scholarly journals The Frequency of Resurgery after Percutaneous Lumbar Surgery Using Dekompressor in a Ten-Year Period

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Stephan Klessinger

To prevent open surgical procedures, minimally invasive techniques, like Dekompressor (PLDD), have been developed. The absence of reherniation is an important factor correlating with clinical success after lumbar surgery. In this retrospective, observational study, the frequency of additional open surgery after PLDD in a long time retrospective was examined. The correlation between clinical symptoms and outcome was assessed, and the time between PLDD and open surgery was analyzed. Consecutive patients after PLDD between 2005 and 2007 were included. MacNab’s outcome criteria were used to evaluate patient satisfaction. The need for additional open surgery of the lumbar spine, the period between Dekompressor and resurgery, and the treated levels were analyzed. In total, 73 patients were included in this study. The patients were seen one month after PLDD. The majority of patients (76.7%) had additional radicular pain. The most common level treated was L4-5 (58.9%). The follow-up time was longer than 5 years in 30.1% of the patients and longer than 10 years in 6.82%. The short-term success rate was 67.1%. Additional surgery was performed in 26.0% of patients, with 78.9% of the reoperations undertaken during the first year after PLDD. These patients had a statistically significant worse outcome (P = 0.025). Radicular pain was present in all patients with an early subsequent surgery, but only in 50% of patients with late surgery (P = 0.035). Significantly more patients with poor pain relief had radicular pain (P = 0.04). The short-term success rate was worsened by a resurgery rate of 26.0%. Subsequent surgery, a short time after PLDD, suggests that PLDD is not a replacement for open discectomy. Because patients with radicular pain had a worse outcome and more frequent resurgeries, whether radicular pain is an ideal indication for PLDD should be discussed.

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yadong Feng ◽  
Qian Yu ◽  
Ming Li ◽  
Wei Xu ◽  
Ye Zhu ◽  
...  

Aims. Endoscopic self-expandable metallic stent (SEMS) insertion for acute colonic obstruction caused by colorectal cancer (CRC) is always performed under fluoroscopic guidance. This study evaluated the feasibility and safety of an endoscopic stenting procedure without fluoroscopic guidance. Methods. A total of 36 patients with an acute colonic obstruction caused by CRC underwent endoscopic SEMS insertion using a colonoscope without fluoroscopic guidance, followed by analyses of the technical and clinical success and short-term complications. Results. Total technical success rate and clinical success rate were 91.7% and 86.1%, respectively. The mean procedure time was 21.2±10.3 minutes. There was no stent dislodgement. One case of hematochezia and two cases of tenesmus occurred in patients with left-sided complete obstructions. No other short-term complications occurred. Procedure time, technical success, and clinical success rate were 16.3±9.4 minutes, 93.1%, and 89.6% for left-sided obstructions, respectively, and were 26.8±10.7 minutes, 85.7%, and 71.4% for right-sided obstructions, respectively. For complete obstructions, procedure time, technical success, and clinical success rate were 22.5±8.9 minutes, 90%, and 83.3%, respectively. In the incomplete cases, procedure time, technical success, and clinical success were 13.5±6.7 minutes, 100%, and 100%, respectively. Technical success, clinical success, and short-term complications were not differed between lesion locations and degrees. Conclusions. This simple technique is feasible and safe for palliation of acute colonic obstruction caused by CRC.


1981 ◽  
Vol 2 (1_suppl) ◽  
pp. 12-14 ◽  
Author(s):  
Clair Williams ◽  
Dale Belvedere ◽  
Daniel Cattran ◽  
Sheila Clayton ◽  
Edward Cole ◽  
...  

During the first four years of the CAPD programs in Toronto, 409 patients completed CAPD training; of these 64 (15.7%) were diahetics. The mean age of the diabetics was 46.7 and of the non-diabetics 51.4 years. One and two-year survival rates were not significantly different between the two groups (93%-82% for the non-diabetics and 90%-72% for the diabetics}. The main cause of death was cardiovascular events, in both groups. During the first year on CAPD, diabetics were transplanted at a higher rate than non-diabetics (20% vs. 9%). The overall technique success rate, the rate of transfer to an alternative dialysis modality and the incidence of peritonitis were similar in the two groups. At least in the short -term, diabetics do well on CAPD. It is suggested that CAPD may be the dialysis modality of choice in diabetics with ESRD.


