Early Stage Blood Purification for Paraquat Poisoning: A Multicenter Retrospective Study

2016 ◽  
Vol 42 (2) ◽  
pp. 93-99 ◽  
Author(s):  
An Li ◽  
Wenxiong Li ◽  
Fengtong Hao ◽  
Haishi Wang
Keyword(s):  
Retrospective Study ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Early Stage ◽  
Survival Rates ◽  
Serum Levels ◽  
Organ Damage ◽  
Blood Levels ◽  
Treatment Results ◽  
Failure Assessment

Objectives: To evaluate the efficacy of conservative treatment vs. hemoperfusion (HP) vs. HP + continuous veno-venous hemofiltration (CVVH) for acute Paraquat (PQ) poisoning. Methods: This was a multicenter retrospective study of patients with PQ poisoning between January 2013 and June 2014. Clinical data and PQ serum levels were collected at baseline and after 24, 48, and 72 h of treatment. Results: Seventy-five, 65, and 43 underwent conservative treatment only (conservative treatment group), conservative treatment + HP (HP group), and conservative treatment + HP + CVVH (HP + CVVH group), respectively. PQ serum levels decreased in all groups after 72 h of treatment (p < 0.001); meanwhile, these values decreased faster in the HP and HP + CVVH groups compared with the conservative treatment group. More importantly, PQ blood levels were significantly lower in the HP + CVVH group compared with the HP group at 24 h (p < 0.05). Sequential organ failure assessment (ΔSOFA) values in the HP and HP + CVVH groups were significantly lower compared with that obtained for the conservative treatment group (p < 0.05). The 60-day survival rates were 21.3, 43.1 and 46.5%, respectively. Multivariate analysis indicated that age, PQ dose, admission PQ levels, and admission SOFA score were independently associated with mortality. HP and HP + CVVH were protective factors. Conclusion: Early HP or HP + CVVH after PQ poisoning could decrease PQ blood levels, alleviate organ damage, and increase survival.

Comparative analysis of accommodative ability in children with hyperopia, anisometropia, amblyopia after femtolaser-assisted laser intrastromal keratomileusis

2021 ◽  
pp. 44-46
Author(s):  
I.L. Kulikova ◽  
◽  
K.A. Aleksandrova ◽  
Keyword(s):  
Comparative Analysis ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Key Words ◽  
Treatment Results ◽  
Accommodative Response

Purpose. Analysis of the accommodative ability in children with hyperopic anisometropia, amblyopia of operated amblyopic and paired leading eyes after femtolaser-assisted laser intrastromal keratomileusis (FS-LASIK). Material and methods. In the 1st group were 20 children with hyperopic anisometropia and amblyopia after FS-LASIK. In the 2nd were children receiving conservative treatment. Results. After 6 months, when analyzing the accommodation, the coefficient of the accommodative response (CAR) of amblyopic eye in the 1st group was 0.05±0.07 conv. units, in the 2nd group was -0.1±0.19 conv. units (рm-u=0.03). The microfluctuation coefficient (CMF) of the amblyopic eye was increased, but the CMF of the paired leading eye in children after FS-LASIK approached the norm and amounted to 58.4±5.4 µF / min. In the conservative treatment group CMF remained high and was 60.8±4.44 µF / min (рm-u= 0.08). The objective accommodative response of the amblyopic eye in the 1st group increased by -1.13±0.03 diopters, in the 2nd group – by -0.82±0.48 diopters (рm-u=0.05). Conclusion. FS-LASIK helps to improve the accommodative ability in children with hyperopia, anisometropia and amblyopia. Key words: accommodation, hyperopia, anisometropia, amblyopia, FS-LASIK.

scholarly journals Diagnosis and Treatment of Mechanical Hemolysis after Mitral Repair in Adult

2021 ◽  
Vol 24 (1) ◽  
pp. E165-E169
Author(s):  
Jing-bin Huang ◽  
Zhao-ke Wen ◽  
Wei-jun Lu ◽  
Chang-chao Lu ◽  
Xian-ming Tang
Keyword(s):  
Retrospective Study ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Medical Records ◽  
Rare Complication ◽  
Nyha Class ◽  
Diagnosis And Treatment ◽  
Mitral Repair ◽  
Hospital Deaths

