scholarly journals Current Trends in the Treatment of Dupuytren Disease in Spain

2020 ◽  
Vol 48 (01) ◽  
pp. 010-019
Author(s):  
Rafael Sanjuan-Cerveró ◽  
Diego Gómez-Herrero ◽  
Carlos Novoa-Parra ◽  
Fernando Peña-Molina ◽  
Nuria Franco-Ferrando
Keyword(s):  
Objective Assessment ◽  
Young Patients ◽  
Treatment Preferences ◽  
Spanish Society ◽  
Current Trends ◽  
Partial Fasciectomy ◽  
Treatment Trends ◽  
Practice Time ◽  
Dupuytren Disease ◽  
Clinical Cases

Abstract Objective Assessment of the treatment trends of Spanish surgeons in clinical practice by making clinical assumptions in Dupuytren's disease (DD). Material and Method A survey was sent to the members of the Spanish Society for Surgery of the Hand (Sociedad Española de Cirugía de la Mano, SECMA) posing primary and secondary clinical cases. A relationship is established between the selected treatment, the characteristics of the participating surgeons, and the characteristics of the primary clinical cases. Treatment preferences in recurrences are assessed descriptively. Results In total, 127 surveys were answered. 62.2% of the participants had experience with the use of collagenase and were the basis of the analysis. In primary cases, surgeons with more practice time tended to choose collagenase as treatment for DD. Surgeons who reported higher frequency of collagenase use (67.4% vs. 25.7%) were up to 6 times more likely to indicate such treatment. The patient's age under 50 years was the variable with the greatest association strength for the choice of collagenase treatment (OR = 3.8; CI95% 1.9–7.6). In recurrences, among all clinical cases, the most common answer given by the surgeons was partial fasciectomy. Conclusions Partial fasciectomy continues to be the most widely used treatment for DD in Spain. In primary cases, collagenase is an alternative adopted by experienced surgeons, and in treatments for young patients. In recurrences, partial fasciectomy is the preferred technique.

Current trends in the structure of eye injuries

2020 ◽  
Vol 21 (3) ◽  
pp. 106-108
Author(s):  
M. N. Ponomareva ◽  
◽  
S. V. Sakharova ◽  
E. M. Pochinok ◽  
E. V. Fomina ◽  
...  
Keyword(s):  
Medical Records ◽  
Young Patients ◽  
Present Stage ◽  
Eye Injuries ◽  
Third Place ◽  
The Third ◽  
Eye Trauma ◽  
Current Trends ◽  
The Poor ◽  
Leading Position

Aim. To identify current trends in hospital eye trauma based on the materials of the specialized ophthalmology department of a round-the-clock hospital. Materials and methods. The analysis of medical records of patients treated in the round-the-clock specialized ophthalmology department of the state medical establishment OKB No. 2 in the period since January 2017-2019. Results. During the analyzed period, 4948 patients were treated, of which 218 patients (5.6%) were identified for nosologies belonging to the category of eye trauma. Men are most often exposed to eye injuries (84%), in addition, in 62% of cases, these are young patients (18-44 years). The structure of eye trauma is almost unchanged: the leading position is occupied by penetrating wounds of the eyeball and contusions, the third place is occupied by burns, through wounds of the eyeball are rare. Conclusions. Given the poor prognosis of the outcome of a severe eyeball injury, it requires the introduction of modern types of microsurgical intervention using endovitreal surgery at the present stage.

Surgical Treatment for Recurrent Dupuytren Disease

Hand ◽  
2021 ◽  
pp. 155894472110604
Author(s):  
Bryan A. Hozack ◽  
Ghazi M. Rayan
Keyword(s):  
Skin Grafting ◽  
Full Thickness ◽  
Surgical Strategies ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Collagenase Injection ◽  
Pip Joint ◽  
Partial Fasciectomy ◽  
Ray Amputation ◽  
Dupuytren Disease

