Efficacy of Short-Term Antibiotic Therapy for Consecutive Patients with Mild Appendicitis

2011 ◽  
Vol 77 (6) ◽  
pp. 752-755 ◽  
Author(s):  
Hyoung-Chul Park ◽  
Byoung-Seup Kim ◽  
Bong Hwa Lee
Keyword(s):  
Antibiotic Therapy ◽  
Prospective Observational Study ◽  
Clinical Observation ◽  
Short Term ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Radiologic Study ◽  
The Mean ◽  
Safe Treatment Option

Although antibiotic therapy seemed to be a safe treatment option for acute appendicitis, indications of this treatment have not been fully evaluated. We hypothesized that clinical and radiologic mild appendicitis may be a candidate for short-term antibiotic therapy. The purpose of present study was to examine the efficacy and the recurrence rate of short-term antibiotic therapy for consecutive patients with mild appendicitis. A prospective observational study was conducted over 3 years. The mild appendicitis was defined as the intermediate Alvarado score (4-8) and dilated appendix from 6 mm to 10 mm in radiologic study. All patients received initial antibiotics administration with clinical observation during 48 hours. The failure to respond to therapy and the incidence of recurrence were assessed. There were 107 enrolled patients with the mean Alvarado score of 6 ± 1 and the mean appendiceal diameter of 7.4 ± 1 mm. Of these, 97 (91%) exhibited improved symptoms and were discharged. The remaining 10 patients underwent surgery because of clinical aggravation, and pathology revealed true appendicitis in six of them. Of the 97 patients in whom the initial treatment was successful, five patients (5%) exhibited recurrent symptoms during a median follow-up period of 18 months. Of these five patients, three were treated with surgery (all true appendicitis), and the remaining two were once again treated with antibiotics. Patients with suspected appendicitis, those in whom mild appendicitis was diagnosed after clinical and radiologic evaluations, were found to benefit from short-term antibiotic therapy.

Evaluating the impact of an international short-term medical mission through diabetic glycemic control

2018 ◽  
Vol 41 (4) ◽  
pp. 815-820
Author(s):  
John C Mach ◽  
Hope Barone ◽  
Christopher Boni ◽  
Humberto Jimenez ◽  
Michael Tinglin
Keyword(s):  
Disease Burden ◽  
Prospective Observational Study ◽  
Glucose Monitoring ◽  
Phone Call ◽  
Short Term ◽  
Education Medical ◽  
The Mean ◽  
The Impact ◽  
Diabetic Care

AbstractBackgroundThis prospective observational study evaluated the impact of a primary care-based, international, short-term medical mission’s (STMM) impact on diabetes disease burden as represented through reductions in hemoglobin A1C (HbA1c).MethodsFrom November 2016 to May 2017, we tracked the HbA1c’s of diabetic individuals in Dajabon, Dominican Republic through care provided by Waves of Health (WOH). Participants were provided counseling, glucose monitoring equipment, a 6-month supply of anti-diabetic medications, and received a ‘check-in’ phone call at 3 months. HbA1c’s were re-measured at 6-month follow up. We hypothesized WOH diabetic care would have a modest impact of reducing mean HbA1c by 0.5%.ResultsIn total, 75% (n = 76) of 101 participants presented for follow-up care. Mean and median HbA1c decreased from 8.71 (SD 2.0) and 8.5% to 8.36 (SD 2.1) and 7.7%, respectively (P = 0.07). The percentage of individuals with HbA1c ≤7.5 increased by 10.4% at follow-up. The mean HbA1c decrease was 1.1%.ConclusionsThough limited by sample size, our results suggest that medical STMM’s may have a clinically meaningful impact in chronic disease management when utilizing a systematic combination of education, medical therapy, clearly documented medication instructions and regular trip intervals.

scholarly journals Imaging and cytopathological correlation of space occupying lesions in liver: a prospective observational study

2017 ◽  
Vol 4 (5) ◽  
pp. 1687
Author(s):  
Sachinkumar Patel ◽  
P. B. Nichkaode ◽  
Prasad Y. Bansod ◽  
Murtaza Akhtar
Keyword(s):  
Longitudinal Study ◽  
Observational Study ◽  
Selection Criteria ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Liver Pathology ◽  
Common Site ◽  
Short Term ◽  
The Mean

