scholarly journals Features of clinical course and treatment principles of endodontic-periodontal lesions

2018 ◽  
Vol 99 (3) ◽  
pp. 362-368 ◽  
Author(s):  
P I Moroz ◽  
A K Iordanishvili ◽  
V A Prohodnaya ◽  
S Yu Maxyukov ◽  
A V Safronenko ◽  
...  
Keyword(s):  
Monitoring System ◽  
Clinical Course ◽  
Combined Treatment ◽  
Age Groups ◽  
Periodontal Treatment ◽  
Clinical Group ◽  
Periodontal Tissues ◽  
Infection Focus ◽  
Group 2

Aim. To study the characteristic differences in the clinical course of chronic generalized periodontitis in the presence of periapical infection focus and the principles of combined treatment of endodontium and periodontium. Methods. A clinical and X-ray examination of 1525 patients of different age groups was performed. As a result, a clinical group of 68 patients with chronic generalized moderate and severe periodontitis was formed, who were divided into two groups depending on the presence or absence of periapical destruction. In group 1, 32 patients with the presence of chronic generalized periodontitis and signs of chronic apical periodontitis were united. Group 2 included 36 patients with chronic generalized periodontitis and no periapical infection and damage. The index estimation of the periodontal tissues state in the dynamics of combined endodontic and periodontal treatment was performed. Results. The initial task of treating endodontic periodontal lesions, regardless of the localization of the primary lesion focus, is the elimination or reversal of chronic periapical inflammatory processes of the teeth. The proposed monitoring system in the course of treatment and dynamic follow-up for 18 months for patients suffering from endodontic periodontal lesions using clinical and radiological methods of examination involves: (1) interim epicrisis or conclusion about negative or positive compliance 1-2 months after the completion of endodontic treatment and hygiene procedures; (2) periodontal treatment (according to indications) with the assessment of clinical efficacy 6 and 12 months after the start of treatment; (3) epicrisis after 18 months. Conclusion. The use of proposed concept of complex treatment of endodontic-periodontal lesions, monitoring system in the course of dental therapeutic and preventive measures and dynamic follow-up for 18 months allows achieving positive compliance in 85% of patients according to the clinical examination and in 80% of patients according to radiologic examination.

scholarly journals The Effect of Manual Therapy and Stabilizing Exercises on Forward Head and Rounded Shoulder Postures: a six-week intervention with a one-month follow-up study (Preprint)

2017 ◽  
Author(s):  
Kiana Fatholahnezhad ◽  
Amir Letafatkar ◽  
Malihe Hadadnezhad
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Combined Treatment ◽  
Control Group ◽  
Post Intervention ◽  
Before And After ◽  
Group 2 ◽  
And Function ◽  
Group 1

BACKGROUND forward head and round shoulder posture is believed to alter scapular kinematics and muscle activity placing increased stress on the shoulder, leading to shoulder pain and dysfunction. OBJECTIVE The purpose of this study was to evaluate the effect of a six-week combined treatment consisting of manual therapy and stabilizing exercises, with a one-month follow-up, on neck pain with forward head and rounded shoulder postures. METHODS A total of 60 women aged 32-42 years of age with neck pain, and forward head and rounded shoulder postures were randomized into three groups: group 1 performed stabilizing exercises and received manual therapy (n=20), group 2 performed stabilizing exercises (n=20), and group 3 (control group) performed home exercises (n=20) over six weeks.The follow-up time was one month after the post test. The craniocervical and rounded shoulder angles, pain, and function were measured before and after six-week interventions, and a one-month follow- up. RESULTS The results showed significant positive changes within the experimental groupsin all variables, but there were minor changes in the control group in all variables before and after the intervention. Also, there were significant function and pain improvement in the experimental group 1 comparing to group 2. There were no differences between post intervention and one-month follow-up on posture and function in the experimental groups. CONCLUSIONS These findings suggest that both interventions were significantly effective for reducing neck pain, and improving function and posture in patients with chronic neck pain, and forward head and rounded shoulder postures. However, the improvement in function and pain was more effective in group 1 than those of group 2 suggesting that manual therapy can be used as a supplement method to the stabilizing intervention in the treatment of neck pain. More research is needed to confirm the result of this study.