Background: Revision procedures for recurrent Dupuytren disease (DD) can be difficult and carry a high risk of complications. Our goal was to describe surgical strategies used for cases of recurrence and report on their outcomes. Methods: We reviewed 1 surgeon’s operative cases for recurrent DD performed at 1 institution. Prior procedures included collagenase injection, percutaneous needle fasciotomy, or open surgical fasciectomy in the same digit or area of the hand. Results: From January 1981 to December 2020, 54 procedures were performed on 33 patients for recurrent DD. Most patients were men (82%), had bilateral involvement (64%) and family history (52%), and some had ectopic disease in their feet (24%). The small finger was involved in 76% of the cases, and the proximal interphalangeal (PIP) joint was involved in 83% of these digits. The procedures included 38 partial fasciectomies (72%), 12 dermofasciectomies (23%), 3 radical fasciectomies (6%), 1 of each needle fasciotomy, ray amputation, and PIP joint arthrodesis (2%). Twenty-three patients (43%) required full thickness skin grafts with an average area of 7.1 cm2 (range: 1-20 cm2). Conclusions: This study highlights the complexity of recurrent DD case management and found the treatment required for 95% of patients in this series was open partial fasciectomy with or without demofasciectomy. Full thickness skin grafting was necessary in nearly half of the cases.

scholarly journals PECULIARITIES OF INTERROGATION IN THE INVESTIGATION OF CRIMINAL OFFENSES IN THE FIELD OF REAL ESTATE

2020 ◽  
Vol 1 (4(106)) ◽  
pp. 207-214
Author(s):  
О. В. Коршун
Keyword(s):  
Real Estate ◽  
Objective Assessment ◽  
Criminal Activity ◽  
Criminal Proceedings ◽  
Current Trends ◽  
Criminal Offenses ◽  
Number Of Factors ◽  
Scientific World ◽  
Depth Study

The article considers the concepts, procedural and tactical features of interrogation of different categories of persons during the investigation of criminal offenses in the field of real estate. It is emphasized that interrogation is the most common investigative (search) action in absolute percentage with other procedural actions. During its holding it is possible to establish information about the event of the crime, its circumstances, participants, the role of each, etc. The information received from the subjects of criminal proceedings may cover a significant number of factors that will allow an objective assessment of the situation and used in the evidentiary process, in order to bring the perpetrators to justice. It is established that the issues of interrogation are constantly in the center of close attention of scientists, which is due to the constant improvement of ways of committing crimes and changing the mechanism of criminal activity in general. Practice is forced to respond to various innovations, and representatives of the scientific world are constantly trying to find new ways to solve problems related to the effective conduct of investigative (search) actions. This presupposes the adoption of effective measures in line with current trends and changes in forms of criminal activity, including in the field of employment. It is emphasized that due to the specifics of criminal offenses in the field of real estate, the question of the need for in-depth study of organizational, tactical and procedural aspects of the interrogation of various persons in proceedings of this category is urgent. It is emphasized that the peculiarities of establishing psychological contact and tactics of direct interrogation differ significantly, depending on the procedural status of the interrogated person. If the victim or witness is mostly in contact and prone to communication, a large arsenal of tactics should be used against the suspects, including: presenting evidence; announcement of testimony of other persons; the use of contradictions in the testimony of the same person; creating the impression of awareness of the investigator; suddenness factor, etc. The organizational and tactical features of interrogations in proceedings of this category are determined, the circumstances to be established are outlined and the list of issues that determine the specifics of criminal offenses in the field of real estate is given.

scholarly journals Current trends in aortic valve-preserving surgery

2020 ◽  
pp. 021849232097593
Author(s):  
Takashi Kunihara
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Objective Assessment ◽  
Young Patients ◽  
Left Ventricular ◽  
Multicenter Studies ◽  
Asymptomatic Patients ◽  
Significant Survival ◽  
History Of ◽  
Aortic Valve Reimplantation

