scholarly journals Combined Treatment Method Comparison Of Medical And Surgical Treatment In Idiopathic Granulomatous Mastitis

2018 ◽  
Vol 5 (4) ◽  
pp. 3737-3742
Author(s):  
Ebubekir Gündeş ◽  
Mehmet Aykut Yildirim ◽  
Tevfik Küçükkartallar ◽  
Faruk Aksoy ◽  
Ahmet Tekin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Combined Treatment ◽  
Granulomatous Mastitis ◽  
Selective Treatment ◽  
Idiopathic Granulomatous Mastitis ◽  
Therapy Algorithm ◽  
Group I ◽  
Significant Difference ◽  
The Mean

Aim:  Our aim in conducting this study was to ascertain the clinical, pathological, and radiological characteristics of patients diagnosed with idiopathic granulomatous mastitis in our clinic and to contribute to related literature by creating a therapy algorithm for granulomatous mastitis. Method: A total of 62 patients diagnosed with granulomatous mastitis in our clinic were classified into three groups as per the mode of treatment they received. Among these, 20 patients who had only been administered corticosteroids were allocated to Group I, while 18 patients who had received surgical treatment in addition to corticosteroid treatment were allocated to Group II, and 24 patients who had only received surgery were allocated to Group III. Results: All the cases were female patients. The mean age of the patients was 33.67 ± 6.35 (21-48). No statistically significant difference was found among the groups as per the mean age figures, pregnancy, breastfeeding, oral contraceptive administration, smoking and alcohol use, and family history (p>0.05). 49 (77.4%) patients were diagnosed with granulomatous mastitis by thick-needle biopsy, 7 (11.2%) by incisional biopsy, 4 (6.4%) by excisional biopsy, and 3 (4.8%) by fine-needle aspiration biopsy (FNAB) before the onset of treatment. The median value for the follow-up of the patients was 40 (6-81) months and there was no statistically significant difference among follow-up periods (p: 0.51). 15 (24.1%) patients among all the cases had recurrence. There was a statistically significant difference among the groups with regards to recurrence (p: 0.015). Conclusion:  Granulomatous mastitis may simulate breast cancer both clinically and radiologically. Recurrence is observed in patients who only received corticosteroid or surgical treatment. The combination of corticosteroid and surgical treatment significantly reduces the rate of recurrence. Therefore, this combination can be recommended as selective treatment.

scholarly journals Surgery of cholesteatoma: Surgical technique and cholesteatoma recurrences

2004 ◽  
Vol 51 (1) ◽  
pp. 103-107
Author(s):  
Nenad Arsovic ◽  
Radomir Radulovic ◽  
Snezana Jesic ◽  
S. Krejovic-Trivic ◽  
P. Stankovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Complete Removal ◽  
Initial Surgery ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Diffuse Form ◽  
Surgical Failure

Past experience with open and closed techniques of tympanoplasty in surgery of cholesteatoma has shown that recurring illness is one of the major causes of surgical failure. The literature has reported varying trend of surgical treatment of cholesteatoma. The objective of the study was to analyze the significance of surgical technique in relation to the incidence and most frequent localization of recurrent cholesteatoma. Our study analyzed 120 patients operated on for cholesteatoma. The patients were divided into two groups, group I (45) with recurring disease and group II (75) without any recurring condition, which were followed up three years. Statistical analysis was carried out by modified t-test. The largest number of patients was re-operated in the first two years from the initial surgery (50%), In the majority of patients (50%), recurrent cholesteatoma was most commonly localized (stage I) in attic (20%) and much rarely in mesotympanum (11,9%). Stage III recurrent cholesteatoma was verified in 35% of patients, most frequently diffuse form (13,4%). The involvement of attic by all three stages of disease accounted for over 60%. The analysis of the used techniques of surgical treatment in both groups revealed significant difference. Open techniques of tympanoplasty were used in 60% of patients with no recurrence. Closed techniques were used more frequently in patients with recurring disease, i.e. in over 90% of cases. Recurrent cholesteatoma develops, in the majority of cases, during the first two years after the surgical intervention. Attic is the most common localization of cholesteatoma. More frequent utilization of open technique of tympanoplasty for surgery of cholesteatoma significantly reduces the incidence of recurring condition. The indications for CWD technique are the initial spread of cholesteatoma, possibility of complete removal of cholesteatoma and postoperative follow-up of patients.

