A prospective comparative study of the role of CT and MRI-MRCP in the preoperative assessment of obstructive jaundice and their intraoperative corroboration

Objectives The aim of our study was to evaluate the role of flavonoids in the improvement of post-operative symptoms after endovenous thermal ablation (EVTA). Methods A prospective comparative study of 120 consecutive patients undergoing EVTA of the greater saphenous vein associated with phlebectomies was undertaken. Patients were grouped in those receiving micronized purified flavonoid fraction (MPFF- 60 patients) agent 500 mg Bid 7 days pre- and 30 days post- operatively (MPFF group) and those in the control group (60 patients) who did not. Demographics, intra-operative details, Clinical –Etiology- Anatomy- Pathophysiology (CEAP) clinical class, 10-cm Visual Analog Scale (VAS) for pain, Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Quality-of-Life Questionnaire (CΙVIQ-20) were recorded. Primary outcome was the postoperative pain assessement using the VAS scale and CIVIQ pain score. Secondary outcomes included assessement of VCSS and CΙVIQ-20 scores. Results There were no significant differences between the groups regarding demographics, clinical and procedural characteristics. Patients in MPFF group reported significantly lower VAS pain levels than control group at 7- (−3.6 ± 1.2 vs −2.7 ± 1.9, p < .0001) and 30- post-operative day (−4.9 ± 0.1 vs −4.2 ± 1, p < .0001). MPFF group also showed better outcome in terms of CIVIQ pain score at 7- (−3.7 ± 1.3 vs −3.5 ± 1.8, p = .008) and 30- post-operative day (−5.3. ± 1.1 vs −4.4 ± 1, p = .017). Both groups showed a significant improvement in VAS pain score (p = .047), global CIVIQ-20 (p = .009) and VCSS (p = .008) at 7- and 30-days post-operatively. Conclusions Administration of flavonoids in patients undergoing EVTA associated with phlebectomies reduces pain by a small amount during early postoperative period.

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Role of Ultrasonography in the Era of 3 Tesla MRCP: A Comparative Study in Obstructive Jaundice.

Asian Journal of Medical Radiological Research ◽

10.21276/ajmrr.2019.7.1.3 ◽

2019 ◽

Vol 7 (1) ◽

Author(s):

Vikram Patil ◽

◽

Sudha Kiran Das ◽

Dr Devkant ◽

Rudresh Hiremath ◽

...

Keyword(s):

Obstructive Jaundice ◽

Comparative Study ◽

3 Tesla

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MODIFICATION OF THE SPINOPELVIC PARAMETERS WITH SURGICAL POSITIONING AND THE ROLE OF THE HIP

Coluna/Columna ◽

10.1590/s1808-185120191804222783 ◽

2019 ◽

Vol 18 (4) ◽

pp. 283-288

Author(s):

Orosco David ◽

Ortiz Pablo Nicolás ◽

Cristiani Mauro ◽

Aguirre Gerardo ◽

Robles Cristian ◽

...

Keyword(s):

Comparative Study ◽

Lumbar Fusion ◽

Lumbar Pain ◽

Sacral Slope ◽

Spinopelvic Parameters ◽

Level Of Evidence ◽

Quadratus Lumborum ◽

Prospective Comparative Study ◽

Hip Flexion

ABSTRACT Post-operative lumbar pain is related to alterations in the sagittal and spinopelvic parameters. A lumbar fusion that fails to maintain, or that worsens the physiological lordosis alters the sagittal balance. Objective: To analyze spinopelvic variation in different surgical positions. Methods: A prospective, analytical and comparative study of spinograms, lumbosacral radiographs in the surgical position over a 4-pole quadratus lumborum, and lumbosacral radiographs with quadratus lumborum and support in the knees. A sample of 129 patients, of both sexes, aged between 18 and 60 years, and presenting with lower back pain. Lumbar Lordosis (LL), Pelvic Tilt (PT), Pelvic Incidence (PI) and Sacral Slope (SS) were measured. Results: PI was the most stable parameter. With quadratus lumborum, a slight increase in PT, a decrease in SS and a significant reduction in LL were found. With quadratus lumborum and support in the knees, a decrease in PT and a slight increase in SS were found, while the LL value remained similar to that of the spinogram. Conclusion: The intraoperative position with hip flexion of between 40° and 45° over quadratus lumborum reduced LL to 10.52° in men and 16.21° in women, increased PT, and decreased SS. The intraoperative position with hip flexion of between 0° and 10° showed the same values as the reference spinogram. Level of Evidence II; Prospective comparative study.

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