scholarly journals Minilaparoscopic lumbar sympathectomy with 3 mm instruments for plantar hyperhidrosis

2020 ◽  
Vol 19 ◽  
Author(s):  
Marcelo Loureiro ◽  
Arlindo Nascimento de Lemos Junior ◽  
Paolo Rogerio Oliveira Salvalaggio ◽  
Mohammad Alwazzan
Keyword(s):  
General Population ◽  
Standard Technique ◽  
Technical Difficulty ◽  
Skin Lesions ◽  
Conventional Technique ◽  
Lumbar Sympathectomy ◽  
The Past ◽  
Laparoscopic Procedures

Abstract Severe palmoplantar hyperhidrosis affects about 1.5-2.8% of the general population. Plantar hyperhidrosis (PHH) is related to foot odor, cold feet, skin lesions and infections, and even instability when walking. Endoscopic Lumbar Sympathectomy (ELS) is the treatment of choice for this condition. However, few surgeons have used this technique over the past 20 years because of its technical difficulty. Two and 3 mm instruments, rather than the standard 5 mm instruments, have been used to improve the results of several standard laparoscopic procedures. Use of these minilaparoscopic instruments to perform ELS so far has not yet been published. We describe a technique for ELS using minilaparocopic instruments, which we have used for our last 70 cases and has become our standard technique. The aim of this study is to demonstrate the feasibility of this technique and its advantages compared to the conventional technique.

President's Address: Twinning in Families of Triplets

1990 ◽  
Vol 39 (3) ◽  
pp. 279-293 ◽  
Author(s):  
A.W. Eriksson
Keyword(s):  
General Population ◽  
Physical Condition ◽  
High Frequency ◽  
Maternal Age ◽  
The Past ◽  
Low Rate

AbstractA study was conducted on twinning in relatives of consecutive triplet sets in the Åland Islands in the years 1740-1939. The incidence of twinning in sibships of triplets was extremely high, 80/1000 (56/1000 before and 143/1000 after the triplet maternity). In Finland as a whole, 1905-1954, the twinning rate was among mothers of triplets 38/1000, ie, about 2.6 times the rate in general population, and was higher after (48/1000) than before the triplet maternity (34/1000). In the sibships of fathers of triplets there was a low rate of twinning (below 10/1000) both of same-sexed (SS) and of opposite-sexed (OS) triplets. Among sibships of mothers of OS triplets the twinning rate was 18/1000 and among mothers' sibships of SS triplets 26/1000. The series of triplet families from both Åland and Finland as a whole indicate a considerably higher frequency of twinning on the maternal than on the paternal side. The sibships of OS triplets in Finland have higher twinning rates than sibships of SS triplets (50/1000 vs 27/1000). In sibships of triplets, not only the DZ but also the MZ twinning rates were approximately twice as high as those in the general population. The triplet rates in Finland were increasing strongly with maternal age and were in the last century among mothers of 30-39 years of age considerably higher than among mothers from this century. This, in combination with higher mean parity, may explain the high rates of multiple maternities in sibships of triplets in the past. The rate of triplet maternities seems to be more sensitive to sociodemographic changes than the rate of twin maternities. Mothers of triplets in Finland had a high frequency (more than 40%) of prenuptially conceived firstborn children. This, and a short protogenesic interval indicate that triplet-prone mothers are more fecundable, ie, they conceive with greater ease and/or may have a better physical condition than other women for completing a gestation with multiple embryos.

scholarly journals COVID-19 and rheumatology: A year later

2021 ◽  
Vol 59 (1) ◽  
pp. 31-36
Author(s):  
B. S. Belov ◽  
A. M. Lila
Keyword(s):  
Clinical Trials ◽  
General Population ◽  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Diseases ◽  
Controlled Clinical Trials ◽  
Antirheumatic Drugs ◽  
The Past ◽  
Immune Mediated ◽  
Great Hope ◽  
Blind Spots

