Factors affecting endoscopic treatment’s failure for primary vesicoureteral reflux in the paediatric population

Objective: The purpose of this study is to identify which factors could determine endoscopic therapy’s failure in the paediatric patients with primary vesicoureteral reflux (VUR). Methods: We reviewed data from patients who underwent endoscopic surgery for primary reflux. We performed a multivariate logistic regression analysis considering factors conditioning therapeutic failure. All the tests were performed considering significant values of p < 0.05. Statistical analysis was performed with the SPSS 19.0 program. Study sample was homogenised by just including patients with primary reflux and excluding both patients with secondary reflux and patients with functional lower urinary conditions. Results: A total of 96 patients were included for review. Median age at surgery was 28 months. The overall success rate of endoscopic surgery for vesicoureteral reflux was 57%. Female sex, age under 24 months at the time of surgical intervention and having suffered a urinary tract infection (UTI) despite antibiotic prophylaxis are statistically significant risk factors for therapy failure. Conclusions: Nonetheless, differences between series could explain these differences in success rates. The lack of standardisation of the definition of ‘success’, the heterogeneity of patients included, and variables such as the degree of reflux, the presence of dysfunctional voiding, age or follow-up make it difficult to compare the success rate between series. Therefore, homogenisation of study samples assessing the evolution of primary reflux and response to endoscopic therapy is warranted. Level of evidence: Not applicable

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447 What Age is Best to Perform Myringoplasty?

British Journal of Surgery ◽

10.1093/bjs/znab134.556 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

L Wilks ◽

R Mcleod ◽

V Unadkat

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Paediatric Population ◽

Cochrane Library ◽

Clear Correlation ◽

Success Rates ◽

Prisma Statement ◽

Transitional Point ◽

The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

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Subureteral Injection with Small-Size Dextranomer/Hyaluronic Acid Copolymer: Is It Really Efficient?

BioMed Research International ◽

10.1155/2016/2168753 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Iyimser Üre ◽

Serhat Gürocak ◽

Özgür Tan ◽

Amirali Farahvash ◽

Cem Senol ◽

...

Keyword(s):

Hyaluronic Acid ◽

Success Rate ◽

Vesicoureteral Reflux ◽

Low Cost ◽

Clinical Results ◽

Voiding Cystourethrogram ◽

Complication Rates ◽

Success Rates ◽

Acid Copolymer ◽

Urinary Infections

The aim of this study was to evaluate the clinical results of patients with vesicoureteral reflux, which were treated with subureteral injection of small-size (80–120 μm) dextranomer/hyaluronic acid copolymer (Dx/HA). Data of 75 children (105 renal units) who underwent STING procedure with small-size Dx/HA for the treatment of vesicoureteral reflux (VUR) in our clinic between 2008 and 2012 were retrospectively analyzed. Preoperative reflux grade and side, injection indication, postoperative urinary infections and urinary symptoms, voiding cystourethrogram, and renal scintigraphy results were evaluated. The success rate of the procedure was 100% in patients with grades 1 and 2 reflux, 91% in patients with grade 3 reflux, and 82.6% in patients with grade 4. Overall success rate of the treated patients was 97%. Endoscopic subureteric injection with Dx/HA procedure has become a reasonable minimally invasive alternative technique to open surgery, long-term antibiotic prophylaxis, and surveillance modalities in treatment of VUR in terms of easy application, low costs and complication rates, and high success rates. Injection material composed of small-size dextranomer microspheres seems superior to normal size Dx/HA, together with offering similar success with low cost.

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SUBURETERAL MUCOSA INJECTION WITH DETRANOMER/HYALURONIC ACID FOR VESICOURETERAL REFLUX TREATMENT: SYSTEMATIC REVIEW

Indonesian Journal of Urology ◽

10.32421/juri.v24i1.271 ◽

2017 ◽

Vol 24 (1) ◽

Author(s):

Nicholas Tambunan ◽

Arry Rodjani ◽

Irfan Wahyudi

Keyword(s):

