scholarly journals Long-Term Effect of Left Atrial Appendage Occlusion in Treating Patients with Previous Ischemic Stroke on the Disease Recurrence

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jia Yu ◽  
Yufeng Liu ◽  
Peng Sun ◽  
Xing Guo ◽  
Haiyang Jiang ◽  
...  

Background and Objective. Thrombolytics and anticoagulants are conventional drugs for ischemic stroke (IS) treatment, whereas some patients have unfavorable responses to these drugs. The disease presents a relatively high recurrence rate. This investigation attempted to unveil the long-term effect of left atrial appendage occlusion (LAAO) in treating patients with previous IS on the disease recurrence. Methods. A total of 120 patients with IS admitted to Tangdu Hospital from July 2016 to September 2017 were grouped into the control group ( n = 60 ) and the observation group ( n = 60 ). Patients in the control group were only treated with thrombolytics and anticoagulants while those in the observation group were treated with both drugs and LAAO. Transesophageal echocardiography (TEE) was performed to observe the occlusion of LAA in patients in the observation group after 45 d and 6 months, respectively. Clinical outcomes in two groups were compared from the following aspects: recurrence of IS, incidence of systemic embolism, and the 3-year recurrence-free survival (RFS). The 3-year IS recurrence of patients was compared by Fisher’s exact test. Results. No significant differences were observed at baseline levels (age, sex, etc.) between the observation group and control group ( p > 0.05 ). During follow-up visit of 45 d and 6 months, all occluders met the efficacious occludsion criteria. The results of TEE at 45 d after LAAO showed that 50% of patients (30/60) in the observation group had complete occlusion of LAA. The results of TEE at 6 months after LAAO suggested that 58.3% of patients (35/60) had complete occlusion of LAA. IS recurrence in the observation group (3.33%, 2/60) was significantly lower than that in the control group (18.33%, 11/60), with the difference presenting statistical significance ( p = 0.008 ). Incidence of systemic embolism in the observation group (1.67%, 1/60) was markedly lower than that in the control group (13.33%, 11/60) ( p = 0.014 ). The average RFS in the observation group (31.97 months, 95% CI: 27.50~32.31 months) was notably longer than that in the control group (29.91 months, 95% CI: 29.85~32.92 months) ( p < 0.05 ). The 3-year IS recurrence of patients between two groups compared by Fisher’s exact test showed significant differences (1 year: p = 0.014 , 2 year: p = 0.008 , 3 year: p = 0.008 ). Conclusion. Regarding patients with previous IS who had poor response to thrombolytics and anticoagulants, LAAO could effectively decrease recurrence of IS and incidence of systemic embolism and prolong RFS of patients. LAAO was, therefore, an alternative for patients with high IS recurrence risk.

2021 ◽  
Author(s):  
Baoshan Li ◽  
Xin Zhang ◽  
Yi Man ◽  
Jiadong Xie ◽  
Wei Hu ◽  
...  

Abstract Porcine small intestine submucosa (SIS) biologic patch has been used in inguinal hernia repair. However, there are little data available to assess the long-term effect after repair. This study aimed to explore the long-term effect of SIS patch in open inguinal hernia repair. Sevent-six patients with unilateral inguinal hernia were treated with Lichtenstein tension-free hernia repair using SIS patch (Beijing Datsing Bio-Tech Co., Ltd.) and Surgisis patch (COOK, USA) in Tianjin Union Medical Center and China-Japan Friendship Hospital. In the trial, the long-term efficacy of the treatment group and the control group were compared. A total of 66 patients in both groups received long-term follow-up (&gt; 5 years) after surgery, with a follow-up rate of 86.8%. During the follow-up period, there was one case of recurrence, one case of chronic pain in the control group. There was no statistically significant difference (P &gt; 0.05) in terms of recurrence, chronic pain, foreign body sensation and infection between the two groups of patients. After long-term observations, it has been found that the porcine small intestinal submucosa (SIS) biological patch is safe and effective for inguinal hernia Lichtenstein repair, and has a low recurrence rate and complication rate.


