scholarly journals COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
José Luis Braga de AQUINO ◽  
Vania Aparecida LEANDRO-MERHI ◽  
José Alexandre MENDONÇA ◽  
Elisa Donalisio Teixeira MENDES ◽  
Conceição de Maria Aquino Vieira CLAIRET ◽  
...  
Keyword(s):  
Late Results ◽  
Esophagogastric Anastomosis ◽  
Systemic Complications ◽  
Early Evaluation ◽  
Group A ◽  
Manual Suture ◽  
Cervical Esophagogastric Anastomosis ◽  
Mechanical Suture ◽  
Group B ◽  
Clinical Conditions

ABSTRACT Background: Among the anastomoses of the gastrointestinal tract, those of the esophagus are of special interest due to several anatomical or even general peculiarities. Aim: Evaluate retrospectively the results comparing mechanical vs. manual suture at cervical esophagogastric anastomosis in megaesophagus treatment. Methods: Were included 92 patients diagnosed with advanced megaesophagus with clinical conditions to undergo the surgery. All underwent esophageal mucosectomy, performing anastomosis of the esophagus stump with the gastric tube at the cervical level. In order to make this anastomosis, the patients were divided into two groups: group A (n=53) with circular mechanical suture, lateral end; group B (n=39) with manual suture in two sides, lateral end. In the postoperative period, an early evaluation was performed, analyzing local and systemic complications and late (average 5.6 y) analyzing deglutition. Results: Early evaluation: a) dehiscence of esophagogastric anastomosis n=5 (9.4%) in group A vs. n=9 (23.0%) in group B (p=0.0418); b) stenosis of esophagogastric anastomosis n=8 (15.1%) in group A vs. n=15 (38.4%) in group B (p=0.0105.); c) pulmonary infection n=5 (9.4%) in group A vs. n=3 (7.6%) in group B (p=1.0000.); d) pleural effusion n=5 (9.4%) in group A vs. n=6 (15.4%) in group B (p<0.518). Late evaluation showed that 86.4-96% of the patients presented the criteria 4 and 5 from SAEED, expressing effective swallowing mechanisms without showing significant differences among the groups. Conclusion: Cervical esophagogastric anastomosis by means of mechanical suture is more proper than the manual with lower incidence of local complications and, in the long-term evaluation, regular deglutition was acquired in both suture techniques in equal quality.

scholarly journals ASSESSMENT OF MECHANICAL AND MANUAL SUTURE IN THE SURGICAL TREATMENT OF THE PHARYNGOESOPHAGEAL DIVERTICULUM

2015 ◽  
Vol 28 (4) ◽  
pp. 239-242
Author(s):  
José Luis Braga de AQUINO ◽  
José Francisco Salles CHAGAS ◽  
Marcelo Manzano SAID ◽  
Maria Beatriz Nogueira PASCOAL ◽  
Luis Antonio BRANDI-FILHO ◽  
...  
Keyword(s):  
Surgical Procedure ◽  
Specific Treatment ◽  
Systemic Complications ◽  
Good Outcome ◽  
Suture Group ◽  
Group A ◽  
Manual Suture ◽  
Mechanical Suture ◽  
Group B ◽  
Suture Device

