P023 THE ASSOCIATION BETWEEN BIOLOGIC USE AND SPECIMEN LENGTH IN CROHN’S DISEASE

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S56-S56
Author(s):  
Trevor Wood ◽  
Karen Zaghiyan ◽  
Phil Fleshner
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Biologic Agents ◽  
Operative Intervention ◽  
Study Cohort ◽  
Specimen Length ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Introduction Despite advances in medical management, including the use of biologic agents, up to 80% of Crohn’s patients (CD) ultimately require operative intervention. Additionally, these patients are at risk for additional operative intervention within their lifetime. Given the risk of short bowel syndrome secondary to multiple bowel resections, conservation of bowel length is of paramount importance. A common yet unproven belief in the gastroenterology community is that intensive preoperative medical therapy might reduce the length of bowel removed at surgery. In this study, we compared specimen length in CD patients treated or not treated with biologic agents before surgery. Objective To determine if there is an association between biologic use and reduced specimen length after bowel resection. Methods Prospectively generated clinical profiles on consecutive CD patients undergoing their first ileocolic or small bowel resection between November 1999 to July 2019 were reviewed. Patients were classified into 2 groups: Group A patients were treated with biologic agents at any time before surgery while Group B patients had never received a biologic agent. Specimen length was determined by review of pathology reports. In patients with multi-segment resections, the sum of the specimens was recorded. The means of the two groups were compared using Students t test. Results The study cohort of 392 patients had a mean age of 36.2 (SD 15.9) years and included 53% males. Group A included 247 (63%) patients and Group B included 145 (37%) patients. Groups were comparable in terms of background demographics with the exception of age, use of preoperative immunomodulator therapy, and medical intractability as an indication for surgery (p value 0.01, <0.01, 0.02 respectively) The mean specimen length in Group A was 29.1cm compared to 29.9cm in the Group B (p=0.68). A subgroup analysis of ileocolic resections and small bowel resections was completed. Within the ileocolic group, there was no significant difference in length between groups with respect to the total specimen length (p=0.92), colonic portion (p=0.15), and small bowel portion (p=0.67). Analysis of small bowel resection specimens also found no difference in length between the groups (p=0.63). Conclusions The use of biologics in CD was not associated with reduced specimen length in ileocolic resections and in small bowel resections

Ophthalmic artery catheterization for retinoblastoma treatment: does reflux affect tumor response?

2020 ◽  
Vol 12 (9) ◽  
pp. 915-920 ◽  
Author(s):  
Ahmad Sweid ◽  
Batoul Hammoud ◽  
Joshua H Weinberg ◽  
Pavlos Texakalidis ◽  
Vivian Xu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Ophthalmic Artery ◽  
Tumor Response ◽  
Retrospective Chart Review ◽  
Primary Treatment ◽  
Study Cohort ◽  
Significant Difference ◽  
Group A ◽  
Poor Outcomes ◽  
Group B

BackgroundIntra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has been established as a primary treatment for the disease. To determine whether the presence of reflux into the ICA is associated with tumor response or with any other adverse events in pediatric retinoblastoma patients.MethodsA retrospective chart review was performed for patients diagnosed with Rb and managed with ophthalmic artery catheterization (OAC).ResultsThe total study cohort included 205 Rb tumors of 205 eyes in 194 consecutive patients who underwent 624 successful intra-arterial chemotherapy infusions using OAC. Of the 205 eyes, 65 eyes (32.7%) underwent 157 OAC procedures constituted group A (no reflux), 64 eyes (31.2%) underwent 236 OAC procedures constituted group B (variable pattern), and 74 eyes (36.1%) underwent 231 OAC procedures constituted group C (reflux). There was no significant difference in baseline characteristics between the three cohorts. Also, there was no significant difference in tumor characteristics between the three groups, except for genetic status. There was no significant difference between the three groups in terms of tumor response at completion of the treatment regimen. Complete tumor response was achieved at 70.2% in Group A, at 83.3% in Group B, and at 78.5% in group C (P=0.39). Similarly, eye enucleation occurred at 38.5% in group A, 31.8% in group B, and 31.5% in group C. None of the patients in both groups had any neurological adverse events or new onset of seizures.ConclusionsThe presence of reflux, which may complicate the procedure and prolong it, was not associated with poor outcomes in our analysis.

scholarly journals Computed Tomography Enterography: Better Luminal Distension with a Shorter Ingestion Time Protocol in an Indian Population