The natural history of aortic regurgitation is not as benign as once believed, even in asymptomatic patients with preserved left ventricular function. Aortic valve surgery can prolong survival in these patients. However, both mechanical and biological aortic valve replacement have major disadvantages, especially in young patients. Aortic valve-preserving surgery has attracted a great deal of attention because it has a significant survival benefit over replacement. Nonetheless, aortic valve-preserving surgery has not been widely adopted due to the complexity of the technique and assessment (i.e., long learning curve). With recent technical and theoretical advances, aortic valve-preserving surgery has increasingly been performed with better outcomes, and therefore earlier surgical intervention in cases of aortic regurgitation has been considered. Recent advances in aortic valve-preserving surgery include repair-oriented classification of the etiology of aortic regurgitation, objective assessment of the cusp configuration (i.e., effective height and geometric height), use of aortic annuloplasty, introduction of two reproducible valve-sparing root replacement procedures (i.e., aortic valve reimplantation and aortic root remodeling techniques), standardization of aortic valve-preserving surgery, and assessment of cusp configuration with aortoscopy. A number of prospective multicenter studies are currently underway and will clarify the role of aortic valve-preserving surgery in the treatment of aortic regurgitation in the near future.

Osteochondromas: An Unusual Cause of Vascular Disease in Young Patients: 2 Clinical Cases

2016 ◽  
Vol 32 ◽  
pp. 129.e7-129.e11 ◽  
Author(s):  
Basso Parente ◽  
Beatrice Fiorucci ◽  
Gioele Simonte ◽  
Deborah Maria Brambilla ◽  
Massimo Lenti
Keyword(s):  
Vascular Disease ◽  
Young Patients ◽  
Clinical Cases

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

2006 ◽  
Vol 57 (1) ◽  
pp. 13-17 ◽  
Author(s):  
J Henk Coert ◽  
Juan P. Barret N??rin ◽  
Marcel F. Meek
Keyword(s):  
Partial Fasciectomy ◽  
Dupuytren Disease

scholarly journals Lateral Meniscal Tears in Young Patients: A Comparison of Meniscectomy and Surgical Repair

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110460
Author(s):  
Nicholas C. Duethman ◽  
Ryan R. Wilbur ◽  
Bryant M. Song ◽  
Michael J. Stuart ◽  
Bruce A. Levy ◽  
...  
Keyword(s):  
Treatment Modality ◽  
Young Patients ◽  
Meniscal Repair ◽  
Failure Rates ◽  
Meniscal Tears ◽  
Treatment Type ◽  
Ikdc Score ◽  
Treatment Trends ◽  
Over Time

Background: Meniscal tears are common in active patients, but treatment trends and surgical outcomes in young patients with lateral meniscal tears are lacking. Purpose: To evaluate treatment trends, outcomes, and failure rates in young patients with lateral meniscal tears. Study Design: Cohort study; Level of evidence, 3. Methods: Patients aged ≤25 years treated surgically for isolated lateral meniscal tears from 2001 to 2017 were identified. Treatment trends were compared over time. International Knee Documentation Committee (IKDC) scores and failure rates were compared by treatment modality (meniscectomy vs meniscal repair). Failure was defined as reoperation, symptomatic osteoarthritis, or a severely abnormal IKDC score. Univariate regression analyses were performed to predict failure and IKDC scores based on treatment, type and location of tear, or extent of meniscectomy. Results: Included were 217 patients (226 knees) with a mean age of 17.4 years (range, 7-25 years); of these patients, 144 knees (64%) were treated with meniscectomy and 82 knees (36%) with meniscal repair. Treatment with repair increased over time compared with meniscectomy ( P < .001). At a minimum 2-year follow-up (mean, 6.1 ± 3.9 years), 107 patients (110 knees) had IKDC scores, and analysis indicated that although scores in both groups improved from pre- to postoperatively (repair: from 69.5 ± 13.3 to 97.4 ± 4.3; meniscectomy: from 75.7 ± 9.0 to 97.3 ± 3.9; P < .001 for both), improvement in IKDC score was greater after repair (27.9 ± 13.9) versus meniscectomy (21.6 ± 9.4) ( P = .005). Included in the failure analysis were 184 patients (192 knees) at a mean follow-up of 8.4 ± 4.4 years. The rates of reoperation, symptomatic osteoarthritis, and failure were not significantly different between the meniscectomy and repair groups. Conclusion: An increase was seen in the rate of isolated lateral meniscal tear repair in young patients. IKDC score improvement was greater after repair than meniscectomy, although postoperative IKDC scores were similar. Symptomatic arthritis, reoperation, and failure rates were similar between groups; however, there was a trend for increased arthritis symptoms in patients treated with meniscectomy, especially total meniscectomy. Treatment modality, type and location of tear, and amount of meniscus removed were not predictive of final IKDC scores or failure.