Background: Liver is a common site for Space occupying lesions. It is difficult to distinguish these entities with imaging criteria alone. Development in liver surgery and liver pathology have led to many new types of primary hepatic space-occupying lesions (PHSOLS) being surgically resected and pathologically diagnosed, which has greatly increased the surgicopathological spectrum of PHSOLS.Methods: A 2-year tertiary care teaching hospital based longitudinal study with 77 participants was done. Selection criteria was defined and a prestructured proforma was made to assess and note the findings.Results: The mean age of occurrence of space occupying lesions of liver was 45.49±13.45 years with a range of 24 to 70 years. Space occupying lesions of liver was commonly observed in 4th Decade of life. 64.93% pathology of Space Occupying Lesions of Liver occur in males. 76.62% patients of space occupying lesions of liver present with pain in right upper quadrant.Conclusions: Majority of space occupying lesions were surgically managed with a short-term follow-up of 1 month in which no complications were noted.

Experience of Health-Related Problems during House Parties in the Netherlands: Nine Years of Experience and Three Million Visitors

2009 ◽  
Vol 24 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Jan Krul ◽  
Armand R. J. Girbes
Keyword(s):  
The Netherlands ◽  
Prospective Observational Study ◽  
First Aid ◽  
Years Of Experience ◽  
Medical Support ◽  
Short Term ◽  
Unique Data ◽  
Paramedical Personnel ◽  
Health Related ◽  
The Mean

AbstractObjective:The objective of this study was to report on a nine years of experience of providing medical support during house parties (raves) in the Netherlands, where they can be organized legally.Design:This was a prospective, observational study of self-referred patients from 1997 to 2005. During raves, first aid stations are staffed with specifically trained medical and paramedical personnel. Self-referred patients were diagnosed, treated, and recorded using standardized methods.Results:During a nine-year period with 219 raves occurred, involving approximately three million participants, 23,581 patients visited the first aid stations. The medical usage rate (MUR) varied from 59–170 patients per 10,000 rave participants. The mean age increased from 1997 to 2005 from 18.7 ±2.7 to 23.3 ±5.7 years. The mean stay at the first aid station was 18 ±46 minutes. Most health problems were mild. Fifteen cases of severe incidents were observed with one death.Conclusions:Unique data from the Netherlands demonstrate a low number of serious, health-related, short-term problems during raves.

scholarly journals Resultats A Court Terme De La Trabeculoplastie Selective Au Laser Chez Les Patients Togolais

2017 ◽  
Vol 13 (30) ◽  
pp. 271
Author(s):  
Dzidzinyo Kossi ◽  
Djagnikpo Akouete ◽  
Ayena Koffi Didier ◽  
Vonor Kokou ◽  
Maneh, Nidain ◽  
...  
Keyword(s):  
Selective Laser Trabeculoplasty ◽  
Treatment Results ◽  
Short Term ◽  
Laser Trabeculoplasty ◽  
The Mean ◽  
Laser Control ◽  
Pre Treatment ◽  
Primary Glaucoma ◽  
Reduction Percentage

Aim: To check the short-term tonometric results of SLT in the treatment of primary glaucoma at the open angle and in charge of ocular hypertonias in Togolese people. Methods: A retrospective study was carried out in an ophthalmology center. The first 130 eyes of 72 patients benefited from the SLT laser procedure. The tonometric controls work object focus on follow-up at 1, 3, and 6 months post laser treatment. Results: 130 eyes of 72 patients were collected. The average age of the patients was 49.74 years (± 17.45) and the ages vary between 10 and 85 years. The average IOP of the laser before the laser (J0) was (24.99 ± 8.41) mm Hg. The mean IOP at the post-laser control at 1 month was (18.79 ± 3.73) mm Hg. The average IOP for the post-laser control at 3 months was (18.44 ± 3.81) mm Hg. The mean IOP at the post-laser control at 6 months was (18.13 ± 3.63) mm Hg. The percentage reduction in intraocular pressure compared to IOP was pretreated from 20.2% to 1 month; 22.1% at 3 months; and 23.3% at 6 months. In 1 month, 49.2% of the eyes we treated showed a reduction in IOP of less than 20% compared to IOP pretreatment. After 3 months and 6 months, it was 55.4% higher. Also, 52.3% have a PIO reduction percentage which is greater than or equal to 20% compared to pre-treatment IOP. Discussion: Selective laser trabeculoplasty, most especially, is interesting in ocular hypertonies. Treatment of over 180 ° allows one patient out of two to have a pressure reduction that is greater than or equal to 20%. Conclusion: The SLT presents a significant advantage for our glaucomatous patients.

