scholarly journals Efficient treatment of chronic endometritis through a novel approach of intrauterine antibiotic infusion: a case series

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Konstantinos Sfakianoudis ◽  
Mara Simopoulou ◽  
Yorgos Nikas ◽  
Anna Rapani ◽  
Nikolaos Nitsos ◽  
...  
Keyword(s):  
Case Series ◽  
Efficient Treatment ◽  
Chronic Endometritis ◽  
Novel Approach ◽  
Antibiotic Infusion

scholarly journals Introducing intrauterine antibiotic infusion as a novel approach in effectively treating chronic endometritis and restoring reproductive dynamics: a randomized pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Konstantinos Pantos ◽  
Mara Simopoulou ◽  
Evangelos Maziotis ◽  
Anna Rapani ◽  
Sokratis Grigoriadis ◽  
...  
Keyword(s):  
Fertility Restoration ◽  
Statistical Significance ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Treatment Rate ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Antibiotic Infusion

AbstractThe chronic nature of Chronic Endometritis (CE) along with the challenging management and infertility entailed, call for cutting-edge therapeutic approaches. This study introduces the novel treatment of intrauterine antibiotic infusion (IAI) combined with oral antibiotic administration (OAA), and it assesses respective performance against the gold standard treatment of OAA. Data sourced herein reports on treatment efficiency and fertility restoration for both patients aiming to conceive naturally or via In Vitro fertilization. Eighty CE patients, 40 presenting with recurrent implantation failure, and 40 with recurrent pregnancy loss, were enrolled in the IVF and the natural conception arm respectively. Treatment was subjected to randomization. Effectively treated patients proceeded with either a single IVF cycle or were invited to conceive naturally over a 6-month period. Combination of IAI and OAA provided a statistically significant enhanced effectiveness treatment rate (RR 1.40; 95%CI 1.07–1.82; p = 0.01). No statistically significant difference was observed regarding the side-effects rate (RR 1.33; 95%CI 0.80–2.22; p = 0.52). No statistically significant difference was observed for either arm regarding live-birth rate. Following an intention-to-treat analysis, employment of IAI corresponds to improved clinical pregnancy rate-albeit not reaching statistical significance. In conclusion, complimentary implementation of IAI could provide a statistically significant enhanced clinical treatment outcome.

scholarly journals TREATMENT OF TRIPLANE FRACTURE ANKLE FRACTURES ASSOCIATED WITH IPSILATERAL TIBIAL FRACTURES USING A NOVEL APPROACH

2021 ◽  
Vol 29 (6) ◽  
pp. 323-326
Author(s):  
WEVERLEY RUBELE VALENZA ◽  
JAMIL FAISSAL SONI ◽  
JEAN CARLO BARBOSA ◽  
CHRISTIANO SALIBA ULIANA ◽  
CAROLINA UMETA MATSUNAGA
Keyword(s):  
Case Series ◽  
Shaft Fracture ◽  
General Information ◽  
Tibial Fractures ◽  
Ankle Fractures ◽  
Tibial Shaft Fracture ◽  
Level Of Evidence ◽  
Novel Approach ◽  
Triplane Fracture ◽  
Salter Harris

ABSTRACT Objective: The aim of this study is to purpose a novel approach to the concomitant triplanar and tibial shaft fracture. Methods: Retrospective study between 2001 and 2019. We collected the patients’ general information, clinical and radiographic data, and complications after the following three-step treatment: (1) fixation of the Salter-Harris II fracture of the triplane fracture, (2) fixation of the Salter-Harris II/IV fracture with cannulated screws, and (3) fixation of the tibial fracture with flexible titanium nails. Results: The study included seven patients (six males) with a mean age of 14 years and a mean follow-up of 6.4 years (minimum two years). Five triplane fractures had two fragments and two had three fragments. Five fractures were classified as Salter-Harris II and two as Salter-Harris IV. Three tibial fractures were long oblique, three were spiral, and one had a third fragment. Six fractures affected the middle third and one affected the distal third of the tibia. All triplane and tibial fractures consolidated without significant displacement. No physeal damage was identified. Conclusions: This study described the association of tibial fractures with triplane ankle fractures managed by our proposed treatment, which proved to be effective for this fracture association. Level of Evidence IV, Case Series.

scholarly journals Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis

2017 ◽  
Vol 9 (3) ◽  
pp. 79-87 ◽  
Author(s):  
Marilla Dickfos ◽  
Robert Franz
Keyword(s):  
Total Thyroidectomy ◽  
Surgical Management ◽  
Medical Therapy ◽  
Clinical Status ◽  
Case Series ◽  
Primary Treatment ◽  
Surgical Removal ◽  
Efficient Treatment ◽  
Select Group ◽  
Small Subgroup

