the primary tumor to this therapy resulted in 11 CRs (91.6%) and one PR, while the response of the largest metastatic lesion in lymph nodes in each patient resulted in three CRs (25%), four PRs (33.3%), and five NCs (41.6%). The 2-year survival rate of all patients was 51.9%, and MST was 28.9 months. The 2-year survival rates of the M1 and A3 patients were 60.0% and 41.7%, respectively. This study revealed that the present chemotherapy regimen is ineffective in treating metastatic lymph node lesions. Therefore, it will be necessary to evaluate the effectiveness of chemoradiotherapeutic agents from the perspective of their effects on metastatic lymph nodes. (author)

  2. Midterm Results of HemiCAP Operation in the Surgical Treatment of ha/lux Rigidus

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    Hasan Gocer

    2016-01-01

    Full Text Available Aim: Hallux rigidus is a disease characterised by pain and reduced range of motion due to osteoarthritis of the first metatarsophalengeal joint. Although there are many differents surgical and conservative methods, no standard treatment protocol is described. In this study, we investigated the results of HemiCap surface arthroplasty of the first metatarsophalengeal joint in a patient who suffered from pain and reduced range of motion. Material and Method: 19 of 29 patients that we treated with HemiCap implant beetween October 2008-March 2013 are included to the study. 20 limbs of 19 patients are radiologically and clinically evaluated. Patients are assessed with American Orthopaedic Foot and Ankle Society (AOFAS and Visual Analog Scale (VAS in their last call. Results: 10 of 19 patients were male, 9 of 19 patients were female. Mean age was 57.4 years (min 32, max 72 years and mean follow up period was 27.2 months (min 5, max 57 months. Preoperative mean AOFAS score was 38 while it was 76 in the last call (p

  3. The Results of the Treatment of Osteogenesis Imperfecta with Corkscrew Tipped Telescopic Nail

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    Hüseyin Günay

    2017-03-01

    Full Text Available Aim: We aimed to evaluate the clinical and radiological results of an intramedullary fixation system used in surgeries for fractures and deformities of osteogenesis imperfecta where we applied a new design corkscrew tipped intramedullary nailing. Materials and Methods: Twenty extremities of 14 osteogenesis cases, who underwent surgery and to whom corkscrew tipped intramedullary treatment was applied, were retrospectively scanned. Ambulation, discrepancies in the lenght of extremities, deformities and joint mobility range were all noted before the operation. Postoperative union rates, complications and our experience regarding the nail were also evaluated. Results: Six tibia and 14 femurs were operated using corkscrew tipped telescopic nails. Two bones were operated due to non-union, while seven bones underwent surgery due to acute fractures and 11 bones due to deformities. All the bones were seen to have achieved the aimed union. No major complications were observed. Infection was present in two cases. Conclusion: Corkscrew tipped telescopic nail is a safe and effective method of fixation in patients with osteogenesis imperfecta.

  4. Evaluation of postoperative results from videoarthroscopic treatment for recurrent shoulder dislocation using metal anchors

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    Éder Menegassi Martel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To clinically and radiologically evaluate the results from videoarthroscopic treatment using metal anchors in patients with recurrent shoulder dislocation and its complications. METHODS: This was a retrospective study on 47 patients (47 shoulders operated by the shoulder group of the orthopedic hospital between February 2010 and February 2012. A questionnaire, interview and physical and radiographic examinations were used, with the classification of Samilson and Pietro. The mean postoperative follow-up was 33 months (range 12-47 months. The statistical analysis consisted of using Fisher's exact test through the IBM SPSS 22 statistical software. The significance level used was 5%. RESULTS: Recurrence was observed in nine cases. The patients were, on average, 26.5 years old at the first episode, and 19.1% were aged 20 years or under. Among these, 55.6% presented recurrence. In relation to age at the time of the surgical procedure, the average age was 27 years, and 12.8% were aged 20 years or under. Nineteen patients presented prominent anchors and, of these, 21% manifested arthrosis. CONCLUSION: There was a statistically identified correlation between the recurrence rate and age less than or equal to 20 years at the times of first dislocation and the surgical procedure. Further studies should be conducted in order to compare the use of absorbable anchors, which despite higher cost, may provide lower risk of developing glenohumeral arthrosis in some cases.

  5. What Are the Results of Surgical Treatment of Hip Dysplasia With Concomitant Cam Deformity?

    Science.gov (United States)

    Goronzy, Jens; Franken, Lea; Hartmann, Albrecht; Thielemann, Falk; Postler, Anne; Paulus, Tobias; Günther, Klaus-Peter

    2017-04-01

    Periacetabular osteotomy (PAO) is a reliable procedure to correct the deficient acetabular coverage in hips with developmental dysplasia. It is unclear how the presence of additional femoral cam-type deformity might influence the clinical and radiographic treatment results of PAO. (1) Are there differences in clinical scores (WOMAC, EQ-5D) and examination findings (impingement sign) or radiographic measures of acetabular orientation and head sphericity after PAO for isolated acetabular dysplasia when compared with the combined pathology of dysplasia and additional femoral cam deformity? (2) Are these clinical and radiographic findings after combined surgical therapy for additional cam deformity influenced by different pathology-adjusted surgical techniques? From July 2005 to December 2010, 86 patients (106 hips) underwent PAO for hip dysplasia. Surgical and outcome data were prospectively collected and retrospectively reviewed in a comparative observational study. Indications for surgery were a lateral center-edge angle less than 25° and hip pain for at least 6 months. The contraindications for surgery were advanced radiographic osteoarthritis (Kellgren-Lawrence Grade 3), incongruency of joint space, and patient age > 50 years. Depending on preoperative hip ROM, impingement test, and presence of a radiographically visible cam deformity, treatment allocation was performed: Group I: isolated PAO in patients without symptomatic asphericity, Group IIa: PAO with subsequent osteochondroplasty through arthrotomy for patients with symptomatic cam deformity and no labrochondral pathology, and Group IIb: arthroscopically assisted osteochondroplasty and additional labrochondral repair with subsequent PAO when patients had labrochondral lesions in addition to a symptomatic cam deformity. Clinical outcome (impingement test, EQ-5D, WOMAC) as well as radiographic parameters (lateral center-edge angle, crossover sign, alpha angle, osteoarthritis grade) were obtained after a mean

  6. A STUDY ON DE QUERVAIN'S STENOSING TENOSYNOVITIS ANALYZING THE RESULTS OF DIFFERENT CO NSERVATIVE TREATMENT MODALITIES

    OpenAIRE

    Sreejith; Althaaf Mohamed

    2015-01-01

    OBJECTIVE : The purpose of this study is to find out, which should be the initial treatment of choice in a case of DQTS that can provide the best symptomatic relief. Comparison was between conservative treatment as against steroid injection. MATERIALS AND METHODS : A prospective randomized study was conducted on patients with dequervain’s disease, in order to compare the outcome of conservative treatment as against steroid injection. Study was conducted o n...

  7. Water balance of rice plots under three different water treatments: monitoring activity and experimental results

    Science.gov (United States)

    Chiaradia, Enrico Antonio; Romani, Marco; Facchi, Arianna; Gharsallah, Olfa; Cesari de Maria, Sandra; Ferrari, Daniele; Masseroni, Daniele; Rienzner, Michele; Battista Bischetti, Gian; Gandolfi, Claudio

    2014-05-01

    input) were calculated for each treatment. The outcomes show that the water application efficiencies of all treatments were higher in 2013 than in 2012 (by 23%, 25% and 4% for FLD, 3L-FLD, and IRR respectively). These results could be ascribed to the higher groundwater level observed in 2013 (about 10-15 cm closer to the soil surface), likely due to the conversion of the field beyond the monitored plots from soybean to flooded rice. Moreover, a small increase of the water application efficiency of 3L-FLD was found if compared to FLD (3% on average), while the water application efficiency of IRR was, on average, higher by 67% compared to FLD. The good performance of IRR is related to lower percolation rates and a relevant contribution of capillary rise due to the shallow groundwater table maintained by the continuous submergence of the surrounding paddy fields. The performed experiment highlighted that significant improvement in the water use efficiency at the field scale can be achieved. However, a widespread adoption of water regimes different from continuous flooding should be carefully evaluated by a larger-scale approach since a consequent drop in the groundwater table depth could have repercussions on the potential gains themselves.

  8. Assessment of the results from arthroscopic surgical treatment of adhesive capsulitis

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    Marcio Cohen

    2013-06-01

    Full Text Available OBJECTIVE: Describe the outcomes of patients with adhesive capsulitis treated with arthroscopic surgical procedure. METHODS: Between January and September of 2009, 9 patients (10 cases underwent arthroscopic surgical release. There were 4 male (one bilateral and 5 female patients. Their mean age was 51 years (27-63. The time from onset of symptoms to the surgical procedure averaged 23.4 months (6-38. Preoperative assessment was based on the UCLA and Constant score. ROM was evaluated with one week and six months of surgery. RESULTS: According to UCLA shoulder score (p < 0.01 it increased from 9.8 preoperatively (6-14 to 31.6 postoperatively (26-35 and the Constant (p < 0.01 from 20 (13-27 to 79.2 (66-91. ROM improved significantly, with mean passive elevation changing from 89° (80-100° preoperatively to 150° postoperatively with one week and 153° with six months, mean passive external rotation changing from 12.5° (0-30° preoperatively to 46° (one week and 56° (six months postoperatively, and passive internal rotation from L5 (T12-gluteus to T11 (one week and T9 (six months. There was not statistical significance of the duration of the disease and the postoperative result. CONCLUSION: This study shows that the surgical treatment of adhesive capsulitis with arthroscopic capsular release and manipulation appears to be a safe procedure that results in pain relief and functional gain.

  9. The surgical treatment of chronic intestinal ischemia: results of a recent series.

    Science.gov (United States)

    Illuminati, G; Caliò, F G; D'Urso, A; Papaspiropoulos, V; Mancini, P; Ceccanei, G

    2004-04-01

    Due to the rarity of the condition, large and prospective series defining the optimal method of digestive arteries revascularization, for the treatment of chronic intestinal ischemia, are lacking. The aim of this consecutive sample clinical study was to test the hypothesis that flexible application of different revascularization methods, according to individual cases, will yield the best results in the management of chronic intestinal ischemia. Eleven patients, of a mean age of 56 years, underwent revascularization of 11 digestive arteries for symptomatic chronic mesenteric occlusive disease. Eleven superior mesenteric arteries and one celiac axis were revascularized. The revascularization techniques included retrograde bypass grafting in 7 cases, antegrade bypass grafting in 2, percutaneous arterial angioplasty in 1, and arterial reimplantation in one case. The donor axis for either reimplantation or bypass grafting was the infrarenal aorta in 4 cases, an infrarenal Dacron graft in 4, and the celiac aorta in one case. Grafting materials included 5 polytetrafluoroethylene (PTFE) and 3 Dacron grafts. Concomitant procedures included 3 aorto-ilio-femoral grafts and one renal artery revascularization. Mean follow-up duration was 31 months. There was no operative mortality. Cumulative survival rate was 88.9% at 36 months (SE 12.1%). Primary patency rate was 90% at 36 months (SE 11.6%). The symptom free rate was 90% at 36 months (SE 11.6%). Direct reimplantation, antegrade and retrograde bypass grafting, all allow good mid-term results: the choice of the optimal method depends on the anatomic and general patient's status. Associated infrarenal and renal arterial lesions can be safely treated in the same time of digestive revascularization. Angioplasty alone yields poor results and should be limited to patients at poor risk for surgery.

  10. Spine deformities in patients with Ehlers-Danlos syndrome, type IV - late results of surgical treatment

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    Tesiorowski Maciej

    2010-11-01

    Full Text Available Abstract Background Spinal deformities in Ehlers-Danlos syndrome are usually progressive and may require operative treatment. There is limited number of studies describing late results of surgery in this disease. Methods This is a retrospective study of the records of 11 patients with Ehlers-Danlos syndrome type IV, treated surgically between 1990 and 2007. All patients underwent surgical treatment for spinal deformity. Duration of operation, type of instrumentation, intraoperative blood loss, complications and number of additional surgeries were noted. Radiographic measurement was performed on standing AP and lateral radiographs acquired before surgery, just after and at final follow up. Results The mean follow up period was 5.5 ± 2.9 years (range 1-10 years. The mean preoperative thoracic and lumbar curve were 109.5 ± 19.9° (range 83° - 142° and 75.6 ± 26.7° (range 40° - 108° respectively. Posterior spine fusion alone was performed on 6 patients and combined anterior and posterior fusion (one- or two stage on 5 cases. Posterior segmental spinal instrumentation was applied with use of hooks, screws and wires. The mean postoperative thoracic and lumbar curve improved to 79.3 ± 16.1° (range 56° - 105° and 58.5 ± 27.7° (range 10° - 95° respectively, with a slight loss of correction during follow up. The average thoracic and lumbar correction was 26.4 ± 14.9% (range 5.3 - 50.4% and 26.3 ± 21.2% (range 7.9 - 75%. Postoperatively, the mean kyphosis was 79.5 ± 40.3° (range 21° -170°, and lordosis was 50.8 ± 18.6° (range 20° -79°. Hyperkyphosis increased during follow up while lordosis remained stable. Mean Th12-L2 angle was -3.5 ±9.9° (range -19° - 15° postoperatively and did not change significantly during follow up. Conclusions Huge spinal deformities in patients with Ehlers-Danlos syndrome require complex and extensive surgery. There is a big risk of sagittal imbalance in this group.

  11. Single-session interventions for problem gambling may be as effective as longer treatments: Results of a randomized control trial.

    Science.gov (United States)

    Toneatto, Tony

    2016-01-01

    Empirically supported treatments for problem gambling tend to be multimodal combining cognitive, behavior and motivational interventions. Since problem gamblers often prefer briefer treatments it is important that interventions adopt strategies that are optimally effective. In this study, 99 community-recruited problem gamblers (74% male, mean age: 47.5 years) were randomized to one of four treatments: six sessions of cognitive therapy, behavior therapy, and motivational therapy or a single-session intervention. The sample was followed up for 12 months post-treatment. In both the Intent-to-Treat and Completer statistical analyses, no significant group differences on key gambling variables (i.e., frequency, expenditures, severity) were found. All four treatments showed significant improvement as a result of treatment that endured throughout the follow-up period. These results, although preliminary, suggest that very brief, single-session interventions may be as effective as longer treatments.

  12. Subject preferences for acne treatments containing adapalene gel 0.1%: results of the MORE trial.

    Science.gov (United States)

    Cook-Bolden, Fran

    2006-07-01

    Acne vulgaris can affect adolescents at a time of profound physical, social, and psychological change. The negative impact of acne on self-image and self-confidence can be severe, leading to potential psychiatric problems and limiting social interactions, even in adults. Adherence is necessary for successful treatment of acne, and patient satisfaction is crucial for adherence. The Measuring Acne Outcomes in a Real-World Experience (MORE) trial enrolled 1979 subjects who used combination acne treatments, all containing adapalene gel 0.1%. Among other measures, subjects were surveyed regarding their satisfaction with treatment. Adherence to treatment protocol was high throughout the study (94.5% and 88.0% at weeks 6 and 12, respectively, determined by self-report, and 93.7% and 80.3%, respectively, determined by filled prescriptions). Of the subjects who completed preference surveys, more than 70% rated adapalene gel 0.1% as much superior or superior to other acne treatments; more than 85% of subjects were very satisfied or satisfied with adapalene gel 0.1% to treat their acne; and more than 85% of subjects reported feeling more confident or positive after using this treatment. About 75% of subjects planned to continue using adapalene gel 0.1% and/or use it in the future if they needed acne treatment, and close to 75% of subjects indicated that they would recommend this treatment to a friend. The high level of patient satisfaction with adapalene gel 0.1% as an acne treatment is likely to translate into a high level of adherence to treatment, including maintenance treatment, and a major improvement in quality of life (QOL) for patients with acne.

  13. RESULTS OF SANATORIUM REHABILITATION IN TREATMENT OF THE PREGNANT WOMEN WITH MISCARRIAGE

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    A. V. Zharkih

    2013-10-01

    Full Text Available Introduction. Miscarriage is one of the important problems in modern obstetrics and pediatrics, which is responsible for its negative impact on women's health, a direct connection to a high perinatal mortality [1, 6, 7]. Pregnancy loss rate changes from 10 up 25% of all pregnancies and is not marked tendency to it’s decrease [2, 6]. Therefore particularly important to the develop new methods of treatment and rehabilitation of pregnant women, especially health resort treatment. This allows to get a set of extremely valuable, long-lasting effects of adaptive-compensatory and protective changes and to reduce the adverse effects on the body of the pregnant woman and the fetus. The aim of the work was to evaluate the effectiveness of rehabilitation of women with miscarriage in clinical sanatorium «Velikij Lug». Materials and methods. We observed 93 women. Thirty women with threatened miscarriage, who received sanatorium treatment, composed the main group. The comparison group included 28 women with threatened miscarriage, who did not receive rehabilitation sanatorium during pregnancy. The control group consisted of 35 women without risk of early termination of pregnancy and physical illness and who didn’t receive sanatorium rehabilitation. The research was conducted on the basis of clinical sanatorium «Velikij Lug» and the birth house number 9. The results of research. The average age of pregnant women was 27,3 ± 0,65 years. Significant differences between the groups were not founded. The threat of miscarriage in the main group was in the first trimester - 58.3% versus 60.7% in the comparison group, in the second trimester - 35.7% vs. 61.6%, while in the third trimester - 8.94% vs. 33.3 %. The threat of preterm birth in the main group was met with the frequency of 14.3%, while in the comparison group - 41.7%. Gestational age of all women ranged from 19 to 33 weeks. Among the most frequent extragenital pathology should be noted anemia during

  14. Anal fistula: results of surgical treatment in a consecutive series of patients

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    Paulo Gonçalves de Oliveira

    2012-03-01

    Full Text Available OBJECTIVES: To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. METHODS: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. RESULTS: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. CONCLUSIONS: There was male prevalence (2.2/1, and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.OBJETIVOS: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. MÉTODOS: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. RESULTADOS: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto

  15. Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

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    de Fátima Guerreiro Godoy, Maria

    2010-01-01

    Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

  16. Xyloglucan for the Treatment of Acute Gastroenteritis in Children: Results of a Randomized, Controlled, Clinical Trial

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    Cătălin Pleșea Condratovici

    2016-01-01

    Full Text Available Background. Xyloglucan, a film-forming agent, improves intestinal mucosa resistance to pathologic damage. The efficacy, safety, and time of onset of the antidiarrheal effect of xyloglucan were assessed in children with acute gastroenteritis receiving oral rehydration solution (ORS. Methods. This randomized, controlled, open-label, parallel-group, multicenter, clinical trial included children (3 months–12 years with acute gastroenteritis of infectious origin. Children were randomized to xyloglucan and ORS, or ORS only, for 5 days. Diarrheal symptoms, including stool number/characteristics, and safety were assessed at baseline and after 2 and 5 days and by fulfillment of a parent diary card. Results. Thirty-six patients (58.33% girls were included (n=18/group. Patients receiving xyloglucan and ORS had better symptom evolution than ORS-only recipients, with a faster onset of action. At 6 hours, xyloglucan produced a significantly greater decrease in the number of type 7 stools (0.11 versus 0.44; P=0.027. At days 3 and 5, xyloglucan also produced a significantly greater reduction in types 6 and 7 stools compared with ORS alone. Xyloglucan plus ORS was safe and well tolerated. Conclusions. Xyloglucan is an efficacious and safe option for the treatment of acute gastroenteritis in children, with a rapid onset of action in reducing diarrheal symptoms. This study is registered with ISRCTN number 65893282.

  17. Periurethral constrictor: late results of the treatment of post prostatectomy urinary incontinence

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    Roberto S. Lima

    2011-08-01

    Full Text Available OBJECTIVES: We evaluated retrospectively, the long-term outcome of patients with post-prostatectomy urinary incontinence (PPUI after placement of the Periurethral Constrictor (PUC. MATERIALS AND METHODS: Fifty-six men with severe PPUI were studied, with a mean age of 68.5 years old. Fifty-one men had PPUI due to radical surgery having the device placed around the bulbous urethra, and five individuals with benign prostatic hypertrophy (BPH had placement around the bladder neck. The mean follow-up was 82.2 months. RESULTS: Twenty-two patients (39.28% became continent (0 to 1 pad a day and 34 (60.72% were incontinent. Complications were as follows: urethral erosion in 15 (26.78%; mechanical malfunction in 2 (3.5%; infection in 2 (3.5%; urinary fistula in 1 (1.7%; Urinary tract infection1 (1.7%. Twenty-three patients needed to have the device removed (41.07%. Success rate (continent me was 30.35%. CONCLUSION: In the present series the PUC was not effective for the treatment of severe PPUI in the long-term follow-up.

  18. Biomechanical analysis of pedicle screw density in spinal instrumentation for scoliosis treatment: first results.

    Science.gov (United States)

    Wang, Xiaoyu; Aubin, Carl-Eric; Larson, A Noelle; Labelle, Hubert; Parent, Stefan

    2012-01-01

    Clinical studies reveal remarkable variation in screw patterns, or screw density in spinal instrumentation. Screw density may have a great impact on blood loss, operative time, radiation, risk of screw malposition, and cost. Thus, there is a need to understanding of the biomechanical effects of screw density so as to minimize the number of pedicle screws while ensuring safe and effective instrumentation. The objective of this study was to compare the deformity correction effects and bone-screw loadings of different pedicle screw densities in spinal instrumentation for scoliosis treatment. Spinal instrumentation simulations were performed on three scoliosis patients using 3 screw density patterns (low, preferred, and high screw density) proposed by two experienced surgeons and basic correction techniques: concave rod attachment, rod derotation, apical vertebral derotation, and convex side rod attachment. Simulation results showed that all tested screw densities generated quite similar correction, with differences between the achieved corrections all below 3°. The average bone-screw forces were 244±67N, 214±66 N, and 210±71 N, respectively for low, preferred, and high densities. It remains a complex challenge balancing the benefit of load sharing between more implants with the overconstraints and limited degrees of freedom introduced by the increased number of implants. Studies on additional screw densities and patterns proposed by more surgeons for a variety of cases, and using more diverse correction techniques are necessary to draw stronger conclusions and to recommend the optimal screw density.

  19. Predictors of favorable results in pulmonary tuberculosis treatment (Recife, Pernambuco, Brazil, 2001-2004).

    Science.gov (United States)

    Sassaki, Cinthia Midori; Scatena, Lucia Marina; Gonzales, Roxana Isabel Cardozo; Ruffino-Netto, Antonio; Hinos, Paula; Villa, Tereza Cristina Scatena

    2010-06-01

    Based on data available in the Information System for Notifiable Diseases, predictive factors of favorable results were identified in the treatment of pulmonary tuberculosis, diagnosed between 2001 and 2004 and living in Recife-PE, Brazil. Uni- and multivariate logistic regression methods were used. In multivariate analysis, the following factors remained: Age (years), 0 to 9 (OR = 4.27; p = 0.001) and 10 to 19 (OR = 1.78; p = 0.011), greater chance of cure than over 60; Education (years), 8 to 11 (OR = 1.52; p = 0.049), greater chance of cure than no education; Type of entry, ne wcase s (OR = 3.31; p abandonment; Time (months) 2, 5--6 (OR = 9.15; p < 0.001); 6--9 (OR = 27.28; p < 0.001) and More than 9 (OR = 24.78; p < 0.001), greater chances of cure than less than 5; Health Unit District, DSII (OR = 1.60; p = 0.018) and DSIIV (OR = 2.87; p < 0.001), greater chance sof cure than DS II.

  20. RENAL DENERVATION IN THE TREATMENT OF RESISTANT HYPERTENSION: RESULTS OF A ONE-YEAR OBSERVATIONAL STUDY

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    V. A. Sulimov

    2015-09-01

    Full Text Available Aim. To study the effect of renal denervation on blood pressure (BP, myocardium function and vegetative status in patients with resistant hypertension (HT.Material and methods. Patients with a provisional resistant HT diagnosis (n=62; 41.3% male were included into the study. 17 patients were selected for renal denervation after correction of previous antihypertensive therapy and examination to exclude symptomatic HT. Two patients refused the procedure, 1 patient hadn’t undergone renal denervation due to anatomical features (renal artery diameter <4 mm. Renal denervation was performed in 14 patients. Office and average daily BP, kidney function, the severity of left ventricular hypertrophy and heart rate variability were assessed initially and after the intervention.Results. Office systolic BP (SBP decreased from 165 to 150 mm Hg (p=0.016, diastolic BP (DBP - from 110 to 95 mm Hg (p=0.019 12 months after the renal denervation. Average daily SBP decreased from 148 to 137 mm Hg (p=0.092, average daily DBP - from 90 to 80 mm Hg (p=0.401. Plasma creatinine level and glomerular filtration rate remained within the reference range at a baseline and in 12 months. Left ventricular hypertrophy measured by echocardiography has not changed significantly. No significant heart rate variability dynamics has been found.Conclusion. Renal denervation is a promising treatment for resistant HT. The effect of renal denervation on the dynamics of left ventricular hypertrophy and heart rate variability requires updating.

  1. RENAL DENERVATION IN THE TREATMENT OF RESISTANT HYPERTENSION: RESULTS OF A ONE-YEAR OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    V. A. Sulimov

    2015-01-01

    Full Text Available Aim. To study the effect of renal denervation on blood pressure (BP, myocardium function and vegetative status in patients with resistant hypertension (HT.Material and methods. Patients with a provisional resistant HT diagnosis (n=62; 41.3% male were included into the study. 17 patients were selected for renal denervation after correction of previous antihypertensive therapy and examination to exclude symptomatic HT. Two patients refused the procedure, 1 patient hadn’t undergone renal denervation due to anatomical features (renal artery diameter <4 mm. Renal denervation was performed in 14 patients. Office and average daily BP, kidney function, the severity of left ventricular hypertrophy and heart rate variability were assessed initially and after the intervention.Results. Office systolic BP (SBP decreased from 165 to 150 mm Hg (p=0.016, diastolic BP (DBP - from 110 to 95 mm Hg (p=0.019 12 months after the renal denervation. Average daily SBP decreased from 148 to 137 mm Hg (p=0.092, average daily DBP - from 90 to 80 mm Hg (p=0.401. Plasma creatinine level and glomerular filtration rate remained within the reference range at a baseline and in 12 months. Left ventricular hypertrophy measured by echocardiography has not changed significantly. No significant heart rate variability dynamics has been found.Conclusion. Renal denervation is a promising treatment for resistant HT. The effect of renal denervation on the dynamics of left ventricular hypertrophy and heart rate variability requires updating.