An enormous body of evidence on various aspects of the coronavirus disease 2019, COVID-19 associated with the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus-2) has been accumulated over the past year. Meanwhile, investigated relationship between COVID-19 and rheumatic immune-mediated inflammatory diseases (IMIDs) and certain identified similarities were of paramount importance. It was shown that the incidence of COVID-19 in patients with rheumatic diseases does not significantly differ from that in general population. The risk of severe course and unfavorable COVID-19 outcomes in patients with rheumatic IMIDs is significantly associated with older age and comorbidities – as in general population, and is not aggravated by preceding use of the majority of antirheumatic drugs. Gaining better insights into pathogenesis of COVID-19 provided sound prerequisites for anti-rheumatic drugs repurposing and substantiated their use for treatment of COVID-19 infection. Under current COVID-19 pandemic circumstances, accelerated development and invention of various COVID-19 vaccines offers a great hope to curb the tide of pandemic. However, the efficacy, immunogenicity, and safety of these vaccines in patients with rheumatic IMIDs must be studied in controlled clinical trials. Generally speaking, there are still numerous blind spots in our knowledge of rheumatological aspects of such a versatile and polymorphous condition as COVID-19 infection.

scholarly journals A patient who does not like insulin

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 122-125
Author(s):  
Paola Ubaldi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Population ◽  
Bone Metastases ◽  
Cancer Symptoms ◽  
The Past ◽  
The Right ◽  
Hypoglycemic Therapy

Hypoglycemic therapy over the past 20 years has expanded considerably with the use of new classes of more effective and safer medicines. Alongside the aging of the general population, the survival of diabetic subjects has significantly increased, thus exposing them to a greater risk of developing co-morbidities. This represents a challenge for the diabetologist, who must acquire ever broader concepts for the management of a complex and multi-organ disease. We report the case of a 72-year-old woman with type 2 diabetes mellitus and pulmonary adenocarcinoma of the right upper lobe with brain and bone metastases who, subjected to innovative and integrated treatments agreed between specialists of different disciplines, is still alive and free of cancer symptoms 23 months after diagnosis (Diabetology)

Lone Actor Terrorism

2021 ◽  
pp. 257-267
Author(s):  
Paul Gill
Keyword(s):  
General Population ◽  
Mental Disorders ◽  
Protective Factors ◽  
Physical Space ◽  
Sociodemographic Characteristics ◽  
Main Research ◽  
The Past ◽  
Research Findings ◽  
Online Forms ◽  
The Relationship

This chapter outlines the main research findings in relation to lone actor terrorism from the past decade of work. The results are clustered across seven core themes. The authors explore (1) the heterogeneity of lone actors in terms of their sociodemographic characteristics; (2) the degree to which people within the lone actor’s social or physical space were aware of a plot developing; (3) the prevalence and forms of mental disorders within lone actor samples and how they differ from what you would expect in the general population; (4) the relationship between offline and online forms of radicalization; (5) their similarity with other forms of violent lone offenders who conduct violence in public spaces; (6) what attack planning looks like; and (7) the key role protective factors might play.

scholarly journals Freestyle-Like V-Y Flaps of the Eyebrow: A New Outlook and Indication of an Historical Technique

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Angelo Alberto Leto Barone ◽  
Matteo Rossi ◽  
Gabriele Giunta ◽  
Marco Carmisciano ◽  
Luigi Di Rosa ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Perforator Flap ◽  
Skin Lesions ◽  
Melanocytic Nevus ◽  
Immediate Reconstruction ◽  
The Past ◽  
Basal Cell Carcinomas ◽  
The Face ◽  
Free Closure ◽  
Excellent Cosmetic Result

The eyebrow region is of utmost importance for facial movement, symmetry, and the overall cosmetic appearance of the face. Trauma or tumor resection often leave scars that may dislocate the eyebrow producing an alteration both in static symmetry of the face and in the dynamic expressivity. The authors present a technique for eyebrow’s defects repair using the remaining eyebrow advancement by means of a “freestyle-like” V-Y flap. In the past two years a total of eight consecutive patients underwent excision of skin lesions in the superciliary region and immediate reconstruction with this technique. On histology, six patients were affected from basal cell carcinomas, one from squamous cell carcinoma, and one from congenital intradermal melanocytic nevus. The pedicle of the flap included perforators from the supratrochlear, supraorbital, or superficial temporalis artery. Advancement of the entire aesthetic subunit that includes the eyebrow using a V-Y perforator flap was performed successfully in all cases achieving full, tension-free closure of defects up to 3.0 cm. “Freestyle-like” V-Y flaps should be considered as a first-line choice for partial defects of the eyebrow. The greater mobility compared to random subcutaneous flaps allows to reconstruct large defects providing an excellent cosmetic result.

