scholarly journals Clinical and endoscopic characteristics of post-colonoscopy colorectal cancers detected within 10 years after a previous negative examination

2021 ◽  
Vol 09 (10) ◽  
pp. E1472-E1479
Author(s):  
Kenta Kodama ◽  
Hideyuki Miyachi ◽  
Shin-ei Kudo ◽  
Kunihiko Wakamura ◽  
Yasuharu Maeda ◽  
...  
Keyword(s):  
Tumor Size ◽  
Odds Ratio ◽  
High Volume ◽  
Control Group ◽  
Time Interval ◽  
Study Group ◽  
Depressed Type ◽  
High Volume Center ◽  
Endoscopic Characteristics

Abstract Background and study aims We sometimes encounter colorectal cancer (CRC) that is discovered during the time interval between initial colonoscopy and the recommended follow-up examination. Although several studies reported such cases of CRC, most were based on registry data, which implied that the endoscopic quality was not consistent or guaranteed. We aimed to clarify these clinical and endoscopic characteristics at our high-volume center where a retrospective survey could be precisely performed. Patients and methods We retrospectively analyzed patients with CRC who underwent endoscopic resection or surgery from April 2002 to December 2010, categorizing them into two groups: a “study group” of patients with a negative colonoscopy during the previous 10 years, and a “control group” of patients without a previous colonoscopy or with a previous colonoscopy more than 10 years prior. Results A total of 2042 patients had CRC, among which 55 patients were classified into the study group and the remaining 1989 into the control group. The CRC cases in the study group showed a significant association with smaller (< 30 mm) tumor size (odds ratio [OR] 2.3; 95 % confidence interval [CI] 1.3–4.0) and proximal tumor site (OR 1.7; 95 %CI 0.9–2.9). In addition, right-sided and depressed-type T1 CRCs were significantly more common in the study group. Conclusions Tumor size and location were associated with CRCs detected within 10 years after the negative examination. In addition, depressed-type T1 CRCs were more common. Therefore, we should pay more attention to small, right-sided, or depressed-type tumors in daily colonoscopy.

A standardized interdisciplinary algorithm for the treatment of prosthetic joint infections

2019 ◽  
Vol 101-B (2) ◽  
pp. 132-139 ◽  
Author(s):  
D. Karczewski ◽  
T. Winkler ◽  
N. Renz ◽  
A. Trampuz ◽  
E. Lieb ◽  
...  
Keyword(s):  
Treatment Algorithm ◽  
Interdisciplinary Team ◽  
Control Group ◽  
Time Interval ◽  
Study Group ◽  
Historical Cohort ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

AimsIn 2013, we introduced a specialized, centralized, and interdisciplinary team in our institution that applied a standardized diagnostic and treatment algorithm for the management of prosthetic joint infections (PJIs). The hypothesis for this study was that the outcome of treatment would be improved using this approach.Patients and MethodsIn a retrospective analysis with a standard postoperative follow-up, 95 patients with a PJI of the hip and knee who were treated with a two-stage exchange between 2013 and 2017 formed the study group. A historical cohort of 86 patients treated between 2009 and 2011 not according to the standardized protocol served as a control group. The success of treatment was defined according to the Delphi criteria in a two-year follow-up.ResultsPatients in the study group had a significantly higher Charlson Comorbidity Index (3.9 vs 3.1; p = 0.009) and rate of previous revisions for infection (52.6% vs 36%; p = 0.025), and tended to be older (69.0 vs 66.2 years; p = 0.075) with a broader polymicrobial spectrum (47.3% vs 33.7%; p = 0.062). The rate of recurrent infection (3.1% vs 10.4%; p = 0.048) and the mean time interval between the two stages of the procedure (66.6 vs 80.7 days; p < 0.001) were reduced significantly in the study group compared with the control group.ConclusionWe were able to show that the outcome following the treatment of PJIs of the hip and knee is better when managed in a separate department with an interdisciplinary team using a standard algorithm.