  2. Observation on Therapeutic Results in Tuina Treatment of 56 Cases of Infantile Constipation

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-mei; SU Chun-lan

    2004-01-01

    将56例小儿便秘患者分为胃肠积热型,气机不畅型和气阴两虚型,取大肠、中脘、八卦、七节骨、承山、足三里和迎香,应用小儿推拿手法治疗.痊愈45例,有效9例,无效2例,总有效率96.5%.%After 56 cases of infantile constipation were divided into the pattern of stagnation of heat in the stomach and intestines, pattern of obstruction of qi activity and pattern of deficiency in both qi and yin, the treatments were given by infantile Tuina techniques on the infantile points of Dachang (Extra),Zhongwan (CV 12), Bagua (Extra), Qijiegu (Extra), Chengshan (BL 57), Zusanli (ST 36) and Yingxiang (LI 20). The results showed cure in 45 cases, effectiveness in 9 cases, failure in 2 cases and the total effective rate was 96.5%.

  3. Minimally Invasive Anal Fistula Treatment (MAFT)-An Appraisal of Early Results in 416 Patients.

    Science.gov (United States)

    Chowbey, P K; Khullar, R; Sharma, A; Soni, V; Najma, K; Baijal, M

    2015-12-01

    Minimally invasive anal fistula treatment (MAFT) was introduced to minimize early postoperative morbidity, preserve sphincter continence, and reduce recurrence. We report our early experience with MAFT in 416 patients. Preoperative MRI was performed in 150 patients initially and subsequently thereafter. The technique involves fistuloscope-aided localization of internal fistula opening, examination and fulguration of all fistula tracks, and secure stapled closure of internal fistula opening within anal canal/rectum. MAFT was performed as day-care procedure in 391 patients (93.9 %). During surgery, internal fistula opening could not be located in 100 patients (24 %). Seven patients required readmission to hospital. Mean visual analog scale scores for pain on discharge and at 1 week were 3.1 (1-6) and 1.6 (0-3), respectively. Mean duration for return to normal activity was 3.2 days (2-11 days). Fistula recurrence was observed in 35/134 patients (26.1 %) at 1 year follow-up. MAFT may be performed as day-care procedure with benefits of less pain, absence of perianal wounds, faster recovery, and preservation of sphincter continence. However, long-term results from more centers are needed especially for recurrence.

  4. Spinal epidural neurostimulation for treatment of acute and chronic intractable pain: initial and long term results.

    Science.gov (United States)

    Richardson, R R; Siqueira, E B; Cerullo, L J

    1979-09-01

    Spinal epidural neurostimulation, which evolved from dorsal column stimulation, has been found to be effective in the treatment of acute and chronic intractable pain. Urban and Hashold have shown that it is a safe, simplified alternative to dorsal column stimulation, especially because laminectomy is not required if the electrodes are inserted percutaneously. Percutaneous epidural neurostimulation is also advantageous because there can be a diagnostic trial period before permanent internalization and implantation. This diagnostic and therapeutic modality has been used in 36 patients during the past 3 years at Northwestern Memorial Hospital. Eleven of these patients had acute intractable pain, which was defined as pain of less than 1 year in duration. Initial postimplantation results from the 36 patients indicate that spinal epidural neurostimulation is most effective in treating the intractable pain of diabetes, arachnoiditis, and post-traumatic and postamputation neuroma. Long term follow-up, varying from 1 year to 3 years postimplantation in the 20 initially responding patients, indicates that the neurostimulation continues to provide significant pain relief (50% or greater) in a majority of the patients who experienced initial significant pain relief.

  5. [Immediate and long-term results of surgical treatment of patients for traumatic mandibular fracture].

    Science.gov (United States)

    Kopchak, A V

    2014-01-01

    The analysis of immediate and long-term results of the surgical treatment of 286 patients, operated for traumatic mandibular fractures in the Department of Oral and Maxillofacial Surgery, National O. O. Bogomolets Medical University. In 67% of patients the anatomical shape of the bone was adequately restored. The presence of residual displacements in other cases was determined by the fracture type and localization, the technical complexity of the surgical intervention, lack of fixation rigidity under certain functional load conditions. In long terms of observation the infection and inflammatory complications were observed in 13.4% of patients, delayed unition and non-unition of bone fragments occurred--in 4.7%, arthosis with persistent dysfunction of the temporomandibular joint--in 6.7%, fibrous ankylosis--in 1.3%. Secondary displacement of fragments was observed in 23.5% of patients due to insufficient stiffness and reliaability of the bone-fixatorsystem. The non-precise reposition of fragments and secondary displacements in the early and late postoperative period were the main cause of occlusal disturbances of various severities, noted in 28% of operated patients, limitation of mouth opening (10%), TMJ disorders and changes in masticatory stereotype (33%), the sensation of pain and discomfort in tough food chewing (35%). A statistical analysis of the effectiveness of different osteosynthesis methods depending on the type and localization of the fracture was carried out and recommendations for usage of fixation devices in clinical practice were given.

  6. Treatment of autoinflammatory diseases: results from the Eurofever Registry and a literature review

    NARCIS (Netherlands)

    Haar, N. Ter; Lachmann, H.; Ozen, S.; Woo, P.; Uziel, Y.; Modesto, C.; Kone-Paut, I.; Cantarini, L.; Insalaco, A.; Neven, B.; Hofer, M.; Rigante, D.; Al-Mayouf, S.; Touitou, I.; Gallizzi, R.; Papadopoulou-Alataki, E.; Martino, S.; Kuemmerle-Deschner, J.; Obici, L.; Iagaru, N.; Simon, A.; Nielsen, S.; Martini, A.; Ruperto, N.; Gattorno, M.; Frenkel, J.

    2013-01-01

    OBJECTIVE: To evaluate the response to treatment of autoinflammatory diseases from an international registry and an up-to-date literature review. METHODS: The response to treatment was studied in a web-based registry in which clinical information on anonymised patients with autoinflammatory diseases

  7. Treatment of autoinflammatory diseases: results from the Eurofever Registry and a literature review

    NARCIS (Netherlands)

    Haar, N. Ter; Lachmann, H.; Ozen, S.; Woo, P.; Uziel, Y.; Modesto, C.; Kone-Paut, I.; Cantarini, L.; Insalaco, A.; Neven, B.; Hofer, M.; Rigante, D.; Al-Mayouf, S.; Touitou, I.; Gallizzi, R.; Papadopoulou-Alataki, E.; Martino, S.; Kuemmerle-Deschner, J.; Obici, L.; Iagaru, N.; Simon, A.; Nielsen, S.; Martini, A.; Ruperto, N.; Gattorno, M.; Frenkel, J.

    2013-01-01

    OBJECTIVE: To evaluate the response to treatment of autoinflammatory diseases from an international registry and an up-to-date literature review. METHODS: The response to treatment was studied in a web-based registry in which clinical information on anonymised patients with autoinflammatory diseases

  8. Antithrombotic treatment of splanchnic vein thrombosis: : Results of an international registry

    NARCIS (Netherlands)

    Ageno, Walter; Riva, Nicoletta; Bang, Soo-Mee; Sartori, Maria Teresa; Grandone, Elvira; Beyer-Westendorf, Jan; Barillari, Giovanni; Di Minno, Matteo N.D.; Duce, Rita; Malato, Alessandra; Santoro, Rita; Poli, Daniela; Verhamme, Peter; Martinelli, Ida; Kamphuisen, Pieter W.; Alatri, Adriano; Oh, Doyeun; Amico, Elbio D.; Schulman, Sam; Dentali, Francesco

    2012-01-01

    Background: Treatment of splanchnic vein thrombosis (SVT) is a clinical challenge due to heterogeneity of clinical presentations, increased bleeding risk and lack of evidences from clinical trials. We carried out an international registry aimed to describe current treatment strategies and factors as

  9. Antithrombotic Treatment of Splanchnic Vein Thrombosis : Results of an International Registry

    NARCIS (Netherlands)

    Ageno, Walter; Riva, Nicoletta; Bang, Soo-Mee; Sartori, Maria Teresa; Grandone, Elvira; Beyer-Westendorf, Jan; Barillari, Giovanni; Di Minno, Matteo N. D.; Duce, Rita; Malato, Alessandra; Santoro, Rita; Poli, Daniela; Verhamme, Peter; Martinelli, Ida; Kamphuisen, Pieter W.; Alatri, Adriano; Oh, Doyeun; Amico, Elbio D.; Schulman, Sam; Dentali, Francesco

    2012-01-01

    Background: Treatment of splanchnic vein thrombosis (SVT) is a clinical challenge due to heterogeneity of clinical presentations, increased bleeding risk and lack of evidences from clinical trials. We carried out an international registry aimed to describe current treatment strategies and factors as

  10. A Review of Verb Network Strengthening Treatment: Theory, Methods, Results, and Clinical Implications

    Science.gov (United States)

    Edmonds, Lisa A.

    2016-01-01

    This article examines Verb Network Strengthening Treatment (VNeST), a relatively new treatment approach for anomia in people with aphasia. The VNeST protocol aims to promote generalization to increased lexical retrieval of untrained words across a hierarchy of linguistic tasks, including single-word naming of nouns and verbs, sentence production,…

  11. Long-term results of carbon dioxide laser treatment of meatal condylomata acuminata

    DEFF Research Database (Denmark)

    Krogh, J; Beuke, H P; Miskowiak, J

    1990-01-01

    A group of 74 men who underwent carbon dioxide laser treatment of meatal condylomata were observed for an average of 18 months. The cure rate after 1 treatment of isolated meatal lesions was 78%; the presence of external lesions lowered the rate to 32% and additional external and urethral warts...

  12. Antithrombotic Treatment of Splanchnic Vein Thrombosis : Results of an International Registry

    NARCIS (Netherlands)

    Ageno, Walter; Riva, Nicoletta; Bang, Soo-Mee; Sartori, Maria Teresa; Grandone, Elvira; Beyer-Westendorf, Jan; Barillari, Giovanni; Di Minno, Matteo N. D.; Duce, Rita; Malato, Alessandra; Santoro, Rita; Poli, Daniela; Verhamme, Peter; Martinelli, Ida; Kamphuisen, Pieter W.; Alatri, Adriano; Oh, Doyeun; Amico, Elbio D.; Schulman, Sam; Dentali, Francesco

    2012-01-01

    Background: Treatment of splanchnic vein thrombosis (SVT) is a clinical challenge due to heterogeneity of clinical presentations, increased bleeding risk and lack of evidences from clinical trials. We carried out an international registry aimed to describe current treatment strategies and factors as

  13. Antithrombotic treatment of splanchnic vein thrombosis: : Results of an international registry

    NARCIS (Netherlands)

    Ageno, Walter; Riva, Nicoletta; Bang, Soo-Mee; Sartori, Maria Teresa; Grandone, Elvira; Beyer-Westendorf, Jan; Barillari, Giovanni; Di Minno, Matteo N.D.; Duce, Rita; Malato, Alessandra; Santoro, Rita; Poli, Daniela; Verhamme, Peter; Martinelli, Ida; Kamphuisen, Pieter W.; Alatri, Adriano; Oh, Doyeun; Amico, Elbio D.; Schulman, Sam; Dentali, Francesco

    2012-01-01

    Background: Treatment of splanchnic vein thrombosis (SVT) is a clinical challenge due to heterogeneity of clinical presentations, increased bleeding risk and lack of evidences from clinical trials. We carried out an international registry aimed to describe current treatment strategies and factors as

  14. Treatment of fear of blushing, sweating, or trembling - Results at long-term follow-up

    NARCIS (Netherlands)

    Scholing, A; Emmelkamp, PMG

    1996-01-01

    This study investigated the long-term effectiveness of cognitive-behavioral treatments for patients with a specific type of social phobia: fear of showing bodily symptoms (blushing, sweating, or trembling). Patients were reassessed 18 months after they had finished one of the following treatments: (

  15. Surgical treatment of trigeminal neuralgia. Results from the use of glycerol injection, microvascular decompression, and rhizotomia

    DEFF Research Database (Denmark)

    Degn, Jørgen; Brennum, Jannick

    2010-01-01

    The study aims to assess the efficacy and safety of surgical treatment of trigeminal neuralgia (TN) in our department and to identify prognostic factors.......The study aims to assess the efficacy and safety of surgical treatment of trigeminal neuralgia (TN) in our department and to identify prognostic factors....

  16. Treatment of generalized social phobia : Results at long-term follow-up

    NARCIS (Netherlands)

    Scholing, A; Emmelkamp, PMG

    1996-01-01

    This study investigated the long-term follow-up effectiveness-of (cognitive-)behavioural group and individual treatments for generalized social phobia. Patients were reassessed 18 months after they had finished one of the following treatment packages: (1) exposure in vivo; (2) cognitive therapy foll

  17. Delayed results of treatment of paracoccidioidomycosis with amphotericin B plus sulfamides versus amphotericin B alone

    Directory of Open Access Journals (Sweden)

    Neuza Lima Dillon

    1986-08-01

    Full Text Available A delayed evaluation of two groups of patients with paracoccidioidomycosis was carried out. Both groups were treated with amphotericin B, "but one of them was submitted to maintenance treatment with sulfonamides. Statistical analysis showed that treatment is more effective when patients are maintained with sulfonamide drugs.

  18. A Review of Verb Network Strengthening Treatment: Theory, Methods, Results, and Clinical Implications

    Science.gov (United States)

    Edmonds, Lisa A.

    2016-01-01

    This article examines Verb Network Strengthening Treatment (VNeST), a relatively new treatment approach for anomia in people with aphasia. The VNeST protocol aims to promote generalization to increased lexical retrieval of untrained words across a hierarchy of linguistic tasks, including single-word naming of nouns and verbs, sentence production,…

  19. Results of Corrective Osteotomy and Treatment Strategy for Ankylosing Spondylitis with Kyphotic Deformity.

    Science.gov (United States)

    Kim, Ki-Tack; Park, Dae-Hyun; Lee, Sang-Hun; Lee, Jung-Hee

    2015-09-01

    To report the radiological and clinical results after corrective osteotomy in ankylosing spondylitis patients. Furthermore, this study intended to classify the types of deformity and to suggest appropriate surgical treatment options. We retrospectively analyzed ankylosing spondylitis patients who underwent corrective osteotomy between 1996 and 2009. The radiographic assessments included the sagittal vertical axis (SVA), spinopelvic alignment parameters, correction angle, correction loss, type of deformity related to the location of the apex, and the craniocervical range of motion (CCROM). The clinical outcomes were assessed by the Oswestry Disability Index (ODI) scores. A total of 292 corrective osteotomies were performed in 248 patients with a mean follow-up of 40.1 months (range, 24 to 78 months). There were 183 cases of single pedicle subtraction osteotomy (PSO), 19 cases of multiple Smith-Petersen osteotomy (SPO), 17 cases of PSO + SPO, 14 cases of single SPO, six cases of posterior vertebral column resection (PVCR), five cases of PSO + partial pedicle subtraction osteotomy (PPSO), and four cases of PPSO. The mean correction angles were 31.9° ± 11.7° with PSO, 14.3° ± 8.4° with SPO, 38.3° ± 12.7° with PVCR, and 19.3° ± 7.1° with PPSO. The thoracolumbar type was the most common. The outcome analysis showed a significant improvement in the ODI score (p ankylosing spondylitis, resulting in satisfactory outcomes with acceptable complications. The CCROM and postoperative SVA were important factors in determining the outcome.

  20. Long term results of mechanical prostheses for treatment of active infective endocarditis

    Science.gov (United States)

    Guerra, J; Tornos, M; Permanyer-Miralda, G; Almirante, B; Murtra, M; Soler-Soler, J

    2001-01-01

    OBJECTIVE—To analyse the long term results of mechanical prostheses for treating active infective endocarditis.
DESIGN—Prospective cohort study of a consecutive series of patients diagnosed with infective endocarditis and operated on in the active phase of the infection for insertion of a mechanical prosthesis.
SETTING—Tertiary referral centre in a metropolitan area.
RESULTS—Between 1975 and 1997, 637 cases of infective endocarditis were diagnosed in the centre. Of these, 436 were left sided (with overall mortality of 20.3%). Surgical treatment in the active phase of the infection was needed in 141 patients (72% native, 28% prosthetic infective endocarditis). Mechanical prostheses were used in 131 patients. Operative mortality was 30.5% (40 patients). Ninety one survivors were followed up prospectively for (mean (SD)) 5.4 (4.5) years. Thirteen patients developed prosthetic valve dysfunction. Nine patients suffered reinfection: four of these (4%) were early and five were late. The median time from surgery for late reinfection was 1.4 years. During follow up, 12 patients died. Excluding operative mortality, actuarial survival was 86.6% at five years and 83.7% at 10 years; actuarial survival free from death, reoperation, and reinfection was 73.1% at five years and 59.8% at 10 years.
CONCLUSIONS—In patients surviving acute infective endocarditis and receiving mechanical prostheses, the rate of early reinfection compares well with reported results of homografts. In addition, prosthesis dysfunction rate is low and long term survival is good. These data should prove useful for comparison with long term studies, when available, using other types of valve surgery in active infective endocarditis.


Keywords: infective endocarditis; surgery; mechanical prosthesis PMID:11410564

  1. Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases

    Directory of Open Access Journals (Sweden)

    Ho KY

    2013-07-01

    Full Text Available Kok-Yuen Ho,1 Mohamed Abdul Hadi,2 Koravee Pasutharnchat,2 Kian-Hian Tan21Pain Management Centre, Raffles Hospital, 2Pain Management Centre, Singapore General Hospital, SingaporeBackground: Sacroiliac joint pain is a common cause of chronic low back pain. Different techniques for radiofrequency denervation of the sacroiliac joint have been used to treat this condition. However, results have been inconsistent because the variable sensory supply to the sacroiliac joint is difficult to disrupt completely using conventional radiofrequency. Cooled radiofrequency is a novel technique that uses internally cooled radiofrequency probes to enlarge lesion size, thereby increasing the chance of completely denervating the sacroiliac joint. The objective of this study was to evaluate the efficacy of cooled radiofrequency denervation using the SInergyTM cooled radiofrequency system for sacroiliac joint pain.Methods: The charts of 20 patients with chronic sacroiliac joint pain who had undergone denervation using the SInergyTM cooled radiofrequency system were reviewed at two years following the procedure. Outcome measures included the Numeric Rating Scale for pain intensity, Patient Global Impression of Change, and Global Perceived Effect for patient satisfaction.Results: Fifteen of 20 patients showed a significant reduction in pain (a decrease of at least three points on the Numeric Rating Scale. Mean Numeric Rating Scale for pain decreased from 7.4 ± 1.4 to 3.1 ± 2.5, mean Patient Global Impression of Change was "improved" (1.4 ± 1.5, and Global Perceived Effect was reported to be positive in 16 patients at two years following the procedure.Conclusion: Cooled radiofrequency denervation showed long-term efficacy for up to two years in the treatment of sacroiliac joint pain.Keywords: ablation, chronic low back pain, intervention, neurotomy, sacroiliitis

  2. Buprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients.

    Science.gov (United States)

    Vicknasingam, B; Dazali, M N M; Singh, D; Schottenfeld, R S; Chawarski, M C

    2015-07-01

    Medication assisted treatment with buprenorphine/naloxone (Bup/Nx), including prescribing and dispensing practices of general practitioners (GPs) in Malaysia and their patients' experiences with this treatment have not been systematically examined. The current study surveyed GPs providing Bup/Nx treatment and patients receiving office-based Bup/Nx treatment in Malaysia. Two cross-sectional surveys of GPs (N=115) providing outpatient Bup/Nx maintenance treatment and of patients (N=253) currently receiving Bup/Nx treatment throughout peninsular Malaysia. Physicians prescribed Bup/Nx dosages in the range of 2-4mg daily for 70% of patients and conducted urine testing in the past month on approximately 16% of their patients. In the patient survey, 79% reported taking daily Bup/Nx doses of 2mg or less; 82% reported that no urine toxicology testing had been conducted on them in the past month, 36% had an opiate positive urine test at the time of the survey, 43% reported illicit opiate use, 15% reported injection of heroin and 22% reported injection of Bup/Nx in the past month. Low daily Bup/Nx doses, lack of behavioral monitoring or counseling, and high rates of continued drug use, including injection of drugs and medications during Bup/Nx treatment in Malaysia, indicate continuing problems with implementation and less than optimal treatment effectiveness. High cost of Bup/Nx in Malaysia may deter patients from seeking treatment and contribute to taking low Bup/Nx dosages. Improved training of physicians and establishing standards for Bup/Nx dosing, routine toxicology testing, and counseling may be needed to improve care and treatment response. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Temperature Fields in Soft Tissue during LPUS Treatment: Numerical Prediction and Experiment Results

    Science.gov (United States)

    Kujawska, Tamara; Wójcik, Janusz; Nowicki, Andrzej

    2010-03-01

    Recent research has shown that beneficial therapeutic effects in soft tissues can be induced by the low power ultrasound (LPUS). For example, increasing of cells immunity to stress (among others thermal stress) can be obtained through the enhanced heat shock proteins (Hsp) expression induced by the low intensity ultrasound. The possibility to control the Hsp expression enhancement in soft tissues in vivo stimulated by ultrasound can be the potential new therapeutic approach to the neurodegenerative diseases which utilizes the known feature of cells to increase their immunity to stresses through the Hsp expression enhancement. The controlling of the Hsp expression enhancement by adjusting of exposure level to ultrasound energy would allow to evaluate and optimize the ultrasound-mediated treatment efficiency. Ultrasonic regimes are controlled by adjusting the pulsed ultrasound waves intensity, frequency, duration, duty cycle and exposure time. Our objective was to develop the numerical model capable of predicting in space and time temperature fields induced by a circular focused transducer generating tone bursts in multilayer nonlinear attenuating media and to compare the numerically calculated results with the experimental data in vitro. The acoustic pressure field in multilayer biological media was calculated using our original numerical solver. For prediction of temperature fields the Pennes' bio-heat transfer equation was employed. Temperature field measurements in vitro were carried out in a fresh rat liver using the 15 mm diameter, 25 mm focal length and 2 MHz central frequency transducer generating tone bursts with the spatial peak temporal average acoustic intensity varied between 0.325 and 1.95 W/cm2, duration varied from 20 to 500 cycles at the same 20% duty cycle and the exposure time varied up to 20 minutes. The measurement data were compared with numerical simulation results obtained under experimental boundary conditions. Good agreement between the

  4. Treatment And Results Of Combined Mild Bone Loss Instability With The Modified Laterjet

    Science.gov (United States)

    Yang, Justin Shu; Mazzocca, Augustus D.; Arciero, Robert A.

    2015-01-01

    Objectives: Recurrent anterior glenohumeral dislocation in the setting of an engaging Hill-Sachs lesion is high. The Latarjet procedure has been well-described for restoring glenohumeral stability in patients with over 25% glenoid bone loss. However, the treatment for patients with combined humeral head and mild (Latarjet for this population. Methods: Modified Latarjet was performed in twenty three patients with recurrent anterior shoulder instability, engaging Hill-Sachs by exam confirmed with arthroscopy, and less than 25% anterior glenoid bone loss. The mean follow-up was 3.5 years. All patients were assessed for their risk of recurrence using the Instability Severity Index Score (ISIS), had pre-operative 3D imaging to assess humeral and glenoid bone loss. Single Assessment Numeric Evaluation (SANE), Western Ontario Shoulder Instability Index (WOSI), recurrence rate, radiographs, range of motion and dynamometer strength were used to assess outcomes. Results: Average pre-operative instability severity index score was 6.2 (range 4-9). Pre-operative glenoid bone loss averaged 15.1% (range 5-25%). The humeral defect averaged 40.4% in width and 13.7% in depth on axial computed tomography scan, with an average Hill-Sachs angle of 28°. The mean WOSI index was 457 of 2100 (range 0-1398). The mean SANE score was 81.2 (range 60-100). Five out of ten competitive athletes returned to play for at least one season. There were no recurrent dislocation and three patients had a single episode of recurrent subluxation. Loss of external rotation at the side averaged 8°, and there was no significant loss of abduction. Subscapularis, abduction and external rotation strength averaged greater than 85% of the contralateral shoulder. Fourteen patients on average had 1.4 (range 1-4) previous open or arthroscopic stabilization procedures prior to the Latarjet, nine others had Latarjet done primarily. WOSI scores correlated directly with number of previous surgery (r=0.81, p=0

  5. RESULTS OF SURGICAL TREATMENT OF INFANTILE AND JUVENILE SCOLIOSIS USING VARIOUS INSTRUMENTATION

    Directory of Open Access Journals (Sweden)

    M. V. Mikhailovsky

    2015-01-01

    Full Text Available Introduction. The analysis Results of surgical treatment of growing children with infantile and juvenile scoliosis (IS can the optimal method of treatment select. In young children with significant growth potential spinal fusion may not be the best option as it limits further longitudinal growth of the spine and may to the thoracic insufficiency syndrome result. To address this problem recently several techniques focused, their have advantages and drawbacks.Material and methods. Since 2008 year 127 patients (64 girls, 63 boys aged (4.5 ± 2.1 years were operated on. In group I 65 patients were operated on using VEPTR (Vertical Expandable Prosthetic Titanium Rib instrumentation, in group II 42 patients using various spinal instrumentation. 20 patients with congenital kyphosis were excluded. The average follow-up time was (5.6 ± 1.1 years.Results. In group I average value of the primary scoliotic curve before surgery was (74.7 ± 22.9, secondary curve (42.8 ± 16.0, thoracic kyphosis (46.3 ± 27.4, lumbar lordosis (54.6 ± 14. Average value of the primary scoliotic curve after surgery was reduced to (51 ± 20 (correction 31.7%, at followup to (56.5 ± 18.5, secondary curve (31.8 ± 12.8 (25.7%, at follow-up to (32.4 ± 18.4, thoracic kyphosis (36.8 ± 20.8 (20,5%, at follow-up to (41.8 ± 21.0, lumbar lordosis (45.4 ± 12.7 (16,9%, at follow-up to (48.2 ± 11.7 (p < 0.05. Space available for lung before surgery was (84.5 ± 8.7 %, after surgery was (94.8 ± 6.7%, at follow-up increased to (98.6 ± 5.4 % (p < 0.05. Complications included 11 implant dislocations and 1 infection. In group II average value of the primary scoliotic curve before surgery was (87.6 ± 6.6, secondary curve (47.8 ± 4.6, thoracic kyphosis (61.4 ± 10.4, lumbar lordosis (61.8 ± 4.9. Average value of the primary scoliotic curve after surgery was reduced to 50.6 ± 5.3 (correction 42.3%, at follow-up to (66.1 ± 6.3

  6. Long-term results of treatment for temporomandibular disorders: an evaluation by patients.

    Science.gov (United States)

    Okeson, J P; Hayes, D K

    1986-04-01

    In this study, 110 patients with temporomandibular disorders who had been treated 2 to 81/2 years earlier were asked to evaluate the treatment they received. Of the patients, 85.5% reported that they were not experiencing pain or that they were experiencing much less pain; 79.1% reported that the treatment they had received had helped them completely or considerably. Analysis of the data did not disclose a subgroup or factor that could be correlated with the reduction of pain or the patient's perception of the success of treatment.

