scholarly journals Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

Author(s):  
Lars Aksel Pedersen ◽  
S. Dölvik ◽  
K. Holmberg ◽  
C. Ahlström Emanuelsson ◽  
H. Johansson ◽  
...  

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tilahun Fufa Debela ◽  
Zerihun Asefa Hordofa ◽  
Aster Berhe Aregawi ◽  
Demisew Amenu Sori

Abstract Background The consequences of obstetric fistula on affected women are more than the medical condition. It has extensive physical, psychological, social, and economic consequences on them. Obstetric fistula affects the entire health and entire life of women. Women suffering from obstetric fistula are often abandoned by her partner, relatives, and the community. This study aimed to determine the quality of life of obstetrics fistula patients before and after surgical repair. Methods Institutional-based prospective, before and after study design was conducted in the Jimma University Medical Center from November 1, 2019–October 30, 2020. A face-to-face interview was conducted with fistula patients who visited Jimma University Medical center, fistula clinic during the study period. All fistula patients were included in the study. Accordingly, 78 women who underwent surgical repair were interviewed. The means and the standard deviation were computed using conventional statistics formulas. The unpaired t-test was used to compare two independent means, and one-way analysis of variance (ANOVA) was used to compare the quality of life before repair and after a successful repair. Linear regression analysis was done for identifying determinants of quality of life. A P value of 0.05 will be considered statistical significance. Result The overall quality of life of women was 58.17 ± 7.2 before the surgical repair and 71.20 ± 10.79 after surgical repair. The result indicates there is a significant difference in the mean value of pre and post-operative (P < 0.001). The overall satisfaction of women with their health status before the surgical repair was 22.5 ± 1.30and it has increased to 53.0 ± .90after surgical repair. The physical health dimension score was 16.51 ± 5.27 before the surgical repair while it has increased to 21.77 ± 5.38 after the surgical repair. The score of the social domain before the surgical repair was 5.19 ± 1.34 and it has increased to 7.13 ± 3.67 after the surgical repair. The score of the environmental health domain was 17.41 ± 2.89 before the surgery while it also increased to 21.65 ± 4.04 after the surgical repair. The results have shown there was a significant difference in the mean values of pre and post-operatives in both social and environmental scores (P < 0.001). The score of the psychological health domain before the surgery was 19.06 ± 1.46 and it was increased to 19.84 ± 3.21 after the surgical repair. The result showed there is a significant difference in mean value pre and post-operative (P = 0.048), though it is a slight improvement compared to other domains. Conclusion The overall quality of life of the patient with fistula was improved after successful surgical repair. Although all domains of quality of life had shown significant improvement after successful surgical repair, the psychological domain showed slight improvement.


1974 ◽  
Vol 77 (2) ◽  
pp. 401-407 ◽  
Author(s):  
J. A. Mahoudeau ◽  
A. Delassalle ◽  
H. Bricaire

ABSTRACT Plasma levels of testosterone (T) and 5α-dihydrotestosterone (DHT) were determined by radioimmunoassay in 29 patients with benign prostatic hypertrophy (BPH) and in 56 control men of various ages. No significant difference was found in T, DHT nor DHT/T ratio between BPH and control subjects of similar age. Plasma DHT was higher in the prostatic than in the peripheral veins in 8/9 patients with BPH during laparotomy, indicating a prostatic secretion of DHT. No difference in the mean T nor the mean DHT was found in peripheral plasma before and after adenomectomy.


2013 ◽  
Vol 24 (5) ◽  
pp. 482-486 ◽  
Author(s):  
Marili Doro Andrade Deonizio ◽  
Gilson Blitzkow Sydney ◽  
Antonio Batista ◽  
Roberto Pontarolo ◽  
Paulo Ricardo Bittencourt Guimarães ◽  
...  

