An Empirical Study on the Operative Treatment of Symptomatic Urolithiasis in Germany

2021 ◽  
pp. 1-7
Author(s):  
Alina Reicherz ◽  
Rüveyde Sahin ◽  
Lorine Häuser ◽  
Joachim Noldus ◽  
Peter Bach
Keyword(s):  
Response Rate ◽  
Intraoperative Complications ◽  
Nationwide Survey ◽  
Treatment Modalities ◽  
European Guidelines ◽  
Operative Care ◽  
Double J Stent ◽  
Before And After ◽  
Related Group ◽  
Ureteral Stenting

<b><i>Purpose:</i></b> The guidelines of the German, European, and American Urological Associations on urolithiasis advise against general ureteral stenting before and after an uncomplicated ureterorenoscopy (URS). However, German and European guidelines state that stenting prior to URS facilitates stone extraction and reduces intraoperative complications. According to the published literature, German practice seems to deviate from recommendations. This nationwide survey aimed to evaluate the treatment modalities of urolithiasis. <b><i>Methods:</i></b> In November 2018 and March 2019, a total of 199 urological hospital departments in Germany were anonymously surveyed about operative care of symptomatic urolithiasis. The response rate was 72.9%. The survey consisted of 25 questions about diagnostics, surgical technique, and aftercare of the URS. This questionnaire is available in the appendix. <b><i>Results:</i></b> A primary URS is performed in ≤10% in 49.6% of the hospitals. In every second urological department (49.7%), the German Diagnosis Related Group (G-DRG) system influences the period of pre-stenting before a secondary URS. After a secondary URS, which is performed in 53.8% of the departments in over 80% of the patients, 14% of the departments omit stenting. The standard for stenting seems to be a 28-cm-long 7 Charrière double-J stent in Germany. <b><i>Conclusion:</i></b> In Germany, the percentage of primary URS is low, and a ureter stenting is performed in most of the urological departments after URS. Delaying therapy due to economic aspects is the standard in almost half of all urological departments.

scholarly journals A Novel Language Paradigm for Intraoperative Language Mapping: Feasibility and Evaluation

2021 ◽  
Vol 10 (4) ◽  
pp. 655
Author(s):  
Katharina Rosengarth ◽  
Delin Pai ◽  
Frank Dodoo-Schittko ◽  
Katharina Hense ◽  
Teele Tamm ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Intraoperative Complications ◽  
Evaluation Study ◽  
Awake Craniotomy ◽  
Language Mapping ◽  
Tumor Patients ◽  
Language Functions ◽  
Before And After ◽  
Assessment Time ◽  
Neuropsychological Outcomes

(1) Background—Mapping language using direct cortical stimulation (DCS) during an awake craniotomy is difficult without using more than one language paradigm that particularly follows the demand of DCS by not exceeding the assessment time of 4 s to prevent intraoperative complications. We designed an intraoperative language paradigm by combining classical picture naming and verb generation, which safely engaged highly relevant language functions. (2) Methods—An evaluation study investigated whether a single trial of the language task could be performed in less than 4 s in 30 healthy subjects and whether the suggested language paradigm sufficiently pictured the cortical language network using functional magnetic resonance imaging (fMRI) in 12 healthy subjects. In a feasibility study, 24 brain tumor patients conducted the language task during an awake craniotomy. The patients’ neuropsychological outcomes were monitored before and after surgery. (3) Results—The fMRI results in healthy subjects showed activations in a language-associated network around the (left) sylvian fissure. Single language trials could be performed within 4 s. Intraoperatively, all tumor patients showed DCS-induced language errors while conducting the novel language task. Postoperatively, mild neuropsychological impairments appeared compared to the presurgical assessment. (4) Conclusions—These data support the use of a novel language paradigm that safely monitors highly relevant language functions intraoperatively, which can consequently minimize negative postoperative neuropsychological outcomes.