  7. Patient-clinician agreement on treatment type and helpfulness: results from a WTC rescue and recovery worker cohort.

    Science.gov (United States)

    Leikauf, John; Schechter, Clyde B; Marrone, Kathryn; Ozbay, Fatih; Rapoport, Alison; Sharma, Vanshdeep; Katz, Craig L

    2013-11-01

    This study assessed patient and clinician agreement about treatment type and its association with treatment helpfulness among World Trade Center rescue and recovery workers. A total of 187 outpatients and 280 clinicians completed a survey, which gathered information on patient characteristics, treatment types, and treatment helpfulness. Kappa statistics and sensitivity and specificity analyses were used, and the association between patient-clinician agreement and reported treatment benefit was determined. Patient-clinician agreement was highest for group therapy, medication management, eye movement desensitization and reprocessing, and couples therapy. Agreement about medication management, individual psychotherapy, and workers' compensation evaluation was associated with higher reported treatment benefits. Findings support the hypothesis that agreement regarding treatment type is associated with higher reported benefit and extend findings of previous studies to a linguistically diverse, naturalistic sample exposed to a disaster trauma. Results also highlight the need for better understanding of eclectic therapies offered in real-world clinical practice.

  8. Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience.

    LENUS (Irish Health Repository)

    Burke, D

    2013-09-01

    Stereotactic radiosurgery is frequently used for the treatment of brain metastases. This study provides a retrospective evaluation of patients with secondary lesions of the brain treated with stereotactic radiosurgery (SRS) at our institution.

  9. Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results

    National Research Council Canada - National Science Library

    Hemmen, Thomas M; Raman, Rema; Guluma, Kama Z; Meyer, Brett C; Gomes, Joao A; Cruz-Flores, Salvador; Wijman, Christine A; Rapp, Karen S; Grotta, James C; Lyden, Patrick D

    2010-01-01

    .... Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke (ICTuS-L) was a randomized, multicenter trial of hypothermia and intravenous tissue plasminogen activator in patients treated within 6 hours after ischemic stroke...

  10. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study

    NARCIS (Netherlands)

    Tabbers, M.M.; de Milliano, I.; Roseboom, M.G.; Benninga, M.A.

    2011-01-01

    Probiotics are increasingly used in the treatment of functional gastrointestinal disorders. Studies in constipated adults with a Bifidus yoghurt (containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus) showed a significant increase in defecation frequency. The aim of

  11. Treatment of inflammatory external root resorption resulting from dental avulsion and pulp necrosis: clinical case report.

    Science.gov (United States)

    Cunha, Rodrigo Sanches; Abe, Flavia Casale; Araujo, Roberta Aranha; Fregnani, Eduardo Rodrigues; Bueno, Carlos Eduardo da Silveiro

    2011-01-01

    The aim of this case report was to present a treatment for severe inflammatory external root resorption. The condition developed due to the patient's neglect to seek adequate treatment following replantation of an avulsed maxillary left central incisor. Following diagnosis, treatment consisted of conventional endodontic therapy with calcium hydroxide dressings and definitive filling of the root canal after the resorption was controlled radiographically. A 24-month follow-up showed that the resorption process had stabilized and the patient was free of symptoms. Successful tooth replantation requires following the indicated therapy effectively. Nevertheless, when an inflammatory external root resorption occurs, adequate endodontic treatment to remove the necrotic content and bacteria is required, as is the use of calcium hydroxide dressings.

  12. Embryos cultured in a time-lapse system result in superior treatment outcomes: a strict matched pair analysis.

    Science.gov (United States)

    Barrie, Amy; Homburg, Roy; McDowell, Garry; Brown, Jeremy; Kingsland, Charles; Troup, Stephen

    2017-09-01

    A retrospective strict matched-pair analysis of 728 treatment cycles between January 2011 and September 2014 was performed. A total of 364 treatment cycles, where all embryos were cultured and examined in EmbryoScope(®), were matched to treatment cycles where all the embryos were cultured in a standard incubator with conventional morphological examination. Matching was performed for patient age, number of oocytes collected, treatment type and date of oocyte collection (± six months). The clinical (CPR), implantation (IR), live birth (LBR) and miscarriage rates (MR) were calculated and considered significant when p result was not statistically significant (18.9% versus 24.4%, p = 0.19). There is a paucity of well-designed studies to confirm that embryos cultured and examined in TLS can result in superior treatment outcomes, and this strict-matched pair analysis with a large cohort of treatment cycles indicates the advantage of using TLS.

  13. Treatment results of radiation therapy for muscle-invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Langsenlehner, Tanja; Doeller, Carmen; Stranzl-Lawatsch, Heidi; Kapp, Karin S. [Univ. Clinic of Therapeutic Radiology and Oncology, Medical Univ. of Graz (Austria); Quehenberger, Franz [Inst. for Medical Informatics, Statistics and Documentation, Medical Univ. of Graz (Austria); Langsenlehner, Uwe [Internal Outpatient Dept., Steiermaerkische GKK, Graz (Austria); Pummer, Karl [Dept. of Urology, Medical Univ. of Graz (Austria)

    2010-04-15

    Purpose: To assess local control and survival rates in patients with muscle-invasive bladder cancer treated with external-beam radiotherapy and to investigate prognostic factors. Patients and methods: Between 1997 and 2007, 75 patients (male, n = 58; female, n = 17, median age, 74.2 years) with localized transitional cell carcinoma of the bladder (T2, n = 34; T3, n = 32; T4, n = 9) not suitable for radical surgery due to advanced age, comorbidity or inoperability underwent external-beam radiotherapy without simultaneous chemotherapy at the University Clinic of Therapeutic Radiology and Oncology, Medical University of Graz, Austria. A conformal four-field technique was used in all patients to treat the tumor and regional lymph nodes with single daily fractions of 1.8-2 Gy to a total dose of 50-50.4 Gy, followed by a cone-down to encompass the empty bladder which was boosted to 70-70.4 Gy. All patients had undergone transurethral tumor resection prior to radiotherapy which was macroscopically incomplete in 62 patients. Results: Complete response was achieved in 65% of patients. Actuarial 3-year local control and metastases-free survival rates were 52.5% and 63.7%, 3-year local recurrence-free survival rate in complete responders was 71%. In univariate analysis, hydronephrosis, lymph vessel invasion, and macroscopic residual tumor were significantly predictive of disease progression. Hydronephrosis and lymph vessel invasion were also associated with a higher risk of local recurrence. The actuarial 3-year progression-free and overall survival rates were 40.1% and 56.9%, respectively. Conclusion: Radiotherapy is an effective treatment option in terms of local control and survival even in elderly patients with locally advanced bladder cancer not suitable for cystectomy. (orig.)

  14. Repetitive transcranial magnetic stimulation as an adjuvant method in the treatment of depression: Preliminary results

    Directory of Open Access Journals (Sweden)

    Jovičić Milica

    2014-01-01

    Full Text Available Introduction. Repetitive transcranial magnetic stimulation (rTMS is a method of brain stimulation which is increasingly used in both clinical practice and research. Up-to-date studies have pointed out a potential antidepressive effect of rTMS, but definitive superiority over placebo has not yet been confirmed. Objective. The aim of the study was to examine the effect of rTMS as an adjuvant treatment with antidepressants during 18 weeks of evaluation starting from the initial application of the protocol. Methods. Four patients with the diagnosis of moderate/severe major depression were included in the study. The protocol involved 2000 stimuli per day (rTMS frequency of 10 Hz, intensity of 120% motor threshold administered over the left dorsolateral prefrontal cortex (DLPFC for 15 days. Subjective and objective depressive symptoms were measured before the initiation of rTMS and repeatedly evaluated at week 3, 6, 12 and 18 from the beginning of the stimulation. Results. After completion of rTMS protocol two patients demonstrated a reduction of depressive symptoms that was sustained throughout the 15-week follow-up period. One patient showed a tendency of remission during the first 12 weeks of the study, but relapsed in week 18. One patient showed no significant symptom reduction at any point of follow-up. Conclusion. Preliminary findings suggest that rTMS has a good tolerability and can be efficient in accelerating the effect of antidepressants, particularly in individuals with shorter duration of depressive episodes and moderate symptom severity. [Projekat Ministarstva nauke Republike Srbije, br. III41029 i br. ON175090

  15. One year results of anti-VEGF treatment in pigment epithelial detachment secondary to macular degeneration

    Directory of Open Access Journals (Sweden)

    Harun Yüksel

    2013-08-01

    Full Text Available PURPOSE:Pigment epithelial detachment (PED may be seen in all stages of age-related macular degeneration (ARMD and may lead to poor prognosis. In this study, we retrospectively examined the effect of anti-VEGF treatments in ARMD patients with vascularized PED. METHODS:Medical records of 15 patients with PED secondary to ARMD were reviewed retrospectively. The diagnosis of PED was made with fundoscopy, fundus fluorescein angiography and optical coherence tomography. Patients were treated with intravitreal ranibizumab or/and bevacizumab and followed up for a minimum of one year. PED height and best corrected visual acuity (BCVA was obtained before the first intravitreal anti-VEGF injection and again at the 1st, 3rd, 6th and 12th month after the injection. RESULTS: The mean baseline BCVA was 0.71 ± 0.48 logarithm of the minimal angle of resolution (logMAR unit and the mean baseline PED height was 361 ± 153 µ. The mean injection count per eye was 3.9 ± 2.9. There was a significant reduce in mean PED height (247 ± 177 µ also in 2 eyes PED completely resolved at the end of the follow up period. The mean BCVA at 12th month (0,69 ± 0,37 were not different from the baseline record. CONCLUSIONS: This retrospective case series showed that intravitreal anti-VEGF therapy preserved vision and reduced PED height in PED patients in a one-year follow-up period.

  16. [Results of the participation of resident physicians in the surgical treatment of gallbladder lithiasis].

    Science.gov (United States)

    González Ojeda, A; Herrera Hernández, M F; Torres Mejía, G; Odor Morales, A; de la Garza Villaseñor, L

    1991-01-01

    The aim of this retrospective study was to evaluate the impact of resident participation in the results of surgical treatment in 1149 consecutive patients operated for biliary disease between January, 1980 and December, 1987 at the Instituto Nacional de la Nutrición "Salvador Zubirán". Patients were divided in three groups: GROUP I. 640 cases treated by surgical residents under a senior surgeon supervision. GROUP II. 168 patients operated by the chief surgical resident. GROUP III. 341 patients treated by senior staff surgeons. Age, sex and risk factors were similar between groups. Residents performed more operative cholangiograms (p less than 0.05). In general, senior surgeons performed more transduodenal sphincteroplasties (p less than 0.05) and other additional procedures like appendectomies and gastrostomies during the same surgery. Wound infection was more frequent in group III patients (p less than 0.005) but there was no significant clinical difference in other postoperative complications like intraabdominal abscess, bile fistula, wound dehiscence, intraabdominal bleeding, iatrogenic injury of the biliary tract, and residual common duct stone. The duration of the in-hospital convalescence period was similar in all three groups. The mortality rate for the total series was 2.2%. In group II there were more patients affected for acute cholecystitis, and more patients died postoperatively (p = less than 0.01). We may consider this difference attributable to the more complex patients handled by the chief resident. Mortality rate among patients with chronic biliary tract disease was less than 1%. We were not able to demonstrate any significant difference in mortality and complication rates between those patients operated by residents, chief residents and senior surgeons.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Early results of thoraco lumbar burst fracture treatment using selective corpectomy and rectangular cage reconstruction

    Science.gov (United States)

    Liang, Bowei; Huang, Guofeng; Ding, Luobing; Kang, Liangqi; Sha, Mo; Ding, Zhenqi

    2017-01-01

    Background: Subsidence and late fusion are commonly observed in anterior subtotal corpectomy and reconstruction for treating thoracolumbar burst fractures. The subsidence rate of this surgical method was reported from 19.6% to 75% in the literatures, which would cause treatment failure. Thus, an improvement of anterior surgery technique should be studied to reduce these complications. Materials and Methods: 130 patients of thoracolumbar burst fractures treated by minimal corpectomy, decompression and U cage, between January 2009 and December 2010 were included in this study. The hospital Ethical Committee approved the protocols. The American Spinal Injury Association (ASIA) scale, visual analog scales, and Oswestry Disability Index (ODI) scores were used for clinical evaluation. The local kyphosis angle, vertebral height (one level above the fractured vertebral to one level below), canal stenosis, and fusion status were used to assess radiological outcome. All complications and demographic data such as number of male/female patients, average age, mode of trauma, burst level involved, mean surgery time and blood lost were reported. Results: 120 patients were followed up for 24 months. Most patients had improvement of at least 1 ASIA grade, and all experienced pain reduction. The mean ODI score steadily decreased after the surgery (P 0.05). The average canal stenosis index was increased from 39% to 99% after surgery. No cage subsidence or implant failure was observed. Conclusions: The clinical outcomes described here suggest that the selective corpectomy and rectangular cage reconstruction can effectively promote solid fusion and eliminate complications related to subsidence or implant failure. PMID:28216750

  18. THE RESULTS OF RADIAL OPTIC NEUROTOMY FOR TREATMENT OF CENTRAL RETINAL VEIN OCCLUSION

    Directory of Open Access Journals (Sweden)

    S A Tabatabaii

    2008-11-01

    Full Text Available "nCentral retinal vein occlusion (CRVO is the third most common blinding vascular retinal disorder. As there is no proven treatment for CRVO, we performed this study to evaluate the effectiveness of radial optic neurotomy (RON on visual acuity in eyes with CRVO. This study was designed as an interventional case series. Pars plana vitrectomy with RON was performed in 18 eyes of 16 patients with ischemic CRVO with visual acuities of 20/400 or less. Postoperative and preoperative visual acuities were compared using t paired test. Mean preoperative visual acuity was 20/1000 (range, 20/1600 to 20/630. Mean follow-up time was 3.6 months (range, 1 to 9 months. Mean postoperative visual acuity was 20/400 (range, 20/1600 to 20/50 at last follow-up and the difference was significant (P < 0.01; t paired test. Six patients (33% improved to 20/200 postoperatively. There were no major complications intraoperatively. Chorioretinal shunts developed in neurotomy site in 9 cases (50% 4 to 10 weeks after procedure which were associated with faster resolving of hemorrhage and venous dilation. There were no major complications noted with this procedure but vitreous hemorrhage and iris neovascularization was observed in the early postoperative period in 2 (11% of 18 cases. RON may improve visual acuity in eyes with CRVO. It is a technically feasible and fairly safe procedure but postoperatively it may result in some complications such as vitreous hemorrhage, iris neovascularization and retinal detachment.

  19. Changes in somatic disease incidents during opioid maintenance treatment: results from a Norwegian cohort study

    OpenAIRE

    Skeie, Ivar; Brekke, Mette; Gossop, Michael; Lindbaek, Morten; Reinertsen, Even; Thoresen, Magne; Waal, Helge

    2011-01-01

    Objectives To examine the effect of opioid maintenance treatment (OMT) on somatic morbidity in a cohort of OMT patients. Design Retrospective cohort study. Setting OMT programme in two Norwegian counties. Participants 200 OMT patients, participation rate 71.2%. Main outcome measures Incidence rates (IR) before, during and after OMT for acute/subacute hospital-treated somatic disease incidents (drug-related, non-drug-related, injuries) and rates for inpatient days and outpatient treatment cont...

  20. Video-assisted anal fistula treatment: technical considerations and preliminary results of the first brazilian experience

    OpenAIRE

    Mendes,Carlos Ramon Silveira; FERREIRA, Luciano Santana de Miranda; Sapucaia,Ricardo Aguiar; LIMA, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    Backgroung : Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. Aim : To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. Technique : A Karl Storz video equipment was used. Main steps included the ...

  1. SLEEP AND TREATMENT OUTCOME IN POSTTRAUMATIC STRESS DISORDER: RESULTS FROM AN EFFECTIVENESS STUDY

    OpenAIRE

    2015-01-01

    BACKGROUND: Most patients with posttraumatic stress disorder (PTSD) suffer from sleep problems. Concerns have been raised about possible detrimental effects of sleep problems on the efficacy of psychological treatments for PTSD. In this study, we investigated the relation of session-to-session changes in PTSD symptoms and sleep, and tested whether sleep problems predicted poorer short- and long-term treatment outcome.METHODS: Self-reported sleep quality, sleep duration, and PTSD symptoms were...

  2. Changes in somatic disease incidents during opioid maintenance treatment: results from a Norwegian cohort study

    OpenAIRE

    Skeie, Ivar; Brekke, Mette; Gossop, Michael; Lindbaek, Morten; Reinertsen, Even; Thoresen, Magne; Waal, Helge

    2011-01-01

    Objectives To examine the effect of opioid maintenance treatment (OMT) on somatic morbidity in a cohort of OMT patients. Design Retrospective cohort study. Setting OMT programme in two Norwegian counties. Participants 200 OMT patients, participation rate 71.2%. Main outcome measures Incidence rates (IR) before, during and after OMT for acute/subacute hospital-treated somatic disease incidents (drug-related, non-drug-related, injuries) and rates for inpatient days and outpatient treatment cont...

  3. Multimodal treatment of peritoneal malignancies - results of the implantation in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    Fernanda Elias Ferreira Rabelo

    2012-06-01

    Full Text Available INTRODUCTION: Peritoneal carcinomatosis is a condition that may be present in the natural history of colorectal cancer and some other tumors, such as pseudomyxoma peritonei. It has been associated with poor prognosis. The treatment for patients with this condition, up until recently, was systemic chemotherapy or palliative care to relieve the pain and suffering caused by peritoneal dissemination of certain cancers. Promising results, however, have been reported after the implementation of radical cytoreductive surgery followed by peroperative hyperthermic intraperitoneal chemotherapy. OBJECTIVE: To evaluate the results of cytoreductive surgery and peroperative hyperthermic intraperitoneal chemotherapy (HIPEC in patients with peritoneal carcinomatosis secondary to colorectal cancer and pseudomyxoma peritonei. RESULTS: We retrospectively evaluated 24 patients from 2004 to 2011. Mean age was 51.31 years, and 54% were female. The primary diagnosis in 50.01% of the cases was pseudomyxoma peritonei, 41.66%, of colon cancer, and 8.33%, of mesothelioma. The overall complication rate was around 83%, two patients (8% subsequently died between the 8th and 30th postoperative day. There was an association between the peritoneal carcinomatosis index (PCI and operative time. The one-year survival rate in the group examined was 60% for colon cancer, and 78.5% for pseudomyxoma. Overall survival was 50% in three years. CONCLUSION: cytoreductive surgery combined with HIPEC is a treatment option for patients with peritoneal carcinomatosis of colorectal origin and pseudomyxoma. Despite the high rate of peroperative complications (83%, it was possible to achieve a superior survival rate in relation to conventional treatments reported in the literature.INTRODUÇÃO: A carcinomatose peritoneal é uma condição que pode estar presente na história natural do câncer colorretal e de algumas outras neoplasias, como o pseudomixoma peritoneal, sendo associada com um progn

  4. Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire.

    Science.gov (United States)

    Harrold, Leslie R; Mazor, Kathleen M; Negron, Amarie; Ogarek, Jessica; Firneno, Cassandra; Yood, Robert A

    2013-09-01

    We sought to examine primary care providers' gout knowledge and reported treatment patterns in comparison with current treatment recommendations. We conducted a national survey of a random sample of US primary care physicians to assess their treatment of acute, intercritical and tophaceous gout using published European and American gout treatment recommendations and guidelines as a gold standard. There were 838 respondents (response rate of 41%), most of whom worked in private practice (63%) with >16 years experience (52%). Inappropriate dosing of medications in the setting of renal disease and lack of prophylaxis when initiating urate-lowering therapy (ULT) accounted for much of the lack of compliance with treatment recommendations. Specifically for acute podagra, 53% reported avoidance of anti-inflammatory drugs in the setting of renal insufficiency, use of colchicine at a dose of ≤2.4 mg/day and no initiation of a ULT during an acute attack. For intercritical gout in the setting of renal disease, 3% would provide care consistent with the recommendations, including initiating a ULT at the appropriate dose with dosing titration to a serum urate level of ≤6 mg/dl and providing prophylaxis. For tophaceous gout, 17% reported care consistent with the recommendations, including ULT use with dosing titration to a serum urate level of ≤6 mg/dl and prophylaxis. Only half of primary care providers reported optimal treatment practices for the management of acute gout and gout, suggesting that care deficiencies are common.

  5. Recurrent Anterior Shoulder Instability With Combined Bone Loss: Treatment and Results With the Modified Latarjet Procedure.

    Science.gov (United States)

    Yang, Justin S; Mazzocca, Augustus D; Cote, Mark P; Edgar, Cory M; Arciero, Robert A

    2016-04-01

    Recurrent anterior glenohumeral dislocation in the setting of an engaging Hill-Sachs lesion is high. The Latarjet procedure has been well described for restoring glenohumeral stability in patients with >25% glenoid bone loss. However, the treatment for patients with combined humeral head and mild (Latarjet for patients with combined humeral and glenoid defects and compares the results for patients with ≤25% glenoid bone loss versus patients with >25% glenoid bone loss. The hypothesis was that the 2 groups would have equivalent subjective outcomes and recurrence rates. Cohort Study; Level of evidence, 3. Modified Latarjet was performed in 40 patients with recurrent anterior shoulder instability, engaging Hill-Sachs by examination confirmed with arthroscopy, and ≤25% anterior glenoid bone loss (group A). A second group of 12 patients were identified to have >25% glenoid bone loss with an engaging Hill-Sachs lesion (group B). The mean follow-up time was 3.5 years. All patients were assessed for their risk of recurrence using the Instability Severity Index score and Beighton score and had preoperative 3-dimensional imaging to assess humeral and glenoid bone loss. Single Assessment Numeric Evaluation (SANE), Western Ontario Shoulder Instability Index (WOSI), recurrence rate, radiographs, range of motion, and dynamometer strength were used to assess outcomes. A multivariate analysis was performed. Glenoid bone loss averaged 15% in group A compared with 34% in group B. Both groups had comparable WOSI scores (356 vs 475; P = .311). In multivariate analysis, the number of previous surgeries and Beighton score were directly correlated with WOSI score in Latarjet patients. The SANE score was better in group A (86 vs 77; P = .02). Group B experienced more loss of external rotation (9.2° vs 15.8°; P = .0001) and weaker thumbs-down abduction and external rotation strength (P .999) were similar for both groups. The complication rate was 25% for both groups. The modified

  6. Differences in treatment of anti-NMDA receptor encephalitis: results of a worldwide survey.

    Science.gov (United States)

    Bartolini, Luca; Muscal, Eyal

    2017-02-02

    The objective of the study was to identify differences in treatment strategies for anti-NMDA receptor encephalitis based on specialty of treating physicians, geographic location, and years in practice. We conducted an anonymous worldwide electronic survey through the Practice Current section of Neurology(®) Clinical Practice to appraise differences in decisions about first- and second-line treatment and timing for initiation of second-line treatment for anti-NMDA receptor encephalitis. 399 participants answered all questions of the survey and were included in the analysis. 261 (65%) were adult neurologists, 86 (22%) were neurologists treating children, and 52 (13%) were pediatric rheumatologists. 179 (45%) responders practiced in the US. The majority agreed on the use of steroids and/or IVIg for first-line therapy and rituximab alone as second line. Differences in initial treatment regimen based on specialty included increased use of plasma exchange by adult neurologists (27%) and rituximab by pediatric rheumatologists (29%) (χ (2)(4) = 27.43, p < 0.001). Trainees opted for plasma exchange (35%) and junior faculty picked rituximab (15%) more as part of first line (χ (2)(4) = 13.37, p = 0.010). There was greater usage of anti-metabolites for second-line therapy outside of the US (15%) (χ (2)(4) = 11.67, p = 0.020). US physicians also utilized second-line treatment earlier than their mostly European counterparts (14 vs. 23% used later than 2 weeks; χ (2)(1) = 4.96, p = 0.026). Although treatment patterns were similar, differences observed across specialties and geographic locations may guide the development of consensus-driven guidelines by multi-disciplinary task forces. These guidelines may promote treatment trials of immunomodulators in autoimmune encephalitides.

  7. Combination treatment in Alzheimer's disease: results of a randomized, controlled trial with cerebrolysin and donepezil.

    Science.gov (United States)

    Alvarez, X Antón; Cacabelos, R; Sampedro, C; Couceiro, V; Aleixandre, M; Vargas, M; Linares, C; Granizo, E; García-Fantini, M; Baurecht, W; Doppler, E; Moessler, H

    2011-08-01

    Treatment with neurotrophic agents might enhance and/or prolong the effects of cholinesterase inhibitors (ChEIs) in Alzheimer's disease (AD). We compared the safety and efficacy of the neurotrophic compound Cerebrolysin (10 ml; n=64), donepezil (10 mg; n=66) and a combination of both treatments (n=67) in mild-to-moderate (mini-mental state examination-MMSE score 12-25) probable AD patients enrolled in a randomized, double-blind trial. Primary endpoints were global outcome (Clinician's Interview-Based Impression of Change plus caregiver input; CIBIC+) and cognition (change from baseline in AD Assessment Scale-cognitive subscale+; ADAS-cog+) at week 28. Changes in functioning (AD Cooperative Study-Activities of Daily Living scale, ADCS-ADL) and behaviour (Neuropsychiatric Inventory, NPI) were secondary endpoints. Treatment effects in cognitive, functional and behavioral domains showed no significant group differences; whereas improvements in global outcome favored Cerebrolysin and the combination therapy. Cognitive performance improved in all treatment groups (mean±SD for Cerebrolysin: -1.7±7.5; donepezil: -1.2±6.1; combination: -2.3±6.0) with best scores in the combined therapy group at all study visits. Cerebrolysin was as effective as donepezil, and the combination of neurotrophic (Cerebrolysin) and cholinergic (donepezil) treatment was safe in mild-to-moderate AD. The convenience of exploring long-term synergistic effects of this combined therapy is suggested.

  8. Biostereometric Analysis Of Therapeutic Results In The Treatment Of Chronic, Progressive, Decompensating Postural Back Strain

    Science.gov (United States)

    Johnson, David M.

