A simple novel technique for closure of simple and complex pilonidal sinus with either simple (tongueshaped) or bilobed rotation fl ap

ABSTRACT Background:Pilonidal sinus is a common disease in young adults that carries high postoperative morbidity and patients′ discomfort; controversy still exists regarding the best surgical technique for the treatment of the disease. We successfully treat it with a rotation flap technique (simple rotation and bilobed rotation flap).Materials and Methods: Sixty-two patients were randomized to receive surgical treatment in the form of either simple rotation or bilobed rotation flap by eccentric elliptical excision of the diseased tissues down to the sacral fascia and closure of the defect with the flap, then placing a closed suction drain at the base of the wound, with its tip being brought out in the gluteal region at least 5 cm laterally to the lower end of the suture. Results: All our patients healed completely without recurrence after a mean follow-up of about one year. Mean hospital stay 1.5 days (range 1-3) Mean time to complete healing 11.9 days (range 8-14). Mean time off work was 11.5 days (range 10-21), wound infection and breakdown, three (4.8%), recurrence (0%), and time to sitting on the toilet and walking without pain was 10-15 days.Conclusions: A tension-free suture and cleft left via the rotation flap, either the bilobed flap or monolobed, is the key to success without recurrence and low patient discomfort.

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Does closure of chronic pilonidal sinus still remain a matter of debate after bilateral rotation flap?(N-shaped closure technique)

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699148 ◽

2006 ◽

Vol 39 (02) ◽

pp. 157-162

Author(s):

M. Saad Khaled ◽

M.S. Awad Mohamed

Keyword(s):

Pilonidal Sinus ◽

Suture Line ◽

Complete Healing ◽

Random Pattern ◽

Closure Technique ◽

Rotation Flap ◽

Suction Drain ◽

Closed Suction Drain ◽

Mean Time

ABSTRACT Background:Controversy still exists about the exact cause of pilonidal sinus either acquired or congenital, and also about what is the best surgical technique for the treatment of the disease. We successfully treated chronic pilonidal sinus with a new flap technique {N-shaped bilateral rotation flap} for closure of the defect.Materials and Methods:Thirty-two patients (30 men and two women) were treated by eccentric elliptical excision of the diseased tissues down to the postsacral fascia and closure of the defect with our flap [which is a random pattern flap], then a closed suction drain was placed at the base of the wound, with its tip being brought out in the gluteal region at least 5 cm lateral to the lower end of the suture line. Results: All our patients healed completely without recurrence during a period of average follow-up of two years. Mean hospital stay was 1.5 days (range 1-5 days). Mean time to complete healing was 11.9 days (range 6-18 days). Mean time off work was 13.7 days (range 10-21 days). Two patients had wound infection and one patient a partial breakdown. The recurrence rate was 0%.Conclusions:A tension-free suture via bilateral rotation flaps with a good suction at the button of the wound for drainage of blood from the bottom of the wound is the key to the success of repair without recurrence.

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Radiographic characteristics in the periapical healing post endodontic treatment in patients of the Autonomous University of Yucatan, School of Dentistry

Nova Scientia ◽

10.21640/ns.v10i21.1592 ◽

2018 ◽

Vol 10 (21) ◽

pp. 379-390

Author(s):

Oscar David Jurado Patrón ◽

Andrés Vargas López ◽

Elma María Vega Lizama ◽

Gabriel Alvarado Cárdenas ◽

María Eugenia López Villanueva ◽

...

Keyword(s):

Longitudinal Study ◽

Sinus Tract ◽

Complete Healing ◽

Endodontic Treatment ◽

Periapical Lesions ◽

Periapical Healing ◽

School Of Dentistry ◽

One Year ◽

Causes Of Failure

Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.