2021 ◽  
Author(s):  
ALI TEKIN ◽  
Sibel Tiryaki ◽  
İsmail Yağmur ◽  
Özge Kılıç ◽  
Ali Avanoğlu ◽  
...  

Abstract Purpose:The treatment of high-grade vesicoureteral reflux in infants is controversial. Subureteric injection has been tried recently with its advantage of easy application and less invasiveness. In this study, we aimed to assess the efficacy of endoscopic sub-ureteric injection to correct high-grade reflux in infants with documented indications for anti-reflux surgery.Materials and Methods:Hospital records of high-grade (grade 4-5) VUR patients who had undergone endoscopic sub-ureteric injection in the first year of life with documented breakthrough infections, between 2009-2016 were reviewed. Radiologic success was defined as complete resolution of reflux in VCUG obtained at least three months after the injection and clinical success was defined as the downgrading of reflux degree below three and absence of urinary infection.Results:A total of 23 patients with 34 high-grade refluxing units were included in the study. The mean age at first injection was 6.3±1.8 months (1-11 months). Radiologic success rate with initial injection was 61.7% and increased to 85.2% after repeated injections. The overall clinical success rate at first injection was 70.6% and 97.1% after repeated injections. Mean injected material volume was 0.34±0.27 (0.1-1) ml per ureter. Conclusion:Endoscopic treatment is a successful alternative in infants with high-grade vesicoureteral reflux suffering breakthrough infections.


2007 ◽  
Vol 22 (6) ◽  
pp. 422-429 ◽  
Author(s):  
José Francisco de Mattos Farah ◽  
José Carlos Del Grande ◽  
Alberto Goldenberg ◽  
Júlio César Martinez ◽  
Renato Arione Lupinacci ◽  
...  

PURPOSE: Evaluate short results after fundoplication procedure, concerning the division of short gastric vessels. METHODS: A prospective randomization of 90 patients with indication for hiatoplasty and total fundoplication with fundus mobilization was performed. They were divided into two groups: no SGV division (group A, n= 46) and with SGV division (Group B, n=44), although in both groups the gastric fundus was mobilized to perform a floppy valve. Early outcome with clinical follow up (1 year) was observed. RESULTS: Both groups were similar regarding preoperative parameters and severity of gastroesophageal reflux disease (GERD). No difference in morbidity was observed during hospital stay. Nevertheless, the median operating time was 80,2 minutes in group A and 94,1 minutes (p=0,021) in Group B. Transitory dysphagia during the first year was significantly lower in group B (46,6% versus 23,2%, p=0,012). However, in 12 months clinical outcome was similar in both groups (clinical symptoms of GERD, persistent dysphagia and reoperations). CONCLUSION: There was no improvement in routine division of SGV in total fundoplication procedure when the gastric fundus was mobilized.


Author(s):  
Abdul Aala Mohammed ◽  
Mohammed Abdul Ali ◽  
Omer wasiq ◽  
Omair Sohail Ahmed

Tedizolid Phosphate is an oxazolidinone-class antibiotic and is used for the treatment of acute bacterial skin and skin structure infections. it is a prodrug activated by plasma or intestinal phosphatases to tedizolid following administration of the drug either orally or intravenously. Once activated, tedizolid exerts its bacteriostatic microbial activity through inhibition of protein synthesis by binding to the 50S ribosomal subunit of the bacteria. The purpose of the study was to evaluate safety and efficacy of Tedizolid phosphate and compare it with that of Lenizolid Phosphate another oxazolidinone class of drugs. The study was conducted at OMNI hospital located at dilsukhnagar, Hyderabad. 126 subjects with skin infections, who satisfied the eligibility criteria, were accrued during the study period. These patients were randomized into 2 groups, and were then evaluated according to the treatment protocol. Investigational product was then administered to evaluate safety and efficacy parameters. Subjects received treatment according to the study arm/group. Subjects were asked to take drug for 7 days daily once orally till the clinical symptoms disappear/ as per PIs discretion. Samples for microbiological evaluation were done at screening, end of the therapy. Among both the formulations the group the received Tedizolid phosphate was considered safer and more efficacious as Clinical success rate was 89.9% and the group that received Lenizolid phosphate had the clinical success rate of 81%. It can be concluded that Tedizolid phosphate could be promising drug in the treatment of various skin infections.


VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Krnic ◽  
Sucic

Background: The aim of this study is to report our results in main stem vein closure using the bipolar radiofrequency induced thermotherapy (RFITT) system and the 1064nm Nd:Yag laser. Patients and methods: 44 incompetent main stem veins (37 great saphenous veins, one lesser saphenous vein, and 6 anterior accessory saphenous veins) in 29 patients were treated using RFITT. 53 incompetent main stem veins (45 great saphenous veins, 4 lesser saphenous veins, and 4 anterior accessory saphenous veins) in 43 patients were treated endovenously with 1064 nm Nd:Yag laser. All patients underwent postoperative duplex scanning within a month after procedure, as well as a short interview regarding postoperative discomfort. Results: In main stem veins treated with RFITT, the success rate within the first month was 86,4 % (38 out of 44 veins). Complete failure rate was 13,6 % (6 out of 44 veins). In 53 main stem veins treated by 1064 nm Nd:Yag laser, the success rate was 100 %, consisting of 98,1 % complete success (52/53 veins), and 1,9 % partial success (1/53 veins). None of the patients treated with RFITT experienced postoperative adverse effects, whereas 13/43 (30,2 %) patients treated with laser had to use oral analgesics after the treatment, and 21/43 (48,8 %) patients reported transient skin changes, such as bruising or skin redness. Conclusions: RFITT system was fairly efficient in the short term for closure of main trunk veins, whereas longer term results are still scarce. Postoperative side effects of RFITT were minimal. 1064nm Nd:Yag laser, according to short term results, proved to be very effective for main stem vein closure. Postoperative side effects related to 1064 nm Nd:Yag endovenous laser treatment proved to be minor, transient, and acceptable.


Author(s):  
Yuhong Jiang

Abstract. When two dot arrays are briefly presented, separated by a short interval of time, visual short-term memory of the first array is disrupted if the interval between arrays is shorter than 1300-1500 ms ( Brockmole, Wang, & Irwin, 2002 ). Here we investigated whether such a time window was triggered by the necessity to integrate arrays. Using a probe task we removed the need for integration but retained the requirement to represent the images. We found that a long time window was needed for performance to reach asymptote even when integration across images was not required. Furthermore, such window was lengthened if subjects had to remember the locations of the second array, but not if they only conducted a visual search among it. We suggest that a temporal window is required for consolidation of the first array, which is vulnerable to disruption by subsequent images that also need to be memorized.


Author(s):  
Mahila Monajati ◽  
Shahram Ala ◽  
Masoud Aliyali ◽  
Roya Ghasemian ◽  
Fatemeh Heidari ◽  
...  

Background: Meropenem standard doses are based on the minimum inhibitory concentration of sensitive pathogens and the pharmacokinetic parameter of not critically ill patients. We compared the efficacy of high versus standard dose of meropenem in ventilator-associated pneumonia (VAP). Methods: 24 out of 34 eligible patients were randomized to receive meropenem 3 g q8h (high dose group, 11 patients) or 2 g q8h (standard dose group, 13 patients) as a 3h infusion. Primary outcome was considered as clinical success that was defined as stable hemodynamic, improved sequential organ failure assessment (SOFA) score, stable or improved PaO2/FiO2 after 7 days. A sputum culture was taken before intervention. Results: Clinical success rate was not significantly different between the high and standard dose group (54.5% vs. 38.5%, P= 0.431). There was a significant difference in reduction of clinical pulmonary infection score (CPIS) compared to high dose with standard group (P=0.038). SOFA score declined significantly in high dose group through the study (P=0.006). A shorter duration of VAP treatment was recorded in high dose group (P=0.061). We did not observe any significant adverse event related to meropenem. Acinetobacter spp. (34.8%), Klebsiella spp. (32.6%) and, Pseudomonas aeruginosa (19.5%) isolated more frequently from sputum cultures. Conclusion: Treatment with high dose of meropenem seems to be safe. However, it did not provide significantly higher clinical success rate in comparison with the standard dose, but could be considered as an appropriate empirical treatment in patients with severe infection due to reducing in SOFA and CPIS.


2000 ◽  
Vol 24 (4) ◽  
pp. 269-272 ◽  
Author(s):  
Hamijeta Ibricevic ◽  
Qumasha Al-Jame

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.


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