scholarly journals Trans-oral Trans-Sheath Forceps Biopsy For Patients With Severe Esophageal Obstruction Under Fluoroscopy

2021 ◽  
Author(s):  
Dechao Jiao ◽  
Kaihao Xu ◽  
Yiming Liu ◽  
Zongming Li ◽  
Yanli Wang ◽  
...  
Keyword(s):  
Irradiation Dose ◽  
Technical Success ◽  
Early Complications ◽  
Tube Insertion ◽  
Esophageal Obstruction ◽  
Karnofsky Score ◽  
Forceps Biopsy ◽  
Before And After ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background: To investigate the safety and effectiveness of trans-oral trans-sheath forceps biopsy (TTFB) for patients with severe esophageal obstruction under fluoroscopy.Methods: From November 2016 to November 2019, 35 patients with level Ⅲ or Ⅳ dysphagia and a Karnofsky score of less than 60 were enrolled to undergo TTFB and esophageal nutrition tube insertion or stenting simultaneously. Data on diagnostic performance, early complications, and radiation dose were collected, and Karnofsky scores before and after the procedures were compared.Results: The technical success of TTFB was 100%. The sensitivity, specificity and accuracy were 92.3% (24/26), 77.8% (7/9), and 88.6% (31/35), respectively. Complications occurred in two cases (5.7%). The mean procedure duration and irradiation dose were 23.2 min and 7.2 mSv, respectively. The Karnofsky scores significantly increased after 2-4 weeks (t = -8.9, P < 0.01).Conclusions: TTFB is a safe and effective method for patients with severe esophageal obstruction under fluoroscopy, especially in those who cannot undergo or refuse endoscopy.

scholarly journals NEURLOGICAL OUTCOME OF GLIOMAS

2016 ◽  
Vol 23 (12) ◽  
pp. 1513-1521
Author(s):  
Muhammad Khalid ◽  
Umer Farooq Raina ◽  
Ejaz Ahmad ◽  
Khaleeq UZ Zaman
Keyword(s):  
Neurological Deficit ◽  
Neurological Outcome ◽  
Radiation Necrosis ◽  
P Value ◽  
Karnofsky Score ◽  
Tumor Study ◽  
Neuroepithelial Cells ◽  
Before And After ◽  
Post Radiation ◽  
The Mean

Background: Mostly Primary brain tumors are derived from neuroglial cells,neuronal or primitive bipotential precursors or neuroepithelial cells and they are calledgliomas. These comprise of 45-65% of intracranial tumors. We aimed to conduct a studyto determine the neurological outcome of patients with gliomas on the basis of karnofskyscore who are managed with craniotomy and excision of tumor. Study Design: Descriptivecase series. Setting: Neurosurgery Department, PIMS, Islamabad. Patients reporting to OPDaccident and emergency department and those admitted to neurosurgery unit or referred fromother units were enrolled. Period: July 2014 to April 2015 in duration of ten months. Methods:140 gliomas patients which were diagnosed on CT/MRI with contrast. Patients with low gradeglioma, those with post radiation necrosis diagnosed on MRI and MR spectroscopy brain,children having glioma and those gliomas patients having co-morbidities were excluded fromthis study. The outcome of this study was determined as neurological outcome of patientswith glioma according to karnofsky score after craniotomy plus excision of tumor. Results:The patients’ average ages were 37.4 + 11.2 years. Male gender was in dominance with83 (59.2%) cases compared to 57 (40.7%) females. Of the total 140 patients of gliomas, 24(17.1%) had neurological deficit. The mean Karnofsky score was 70.0 + 10.0 before surgeryand after surgery it improved to 90.0 + 10.0 and this difference in mean karnofsky scorebetween before and after surgery was found statistically significant (p-value = 0.001). Themean Glasgow coma scale was 12.0 + 2.0 before surgery and 14.0 + 1.0 post operatively.Post operatively it was observed that, of the 24 patients with neurological deficit, 18 (75.0%)improved completely whereas 6 (25.0%) patients could not improve. Conclusion. There isa significant improvement in nuerological outcome which is measure through the karnofskyscore of gliomas patients whose undergoing craniotomy and excision of tumor.

scholarly journals QUALITY OF LIFE COMPARATION IN METASTATIC BONE DISEASE PATIENT BEFORE AND AFTER SURGERY IN DR. SOETOMO GENERAL HOSPITAL