This study evaluated the influence of apical patency, root filling removal technique and cleaning of the apical foramen, concerning the amount of debris extruded during root canal retreatment. Forty mandibular incisors were randomly assigned to 4 groups - GIM (n=10), GIIM (n=10), GIPT (n=10) and GIIPT (n=10), which were named according to leaving (I) or not (II) apical patency during canal preparation and filling removal technique (manual - M or ProTaper system - PT). After filling material removal, each specimen of each group had the apical foramen cleaned by sizes 15, 20 and 25 instruments, generating 12 subgroups: GIM15, GIM20, GIM25, GIIM15, GIIM20, GIIM25, GIPT15, GIPT20, GIPT25, GIIPT15, GIIPT20 and GIIPT25. Extruded filling debris was collected by a Milipore filtration system, an HV-durapore, 0.45 µm pore filter with a 25 mm diameter. The filters were weighed before and after the collection on an analytical scale (10–5 g), and the difference was calculated. The mean weight of extruded filling debris was analyzed statistically by Kruskal-Wallis and Friedman ANOVA tests (α=0.05). The mean values found in the groups (in mg) were: GIM (0.95±0.94), GIIM (0.47±0.62), GIPT (0.30±0.31) and GIIPT (0.32±0.44). There was no statistically significant difference among any of the groups or subgroups (p>0.05). ProTaper provided the smallest amount of extruded filling material, regardless of presence or absence of apical patency, followed by manual technique, without and with apical patency. Additional amounts of debris were collected during cleaning of the apical foramen, regardless of the instrument, presence/absence of patency or root filling removal technique.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poletto ◽  
G Perri ◽  
F Malacarne ◽  
B Bianchet ◽  
A Doimo ◽  
...  

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.


2018 ◽  
Vol 21 (4) ◽  
pp. 447-455
Author(s):  
Sirlei Ricarte Bento ◽  
Ana Carolina Ottaviani ◽  
Allan Gustavo Brigola ◽  
Vânia Paula de Almeida Neris ◽  
Fabiana de Souza Orlandi ◽  
...  

Abstract Objective :to evaluate the presence of depressive symptoms and cognitive disorders before and after an intervention program with a digital therapeutic game among elderly persons undergoing hemodialysis. Method: a quasi-experimental study was carried out with 26 elderly patients on hemodialysis. For the data collection, a questionnaire relating to sociodemographic and health conditions, the Geriatric Depression Scale - 15 items and Addenbrooke’s Cognitive Examination Revised were used. The intervention with the digital therapeutic game was performed over 5 sessions. Results: of the participants, 80.8% were male, with a mean age of 66.7 (± 5.8) years. The mean pre-intervention depressive symptom score was 3.9 (± 3.0) while post-intervention it was 2.8 (± 2.9), representing a statistically significant difference (p = 0.005). Regarding cognitive function, there was no statistically significant difference before and after the intervention. There was a statistically significant difference in the mean of the depressive symptom scores, which were lower after the intervention. In addition, there was no statistically significant difference in the mean of the cognitive assessments. Conclusion: intervention studies with patients undergoing hemodialysis treatment are still scarce and this study describes the positive results of an intervention with a digital therapeutic game, demonstrating improvement in the depressive symptoms of the participants.


2020 ◽  
pp. 112067212096345
Author(s):  
Marco Lupidi ◽  
Ramkailash Gujar ◽  
Alessio Cerquaglia ◽  
Jay Chhablani ◽  
Daniela Fruttini ◽  
...  

Purpose: To quantitatively assess retinal neovascularizations (RNVs) in proliferative diabetic retinopathy (PDR) before and after photocoagulative laser treatment (PLT) using Optical Coherence Tomography Angiography (OCT-A). Methods: Consecutive patients with PDR were examined with fluorescein angiography (FA) and OCT-A before and after PLT. Baseline and after-treatment FA images were quantitatively analyzed to assess both the RNVs area and leakage area. On OCT-A RNVs area, vascular perfusion density (VPD), vessel length density (VLD) and fractal dimension were computed. VPD of the full-retina OCT-A underneath the RNV was determined to evaluate potential laser-induced changes in vascular perfusion. Results: Fifteen eyes of 13 patients with PDR were enrolled. The mean area of the RNVs was 0.47 ± 0.50 mm2 in the baseline OCT-A and 0.32 ± 0.40 mm2 in the post-treatment assessment ( p = 0.0002). The mean RNV VPD of RNV was 2% ± 4% in pre-treatment and 1% ± 1% for the post-treatment ( p = 0.0001). The mean VLD of RNV was 7.26 ± 1.53 at baseline and 6.64 ± 1.65 in the post treatment ( p = 0.0002). A significant difference in terms of mean RNVs area and VPD reduction between eyes that needed additional treatment and those that did not (~40% vs ~20%; p < 0.05), was observed. Mean VPD of full-retinal thickness OCT-angiogram was 55% ± 10% for the pre-treatment and 53% ± 8% for the post treatment scan ( p = 0.02). Conclusion: The quantitative OCT-A assessment of laser-induced changes of RNVs can be a useful non-invasive approach for determining treatment efficacy. A reduction of RNVs area or VPD ⩾ 40% might reveal those eyes that won’t require additional treatment. Retinal perfusion impairment seemed to progress independently from the treatment.


