scholarly journals Illicit Penile Augmentation: A Short Review in a Single Institution

2020 ◽  
pp. 7-12
Author(s):  
Muhammad Izzuddin Hamzan ◽  
Mohamad Jeremi Jeffrey ◽  
Ahmad Sukari Halim
Keyword(s):  
Sexual Satisfaction ◽  
Large Scale ◽  
Well Being ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Presenting Symptoms ◽  
Post Surgery ◽  
Constant Pain ◽  
Surgical Methods

Illicit penile augmentation is thought to be a common practice in Southeast Asia. This article aimed to explore the demographics of the patient who had illicit penile augmentation, its complications, surgical methods employed for removal as well as the long-term outcome following treatment, specifically on sexual satisfaction. Method. Records of patients with a penile foreign body to the Reconstructive Science Unit were retrieved. Demographics, presenting symptoms, surgical methods and outcomes were recorded and analyzed. Results. A total of 14 patients was identified. The median age at implantation and duration is 36 years old and 48 months respectively. The penile subdermal injection was the sole method utilized with the use of liquid silicone in 7 patients. Constant pain, painful erection, and discomfort were common symptoms (42.8%). All patients underwent surgical excision followed with either native (penile skin) full-thickness skin graft (FTSG), distant donor FTSG or primary closure. Five out of 7 patients report improved sexual satisfaction post-surgery. Conclusion. This report demonstrated two groups of men with distinct age, duration of implant and possibly differing motivation for penile augmentation. The various complications presented stem from inflammation and scarring. Distant FTSG donor has a superior take rate compared to native FTSG. Long term outcome following treatment on sexual well-being is generally good. Illicit penile augmentation is generally unsafe, however, a large-scale study is required to establish the prevalence of the practice. 

scholarly journals Non-functioning pituitary adenoma database: a useful resource to improve the clinical management of pituitary tumors

2006 ◽  
Vol 155 (6) ◽  
pp. 823-829 ◽  
Author(s):  
Emanuele Ferrante ◽  
Monica Ferraroni ◽  
Tristana Castrignanò ◽  
Laura Menicatti ◽  
Mascia Anagni ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Tumors ◽  
Term Outcome ◽  
Long Term Outcome ◽  
North West ◽  
Presenting Symptoms ◽  
Post Surgery ◽  
First Choice

Objective: The long-term outcome of non-functioning pituitary adenoma (NFPA) patients is not clearly established, probably due to the low annual incidence and prolonged natural history of these rare tumors. The aim of this study was to evaluate clinical data at presentation and long-term post-surgery and radiotherapy outcome in a cohort of patients with NFPA. Design and methods: A computerized database was developed using Access 2000 software (Microsoft Corporation, 1999). Retrospective registration of 295 NFPA patients was performed in seven Endocrinological Centers of North West Italy. Data were analyzed by STATA software. Results: The main presenting symptoms were visual defects (67.8%) and headache (41.4%) and the most frequent pituitary deficit was hypogonadism (43.3%), since almost all tumors were macroadenomas (96.5%). Surgery was the first choice treatment (98% of patients) and total debulking was achieved in 35.5%. Radiotherapy was performed as adjuvant therapy after surgery in 41% of patients. At the follow-up, recurrence occurred in 19.2% of patients without post-surgical residual tumor after 7.5 ± 2.6 years, regrowth in 58.4% of patients with post-surgical remnant after 5.3 ± 4.0 years and residue enlargement in 18.4% of patients post-surgically treated with radiotherapy after 8.1 ± 7.3 years. Conclusions: Our database indicates that the goal of a definitive surgical cure has been achieved during the last decade in a low percentage of patients with NFPA. This tumor database may help to reduce the delay between symptom onset and diagnosis, to assess prognostic parameters for the follow-up of patients with different risk of recurrence and to define the efficacy and safety of different treatments and their association with mortality/morbidity.

Evaluation of Clinical, Laboratory and Ultrasonography Variables as Prognostic Indicators in Equine Colic Surgery

2021 ◽  
Author(s):  
Gurpal Singh ◽  
Vandana Sangwan ◽  
Arun Anand ◽  
Jasmeet Singh Khosa ◽  
Simrat Sagar Singh ◽  
...  
Keyword(s):  
Wheat Straw ◽  
Prognostic Indicators ◽  
Peritoneal Cytology ◽  
Polymorphonuclear Cells ◽  
Intestinal Histology ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Surgery ◽  
Equine Colic