2018 ◽  
Vol 01 (01) ◽  
pp. 033-040
Author(s):  
Ambika R. ◽  
Vidhya Rani Reddy
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Abdominal Cavity ◽  
Bowel Distension ◽  
Significant Difference ◽  
Ingestion Time ◽  
Computed Tomography Enterography ◽  
Group A ◽  
Group B ◽  
Contrast Ct

Abstract Aim This article prospectively evaluates the adequacy of bowel distension in computed tomography enterography (CTE) with a 45-minute contrast ingestion time and compares it with the most widely used protocol in the literature of 1 hour 20 minutes. Materials and Methods The CTE was performed in 42 consecutive patients divided into two groups—A and B. Group A patients were instructed to drink 2 L of polyethylene glycol electrolyte solution over 1 hour 20 minutes. Group B patients were instructed to do the same over 45 minutes. At the end of contrast ingestion, plain and contrast CT abdomen was performed and CTE images were reviewed. Manual quantitative analysis of degree of small bowel distension was performed in the following manner: on coronal images, the abdominal cavity was divided into four quadrants: right upper, left upper, right lower, and left lower quadrants. The maximum small bowel lumen diameter (inner-to-inner wall) was measured in five different loops within each of the four quadrants. If four or more measurements in a quadrant ≥ 1.8 cm (considered “adequate luminal distension”), a score of 1 was assigned to that quadrant. If less than 4 measurements in the quadrant > 1.8 cm, a score of 0 was assigned to that quadrant. The ensuing sum of scores from all four quadrants resulted in the distension grade for that CTE study (Grades 1–4). Results There was a statistically significant difference in the degree of small bowel distension between the two groups with better distension seen in group B (p < 0.001). Conclusion Indians have a rapid gut transit time compared with Western populations. Hence, CTE contrast ingestion time protocols optimized in Western populations may not be suitable in Indians. The shorter 45-minute ingestion protocol provided consistently better luminal distension in our population than the longer 1 hour 20-minute protocol described in the literature. To the best of our knowledge, there are no other studies comparing CTE ingestion time protocols in a given population.

scholarly journals Early Continence Recovery after Preservation of Maximal Urethral Length until the Level of Verumontanum during Radical Prostatectomy: Primary Oncological and Functional Outcomes after 1 Year of Follow-Up

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Stavros Sfoungaristos ◽  
Stavros Kontogiannis ◽  
Petros Perimenis
Keyword(s):  
Radical Prostatectomy ◽  
Functional Outcomes ◽  
Oncological Outcome ◽  
Functional Results ◽  
Study Groups ◽  
Study Cohort ◽  
Open Radical Prostatectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To investigate the effect of preventing maximal urethral length until the level of verumontanum during radical prostatectomy on both oncologic and functional outcomes.Patients and Methods. We recruited 329 patients, and they underwent an open radical prostatectomy by a single surgeon. The study cohort was randomized in 2 groups. A standard radical prostatectomy was performed in group A patients, while in group B the urethra was preserved until the level of verumontanum.Results. There was no statistically significant difference between the study groups in terms of positive surgical margins or biochemical relapse. Regarding the functional results, the incidence of incontinence, urgency, and nocturia at 1st month, statistically significant higher rates were seen in group A. In addition, there was a statistically significant difference in the number of pads/day in favor of group B at the 1st, 3rd, and 6th months after surgery. However, this difference was eliminated at 12 months postoperatively. Similar results were seen with the scores of the ICIQ-SF and IIQ-SF questionnaires.Conclusions. Without compromising the oncological outcome, our surgical modificated technique showed earlier recovery of continence in the first 6 months, having though the same rates of continence at 12 months.

Relation of Small Bowel Resection to Nutrition in Man

1960 ◽  
Vol 38 (4) ◽  
pp. 605-615 ◽  
Author(s):  
M.H. Kalser ◽  
J.L.A. Roth ◽  
H. Tumen ◽  
T.A. Johnson
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Small Bowel Resection

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

Comparative Clinical study of Jatyadi Taila and Jatyadi Ghrita in the management of Dushta Vrana

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Rajendra Joshi ◽  
N. B. Mashetti ◽  
Rakesh Kumar Gujar
Keyword(s):  
Clinical Study ◽  
Burning Sensation ◽  
Normal Process ◽  
Surgical Practice ◽  
Local Factors ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
Group A ◽  
Contaminated Wound ◽  
Group B

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.

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