Evaluation von Messmethoden zur Erfassung der Durchblutung bei chronischer kritischer Extremitätenischämie

VASA ◽  
2002 ◽  
Vol 31 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Zwicky ◽  
Mahler ◽  
Baumgartner
Keyword(s):  
Clinical Improvement ◽  
Clinical Course ◽  
Limb Ischemia ◽  
University Hospital ◽  
Poor Correlation ◽  
Capillary Microscopy ◽  
Chronic Critical Limb Ischemia ◽  
Group 2 ◽  
The University

Background: Evaluation of macro- and microcirculatory tests to confirm diagnosis, and recognize perfusion changes in chronic critical limb ischemia (CLI). Patients and methods: Forty-two consecutive patients with CLI examined at the University Hospital Bern, with 21 included in this prospective follow-up analysis. Patients underwent serial clinical examinations, and assessment of the macro- (ankle arterial pressure [AP], great toe pressure [TP], oscillography) and microcirculation (transcutaneous partial oxygen pressure [tcPO2] recumbent, sitting, O2-inhalation; capillary microscopy) at baseline, 6 weeks after revascularization (group 1; [n = 11]), or after 10 weeks in patients unsuitable for revascularization (group 2; [n = 10]). Clinical improvement was considered to indicate increased perfusion. Results: Eleven patients with revascularization (11/11), and 2 without revascularization (2/10) showed clinical improvement. AP measurements were not reliable or feasible in 9 (43%), TP in 4 patients (19%), respectively. All measurable pressures were in accordance to clinical course. Oszillography gave a moderate perception of perfusion changes. Baseline tcPO2 levels were critical (< 30 mmHg) in all 21 patients, whereas follow-up gave poor correlation with the clinical course. Reliability to detect perfusion changes increased by adding provocation manoeuvers in patients with clinical improvement (39% [5/13] recumbent, 77% [10/13] sitting, 85% [11/13] O2-inhalation). Capillary microscopy revealed a relevant pathology at the forefoot level in all patients with feasible examinations (18/21), and significant improvements according to the clinical course in 92% of patients (12/13). Conclusions: TP measurements represented most reliable test to confirm diagnosis and disclose improved perfusion in CLI. TcPO2 measurements in recumbent position gave unreliable results, improved by provocation manoeuvers. Capillary microscopy was reliable, but time consuming and limited by anatomical restrictions.

Multiple evanescent white dot syndrome: clinical course and factors influencing visual acuity recovery

2020 ◽  
pp. bjophthalmol-2020-317357
Author(s):  
Francesca Bosello ◽  
Mark Westcott ◽  
Giuseppe Casalino ◽  
Georgios Agorogiannis ◽  
Rocco Micciolo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Near Infrared ◽  
Clinical Course ◽  
Fundus Autofluorescence ◽  
Young Age ◽  
Imaging Features ◽  
Near Infrared Reflectance ◽  
White Dot Syndrome ◽  
Group 2

ObjectiveTo report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery.MethodsThis is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 <0.18 LogMAR. All patients had non-invasive multimodal imaging including optical coherence tomography, near-infrared reflectance imaging and blue fundus autofluorescence at presentation and during follow-up.ResultsA total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X2=8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery.ConclusionsAlthough the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings.

scholarly journals Increased FVIII and Anti-Phospholipid Antibodies Do Not Modify the Clinical Course of Chronic Immune Thrombocytopenia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5013-5013
Author(s):  
Meet Kumar ◽  
Maitryee Bhattyacharyya ◽  
Shyamali Datta
Keyword(s):  
Platelet Count ◽  
Lupus Anticoagulant ◽  
Immune Thrombocytopenia ◽  
Clinical Course ◽  
Conflicts Of Interest ◽  
Age Groups ◽  
Platelet Counts ◽  
Bleeding Score ◽  
Chronic Immune Thrombocytopenia