scholarly journals Comparison of Conservative versus Surgical Treatment Protocols in Treating Idiopathic Granulomatous Mastitis: A Meta-Analysis

Breast Care ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 415-420
Author(s):  
Fei Zhou ◽  
Lu Liu ◽  
Liyuan Liu ◽  
Lixiang Yu ◽  
Fei Wang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Breast Disease ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Treatment Protocols ◽  
Significant Difference ◽  
Conservative And Surgical Treatment

Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign breast disease without any definitive therapeutic strategy. It is controversial whether to use conservative or surgical treatment of IGM and high-level evidence-based medicine data are lacking. The purpose of this study was to systemically evaluate the clinical effectiveness of the conservative versus surgical treatment for IGM. Methods: In this meta-analysis, we searched PubMed, EMbase, ScienceDirect, and Web of Science for comparative studies about the conservative versus surgical treatment of IGM. Two researchers independently identified reports and extracted data. We used Stata 11 for data analysis. A meta-analysis was performed to investigate the differences in the recurrence rate of conservative and surgical treatment using a random effects model. Results: A total of 10 studies involving 1,101 patients were included. The results demonstrated that there was no significant difference in the recurrence rate among patients who were treated by nonsurgical therapy and surgical treatment. No publication bias was detected. Conclusion: This meta-analysis demonstrates that both the conservative and surgical treatment approaches have appropriate efficacy in IGM treatment and relapse. Further randomized controlled trials with longer follow-up periods are required to confirm the advantages of each approach.

Prospective cohort study of mild cervical spondylotic myelopathy without surgical treatment

2012 ◽  
Vol 16 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Masatoshi Sumi ◽  
Hiroshi Miyamoto ◽  
Teppei Suzuki ◽  
Shuichi Kaneyama ◽  
Takako Kanatani ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Mr Imaging ◽  
Cervical Spondylotic Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Rank Test ◽  
Imaging Findings ◽  
Significant Difference ◽  
The Mean

Object Because the main pathology of cervical spondylotic myelopathy (CSM) is spinal cord damage due to compression, surgical treatment is usually recommended to improve patient symptoms and prevent exacerbation. However, lack of clarity of prognosis in cases that present with insignificant symptoms, particularly those of mild CSM, lead one to question the veracity of this course of action. The purpose of this study was to elucidate the prognosis of mild CSM without surgical intervention by evaluation of clinical symptoms and MR imaging findings. Methods Sixty cases of mild CSM (42 males and 18 females, average age 57.2 years) presenting with scores of 13 or higher on the Japanese Orthopaedic Association (JOA) scale were treated initially by in-bed Good Samaritan cervical traction without surgery. These patients were enrolled between 1995 and 2003 and followed up periodically until the date of myelopathy deterioration or until the end of March 2009. The deterioration of myelopathy was defined as a decline in JOA score to less than 13 with a decrease of at least 2 points. As a prognostic factor, the authors used their classification of spinal cord shapes at their lateral sides on axial T1-weighted MR imaging. “Ovoid deformity” was classified as a situation in which both sides were round and convex, and “angular-edged deformity” where one or both sides exhibited an acute-angled lateral corner. The duration of follow-up was assessed as the tolerance rate of mild CSM using Kaplan-Meier survival analysis and compared between 2 groups classified by MR imaging findings. Furthermore, differences between groups were analyzed by various applications of the log-rank test. Results Of the initial 60 cases, follow-up records existed for 55, giving a follow-up rate of 91.7% (38 males and 17 females, average age 56.1 years). The mean JOA score at end point was 14.1, which was not statistically different from the mean of 14.5 at the initial visit. Deterioration in myelopathy was observed in 14 (25.5%) of 55 cases, whereas 41 (74.5%) of 55 cases maintained mild extent myelopathy without deterioration through the follow-up period (mean 94.3 months). The total tolerance rate of mild CSM was 70%. However, there was a significant difference in the tolerance rate between the cases with angular-edged deformity (58%) and cases with ovoid deformity (95%; p = 0.049). Conclusions The tolerance rate of mild CSM was 70% in this study, which proved that the prognosis of mild CSM without surgical treatment was relatively good. However, the tolerance rate of the cases with angular-edged deformity was 58%. Therefore, surgical treatment should be considered when mild CSM cases show angular-edged deformity on axial MR imaging, even if patients lack significant symptoms.

