Cisplatin, vinblastine, and mitoguazone chemotherapy for epidermoid and adenocarcinoma of the esophagus.

1987 ◽  
Vol 5 (8) ◽  
pp. 1143-1149 ◽  
Author(s):  
A A Forastiere ◽  
M Gennis ◽  
M B Orringer ◽  
F P Agha
Keyword(s):  
Pilot Trial ◽  
Transhiatal Esophagectomy ◽  
Newly Diagnosed ◽  
Surgical Specimen ◽  
Carcinoma Of The Esophagus ◽  
Group A ◽  
Tumor Measurements ◽  
Regional Disease ◽  
Group B

Thirty-six patients with adenocarcinoma or epidermoid carcinoma of the esophagus were entered into a phase II trial evaluating the combination of cisplatin 100 mg/m2 intravenously (IV) day 2, vinblastine 1.6 mg/m2 IV days 1 to 4, and mitoguazone (MGBG) 500 mg/m2 IV days 1 and 8. Twenty-nine patients (group A) were newly diagnosed with local-regional disease only and were candidates for transhiatal esophagectomy (THE). These patients received two courses of chemotherapy at 3-week intervals prior to surgery. Response was assessed by measuring changes in the primary tumor length and depth on serial biphasic contrast esophagrams and comparing this result with tumor measurements obtained from the surgical specimen. Complete (CR) and partial responders (PR) received three additional postoperative cycles. Seven patients had recurrent or metastatic disease (group B) and were treated every 4 weeks until disease progression. Of 34 patients evaluable for response, there was one pathologically confirmed CR and 15 PRs (47%). This consisted of 12 of 27 (44%) group A patients (seven of 11 epidermoid, five of 16 adenocarcinoma) and four of seven (57%) group B patients (two of four epidermoid, two of three adenocarcinoma). Toxicity included leukopenia in one third of treatment courses and thrombocytopenia in 21%. Nausea and vomiting occurred in 60% of patients, diarrhea in 18%, transient nephrotoxicity in 18%, peripheral neuropathy in 12%, and ototoxicity in 3%. Twenty-five group A patients underwent resection. Four chemotherapy nonresponders (NR) and one PR had known disease left at surgery; all others (80%) had gross total removal of their disease. The median survival time (MST) of the 29 group A patients was 14 months, with 21% alive at 36 months. The MST of group A chemotherapy responders was 15 months compared with 9 months for NRs (P = .032). Initial sites of recurrence in 14 patients were local-regional in six, distant only in six, both local-regional and distant in two. This regimen, administered in maximally tolerated doses, was active in epidermoid and adenocarcinoma histologies, recurrent disease and newly diagnosed patients. However, nearly all responses were PRs and the MST of resected patients was similar to a prior series of patients treated with esophagectomy alone. Observations from this pilot trial and those of others have led to a follow-up study, in progress, evaluating intensive preoperative chemotherapy and concurrent radiation therapy (RT).

scholarly journals Pegaspargase Plus Gemcitabine, Oxaliplatin(P-Gemox) and Thalidomide Versus Aspermetdex Regimen for the Patients with Early or Advanced/Relapsed Extranodal Natural Killer/T Cell Lymphoma: Interim Analysis of a Prospective,Multicenter, Randomized, Phase III Non-Inferiority Clinical Trial

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1819-1819
Author(s):  
Yan Gao ◽  
Huiqiang Huang ◽  
Yujing Zhang ◽  
Hang Su ◽  
Xiaoxiao Wang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Stage I ◽  
Phase Iii ◽  
Stage Iii ◽  
Newly Diagnosed ◽  
Natural Killer T Cell ◽  
Group A ◽  
Group B ◽  
Killer T Cell

