scholarly journals Human amniotic membrane: an improvement in the treatment of Medication-related osteonecrosis of the jaw (MRONJ)? A case–control study

2021 ◽  
Author(s):  
Mirko Ragazzo ◽  
Matteo Val ◽  
Giulia Montagner ◽  
Diletta Trojan ◽  
Stefano Fusetti ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Amniotic Membrane ◽  
Osteonecrosis Of The Jaw ◽  
Case Control ◽  
Human Amniotic Membrane ◽  
Surgical Wound ◽  
Resective Surgery ◽  
Significant Difference ◽  
Group A ◽  
Group B

AbstractThe aim of this article is to report the results obtained by the use of HAM in surgical wound healing and the reduction of relapse in patients affected by Medication-related osteonecrosis of the jaw (MRONJ).The study involved patients with the diagnosis of MRONJ, surgically treated between October 2016 and April 2019, in a case–control setting. Enrolled patients were randomly divided into 2 groups. One group will be treated with resective surgery and with the insertion of HAM patch (Group A), while the second group had been treated exclusively with resective surgery (Group B).The patients underwent MRONJ surgical treatment with the placement of amniotic membrane patches at the wound site. Data regarding the long-term complications/functions were evaluated at 3, 6, 12, and 24 months after surgery. Pain measurements were performed before the intervention (T0), 7(T1) and 30(T2) days after surgery. 49 patients were included in the study. 2 patients of GROUP A after 30 days since they were surgically treated showed persistent bone exposure. 5 patients of group B demonstrated a lack of healing of the surgical wound with the persistence of bone exposed to 30 days after surgery. Statistical analysis ruled out any difference in OUTCOME (relapse) between GROUP A and B (p = 0.23). However, the Fisher test highlighted a significant difference between the use of HAM and only surgical treatment in pain at rest (p = 0.032). The use of amniotic membrane implement the patient's quality of life and reduce pain perception. has a learning curve that is fast enough to justify its routine use.

scholarly journals Amniotic Membrane Transplantation in the Treatment of Primary Pterygium: A Comparative Study of Two Techniques

2014 ◽  
Vol 48 (1) ◽  
pp. 1-7
Author(s):  
Reema Bansal ◽  
R Sehgal
Keyword(s):  
Comparative Study ◽  
Amniotic Membrane ◽  
Free Edge ◽  
Amniotic Membrane Transplantation ◽  
Human Amniotic Membrane ◽  
Purse String ◽  
Group A ◽  
End To End ◽  
Group B ◽  
Primary Pterygium

ABSTRACT Purpose To compare two techniques of human amniotic membrane transplantation (AMT) following pterygium excision: (1) end to end suturing of the amniotic membrane graft (AMG) with the conjunctiva versus (2) a new technique of purse-string suturing of the AMG and tucking of AMG under the free edge of conjunctiva. Materials and methods Pterygium surgery with human AMT was done in 42 eyes with primary pterygium. Twenty four eyes (group A) underwent end-to-end suturing of AMG with conjunctiva. Eighteen eyes (group B) underwent purse-string suturing of AMG with underlying sclera with free edge of AMG tucked under conjunctiva on three sides. The two groups were compared in terms of the outcome measures, i.e. complete epithelialization time of AMG and recurrence of pterygium within 1 year. Results The complete epithelialization of AMG occurred in 21 days (range 14 to 28 days) and 14 days (range 7 to 21 days) in groups A and B respectively. In group A, 7 eyes (29.17%) developed recurrence. In group B, 2 eyes (11.11%) developed recurrence. Conclusion Purse string suturing and tucking of AMG resulted in faster epithelization of AMG and lower recurrences in comparison with end to end suturing of AMG in the management of primary pterygium. How to cite this article Bansal R, Jain AK, Sehgal R. Amniotic Membrane Transplantation in the Treatment of Primary Pterygium: A Comparative Study of Two Techniques. J Postgrad Med Edu Res 2014;48(1):1-7.