ABSTRACT Introduction Amiodarone can be a life-saving medication; however, it can also cause amiodarone-induced thyrotoxicosis (AIT). Though rare, AIT is a complex and life-threatening side effect, which can cause significant cardiac dysfunction and lead to cardiac failure. Primary treatment is with thionamides, perchlorates, and steroids. However, a small subgroup does not respond and their cardiovascular function continues to deteriorate. This select group is referred for a semi-elective total thyroidectomy. Without surgical removal of their thyroid gland, these patients will continue to deteriorate, with a 30 to 50% mortality rate for those not operated on. Aim The aim of this case series was to assess for any indicators as to when these patients should be referred for total thyroidectomies and the efficacy of this method of treatment. Materials and methods A case series of patients with AIT treated with a total thyroidectomy from 1998 to 2015 was used to assess the efficacy of and indicators for surgery. Results Total thyroidectomy results in efficient and significant improvement in the patient's biochemistry and symptoms. The patient's symptoms and options for medical therapy have an influence on the duration of the trial of medical therapy. Conclusion Surgery is an effective and efficient treatment for AIT. However, there does not appear to be a specific indicator for when this treatment should be instigated. A case-by-case approach should be adopted when treating these complicated patients. Clinical significance Clinicians should see surgery as an effective and efficient treatment for AIT. The timing of surgery should be assessed on a case-by-case basis considering the patient's clinical status and therapeutic options and not as a last resort. How to cite this article Dickfos M, Franz R. Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis. World J Endoc Surg 2017;9(3):79-87.

The Bone Lamina Technique: A Novel Approach for Lateral Ridge Augmentation—A Case Series

2013 ◽  
Vol 33 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Hannes Wachtel ◽  
Stefan Fickl ◽  
Marc Hinze ◽  
Wolfgang Bolz ◽  
Tobias Thalmair
Keyword(s):  
Case Series ◽  
Ridge Augmentation ◽  
Novel Approach ◽  
Lateral Ridge ◽  
Lateral Ridge Augmentation

P–345 Reproductive outcome after treatment of chronic endometritis in patients with recurrent implantation failure

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Vega. Carrill. d. Albornoz ◽  
E Carrill. D. Alborno. Riaza ◽  
Á Martíne. Acera ◽  
I Lópe. Carrasco ◽  
N Monter. Pastor ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Case Series ◽  
Pregnancy Rates ◽  
Diagnostic Methods ◽  
Microbiological Analysis ◽  
Implantation Failure ◽  
Reproductive Outcome ◽  
Recurrent Implantation Failure ◽  
Chronic Endometritis ◽  
Number Of Patients

Abstract Study question Does the treatment of chronic endometritis (CE) improve reproductive outcome in patients with recurrent implantation failure (RIF)? Summary answer Treatment and resolution of CE seem to improve pregnancy rates in patients with implantation failure and CE. What is known already Over the last 10 years, the interest in the study of CE has increased given its important association with reproductive failure. The main cause of CE is an infection of the endometrial cavity caused by common microorganisms. Therefore, the recommended treatment is antibiotic therapy. Numerous studies demonstrate an improvement in reproductive outcome in patients with treated and resolved CE. The objectives of this study are to evaluate the resolution rate of CE after antibiotic treatment in patients with implantation failure diagnosed with CE and to analyse their reproductive outcome after treatment. Study design, size, duration In this prospective case series, all patients with RIF who underwent diagnostic hysteroscopy, IHC analysis with CD138 of an endometrial biopsy and microbiological analysis of an endometrial sample between October 2018 and February 2019 were included. Participants/materials, setting, methods Hysteroscopic findings suggestive of CE were collected and endometrial biopsies were taken for pathological study with CD138 and microbiological assessment. Likewise, treated endometrial samples and the results of hysteroscopy or control biopsies after treatment were collected. The data of embryo transfers post-treatment were also included in our study. Main results and the role of chance 30 patients with implantation failure were included. 15 patients (50%) were diagnosed with CE using any of the aforementioned diagnostic methods. All diagnosed patients were treated with antibiotic therapy: positive microbiological samples (9) were treated according to our antibiogram whereas those samples who were negative but were confirmed to have CE by hysteroscopy or pathological assessment (6) were treated with doxycycline. In all cases, CE resolved after treatment, except only one patient who required a second course of antibiotics to acquire a negative result. Ten patients underwent an embryo transfer after resolution of CE, resulting in 60% of ongoing pregnancies. Limitations, reasons for caution Although our results are encouraging and in accordance with other studies, we are aware that this is an observational non-randomised study with a limited number of patients. Wider implications of the findings: It seems that the treatment of CE, following its diagnosis using the aforementioned methods, can improve pregnancy rates in patients with RIF and CE. Therefore, it is likely recommendable to study CE using these three tests. Trial registration number Not applicable

scholarly journals The Arrowhead Ministernotomy with Rigid Sternal Plate Fixation: A Minimally Invasive Approach for Surgery of the Ascending Aorta and Aortic Root

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mark J. Russo ◽  
John Gnezda ◽  
Aurelie Merlo ◽  
Elizabeth M. Johnson ◽  
Mohammad Hashmi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Aortic Root ◽  
Plate Fixation ◽  
Aortic Surgery ◽  
Case Series ◽  
Ascending Aorta ◽  
The Body ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Novel Approach