2018 ◽  
Vol 4 (1) ◽  
pp. e000328 ◽  
Author(s):  
Carlos César Vassalo ◽  
Antônio Augusto Guimarães Barros ◽  
Lincoln Paiva Costa ◽  
Euler de Carvalho Guedes ◽  
Marco Antônio Percope de Andrade

PurposeTo evaluate the primary clinical outcomes of arthroscopic labral repair.MethodsAll patients who underwent arthroscopic repair of the acetabular labrum performed by a senior surgeon between October 2010 and December 2013 were invited to participate in this prospective study. Patients included were those who had a preoperative diagnosis of labral tears, a lateral centre edge greater than 25° and a labral tear believed to be suturable during the intraoperative evaluation. Patients with Tönnis grade 2 or grade 3 hip osteoarthritis and those who had undergone a previous hip surgery were excluded. All patients were evaluated using the modified Harris Hip Score (mHHS) during the final appointment before surgery, 4 months after surgery and at the final evaluation. Interviews were conducted by the senior surgeon.ResultsEighty-four patients (90 hips) underwent arthroscopic repair. The mean age was 44.2 years and the mean follow-up period was 43.0 months (minimum of 25 months and maximum of 59 months). The mean mHHS was 80.4 preoperatively, 95.0 at 4 months postoperatively and 96.6 at final evaluation. A statistically significant difference existed among these scores (p<0.001).ConclusionArthroscopic labral repair was associated with a clinically significant improvement in mHHS after short-term (4 months) and medium-term (43 months) follow-up.Level of evidenceLevel IV, therapeutic case series.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Moshkani Farahani ◽  
M Shirdel

Abstract Introduction With regular and long-term exercises, the heart undergoes changes that are called the adaptation of the heart in response to exercise or physiological changes, which contrasts with the pathological changes caused by hypertension and aortic valve stenosis. However, the exact effects of exercise on the structure and function of the heart depend on the type, intensity and duration of exercise, the amount of physical fitness, inheritance, and gender. Materials and Methods In this prospective clinical trial study, 40 subjects, including 20 in the endurance exercise group and 20 in the exercise group, were evaluated. Echocardiography was performed for all of these subjects before and after the exercises that was performed professionally for 8 weeks under the supervision of the trainer and the changes were recorded. The data were analyzed statistically by SPSS20 software. A significant level of 0.05 was considered. Results The mean ± standard deviation of the age was 20/80 ± 1/42 years. Significant decrease in mean RVSM was observed only in the strength group (P = 0.008). There was no significant difference in the endurance group . There was no significant difference between the two groups before the test in the mean TAPSE (P = 0.46). The mean of TAPSE in the endurance group was 0.22 ± 1.99 and in the strength group was 0.31 ± 1.95. There was no significant difference between the two groups (P 0.46). There was no significant difference between the two groups before the test in the mean E / e (P = 0.51). The mean E / e "in the endurance group was 0.47 ± 4.75 and in the strength group was 0.54 ± 5.50, and there was a significant difference between the two groups (P &lt;0.001). The mean SWDT in the endurance group was 0.12 ± 0.95 and in the strength group was 0.11 ± 1.06, and there was a significant difference between the two groups (P = 0.002). There was a significant increase in mean SWDT in the strength group after the test (P &lt;0.001) .There was a significant increase in mean PAP in the strength group (P = 0.007) . There was a significant increase in mean LV mass index in the strength group (P &lt;0.001),with no significant difference between the two groups in mean FAC. Conclusion It seems that any kind of strength and endurance exercise affects the performance status, however, strength exercises have more effects which causes RV dysfunction. All indexes measured changed within normal level except for PAP that had abnormal changes after endurance exercise .


Author(s):  
Simin Jahani ◽  
Fatemeh Salari ◽  
Nasrin Elahi ◽  
Bahman Cheraghian

Objective: Findings suggest dissatisfaction of half of the cancer patients regarding pain and anxiety management. This study aimed to determine the effect of reflexology on the intensity of pain and anxiety among patients with metastatic cancer hospitalized inadulthematology ward.  Methods: In this study, the samples were selected from adult hematology ward in Baghaei 2 hospital in Ahwaz, Iran, according to the inclusion criteria. They were then assigned into treatment and control groups. In the treatment group, reflexology protocol was performed following manual reflexology method by Fr Josef Eugster based on Ingham method on the patient’s bed. In the control group, sole touching was used as the placebo. Reflexology was performed for three days, 30 min per day. Spielberger questionnaire were provided to the samples and completed in the first and third days, and Spielberger questionnaire was provided to the samples and completed. The data obtained from this study were then analyzed by SPSS 20.Results: The two groups did not show a significant difference in terms of demographic characteristics (p>0.05). Based on the obtained results, it was found that in the test group, there was a significant difference between the mean intensity of pain before and after the treatment across all 3 days as well as the mean anxiety of the 1st and 3rd days (p<0.05). However, in the control group, there was no significant difference in terms of mean pain intensity before and after the treatment across 3 days (p>0.05). No significant difference was observed between the mean anxiety of the 1st and 3rd days either (p>0.05).Conclusion: Considering the findings of this research, it can be concluded that reflexology has a positive effect on mitigating the intensity of pain and anxiety in metastatic cancer patients. Therefore, it is recommended that nurses employed in cancer centers benefit from the findings of this research to further help patients with cancer. It is also suggested that further research be conducted on the effect of reflexology on the pain and anxiety of other patients.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1323-1323
Author(s):  
Loretta A. Williams ◽  
Xin S. Wang ◽  
Charles S. Cleeland ◽  
Gary Mobley ◽  
Sergio Giralt