Abstract INTRODUCTION: Immune thrombocytopenia is a heterogenous disease with majority patients having a mild bleeding phenotype and one-fourth being asymptomatic. Bleeding episodes are usually seen in patients with platelet counts typically <30,000/cumm. There is no study till date to identify patients with platelet count <30,000/cumm and at high risk for bleeding. Although patients who harbor anti phospholipid antibodies have a higher risk of arterial and venous thrombosis, it is not known whether presence of acquired thrombophilia modifies the clinical course of bleeding in low platelet count ITP patients. We evaluated the role of FVIII and lupus anticoagulant in modifying the clinical course of such patients. MATERIALS AND METHODS: Patients of all age groups with persistent and chronic immune thrombocytopenia were eligible for study enrolment. Patients with acute ITP and secondary ITP were excluded. Eligible patients were evaluated with baseline parameters, ITP bleeding score (ITP-BAT, version 1.0 by IWG on ITP) at baseline and then at every visit and FVIII and lupus anticoagulant at baseline and repeat at six months.Patients were called for monthly scheduled visits if platelet counts were >30,000/cummand more frequently at lower platelet counts. Patients with any evidence of underlying infection or raised c-reactive protein and procalcitonin were deferred evaluation.All patients were treated as per institutional protocol to avoid treatment bias. Patients were followed up for one year. We finally calculated the average bleeding scores of all patients at different platelet counts (for eg. average of skin, mucosal and organ bleeding scores of all patients that had platelet counts <10,000/cumm, 10-30,000/cumm etc) and analysed it with FVIII and anti-phospholipid antibody levels. RESULTS: A total of 45 patients were enrolled with M:F=1:3.2. Median age of patients is 28years (3-72 years). Two patients were excluded (both progressed to SLE) and another two were lost to follow-up. Median duration from ITP diagnosis to study enrolment was 62.4months (8-590 months). Median follow-up of all patients was 14.2 months (13.2-16.4 months). Nine patients had persistent and 32 patients had chronic ITP. ITP-BAT could differentiate intensity of bleeding at different platelet counts by means of bleeding scores (Table 1). Correlation of bleeding scores with prothrombotic markers could not establish a disease course modifying relationship between the two (Table 2). CONCLUSION: Presence of high FVIII and anti phosphoilipid antibodies donot modify the bleeding risks in patients with ITP and low platelet counts. Table 1Platelet count (x109/cumm)Total episodesAverage bleeding scoreP value<1014S2.4 M1.4 O0 0.00210-3015S1.4 M0.9 O030-6018S0.3 M0.1 O0>600S0 M0 O0 Table 2 Platelet count <10,000/cumm Platelet count 10-30,000/cumm N Av BS P= N Av BS P= FVIII>150 5 S2.5M1.1O0 0.02 6 S1.1M0.8O0 0.1 FVIII<150 9 S2M0.7O0 11 S1.4M0.6O0 LA1:LA2>2 1 S2.2M1.5O0 0.03 S1.1M0.8O0 0.2 LA1:LA2<1 12 S2.6M1.2O0 S1.2M0.6O0 Table 3 Platelet count 30-60,000/cumm Av BS P= FVIII>150 4 S0.9M0.1O0 0.2 FVIII<150 11 S0.3M0.1O0 LA1:LA2>2 Nil LA1:LA2<1 9 S1.1M0.4O0 Disclosures No relevant conflicts of interest to declare.

