scholarly journals Hysterectomy and bilateral salpingoophorectomy in female-to-male transsexual: does testosterone induce anatomopatological changes? A retrospective study

2021 ◽  
Author(s):  
Marina Martin Pereda ◽  
Maria Amores Vergara ◽  
Lorena Sabonet Morente ◽  
Ernesto Gonzalez Mesa ◽  
Pilar Espejo Reina ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Administration ◽  
Duration Of Treatment ◽  
Replacement Treatment ◽  
Pathological Result ◽  
Number Of Patients ◽  
Gender Reassignment ◽  
Secretory Type ◽  
Long Term Studies

Abstract Background Testosterone replacement treatment as part of gender reassignment therapy has repercussions on the final pathological result of the hysterectomies that are performed. The objective of this review is to analyze the surgical pieces of hysterectomies performed on FTM patients (female-to-male) and to describe possible changes related to testosterone. There are few studies and with a low number of patients where this possible repercussion is addressed. Methods A retrospective study was carried out, which included 117 patients between the ages of 21 and 56, operated on between 2010 and 2019, with at least an average duration of treatment of 5 years before gender reassignment surgery. Main outcome measure were changes in follicle stimulating hormone (FSH), luteinizin hormone (LH), testosterone (TST) and estradiol in blood, both preoperatively and postoperatively. Also the differente types of endometrium and ovaries found in histerectomy pieces. Results the pathological study revealed that 95 (80.3%) cases showed an atrophic endometrium, 7 (6%) cases an endometrium with secretory-type changes, and 15 (13.7%) cases with weakly proliferating endometrium. Conclusions Our data revealed that the most frequent histology after chronic administration of parenteral testosterone was such compatible with atrophic endometrium, coinciding with what has been published in the literature up to now. More long-term studies on the effects of parenteral testosterone are still needed.

P1700CYTOMEGALOVIRUS DISEASE IN RENAL TRANSPLANTED PATIENTS: DETERMINING FACTORS AND ITS RELATION WITH GRAFT OUTCOME AND PATIENTS SURVIVAL

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Carlo Maria Alfieri ◽  
Paolo Molinari ◽  
Maria Teresa Gandolfo ◽  
Maria Rosaria Campise ◽  
Donata Cresseri ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Induction Therapy ◽  
Graft Loss ◽  
Clinical Signs ◽  
Female Gender ◽  
First Year ◽  
Number Of Patients ◽  
Dialysis Vintage ◽  
Cmv Disease

