Muller muscle conjunctival resection or external levator advancement; a quantitative comparison of symmetry in unilateral ptosis

2021 ◽  
pp. 112067212110490
Author(s):  
Kubra Serefoglu Cabuk ◽  
Senay Asik Nacaroglu ◽  
Gamze Ozturk Karabulut ◽  
Korhan Fazil ◽  
Mehmet Selcuk Arslan ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Quantitative Comparison ◽  
Strong Correlations ◽  
Upper Eyelid ◽  
Automated Measurements ◽  
The Difference ◽  
Group 2

Purpose To compare muller muscle conjunctival resection (MMCR) and external levator advancement (ELA) in terms of objective and subjective symmetry in unilateral ptosis. Methods The patients who underwent unilateral MMCR (group1, n = 25) and ELA (group2, n = 25) were reviewed retrospectively. With the written algorithm, margin reflex distance-1 (MRD1), localization of the contour peak, and the percentage of overlapping curvatures (POC) of both upper eyelid curves were calculated. Semi-automated measurements were compared with the manual measurements. The correlation between objective and subjective symmetry was evaluated. Results Preoperative levator functions were similar in both groups (13.93 ± 3.25 mm and 13.3 ± 2.86 mm, respectively). We found strong correlations between manual and semi-automated measurements (ICC: 0.942, 95% CI = 0.924–0.956, p < 0.001). Preoperative MRD1 (2.15 ± 0.90 vs 1.51 ± 1.01, p = 0.022) and POC was lower in group 2 (66% vs 47.2%, p = 0.01). In the postoperative period, the increase in MRD1 and POC were similar in both groups ( p = 0.2 and p = 0.7 respectively), and the contour peak displaced temporally ( p < 0.01) providing a symmetric peak in both groups. Subjective symmetry increased as the difference in MRD1 between two eyes decreased ( r = −0.456, p = 0.001), and POC increased ( r = 0.396, p = 0.004). Conclusions Besides subjective symmetry, MMCR and ELA are equally effective in ensuring symmetry objectively, as measured with MRD1 and contour peak symmetry and POC in unilateral ptosis. POC may be used as a criterion of symmetry in the evaluation of ptosis.

scholarly journals Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 661 ◽  
Author(s):  
Zekeriya Okan Karaduman ◽  
Ozan Turhal ◽  
Yalçın Turhan ◽  
Zafer Orhan ◽  
Mehmet Arican ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Thermal Camera ◽  
Prosthesis Infection ◽  
Total Knee ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

scholarly journals Relationship between Medium-Term Changes in Intraocular Lens Position and Refraction after Cataract Surgery with Two Different Models of Monofocal Lenses

2021 ◽  
Vol 10 (17) ◽  
pp. 3856
Author(s):  
Hideki Fukumitsu ◽  
Vicent J. Camps ◽  
Sara Miraflores ◽  
David P. Piñero
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Statistical Significance ◽  
Anterior Chamber Depth ◽  
Strong Correlations ◽  
Lens Position ◽  
Single Piece ◽  
Iol Power ◽  
The Difference ◽  
Group 2

The aim of this prospective descriptive study was to characterize the variations of the clinical effective lens position (ELP) (considering paraxial optics and postoperative data) and the intraocular lens (IOL) position, using “eye” data gathered from a 6-month follow-up of patients who underwent uneventful cataract surgery. Patients were implanted with two different monofocal IOLs: AcrySof IQ SN60WF (Alcon) (Group 1, 247 eyes) and Akreos MI60L (Bausch & Lomb) (Group 2, 104 eyes). No significant differences were found between groups concerning spherical equivalent (SE), axial length, and clinical ELP changes, from 1 to 6 months after surgery (p ≥ 0.516). A more positive change in postoperative anterior chamber depth was found in Group 2, but the difference did not reach statistical significance (p = 0.065). No significant moderate to strong correlations were found between the changes in clinical ELP and preoperative data. The correlation between the changes in SE and clinical ELP over time was strong and statistically significant (groups 1 and 2: r = 0.957 and r = 0.993, p < 0.001). In conclusion, changes in refraction from 1 to 6 months after cataract surgery, with single-piece monofocal IOLs, are not clinically relevant, which correlates with the presence of good positional stability. These changes cannot be predicted preoperatively and considered in IOL power calculations.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty

2021 ◽  
pp. 105566562199265
Author(s):  
Ishwarya Shradha Mamidi ◽  
Esperanza Mantilla-Rivas ◽  
Brynne A. Ichiuji ◽  
Md Sohel Rana ◽  
Karen I. Ramirez ◽  
...  
Keyword(s):  
Single Dose ◽  
Fistula Formation ◽  
Readmission Rates ◽  
Oronasal Fistula ◽  
Inadequate Sample Size ◽  
Perioperative Antibiotics ◽  
The Difference ◽  
Group 2 ◽  
National Databases ◽  
Group 1

Objective: Oronasal fistula (ONF) is a known complication after primary palatoplasty (PP). Studies investigating the effect of perioperative antibiotics on fistula rates after PP are limited by inadequate sample size or reliance on self-reporting through national databases. In this study, the authors evaluated the association between single-dose perioperative antibiotics and postoperative fistula rates after PP at a single institution. Design: A retrospective study. Participants: Children younger than 2 years who underwent PP from April 2009 to September 2019 were included. Interventions: Patients were divided into 2 categories: Group 1 received a single intraoperative dose of IV antibiotic, while group 2 did not. Main Outcome Measure(s): Outcome measures included ONF formation, length of stay (LOS), and 30-day readmission rates. Multivariable firth logistic regression, quantile regression, and χ2 tests were performed. Results: Of the 424 patients, 215 and 209 patients were in groups 1 and 2, respectively. The overall ONF rate was 1.9% among all patients. Patients in group 1 experienced an ONF rate of 3.3%, while patients in group 2 had an ONF rate of 0.5%. After correcting for confounding variables, the difference in ONF rates was not statistically different ( P = .68). Median LOS was 35.7 hours and 35.5 hours ( P = .17), while the rate of readmission within 30 days was 4.7% and 2.4% for group 1 and 2, respectively ( P = .96). Conclusions: Administration of a single-dose perioperative antibiotic did not decrease fistula formation after PP, nor did it affect the patient’s LOS or 30-day readmission rate.

scholarly journals Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study

Materials ◽  
2021 ◽  
Vol 14 (10) ◽  
pp. 2661
Author(s):  
Kiche Shim ◽  
Young-Eun Jang ◽  
Yemi Kim
Keyword(s):  
Postoperative Pain ◽  
Postoperative Period ◽  
Root Canal ◽  
Continuous Wave ◽  
Root Canal Treatment ◽  
Root Canals ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Ah Plus ◽  
Group 2

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.

A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

2021 ◽  
pp. 1-5
Author(s):  
A H A Baazil ◽  
J G G Dobbe ◽  
E van Spronsen ◽  
F A Ebbens ◽  
F G Dikkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Three Dimensional ◽  
Endoscopic Approach ◽  
Microscopic Approach ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

Usage of 25% albumin solution in the intraoperative and early postoperative periods of liver transplantation from a cadaveric donor.

2021 ◽  
Author(s):  
С.В. Журавель ◽  
Н.К. Кузнецова ◽  
В.Э. Александрова ◽  
П.В. Гаврилов ◽  
А.М. Талызин ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Postoperative Period ◽  
Human Albumin ◽  
Early Postoperative Period ◽  
Hemodynamic Parameters ◽  
Albumin Solution ◽  
Transfusion Therapy ◽  
Group 2 ◽  
Human Albumin Solution ◽  
Group 1