The Current Role of Immunotherapy in mCRPC: A Systematic Review

2021 ◽  
Vol 8 (7) ◽  
Author(s):  
Dalibey H ◽  
◽  
Hansen TF ◽  
Zedan AH ◽  
◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Response Rate ◽  
Checkpoint Inhibitors ◽  
Specific Antigen ◽  
Treatment Modalities ◽  
Significant Difference

Background: The development of immunotherapy has shown promising results in several malignant diseases, including prostate cancer, calling for a systematic review of the current literature. This review aims to evaluate the present data and prospects of immune checkpoint inhibitors in metastatic Castration Resistant Prostate Cancer (mCRPC). Methods: Articles were identified via a systematic search of the electronic database Pubmed, in accordance with the PICO process and following the PRISMA guidelines. Articles in English studying immune checkpoint inhibitors in patients with mCRPC published between March 2010 and March 2020 were eligible for inclusion. Endpoints of interest were Overall Survival (OS), Progression-Free Survival (PFS), clinical Overall Response Rate (ORR), and Prostate-Specific Antigen (PSA) response rate. Results: Ten articles were identified as eligible for inclusion. The studies primarily explored the use of Ipilimumab, a CTLA-4 inhibitor, and Pembrolizumab, a PD-1 inhibitor. These drugs were both used either as monotherapy or in combination with other treatment modalities. The largest trial included in the review demonstrated no significant difference in overall survival between the intervention and placebo. However, two studies presented promising data combing immunotherapy and immune vaccines. Grade 3 and 4 adverse events ranging from 10.1% to 82.3%, whit diarrhea, rash, and fatigue were the most frequently reported. Forty relevant ongoing trials were identified exploring immunotherapy with or without a parallel treatment modality. Conclusion: Overall, the current data shows that the effect of immune checkpoint inhibitors as monotherapy may have limited impact on mCRPC, and the results from ongoing combinational trials are eagerly awaited.

scholarly journals Nationwide Representative Survey of Dietary Iodine Intake and Urinary Excretion in Postpartum Korean Women

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3955
Author(s):  
Do-Kyung Lee ◽  
Hunjoo Lee ◽  
Hyeyoung Lee ◽  
Taehyung Yoon ◽  
Seon-Joo Park ◽  
...  
Keyword(s):  
Large Scale ◽  
Urinary Iodine ◽  
Brown Seaweed ◽  
Nationwide Survey ◽  
Iodine Intake ◽  
Urinary Iodine Excretion ◽  
Korean Women ◽  
Spot Urine ◽  
Before And After ◽  
Iodine Excretion

Iodine is an essential component of thyroid hormones, but excessive iodine intake can lead to thyroid dysfunction. Traditionally, Korean mothers consume brown seaweed soup (miyeokguk), a high source of iodine, after childbirth. There is controversy regarding the effects of excessive postpartum iodine intake on the health of mothers and infants. Thus far, there have been no nationwide large-scale surveys regarding the status of iodine intake among postpartum women in Korea. Therefore, we conducted a nationwide survey of postpartum dietary iodine intake among Korean women. In total, 1054 Korean women aged ≥19 years, at less than 8 weeks postpartum, participated in this survey. Dietary data were collected using self-reported 2-day dietary records, along with before-and-after meal photos. To evaluate the correlation between dietary iodine and urinary iodine excretion (UIE), spot urine, and 24 h urine samples were collected from 98 and 29 participants, respectively. The mean daily iodine intake among all participants was 2945.6 μg, and it gradually decreased over time after childbirth. Dietary iodine intake was significantly correlated with 24 h UIE (r = 0.396, p < 0.05) and spot urine UIE (r = 0.312, p < 0.05). Follow-up studies are required to examine the influence of excessive postpartum iodine intake on thyroid health in mothers and their infants.

scholarly journals Characteristics and treatment outcomes of patients with primary ocular adnexal lymphoma in Northern Thailand