scholarly journals Clinical and functional profile of children with autism spectrum disorders

2021 ◽  
Vol 24 (4) ◽  
pp. 231-235
Author(s):  
Elena A. Galova ◽  
Svetlana A. Chekalova ◽  
Olesya L. Kotelnikova ◽  
Ol’ga V. Vorob'eva ◽  
Anna S. Blagonravova ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Sleep Disturbances ◽  
Objective Assessment ◽  
Young Patients ◽  
Allergic Diseases ◽  
Autism Spectrum ◽  
Healthy Children ◽  
Micronutrient Deficiencies ◽  
Patient Profile ◽  
Spectrum Disorders

Introduction. Currently, the gain in the number of children patients diagnosed with Autism Spectrum Disorders (ASD) has been recorded. The key feature of the given group is the polysystemic expression, with considerable disruption of the central nervous system, gastrointestinal tract and immune processes. The research of their counteraction and development is essential for determining tactics for ASD patients’ combination treatment. Aim of the study is to present a clinical and functional patient profile with Autism Spectrum Disorders based on the clinical, medical and social trial. Materials and methods. We conducted a pilot observational, comparative study within two groups of children (62 ASD patients and 48 healthy children dominated by boys). The examination included receiving complaints, objective assessment by the paediatrician and neurologist, filling in medical records, covering complaints and the results of patients’ objective examination and parents/caretakers surveys. Results. The study revealed the predominance of complaints about mental disruptions over somatic complaints. Notably, parents/ caretakers indicated the presence of sleep disturbances (up to 22.5%) and specific eating habits (up to 27.4%) in their children. Young patients in the group under consideration exposed signs of allergic diseases chronic intoxication syndromes and micronutrient deficiencies. Nearly one-third of children reported the presence of functional disorders/digestive diseases. Conclusion. Young patients with Autism Spectrum Disorder are diagnosed with burdened physical status in the form of functional disruptions and diseases. These findings necessitate the paediatrician’s active early detection of organs’ malformation and require somatic systematic monitoring by the psychiatrist and skilled attendance of other medical specialists.

scholarly journals Objective assessment of compliance with intra- and extraoral removable appliances

2016 ◽  
Vol 87 (1) ◽  
pp. 88-95 ◽  
Author(s):  
Angela Arreghini ◽  
Silvia Trigila ◽  
Luca Lombardo ◽  
Giuseppe Siciliani
Keyword(s):  
Treatment Duration ◽  
Objective Assessment ◽  
Young Patients ◽  
Face Mask ◽  
Control Scale ◽  
Psychological Maturity ◽  
The Mean ◽  
Removable Appliance ◽  
Removable Appliances ◽  
Mean Compliance

ABSTRACT Objective: To conduct an objective assessment of the level of compliance in young patients prescribed various types of removable appliances and to determine the influence of device type, treatment duration, and patient age, gender, psychological maturity, and awareness of monitoring on compliance. Materials and Methods: A total of 30 patients were fitted with either a class 2 (Frankel or bionator) or a class 3 (face mask) removable appliance, each bearing a compliance indicator chip, and they were instructed to wear them for 13 hours per day. Compliance was monitored by means of the sensor for an average of 8 months. Of the patients, 14 were informed that their appliance was fitted with a monitoring sensor, and 16 were not. The psychological maturity of all patients was assessed on the Nowicki-Strickland Locus of Control Scale, and the effect on compliance of this score as well as the patient- and treatment-related variables considered were determined via statistical analysis Results: The mean compliance recorded by the chips was 8.6 ± 2.9 hours, far lower than the 13 hours prescribed, and younger patients showed significantly greater compliance than adolescents (P &lt; .01). However, no significant differences in compliance were found between intra- and extraoral appliances, and neither gender, psychological scores, treatment duration, nor awareness of being monitored had any significant effect. Conclusions: Compliance is generally very poor in young patients, regardless of their gender and psychological maturity. Although awareness of monitoring does not appear to boost compliance, such systems may be a valuable means of providing a dentist with objective information regarding their patients' compliance.

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