scholarly journals O36 LOD (LOSS-OF-DOMAIN) HERNIA TREATMENT WITH INTRAOPERATIVE FASCIA TRACTION. DOES THIS TECHNIQUE MAKE RELEASE OPERATIONS SUPERFLUOUS?

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Henning Niebuhr ◽  
Thomas Aufenberg ◽  
Halil Dag ◽  
Wolfgang Reinpold ◽  
Christian Peiper ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Average Duration ◽  
The Body ◽  
Component Separation ◽  
Gender Ratio ◽  
Abdominal Wall Closure ◽  
Traction Method ◽  
Length Increase ◽  
Sublay Technique ◽  
Average Patient

Abstract Aim Measurable and controlled stretching of the fascia for 30 minutes during surgery to achieve primary tension-free abdominal wall closure in LOD hernias. This prospective observational study aimed to clarify the extent to which this traction method can function as an alternative to component separation methods. Material and Methods We have already applied this technique in > 50 procedures of LOD hernias. We published the data of first 21 patients treated with intraoperative fascia stretching in seven specialized hernia centers between November 2019 and August 2020. The average patient age was 58 years with a gender ratio of 2.5 males: 1 female. ASA scores were III in 66.7% and II in 33.3%. The body mass index (BMI) averaged 32.5 kg/m2. Thirteen patients were treated with BTA 4 weeks before surgery. Results Intraoperatively-measured fascial distance averaged 17.3 cm (range 8.5–44 cm). After application of diagonal-anterior traction >10 kg for an average duration of 32.3 min (range 30–40 min), the fascial distance decreased by 9.8 cm (1–26 cm) to an average 7.5 cm (range 2–19 cm), which is a large effect (r = 0.62). The fascial length increase (average 9.8 cm) after applied traction was highly significant. All hernias were closed under moderate tension after the traction phase. In 19 patients, this closure was reinforced with mesh using a sublay technique. Conclusions This method allows primary closure of complex LOD hernias and is potentially less prone to complications than component separation methods.

scholarly journals Intraoperative Fascia Tension as an Alternative to Component Separation. A Prospective Observational Study

2021 ◽  
Vol 7 ◽  
Author(s):  
Henning Niebuhr ◽  
Thomas Aufenberg ◽  
Halil Dag ◽  
Wolfgang Reinpold ◽  
Christian Peiper ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Average Duration ◽  
Late Complications ◽  
Component Separation ◽  
Traction Method ◽  
Length Increase ◽  
Sublay Technique ◽  
Severe Peritonitis ◽  
Giant Hernia

Incisional hernias are common late complications of abdominal surgery, with a 1-year post-laparotomy incidence of about 20%. A giant hernia is often preceded by severe peritonitis of various causes. The Fasciotens® Abdomen device is used to stretch the fascia in a measurably controlled manner during surgery to achieve primary tension-free abdominal closure. This prospective observational study aims to clarify the extent to which this traction method can function as an alternative to component separation (CS) methods.Methods: We included data of 21 patients treated with intraoperative fascia stretching in seven specialized hernia centers between November 2019 and August 2020.Results: Intraoperatively-measured fascial distance averaged 17.3 cm (range 8.5–44 cm). After application of diagonal-anterior traction >10 kg for an average duration of 32.3 min (range 30–40 min), the fascial distance decreased by 9.8 cm (1–26 cm) to an average 7.5 cm (range 2–19 cm), which is a large effect (r = 0.62). The fascial length increase (average 9.8 cm) after applied traction was highly significant. All hernias were closed under moderate tension after the traction phase. In 19 patients, this closure was reinforced with mesh using a sublay technique.Conclusion: This method allows primary closure of complex (LOD) hernias and is potentially less prone to complications than component separation (CS) methods.

scholarly journals P.058 Length dependent sensorimotor peripheral neuropathy often results in ventral abdominal sensory loss

