A prospective study of fistula in ano with reference to clinicopathology, imaging and management

Background: The aim was to study and review clinical presentation, pathological aspects & prevalent modalities of investigation and treatment for fistula in ano.Methods: A prospective study of 90 patients of fistula in ano admitted from March 2015 to December 2016 was done. Fistulography was done as a preliminary investigation in 72 cases and MR Fistulography was done for complex and recurrent fistula (16 cases). Patients were operated and histopathology of fistula tract was done. In patients with clinical suspicion of tuberculosis smear examination of pus with ziehl neelsen staining for acid fast bacilli (AFB) and Cartridge Based Nucleic Acid Amplification Test (CBNAAT) on pus/slide was used to find out tuberculosis in patients of anal fistula. The clinical presentation, operation performed, pathological findings were recorded & a descriptive analysis was done.Results: A prospective study of 90 patients of fistula in ano admitted from March 2015 to December 2016 was done. Fistulography was done as a preliminary investigation in 72 cases and MR Fistulography was done for complex and recurrent fistula (16 cases). Patients were operated and histopathology of fistula tract was done. In patients with clinical suspicion of tuberculosis smear examination of pus with ziehl neelsen staining for acid fast bacilli (AFB) and Cartridge Based Nucleic Acid Amplification Test (CBNAAT) on pus/slide was used to find out tuberculosis in patients of anal fistula. The clinical presentation, operation performed, pathological findings were recorded & a descriptive analysis was done.Conclusions: With careful clinical evaluation, appropriate imaging studies and conventional surgical techniques anal fistula can be treated effectively with less morbidity, incontinence and recurrence.

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Faculty Opinions recommendation of Fistulotomy with end-to-end primary sphincteroplasty for anal fistula: results from a prospective study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717972487.793469665 ◽

2013 ◽

Author(s):

Filippo La Torre

Keyword(s):

Prospective Study ◽

Anal Fistula ◽

End To End ◽

A Prospective Study

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Attendance, activation and health profiles of participants, a prospective study on a regional cardiometabolic disease self-management program in Laval, Canada

BMC Public Health ◽

10.1186/s12889-021-10558-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Magali Girard ◽

Janusz Kaczorowski ◽

Marie-Thérèse Lussier ◽

Vivianne Martin

Keyword(s):

Primary Care ◽

Waist Circumference ◽

Prospective Study ◽

Cardiovascular Health ◽

Descriptive Analysis ◽

Management Program ◽

Self Management ◽

Controlled Study ◽

Cardiometabolic Disease ◽

A Prospective Study

Abstract Background Chronic diseases are responsible for over 70% of all deaths globally. While some self-management programs have been shown to be efficacious in preventing or altering trajectories for some chronic conditions, scaling-up and sustaining such programs beyond tightly-controlled study conditions remain a major challenge. CISSS-Laval partnered with the Cardiovascular Health Awareness Program team to co-develop Cible-santé/prévention and evaluate the first cohort of participants enrolled in the program, in order to better understand the program’s implementation and scope. The objective of the current study was to describe the profile of attendees and the level of engagement of participants in a new, region-wide cardiometabolic disease self-management program offered in Laval, Canada. Methods This was a prospective study with no comparison group. Potential participants were identified and referred to the program from April to December 2015 by their primary care health professional practicing in one of the city’s interdisciplinary primary care clinics. They had their blood pressure, waist circumference and body mass index measured by trained volunteers, and completed a questionnaire on health habits, level of activation and the risk of developing prediabetes and type 2 diabetes over the next 10 years. Results A descriptive analysis of the first cohort of 141 Cible-Santé/prévention participants showed very low attendance. Furthermore, only 1 in 10 of enrolled participants completed the full program. The program typically attracted adults with some risk factors associated with their conditions (high waist circumference, obesity), but with an already high level of knowledge, skills and confidence to participate in self-management activities. Conclusion This study provides a portrait of new participants to a self-management cardiometabolic disease program, which highlights the potential of supporting patients ready to make changes but also exposes the difficulty of attracting a larger number and diversity of participants and in encouraging completion of the program.

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Clinical presentation, outcomes and factors associated with mortality: a prospective study from three COVID-19 referral care centers in West Africa

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2021.05.024 ◽

2021 ◽

Author(s):

Marie Jaspard ◽

Mamadou Saliou Sow ◽

Sylvain Juchet ◽

Eric Dienderé ◽

Beatrice Serra ◽

...