    1980-07-01

    A two year pilot program for biostereometric analysis of treatment effectiveness in five patients with chronic decompensating back strain has been completed. The patients came from the investigators family practice of osteopathic medicine. They all manifested objective signs of ligamentous and muscular strain of their postural biomechanics due to the combined effects of prior injury to the musculoskeletal system, gravity strain and the passage of time. Two of the patients were treated with osteopathic manipulative treatment plus a pelvic leverage treatment device developed by Martin Jungman, M.D. Two patients received osteopathic treatment alone and the fifth individual switched from control to full program status in the middle of the study after the second stereophotography recording. Signs and symptoms of all patients' gravity strain syndrome changed during the program. Those patients who had the full combination of treatment modalities showed the most positive and significant postural changes as demonstrated by the biostereometric technique developed and performed by the Department of Biostereometrics, Texas Institute of Rehabilitation and Research, Baylor College of Medicine, Houston, Texas. Improvement was clearly demonstrated more quickly than with the prior radiographic measuring methods. X-ray and other studies have also been done on this group. All of the data has not been processed yet in this program. The test patients have improved posture, muscle mass and tone, more stamina and reduced pain.

  9. Preliminary results of the global audit of treatment of refractory status epilepticus.

    Science.gov (United States)

    Ferlisi, M; Hocker, S; Grade, M; Trinka, E; Shorvon, S

    2015-08-01

    The treatment of refractory and super refractory status epilepticus is a "terra incognita" from the point of view of evidence-based medicine. As randomized or controlled studies that are sufficiently powered are not feasible in relation to the many therapies and treatment approaches available, we carried out an online multinational audit (registry) in which neurologists or intensivists caring for patients with status epilepticus may prospectively enter patients who required general anesthesia to control the status epilepticus (SE). To date, 488 cases from 44 different countries have been collected. Most of the patients had no history of epilepsy and had a cryptogenic etiology. First-line treatment was delayed and not in line with current guidelines. The most widely used anesthetic of first choice was midazolam (59%), followed by propofol and barbiturates. Ketamine was used in most severe cases. Other therapies were administered in 35% of the cases, mainly steroids and immunotherapy. Seizure control was achieved in 74% of the patients. Twenty-two percent of patients died during treatment, and four percent had treatment actively withdrawn because of an anticipated poor outcome. The neurological outcome was good in 36% and poor in 39.3% of cases, while 25% died during hospitalization. Factors that positively influenced outcome were younger age, history of epilepsy, and low number of different anesthetics tried. This article is part of a Special Issue entitled "Status Epilepticus".

  10. Skin-derived fibroblasts for the treatment of refractory Achilles tendinosis: preliminary short-term results.

    Science.gov (United States)

    Obaid, Haron; Clarke, Andrew; Rosenfeld, Peter; Leach, Christopher; Connell, David

    2012-02-01

    Chronic Achilles tendinosis is a common musculoskeletal disorder often refractory to conservative management. Our study aimed to assess the safety and efficacy of the use of autologous skin-derived collagen-producing cells in the treatment of refractory Achilles tendinosis. We conducted a randomized, double-blind study on forty Achilles tendons in thirty-two patients (eight with bilateral involvement) who had a clinical and radiographic diagnosis of Achilles tendinosis. The patients ranged from twenty-two to sixty-seven years old and had a mean age of 45.2 years. The patients with unilateral involvement were randomized into the treatment group (twelve patients) and control group (twelve patients). The eight patients with bilateral involvement were individually randomized into treatment and control groups, with eight Achilles tendons in each group. Achilles tendons in the treatment group were injected under ultrasound guidance with laboratory-expanded, skin-derived fibroblasts suspended in autologous plasma. The control group received ultrasound-guided injection of a local anesthetic and physiotherapy. The Victorian Institute of Sport Assessment (VISA) questionnaire and visual analog scale (VAS) scores were used as the main outcome measures for both groups. Significant differences in the mean VISA and VAS scores were detected between the treatment and the control groups for the patients with unilateral involvement at six months (p tendinosis is safe. However, larger studies with a longer duration of follow-up are required to determine the long-term effectiveness before wider clinical application is considered.

  11. Orthodontic treatment results following grafting autologous mandibular bone to the alveolar cleft in patients with a complete unilateral cleft.

    NARCIS (Netherlands)

    Ruiter, A. de; Bilt, A. van der; Meijer, G.J.; Koole, R.

    2010-01-01

    OBJECTIVE: To analyze orthodontic treatment results following mandibular symphysis bone grafting and postoperative orthodontic treatment. DESIGN: Randomized selection of 75 patients out of 308 with unilateral cleft of lip, alveolus, and palate, operated upon according to protocol between 1990 and 20

  12. A novel marker for the assessment of the treatment result in pelvic inflammatory disease.

    Science.gov (United States)

    Akopuz, Aycan; Turan, Volkan; Ozcan, Aycut; Kopuz, Yeliz; Toz, Emrah; Kurt, Sefa

    2016-04-01

    Although various laboratory tests have been studied with an intended use in the diagnosis of pelvic inflammatory disease (PID) and the assessment of treatment response, the neutrophil/lymphocyte ratio (NLR) has not been investigated in PID. We aimed to explore the value of blood NLR in diagnosis of PID and assessment of the treatment response. Sixty-five patients followed-up and treated with the diagnosis of PID in Izmir Tepecik Training and Research Hospital were retrospectively reviewed. The NLR measured before treatment and after clinical remission in the patients diagnosed with PID were assessed and compared with controls (N.=65). In the patient group, the NLR measured before treatment was statistically significantly higher than the NLR measured after clinical remission (6.9±6.4 vs. 2.03±0.8, P<0.001). Similarly, comparison of the NLR measured in the patient group before treatment with the control group showed that this ratio was statistically significantly higher in the patient group before treatment (6.9±6.4 vs. 1.9±0.5, P<0.001). A comparison of the NLR measured after clinical remission did not reveal a statistically significant difference when compared with control group (1.9±0.5 vs. 2.03±0.8, P=0.981). The NLR increases in patients diagnosed with PID and returns to normal levels when the patients enter clinical remission. Since there is currently no laboratory test available that indicates clinical improvement by returning to normal levels, as achieved by the NLR, and since it is an inexpensive and easy-to-apply test, we suggest that the NLR can be conveniently used to show clinical improvement in PID.

  13. Long term result of silicone oil versus gas tamponade in the treatment of traumatic macular holes

    Directory of Open Access Journals (Sweden)

    Ghoraba HH

    2012-01-01

    Full Text Available Hammouda H Ghoraba1, Amin F Ellakwa2, Ali A Ghali31Tanta University, Magrabi Eye Hospital, Tanta, Egypt; 2Menoufiya University, Shebin Elkom, Menoufiya, Egypt; 3Alazhar University, Damitta, EgyptPurpose: To compare the effectiveness of pars plana vitrectomy (PPV with either silicone oil or gas tamponade for the treatment of traumatic macular holes.Methods: A retrospective comparative study included 22 patients who were operated on by PPV for repair of traumatic macular holes with either silicone oil tamponade (nine patients or perfluoropropane (C3F8 gas tamponade (13 patients.Results: Twenty-two cases were reviewed to assess the anatomical and visual outcomes of surgery with silicone oil tamponade in nine cases (40.9% vs 14% C3F8 gas tamponade in 13 cases (59.1%. The age of the silicone oil-treated patients ranged from 10 to 40 years (mean 27.4 ± 11.3 years, while that of the gas-treated patients ranged from 19 to 35 years (mean 26.54 ± 5.68 years. Female patients accounted for 33.3% of the silicone oil group and 30.77% of the gas-treated group. The minimal follow-up time for the silicone oil-treated group was 13 months, with a maximum of 18 months after silicone oil removal. The minimal follow-up time for the gas-treated group was 12 months and the maximum was 24 months. The rate of hole closure after the primary operation with oil tamponade was significantly lower than that with gas tamponade (66.67% vs 92.3%; P = 0.022. With re-operations, the final rate of hole closure was higher in the gas group (100% than in the silicone oil group (77.8%. The final postoperative decimal visual acuity for the gas group was significantly better than for the oil group (0.433 vs 0.245; P = 0.047.Conclusions: C3F8 gas was a more effective tamponade than silicone oil in achieving initial closure of traumatic macular holes. Eyes receiving an oil tamponade required significantly more re-operations to achieve hole closure than did eyes undergoing a gas tamponade

  14. Long term result of silicone oil versus gas tamponade in the treatment of traumatic macular holes

    Science.gov (United States)

    Ghoraba, Hammouda H; Ellakwa, Amin F; Ghali, Ali A

    2012-01-01

    Purpose To compare the effectiveness of pars plana vitrectomy (PPV) with either silicone oil or gas tamponade for the treatment of traumatic macular holes. Methods A retrospective comparative study included 22 patients who were operated on by PPV for repair of traumatic macular holes with either silicone oil tamponade (nine patients) or perfluoropropane (C3F8) gas tamponade (13 patients). Results Twenty-two cases were reviewed to assess the anatomical and visual outcomes of surgery with silicone oil tamponade in nine cases (40.9%) vs 14% C3F8 gas tamponade in 13 cases (59.1%). The age of the silicone oil-treated patients ranged from 10 to 40 years (mean 27.4 ± 11.3 years), while that of the gas-treated patients ranged from 19 to 35 years (mean 26.54 ± 5.68 years). Female patients accounted for 33.3% of the silicone oil group and 30.77% of the gas-treated group. The minimal follow-up time for the silicone oil-treated group was 13 months, with a maximum of 18 months after silicone oil removal. The minimal follow-up time for the gas-treated group was 12 months and the maximum was 24 months. The rate of hole closure after the primary operation with oil tamponade was significantly lower than that with gas tamponade (66.67% vs 92.3%; P = 0.022). With re-operations, the final rate of hole closure was higher in the gas group (100%) than in the silicone oil group (77.8%). The final postoperative decimal visual acuity for the gas group was significantly better than for the oil group (0.433 vs 0.245; P = 0.047). Conclusions C3F8 gas was a more effective tamponade than silicone oil in achieving initial closure of traumatic macular holes. Eyes receiving an oil tamponade required significantly more re-operations to achieve hole closure than did eyes undergoing a gas tamponade. Final visual acuity was better for gas-treated eyes than for silicone oil-treated eyes. PMID:22259236

  15. Photodynamic therapy for the treatment of recurrent herpes labialis: preliminary results.

    Science.gov (United States)

    Sperandio, Felipe Fornias; Marotti, Juliana; Aranha, Ana Cecilia Correa; Eduardo, Carlos de Paula

    2009-01-01

    This study sought to evaluate the clinical outcome of patients who had been diagnosed with recurrent herpes labialis (RHL) after treatment with photodynamic therapy (PDT) associated with low-level laser therapy (LLLT). PDT has shown great effectiveness for treating already-established RHL vesicles, compared to ordinary treatments involving antiviral compounds. Two patients with vesicles on their lips were treated with PDT, followed by irradiation with LLLT. Both patients reported pain relief immediately after the procedure; at a six-month follow-up, neither patient showed signs or symptoms that related to RHL.

  16. Preliminary results on optimising hydrothermal treatment used in co-production of biofuels

    DEFF Research Database (Denmark)

    Thomsen, M.H.; Thomsen, A.B.; Jørgensen, H.

    In December 2002, an EU-project for co-production of biofuels was started. The overall objective is to develop cost and energy effective production systems for co-production of bio ethanol and electricity based on integrated biomass utilization. Duringthe first 12 months period of the project...... illustrates that it is possible to extract more than 95% of the alkaline salts (at 200 C) leaving a solid cellulose rich biofuel for combustion or for further treatment in the ethanol process. In the experiments performed at 190 C, the best totalglucose yield after pre-treatment and following enzymatic...

  17. Treatment And Results Of Combined Mild Bone Loss Instability With The Modified Laterjet

    OpenAIRE

    Yang, Justin Shu; Mazzocca, Augustus D.; Arciero, Robert A.

    2015-01-01

    Objectives: Recurrent anterior glenohumeral dislocation in the setting of an engaging Hill-Sachs lesion is high. The Latarjet procedure has been well-described for restoring glenohumeral stability in patients with over 25% glenoid bone loss. However, the treatment for patients with combined humeral head and mild (

  18. Humeral shaft fractures: Retrospective results of non-operative and operative treatment of 186 patients

    NARCIS (Netherlands)

    K.C. Mahabier (Kiran); L.M.M. Vogels (Lucas); B.J. Punt (Bas); G.R. Roukema (Gert); P. Patka (Peter); E.M.M. van Lieshout (Esther)

    2013-01-01

    textabstractBackground: Humeral shaft fractures account for 1-3% of all fractures and 20% of the fractures involving the humerus. The aim of the current study was to compare the outcome after operative and non-operative treatment of humeral shaft fractures, by comparing the time to radiological unio

  19. Constraints on Enhanced Extinction Resulting from Extinction Treatment in the Presence of an Added Excitor

    Science.gov (United States)

    Urcelay, Gonzalo P.; Lipatova, Olga; Miller, Ralph R.

    2009-01-01

    Three Pavlovian fear conditioning experiments with rats as subjects explored the effect of extinction in the presence of a concurrent excitor. Our aim was to explore this particular treatment, documented in previous studies to deepen extinction, with novel control groups to shed light on the processes involved in extinction. Relative to subjects…

  20. The morbidity of treatment for patients with stage I endometrial cancer : Results from a randomized trial

    NARCIS (Netherlands)

    Creutzberg, CL; van Putten, WLJ; Koper, PC; Lybeert, MLM; Jobsen, JJ; Warlam-Rodenhuis, CC; De Winter, KAJ; Lutgens, LCHW; van den Bergh, ACM; van der Steen-Banasik, E; Beerman, H; van Lent, M

    2001-01-01

    Purpose: To compare the treatment complications for patients with Stage I endometrial cancer treated with surgery and pelvic radiotherapy (RT) or surgery alone in a multicenter randomized trial. Methods and Materials: The Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial includ

  1. Chronic ischaemic mitral regurgitation. Current treatment results and new mechanism-based surgical approaches

    NARCIS (Netherlands)

    Bouma, Wobbe; van der Horst, Iwan C. C.; Wijdh-den Hamer, Inez J.; Erasmus, Michiel E.; Zijlstra, Felix; Mariani, Massimo A.; Ebels, Tjark

    2010-01-01

    Chronic ischaemic mitral regurgitation (CIMR) remains one of the most complex and unresolved aspects in the management of ischaemic heart disease. This review provides an overview of the present knowledge about the different aspects of CIMR with an emphasis on mechanisms, current surgical treatment

  2. Biological treatment in rheumatic diseases: results from a longitudinal surveillance: adverse events.

    Science.gov (United States)

    Konttinen, L; Honkanen, V; Uotila, T; Pöllänen, J; Waahtera, M; Romu, M; Puolakka, K; Vasala, M; Karjalainen, A; Luukkainen, R; Nordström, D C

    2006-08-01

    The objective of this study was to assess the long-term safety and tolerability of biologicals in a clinical setting. Data on adverse events (AEs) have been collected over a 5-year period by means of detailed reports sent in to the National Register of Biological Treatment in Finland (ROB-FIN) and validated by information collected by the National Agency for Medicines. Three hundred and eight reports on AEs were filed, concerning a total of 248 patients; this corresponds to 17% of all patients in the ROB-FIN register who started biological treatments. Skin reactions and infections comprised 35 and 28% of the AEs, respectively. Some cases of tuberculosis and other infections, heart failure and demyelinating conditions were seen. Our work demonstrates no unexpected AEs in a Finnish patient cohort consisting of rheumatoid arthritis and spondylarthropathy patients, although many of them were treated with combination treatments in common use in Finland. Biological treatment appears safe in the hands of the Finnish rheumatologists.

  3. Homogenization and lipase treatment of milk and resulting methyl ketone generation in blue cheese.

    Science.gov (United States)

    Cao, Mingkai; Fonseca, Leorges M; Schoenfuss, Tonya C; Rankin, Scott A

    2014-06-25

    A specific range of methyl ketones contribute to the distinctive flavor of traditional blue cheeses. These ketones are metabolites of lipid metabolism by Penicillium mold added to cheese for this purpose. Two processes, namely, the homogenization of milk fat and the addition of exogenous lipase enzymes, are traditionally applied measures to control the formation of methyl ketones in blue cheese. There exists little scientific validation of the actual effects of these treatments on methyl ketone development. The present study evaluated the effects of milk fat homogenization and lipase treatments on methyl ketone and free fatty acid development using sensory methods and the comparison of selected volatile quantities using gas chromatography. Initial work was conducted using a blue cheese system model; subsequent work was conducted with manufactured blue cheese. In general, there were modest effects of homogenization and lipase treatments on free fatty acid (FFA) and methyl ketone concentrations in blue cheese. Blue cheese treatments involving Penicillium roqueforti lipase with homogenized milk yielded higher FFA and methyl ketone levels, for example, a ∼20-fold increase for hexanoic acid and a 3-fold increase in 2-pentanone.

  4. Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis

    Directory of Open Access Journals (Sweden)

    Tim Claßen

    2016-03-01

    Full Text Available The treatments of avascular osteonecrosis (AVN include both conservative and surgical methods which are dependent on the stage and progression of the disease. The vasoactive- prostaglandin-analogue iloprost (PGI2 has been utilized in several areas of medicine and recently has been used for the treatment of AVN. A total of 108 patients with 136 osteonecrosis of different joints, etiology and severity were treated with iloprost. The mean follow-up was 49.71 months: range 15-96 months, and outcome measurements recorded regarding subjective complaints, visual analog scale (pain, function and survival. The outcome scores used include the Harris Hip Score, Knee Society score, Foot and Ankle Survey, visual analogue scale (VAS and a separate questionnaire. The location and etiology of AVN in our study demonstrated the typical pattern. All of the observed side effects of the therapy were minor and completely reversible. Most of patients (74.8% showed a significant improvement of subjective complaints and decrease in VAS pain scores after the treatment with iloprost. However, 20% of the treated joints with the stadium Association for Research on Osseous Circulation (ARCO grade 2, 71% with ARCO 3 and 100% with ARCO 4 underwent subsequent total joint replacement. The medical treatment of bone marrow edema or avascular osteonecrosis by Iloprost provides an safe and effective alternative strategy in the management of AVN presenting in the early stages (ARCO 1 or 2. For more advanced stages (ARCO 3 or 4, surgical intervention should be prioritized.

  5. Approaches to improvement of treatment results of malignant tumors in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    A. G. Rumyantsev

    2011-01-01

    Full Text Available This article provides an overview of clinical and biological features of most common malignant tumors in adolescents and young adults. The most effective pediatric and oncological treatment approaches to described diseases based on own experience are summarized.

  6. Acoustic Treatment Design Scaling Methods. Volume 1; Overview, Results, and Recommendations

    Science.gov (United States)

    Kraft, R. E.; Yu, J.

    1999-01-01

    Scale model fan rigs that simulate new generation ultra-high-bypass engines at about 1/5-scale are achieving increased importance as development vehicles for the design of low-noise aircraft engines. Testing at small scale allows the tests to be performed in existing anechoic wind tunnels, which provides an accurate simulation of the important effects of aircraft forward motion on the noise generation. The ability to design, build, and test miniaturized acoustic treatment panels on scale model fan rigs representative of the fullscale engine provides not only a cost-savings, but an opportunity to optimize the treatment by allowing tests of different designs. The primary objective of this study was to develop methods that will allow scale model fan rigs to be successfully used as acoustic treatment design tools. The study focuses on finding methods to extend the upper limit of the frequency range of impedance prediction models and acoustic impedance measurement methods for subscale treatment liner designs, and confirm the predictions by correlation with measured data. This phase of the program had as a goal doubling the upper limit of impedance measurement from 6 kHz to 12 kHz. The program utilizes combined analytical and experimental methods to achieve the objectives.

  7. Treatment of extraskeletal osteosarcoma at a previous injection site resulting in prolonged survival in 1 dog.

    Science.gov (United States)

    Selmic, Laura E; Griffin, Lynn R; Rector, Megan H; Lafferty, Mary; Pool, Roy; Ehrhart, Nicole P

    2016-09-01

    A rare presentation of an extraskeletal osteosarcoma at a previous interscapular injection site in a dog is described. Treatment included surgical excision of the tumor followed by 6 rounds of intravenous carboplatin, oral toceranib, and cyclophosphamide. The dog survived for 20.5 months after diagnosis despite early development of pulmonary metastases.

  8. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    Science.gov (United States)

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  9. Endometrial cancer survival after breast cancer in relation to tamoxifen treatment : Pooled results from three countries

    NARCIS (Netherlands)

    Jones, Michael E.; van Leeuwen, Flora E.; Hoogendoorn, Wilhelmina E.; Mourits, Marian J. E.; Hollema, Harry; van Boven, Hester; Press, Michael F.; Bernstein, Leslie; Swerdlow, Anthony J.

    2012-01-01

    Introduction: Tamoxifen is an effective treatment for breast cancer but an undesirable side-effect is an increased risk of endometrial cancer, particularly rare tumor types associated with poor prognosis. We investigated whether tamoxifen therapy increases mortality among breast cancer patients subs

  10. Biofeedback-Based Behavioral Treatment for Chronic Tinnitus: Results of a Randomized Controlled Trial

    Science.gov (United States)

    Weise, Cornelia; Heinecke, Kristin; Rief, Winfried

    2008-01-01

    Many tinnitus sufferers believe that their tinnitus has an organic basis and thus seek medical rather than psychological treatments. Tinnitus has been found to be associated with negative appraisal, dysfunctional attention shift, and heightened psychophysiological arousal, so cognitive-behavioral interventions and biofeedback are commonly…

  11. Biofeedback-Based Behavioral Treatment for Chronic Tinnitus: Results of a Randomized Controlled Trial

    Science.gov (United States)

    Weise, Cornelia; Heinecke, Kristin; Rief, Winfried

    2008-01-01

    Many tinnitus sufferers believe that their tinnitus has an organic basis and thus seek medical rather than psychological treatments. Tinnitus has been found to be associated with negative appraisal, dysfunctional attention shift, and heightened psychophysiological arousal, so cognitive-behavioral interventions and biofeedback are commonly…

  12. Antithrombotic treatment of splanchnic vein thrombosis: results of an international registry.

    Science.gov (United States)

    Ageno, Walter; Riva, Nicoletta; Schulman, Sam; Bang, Soo Mee; Sartori, Maria Teresa; Grandone, Elvira; Beyer-Westendorf, Jan; Barillari, Giovanni; Di Minno, Matteo Nicola Dario; Dentali, Francesco

    2014-02-01

    Treatment of splanchnic vein thrombosis (SVT) is a clinical challenge due to heterogeneity of clinical presentations, increased bleeding risk, and lack of evidences from clinical trials. We performed an international registry to describe current treatment strategies and factors associated with therapeutic decisions in a large prospective cohort of unselected SVT patients. A total of 613 patients were enrolled (mean age 53.1 years, standard deviation ± 14.8); 62.6% males; the majority (468 patients) had portal vein thrombosis. Most common risk factors included cirrhosis (27.8%), solid cancer (22.3%), and intra-abdominal inflammation/infection (11.7%); in 27.4% of patients, SVT was idiopathic. During the acute phase, 470 (76.7%) patients received anticoagulant drugs, 136 patients (22.2%) remained untreated. Incidental diagnosis, single vein thrombosis, gastrointestinal bleeding, thrombocytopenia, cancer, and cirrhosis were significantly associated with no anticoagulant treatment. Decision to start patients on vitamin K antagonists after an initial course of parenteral anticoagulation was significantly associated with younger age, symptomatic onset, multiple veins involvement, and unprovoked thrombosis. Although a nonnegligible proportion of SVT patients did not receive anticoagulant treatment, the majority received the same therapies recommended for patients with usual sites thrombosis, with some differences driven by the site of thrombosis and the pathogenesis of the disease.

  13. Clinical experiences of intracavitary hyperthermo-radiotherapy. Analysis of treatment results and adverse reactions

    Energy Technology Data Exchange (ETDEWEB)

    Kawamori, Jiro; Hirayama, Michiko; Fukushima, Shoko; Saito, Tsutomu; Tanaka, Yoshiaki [Nihon Univ., Tokyo (Japan). School of Medicine

    1999-09-01

    We have applied intracavitary hyperthermo-radiotherapy to the treatment of various cancers. In this study, early response and acute reaction were analyzed. Eighteen patients treated with intracavitary hyperthermo-radiotherapy were as follows; 4 of esophageal cancer, 6 of uterine cervical cancer, 3 of rectal cancer, and 5 of others. Intracavitary hyperthermia was performed with Endoradiotherm 100A (OLYMPUS) once or twice a week with a total number of heating sessions ranging from 2 to 12 times. The heating was started just after the irradiation, and the temperature measured at the surface of applicator was kept at 42-44 deg C during the treatment for 30-40 min. External irradiation was performed in the majority of these 18 patients. Nine cases achieved complete response (CR), 6 cases did partial response (PR) and 3 cases were no change (NC). Of CR 9 cases, 6 cases showed 2-year local control. There were 2 esophageal tumors, 2 cervical tumors, 1 rectal tumor, and 1 vaginal stump tumor among 2-year local control cases. The treatment was interrupted in 2 patients from severe local pain during the heating. Severe vaginal mucositis occurred in 4 stump tumors. Intracavitary hyperthermoradiotherapy showed good early response for esophageal cancer and stump tumor. The advantages of intracavitary hyperthermia might be the reliability of heating for the treatment of localized tumors. (author)

  14. The treatment of insomnia through mass media, the results of a televised behavioural training programme

    NARCIS (Netherlands)

    Klip, EC

    1997-01-01

    An important trend in behavioural medicine is a psyche-educational approach to health problems. A training course aimed at the treatment of sleep disorders has been developed using the following basic principles: (1) a symptomatic approach, (2) emphasis on information on sleep and sleep disorders,

  15. Endometrial cancer survival after breast cancer in relation to tamoxifen treatment : Pooled results from three countries

    NARCIS (Netherlands)

    Jones, Michael E.; van Leeuwen, Flora E.; Hoogendoorn, Wilhelmina E.; Mourits, Marian J. E.; Hollema, Harry; van Boven, Hester; Press, Michael F.; Bernstein, Leslie; Swerdlow, Anthony J.

    2012-01-01

    Introduction: Tamoxifen is an effective treatment for breast cancer but an undesirable side-effect is an increased risk of endometrial cancer, particularly rare tumor types associated with poor prognosis. We investigated whether tamoxifen therapy increases mortality among breast cancer patients subs

  16. Treatment with rivastigmine or galantamine and risk of urinary incontinence : results from a Dutch database study

    NARCIS (Netherlands)

    Kroger, Edeltraut; Van Marum, Rob; Souverein, Patrick; Carmichael, Pierre Hugues; Egberts, Toine

    2015-01-01

    Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). Objective: To assess whether ChEI use was associated with the risk of UI among older patients with AD. Methods: A crossover cohort study using the PHARMO Record Linkage Syst

  17. The treatment of insomnia through mass media, the results of a televised behavioural training programme

    NARCIS (Netherlands)

    Klip, EC

    1997-01-01

    An important trend in behavioural medicine is a psyche-educational approach to health problems. A training course aimed at the treatment of sleep disorders has been developed using the following basic principles: (1) a symptomatic approach, (2) emphasis on information on sleep and sleep disorders, (

  18. Sleep and treatment outcome in posttraumatic stress disorder : Results from an effectiveness study

    NARCIS (Netherlands)

    Lommen, Miriam J.J.; Grey, Nick; Clark, David M.; Wild, Jennifer; Stott, Richard; Ehlers, Anke

    2016-01-01

    BackgroundMost patients with posttraumatic stress disorder (PTSD) suffer from sleep problems. Concerns have been raised about possible detrimental effects of sleep problems on the efficacy of psychological treatments for PTSD. In this study, we investigated the relation of session-to-session changes

  19. Recurrence of major depressive disorder across different treatment settings : Results from the NESDA study

    NARCIS (Netherlands)

    Hardeveld, Florian; Spijker, Jan; De Graaf, Ron; Hendriks, Sanne M.; Licht, Carmilla M. M.; Nolen, Willem A.; Penninx, Brenda W. J. H.; Beekman, Aartjan T. F.