Bisphosphonates and Osteonecrosis of the Jaw: Advantages of a New Schedule.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3590-3590
Author(s):  
Patrizia Zappasodi ◽  
Alessandro Corso ◽  
Marzia Varettoni ◽  
Catherine Klersy ◽  
Gianmatteo Pica ◽  
...  
Keyword(s):  
Median Time ◽  
Standard Treatment ◽  
Performance Status ◽  
Pathologic Fracture ◽  
Disease Status ◽  
Osteonecrosis Of The Jaw ◽  
Standard Group ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: Bisphosphonates (Bi) have been proven to be effective in preventing or delaying skeletal complications in multiple myeloma (MM) with a significant improvement of the quality of life. The 2002 ASCO guidelines indicate that once initiated intravenous Bi should be continued until an evident substantial decline of performance status. Recently, osteonecrosis of the jaw (ONJ) has been reported as complication of intravenous Bi treatment, with an incidence ranging between 6 and 13% and a greater occurrence in patients (pts) receiving zoledronic acid (Zol) than in those treated with pamidronate (Pam). Aim. In this retrospective study we evaluated the incidence of ONJ and of skeletal related events (SRE) in a cohort of MM pts divided in two groups according to the schedule of administration of Bi; group A: monthly administrations until tolerated (standard), group B: monthly administrations during the first year and then every 3 months (reduced). Methods: One hundred and six MM pts (M: 63, F: 43) were included in this study: 51 pts received a standard treatment (group A) and 55 a reduced schedule (group B). Pam 90 mg i.v. was administered as a three hour infusion and Zol 4 mg i.v. as a 15 minutes infusion. SRE was defined as: pathologic fracture, radiation to bone, spinal cord compression with vertebral fracture, hypercalcemia. Results: No difference was found between the two groups concerning pts characteristics at the onset: age, sex, extension of bone disease, status of the disease (progressive or responsive). Twenty pts received only Pam, 42 only Zol and 44 pts Pam followed by Zol. The distribution of the different type of Bi was not different in the two groups. ONJ occurred in 7 pts (6.6%) with a significant difference between the two groups: 6 pts in standard schedule (11.7%) and 1 in the reduced (1.8%), p=0.01, after a median time of 22.8 months in group A, and 37.8 months in the case of group B. Four of out 7 ONJ occurred during the second year of treatment (12–24 months): that period resulted significantly related (p=0.000) to the occurrence of ONJ with respect to the others (24–38 months, 40–100 months). All ONJ occurred in pts treated with Zol alone (5 pts) or with Zol after Pam (2 pts), whereas no cases were observed in Pam alone pts (p= 0.005). The median number of infusions was 20 with comparable results in the two groups (20 in group A, 19 in group B). SRE was observed in 38 pts (35.8%): 16 pts in group A and 22 pts in group B without statistical difference (p=0.6), after a median time of 9.8 months. Conclusions: These results suggest that the reduced schedule of Bi is associated with a significant lower incidence of ONJ and, although the sample size is limited, the appearance of ONJ seems delayed with respect to the standard treatment. Moreover, the incidence of SRE is similar in the two groups. In conclusion, the reduced schedule, could be applied in order to combine the antiresorptive efficacy of Bi with a higher safety and a better compliance.

scholarly journals The use of amniotic membrane in the repair of duodenal wounds in Wistar rats

2010 ◽  
Vol 25 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Luciano Rodrigues Schimidt ◽  
Edson José Cardoso ◽  
Rogério Rodrigues Schimidt ◽  
Luiz Augusto Back ◽  
Maria Beatriz Schiazawa ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Wistar Rats ◽  
Muscle Layer ◽  
Wall Structure ◽  
Duodenal Wall ◽  
Control Group ◽  
Human Amniotic Membrane ◽  
New Material ◽  
Group A ◽  
Group B

