scholarly journals ANATOMICAL KNOWLEDGE AND DIAGNOSTIC IMAGES IN MEDICAL EDUCATION. EL CONOCIMIENTO ANATÓMICO Y LAS IMÁGENES DIAGNÓSTICAS EN LA ENSEÑANZA DE LA MEDICINA

2016 ◽  
Vol 2 (3) ◽  
pp. 112-114
Author(s):  
Susana N Biasutto
Keyword(s):  
Magnetic Resonance ◽  
Long Term Results ◽  
Core Knowledge ◽  
Evaluation Instrument ◽  
Anatomical Structures ◽  
The People ◽  
Anatomical Knowledge ◽  
Group A ◽  
Group B ◽  
First Year Medical Students

La importancia del conocimiento anatómico para la interpretación de las imágenes diagnósticas es reconocida y aceptada. El desarrollo tecnológico basado en tomografía axial computada y resonancia magnética nuclear han incrementado los requerimientos. En nuestra Facultad, el curso de Anatomía incluye la identificación de estructuras anatómicas normales. Intentamos demostrar los resultados a largo plazo de este cambio curricular. Este estudio consideró dos grupos: A) 274 estudiantes de primer año, B) 100 médicos recientemente graduados. Ambos grupos fueron evaluados con un cuestionario sobre las mismas tomografía axial computada y resonancia magnética nuclear. En el grupo A, el 13% de los estudiantes respondió correctamente, mientras que nadie lo hizo así en el grupo B. Dos por ciento del grupo A dieron respuestas erróneas a todas las preguntas, mientras que ascendió al 26% en el grupo B. El promedio de respuestas correctas fue de 60% en el grupo A y de 45% en el B. El grupo B se subdividió en B1) aquellos graduados que estudiaron anatomía con imágenes diagnósticas y B2) quienes no lo hicieron. Las respuestas correctas del grupo B1 fue 66% y del grupo B2, 40%. Estos resultados muestran la significación del conocimiento anatómico para la identificación de las diferentes estructuras en imágenes diagnósticas. Mientras los estudiantes desarrollaban el curso de Anatomía la identificación fue más sencilla, y resultó más compleja cuando transcurrió el tiempo. Sin embargo, los resultados fueron mejores en  aquellos graduados que cursaron con identificación de estructuras anatómicas en imágenes diagnósticas que en aquellos que no lo hicieron. The importance of anatomical knowledge for the comprehensive understanding of the diagnostic images is well known and accepted. Development of new techniques, based on computerized tomography and magnetic resonance have increased the requisite core knowledge. In our Faculty, the course of Anatomy includes the identification of normal anatomical structures in diagnostic images. We intend to demonstrate the long-term results provided by this curricular change. This study considered the following two groups: A) 274 first year medical students, B) 100 recently graduated physicians. Both groups were evaluated on their comprehension of computed tomography and magnetic resonance. In group A, 13% of the students answered all questions correctly; while 0% did in group B. Two per cent of the people in group A incorrectly answered all the questions; this percentage rose to 26% in group B. The average of correct answers in group A was 60%, while it was 45% in group B. Group B was further subdivided into B1) those graduates that studied anatomy with diagnostic images and B2) those who did not. Group B1 answered correctly on 66% of questions and group B2’s correct responses were at 40%.These results showed the significance of anatomical knowledge necessary to identify the different structures in diagnostic images. Students scored better on this evaluation instrument when they were taking Anatomy, as compared to graduates who were further removed from the content. However, results were better for those graduates that had taken an anatomy course identifying the anatomical structures in the diagnostic images, than those who did not. 

Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 157-163 ◽  
Author(s):  
A. Franek ◽  
L. Brzezinska-Wcislo ◽  
E. Blaszczak ◽  
A. Polak ◽  
J. Taradaj
Keyword(s):  
Drug Therapy ◽  
Randomized Clinical Trials ◽  
Therapy Group ◽  
Long Term Results ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Group A ◽  
Group B ◽  
Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

Evaluation of comparative efficacy of Guda Sunthi and Manjistha Guggulu Avapeedana Nasya in Manyastambha (Cervical Spondylitis)

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Manjunath Akki ◽  
Suresh Hakkandi ◽  
Arti Panwar
Keyword(s):  
Complete Remission ◽  
Routine Activities ◽  
Household Work ◽  
Comparative Efficacy ◽  
Exclusion Criteria ◽  
Patient Complaints ◽  
The People ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B