Abstract Backgroud and Purpose Extranodal natural killer/T-cell lymphoma (ENKTL) is an uncommon, aggressive form of non-Hodgkin's lymphoma. Optimal therapeutic strategies have not been fully defined yet. Both AsperMetDex and P-Gemox is recommended as major effective regimen by 2016 NCCN guideline. Therefore, we try to evaluate the efficacy and toxicity for P-Gemox plus thalidomide and AsperMetDex followed by EIFRT as first-line treatment for newly diagnosed stage I/II patients and as salvage regimen for newly diagnosed stage III/IV or relapsed/refractory ENKTL in this study. Patients and methods We initiated a prospective, multicentre, randomized, phase III ,non-inferiority clinical trial at 12 centers in China at March 2014. Patients were randomly assigned to receive either P-Gemox+thalidomide regimen (Group A: Pegaspargase 2000U/m2; im d1, Gemcitabine 1000mg/m2; ivdrip , d1, d8. Oxaliplatin 130mg/m2; ivdrip, d1, thalidomide 100mg/d po, for one year.) or AsperMetDex regimen(Group B: Pegaspargase 2000U/m2; im, d1, Methotrexate 3000mg/ m2; civ 6-hour, d1, calcium folinate 30mg iv, q6h, until reach safe serum MTX concentration, Dexamethasone 40mg/d ivdrip, d1-4.). For newly diagnosed stage I/II patients, both regimens were repeated every three weeks for a maximum four cycles as induction chemotherapy and followed by EIFRT at the dosage of 56Gy in 28 fractions over 4 weeks. Primary EIFRT was delivered using 6-MeV linear accelerator using 3-dimensional conformal treatment planning. For newly diagnosed stage III/IV or relapsed/refractory ENKTL, the regimens were repeated every three weeks for a maximum six cycles. Patients underwent autologous hematopoietic stem cell transplantation (ASCT) as consolidation if they achieved response (complete remission, CR or partial remission, PR). The primary endpoint was progression-free survival(PFS), with a non-inferiority margin of 15%. Results 110 patients were enrolled (56 patients in Group A, 54 in Group B) and 96 patients were evaluable for response. Among 63 newly diagnosed stage I/II patients, 32 patients were assigned to Group A (27 assessed), and 31 to Group B (27 assessed). At median follow-up of 13.5 months (IQR 0.5¨C27.5), 2-year PFS were 82.9%(95%CI:17.574-24.111) and 84.5% (95%CI:18.849- 25.688). 2-year OS were 95.0%(95%CI:13.023-22.896) and 75.8%(95%CI:11.647-21.269), P=0.089, (Figure1). CR rate of both group were all 59.3%(16/27), and objective response rate(ORR) were 85.2%(23/27) and 81.5%(16/27), respectively. After EIFRT, ORR of Group A increased to 92.6% (25/27), CR rate was 88.8% (24/27). ORR of Group B increased to 88.8% (24/27), CR rate was 85.1% (23/27). For 47 newly diagnosed stage III/IV or relapsed/refractory patients, 24 patients were assigned to Group A (22 assessed) and 23 to Group B (20 assessed). At median follow-up of 14.5 months (IQR 0.6¨C28.1), median PFS was longer in the Group A than Group B(12.2 vs. 7.6 months, P=0.365). 2-year OS were 52.5%(95%CI:13.023-22.896) and 48.9% (95%CI:11.647- 21.269), P=0.935 (Figure2). The ORR were 86.4%(19/22) and 70%(14/20), respectively. CR rate were similar for both group with 50%. Six cases (3 cases in each group ) had received ASCT after response, 3 patients relapsed in 6 months after ASCT(2 cases in group A, 1 case in group B) , 2 patients died of disease progression. Group B was better tolerated than Group A, with lower rates of agranulocytosis, thrombocytopenia and infections. While anemia, hyperbilirubinemia, edema, and increased BUN/Cr were more common in Group B. Three patients died of treatment related toxicity only in Group B. Two patients died of severe acute renal failure and sepsis at the first cycle, and one patient died of sepsis at the third cycle (Table 1). Median hospitalization time were 1.9 days for Group A and 4.9 days for Group B(P<0.01), respectively. CONCLUSION: Induction chemotherapy of both P-Gemox+Thalidomide and AsperMetDex regimen followed by ENKTL yielded promising efficacy for patients with stage I/II ENKTL. For advanced or relapsed patients, both regimen showed unsatisfied survival outcome. Meanwhile, P-Gemox+ Thalidomide may be less toxic with more simple and convenient administration in outpatients clinics in comparison to AsperMetDex. This clinical trial is still ongoing . (ClinicalTrials.gov, NCT 2085655). Funding: 5010 Program for Clinical Research , Sun Yat -Sen University. Disclosures No relevant conflicts of interest to declare.

