Rational approach, technique and selection criteria treating lumbar disk herniations by oxygen–ozone therapy

Radicular lumbar back pain is an important public health problem not already provided with a unequivocal treatment approach. Medical and physical therapies represent the first solution, however when these are not successful, the second therapeutic step is still controversial and mini-invasive treatment may play an important role. In these cases oxygen-ozone therapy has been proved to be a very safe and effective option that is widely used with different modalities. This paper, by reviewing oxygen-ozone therapy literature data, aims to propose an effective procedural technique and to clarify patient’s selection criteria; furthermore complications and follow-up management are also considered.

Download Full-text

Effect of Method of Defining the Active Patient Population on Measured Immunization Rates in Predominantly Medicaid and Non-Medicaid Practices

PEDIATRICS ◽

10.1542/peds.106.s1.171 ◽

2000 ◽

Vol 106 (Supplement_1) ◽

pp. 171-176

Author(s):

Ardythe L. Morrow ◽

R. Clinton Crews ◽

Henry J. Carretta ◽

Mekibib Altaye ◽

Albert B. Finch ◽

...

Keyword(s):

Selection Criteria ◽

Immunization Practice ◽

Immunization Rate ◽

The Past ◽

Immunization Rates ◽

Patient Selection Criteria ◽

Definition Of ◽

Practice Assessment ◽

Active Patients

Objective. To examine the effect of patient selection criteria on immunization practice assessment outcomes. Methods. In 3 high- (50%–85%) and 7 low- (<25%) Medicaid pediatric practices in urban eastern Virginia, we assessed immunization rates of children 12 and 24 months old comparing thestandard criteria (charts in the active files excluding those that documented the child moved or went elsewhere) with 3 alternative criteria for selecting active patients: 1)follow-up: the chart contained a complete immunization record or the patient was found to be active in the practice through follow-up contact by phone or mail; 2) seen in the past year: the chart indicated that the patient was seen in the practice in the past year; 3) consecutive: patients that were seen consecutively for any reason. Results. Of the 1823 charts assessed in the high- and low-Medicaid practices, follow-up identified 61% and 83% as active patients; 78% and 95% were ever seen in the past year. At 24 months, mean practice immunization rates were lower for standard (70%) than all 3 alternative criteria (78%–86%). Immunization rate differences between standard and alternative criteria were greater in high- (17%–23%) than low-Medicaid practices (5%–13%). Conclusion. The standard for practice assessment should be based on a consistent definition of active patients as the immunization rate denominator.

Download Full-text

E-Ophthalmology in the Diagnosis and Follow-Up of Chronic Glaucoma

Handbook of Research on ICTs and Management Systems for Improving Efficiency in Healthcare and Social Care ◽

10.4018/978-1-4666-3990-4.ch005 ◽

2013 ◽

pp. 88-108 ◽

Cited By ~ 1

Author(s):

Jose Andonegui ◽

Aitor Eguzkiza ◽

Mikel Auzmendi ◽

Luis Serrano ◽

Ane Zurutuza ◽

...

Keyword(s):

Public Health ◽

Intraocular Pressure ◽

Visual Fields ◽

Public Health Problem ◽

Current Status ◽

Future Trends ◽

Important Public Health Problem ◽

Important Public Health ◽

Chronic Glaucoma

e-Ophthalmology is the use of information and telecommunications technologies to provide or support a group of activities related to ophthalmic care. Chronic glaucoma is an ocular disease characterized by optic neuropathy that leads to progressive loss of the visual fields and often is associated with elevated intraocular pressure levels. Glaucoma is an important public health problem because it is one of the main causes of blindness worldwide and generates an important demand for ophthalmologic consultations. The aim of this chapter is to discuss the application e-Ophthalmology-based models in the diagnosis and follow-up of chronic glaucoma. The authors describe the current status of the use of e-Ophthalmology-based models in the screening and follow-up of chronic glaucoma, the main advantages of these models, the technologic requirements for their implementation, and future trends in this field.

Download Full-text

Implementation of Transforaminal Endoscopic Lumbar Sequestrectomy in a German University Hospital Setting: A Long and Rocky Road

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0039-1694040 ◽

2019 ◽

Vol 81 (01) ◽

pp. 017-027

Author(s):

Michael Bender ◽

Carolin Gramsch ◽

Lukas Herrmann ◽

Seong Woong Kim ◽

Eberhard Uhl ◽

...