scholarly journals P1112COMPARISON OF EFFICACY BETWEEN MAINTENANCE HEMODIALYSIS AND THEIR COMBINATION WITH HEMOPERFUSION IN PATIENTS UNDERGOING CHRONIC HEMODIALYSIS TREATMENT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Amela Beciragic ◽  
Alma Mutevelic-Turkovic ◽  
Badema Äœengiä† Roljiä† ◽  
Fahrudin Masnic ◽  
Aida Coric ◽  
...  
Keyword(s):  
Statistical Difference ◽  
Combined Treatment ◽  
Serum Levels ◽  
Uremic Toxins ◽  
Maintenance Hemodialysis ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims The occurance of mid- and longterm uremic complications is related to the low clearance rate of middle and large molecule uremic toxins when hemodialysis (HD) alone is adopted. As the uremic toxins and their corresponding biological effects become increasingly clear, blood purification treatment that aims to remove these toxins, has developed from a stage of life-sustaining to improving the quality of life. The objective of this study was to evaluated demographic, clinical and laboratory data in patients who underwent the combination of maintenance hemodialysis with hemoperfusion (HP) and in those who recieved HD alone and to investigate whether this combination could improve the clearance rate of middle and large molecule uremic toxins. Method A total of 26 patients, who underwent routine hemodialysis, were assessed in this study. Those patients were randomly divided into three groups: Group 1 (7 patients) received combined treatment of HD with HP biweekly (HD 2 times a week with HD+HP once a week), whereas Group 2 (10 patients) was given HD with high flux dialyzer and Group 3 (9 patients) was given HD with low flux dialyzer 3 times a week. This study was followed for 4 months. Before and after the observational period demographic and clinical data were taken from the medical history and blood samples were taken for hemoglobin (Hb), iron (Fe), total iron binding capacity (TIBC), albumin (Alb), calcium (Ca), phosphorus (P04) and parathyroid hormone (PTH). Results This study included 13 female and 13 male patients with a mean age of 41, 62 + 11.12 and a mean dialysis duration of 62, 78+53, 33 months. When it comes to baseline characteristics, patients of the group 3 were significantly older than patients in other groups (p=0.001). At the end of the four months observation period, the same difference according to age was noticed (p=0.01). Also, HD+HP group had significantly higher values of TIBC (p=0.006) and significantly lower serum levels of P04 (p=0.001). EPO doses were very similar in group 1 and 2, but in group 3 there were noticeably lower than in those two groups but without a significant difference. The serum levels of albumin were higher in group 3 compared to the other two groups but also without statistical difference. No statistical difference between groups after the follow up period was observed in terms of Hb, Fe, PTH, Ca, BMI, duration of dialysis treatment and vascular access. When groups are viewed individually, in the HD+HP group serum P04 levels were significantly lower after the 4 months off the follow up period than it was at the beginning (p=0.031) and also TIBC was significantly higher (p=0.018). In group 2 the values of TIBC were significantly lower after the follow up period than it was at the beginning (p=0.025). No significant difference was noticed in group 3 but serum PTH levels tends to decrease after 4 months compared to baseline measurement. Conclusion This combination treatment of HD with HP was superior to HD in reducing levels of phosphorus. These findings suggests a potential role of reducing the risk of cardiovascular events in this population especially when it is known that hyperphosphatemia has been pointed out as the primary culprit in the process of cardiovascular calcification. Also, patients who underwent the combined treatment showed higher values of TIBC but unfortunately no difference was noticed between Hb levels and EPO doses. These results eventually demonstrates their role in the improvement of renal disease anemia, which opens up the possibility of further research on a larger sample and over a longer period of time.

scholarly journals THE APPROVAL OF COMPLEX TREATMENT EFFECTIVENESS OF GENERALIZED PERIODONTITIS FOR THE PATIENTS AFTER TRANSMITTED CORONAVIRUS DISEASE AND REMAIN ON REHABILITATION

2021 ◽  
pp. 5-9
Author(s):  
T.I. Matviykiv ◽  
M.M. Rozhko
Keyword(s):  
Oral Cavity ◽  
Risk Groups ◽  
Root Surface ◽  
Pulmonary Complications ◽  
Periodontal Treatment ◽  
Dental Patients ◽  
Periodontal Tissues ◽  
Significant Difference ◽  
Boiled Water