Purpose: In the search of a new material to repair duodenal wounds, a trial was conducted to assess the behavior of human amniotic membrane in the repair of the duodenal wall in rats. METHODS: Fifty Wistar rats weighing between 250 and 350g, male, were submitted to duodenotomy and randomly distributed into two groups. Group A (n=8) had no treatment and was used as the control group. In Group B (n=42) the duodenal wound was treated with a patch of human amniotic membrane. RESULTS: All animals in Group A died. In Group B no changes were observed with regards to death or the formation of duodenal fistula. All animals presented peritoneal adherences in the region on the duodenal wall repair and intestinal obstruction was observed in two animals. Healing of the duodenal wall in the region of the patch took place progressively as the post-operatory period increased, with regeneration of the mucosa and of the smooth muscle layer. CONCLUSION: From the clinical standpoint, the amniotic membrane proved to be a biological tissue which served as a temporary seal and allowed the wound to heal by second-intention, with re-establishment of the duodenal wall structure.

scholarly journals MEDICAL VS SURGICAL TREATMENT FOR SYMPTOMATIC ENLARGED INFERIOR TURBINATE: A COMPARATIVE STUDY

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S487-90
Author(s):  
Habib -Ur- Rehman ◽  
Fazal -I- Wahid ◽  
Bakht Zada ◽  
Muhammad Javaid ◽  
Naseem Ul Haq
Keyword(s):  
Surgical Treatment ◽  
Comparative Study ◽  
Sample Size ◽  
Sample Size Calculation ◽  
Inferior Turbinate ◽  
Nasal Patency ◽  
Female Ratio ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To determine the nasal patency after reducing the size of hypertrophied inferior turbinate with medication and surgery. Study Design: Prospective comparative study. Place and Duration of Study: Department of Ear, Nose, Throat, Head and Neck Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar Pakistan, from Jan to Dec 2019. Methodology: This study was conducted at the After-sample size calculation using an online sample size calculator (OpenEpi) and after obtaining informed consent patients were divided into two groups. Patients in group A were put on medicine only and in group B surgery was conducted to reduce the size of hypertrophied inferior turbinate. Data were analyzed using SPSS version 25 and p<0.05 was considered significant. Results: This study comprised of total 86 patients, in the age range 15-55 years with mean ± SD age 33.47 ± 9.57 years. Males were 47 (54.7%) and females were 39 (45.3%) with male to female ratio of 1.2:1. In group A, males were 22 (25.25%), females were 21 (24.41%), while in group B males were 25 (29.1%) and females were 18 (20.3%). There was no statistically significant difference in nasal patency between the two groups before treatment (p=0.59) and after 10 days of treatment (p=0.69). However, at the end of one month, there was a statistically significant difference in nasal patency between the medically treated and surgically treated groups of patients (p=0.023).Conclusion: Surgical treatment is significantly effective than medical treatment alone.

scholarly journals Use of the amniotic membrane to cover the peritoneal cavity in the reconstruction of the abdominal wall with polypropylene mesh in rats

2015 ◽  
Vol 42 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Rafael Calvão Barbuto ◽  
Ivana Duval de Araujo ◽  
Daniel de Oliveira Bonomi ◽  
Luciene Simões de Assis Tafuri ◽  
Antônio Calvão Neto ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Amniotic Membrane ◽  
Polypropylene Mesh ◽  
Control Group ◽  
Angiogenic Activity ◽  
Microscopic Evaluation ◽  
Significant Difference ◽  
Female Wistar Rats ◽  
Group A ◽  
Group B