scholarly journals Short and Long-Term Follow up Results of Daily 5 Mg Tadalafil as a Treatment for Erectile Dysfunction and Premature Ejaculation

2021 ◽  
Author(s):  
Tarek Gharib ◽  
Ibrahim Abdelal ◽  
Adel Elatreisy ◽  
Elsayed Salih ◽  
Ahmed Sebaey
Keyword(s):  
Erectile Dysfunction ◽  
Premature Ejaculation ◽  
P Value ◽  
Group I ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
The Mean ◽  
Group Ii

Abstract Objective: To evaluate effectiveness and safety of a 5mg tadalafil daily treatment for men with erectile dysfunction (ED) and premature ejaculation (PE) and assessment of long-term follow up by persistence of improvement 2 years after stoppage of tadalafil.Materials and Methods: The study included 160 patients diagnosed with erectile dysfunction from April 2018 to June 2020. All were evaluated using the international index of erectile function questionnaire-5 (IIEF-5) to evaluate ED and intravaginal ejaculatory latency time (IELT) for PE. Patients subdivided into two equal groups. I included 80 patients treated with tadalafil 5 mg daily for 3 months, and group II included 80 patients treated with a placebo for same period. After 3 months treatment and 2 years later after stoppage of tadalafil, all patients were assessed for ED and PE using the same questionnaires. Results: The mean IELT and IIEF pretreatment were 37±11.24 s and 13.2±4.2 respectively for group I, while in group II was 35.98±10.8 s and 13.12±4.11, respectively. After 3 months of treatment, the mean value of IELT in group I showed a highly significant improvement from 37±11.24 sec to 120.5±47.37 sec (p-value < 0.001), but for group II, the mean values of IELT showed no significant improvement from baseline 35.98±10.8 to endpoint 39.43±13.6 ( p-value > 0.05). As regarding the IIEF, there was a highly significant improvement from baseline 13.2±4.2 to endpoint 20.45±4.5 in group I (p-value < 0.001) while there was no significant difference in group II from baseline 13.12±4.11 to endpoint 15±4.84 (p-value > 0.05) . 2 years later after stoppage of tadalafil , 75 patients from group I complete follow up and there was significant improvement in IELT and IIEF form base line (37±11.24) (13.2±4.2) to endpoint (98±18.3) (19.1±2.3) respectively but less than the results after 3 months treatment.ConclusionDaily Tadalafil 5 mg was effective, tolerable, and safe treatment for patients suffering from ED and PE. Long-term follow up after 2 years declared persistence of significant improvement.

Risk factors affecting the development of nephrocalcinosis, the most common complication of hypophosphatemic rickets

2015 ◽  
Vol 28 (11-12) ◽  
Author(s):  
Melikşah Keskin ◽  
Şenay Savaş-Erdeve ◽  
Elif Sağsak ◽  
Semra Çetinkaya ◽  
Zehra Aycan
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Significant Relationship ◽  
Combined Treatment ◽  
Hypophosphatemic Rickets ◽  
Common Complication ◽  
Factors Affecting ◽  
Significant Difference ◽  
The Mean

AbstractThe aim of the present study was to analyse the effects of combined treatment with calcitriol and phosphate, to find out the incidence of the nephrocalcinosis, and to elucidate the risk factor of nephrocalcinosis in patients with hypophosphatemic rickets. We followed six patients. The median age at diagnosis was 3.25 (0.75–10.5) years. The median follow-up duration was 8.25 (3.5–12.5) years. The mean dose of calcitriol and phosphate treatments was 39.1±8 ng/kg/day, 90.5±57.1 mg/kg/day, respectively. Nephrocalcinosis was detected in three patients (50%). The mean dose of phosphate taken by the patients found to have nephrocalcinosis was detected to be high with a statistically significant difference (p=0.041). No significant relationship was found the mean dose of calcitriol. We found no relationship between the development of nephrocalcinosis and the incidence of hypercalciuria or hypercalcemia episodes. We found the increased phosphate dose administered for treatment to play a role in nephrocalcinosis development.

