scholarly journals Effective and safe reduction in visceral fat using a formula diet in a short period before highly invasive endoscopic surgery. – Case series

2021 ◽  
pp. 106026
Author(s):  
Kiyotomi Maruyama ◽  
Kou Shimada ◽  
Arano Makino ◽  
Ryo Hisamune ◽  
Tomoki Shirota ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Visceral Fat ◽  
Case Series ◽  
Formula Diet ◽  
Short Period

scholarly journals Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

2021 ◽  
Vol 11 (8) ◽  
pp. 3365
Author(s):  
Benjie Law ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rama Krsna Rajandram ◽  
Abd Jabar Nazimi ◽  
...  
Keyword(s):  
Case Series ◽  
Cost Effective ◽  
Control Group ◽  
Platelet Rich Fibrin ◽  
Tissue Healing ◽  
Number Of Patients ◽  
Short Period ◽  
Oral And Maxillofacial Region ◽  
Surgical Adjunct ◽  
Autologous Platelet

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

scholarly journals Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

2020 ◽  
Vol 81 (04) ◽  
pp. 357-368
Author(s):  
N. Goncalves ◽  
D.E. Lubbe
Keyword(s):  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Case Series ◽  
Surgical Approaches ◽  
Benign Tumors ◽  
Long Term Outcomes ◽  
Invasive Approach ◽  
Visual Outcomes ◽  
Presenting Symptoms

AbstractSphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Case series reporting transorbital endoscopic resection of sphenoid wing meningiomas using combined endonasal, pre-caruncular, and extended superior eyelid approaches have demonstrated stable and/or improved short- and medium-term visual outcomes. Earlier medial optic nerve decompression appears to result in more favorable long-term visual outcomes. Transorbital endoscopic surgery therefore represents an emerging minimally invasive alternative to deal with these challenging lesions.

scholarly journals Novel treatment of opioid use disorder using ibogaine and iboga in two adults

2020 ◽  
Author(s):  
Claire Wilson ◽  
Trevor Millar ◽  
Zak Matieschyn
Keyword(s):  
Addiction Treatment ◽  
Case Series ◽  
Opioid Use Disorder ◽  
Opioid Withdrawal ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Therapy ◽  
Safety Risks ◽  
Short Period ◽  
Multiple Treatments

AbstractIbogaine is a naturally occurring psychedelic medicine with anti-addictive properties. While research on ibogaine is limited, several observational studies have shown ibogaine can mitigate opioid withdrawal, as seen with reductions in clinical and subjective opioid withdrawal scores and reduced drug use severity (Noller, Frampton, & Yazar-Klosinski, 2018; Brown & Alper 2018). Furthermore, the psychoactive experience may help individuals to realign their values, purpose and sense of connection, as seen with post treatment reductions in depression scores (Noller et al., 2018; Mash et al., 2000).Case seriesThis case series describes two cases of individuals accessing ibogaine through private unregulated clinics in the Vancouver area to treat their opioid use disorder.ConclusionsIn case 1, the client achieved total abstinence from all opioids within 5–6 days of starting ibogaine treatment, did not experience any opioid withdrawal symptoms after ibogaine treatment and maintained abstinence from opioids for 3 years. In case 2, the patient took ibogaine/iboga in multiple treatments over a short period of time (<4 months). The patient stopped all non-medical opioids after the first iboga treatment and then used ibogaine to aid with further dose reductions of her opioid agonist therapy (OAT) and has maintained abstinence from opioids for 2 years. Ibogaine offers a unique and novel therapeutic approach to treating opioid use disorder. Further studies are needed to establish the safety, risks and potential role for ibogaine as a mainstream, evidence-based addiction treatment.

scholarly journals Subcutaneous Endoscopy in Plastic and Reconstructive Surgery

2021 ◽  
Author(s):  
Bharatendu Swain
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Endoscopic Surgery ◽  
Reconstructive Surgery ◽  
Single Port ◽  
Case Series ◽  
High Patient Satisfaction ◽  
Intraoperative Bleeding ◽  
Wide Range ◽  
Scar Visibility

Abstract Background Scar visibility is a major deterrent to patients seeking reconstructive surgery. Endoscopic surgery can address a wide range of problems, from minimizing or concealing scars to improving access and outcomes in certain situations. This case series includes a wide range of reconstructive surgery problems addressed by subcutaneous endoscopic surgery. Having one or more trained assistants is a major deterrent to the performance of endoscopic surgery by the lone practitioner. The single (or two-port technique for muscle harvest) used in most cases simplifies subcutaneous endoscopic surgery. Methods A single-port endoscopy technique, with a 4-mm, 30-degree side viewing telescope and sheath, optical camera and cold light source, was used. Case records were reviewed for access incisions, procedure abandonment, postoperative pain, complications, and patient satisfaction. Results A total of 53 endoscopic surgical episodes between 2003 and 2013 were reviewed. Using a single port, most cases were done successfully. The access site was changed peroperatively in one case. Complications included transient nerve palsy in one case, which recovered completely. There was minimal intraoperative bleeding. Postoperative pain was low except in one case and managed with minimal analgesia. Patient satisfaction was high in all cases. Conclusions Subsurface endoscopy done on a wide range of reconstructive surgery procedures and resulted in minimal scars and high patient satisfaction.

scholarly journals A Series of Pure Ankle Dislocations without Associated Fracture: Our Clinical Experience

2021 ◽  
Author(s):  
Tingjiang Gan ◽  
Yaxing Li ◽  
Wei Deng ◽  
Boquan Qin ◽  
Xi Liu ◽  
...  
Keyword(s):  
Case Reports ◽  
Degenerative Change ◽  
Treatment Protocol ◽  
Case Series ◽  
Published Data ◽  
External Fixators ◽  
Functional Rehabilitation ◽  
Short Period ◽  
Ankle Dislocation