Abstract Background CMV disease (CMVd) is a frequent complication in renal transplanted patients (RTxp), especially during the first year of transplantation (RTx). CMVd impacts on long term graft and patients outcomes is still debated. Our observational retrospective study aims to evaluate: 1) the prevalence of CMVd during the first year of RTx; 2) the factors related to CMVd; 3) the relationship between CMVd and early and long term graft and patients survival. Method In 505 RTxp (age: 50[41;58]yrs – 292 males), up to the 616 transplanted in our unit between 2004 and 2016, clinical, blood and urinary parameters were recorded after 1 (T1) and 12 (T12) months of RTx. eGFR was estimated by MDRD formula. Donor (D) and Recipient (R) CMV serology was tested at the moment of RTx. CMV IgG-D+/IgG-R- RTxp (12%) and high risk patients (second or more RTx, ATG induction therapy), received prophylaxis therapy until the 3rd month of RTx. CMVd, was defined by the presence either of CMVr (CMV replication without clinical signs of CMV disease) or CMVs (CMV replication with signs of disease and/or need of antiviral therapy/reduction of immunosuppressive therapy). Median follow up (FU) was 8[5-11]yrs. The following outcomes were investigated: 1) graft: reduction of eGFR >20% between T1 and T12; reduction of eGFR >50% between T1 and end of FU (eGFRr>50%); graft loss (GL); eGFRr>50% + GL.; 2) RTxp survival at the end of FU. Results Ninty percent of RTxp had a kidney from a deceased D; 73% and 21% received haemodialysis (HD+) and peritoneal dialysis before RTx. Dialysis vintage was 50[33-75] months. In 12% of RTxp, induction therapy included ATG. Cumulative steroids dose was 880[840-105]mg and 2272[2598-3223]mg at T1 and T12 respectively. During the first year of RTx, 45% of patients had CMVd (CMVd+). CMVd+ were older than CMV free RTxp (CMVd-). Female gender, HD+ and CMV IgG-D+/IgG-R- were more prevalent in CMVd+. In addition, at T1, CMVd+ had lower albumin, haemoglobin and higher PTH, uric acid and reactive C protein levels than CMVd- and, both at T1 and T12, received higher steroid dose. In multivariate analysis, albumin-T1 was the most significant modifiable factor in determining CMVd+ (p=0.009 OR 0.50 – IC 0.29-0.84). Albumin-T1 maintained its significance also after the addiction of CMV serology IgG-D+/IgG-R- to the model (albumin T1: p=0.008 OR 0.48 – IC 0.29-0.84; CMV serology IgG-D+/IgG-R-: p=0.01 OR 2.16 – IC 1,18 -3,95). Among CMVd, 19% and 25% had respectively CMVr and CMVs. CMVs were characterized by lower dialysis vintage and higher prevalence of CMV IgG-D+/IgG-R- than CMVr. GL and death were observed in 11% and 8% of RTxp respectively. In univariate and survival analyses, CMVd, CMVr and CMVs didn’t show any impact on the graft and patients outcomes examined. Conclusion Our retrospective study confirms the high prevalence of CMVd during the first year of RTx, and identifies albumin at T1 as the most impacting parameter in influence CMVd insurgence. This might reflect the importance of the pre-RTx status in CMVd development after RTx. Nevertheless, CMVd seems not impact significantly on early and long term outcomes, experienced however in a small part of the cohort studied. Future studies, possibly prospective and including higher number of patients might better elucidate this issue.

scholarly journals Survival of Dyna Implants: A Retrospective Study with 1 to 6 Years of Follow Up

2022 ◽  
Author(s):  
Hamidreza Barikani ◽  
Mohadeseh Heidari ◽  
Mohammadjavad Kharazifard ◽  
Amirreza Rokn
Keyword(s):  
Retrospective Study ◽  
Dental Implant ◽  
Point Of View ◽  
Implant Survival ◽  
Missing Teeth ◽  
World Class ◽  
Implant System ◽  
Long Term Studies

Objectives: Dental implants are a prominent scientific breakthrough and are frequently applied for replacement of the missing teeth. From the clinicians’ point of view, long-term studies are essential to find out the predictability of dental implant systems. Materials and Methods: In this retrospective study, 1,626 patients who received 4,389 Dyna implants in a private office between 2013-2019 were evaluated. All statistical analyses were performed using SPSS 25 for Windows. P values less than 0.1 were considered significant for regression analysis. Results: Dyna implantts (4389) placed from 2013 to 2019 were evaluated in this study. One-hundred and thirty-three (3.03%) implants failed during the healing period or recall visits. Eighty-nine implants (2.03%) failed immediately and 44 (1%) failed after 3 months. Conclusion: The present study showed that the Dyna dental implant system had high implant survival, and it had all the survival criteria similar to world-class dental implant systems.  

What is the best treatment option for second line in long responders to the first-line TKI in metastatic renal cell carcinoma (mRCC) patients (pts): TKI-TKI or TKI-mTORi? A European retrospective study.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 375-375 ◽  
Author(s):  
Reza-Thierry Elaidi ◽  
Benoit Beuselinck ◽  
Agnes Maj-HES ◽  
Delphine Carmier ◽  
Aristotelis Bamias ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mtor Inhibitor ◽  
Clear Cell ◽  
First Line ◽  
Short Term ◽  
Duration Of Treatment ◽  
Eligibility Criteria ◽  
Radiological Response ◽  
L1 And L2