2016 ◽  
Vol 43 (S2) ◽  
pp. S35-S35
Author(s):  
CB Gervais ◽  
MA Ross ◽  
BP Goodman ◽  
LA Angel ◽  
SE Benn
Keyword(s):  
Peripheral Neuropathy ◽  
Final Diagnosis ◽  
Nerve Fibers ◽  
Demographic Variables ◽  
The Body ◽  
Sensory Loss ◽  
Gender Ratio ◽  
Clinical Exam ◽  
Impairment Score ◽  
Sensory Fibers

Background: Length-Dependent Sensorimotor Peripheral Neuropathy (LDSMPN) affects the longest nerve fibers in the body. Less well-appreciated, and absent from the current literature, is that LDSMPN affecting thoracic segments gives rise to ventral abdominal sensory loss on clinical exam. Methods: Consecutive patients seen for LDSMPN (n=30) were evaluated prospectively for the presence or absence of ventral abdominal sensory loss. Demographic variables, symptoms, quantitative neurologic findings (Neuropathy Impairment Score [NIS]) and final diagnosis were examined using descriptive statistics. Results: Ventral abdominal sensory loss was documented in 20/30 LDSMPN patients (66.7%), mean age was 64.1 years (range 33-81), M:F gender ratio was 19:11, mean NIS was 21.4 (range 0-77). NCS/EMG abnormalities were found in 25/30 patients, with 5/30 having a clinical exam and/or other electrophysiological evidence convincing for LDSMPN. LDSMPN patients without ventral abdominal sensory loss (n=10) had a mean age of 61.2 (range 45-73), M:F of 7:3, and mean NIS of 20.9 (range 0-54). Conclusions: 1) Ventral abdominal sensory loss appears to be common in patients diagnosed with LDSMPN of a variety of causes; 2) in addition to those innervating distal limb territories, distal sensory fibers from the thoracic region represent another category of length dependent involvement in LDSMPN; 3) the clinical examination of LDSMPN should include the ventral abdomen.

scholarly journals Using Chinese Body Constitution Concepts and Measurable Variables for Assessing Risk of Coronary Artery Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yi-Chia Huang ◽  
Chien-Jung Lin ◽  
Shu-Meng Cheng ◽  
Chi-Kuei Lin ◽  
Sunny Jui-Shan Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Prospective Observational Study ◽  
Case Control Study ◽  
Case Control ◽  
The Body ◽  
Healthy Controls ◽  
Body Constitution ◽  
Artery Disease ◽  
Control Study

Background. Identifying patients with high risk of coronary artery disease (CAD) is often difficult in outpatient clinic settings. This study aimed to explore if the measurement of body constitution can be adopted to predict the risk of CAD diagnosis. The objective of this study is to conduct a prospective observational study and a case-control study to answer the research question. Study Design. Part 1 (prospective observational study): a total of 143 patients with chest pain and admitted to receive cardiac catheterization were enrolled, and 108 of them were diagnosed with CAD. Part 2 (case-control study): the above 108 CAD patients and 476 healthy controls matched by age and gender from the participants of Taiwan Biobank were adopted for comparison. Main Outcome Measures. The body constitution of both patients and healthy controls were measured by the Body Constitution Questionnaire (BCQ). Each one received scores of Yang-Xu (Yang-deficiency), Yin-Xu (Yin-deficiency), and Stasis. These 3 scores together with demographic characteristics and CAD risk factors were used in the logistic multiple regression model to predict the risk of CAD. Results. (Part 1) No difference was found between the scores of Yang-Xu, Yin-Xu, and Stasis between the patients with and without CAD. (Part 2) The scores of Yang-Xu, Yin-Xu, and Stasis of the CAD patients were significant higher those of the healthy controls. Yang-Xu and Stasis scores were obtained with age, BMI, and hypertension in the model with prediction rate 89.0%. The area under receiver operating characteristic curve of this model was 0.896. Conclusions. This study is the first to apply Chinese body constitution concepts and measurable variables to assess the risk of having CAD of the patients with chest pain prior to receiving cardiac catheterization. The higher scores of Yang-Xu and Stasis were found to be risk factors. Our results revealed that BCQ has the potential to be a first-line diagnostic tool for patients with chest pain to facilitate early recognition and diagnosis of CAD.

