scholarly journals Minimally invasive combined surgical treatment of postcoital cystitis

2020 ◽  
Vol 21 (2) ◽  
pp. 20-25
Author(s):  
J. Sh. Inoyatov ◽  
O. V. Snurnitsyna ◽  
M. V. Lobanov ◽  
O. Yu. Malinina ◽  
Yu. L. Demidko ◽  
...  

Introduction. Urethral transposition remains the most popular operation for postcoital cystitis, however, traumatism and complications, especially such as pudendal neuropathies, dyspareunia and anorgasmia, make us continue to search for effective, but safer techniques.The study objective is to evaluate the efficacy and safety of the proposed treatment of postcoital cystitis, including removal of urethrogymenal adhesions and subsequent paraurethral filler implantation, in comparison with isolated hymenoplasty.Materials and methods. Since 2013, 75 patients with postcoital cystitis have been treated. Patients were divided into two groups: main group – hymenoplasty (removal of urethral adhesions) with paraurethral filler implantation (n = 45), control group – hymenoplasty (n = 30). The gel was injected paraurethrically, fan-shaped, in the volume of 1–2 ml, from a point on the 6-hour conditional dial, creating a gel cushion and thus raising the meautus and distal urethra. To assess the quality of treatment, profile questionnaires were used.Results. In the main group of patient, the quality of life improved in 35 (78 %); in 5 patients, due to the process of biodegradation of the gel during 1 year, the cystitis recidivated, which required the filler reimplantation. In 5 patients, the operation was not effective. In the control group the efficiency of isolated hymenoplasty was noted in 3 (10 %) patients, relapse of cystitis occurred in 27 (90 %) patients, which later required the implantation of a filler. No complications were observed.Conclusions. The suggested combined technique allows to improve the results of treatment of patients with postcoital cystitis. The operation does not carry the risk of damage to the sprigs of the genital nerve, can serve as an alternative to traditional urethral transposition. The main disadvantage is the natural biodegradation of the gel, which may create the need for its reintroduction.

Author(s):  
P.F. Kolisnyk ◽  
I.V. Baranova ◽  
S.P. Kolisnyk ◽  
O.V. Dolynna ◽  
Y.O. Bezsmertnyi ◽  
...  

Annotation. Diabetes is one of the most common metabolic diseases in the world with a large number of complications. Threatening conditions that significantly reduce the quality of life and even lead to the death include a diabetic foot syndrome. The aim of the study was to investigate the effectiveness of combined ozone therapy in the treatment of patients with type 2 diabetes with chronic lower extremity trophic ulcers. A prospective study of the effectiveness of using the combined method of ozone therapy in the treatment of trophic ulcers of the lower extremities was conducted in the surgical and rehabilitation departments of the University Clinic of the National Pirogov Memorial Medical University. The study involved 52 patients with diadetes mellitus 2 type, who were randomly assigned to the main (n=26) and control (n=26) groups. Subjective and objective changes in the condition of patients were evaluated: an area of trophic ulcers (by A.V. Kuleshov's method), a rate of ulcer’s defect epithelization (by L. Popova's formula) and the quality of life parameters of patients (by the questionnaire SF-36) before and after the treatment. The endpoint of the study was a complete epithelization of the diabetic trophic ulcer. The treatment was carried out according to the generally accepted methodology in both observation groups, and the combination ozone therapy was additionally used for patients of the main group. The latter provided for the intravenous administration of an oxygen-ozonized 0.9% NaCl solution and local exposure of the trophic ulcer defect to the ozonized mixture by chamber aeration. The course of complex treatment was carried out after removal of necrotic tissue and wound cleansing, consisted of 10 local and general ozone therapy procedures, which were carried out every other day. The data obtained were processed using the SPSS for Windows 10.0 and STATISTICA 6.1 application software package (license number BXXR901E245722FA). One month after, the observation changes of the trophic skin defects and Quality of life indicators showed the significantly (p<0.01) better results of treatment in the main group than in the control group. The endpoint of the study was achieved in 85% of patients after complex treatment versus 29% of patients in the control group after a conventional treatment (p<0.01). Using as modern rehabilitation method as ozone therapy is an appropriate complement to the existing treatment regimens, which can significantly accelerate the clinical recovery of patients and, as a result, improve the quality of life. The particular value of the method confirmed by an absence of contraindications and drug overloads of the patient. The study of the effects of ozone therapy on the metabolism of patients with diabetes mellitus type 2 can be a promising area for further research.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Evdokimov ◽  
E Yushchuk ◽  
A Evdokimova ◽  
S Ivanova ◽  
I Sadulaeva