2020 ◽  
Vol 17 (1) ◽  
pp. 86-97
Author(s):  
Kasem Seresirikachorn ◽  
Sakarin Ausayakhun ◽  
Damrong Wiwatwongwana ◽  
Ponsak Mahanupab ◽  
Teerada Daroontum ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Response Rate ◽  
Stage Iv ◽  
High Response Rate ◽  
University Hospital ◽  
Treatment Modalities ◽  
Low Grade ◽  
Northern Thailand ◽  
Ocular Adnexal Lymphoma ◽  
Operative Notes

Purpose: To assess the characteristics and treatment outcomes of patients with primary ocular adnexal lymphoma (OAL) in Northern Thailand. Design: Retrospective cohort study. Methods: Data was collected from electronic medical records and operative notes from Chiang Mai University Hospital between January 2009 and December 2014. All available tissue biopsies of 54 patients were reviewed by agreement of two pathologists. The clinical characteristics and treatment outcomes were collected and analyzed. Results: A total number of 54 patients were identified of which 57.4% were female. The median age was 61.0 years (range, 4-86). The most common subtype of lymphoma was extranodal marginal zone lymphoma (ENMZL) of mucosa-associated lymphoid tissue (MALT) (n = 46, 85.2%). Seventy-five percent of the patients presented with a mass at the ocular adnexa, while 14.8% of the patients presented with proptosis. The sites of origin were as follows: lacrimal (46.3%), orbit (31.5%), conjunctiva (13%) and eyelid (7.4%). Two-thirds of the patients had Ann-Arbor Stage I, while 22% of patients had Stage IV. The majority of the patients (68.1%) had a low-risk international prognosis index (IPI). Treatment modalities involved field radiation (IFRT, 50%), chemotherapy (31.6%), combined chemoradiotherapy (7.9%) and surgical resection (10.5%). The overall response rate was 100% with a complete response rate of 77.8%. In patients with low-grade lymphoma, including MALT lymphoma, the 3-year progression-free survival (PFS) and overall survival were 69.9% and 92.5%, respectively. Conclusion: ENMZL of MALT was the major subtype of primary OAL. Radiotherapy was an effective treatment for the lower stages of disease providing a high response rate and encouraging survival outcomes.

Brain Tumors

2020 ◽  
pp. 23-42
Author(s):  
Angela M. Bohnen ◽  
Kaisorn L. Chaichana ◽  
Alfredo Quinones-Hinojosa
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumors ◽  
Demyelinating Disease ◽  
Intraoperative Complications ◽  
Postoperative Management ◽  
Treatment Modalities ◽  
Adjuvant Radiation ◽  
Term Care ◽  
Metastatic Lesions

Having a general understanding of brain tumors is integral to mastering the oral board examination. For the general session, examinees should be able to identify both intra-axial and extra-axial tumors and provide a comprehensive understanding of the differential diagnosis and plan regarding treatment, while also verbalizing concepts behind the treatment modalities and articulating to a patient and family the alternative approaches as well as the complications related to management. Pathologies to familiarize oneself with include gliomas, meningiomas, metastatic lesions, and pituitary lesions. For subspecialty examinees, complex cases such as endonasal, endoscopic, keyhole, and skull base approaches should be mastered. For each case, a broad differential diagnosis should include infection, hematoma, infarction, thrombosed aneurysm, inflammation, and/or demyelinating disease. Discuss the preoperative workup the indications for surgery and surgical approach. Interpret the preoperative and postoperative imaging critically. Be prepared for potential intraoperative complications and discussion of postoperative management including adjuvant radiation and chemotherapy and long-term care.

scholarly journals The anti-inflammatory effect of the platelet-rich plasma in the periodontal pocket

2018 ◽  
Vol 12 (04) ◽  
pp. 528-531 ◽  
Author(s):  
Lubaba A. Abdul Ameer ◽  
Zainab J. Raheem ◽  
Saif Saadedeen Abdulrazaq ◽  
Basima Gh. Ali ◽  
Maysaa Mahdi Nasser ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
Platelet Rich Plasma ◽  
Periodontal Treatment ◽  
Periodontal Pocket ◽  
Treatment Modalities ◽  
Pocket Depth ◽  
Before And After ◽  
Noticeable Reduction ◽  
Anti Inflammatory ◽  
Inflammatory Effect