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

scholarly journals Engineered Fat Graft Enhanced with Adipose-Derived Stromal Vascular Fraction Cells for Regenerative Medicine: Clinical, Histological and Instrumental Evaluation in Breast Reconstruction

2019 ◽  
Vol 8 (4) ◽  
pp. 504 ◽  
Author(s):  
Pietro Gentile ◽  
Donato Casella ◽  
Enza Palma ◽  
Claudio Calabrese
Keyword(s):  
Breast Reconstruction ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Stromal Vascular Fraction ◽  
Fat Graft ◽  
Control Group ◽  
Study Group ◽  
Fat Tissue ◽  
Calvarial Defects

The areas in which Stromal Vascular Fraction cells (SVFs) have been used include radiotherapy based tissue damage after mastectomy, breast augmentation, calvarial defects, Crohn’s fistulas, and damaged skeletal muscle. Currently, the authors present their experience using regenerative cell therapy in breast reconstruction. The goal of this study was to evaluate the safety and efficacy of the use of Engineered Fat Graft Enhanced with Adipose-derived Stromal Vascular Fraction cells (EF-e-A) in breast reconstruction. 121 patients that were affected by the outcomes of breast oncoplastic surgery were treated with EF-e-A, comparing the results with the control group (n = 50) treated with not enhanced fat graft (EF-ne-A). The preoperative evaluation included a complete clinical examination, a photographic assessment, biopsy, magnetic resonance (MRI) of the soft tissue, and ultrasound (US). Postoperative follow-up took place at two, seven, 15, 21, 36 weeks, and then annually. In 72.8% (n = 88) of breast reconstruction treated with EF-e-A, we observed a restoration of the breast contour and an increase of 12.8 mm in the three-dimensional volume after 12 weeks, which was only observed in 27.3% (n = 33) of patients in the control group that was treated with EF-ne-A. Transplanted fat tissue reabsorption was analyzed with instrumental MRI and US. Volumetric persistence in the study group was higher (70.8%) than that in the control group (41.4%) (p < 0.0001 vs. control group). The use of EF-e-A was safe and effective in this series of treated cases.

Outcomes More Than 2 Years After Meniscal Repair for Longitudinal Tears of the Lateral Meniscus Combined With Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652098197
Author(s):  
Akira Tsujii ◽  
Yasukazu Yonetani ◽  
Kazutaka Kinugasa ◽  
Tomohiko Matsuo ◽  
Kenji Yoneda ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Complete Healing ◽  
Control Group ◽  
Study Group ◽  
Meniscal Extrusion ◽  
Second Look ◽  
Anterior Cruciate

Background: Meniscal function after repair of longitudinal tears of the lateral meniscus (LM) with anterior cruciate ligament reconstruction (ACLR) has not been comprehensively investigated. Purpose: To evaluate not only the clinical outcomes and radiographic findings of patients who underwent repair of longitudinal tears of the LM combined with ACLR but also the healing status of the repaired meniscus and changes in chondral status with second-look arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: Among 548 patients who underwent primary anatomic ACLR at our institution between 2010 and 2017, 39 who had concomitant longitudinal tears of the LM and underwent repair were studied. During follow-up for more than 2 years, all patients were evaluated clinically (pain, range of motion, swelling, and knee instability) and with imaging (plain radiograph and magnetic resonance imaging [MRI]), and compared with a matched control group (based on age, sex, body mass index, and follow-up period) without any concomitant injuries who underwent ACLR. Measurements on MRI were recorded preoperatively, immediately after surgery, and at final follow-up, and the change in the values over time was assessed. Of the 39 patients in each group, 24 were assessed by second-look arthroscopy with hardware removal 2 years postoperatively. Results: The mean follow-up times of the study and control group were at a mean of 42.4 and 45.4 months, respectively. There were no significant differences in clinical findings, lateral joint space narrowing on radiographs, and chondral status at the lateral compartment between groups, whereas lateral and posterior meniscal extrusion on MRI progressed significantly in the study group (0.43 ± 1.0 mm vs -0.29 ± 1.1 mm, P = .003; 1.9 ± 1.9 mm vs 0.14 ± 1.1 mm, P < .0001, respectively). Second-look arthroscopy revealed complete healing in 12 patients (50%), partial healing in 9 (37.5%), and failure in 3 (12.5%) in the study group, and no new tear in the control group. Conclusion: The clinical and imaging outcomes after repair of longitudinal tears of the LM combined with anatomic ACLR were successful and comparable with those after isolated ACLR without any other injuries at 42 months postoperatively, although meniscal extrusion showed progression on coronal/sagittal MRI. Based on the MRI findings and the result that only half of patients achieved complete healing, meniscal function could not be fully restored even after repair. Although degenerative changes were not apparent, longer-term follow-up is needed.

