scholarly journals The effect of tonsillectomy with adenoidectomy on medical services used in association with otitis media based on Korean national sample cohort data

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Junhui Jeong ◽  
Jung Kyu Choi ◽  
Jae Sung Nam ◽  
Hyang Ae Shin ◽  
Jung Hyun Chang ◽  
...  

Abstract Background The effect of tonsillectomy with adenoidectomy (T&A) on otitis media has been investigated, but there have been no reports of the relationship between T&A and medical services used in association with otitis media. We investigated the effect of T&A on otitis media with regard to the number and cost of medical services used. Methods From the National Health Insurance Service National Sample Cohort data in Korea, we selected patients 7 years old or younger in 2002 who had T&A in 2005 while between the ages of three and ten. A control group was established matching the patient group with similar propensities of demographic characteristics. The number and cost of medical services used in association with otitis media were analyzed for 3 years before T&A through 8 years after T&A. Results The total number of patients was 1,338, with 227 in the T&A group and 1,111 in the non-T&A group. The number of medical services used was not significantly different between the T&A and non-T&A groups before and after surgery. The cost of medical services used was significantly higher in the T&A group than in the non-T&A group one year before surgery. The cost of medical services used was not significantly different between the two groups after surgery. Conclusions There were no significant differences between the T&A and non-T&A groups in the number and cost of medical services used in association with otitis media after surgery.

2021 ◽  
Vol 11 (6) ◽  
pp. 478
Author(s):  
Ching Chang ◽  
Chien-Hao Huang ◽  
Hsiao-Jung Tseng ◽  
Fang-Chen Yang ◽  
Rong-Nan Chien

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.


Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.


Author(s):  
A. G. Khrykova

Background. The prevalence of allergic rhinitis, which is an intermittent or permanent inflammation of the nasal mucosa caused by exposure to allergens, reaches 35%, according to different authors. Currently, this pathology is often complicated by exudative otitis media, especially in young children. Aim: to develop and justify the feasibility of using laser phoresis of sodium deoxyribonucleate for the treatment of exudative otitis media in children with allergic rhinitis. Methods. A clinical examination, a clinical blood test, rhinoscopy and otoscopy, as well as rhinocytogram, tympanometry (impedance audiometer Heinemann Titan) were performed. In diagnostics of allergic rhinitis, methods of a multifaceted otorhinolaryngological and allergological examination of the patient were used, as well as immunological tests (determination of the level of IgE and allergen-specific antibodies in the blood serum), and skin allergological tests. The examination was conducted before and after the course of treatment, as well as after 6 and 12 months. Results. With drug laser phoresis of sodium deoxyribonucleate administered endonasally and endourally, a stable result was obtained in restoring the drainage functions of the pharyngotympanic tube and reducing the symptoms of allergic rhinitis in preschool children and primary school children. Hearing is objectively improved in patients, and the conductive component is stopped, there is no fluid in the middle ear, sleep improves, the sense of smell is restored, physical performance increases, and childrens fatigue decreases in doing sports. A comparative analysis of the effectiveness of treatment in two groups showed the best results in the group of children receiving laser therapy using sodium desoxyribonucleate from medicinal non-woven textiles for up to 1 year. Repeated treatment with exacerbation of exudative otitis media was necessary to 40% of children in the control group, 12% of children after a course of laser therapy, and only one patient after a course of laser phoresis of sodium deoxyribonucleate. Conclusion. The use of laser radiation reduces the manifestations of the inflammatory process, and the allergic component.


2020 ◽  
Vol 9 (12) ◽  
pp. 3986
Author(s):  
Sinem Ünlü ◽  
Nils Lachmann ◽  
Maximilian Jara ◽  
Paul Viktor Ritschl ◽  
Leke Wiering ◽  
...  

Donor-specific anti-human leukocyte antigen antibodies (DSA) are controversially discussed in the context of liver transplantation (LT). We investigated the relationship between the presence of DSA and the outcome after LT. All the LTs performed at our center between 1 January 2008 and 31 December 2015 were examined. Recipients < 18 years, living donor-, combined, high-urgency-, and re-transplantations were excluded. Out of 510 LTs, 113 DSA-positive cases were propensity score-matched with DSA-negative cases based on the components of the Balance of Risk score. One-, three-, and five-year survival after LT were 74.3% in DSA-positive vs. 84.8% (p = 0.053) in DSA-negative recipients, 71.8% vs. 71.5% (p = 0.821), and 69.3% vs. 64.9% (p = 0.818), respectively. Rejection therapy was more often applied to DSA-positive recipients (n = 77 (68.1%) vs. 37 (32.7%) in the control group, p < 0.001). At one year after LT, 9.7% of DSA-positive patients died due to sepsis compared to 1.8% in the DSA-negative group (p = 0.046). The remaining causes of death were comparable in both groups (cardiovascular 6.2% vs. 8.0%; p = 0.692; hepatic 3.5% vs. 2.7%, p = 0.788; malignancy 3.5% vs. 2.7%, p = 0.788). DSA seem to have an indirect effect on the outcome of adult LTs, impacting decision-making in post-transplant immunosuppression and rejection therapies and ultimately increasing mortality due to infectious complications.