Background: The occurrence of the pharyngoesophageal, or Zenker diverticulum is not frequent in the national scenario, and the technique of the diverticulectomy with cricomyotomy in medium and great dimension diverticula is still the most indicated. Because the resection of the diverticulum requires the suture of the pharynx, dehiscence can occur, thereafter delaying swallowing. Hence, the idea is to accomplish this surgical procedure, comparing the manual and mechanical suture, in order to evaluate the real benefit of the mechanical technique. Aim: To evaluate the results of the pharyngoesophageal diverticulectomy with cricomyotomy using manual and mechanical suture with regard to local and systemic complications. Method: Fifty-seven patients with pharyngoesophageal diverticula diagnosed through high digestive endoscopy and pharyngeal esophagogram were studied. The applied surgical technique was diverticulectomy with myotomy of the cricopharyngeal muscle, done in 24 patients (42.2%) the mechanical suture (group A) with the mechanical linear suture device and in 33 (57.8%) a manual closure of the pharynx (group B). Results: In the postoperative period, one patient of group A (4.1%) presented fistula caused by dehiscence of the pharyngeal suture, and three of group B (15.1%) presented the same complication, with a good outcome using a conservative treatment. In the same group, three patients (9.0%) presented stenosis of the suture of the pharynx, with good outcome and with endoscopic dilatations, and no patient from group A presented such complication. Lung infection was present in five patients, being two (8.3%) of group A and three (9.0%) on B, having good outcomes after specific treatment. In the late review, done with 43 patients (94.4%) of group A and 22 (88.0%) on B, the patients declared to be pleased with the surgical procedure, because they were able to regain normal swallowing. Conclusion: The diverticulectomy with myotomy and pharyngeal closure using mechanical suture was proven appropriate, for having restored regular swallowing in most of the patients, and the mechanical closure of the pharynx proved to be more effective in comparison to the manual one, because it provided a lower index of local post-surgical complications.

scholarly journals CLINICAL STUDY ON SHIREESHADI AVAPEEDANA NASYA IN THE MANAGEMENT OF SURYAVARTHA (FRONTAL SINUSITIS)

2021 ◽  
Vol 9 (8) ◽  
pp. 1654-1658
Author(s):  
Amarnath H K
Keyword(s):  
Clinical Study ◽  
Economic Status ◽  
Age Groups ◽  
Frontal Sinusitis ◽  
Nasal Blockage ◽  
X Ray ◽  
Group A ◽  
Foul Smell ◽  
Group B ◽  
Clinical Conditions

Nasya karma is considered a prime treatment modality in all types of Shiroroga (Headache) and also in Suryavar- tha (Frontal Sinusitis). Suryavartha (Frontal Sinusitis) is one of the 11 types of Shiroroga. It is one of the com- mon clinical conditions found in day to day general as well as Shalakya (ENT) practice. It presents with headache as one of its cardinal features and its occurrence is found in both genders and in all age groups. Objective: To study the efficacy of Shireeshadi Avapeedana Nasya in the management of Suryavartha (Frontal Sinusitis). Ma- terial methods: Twenty patients of Suryavartha (Frontal Sinusitis) were diagnosed and registered for the clinical study irrespective of sex, socio-economic status, and religion. The study was divided into two groups - Group A and Group B. Group – A patients were treated with Shireeshadi Avapeedana Nasya for 7 days and Group – B patients were treated by Nasya with milk for 7 days. Observation and result: Among 20 patients of Suryavartha / frontal sinusitis, 20 (100%) of patients had headache, 11 (55%) had nasal blockage, 05 (25%) had nasal dis- charge, 08 (40%) had foul smell in their breath and 14 (70%) have variations from normal X-Ray. The severity of headache is significantly reduced after treatment in both Groups A and B (92.95% and 73.07%) respectively. Conclusion: Administration of Shireeshadi Avapeeda Nasya showed statistically significant improvement in the management of Suryavartha (Frontal Sinusitis). Keywords: Suryavartha, Nasya, Shireeshadi Avapeedana Nasya, Frontal Sinusitis, Shigru, Mulaka, Ksheera.

scholarly journals Experimental poisoning by Crotalaria lanceolata and Crotalaria pallida seeds in broilers

2019 ◽  
Vol 39 (11) ◽  
pp. 863-869
Author(s):  
Thaiza Savaris ◽  
Claudia P. Biffi ◽  
Daiane Ogliari ◽  
Nathalia Wicpolt ◽  
Franciéli Adriane Molossi ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Vacuolar Degeneration ◽  
Subcutaneous Edema ◽  
Group A ◽  
Gross Lesions ◽  
Crotalaria Pallida ◽  
Production Animals ◽  
Group B ◽  
Clinical Conditions ◽  
Group D