Abstract Symptom burden (SB) is the combined impact of all disease- or therapy-related symptoms on one’s ability to function as one did before onset of disease or therapy. Clinician report of BMT toxicities is well described, but patient report of symptoms is not. Lack of understanding of symptoms and SB may result in failure to address symptoms and return patients to optimum functioning. The purpose of this study was to describe symptoms and SB in AML/MDS patients undergoing allogeneic BMT before and after neutrophil engraftment (first of 3 consecutive days ANC ≥ 500 cells/mm3). Methods: 30 patients with a mean age of 52.9 yrs (SD 9.6) rated 19 symptoms on a 0-10 scale twice weekly from baseline before the start of conditioning to 28 days post-BMT using the M. D. Anderson Symptom Inventory. Results: Patient/treatment characteristics are summarized in Table 1. Table 1: Patient/Treatment Characteristics n % Sex Male 17 56.7 Female 13 43.3 Conditioning Myeloablative 17 56.7 Non-myeloablative 13 43.3 Donor Related 13 43.3 Unrelated 17 56.7 Cell Source BM 13 43.3 PBSCs 17 56.7 Mean global symptom intensity (GSI) peaked at Day +11 post-BMT. The 7 most severe symptoms on Day +11 were pain, drowsiness, lack of appetite, dry mouth, mouth sores, physical weakness, and fatigue. Mean symptom intensity scores and SDs are reported in Table 2. Table 2: Mean Symptom Intensity Scores Symptom Baseline Day +11 Day +15 Day +29 Mean, SD Mean, SD Mean, SD Mean, SD GSI 1.32, 1.38 3.08, 1.74 2.72, 1.91 2.24, 1.59 Pain 1.80, 2.91 5.30, 2.68 3.52, 2.84 2.29, 2.45 Drowsiness 1.87, 2.50 5.20, 2.89 4.48, 3.00 3.75, 3.08 Lack of Appetite 1.10, 2.22 4.57, 3.18 4.14, 3.32 3.18, 2.88 Dry Mouth 0.87, 1.61 4.52, 3.21 3.97, 3.52 2.93, 3.21 Mouth Sores 0.03, 0.18 4.50, 3.95 2.93, 3.21 0.82, 2.06 Physical Weakness 2.03, 2.55 4.37, 2.86 3.83, 2.90 3.96, 2.76 Fatigue 3.00, 2.29 4.20, 2.57 4.41, 2.78 4.46, 2.82 There was a significant difference (t=−4.34, p&lt;.001) between the mean GSI at baseline and Day +11. Neutrophil engraftment occurred on average 13.7 days (SD=3.00) post-BMT. There was no significant difference (t=0.75, p=.455) in mean GSI from Day +11 to Day + 15, the first post-engraftment assessment. Mean GSI declined by Day +29, but the difference between the mean GSI on Day +11 and Day +29 was not significant (t=1.92, p=.060). At Day +15, only mean pain intensity had declined significantly (t=2.48, p=.016) from Day +11. At Day +29, mean pain and mouth sores intensity had declined significantly (t=4.46, p&lt;.001 and t=2.26, p=.031, respectively) from Day+11. Conclusion: Patients report various symptoms post-allogeneic BMT, with the most intense involving the upper GI tract, pain, fatigue, and weakness. After engraftment, pain intensity declines rapidly, GI symptoms decline more slowly, and fatigue and weakness do not decline. Figure Figure Most symptoms have not declined significantly a month post-BMT and patients remain burdened by symptoms. Clinicians should verify with patients the symptoms they are experiencing and intervene to control them. Further research is needed in SB and causative mechanisms of symptoms after BMT to improve treatment outcomes.


Sign in / Sign up

Export Citation Format

Share Document