Boneloc versus Simplex Cement for Fixation of Femoral Components. An Interim Report of a Prospective Randomized Study of THRs with a 2,5 Year Mean Follow-Up Time

1996 ◽  
Vol 6 (3) ◽  
pp. 112-118 ◽  
Author(s):  
H. Klyver ◽  
K Jacobsen ◽  
H. Kofoed
Keyword(s):  
Femoral Component ◽  
Randomized Study ◽  
Femoral Stem ◽  
Prospective Randomized Study ◽  
Bone Cements ◽  
Interim Report ◽  
Short Term ◽  
Cement Interface ◽  
The Mean

A prospective randomized study of femoral stem fixation comparing Boneloc and Simplex cements was carried out. A collarless double-tapered femoral component was used in all cases. The material consisted of 94 patients representing 97 THRs (3 bilateral cases). Their mean age was 76 years (range 58-88). Clinico-radiographic follow-ups were carried out after 3 months, 12 months and 2 to 3 years. The mean follow up time was 2.5 years. Clinically there was no difference between the groups. Radiolucencies at the bone-cement interface and metal-cement interface, cement cracks, and subsidence of the femoral component were compared. No significant differences could be proven between the fixation patterns of the bone cements during this short-term follow-up.

scholarly journals Treatment Outcomes of Total Ankle Arthroplasty Using an Artificial Talus

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0021
Author(s):  
Takaaki Hirano ◽  
Yui Akiyama ◽  
Tomoko Karube ◽  
Naoki Haraguchi ◽  
Hisateru Niki ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Japanese Society ◽  
Japanese Orthopaedic Association ◽  
Total Ankle Arthroplasty ◽  
Short Term ◽  
Short Term Treatment ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
The Mean

Category: Ankle Arthritis Introduction/Purpose: Problems associated with mid- to long-term total ankle arthroplasty (TAA) include loosening and sinking of the talus implant. These problems arise due to a lack of stability compared with artificial joints such as knees and hips. In Japan, aluminum ceramic talus implants have been developed and are reported to result in good treatment outcomes. Here we investigated and report the treatment outcomes for combined TAA (cTAA), in which TAA is combined with a talus implant during the initial procedure. Methods: We assessed 15 cases involving 16 feet that underwent cTAA for which follow-up was available for at least 6 months. These cases comprised five feet with stage IIIb osteoarthritis and nine feet with stage IV osteoarthritis according to the Takakura classification as well as two feet with talus necrosis. The mean patient age was 73.5 years, and the mean follow-up period was 9.1 months. The talus implant was completely customized for all cases, and TNK Ankle (Kyocera, Japan) tibial components were used. Assessments were performed before and after surgery using the Japanese Society for Surgery of the Foot scale (JSSF scale) for physician-led objective evaluation and the Japanese Orthopaedic Association/Japanese Society for Surgery of the Foot and Self- Administered Foot Evaluation Questionnaire (SAFE-Q) subscales for patient-reported subjective evaluation. The validity and reliability of the JSSF scale and SAFE-Q have been verified by metering psychological verification. Scores were compared using paired t-tests. Results: The mean JSSF score improved significantly from 46.7 points preoperatively to 85.3 points postoperatively. For the SAFE-Q, pain and pain-related scores improved significantly from 40.5 points preoperatively to 75.8 points postoperatively (p < 0.001), physical function and daily lifestyle status improved significantly from 41.1 points preoperatively to 72.9 points postoperatively (p < 0.001), social lifestyle function improved significantly from 37.8 points preoperatively to 76.4 points postoperatively (p < 0.001), and overall sense of health improved significantly from 51.7 preoperatively to 80.7 postoperatively (p < 0.001). Shoe-related results improved from 50.0 points preoperatively to 69.4 points postoperatively (p = 0.038). Only one postoperative complication was noted, which was a case of deep wound infection. Conclusion: Short-term outcomes for cTAA were mostly good in our study population. The findings suggest that talus implants could be used as a treatment option for cases involving severe deformities, crushed talus injuries, and bone defects in which the use of TAA had previously been difficult, which can be handled with cTAA. These findings reveal new possibilities for expanded indications going forward. However, as these were short-term treatment outcomes, further follow-up is required in future studies.