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Brief Intermittent Neuroleptic Prophylaxis for Selected Schizophrenic Out-patients

The British Journal of Psychiatry ◽

10.1192/s0007125000018237 ◽

1989 ◽

Vol 155 (05) ◽

pp. 702-706 ◽

Cited By ~ 3

Author(s):

H. A. McClelland ◽

G. Harrison ◽

S. D. Soni

Keyword(s):

Psychotic Symptoms ◽

Intermittent Treatment ◽

Double Blind ◽

Prodromal Symptoms ◽

Novel Approach ◽

Depot Neuroleptic ◽

One Year ◽

Depot Injections ◽

To Receive

“A study was conducted to investigate a novel approach to the prophylaxis of schizophrenic relapse. The treatment strategy comprised brief intermittent courses of neuroleptic agents begun as soon as non-psychotic symptoms believed to be early signs of relapse appeared. Fifty four stable, remitted outpatients meeting the American Psychiatric Association's DSM–III criteria for schizophrenia were randomised double blind to receive brief intermittent treatment with either active or placebo depot neuroleptic injections. Only three patients given placebo injections and two controls were admitted to hospital during one year of follow up. Eight (30%) of the patients given placebo injections and only 2 (7%) of the controls, however, had a recurrence of schizophrenic symptoms. Patients given placebo injections experienced fewer extrapyramidal side effects and showed a trend towards a reduction in tardive dyskinesia. Dysphoric and neurotic symptoms were identified before eight out of 11 relapses, and these symptoms were more frequent in patients given placebo depot injections. These results suggest a viable but not necessarily better alternative to continuous oral or depot treatment for less ill, chronic, stabilised schizophrenics based on the early treatment of putative prodromal symptoms of relapse.”

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Discovery of increased epidermal DNAH10 expression after regeneration of dermis in a randomized with-in person trial — reflections on psoriatic inflammation

Scientific Reports ◽

10.1038/s41598-019-53874-z ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Heli Lagus ◽

Mariliis Klaas ◽

Susanna Juteau ◽

Outi Elomaa ◽

Juha Kere ◽

...

Keyword(s):

Protein Expression ◽

Psoriatic Skin ◽

Dermal Matrix ◽

Thickness Skin ◽

Dermal Regeneration ◽

Unaffected Skin ◽

One Year ◽

To Receive

AbstractBecause molecular memories of past inflammatory events can persist in epidermal cells, we evaluated the long-term epidermal protein expression landscapes after dermal regeneration and in psoriatic inflammation. We first characterized the effects of two dermal regeneration strategies on transplants of indicator split-thickness skin grafts (STSGs) in ten adult patients with deep burns covering more than 20% of their body surface area. After fascial excision, three adjacent areas within the wound were randomized to receive a permanent dermal matrix, a temporary granulation-tissue-inducing dressing or no dermal component as control. Control areas were covered with STSG immediately, and treated areas after two-weeks of dermis formation. Epidermis-dermis-targeted proteomics of one-year-follow-up samples were performed for protein expression profiling. Epidermal expression of axonemal dynein heavy chain 10 (DNAH10) was increased 20-fold in samples having had regenerating dermis vs control. Given the dermal inflammatory component found in our dermal regeneration samples as well as in early psoriatic lesions, we hypothesized that DNAH10 protein expression also would be affected in psoriatic skin samples. We discovered increased DNAH10 expression in inflammatory lesions when compared to unaffected skin. Our results associate DNAH10 expression with cell proliferation and inflammation as well as with the epidermal memory resulting from the previous regenerative signals of dermis. This study (ISRCTN14499986) was funded by the Finnish Ministry of Defense and by government subsidies for medical research.

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Does Teacher Training Actually Work? Evidence from a Large-Scale Randomized Evaluation of a National Teacher Training Program

American Economic Journal Applied Economics ◽

10.1257/app.20170226 ◽

2019 ◽

Vol 11 (3) ◽

pp. 128-154 ◽

Cited By ~ 3

Author(s):

Prashant Loyalka ◽

Anna Popova ◽

Guirong Li ◽

Zhaolei Shi

Keyword(s):

Teacher Training ◽

Teacher Professional Development ◽

Student Outcomes ◽

Large Scale ◽

Causal Chain ◽

Randomized Evaluation ◽

Teacher Professional ◽

One Year ◽

To Receive

Despite massive investments in teacher professional development (PD) programs in developing countries, there is little evidence on their effectiveness. We present results of a large-scale, randomized evaluation of a national PD program in China in which teachers were randomized to receive PD; PD plus follow-up; PD plus evaluation of the command of PD content; or no PD. Precise estimates indicate PD and associated interventions failed to improve teacher and student outcomes after one year. A detailed analysis of the causal chain shows teachers find PD content to be overly theoretical, and PD delivery too rote and passive, to be useful. (JEL I21, I28, J24, J45, O15, P36)

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Survival outcomes in U.S. patients with metastatic colorectal cancer (mCRC).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.559 ◽

2013 ◽

Vol 31 (4_suppl) ◽

pp. 559-559 ◽

Cited By ~ 1

Author(s):

Kevin Knopf ◽

Sheikh Usman Iqbal ◽

Stephen F Thompson ◽

Elisabetta Malangone ◽

Magdaliz Gorritz-Kindu ◽

...