Abstract Purpose To compare clinical efficacy and safety of various treatment regimens with the inclusion of beta-blockers, RAAS antagonists (ACE inhibitors or ARBs), prolonged bronchodilators (LABA, LAMA) in heart failure patients with CAD and COPD. Methods 385 patients (292 men and 93 women), aged 66.3±4.1 years, with CHF classes II to III (NYHA) combined with moderate to severe COPD (GOLD) and with LVEF less than 45% were randomized into nine groups: enalapril + LAMA (control group), nebivolol + enalapril + LAMA, nebivolol + losartan + LAMA, nebivolol + losartan + LABA, nebivolol + losartan + LAMA/LABA, carvedilol + enalapril + LAMA, carvedilol + losartan + LAMA, carvedilol + losartan + LABA, carvedilol + losartan + LAMA/LABA. Patients of all groups received complex CHF treatment comprising diuretics, nitrates, cardiac glycosides (if necessary). Clinical examination, TTE, 6-minute walk test (6MWT), 24-hour electrocardiogram and blood pressure monitoring, respiratory function test were assessed at baseline and after 6 months of treatment. The quality of life was evaluated by MYHFQ, SGRQ and mMRC scale. Results After 6 months of therapy the improvement of clinical condition and quality of life were marked in all groups. At the end of observation period there was a significant improvement of patients clinical condition, quality of life, reduction of mean CHF FC and dyspnea severity, increase of exercise tolerance, slowing of progression of CHF and COPD, improvement of the parameters of intracardiac hemodynamics, structural and functional parameters of the left and right heart (a decrease in the size of the atria, LV volumes and internal dimension at end-diastole and end-systole, cardiac index, LVMMI, an increase of LVEF, a significant decrease in systemic vascular resistance and the pulmonary hypertension grade, significant improvement in systolic and diastolic function of the ventricles, regression of pathological remodeling of the heart, reduction of heart rate, duration and frequency of myocardial ischemia episodes (including its “silent” form). The best results were obtained in groups using a beta-blocker (nebivolol or carvedilol), a RAAS antagonist, and a combination of long-acting bronchodilators (indacaterol and tiotropium) – group 5 and 9. It is worth noting that beta-blockers, LABA and LAMA were well tolerated in all observation groups and serious adverse events were absent. Conclusions The appointment of 3-generation beta-blockers to patients with CHF on the background of CAD and COPD can significantly increase the effectiveness of treatment and does not cause a deterioration in spirometry in patients with such cardiopulmonary pathology. In our opinion, the most important point in the appointment of beta blockers to patients with moderate to severe COPD is low start dose and slow titration of the dose at the beginning of the therapy. It is advisable to include in the complex therapy of such patients a combination of LABA and LAMA as a basic bronchodilator support. Funding Acknowledgement Type of funding source: None


Neurosurgery ◽  
2017 ◽  
Vol 83 (1) ◽  
pp. 146-153 ◽  
Author(s):  
Pierre-Yves Borius ◽  
Stéphanie Ranque Garnier ◽  
Karine Baumstarck ◽  
Frédéric Castinetti ◽  
Anne Donnet ◽  
...  

Abstract BACKGROUND Hypophysectomy performed by craniotomy or percutaneous techniques leads to complete pain relief in more than 70% to 80% of cases for opioid refractory cancer pain. Radiosurgery could be an interesting alternative approach to reduce complications. OBJECTIVE To assess the analgesic efficacy compared with standard of care is the primary goal. The secondary objectives are to assess ophthalmic and endocrine tolerance, drug consumption, quality of life, and mechanisms of analgesic action. METHODS The trial is multicenter, randomized, prospective, and open-label with 2 parallel groups. This concerns patients in palliative care suffering from nociceptive or mixed cancer pain, refractory to standard opioid therapy. Participants will be randomly assigned to the control group receiving standards of care for pain according to recommendations, or to the experimental group receiving a pituitary GammaKnife (Elekta, Stockholm, Sweden) radiosurgery (160 Gy delivered in pituitary gland) associated with standards of care. Evaluation assessments will be taken at baseline, day0, day4, day7, day14, day28, day45, month3, and month6. EXPECTED OUTCOMES We could expect pain improvement in 70% to 90% of cases at day4. In addition we will assess the safety of pituitary radiosurgery in a vulnerable population. The secondary endpoints could show decay of opioid consumption, good patient satisfaction, and improvement of the quality of life. DISCUSSION The design of this study is potentially the most appropriate to demonstrate the efficacy and safety of radiosurgery for this new indication. New recommendations could be obtained in order to improve pain relief and quality of life.