2020 ◽  
Vol 59 (03) ◽  
pp. 269-275
Author(s):  
Imre Szerb ◽  
Tamás Gál ◽  
Dániel Kiss ◽  
Viktória Nagy ◽  
László Hangody

Abstract Objective The study objective was to evaluate the long-term effect of radiosynoviorthesis (RSO) on the progression of radiological and nuclear-medical osteoarthritic features of hip and ankle joint in patients with osteoarthritis and rheumatoid arthritis. Patients and Methods The study included 89 hip joints of 81 patients, of which 48 had osteoarthritis (OA) and 33 had rheumatoid arthritis (RA). In terms of ankle joints, 64 patients were included of which 43 suffered from OA and 21 from RA. The mean follow-up time was 9.2 years for OA and 8.9 years for RA patients. Patients with RA were the active control group. Structural alterations of the hip joints were evaluated following Kellgren-Lawrence score and of ankle joint following Takakura score for both disease entities. For the evaluation of synovitis 2-phase bone scintigraphy was performed. Results RSO could prevent radiologic status deterioration among 70.6 % of hip osteoarthritic patients and 73.7 % among the hip RA patients. No structural progression was observed in 79.1 % of the treated ankle joints in patients with OA and in 85.7 % of the ankle joints in patients with RA.The scintigraphic response rate for the hip joints of OA patients was 68.6 %, 76.3 % for hip joints of RA patients, 83.1 %, ankle joints of OA patients, and 90.4 % ankle joints of RA patients.The radiographic and scintigraphic RSO response rates were not significantly higher for both joints in RA than OA patients. Conclusion RSO can be a good alternative in the treatment of synovitis and prevention of deterioration of inflammatory and radiographic features even in patients suffering from osteoarthritis and rheumatoid arthritis. RSO may have also a long-term effect to stop or delay progression of both diseases.


2020 ◽  
Author(s):  
Alexandre Mazéas ◽  
Martine Duclos ◽  
Bruno Pereira ◽  
Aïna Chalabaev

Background. The use of gamification to change behaviors and promote physical activity is a promising avenue to tackle the global physical inactivity pandemic and the current prevalence of chronic diseases. However, we do not have yet evidence of the effectiveness of gamified interventions with the existence of mixed results in the literature.Objective. This systematic review and meta-analysis aimed to evaluate the effectiveness of gamified interventions and their healthcare potential by testing the scalability and sustainability of their influence on physical activity (PA) and sedentary behaviors (SB).Methods. Five electronic databases (Pubmed, EMBASE, Scopus, Web of Science and CENTRAL) were searched for randomized controlled trials (RCTs) published since 2010. Eligibility criteria were based on components of PICO (participants, interventions, comparators, and outcomes). Studies were included when they used gamified interventions in daily life with an active or inactive control group, and when they assessed a PA or SB outcome. Studies were excluded when the intervention was based on an active video game using a gaming console. We conducted meta-analyses using a random effects model approach. Sensitivity analyses, influence analyses and publication bias analyses were performed to examine the robustness of our results.Results. The main meta-analysis performed on 16 studies and 2407 participants, revealed a small to medium summary effect of gamified interventions on PA behavior (g = 0.42 (95%CI [0.14, 0.69]). No statistical difference was found between different subgroups (adults vs adolescents, healthy participants vs adults with chronic diseases) and no interaction effects with moderators like age, gender or BMI, suggesting good scalability of gamified interventions. Moreover, the effect appears better on the step count (MD = +1609.56 steps per day (95%CI [372.39, 2846.73]) than on moderate-to-vigorous PA (g = 0.31 (95%CI [-0.19, 0.80]). The long-term effect (measured with follow-up averaging 14 weeks after the end of the intervention) is more volatile with a very small to small effect (g = 0.15, [0.07, 0.23]). Conclusions. This meta-analysis confirms that gamified interventions are promising to promote PA in various publics. However, if the effect persists after the end of the program, suggesting that it is not just a novelty effect due to the playful nature of gamification, it seems volatile with a small long-term effect. The integration of gamification in more global healthcare interventions could be a way to address this low sustainability. Future rigorous trials are needed to explore these perspectives.


2021 ◽  
Vol 7 (5) ◽  
pp. 1681-1685
Author(s):  
Panpan Liu ◽  
Meifang Dou ◽  
Li’an Yi ◽  
Kemei Li ◽  
Fenghua Yan

To explore the long-term effect of low-dose mifepristone in the treatment of uterine leiomyoma. Methods: 90 cases of hysteromyoma treated in our hospital from December 2018 to May 2019 were randomly divided into control group and observation group, 45 cases in each group. The control group was treated with conventional dose (25mg / D) of mifepristone, and the observation group with low dose (12.5mg / D) of mifepristone. The uterine volume, uterine fibroid volume, hormone level, therapeutic effect and adverse reactions were compared between the two groups. Results: After treatment, the volume of uterus and hysteromyoma in the two groups decreased significantly, but there was no significant difference between the observation group and the control group (P > 0.05); the level of E2, P, FSH in the two groups decreased, but there was no significant difference between the observation group and the control group (P > 0.05); the treatment effect of the observation group and the control group was no significant difference (P > 0.05); the adverse reactions of nausea, anorexia, hot flashes and fatigue in the observation group The birth rate was significantly lower than that of the control group (P < 0.05). Conclusion: Low dose mifepristone can also effectively reduce the level of estrogen and progesterone in patients with uterine leiomyoma, reduce the volume of leiomyoma, reduce the incidence of adverse reactions, with high safety, which is worthy of clinical application.