2019 ◽  
Vol 7 (2) ◽  
pp. 132
Author(s):  
Ferdiansyah Mahyudin ◽  
Mouli Edward ◽  
Muhammad Hardian Basuki ◽  
Rizky Agung Satria
Keyword(s):  
Quality Of Life ◽  
General Hospital ◽  
Operative Treatment ◽  
Bone Disease ◽  
Disease Patient ◽  
Metastatic Bone Disease ◽  
Karnofsky Score ◽  
Before And After ◽  
The Mean

Background: Metastatic bone disease is bone pathologic process caused by spread of primary tumor. The incidence of metastatic bone disease varies between 20-75% corresponds to the primary site of the malignancy. Surgery in metastatic bone disease aim to cure or palliate the morbidity caused by the disease. Operative treatment could reduce pain, improve function, control metastatic focus of the malignancy, and provide mechanical stabilization. Based on those benefits, operative treatment is important to improve quality of life in patients with metastatic bone disease. Purpose:  Proved that there was a difference in the quality of life MBD patients before and after surgery.Methods: This research was a retrospective cohort on MBD patients which undergone surgery, and never given any other treatment in the course of the disease. The research was conducted in Dr. Soetomo General Hospital, Surabaya. Patient sampling was done using consecutive sampling. Karnofsky score was taken from the medical record before the procedure and direct interview via phone or completing questionnaire. Data analysis was done descriptively and analytically. Statistical tests were done using Wilcoxon test.Results: 146 patients enrolled in the research. The mean age of the sample was 48.77 ± 13.34 years. The mean of Karnofsky score before and after the procedure was 53.69±13.07 and 75.54±13.69 with statistical result of p<0.001.Conclusion: The Karnofsky score in MBD patients was higher after the surgery compared to before the surgery.

Selective Intra-Arterial Calcium Stimulation Venous Sampling Test for Preoperative Localization of Occult Neuroendocrine Tumors: Recall for an Old Technique

2021 ◽  
Author(s):  
Mangaladevi S. Patil ◽  
Nariman Nezami ◽  
Zachary L. Bercu ◽  
Louis G. Martin ◽  
Sean R. Dariushnia ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Predictive Value ◽  
Preoperative Localization ◽  
Maximal Dimension ◽  
Technical Success ◽  
Venous Sampling ◽  
Calcium Stimulation ◽  
Resected Tumor ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background Surgical resection is the curative treatment for neuroendocrine tumors (NETs). Noninvasive imaging is unreliable in localizing NETs measuring less than 2 cm. This study investigates the safety and efficacy of the selective intra-arterial calcium stimulation venous sampling test (SACST) for preoperative localization of functional NETs within the pancreas. Methods This retrospective analysis of the patients referred for localization of radiologically occult functional NETs from 2004 to 2019 was performed at a single institution. The technical success, diagnostic accuracy, and complications of the test were evaluated. Results Twenty-three patients underwent SACST. The SACST was technically successful in 100% of the patients. Lesions were successfully localized in 19 (83%) patients. Tumor blush was seen in one patient. The mean ± standard deviation of maximal dimension of the resected tumor was 2.0 ± 1.9 cm. Sensitivity, specificity, positive predictive value, and negative predictive value of the SACST for localization of all lesions were 1.0, 0.57, 0.84, and 1.0, as well as 1.0, 0.57, 0.80, and 1.0 for insulinomas, respectively. Conclusion SACST is a feasible, safe, well-tolerated, and effective procedure to preoperatively localize radiologically occult NETs within the pancreas.

Experience with VariClose® vein sealing system in the Czech Republic

2021 ◽  
pp. 026835552110515
Author(s):  
Peter Balaz ◽  
Slavomir Rokosny ◽  
Jiri Herman ◽  
Miloslav Pirkl ◽  
Robert Vlachovsky ◽  
...  
Keyword(s):  
Czech Republic ◽  
Duplex Ultrasound ◽  
Average Difference ◽  
Technical Success ◽  
The Czech Republic ◽  
Saphenous Veins ◽  
Kaplan Meier ◽  
Before And After ◽  
The Mean

Objectives The aim of this study was to assess occlusion rates of saphenous veins treated with the VariClose vein sealing system. Methods A retrospective analysis including a total of 64 patients from four centres from the Czech Republic. Occlusion was defined as a non-compressible vein with absence of flow with exception to the first 3 cm from the saphenofemoral or saphenopopliteal junction on duplex ultrasound. Results In 64 patients a total of 79 veins were treated. Technical success of the procedure was achieved in 74 (94%) of cases. The mean follow-up was 5.5 months. The closure rates calculated by the Kaplan-Meier method at 1, 3, 6 and 12 months were 94%, 85%, 69% and 36%, respectively, and there were no significant differences between centers. The average difference in VCSS score before and after the procedure was 1.8. Conclusions The present study demonstrated surprisingly worse occlusion rates than the current literature.