Manyastambha is described under Nanatmaja Vatavyadhi. It is a condition where, the aggravated Vata get localized in the Manya Pradesha causing symptoms like Stambha and Shoola. Manyastambha can be compared with earliest symptoms of cervical spondylitis. In this condition, patient complaints of neck pain. The neck is held rigidly and neck movements may exacerbate pain. Now a day, Cervical spondylitis is very common in the people who do routine activities like travelling, household work, desk job etc. It can be seen in people as early as 25 years of age. In Manyastambha, Nasya is the main line of treatment. (i.e. Vatakaphahara Nasya). Objectives: To evaluate the comparative efficacy of Guda Sunthi Avapeedana Nasya and Manjistha Guggulu Avpeedana Nasya in Manyastambha (Cervical Spondylitis). Materials and Methods: This is a comparative clinical study conducted to assess the efficacy in Manyastambha. As per the inclusion and exclusion criteria, the patients who fulfill the criteria were randomly selected and equally divided into two groups. Group A - 15 Patients received Guda-Sunthi Avapeedana Nasya. Group B - 15 Patients received Manjistha-Guggulu Avapeedana Nasya. Results and Conclusion: In Group A, 9 patients (60%) showed complete remission and 6 patients (30%) showed marked response. In Group B, 3 patients (20%) showed complete remission, 1 patient (7%) showed marked response. 6 patients (30%) showed moderate response, 4 patients (26%) showed mild response and 1 patient (7%) showed unchanged response.

Risk of Damaging Anatomical Structures During Minimally Invasive Hallux Valgus Correction (Bösch Technique): An Anatomical Study

2018 ◽  
Vol 39 (11) ◽  
pp. 1355-1359 ◽  
Author(s):  
Martin Kaipel ◽  
Lukas Reissig ◽  
Lukas Albrecht ◽  
Stefan Quadlbauer ◽  
Joachim Klikovics ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Complication Rate ◽  
Metatarsal Osteotomy ◽  
Anatomical Structures ◽  
Intensive Training ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Percutaneous, transverse distal metatarsal osteotomy with K-wire fixation (the Bösch technique) is an established technique for hallux valgus correction. Nevertheless, the risk of damaging the anatomical structures during the operation is unknown. Methods: Forty fresh-frozen anatomical foot specimens with hallux valgus deformity underwent a percutaneous corrective procedure. Specimens of group A (n = 20) were operated by an experienced surgeon while specimens of group B (n = 20) were done by untrained residents. Results: The dorsal cutaneous nerve was injured in 1 of 20 cases in group A and 6 of 20 cases in group B ( P = .037). There was a significant difference in overall complication rate between specimens of group A and group B ( P = .043). Conclusions: The results show an increased risk of perioperative injury of the dorsal cutaneous branch of the deep peroneal nerve as well as a significant effect of the surgeon’s experience on the overall complication rate. Clinical Relevance: Results of this study are highly relevant for all surgeons who perform percutaneous, minimally invasive hallux valgus surgery to avoid damage to the peripheral nerves. In addition, the data suggest an intensive training for surgeons before minimally invasive hallux valgus surgery is performed without supervision.

scholarly journals Surgical treatment of pulmonary sequestration in adults and children: long-term results

2020 ◽  
Vol 31 (1) ◽  
pp. 71-77
Author(s):  
Beatrice Trabalza Marinucci ◽  
Giulio Maurizi ◽  
Camilla Vanni ◽  
Giuseppe Cardillo ◽  
Camilla Poggi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory Symptoms ◽  
Pulmonary Sequestration ◽  
Adult Patients ◽  
Long Term Results ◽  
Study Results ◽  
Group A ◽  
Group B ◽  
Histological Results

Abstract OBJECTIVES Few experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection. METHODS Between 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: ≤16 years old) and 14 were adults (group B: >16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared. RESULTS Thirty-seven percent of the patients in group A presented with respiratory symptoms and 79% in group B (P = 0.44). Most symptomatic patients were treated with a lobectomy. In group A, 2 patients (3%) had a malignant transformation of the lesion. Patients with a prenatal diagnosis treated after the age of 1 year became more symptomatic than those operated on before the age of 1 year (57% vs 23%; P = 0.08). No differences were found in postoperative complications. Long-term stable remission of respiratory symptoms was obtained in 91% of patients in group A and 100% in group B. Adulthood (P = 0.03) and the association with congenital cystic adenomatoid malformation (P = 0.03) were negative prognostic factors for the development of respiratory symptoms. CONCLUSIONS Surgical treatment of PS is safe and feasible. Despite the small number of patients included, study results indicated that an early operation during childhood may prevent the subsequent development of respiratory symptoms. Surgical treatment is also recommended to prevent the rare transformation into malignancy.