Bevacizumab in combination with radiotherapy plus concomitant and adjuvant temozolomide for newly diagnosed glioblastoma: Update progression-free survival, overall survival, and toxicity

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 2017-2017 ◽  
Author(s):  
M. L. Gruber ◽  
S. Raza ◽  
D. Gruber ◽  
A. Narayana
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Newly Diagnosed ◽  
Similar Treatment ◽  
Macdonald Criteria ◽  
Newly Diagnosed Glioblastoma ◽  
Group A ◽  
Group B ◽  
Cycle Group

2017 Background: Prognosis of glioblastoma (GBM) is very poor. Standard treatment includes surgical resection (SR), radiation (RT), concomitant and adjuvant chemotherapy with temozolomide (TMZ). Our objective is to assess the treatment efficacy, safety and survival in patients with newly-diagnosed GBM treated with RT, TMZ, and bevacizumab in the upfront management. Methods: From 2006–2008, 51 eligible patients (age >18, KPS >70) with newly-diagnosed GBM divided into two groups. Group A (n = 20) was treated with RT (60Gy) and concomitant TMZ (75mg/m2 daily for 42 days) with bevacizumab (10mg/kg every 2 weeks), 29 days following surgery, followed by up to six cycles of adjuvant TMZ (150mg/m2,daily x 7d, q28 with bevacizumab at 10mg/kg days 8 and 22 of each 28 day cycle. Group B (n = 31) received similar treatment without bevacizumab. Both groups were followed up until tumor progression (PFS). Recurrence was defined according to MacDonald Criteria. The end points were PFS, overall survival (OS) and toxicity. Results: Median bevacizumab infusions were 12 (4–32). Median follow-up was14 months for both groups. 6 months PFS survival in Group A was 77.5% and in Group B was 51.6%. Median PFS in Group A was 17 months compared to 7 months in Group B (p < 0.0001, HR = 0.26). Median OS has not been reached in Group A and was 17 months in Group B. One and 2 year OS were 83% and 57% in Group A compared to 72% and 6.5% in Group B (p = 0.02) ). Post-RT and temodar toxicities include thrombocytopenia (1 patient; Gr 3 and fatigue (3 patient;1 Gr 3), bevacizumab related toxicities with RT include leg ulcer with cellulites (1 patient; Gr 3) and pulmonary embolism with thrombocytopenia (1 patient; Gr 4), hypertension (2 patients; Gr 1), and asymptomatic blood products on MRI (2 patients). Conclusions: Bevacizumab has demonstrated efficacy, acceptable toxicity, improved PFS and OS in the upfront management of GBM. No significant financial relationships to disclose.

scholarly journals The Clinical Characteristics, Perioperative Management, and Treatment Outcomes of Spinal Tuberculosis Associated With Diabetes Mellitus

2021 ◽  
Author(s):  
Hongqi Zhang ◽  
Lige Xiao ◽  
Mingxing Tang ◽  
Yang Sun ◽  
Guanteng Yang
Keyword(s):  
Diabetes Mellitus ◽  
Postoperative Complications ◽  
Clinical Characteristics ◽  
Perioperative Management ◽  
Spinal Tuberculosis ◽  
Newly Diagnosed ◽  
Intraoperative Blood Loss ◽  
Group A ◽  
Group B