scholarly journals The effects of strengths coaching program on strengths self efficacy, positive affect, self efficacy, job engagement and organizational commitment based on Korean employees

2017 ◽  
Vol 30 (2) ◽  
pp. 221-246
Author(s):  
Hyaeyeong Seon ◽  
Suyeon Kim ◽  
Miae Lee ◽  
Jinkook Tak
Keyword(s):  
Organizational Commitment ◽  
Positive Affect ◽  
Work Engagement ◽  
Self Efficacy ◽  
Control Group ◽  
Time Interval ◽  
Job Engagement ◽  
Group Data ◽  
Dependent Variables

This study was designed to examine the effects of strengths coaching program on strengths self efficacy, positive affect, self efficacy, work engagement, and organizational commitment based on Korean employees. Participants were 43 Korean employees, 21 for the experiment group and 22 for the control group. Data were collected across three times(pre, post, follow-up). To measure overall effects, strengths self efficacy, positive affect, self efficacy, work engagement and organizational commitment were measured. Results showed that there were significant interaction effects between time interval and groups for all the dependent variables, confirming the effects of the coaching program. Also, there were non significant effects of time interval(post and follow-up) for all the dependent variables, confirming the duration of the program effect across time. Finally, implications and limitations of the study were discussed.

scholarly journals AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY

2015 ◽  
Vol 7 (4) ◽  
pp. 38-42 ◽  
Author(s):  
A V Sotnikov ◽  
V M Melnikov ◽  
R V Almadi ◽  
G N Gorbunov
Keyword(s):  
Cardiac Surgery ◽  
Wound Infection ◽  
Incidence Rate ◽  
Control Group ◽  
Study Group ◽  
Intravenous Injections ◽  
Deep Wound Infection ◽  
Period 2 ◽  
Deep Wound

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.

scholarly journals Uni-port total thoracoscopic surgery versus median sternotomy for redo tricuspid valve replacement: A retrospective study

2020 ◽  
Author(s):  
Licheng Yan ◽  
Fuzhen Zheng ◽  
Haiyu Chen ◽  
Jiayin Bao ◽  
Guoxing Weng
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Thoracoscopic Surgery ◽  
Median Sternotomy ◽  
Control Group ◽  
Study Group ◽  
Valve Regurgitation ◽  
Tricuspid Valve Replacement ◽  
Tricuspid Valve Regurgitation

Abstract BACKGROUNDː This study compared the perioperative and follow-up period data of patients who underwent redo tricuspid valve replacements performed via thoracoscopic surgery or median sternotomy. The purpose was to evaluate the feasibility, safety, and surgical outcomes of redo tricuspid valve replacement via uni-port thoracoscopic surgery. METHODSː Forty-nine patients with severe tricuspid valve regurgitation after left-side valve replacement underwent redo tricuspid valve replacements in our hospital from April 2012 to September 2019. 26 patients underwent uni-port total thoracoscopy surgery, whereas 23 patients had the surgery performed via median sternotomy. We collected perioperative and 3- to 36-month postoperative data. RESULTSː No deaths occurred in the intraoperative period. Time of cardiopulmonary bypass in the study group was significantly longer than that in the control group (P<0.05), but the operative times in the study and control groups were not significantly different. Thoracic drainage, length of ICU stay, postoperative hospital stay and complication rates in the study group were significantly different from those in the control group (P<0.05). Throughout the follow-up period, uni-port total thoracoscopic TVR is not inferior to traditional surgery with respect to cardiac function and recurrence of tricuspid valve regurgitation. CONCLUSIONSː Uni-port total thoracoscopic tricuspid valve replacement is safe, feasible and effective, and that can be considered as a primary treatment strategy for patients with severe TR after previous left-sided valve procedure.