Введение. Терапевтическое использование раствора человеческого альбумина у пациентов в периоперационном периоде трансплантации печени (ТП) представляет интерес в контексте осложнений и исходов операции. Цель исследования: оценить влияние интраоперационной трансфузии 25% раствора человеческого альбумина на течение раннего послеоперационного периода при ортотопической ТП от посмертного донора. Материалы и методы. В исследование включены 47 пациентов, которым была выполнена трупная ТП. Были сформированы 2 группы: пациенты группы 1 (n = 21) получали трансфузию 25% раствора человеческого альбумина в конце операции ТП и через 24 ч после операции; пациенты группы 2 (n = 26) получали трансфузию 25% раствора человеческого альбумина в первые сутки послеоперационного периода. Осуществляли контроль лабораторных параметров крови пациента перед началом оперативного вмешательства, через 24 ч и через 48 ч после операции. Интраоперационно оценивали значения систолического (САД) и диастолического (ДАД) артериального давления, частоту сердечных сокращений (ЧСС), дозу вазопрессоров, объем инфузионно-трансфузионной терапии, кровопотерю и диурез. В послеоперационном периоде фиксировали возможные осложнения, проведенные сеансы заместительной почечной терапии (ЗПТ), а также количество дней в стационаре. Результаты. Оценка значений САД, ДАД и ЧСС в начале и конце операции показала достоверно лучшие показатели гемодинамики и снижение дозировок вазопрессорной поддержки в конце вмешательства в группе 1 по сравнению с группой 2 (p < 0,05). В послеоперационном периоде инфекционные осложнения зарегистрированы у одного пациента группы 1 и у трех пациентов группы 2. Проведение ЗПТ потребовалось двум пациентам из группы 2. Все пациенты обеих групп были выписаны из стационара, при этом число дней госпитализации в группе 2 было статистически значимо больше по сравнению с пациентами группы 1: 26,9 ± 3,9 против 17,2 ± 4,3 (p < 0,05). Заключение. Интраоперационная инфузия 25% раствора альбумина позволяет стабилизировать показатели гемодинамики в конце операции ТП, снизить потребность в кардиотонической поддержке и сократить время госпитализации у пациентов после ТП. Background. The therapeutic use of human albumin solution in patients in the perioperative period of liver transplantation (LT) is of interest in the context of complications and outcomes of surgery. Objectives: to assess the effect of intraoperative transfusion of 25% human albumin solution on the early postoperative period in orthotopic LT from a postmortem donor. Patients/Methods. The study included 47 patients who underwent cadaveric LT. Two groups were formed: patients in group 1 (n = 21) received transfusion of 25% human albumin solution at the end of LT and 24 hours after surgery; patients in group 2 (n = 26) received transfusion of 25% human albumin solution on the first day of the postoperative period. The laboratory parameters of the patient’s blood were monitored before surgery, 24 hours later, and 48 hours after surgery. Intraoperatively, the values of systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), dose of vasopressors, volume of infusion- transfusion therapy, blood loss and diuresis were assessed. In the postoperative period, possible complications, renal replacement therapy (RRT) sessions performed, and the number of days in the hospital were recorded. Results. Assessment of SBP, DBP and HR values showed significantly better hemodynamic parameters and reduced dosages of vasopressor support at the end of surgery in group 1 compared to group 2 (p < 0.05). In the postoperative period, infectious complications were registered in one patient of group 1 and in three patients of group 2. Two patients from group 2 required RRT. All patients were discharged from the hospital, while the number of hospitalization days in group 2 was statistically significantly greater than in patients in group 1: 26.9 ± 3.9 versus 17.2 ± 4.3 (p < 0.05). Conclusions. Intraoperative infusion of 25% albumin solution allows stabilizing hemodynamic parameters at the end of LT surgery, reducing the need for cardiotonic support and shortening the hospitalization time in patients after LT.

Abstract 2611: Transcatheter Valve Insertion A Model Of Enlarged Right Ventricular Outflow Tracts

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Adeline Basquin ◽  
Younes Boudjemline
Keyword(s):  
Right Ventricular ◽  
Pulmonary Valve ◽  
Main Pulmonary Artery ◽  
Pulmonary Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
The Difference ◽  
Group 2 ◽  
Transcatheter Valve ◽  
Group B

Background: Transcatheter pulmonary valve insertion has recently emerged as an alternative to surgery. To extend the indications to patients with large right ventricular outflow tract (RVOT), we previously developed an intravascular device that reduces the diameter of the main pulmonary artery (MPA) allowing the insertion of available valved stents. We report its use in a model of animals with enlarged RVOT and pulmonary valve incompetence (PVI). Methods and Results: 33 sheep were included. They first underwent surgical MPA enlargement. We then intended to implant percutaneously a reducer followed by the insertion of a valve. Three animals died during interstage. The remaining were sacrificed acutely (group 1, n=6), after a mean follow-up of 1 (group 2, n=12) and 2 months (group 3, n=12). Animals from chronic groups were equally divided into 2 subgroups according to the difference between diameters of the device inserted and MPA (A: < 5-mm, B: ≥ 5-mm). Reducers were inserted successfully (n=30). One embolized after its insertion (Group 3A). A valved stent could be implanted in all animals but one which experienced a balloon ruptured during its inflation leading to incomplete expansion and death of the animal. Six animals had pulmonary regurgitation after valve insertion. Five of them (Group A, n=5; Group B, n=1) had downsizing of the reducer. Conclusion: Pulmonary valve insertion is possible through a transcatheter technique using a PA reducer. Oversizing of this device reduces the risk of embolisation and paraprosthetic leak.