Keyword(s):

West Africa ◽

Prospective Study ◽

Clinical Presentation ◽

Factors Associated ◽

A Prospective Study

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Neuropathic Pain in Children with Sickle Cell Disease: The Hidden Side of the Vaso-Occlusive Crisis

Children ◽

10.3390/children8020084 ◽

2021 ◽

Vol 8 (2) ◽

pp. 84

Author(s):

Jeanne Sigalla ◽

Nathalie Duparc Alegria ◽

Enora Le Roux ◽

Artemis Toumazi ◽

Anne-Françoise Thiollier ◽

...

Keyword(s):

Risk Factors ◽

Neuropathic Pain ◽

Sickle Cell Disease ◽

Sex Ratio ◽

Prospective Study ◽

Sickle Cell ◽

Clinical Presentation ◽

Early Stage ◽

Cell Disease ◽

A Prospective Study

The majority of hospitalizations of patients with sickle cell disease (SCD) are related to painful vaso-occlusive crises (VOCs). Although the pain of VOC is classically nociceptive, neuropathic pain (NP) has also been demonstrated in SCD patients. The aim of our study is to specify the prevalence of NP during VOCs in SCD children using a dedicated scale and to measure its characteristics. We performed a prospective study that included SCD children hospitalized for an acute VOC. The presence of NP was sought with the DN4 scale on the second and fourth days of hospitalization. A total of 54 SCD children were included in the study. Overall, 41% of the patients (n = 22) experienced neuropathic pain during the VOC, mostly at an early stage (Day 2). The median age, the sex ratio, the location of the pain, and the morphine consumption were similar for patients with and without NP. Our study shows that neuropathic pain is very common during VOCs in SCD children. The absence of identified risk factors should prompt us to be vigilant regardless of the patient’s age, sex, and clinical presentation.

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The Use of Seton as a Bridge to Definitive Ligation of the Intersphincteric Fistula Tract Procedure for Fistula-in-ano: A Systematic Review and Meta-analysis

Journal of Coloproctology ◽

10.1055/s-0041-1730039 ◽

2021 ◽

Author(s):

Carlos Placer-Galán ◽

Jose Mª Enriquez-Navascués ◽

Tania Pastor-Bonel ◽

Ignacio Aguirre-Allende ◽

Yolanda Saralegui-Ansorena

Keyword(s):

Systematic Review ◽

Anal Fistula ◽

Meta Analysis ◽

Fistula Tract ◽

Cochrane Library ◽

Fistula In Ano ◽

Intersphincteric Fistula ◽

The Impact ◽

Seton Placement ◽

Primary Healing

Abstract Background There is still controversy over the usefulness of seton placement prior to the ligation of the intersphincteric fistula tract (LIFT) surgery in the management of anal fistula. Objective To evaluate the impact of preoperative seton placement on the outcomes of LIFT surgery for the management of fistula-in-ano. Design systematic review and meta-analysis. Data Sources A search was performed on the MEDLINE (PubMed), EMBASE, Scopus, Web of Science, Cochrane Library and Google Scholar databases. Study Selection Original studies without language restriction reporting the primary healing rates with and without seton placement as a bridge to definitive LIFT surgery were included. Intervention The intervention assessed was the LIFT with and without prior seton placement. Main Outcome Measures The main outcome was defined as the primary healing rate with and without the use of seton as a bridge to definitive LIFT surgery. Results Ten studies met the criteria for systematic review, all retrospective, with a pooled study population of 772 patients. There were no significant differences in the percentages of recurrence between patients with and without seton placement (odds ratio [OR] 1.02; 95% confidence interval [CI] 0.73–1.43: p = 0.35). The I2 value was 9%, which shows the homogeneity of the results among the analyzed studies. The 10 included studies demonstrated a weighted average overall recurrence of 38% (interquartile range [IQR] 27–42.7%), recurrence with the use of seton was 40% (IQR 26.6–51.2%), and without its use, the recurrence rate was 51.3% (IQR 31.3–51.3%) Limitations The levels of evidence found in the available literature were relatively fair, as indicated after qualitative evaluation using the Newcastle-Ottawa scale and the Attitude Heading Reference System (AHRS) evidence levels. Conclusions Our meta-analysis suggests that the placement of seton as a bridge treatment prior to LIFT surgery does not significantly improve long-term anal fistula healing outcomes. Ligation of the intersphincteric fistula tract surgery can be performed safely and effectively with no previous seton placement.International prospective register of systematic reviews—PROSPERO registration number: CDR42020149173.

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