375 Background: The question regarding the benefit of a TKI rechallenge versus switch to an mTOR inhibitor (mTORi) in mRCC pts who responded to a previous line of TKI remains unanswered and is a common dilemma in clinical practice. We report results of a retrospective study to address this question. Methods: This study retrospectively investigated Duration of Treatment (DT), best radiological response (OR) and predictive factors in pts treated with either TKI-TKI or TKI-mTORi sequences for clear-cell mRCC. Eligibility criteria: 1 TKI in 1st line (L1) followed by another TKI or mTORi as 2nd line (L2). Prior immunotherapy was allowed but not intermediate lines with other drugs. Pts characteristics and Heng’s prognostic factors were collected at each line initiation. Response (resp) was classified with regard to DT and OR using 2 different definitions: def1 = Non Responders (NR): < 4months (m) + PD; Short-Term responders (STR): [4–6]m + SD/PR, Long-term Responders (LTR): >6m + SD/PR, and def2 = NR: < 4m + PD, STR: [4–12]m + SD/PR, LTR: >12m + SD/PR. Results: 127 pts from 7 European centers were retrospectively analyzed. Based on def1, resp to L1 was: LTR=93, STR=20, NR=14; among LTR pts, 54 received a L2=TKI and 39 a L2=mTORi. Based on def2, resp to L1 was: LTR=59, STR=53, NR=15; among LTR pts, 35 received a L2=TKI and 24 a L2=mTORi. Whether def1 or def2, resp (L1 and L2) was never related to Heng’s score. Among LTR pts at L1, 26 out of 54 were LTR after L2=TKI vs 18 out of 39 after L2=mTORi (p=0.85, Z-test) for def1 and 9 out of 35 were LTR after L2=TKI vs 6 out of 24 after L2=mTORi (p=0.95) for def2 (see table). For both def1 and def2, median DT was 7.2m and 6.9m for L2=TKI and L2=mTORi, respectively (p=0.86 and p=0.95, Log-Rank). Conclusions: Results suggest that long-term responders on 1st line TKI could benefit both from TKI and mTORi as 2nd line and there is no evidence to favor one sequence over the other. [Table: see text]

scholarly journals NEW TECHNOLOGIES IN TREATMENT OF FRACTURES OF THE UPPER EXTREMITIES IN PATIENTS WITH SEVERE MULTIPLE AND POLYTRAUMA

2016 ◽  
Vol 175 (5) ◽  
pp. 46-51
Author(s):  
E. K. Gumanenko ◽  
A. A. Khromov ◽  
S. A. Linnik ◽  
Kh. N. Nazarov ◽  
V. A. Chapurin ◽  
...  
Keyword(s):  
New Technologies ◽  
Damage Control ◽  
Upper Extremities ◽  
Long Term Results ◽  
Duration Of Treatment ◽  
Damage Control Orthopedics ◽  
Number Of Patients ◽  
The Common ◽  
Made In

A comparative analysis of treatment results of fractures of long bones of the upper extremities was made in 172 victims with severe polytrauma. The traditional strategy of treatment was used in the first group. The new technologies such as prognostic tactics, method of Damage control orthopedics and low-invasive osteosynthesis developed by the authors were applied in the second group. The application of new technologies allowed doctors to improve the immediate and long-term results of surgery. The rate of lethality decreased in 1,6 times, incidence of complications reduced in 1,4 times. Hospital stay shortened in 2 times: for victims with favorable prognosis - on 7 days; for patients with unfavorable prognosis - on 13 days. The long-term results were studied in 154 (89,5%) patients. The common duration of treatment reduced on 30 days and the quantity of good results increased on 18,6%. The number of patients with vocational rehabilitation increased from 82,3 to 90,7%.