OBJECTIVE: to evaluate the efficacy of the amniotic membrane used with polypropylene mesh against the formation of adhesions and its influence on healing. METHODS: twenty five female Wistar rats were anesthetized for creating a parietal defect in the anterior abdominal wall. Its correction was made with polypropylene mesh alone and associated with amniotic membrane. In the control group (n=11), the screen was inserted alone. In group A (n=7) we interposed the amniotic membrane between the screen and the abdominal wall. In group B, the amniotic membrane was placed on the mesh, covering it. After seven days, the animals were euthanized for macroscopic and microscopic evaluation of healing. RESULTS: adhesions were observed in all animals except one in the control group. Severe inflammation was observed in all animals in groups A and B and in three of the control group, with significant difference between them (A and B with p=0.01). Pronounced angiogenic activity was noted in one animal in the control group, six in group A and four in group B, with a significant difference between the control group and group A (p=0.002) and group B (p=0.05). The scar collagen was predominantly mature, except in five animals of the control group, with significant difference between the control group and group A (p=0.05) and group B (p=0.05). CONCLUSION: The amniotic membrane did not alter the formation of adhesions in the first postoperative week. There were also pronounced inflammation, high angiogenic activity and predominance of mature collagen fibers, regardless of the anatomical plane that it was inserted in.

scholarly journals Comparison of Shape Memory Staple and Gelled Platelet-Rich Plasma versus Shape Memory Staple alone for the Treatment of Waist Scaphoid Nonunion: A Single-Center Experience

Joints ◽  
2020 ◽  
Author(s):  
Rocco De Vitis ◽  
Marco Passiatore ◽  
Andrea Perna ◽  
Giulio Fioravanti Cinci ◽  
Giuseppe Taccardo
Keyword(s):  
Surgical Treatment ◽  
Shape Memory ◽  
Platelet Rich Plasma ◽  
Level Of Evidence ◽  
Single Center Experience ◽  
Upper Limb Function ◽  
Mayo Wrist Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Purpose The aim of this study was to analyze the results of two different methods of surgical treatment of waist scaphoid nonunions (SNUs). We retrospectively analyzed data from 87 patients referred to our department from January 2010 to December 2017 who were surgically treated for waist SNU. Methods The mean period of time passed from trauma was 11.2 (±5.6) months. Patients were divided into two groups based on surgical treatment received: volar exposure osteosynthesis with shape memory staple (SMS) (group A) and volar exposure osteosynthesis with SMS and gelled platelet-rich plasma (GPRP) application at the bone defect level (group B). A cast (thumb excluded) was maintained for 4 weeks. Healing was checked clinically (pain, QuickDASH [Disabilities of the Arm, Shoulder, and Hand] score, Mayo Wrist Score) and radiologically (standard X-ray). Results Union was achieved in 40 patients in group A (95.2%) and in all patients in group B (45 patients; 100%). A statistically significant difference was observed in the improvement of the Mayo Wrist Score, QuickDASH score, and pain (measured through the visual analog scale) after 3 months from surgery (p = 0.02). Conclusion SMS is effective in treating waist SNU at more than 6 months from trauma. GPRP application can improve bone healing and upper limb function. Level of Evidence This is a retrospective observational Level III study.

scholarly journals Effectiveness and Safety of Trabeculectomy along with Amniotic Membrane Transplantation on Glaucoma: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Tian-yi Shen ◽  
Wei-nan Hu ◽  
Wen-ting Cai ◽  
Hui-zi Jin ◽  
Dong-hui Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Amniotic Membrane ◽  
Cochrane Library ◽  
Amniotic Membrane Transplantation ◽  
Control Group ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Cochrane Library ◽  
And Control

Purpose. To determine the effectiveness and safety of trabeculectomy along with amniotic membrane transplantation (AMT) for glaucoma. Methods. This systematic review was performed using RevMan 5.3. We searched PubMed, EMBASE, and the Cochrane Library and included studies published until September 2019. The treatment group included patients with AMT and trabeculectomy (group A), and the control group had only trabeculectomy (group B). We only included randomized controlled trials. The outcomes were intraocular pressure (IOP), complete success rate, number of antiglaucoma medications, and complications. Results. Five studies, including 174 eyes (87 eyes in the AMT group and 87 eyes in the control group), were eligible in this review. The parameters had no significant difference in heterogeneity between the AMT and control groups preoperatively. In the AMT group, the mean IOP was significantly lower at 3 and 12 months after operation (P < 0.0001 and P = 0.02, respectively), while the number of complete successes in the AMT group was significantly higher at 6 and 12 months (P = 0.02 and P = 0.003, respectively) compared with the control group. Complications, including a flat anterior chamber and hyphema, appeared to be decreased in the AMT group compared to the control group (P = 0.02 and P = 0.02, respectively). No differences were observed in the number of antiglaucoma medications, hypotony, encapsulated bleb, or choroidal detachment. Conclusion. Compared with only trabeculectomy, it is more efficient and safer to add AMT to trabeculectomy during glaucoma filtering surgery.