Generalized periodontitis is one of the most common dental diseases. This pathology very often occurs, progresses or exacerbates on the background of concomitant somatic pathologies, such as diabetes, obesity, aging, hypertension, and in the last year, coronavirus disease. The main mechanisms or causal relationships of these pathologies with dental status have not been studied enough. The course of generalized periodontitis includes inflammatory-dystrophic, dysbiotic manifestations that affect periodontal tissues and may have systemic consequences. Interestingly, these same factors are widely associated with the progression or severe coronavirus disease caused by the coronavirus type SARS-CoV-2. However, the assessment of oral health, including the condition of periodontal tissues for the patients diagnosed with COVID-19 has not been studied and has not been widely described in the scientific literature. The course of generalized periodontitis associated with severe COVID-19 might help to identify the risk groups and establish appropriate recommendations for the treatment and follow-up of this group of dental patients and will allow choosing the effective treatment of periodontal disease for such patients, which is one of the most pressing tasks of modern dentistry today. The study aims to evaluate the effectiveness of standard and proposed comprehensive periodontal treatment, taking into account the mobility of teeth, determining the depth of periodontal pockets, and the level of epithelial attachment for the periodontal patients with lung diseases caused by coronavirus infection in rehabilitation. We examined, observed, and treated 60 dental patients diagnosed with generalized I-II stage periodontitis (chronic course) who were treated in the hospital for pulmonary complications of COVID-19 and were in rehabilitation at the time of the study. The duration of treatment and observation is approximately 7-10 days and 30 days after discharge from the hospital. 30 patients (Group A) were treated according to the standard treatment protocol, and the other 30 patients (Group B) were treated accordingly to the proposed complex. The patients were examined based at the University Clinic of Ivano-Frankivsk National Medical University in the clinic of the Therapeutic Dentistry Department. The age of the examined patients ranged from 25 to 61 years, including 30 women and 30 men. Both standard and proposed algorithms of procedures for treating the first stage included thorough removal of all local irritants of periodontal tissues, mechanical treatment of the tooth root surface, manual and ultrasonic scaling, removal of super- and subgingival soft and hard dental deposits, smoothing of the root surface with the following polishing of the treated surfaces and applying a desensitizer. The local drug therapy, according to the standard protocol, consisted of antiseptic treatment of the oral cavity, irrigation of periodontal pockets with an antiseptic solution; application of sorbent on the gums for 10 minutes, followed by application of the pharmaceutical preparation in gel form which contains chlorhexidine in a stable concentration of 0.25% and metronidazole 10% under the insulating cap. The treatment was completed by applying "Solcoseryl-dental adhesive paste". All the patients were prescribed a multivitamin-microelement complex, as well as hyposensitizing therapy, and oral care products were individually selected. According to the algorithm of the proposed additional local drug treatment we conducted a course of instillation into the periodontal pockets, by introducing cotton swabs soaked in 2% solution of Protargol, for 7-10 15-20 minute sessions; followed by simultaneous application of Resistol solution (from Pelargonium sidoides roots extract), which was pre-dissolved in 50 ml of boiled water and was used to rinse the oral cavity and swallowed according to the scheme: 1st week – 30 drops for solution 3 times a day, 2nd week – 20 drops 3 times a day which should be continued for up to 1 month. Then we recommended to use "Gingigel", a hyaluronic acid-based gel, which is applied on the gums with clean fingers, by gently massaging and evenly distributing it on the surface of the gingival mucous membrane, 3-4 times a day for 3-4 weeks; 8 tablets of "Imudon" a day should be taken orally for 14 days, followed by subsequent reduction to 4 tablets per month, while the tablets are absorbed in the mouth with an interval of 1-2 hours. In addition, we prescribed "ELGYDIUM", a therapeutic and prophylactic toothpaste with chlorhexidine, as well as antibacterial solution of "Chlorhexidine-Denta" 0.12%, for 14 days, which is then replaced with sea salt-based toothpaste "Parodontax" and rinsing the mouth twice a day with 15% aqueous solution of "Stomatofit" according to the scheme: dilution of 10 ml of the drug in 1/4 cup of boiled water during the next months. The received results of the clinical study revealed that generalized periodontitis associated with COVID-19 has an extremely aggressive clinical manifestation. Treatment and follow-up of dental patients with severe COVID-19 can help identify risk groups and establish appropriate recommendations for the effectiveness of standard and proposed comprehensive periodontal treatment. The comparison of the effectiveness of treatment protocols for the patients diagnosed with generalized periodontitis and those hospitalized for pulmonary complications of coronavirus did not reveal a significant difference in the obtained clinical data on the choice of treatment. Examination of areas compromised by generalized periodontitis and abutment teeth based on the obtained periotestometric data of tooth mobility, indicates a significant reduction in inflammation and strengthening of the ligaments and is a highly informative diagnostic method.