    Objective: Examine time to recurrence of major depressive disorder (MDD) across different treatment settings and assess predictors of time to recurrence of MDD. Methods: Data were from 375 subjects with a MDD diagnosis from the Netherlands Study of Depression and Anxiety (NESDA). The study sample

  20. Family-focused treatment for childhood-onset depressive disorders: results of an open trial.

    Science.gov (United States)

    Tompson, Martha C; Pierre, Claudette B; Haber, Fawn McNeil; Fogler, Jason M; Groff, April R; Asarnow, Joan R

    2007-07-01

    Study objectives were to develop a treatment manual for a family-focused intervention for depressed school-aged children, evaluate its feasibility and acceptability, and complete an initial open trial to examine treatment effects. Nine young people meeting criteria for depression (major depressive disorder, dysthymic disorder, or depression not otherwise specified), completed a 12-week family intervention, and were assessed immediately and at 9 months following treatment completion. The intervention presented an interpersonal model of how depressive symptoms are maintained, and emphasized developing family strategies for altering interpersonal processes, supporting recovery and enhancing resilience. At posttreatment 66% of the young people had recovered from their depressive episodes; by 9 months posttreatment 77% had recovered. Significant improvements in global functioning were noted. There were no relapses in the follow-up period and no instances of suicidal behavior during the intervention or follow-up. Mothers' and fathers' Child Behavior Checklist reports and children's self reports indicated significant symptom reductions. Exploratory analyses suggest particular benefit for young people with parents high in criticism. The family-focused intervention for childhood-onset depression demonstrated gains similar to those seen with empirically supported treatments for depressed adolescents and superior to those seen in naturalistic studies of depression outcomes. This favorable risk/benefit profile supports the value of a randomized controlled trial.

  1. Cerebral aneurysm treatment in India: Results of a national survey regarding practice patterns in India

    Directory of Open Access Journals (Sweden)

    Sudheer Ambekar

    2016-01-01

    Conclusion: Our study demonstrates the prevailing practice patterns in the management of IAs in India. Surgical clipping is the preferred treatment of choice for anterior circulation aneurysms and EVT for aneurysms along the posterior circulation. Corticosteroids and prophylactic "triple-H" therapy are still used by a large proportion of physicians.

  2. Effect of Comorbidity on Treatment of Anxious Children and Adolescents: Results from a Large, Combined Sample

    Science.gov (United States)

    Rapee, Ronald M.; Lyneham, Heidi J.; Hudson, Jennifer L.; Kangas, Maria; Wuthrich, Viviana M.; Schniering, Carolyn A.

    2013-01-01

    Objective: The purpose of the present study was to evaluate the influence of comorbid disorders on the degree of change and the endpoint of cognitive-behavioral treatment in anxious young people. Method: Data on 750 children 6 to 18 years old were compiled from different samples within one clinic. All children had a primary anxiety disorder and…

  3. Video-assisted anal fistula treatment: technical considerations and preliminary results of the first Brazilian experience.

    Science.gov (United States)

    Mendes, Carlos Ramon Silveira; Ferreira, Luciano Santana de Miranda; Sapucaia, Ricardo Aguiar; Lima, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. A Karl Storz video equipment was used. Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening which can be accomplished through firing a stapler, cutaneous-mucosal flap, or direct closure using suture. The mean distance between the anal verge and the external anal orifice was 5.5 cm. Mean operative time was 31.75 min. In all cases, the internal fistula opening could be identified after complete fistuloscopy. In all cases, internal fistula opening was closed using full-thickness suture. There were no intraoperative or postoperative complications. After a 5-month follow-up, recurrence was observed in one (12.5%) patient. Video-assisted anal fistula treatment is feasible, reproducible, and safe. It enables direct visualization of the fistula tract, internal opening and secondary paths.

  4. Therapeutic effects of ritual ayahuasca use in the treatment of substance dependence--qualitative results.

    Science.gov (United States)

    Loizaga-Velder, Anja; Verres, Rolf

    2014-01-01

    This qualitative empirical study explores the ritual use of ayahuasca in the treatment of addictions. Ayahuasca is an Amazonian psychedelic plant compound created from an admixture of the vine Banisteriopsis caapi and the bush Psychotria viridis. The study included interviews with 13 therapists who apply ayahuasca professionally in the treatment of addictions (four indigenous healers and nine Western mental health professionals with university degrees), two expert researchers, and 14 individuals who had undergone ayahuasca-assisted therapy for addictions in diverse contexts in South America. The study provides empirically based hypotheses on therapeutic mechanisms of ayahuasca in substance dependence treatment. Findings indicate that ayahuasca can serve as a valuable therapeutic tool that, in carefully structured settings, can catalyze neurobiological and psychological processes that support recovery from substance dependencies and the prevention of relapse. Treatment outcomes, however, can be influenced by a number of variables that are explained in this study. In addition, issues related to ritual transfer and strategies for minimizing undesired side-effects are discussed.

  5. Brain injury due to anaphylactic shock as a result of formocresol used during root canal treatment.

    Science.gov (United States)

    Ding, Y-J; Song, H; Liu, J-H; Wang, G-H

    2013-10-01

    Formocresol is still used in many parts of the world despite concerns over its toxicity. A case of a 45-year-old women who experienced brain injury after an analyphlactic reaction to formocresol is presented. During routine root canal treatment, the patient experienced nausea and vomiting after formocresol was used as an antibacterial agent in the pulp chamber. The procedure was discontinued and the symptoms resolved. Four days later, the treatment was continued by a different dentist, and the patient developed anaphylactic shock within 10 min of placement of a formocresol-soaked cotton pellet. She received emergency medical treatment and magnetic resonance imaging (MRI) revealed brain injury characterized by swelling of the gyrus in the cerebral watershed territory of the left parietal-occipital lobe. The patient subsequently made a full recovery after supportive treatment. A type-I allergic reaction can be induced by formocresol. The reasons for the brain injury are thought to be cerebral hypoxia, which was induced by the anaphylactic shock and/or cerebral parenchymal oedema. All dentists should be aware of the risks involved in the use of formocresol and avoid using materials containing formocresol and related agents. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  6. Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy

    DEFF Research Database (Denmark)

    Nerup, Nikolaj; Johansen, John Lykkegaard; Alkhefagie, Ghalib Ali Abod;

    2013-01-01

    INTRODUCTION: In colorectal surgery, the most feared complication is anastomotic leakage (AL), which is associated with a high morbidity and mortality. In this study, we focus on treatment of perianastomotic abscess following AL after low anterior resection (LAR) of rectal cancer. In the literatu...

  7. Results from an online survey investigating ED patients' insights and treatment expectations.

    Science.gov (United States)

    Burri, A; Porst, H

    2015-01-01

    Data suggest that the currently available therapies for erectile dysfunction (ED) do not meet all the patients' and their partners' expectations. The aim was to assess ED patients' treatment expectations for a variety of sex- and drug-related aspects such as importance of spontaneity, partner satisfaction, ideal onset of action and ideal duration of action. A total of n=1124 men with ED and n=410 healthy men, aged 30-75, participated in this online survey. The ED sample was further divided into patients currently undergoing treatment (CTG), patients who had been undergoing treatment in the past (PTG) and naïve patients (NG). The International Index of Erectile Function as well as a mix of study-specific questions was used. All groups considered 'maintaining an erection until the partner reaches orgasm' the most important aspect regarding erectile function. 'Being able to please the partner' was considered as the most important aspect for a fulfilled sex life. The majority of men (38.1%) further considered an onset of action of about 15 min to be desirable. In all, 95.9% further considered a duration of action up to 4 h to be desirable whereas approximately 71% of men considered a duration of more than 12 h to be too long. It seems that once the basic functional aspects related to erectile function have been covered, additional benefits such as 'spontaneity' and 'pleasing the partner' become important and may be critical for choosing the optimum individual treatment, to improve the sexual satisfaction and the adherence to the treatment.

  8. The ARBITER 6-HALTS Trial (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies in Atherosclerosis): final results and the impact of medication adherence, dose, and treatment duration

    National Research Council Canada - National Science Library

    Villines, Todd C; Stanek, Eric J; Devine, Patrick J; Turco, Mark; Miller, Michael; Weissman, Neil J; Griffen, Len; Taylor, Allen J

    2010-01-01

    This report describes the final results of the ARBITER 6-HALTS (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies in Atherosclerosis) trial...

  9. Biostatistical analysis of treatment results of bacterial liver abscesses using minimally invasive techniques and open surgery

    Directory of Open Access Journals (Sweden)

    Кipshidze A.A.

    2013-12-01

    Full Text Available Today bacterial abscesses remain one of the most difficult complications in surgical hepatology, both traditional and minimally invasive methods of their treatment are used. Bio-statistical analysis is used due to the fact that strong evidences are required for the effectiveness of one or another method of surgical intervention. The estimation of statistical significance of differences between the control and the main group of patients with liver abscesses is given in this paper. Depending on the treatment method patients were divided into two groups: 1 - minimally invasive surgery (89 cases; 2 – laporatomy surgery (74 patients. Data compa¬ri¬son was performed by means of Stjudent's criterion. The effectiveness of method of abscesses drainage using inter¬ventional sonography, outer nazobiliar drainage with reorganization of ductal liver system and abscess cavity with the help of modern antiseptics was considered. The percentage of cured patients was also estimated.

  10. Result of bilateral total hip replacement in the treatment of a child with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Владимир Евгеньевич Басков

    2015-12-01

    Full Text Available Total hip replacement in children is performed according to very limited and compelling indications. The principal of such a treatment is the complete and irreversible destruction of the hip joint accompanied by a permanent loss of function of the lower limb. Hip replacement in children with cerebral palsy is a very rare method of treatment. According to observations from the Turner Institute, it was performed in only 2% of all replacement cases. After the placement of an artificial joint, the atherogenic component of the contractures disappears and improves the motor activity of patients. In this paper, a 3-year follow-up of the bilateral total hip replacement in a child with cerebral palsy and bilateral secondary stage III coxarthrosis is presented.

  11. Laser immunotherapy for the treatment of human breast cancer: one-year follow up results

    Science.gov (United States)

    Hode, Tomas; Adalsteinsson, Orn; Ferrel, Gabriela L.; Lunn, John A.; Guerra, Maria C.; Li, Xiaosong; Nordquist, Robert E.; Chen, Wei R.

    2011-03-01

    The immediate goal of the trial was to determine the breast cancer patient tolerance and the toxicity of Laser immunotherapy (LIT), the optimal dose for the alteration of the course of the disease, and the reduction of the tumor burden. Ten stage III and IV cancer patients were treated, all of which were considered to be out of all other options. No toxicity or significant adverse reactions were observed and the treatment was well tolerated by all patients. Almost all the treated patients have had positive responses: A majority of patients experienced large-scale reduction of primary breast tumors, and all the stage IV patients experienced either complete or significant reductions in distant metastases in the lungs, liver, bone, and the brain, indicating a strong systemic effect of the treatment. We also report two cases of triple negative breast cancer patients that showed limited or no response to LIT.

  12. Results of Endoscopic Treatment for Early Gastric Cancer by Nd-YAG Laser

    Directory of Open Access Journals (Sweden)

    M. Tani

    1997-01-01

    Full Text Available We have introduced two endoscopic treatments for early gastric cancer: endoscopic mucosal resection using a cap-fitted panendoscope (EMRC, and endoscopic laser therapy using a Nd-YAG laser. Thirty-two patients (34 lesions with gastric cancer were treated by Nd-YAG laser; including 23 initial-therapy cases (25 lesions and 9 second-therapy cases representing failures of endoscopic mucosal resection or endoscopic ethanol injection. Endoscopic laser therapy was performed safely without complication in all patients. Three patients had residual cancer, and 2 of these required surgery. Six patients died from other disease. Endoscopic laser therapy can remove early gastric cancer even when the lesion has ulceration or submucosal invasion, and has a powerful hemostatic effect. It is a safe and effective treatment for early gastric cancer.

  13. Medulloblastoma in childhood: long-term results of treatment. [X rays; /sup 60/Co

    Energy Technology Data Exchange (ETDEWEB)

    Broadbent, V.A.; Barnes, N.D.; Wheeler, T.K.

    1981-07-01

    Thirty-one children under the age of 15 years with verified medulloblastoma were treated at Addenbrookes Hospital from 1940 to 1976. In addition to surgical treatment, all received high dose irradiation to the whole neuraxis. Nine were still alive in 1979, of whom eight were examined. All these patients showed some residual problems, but five were leading active lives and had only minor physical disability. There was evidence of disturbance in growth in all the children. Growth hormone secretion in response to exercise was, however, normal in five of six patients tested. Frank mental retardation was present in three children. A raised resing TSH level was found in two children, one of whom had a multinodular goiter. Long-term follow-up of children who survive medulloblastoma is clearly necessary and consideration should perhaps be given to revision of current treatment regimes in very young children.

  14. Radiotherapy in prostate cancer treatment: Results of the patterns of care study in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Ah Ram; Park, Won [Division for Urologic Cancer, Korean Radiation Oncology Group, Seoul (Korea, Republic of)

    2017-03-15

    The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24–39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

  15. Sexual Orientation and Substance Abuse Treatment Utilization in the United States: Results from a National Survey

    OpenAIRE

    McCabe, Sean Esteban; West, Brady T.; Hughes, Tonda L.; Boyd, Carol J.

    2012-01-01

    This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, behavior) in a large national sample of adults in the United States. Prevalence estimates were based on data collected from the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults aged 20 years and older: 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. Appro...

  16. Treatment of accommodative dysfunction in children: results from a randomized clinical trial.

    Science.gov (United States)

    Scheiman, Mitchell; Cotter, Susan; Kulp, Marjean Taylor; Mitchell, G Lynn; Cooper, Jeffrey; Gallaway, Michael; Hopkins, Kristine B; Bartuccio, Mary; Chung, Ida

    2011-11-01

    To report the effectiveness of various forms of vision therapy/orthoptics in improving accommodative amplitude and facility in children with symptomatic convergence insufficiency (CI) and co-existing accommodative dysfunction. In a randomized clinical trial, 221 children aged 9 to 17 years with symptomatic CI were assigned to one of four treatments. Of the enrolled children, 164 (74%) had accommodative dysfunction; 63 (29%) had a decreased amplitude of accommodation with respect to age, 43 (19%) had decreased accommodative facility, and 58 (26%) had both. Analysis of variance models were used to compare mean accommodative amplitude and accommodative facility for each treatment group after 4, 8, and 12 weeks of treatment. After 12 weeks of treatment, the increases in amplitude of accommodation [office-based vergence/accommodative therapy with home reinforcement group (OBVAT) 9.9 D, home-based computer vergence/accommodative therapy group (HBCVAT+) 6.7 D, and home-based pencil push-up therapy group (HBPP) 5.8 D] were significantly greater than in the office-based placebo therapy (OBPT) group (2.2 D) (p-values ≤0.010). Significant increases in accommodative facility were found in all groups (OBVAT: 9 cpm, HBCVAT+: 7 cpm, HBPP: 5 cpm, OBPT: 5.5 cpm); only the improvement in the OBVAT group was significantly greater than that found in the OBPT group (p = 0.016). One year after completion of therapy, reoccurrence of decreased accommodative amplitude was present in only 12.5% and accommodative facility in only 11%. Vision therapy/orthoptics is effective in improving accommodative amplitude and accommodative facility in school-aged children with symptomatic CI and accommodative dysfunction.

  17. Lost in Translation: Ambiguity in Nerve Sheath Tumor Nomenclature and Its Resultant Treatment Effect

    Energy Technology Data Exchange (ETDEWEB)

    Bernthal, Nicholas M., E-mail: Nicholas.bernthal@hsc.utah.edu; Jones, Kevin B.; Monument, Michael J. [Sarcoma Services, Department of Orthopaedics, Huntsman Cancer Institute and Primary Childrens Medical Center, University of Utah, Salt Lake City, UT 84112 (United States); Liu, Ting [Department of Pathology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112 (United States); Viskochil, David [Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UT 84112 (United States); Randall, R. Lor, E-mail: Nicholas.bernthal@hsc.utah.edu [Sarcoma Services, Department of Orthopaedics, Huntsman Cancer Institute and Primary Childrens Medical Center, University of Utah, Salt Lake City, UT 84112 (United States)

    2013-05-08

    There is much ambiguity surrounding the diagnosis of nerve sheath tumors, including atypical neurofibroma and low-grade MPNST, and yet, the distinction between these entities designates either benign or malignant behavior and thus carries presumed profound prognostic importance that often guides treatment. This study reviews the diagnostic criteria used to designate atypical neurofibroma from low-grade MPNSTs and reviews existing literature the natural history of each of these tumors to see if the distinction is, in fact, of importance.

  18. Unilateral surgical treatment for patients with midportion Achilles tendinopathy may result in bilateral recovery.

    Science.gov (United States)

    Alfredson, Håkan; Spang, Christoph; Forsgren, Sture

    2014-10-01

    Bilateral midportion Achilles tendinopathy/tendinosis is not unusual, and treatment of both sides is often carried out. Experiments in animals suggest of the potential involvement of central neuronal mechanisms in Achilles tendinosis. To evaluate the outcome of surgery for Achilles tendinopathy. This observational study included 13 patients (7 men and 6 women, mean age 53 years) with a long duration (6-120 months) of chronic painful bilateral midportion Achilles tendinopathy. The most painful side at the time for investigation was selected to be operated on first. Treatment was ultrasound-guided and Doppler-guided scraping procedure outside the ventral part of the tendon under local anaesthetic. The patients started walking on the first day after surgery. Follow-ups were conducted and the primary outcome was pain by visual analogue scale. In an additional part of the study, specimens from Achilles and plantaris tendons in three patients with bilateral Achilles tendinosis were examined. Short-term follow-ups showed postoperative improvement on the non-operated side as well as the operated side in 11 of 13 patients. Final follow-up after 37 (mean) months showed significant pain relief and patient satisfaction on both sides for these 11 patients. In 2 of 13 patients operation on the other, initially non-operated side, was instituted due to persisting pain. Morphologically, it was found that there were similar morphological effects, and immunohistochemical patterns of enzyme involved in signal substance production, bilaterally. Unilateral treatment with a scraping operation can have benefits contralaterally; the clinical implication is that unilateral surgery may be a logical first treatment in cases of bilateral Achilles tendinopathy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Misoprostol for treatment of incomplete abortion at the regional hospital level: results from Tanzania.

    Science.gov (United States)

    Shwekerela, B; Kalumuna, R; Kipingili, R; Mashaka, N; Westheimer, E; Clark, W; Winikoff, B

    2007-11-01

    To investigate the safety, efficacy, and acceptability of misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion. A prospective open-label randomised trial. Kagera Regional Hospital, Bukoba, Tanzania. Three hundred women with a clinical diagnosis of incomplete abortion and a uterine size misoprostol or MVA. If abortion was clinically complete at 7-day follow up, the woman was released from the study. If it was still incomplete, the woman was offered the choice of an additional 1-week follow up or immediate MVA. Cases still incomplete after a further week were offered MVA. Incidence of successful abortion (success defined as no secondary surgical intervention provided), incidence of adverse effects, patient satisfaction. Success was very high in both arms (misoprostol: 99%; MVA: 100%; difference not significant). Most adverse effects were higher in the misoprostol arm, although the mean pain score was higher in the MVA arm (3.0 versus 3.5; P misoprostol (75%) than with MVA (55%, P = 0.001), and a higher proportion of women in the misoprostol arm said that they would recommend the treatment to a friend (95% versus 75%, P Misoprostol is as effective as MVA at treating incomplete abortion at uterine size of misoprostol appears higher. Given the many practical advantages of misoprostol over MVA in low-resource settings, misoprostol should be more widely available for treatment of incomplete abortion in the developing world.

  20. Fidaxomicin in the treatment of colitis due to Clostridium difficile: preliminary results

    Directory of Open Access Journals (Sweden)

    Francesco Cortese

    2014-12-01

    Full Text Available The incidence of Clostridium difficile infections (CDI and Clostridium difficile-Associated Diarrhea (CDAD is increasing in Canada, USA, and Europe and represents a considerable clinical problem. Both naïve and hypervirulent strains can be considered as opportunistic bacteria affecting immunocompromised, antibiotic-treated, critical, or subcritical patients with a microbiota disruption. CDI arising is strictly related to antibiotic, single or combined, and/or proton pump inhibitor treatment. CDI can cause a syndrome with systemic involvement and complex treatment, sometimes requiring surgical interventions (e.g. colectomy in fulminant colitis. Antibiotic treatment with metronidazole by mouth is the first choice and generally vancomycin is administered in case of lack of effectiveness. Fidaxomicin is a new macrocyclic antibiotic for C. difficile with microflora-sparing properties. This paper reports our initial experience in 11 patients with non-responder or relapsing CDIs. Fidaxomicin was effective in 10 cases (91%. Only one patient with an active ulcerative colitis did not respond and was treated with fecal-microbiota transplantation. In two patients diarrhea persisted, but just the ulcerative colitis one was C. difficile-related. No adverse events were experienced.http://dx.doi.org/10.7175/cmi.v8i1s.956

  1. Prevalence, awareness and treatment of hypercholesterolaemia in 32 populations: results from the WHO MONICA Project.

    Science.gov (United States)

    Tolonen, Hanna; Keil, Ulrich; Ferrario, Marco; Evans, Alun

    2005-02-01

    Several studies have been conducted to estimate the population prevalence of hypertension, or its diagnosis and treatment. There is no multinationally comparable information on the prevalence of hypercholesterolaemia, or its diagnosis and treatment, since individual studies are often not directly comparable. Data from the WHO MONICA Project's final risk factor surveys were used. Data were collected using standardized methods between 1989 and 1997 for the 35-64 year age range in 32 populations, in 19 countries on 3 continents. The prevalence of hypercholesterolaemia (total cholesterol > or = 6.5 mmol/l or taking lipid-lowering drugs) varied across populations from 3% to 53% in men, and from 4% to 40% in women. Awareness of hypercholesterolaemia varied from 1% to 33% in men, and from 0% to 31% in women. In most populations, over 50% of men and women on lipid-lowering drugs had a cholesterol level < 6.5 mmol/l. There is wide variation in the prevalence, awareness, and treatment of hypercholesterolaemia between populations. For the planning and implementation of primary prevention programmes and for the development of health care systems, monitoring of changes, both within and between populations, is essential. To obtain reliable information on these changes, well-standardized methods must be applied.

  2. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy.

    Science.gov (United States)

    Acar, Turan; Kamer, Erdinç; Acar, Nihan; Atahan, Kemal; Bağ, Halis; Hacıyanlı, Mehmet; Akgül, Özgün

    2017-01-01

    Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic gallstones. The common opinion about treatment of acute cholecystitis is initially conservative treatment due to preventing complications of inflamation and following laparoscopic cholecystectomy after 6- 8 weeks. However with the increase of laparoscopic experience in recent years, early laparoscopic cholecystectomy has become more common. We aimed to compare the outcomes of the patients to whom we applied early or late cholecystectomy after hospitalization from the emergency department with the diagnosis of AC between March 2012-2015. We retrospectively reviewed the files of totally 66 patients in whom we performed early cholecystectomy (within the first 24 hours) (n: 33) and to whom we firstly administered conservative therapy and performed late cholecystectomy (after 6 to 8 weeks) (n: 33) after hospitalization from the emergency department with the diagnosis of acute cholecystitis. The groups were made up of patients who had similar clinical and demographic characteristics. While there were no statistically significant differences between the durations of operation, the durations of hospitalization were longer in those who underwent early cholecystectomy. Moreover, more complications were seen in the patients who underwent early cholecystectomy although the difference was not statistically significant. Early cholecystectomy is known to significantly reduce the costs in patients with acute cholecystitis. However, switching to open surgery as well as increase of complications in patients who admitted with severe inflammation attack and who have high comorbidity, caution should be exercised when selecting patients for early operation.

  3. Long-term treatment results for nasopharyngeal carcinoma: The Sahlgrenska Univ. Hospital experience

    Energy Technology Data Exchange (ETDEWEB)

    Taheri-Kadkhoda, Zahra; Bjoerk-Eriksson, Thomas; Mercke, Claes [Dept. of Oncology, Sahlgrenska Univ. Hospital, Goeteborg (Sweden); Johansson, Karl-Axel [Dept. of Radiophysics, Sahlgrenska Univ. Hospital, Goeteborg (Sweden)

    2007-08-15

    Nasopharyngeal carcinoma (Nc) is a rare disease in Sweden. For evaluation of the treatment outcomes in our NPC patients, 52 new cases that were referred to our department between 1991 and 2002 were retrospectively analysed. Tumor stage, according to the 1997 AJCC staging system, was I in five, II in ten, III in 12 and IV in 25 patients. Majority of the patients (87%) had World Health Organization type II-III tumors. Neoadjuvant chemotherapy was delivered in 33 patients. Thirty-two patients received hyperfractionated accelerated radiation therapy with a median dose of 64.6Gy (1.7Gy/fr bid). Conventional external irradiation with a median dose of 66Gy (2Gy/fr) was delivered to 18 patients. An intracavitary brachy-boost of 4.5-12Gy was delivered to 40 patients. Two patients were excluded from the analysis due to treatment refusal. For the patients with tumor stages I-IVB, the 5-year disease-free and overall survival rates were 61% and 55%, respectively. The 5-year local, regional, and distant relapse-free survival rates were 70%, 92% and 77%, respectively. The most frequent late side effects were xerostomia (98%), otitis (70%) and hearing deterioration (64%). Our data suggest that optimization of the treatment outcomes in NPC patients requires implementation of new therapeutic strategies.

