Adjuvant radiofrequency thermocoagulation improves the outcome of liquid sclerotherapy in the treatment of spider veins of the leg: A pilot study

2021 ◽  
pp. 026835552110065
Author(s):  
Adem İlkay Diken ◽  
Utku Alemdaroğlu ◽  
Sertan Özyalçın ◽  
İzzet Hafez ◽  
Hüseyin A Tünel ◽  
...  
Keyword(s):  
Study Groups ◽  
Low Energy ◽  
Clinical Severity ◽  
Complication Rates ◽  
Radiofrequency Thermocoagulation ◽  
Severity Scores ◽  
Significant Difference ◽  
Cosmetic Outcomes ◽  
Group 2 ◽  
Spider Veins

Objective This study evaluated the effect of low-energy radiofrequency thermocoagulation added to standard liquid sclerotherapy on clinical outcomes of patients with venous insufficiency. Patients and method We included 111 patients with spider veins CEAP/C1 stage. The patients were randomized into sclerotherapy (Group 1) and sclerotherapy + sclerotherapy immediately followed by low energy percutaneous RF thermocoagulation (Group 2) groups and followed up with same protocols prospectively. Results The study groups did not differ in terms of the mean age, body mass index, the number of spider veins and pre-interventional venous clinical severity scores (VCSS). Patients' self-assessed satisfaction ratings of cosmetic outcomes were found to be higher compared to the baseline (p = 0.001). While both techniques caused a significant decline in VCSS at postprocedural third month, it was observed that the type of applied intervention did not affect the VCSS (p = 0.43 and p = 0.93, respectively). There was a significant difference in hyperpigmentation and trapped blood between the two groups after the procedure (p = 0.009 and p = 0.02, respectively), there was no statistically significant difference in terms of skin necrosis (p = 0.52). A significant difference in the self-assessed cosmetic outcomes was observed in patients treated with sclerotherapy followed by low energy percutaneous RF thermocoagulation compared with patients whom sclerotherapy performed alone (p = 0.001). Discussion This study suggests that radiofrequency thermocoagulation added to the sclerotherapy provides better cosmetic outcomes with less treatment sessions and no additional complication rates.

A Comparative Analysis of Outcome of Open Reduction and Internal Fixation of Mandibular Fracture With or Without Intermaxillary Fixation

2021 ◽  
Vol 15 (8) ◽  
pp. 2181-2183
Author(s):  
Sadiq Ali ◽  
Ashfaq-ur- Rahim ◽  
Muhammad Nauman ◽  
Tannaza Qayyum ◽  
Urooj Kirmani ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Posterior Arch ◽  
Intermaxillary Fixation ◽  
Mandible Fracture ◽  
Manual Reduction ◽  
Severity Scores ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Aim: To evaluate the difference and functional outcome between open reduction and internal fixation (ORIF) and intermaxillary fixation (IMF) in mandibular fractures. Study Design: Retrospective study. Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Faryal Dental College, Sheikhupura, Lahore from 1st February 2019 to 31st January 2021. Methodology: One hundred and fifty seven patients treated for fractures of mandible and reviewed their prognosis based on use of intermaxillary fixation after reduction of fracture. The patients were divided into two groups; Manual reduction group without the intermaxillary fixation and the intermaxillary fixation group. Results: Good results have been obtained in most patients after mandible fracture reduction. However, complications occurred in 19 (27.5%) patients in group 2 after surgery. 6 patients had an infection, 4 patients had a wound dehiscence, and 4 patients had osteomyelitis. No loosening of the mounting bolts and/or crack of the mounting plates was observed. Correct occlusion was achieved using posterior arch wires and elastic rings in 2 malocclusion patients. Occlusion failed in two patients in Group 1 due to osteomyelitis, and the second operation was performed under general anaesthesia. The mean complication severity scores for Group 1 and Group 2 were 1.37 and 1.38, respectively, with no significant difference. Conclusion: Among the patients treated with manual reduction, 2 patients had malocclusion and 1 patient required a new surgery. Such a simple mandible fracture can give good results even with manual reduction without intermaxillary fixation. For a simple mandible fracture, only manual reduction without intermaxillary fixation or intermaxillary fixation was recommended for a short time. Key words: Complication, Fracture, Internal fixation, Mandible

scholarly journals Cryosclerosis. Az elfelejtett endovénás cryoablatio a vena saphena magna elégtelenségének kezelésében. Egy prospektív összehasonlító vizsgálat középtávú eredményei

