Prospective evaluation of paravaginal defect repair with and without apical suspension: a 6-month postoperative follow-up with MRI, clinical examination, and questionnaires

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

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Comparison of treatment outcomes for native tissue repair and sacrocolpopexy as apical suspension procedures at the time of hysterectomy for uterine prolapse

Scientific Reports ◽

10.1038/s41598-021-82732-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sumin Oh ◽

E. Kyung Shin ◽

Sowoon Hyun ◽

Myung Jae Jeon

Keyword(s):

Treatment Outcomes ◽

Tissue Repair ◽

Uterine Prolapse ◽

Reoperation Rate ◽

Complication Rates ◽

Native Tissue Repair ◽

Apical Suspension ◽

Native Tissue ◽

Surgical Failure

AbstractConcomitant apical suspension should be performed at the time of hysterectomy for uterine prolapse to reduce the risk of recurrent prolapse. Native tissue repair (NTR) and sacrocolpopexy (SCP) are commonly used apical suspension procedures; however, it remains unclear which one is preferred. This study aimed to compare the treatment outcomes of NTR and SCP in terms of surgical failure, complication and reoperation rates. Surgical failure was defined as the presence of vaginal bulge symptoms, any prolapse beyond the hymen, or retreatment for prolapse. This retrospective cohort study included 523 patients who had undergone NTR (n = 272) or SCP (n = 251) along with hysterectomy for uterine prolapse and who had at least 4-month follow-up visits. During the median 3-year follow-up period, the surgical failure rate was higher in the NTR group (21.3% vs 6.4%, P < 0.01), with a low rate of retreatment in both groups. Overall complication rates were similar, but complications requiring surgical correction under anesthesia were more common in the SCP group (7.2% vs 0.4%, P < 0.01). As a result, the total reoperation rate was significantly higher in the SCP group (8.0% vs 2.6%, P = 0.02). Taken together, NTR may be a preferred option for apical suspension when hysterectomy is performed for uterine prolapse.

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Laparoscopic sacrohysteropexy versus vaginal hysterectomy and apical suspension: 7-year follow-up of a randomized controlled trial

International Urogynecology Journal ◽

10.1007/s00192-021-04932-6 ◽

2021 ◽

Author(s):

Matthew L. Izett-Kay ◽

Philip Rahmanou ◽

Rufus J. Cartwright ◽

Natalia Price ◽

Simon R. Jackson

Keyword(s):

Vaginal Hysterectomy ◽

Uterine Prolapse ◽

Controlled Trial ◽

Apical Prolapse ◽

Apical Suspension ◽

Vaginal Length ◽

Patient Reported ◽

Laparoscopic Sacrohysteropexy ◽

Total Vaginal Length

Abstract Introduction and hypothesis Laparoscopic mesh sacrohysteropexy offers a uterine-sparing alternative to vaginal hysterectomy with apical suspension, although randomised comparative data are lacking. This study was aimed at comparing the long-term efficacy of laparoscopic mesh sacrohysteropexy and vaginal hysterectomy with apical suspension for the treatment of uterine prolapse. Methods A randomised controlled trial comparing laparoscopic mesh sacrohysteropexy and vaginal hysterectomy with apical suspension for the treatment of uterine prolapse was performed, with a minimum follow-up of 7 years. The primary outcome was reoperation for apical prolapse. Secondary outcomes included patient-reported mesh complications, Pelvic Organ Prolapse Quantification, Patient Global Impression of Improvement in prolapse symptoms and the International Consultation on Incontinence Questionnaire Vaginal Symptoms, Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and PISQ-12 questionnaires. Results A total of 101 women were randomised and 62 women attended for follow-up at a mean of 100 months postoperatively (range 84–119 months). None reported a mesh-associated complication. The risk of reoperation for apical prolapse was 17.2% following vaginal hysterectomy (VH) and 6.1% following laparoscopic mesh sacrohysteropexy (LSH; relative risk 0.34, 95% CI 0.07–1.68, p = 0.17). Laparoscopic sacrohysteropexy was associated with a statistically significantly higher apical suspension (POP-Q point C −5 vs −4.25, p = 0.02) and longer total vaginal length (9 cm vs 6 cm, p < 0.001). There was no difference in the change in ICIQ-VS scores between the two groups (ICIQ-VS change −22 vs −25, p = 0.59). Conclusion Laparoscopic sacrohysteropexy and vaginal hysterectomy with apical suspension have comparable reoperation rates and subjective outcomes. Potential advantages of laparoscopic sacrohysteropexy include a lower risk of apical reoperation, greater apical support and increased total vaginal length.

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Prospective Evaluation of Serum β-Glucan Testing in Patients With Probable or Proven Fungal Diseases

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw128 ◽

2016 ◽

Vol 3 (3) ◽

Cited By ~ 26

Author(s):

Cécile Angebault ◽

Fanny Lanternier ◽

Frédéric Dalle ◽

Cécile Schrimpf ◽

Anne-Laure Roupie ◽

...