Abstract Background. Diabetes mellitus (DM) is a chronic systemic disorder that mainly damages small blood vessels and nerves. Previous studies indicate that DM is a major risk factor for perioperative complications of spine surgeries, such as wound infection, prolonged operative time, longer hospitalization, and higher nonunion rates. However, to the best of our knowledge, no study has compared differences between spinal tuberculosis associated with diabetes mellitus (DMSTB) and non-DMSTB in terms of clinical characteristics, perioperative management, radiographic outcomes and surgical complications.Methods. We performed a retrospective study of 11 DMSTB patients who underwent surgical treatment between January 2014 and April 2018. We also reviewed 11 matching non-DMSTB patients. Matching characteristics included age, sex, and the range of bone destruction by spine tuberculosis. All patients underwent the same surgical procedure. For each patient, demographic information, including age, sex, residence, chief complaints, preoperative complications, the length of stay (LOS), and hospitalization expenses (USD), was reviewed. In addition, operation time, intraoperative blood loss, and postoperative complications were reviewed from digital medical records. Moreover, laboratory examination and radiographic assessments were conducted before operation and at 3-month follow-up/final follow-up (FFU).Results. A total of 22 patients were divided into two groups: Group A (DMSTB) and Group B (non-DMSTB). All patients in Group A were newly diagnosed with spinal tuberculosis, while 4 were newly diagnosed with DM. The remaining 7 patients had been diagnosed with DM for an average of 6.15 ±5.87 yrs. The lumbar and lumbosacral regions were the most affected regions for 6 patients. Significant differences in residence (p=0.02) and preoperative complications (p=0.002) were found between Groups A and B. There were no differences in operation times (292.72±56.74 vs. 281.81±46.28 min, p=0.64), intraoperative blood loss levels (627.27±486.34 vs. 668.18±350.50 ml, p=0.83), hospitalization expenses ($19713.13±5816.89 vs. $16509.78±3170.89, p=0.14), or LOS periods (25.54±4.65 vs. 27.63±10.79 days, p=0.58). There were no significant differences in erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) between Groups A and B at each time point: preoperation and at 3-month follow-up/FFU. The albumin level was lower than that in the normal stand in both groups preoperatively (35.82±4.22 vs. 37.7±2.57g/L, p=0.24) and returned to normal at FFU (42.67±2.91 vs. 43.26±2.48 g/L, p=0.63). The imaging analysis shows no significant differences in vertebral body destruction between Group A and Group B (1.45±0.75 vs. 1.31±0.71, p=0.68) with a similar fusion level (2.63±1.43 vs. 2.81±1.74, p=0.8). The bone fusion times for Groups A and B were measured as 10.27±3.01 months and 9.9±2.11 months, respectively (p=0.87). There were no significant differences in postoperative complications between the DMSTB and non-DMSTB groups (p=0.42).Conclusion. Our study demonstrates that DMSTB has a higher incidence of preoperative complications than non-DMSTB, which increases the difficulty of perioperative management for spinal tuberculosis. However, DMSTB does not significantly affect postoperative recovery as long as the glycemic level remains well controlled, nutritional supplementation is adequate, and antituberculosis treatment is sufficient.

Durable Remissions with Single Agent As2O3 in the Treatment of Newly Diagnosed Cases of Acute Promyelocytic Leukemia: Risk Stratification within This Group and Potential Impact on Future Algorithms.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 892-892
Author(s):  
Vikram Mathews ◽  
Biju George ◽  
Kavitha M. Lakshmi ◽  
Auro Viswabandya ◽  
Ashish Bajel ◽  
...  
Keyword(s):  
Platelet Count ◽  
Single Agent ◽  
Promyelocytic Leukemia ◽  
Adverse Impact ◽  
Newly Diagnosed ◽  
P Values ◽  
Group A ◽  
Grade 3 ◽  
Group B

Abstract There is limited long term follow up data with the use of single agent As2O3 in the treatment of newly diagnosed cases of acute promyelocytic leukemia (APL). Between January 1998 and December 2004, 72 newly diagnosed patients with APL were treated with single agent As2O3 administered in induction, consolidation and in maintenance at 10mg/day for adults and 0.15mg/kg/day for the pediatric population. Figure Figure The mean age was 28.6 years (range: 3–75) with 38 (52.8%) males. Six patients (11.1%) received 1 – 2 doses of an anthracycline and 53 (73.6%) received hydroxyurea in induction for either onset of a differentiation syndrome or for leucocytosis. The regimen was well tolerated. Eight (11%) patients developed grade 3 – 4 toxicity (5-hepatic, 2-neuropathy and 1-prolonged neutropenia). None of these toxicities were irreversible or contributed to mortality. Grade 3 – 4 cytopenia did not occur in any patient in remission after the initial induction. Following the initial portion of induction the rest of the protocol was completed on an outpatient basis. At a mean follow up of 31.4 months (range: 7.8–91) the EFS, DFS and OS was 70.19%, 90% and 81.33% respectively. In a univariate analysis of factors at diagnosis that had an adverse impact on survival a statistically significant effect was seen with a WBC &gt;5000/mm3, Platelet &lt;20,000/mm3 and a prolonged prothrombin time (PT) (p-values: 0.032, 0.020 and 0.023 respectively). In a multivariate analysis only a platelet count &lt;20,000/mm3 retained its significant adverse impact. Prolonged PT, platelet &lt;20,000/mm3 and WBC &gt;5000/mm3 at diagnosis was seen in 12 (16.7%), 43 (59.7%) and 27 (37.5%) respectively. Using the WBC and platelet count at diagnosis two risk groups were identified, one with WBC &lt;5000/mm3 and Platelet &gt;20,000/mm3 (Group A, n=22[30.5%]) and the remaining patients (Group B, n=50[69.5%]). In group A the EFS and OS was 100% while in group B the EFS and OS was 56.5% and 73.33% respectively. Statistical analysis of the survival curves by log rank test between these two groups for EFS and OS was significant (p-values: 0.0019 and 0.0206 respectively) and there was a trend to significance for the DFS (p=0.079). Conclusion: As2O3 is effective in the management of newly diagnosed cases of APL and can induce durable remissions. The regimen used in this study is well tolerated. Following remission induction it can be administered in the out-patient and has no irreversible or delayed toxicities. A subset that responds well to this regimen which has minimal toxicity can be identified and one could consider adding a synergistic agent such as ATRA or an anthracycline in the remaining patients. Figure Figure