2016 ◽  
Vol 157 (50) ◽  
pp. 1994-2001
Author(s):  
István Bence Bálint ◽  
Ákos Farics ◽  
László Vizsy ◽  
Eszter Vargovics ◽  
Renáta Bálint ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Secondary Outcome ◽  
Rank Test ◽  
Clinical Failure ◽  
Severity Scores ◽  
Significant Difference ◽  
Vena Saphena Magna ◽  
Occlusion Rate

Introduction: Cryosclerosis was introduced by Milleret and Le Pivert in the 1980s. Method: A prospective non-randomized comparative study has been performed on initial 96 patients. 48 patients were treated by cryosclerosis and the others received conventional stripping. 52 cases were analyzed for 2-years. The primary end-point of the study was to determine the occlusion rate of cryosclerosis. The clinical failure, the improvement in the Clinical Etiologic Anatomic Pathophysiologic classification and Venous Clinical Severity Scores were analyzed as secondary outcome. Results: Total recanalization of the great saphenous vein causing clinical failure was observed in one case (4%). The reopening of the great saphenous vein was observed in 4 limbs (15%) that did not cause the incompetence of the trunk. The occlusion rate was 81%. Recurrent varicosity was observed by 35% and 42% of the patients in the cryosclerosis and stripping groups respectively. There was no significant difference between the groups (log rank test, p = 0.391). There was significant improvement in both the Clinical Etiologic Anatomic Pathophysiologic classification and Venous Clinical Severity Scores in each group without remarkable differences observed between the groups either at baseline or on the mid-term. Conclusions: Cryosclerosis seems to be effective in the remodeling of the great saphenous vein. The method has no remarkable mid-term clinical advantages over classical stripping so far. Orv. Hetil., 2016, 157(50), 1994–2001.

scholarly journals Type 1 FSHD with 6–10 Repeated Units: Factors Underlying Severity in Index Cases and Disease Penetrance in Their Relatives Attention

2020 ◽  
Vol 21 (6) ◽  
pp. 2221
Author(s):  
Emmanuelle Salort-Campana ◽  
Farzad Fatehi ◽  
Sadia Beloribi-Djefaflia ◽  
Stéphane Roche ◽  
Karine Nguyen ◽  
...  
Keyword(s):  
Disease Severity ◽  
Facioscapulohumeral Muscular Dystrophy ◽  
Clinical Severity ◽  
Cross Sectional ◽  
Repeat Array ◽  
D4z4 Repeat ◽  
Severity Scores ◽  
Group 2 ◽  
Group 1

Molecular defects in type 1 facioscapulohumeral muscular dystrophy (FSHD) are caused by a heterozygous contraction of the D4Z4 repeat array from 1 to 10 repeat units (RUs) on 4q35. This study compared (1) the phenotype and severity of FSHD1 between patients carrying 6–8 vs. 9–10 RUs, (2) the amount of methylation in different D4Z4 regions between patients with FSHD1 with different clinical severity scores (CSS). This cross-sectional multicenter study was conducted to measure functional scales and for genetic analysis. Patients were classified into two categories according to RUs: Group 1, 6–8; Group 2, 9–10. Methylation analysis was performed in 27 patients. A total of 99 carriers of a contracted D4Z4 array were examined. No significant correlations between RUs and CSS (r = 0.04, p = 0.73) and any of the clinical outcome scales were observed between the two groups. Hypomethylation was significantly more pronounced in patients with high CSS (>3.5) than those with low CSS (<1.5) (in DR1 and 5P), indicating that the extent of hypomethylation might modulate disease severity. In Group 1, the disease severity is not strongly correlated with the allele size and is mostly correlated with the methylation of D4Z4 regions.