ABSTRACT: Crotalaria lanceolata E. Mey. and Crotalaria pallida Aiton. are leguminous plants of family Fabaceae found in most of the Brazilian territory. They were initially used as green manure and due their easy spread they are currently considered weeds in crops. Soybean and corn contamination can occur through the mechanical harvesting of these grains along with seeds of the Crotalaria species, which end up in the formulation of feed for production animals. Crotalaria spp. genus has toxic pyrrolizidine alkaloids (PA). Most plant species belonging to this genus can cause acute or chronic liver injury. In a first stage, one-day old broilers were divided into three groups: Group A (C. pallida seeds), Group B (C. lanceolata seeds), and Group C (Control). Groups A and B were divided into five subgroups, each with eight broilers, which received the following doses of the respective seeds in feed as of the 7th day of age: daily doses of 0.4%, 0.8% and 2.5%, and single doses of 15% and 25%. Four broilers in each study group were euthanized at 28 days of age - completing 21 days of seed consumption, and the four remaining broilers were euthanized at 42 days of age - completing 35 days of seed consumption. In a second stage, experiments were conducted using seeds of both the aforementioned plants with 28-day old broilers. These were divided into three groups of four animals each: Group D (C. pallida seeds) and Group E (C. lanceolata seeds), which received the respective seeds at daily doses of 1% and 2% in feed for 20 days, and Group F (Control). These broilers were euthanized when they were 80 days old. C. lanceolata seeds showed higher toxicity to broilers than C. pallida seeds, both supplied as of the 7th day of life. Clinical signs included inappetence, ruffled feathers, and brown diarrhea. The following gross lesions were observed: subcutaneous edema, ascites, hydropericardium, yellowish liver with hypertrophy or atrophy and enhanced lobular pattern, and distended gallbladder. Histologic lesions present in all birds in varying degrees were characterized by tumefaction and vacuolar degeneration of hepatocytes. The following clinical conditions and gross lesions were observed in the broilers: hepatocyte megalocytosis and karyomegaly, slight biliary epithelial hyperplasia, eosinophilic spheroids, and nuclear invagination with loss of hepatocyte cord architecture.

scholarly journals Multiple screw fixation versus cementless bipolar hemiarthroplasty for femur neck fracture using a nationwide hip fracture registry

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jin-Woo Kim ◽  
Kyung-Soon Park ◽  
Young-Kyun Lee ◽  
Ji Wan Kim ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Operation Time ◽  
Reoperation Rate ◽  
Bipolar Hemiarthroplasty ◽  
Systemic Complications ◽  
Femur Neck ◽  
Femur Neck Fracture ◽  
Estimated Blood Loss ◽  
Neck Fracture ◽  
Group A ◽  
Group B

AbstractCementless bipolar hemiarthroplasty (BHA) recently gained popularity as a treatment for femur neck fracture (FNF), but there have been few studies comparing this with multiple screw fixation (MSF) in the elderly population. The purpose of this study is to compare (1) surgery-related parameters, (2) reoperation rate as a local complication, (3) in-hospital systemic complication rate, and (4) mortality rate at 1 year after MSF and cementless BHA in patients with FNF using nationwide data. Six-hundred sixty-six hips (aged ≥ 50 years) extracted from nationwide Hip Fracture Registry were included in this study (133 MSF and 533 cementless BHA). One hundred fifty-six hips were divided into nondisplaced FNF (Group A) and 510 into displaced FNF (Group B). We evaluated (1) surgery-related parameters (anesthesia type, time to surgery, operation time, estimated blood loss and volume of postoperative transfusion), (2) the rate of and reasons for reoperation, (3) the rate and type of in-hospital systemic complications and (4) one-year mortality rate after surgery. In Group A, MSF showed shorter operation time (p = 0.004) and lower incidence of in-hospital systemic complications (p = 0.003). In Group B, cementless BHA demonstrated lower reoperation rate than MSF (p < 0.001). In both Group A and B, cementless BHA was associated with higher estimated blood loss than MSF (p < 0.001). Based on findings in our study, MSF might be a more favorable option for nondisplaced FNF, whereas cementless BHA might be a better one for displaced FNF in patients older than fifty. Nevertheless, our nationwide study also showed that numbers of cementless BHAs were being performed for nondisplaced FNF even in teaching hospitals.