scholarly journals Development of a Web-Based Monitoring System for Power Tilt-in-Space Wheelchairs: Formative Evaluation (Preprint)

2019 ◽  
Author(s):  
Charles Campeau-Vallerand ◽  
François Michaud ◽  
François Routhier ◽  
Philippe S Archambault ◽  
Dominic Létourneau ◽  
...  
Keyword(s):  
Monitoring System ◽  
Formative Evaluation ◽  
Age Groups ◽  
Feedback System ◽  
Evaluation Framework ◽  
Web Interface ◽  
Web Based ◽  
Wheelchair Users ◽  
The Web

BACKGROUND A power tilt-in-space wheelchair meets many clinical purposes, including pressure management, increased postural control, and pain management. However, there is a significant gap between the use of tilt as recommended by clinicians and its actual usage. A Web-based electronic health (eHealth) intervention, including a goal setting, monitoring, reminder, and feedback system of the use of power tilt-in-space wheelchairs was developed. The intervention incorporates behavior change principles to promote optimal use of tilt and to improve clinical postprocurement follow-up. OBJECTIVE This study aimed to conduct a formative evaluation of the intervention prototype to pinpoint the functionalities needed by end users, namely, power wheelchair users and clinicians. METHODS On the basis of an evaluation framework for Web-based eHealth interventions, semistructured interviews were conducted with power wheelchair users and clinicians. A content analysis was performed with a mix of emerging and a priori concepts. RESULTS A total of 5 users of power tilt-in-space wheelchairs and 5 clinicians who had experience in the field of mobility aids aged 23 to 55 years were recruited. Participants found the Web interface and the physical components easy to use. They also appreciated the reminder feature that encourages the use of the tilt-in-space and the customization of performance goals. Participants requested improvements to the visual design and learnability of the Web interface, the customization of reminders, feedback about specific tilt parameters, and the bidirectionality of the interaction between the user and the clinician. They thought the current version of the intervention prototype could promote optimal use of the tilt and improve clinical postprocurement follow-up. CONCLUSIONS On the basis of the needs identified by power wheelchair users and clinicians regarding the prototype of a power tilt-in-space wheelchair monitoring system, 3 main directions were defined for future development of the intervention. Further research with new wheelchair users, manual tilt-in-space wheelchairs, various age groups, and family caregivers is recommended to continue the formative evaluation of the prototype.

scholarly journals Assesment of the treatment of earlobe keloids with triamcinolone injections, surgical resection, and local pressure

2015 ◽  
Vol 42 (1) ◽  
pp. 09-13 ◽  
Author(s):  
Silvia Mandello Carvalhaes ◽  
Andy Petroianu ◽  
Mauro Augusto Tostes Ferreira ◽  
Virgínea Magalhães de Barros ◽  
Raquel Virgínea Lopes
Keyword(s):  
Combined Treatment ◽  
Surgical Excision ◽  
Local Pressure ◽  
Local Infiltration ◽  
Pressure Application ◽  
Group 3 ◽  
Group 2 ◽  
Lesion Treatment ◽  
Group 1

OBJECTIVE: To evaluate the combined treatment of ear lobe keloids. METHODS: We studied 46 consecutive patients with 81 ear lobe keloids. Patients underwent local infiltration of triamcinolone acetonide (TCN) at concentrations of 40mg/ml (Group 1), 20 mg/ml (Group 2) and 10mg/ml (Group 3). The volume of TCN infiltrate varied according to the size of the lesion. Treatment consisted of three monthly injections before surgery, excision of keloid in the fourth month and perioperative infiltration, followed by two more leaks TCN within two months. Patients used earrings pressure on the scar after operation for four months. The pressure exerted by earrings in the ear lobe was measured electronically. Post-treatment follow-up of patients was 24 months. RESULTS: TCN at concentrations of 20mg/ml and 40mg/ml were effective for the treatment of keloids, no difference between the groups (p = 0.58). However, patients in which TCN was infiltrated the 10mg/ml had poor involution of keloid and the study of this group was stopped. CONCLUSION: the combination of infiltration TCN month to 20 mg/mL (1.2mg to 2.0mg per mm3 TCN injury), surgical excision and pressure application device is effective for treatment of keloid ear lobe.