scholarly journals Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

2017 ◽  
Vol 89 (3) ◽  
pp. 226
Author(s):  
Bilal Eryildirim ◽  
Murat Tuncer ◽  
Emre Camur ◽  
Fatih Ustun ◽  
Fatih Tarhan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Total Duration ◽  
Renal Stones ◽  
Complication Rates ◽  
Nephrostomy Tube ◽  
Ureteral Catheter ◽  
Sonographic Guidance ◽  
Hospitalization Period ◽  
Significant Difference ◽  
Group 2

Purpose: To evaluate the true necessity of open end ureteral catheter insertion in patients with moderate to severe pelvicalyceal system dilation treated with percutaneous nephrolithotomy (PNL) under sonographic guidance. Patients and methods: 50 cases treated with PNL under sonographic guidance in prone position for solitary obstructing renal stones were evaluated. Patients were randomly divided into two groups; Group 1: Patients in whom a open end ureteral catheter was inserted prior to the procedure; Group 2: Patients receiving no catheter before PNL. In addition to the duration of the procedure as a whole and also all relevant stages as well, radiation exposure time, hospitalization period, mean nephrostomy tube duration, mean drop in Hb levels and all intra and postoperative complications have been evaluated. Results: Mean size of the stones was 308.5 ± 133.2 mm2. Mean total duration of the PNL procedure in cases with open end ureteral catheter was significantly longer than the other cases (p < 0.001). Evaluation of the outcomes of the PNL procedures revealed no statistically significant difference between two groups regarding the stone-free rates (86% vs 84%). Additionally, there was no significant difference with respect to the duration of nephrostomy tube, hospitalization period and secondary procedures needed, complication rates as well as the post-operative Hb drop levels in both groups (p = 0.6830). Conclusions: Our results indicate that the placement of an open end ureteral catheter prior to a PNL procedure performed under sonographic access may not be indicated in selected cases presenting with solitary obstructing renal pelvic and/or calyceal stones.

Evolution of an Endovenous Laser Ablation Practice for Varicose Veins

2012 ◽  
Vol 28 (5) ◽  
pp. 248-256 ◽  
Author(s):  
N Samuel ◽  
T Wallace ◽  
D Carradice ◽  
G Smith ◽  
F Mazari ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Complication Rates ◽  
Technical Failure ◽  
Normal Functioning ◽  
Endovenous Laser Ablation ◽  
Pain Scores ◽  
Sf 36 ◽  
Severity Scores

Objective: We aimed to assess the evolution of an endovenous laser ablation (EVLA) practice in the management of varicose veins in a university teaching hospital vascular surgical unit, over five years. Methods: This was a retrospective review of a prospectively collected database of patients undergoing EVLA for great saphenous vein incompetence and followed up for a year. For inter- and intragroup comparison, patients were divided into three groups: group A: endovenous access generally established at the perigenicular level ( n = 105); group B: when practice changed to gain access at lowest point of demonstrable reflux ( n = 70); and group C: when tumescence delivery changed from manual injections to delivery via peristaltic pump ( n = 49). Outcomes including pain scores, time taken to return to normal functioning, quality of life (QoL), venous clinical severity scores (VCSS) and complication rates were evaluated. Results: Intergroup analysis: increase in the length of vein treated and laser density delivered was observed over time, even as median procedure duration decreased ( P < 0.001). An increase in sensory disturbance was noticed in group C ( P = 0.047) while better Aberdeen Varicose Vein Questionnaire (AVVQ) ( P = 0.004), SF-36® physical domains ( P < 0.05) and patient satisfaction with treatment ( P = 0.025) were recorded in the same group at 52 weeks. No significant difference was observed in technical failure, pain scores, return to normal functioning, VCSS and recurrence rates post-intervention. Intragroup analysis: QoL measures (AVVQ, SF-36®, EQ-5D) and VCSS scores demonstrated significant improvement at 12 and 52 weeks compared with baseline ( P < 0.05). Conclusions: Increase in length of vein treated and energy delivery seems to improve short-term outcomes; however, operators need to be wary of a possible concurrent increase in paraesthetic complications.