  4. Update on quetiapine in the treatment of bipolar disorder: results from the BOLDER studies

    Directory of Open Access Journals (Sweden)

    Prashant Gajwani

    2007-01-01

    Full Text Available Prashant Gajwani1, David J Muzina2, David E Kemp3, Keming Gao1, Joseph R Calabrese11Case Western Reserve University (CWRU School of Medicine, 2Cleveland Clinic Lerner College of Medicine of CWRU, 3Case Western Reserve University, Cleveland OH, USAAbstract: The essential features of bipolar affective disorder involve the cyclical occurrence of high (manic or hypomanic episodes and low mood states. Depressive episodes in both bipolar I and II disorder are more numerous and last for longer duration than either manic or hypomanic episodes. In addition depressive episodes are associated with higher morbidity and mortality. While multiple agents, including all 5 atypical antipsychotics, have demonstrated efficacy and earned US FDA indication for manic phase of bipolar illness, the acute treatment of bipolar depression is less well-studied. The first treatment approved by the US FDA for acute bipolar depression was the combination of the atypical antipsychotic olanzapine and the antidepressant fluoxetine. Recently, quetiapine monotherapy has demonstrated efficacy in the treatment of depressive episodes associated with both bipolar I and II disorder and has earned US FDA indication for the same.Keywords: bipolar disorder, quetiapine, BOLDER studies

  5. Estimation of waste water treatment plant methane emissions: methodology and results from a short campaign

    Directory of Open Access Journals (Sweden)

    C. E. Yver-Kwok

    2013-10-01

    Full Text Available This paper describes different methods to estimate methane emissions at different scales. These methods are applied to a waste water treatment plant (WWTP located in Valence, France. We show that Fourier Transform Infrared (FTIR measurements as well as Cavity Ring Down Spectroscopy (CRDS can be used to measure emissions from the process to the regional scale. To estimate the total emissions, we investigate a tracer release method (using C2H2 and the Radon tracer method (using 222Rn. For process-scale emissions, both tracer release and chamber techniques were used. We show that the tracer release method is suitable to quantify facility- and some process-scale emissions, while the Radon tracer method encompasses not only the treatment station but also a large area around. Thus the Radon tracer method is more representative of the regional emissions around the city. Uncertainties for each method are described. Applying the methods to CH4 emissions, we find that the main source of emissions of the plant was not identified with certainty during this short campaign, although the primary source of emissions is likely to be from solid sludge. Overall, the waste water treatment plant represents a small part (3% of the methane emissions of the city of Valence and its surroundings,which is in agreement with the national inventories.

  6. Macrolide treatment failure in streptococcal pharyngitis resulting in acute rheumatic fever.

    Science.gov (United States)

    Logan, Latania K; McAuley, James B; Shulman, Stanford T

    2012-03-01

    Macrolide resistance (MR) in group A Streptococcus (GAS) has been well documented in several countries and has become clinically significant since the large increases in macrolide usage during the 1970s. Macrolides are recommended as an alternative therapy for GAS pharyngitis, the most common cause of bacterial pharyngitis. Macrolide resistance has been associated with certain emm types, a sequence-based typing system of the hypervariable region of the GAS M-protein gene. Clinical failure of macrolide treatment of GAS infections can be associated with complications including acute rheumatic fever and rheumatic heart disease, the leading cause of acquired heart disease in children worldwide. Here we report 2 pediatric cases of MR and/or treatment failure in the treatment of GAS pharyngitis with the subsequent development of acute rheumatic fever. We also review the literature on worldwide MR rates, molecular classifications, and emm types, primarily associated with GAS pharyngeal isolates between the years of 2000 and 2010. The use of macrolides in the management of GAS pharyngitis should be limited to patients with significant penicillin allergy.

  7. Sexual orientation and substance abuse treatment utilization in the United States: results from a national survey.

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T; Hughes, Tonda L; Boyd, Carol J

    2013-01-01

    This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, and behavior) in a large national sample of adults in the United States. Prevalence estimates were based on data collected from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults 20 years and older, and represented a population that was 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. An estimated 2% of the target population self-identified as lesbian, gay or bisexual; 4% reported same-sex sexual behavior, and 6% reported same-sex sexual attraction. Sexual minorities, especially women, had a greater likelihood of lifetime substance use disorders and earlier age of drinking onset. The majority of respondents with substance use disorders were untreated and lifetime substance abuse treatment utilization differed based on sexual orientation. Sexual minorities were found to have more extensive family histories of substance abuse problems. The findings indicate the underutilization of substance abuse treatment among all adults, and highlight some important factors to consider when working with sexual minorities. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Reasons for schizophrenia patients remaining out of treatment: results from a prospective study in a rural south indian community

    Directory of Open Access Journals (Sweden)

    Channaveerachari Naveen Kumar

    2016-01-01

    Full Text Available Background: A few studies have examined the factors associated with schizophrenia patients remaining untreated in India. Materials and Methods: We identified 184 schizophrenia patients in a rural community, offered the treatment with antipsychotics and followed them up in their Primary Health Centers for 1-year. Twenty-nine (15.8% patients remained untreated at both the baseline and 1-year follow-up despite our best attempts to keep them under the treatment umbrella. They were interviewed in detail regarding the reasons for remaining untreated. This group was compared with another group of patients (n = 69 who had stopped the treatment at baseline but were successfully brought under the treatment umbrella throughout the 1-year follow-up period. Results: The reasons for remaining untreated were (n; %: (a Unsatisfactory improvement with previous treatment attempts (19; 65.5%, (b poor bond between the patients and the families (6; 20.7%, (c active symptoms not allowing any treatment efforts from the family members (6; 20.7%, (d magico-religious beliefs about the illness and its treatment (4; 13.8%, (e poor social support (3; 10.3%, (f adverse effects of the medications (2; 6.9%, and (g perception of recovery and cure (1; 3.4%. For many patients, a constellation of these reasons was responsible for them remaining untreated. In contrast, the common reasons for those who restarted medications to have stopped the treatment at some time were the lack of awareness, the need to continue medications (47; 68.1%, and the financial constraints (28; 40.6%. Conclusion: The predominant reason for schizophrenia patients not remaining on the treatment in this rural community was the families′ lack of faith in antipsychotic treatment. Provision of comprehensive treatment package including medical, psychosocial and rehabilitative services, and sensitizing the community about benefits of the treatment may help in ensuring that all patients with psychosis receive

  9. Novel antiretroviral combinations in treatment-experienced patients with HIV infection: rationale and results.

    Science.gov (United States)

    Taiwo, Babafemi; Murphy, Robert L; Katlama, Christine

    2010-09-10

    Novel antiretroviral drugs offer different degrees of improvement in activity against drug-resistant HIV, short- and long-term tolerability, and dosing convenience compared with earlier drugs. Those drugs approved more recently and commonly used in treatment-experienced patients include the entry inhibitor enfuvirtide, protease inhibitors (PIs) [darunavir and tipranavir], a C-C chemokine receptor (CCR) type 5 antagonist (maraviroc), an integrase inhibitor (raltegravir) and etravirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI). Novel agents in earlier stages of development include a CCR5 monoclonal antibody (PRO 140) administered subcutaneously once weekly, once-daily integrase inhibitors (elvitegravir and S/GSK1349572), and several nucleoside (nucleotide) reverse transcriptase inhibitors and NNRTIs. Bevirimat, a maturation inhibitor, has compromised activity in the presence of relatively common Gag polymorphisms. Viral suppression is necessary to control the evolution of drug resistance, reduce chronic immune activation that probably underlies the excess morbidity and mortality in HIV-infected patients, and reduce viral transmission, including transmitted drug resistance. In general, the proportion of viraemic patients who achieve suppression increases with the number of active pharmacokinetically compatible antiretroviral drugs in the regimen. In the ANRS139-TRIO trial, 86% of highly treatment-experienced patients treated with darunavir-ritonavir, etravirine and raltegravir had HIV RNA suppression, novel agents may be used to simplify the dosing schedule, lower costs (such as by switching to boosted PI monotherapy), reduce adverse events or preserve antiretroviral drug options, especially since the absence of an HIV eradication strategy implies the need for life-long combination antiretroviral therapy. Switching enfuvirtide to raltegravir eliminated painful injection-site reactions without compromising virological suppression. Two studies found

  10. Identification of a small molecule that modifies MglA/SspA interaction and impairs intramacrophage survival of Francisella tularensis.

    Directory of Open Access Journals (Sweden)

    Algevis P Wrench

    Full Text Available The transcription factors MglA and SspA of Francisella tularensis form a heterodimer complex and interact with the RNA polymerase to regulate the expression of the Francisella pathogenicity island (FPI genes. These genes are essential for this pathogen's virulence and survival within host cells. In this study, we used a small molecule screening to identify quinacrine as a thermal stabilizing compound for F. tularensis SCHU S4 MglA and SspA. A bacterial two-hybrid system was used to analyze the in vivo effect of quinacrine on the heterodimer complex. The results show that quinacrine affects the interaction between MglA and SspA, indicated by decreased β-galactosidase activity. Further in vitro analyses, using size exclusion chromatography, indicated that quinacrine does not disrupt the heterodimer formation, however, changes in the alpha helix content were confirmed by circular dichroism. Structure-guided site-directed mutagenesis experiments indicated that quinacrine makes contact with amino acid residues Y63 in MglA, and K97 in SspA, both located in the "cleft" of the interacting surfaces. In F. tularensis subsp. novicida, quinacrine decreased the transcription of the FPI genes, iglA, iglD, pdpD and pdpA. As a consequence, the intramacrophage survival capabilities of the bacteria were affected. These results support use of the MglA/SspA interacting surface, and quinacrine's chemical scaffold, for the design of high affinity molecules that will function as therapeutics for the treatment of Tularemia.

  11. Long-term results of two schedules of radioiodine treatment for toxic multinodular goitre

    Energy Technology Data Exchange (ETDEWEB)

    Huysmans, D.A.K.C. (Dept. of Nuclear Medicine, Univ. Hospital Nijmegen St. Radboud (Netherlands)); Hermus, A.R.M.M. (Dept. of Medicine, Div. of Endocrinology, Univ. Hospital Nijmegen St. Radboud (Netherlands)); Corstens, F.H.M. (Dept. of Nuclear Medicine, Univ. Hospital Nijmegen St. Radboud (Netherlands)); Kloppenborg, P.W.C. (Dept. of Medicine, Div. of Endocrinology, Univ. Hospital Nijmegen St. Radboud (Netherlands))

    1993-11-01

    The long-term effects of two schedules of radioiodine therapy in patients with toxic multinodular goitre were evaluated. Forty-five patients (group A) were treated with low doses and 58 patients (group B) with calculated doses adjusted for thyroid weight (1.85-3.70 MBq/g) and radioactive iodine uptake. Follow-up (mean[+-]SEM) was 4.3[+-]0.2 years and 5.2[+-]0.3 years, respectively (P0.1). At the end of follow-up, hyperthyroidism was succesfully reversed in 73% (group A) and 88% (group B). In each group, hypothyroidism was present in 7%. The total dose per gram of thyroid tissue was not significantly different in groups A and B (2.1[+-]0.2 vs 2.7[+-]0.2 MBq/g). However, for patients treated with calculated doses the number of [sup 131]I administrations was significantly lower (1.3[+-]0.1) than for patients treated with low doses (2.2[+-]0.2), and the percentage of patients who were adequately treated with a single dose was more than twice as high (66% in group B versus 27% in group A). Euthyroidism was reached within a significantly shorter time after treatment with calculated doses (media time 0.6 years in group BVS 1.5 years in group A; life table analysis). It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a low risk of post-treatment hypothyroidism and that calculated (higher) doses appear to be preferable to low doses. (orig.)

  12. Treatment of acute alcohol withdrawal with gabapentin: results from a controlled two-center trial.

    Science.gov (United States)

    Bonnet, Udo; Banger, Markus; Leweke, F Markus; Specka, Michael; Müller, Bernhard W; Hashemi, Thilo; Nyhuis, Peter W; Kutscher, Sven; Burtscheidt, Wilhelm; Gastpar, Markus

    2003-10-01

    A few case reports and data from animal experiments point to a possible efficacy of gabapentin (GP) in the treatment of alcohol withdrawal syndrome (AWS). Because of ethical considerations, the efficacy of GP in acute AWS was tested in an add-on fashion to clomethiazole (CLO). Given that the symptom-triggered amount of CLO required to limit AWS within the first 24 hours is related to the severity of AWS, we tested this amount of CLO during placebo (P) or GP (400 mg qid) under double blind, randomized conditions. Sixty-one patients (P = 29/GP = 32) suffering from alcohol dependence (ICD-10) and without any other psychiatric condition or psychotropic medication were included. The groups were not significantly different in baseline characteristics (eg, demographic data, severity of AWS). Both ITT and completer analyses revealed no significant differences between the groups considering the primary effectiveness measure: amount of CLO required in the first 24 hours (P = 6.1 +/- 5.4/GP = 6.2 +/- 4.7 capsules). In addition, premature discontinuations (P = 3/GP = 2) and decreases in Mainz Alcohol Withdrawal Scores were not significantly different in the first 48 hours of AWS (secondary effectiveness measures). Tolerability of combined CLO/GP was studied throughout the whole treatment comprising a 5-day lasting reduction part subsequent to the first 48 hours. Throughout the whole 7-day treatment a total of 5 and 2 patients dropped out and 6 and 5 patients reported adverse clinical events in the P and GP groups, respectively. All together, GP (400 mg qid) was no better than P in saving initial consumption of CLO or decreasing initial Mainz Alcohol Withdrawal Scores suggesting that GP was ineffective in the management of acute AWS in this model. The combination of GP and CLO was safe.

  13. Treatment results of brain metastasis from breast cancer. Course of the disease and radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Kazunari; Murakami, Masao; Kuroda, Yasumasa [Tenri Hospital, Nara (Japan)

    1997-01-01

    Thirty-nine patients with brain metastasis from breast cancer who were treated in our hospital between 1978 and 1992 and followed up until November 1995 were reviewed. The initial diagnosis of brain metastasis and follow-up were made by MRI and/or CT. Extracranial metastases were found in 90% of the patients and were the cause of death in 89%. Treatments included surgery alone in 2 patients (group S), surgery plus postoperative radiotherapy in 8 (group SR), radiotherapy alone in 28 (group R) and conservative therapy in 1 (group C). Radiotherapy of up to 40 Gy to the whole brain was carried out, but was performed in only 75% of patients in group R. The overall median survival was 5.4 months with a 1-year survival rate of 23% and a two-year rate of 10%. In patients treated with over 40 Gy, the survival time for radiotherapy alone was 5.1 months, with a 1-year survival rate of 9.5%; relief of specific neurologic symptoms was noted in 80%. The longest survival was noted in a patient with a single brain metastasis, who, to date, has survived for five years and two months following 60 Gy of irradiation. Patients with the following clinical conditions should have a good prognosis; no further metastases in other sites, or well controlled if existing, no symptoms of NF (neurological function: RTOG) or slight, and improved NF by treatment, surgical candidate, good response to initial treatment on CT or MRI. Despite a bad prognosis in general, brain metastasis from breast cancer can be treated affirmatively, if these clinical conditions are fulfilled. (author)

  14. An economic evaluation of implant treatment in edentulous patients-preliminary results.

    Science.gov (United States)

    Zitzmann, Nicola U; Sendi, Pedram; Marinello, Carlo P

    2005-01-01

    Edentulous patients with denture problems benefit from implant treatment with overdenture prostheses. The aim of this prospective study was to investigate a method of analyzing cost effectiveness in dentistry. As an example, overdenture treatment with two or four implants was compared to the conventional complete denture (CD). In a self-selected trial, 20 patients each were treated with implant-retained overdentures (two implants, IRET), implant-supported overdentures (four implants, ISUP), or CDs (control group) in the edentulous mandible. A cost-effectiveness analysis was performed from the patient's perspective, with a time horizon of 6 months. Direct health-care costs were calculated in Swiss Francs (in 2000), and effects were defined as improvements in perceived chewing ability compared with the baseline value before treatment (measured on a VAS). Point estimates for mean incremental cost-effectiveness ratios were complemented with cost-effectiveness acceptability curves to account for uncertainties associated with costs and effects. Mean incremental costs were CHF 4,329 (IRET-CD), CHF 13,360 (ISUP-CD), and CHF 9,031 (ISUP-IRET); these cost differences were all statistically significant. The mean incremental effects at 6 months were 19% (IRET-CD), 23% (ISUP-CD), and 4% (ISUP-IRET). Incremental cost-effectiveness ratios were CHF 228 (IRET-CD), CHF 581 (ISUP-CD), and CHF 2,258 (IRET-ISUP) per percentage increase in chewing ability. From an economic point of view, IRETs were more attractive than ISUPs. The latter were associated with a statistically significant improvement in perceived chewing ability compared to CDs, but at substantially higher costs.

  15. Comparison of the treatment results of physical therapy and manipulation in back pain due to discopathy

    OpenAIRE

    Ozcan, Emel; Aydin, Resa

    2004-01-01

    In this study, 20 cases with low back pain due to discopathy were treated by physical therapy in the form of infrared, ultrasound and diadinamic current for 15 sessions. Rotitional manipulation without anesthesia was performed on another group of 20 patients with intervals of 5.1+ 0.3 days for 4.3 + 0.2 sessions. Patients were compared and evaluated before and after the treatment with visual analog scale for the severity of pain, schoeber test straigt leg raising test, clinical findings, func...

  16. Lost in Translation: Ambiguity in Nerve Sheath Tumor Nomenclature and Its Resultant Treatment Effect

    Directory of Open Access Journals (Sweden)

    R. Lor Randall

    2013-05-01

    Full Text Available There is much ambiguity surrounding the diagnosis of nerve sheath tumors, including atypical neurofibroma and low-grade MPNST, and yet, the distinction between these entities designates either benign or malignant behavior and thus carries presumed profound prognostic importance that often guides treatment. This study reviews the diagnostic criteria used to designate atypical neurofibroma from low-grade MPNSTs and reviews existing literature the natural history of each of these tumors to see if the distinction is, in fact, of importance.

  17. A case of subacute cutaneous lupus erythematosus as a result of ranibizumab (Lucentis treatment

    Directory of Open Access Journals (Sweden)

    Marko Andric

    2013-01-01

    Full Text Available Cutaneous lupus erythematosus is a previously undiagnosed side-effect of ranibizumab. Here, we present a case of an 82-year-old female Caucasian patient with wet age-related macular degeneration. Following a single intraocular injection of Lucentis (ranibizumab, she developed a subacute cutaneous lupus erythematosus which, with treatment, took nearly 12 months to resolve. This shows that cutaneous lupus erythematosus is a potential side-effect of many medications, including ranibizumab, as in our case and, in an aging population where polypharmacy is a growing reality, clinicians should be aware of how to diagnose and best manage such cases.

  18. Treatment of 10 cases of trismus resulting from head and neck radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wakamatsu, Keita; Harashina, Takao [Saitama Medical School, Kawagoe (Japan). Saitama Medical Center; Tsuchiya, Yuichi; Ohtsuru, Hiroshi

    2001-07-01

    Ten cases of trismus following irradiation of head and neck cancer are reported. The patients were 4 males and 6 females with a mean age of 54.2 years. We preformed 2 arthroplasties, and used 4 scapular flaps, 2 groin flaps, 1 omental flap, and 1 latissimus dorsi flap. The maximum mouth opening in each patient improved, and all patients were able to open past 2 finger breadth after treatment. Use of vascularized tissue is important to prevent atrophy of transferred bone and other soft tissues, and infection. In addition, even if trismus is improved after surgery, mouth opening exercises are needed to prevent recurrence of trismus. (author)

  19. The clinical features, laboratory findings, treatment and follow-up results of patients with morphea

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    Nehir Parlak

    2013-12-01

    Full Text Available Objective: Morphea, also known as localized scleroderma, is a rare skin disease of unknown pathogenesis, characterized by fibrosis in the skin and subcutaneous tissue. In this study, we aim to evaluate the demographic features, clinical characteristics, laboratory findings, and response to treatment in patients diagnosed with morphea. Materials and Methods: The findings of fifty eight patients diagnosed with morphea were retrospectively evaluated between 1995-2011. All patients' clinical symptoms, concomitant diseases, symptoms, immunological features and presence of peripheral eosinophilia were investigated. Treatment methods, response to therapy of 40 patients whose treatment continued for 2-12 months were examined. Fourty nine patients (84.5% were female and 9 patients (15.5% were male of 58 patients who were diagnosed with morphea. The mean age of patients was 42.33±18.44 years (range: 7-75 years. Diagnosis was made histopathologically in all cases. Borrelia antibodies were negative in all patients enrolling the study. Thirty six patients (62.1% had plaque type, 17 patients (29.3% had generalized type, 3 patients (5.2% had mixed type (linear + plaque and 2 patients (3.4% had linear type of morphea. ANA was found to be positive in 12 (26.2% of 46 patients. Considering the relationship between the clinical types of morphea with ANA, 38.5% of plaque type, 53.8% of generalized type, 7.7% of mixed type patients showed ANA positivity. ANA positivity was statistically significant in patients with generalized morphea (p=0.027. Peripheral eosinophilia was detected in one case in whom lesions were generalized (2.1%. Colchicine therapy was given to 23 cases. Complete and partial response rates are 47.8% and 26.1%, respectively. However, 17.4% of patients remained stable and progression was noted in 8.7% of the cases. Conclusion: In conclusion, plaque type morphea is the most common type of morphea. ANA positivity was statistically significant in

  20. Long-term results and complications of preoperative radiation in the treatment of rectal cancer

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    Reed, W.P.; Garb, J.L.; Park, W.C.; Stark, A.J.; Chabot, J.R.; Friedmann, P.

    1988-02-01

    A retrospective study of 149 patients with rectal cancer diagnosed between 1972 and 1979 was undertaken to compare survival, disease-free survival, recurrence sites, and long-term complications of 40 patients who received 4000 to 4500 rads of preoperative adjuvant radiotherapy (radiation group) with those of 109 patients treated by resection alone (control group). After a mean follow-up of 84 months and 99 months, respectively, survival of the irradiated patients was significantly better than that of controls (68% versus 52%, p less than 0.05). Disease-free survival of those patients rendered free of disease by treatment was also superior for the irradiated group (84% versus 57%, p less than 0.005). Local recurrence without signs of distant metastases developed only one-third as often in irradiated patients (6% versus 18%). Distant metastases, alone or in combination with local recurrence, were also less common after radiation (12% versus 27%). Second primary tumors developed in 15% and 10% of the respective groups, a difference that was not statistically significant. When we consider the survival benefit of preoperative radiation therapy, long-term complications were relatively mild. Delayed healing of the perineum was noted in two irradiated patients. Persistent diarrhea was severe enough to warrant treatment in only one case, and one patient required a colostomy for intestinal obstruction from pelvic fibrosis.

  1. Entire papilla preservation technique in the regenerative treatment of deep intrabony defects: 1-Year results.

    Science.gov (United States)

    Aslan, Serhat; Buduneli, Nurcan; Cortellini, Pierpaolo

    2017-09-01

    This study evaluates the clinical outcomes of a novel tunnel-like surgical technique in the treatment of isolated deep intrabony defects. Twelve patients presenting with at least one isolated deep intrabony defect received regenerative periodontal treatment with "entire papilla preservation (EPP)" technique. Access to the intrabony defect for debridement was provided by a bevelled vertical releasing incision positioned in the buccal gingiva of the neighbouring inter-dental space. Following the elevation of a buccal flap, an inter-dental tunnel was prepared undermining the defect-associated papilla. Granulation tissue was removed, root surfaces were carefully debrided and bone substitutes and enamel matrix derivative were applied. Microsurgical suturing technique was used for optimal wound closure. Early healing was uneventful in all cases, and 100% wound closure was maintained during the entire healing period. At 1-year, there was significant attachment gain of 6.83±2.51 mm (p<0.001). The 7±2.8 mm reduction in probing depth was also significant (p<0.001), which was associated with minimal increase in gingival recession (0.16±0.38 mm, p=0.166). Tunnel-like "EPP" technique may limit the risk of wound failure particularly in the early healing phase, thereby preventing exposure of regenerative biomaterials, possibly enhancing stabilization of blood clot in deep intrabony defects and leading to optimal clinical outcomes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Long-term results of prednisone treatment for the anemia of myelofibrosis.

    Science.gov (United States)

    Hernández-Boluda, Juan-Carlos; Martínez-Trillos, Alejandra; García-Gutiérrez, Valentín; Ferrer-Marín, Francisca; Xicoy, Blanca; Alvarez-Larrán, Alberto; Kerguelen, Ana; Barba, Pere; Gómez, Montse; Herrera, Juan-Carlos; Correa, Juan-Gonzalo; Cervantes, Francisco

    2016-01-01

    This study has retrospectively analyzed the efficacy of single-agent prednisone, usually given after failure of other therapies, in 30 patients with myelofibrosis (MF) and severe anemia. Initial dose was 0.5-1 mg/kg daily, with tapering to the minimum effective dose in responders. Twelve patients (40%) achieved anemia response according to the revised International Working Group for Myelofibrosis Research and Treatment criteria, after a median time of 1.1 months on treatment. Median response duration was 12.3 months. Patients with constitutional symptoms or > 2% circulating blasts had a trend for a lower response rate. A platelet increase > 50 × 10(9)/L was observed in three out of 11 patients with baseline counts prednisone start was significantly longer in anemia responders (5.0 years, 95% CI = 3.5-6.5, vs 1.5 years, 95% CI = 0.2-2.8; p = 0.002). Prednisone can improve the anemia and thrombocytopenia in selected MF patients after failure to standard therapies.

  3. Why hypertensive patients do not comply with the treatment: results from a qualitative study.

    Science.gov (United States)

    Gascón, Juan J; Sánchez-Ortuño, Montserrat; Llor, Bartolomé; Skidmore, David; Saturno, Pedro J

    2004-04-01

    Medical non-compliance has been identified as a major public health problem in the treatment of hypertension. There is a large research record focusing on the understanding of this phenomenon. However, to date, the majority of studies in this field have been focused from the medical care perspective, but few studies have focused on the patients' point of view. Our aim was to identify factors related to non-compliance with the treatment of patients with hypertension. We use a qualitative study in which data were gathered from seven focus group discussions conducted in March-May 2001. Patients were identified as non-compliant, using the Morisky-Green test, at two primary health care centres of the Spanish National Health Service. A complex web of factors was identified that influenced non-compliance. Patients had fears and negative images of antihypertensive drugs. The data also revealed a lack of basic background knowledge about hypertension. The clinical encounter was viewed as unsatisfactory because of its length, few explanations given by the physician and low physician-patient interaction. Most of the factors related to poor compliance have implications for patient management. Knowing patients' priorities regarding the most important aspects of care that have high potential for low compliance may be helpful in improvement of the quality of hypertensive patient care.