2020 ◽  
Author(s):  
Alexandre Mazeas ◽  
Martine Duclos ◽  
Bruno Pereira ◽  
Aïna Chalabaev

BACKGROUND The use of gamification to change behaviors and promote physical activity is a promising avenue to tackle the global physical inactivity pandemic and the current prevalence of chronic diseases. However, we do not have yet evidence of the effectiveness of gamified interventions with the existence of mixed results in the literature. OBJECTIVE This systematic review and meta-analysis aimed to evaluate the effectiveness of gamified interventions and their healthcare potential by testing the scalability and sustainability of their influence on physical activity (PA) and sedentary behaviors (SB). METHODS Five electronic databases (Pubmed, EMBASE, Scopus, Web of Science and CENTRAL) were searched for randomized controlled trials (RCTs) published since 2010. Eligibility criteria were based on components of PICO (participants, interventions, comparators, and outcomes). Studies were included when they used gamified interventions in daily life with an active or inactive control group, and when they assessed a PA or SB outcome. Studies were excluded when the intervention was based on an active video game using a gaming console. We conducted meta-analyses using a random effects model approach. Sensitivity analyses, influence analyses and publication bias analyses were performed to examine the robustness of our results. RESULTS The main meta-analysis performed on 16 studies and 2407 participants, revealed a small to medium summary effect of gamified interventions on PA behavior (g = 0.42 (95%CI [0.14, 0.69]). No statistical difference was found between different subgroups (adults vs adolescents, healthy participants vs adults with chronic diseases) and no interaction effects with moderators like age, gender or BMI, suggesting good scalability of gamified interventions. Moreover, the effect appears better on the step count (MD = +1609.56 steps per day (95%CI [372.39, 2846.73]) than on moderate-to-vigorous PA (g = 0.31 (95%CI [-0.19, 0.80]). The long-term effect (measured with follow-up averaging 14 weeks after the end of the intervention) is more volatile with a very small to small effect (g = 0.15, [0.07, 0.23]). CONCLUSIONS This meta-analysis confirms that gamified interventions are promising to promote PA in various publics. However, if the effect persists after the end of the program, suggesting that it is not just a novelty effect due to the playful nature of gamification, it seems volatile with a small long-term effect. The integration of gamification in more global healthcare interventions could be a way to address this low sustainability. Future rigorous trials are needed to explore these perspectives.


2020 ◽  
Vol 98 (12) ◽  
Author(s):  
Daolin Mou ◽  
Dajiang Ding ◽  
Shuang Li ◽  
Hui Yan ◽  
Binting Qin ◽  
...  

Abstract Selenium (Se) is an essential trace element for animals and exists in nature in both inorganic and organic forms. Although organic Se is more bioavailable than inorganic Se, there are inconsistent reports on the effect of organic Se on the reproductive performance of sows. This study was conducted to investigate the effect of maternal organic Se (2-hydroxy-4-methylselenobutanoic [HMSeBA]) supplementation on reproductive performance and antioxidant capacity of sows, and the long-term effect on the growth performance and antioxidant capacity of their offspring with or without lipopolysaccharide (LPS) challenge. The experimental design used in this study was a completely randomized design; 45 Landrace × Yorkshire sows were randomly allocated to receive one of the following three diets during gestation: control diet (Control, basal diet, n = 15), sodium selenite (Na2SeO3)-supplemented diet (Na2SeO3, basal diet + 0.3 mg Se/kg Na2SeO3, n = 15), and HMSeBA-supplemented diet (HMSeBA, basal diet + 0.3 mg Se/kg HMSeBA, n = 15). On day 21 of age, male offspring from each group were injected with LPS or saline (n = 6). As compared with the control group, maternal HMSeBA supplementation increased the number of total born piglets, while decreased birth weight (P &lt; 0.05). In the first week of lactation, maternal HMSeBA supplementation increased litter weight gain compared with the Na2SeO3 group (P &lt; 0.05) and increased the average daily gain of piglets compared with the control group and Na2SeO3 group (P &lt; 0.05). Meanwhile, maternal HMSeBA supplementation decreased piglet birth interval as compared with the control group and Na2SeO3 group (P &lt; 0.05). Besides, plasma glutathione peroxidase (GSH-Px) activity was higher in the HMSeBA group on farrowing 0 min and 90 min, while malondialdehyde (MDA) concentration was lower on farrowing 0, 90, and 135 min than those in the control group (P &lt; 0.05). In addition, maternal HMSeBA supplementation increased the concentration of selenoprotein P (SELENOP) in colostrum compared with the control group (P &lt; 0.05). Further study revealed that the LPS-challenged HMSeBA group had higher GSH-Px and total antioxidant capacity and lower MDA in weaning piglets compared with the LPS-challenged control group (P &lt; 0.05). Taken together, maternal HMSeBA supplementation increased the number of total born piglets, shortened the duration of farrowing, improved the antioxidant capacities of sows and their offspring, and improved the growth performance of suckling pigs at the first week of lactation. Thus, HMSeBA supplementation during gestation has the potentiality to produce more kilogram of meat.