The Mayo Conservative hip: Experience from a District General Hospital

2009 ◽  
Vol 19 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Rob E. Gilbert ◽  
Seema Salehi-Bird ◽  
Peter D. Gallacher ◽  
Phillip Shaylor
Keyword(s):  
Femoral Component ◽  
Hip Replacement ◽  
District General Hospital ◽  
Fracture Rate ◽  
Bone Stock ◽  
Femoral Prosthesis ◽  
Femoral Bone ◽  
Short Term ◽  
The Mean

The Mayo Conservative Hip femoral prosthesis has been designed to optimise proximal femoral loading as well as preserving proximal femoral bone stock. Between October 2003 and May 2006, 42 patients (49 hips) underwent total hip replacement (THR) using the Mayo Conservative Hip femoral component. The mean age at operation was 57.8 years (range 44 to 74) and the mean clinical follow up was 3.1 years (range 2.3 to 4.7 years). The aim of our study was to review the short term results of this unorthodox femoral component. We found that 18%° of stems were malaligned ≥ 5° and the prevalence of intra-operative femoral fracture was 4%. We feel this prosthesis is difficult to implant and has an unacceptable fracture rate.

Tethered cord syndrome in adults

2011 ◽  
Vol 15 (3) ◽  
pp. 258-270 ◽  
Author(s):  
Jörg Klekamp
Keyword(s):  
Spinal Cord ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Neurological Deficits ◽  
Short Term ◽  
Group A ◽  
The Mean ◽  
Group B

Object The treatment of tethered cord syndromes in adults is discussed regarding the natural history and surgical indications. The author analyzes data obtained in patients who were diagnosed with a tethered cord in adulthood and either underwent surgical or conservative therapy between 1991 and 2009. Methods Since 1991, data obtained in 2515 patients with spinal cord pathologies were entered into the spinal cord database, and prospective follow-up was performed through outpatient visits and questionnaires. Of the 2515 patients, 85 adults with a tethered cord syndrome formed the basis of this study. The tethering effect was caused either by a split cord malformation, a thick filum terminale, a conus medullaris lipoma with extradural extension, or various combinations of these mechanisms. The mean age of the patients was 46 ± 13 years (range 23–74 years) and the mean follow-up duration was 61 ± 62 months. Two groups were distinguished based on the absence (Group A, 43 patients) or presence (Group B, 42 patients) of an associated lipoma or dysraphic cyst (that is, dermoid, epidermoid, or neurenteric cyst). Surgery was recommended for patients with symptoms only. Short-term results were determined within 3 months of surgery, whereas long-term outcomes (clinical recurrences) were evaluated using Kaplan-Meier statistics. Results For all patients, pain was the most common major complaint. Severe neurological deficits were rare. In Group A, 20 of 43 patients underwent surgery, whereas in Group B 23 of 42 patients underwent surgery. Among individuals who did not undergo surgery, 17 patients refused surgery and 25 patients underwent recommended conservative treatment. Short-term postoperative results indicated a significant improvement of pain and a stabilization of neurological symptoms. Long-term results showed a good prognosis in patients in whom first-time (that is, nonrevision) surgery achieved successful untethering, with a 10-year rate of neurological stabilization in 89% of Group A and a 10-year rate of neurological stabilization in 81% of Group B patients. The benefit of secondary operations in Group B was limited, with eventual clinical deterioration occurring in all patients within 10 years. For patients treated conservatively, follow-up information could be obtained in 33 of 42 patients. Twenty-eight patients remained in stable clinical condition. Only 5 of the conservatively treated patients experienced clinical deterioration over time; in 4 of these individuals with deterioration, surgery had been recommended but was refused by the patient. The clinical recurrence rate in all conservatively treated patients was 21% after 10 years. With a recommendation for surgery this figure rose to 47% within 5 years. Conclusions Surgery in adult patients with a tethered cord syndrome should be reserved for those with symptoms. In surgically treated patients, pain relief can often be achieved, and long-term neurological stabilization tends to persist more often than it does in conservatively treated patients. A conservative approach is warranted, however, in adult patients without neurological deficits. Revision surgery in patients with complex dysraphic lesions should be performed in exceptional cases only.