  4. Hypertension Prevalence, Awareness, Treatment and Control, and Associated Factors: Results from a National Survey, Jordan

    Directory of Open Access Journals (Sweden)

    H. Y. Jaddou

    2011-01-01

    Full Text Available The study examined prevalence, awareness, treatment and control of hypertension (HTN, and associated factors and to evaluate the trend in hypertension between 2009 (period 2 and 1994–1998 (period 1. A national sample of 4117 adults aged 25 years and older was selected. Prevalence rate of HTN (SBP ≥ 140 or DBP ≥ 90 or on antihypertensive therapy was 32.3% and was higher than the 29.4% prevalence rate reported in period 1. Prevalence rate was significantly higher among males, older age groups, least educated, obese, and diabetics than their counterparts. The rate of awareness among hypertensives was 56.1% and was higher than the 38.8% rate reported form period 1 data. Awareness was positively associated with age, smoking, and diabetes for both men and women, and with level of education and body mass index for men. Rate of treatment for HTN among aware patients was 63.3% and was significantly higher than the 52.8% rate reported in period1. Control rate of HTN among treated hypertensives was 39.6%; significantly higher than the 27.9% control rate in period 1. Control of HTN was positively associated with age but only for women. In conclusion, HTN is still on the rise in Jordan, and levels of awareness and control are below the optimal levels.

  5. What sex abusers say about their treatment: results from a qualitative study on pedophiles in treatment at a Canadian penitentiary clinic.

    Science.gov (United States)

    Drapeau, Martin; Korner, Annett C; Granger, Luc; Brunet, Louis

    2005-01-01

    This exploratory study used qualitative methodology to examine what pedophiles think about treatment, as well as their daily experience of a treatment program. To this end, twenty-three offenders receiving treatment from the La Macaza federal penitentiary clinic were interviewed using non-directive semi-structured interviews. Comparative analysis was used to analyze the resulting material. The following themes are discussed based on the results of this analysis: (a) the participants' past experience of therapy; (b) motivations for choosing the La Macaza clinic for treatment; (c) the structure of the program; (d) the group dynamics; (e) the therapists; and (f) the hardships and difficulties of treatment. Results suggest that the therapists and the program may have a function of containment or holding. Although part of the therapeutic process involves a focus on identifying and reducing cognitive distortions, results also warn therapists against misusing this concept by applying it to legitimately different opinions. Findings are discussed in terms of possible program improvements. The authors conclude that greater attention must be given to process research.

  6. Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial

    Science.gov (United States)

    Beattie, Karen A.; Ioannidis, George; MacDermid, Joy C.; Grewal, Ruby; Papaioannou, Alexandra; Adachi, Jonathan D.; Hodsman, Anthony B.

    2016-01-01

    Canadian guidelines recommend either the FRAX or the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) fracture risk assessment tools to report 10-yr fracture risk as low (20%). It is unknown whether one reporting system is more effective in helping family physicians (FPs) identify individuals who require treatment. Individuals ≥50 yr old with a distal radius fracture and no previous osteoporosis diagnosis or treatment were recruited. Participants underwent a dual-energy x-ray absorptiometry scan and answered questions about fracture risk factors. Participants’ FPs were randomized to receive either a FRAX report or the standard CAROC-derived bone mineral density report currently used by the institution. Only the FRAX report included statements regarding treatment recommendations. Within 3 mo, all participants were asked about follow-up care by their FP, and treatment recommendations were compared with an osteoporosis specialist. Sixty participants were enrolled (31 to FRAX and 29 to CAROC). Kappa statistics of agreement in treatment recommendation were 0.64 for FRAX and 0.32 for bone mineral density. The FRAX report was preferred by FPs and resulted in better postfracture follow-up and treatment that agreed more closely with a specialist. Either the clear statement of fracture risk or the specific statement of treatment recommendations on the FRAX report may have supported FPs to make better treatment decisions. PMID:24206869

  7. Multi-method psycho-educational intervention for preschool children with disruptive behavior: preliminary results at post-treatment.

    Science.gov (United States)

    Barkley, R A; Shelton, T L; Crosswait, C; Moorehouse, M; Fletcher, K; Barrett, S; Jenkins, L; Metevia, L

    2000-03-01

    Annual screenings of preschool children at kindergarten registration identified 158 children having high levels of aggressive, hyperactive, impulsive, and inattentive behavior. These "disruptive" children were randomly assigned to four treatment conditions lasting the kindergarten school year: no treatment, parent training only, full-day treatment classroom only, and the combination of parent training with the classroom treatment. Results showed that parent training produced no significant treatment effects, probably owing largely to poor attendance. The classroom treatment produced improvement in multiple domains: parent ratings of adaptive behavior, teacher ratings of attention, aggression, self-control, and social skills, as well as direct observations of externalizing behavior in the classroom. Neither treatment improved academic achievement skills or parent ratings of home behavior problems, nor were effects evident on any lab measures of attention, impulse control, or mother-child interactions. It is concluded that when parent training is offered at school registration to parents of disruptive children identified through a brief school registration screening, it may not be a useful approach to treating the home and community behavioral problems of such children. The kindergarten classroom intervention was far more effective in reducing the perceived behavioral problems and impaired social skills of these children. Even so, most treatment effects were specific to the school environment and did not affect achievement skills. These findings must be viewed as tentative until follow-up evaluations can be done to determine the long-term outcomes of these interventions.

  8. A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment

    Directory of Open Access Journals (Sweden)

    van Loon Piet JM

    2012-10-01

    Full Text Available Abstract Study design A prospective treatment study with a new brace was conducted Objective. To evaluate radiological and subjective clinical results after one year conservative brace treatment with pressure onto lordosis at the thoracolumbar joint in children with scoliosis and kyphosis. Summary of background data Conservative brace treatment of adolescent scoliosis is not proven to be effective in terms of lasting correction. Conservative treatment in kyphotic deformities may lead to satisfactory correction. None of the brace or casting techniques is based on sagittal forces only applied at the thoracolumbar spine (TLI= thoracolumbar lordotic intervention. Previously we showed in patients with scoliosis after forced lordosis at the thoracolumbar spine a radiological instantaneous reduction in both coronal curves of double major scoliosis. Methods A consecutive series of 91 children with adolescent scoliosis and kyphosis were treated with a modified symmetric 30 degrees Boston brace to ensure only forced lordosis at the thoracolumbar spine. Scoliosis was defined with a Cobb angle of at least one of the curves [greater than or equal to] 25 degrees and kyphosis with or without a curve Results Before treatment start ‘in brace’ radiographs showed a strong reduction of the Cobb angles in different curves in kyphosis and scoliosis groups (sagittal n = 5 all p Conclusion Conservative treatment using thoracolumbar lordotic intervention in scoliotic and kyphotic deformities in adolescence demonstrates a marked improvement after one year also in clinical and postural criteria. An effect not obtained with current brace techniques.

  9. Application of Artificial Neural Networks and Principal Component Analysis to Predict Results of Infertility Treatment Using the IVF Method

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    Milewski Robert

    2016-12-01

    Full Text Available There are high hopes for using the artificial neural networks (ANN technique to predict results of infertility treatment using the in vitro fertilization (IVF method. Some reports show superiority of the ANN approach over conventional methods. However, fully satisfactory results have not yet been achieved. Hence, there is a need to continue searching for new data describing the treatment process, as well as for new methods of extracting information from these data. There are also some reports that the use of principal component analysis (PCA before the process of training the neural network can further improve the efficiency of generated models. The aim of the study herein presented was to verify the thesis that the use of PCA increases the effectiveness of the prediction by ANN for the analysis of results of IVF treatment. Results for the PCA-ANN approach proved to be slightly better than the ANN approach, however the obtained differences were not statistically significant.

  10. Percutaneous Nucleoplasty Using Coblation Technique for the Treatment of Chronic Nonspecific Low Back Pain: 5-year Follow-up Results

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    Da-Jiang Ren

    2015-01-01

    Conclusions: Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.

  11. Changing the surface properties on naval steel as result of non-thermal plasma treatment

    Science.gov (United States)

    Hnatiuc, B.; Sabău, A.; Dumitrache, C. L.; Hnatiuc, M.; Crețu, M.; Astanei, D.

    2016-08-01

    The problem of corrosion, related to Biofouling formation, is an issue with very high importance in the maritime domain. According to new rules, the paints and all the technologies for the conditioning of naval materials must fulfil more restrictive environmental conditions. In order to solve this issue, different new clean technologies have been proposed. Among them, the use of non-thermal plasmas produced at atmospheric pressure plays a very important role. This study concerns the opportunity of plasma treatment for preparation or conditioning of naval steel OL36 type. The plasma reactors chosen for the experiments can operate at atmospheric pressure and are easy to use in industrial conditions. They are based on electrical discharges GlidArc and Spark, which already proved their efficiency for the surface activation or even for coatings of the surface. The non-thermal character of the plasma is ensured by a gas flow blown through the electrical discharges. One power supply has been used for reactors that provide a 5 kV voltage and a maximum current of 100 mA. The modifications of the surface properties and composition have been studied by XPS technique (X-ray Photoelectron Spectroscopy). There were taken into consideration 5 samples: 4 of them undergoing a Mini-torch plasma, a Gliding Spark, a GlidArc with dry air and a GlidArc with CO2, respectively the fifth sample which is the untreated witness. Before the plasma treatment, samples of naval steel were processed in order to obtain mechanical gloss. The time of treatment was chosen to 12 minutes. In the spectroscopic analysis, done on a ULVAC-PHI, Inc. PHI 5000 Versa Probe scanning XPS microprobe, a monocromated Al Kα X-ray source with a spot size of 100 μm2 was used to scan each sample while the photoelectrons were collected at a 45-degree take-off angle. Differences were found between atomic concentrations in each individual case, which proves that the active species produced by each type of plasma affects

  12. Influence of circadian time of hypertension treatment on cardiovascular risk: results of the MAPEC study.

    Science.gov (United States)

    Hermida, Ramón C; Ayala, Diana E; Mojón, Artemio; Fernández, José R

    2010-09-01

    Clinical studies have documented morning-evening, administration-time differences of several different classes of hypertension medications in blood pressure (BP)-lowering efficacy, duration of action, safety profile, and/or effects on the circadian BP pattern. In spite of these published findings, most hypertensive subjects, including those under combination therapy, are instructed by their physicians and pharmacists to ingest all of their BP-lowering medications in the morning. The potential differential reduction of cardiovascular (CVD) morbidity and mortality risk by a bedtime versus upon-awakening treatment schedule has never been evaluated prospectively. The prospective MAPEC study was specifically designed to test the hypothesis that bedtime chronotherapy with ≥1 hypertension medications exerts better BP control and CVD risk reduction than conventional therapy, i.e., all medications ingested in the morning. A total of 2156 hypertensive subjects, 1044 men/1112 women, 55.6 ± 13.6 (mean ± SD) yrs of age, were randomized to ingest all their prescribed hypertension medications upon awakening or ≥1 of them at bedtime. At baseline, BP was measured at 20-min intervals from 07:00 to 23:00 h and at 30-min intervals at night for 48 h. Physical activity was simultaneously monitored every min by wrist actigraphy to accurately determine the beginning and end of daytime activity and nocturnal sleep. Identical assessment was scheduled annually and more frequently (quarterly) if treatment adjustment was required. Despite lack of differences in ambulatory BP between groups at baseline, subjects ingesting medication at bedtime showed at their last available evaluation significantly lower mean sleep-time BP, higher sleep-time relative BP decline, reduced prevalence of non-dipping (34% versus 62%; p risk of total CVD events than those ingesting all medications upon awakening (0.39 [0.29-0.51]; number of events 187 versus 68; p risk of major events (including

  13. The late treatment of vertical orbital dystopia resulting from an orbital roof fracture.

    Science.gov (United States)

    Horowitz, J H; Persing, J A; Winn, H R; Edgerton, M T

    1984-12-01

    Traumatic fracture of the orbital roof is uncommon and it may be unrecognized at the time of injury. In this article we describe a patient with progressive vertical orbital dystopia four years after he sustained a fracture of his "frontal" bone. Surgical exploration revealed an orbital roof fracture complicated by a chronic dural leak. An intracranial-extracranial approach through a modified frontal craniotomy provided excellent visualization to elevate the bony orbit and globe safely and repair the dural tear. Our study illustrates the need to correct residual soft tissue deformity at a second operation. Orbital roof fracture is a complex injury and is best treated by a multispecialty team using the methods learned from the treatment of patients with congenital orbital dystopia.

  14. An Unexpected Result of Obesity Treatment: Orlistat-Related Acute Pancreatitis.

    Science.gov (United States)

    Kose, Murat; Emet, Samim; Akpinar, Timur Selcuk; Ilhan, Mehmet; Gok, Ali Fuat Kaan; Dadashov, Mubariz; Tukek, Tufan

    2015-01-01

    Orlistat is a pancreatic lipase inhibitor which is used to treat obesity. Due to the increasing prevalence of obesity, orlistat use is thought to rise progressively. We report an interesting case caused by orlistat use caught in the early stages of acute pancreatitis through imaging; in addition, the case had significantly elevated serum amylase levels. A 54-year-old male who had a history of orlistat treatment started 7 days before was admitted to the emergency department with complaints of abdominal pain, nausea and vomiting lasting for 24 h. Abdominal computed tomography revealed peripancreatic fat tissue edema and a heterogeneous appearance of the pancreas. Based on these findings, it was concluded that edematous pancreatitis was in its initial stage. Orlistat is a drug that is increasingly widespread use due to obesity. More attention must be paid when planning to prescribe orlistat to patients if there are risk factors for acute pancreatitis (alcohol use, height, serum calcium and lipid levels).

  15. An Unexpected Result of Obesity Treatment: Orlistat-Related Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Murat Kose

    2015-05-01

    Full Text Available Orlistat is a pancreatic lipase inhibitor which is used to treat obesity. Due to the increasing prevalence of obesity, orlistat use is thought to rise progressively. We report an interesting case caused by orlistat use caught in the early stages of acute pancreatitis through imaging; in addition, the case had significantly elevated serum amylase levels. A 54-year-old male who had a history of orlistat treatment started 7 days before was admitted to the emergency department with complaints of abdominal pain, nausea and vomiting lasting for 24 h. Abdominal computed tomography revealed peripancreatic fat tissue edema and a heterogeneous appearance of the pancreas. Based on these findings, it was concluded that edematous pancreatitis was in its initial stage. Orlistat is a drug that is increasingly widespread use due to obesity. More attention must be paid when planning to prescribe orlistat to patients if there are risk factors for acute pancreatitis (alcohol use, height, serum calcium and lipid levels.

  16. Treatment and functional result of desmoplastic fibroma with repeated recurrences in the forearm: A case report

    Science.gov (United States)

    RUI, JING; GUAN, WENJIE; GU, YUDONG; LAO, JIE

    2016-01-01

    Desmoplastic fibroma, alternatively known as aggressive fibromatosis or desmoid tumors, occurs in the form of benign locally aggressive tumors that possess a high rate of recurrence. The forearm bones are rarely involved. The current study presents a case of desmoplastic fibroma in the distal forearm of a 23-year-old man. The tumor was widely resected, and the bone defect was reconstructed using an autologous vascularized fibular graft during the resection procedure. The patient experienced recurrence three times and underwent four resections during the subsequent 3 years following the initial resection. After 10 years of follow-up, the patient's functional recovery remains positive. Despite the implication that surgical resection may be involved in the development of aggressive fibromatosis, surgical wide local excision and functional reconstruction were recommended for the treatment of the present patient. PMID:26893769

  17. [Auranofin in the treatment of chronic polyarthritis. Results of an open multicenter study].

    Science.gov (United States)

    Siegmeth, W

    1984-01-01

    Auranofin (Ridaura SK and F 39 162) was tested in an open multicenter study with regard to its anti-inflammatory effect in 166 patients suffering from rheumatoid arthritis. The time for treatment lasted for one or two years. The therapeutic effect of the drug was judged by its influence on pain, joint swelling, morning stiffness, grip strength, blood-sedimentation rate and rheumatoid factor etc. The serum gold concentration was measured regularly. With Auranofin the majority of the patients achieved a lasting improvement of the condition. The therapeutical effect was observed gradually. Side-effects were frequent but removal from the therapy was rare. Most of the side-effects were diarrhea, rash, pruritus and conjunctivitis. Regular laboratory controls revealed in some cases toxic organic reactions.

  18. Surgical Treatment of Intra-Abdominal Desmoid Tumors Resulting In Short Bowel Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Wheeler, Matthew; Mercer, David; Grant, Wendy; Botha, Jean; Langnas, Alan; Thompson, Jon, E-mail: jthompso@unmc.edu [Department of Surgery, University of Nebraska Medical Center, The Nebraska Medical Center 3280, Omaha, NE 68198 (United States)

    2012-01-19

    Advanced intra-abdominal desmoids tumors present with severe symptoms, complications or rapid growth, which lead to adverse outcomes. Our aim was to evaluate the treatment and outcome of patients with advanced intra-abdominal desmoids tumors, and develop guidelines for surgical management of these patients. We reviewed the clinical courses of 21 adult patients with advanced stage intra-abdominal desmoid tumors who presented to an intestinal rehabilitation and transplantation program. Patients with massive intestinal resection presented in two groups. The first group had a short small intestinal remnant after resection (<60 cm). These patients were poor rehabilitation candidates and eventually met criteria for transplant. The second had longer intestinal remnants and were more successfully rehabilitated and have not had complications that would lead to transplantation. Advanced intra-abdominal desmoid tumors have outcomes after resection that merit aggressive resection and planned intestinal rehabilitation and intestinal transplantation as indicated.

  19. Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: preliminary result

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    Hafez Raef FA

    2007-03-01

    Full Text Available Abstract Background Low-grade gliomas are uncommon primary brain tumors, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Case presentations Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain (thalamic and brain stem were treated with gamma knife surgery. Gamma knife surgery (GKS did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging (MRI studies of the solid part of the tumor and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the (thalamic located lesion and 22 months in the second case with the (brain stem located lesion. Conclusion Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially if they are critically located

  20. Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: preliminary result

    Science.gov (United States)

    Hafez, Raef FA

    2007-01-01

    Background Low-grade gliomas are uncommon primary brain tumors, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Case presentations Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain (thalamic and brain stem) were treated with gamma knife surgery. Gamma knife surgery (GKS) did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging (MRI) studies of the solid part of the tumor and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the (thalamic located lesion) and 22 months in the second case with the (brain stem located lesion). Conclusion Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially if they are critically located PMID:17394660

  1. [Results of the treatment of open heart injuries at a central regional hospital].

    Science.gov (United States)

    Segida, V F; Efremov, N I; Chernov, A I

    1994-09-01

    In a period of 10 years seven patients with open injury to the heart were treated. Their ages ranged from 17 to 39 years. One patient had a gunshot injury, in six the injury was inflicted with a knife. In three patients the injuries were combined (concurrent injury to the lung in 2 and to the diaphragm in one) and in four isolated. Perforating injury of both ventricles and damage of the interventricular septum were found in one case. All patients underwent emergency closure of the heart wounds with an atraumatic synthetic thread and drainage of the pleural cavity. Complications developed in the postoperative period in six patients: suppuration of the operative wound in one and pericarditis in five. One patient died. Analysis of the obtained data testifies to the expediency of two-stage treatment with rehabilitation in cardiological departments. This shortens the period of rehabilitation of patients with open injuries to the heart treated in a central regional hospital.

  2. Preliminary functional results of endoscope-assisted transoral treatment of displaced bilateral condylar mandible fractures.

    Science.gov (United States)

    Schoen, R; Fakler, O; Metzger, M C; Weyer, N; Schmelzeisen, R

    2008-02-01

    Temporomandibular joint (TMJ) function was evaluated following endoscope-assisted transoral open reduction and miniplate fixation of displaced bilateral condylar mandibular fractures. The transoral treatment of bilateral condylar fractures was performed in 13 patients from May 2000 to December 2004. Eleven of the 13 patients had additional mandibular fractures. Out of 26 fractures of the condylar process, 11 were located at the condylar neck and 15 were subcondylar. One, 6 and 12 months after surgery TMJ function was evaluated. Anatomic reduction was achieved using an endoscope-assisted transoral approach even when the condylar fragment was displaced medially and in fractures with comminution. Good TMJ function was noted 6 and 12 months after surgery. Mouth opening was measured to be more than 40 mm without deviation. Postoperative range of motion with a satisfying lateral excursion was found. Early rehabilitation and pre-injury TMJ function was achieved following minimally invasive anatomic fracture reduction.

  3. Examination of the properties of IMRT and VMAT beams and evaluation against pre-treatment quality assurance results

    Science.gov (United States)

    Crowe, S. B.; Kairn, T.; Middlebrook, N.; Sutherland, B.; Hill, B.; Kenny, J.; Langton, C. M.; Trapp, J. V.

    2015-03-01

    This study aimed to provide a detailed evaluation and comparison of a range of modulated beam evaluation metrics, in terms of their correlation with QA testing results and their variation between treatment sites, for a large number of treatments. Ten metrics including the modulation index (MI), fluence map complexity, modulation complexity score (MCS), mean aperture displacement (MAD) and small aperture score (SAS) were evaluated for 546 beams from 122 intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) treatment plans targeting the anus, rectum, endometrium, brain, head and neck and prostate. The calculated sets of metrics were evaluated in terms of their relationships to each other and their correlation with the results of electronic portal imaging based quality assurance (QA) evaluations of the treatment beams. Evaluation of the MI, MAD and SAS suggested that beams used in treatments of the anus, rectum, head and neck were more complex than the prostate and brain treatment beams. Seven of the ten beam complexity metrics were found to be strongly correlated with the results from QA testing of the IMRT beams (p VMAT beams, whether they were evaluated as whole 360° arcs or as 60° sub-arcs. Select evaluation of beam complexity metrics (at least MI, MCS and SAS) is therefore recommended, as an intermediate step in the IMRT QA chain. Such evaluation may also be useful as a means of periodically reviewing VMAT planning or optimiser performance.

  4. Long-term results of endoscopic sinus surgery-oriented treatment for chronic rhinosinusitis with asthma.

    Science.gov (United States)

    Chen, Feng-Hong; Zuo, Ke-Jun; Guo, Yu-Biao; Li, Zhi-Ping; Xu, Geng; Xu, Rui; Shi, Jian-Bo

    2014-01-01

    The aims of this study were to evaluate the efficacy of functional endoscopic sinus surgery (FESS)-oriented multimodality treatment in chronic rhinosinusitis (CRS) patients with asthma and its impact on asthma. Prospective, nonrandomized cohort. Twenty-seven CRS patients with asthma who underwent FESS with postoperative topical corticosteroid spray were evaluated preoperatively; 25 of them were evaluated 1 year and 3 years postoperatively. CRS was evaluated by visual analogue scale, clinical control of CRS, and objective measurement endoscopy Lund-Kennedy scores. Asthma was assessed by subjective asthma control test and asthma control level, also by objective antiasthma medication use and pulmonary function tests. VAS scores of general symptoms (8.09 ± 0.87 preoperatively) were significantly improved at 1 year (2.94 ± 2.21) and 3 years (3.77 ± 2.16) postoperation (P = .000). No difference in these items was found between 1 year and 3 years (P = .463). Endoscopy Lund-Kennedy scores at 1 year (4.34 ± 3.09) and 3 years (5.80 ± 3.38) postoperatively were significantly better (9.33 ± 2.03 preoperatively, P = .000), and there was no difference between 1 year and 3 years of follow-up (P > .05). Significantly, asthma control level improved postoperatively (P = .025). However, antiasthma drug and pulmonary function showed no significant change postoperatively (P > .05). FESS-oriented multimodality treatment improves CRS with asthma significantly and persistently. Asthma control level improved. Antiasthma medication use and pulmonary function remained stable. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Complications and treatment of patients with β-thalassemia in France: results of the National Registry.

    Science.gov (United States)

    Thuret, Isabelle; Pondarré, Corinne; Loundou, Anderson; Steschenko, Dominique; Girot, Robert; Bachir, Dora; Rose, Christian; Barlogis, Vincent; Donadieu, Jean; de Montalembert, Mariane; Hagege, Isabelle; Pegourie, Brigitte; Berger, Claire; Micheau, Marguerite; Bernaudin, Françoise; Leblanc, Thierry; Lutz, Laurence; Galactéros, Frédéric; Siméoni, Marie-Claude; Badens, Catherine

    2010-05-01

    beta-thalassemia is a rare disease in France, encountered mainly in patients originating from Italy and North Africa. In the setting of the recent French plan for rare diseases, a National Registry for thalassemia has been developed since 2005. Epidemiological and clinical data have been collected on living patients with beta-thalassemia major or intermedia, including those who underwent hematopoietic stem cell transplantation. A standardized questionnaire was sent to clinicians throughout the national professional networks involved in the management of thalassemic patients and data were updated every 18 months. A cross-sectional study was performed in February 2009. Data on 378 patients (267 with thalassemia major) with a median age of 20 were recorded. Hematopoietic stem cell transplantation was performed in 52 patients. Stature, rates of parenthood, splenectomy, and cholecystectomy were no different between non-transplanted thalassemia major and thalassemia intermedia patients, after adjustment for age. Among the 215 non-transplanted thalassemia major patients, the median serum ferritin level was 1240 ng/mL and the rates of iron-related complications were 10%, 6%, 10% and 48% for cardiac failure, diabetes, hypothyroidism, and hypogonadism, respectively. From 2005 to 2008, a dramatic switch in chelation treatment, from deferoxamine to deferasirox, was observed. The rates of complications of iron overload in French thalassemia major patients appeared similar to those reported in other developed countries in which this condition is not endemic. There were no significant differences in height and parenthood rates between patients with the major and the intermedia forms of the disease, underlining the progress in clinical care. Future developments will focus on mortality and morbidity under oral chelation treatment.

  6. Drug safety of systemic treatments for psoriasis: results from The German Psoriasis Registry PsoBest.

    Science.gov (United States)

    Reich, K; Mrowietz, U; Radtke, M A; Thaci, D; Rustenbach, S J; Spehr, C; Augustin, M

    2015-12-01

    The German Psoriasis Registry PsoBest was conducted in 2008 in order to investigate the long-term outcomes and safety of systemic treatments for moderate-to-severe psoriasis. Safety analysis of antipsoriatic drugs with special focus on serious adverse events (SAE) for infections, malignancies and major cardiac events (MACE) was done. Nationwide non-interventional patient treatment registry conducted in 251 active dermatology centers. Until June 2012, n = 2444 patients [40 % female; mean age 47.3 (SD 14.1) years; mean duration of disease 18.2 (SD 14.7) years] were recruited, including n = 1791 patients (3842 patient years) with conventional systemic drugs and n = 908 (3442 patient years) with biological drugs. Mean PASI (Psoriasis Area and Severity Index) at inclusion was 14.7, mean DLQI (Dermatology Life Quality Index) 11.1, mean BMI (Body Mass Index) 28.2. The overall rate of SAE per 100 patient years were 1.3 (SD 0.9) per 100 patient years in conventional systemic and 1.5 (SD 1.2) in biologics (p > 0.5, no significant difference). The rates per 100 patient years for single severe adverse events were as follows (systemic/biologics): serious infections, 0.33/0.65 [CI (confidence interval) 0.13-0.54/0.35-0.98]; MACE, 0.56/0.77 (CI 0.29-0.97/0.41-1.31); malignancies (except non-melanoma skin cancer), 0.46/0.49 (CI 0.22-0.84/0.21-0.97). There were no significant differences between single drugs in any of the safety parameters. The conventional systemic and biologic drugs for psoriasis show satisfying safety under routine psoriasis care in Germany with respect to infections, MACE and malignancies.

