scholarly journals Role of tunica vaginalis interposition layer in hypospadias surgery

2006 ◽  
Vol 39 (02) ◽  
pp. 152-157
Author(s):  
Handoo Yog Raj
Keyword(s):  
Suture Line ◽  
Vascular Supply ◽  
Common Complication ◽  
Tunica Vaginalis ◽  
Cutaneous Fistula ◽  
Impaired Wound Healing ◽  
Fistula Rate ◽  
Water Proofing ◽  
Hypospadias Surgery

ABSTRACTHypospadias surgery has evolved with more than 150 procedures for surgical correction of single anomaly .urethro-cutaneous fistula continues to be single most common complication of regardless of location of meatus, procedure performed and experience of surgeon. Every effort goes in prevention of this complication including overlapping suture line. Two stage repair, burying repaired urethra in scrotum, dartose flap. Parietal layer of tunica vaginalis from testis as a water proofing layer over reconstructed neo urethra decreasing fistula rate. Unlike dissection of dartose layer which can damage blood supply of overlying skin with impaired wound healing, tunica vaginalis brings vascular supply from outside source hence helping in healing of suture line of neo-urethra. Study of effectiveness of tunica vaginalis flap covering different hypospadias procedures in 126 cases over 6 years is presented with inference of significant decrease of urethra-cutaneous fistula rate.

scholarly journals Risk Factors of Urethro-cutaneous Fistula Development in Hypospadias Surgery

2021 ◽  
Vol 31 (3) ◽  
pp. 177
Author(s):  
Wien Permana ◽  
Tarmono Tarmono ◽  
Johan Renaldo
Keyword(s):  
Risk Factors ◽  
Operative Technique ◽  
Common Complication ◽  
Urethrocutaneous Fistula ◽  
Cutaneous Fistula ◽  
Factors Associated ◽  
Significant Difference ◽  
Hypospadias Surgery

<p align="justify">Urethrocutaneous fistula development is the most common complication found hypospadias surgery. Several factors associated with the incidence of fistulas are the age at the time the surgery. The type of hypospadias, the degree of chordae, the operative technique applied and catheter type. This study aimed to determine the risk factors associated with the urethro-cutaneous fistula development in hypospadias surgery. The results showed that from 310 hypospadias patients undergoing urethroplasty, urethra cutaneous fistula development occurred among 105 patients (30.6%) with a mean age of surgery 10.89+6.27 years. Hypospadias type has a significant difference with the incidence of urethro-cutaneous fistula development (p = 0.027). Age (p = 0.615), degree of chordae (P=0.805), operative technique (P=0.901) and catheter type (P=691) do not have a significant impact to urethro-cutaneous fistula development. It can be concluded that operative urethroplasty has a risk of urethra-cutaneous fistula that associated with hypospadias type.</p>

scholarly journals Use of fibrin sealant and tunica vaginalis flap in the repair of urethro-cutaneous fistulas: experience in a tertiary care centre

2018 ◽  
Vol 5 (7) ◽  
pp. 2497
Author(s):  
Apoorva Kulkarni ◽  
Vishesh Dikshit ◽  
Abhaya Gupta ◽  
Paras Kothari ◽  
Shalika Jayaswal ◽  
...  
Keyword(s):  
Fibrin Sealant ◽  
Primary Repair ◽  
Tertiary Care ◽  
Fistula Repair ◽  
Tunica Vaginalis ◽  
Tertiary Care Centre ◽  
Cutaneous Fistula ◽  
Dartos Flap ◽  
Hypospadias Surgery ◽  
Sealant Group

Background: Urethro-cutaneous (UC) fistulas are one of the most common complications after hypospadias surgery. To repair a UC fistula, an experienced surgeon with vast knowledge in the field of hypospadias is essential. Various techniques of UC fistula repair have been described. We share our experience in the use of fibrin sealant and tunica vaginalis flap as intermediate cover in UC fistula repairs.Methods: Our objective was to evaluate the efficacy of fibrin sealant and tunica vaginalis flap in urethro-cutaneous fistula repair in those patients where dartos flap is not available. Total 40 patients were retrospectively evaluated and segregated into the fibrin sealant group and the tunica vaginalis flap group. All repairs had been done by the same surgeon with 6-0 polyglactin suture at least 6 months from the primary repair. The re-fistulation rate was noted in both the groups.Results: Re-fistulation rate was 20% for tunica vaginalis flap and 70% for fibrin sealant. The general re-fistulation rate with the use of dartos flap is 20-30% at our institute.Conclusions: We concluded that tunica vaginalis flap as intermediate cover gives good results in urethro-cutaneous fistula repair.