Evolutionary Computing in Engineering Design

2011 ◽  
pp. 167-184
Author(s):  
Rajkumar Roy ◽  
Ashutosh Tiwari ◽  
Yoseph Tafasse Azene ◽  
Gokop Goteng
Keyword(s):  
Engineering Design ◽  
Optimal Solution ◽  
Evolutionary Computing ◽  
Conventional Technique ◽  
Substantial Improvement ◽  
Process Time ◽  
Natural Processes ◽  
The Past ◽  
Performance Requirements ◽  
The One

This chapter presents an overview of the application of evolutionary computing for engineering design. An optimal design may be defined as the one that most economically meets its performance requirements. Optimisation and search methods can assist the designer at all stages of the design process. The past decade has seen a rapid growth of interest in stochastic search algorithms, particularly those inspired by natural processes in physics and biology. Impressive results have been demonstrated on complex practical optimisation of several schools of evolutionary computation. Evolutionary computing unlike conventional technique, have the robustness for producing variety of optimal solutions in a single simulation run, giving wider options for engineering design practitioners to choose from. Despite limitations, the act of finding the optimal solution for optimisation problems has shown a substantial improvement in terms of reducing optimisation process time and cost as well as increasing accuracy. The chapter aims to provide an overview of the application of evolutionary computing techniques for engineering design optimisation and the rational behind why industries and researchers are in favor of using it. It also presents the techniques application trend rise in the past decade.

scholarly journals Functional and Neuroanatomical Bases of Developmental Stuttering: Current Insights

2018 ◽  
Vol 25 (6) ◽  
pp. 566-582 ◽  
Author(s):  
Soo-Eun Chang ◽  
Emily O. Garnett ◽  
Andrew Etchell ◽  
Ho Ming Chow
Keyword(s):  
General Population ◽  
Speech Production ◽  
Neurodevelopmental Disorder ◽  
Future Research ◽  
Childhood Onset ◽  
Structural Neuroimaging ◽  
The Past ◽  
Adults Who Stutter ◽  
Developmental Stuttering ◽  
Preschool Aged Children

Affecting 5% of all preschool-aged children and 1% of the general population, developmental stuttering—also called childhood-onset fluency disorder—is a complex, multifactorial neurodevelopmental disorder characterized by frequent disruption of the fluent flow of speech. Over the past two decades, neuroimaging studies of both children and adults who stutter have begun to provide significant insights into the neurobiological bases of stuttering. This review highlights convergent findings from this body of literature with a focus on functional and structural neuroimaging results that are supported by theoretically driven neurocomputational models of speech production. Updated views on possible mechanisms of stuttering onset and persistence, and perspectives on promising areas for future research into the mechanisms of stuttering, are discussed.

Adolescence and emerging adulthood

2016 ◽  
Author(s):  
David Levy
Keyword(s):  
Smoking Cessation ◽  
Glycaemic Control ◽  
General Population ◽  
Emerging Adulthood ◽  
Early Onset ◽  
Microvascular Complications ◽  
Macrovascular Disease ◽  
The Past ◽  
Adult Diabetes

Adolescence and emerging childhood forms an increasing proportion of the lifespan of urbanized individuals. Glycaemic control worsens during adolescence; physiology and psychology contribute. A1C levels peak around 9% (75 mmol/mol) before declining from late teens onwards. However, unchanging glycaemia (tracking) is common. Glycaemia has generally improved in the past 10–15 years, but significant differences between and within countries persist. Microvascular complications are prevalent at this stage, but have probably also decreased with time. During this important period, the stage can be set for premature macrovascular disease (early onset hypertension, arterial stiffening, dyslipidaemia, and smoking). Exercise reduces the risk of microvascular complications. Smoking is as common in young Type 1 patients than in the general population. Efforts at smoking cessation need reinforcing. Glycaemic control during university does not improve. Transition from paediatric to adult diabetes services is often unsatisfactory; clinics should implement simple procedures focusing on accessibility, flexibility, and improved communications.