Background: Mitral repair has been widely used in the treatment of secondary mitral lesions in recent years. Hemolytic anemia is known to be a rare complication after mitral repair. This study aimed to investigate the diagnosis and treatment of mechanical hemolysis after mitral repair in adults. Methods: In this retrospective study, we reviewed the medical records of patients undergoing mitral repair complicated with mechanical hemolysis at our institution between August 2006 and May 2020. Results: Twenty-four patients undergoing mitral repair complicated with mechanical hemolysis were included in the study. They were divided into two groups: the reoperation group (patients who underwent reoperation; N = 18) and the conservative treatment group (patients who received symptomatic treatments, including blood transfusion, diuresis, alkalization of urine, liver protection, hemodialysis, and oral metoprolol; N = 6. All patients in the reoperation group underwent mitral valve replacement. There were six hospital deaths, all in the conservative treatment group. Seventeen of eighteen patients (94.4%) completed follow up. Fifteen of seventeen survivors (88.2%) were in NYHA class I and 11.8% (2/17) in NYHA class II at the last time follow up. Conclusions: Hemolysis is a sign of failure of mitral repair. Reoperation is the best choice once the hemolysis has been diagnosed. Reoperation should be carried out as soon as possible.

scholarly journals Increasing effectiveness of conservative treatment of Peyronie’s disease

2018 ◽  
Vol 19 (4) ◽  
pp. 78-84
Author(s):  
O. B. Zhukov ◽  
A. E. Vasilyev ◽  
M. E. Novikov
Keyword(s):  
Treatment Group ◽  
Conservative Treatment ◽  
Erectile Function ◽  
Early Stage ◽  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Control Group ◽  
Plaque Size ◽  
Study Objective ◽  
Peyronie's Disease

The study objectiveis to investigate the effectiveness of conservative treatment of Peyronie’s disease using antifibrotic agents.Materials and methods. The study included 32 patients aged 44–65 years with diagnosed Peyronie’s disease. The patients were examined using the International Index of Erectile Function, Visual Analog Scale, tunica albuginea of the penis elasticity testing, ultrasound examination (with intracavernous pharmacological testing and dynamic spiral tomography if necessary). The patients were divided into 2 groups. The patients in the treatment group (n = 16) received magnetic laser therapy at the area of the plaque with the “Mustang-urolog” device, as well as vacuum laser treatment with the “Yarovit” device and bovhyaluronidase azoximer as injections and later suppositories. In the comparison group (n = 16), similar therapy was used without bovhyaluronidase azoximer. Control examination was performed 3 months later. If conservative treatment was ineffective, the patients were forwarded to surgical treatment.Results. As a result of conservative treatment, density of the tunica albuginea and cavernous bodies, structure of the cavernous bodies improved; the International Index of Erectile Function increased, and pain intensity decreased. In the treatment group, a stronger tendency toward improvement was observed compared to the control group. Decrease in the plaque size was observed in 63.3 % of the patients in the treatment group and in 43.7 % of the patients in the control group. At the control examination, plaques weren’t detected in 6 and 3  patients, respectively.Conclusion. Conservative treatment is effective in patients with early stage of Peyronie’s disease with moderate curvature of the penis (<30°) and plaque size <2 cm. We recommend including bovhyaluronidase azoximer in the combination treatment regimen of these patients for increased effectiveness.

PS02.223: EFFECTIVENESS OF ETILEFRINE REGIMEN FOR CHYLOTHORAX AFTER ESOPHAGECTOMY WITH THORACIC DUCT RESECTION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 185-185
Author(s):  
Ryosuke Umino ◽  
Yu Ohkura ◽  
Masaki Ueno ◽  
Harushi Udagawa
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Thoracic Duct ◽  
Conflicts Of Interest ◽  
Early Stage ◽  
Treatment Options ◽  
Type I ◽  
Subtotal Esophagectomy ◽  
Toranomon Hospital

Abstract Background Management of postoperative chylothorax generally involves nutritional regimens as well as pharmacological and surgical therapies, but a clear consensus has yet to be reached. The aim of this study was to clarify the usefulness of an etilefrine regimen to broaden the medical treatment options for postoperative chylothorax after esophagectomy with resection of the thoracic duct. Methods A total of 371 consecutive patients with esophageal cancer were identified from a prospectively constructed database at the Department of Gastroenterological Surgery, Toranomon Hospital between January 2011 and February 2017. They were patients with squamous cell carcinoma or adenocarcinoma of the esophagus including Siewert type I, II tumor of the esophagogastric junction who underwent subtotal esophagectomy. Of these 371 patients, 19 patients who were diagnosed with chylothorax as a postoperative complication were enrolled in this study. Results Conservative treatment achieved cure in 16 patients among 19 patients. The duration of chylothorax tended to be longer in the no-etilefrine group (n = 5) than in the etilefrine group (n = 11) (27.8 vs. 11.6 days; P = 0.078). The 14 patients among 19 patients was resected the thoracic duct. Etilefrine was used in 12 of these 14 patients. Among these 12 patients, 3 required surgical treatment and the remaining 9 patients were cured with conservative treatment. The duration of chylothorax was shorter in the conservative treatment group than in the surgical treatment group (11.9 vs. 36.3 days; P = 0.052). And also, with the use of etilefrine as adjuvant therapy, cure was achieved in 9 patients (75%) without surgical intervention. Conclusion The findings of this study suggest the effectiveness of etilefrine in patients with chylothorax following esophagectomy. The drug was effective even in post-TDR chylothorax, an often intractable condition that is difficult to treat conservatively. However, when the effectiveness of etilefrine regimen is unexpectedly poor, it is important to switch from drug therapy to surgical treatment in the early stage of this complication. Disclosure All authors have declared no conflicts of interest.