Epigenetic factors and molecular markers of the risk of early pregnancy losses

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 9-16
Author(s):  
Nataly I Frolova ◽  
Tatiana E Belokrinitskaya
Keyword(s):  
Early Pregnancy ◽  
Genetic Factors ◽  
Molecular Genetic ◽  
Pregnancy Complication ◽  
Common Complication ◽  
Epigenetic Factors ◽  
Genetic Determination ◽  
Periconceptional Period ◽  
Combined Impact

Background. Miscarriage is a common complication in early pregnancy. Current studies have shown a higher prevalence of miscarriage, ranging from 10 to 20%. The review is devoted to modern concepts of etiology and pathogenesis of early pregnancy losses. Aim. Assess the role of epigenetic factors and molecular-genetic markers in the pathogenesis and prediction of early pregnancy losses Materials and methods. In order to write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 10-15 years. Relevant articles from the peer-reviewed literature and clinical practice guidelines were included. Results. Many recent studies have proved the contribution of various epigenetic factors to the pathogenesis of spontaneous miscarriages, and the molecular-genetic determination such kinds of pregnancy complication has been confirmed. Conclusion. The miscarriage in early gestation is driven by combined impact of epigenetic and molecular-genetic factors, as well as the presence of intergenic interactions. It is may lead to deterioration of physiological functions, and maternal pathologenic pathways could be changed as during her periconceptional period as so during the pregnancy.

Mechanistic Insights into Immunological Therapy for Targeting Diabetic Retinopathy

2021 ◽  
Vol 5 (3) ◽  
pp. 01-05
Author(s):  
Imteyaz Qamar
Keyword(s):  
Diabetic Retinopathy ◽  
Progressive Disease ◽  
Common Complication ◽  
Blood Retinal Barrier ◽  
Immunological Therapy ◽  
Tnf Α ◽  
Capillary Occlusion ◽  
Inflammatory Molecules ◽  
Inflammatory Effect

Diabetic retinopathy (DR) is a common complication amongst patients that have diabetes. It is a leading cause of blindness in middle age people. A large proportion of patients who have diabetes develop retinopathy. There are several immunological reasons associated with the pathophysiology of this disease. Role of several mediators that increase the oxidative stress and have a pro-inflammatory effect which leads to capillary occlusion and neovascularization (NV). Increased vasopermeability due to disruption of the blood-retinal barrier (BRB) leading to diabetic macular edema (DME). Immunotherapies utilise different compounds and target various inflammatory molecules like TNF-α and pathways such as PPARγ for treatment of this progressive disease. Inflammatory and pro-inflammatory pathways are found to have an essential role in promoting DR; therefore, targeting them provides a useful technique for curing DR.

Appropriate Antibiotic Selection and Use for Intensive Care Unit Patients, Part I: Rationale for Antibiotic Choices

2018 ◽  
Author(s):  
Richard M Pino ◽  
Molly Paras ◽  
Erica S Shenoy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Vascular Supply ◽  
Surgical Patient ◽  
Risk Of Infection ◽  
Antibiotic Selection ◽  
Key Words Antibiotics ◽  
Surgical Icu ◽  
Selection Of

The aim of this review is to help clinicians optimize treatment of infections and reduce adverse events. With that goal in mind, we discuss the basis for the selection of antibiotics for the surgical patient in the intensive care unit (ICU), the mechanism of antibiotic action, and resistance of pathogens to antibiotic therapy—factors that may affect antibiotic levels, the rationales for dosing, and the role of antimicrobial stewardship programs. The evaluation and management of infections in critically ill patients are uniquely different from those of the general patient population. Age, medical comorbidities, alterations in anatomy, changes in vascular supply, insertion of vascular conduits, and orthopedic hardware are some factors that increase the risk of infection and influence antibiotic choice in the surgical ICU patient.  Key words: antibiotics, antibiotic resistance, antibiotic stewardship, intensive care unit

scholarly journals The Role of Matrix Metalloproteinases in Diabetic Wound Healing in relation to Photobiomodulation

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Sandra Matabi Ayuk ◽  
Heidi Abrahamse ◽  
Nicolette Nadene Houreld
Keyword(s):  
Wound Healing ◽  
Matrix Metalloproteinases ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Main Function ◽  
Diabetic Wound ◽  
Impaired Wound Healing ◽  
Inflammatory Phase ◽  
Diabetic Wound Healing