scholarly journals Morphological Study on Age Related Changes of Prostate

1970 ◽  
Vol 7 (2) ◽  
pp. 68-72
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara ◽  
Manowara Begum ◽  
Segupta Kishwara ◽  
Khandaker Abu Rayhan ◽  
...  
Keyword(s):  
Transverse Diameter ◽  
Morphological Knowledge ◽  
Medical College ◽  
Age Related ◽  
Carcinoma Prostate ◽  
Keywords Prostate ◽  
Group A ◽  
Group B ◽  
Disease Study ◽  
Clinical Conditions

Context: Prostate related clinical conditions such as prostatic benign hyperplasia and carcinoma prostate are major medical conditions within aging population. Detailed morphological knowledge is essential for proper diagnosis and management of prostatic disease. Study design: Descriptive type of study. Place and Period of study: Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. Materials: Present study was performed on 70 post mortem human prostate. The samples were collected from unclaimed dead bodies that were under examination in the Morgue of Department of Forensic Medicine of Dhaka Medical College, Method: The samples were divided into three age group; Group A (10-20 years), Group B (21-40 years), Group C (41-70 years). All samples were studied morphologically. Result: Statistically significant positive correlation was found between age and weight, length, transverse diameter, antero-posterior diameter of prostate. Conclusion: There were changes in the morphology of prostate in relation to age. Keywords: Prostate; morphology. DOI: 10.3329/bja.v7i2.6085 Bangladesh J. Anat. 2009; 7(2) : 68-72

scholarly journals Primary Stability of Dental Implants in Low-Density (10 and 20 pcf) Polyurethane Foam Blocks: Conical vs Cylindrical Implants

2020 ◽  
Vol 17 (8) ◽  
pp. 2617 ◽  
Author(s):  
Luca Comuzzi ◽  
Margherita Tumedei ◽  
Ana Emilia Pontes ◽  
Adriano Piattelli ◽  
Giovanna Iezzi
Keyword(s):  
Primary Stability ◽  
Insertion Torque ◽  
Low Density ◽  
Implant Stability ◽  
Implant Stability Quotient ◽  
Pull Out ◽  
Group A ◽  
Group B ◽  
Torque Values ◽  
Clinical Conditions

Background: The aim of the present study was to compare, in low-density polyurethane blocks, the primary implant stability values (micromobility) and removal torque values of three different implant geometries in two different bone densities representing the structure of the human posterior jaws. Methods: A total of 60 implants were used in the present investigation: twenty implants for each of three groups (group A, group B, and group C), in both polyurethane 10 pcf and 20 pcf densities. The insertion torque, pull-out torque, and implant stability quotient (ISQ) values were obtained. Results: No differences were found in the values of Group A and Group B implants. In both these groups, the insertion torques were quite low in the 10 pcf blocks. Better results were found in the 20 pcf blocks, which showed very good stability of the implants. The pull-out values were slightly lower than the insertion torque values. High ISQ values were found in Group A and B implants. Lower values were present in Group C implants. Conclusions: The present investigation evaluated implants with different geometries that are available on the market, and not experimental implants specifically created for the study. The authors aimed to simulate real clinical conditions (poor-density bone or immediate post-extraction implants) in which knowledge of dental implant features, which may be useful in increasing the primary stability, may help the oral surgeon during the surgery planning.