Background: Equine colic surgery is an expensive procedure and availability of reliable prognostic indicators aid in decision making process. This study aimed to evaluate clinical, hemato-biochemistry, ultrasonography, surgery and peritoneal cytology / intestinal histology as prognostic indicators (based on strangulating vs non-strangulating lesion) for equine colic surgery. Methods: Fifteen equines {13 females and 2 males; 5 Thoroughbred, 9 Marwari and one mule} operated for intestinal colic were investigated. The feeding history, pre and post-surgery clinical, hematological and biochemical findings were recorded. Pre and post-surgery ultrasonography, peritoneal cytology and intestinal histology were done. Three equine were euthanized intra-operatively and 12 were followed for short and long term outcome. Result: On surgery, three equine were diagnosed for strangulating (right dorsal displacement of large colon, large colon volvulus and small colon strangulation) and 12 for non-strangulating colic {impaction (3), fecalith (5), sand colic (2), foreign body (1) and small intestine ileus (1)}. Detection of polymorphonuclear cells alone or with lymphocytes on peritoneal fluid cytology was indicator of good prognosis. Feeding of wheat straw is major predisposing factor for non-strangulating colic in Marwari breed but had favorable surgical prognosis (7/9=77.78%). While Thoroughbreds, not on wheat straw, are susceptible to strangulating colic that require early referral for favorable surgical outcome. Prolonged capillary refill time, injected mucous membranes, absent borborygymi, high serum creatine kinase and glucose are poor prognostic indicators for colic surgery. Thoroughbred equine with severe pain, elevated levels of Hb, neutrophils, packed cell volume (PCV), serum glucose and low peritoneal total protein are indicators of strangulating lesion. The equine colic surgery bears a very good short term (10/12=83.33%) and excellent (10/10=100%) long term outcome. 

P2267CTEPH patients long term follow-up: results from a single center

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Mladoniczky ◽  
M Szegedi ◽  
Z S Piroth ◽  
J Nemeth ◽  
L Ablonczy ◽  
...  
Keyword(s):  
Nyha Class ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Walking Distance ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Surgery ◽  
Significant Difference ◽  
Long Term Follow Up

Abstract Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a thrombotic pulmonary disease associated with pulmonary vasculopathy. Pulmonary endarterectomy (opus, PEA) is the first treatment choice in CTEPH, and specific PAH medication when there is a contraindication for surgery or residual pulmonary arterial hypertension (rPAH) occurs. In the presence of PAH balloon pulmonary angioplasty (BPA) might be also recommended if available. Objective We investigated the long term outcome of our CTEPH patients. Methods CTEPH from our institution retrospectively analyzed (data between 2003 and 2018). Baseline, treatment and outcome data were documented. We compared the outcome, together with mortality in those with and without surgery (PEA vs. non PEA group). NYHA class, 6 minutes walking distance (6MWD) and NT-proBNP were also reported during follow-up. Results Of 29 CTEPH patients (mean age was 62±19 years, 52% male) 16 (55%) were accepted for PEA, and further 12 of them had a long term follow-up post surgery (n=3 periop exit, n=1 waiting for surgery). Half of the PEA patients were cured (n=6) and the other half (n=6) required specific PAH treatment (n=1, in combination with BPA) for rPAH. All patients from the non-PEA group (n=13) were started on specific PAH treatment (n=1 in combination with BPA). Patients with or without PEA did not differ hemodynamically. At the late follow-up there was a significant improvement in PEA group for NYHA class and NT-proBNP (p<0,001, and p=0,046), and in non PEA group for NYHA class and the 6MWD (p=0,012, and 0,006). We found significant difference in mortality at 1,3,5 year (Kaplan-Meier survival analysis) follow-up, for PEA group 100%-100%-100% and non PEA group 100%-85%-78% (p=0,013), respectively. Conclusions 55% of CTEPH patients were suitable for PEA, and those who survived the surgery 50% were cured. Non PEA patients improved functionally on the long term, but had worse survival.

scholarly journals Long-term outcome after resection of brainstem hemangioblastomas in von Hippel-Lindau disease

2011 ◽  
Vol 114 (5) ◽  
pp. 1312-1318 ◽  
Author(s):  
Joshua J. Wind ◽  
Kamran D. Bakhtian ◽  
Jennifer A. Sweet ◽  
Gautam U. Mehta ◽  
Jayesh P. Thawani ◽  
...  
Keyword(s):  
Functional Status ◽  
Functional Decline ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Von Hippel Lindau ◽  
Presenting Symptoms ◽  
Vhl Disease