scholarly journals ADOLESCENT IDIOPATHIC SCOLIOSIS AND SIMILAR CONDITIONS: NEW TOOL TO MEASURE THE CORONAL PLANE

2018 ◽  
Vol 17 (4) ◽  
pp. 281-285
Author(s):  
Enguer Beraldo Garcia ◽  
Guilherme Brescia Payão ◽  
Liliane Faria Garcia ◽  
Enguer Beraldo Garcia Jr ◽  
Marcos Felipe Camarinha ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Postoperative Period ◽  
Central Line ◽  
Coronal Plane ◽  
Fixation Method ◽  
Preoperative Period ◽  
Level Of Evidence ◽  
Proximal Extension ◽  
The Difference ◽  
Third Line

ABSTRACT Objective: To create a method to measure the overall coronal plane of the spine, called the sacral clavicular angle (SCA). Methods: A line is drawn at the base of the sacrum; a second central line is drawn perpendicular to the first one in the proximal extension of the spine. A third line is drawn passing through the intersections of the superior points of the clavicles with the two second ribs, forming two angles, the greater of which is measured. Therefore, the degrees exceeding 90° are the SCA values. This tool was tested retrospectively in a study of 46 patients with idiopathic scoliosis who underwent short, apical, single or multiple fixations. Third generation instrumentation was used and the SCA was evaluated in the pre- and postoperative periods, which were compared with another group of 46 patients treated with the traditional technique. Results: Patients submitted to the traditional fixation method presented a median SCA of 3° in the preoperative period, and in the postoperative period, the SCA remained in 3°. Therefore, there was a 0% reduction. Patients submitted to short, apical, single or multiple fixation method presented a median preoperative SCA of 6°, and a postoperative median SCA of 1°, a reduction of approximately 83%. Conclusions: The group treated with short, apical, single or multiple instrumentation presented a reduction in the SCA of approximately 83% in the postoperative period compared to the preoperative period. The difference between preoperative and postoperative values was considered statistically significant. Level of Evidence II; Retrospective study.

scholarly journals The Effect of the Difference Between Infographic Designing Types (Static vs Animated) on Developing Visual Learning Designing Skills and Recognition of its Elements and Principles

2018 ◽  
Vol 13 (09) ◽  
pp. 204 ◽  
Author(s):  
Mohammed Kamal Afify
Keyword(s):  
Learning Outcomes ◽  
Visual Learning ◽  
College Of Education ◽  
Kingdom Of Saudi Arabia ◽  
Learning Materials ◽  
Design Elements ◽  
Learning Content ◽  
Instructional Processes ◽  
The Difference ◽  
Group 2

This In the scope of improving learning outcomes in the age of technology, this study comes as an attempt to investigate the extent to which infographics are effective in developing learning outcomes for students. It has also attempted to study the effect of infographics types, static versus animated , on developing the skills of designing and producing visual learning materials, and the recognition of design elements and principles. The study was conducted on a sample of students of the College of Education at Imam Abdu Rahman bin Faisal University (IAU) in the Kingdom of Saudi Arabia. The sample students number is 36, and they are from students enrolled to study design and production of instructional media course (EDU195N) in the second semester of 2016/2017. The students involved are divided into two experimental groups, group (1) with 19 students who have studied the learning content through static infographics via WhatsApp platform, group (2) with 17 students who have studied the learning content through animated infographics via WhatsApp platform. In the overall, the results revealed that infographics effect the development of some learning outcomes. Besides, the results also demonstrated that static infographic type has more effects on developing skills of designing and producing visual learning materials and recognizing its elements and principles compared to the animated type. And this suggests deep consideration of integrating infographics in teaching e-courses, as well as considering the characteristics and appropriateness of each of the designing types, static versus animated when implemented in instructional processes for better outcomes for learners.

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