FIBRINOLYTIC THERAPY IN ACUTE VERTEBROBASILAR STROKE

1987 ◽  
Author(s):  
G J Del Zoppo ◽  
H Bruckmann ◽  
A Ferbert ◽  
R Drummen ◽  
W Hacke ◽  
...  
Keyword(s):  
Therapy Group ◽  
Clinical Signs ◽  
Arterial Occlusion ◽  
Fibrinolytic Therapy ◽  
Thrombotic Occlusion ◽  
Unfavorable Clinical Outcome ◽  
Group A ◽  
Vertebrobasilar Stroke ◽  
Group B ◽  
Clinical Conditions

Local intra-arterial administration of fibrinolytic agents has been successfully used to achieve recanalization in acute thrombotic stroke patients (Zeumer, H., J Neurol 231:287-294, 1985).65 consecutive patients with clinical signs of severe brainstem ischemia and angiographically demonstrated vertebrobasilar (VB) thrombotic occlusion were treated with antithrombotic therapy.22 patients (Group A) received antiplatelet/anticoagulant treatment. 43 patients (Group B) received local intra-arterial infusion of streptokinase or urokinase proximal to the thrombotic occlusion. In 19 patients of Group B (Group B1) arterial recanalization was achieved as demonstrated angiographically; in 24 patients (Group B2) the arterial occlusion could not be resolved. None of the patients in Group B2 survived.When clinically favorable (minimal/moderate deficit) and unfavorable (severe deficit/demise) outcomes are compared, the results are highly significant (B1 vs A; p <0.007; B1 vs B2; p <0.0003 .It was possible to describe the vascular conditions associated with angiographically unsuccessful fibrinolytic therapy (Group B2) and to identify the clinical conditions associated with an unfavorable clinical outcome in patients with successful lysis (Group B1). These data indicate that successful fibrinolytic therapy is associated with a beneficial clinical effect in VB thrombotic stroke.

Retrospective observational study of sunitinib administered on schedule 2/1 in patients with metastatic renal cell carcinoma (mRCC): The rainbow study.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 471-471 ◽  
Author(s):  
Sergio Bracarda ◽  
Roberto Iacovelli ◽  
Mimma Rizzo ◽  
Marta Rossi ◽  
Luca Galli ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Clear Cell ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Initial Therapy ◽  
Control Group ◽  
Group A ◽  
Grade 3 ◽  
Group B ◽  
Clinical Conditions

471 Background: Sunitinib is a standard of care in first line mRCC; however, an increasing percentage of treatment-related adverse events are observed in the last 2 treatment weeks of the standard schedule 4/2 (4-weeks-on/2-weeks-off). In a multicenter, retrospective study, we evaluated the efficacy and safety of a modified 2/1 schedule (2-weeks-on/1-week-off), largely used in Italy based on a favorable initial experience. Methods: Data from all consecutive patients (pts) treated in 24 Italian centers with sunitinib on schedule 2/1 were analyzed according to the following groups: Group A, pts moved to schedule 2/1 because of treatment-related toxicities during initial therapy using schedule 4/2; Group B, pts treated ab initio with schedule 2/1, mainly because of poorer clinical conditions. A small group of pts treated with schedule 4/2 served as a control (Group C). Results: 276 consecutive pts treated from November 2005 to August 2013 were analyzed, including 249 treated with schedule 2/1 (Group A, n=208; Group B, n=41; respectively, median age 62 and 61 years; clear cell 94.7% and 87.8%; MSKCC good/intermediate/poor 47.1%/46.6%/6.3% and 36.5%/53.7%/9.8%; brain metastases 3.8% and 9.8%) and 27 pts in Group C (median age 59 years; clear cell 96.3%; MSKCC good/intermediate/poor 22.2%/70.4%/7.4%; no brain metastases). In Group A, the median treatment duration (TD) was 28.2 months (m) (with a median of 4.3 on the initial schedule 4/2 and 19.7 on the following schedule 2/1); median progression-free survival (PFS) was 38.6 m (95% CI, 24.0-58.6). In Group B (with less clear cell cases and more pts of intermediate risk or with brain metastases) median TD was 7.8 m and median PFS was 9.6 m (95% CI, 6.3-14.2). Median TD in Group C was 10.4 m. Maximum toxicity grade (≥3) and specific toxicities such as fatigue and hypertension were significantly reduced on schedule 2/1 in Group A compared with the initial schedule 4/2 (respectively, 8% vs 46% and 0% vs 10%, p < .001, and 2% vs 9%, p = .007). Conclusions: In our experience, sunitinib on a modified schedule 2/1 has an improved safety profile and increased efficacy compared with schedule 4/2. Prospective evaluation of this schedule is warranted.