Pharmacologic Monitoring of Dasatinib As First Line Therapy in Newly Diagnosed Chronic Phase Chronic Myelogenous Leukemia (CP-CML) Identifies Patients At Higher Risk of Pleural Effusion: A Sub-Analysis of the OPTIM-Dasatinib Trial

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3770-3770 ◽  
Author(s):  
Philippe Rousselot ◽  
Luigina Mollica ◽  
Gabriel Etienne ◽  
Stephane Bouchet ◽  
Agnès Guerci ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Research Funding ◽  
Chronic Phase ◽  
Myelogenous Leukemia ◽  
Molecular Response ◽  
Newly Diagnosed ◽  
First Line ◽  
Group A ◽  
Group B

Abstract Abstract 3770 Background: Second generation tyrosine kinase inhibitors such as dasatinib (Sprycel®, Bristol-Myers Squibb) induce significantly higher levels of cytogenetic and molecular responses than imatinib when given as frontline therapy for chronic phase chronic myelogenous leukemia (CP-CML) (DASISION trial, Kantarjian et al., NEJM 2010). Dasatinib is associated with the occurrence of pleural effusions (PE). The cumulative incidence of all grades PE in DASISION trial was reported to be 10% by 12 months and 14% by 24 months. Aims: To analyse efficacy of dasatinib first line and to test risk factors associated with the occurrence of PE. (EudraCT 2008–006854–17). Methods: Newly diagnosed CP-CML patients (pts) were assigned to dasatinib 100 mg/d. Dasatinib Cmin levels were assessed 24+/−2h after intake by tandem mass spectrometry after 2 weeks of therapy and every 3 months during 12 months thereafter. Pts with high Cmin values (Cmin ≥ 3 nM) at day 15 were randomized between dasatinib dose reduction or not. As the trial is still recruiting, the effect of randomization (treatment adaptation) was not analysed. For the purpose of this study, patients with at least 12 months follow-up were analysed for efficacy and all enrolled patients were analysed for safety. Molecular assessments were expressed as BCR-ABL/ABL (IS) in %. Results: Efficacy. In March 2012, 125 pts out of 191 pts enrolled in the trial had at least 12 months follow-up. Sokal scores were high for 18%, intermediate for 36% and low for 46% of pts. The median age was 52 (18–89) years. The rates of complete cytogenetic responses (CCyR) at 3, 6, and 12 months were 74%, 87%, and 97% respectively on evaluable samples, and 60%, 82%, and 95% when results were analysed according to the intention-to-treat principle taking into account missing values. The cumulative incidences of major molecular response (MMR) by 3, 6, 9 and 12 months were 21%, 46%, 56%, and 62% respectively. Of note 11 pts (9%) did not have a BCR-ABL (IS) ≤10% at 3 months. None of these patients reached a MMR by 12 months compared to a 68% (95% CI: 60–77) cumulative incidence of MMR in the other 114 pts. At 12 months, molecular response 4.5 (MR4.5) rate was 25%, including 80% of the pts with undetectable BCR-ABL transcript (sensitivity 4 to 5 log). Safety. 12 pts out of 191 (6.3%) presented a PE corresponding to a cumulative incidence of 9% by 24 months. 