Neuronal Lipopigment: A Marker for Cognitive Impairment and Long-Term Effects of Psychotropic Drugs

1989 ◽  
Vol 155 (1) ◽  
pp. 1-11 ◽  
Author(s):  
J. H. Dowson
Keyword(s):  
Free Radicals ◽  
Chronic Administration ◽  
Long Term Effects ◽  
Neuronal Function ◽  
Alzheimer Dementia ◽  
Cellular Debris ◽  
Normal Ageing ◽  
Prophylactic Use ◽  
Long Term Studies

Lipopigment, identifiable in the fluorescence microscope, is thought to be cellular debris partly derived from free-radical-induced peroxidation of cellular constituents. The volume of neuronal lipopigment has been positively correlated with advancing age, Alzheimer dementia, and the neuronal ceroidoses, while various changes in neuronal lipopigment have been reported in association with the chronic administration of dihydroergotoxine, ethanol, phenytoin, centrophenoxine, and chlorpromazine. An increase in the volume of neuronal lipopigment may indicate increased functional activity of the cell, impaired removal of pigment or anoxia. Chronic administration of agents which can be correlated with decreased neuronal lipopigment in animal models might protect neuronal function against any adverse effects associated with (but not necessarily resulting from) lipopigment accumulation in normal ageing, anoxia, or certain degenerative diseases. Long-term studies of the prophylactic use of such agents, or of drugs which neutralise free radicals, may be indicated. Other clinical applications of such drugs may include protection against the effects of free radicals formed during periods of oxygen deprivation.

Is Conventional Allogeneic Haematopoietic Stem Cell Transplantation (HSCT) an Optimal Long-Term Strategy for Non Hodgkin Lymphomas: A Retrospective Study from 1987 to 2004.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3328-3328
Author(s):  
Anne-Sophie A.S. Michallet ◽  
Sophie S. Tartas ◽  
Quoc-Hung Q.H. Le ◽  
Franck F. Nicolini ◽  
Nicole N. Raus ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Overall Survival ◽  
Retrospective Study ◽  
Acute Gvhd ◽  
Chronic Gvhd ◽  
Haematopoietic Stem Cell ◽  
Allogeneic Hsct ◽  
Number Of Patients

Abstract Conventional chemotherapy in NHL does not substantially modify the natural course of disease especially for indolent lymphomas. A major advantage of allogeneic HSCT is the immunological recognition of lymphoma cells by the allogeneic donors cells and the low relapse risk in long-term survivors is highly suggestive of a graft-versus-lymphoma effect. However the still high mortality rate of this procedure mainly due to GVHD limits its indications. To determine the place of allogeneic HSCT in the NHL therapeutic strategies, we performed a retrospective study from 1987 to 2004. Twenty-six patients [17 males, 9 females, median age of 37 years (18–61)] underwent allogeneic HSCT: 18 conventional bone marrow transplantations and 8 allogeneic HSCT after reduced intensity conditioning (RICT) from HLA identical sibling donors. The diagnosis pre transplant were: 11 high grade lymphomas (9 phenotype B and 2 T), 8 patients with a transformation of an indolent form (2 CLL, 2 follicular and 3 marginal zone lymphomas, 1 mycosis fungoides) [73% aggressive forms of NHL] and 7 indolent forms (3 lymphocytic lymphomas, 3 follicular lymphomas and 1 mantle cell). All patients have received at least 3 courses of chemotherapy (3–7). Eighty-eight percent had a stage IV at diagnosis, 7% a stage III and 7% a stage II. At transplant, 10 (38.5%) were in complete remission, 2 in partial response, 9 in stable disease and 5 (19%) in relapse or progressive disease. Twenty-two patients received bone marrow as HSC source and 4 PBSC. Total body irradiation was used as part of the conditioning regimen in 78% of patients. With a median follow-up of 85 months (41–225) from diagnosis and 66 months (9–185) from transplantation, 13 (50%) are alive without evidence of lymphoma at last follow-up and 13 died [9 (35%) from transplant-related causes (1 acute GVHD grade IV, 3 pneumonitis, 1 septicemia, 1 veino-occlusive disease, 1 leucoencephalitis and 2 others causes) and 4 (15%) from relapse. Eight (30%) did not develop any acute GVHD, 9 a grade I, 4 a grade II, 3 a grade III and 2 a grade IV. Nineteen patients did not develop chronic GVHD, 6 a limited form and only one an extensive form. Overall survival at 5 years was 61.5% [95%CI (48%–83%)] from diagnosis and 57% [95% CI (40%–80%)] from transplantation. Transplant-related mortality was estimated at 35%. Multivariate analysis did not show any significant influence on overall survival (OS) of age, disease status, type of transplantation (conventional vs RICT), HSC source, TBI, acute or chronic GVHD but this lack of significance is probably in relation with the small number of patients. The long-term follow-up in this study demonstrated the effectiveness of allogeneic HSCT in achieving long-term disease control even in heavily pretreated aggressive NHL patients.