Preoperative Intra-Arterial Mitomycin-C in the Management of Sigmoid Adenocarcinoma: Long-Term Results of a Pilot Study

1994 ◽  
Vol 80 (5) ◽  
pp. 339-343
Author(s):  
Giovanni Battista Secco ◽  
Roberto Fardelli ◽  
Elisabetta Campora ◽  
Mario Roberto Sertoli ◽  
Giovanni De Caro ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sigmoid Colon ◽  
Mitomycin C ◽  
Mesenteric Artery ◽  
Long Term Results ◽  
Curative Surgery ◽  
Arterial Infusion ◽  
Group A ◽  
Group B

Aims and background In patients undergoing potentially curative surgery for colorectal adenocarcinoma, the presence of occult disease is thought to be responsible for distant metastases, particularly of the liver. During the 1980's preoperative intra-arterial chemotherapy was used in patients with adenocarcinoma of the sigmoid colon since it was thought that the biological effects induced by radiation in rectal lesions could be induced by cytotoxic agents in sigmoid cancer which was found to be less sensitive to radiation. The aim of the present paper is to report long-term results of an early pilot study on 20 patients with sigmoid colon adenocarcinoma treated with a 6 preoperative intra-arterial infusion of mitomycin-C followed by curative surgery. Methods From January 1980 to December 1986, 20 patients with adenocarcinoma of the sigmoid colon were treated with a 6 hours preoperative intra-arterial infusion of mitomycin-C followed by potentially curative surgery (Group A). Eighteen hours prior to surgery the patients underwent selective arteriography of the inferior mesenteric artery through puncture of the femoral artery at the inguinal fold. The Seldinger technique was applied and Cook BP6 catheter was used. At the end of the examination, the catheter was positioned in the inferior mesenteric artery and mitomycin-C, 10 mg/m2, was infused in 500 mi of normal saline over a 6 hours period after which the catheter was definitively removed. Within 18 hours following intra-arterial mitomycin-C infusion all 20 patients underwent potentially curative surgery of their sigmoid adenocarcinoma. During the same period, 48 comparable sigmoid colon cancer patients underwent potentially curative resection alone (Group B). Results At 5 years overall recurrence rate was 30% and 39.6% in Group A and B patients, respectively (P = n.s.). In patients with Stage C disease, recurrence was less frequently observed in Group A (44.4%) than in Group B (77.7%) (P = n.s.). Overall survival at 5 years was comparable in the two groups of patients (70% and 64% for Group A and B, respectively) and median survival was >60 months in both groups. In patients with Stage C lesions, there was a trend for improved survival at 5 years in Group A patients (55%; median >60 months) compared to Group B (22%; median 27 months) patients (P = n.s.). Conclusions Although the difference indicating decreased recurrences and improved survival for Stage C patients treated with preoperative intra-arterial mitomycin-C were not statistically significant, the long term results of this small pilot study are encouraging.

Absence of Relationship of Myocardial T2* to Right Ventricular Function In Thalassaemia Major

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5160-5160
Author(s):  
Vassilios Perifanis ◽  
Antonia Kondou ◽  
Aikaterini Teli ◽  
Efthimia Vlachaki ◽  
Marina Economou ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Right Ventricular ◽  
Right Ventricular Function ◽  
Lv Function ◽  
Iron Loading ◽  
Thalassaemia Major ◽  
Cardiac Iron ◽  
Group A ◽  
Group B ◽  
Rv Function