Hyaluronic Acid ◽

Success Rate ◽

Vesicoureteral Reflux ◽

Random Effects Model ◽

Success Rates ◽

Statistical Software ◽

Hyaluronic Acid Injection ◽

Grade 5 ◽

Meta Regression ◽

It Success

Objective: The aim of this study is to search the success rate of detranomer-hyaluronic acid (Dx/HA) used as injection through endoscopy approach and grades of vesicoureteral reflux (VUR) that could affect it success rate. Material & methods: We searched the literatures from MEDLINE database and PubMed from year 2001 until 2013. The data was analyzed using Random Effects Model with the method of Mantzel-Haenzel to analyze the success rates of dextranomer/hyaluronic acid and was determined by 95% Confidence of Interval (CI) disclosure. Meta-regression was performed to adjust the success rate compared with the grade of VUR as covariate. We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata Statistical Software Version 12.0 (StataCorp). Results: We identified 9 literatures in full review. Of 1105 ureters that were injected with dextranomer/hyaluronic acid, 817 (72%; CI: 67-76%) were successfully treated according to author’s definition. The success rates of Dx/HA for pediatric with grade 1 VUR reached 80% (95% CI: 66-89%), whereas in grade 5 VUR only 50% (95% CI: 34-66%; p<0.05). Conclusion: The overall success rate of dextranomer/hyaluronic acid injection treatment was 72% after 3 months, although success rates varied widely among studies. Preoperative grade of VUR was significantly associated with treatment outcome. Increased VUR grade negatively affected success rates.

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Treatment outcome of oral appliance in patients with REM-related obstructive sleep apnea

Sleep And Breathing ◽

10.1007/s11325-019-01966-5 ◽

2019 ◽

Vol 24 (4) ◽

pp. 1339-1347 ◽

Cited By ~ 2

Author(s):

Yoshitomo Nishio ◽

Tetsuro Hoshino ◽

Kenta Murotani ◽

Akifumi Furuhashi ◽

Masayo Baku ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Treatment Outcome ◽

Sleep Apnea ◽

Success Rate ◽

Treatment Success ◽

Multivariate Logistic Regression Analysis ◽

Youden Index ◽

Apnea Hypopnea Index ◽

Success Rates ◽

Obstructive Sleep

Abstract Purpose Oral appliances (OA) are used to treat patients with obstructive sleep apnea (OSA). The purpose of this study is to evaluate the efficacy of OA treatment in patients with rapid eye movement (REM)–related OSA. Methods Forty-six patients with REM-related OSA and 107 with non-stage-specific OSA were prescribed OA treatment after diagnosis by polysomnography (PSG) and a follow-up sleep test by PSG was conducted. Efficacy and treatment outcome predictors were evaluated according to the following criteria for treatment success: #1, reduction of the apnea-hypopnea index (AHI) to less than 5 and > 50% compared with baseline; #2, AHI reduction to less than 10 and > 50% compared with baseline; and #3, > 50% AHI reduction compared with baseline. Results Success rates according to criteria #1, #2, and #3 were 45.7%, 50.0%, and 50.0% in REM-related OSA and 36.4%, 52.3%, and 63.6% in non-stage-specific OSA, respectively. No significant differences in success rate were found between the two groups. In multivariate logistic regression analysis with each criterion as the response variable, only BMI was extracted as a significant predictor. The BMI cutoff values defined based on the maximum Youden index according to the three criteria were 26.2 kg/m2, 25.6 kg/m2, and 26.2 kg/m2, respectively. Conclusions No significant differences in success rate of OA treatment were found between REM-related OSA and non-stage-specific OSA. BMI has greater impact on treatment outcome of OA in patients with REM-related OSA.

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Stainless steel or titanium mini-implants?

The Angle Orthodontist ◽

10.2319/081619-536.1 ◽

2020 ◽

Vol 90 (4) ◽

pp. 587-597 ◽

Cited By ~ 1

Author(s):

Paulo Mecenas ◽

Daybelis Gonzalez Espinosa ◽

Paula Coutinho Cardoso ◽

David Normando

Keyword(s):