2019 ◽  
Vol 6 (3) ◽  
pp. 108-114 ◽  
Author(s):  
A. D. Sergienko ◽  
V. E. Khoronenko ◽  
E. V. Gameeva ◽  
A. B. Ryabov ◽  
V. M. Khomyakov

Purpose of the study. To determine the effect of nutritional deficiency and nutritional therapy on the quality of life of patients with gastric cancer at the stage of surgical treatment. Patients and methods. In Thoracoabdominal Department of P. Herzen Moscow Oncology Research Institute within 2017– 2019 the quality of life at the stage of surgical treatment of gastric malignant neoplasms was evaluated in 62 patients (36 men and 26 women) aged 34 to 79 years (mean age 61.9 ± 9.55). At the outpatient stage, patients were divided into 2 groups: in the 1st (main) group, patients received nutritive support with specialized mixtures for 10 days before hospitalization, in the 2nd (control) group, patients were asked to follow a high-protein diet without adding specialized mixtures. The quality of life assessment was carried out on the basis of the EORTC-QLQ-C30 Questionnaire, which patients received on the day of hospitalization. Patients repeatedly filled in EORTC-QLQ-C30 Questionnaire before discharge from the hospital, which allowed to assess the dynamics of the quality of life indicators of the studied patients. The study groups were comparable in social and medical indicators. Results. The analysis of the survey results showed that the “general state of health” in the studied groups at the stage of hospitalization is estimated �bove average. Also, in both groups there is a positive dynamics in the values of the above indicator before discharge. Patients of the 1st group who received specialized nutritional mixtures, developed the statistical significance of the differences in the assessment of the quality of life upon admission and before discharge. Thus, it can be argued that nutritional therapy had a significant positive impact on the quality of life in terms of “general health”, in contrast to the control group of patients who did not receive specialized nutritional therapy. There was a general tendency toward an increase in the quality of life indicators at admission and before discharge on all scores of the questionnaire in groups. Thisis a positive assessment by patients of their condition after providing them with medical services. In this case, the discomfort from the symptoms accompanying the disease is reduced, which is confirmed by the scoring results. Statistically significant differences in the assessment of symptoms occur in the study group. Patients having received nutritional therapy noted a decrease in pain, an improvement in the processes of assimilation of food, as well as an improvement in well-being, physical condition, an increase in general tone and energy, a surge of strength and a sense of vitality. In “decreased appetite”score the indices of patients in the main group decreased by more than 3 times, i. e. their appetite improved significantly under treatment. Improving appetite in patients of the main group led to an improvement in the functioning of the gastrointestinal tract as a whole. Patients in this group noted an improvement in digestion and bowel movements. Conclusion The study showed that the quality of life of patients with gastric cancer largely depends on their nutritional deficiency, and nutritional therapy at the stages of surgical treatment, in turn, can significantly improve its results, including in the aspect of their perception by patients. Using the general EORTC QLQ-C30 questionnaire is one of the available methods for assessing the quality of life in patients with gastric cancer.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyu Yue ◽  
Shuang Zhou ◽  
Huangan Wu ◽  
Xuan Yin ◽  
Shanshan Li ◽  
...  

Abstract Background Cancer-related insomnia (CRI) is one of the most prevalent complaints among cancer survivors and severely impairs patients’ quality of life. As a popular non-pharmacological alternative treatment, acupuncture provides a good clinical curative effect on insomnia. The aim of this trial is to evaluate efficacy and safety of electro-acupuncture on insomnia in patients with lung cancer. Method This is a protocol for a multicenter randomized single-blinded sham-controlled trial. We will randomly assign 252 eligible patients with lung cancer-related insomnia into two groups at a ratio of 1:1, the treatment group (EA) and the control group (sham EA). All treatment will be given 3 times per week for 8 weeks, and a 12-week follow-up will be conducted. The primary outcome will be measured by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes will include sleep parameters recorded from the actigraphy, scores from Quality of Life Questionnaire Core-30 (QLQ-C30), and Patient Health Questionnaire-9 (PHQ-9). All adverse effects during the trial will be assessed by the Treatment Emergent Symptom Scale (TESS). All analyses will be based on ITT principle and performed with the statistical software SPSS (version 24.0) by t test, rank-sum test, chi-square, and so on. A two-sided significance level will be set at 5%. Discussion This large-sample trial protocol will evaluate the efficacy of electro-acupuncture on insomnia in patients with lung cancer. This protocol, if proven to be effective, will contribute to filling the gap in treatment options in the CRI field and provide a promising intervention for insomnia in lung cancer survivors. Trial registration ChiCTR ChiCTR1900026395. Registered on 8 October 2019, http://www.chictr.org.cn/showproj.aspx?proj=44068