ABSTRACT Objective: Chronic periodontitis (CP) is a common inflammatory disease that causes destruction to the supporting tissues of the teeth. Many treatment modalities tried to stop the disease progression. Platelet-rich plasma (PRP) is one of the regenerative methods that used in adjunct to conventional periodontal treatment. The aim of this study was to evaluate the anti-inflammatory effect of PRP by monitoring the lymphocyte count before and after its application to the periodontal pocket. Materials and Methods: Twenty patients, with CP and a pocket depth equal to or deeper than 4 mm, subjected to scaling, root planing, and PRP injection into the pocket. The lymphocyte count measured before and after 1 month from PRP application. Clinical periodontal parameters were taken during two visits (1 month apart), with customized stent fabrication. Results: All clinical periodontal parameters showed a reduction in their value following 1 month of PRP application. . There was a noticeable reduction in lymphocyte count from (mean 2.47 ± 0.91) to (mean 1.94 ± 0.77). Conclusion: In addition to its traditional uses, PRP has a great role in the periodontal treatment by its anti-inflammatory effect.

scholarly journals Rhinitis medicamentosa: a nationwide survey of Canadian otolaryngologists

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
James Fowler ◽  
Christopher J. Chin ◽  
Emad Massoud
Keyword(s):  
Practice Patterns ◽  
Response Rate ◽  
Nationwide Survey ◽  
Neck Surgery ◽  
Electronic Survey ◽  
Nasal Decongestants ◽  
Intranasal Steroids ◽  
Oral Steroids ◽  
Topical Medications ◽  
Rhinitis Medicamentosa

Abstract Background Rhinitis medicamentosa is a non-allergic form of rhinitis that is typically caused by prolonged use of topical nasal decongestants. This condition commonly affects young adults and treatment is not trivial. We aimed to survey Canadian Otolaryngologists to determine practice patterns and their opinions regarding this under-studied condition. Methods An electronic survey was sent to practicing Otolaryngologists within the Canadian Society of Otolaryngology – Head and Neck Surgery. The survey contained 16 questions pertaining to the diagnosis and treatment of rhinitis medicamentosa, as well as opinions on public and primary care awareness of proper use of nasal decongestants. Results The survey was distributed to 533 Otolaryngologists and 69 surveys were returned (response rate of 13%). Cessation and weaning of decongestant (96%), and intranasal steroids (94%) were the most common methods for treating RM. Intranasal saline rinses (55%) and oral steroids (25%) were also supported by some respondents. For those who recommended cessation/weaning, 61% also concurrently introduced an intranasal steroid during this process. The majority responded that current warnings on nasal decongestants were inadequate (75%), and were not visible enough (79%). Conclusions Rhinitis medicamentosa is a common, and very preventable condition. Although the literature lacks a standardized approach to RM, our survey has shown that many Otolaryngologists diagnose and treat RM in a similar manner. Treatment tends to focus on decongestant cessation, often with concurrent introduction of intranasal steroids. It was felt the warning labels on the topical medications are not currently satisfactory.

Management of refractory myeloma: a review.

1988 ◽  
Vol 6 (5) ◽  
pp. 889-905 ◽  
Author(s):  
A C Buzaid ◽  
B G Durie
Keyword(s):  
Protein Concentration ◽  
Response Rate ◽  
Clinical Problem ◽  
Initial Therapy ◽  
M Protein ◽  
Treatment Modalities ◽  
High Dose ◽  
First Line ◽  
First Line Therapy ◽  
New Treatment