Abstract Abstract 5160 Iron-induced cardiac dysfunction is a leading cause of death in transfusion-dependent anemia. Myocardial T2* magnetic resonance imaging (MRI) provides a rapid and reproducible measure of cardiac iron loading and is being increasingly used worldwide for monitoring of transfusion-dependent thalassaemia patients. Recent reports associate myocardial siderosis (T2* <20 ms) with impaired left ventricular (LV) function, as well as with right ventricular (RV) function. As RV dysfunction may play a significant role in heart failure associated with myocardial siderosis the aim of this study was to investigate the relationship between cardiac T2* and RV function in patients treated in a single institution. Methods: A retrospective analysis of 190 well chelated patients with beta-thalassaemia major presenting for their first T2*. MRI scan (examination year 2005) was performed (53.7% male, mean age 26,2±8,3 years). The majority of patients were on Desferrioxamine and 30% were on Deferiprone. Patient's mean ferritin, mean T2* and mean RVEF was 1467±1087 ng/ml, 32,5±15,8ms and 67,9±5,25% respectively. Magnetic resonance images were acquired using a single imager (Philips®, Philips Medical Systems Ltd, Eindhoven, The Netherlands) equipped with a 1.5 Tesla magnet. Each scan included the measurement of heart T2* (mid-septum) together with LV and RV volumes, EF, and mass using previously published techniques. Pearson correlation was used to assess the statistical significance between myocardial T2*, ferritin, RV volumes (End Systolic and End Diastolic), and EF. Results: In 156 patients (Group A) with normal myocardial T2* (>20 ms), the RV ejection fraction (EF) was within the normal range (>55%) in all of them. Mean ferritin, mean T2* and mean RVEF for Group A was 1397±1007ng/ml, 39±11ms and 68,6 ±4,8% respectively. No correlation with feritin was found. In the remaining 34 patients (Group B) with myocardial T2* <20ms, mean ferritin, mean T2* and mean RVEF was 1664±1341ng/ml, 10,8±4,2ms and 64,8±7,35% respectively. Although there was a good correlation between T2* and RVEF for the entire group (A+B) (r=0,312, p=0,001) we did not find a correlation between T2* and RVEF for Group B (r=0,074, p=ns). In the contrary there was a strong correlation between T2* and ferritin for Group B (r=0,382, p=0,0034). There was no other significant correlation between T2* and RESV, REDV for both groups. There was a linear relationship between RV and LVEF for the whole group (r=0,454, p=0,001), for Group A (r=0,269, p=0,015) and more significant for Group B (r=0,720, p=0,001). Conclusions: Myocardial iron deposition by MRI seems not to be associated with RV dysfunction, although it is related to ferritin. The decrease in LV function seen with worsening cardiac iron loading does not necessarily predicts right ventricular dysfunction. The only limitation of our study is that in contrast with other reports the percentage of patients with abnormal T2* was smaller (18%). Larger studies are required to determine the relation of right ventricular function and cardiac iron overload. Disclosures: No relevant conflicts of interest to declare.

Surgical Versus Non-Surgical Treatment of Calcaneal Fractures in Children: A Long-term Results Comparative Study

2000 ◽  
Vol 21 (10) ◽  
pp. 825-832 ◽  
Author(s):  
Francesco Ceccarelli ◽  
Cesare Faldini ◽  
Franco Piras ◽  
Sandro Giannini
Keyword(s):  
Surgical Treatment ◽  
Skeletal Maturity ◽  
Long Term Results ◽  
Calcaneal Fractures ◽  
Articular Fractures ◽  
Fractures In Children ◽  
Group A ◽  
Group B ◽  
Non Surgical Treatment

This study compared surgical and non-surgical treatment of 46 calcaneal fractures in children aged 3-17 years. Patients were divided into: Group A ranging 3-14 years and Group B 15-17 years, and classified according to surgical or non-surgical treatment. Mean follow-up was 22.8 years. Extra-articular fractures were treated non-surgically and all results were satisfactory. Results of articular fractures in Group A were satisfactory regardless of the type of treatment. Articular fractures surgically treated in group B were satisfactory, and those non-surgically treated were mainly poor. Extra-articular fractures can be treated non-surgically. Articular fractures in skeletally immature children can be treated non-surgically; conversely, those in children with skeletal maturity must be treated surgically.