Object Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in patients who underwent resection of brainstem hemangioblastomas. Methods Consecutive patients with VHL disease who underwent resection of brainstem hemangioblastomas with a follow-up of 12 months or more were included in this study. Serial functional assessments, radiographic examinations, and operative records were analyzed. Results Forty-four patients (17 male and 27 female) underwent 51 operations for resection of 71 brainstem hemangioblastomas. The most common presenting symptoms were headache, swallowing difficulties, singultus, gait difficulties, and sensory abnormalities. The mean follow-up was 5.9 ± 5.0 years (range 1.0–20.8 years). Immediately after 34 operations (66.7%), the patients remained at their preoperative functional status; they improved after 8 operations (15.7%) and worsened after 9 operations (17.6%) as measured by the McCormick scale. Eight (88.9%) of the 9 patients who were worse immediately after resection returned to their preoperative status within 6 months. Two patients experienced functional decline during long-term follow-up (beginning at 2.5 and 5 years postoperatively) caused by extensive VHL disease–associated CNS disease. Conclusions Generally, resection of symptomatic brainstem hemangioblastomas is a safe and effective management strategy in patients with VHL disease. Most patients maintain their preoperative functional status, although long-term decline in functional status may occur due to VHL disease–associated progression.

scholarly journals Del Nido vs St Thomas II Cardioplegia in Adult cardiac surgery: A prospective randomized trial of short-term outcomes

2021 ◽  
Author(s):  
Aravind Kalyanasundaram ◽  
Sreevathsa Prasad ◽  
Ram Sankar Padmanabhan ◽  
Hemachandran Munusamy ◽  
Bathal SaiChandran ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Myocardial Protection ◽  
Troponin T ◽  
Adult Population ◽  
Randomized Study ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Surgery

Aim/Objective: To assess short term clinical outcomes based on peri-operative troponin T levels (before start of surgery, 2 hours and 12 hours after coming of CPB) of adult patients undergoing cardiac surgery using the del Nido cardioplegia technique compared with st thomas conventional blood cardioplegia Material and method: This was a prospective randomized study with a sample size of 100, which included patients with valvular heart disease requiring single valve replacement in our center from February 2019 to march 2020. Simple randomization technique was used for dividing into two groups of 50 patients each and were given del-nido or st Thomas II cardioplegia accordingly. Perioperative TROPONIN levels, TEE ejection fraction, post-operative inotrope requirement was analyzed. Results: Total of 100 Patients were enrolled in the studie. Mean troponin T immediate post CPB was 559.76 in del nido and 531.14 in blood showing no significance (P 0.146) and 24hrs post-surgery where 290.08 and 231.6 respectively with no significant (0.089) difference. Other parameters like coming of pump need for defibrillation(p-0.629), change in EF measured pre and post CPB (p-0.678) did not show any signifance. Conclusion: Myocardial protection in open cardiac surgery is still evolving. Del-nido cardioplegia is a viable alternative to st thomas cardioplegia which has proven to be statically equivalent in myocardial protection in adult population also. Further studies are required to look into the long-term outcome of use of del nido and to expand the use of del-nido cardioplegia in other adult open cardiac surgeries.

Clinical outcome of glioblastoma multiforme patients with long-term survival

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2069-2069 ◽  
Author(s):  
H. Yoon ◽  
A. F. Hottinger ◽  
L. M. DeAngelis ◽  
A. B. Lassman ◽  
L. E. Abrey
Keyword(s):  
Glioblastoma Multiforme ◽  
Clinical Outcome ◽  
Age Groups ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Presenting Symptoms ◽  
Dismal Prognosis

2069 Background: Glioblastoma multiforme (GBM) patients generally have a dismal prognosis with average survival of one year. Long-term survival of 3 years or more is rare and the clinical outcome of these patients has been poorly studied. Methods: Retrospective review of patients surviving 3 years or longer following diagnosis of GBM at our institution between 1985 and 2003. Clinical characteristics and long-term outcome were reviewed. Pathology was confirmed at our institution for all patients. Results: 39 long-term survivors of GBM were identified. Median age at diagnosis was 47 years (range: 14 - 69 years). Fifteen patients (pts) were older than 55 at time of diagnosis, and 5 were over 60. Presenting symptoms were headaches (56%), seizures (28%), hemiparesis (12%), aphasia (17%) or confusion (5%). Median KPS at diagnosis was 90 (range: 50–100). One patient (4%) underwent biopsy and X patients each (48%) underwent complete resection and incomplete resections. All patients received focal radiation therapy (RT) with a median dose of 5940 cGy (range: 4500 - 6120 cGy); 7 received concurrent temozolomide. Adjuvant chemotherapy in 35 pts consisted of temozolomide (54%), BCNU (38%), intra-arterial cisplatin (4%), or PCV (4%). Estimated median survival was 6.16 years (range: 3.1 - 18.2). After initial treatment, 11 pts had continuous clinical and radiographic remission, 28 relapsed, and 12 died. Median KPS at last follow-up was 70 (range 40 - 100). However, 19 pts (49%) developed delayed treatment-related complications at a median of 2.7 years (range: 1 -12 years) from initial diagnosis. Six (15%) developed RT necrosis (none of whom received concurrent temozolomide), 12 (31%) developed a subcortical dementia with associated leukoencephalopathy, and 9 (23%) developed strokes thought to be related to prior treatment. Conclusions: Long-term GBM survivors remain rare but occur in all age groups. These patients have a high risk of developing clinically significant long-term complications of their treatment. No significant financial relationships to disclose.