The integration of several cellular responses initiates the process of wound healing. Matrix Metalloproteinases (MMPs) play an integral role in wound healing. Their main function is degradation, by removal of damaged extracellular matrix (ECM) during the inflammatory phase, breakdown of the capillary basement membrane for angiogenesis and cell migration during the proliferation phase, and contraction and remodelling of tissue in the remodelling phase. For effective healing to occur, all wounds require a certain amount of these enzymes, which on the contrary could be very damaging at high concentrations causing excessive degradation and impaired wound healing. The imbalance in MMPs may increase the chronicity of a wound, a familiar problem seen in diabetic patients. The association of diabetes with impaired wound healing and other vascular complications is a serious public health issue. These may eventually lead to chronic foot ulcers and amputation. Low intensity laser irradiation (LILI) or photobiomodulation (PBM) is known to stimulate several wound healing processes; however, its role in matrix proteins and diabetic wound healing has not been fully investigated. This review focuses on the role of MMPs in diabetic wound healing and their interaction in PBM.

scholarly journals The Role Of Erythropoietin In The Treatment Of Anemia In Patients With Malignant Lymphoma

2013 ◽  
Vol 59 (3) ◽  
pp. 169-171
Author(s):  
Aranka Kurtus ◽  
Erzsébet Benedek ◽  
Judith Beáta Köpeczi ◽  
Enikő Kakucs ◽  
Aliz-Beáta Tunyogi ◽  
...  
Keyword(s):  
Malignant Lymphoma ◽  
Symptom Relief ◽  
Hemoglobin Concentration ◽  
Direct Consequence ◽  
Common Complication ◽  
Malignant Lymphomas ◽  
Acceptable Quality ◽  
Erythropoietin Treatment

Abstract Introduction: Anemia is a common complication of malignant lymphomas, which could be a direct consequence of the disease or secondary to the myelosupressive chemotherapy. The aim of this study was to assess the effect of erythropoietin to treat anemia. The main objectives were to demonstrate increases in hemoglobin levels and the existence of an association between symptom relief and treatment. Material and method: In the Clinical Hematology and BMT Unit Tîrgu Mureș we performed an analytical, observational study to assess the role of erythropoietin treatment in malignant lymphoma related anemia. This linear, retrospective study included 127 patients diagnosed and treated with malignant lymphoma between January 1st, 2007 and December 30, 2011. The 127 patients were divided into two groups: a group of patients (n = 88) who were treated with erythropoietin and the other group (n = 39) who did not receive this treatment. Patients included in the study received treatment with epoetin beta 40,000 IU/week. We followed the hemoglobin level and the symptomatology at baseline and after 4 weeks. Results: Patients who received treatment with erythropoietin had a 7.12 times higher possibility of being asymptomatic than patients who did not receive this treatment. The hemoglobin concentration of patients with erythropoietin treatment increased significantly (p <0.0001) compared to the patients who did not receive this treatment. Conclusion: Effective treatment of anemia is an important aim in the management of patients with malignant lymphomas, because it increases their hemoglobin concentration, decreases the need of transfusion and maintains an acceptable quality of life.

scholarly journals Barotrauma in COVID-19 Patients

2022 ◽  
Author(s):  
Farahnaz Fallahian ◽  
Atabak Najafi ◽  
Arezoo Ahmadi
Keyword(s):  
Retrospective Study ◽  
Lung Injury ◽  
Host Response ◽  
Clinical Manifestations ◽  
Chest Imaging ◽  
Common Complication ◽  
Invasive Ventilation ◽  
Pulmonary Barotrauma ◽  
Ventilation Induced Lung Injury

Clinical manifestations of COVID 19 is still unknown. We performed this study to determine the occurrence of pulmonary barotrauma as a complication of this disease. In this retrospective study, a total of 955 COVID 19 patients with respiratory insufficiency requiring oxygen support or invasive ventilation admitted to ICU of Sina Hospital from 20 March 2020 to 9 June 2021, were included and their chest imaging reviewed. Here, we report results of chest imaging of first 92 patients of this group. Barotrauma (pneumothorax, pneumomediastinum, pneumopericardium) occurred in 11 (11.9%) of 92 patients with coronavirus disease 2019 (COVID-19) infection requiring ICU admission for respiratory support and monitoring. It seems barotrauma is a common complication of COVID 19 disease. The role of increased respiratory efforts, patient or ventilation induced lung injury, viral and host response should be assessed. It needs to consider the occurrence of barotrauma in Patients with COVID-19, before expansion of dead space for treatment and limiting the ventilation effects.

Sign in / Sign up

Export Citation Format

Share Document