Abstract Background: Pure ankle dislocation without associated fracture is extremely rare, thus the literature almost limited to case reports and small case series. The standardized treatment protocol is in controversy and the studies of mechanism and outcome of the injury are still deficient. We report a series of eight cases of pure tibiotalar dislocations managed with emergency reduction and other heterogenic procedures, hoping to add some material to the published data on this topic and present our clinical experience.Methods: We retrospectively reviewed the eight cases of isolated ankle dislocations without associated fracture that were treated in our department from 2015 to 2019. Results: The eight cases were all posteromedial dislocations with six open and two closed. Emergency reduction was performed for all patients followed by average 6 weeks’ immobilization with external fixators in five and short leg cast in three. The mean follow-up period was 33 (range, 12 to 61) months. None of the eight patients showed obvious instability though only one patient underwent ligaments repair. The average range of motion (ROM) loss of the ankles was 10 degrees for plantarflexion and 3 degrees for dorsiflexion. Two patients complained of moderate stiffness and three complained of persistent mild pain in whom degenerative change was found. Neurovascular sequela was presented in one patient with numbness. Only one patient developed superficial infection. The average AOFAS score was 90 (range, 78 to 100) points at the final follow-up with five ankles rated as excellent and three rated as good. All of the eight patients returned to their prior daily life and the two closed patients with sports injuries resumed sports activity.Conclusion: Pure ankle dislocation is a rare ligamentous ankle injury with complicated mechanism. Most of the injuries treated with emergency reduction and thorough debridement followed by a short period of immobilization and functional rehabilitation have good clinical outcomes. Ligaments repair should only be considered in cases of chronic ankle instability after failed conservative treatment.

scholarly journals Robotic Radical Prostatectomy at the Egyptian National Cancer Institute: Overcoming the Challenges in the Initial Case Series

2021 ◽  
Vol 9 (B) ◽  
pp. 367-372
Author(s):  
Ashraf Zaghloul ◽  
Ahmed Abdelbary ◽  
Amr Fergany ◽  
Hatem Aboulkassem ◽  
Waleed Mohamed Fadlalla
Keyword(s):  
Radical Prostatectomy ◽  
Blood Loss ◽  
National Cancer Institute ◽  
Case Series ◽  
Setup Time ◽  
Robotic Prostatectomy ◽  
Outcome Evaluation ◽  
Robotic Radical Prostatectomy ◽  
Open Conversion ◽  
Short Period

BACKGROUND: Robotic prostatectomy is showing progressive worldwide spread owing to potential clinical benefits, but at a higher cost. AIM: This article describes the challenges and clinical outcomes of the first group of patients undergoing robotic prostatectomy in Egypt. DESIGN, SETTING, PARTICIPANTS: From 2017 to 2019, the data of all (55) patients undergoing robotic radical prostatectomy at the National Cancer Institute of Egypt were retrospectively analyzed. OUTCOME EVALUATION: Short-term operative outcomes, complications, technical difficulties, pathologic data, and biochemical recurrence were reported. RESULTS: Average blood loss was 296 ml; one patient required blood transfusion. One case required open conversion, another required re-docking of the robot. Setup time was significantly improved from an average of 27.7 min in the first 27 cases to an average of 17.3 min in the final 28 cases (p < 0.0001). Complications developed in 27% of our patients. Continence recovery at catheter removal, 1st, 3rd, 6th, and 12th months were 32.7%, 50.9%, 65.5%, 74.5%, and 96%, respectively. CONCLUSIONS: Results from the first series of robotic radical prostatectomy were encouraging. Technical challenges can be overcome in a short period using a dedicated team supplemented by institutional support. Acceptable complication rate and satisfactory outcomes regarding continence and blood loss were observed.

scholarly journals Micronutrient Monitoring and Management in Parenteral Nutrition–Dependent Premature Neonates: A Case Series

2021 ◽  
Vol 26 (2) ◽  
pp. 200-204
Author(s):  
Kassandra L. Vettleson ◽  
Hannah J. Larson ◽  
Mohamed W. Mohamed ◽  
Carlina J. Grindeland ◽  
Julia D. Muzzy Williamson
Keyword(s):  
Parenteral Nutrition ◽  
Lipid Emulsion ◽  
Case Series ◽  
Gastrointestinal Complications ◽  
Premature Neonates ◽  
Short Period ◽  
Pediatric Nutrition ◽  
Prospective Case Series ◽  
American Society ◽  
Spontaneous Intestinal Perforation

We present a prospective case series of 3 premature neonates with abnormal vitamin A, vitamin E, and selenium levels after being managed on prolonged parenteral nutrition (PN). All 3 patients experienced gastrointestinal complications including spontaneous intestinal perforation, necrotizing enterocolitis, and/or short bowel syndrome. Additionally, all 3 patients developed PN-associated liver disease, which required the use of a mixed lipid emulsion and a fish oil–based lipid emulsion for a short period of time. We evaluated the micronutrient levels of these patients after they had been receiving PN for 1 to 2 months. After the early identification of these abnormalities, we promptly attempted to correct the levels through supplementation and restriction, as appropriate. One barrier we experienced in the treatment of these patients was the conflicting guidance of daily micronutrient dosing in PN and when to evaluate levels in premature infants from the European and American pediatric nutrition organizations, the European Society for Paediatric Gastroenterology Hepatology and Nutrition and the American Society for Parenteral and Enteral Nutrition. Additionally, after we assessed micronutrient levels, we experienced a lack of guidance on how to adjust dosing and when to monitor subsequent levels.

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