Keyword(s):

Blood Loss ◽

Pain Score ◽

Hospital Setting ◽

University Hospital ◽

Disk Herniation ◽

Training Requirements ◽

Lumbar Disk ◽

Duration Of Surgery ◽

Lumbar Disk Herniations

Abstract Objective Microsurgical diskectomy/sequestrectomy is the standard procedure for the surgical treatment of lumbar disk herniations. The transforaminal endoscopic sequestrectomy technique is a minimally invasive alternative with potential advantages such as minimal blood loss and tissue damage, as well as early mobilization of the patient. We report the implementation of this technique in a German university hospital setting. Methods One single surgeon performed transforaminal endoscopic sequestrectomy from February 2013 to July 2016 for lumbar disk herniation in 44 patients. Demographic as well as perioperative, clinical, and radiologic data were analyzed from electronic records. Furthermore, we investigated complications, intraoperative change of the procedure to microsurgery, and reoperations. The postoperative course was analyzed using the Macnab criteria, supplemented by a questionnaire for follow-up. Pre- and postoperative magnetic resonance imaging volumetric analyses were performed to assess the radiologic efficacy of the technique. Results Our study population had a median age of 52 years. The median follow-up was 15 months, and the median length of hospital stay was 4 days. Median duration of surgery was 100 minutes with a median blood loss of 50 mL. Surgery was most commonly performed at the L4–L5 level (63%) and in caudally migrated disk herniations (44%). In six patients, surgery was performed for recurrent disk herniations. The procedure had to be changed to conventional microsurgery in four patients. We observed no major complications. Minor complications occurred in six patients, and in four patients a reoperation was performed. Furthermore, a significantly lower Oswestry Disability Index score (p = 0.03), a lower Short Form 8 Health Survey (SF-8) score (p = 0.001), a lower visual analog scale (VAS) lower back pain score (p = 0.03) and VAS leg pain score (p = 0.0008) at the 12-month follow-up were observed in comparison with the preoperative examination. In MRI volumetry, we detected a median postoperative volume reduction of the disk herniation of 57.1% (p = 0.02). Conclusions The transforaminal endoscopic sequestrectomy can be safely implemented in a university hospital setting in selected patients with primary and recurrent lumbar disk herniations, and it leads to good clinical and radiologic results. However, learning curve, caseload, and residents' microsurgical training requirements clearly affect the implementation process.

Download Full-text

Sífilis: Prevalência num Hospital de Lisboa

Acta Médica Portuguesa ◽

10.20344/amp.6247 ◽

2016 ◽

Vol 29 (1) ◽

pp. 52 ◽

Cited By ~ 2

Author(s):

Leonor Lopes ◽

Rita Ferro-Rodrigues ◽

Samuel Llobet ◽

Luís Lito ◽

João Borges-Costa

Keyword(s):

Clinical Laboratory ◽

Transmitted Disease ◽

Public Health Problem ◽

Secondary Syphilis ◽

Disease Classification ◽

Serological Tests ◽

Important Public Health Problem ◽

Early Syphilis ◽

Latent Syphilis

Introduction: Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal. Material and Methods: A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors. Results: We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously. Discussion: We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation. Conclusion: Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners.

Download Full-text

Sífilis: Prevalência num Hospital de Lisboa

Acta Médica Portuguesa ◽

10.20344/amp6247 ◽

2016 ◽

Vol 29 (1) ◽

pp. 52

Author(s):

Leonor Lopes ◽

Rita Ferro-Rodrigues ◽

Samuel Llobet ◽

Luís Lito ◽

João Borges-Costa

Keyword(s):

Clinical Laboratory ◽

Transmitted Disease ◽

Public Health Problem ◽

Secondary Syphilis ◽

Disease Classification ◽

Serological Tests ◽

Important Public Health Problem ◽

Early Syphilis ◽

Latent Syphilis

Introduction: Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal. Material and Methods: A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors. Results: We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously. Discussion: We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation. Conclusion: Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners.

Download Full-text

Taming Cryoablation for Lung Tumors

10.1093/med/9780199986071.003.0072 ◽

2018 ◽

Author(s):

Anshuman Bansal ◽

Fereidoun Abtin

Keyword(s):

Patient Selection ◽

Selection Criteria ◽

Patient Positioning ◽

Lung Tumors ◽

Lung Cancers ◽

Percutaneous Cryoablation ◽

Patient Selection Criteria ◽

Physical Principles

This chapter details the indications, uses, and techniques of using percutaneous cryoablation to treat lung tumors. The chapter reviews the role of ablative therapy for primary lung cancers as well as metastatic disease to the lung. It reviews the basic physical principles of cryoablation and the advantages of percutaneous cryoablation compared to other percutaneous heat-based ablative modalities. Patient selection criteria and post-ablation follow-up protocols are discussed. The chapter reviews procedural considerations, including choice of anesthesia, patient positioning, probe trajectory, and post-procedural recovery. It also details techniques that can be used to minimize and treat complications as well as tips for treating more challenging lesions.