scholarly journals 437. Longitudinal Plasma Cytokine Profiles Differentiating COVID-19 Severity Groups

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S320-S320
Author(s):  
Amanda M Green ◽  
Aisha Souquette ◽  
Mona Agrawal ◽  
Joshua Wolf ◽  
Joshua Wolf ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Clinical Severity ◽  
Cytokine Profiles ◽  
Severity Scores ◽  
Significant Difference ◽  
Cytokine Levels ◽  
Longitudinal Plasma ◽  
Prospective Cohorts ◽  
Polymerase Chain ◽  
Inflammatory Syndrome

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an infection with widely varying clinical severity. Severe COVID-19 was initially proposed to be secondary to cytokine storm syndrome (CSS). However, studies since showed that patients with severe COVID-19 rarely display CSS cytokine phenotypes, and may have more limited inflammatory responses instead. Methods Prospective cohorts, aged 0-90 years of age who tested positive by polymerase chain reaction (PCR) for SARS-CoV-2 were enrolled from inpatient hospitals and outpatient testing centers in Memphis, TN from May 2020-January 2021. Longitudinal blood samples were obtained including acute, sub-acute and convalescent timepoints. Severity scores of asymptomatic, mild, moderate, and severe COVID-19 were assigned at time of convalescent assessment. Plasma was analyzed with a quantitative human magnetic 38-plex cytokine assay. Results : 169 participants were enrolled, including 8 asymptomatic, 117 mild, 22 moderate and 17 severe cases, and 5 children with post-COVID-19 multisystem inflammatory syndrome in children (MIS-C). All moderate and severe patients were hospitalized and received treatment (39%). Clear distinctions were seen between asymptomatic-mild cases and moderate-severe cases at acute timepoints and during disease progression for GCSF, IL-8, IL-10, IL-15, IL-1Ra, IP-10, MIP-1a, MIP-1β, and TGFα. There was a significant difference between participants who did and did not require hospitalization for acute timepoint levels of IL-10, IL-15, MIP-1 β and TGFα (p&lt; 0.01). Only 4 participants with active COVID-19 were found to meet criteria for CSS (2%), only 3 of which were severe. MIS-C participants showed nearly universally elevated cytokine levels compared to those with active COVID-19. Temporal and severity associations of IL-10 and IP-10 Figure 1. Temporal and severity associations of IL-10 and IP-10 Examples of differentiating cytokine profiles by severity and time. Among SARS-CoV-2 PCR positive participants, IL-10 and IP-10 displayed increased levels in their acute plasma samples as clinical severity increased [A,C]. IL-10 and IP-10 also showed distinct time-dependent responses (ln(Cytokine level (pg/mL)) that differentiated the more severe from the less severe groups [B,D]. Conclusion Moderate and severe acute COVID-19 has a distinct cytokine profile from asymptomatic and mild cases, as detected from acute, subacute and convalescent plasma. Disclosures Joshua Wolf, MBBS, PhD, FRACP, Karius Inc. (Research Grant or Support) Joshua Wolf, MBBS, PhD, FRACP, Nothing to disclose Paul Thomas, PhD, Cytoagents (Consultant)Immunoscape (Consultant)

scholarly journals Comparison of objective wear time between monoblock and twin-block appliances measured by microsensor

2021 ◽  
Author(s):  
Cansın Kutay ◽  
Hülya Kılıçoğlu ◽  
Gülşilay Sayar
Keyword(s):  
Study Groups ◽  
Prospective Clinical Study ◽  
Twin Block ◽  
Skeletal Class ◽  
Wear Time ◽  
Skeletal Class Ii ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Mandibular Retrognathia