Reinforcement of the Flexor Tendon Repair Using Human Amniotic Membrane

2016 ◽  
Vol 106 (5) ◽  
pp. 319-322 ◽  
Author(s):  
Yunus Dogramaci ◽  
Ibrahim Gökhan Duman
Keyword(s):  
Amniotic Membrane ◽  
Mechanical Performance ◽  
Testing Machine ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Human Amniotic Membrane ◽  
Load To Failure ◽  
Group A ◽  
Group B ◽  
Flexor Digitorum

Background: Human amniotic membrane is used to prevent peritendinous adhesions after tendon injuries. This study compares the mechanical properties of modified Kessler repairs and modified Kessler repairs strengthened using multiple layers of human amniotic membrane. Methods: Twenty flexor digitorum profundus tendons of sheep forelimbs were sutured by the two-strand modified Kessler technique (group A) and by the two-strand modified Kessler repair reinforced with multiple layers of human amniotic membrane (group B). To assess the mechanical performance of the repairs, tendons were subjected to a linear noncyclic load-to-failure test using a material testing machine. Outcome measures included ultimate forces and the mode of failure. Results: The mean ± SD value of the failure strength was 34.6 ± 1.64 N for group A and 50.6 ± 5.60 N for group B. The reinforced repair provided a significantly higher ultimate load compared with the nonreinforced group (P &lt; .001). All of the specimens failed due to suture breakage at the repair site. Conclusions: The results of this study show that the modified Kessler repair can be reinforced effectively with human amniotic membrane.

scholarly journals Prevalence of Wound Infection in Patients Undergoing Elective or Emergency Abdominal Surgery

2021 ◽  
Vol 15 (7) ◽  
pp. 1697-1699
Author(s):  
Arshid Mahmood ◽  
Aqeel Ahmad ◽  
Muhammad Hammad Muzaffar ◽  
Sarfraz Ahmad
Keyword(s):  
Wound Infection ◽  
Elective Surgery ◽  
Surgical Wound Infection ◽  
Emergency Laparotomy ◽  
Surgical Wound ◽  
Surgical Infection ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Intra Abdominal Infection

Objective: To compare the surgical wound infection in patients undergoing elective or emergency abdominal surgeries. Study Design: Comparative study Place & Duration of Study: Study was conducted at surgery department of Divisional Headquarter Teaching hospital Mirpur Azad Kashmir for eighteen months duration from June 2019 to November 2020. Materials and Methods: 150 patients of both genders with ages 15 to 65 years who received laparotomy treatment due to intra-abdominal infection or complicated appendicitis were included in this study. Patient’s medical history, age, sex and residency were recorded after taking informed consent. All the patients were divided into two groups, Group A contained 75 patients (Elective) and Group B contains 75 patients (emergency) received laparotomy. Deep surgical wound infection was examined at the 7th day after surgery and compared between both groups. Results: Ninety eight (65.3%) patients 49 in each group were males and 52 (34.7%) patients 26 in each group were females. In Group A and B 27 and 29 patients were ages 15 to 30 years, 33 and 31 patients had ages 36 to 45 years, 15 and 15 patients were ages between 46 to 60 years. 10 (13.3%) patients in Group A and 12 (16%) patients in group B had deep surgical infection within 1 week after surgery. Statistically there is no significant difference between the both groups (p>0.356) Conclusion: It is concluded that the frequency of wound infection was high in emergency abdominal surgeries as compared to patients undergoing elective surgery, but the difference was not statistically significant. Keywords: Emergency laparotomy, Deep surgical site infection, PO Drain placement

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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