Keyword(s):

Clinical Utility ◽

Clinical Suspicion ◽

Fungal Diseases ◽

Prospective Evaluation ◽

Invasive Fungal Diseases ◽

Undetectable Serum ◽

Antifungal Use ◽

Kinetics Of ◽

Rule Out

Abstract Background. Early diagnosis and treatment are crucial in invasive fungal diseases (IFD). Serum (1-3)-β-d-glucan (BG) is believed to be an early IFD marker, but its diagnostic performance has been ambiguous, with insufficient data regarding sensitivity at the time of IFD diagnosis (TOD) and according to outcome. Whether its clinical utility is equivalent for all types of IFD remains unknown. Methods. We included 143 patients with proven or probable IFD (49 invasive candidiasis, 45 invasive aspergillosis [IA], and 49 rare IFD) and analyzed serum BG (Fungitell) at TOD and during treatment. Results. (1-3)-β-d-glucan was undetectable at TOD in 36% and 48% of patients with candidemia and IA, respectively; there was no correlation between negative BG results at TOD and patients' characteristics, localization of infection, or prior antifungal use. Nevertheless, patients with candidemia due to Candida albicans were more likely to test positive for BG at TOD (odds ratio = 25.4, P = .01) than patients infected with other Candida species. In 70% of the patients with a follow-up, BG negativation occurred in >1 month for candidemia and >3 months for IA. A slower BG decrease in patients with candidemia was associated with deep-seated localizations (P = .04). Thirty-nine percent of patients with rare IFD had undetectable BG at TOD; nonetheless, all patients with chronic subcutaneous IFD tested positive at TOD. Conclusions. Undetectable serum BG does not rule out an early IFD, when the clinical suspicion is high. After IFD diagnostic, kinetics of serum BG are difficult to relate to clinical outcome.

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B-PO04-064 A PROSPECTIVE EVALUATION OF SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR INFECTIONS WITH MID TERM FOLLOW-UP

Heart Rhythm ◽

10.1016/j.hrthm.2021.06.760 ◽

2021 ◽

Vol 18 (8) ◽

pp. S304-S305

Author(s):

Michael R. Gold ◽

Mark P. Miller ◽

Johan D. Aasbo ◽

Raul Weiss ◽

Martin C. Burke ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Prospective Evaluation ◽

Cardioverter Defibrillator

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Significance of SCIWORA in adults

Coluna/Columna ◽

10.1590/s1808-1851201514020r130 ◽

2015 ◽

Vol 14 (2) ◽

pp. 134-137

Author(s):

Pedro Luis Bazán

Keyword(s):

Japanese Orthopaedic Association ◽

Prospective Evaluation ◽

Resonance Imaging ◽

Adult Age ◽

Intramedullary Lesion ◽

Central Cord Syndrome ◽

Asia Score ◽

The Relationship ◽

Cervical Arthrosis

<sec><title>OBJECTIVE:</title> Recognizing the importance of SCIWORA in adult age; analyze the usefulness of complementary studies; evaluating therapeutic options; learn about the evolution of the treated patients.</sec><sec><title>METHODS:</title> A prospective evaluation with a minimum follow-up of 5 years, eight elderly patients with cervical arthrosis and diagnosis of SCIWORA. The Japanese Orthopaedic Association (JOA) scale and ASIA were used on admission and at 6, 12, 24, 36, 48 and 60 months.</sec><sec><title>RESULTS:</title> The central cord syndrome (CCS) was the neurological condition at admission. One patient recovered after corticosteroid therapy, but later, his disability worsened, and he was operated at 18 months, another patient recovered and a third died. The other patients underwent laminoplasty in the first 72 hours; patients with partial severity condition had a minimum improvement of five points in JAO scale and those with severe conditions died.</sec><sec><title>CONCLUSIONS:</title> The low-energy trauma can decompensate the relationship between container and content in the spine with asymptomatic arthrosis, and can be devastating to the patient. The diagnosis of intramedullary lesion is made by magnetic resonance imaging. Patients with incomplete deficit undergoing laminoplasty reached at least one level in ASIA score. The potential postoperative complications can be serious.</sec>

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Prospective evaluation of a dorsal decompression and posterior dynamic flexion-limiting stabilization in patients with spinal stenosis and degenerative disk disease: Twelve-month follow-up

Bone ◽

10.1016/j.bone.2012.02.406 ◽

2012 ◽

Vol 50 ◽

pp. S132

Author(s):

T.R. Jansen⁎ ◽

R. Bornemann ◽

D.C. Wirtz ◽

R. Pflugmacher

Keyword(s):

Spinal Stenosis ◽

Prospective Evaluation ◽

Degenerative Disk Disease

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Case Report: a 5-Year Follow-up of Proximal Caries Lesion Diagnosis

Journal of Health Sciences ◽

10.17921/2447-8938.2018v20n3p158-163 ◽

2018 ◽

Vol 20 (3) ◽

pp. 158

Author(s):

Renata Espíndola Silveira ◽

Isabela Pereira Furtado ◽

Marco Aurélio Carvalho ◽

Lawrence Gonzaga Lopes ◽

João Batista Souza ◽

...