  7. THE ACCOUNTING TREATMENT OF ASSET DEPRECIATION AND THE IMPACT ON RESULT

    Directory of Open Access Journals (Sweden)

    MARILENA ROXANA ZUCA

    2013-12-01

    Full Text Available The users of the financial statements have long been limited to perusing the loss and profit account to find out information about the accounting result. It has been considered the most significant indicator to measure the performance of a company, without taking into account, however, the relevance of such information. The accounting result is the result of the free choice on accounting policies of companies and leads to an increase or decrease of this result. It is difficult to select the most relevant policy of the multiple accounting policies provided by the International Financial Reporting Standards with impact on a company’s financial performance. Such various accounting practices make an accurate evaluation of the performance and financial situation of companies of different nationalities difficult. It is certain, though, that different accounting solutions used for re-evaluations, amortizations and adjustments lead to different financial results for identical exploitation conditions.

  8. Qualitative and quantitative results of interferon-γ release assays for monitoring the response to anti-tuberculosis treatment

    Science.gov (United States)

    Park, I-Nae; Shim, Tae Sun

    2017-01-01

    Background/Aims The usefulness of interferon-γ release assays (IGRAs) in monitoring to responses to anti-tuberculosis (TB) treatment is controversial. We compared the results of two IGRAs before and after anti-TB treatment in same patients with active TB. Methods From a retrospective review, we selected patients with active TB who underwent repeated QuantiFERON-TB Gold (QFN-Gold, Cellestis Limited) and T-SPOT.TB (Oxford Immunotec) assays before and after anti-TB treatment with first-line drugs. Both tests were performed prior to the start of anti-TB treatment or within 1 week after the start of anti-TB treatment and after completion of treatment. Results A total of 33 active TB patients were included in the study. On the QFN-Gold test, at baseline, 23 cases (70%) were early secreted antigenic target 6-kDa protein 6 (ESAT-6) or culture filtrate protein 10 (CFP-10) positive. On the T-SPOT. TB test, at baseline, 31 cases (94%) were ESAT-6 or CFP-10 positive. Most of patients remained both test-positive after anti-TB treatment. Although changes in interferon-γ release responses over time were highly variable in both tests, there was a mean decline of 27 and 24 spot-forming counts for ESAT-6 and CFP-10, respectively on the T-SPOT.TB test (p < 0.05 for all). Conclusions Although limited by the small number of patients and a short-term follow-up, there was significant decline in the quantitative result of the T-SPOT. TB test with treatment. However, both commercial IGRAs may not provide evidence regarding the cure of disease in Korea, a country where the prevalence of TB is within the intermediate range. PMID:27951621

  9. Surgical treatment results of hand deformities in patients with Apert syndrome

    Directory of Open Access Journals (Sweden)

    Ufuk Nalbantoglu

    2015-12-01

    Results: The mean age at the first operation was 2.7 years and the mean number of operations was 3 per patient. No patient developed graft-flap necrosis and no patients required amputations. All patients were able to perform grasping and pinching functions and families were satisfied with the cosmetic results. Conclusion: Using a two-stage surgical protocol, achieving satisfactory results with a minimal number of operations is possible in patients with Apert Syndrome. [Hand Microsurg 2015; 4(3.000: 53-57

  10. [Tibial defects and infected non-unions : Treatment results after Masquelet technique].

    Science.gov (United States)

    Moghaddam, A; Ermisch, C; Fischer, C; Zietzschmann, S; Schmidmaier, G

    2017-03-01

    The treatment of non-unions with large bone defects or osteitis is a major challenge in orthopedic and trauma surgery. A new concept of therapy is a two-step procedure: Masquelet technique according to the diamond concept. Between February 2010 and June 2014, 55 patients with tibia non-unions or infections were treated in a two-step Masquelet technique in our center. The patients' average age was 48 (median 50; minimum 15-maximum 72) with an average BMI (body mass index) of 28 (27; 18-52). There were 10 (18 %) female and 45 (82 %) male patients in the group. All study patients went through a follow up. Bone healing and clinical functional data were collected, as well as data according to subjective patient statements about pain and everyday limitations. In 42 cases (76.4 %) the outcome was a sufficient bony consolidation. On average, the time to heal was 10.3 (8, 5; 3-40) months, defect gaps were 4 cm (3 cm; 0,6-26 cm), and on average the patients had had 6 (median 4; range 1-31) previous operations . In all cases patients received osteosynthesis as well as a defect filling with RIA (reamer-irrigator-aspirator), and growth factor BMP-7 (bone morphogenetic protein-7). In 13 cases (23.6 %) there was no therapeutic success. In the evaluation of the SF12 questionnaire the mental health score increased from 47.4 (49.1; 27.6-65.7) to 49.8 (53.0; 28.7-69.4) and the well-being score from 32.7 (32.7;16.9-55.7) to 36.6 (36.5; 24.6-55.9). The two-step bone grafting method in the Masquelet technique used for tibia non-unions according to the diamond concept is a promising treatment option. Its application for tibia shaft non-unions with large bone defects or infections means a high degree of safety for the patient.

  11. Perceptions on the surgical treatment of inflammatory bowel disease in Spain. Results of a national survey.

    Science.gov (United States)

    Sánchez-Guillén, Luis; Blanco-Antona, Francisco; Millán-Scheiding, Mónica

    2016-12-01

    The incidence of inflammatory bowel disease (IBD) is increasing in Spain but there is little information on the availability of multidisciplinary care. This study aims to assess surgeon's opinions on the current situation of surgery for IBD in Spain. An electronic closed survey was sent to members of the Spanish Association of Surgeons (AEC) from January to March 2015. This was a 52-item anonymised questionnaire with questions about how the treatment of IBD patients is organized in each centre, the existence of specific units, the management strategy in IBD patients, and the opinion of colorectal, general and trainee surgeons about the surgical treatment of IBD in their centre and in Spain. One hundred and ninety-two surgeons responded. Most participants work in tertiary hospitals (45%), most of them from different hospitals, some from the same hospital. Only 50% of hospitals have multidisciplinary teams for IBD. The initial approach is laparoscopic in 56% of cases, and 80% of participants in centres with multidisciplinary teams consider the timing of surgery to be appropriate. The annual number of IBD surgeries in tertiary hospitals is higher than in secondary hospitals in ulcerative colitis (57 vs. 24% 10-15 patients/year, P<.001) and Crohn's disease (68 vs. 28% 3-5 patients/month, P<.001). Most centres operate less than 10 ulcerative colitis patients per year, even larger centres (67%) and they perform ≤3 J-pouches/month (ulcerative colitis and other indications) (P<.001). Ninety-five percent of surgeons consider that centralization of complex cases in specialized units and the creation of national registries should be developed. The majority of participants (70%) believe that there is a deficit in research and educational activities in IBD surgery in Spain. This survey suggests that most Spanish hospitals have a low volume of IBD surgery, even large tertiary hospitals, and many centres do not have a multidisciplinary team dedicated to IBD patients. Most

  12. Health locus of control as a psychological factor in improving treatment results in adolescents with primary hypertension and diabetes

    Directory of Open Access Journals (Sweden)

    Marta Anna Biernacka

    2016-10-01

    Full Text Available Background The belief that an individual can influence and control the course of events is a factor which enables a person to overcome difficulties. Some studies, however, have questioned the universality of this statement. This study aims to investigate and explore the relationship between the self-health locus of control and the effectiveness of cooperation in the treatment process in adolescents with chronic diseases. Participants and procedure One hundred and sixty-four adolescent patients suffering from chronic diseases (61 girls and 103 boys ranging from 11 to 17 years old participated in the study. Eighty-seven had primary hypertension and 77 had type 1 diabetes. To investigate their sense of health control we used the Health Locus of Control Scale (HLC. Cooperation in the treatment process was assessed using a 4-item scale completed by a doctor. Results Better results in the treatment were positively correlated with a better internal health locus of control. A negative correlation between the chance health locus of control and results in the treatment was found. Differences in the health locus of control proved to be dependent on gender, age and different clinical groups. Conclusions Health locus of control in patients with chronic diseases seems to be a crucial factor in determining the results of the treatment process in such patients.

  13. The Use of Data Mining Methods to Predict the Result of Infertility Treatment Using the IVF ET Method

    Directory of Open Access Journals (Sweden)

    Malinowski Paweł

    2014-12-01

    Full Text Available The IVF ET method is a scientifically recognized infertility treat- ment method. The problem, however, is this method’s unsatisfactory efficiency. This calls for a more thorough analysis of the information available in the treat- ment process, in order to detect the factors that have an effect on the results, as well as to effectively predict result of treatment. Classical statistical methods have proven to be inadequate in this issue. Only the use of modern methods of data mining gives hope for a more effective analysis of the collected data. This work provides an overview of the new methods used for the analysis of data on infertility treatment, and formulates a proposal for further directions for research into increasing the efficiency of the predicted result of the treatment process.

  14. Long-term results of radiotherapy in the treatment of pituitary adenomas in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Grigsby, P.W.; Thomas, P.R.; Simpson, J.R.; Fineberg, B.B.

    1988-12-01

    A retrospective review was performed of 11 children and adolescents (less than 19 years of age) with diagnosed pituitary adenomas. The patients were treated with subtotal resection and postoperative irradiation (S + R) or with irradiation alone (RT) at the Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University Medical Center, from January 1958 through December 1982. Patient conditions at diagnosis were acromegaly in one, Nelson's syndrome in one, prolactinoma in three, chromophobe adenoma in three, and Cushing's disease in three. Median follow-up was 15.6 years (range 6.3-29.5 years). Only two patients have had failure: one at 8.6 years and the other at 20.7 years following treatment. All four patients with visual field (VF) defects at diagnosis underwent S + R, with only one developing recurrent disease. The remaining seven patients, who did not have VF defects, received RT only, and there has been one failure in this group. None have suffered long-term visual complications. All have been able to continue school and/or work. Three of eight females have borne children. Hypopituitarism requiring medication occurred in all who received S + R and in four of seven who received RT only.

  15. Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment

    Directory of Open Access Journals (Sweden)

    Meir Plotnik

    2012-01-01

    Full Text Available Several gait impairments have been associated with freezing of gait (FOG in patients with Parkinson's disease (PD. These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independent gait features may have mutual interactions which, during certain circumstances, jointly drive the predisposed locomotion system into a FOG episode. This new theoretical framework is illustrated by the evaluation of the potential relationships between the so-called “sequence effect”, that is, impairments in step scaling, and gait asymmetry just prior to FOG. We further discuss what factors influence gait control to maintain functional gait. “Triggers”, for example, such as attention shifts or trajectory transitions, may precede FOG. We propose distinct categories of interventions and describe examples of existing work that support this idea: (a interventions which aim to maintain a good level of locomotion control especially with respect to aspects related to FOG; (b those that aim at avoiding FOG “triggers”; and (c those that merely aim to escape from FOG once it occurs. The proposed theoretical framework sets the stage for testable hypotheses regarding the mechanisms that lead to FOG and may also lead to new treatment ideas.

  16. Results of multimodality treatment with promisan incorporated into its regimen for patients with disseminated ovarian cancer

    Directory of Open Access Journals (Sweden)

    A. V. Zharov

    2011-01-01

    Full Text Available The problem of ovarian cancer (OC is considered. The efficiency of multimodality treatment with and without promisan incorporated into its regimen was evaluated in 2 groups of patients with disseminated OC. The efficacy and tolerance of promisan used in patients with disseminated OC are analyzed.А.В. Жаров, Г.Р. Кравченко, Л.Ф. Чернова, Т.Н. ГубайдуллинаЧелябинский окружной клинический онкологический диспансер Контакты: Александр Владимирович Жаров roc_chel@mail.ru

  17. Extracorporeal shock wave treatment of capsular fibrosis after mammary augmentation - Preliminary results.

    Science.gov (United States)

    Heine, Norbert; Prantl, Lukas; Eisenmann-Klein, Marita

    2013-12-01

    Extracorporeal shock wave therapy has undergone continuous development and has become a well-established therapy option both in urology and in orthopaedics/trauma surgery. Experimental and clinical studies have proved the effectiveness of extracorporeal shock wave therapy in the treatment of connective tissue diseases such as fibromatosis. The pathomechanism of capsular fibrosis after augmentation of the female breast with silicone implants presents a series of analogies with mechanisms that are generally recognised to be associated with fibroproliferative diseases. The starting point of the disease is the inflammatory reaction caused by the silicone and/or by the sub-clinical bacterial contamination of the implant surface and can create an inflammatory reaction and fibrosis. A total of 19 cases of capsular fibrosis in 12 patients following insertion of mammary implants were treated with extracorporeal shock wave therapy. The therapy was performed with the Duolith SD1 system manufactured by Storz Medical. Shock waves were applied with the C-Actor handpiece designed for planar shock waves. Extracorporeal shock wave therapy appears to be a non-invasive, well-tolerated and easy-to-use procedure for pain reduction and fibrotic tissue softening, especially after aesthetic breast implant augmentation.

  18. Safety and efficacy of adalimumab treatment in Japanese patients with psoriasis: Results of SALSA study.

    Science.gov (United States)

    Asahina, Akihiko; Torii, Hideshi; Ohtsuki, Mamitaro; Tokimoto, Toshimitsu; Hase, Hidenori; Tsuchiya, Tsuyoshi; Shinmura, Yasuhiko; Reyes Servin, Ofelia; Nakagawa, Hidemi

    2016-11-01

    The safety and efficacy of adalimumab were evaluated over 24 weeks in Japanese patients with psoriasis in routine clinical practice. In this multicenter, observational, open-label, postmarketing study, primary efficacy measures included the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) in all patients with psoriasis. In patients with psoriatic arthritis (PsA), the 28-joint Disease Activity Score (DAS28) and the visual analog scale (VAS) pain were also evaluated. Safety was assessed based on the frequency of adverse drug reactions (ADR). Among patients with psoriasis evaluated for efficacy (n = 604), significant improvements from baseline were observed in mean PASI and DLQI scores at weeks 16 and 24 (all P psoriasis patients without PsA, the PASI 75/90 response rates were 55.9%/28.4% at week 16 (n = 306) and 65.6%/43.3% at week 24 (n = 270), respectively. In patients with PsA evaluable for effectiveness, significant improvements from baseline were observed in PASI, DAS28 erythrocyte sedimentation rate, DAS28 C-reactive protein and VAS pain at weeks 16 and 24 (all P psoriasis; no unexpected safety findings were noted. The safety profile and effectiveness of adalimumab for the treatment of psoriasis in a routine clinical setting were as expected in Japanese patients. © 2016 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  19. Impact of adalimumab treatment on cardiovascular risk biomarkers in psoriasis: Results of a pilot study.

    Science.gov (United States)

    Gkalpakiotis, Spyridon; Arenbergerova, Monika; Gkalpakioti, Petra; Potockova, Jana; Arenberger, Petr; Kraml, Pavel

    2017-04-01

    Psoriasis is a chronic systemic immune-mediated inflammatory dermatosis associated with several comorbidities. Psoriasis patients are at increased risk of developing cardiovascular diseases (CVD), namely, coronary heart disease, stroke or peripheral vascular disease, and psoriasis seems to be an independent cardiovascular risk factor. Antipsoriatic systemic therapy, especially anti-tumor necrosis factor (TNF)-α, seems to exert a beneficial effect on these comorbidities. The purpose of this study was: (i) to measure the level of cardiovascular serum markers in psoriasis patients in comparison with healthy volunteers; and (ii) to compare the serum level of the same markers in patients before and 3 months after adalimumab therapy. We investigated six biomarkers connected to CVD: C-reactive protein (measured high sensitively, hsCRP), oxidized low-density lipoproteins (oxLDL), oxLDL/β-glycoprotein I complex (oxLDL/β2GPI), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin and interleukin (IL)-22. These biomarkers were measured in 21 patients with moderate/severe psoriasis before and after treatment with adalimumab and in healthy volunteers. hsCRP (P psoriasis patients but the difference did not reach statistical significance. A decrease of E-selectin (P psoriasis but also decreases serum cardiovascular biomarkers. E-selectin and IL-22 could serve for monitoring of the efficacy of antipsoriatic systemic therapy on cardiovascular risk. © 2016 Japanese Dermatological Association.

  20. Radiofrequency ablation in the treatment of osteoid osteoma: results and complications

    Energy Technology Data Exchange (ETDEWEB)

    Earhart, Jeffrey [Case Western Reserve University, Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH (United States); Wellman, David [Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, NY (United States); Donaldson, James [Feinberg School of Medicine at Northwestern University, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Chesterton, Julie [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); King, Erik [Northwestern University Feinberg School of Medicine, Department of Orthopaedic Surgery, Ann and Robert H. Lurie Children' s Hospital of Chicago, Chicago, IL (United States); Janicki, Joseph A. [Northwestern University Feinberg School of Medicine, Department of Orthopaedic Surgery, Children' s Hospital of Chicago, Chicago, IL (United States); Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Orthopaedic Surgery, Chicago, IL (United States)

    2013-07-15

    Percutaneous radiofrequency ablation (RFA) for treatment of osteoid osteoma is effective and avoids the potential complications of open surgical resection. This study evaluates the efficacy of RFA at a single tertiary-care pediatric hospital and highlights an important complication. The medical records of 21 cases of RFA in 21 children between 2004 and 2010 were reviewed retrospectively for demographic data, lesion site, access point and technique for ablation, clinical outcome and complications. Clinical follow-up was available for 17/21 children (81%) at an average of 17.0 months (range 0.5-86.1 months). No persistence or recurrence of pre-procedural pain was noted. Two children (9.5%) had a complication, including a burn to the local skin and muscle requiring local wound care, and a late subtrochanteric femur fracture treated successfully with open reduction internal fixation. RFA is a safe and effective alternative to surgical resection of the osteoid osteoma nidus. When accessing the proximal femur, the risk of late post-procedural fracture must be considered and discussed with the family. An understanding of biomechanical principles in the proximal femur might provide an effective strategy for limiting this risk. (orig.)

  1. The use Prometheus FPSA system in the treatment of acute liver failure: preliminary results.

    Science.gov (United States)

    Skwarek, A; Grodzicki, M; Nyckowski, P; Kotulski, M; Zieniewicz, K; Michalowicz, B; Patkowski, W; Grzelak, I; Paczkowska, A; Giercuszkiewicz, D; Sańko-Resmer, J; Paczek, L; Krawczyk, M

    2006-01-01

    The preliminary outcomes of patients with acute liver failure treated with the Prometheus Fractionated Plasma Separation and Absorption (FPSA) system are presented herein. The procedures were performed in 13 patients (4, intoxication by Amanita phalloides; 4, unknown reason; 3, acetaminophen intoxication; 1, Wilson disease, and 1, liver insufficiency after hemihepatectomy owing to metastases of colon adenocarcinoma). The patients were qualified for the procedure according to the King's College Hospital criteria. The patients' general status was assessed on basic of GCS, UNOS, and the 4-grade encephalopathy classifications. The procedures were performed with the Prometheus 4008H Fresenius Medical Care unit. The 29 procedures were of mean duration 6.5 hours. There were statistically significant reductions in total bilirubin, ammonia, and aminotransferase levels. In addition, the procedures corrected water, mineral, and carbohydrate disorders. One patient did not require liver transplantation. Seven patients received liver transplants: three patients with positive outcomes; two died due to septicemia within 30 days perioperatively, one died at 6 months after OLT owing to respiratory failure; and one, owing to hemorrhagic diathesis. Four patients did not receive a liver transplant because of lack of a organ, no consent for the surgery, or neoplastic disease with metastases. The Prometheus FPSA-System was an effective detoxication method for patients with acute liver failure. The system was useful as a symptomatic treatment before liver transplantation allowing a longer wait for a graft.

  2. A History of Childhood Trauma and Response to Treatment With Antipsychotics in First-Episode Schizophrenia Patients: Preliminary Results.

    Science.gov (United States)

    Misiak, Błażej; Frydecka, Dorota

    2016-10-01

    In this study, we aimed to investigate whether a history of childhood trauma (CT) can help predict early response to antipsychotic treatment in patients with first-episode schizophrenia (FES). We recruited 64 FES patients who were followed up after 12 weeks of treatment with second-generation antipsychotics. Symptomatic manifestation was examined using the Positive and Negative Syndrome Scale (PANSS). Childhood adversities were assessed using the Early Trauma Inventory Self-Report-Short Form. Nonresponders had significantly higher general trauma score, emotional abuse score, total trauma score, and baseline PANSS negative factor score. A history of CT was significantly more frequent among nonresponders. Logistic regression analysis revealed that positive history of CT, higher emotional abuse score, and higher baseline PANSS negative factor score are significant predictors of poor response to treatment. Our results indicate that a history of CT, especially emotional abuse, and higher severity of negative symptoms are independent predictors of poor response to treatment with antipsychotics.

  3. Disaggregating measurement uncertainty from population variability and Bayesian treatment of uncensored results.

    Science.gov (United States)

    Strom, Daniel J; Joyce, Kevin E; MacLellan, Jay A; Watson, David J; Lynch, Timothy P; Antonio, Cheryl L; Birchall, Alan; Anderson, Kevin K; Zharov, Peter A

    2012-04-01

    In making low-level radioactivity measurements of populations, it is commonly observed that a substantial portion of net results is negative. Furthermore, the observed variance of the measurement results arises from a combination of measurement uncertainty and population variability. This paper presents a method for disaggregating measurement uncertainty from population variability to produce a probability density function (PDF) of possibly true results. To do this, simple, justifiable and reasonable assumptions are made about the relationship of the measurements to the measurands (the 'true values'). The measurements are assumed to be unbiased, that is, that their average value is the average of the measurands. Using traditional estimates of each measurement's uncertainty, a likelihood PDF for each individual's measurand is produced. Then using the same assumptions and all the data from the population of individuals, a prior PDF of measurands for the population is produced. The prior PDF is non-negative, and the average is equal to the average of the measurement results for the population. Using Bayes's theorem, posterior PDFs of each individual measurand are calculated. The uncertainty in these bayesian posterior PDFs appears to be all Berkson with no remaining classical component. The method is applied to baseline bioassay data from the Hanford site. The data include (90)Sr urinalysis measurements of 128 people, (137)Cs in vivo measurements of 5337 people and (239)Pu urinalysis measurements of 3270 people. The method produces excellent results for the (90)Sr and (137)Cs measurements, since there are non-zero concentrations of these global fallout radionuclides in people who have not been occupationally exposed. The method does not work for the (239)Pu measurements in non-occupationally exposed people because the population average is essentially zero relative to the sensitivity of the measurement technique. The method is shown to give results similar to

  4. Comparison of Surgical Blade and Cryosurgery with Liquid Nitrogen Techniques in Treatment of Physiologic Gingival Pigmentation: Short Term Results

    Directory of Open Access Journals (Sweden)

    Saeed Rahmati

    2014-12-01

    Full Text Available Statement of the Problem: Melanin pigmentation of the gingiva is a crucial esthetic problem. A variety of methods have been used for gingival depigmentation. Purpose: The purpose of this study was to compare the results of two treatment modalities: scalpel technique and cryotherapy with liquid nitrogen in treatment of gingival pigmentation. Materials and Method: Twenty patients with chief complaint of gingival pigmentation participated in our study. 10 patients were treated with cryotherapy and remaining 10 participants were undergone the scalpel technique surgery. We evaluated acquiescence and comfort of the patients, degree of depigmentation, based on the area of pigmentation shown by gridlines option in Microsoft Paint software, and the presence or absence of gingival recession before and one month after treatment. Data was analyzed using Mann-Whitney and Chi-Square tests. A significance level of p≤ 0.05 was adopted. Results: Mean value and standard deviation of depigmentation for group A and group B was 96.17±2.51 and 95±2.48, respectively. The difference was not statistically significant (p= 0.225. There was no association between the treatment modality and the gingival recession (p= 0.303 or the treatment modality and the patient satisfaction (p= 0.346. No significant difference was found between gingival recession measures before and after the operation in the two treatment modalities. Conclusion: Surgical blade and cryosurgery with liquid nitrogen had no significant difference in treatment of physiologic gingival pigmentation. Both Techniques are acceptable in the treatment of gingival pigmentation.

  5. Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital

    Directory of Open Access Journals (Sweden)

    Lasse Skovgaard

    2010-12-01

    Full Text Available Introduction: More than 50% of the People with Multiple Sclerosis (PwMS in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that there is no dialogue, coordination or synergy between the parallel courses of treatment offered. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. Materials and methods: Empirical material consist of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS hospital that provided the organisational framework for the project, interviews with patients as well as written responses from participating treatment providers in connection with practitioner-researcher seminars held. Results: Collaboration between researchers and the treatment team resulted in the development examination of several models which describe the strengths and weaknesses of various types of collaboration. The models also show that the various types of collaboration place different requirements on the degree of 1 mutual acknowledgement and understanding among practitioners, 2 flexibility and resources in the organizational framework, and 3 patients' activities and own efforts, respectively.    Perspectives: The relationship between integration and pluralism can contribute to a fruitful discussion in regards to the value of treatment collaboration. In addition to the many positive perspectives the characterise integration of different treatment modalities the project points to the importance of not overlooking the opportunities, values and potential inherent in a pluralistic ideal in the form of patients' own active efforts and the dynamism that can arise when the patient becomes a co-informant, co-coordinator and/or co-integrator.

  6. Types of treatment collaboration between conventional and alternative practitioners – results from a research project at a Danish MS hospital

    Directory of Open Access Journals (Sweden)

    Lasse Skovgaard

    2010-12-01

    Full Text Available Introduction: More than 50% of the People with Multiple Sclerosis (PwMS in Denmark use alternative treatment. Most of them combine alternative and conventional treatment, but PwMS often find that there is no dialogue, coordination or synergy between the parallel courses of treatment offered. For this reason the Danish Multiple Sclerosis Society conducted a research project to develop and examine different models for collaboration between conventional and alternative treatment providers. Materials and methods: Empirical material consist of individual interviews with practitioners, a group interview with practitioners, a group interview with professional staff at the Danish MS hospital that provided the organisational framework for the project, interviews with patients as well as written responses from participating treatment providers in connection with practitioner-researcher seminars held. Results: Collaboration between researchers and the treatment team resulted in the development examination of several models which describe the strengths and weaknesses of various types of c