Disruption of the Finger Flexor Pulley System in Elite Rock Climbers

1998 ◽  
Vol 26 (5) ◽  
pp. 651-655 ◽  
Author(s):  
Markus Gabl ◽  
Christoph Rangger ◽  
Martin Lutz ◽  
Christian Fink ◽  
Ansgar Rudisch ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Nonoperative Treatment ◽  
Proximal Interphalangeal Joint ◽  
Magnetic Resonance Images ◽  
Resonance Imaging ◽  
Pulley System ◽  
Group A ◽  
Complete Disruption ◽  
Group B

We treated 13 elite rock climbers for isolated disruptions of the pulleys of the long fingers. Diagnosis and treatment were based on the clinical finding of bowstringing, which was confirmed by magnetic resonance imaging. Eight patients had bowstringing indicating incomplete disruption of the major pulley A2 and were treated nonoperatively (group A). Five patients showed bowstringing indicating complete disruption of the pulley A2. After failed nonoperative treatment, the pulleys were reconstructed (group B). The mechanism of injury and clinical and subjective results were evaluated. At a 31-month follow-up (range, 18 to 43 months), loss of extension in the proximal interphalangeal joint measured 5.6° (range, 0° to 10°) in group A and 4° (range, 0° to 10°) in group B. Circumference of the finger section was increased 4.2 mm in group A (range, 0 to 10 mm) and 4.8 mm in group B (range, 0 to 10 mm). Grip strength decreased 20 N in group A (range, 10 to 50 N) and 12 N in group B (range, 10 to 30 N). Four patients in group A and one in group B had bowstringing at clinical evaluation. On follow-up magnetic resonance images, bowstringing remained unchanged in group A but was reduced in all patients in group B. Good subjective results were seen in both groups.

scholarly journals Standard Surgical Approaches to Primary Choledocholithiasis — Definitive Versus Temporary Decompression

HPB Surgery ◽  
1992 ◽  
Vol 6 (1) ◽  
pp. 35-49
Author(s):  
António Castro Mendes de Almeida ◽  
Fernando José Aldeia ◽  
Noel Medina dos Santos ◽  
Caetano Winston Gracias
Keyword(s):  
Revisional Surgery ◽  
Imaging Techniques ◽  
Intraoperative Imaging ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Anastomotic Complications ◽  
T Tube ◽  
Group A ◽  
Group B

The occurrence of retained/recurrent calculi after primary CBDE followed by temporary T-tube decompression, have remained at rates varying from 5.4% to 20.9% over the last 10 years in spite of sophisticated pre and intraoperative imaging techniques. It is postulated that a functional obstruction, due to dysmotility of the SO, lies behind most stone-containing ducts. Thus it seems logical to us that a permanent “fenestration” should be the management of most such ducts.We prospectively followed-up, for one to 10 years, two groups of patients submitted to primary CBDE aiming to assess the short and long-term results of two different surgical approaches to duct lithiasis. In one (Group A) 162 CBDE's were performed, out of 680 CHE's (24%), with a “positivity” of 68% and in the other (Group B) 80 CBDE's, out of 438 CHE's (18%), with a “positivity” of 70%. In Group A a T-tube decompression was used in 79(49%) and a definitive drainage in 83(51%) whereas in Group B the T-tube was employed in only 3(4%) and some form of permanent “fenestration” in 77(96%). There were no significant differences between the operative mortality rates, which were 2.5% in Group A (1 death post T-tube, 3 post CDJ) and 1.3% in Group B (1 death post CDD). The long-term results, though, were significantly worse among patients of Group A whose ducts were temporarily decompressed: 10/79 (12.7%) required further aggressive interventional therapy for retained/recurrent stones while only 3.8% (3/80) in Group A and 1.3% (1/76) in Group B required revisional surgery for bilio-digestive anastomotic complications with cholangitis.It is concluded that it is against the long-term efficiency of the approach utilized in Group B that the new laparoscopic techniques should be compared.

scholarly journals Is Additional Cardiac Procedure A Catastrophic Risk During Bentall Operation? Long Term Results in A Tertiary Center

2021 ◽  
Vol 16 (5) ◽  
Author(s):  
Mehmet Ali Yesiltas
Keyword(s):  
Cardiac Surgery ◽  
Long Term Results ◽  
Mortality And Morbidity ◽  
Single Center Experience ◽  
Bentall Procedure ◽  
Cardiac Procedure ◽  
Tertiary Center ◽  
Surgical Data ◽  
Group A ◽  
Group B

The aim of this study was to assess the influences of concomitant cardiac surgery on the risk for mortality and morbidity after Bentall procedure. This retrospective study was a review of patients who underwent Bentall procedure from a single center experience over a 7-year period. Demographic features, surgical data, postoperative period and outcomes were analyzed. Patients with isolated Bentall surgery (Group A) were compared and concomitant cardiac surgery with Bentall procedure were compared (Group B).

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