scholarly journals Clinical Study of Acupotomy Treatment for Tarsal Tunnel Syndrome

2020 ◽  
Vol 37 (2) ◽  
pp. 118-122
Author(s):  
Xinyi Fu ◽  
Mira Lee ◽  
Changqing Guo
Keyword(s):  
Therapy Group ◽  
Effective Rate ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
Long Term Effects ◽  
Duration Of Treatment ◽  
Number Of Patients ◽  
Tunnel Syndrome ◽  
The Difference

Background: Compared with conventional closed therapy, acupotomy has the advantages of lower cost, convenient application, and better single and long-term effects. The aim of this study was to explore the clinical effect of acupotomy in the treatment of Tarsal Tunnel syndrome.Methods: There were 80 patients enrolled into the study who were randomly assigned to either the acupotomy or closed therapy group, with 40 patients in each group. The acupotomy group was treated once every 6 days, on 3 occasions for the duration of treatment, and the closed therapy group was treated twice a week, for 3 weeks as the course of treatment. The effects of treatment were analyzed and evaluated according to the standard of curative effect.Results: The “cure rate” of the number of patients in the acupotomy group whose symptoms had completely disappeared (13 patient out of 39) was higher than the closed therapy group (1 patient out of 39), and this difference was significant (<i>p</i> < 0.01). The number of patients in the acupotomy group who did not benefit from the therapy (5 patients) was significantly lower than the closed therapy group (15 patients; <i>p</i> < 0.05). The total number of patients in the acupotomy group who benefitted from the therapy (34 patients) resulted in an effective rate of 87.18%, which was higher than the closed therapy group (24 patients; 61.53%). The difference was statistically significant (<i>p</i> < 0.05).<br/>Conclusion: Acupotomy is effective in the treatment of Tarsal Tunnel syndrome, was superior to traditional closed therapy, and is worthy of clinical application.

Implications of Long-Term Studies of Three Model Preschool Programs for Head Start

2008 ◽  
Author(s):  
Lawrence J. Schweinhart ◽  
Elena V. Malofeeva ◽  
Lawrence J. Schweinhart ◽  
Michelle M. Englund ◽  
Arthur J. Reynolds ◽  
...  
Keyword(s):  
Head Start ◽  
Preschool Programs ◽  
Long Term Studies

Primary varicose veins

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 133-137
Author(s):  
H. Partsch
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Daily Practice ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Primary Varicose Veins ◽  
The Cost ◽  
Convincing Data ◽  
Long Term Studies

SummaryBackground: Compression stockings are widely used in patients with varicose veins. Methods: Based on published literature three main points are discussed: 1. the rationale of compression therapy in primary varicose veins, 2. the prescription of compression stockings in daily practice, 3. studies required in the future. Results: The main objective of prescribing compression stockings for patients with varicose veins is to improve subjective leg complaints and to prevent swelling after sitting and standing. No convincing data are available concerning prevention of progression or of complications. In daily practice varicose veins are the most common indication to prescribe compression stockings. The compliance depends on the severity of the disorder and is rather poor in less severe stages. Long-term studies are needed to proof the cost-effectiveness of compression stockings concerning subjective symptoms and objective signs of varicose veins adjusted to their clinical severity. Conclusion: Compression stockings in primary varicose veins are able to improve leg complaints and to prevent swelling.

Ixekizumab in the Management of Non-Selected Out Patients with Moderate to Severe Psoriasis -New Data and Personal Clinical Experience

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Clinical Experience ◽  
Personal Experience ◽  
Therapeutic Response ◽  
Systemic Disease ◽  
Severe Psoriasis ◽  
Adequate Treatment ◽  
Scalp Psoriasis ◽  
Number Of Patients ◽  
Genital Psoriasis

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.

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