1992 ◽  
Vol 29 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Raul Carvajal ◽  
Rodolfo Miralles ◽  
Doris Cauvi ◽  
Barbara Berger ◽  
Andres Carvajal ◽  
...  

An analysis of integrated electromyographic (IEMG) activity of the superior orbicularis oris muscle was undertaken in 15 children with cleft lip and palate who have undergone surgery compared to 10 children without clefts (control group). Bipolar surface electrodes were used for IEMG recordings of resting level activity and during the swallowing of saliva. Similar resting level activity was observed in both groups. During the swallowing of saliva, activity in children with cleft lip and palate was higher than in children without clefts (noncleft children). Moreover, in the cleft lip and palate group, children with abnormal lip seal showed the highest values for IEMG activity during the swallowing of saliva. This fact suggests that with each swallow of saliva, a greater counteracting effect of the superior orbicularis oris muscle could be produced on the growing maxilla. This may result in a significant long-term effect on the growth of the stomatognathic system, since the process of swallowing is a 24-hour function repeated between 600 and 2400 times each day.


2017 ◽  
Author(s):  
Arab World English Journal ◽  
Ghazi Algethami

Most previous studies, that have examined the effect of explicit pronunciation instruction on foreign language speech, have focused on the short term effect of explicit pronunciation instruction, usually measured immediately after instruction. For this reason, it is not yet clear whether the attested benefit from pronunciation instruction can be sustained for a long time after instruction. The current study attempted to explore the long term effect of phonetic instruction on the production of the English bilabial voiceless stop /p/ by Arab learners of English as foreign language (EFL, henceforth). Nine Arab EFL learners were assigned to two groups, control and experimental. The experimental group received phonetic instruction on how to produce the English sound /p/, whereas the control group did not. The production of the English sound /p/ was elicited from all the learners in both groups, once before the instruction and once after 11 weeks of the instruction. Two experienced native English instructors were asked to judge whether the students produced /p/ or /b/. The results generally showed no benefit from the phonetic instruction on the delayed production of /p/ by the EFL Arab learners. Although the results do not seem encouraging for pronunciation instruction, it is difficult to reach a conclusion with regard to pronunciation instruction due to the small sample size used in the current exploratory study, and to the difficulty to generalize the results on /p/ to all other sounds. Future studies may use larger sample sizes and include more sounds in their instruction methods.


2021 ◽  
pp. 00321-2021
Author(s):  
Osamu Nishiyama ◽  
Kensuke Kataoka ◽  
Masahiko Ando ◽  
Shinichi Arizono ◽  
Akira Morino ◽  
...  

BackgroundPulmonary rehabilitation (PR) causes short-term improvement in exercise capacity, dyspnea, and health-related quality of life in idiopathic pulmonary fibrosis (IPF); however, long-term maintenance of the improvement is difficult. Nintedanib, an antifibrotic drug, has been shown to delay the worsening of pulmonary function in IPF. Therefore, the concomitant use of nintedanib with PR is anticipated to contribute to the long-term maintenance of the PR effects. The long-term effect of PR under nintedanib treatment in IPF (FITNESS) study is a multicenter, randomised, prospective, parallel-group, open-label trial.MethodsThe study will enroll 82 patients with IPF who have been treated with nintedanib. Patients in the PR group will receive a programmed short-term induction PR program, followed by a maintenance home-based PR program, while patients in the control group will receive usual outpatient care. Patients in both groups will continue to receive nintedanib treatment throughout the study period. The primary endpoint of the study is to compare the change in the 6-min walk distance from the baseline to 12-months between the PR and control groups. The main secondary endpoint is endurance exercise time, measured using a bicycle ergometer.DiscussionFITNESS is the first randomised controlled study to evaluate the long-term effects of PR in IPF treated with nintedanib. This study will address the hypothesis that concomitant use of nintedanib contributes to the maintenance of long-term effects of PR, thus leading to a comprehensive therapeutic approach of “nintedanib and PR” in the antifibrotic era.


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