Perbedaan Pengetahuan Siswa Tentang Penyakit Hepatitis A Sebelum Dan Sesudah Penyuluhan Di MTsN 02 Bondowoso Tahun 2015

2017 ◽  
Vol 4 (2) ◽  
pp. 14
Author(s):  
Putri Megasari
Keyword(s):  
Hepatitis A ◽  
Hepatitis Virus ◽  
Sampling Technique ◽  
Mean Value ◽  
Test Design ◽  
The World ◽  
Before And After ◽  
Post Test ◽  
The Mean ◽  
Paired T Test

Hepatitis has become a health problem in the world. The hepatitis virus infected many people. According to the teacher of MTsN 02 Bondowoso more than 20 students have hepatitis A viral infection. The purpose of this research was to know the differences of students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study used pre-experimental (pre-post test design). This study used stratified random sampling technique, 127 students from 270 sample involved this research,and 143 students was excluded. We used questionnaires to collect data. The results showed that the mean value of the students 'knowledge about hepatitis A before counseling in MTsN 02 Bondowoso 2015 was 83.96 with the lowest value of 37.5 and the highest value was 100. The mean value of the students' knowledge about hepatitis A after counseling in MTsN 02 Bondowoso 2015 was 93.21 with the lowest value waf 62.5 and the highest value was 100. Paired t test showed that t (-9.07) > t table (1.98), the null hypothesis (H0) was rejected. There was a difference between students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study showed that routine counseling by healthcare provider was important to prevent hepatitis A infection.; Keywords: counseling, knowledge of students, hepatitis

Outcomes and Postoperative Complications of Robot-Assisted Laparoscopic Hysterosacropexy: Initial Experience

2015 ◽  
Vol 95 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Maria Angela Cerruto ◽  
Carolina D'Elia ◽  
Francesca Maria Cavicchioli ◽  
Stefano Cavalleri ◽  
Matteo Balzarro ◽  
...  
Keyword(s):  
Uterine Prolapse ◽  
Pelvic Organ ◽  
Consecutive Series ◽  
Complication Rates ◽  
Early Complications ◽  
Robot Assisted ◽  
Female Patients ◽  
The Mean ◽  
Record Review

Background: Pelvic organ prolapse is a common condition, affecting about 50% of women with children. The aim of our study was to evaluate results and complication rates in a consecutive series of female patients undergoing robot-assisted laparoscopic hysterosacropexy (RALHSP). Materials and Methods: We performed a medical record review of female patients with uterine prolapse who had consecutively undergone RALHSP from February 2010 to 2013 at our department. Results: Fifteen patients were included in the analysis. All patients had uterine prolapse stage ≥II and urodynamic stress urinary incontinence. The mean age was 58.26 years. According to the Clavien-Dindo system, 4 out of 15 patients (26.6%) had grade 1 early complications and 1 patient had a grade 2 complication. At a median follow-up of 36 months, there was a significant prolapse relapse rate of 20% (3/15). Conclusion: In our hands RALHSP is easy to perform, with satisfying mid-term outcomes and a low complication rate.

Quality of Life for Children with Persistent Sinonasal Symptoms

2003 ◽  
Vol 128 (1) ◽  
pp. 17-26 ◽  
Author(s):  
David J. Kay ◽  
Richard M. Rosenfeld
Keyword(s):  
Quality Of Life ◽  
Clinical Care ◽  
Longitudinal Change ◽  
Good Test ◽  
Routine Clinical Care ◽  
Before And After ◽  
The Mean ◽  
The Individual ◽  
Sinonasal Symptoms

OBJECTIVE: The goal was to validate the SN-5 survey as a measure of longitudinal change in health-related quality of life (HRQoL) for children with persistent sinonasal symptoms. DESIGN AND SETTING: We conducted a before and after study of 85 children aged 2 to 12 years in a metropolitan pediatric otolaryngology practice. Caregivers completed the SN-5 survey at entry and at least 4 weeks later. The survey included 5 symptom-cluster items covering the domains of sinus infection, nasal obstruction, allergy symptoms, emotional distress, and activity limitations. RESULTS: Good test-retest reliability ( R = 0.70) was obtained for the overall SN-5 score and the individual survey items ( R ≥ 0.58). The mean baseline SN-5 score was 3.8 (SD, 1.0) of a maximum of 7.0, with higher scores indicating poorer HRQoL. All SN-5 items had adequate correlation ( R ≥ 0.36) with external constructs. The mean change in SN-5 score after routine clinical care was 0.88 (SD, 1.19) with an effect size of 0.74 indicating good responsiveness to longitudinal change. The change scores correlated appropriately with changes in related external constructs ( R ≥ 0.42). CONCLUSIONS: The SN-5 is a valid, reliable, and responsive measure of HRQoL for children with persistent sinonasal symptoms, suitable for use in outcomes studies and routine clinical care.