Management of refractory myeloma represents a common and challenging clinical problem. Approximately 30% to 50% of patients with multiple myeloma do not respond to first-line therapy, and those who initially achieve a remission will eventually relapse. Surprisingly, there is no routinely accepted approach to patients with refractory disease. Therefore, we review the literature in an attempt to provide an overview of the published results and outline our treatment recommendations for such patients. We suggest the following: (1) for truly resistant patients (ie, those who clearly progress with initial therapy), administration of high-dose or pulsed glucocorticosteroids is the best treatment, with an expected response of 40% (defined as a greater than or equal to 50% reduction in monoclonal [M]-protein concentration); (2) for patients who relapse during therapy or relapse within 6 months of stopping the initial treatment, the VAD regimen (vincristine, doxorubicin, and dexamethasone) is one of the most effective salvage therapies, resulting in an approximately 75% response rate (greater than or equal to 50% reduction in M-protein concentration); (3) for patients who relapse within more than 6 months of stopping therapy (unmaintained remission), reinitiation of the initial therapy represents an excellent alternative, leading to recontrol in 60% to 70% of patients (greater than or equal to 50% reduction in M-protein concentration). If progression is observed or if there is response and then relapse in this setting, VAD chemotherapy can be administered again. (4) Patients who fail second-line salvage therapies should enter well-designed clinical trials to evaluate new treatment modalities. If this is not feasible, alpha-interferon or "systemic" radiotherapy are recommended in selected cases.

scholarly journals On teaching styles of water educators and the impact of didactic training

2012 ◽  
Vol 16 (10) ◽  
pp. 3677-3688 ◽  
Author(s):  
A. Pathirana ◽  
J. H. Koster ◽  
E. de Jong ◽  
S. Uhlenbrook
Keyword(s):  
Creative Thinking ◽  
Response Rate ◽  
Teaching Style ◽  
Teaching Styles ◽  
University Teaching ◽  
Teaching Staff ◽  
Certification Program ◽  
Didactic Training ◽  
Before And After ◽  
The Impact

Abstract. Solving today's complex hydrological problems requires originality, creative thinking and trans-disciplinary approaches. Hydrological education that was traditionally teacher centred, where the students look up to the teacher for expertise and information, should change to better prepare hydrologists to develop new knowledge and apply it in new contexts. An important first step towards this goal is to change the concept of education in the educators' minds. The results of an investigation to find out whether didactic training influences the beliefs of hydrology educators about their teaching styles is presented. Faculty of UNESCO-IHE has been offered a didactic certification program named university teaching qualification (UTQ). The hypothesis that UTQ training will significantly alter the teaching style of faculty at UNESCO-IHE from expert/formal authority traits towards facilitator/delegator traits was tested. A first survey was conducted among the entire teaching staff (total 101, response rate 58%). The results indicated that there are significantly higher traits of facilitator and delegator teaching styles among UTQ graduates compared to faculty who were not significantly trained in didactics. The second survey which was conducted among UTQ graduates (total 20, response rate 70%), enquiring after their teaching styles before and after UTQ, corroborated these findings.

A Nationwide Study of Norwegian Drug Abusers in Treatment: Methods and findings

1997 ◽  
Vol 14 (1_suppl) ◽  
pp. 43-63 ◽  
Author(s):  
Grethe Lauritzen ◽  
Helge Waal ◽  
Arvid Amundsen ◽  
Oddvar Arner
Keyword(s):  
Outpatient Treatment ◽  
Drug Research ◽  
Risk Behaviour ◽  
Nationwide Survey ◽  
Treatment Modalities ◽  
Drug Abusers ◽  
Preventive Strategies ◽  
Nationwide Study ◽  
Treatment Measures

The National Institute for Alcohol and Drug Research (SIFA) has completed the first nationwide survey of drug abusers in treatment in Norway. Experiences from the study have contributed to the creation and initial implementation of a monitoring system for treatment demands and treatment measures in the country. This article presents the approach and methods used in the SIFA study. It provides an overview of the material and focusses on describing clients from long-term residential and outpatient treatment modalities. The results are presented within seven areas: socio-demographics, substance abuse, mental health and significant problems, risk behaviour, social functioning, social network, and biographical data on childhood/adolescence. These areas are analysed by the variables of gender, age, urban Oslo/outside Oslo clients, and client populations from residential/outpatient treatment. The authors reflect upon the prospects opened by such comprehensive documentation concerning preventive strategies, planning of treatment, and further research in Norway.

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