Author(s):  
Nawel Abdesslem ◽  
Sabeur Hamrouni ◽  
Roy Jesse Shephard ◽  
Mohamed Souhaiel Chelly

Objective: This study made a preliminary exploration of the efficacy of physically-based cognitive-behavioral therapy and deep relaxation for children with attention-deficit hyperactivity disorder (ADHD). Methods: ADHD behavior and cognitive functions were assessed by test D2 and Conner’s scale before and after a one-year physically-based training program. The reliability of test scores was assessed by repeat testing of a control group (CG) of 10 students who did not have ADHD. Children (10 per group) with ADHD were assigned to physically-based cognitive-behavioral therapy and deep relaxation (E1) or physically-based cognitive-behavioral alone (E2). Results: After 52 weeks of treatment, an intra-group comparison showed that E1 and E2 had improved their scores on the test D2, whereas CG showed no significant change. In addition, most participants with ADHD showed a remarkable improvement in their attentional behavior, with group E1 responding better to treatment than group E2. Conclusions: Physically-based cognitive behavioral therapy appears to improve function and social competence in children with ADHD, and should be recommended as an alternative or supplement to pharmaceutical treatment.


2009 ◽  
Vol 76 (2) ◽  
pp. 87-89 ◽  
Author(s):  
C. Giberti ◽  
M. Schenone ◽  
P. Cortese ◽  
F. Gallo ◽  
E Gastaldi ◽  
...  

The RALP is the most modern technology available for the treatment of intracapsular prostate cancer (CaP), which can produce a shorter learning curve and better results than the traditional techniques. Methods Between March 2005 and March 2008, 90 patients (64.3 ys, range 52–71) with intracapsular CaP underwent RALP at our institute. Before surgery the patients underwent routine examinations and filled in IIEF, IPSS and EORTC-QLQC30/PR 25 questionnaires. Patients were followed up with PSA assay, physical examination and compilation of the questionnaires. Median follow-up was 12.5 months (range 1–35 months). Results Mean operative time was 230 min. Discharge and catheter removal were at day 7.4 and 8.2, respectively, after surgery. Pathological staging reported pT2 and pT3 in 57 (63%) and 33 patients (37%), respectively. Positive surgical margins were assessed in 30 patients (33%), particularly 8.7% in pT2 tumors. The one-year biochemical disease-free survival rate was 90%. Regarding the functional results, 81 patients (90%) were perfectly continent while a mild and a moderate incontinence were reported in 7 (8%) and 2 (2%) patients, respectively. Mean IPSS score decreased from 8 to 4; among the patients who underwent bilateral nerve sparing RALP and no adjuvant therapy, 31 (70.4%) reported satisfactory sexual intercourses. Concerning postoperative quality of life, mean EORTC-QLQC30/PR 25 questionnaires scores were very similar before and after RALP. Conclusions After 90 cases of RALP the oncological and functional results are definitely promising. However, a wider number of patients and a greater follow-up are needed to confirm these data particularly as regards the functional results.


1980 ◽  
Vol 10 (4) ◽  
pp. 331-341
Author(s):  
Jean K. Boullion ◽  
W. William Chen

The tremendous potential for autogenic feedback training in helping smokers to deal with their anxiety before and after termination as well as the need to make autogenic feedback training in a practical method for smoking termination prompted this study which: (1) investigated the changes in smoking activity in subjects who have had autogenic feedback training and those who have not; (2) investigated the relationship between the success in performing autogenic feedback and the success in smoking termination; and (3) investigated the effect of autogenic feedback training on anxiety reduction before and after smoking termination. Twenty-three subjects were randomly assigned to two groups. The first group received the autogenic feedback training initially while the second group served as the control. This control group became a second experimental group upon the completion of the first phase. The results of the study revealed that the autogenic feedback training was an effective adjunct to a smoking termination program. Eighty-one per cent reduction in smoking activity was found for the subjects that received the training.


2018 ◽  
Vol 76 (7) ◽  
pp. 430-435 ◽  
Author(s):  
Alejandro Nasimbera ◽  
Julieta Rosales ◽  
Berenice Silva ◽  
Ricardo Alonso ◽  
Natalia Bohorquez ◽  
...  