Age-related multifactorial causes of neurological deterioration after early surgery for aneurysmal subarachnoid hemorrhage

1995 ◽  
Vol 83 (6) ◽  
pp. 984-988 ◽  
Author(s):  
Yuhei Yoshimoto ◽  
Suyong Kwak
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Elderly Patients ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Neurological Deterioration ◽  
Electrolyte Imbalance ◽  
Early Surgery ◽  
Systemic Complications ◽  
Angiographic Vasospasm ◽  
Group A ◽  
Group B

✓ The factors contributing to neurological deterioration after early surgery for aneurysmal subarachnoid hemorrhage (SAH) were investigated. One hundred forty-two patients who underwent surgery within 3 days after SAH and recovered consciousness were divided into three age groups: 49 years of age or younger (Group A), 50 to 64 years old (Group B), and 65 years of age or older (Group C). Among these, 40 patients (28%) overall showed neurological deterioration; these cases were analyzed in detail. Although the highest incidence of deterioration was noted in patients in Group C (42%), angiographic vasospasm, quantified by measuring the change in the ratio of the diameters of the intracranial arteries to the extracranial internal carotid artery, was negatively correlated with age. In elderly patients, the severity of angiographic vasospasm was not related to the reversibility of symptoms or the outcome. At the time of aggravation, associated systemic complications such as cardiac decompensation, hypoxia, and electrolyte imbalance were noted in two (18%) of 11 patients in Group A, five (38%) of 13 in Group B, and eight (50%) of 16 in Group C, and these complications were significantly correlated with poor outcome in Group C. Although arterial narrowing is a leading cause of neurological deterioration after early aneurysmal surgery, the etiology is often multifactorial, especially in elderly patients, suggesting that hypervolemic therapy, which might provoke various complications, should be performed carefully under intensive monitoring.

scholarly journals Evaluation of role of granulocyte macrophage colony stimulating factor (GM-CSF) in treatment of patients with perforation peritonitis: a prospective study

2018 ◽  
Vol 5 (5) ◽  
pp. 1902
Author(s):  
Tapan Singh Chauhan ◽  
Chisel Bhatia ◽  
Satish Dalal ◽  
Nityasha Nara ◽  
Tulit Chhabra
Keyword(s):  
Antibiotic Therapy ◽  
Hospital Stay ◽  
Neutropenic Patient ◽  
Septic Complications ◽  
Systemic Complications ◽  
Anticancer Chemotherapy ◽  
Gm Csf ◽  
Group A ◽  
Group B

Background: GM-CSF has been demonstrated to be effective in reducing the incidence of infection in patients who receive myelosuppressive anticancer chemotherapy or patients who are neutropenic and agranulocytic. We study the role of GM-CSF in non-neutropenic patients with Systemic Inflammatory Response Syndrome (SIRS), infections and sepsis with impaired neutrophil function to access the current rationale for administering GM-CSF in addition to standard antibiotic therapy to critically ill patientsMethods: All patients undergoing surgery for peritonitis due to gastrointestinal perforations were included in this study and were divided into two groups alternatively to avoid any bias i.e. Group A 1, 3, 5 etc. and Group B 2, 4, 6 etc. Group A - all patients received GM-CSF along with standard antibiotics. Group B patients received antibiotics only. Course of patient in immediate postoperative period, time to improvement, duration of hospital stay, antibiotic therapy, rate of complications were compared.Results: Patients in group A had a lower duration of antibiotic therapy and hospital stay. Patients in group A took less time to show clinical improvement compared to patients in Group B. Group A also had a much lower rate of infectious and systemic complications compared to group B. Conclusions: Results of the present study show that GM-CSF is an important molecule when used as adjunct to antibiotics in cases of abdominal sepsis. Use of this growth factor is associated with less incidence of septic complications and morbidity, a shorter duration of antibiotic therapy and hospital stay without significantly compromising the cost. The results of present study help in identifying its role in non-neutropenic patient groups who are most likely to benefit from its administration.

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