scholarly journals AB1053 EFFECTIVENESS OF METHOTREXATE IN IDIOPATHIC GRANULOMATOUS MASTITIS TREATMENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1816.1-1817
Author(s):  
D. Yalcin Kehribar ◽  
T. Izci Duran ◽  
A. Kamali Polat ◽  
M. Ozgen
Keyword(s):  
Surgical Treatment ◽  
Nipple Discharge ◽  
Treatment Protocol ◽  
Post Treatment ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Clin Pathol ◽  
Methotrexate Treatment

Background:Idiopathic granulomatous mastitis (IGM) is a rare inflammatory disease of the breast [1], for which there is a lack of consensus on the treatment protocol [2, 3]; it requires long-term follow-up and is associated with a high rate of relapse after surgical treatment. In this study, we report on the largest single-center cohort of idiopathic granulomatous mastitis treated with steroids + methotrexate.Objectives:We present this study believing that our experience with patients with IGM and use of steroid + methotrexate treatment in them will contribute to the literature.Methods:We retrospectively examined the data of 33 patients histopathologically diagnosed with idiopathic granulomatous mastitis who were evaluated by our Rheumatology or General Surgery Clinics between 2013 and 2016.Results:Of the 33 female patients (age: 38.64 ± 6.9 years), 24 were admitted with an initial diagnosis of Idiopathic granulomatous mastitis, whereas 9 were admitted after surgical treatment. The breast symptoms and laboratory values of the patients before and after the steroid and methotrexate treatment are shown in Table 1. Remission was achieved in 87.9% patients with steroid + methotrexate treatment, and there were no relapses during the 24-month follow-up.Table 2.Pre- and post-treatment laboratuary and clinical findings.Pre-treatmentPost-treatmentP valueESR (mm/h)42.45±28.8817.24±11.31<0.001*CRP (mg/L)24.72±35.325.37±6.50.004*Mass Size (mm)36.94±16.4010.79±15.01<0.001*Fistula (n)15/33 (45%)2/33(6%)<0.001**Nipple discharge(n)17/33(52%)1/33(3%)<0.001**ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein; *Paired T Test;**Chi-Square test.Conclusion:Methotrexate has so far been added to IGM treatment in order to decrease steroid dosage or to treat relapses, and it has been reported to be effective in case study and a limited number of studies with few patients [2, 4, 5]. Steroid + methotrexate treatment used by us in patients with IGM, which is a rare disease and for which no consensus exists regarding the treatment protocol, is effective and reliable in providing clinical improvement and long-term remission. Therefore, this treatment appears to be successful owing to long-term remission outcomes and very low relapse rates, without the patients having to undergo a surgical procedure and experience the associated anxiety and complications.References:[1]Kessler, E. and Y. Wolloch, Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol, 1972. 58(6): p. 642-6.[2]Schmajuk, G. and M.C. Genovese, First report of idiopathic granulomatous mastitis treated with methotrexate monotherapy. J Rheumatol, 2009. 36(7): p. 1559-60.[3]Patel, R.A., et al., Idiopathic granulomatous mastitis: case reports and review of literature. J Gen Intern Med, 2010. 25(3): p. 270-3.[4]Sheybani, F., et al., Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol, 2015. 125(4): p. 801-7.[5]Aghajanzadeh, M., et al., Granulomatous mastitis: Presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran. Breast, 2015. 24(4): p. 456-60.Disclosure of Interests:None declared

scholarly journals THU0517 THE ROLE OF ULTRASOUND-DEFINED SYNOVITIS GRADE I IN PATIENTS PRESENTING WITH INFLAMMATORY ARTHRALGIA, A RETROSPECTIVE STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 497.2-497
Author(s):  
J. Arroyo Palomo ◽  
M. Arce Benavente ◽  
C. Pijoan Moratalla ◽  
B. A. Blanco Cáceres ◽  
A. Rodriguez
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Arthritis ◽  
Statistical Tests ◽  
Median Number ◽  
Painful Joint ◽  
Significant Difference ◽  
The Mean ◽  
Specialized Unit

