scholarly journals Non-papillary Percutaneous Puncture: A Safe Approach to Consider

EMJ Urology ◽  
2021 ◽  
pp. 91-94
Author(s):  
Arman Tsaturyan ◽  
Panagiotis Kallidonis ◽  
Evangelos Liatsikos
Keyword(s):  
Gold Standard ◽  
Treatment Modality ◽  
Standard Treatment ◽  
Renal Stones ◽  
Field Studies ◽  
Renal Papilla ◽  
Puncture Site ◽  
Perioperative Bleeding ◽  
Safe Approach ◽  
Puncture Technique

Percutaneous nephrolithotomy (PCNL) is the ‘gold standard’ treatment modality for renal stones larger than 2 cm. It can be also applied to manage smaller renal stones and large, impacted stones located in the proximal ureter. Nevertheless, even in experienced hands, the PCNL procedure is associated with the development of several complications. Despite the existing extensive research in this field, studies evaluating the effect of puncture site on perioperative bleeding are very few. In part, this can be explained by the dogma that the safest way to perform kidney puncture is through the renal papilla. In this paper, the authors summarise their experience of non-papillary PCNL and demonstrate this puncture technique for PCNL tract establishment.

scholarly journals Is standard percutaneous nephrolithotomy still the standard treatment modality for renal stones less than three centimeters?

2017 ◽  
Vol 43 (2) ◽  
pp. 165-170
Author(s):  
Omer Sarilar ◽  
Faruk Ozgor ◽  
Onur Kucuktopcu ◽  
Burak Ucpinar ◽  
Mehmet Fatih Akbulut ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Treatment Modality ◽  
Standard Treatment ◽  
Renal Stones

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Delayed unilateral pneumocephalus after bilateral endoscopic dacryocystorhinostomy in an elderly patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241540
Author(s):  
Jaekyoung Lee ◽  
Dong Cheol Lee
Keyword(s):  
Elderly Patient ◽  
Cerebrospinal Fluid ◽  
Gold Standard ◽  
Standard Treatment ◽  
Nasolacrimal Duct ◽  
Intravenous Antibiotic ◽  
Duct Obstruction ◽  
Orbital Wall ◽  
Silicone Intubation ◽  
Endoscopic Dcr

Dacryocystorhinostomy (DCR) is the ‘gold standard’ treatment for nasolacrimal duct obstruction (NLDO). However, despite its recent technical advancements, complications are possible. Herein, to the best of our knowledge, we present the first reported case of delayed unilateral pneumocephalus after bilateral endoscopic DCR. An 85-year-old man with bilateral NLDO underwent endoscopic DCR with silicone intubation. After 1 month, he became lethargic and was admitted to emergency room. Brain CT demonstrated left pneumocephalus and a suspected microfistula in left orbital wall. Intravenous antibiotic therapy was started, and cerebrospinal fluid studies showed no evidence of meningitis. After 13 days of antibiotic treatment, his mental state recovered with no signs of pneumocephalus. Although DCR has high success rate and is relatively safe, surgeons should be aware of the risk, although low, of pneumocephalus, especially in elderly patients who are vulnerable to fractures and who exhibit headache or mental status changes after endoscopic DCR.

scholarly journals Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

2021 ◽  
Vol 28 (4) ◽  
pp. 2317-2325
Author(s):  
Luigi Bennardo ◽  
Francesco Bennardo ◽  
Amerigo Giudice ◽  
Maria Passante ◽  
Stefano Dastoli ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gold Standard ◽  
Systemic Chemotherapy ◽  
Standard Treatment ◽  
Case Reports ◽  
Case Series ◽  
Surgical Removal ◽  
Local Chemotherapy

Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

Treatment of vertigo and postural instability using visual illusions

2014 ◽  
Vol 128 (11) ◽  
pp. 1005-1007 ◽  
Author(s):  
G van Kerckhoven ◽  
A Mert ◽  
J A De Ru
Keyword(s):  
Gold Standard ◽  
Prosthetic Valve ◽  
Standard Treatment ◽  
Vestibular Function ◽  
Prosthetic Valve Endocarditis ◽  
Postural Instability ◽  
Risk Of Falling ◽  
Important Advance ◽  
Dizziness Handicap Inventory ◽  
Increased Risk

AbstractBackground:Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current ‘gold standard’ treatment available.Case report:A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function.Results:The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score.Conclusion:Computer-aided rehabilitation programmes might represent an important advance in gait and posture training.

scholarly journals The Clinical Concept of Fibromyalgia as a Changing Paradigm in the Past 20 Years

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Mary-Ann Fitzcharles ◽  
Muhammad B. Yunus
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Good Health ◽  
Pain Processing ◽  
Predictors Of Outcome ◽  
Rational Treatment ◽  
The Past ◽  
Active Patient ◽  
Pharmacologic Treatments ◽  
Clinical Concept

Fibromyalgia (FMS) is a valid clinical condition that affects 2%–4% of the population with a pivot symptom of widespread body pain. The cause and cure of FMS are as yet unknown. The concept of FMS has evolved over the past two decades to incorporate symptoms beyond pain as contributing to the global spectrum of suffering. FMS is now recognized to be grounded in the neurological domain with evidence of dysregulation of pain processing. Appreciation of the neurophysiologic mechanisms operative in FMS has contributed to rational treatment recommendations, although a “gold standard treatment” does not currently exist. Ideal treatments for FMS patients should be individualized with emphasis on active patient participation, good health practices, and multimodal intervention, incorporating nonpharmacologic and pharmacologic treatments. Predictors of outcome, which is favourable in over 50% of patients, are unknown, but those with better outcome do more physical activity and use fewer medications.

scholarly journals Submandibular schwannoma: is excision a ‘gold standard treatment’?

2015 ◽  
pp. bcr2015209900
Author(s):  
Sarah Siaki Loterh ◽  
Vinod Prabhu ◽  
Ciaran O'Brien
Keyword(s):  
Gold Standard ◽  
Standard Treatment

scholarly journals Gallbladder volvulus: a case report

2019 ◽  
pp. 1-2
Author(s):  
Tomas Urbonas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Computer Tomography ◽  
Small Proportion ◽  
Gold Standard ◽  
Crucial Role ◽  
Standard Treatment ◽  
Rare Condition ◽  
Computer Tomography Scan ◽  
Tomography Scan

The gallbladder volvulus is a rare condition. There have been around 500 cases described worldwide. It is virtually impossible to diagnose it clinically as symptoms are analogous to those of acute cholecystitis. Small proportion of gallbladder volvulus cases get accurately diagnosed preoperatively according to available literature. The imaging such as computer tomography plays a crucial role in diagnosing this condition. Laparoscopic cholecystectomy is considered to be a gold standard treatment for this condition. In our report we present a case of gallbladder volvulus which was successfully diagnosed by means of computer tomography scan

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