T1G3 bladder carcinoma: Can we still judge them as superficial tumours?

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 144-149
Author(s):  
S. Pagano ◽  
F. Franzoso
Keyword(s):  
High Risk ◽  
Prognostic Factor ◽  
Conservative Treatment ◽  
Survival Rates ◽  
Cytotoxic Chemotherapy ◽  
Significant Prognostic Factor ◽  
Treatment Results ◽  
Risk Of Progression ◽  
Bladder Carcinomas

— T1G3 bladder carcinomas are classified as superficial tumours and treatment results are included in low stage tumour groups. A review of survival rates shows that there is a high risk of progression, about 50–78%. Among other things this is due to some commonly-accepted factors. The grade is by now considered the most significant prognostic factor. It is easy in this stage for clinical understaging to occur and cases of N + are to be found in all early cystectomies. Another important factor is the differing interpretations by pathologists of the pT category and grade. With conservative treatment there is a progression of 50% after radiotherapy, 40% after endoscopic surgery and 40% after cytotoxic chemotherapy. Better results with BCG immunotherapy are reported with 10–19% progression; however, there is no significant follow-up yet in these cases and they often refer to all superficial tumours including T1G3 which taken singly have clearly worse percentages of recurrence and progression. Best survival rates are achieved with early cystectomy (76–95% at 5 years). These data advise considering T1G3 carcinomas clinically like invasive tumours and early cystectomy as the best therapy, while the risks of delaying cystectomy should be fully assessed.

Cirurgia Paliativa em Pacientes com Tumor Periampular Irressecável: Estudo Retrospectivo de 5 Anos em um Hospital em São José dos Campos – SP/Surgical Palliation in Patients with Unresectable Periampullary Tumor: a Retrospective Study of 5 Years in a Hosp

1970 ◽  
Vol 3 (4) ◽  
pp. 9-20
Author(s):  
José Henrique Gomes Torres ◽  
Rosyane Rena De Freitas
Keyword(s):  
Pancreatic Cancer ◽  
Retrospective Study ◽  
Survival Rates ◽  
Periampullary Tumor ◽  
The Past ◽  
Palliative Procedure ◽  
Surgical Palliation ◽  
Head Of The Pancreas ◽  
Keywords Pancreatic Cancer ◽  
Main Complication

Objetivo: Avaliar diferentes métodos paliativos quanto a sua resolução, complicações e sobrevida em pacientes com tumor periampular irressecável. Materiais e métodos: Estudo retrospectivo com análise dos prontuários de pacientes com tumor periampular irressecável e que foram submetidos a procedimento paliativo no Hospital Municipal Dr José de Carvalho Florence nos últimos cinco anos. Resultados: O principal tumor periampular foi o de cabeça de pâncreas, com incidência de 94%, acometendo pacientes com média de 66 anos, sem preferência por sexo. Os procedimentos mais realizados foram derivação biliar e colocação de endoprótese através de colangiopancreatografia endoscópica retrógrada, apresentando sobrevidas de 586 e 56 dias, respectivamente. Conclusão: A coledocojejunostomia foi o procedimento mais realizado e apresentou menor tempo de internação e maiores sobrevida e tempo de permanência anictérico. Pneumonia foi a complicação mais frequente.  Palavras chave: Câncer pancreático, Colangiocarcinoma, Cuidados paliativos.  Objective: To evaluate different palliative methods concerning its resolution, complications and survival in patients with unresectable periampular tumor. Materials and methods: Retrospective study analysing records of patients with unresectable periampullary tumor and who underwent palliative procedure in the Hospital Municipal Dr José de Carvalho Florence in the past five years. Results: The main periampullary tumor was the head of the pancreas, with an incidence of 94%, affecting patients with an average of 66 years old, regardless of gender. The most common procedures were bypass and biliary stent, with survival rates of 586 and 56 days, respectively. Conclusion: Coledocojejunostomy was the procedure which was the most often performed and showed a shorter hospital stay and longer survival time and time without jaundice. Pneumonia was the main complication.  Keywords: Pancreatic cancer, Cholangiocarcinoma, Palliative care  