ABSTRACT Objectives To assess the objective compliance levels in skeletal Class II patients with mandibular retrognathia wearing monoblock and twin-block appliances. Materials and Methods A prospective clinical study was conducted with 30 patients between 10 and 15 years old who were equally divided into two study groups. Group 1 was treated with monoblock, and group 2 was treated with twin-block appliances. The patients were instructed to wear their appliance for 15 hours per day. Wear times were monitored by a microsensor. (TheraMon; MCTechnology, Hargelsberg, Austria) for an average of six appointments. Patients were also instructed to record their wear times on a chart, and this record was admitted as subjective wear time. Statistical analysis was performed with the data derived from both the patients' charts and the monitoring records. Results The mean wear time by the patients was 10.67 ± 3.93 hours, which was less than the 15 hours prescribed by the orthodontist, with no difference between the two appliances (P &gt; .05). The regular use rate, which included the days with a wear time of 8 hours or more per day, was 75%. Compliance levels decreased by 35% throughout the six control appointments. Patients declared that their wear time was more than their objective wear time by an average of 3.76 hours. Conclusions Despite their different designs, there was no significant difference between the monoblock and twin-block appliances in terms of compliance.

Potential synergistic effects of bisphosphonates with sorafenib on renal cell carcinoma with bone metastases.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 496-496
Author(s):  
Ye Ding-Wei ◽  
Zhang Hai-Lang
Keyword(s):  
Renal Cell Carcinoma ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Independent Predictor ◽  
Study Groups ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

496 Background: We evaluated the role of bisphosphonates in conjunction with sorafenib in improving progression-free survival (PFS) and overall survival (OS) in bone metastatic renal cell carcinoma (mRCC) patients. Methods: A total of 81 sorafenib-treated patients were retrospectively divided into 3 groups at our single study center: Group 1 (n=26, sorafenib single agent); Group 2 (n=26, sorafenib plus oral Bonefos); Group 3 (n=29, sorafenib plus intravenous zoledronic acid). Alkaline phosphatase (ALP) before and 12 weeks after treatment were evaluated as prognostic factor for PFS and OS. Results: The majority of the patients were males (67.9%) with mean age of 57.2 ± 11.2 years. Baseline demographic characteristics were similar across the 3 study groups, and the known prognostic factors were balanced across the cohort. There was no significant difference observed in the objective response between the 3 study groups (Group 1 vs. 2 vs. 3; p=0.659); partial remission (8% vs. 8% vs. 10%), stable disease (65% vs. 80% vs. 66%), progressive disease (27% vs. 12% vs. 24%). Median PFS was significantly higher in Group 2 vs 1 vs 2 (18.7 vs. 6.7 vs. 10.5 months; p=0.024). Median OS was 16.8, 22.1, and 20.7 months; p=0.052 in Group 1, 2 and 3, respectively. Multivariate analysis demonstrated that bisphosphonate use (hazard ratio [HR]=0.36, p=0.006), Memorial Sloan Kettering Cancer Center (MSKCC) score (HR=4.10, p<0.001), non-clear cell subtype (HR=1.26, p=0.039), and elevated ALP after 12 weeks’ treatment (HR=3.53, p<0.001) were associated with PFS. MSKCC score (HR=5.24, p<0.001), elevated ALP after 12 weeks’ treatment (HR=4.71, p<0.001), and metastatic organs (HR=1.93, p=0.008) were associated with OS. Bisphosphonates use was not an independent predictor of OS (HR=0.55, p=0.160). Conclusions: Bisphosphonates administered with sorafenib could synergistically improve PFS and OS in RCC with bone metastases, with the benefit of being more efficacious and safer than intravenous zoledronic acid. Elevated ALP following the treatment could be an independent predictor for both PFS and OS in bone mRCC.