scholarly journals Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination

2017 ◽  
Vol 89 (2) ◽  
pp. 127-137 ◽  
Author(s):  
Sudarshini Ramanathan ◽  
Shekeeb Mohammad ◽  
Esther Tantsis ◽  
Tina Kim Nguyen ◽  
Vera Merheb ◽  
...  
Keyword(s):  
Clinical Course ◽  
Oral Prednisone ◽  
Age Groups ◽  
Acute Disseminated Encephalomyelitis ◽  
Brain Lesions ◽  
Expanded Disability Status Scale ◽  
Dominant Phenotype ◽  
Disability Status ◽  
Relapse Rates

ObjectiveWe characterised the clinical course, treatment and outcomes in 59 patients with relapsing myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination.MethodsWe evaluated clinical phenotypes, annualised relapse rates (ARR) prior and on immunotherapy and Expanded Disability Status Scale (EDSS), in 218 demyelinating episodes from 33 paediatric and 26 adult patients.ResultsThe most common initial presentation in the cohort was optic neuritis (ON) in 54% (bilateral (BON) 32%, unilateral (UON) 22%), followed by acute disseminated encephalomyelitis (ADEM) (20%), which occurred exclusively in children. ON was the dominant phenotype (UON 35%, BON 19%) of all clinical episodes. 109/226 (48%) MRIs had no brain lesions. Patients were steroid responsive, but 70% of episodes treated with oral prednisone relapsed, particularly at doses <10 mg daily or within 2 months of cessation. Immunotherapy, including maintenance prednisone (P=0.0004), intravenous immunoglobulin, rituximab and mycophenolate, all reduced median ARRs on-treatment. Treatment failure rates were lower in patients on maintenance steroids (5%) compared with non-steroidal maintenance immunotherapy (38%) (P=0.016). 58% of patients experienced residual disability (average follow-up 61 months, visual loss in 24%). Patients with ON were less likely to have sustained disability defined by a final EDSS of ≥2 (OR 0.15, P=0.032), while those who had any myelitis were more likely to have sustained residual deficits (OR 3.56, P=0.077).ConclusionRelapsing MOG antibody-associated demyelination is strongly associated with ON across all age groups and ADEM in children. Patients are highly responsive to steroids, but vulnerable to relapse on steroid reduction and cessation.

School children systolic and diastolic blood pressure values: YUSAD study

Open Medicine ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. 634-639
Author(s):  
Zeljka Milincic ◽  
Dejan Nikolic ◽  
Slavko Simeunovic ◽  
Ivana Novakovic ◽  
Ivana Petronic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Fluctuations ◽  
Age Groups ◽  
Old Patients ◽  
Hypertensive Group ◽  
Group 3 ◽  
Group 2

AbstractThe aim of the study was to analyze changes of systolic and diastolic blood pressure values over five and ten years separately boys and girls and to estimate correlation between them. Three age groups from 8 centers in Serbia were evaluated: Group 1: 10 year old patients, Group 2: 15 year old and Group 3: 20 year old. Group with normal blood pressure values, prehypertensive and hypertensive group were analyzed. Regarding the period of follow-up we analyzed: 10/15 years period-children between 10 and 15 years, 15/20 years period-children between 15 and 20 years, and 10/20 years period-children between 10 and 20 years. Significant increase of diastolic blood pressure was noticed for both genders in 10/15 years period of prehypertensive population, while in hypertensive children, boys showed decline in frequency for systolic and diastolic blood pressure and girls only for diastolic. In 15/20 years period there was significant decrease of prehypertensive and significant increase of hypertensive diastolic blood pressure frequency. In 10/20 years period significant reduction in frequency of prehypertensive systolic blood pressure was noticed, while only hypertensive group of boys showed significant reduction regarding systolic blood pressure frequency. Prehypertensive diastolic and hypertensive systolic blood pressure fluctuations are more related to age.

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