scholarly journals Efficacy of Adding Oral Simvastatin to Topical Therapy for Treatment of Psoriasis: The Vietnamese Experience

2019 ◽  
Vol 7 (2) ◽  
pp. 237-242
Author(s):  
Hao Nguyen Trong ◽  
Thang Nguyen Tat ◽  
Tu Tran Nguyen Anh ◽  
Nhi Pham Uyen ◽  
Thuong Nguyen Van ◽  
...  
Keyword(s):  
General Population ◽  
Skin Disorder ◽  
Systemic Disease ◽  
Topical Therapy ◽  
Skin Lesions ◽  
Healthy Controls ◽  
Healthy Group ◽  
Pasi Score ◽  
Inflammatory Skin Disorder ◽  
Age And Sex

BACKGROUND: Psoriasis, the prevalence of which ranges from 2% to 3% of the general population, has been recently recognised as not only a chronic inflammatory skin disorder but also an immunometabolic systemic disease. Dyslipidemia is one of the most important comorbidities of psoriasis. Statins, frequently used as anti-hyperlipidemic agents, may be beneficial in the treatment of several autoimmune diseases, including psoriasis, due to their anti-inflammatory and immunomodulatory characteristics. Hence, we hypothesised that using this medication was not only beneficial for reducing hyperlipidemia but also improving psoriatic conditions. AIM: We conducted a study to determine the prevalence of dyslipidemia in psoriatic patients as well as whether the addition of statins (simvastatin prescribed forms) to standard topical antipsoriatic treatment can improve skin lesions in psoriatic patients. METHODS: A group of 128 psoriatic patients and 128 healthy controls who were matched with the patients regarding ethnicity, age, and sex were enrolled, and their lipid concentrations were determined. Furthermore, sixty patients were randomly selected from the former group and divided into two treatment subgroups to evaluate the effect of statins on the severity of psoriasis using the PASI score. RESULTS: We found that the rate of dyslipidemia in the patient group was significantly higher than in the healthy group (53.9% versus 21.9%, p < 0.001), particularly the triglyceride concentration (1.86 ± 1.17 versus 1.43 ± 0.79 mg/dL, p < 0.001). Also, the PASI score reduction in the simvastatin-treated subgroup was significantly different from that in the placebo-treated one after eight weeks of therapy (8.63 ± 4.78 versus 5.34 ± 3.59, p < 0.01). CONCLUSION: This study showed that simvastatin might play a role in controlling hyperlipidemia and in turn decrease the PASI score in psoriatic patients.

scholarly journals Multicentric Cutaneous Crohn's Disease: A Case Report and Review of Literature

1990 ◽  
Vol 4 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Robert Prokopetz ◽  
J Barrie Ross ◽  
Peter Smith ◽  
Joseph J Sidorov
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Erythema Nodosum ◽  
Skin Lesions ◽  
Review Of Literature ◽  
Histological Features ◽  
The Past ◽  
Common Skin ◽  
Skin Conditions

A patient presented with skin lesions at sites not contiguous with Crohn's disease of the bowel and with specific histological features of Crohn's disease occurring two weeks from the onset of bowel symptoms. Currently a number of nonspecific skin conditions such as erythema nodosum, pyoderma gangrenosum and erythema multiforme are accepted as being the most common skin manifestations of Crohn's disease. It is likely, however, that specific lesions of Crohn's disease in the skin have been underdiagnosed either because of lack of biopsy or misinterpretation of the histology. Twenty-three cases with specific Crohn's disease in the skin have been recorded in the past 25 years, since the condition has been recognized. Sarcoidosis has been a common misdiagnosis. The literature relating to multicentric Crohn's disease is reviewed and attention drawn to its protean and masquerading features. An argument is made for the use of the term 'multicentric' rather than 'metastatic' in relation to cutaneous Crohn's disease.

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