95 pts had at least one high Cmin value during the pharmacokinetic follow-up and 10 pts developed PE as compared to 2 out of the 96 remaining pts (p= 0.018). Cumulative incidence of PE by 24 months was 13.4% in high Cmin group as compared to 4.8% in low Cmin group (p=0.04). We next analysed whether the measurement of dasatinib Cmin at day 15 could predict the risk to develop a PE. Fifty pts (26%) had a high Cmin value at day 15 (group A) and 141 had a low Cmin (group B). The cumulative incidence of PE by 24 months was 17.4% in group A compared to 6.9% in group B (p=0.021) (fig 1). We next search for clinical factors influencing Cmin value at day15 of dasatinib 100 mg/d. Median Cmin values were significantly higher in patients aged 50 and over as compared to younger patients (2.5 nM versus 1.6 nM, p=0.0032). As expected, age 50 and over was also associated with an increased risk of pleural effusion. Conclusion: Current data demonstrate efficacy of dasatinib 100 mg/d similar or even better to that reported in other frontline trials such as the DASISION trial. We provide evidences suggesting that a high Cmin (>3nM) at day 15 and/or age 50 and over identify patients treated with dasatinib 100 mg/d with a high risk of PE. The benefit of dasatinib dose reduction is randomly tested for this group of patients in the OPTIM-Dasatinib trial and may be a major issue in elderly patients. Disclosures: Rousselot: BMS, Novartis: Research Funding. Nicolini:BMS, Novartis: Consultancy, Research Funding. Coiteux:Novartis, BMS: Speakers Bureau. Gardembas:Novartis: Speakers Bureau. Roy:Novartis, BMS: Speakers Bureau. Dartigeas:Roche: Consultancy. Guilhot:ARIAD: Honoraria. Mahon:Novartis Pharma: Consultancy, Honoraria, Research Funding; Bristol-Myers Squibb: Consultancy, Honoraria; Pfizer: Consultancy.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Renuka M. Tenahalli
Keyword(s):  
Vitamin C ◽  
Early Stage ◽  
Pathological Condition ◽  
Before And After ◽  
Group A ◽  
Phosphorus Iron ◽  
Group B ◽  
Busy Schedule ◽  
Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

scholarly journals Oral Tranexamic Acid for the Treatment of Melasma

2014 ◽  
Vol 10 (4) ◽  
pp. 40-43 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina
Keyword(s):  
Tranexamic Acid ◽  
Controlled Trial ◽  
Severity Index ◽  
Sustained Improvement ◽  
Treatment Measures ◽  
Group A ◽  
Group B ◽  
Novel Concept ◽  
High Treatment

Background Melasma poses a great challenge as its treatment is unsatisfactory and recurrence is high. Treatment of melasma using tranexamic acid (oral, topical or intralesional) is a novel concept. Objective To compare the efficacy of oral tranexamic acid with routine topical therapies for the treatment of melasma. Methods It is a prospective, interventional, randomized controlled trial conducted among 260 melasma patients. Patients were divided into two groups consisting of 130 patients each. First group (Group A) was given routine treatment measures and oral Tranexamic Acid while second group (Group B) was treated only with routine topical measures. Capsule Tranexamic Acid was prescribed at a dose of 250 mg twice a day for three months and cases were followed for three months. Response was evaluated on the basis of Melasma Assessment Severity Index (MASI). Mean scores between the two groups were then compared. Results Statistically significant decrease in the mean Melasma Assessment Severity Index from baseline to 8 and 12 weeks was observed among group A patients (11.08±2.91 vs 8.95±2.08 at week 8 and vs. 7.84±2.44 at week 12; p<0.05 for both). While among group B patients the decrease in mean score was significant at 8 weeks and insignificant at 12 weeks follow up (11.60±3.40 vs 9.9±2.61 at 8 weeks and vs. 9.26±3 at 12 weeks; p<0.05 for former but p>0.05 for later). Conclusion Addition of oral tranexamic acid provides rapid and sustained improvement in the treatment of melasma. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10993 Kathmandu Univ Med J 2012;10(4):40-43

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