scholarly journals The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
John M. Stacy ◽  
Jacob R. Greenmyer ◽  
James R. Beal ◽  
Abe E. Sahmoun ◽  
Erdal Diri
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Severity ◽  
Low Dose ◽  
Response Criteria ◽  
Newly Diagnosed ◽  
Short Term ◽  
Eular Response ◽  
The Mean ◽  
Dose Prednisone

Abstract Background The ACR/EULAR recommendations endorse the use of glucocorticoids (GCs) for rheumatoid arthritis (RA) patients’ flares and as a bridge to a DMARD. However, the recommendation of low dose short-term monotherapy with (GCs) remains open to the discretion of the clinician. The aim of this study was to assess whether a short-term use of low dose prednisone monotherapy was effective in inducing remission in newly diagnosed RA patients. Methods A retrospective analysis of patients newly diagnosed with RA at a Community Health Center in North Dakota was performed based on the ACR/EULAR RA classification criteria. Demographic and clinical data were abstracted from patients’ medical charts. Patients treated with (< 10 mg/day) of prednisone up to 6 months were included. Response to prednisone was analyzed according to pre- and post-treatment DAS28-ESR score and EULAR response criteria. Results Data on 201 patients were analyzed. The mean prednisone dose was 8 mg/day (range: 5–10; SD = 1.2) and the mean treatment duration was 42.2 days (12–177; 16.9). Disease severity significantly improved from baseline to follow-up for: tender joint count (8.6 ± 4.8 vs. 1.5 ± 3.3; P < 0.001), swollen joint count (6.2 ± 5.0 vs. 1.4 ± 3.0; P < 0.001), and visual analog pain score (4.8 ± 2.6 vs. 2.1 ± 2.5; P < 0.001). DAS28-ESR disease severity significantly improved from baseline to follow-up: (5.1 ± 1.2 vs. 2.7 ± 1.3; P < 0.001). Per EULAR response criteria, 69.7% of patients showed good response to treatment and 20.4% showed moderate response. 54.2% of patients reached remission. Conclusion Short-term use of low dose prednisone monotherapy induced disease remission and improved clinical severity of RA in the majority of newly diagnosed patients.

scholarly journals Significance of Correct Diagnosis of Odontogenic Extraoral Sinus: A Report Of Two Cases

2018 ◽  
Vol 1 (11) ◽  
pp. 334-338
Author(s):  
Shweta Bansal ◽  
Ruchi Juneja ◽  
Gyanendra Mishra ◽  
Akshay Nambiar
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Antibiotic Therapy ◽  
Clinical Course ◽  
Correct Diagnosis ◽  
Sinus Tract ◽  
Short Term ◽  
Diagnostic Challenge ◽  
Odontogenic Origin

Cutaneous draining sinus tracts of odontogenic origin often are a diagnostic challenge. A delay in correctly diagnosing these types of lesions can result in unnecessary antibiotic therapy and surgical treatment. This case report presents the clinical course of two cases with extra-oral sinus tract formation, from diagnosis and treatment to short-term follow-up and evaluation. These facial lesions were initially misdiagnosed as lesions of non-odontogenic origin. Later on an odontogenic cause was identified and endodontic intervention resulted in resolution of the problem, confirming the initial misdiagnosis.

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