Keyword(s):

Median Survival ◽

Observational Studies ◽

Survival Rates ◽

Stage Iv ◽

Survival Outcomes ◽

Biologic Treatment ◽

Kaplan Meier ◽

To Receive ◽

Mean Time

559 Background: The increase in survival seen in recent years in patients with mCRC has been attributed to improvements in treatments, including the introduction of targeted biologic agents. The objectives of this retrospective, observational study are to investigate recent treatment patterns in US mCRC patients and examine real-world survival outcomes. Methods: Data were obtained from a large U.S. database (SDI/IMS Health) of mCRC patients diagnosed from January 1, 2004 to June 30, 2011, ≥18 y at diagnosis, and who received chemotherapy and/or biologic treatment. Complete follow-up was defined as those who either died before June 2011 or who had at least 1 claim within 30 days of June 30, 2011. Kaplan-Meier curves were generated to determine overall survival (OS) from the date of mCRC diagnosis. Results: 1,066 stage IV mCRC patients with complete follow-up were identified (57.5% male; mean age, 61.6 y). Approximately 80% were diagnosed with mCRC after 2006; 51.7% had liver metastases. The most common 1L, 2L, and 3L regimens were FOLFOX plus bevacizumab (34.52%), FOLFIRI plus bevacizumab (21.83%), and irinotecan plus cetuximab (15.83%), respectively. A total of 445 patients died during the study period, yielding a mortality rate of 41.74%. Mean time from diagnosis to first treatment was 3.31 months (SD=7.13). All patients received 1L therapy; OS from diagnosis was 35.77 months (95% CI: 32.57-38.10); 5-year survival was approximately 28%. After 1L, 591/1066 (55%) patients went on to receive 2L therapy; for these patients, median survival from diagnosis was 37.13 months (95% CI: 34.07-40.43) and 5-year survival was approximately 25%. After 2L, 278/591 (47%) patients received 3L therapy; for these patients, median survival from diagnosis was 38.10 months (95% CI: 34.83-43.13); 5-year survival was approximately 25%. Conclusions: In this study, OS (35.77 months) was longer than for other mCRC observational studies that have reported survival from start of treatment, but is more comparable when the ~3 months from diagnosis to start of treatment are not included. Addition of targeted agents and novel chemotherapy has prolonged OS in mCRC patients. Because of poor 5-year survival rates, the need for additional agents in later lines of therapy still exists.

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Brief Intermittent Neuroleptic Prophylaxis for Selected Schizophrenic Out-patients

The British Journal of Psychiatry ◽

10.1192/bjp.155.5.702 ◽

1989 ◽

Vol 155 (5) ◽

pp. 702-706

Author(s):

H. A. McClelland ◽

G. Harrison ◽

S. D. Soni

Keyword(s):

Psychotic Symptoms ◽

Intermittent Treatment ◽

Double Blind ◽

Prodromal Symptoms ◽

Novel Approach ◽

Depot Neuroleptic ◽

One Year ◽

Depot Injections ◽

To Receive

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Addition of an Oblique Interfragmentary Screw to T-plate Fixation Decreases Nonunion Rate in Trapeziometacarpal Arthrodesis

Hand ◽

10.1177/1558944720937366 ◽

2020 ◽

pp. 155894472093736

Author(s):

Lacey R. Pflibsen ◽

Shelley S. Noland ◽

Annica C. Eells ◽

Anthony A. Smith

Keyword(s):