Improving technical fitness of race walkers on the basis of special exercises to focus on key parameters of movements

2020 ◽  
Vol 24 (2) ◽  
pp. 100-105
Author(s):  
O. A. Vinogradova ◽  
S. P. Sovenko
Keyword(s):  
Degrees Of Freedom ◽  
Stride Length ◽  
Body Position ◽  
The Body ◽  
Fatigue Development ◽  
Length Increase ◽  
Before And After ◽  
The Face ◽  
Race Walking ◽  
Motion Characteristics

In race walking, the reliability of competitive activity, the risks of disqualification are determined by athlete's stable control of the key motion characteristics at a distance, especially in the face of fatigue. Therefore, the formation of specialized sensations in an athlete to control these movements is an important condition for sports technique improvement. Hypothesis of study: the use of special exercises to increase the analytical perception of motion key parameters will increase the effectiveness of race walking technique, control for fatigue development. Objective of study: to show the possibilities of increasing special fitness in race walking through the use of special exercises, improvement of the analytical perception of motion key parameters. Subjects and methods of study: 10 athletes aged 17-20 years and engaged in sports training for 4-6 years participated in the study. Special exercises, assessment of race walking technique (video shooting) before and after their performance within three weeks (10 sessions) were used. Results: it is shown that the targeted use of special exercises with the analysis of subjective sensations creates conditions for the activation in the athlete of specialized perceptions for the basic sports technique elements. After the use of special exercises, the increase in speed was due to an increase in the stride length - 1.14 m (S = 0.04), relative to the initial one - 1.09 m (S = 0.03) (p < 0.01). The stride length increase in athletes occurred at the expense of the length of the “rear” stride ( = 0.43 м; S = 0.02) at statistically significant differences from the initial indices. This created the prerequisites for improving athletic performance. Conclusions. Special exercises focusing on key parameters of movements contribute to increase of technical fitness of race walkers. The proposed approach creates the prerequisites for further research on the formation of the motor composition of the skill of body position accuracy, the development of sensations of free movement, inertia, liberation from excessive degrees of freedom in the parts of the body with account for the functional state of the athlete.

Postmetamorphic growth rates in a natural population of Fowler's toad, Bufo woodhousei fowleri

1974 ◽  
Vol 52 (12) ◽  
pp. 1489-1498 ◽  
Author(s):  
Raymond D. Clarke
Keyword(s):  
Growth Rates ◽  
The Body ◽  
Individual Growth ◽  
Length Increase ◽  
Sexual Characteristics ◽  
Size Growth ◽  
Body Sizes ◽  
Bufo Woodhousei ◽  
Fowler's Toad ◽  
Toad Bufo

A population of Fowler's toad (Bufo woodhousei fowleri) living on a golf course in New Haven, Connecticut, was studied for 3 years by the capture–mark–recapture method. Individual growth rates were determined using tibia length, which is isometric with body length, as the measure of size. Growth was rapid, with an average 6.58-fold length increase during the 1st year after metamorphosis. Males began to show secondary sexual characteristics about 1 year after metamorphosis; at this age the cohort began to overlap in body size with the older males. Females grew faster than males, but also reached a larger size, and the body sizes of the maturing female cohort began to overlap with the older females 1 month later than the males. The growth curve for length was inflected, which is predicted by von Bertalanffy's growth model.

Scabies by Kenneth Mellanby

2004 ◽  
Vol 8 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Robert Jackson
Keyword(s):  
Great Britain ◽  
Second World War ◽  
The Body ◽  
Diagnosis And Treatment ◽  
World War ◽  
Average Patient ◽  
Social Upheaval ◽  
Second World

Background: Epidemics of scabies are often associated with wars or other times of social upheaval. This was particularly evident during the Second World War when it was estimated that there were one to two million patients with scabies in Great Britain. Objective: This article reviews the work of the zoologist Kenneth Mellanby of England and evaluates his contribution to our knowledge of the diagnosis and treatment of scabies in the Second World War. Conclusion: Using humans, Mellanby studied the transmission and treatment of this disease. Among his contributions were knowledge of how many mites the average patient had, and where they were located. He clearly noted and described that the scabies rash was not limited to the location of the mites on the body; he attributed the rash in areas with no mites to “a true sensitization.” He found that “fomites were not the major method of transmissions.”