Effects of propofol and dexmedetomidine in sleep videoendoscopy: a comparative study in Ukraine

2020 ◽  
Vol 9 (3) ◽  
pp. 12-16
Author(s):  
Roman Denysenko ◽  
Oleksandr Dichtiaruk ◽  
Oleksandr Naumenko
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Minute Ventilation ◽  
Study Groups ◽  
P Value ◽  
Small Series ◽  
Obstructive Sleep ◽  
Study Results ◽  
Significant Difference ◽  
Group 2

Introduction: Snoring and obstructive sleep apnea (OSA) are associate with a high socio-economic burden. According to statistics snoring is found in 44% of men and 28% of women aged 30 to 60 years. Treatment involves several main approaches including uvulopalatopharyngoplasty with or without tonsillectomy. Preparation for this procedure includes sleep videoendoscopy. Currently, we mainly use two effective agents, propofol and dexmedetomidine. That said, there is still no consensus on which one is safer and better. Material and methods: The study involved 50 people aged 18 to 62 with a history of snoring and OSA, previously ineligible or insensitive to CPAP therapy, thus preparing for surgical treatment of these disorders. All patients were randomized to two study groups: group 1 with propofol as a sedative and group 2 with dexmedetomidine. Each treatment was divided into three periods: (1) initial testing before the use of intravenous hypnotic agents, (2) sedation, and (3) regaining consciousness. In each period, we measured the following parameters: minute ventilation, respiratory rate, oxygen saturation, blood concentration of hypnotic agent, BIS index. Statistical analysis was performed on IBM SPSS Statistics v. 22. Rusults: The OAA/S scale showed that the recovery time after sedation was longer for dexmedetomidine than for propofol: 38 ± 10 min and 27 ± 3 min, respectively (p value = 0.305, which means no statistically significant difference between the groups). Based on monitoring of circulation and respiratory rate, heart rate tended to decrease with dexmedetomidine sedation and increase with propofol infusion. Blood pressure tended to drop in both groups, more so with dexmedetomidine. In the postsedation period, blood pressure stabilized faster in the propofol group than in the dexmedetomidine group, but it was not statistically significant. Wnioski: According to the study results, there was no statistically significant difference between the propofol or dexmedetomidine groups. However, the paper presents a small series of cases, therefore extensive clinical research is needed to clarify the problem further.

Is the Preoperative Glycated Hemoglobin (HbA1c) Level Predictive of the Severity of Diabetic Hand Infection According to Surgical and Clinical Outcomes?

2019 ◽  
Author(s):  
Kaan Gürbüz ◽  
Yakup Ekinci
Keyword(s):  
Surgical Treatment ◽  
Hba1c Level ◽  
Surgical Techniques ◽  
Study Groups ◽  
Clinical Findings ◽  
Diabetic Patients ◽  
Hand Infection ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective We purposed to investigate whether preoperative HbA1c level is associated with the severity of surgical treatment in diabetic hand infection cases. Materials and Methods Between December 2015 and October 2018, 102 patients were surgically treated due to diabetic hand infection. Of the patients, 75 who met the criteria for diabetic hand infection were included in the study. The patients were divided into two groups: Group 1, < 8.5% HbA1c level (poorly controlled); and Group 2, 8.5% or higher HbA1c level (uncontrolled). Preoperative, intraoperative, and postoperative data were recorded. Drainage, VAC, ray/open amputation, and microsurgical reconstruction were performed according to the examination and clinical findings. p<0.05 was considered statistically significant. Results The study groups consisted of 41 patients (5 female/36 male; median age 59 years, range 32–68) in Group 1 and 34 patients (6 female/28 male; median age 62 years, range 28–67) in Group 2. The mean follow-up period was 21.14±10.42 months in Group 1 and 16.70±10.19 months in Group 2, which were not significantly different (p>0.05). The most common microbiological pathogen was polymicrobial in both study groups (39% in Group 1 and 41.2% in Group 2). Drainage was the most common surgical procedure in both groups and there was no significant difference between the groups in terms of the surgical techniques that were used (p>0.05). Conclusion Although HbA1c level is an important biomarker for monitoring glycemia in diabetic patients, it is not associated with the severity of surgical treatment in diabetic hand infections.

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