Keyword(s):

Dental Caries ◽

Clinical Examination ◽

Oral Hygiene ◽

Dietary Habits ◽

Treatment Plan ◽

Preventive Treatment ◽

Diagnostic Methods ◽

Carious Lesions ◽

Oral Hygiene Instructions

Abstract This clinical case was aimed at reporting and discussing diagnostic methods for early detection and preventive treatment of proximal carious lesions. The patient presented to the dental clinic seeking treatment of a problem she reported as being “dental caries”. The patient’s orthodontist diagnosed dental caries, by means of radiographic exam. There was no evidence of any proximal carious lesion in the intraoral examination. The bitewing radiographs presented a radiolucent area limited to enamel in the mesial of maxillary left-second-bicuspid. For the purpose of confirming the intraoral diagnosis, an immediate tooth separation was performed. The immediate separation was unable to provide sufficient access; thus, the slow separation approach was performed. After 24-hours, tooth separation of 1mm was obtained, providing enough access for clinical examination. The proximal areas were evaluated by transillumination and impression taking. During the visual inspection, an area of enamel staining was observed, with no roughness due to tactile inspection and the evaluation by transillumination and impression showed no cavitation. The following preventive treatment plan was endorsed: oral hygiene instructions with emphasis to the importance of flossing the proximal areas, and healthy dietary habits. After a 5-years period of follow-up, the enhanced oral hygiene and heathy dietary habits were observed. A clinical examination with immediate tooth separation and bitewing radiographs was performed and showed no cavitation. Thecombination of methods for detecting carious lesions in proximal surfaces was effective in obtaining a diagnosis of cariesin the permanent dentition. The absence of cavitated lesions must be indicative of preventive treatment.Keywords: Dental Caries. Preventive Dentistry. Diagnosis, Oral.ResumoEste caso clínico objetivou relatar e discutir os métodos diagnósticos para detecção e tratamento preventivo de lesões cariosas proximais. A paciente procurou atendimento restaurador com queixa de cárie diagnosticada por exame radiográfico realizado após término de seu tratamento ortodôntico. Ao exame clínico não havia suspeita de lesão cariosa. A avaliação radiográfica revelou, na face mesialdo dente 25, presença de área radiolúcida limitada à metade externa do esmalte. Para confirmação do diagnóstico realizou-se a separação interdentária imediata, porém como a mesma não permitiu adequada visualização foi realizada a separação mediata e após 24 horas obteve-se adequada separação (1 mm) para o exame clínico. Em seguida, a superfície proximal foi avaliada por transiluminação e moldagem. Durante a inspeção visual foi constatada área de manchamento do esmalte, com ausência de rugosidade pela inspeção tátil e a avaliação tanto por transiluminação da superfície proximal, quanto por moldagem revelou ausência de cavitação. Devido o diagnóstico obtido o seguinte tratamento preventivo foi indicado: reforço de higiene oral com ênfase na importância do uso do fio dental e hábitos dietéticos saudáveis. Após 5 anos de acompanhamento melhoria da higiene oral e hábitos dietéticos foram constatados. O exame clínico com separação interdentária imediata e exame radiográfico revelaram ausência de cavitação. Conclui-se que a combinação de métodos de detecção de lesões cariosas proximais foi efetivo no diagnóstico da cárie dentária na dentição permanente. O resultado deste relato de caso mostrou que a ausência de lesões cariosas cavitadas deve ser um indicativo de tratamento preventivo.Palavras-chave: Cárie Dentária. Odontologia Preventiva. Diagnóstico Bucal.

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Hammer-Chisel Technique in Endoscopic Dacryocystorhinostomy

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940311200511 ◽

2003 ◽

Vol 112 (5) ◽

pp. 444-449 ◽

Cited By ~ 13

Author(s):

Yasar Cokkeser ◽

Mustafa Tercan ◽

Cem Evereklioglu ◽

Ibrahim F. Hepsen

Keyword(s):

Postoperative Complications ◽

Success Rate ◽

External Approach ◽

Prospective Evaluation ◽

Lacrimal Sac ◽

Successful Completion ◽

Patients Âgés ◽

Minimal Morbidity ◽

Patient Tolerance

We performed a prospective evaluation of endoscopic hammer-chisel dacryocystorhinostomy (DCR) procedures on 62 eyes of 44 patients (40 female and 4 male) with chronic epiphora or dacryocystitis (26 unilateral and 18 bilateral). The technique included chisel removal of bone over the lacrimal sac. The follow-up period was 12 to 54 months (mean, 28 months), and the patients' ages ranged from 17 to 67 years (mean, 35.5 years). The success rate of the consecutive endoscopic hammer-chisel DCR procedures was 87%. During operation, 8 patients had mild mucosal hemorrhage, which did not prevent the successful completion of the operation. Excellent patient tolerance was observed, with minimal morbidity and no major complications. As compared to the external approach, endoscopic hammer-chisel DCR is less traumatic, is less time-consuming, and is practical and cosmetically convenient, with minimal perioperative and postoperative complications. It also allows the simultaneous correction of any intranasal disease. It requires minimal instrumentation and is a relatively easy and fast technique.

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