Changes in growth rate and thyroid- and sex-hormones blood levels in rats under sub-chronic lithium treatment

2006 ◽  
Vol 25 (5) ◽  
pp. 243-250 ◽  
Author(s):  
M S Allagui ◽  
N Hfaiedh ◽  
C Vincent ◽  
F Guermazi ◽  
J-C Murat ◽  
...  
Keyword(s):  
Growth Rate ◽  
Lithium Treatment ◽  
Lithium Carbonate ◽  
Serum Levels ◽  
Antagonistic Effect ◽  
Blood Levels ◽  
Vaginal Mucosa ◽  
Dependent Manner ◽  
Serum Concentrations ◽  
Dose Dependent

Lithium therapy, mainly used in curing some psychiatric diseases, is responsible for numerous undesirable side effects. The present study is a contribution to the understanding of the pathophysiological mechanisms underlying lithium toxicity. Male and female mature rats were divided into three batches and fed commercial pellets: one batch was the control and the second and third batches were given 2 g (Li1) and 4 g (Li2) of lithium carbonate/kg of food/day, respectively. After 7, 14, 21 and 28 days, serum levels of free tri-iodothyronine (FT3), thyroxine (FT4), testosterone and estradiol were measured. Attention was also paid to growth rate and a histological examination of testes or vaginal mucosa was carried out. In treated rats, a dose-dependent loss of appetite and a decrease in growth rate were observed, together with symptoms of polydypsia, polyuria and diarrhea. Lithium serum concentrations increased from 0.44 mM (day 7) to 1.34 mM (day 28) in Li1 rats and from 0.66 to 1.45 mM (day 14) in Li2 rats. Li2 treatment induced a high mortality after 14 days, reaching 50-60% in female and male animals. From these data, the LD50 (14 days Li2 chronic treatment) was calculated to be about 0.3 g/day per kilogram of animal, leading to Li serum concentrations of about 1.4 mM. A significant decrease of FT3 and FT4 was observed in treated rats. This effect appeared immediately for the highest dose and was more pronounced for FT3, resulting in an increase of the FT4/FT3 ratio. In males, testosterone decreased and spermatogenesis was stopped. Conversely, in females, estradiol increased in a dose-dependent manner as the animals were blocked in the diestrus phase at day 28. This finding supports a possible antagonistic effect of lithium on the estradiol receptors.

scholarly journals The survival rates and risk factors of implants in the early stage: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Yang ◽  
Huiting Hu ◽  
Mianyan Zeng ◽  
Hongxing Chu ◽  
Zekun Gan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Survival Rate ◽  
Dental Implants ◽  
Bone Quality ◽  
Early Stage ◽  
Survival Rates ◽  
Bone Augmentation ◽  
Early Survival ◽  
Immediate Implantation ◽  
Implant Length

Abstract Background Few large-sample studies in China have focused on the early survival of dental implants. The present study aimed to report the early survival rates of implants and determine the related influencing factors. Methods All patients receiving dental implants at our institution between 2006 and 2017 were included. The endpoint of the study was early survival rates of implants, according to gender, age, maxilla/mandible, dental position, bone augmentation, bone augmentation category, immediate implant, submerged implant category, implant diameter, implant length, implant torque, and other related factors. Initially, SPSS22.0 was used for statistical analysis. The Chi-square test was used to screen all factors, and those with p < 0.05 were further introduced into a multiple logistic regression model to illustrate the risk factors for early survival rates of implants. Results In this study, we included 1078 cases (601 males and 477 females) with 2053 implants. After implantation, 1974 implants were retained, and the early survival rate was 96.15%. Patients aged 30–60 years (OR  2.392), with Class I bone quality (OR  3.689), bone augmentation (OR  1.742), immediate implantation (OR  3.509), and implant length < 10 mm (OR  2.972), were said to possess risk factors conducive to early survival rates. Conclusions The early survival rate of implants in our cohort exceeded 96%, with risk factors including age, tooth position, bone quality, implant length, bone augmentation surgery, and immediate implantation. When the above factors coexist, implant placement should be treated carefully.

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