2021 ◽  
Vol 12 ◽  
Author(s):  
Tianye Hu ◽  
Hantong Hu ◽  
Feng Chen ◽  
Bin Jiang ◽  
Fengfei Shen ◽  
...  

Introduction: With a high incidence rate and low diagnosis rate, vestibular migraine (VM) can seriously affect the quality of life of patients, but it remains difficult to manage by current treatment options. Acupuncture may be a potential treatment option for VM prophylaxis, but the currently available evidence is still uncertain. Therefore, this trial aims to evaluate the efficacy and safety of acupuncture for VM prophylaxis.Methods: This is a 28-week parallel, randomized, controlled clinical trial including 4 weeks of baseline, 8 weeks of treatment, and 16 weeks of follow-up. A total of 72 participants will be randomly assigned to two groups. The participants will receive acupuncture in the experimental group, while the participants in the control group will be treated with venlafaxine. The primary outcome measures are change in vertigo/migraine days and vertigo/migraine attacks, vertigo severity, and migraine intensity per 4 weeks from baseline. The secondary outcome measures are change in doses of rescue medication, anxiety level, depression level, and quality of life per 4 weeks from baseline. Adverse events will be recorded for safety evaluation.Discussion: This study will investigate the efficacy and safety of acupuncture for VM prophylaxis. The results will contribute to determining whether acupuncture can serve as an optional treatment strategy for treating VM.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT0464088.


Author(s):  
L. Odiyaka ◽  
T. Baryshok

The article deals with the problem of overweight women and the measures that can influence it. The actual problem of reducing the quality of life of overweight women and the need to take this indicator into consideration when selecting the measures of physical therapy and assessing the quality of their use are raised. The results of the study of changes in quality of life after using of programs of physical therapy for the correction of excess weight are presented. The quality of life of young overweight women was evaluated using the SF-36 survey (physical and mental health). Experimental sample size: 10 females in the main group and 10 females in the control group. Weight loss program and improving the quality of life of young women through physical therapy lasted for 6 months. Programs of physical therapy in the main group was included elements of different directions of aerobics (classical aerobics, power aerobics, aerobics using different tools, aerobics with psycho-regulatory orientation) and nutrition correction. Programs of physical therapy in the control group was also included nutrition correction and fitness workouts with the use of simulators with a focus on strength and cycling. According to recent estimates, at least one in three adults in the world is overweight and almost one in 10 is obese. Being overweight is not only an aesthetic problem, it is a health threat that entails a number of illnesses and complications, reducing the quality of life. Not everyone knows that the risk of health problems manifests itself even with a slight overweight, and increases as you gain weight. For greater results in overweight correction, it is best to use aerobic and anaerobic fitness programs. A comprehensive physical therapy program has significantly improved the health of young women and has had a positive effect on physical and mental health. We have reason to believe that the overweight correction technique of the main group has proven to be more effective in improving the quality of life of women than the control group program.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Wen-chao Zhang ◽  
Deng Xiao

Abstract Background Optimal balance control is of paramount importance for function recovery after total joint arthroplasty (TJA). The study objective of this meta-analysis was to assess the short- and mid-term effects of proprioceptive and balance training for patients undergoing TJA. Methods Electronic searches were conducted from PubMed, Cochrane library, and Embase databases to identify eligible RCTs through May 2020. Standard mean difference (SMD) with 95% confidence interval (95%CI) was applied to calculate pooled effect estimates between proprioceptive and balance training and control group. Main outcomes were self-reported functionality, balance, pain, quality of life, and function (range of motion). Results Seven randomized controlled trials were finally included in this meta-analysis. Pooled results found that balance and proprioceptive trainings have a positive role in improving self-reported functionality at short-term after TJA. Moreover, balance and proprioceptive trainings were associated with an increase of the balance at short- and mid-term after TJA. These results were further confirmed by subgroup analysis between preoperative and postoperative administration of balance and proprioceptive trainings. Conclusion Our meta-analysis suggests that balance and proprioceptive trainings after TJA improved self-reported functionality and balance. These improvements were maintained at mid-terms. More research is needed to confirm balance and proprioceptive trainings for pain and quality of life for TJA.