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

2016 ◽  
Vol 30 (1) ◽  
pp. 15-19
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Fahmida Khan ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Prospective Observational Study ◽  
Average Duration ◽  
Target Population ◽  
Bladder Injury ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Duration Of Surgery ◽  
Abdominal Route

Objective(s): The aim of the study wasto evaluate the safety and feasibility of non-descent vaginal hysterectomy in advancing gynaecological practice.Materials and methods: This prospective observational study was conducted from 1st July 2013 to 31st June 2014 in Obstetrics and Gynaecology Department of Kumudini Women’s Medical College & Hospital, Mirzapur, Tangail. Fifty patients who needed hysterectomy for benign gynaecological disorders and who had no descent of uterus or vagina were the target population for this study. Main outcome measures were i) difficulty of operation, ii) procedures for overcoming the difficulties,iii) switch over to abdominal route, iv) time taken to complete the operation, v) blood loss during operation vi) need of blood transfusion and vii) postsurgical hospital stay.Results: In all (100%) cases vaginal hysterectomy was completed successfully. Commonest age group (46%) was between 41-45 years. All patients were parous. Size of the uterus was less then 8 wks in 21 cases, 8wks to 12 wks in 27 cases and more than 12 wks in 02 cases. Commonest indication was dysfunctional uterine bleeding (DUB) (44%). Mean duration of surgery was 50.5 ± 5.46 minutes. Mean blood loss was 100± 22.43 ml.Blood transfusion was required in four cases. Average duration of hospital stay was 3.1± 1.2 days. Complications were minimum which included, bladder injury, UTI and Vault infection.Conclusions: In properly selected cases non-descent vaginal hysterectomy is safe, feasible and patient friendly.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 15-19

scholarly journals Non venereal benign dermatoses of vulva in sexually active women: a clinical study

2016 ◽  
Vol 2 (2) ◽  
pp. 25
Author(s):  
Garima Singh ◽  
B. S. Rathore ◽  
Abhishek Bhardwaj ◽  
Charu Sharma
Keyword(s):  
Health Care ◽  
Prospective Observational Study ◽  
Pelvic Organ ◽  
The Body ◽  
Sexually Active ◽  
Common Site ◽  
Health Care Centre ◽  
Sexually Transmitted ◽  
Routine Clinical Examination ◽  
Spss Software

<p class="abstract"><strong>Background:</strong> Vulvar complaints are usually an uncomfortable discussion not only for the patient but also for the health care provider. Vulva remains one of the most covered regions of the body and seems truly to be a forgotten pelvic organ.  Any genital lesion or related symptoms are erroneously considered to be sexually transmitted. Hence this study was conducted to emphasize on the fact that all genital lesions are not sexually transmitted.  Objective of the study was to determine the clinical pattern and relative frequency of non-venereal benign dermatoses of vulva in sexually active women at a tertiary health care centre.</p><p class="abstract"><strong>Methods:</strong> It was a prospective, observational study. All sexually active women attending the outpatient department of Dermatology and Gynecology, who presented either with vulvar complaints or with vulvar dermatoses on routine clinical examination were included in the study. Women with six classical venereal diseases or with vulvar malignancies were excluded from the study. After detailed history &amp; examination, results were tabulated and analysed by SPSS software.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 70 sexually active women were observed. Majority of women were from rural background (54.28%), were housewives (81.42%) and were illiterate (42.85%). The commonest presenting feature was itching. Labia majora was the most common site of involvement and Tinea cruris was the most common dermatoses involved.</p><strong>Conclusions:</strong> All vulvar dermatoses are not sexually transmitted.

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