Judge grants partial relief

2019 ◽  
Vol 24 (8) ◽  
pp. 13-13
Keyword(s):  

2018 ◽  
Vol 15 (9) ◽  
pp. 11-11
Keyword(s):  




2020 ◽  
Author(s):  
Cordula Schippert ◽  
Yvonne Witte ◽  
Janina Bartels ◽  
Guillermo-José Garcia-Rocha ◽  
Matthias Jentschke ◽  
...  

Abstract Background: Endometriosis can be associated with considerable pain and sterility. After surgical excision of moderate or severe endometriosis lesions, the rate of recurrence reaches up to 67%. The objective of this retrospective study was to establish the recurrence and pregnancy rates following surgical resection of stage III/IV endometriosis lesions. Indications for operation were endometriosis symptoms, sonographic findings and/or infertility. Methods : A total of 456 patients who underwent stage III/IV endometriosis surgery between 2004 and 2014 were sent a questionnaire relating to their postoperative medical treatment, pregnancies, relief of symptoms and recurrence. Responses of 206 patients (45.2%) and their clinical data were analysed for this study. Results : A total of 66.5% (N=137) of patients had stage III disease, and 33.5% (N=69) had stage IV disease. The average age was 37 years (17-59). A total of 63.1% (N=130) of surgeries were performed by laparoscopy, 21.8% (N=45) were performed by laparotomy and 15% (N=31) were performed by conversion. Complete resection of endometriosis lesions was achieved in 90.8% of patients (N=187). After surgery, 48.5% (N=100) of the women did not receive hormonal treatment; the main reason was the desire for children in 53%. Complete or partial relief in complaints was achieved in 93.2% (N=192). The rate of recurrence was 21.8% (N=45). The statistically significant factors that was associated with a higher risk to develop recurrence was an age <35 (p<0.005).After surgery, 65.8% (79/120) of patients who wished to have children became pregnant. There was a statistically significant association among a higher postoperative pregnancy rate and age <35 (p<0.003) in multivariante logistic regression analysis and laparoscopic surgical access in univariante logistic regression analysis (p<0.01). Conclusion: We assessed the high percentage of complete or partial relief of symptoms of 93.2%, the high postoperative pregnancy rate of 65.8% and the low rate of recurrence of 21.8% compared to international literature to be very encouraging for women suffering from moderate and severe endometriosis. Though laparoscopy is considered the ´gold standard` of endometriosis surgery, laparotomy still may be indicated in patients with extensive endometriosis especially to preserve reproductive function.



1979 ◽  
Vol 7 (2) ◽  
pp. 121-135 ◽  
Author(s):  
M. J. Cousins ◽  
T. S. Reeve ◽  
C. J. Glynn ◽  
J. A. Walsh ◽  
D. A. Cherry

In an objective evaluation, 386 patients with rest pain due to occlusive vascular disease were studied before and after neurolytic lumbar sympathectomy by either 100% alcohol (n = 35), 6% phenol in water (n = 151) or 10% phenol in Conray 420 contrast medium (n = 200). A trained independent observer made assessments of:— (a) Completeness and duration of sympathetic ablation; (b) Degree and duration of pain relief; (c) Changes in skin temperature and skin plethysmography; (d) Completeness of coverage of antero-lateral aspects of L2, L3, and L4, by contrast medium (in patients receiving 10% phenol). (e) Side effects, including L1 neuralgia and postural hypotension. Mean duration of sweat test modification (6.0 ± 1.0 months) and pain relief (5.9 ± 0.6 months) were similar; onset of pain relief also coincided with onset of sympathetic blockade and increase in skin blood flow. This strongly pointed to sympathetic denervation as the basis for the relief of rest pain rather than a placebo response. Complete pain relief was achieved in 49% of patients, 31% had partial relief and 20% none. In the absence of pre-existing gangrenous changes a higher percentage of patients had complete or partial relief (84%) compared to those with gangrenous changes (56%). Significant postural hypotension was not observed. Frequency of L, neuralgia differed markedly for the three agents: 100% alcohol > 6% phenol in water > 10% phenol in Conray. It is concluded that neurolytic lumbar sympathectomy is an effective method of relief of rest pain with the advantage over surgical sympathectomy of performance without general anaesthesia on an outpatient basis. It is estimated that, in a series of the size reported in this paper, the potential economic benefit could be a saving of the order of $360,000. The technique deserves further controlled evaluation in comparison to surgical sympathectomy.



1998 ◽  
Vol 173 (S35) ◽  
pp. 79-90 ◽  
Author(s):  
M. A. Jenike

Background Case reports suggest that neurosurgical operations can improve symptoms in patients with severe treatment-refractory obsessive-compulsive disorder (OCD). However, it is unclear which procedure is best and which may produce the most side-effects.Method I review the literature on the efficacy and complications of four frequently used neurosurgical procedures (cingulotomy, capsulotomy, limbic leucotomy and subcaudate tractotomy) that are used to treat refractory OCD.Results Since the vast majority of patients who underwent surgery were severely and chronically disabled, it is likely that these procedures were of assistance in alleviating some of their symptoms. It is currently impossible to determine which surgical procedure is the best for a particular patient.Conclusions Despite a lack of controlled data and inconsistencies in the literature, it appears that when nonsurgical treatments have failed to improve OCD symptoms significantly in severely ill patients, at least partial relief can be obtained by some people with OCD by neurosurgery Results of cumulative studies strongly support the need for continued research in this area.



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