Surgical Technique ◽

Plate Fixation ◽

Complete Healing ◽

Dominant Hand ◽

Popular Method ◽

Novel Technique ◽

Clinical Healing ◽

Mean Time ◽

Radiographic Union

Background: T-plate fixation is a popular method for trapeziometacarpal arthrodesis in patients with osteoarthritis. Previous studies report an 8% to 18% rate of symptomatic nonunion and a 26% rate of radiographic nonunion. In this study, we present our surgical technique of trapeziometacarpal arthrodesis using the addition of an oblique interfragmentary screw to T-plate fixation on the rate of symptomatic and radiographic nonunion. Methods: A retrospective review of all trapeziometacarpal arthrodeses for osteoarthritis was completed by a single surgeon between 2010 and 2018. Preoperative demographics, pain, and Eaton classification were included. The technique was identical in all surgical cases, using a T-plate and oblique interfragmentary screw across the arthrodesis site from the metacarpal to the trapezium. Postoperative nonunion rate and time to clinical healing (absence of pain) and radiographic union were reviewed. Results: A total of 22 trapeziometacarpal arthrodeses were performed on 17 patients using the above technique. The average age was 53 years, 71% were women, and 53% involved the dominant hand. Mean preoperative Eaton classification was 2.74 (±0.73). Mean time to clinical healing was 34 days (±12 days), and mean time to radiographic union was 55 days (±23 days). Mean follow-up was 9 months, and no patients were found to have symptomatic or radiographic nonunion. Hardware removal was required bilaterally in 1 patient after complete healing. Conclusions: The addition of an oblique interfragmentary screw to T-plate fixation is a novel technique in trapeziometacarpal arthrodesis, resulting in no symptomatic or radiographic nonunion.

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Papular granuloma annulare of palms and soles: case report of a rare presentation.

F1000Research ◽

10.12688/f1000research.3-32.v1 ◽

2014 ◽

Vol 3 ◽

pp. 32 ◽

Cited By ~ 1

Author(s):

Sidharth Sonthalia ◽

Rahul Arora ◽

Rashmi Sarkar ◽

Uday Khopkar

Keyword(s):

Case Report ◽

Male Patient ◽

Topical Steroid ◽

Granuloma Annulare ◽

Common Disease ◽

Rare Presentation ◽

Soles Of The Feet ◽

One Year ◽

Indian Male

We report the case of a 44-year-old Indian male patient who presented with mildly tender isolated papular lesions confined to the palms of the hands and soles of the feet. The histopathology was characteristic of granuloma annulare. There was an excellent response with 4-week treatment with a potent topical steroid ointment and no recurrence was reported at the follow-up one year later. This report is interesting because of the rare presentation of a common disease.

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A Case Report of Infective Endocarditic Aortic Valve Abscess with Perforation in Infant

10.21203/rs.3.rs-58089/v1 ◽

2020 ◽

Author(s):

Yanfeng Yang ◽

Feifei Si ◽

Mei Jin ◽

Sheng Yang

Keyword(s):

Infective Endocarditis ◽

Aortic Valve ◽

Structural Damage ◽

Autologous Pericardial Patch ◽

Life Threatening ◽

One Year ◽

Surgery Department ◽

Short Time ◽

To Receive

Abstract Background: Infective endocarditis (IE) is an uncommon but a potentially life-threatening infectious disease in children. The epidemiology of IE has changed in the past three to four decades and its incidence has been increasing recently. This case with atypical present including culture-negative and no-cardiovascular diseases got cardiovascular structural damage that deteriorate in short time. Case presentation: This case was an infant less than one year old without basic cardiovascular disease,and this case was admitted with Kawasaki disease early. His diagnosis was infective endocarditic aortic valve abscess with perforation. The patient received intravenous injection of cefotaxime for two days and piperacillin sulbactam and cefazolin for six days. On 9 th day, piperacillin sulbactam combining with vancomycin were used. On 10 th day, the patient was sent to cardiac surgery department to receive aortic valve repair. The operation is successful.The abscess cavity of the inferior aortic valve and the vegetations on the aortic valve were completely removed, the left coronary valve was removed, and the left coronary valve was locally widened by autologous pericardial patch. Conclusions: Infective Endocarditis in children may be difficult to diagnosis and manage.and the treatment are becoming a new challenge for conventional antibiotic therapy. Some IE require serial follow-up to determine potential need for subsequent cardiovascular surgery (CVS) intervention despite microbiologic cure with antimicrobial therapy.

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