Background. Ministernotomy incisions have been increasingly used in a variety of settings. We describe a novel approach to ministernotomy using arrowhead incision and rigid sternal fixation with a standard sternal plating system.Methods. A small, midline, vertical incision is made from the midportion of the manubrium to a point just above the 4th intercostal mark. The sternum is opened in the shape of an inverted T using two oblique horizontal incisions from the midline to the sternal edges. At the time of chest closure, the three bony segments are aligned and approximated, and titanium plates (Sternalock, Jacksonville, Florida) are used to fix the body of the sternum back together.Results. This case series includes 11 patients who underwent arrowhead ministernotomy with rigid sternal plate fixation for aortic surgery. The procedures performed were axillary cannulation (n=2), aortic root replacement (n=3), valve sparing root replacement (n=3), and replacement of the ascending aorta (n=11) and/or hemiarch (n=2). Thirty-day mortality was 0%; there were no conversions, strokes, or sternal wound infections.Conclusions. Arrowhead ministernotomy with rigid sternal plate fixation is an adequate minimally invasive approach for surgery of the ascending aorta and aortic root.

Pars plana Ex-Press mini shunt for management of persistent glaucoma in vitrectomized eyes: A novel technique

2020 ◽  
Vol 30 (5) ◽  
pp. 1179-1184 ◽  
Author(s):  
Abdussalam Abdullatif ◽  
Heba El-Saied
Keyword(s):  
Intraocular Pressure ◽  
Silicone Oil ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Secondary Glaucoma ◽  
Antiglaucoma Medication ◽  
Novel Approach ◽  
Pars Plana ◽  
Secondary Refractory

Purpose: To evaluate the safety and efficacy of a novel approach to implant Ex-Press mini shunt via the pars plana under a scleral flap in pseudophakic or aphakic, vitrectomized patients with secondary refractory glaucoma. Methods: A prospective interventional case series of three patients with secondary glaucoma after pars plana vitrectomy. Intraocular pressure was not controlled by silicone oil removal, if the patient was siliconized, nor the maximum medical treatment. Ex-Press mini shunt via the pars plana was implanted. We evaluated the control of intraocular pressure and the development of intraoperative and postoperative complications. Results: During 1-year follow-up, control of intraocular pressure was achieved; 14, 15, and 15 mmHg at the 3 months, and 15, 15, and 16 mmHg at the 6 months in our three cases without antiglaucoma treatment and 16, 16, and 18 with single antiglaucoma medication at 1 year. Blebs were posterior and diffuse. No complications were encountered intraoperatively or postoperatively. Ultrasound biomicroscopy showed suprachoroidal posterior lake of fluid as an additional filtration route without any choroidal or retinal complication. Conclusion: Implantation of Ex-Press mini shunt via the pars plana in aphakic or pseudophakic, vitrectomized eyes is a promising, safe, and effective technique in patients with secondary glaucoma.

Management of direct carotid-cavernous sinus fistulas with the use of ethylene-vinyl alcohol (Onyx) only: preliminary results

2010 ◽  
Vol 112 (3) ◽  
pp. 595-602 ◽  
Author(s):  
Marco Zenteno ◽  
Jorge Santos-Franco ◽  
Vladimir Rodríguez-Parra ◽  
Jorge Balderrama ◽  
Yolanda Aburto-Murrieta ◽  
...  
Keyword(s):  
Case Series ◽  
Endovascular Techniques ◽  
Embolic Material ◽  
Ethylene Vinyl Alcohol ◽  
Sole Agent ◽  
Novel Approach ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Carotid Cavernous Fistulas

Object So-called direct carotid-cavernous fistulas (CCFs) are commonly treated by detachable balloons or coils to occlude the shunt while sparing the carotid artery. Liquid embolic agents have been rarely used, and in particular, to the authors' knowledge, the use of Onyx as the sole agent has never been reported in an indexed publication. Methods The authors describe a case series of 5 patients with posttraumatic CCF in whom embolization with Onyx was prospectively used as the sole strategy of management. Results Complete occlusion was obtained at the end of the procedure in 4 cases, and the lesion in the remaining patient subsequently occluded at the 6-month follow-up evaluation. Conclusions As endovascular techniques for treatment of direct CCFs continue to evolve, this novel approach with Onyx as the sole embolic material seems promising in treating these lesions.

The PediSedate® device, a novel approach to pediatric sedation that provides distraction and inhaled nitrous oxide: clinical evaluation in a large case series

2006 ◽  
Vol 17 (2) ◽  
pp. 162-166 ◽  
Author(s):  
WILLIAM T. DENMAN ◽  
PACIFICO M. TUASON ◽  
MOHAMMED I. AHMED ◽  
LORALIE M. BRENNEN ◽  
M. SOLEDAD CEPEDA ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Clinical Evaluation ◽  
Case Series ◽  
Novel Approach ◽  
Large Case Series ◽  
Pediatric Sedation ◽  
Large Case
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