Clinical Trial ◽

Stainless Steel ◽

Success Rate ◽

Randomized Clinical Trial ◽

Risk Of Bias ◽

Current Evidence ◽

Success Rates ◽

Level Of Evidence ◽

Manual Search ◽

Mini Implants

ABSTRACT Objectives To investigate whether there was a difference in success rates when stainless steel (SS) was compared to titanium mini-implants (MIs) in orthodontic patients. Materials and Methods PubMed, Cochrane, Scopus, Web of Science, Lilacs, Google Scholar, Clinical Trials, and OpenGray were searched without restrictions. A manual search was also performed in the references of the included articles. Studies comparing the success rate between SS and titanium MIs were included. Risk of bias (RoB) was assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies-of Interventions) Tool or RoB 2.0 according to the study design. The level of evidence was assessed through GRADE (Grading of Recommendation, Assessment, Development, and Evaluation). Results Six studies met the eligibility criteria. One study was a randomized clinical trial that evaluated extraalveolar MIs, and nonrandomized trials examined interradicular MIs. The RCT presented a low RoB, two nonrandomized trials presented a moderate risk, and three presented a high risk. The quality of the evidence was high for the randomized clinical trial and moderate for the nonrandomized trials. Most studies found no difference between materials, with good success rates for both (SS, 74.6%–100%; titanium: 80.9%–100%) and only one study, with a high RoB, showed a higher success rate with titanium MIs (90%) when compared with SS (50%). A quantitative analysis was not because of the great heterogeneity among the studies. Conclusions Although limited, the current evidence seems to show that the material used is not a major factor in the success rate of MIs. Because it has a lower cost than titanium and presents similar clinical efficiency, SS is a great material for orthodontic MIs.

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Renal Scarring in Children with Primary Vesicoureteral Reflux Disease

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v29i330070 ◽

2019 ◽

pp. 1-7

Author(s):

Khalid Kawoosa ◽

Rahid Rasool Malla ◽

Wasim Ahmad Wani ◽

Mudasir Nazir ◽

Syed Heena Kubravi

Keyword(s):

Risk Factors ◽

Vesicoureteral Reflux ◽

Prospective Observational Study ◽

Renal Scarring ◽

Age Groups ◽

Significant Risk ◽

Medical Sciences ◽

Significant Difference ◽

End Stage ◽

Primary Vesicoureteral Reflux

Aims: To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR) and the possible risk factor(s), we studied 69 children (42 girls and 27 boys) with VUR attending the Pediatric opd. Study Design: Prospective Observational study. Place and duration of Study: Department of pediatrics, Sher I Kashmir Institute of Medical Sciences, Srinagar, Kashmir between June 2017 to June 2018. Methodology: All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m) technetium dimercapto–succinic acid scintigraphy. Results: Grade of reflux and number of urinary tract infection (UTI) episodes (≥3) were found to be statistically significant risk factors for renal scarring (P <0.05). However, there was no significant association with gender, familial history and laterality of the disease (P >0.05). Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05). Conclusions: It was concluded that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

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Entscheidungsprozesse beim Übersetzen: Routine und Reflexion bei Novizen und Berufsübersetzern

Fachsprache ◽

10.24989/fs.v32i3-4.1393 ◽

2017 ◽

Vol 32 (3-4) ◽

pp. 100-121

Author(s):

Friederike Prassl

Keyword(s):

Decision Making ◽

Success Rate ◽

Knowledge Integration ◽

Popular Science ◽

Failure Rates ◽

Science Text ◽

Success Rates ◽

Preliminary Results ◽

Decision Making Processes ◽

Cognitive Involvement

This article focuses on the decision-making processes involved in research and knowledge integration in translation processes. First, the relevance of decision taking intranslation is discussed. Second, the psychology of decision making as seen by Jungermann et al. (2005) is introduced, who propose a categorization of decision-making processes intofour types: “routinized”, “stereotype”, “reflected” and “constructed”. This classification is then applied to the translations by five professional translators and five novices of five segments occurring in a popular-science text. The analysis reveals that the decision-making types are distributed differently among students and professional translators, which also has to be seen against the background of whether the decisions made were successful or not. The preliminary results of this study show that students resort to reflected decisions in most cases, but with a low success rate. Professionals achieve a higher success rate when making reflected decisions. As expected, they also make more routinized decisions than students. The professionals’ success rates improve with increasing cognitive involvement, while their failure rates are relatively high when making routinized decisions, an aspect worthwhile considering in translation didactics.

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