scholarly journals P74 Group counselling: a holistic care model

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Kavitha Nadesalingam ◽  
Catherine Short
Keyword(s):  
Patient Education ◽  
Waiting Times ◽  
Well Being ◽  
Holistic Care ◽  
Dietary Advice ◽  
Holistic Model ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Feedback

Abstract Background Disease modifying anti rheumatic drugs (DMARDs) play a vital role in controlling autoimmune disease. They are complex medications requiring nurse counselling to initiate. Staff vacancies and increasing referrals led to 12-week waiting times from decision to treat in our Trust. We wanted to improve the efficiency of the medication counselling process, but at the same time use it as an opportunity to educate our patients on their disease, management and self-care. Methods We designed and delivered a successful group clinic to improve patient experience, reduce waiting times and improve efficiency. As well as covering the necessary DMARD information, the clinic includes patient education on general, physical and mental well-being, dietary advice as well as physiotherapy and occupational therapy input. The clinic format consists of a presentation/discussion, peer support and individual consultation, providing truly holistic care. Results Waiting times: reduction from 84 days to 7-14 days from decision to treat for our two main DMARDS and 56 days to 14 days for our anti TNF therapies. Clinical outcome/patient safety: Earlier initiation of DMARDs has been shown to reduce morbidity. Financial: Additional £444 income per clinic (compared with previous clinic process) at a tariff of £111 per patient. Group clinics currently run weekly. Patient feedback: 50 patient feedback forms have been collected and reviewed. Of these 50 patients 97.8% of questions asked were marked as agree or strongly agree to a positive experience. Shared learning: The clinic format was presented at a regional meeting and at our Trusts Quality Improvement Day. There is interest in adopting a similar approach in other departments in the Trust and in other rheumatology departments in the region. Conclusion Our group consultation model provides a holistic model to care that has been very popular with our patients. We have subjectively had an increase uptake in physiotherapy services and patients seem to be persevering and tolerating their medications better. Our group consultations have been running successfully for a year, and we have expanded the sessions to cover more drugs including our anti TNF therapies. It is yet early days to comment on the long-term impact our clinic has on patients, but with our clinic providing patient education and empowering patients through self management we are hopeful that we will be improving the long-term outcome of our patients. Disclosures K. Nadesalingam None. C. Short None.

Treatment optimization: The long-term perspective in bipolar disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 2216-2216
Author(s):  
M. Bauer ◽  
P. Ritter ◽  
A. Pfennig
Keyword(s):  
Bipolar Disorder ◽  
Large Scale ◽  
Functional Disability ◽  
Term Treatment ◽  
Documentation System ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Combination Treatments ◽  
Long Term Treatment

Bipolar disorder is for most patients a life-long illness, associated with a recurrent, chronic course, and functional disability. Primary treatment goals are to stabilize the patient and prevent recurrence of episodes and suicide.Although bipolar disorder has traditionally been regarded as an illness with good prognosis and most patients returning to normal functioning when a mood episode is over, several longitudinal studies suggest that the long-term outcome is less favorable than previously thought. Combinations of drugs are frequently used in clinical practice for mood stabilization, especially for those who have not responded to monotherapy. Although combination treatments are commonly administered, full interepisode recovery is not achieved in all patients, and as a consequence, bipolar disorder is one of the leading causes of disability.Among clinicians and in international guidelines, lithium is widely considered as the ‘gold standard’ for long-term treatment. The choice of treatments is undergoing considerable change as new treatments are available, anticonvulsants and atypical antipsychotics are taking a more prominent position. However, the evidence available for the newer treatment options including the various combination treatments varies greatly.The episodic nature of bipolar disorder requires prophylactic long-term treatment. Many previous worthwhile treatment effects of available mood stabilizing agents and psychotherapeutic interventions on major outcomes in bipolar disorder are only of moderate size and therefore require large-scale studies. Such trials to investigate longer-term outcomes are logistically challenging and expensive, and therefore only feasible within a multisite and multinational approach based on a common documentation system of the illness course.

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