Download Full-text

Proposal for Patient Selection Criteria and Follow-Up for BNCT in Patients with Supratentorial Malignant Gliomas

Boron Neutron Capture Therapy ◽

10.1007/978-1-4615-3408-2_23 ◽

1992 ◽

pp. 211-218

Author(s):

Heinz Fankhauser ◽

Giuseppe Stragliotto

Keyword(s):

Patient Selection ◽

Selection Criteria ◽

Malignant Gliomas ◽

Patient Selection Criteria

Download Full-text

Posttraumatic Displacement Management: Lateral Luxation and Alveolar Bone Fracture in Young Permanent Teeth with 5 Years of Follow-Up

Case Reports in Dentistry ◽

10.1155/2015/634237 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Heitor Marques Honório ◽

Catarina Ribeiro Barros de Alencar ◽

Edmer Silvestre Pereira Júnior ◽

Daniela Silva Barroso de Oliveira ◽

Gabriela Cristina de Oliveira ◽

...

Keyword(s):

Bone Fracture ◽

Alveolar Bone ◽

Treatment Success ◽

Dental Trauma ◽

Public Health Problem ◽

Permanent Teeth ◽

Important Public Health Problem ◽

Radiographic Findings ◽

External Impact

Dental trauma is an important public health problem due to high prevalence and associated limitations. The external impact accounting for trauma may result in different injury types to teeth and supporting structures. This paper describes a clinical case of tooth trauma in an 8-year-old patient exhibiting the displacement of three permanent teeth with open root apexes. Although the traumatic impact resulted in two injury types to teeth and supporting tissues (lateral luxation and alveolar bone fracture), the therapeutic approach was the same in both situations. The bone and teeth were repositioned by digital pressure, stabilized by semirigid splint, and followed up at every week. After six weeks, the splint was removed. At that moment, the clinical and radiographic findings indicated normal soft/hard tissues and absence of pulp/periodontal pathologies. At the fifth year of follow-up, the treatment success of the case was confirmed, although it has been observed that all lower incisors exhibited pulp obliteration as a consequence of the dental trauma.

Download Full-text

Dalbavancin Use in the Emergency Department Setting

Annals of Pharmacotherapy ◽

10.1177/1060028019855159 ◽

2019 ◽

Vol 53 (11) ◽

pp. 1093-1101 ◽

Cited By ~ 7

Author(s):

Mitulkumar Patel ◽

Samantha Smalley ◽

Yanina Dubrovskaya ◽

Justin Siegfried ◽

Christopher Caspers ◽

...

Keyword(s):

Emergency Department ◽

Selection Criteria ◽

Primary Objective ◽

Ambulatory Setting ◽

Time To Recurrence ◽

Emergency Department Setting ◽

Patient Selection Criteria ◽

Dosing Strategy

Background: Although dalbavancin’s (DBV’s) long half-life and one-time dosing strategy confer ideal administration in the ambulatory setting, the optimal role of DBV in the management of acute bacterial skin and skin structure infections (ABSSSIs) remains to be elucidated. Objectives: The primary objective of this study was to compare treatment outcomes of ABSSSI between patients who received DBV in the emergency department (ED) as part of standard care versus patients who received DBV as part of a telehealth program. Methods: This was a retrospective cohort study evaluating patients who received DBV at 3 urban EDs. The primary end point was the incidence of ABSSSI recurrence. Secondary outcomes included need for hospital admission and ED length of stay (LOS; in hours). Results: A total of 65 ABSSSI treatment courses were included; 42 were included in the telehealth criteria (TC) cohort and 23 in the initial criteria (IC) cohort. There were 14% (6/42) infection recurrences in the TC cohort and 22% (5/23) in the IC cohort, with median time to recurrence being 4 and 14 days, respectively. Median ED LOS was significantly shorter in the TC (5 vs 25 hours, P < 0.05). Numerically fewer individuals in the TC cohort required inpatient admission (0 vs n = 2, 9%). Conclusion and Relevance: Our results suggest that patients may be safely administered DBV in an ED setting, with telehealth follow-up. Providing structured patient selection criteria is an effective method of assisting ED providers in selecting appropriate DBV candidates to limit potential recurrences and readmissions.

Download Full-text