2017 ◽  
Vol 17 (2) ◽  
pp. 437-443 ◽  
Author(s):  
Hua-dong Zhu ◽  
Zhen Gong ◽  
Bing-wei Hu ◽  
Qiao-ling Wei ◽  
Jun Kong ◽  
...  

Introduction. Opioid-induced constipation (OIC) is a principal complication secondary to analgesic therapy for cancer pain patients who suffer moderate to severe pain. In this study, we observe the efficacy and safety of transcutaneous acupoint interferential current (IFC) stimulation in those patients with OIC. Methods. A total of 198 patients were randomly allocated to the IFC group and control group in a 1:1 ratio. Finally, 98 patients in the IFC group received 14 sessions administered over 2 weeks, whereas 100 patients in the control group took lactulose orally during the same period. Observation items were documented at management stage and at follow-up stage according to Cleveland Constipation Scales (CCS), pain Numeric Rating Scales (NRS) and Patient Assessment of Constipation Quality of Life (PAC-QoL). Results. The total curative effects of the IFC group and the control group were indistinguishable (76.5% vs 70.0%, P = .299). Regarding CCS and PAC-QoL scores, no significant difference was observed between the 2 groups during the management time and at the follow-up stage of week 3 ( P > .05, respectively), but groups were distinguished at the follow-up stage of week 4 ( P < .001 and P = .031, respectively). The pain NRS decreased significantly at management stage week 2 and follow-up stage week 3 and week 4 ( P = .013, P = .041, P = .011, respectively). Conclusions. Transcutaneous acupoint IFC therapy over acupoints of Tianshu (ST25) and Zhongwan (RN12) may improve constipation and quality of life in cancer patients receiving opiates; further studies are worthwhile.


2021 ◽  
Vol 27 (1) ◽  
pp. 34-43
Author(s):  
Oleksandr Y. Glavatskyi ◽  
Oksana V. Zemskova ◽  
Hennadii V. Khmelnytskyi ◽  
Konstantin A. Kardash ◽  
Iryna M. Shuba ◽  
...  

Objective: to study the effect of antiangiogenic therapy on the quality of life and the level of headache in patients with recurrent glioblastoma who underwent radiosurgical treatment. Materials and methods. A prospective randomized single-center study carried out at the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine in 2019-2020 involving 45 patients with GB with clinical and radiological signs of disease progression and local tumor recurrence. In this regard, patients underwent radiosurgical treatment. In the main group (BEV+) 21 patients after stereotactic radiosurgery (SRS) underwent antiangiogenic therapy with Bevacizumab (BEV). In the control group (BEV–), 24 patients did not receive antiangiogenic therapy after SRS. SRS with the use of a linear accelerator «Trilogy» (6 MeV) using intensity-modulated radiotherapy (IMRT). BEV was administered intravenously, once every 3 weeks at a dose of 10 mg / kg body weight. Antiangiogenic therapy was performed under the condition of preserved liver and kidney function, values of full blood count and blood biochemistry within normal range. Global health status and headache levels were calculated according to EORTC QLQ-C30 v. 3.0 and QLQ-BN20 before and six weeks after radiosurgery in the main and control groups. Results. There was no a statistically significant difference between the studied groups of patients’ in quality of life (p = 0.707372) and in headache level (p = 0.846660) before the SRS. Six weeks after SRS, patients in the main group had a statistically significantly higher quality of life (p = 0.000015) and a lower level of headache than patients in the control group (p = 0.000035). During the observation period in patients of both groups there were no adverse events of III-IV degree of toxicity, in particular specific complications of antiangiogenic therapy (hypertension, bleeding, thromboembolism, leukopenia, proteinuria, gastrointestinal disorders, etc.). Conclusions. Antiangiogenic therapy statistically significantly improves the quality of life and reduces the level of headache in patients who underwent radiosurgical treatment for glioblastoma recurrence.


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