Background:Musculoeskeletal ultrasound (MSUS) is frequently used in several rheumatology units to detect subclinical inflammation in patients with joint symptoms suspected for progression to inflammatory arthritis (IA). Synovitis grade I (EULAR-OMERACT combined score) is known to be a casual finding in healthy individuals, but studies headed to unravel its possible role on rheumatic diseases are sparse.Objectives:To investigate the correlation between synovitis grade I, and the diagnosis of IA made after a year follow-up period since MSUS findings, in patients of an MSUS-specialized unit of a Rheumatology Department.Methods:We conducted a descriptive, retrospective and unicentric study. 30 patients were selected from the MSUS-specialized unit of our Rheumatology Department from July-18 to January-19. Patients presenting synovitis grade 0 (exclusively), 2 and/or 3 on combined score were excluded. Data collection at baseline included age, sex, immunological profile and previous physical examination to the MSUS findings, as well as the diagnosis made by the rheumatologist in 1-year visit follow-up: dividing the patient sample into two groups: those who were diagnosed with IA and those not. Non-parametric statistical tests for comparing means were used.Results:The mean age was 51,6 years and 70% were females. 6 (20%) patients were diagnosed with inflammatory arthritis after a year follow-up: 2 (4,8%) psoriatic arthritis, 1 (3,3%) undifferentiated arthritis, 1 (3,3%) rheumatoid arthritis, 1 (3,3%) Sjögren’s syndrome. Non-inflammatory arthropathies were also found 24 (80%), of which, 12 (40%) were non-specific arthralgias and 8 (19%) osteoarthritis.In the group of patients who did not developed an IA the mean C-reactive protein (CPR) value was 3,12 mg/L and erythrocyte sedimentation rate (ESR) was 8,2 mm; all of them were rheumatoid factor (RF) positive and ACPA-negative except one patient. 5 (31,3%) patients presented low antinuclear antibodies (ANAs) levels. In those who HLA B-27 and Cw6 were tested (4,25%); both were negative except for one that was HLA B-27 positive. The median number of swollen and painful joint count was 0, and the mean of joints with MSUS involvement was 3,5; the mean involved metacarpophalangeal (MCP) joints was 1,83; proximal interphalangeal (PIP) joints was 1,48 and distal interphalangeal (DIP) joints 0,21.Among the group of patients that developed an IA the mean of CPR and ESR was 9,27 mg/L and 14,17 mm respectively; 2 (33%) patients were RF- positive, and 1 ACPA-positive. ANAs were positive in 3 cases (50%). The median of swollen joint count was 2 and for painful joint count was 0, the median of joints with MSUS involvement was 4,5. The mean of MSUS involvement was for MCP, PIP and DIP joints: 1,67, 2 and 0. Comparing the means of CPR values in the two groups with Student’s t-test we obtained a statistically significant difference (p=0,023). No other significant differences were found.Conclusion:Despite the limitations and possible statistical bias, the presence of MSUS-defined synovitis grade I and elevated CRP levels could be related to further diagnoses of inflammatory arthropathy. Besides, the absence of synovitis in DIP joints might have a diagnostic role. Normal physical exploration and normal levels of CRP might suggest low MSUS value. However, further research is needed to clarify the role of MSUS-defined synovitis grade I.References:[1]D’Agostino MA et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardized, consensus-based scoring system. RMD Open. 2017;3(1):e000428.[2]Van den Berg R et al. What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review. Arthritis Research & Therapy (2018) 20:228.Disclosure of Interests:None declared

scholarly journals Importance of a Follow-Up Ultrasound Protocol in Monitoring Posttraumatic Spleen Complications in Children Treated with a Non-Operative Management

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 734
Author(s):  
Ivona Djordjevic ◽  
Dragoljub Zivanovic ◽  
Ivana Budic ◽  
Ana Kostic ◽  
Danijela Djeric
Keyword(s):  
Splenic Abscess ◽  
Operative Management ◽  
High Energy ◽  
Significant Difference ◽  
Injury Grade ◽  
Grade Ii ◽  
The Mean ◽  
Non Operative Management ◽  
Grade Iii