scholarly journals Evaluation of pharmacy-led weight management service to minimise the risk of cardiovascular disease

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aliki Peletidi ◽  
Reem Kayyali
Keyword(s):  
Physical Activity ◽  
Weight Management ◽  
Activity Levels ◽  
Management Service ◽  
Initial Weight ◽  
Public Health Services ◽  
Clinical Role ◽  
Physical Activity Levels ◽  
Before And After ◽  
The Mean

Abstract Aims The primary aim of the programme was a minimum of a 5% weight reduction of the initial weight, while the secondary outcomes were a reduction in participants’ body mass index (BMI), waist circumference (WC), blood pressure (BP), AUDIT-C score and an increase in the Mediterranean diet (MD) score and an improvement in physical activity levels. Methods This 'before and after' study was a 10-week weight management (WM) programme and it was developed and delivered in community pharmacies in Patras chosen for convenience, thus consisting the first service of its type in Greece. The sample size was calculated (n = 96) based on the mean BMI for a Greek male and female individual, and the standard deviation (SD) of weight at baseline of 14 kg. Results Nearly every participant enrolled in the 20 participating pharmacies, 97.4% (n = 114/117), achieved the programme’s aim, losing at least 5% of their initial weight. The mean percentage of total weight loss of the 117 participants at the 10th week was 8.97% (SD 2.65), and the t-test showed statistically significant results (P-value < 0.001; 95% CI [8.48, 9.45]). A significant reduction in the waist-to-height ratio (WHtR) was observed in both male (P-value = 0.004) and female (P-value < 0.001) participants. The participants’ BP and AUDIT-C score and physical activity levels significantly improved (P-value < 0.001), as well as their MD score. Conclusion This study provides the first evidence that Greek pharmacists have the potential to play an important role within primary healthcare and that after training they are able to provide public health services for both the public’s benefit and their clinical role enhancement.

Can the Expiratory Disproportion Index Distinguish PVFMD from Subglottic Stenosis in Obese Patients?

2021 ◽  
pp. 000348942199015
Author(s):  
Kevin Calamari ◽  
Stephen Politano ◽  
Laura Matrka
Keyword(s):  
Vocal Fold ◽  
Forced Expiratory Volume ◽  
Subglottic Stenosis ◽  
Obese Patients ◽  
Level Of Evidence ◽  
Prior Literature ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Paradoxical Vocal Fold Movement ◽  
Rule Out

Objectives: Expiratory disproportion index (EDI) is the ratio of forced expiratory volume in 1 second (FEV1) divided by peak expiratory flow rate (PEFR) multiplied by 100. Prominent EDI (>50) values can differentiate subglottic stenosis (SGS) from paradoxical vocal fold movement disorder (PVFMD), but this has not been verified when considering body habitus. We hypothesize that the predictive value of elevated EDI in differentiating SGS from PVFMD will be lower in obese patients than non-obese patients. Methods: Patients ≥ 18 years old with recorded PFT values, BMI, and airway imaging were reviewed retrospectively from 01/2011 to 10/2018. EDI was recorded for 4 cohorts: non-obese/SGS, non-obese/ PVFMD, obese/SGS, and obese/ PVFMD, to determine the mean EDI and the sensitivity/specificity of an elevated EDI. Results: Mean EDI values were 69.32 and 48.38 in the non-obese SGS and PVFMD groups, respectively ( P < .01). They were 58.89 and 47.67 in the obese SGS and PVFMD groups, respectively ( P < .05). At a threshold of >50, EDI had a sensitivity of 90.0% and specificity of 51.6% in differentiating between SGS and PVFMD cases in non-obese patients and 51.6% and 63.6% in obese patients. Conclusion: Prior literature has established that EDI can distinguish SGS from PVFMD in the general population. Our results show that the mean EDI values were significantly different in both cohorts, but an elevated EDI was not as sensitive at identifying SGS cases in obese patients. This suggests that the EDI should be used with caution in obese patients and should not be relied upon to rule out SGS. Level of Evidence: 3.

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

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