ABSTRACT Chronic neurological disorders generate disabilities affecting multiple aspects of life, including sexuality. Objective To describe the presence of sexual dysfunction and comorbidities in a population with chronic neurological disorders. To analyze the relationship between disability and sexual dysfunction. Methods A cross-sectional case-control study was carried out. Patients with amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Parkinson’s disease (PD), and stroke of at least one year since the onset of symptoms were included, and compared with controls with no neurological disease, matched by age and sex. Results We included 71 participants: 29 controls, with a mean age of 49.4 years, and 42 patients with a mean age of 53.8 years. Sexual dysfunction was present in 22.5% of the controls and 77.5% of the patients. A statistically significant relationship between sexual dysfunction and disability was found in the logistic regression analysis (OR = 20.38, 95%CI: 2.5 –165.86). Conclusions Disability proved to be the main variable related to the presence of sexual dysfunction. Patients with ALS had the worst rates of sexual dysfunction. Patients with MS were similar to the control group. As for the PD group, no patient had normal sexuality. Finally, in stroke patients, the presence of comorbidities and their treatment may have negatively influenced sexuality. These findings showed that patients with chronic neurological diseases have sexual dysfunction and underscore the need for neurologists to know and address this problem.


2021 ◽  
Vol 25 (3) ◽  
pp. 146-151
Author(s):  
Yehree Kim ◽  
Chan Joo Yang ◽  
Myung Hoon Yoo ◽  
Chan Il Song ◽  
Jong Woo Chung

Background and Objectives: The relationship between hearing aid (HA) use and improvement in cognitive function is not fully known. This study aimed to determine whether HAs could recover temporal resolution or hearing in noise functions.Materials and Methods: We designed a prospective study with two groups: HA users and controls. Patients older than 45 years, with a pure tone average threshold of worse than 40 dB and a speech discrimination score better than 60% in both ears were eligible. Central auditory processing tests and hearing in noise tests (HINTs) were evaluated at the beginning of the study and 1, 3, 6, and 12 months after the use of a monaural HA in the HA group compared to the control group. The changes in the evaluation parameters were statistically analyzed using the linear mixed model.Results: A total of 26 participants (13 in the HA and 13 in the control group) were included in this study. The frequency (<i>p</i><0.01) and duration test (<i>p</i>=0.02) scores showed significant improvements in the HA group after 1 year, while the HINT scores showed no significant change.Conclusions: After using an HA for one year, patients performed better on temporal resolution tests. No improvement was documented with regard to hearing in noise.


2021 ◽  
Vol 17 (1) ◽  
pp. 16-22
Author(s):  
M. D. Goncharov ◽  
A. A. Savchenko ◽  
Yu. I. Grinshtein ◽  
I. I. Gvozdev ◽  
A. A. Kosinova ◽  
...  

Aim. To study the relationship between the levels of synthesis of reactive oxygen species (ROS) by platelets and neutrophils in patients with coronary heart disease (CHD) before and after coronary artery bypass grafting (CABG), depending on sensitivity to acetylsalicylic acid (ASA).Material and methods. The study included 95 patients with coronary artery disease who are indicated for CABG surgery. The control group consisted of 30 healthy donors. The antiplatelet therapy was stopped for at least 5 days before CABG. In the postoperative period, from the first day, all patients were received 100 mg of an enteric form of acetylsalicylic acid (ASA). Resistance to ASA was determined at the level of platelet aggregation with arachidonic acid ≥20% by optical agregometry at least at one observation point: before CABG, on 1-3 day and on 8-10 day after surgery. We evaluated the spontaneous and induced lucigenin-dependent chemiluminescence (CL) of platelets (ADP induction) and neutrophils (zymosan induction) by the exit time to maximum intensity (Tmax), maximum intensity (Imax) and area (S) under the CL curve.Results. 70.5% sensitive (sASA) and 29.5% resistant (rASA) to ASA patients were revealed. Prior to CABG, in sASA patients, the Imax of spontaneous and zymosan-induced neutrophil CL and CL platelet activity was increased relative to control values. Tmax of spontaneous platelet CL, Imax and S under the ADP-induced platelet CL curve were lower in sASA patients, if to compare with rASA patients. On the 1st and 8-10th day after CABG in sASA patients, the CL indicators of neutrophil and platelet activity also remained elevated compared to control values. On the 1st day after CABG decreased levels of S under the spontaneous CL curve of neutrophils in rASA patients was established compared with sASA patients, and increased levels of Imax and S under the curve of induced neutrophil CL were detected in comparison with the control range. In rASA patients, the values of Tmax of spontaneous platelet CL decreased in relation to the values detected in the control group and sASA patients. On the 8–10th day after CABG, most indicators of spontaneous and zymosan-induced CL neutrophils in rASA patients were also increased compared to control values. In rASA patients a positive correlation of Imax-induced CL was found (r=0.83) on the 1st day after CABG and negative correlations of Tmax of spontaneous CL (r=- 0.75) and S under the curve induced CL (r=-0.70) on the 8-10th day were detected between platelets and neutrophils.Conclusion. In sASA patients with coronary heart disease before and after CABG, a high level of synthesis of superoxide radical by neutrophils and platelets was detected. The relationship between the levels of the synthesis of superoxide radical by neutrophils and platelets was found only after CABG in rASA patients. Increased synthesis of superoxide radical due to metabolic and regulatory relationships in neutrophils and platelets stimulates pro-inflammatory processes in coronary artery disease and determines the sensitivity of platelets to ASA.


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