Background and objectives: For the last three decades, non-operative management (NOM) has been the standard in the treatment of clinically stable patients with blunt spleen injury, with a success rate of up to 95%. However, there are no prospective issues in the literature dealing with the incidence and type of splenic complications after NOM. Materials and methods: This study analyzed 76 pediatric patients, up to the age of 18, with blunt splenic injury who were treated non-operatively. All patients were included in a posttraumatic follow-up protocol with ultrasound examinations 4 and 12 weeks after injury. Results: The mean age of the children was 9.58 ± 3.97 years (range 1.98 to 17.75 years), with no statistically significant difference between the genders. The severity of the injury was determined according to the American Association for Surgery of Trauma (AAST) classification: 7 patients had grade I injuries (89.21%), 21 patients had grade II injuries (27.63%), 33 patients had grade III injuries (43.42%), and 15 patients had grade IV injuries (19.73%). The majority of the injuries were so-called high-energy ones, which were recorded in 45 patients (59.21%). According to a previously created posttraumatic follow-up protocol, complications were detected in 16 patients (21.05%). Hematomas had the highest incidence and were detected in 11 patients (14.47%), while pseudocysts were detected in 3 (3.94%), and a splenic abscess and pseudoaneurysm were detected in 1 patient (1.31%), respectively. The complications were in a direct correlation with injury grade: seven occurred in patients with grade IV injuries (9.21%), five occurred in children with grade III injuries (6.57%), three occurred in patients with grade II injuries (3.94%), and one occurred in a patient with a grade I injury (1.31%). Conclusion: Based on the severity of the spleen injury, it is difficult to predict the further course of developing complications, but complications are more common in high-grade injuries. The implementation of a follow-up ultrasound protocol is mandatory in all patients with NOM of spleen injuries for the early detection of potentially dangerous and fatal complications.

scholarly journals Partial pulpotomy without age restriction: a retrospective assessment of permanent teeth with carious pulp exposure

2021 ◽  
Author(s):  
Florin Eggmann ◽  
Thomas J. W. Gasser ◽  
Hanjo Hecker ◽  
Mauro Amato ◽  
Roland Weiger ◽  
...  
Keyword(s):  
Survival Rates ◽  
Age Groups ◽  
Permanent Teeth ◽  
Eligibility Criteria ◽  
Presumptive Diagnosis ◽  
Tooth Discoloration ◽  
Significant Difference ◽  
Pulp Exposure ◽  
The Mean

Abstract Objectives This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure. Materials and methods Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05. Results Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively. Conclusions Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure. Clinical relevance Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients’ age.

scholarly journals Long-term follow-up of therapeutic efficacy of everolimus-eluting bioresorbable vascular scaffold in comparison to everolimus-eluting stent in treatment of chronic total occlusion guided by intracoronary imaging

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohammad Abdallah Eltahlawi ◽  
Abdel-Aziz Fouad Abdel-Aziz ◽  
Abdel-Salam Sherif ◽  
Khalid Abdel-Azeem Shokry ◽  
Islam Elsayed Shehata
Keyword(s):  
Chronic Total Occlusion ◽  
Bioresorbable Vascular Scaffold ◽  
Total Occlusion ◽  
Intracoronary Imaging ◽  
Group I ◽  
Significant Difference ◽  
Vascular Scaffold ◽  
Long Term Follow Up

Abstract Background We hypothesized that 1st generation everolimus-eluting bioresorbable vascular scaffold (BVS) stent associated with less complication and less restenosis rate than everolimus-eluting stent (EES) in chronic total occlusion (CTO) recanalization guided by intracoronary imaging. Therefore, we aimed to assess the safety and performance of BVS stent in CTO revascularization in comparison to EES guided by intracoronary imaging. Our prospective comparative cross-sectional study was conducted on 60 CTO patients divided into two groups according to type of stent revascularization: group I (EES group): 40 (66.7%) patients and group II (BVS group): 20 (33.3%) patients. All patients were subjected to history taking, electrocardiogram (ECG), echocardiography, laboratory investigation, stress thallium study to assess viability before revascularization. Revascularization of viable CTO lesion guided by intracoronary imaging using optical coherence tomography (OCT). Then, long-term follow-up over 1 year clinically and by multi-slice CT coronary angiography (MSCT). Our clinical and angiographic endpoints were to detect any clinical or angiographic complications during the follow-up period. Results At 6 months angiographic follow-up, BVS group had not inferior angiographic parameters but without statistically significant difference (p = 0.566). At 12 months follow-up, there was no difference at end points between the two groups (p = 0.476). No differences were found at angiographic or clinical follow-up between BVS and EES. Conclusion This study shows that 1st generation everolimus-eluting BVS is non-inferior to EES for CTO revascularization. Further studies are needed to clearly state which new smaller footprint BVS, faster reabsorption, magnesium-based less thrombogenicity, and advanced mechanical properties is under development. We cannot dismiss the efficacy and safety of new BVS technology. Trial registration ZU-IRB#2498/3-12-2016 Registered 3 December 2016, email: [email protected]

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