Application of a collagen matrix dressing on a neuropathic diabetic foot ulcer: a randomised control trial

2020 ◽  
Vol 29 (Sup3) ◽  
pp. S13-S18 ◽  
Author(s):  
Gholamreza Esmaeeli Djavid ◽  
Seyed Mehdi Tabaie ◽  
Siamak Bashardoust Tajali ◽  
Mehrangiz Totounchi ◽  
Amirreza Farhoud ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Healing Process ◽  
Collagen Matrix ◽  
Complete Healing ◽  
Randomised Control Trial ◽  
Control Group ◽  
Study Group ◽  
Number Of Patients

Objective: Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU. Method: This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up. Results: A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively). Conclusion: The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.

scholarly journals Effect of cervical headgear on dental arch area, shape and interarch dimensions

2020 ◽  
Author(s):  
Toni Heino ◽  
Heta Kokko ◽  
Ville Vuollo ◽  
Pertti Pirttiniemi
Keyword(s):  
Standard Deviation ◽  
Early Phase ◽  
Three Dimensional ◽  
Polynomial Equation ◽  
Control Group ◽  
Dental Arch ◽  
Study Group ◽  
Class Ii Malocclusion ◽  
Angle Class Ii

Abstract Purpose The goal was to study the effects of early cervical headgear treatment on maxillary and mandibular dental arch area, shape and interarch dimensions. Methods The total study group comprised 67 children aged 7.6 years (standard deviation 0.3) with Angle class II malocclusion collected between 1992 and 1996. The children were randomly divided into two groups of equal size. In the first group, cervical headgear treatment was started immediately and undertaken for 2 years. The remaining patients served as untreated controls. Dental casts were taken and scanned at the beginning of treatment (T0) and at the 2‑year (T1) and 4‑year follow-up (T2). Three-dimensional landmarks describing the positions of maxillary and mandibular incisors, canines, first and second premolars and first molars were used to calculate and visualize the maxillary and mandibular dental arch area and shape using the polynomial equation y = Ax6 + Bx2. Results Significant changes in the shape and area of both maxillary and mandibular dental arches were induced with cervical headgear. The headgear increased dental arch area, sagittal dimensions at the mid-sagittal line and transversal dimensions at all of the measured levels in both dental arches compared to the control group. Conclusions Cervical headgear is an effective treatment device to gain space in both dental arches. Furthermore, when used as an early phase treatment, relapse is relatively small compared to the gained space.

scholarly journals Short-Segment Instrumentation with Fractured Vertebrae Augmentation by Screws and Bone Substitute for Thoracolumbar Unstable Burst Fractures

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Jen-Chung Liao ◽  
Wen-Jer Chen
Keyword(s):  
Bone Substitute ◽  
Bone Substitutes ◽  
Control Group ◽  
Study Group ◽  
Short Segment ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Local Kyphosis ◽  
Surgical Failure

Background. For thoracolumbar burst fractures, traditional four-screw (one above and one below) short-segment instrumentation is popular and has a high failure rate. Additional augmentation at the fractured vertebrae is believed to reduce surgical failure. The purpose of this study was to examine the clinical and radiographic results of patients who underwent short-segment posterior instrumentation with augmentation by screws and bone substitutes at the fractured vertebrae and to compare these data to those of patients who underwent long-segment instrumentation for thoracolumbar burst fractures. Methods. The study group had twenty patients who underwent short-segment instrumentation with additional augmentation by two screws and bone substitutes at the fractured vertebrae. The control group contained twenty-two patients who underwent eight-screw long instrumentation without vertebra augmentation. Local kyphosis and the anterior body height of the fractured vertebrae were measured. The severity of the fractured vertebrae was evaluated with the load sharing classification (LSC). Any implant failure or loss of correction >10° at the final follow-up was defined as surgical failure. Results. Both groups had similar distributions in terms of age, sex, the injured level, and the mechanism of injury before operation. During the operation, the study group had significantly less blood loss (136.0 vs. 363.6 ml, p=0.001) and required shorter operating times (146.8 vs. 157.5 minutes, p=0.112) than the control group. Immediately after surgery, the study group had better correction of the local kyphosis angle (13.4° vs. 11.9°, p=0.212) and restoration of the anterior height (34.7% vs. 31.0%, p=0.326) than the control group. At the final follow-up, no patients in the study group and only one patient in the control group experienced surgical failure. Conclusions. Patients with thoracolumbar burst fractures who received six-screw short-segment posterior fixators with augmentation at the level of the fractured vertebrae via injectable artificial bone substitute achieved satisfactory clinical and radiographic results, and this method could replace long-segment instrumentation methods used in unstable thoracolumbar burst fractures.

Sign in / Sign up

Export Citation Format

Share Document