Clinical and Radiological Changes after use of Alpha-1 Blocker Therapy in Patients of Posterior Urethral Valve with Bladder Neck Hypertrophy

JMS SKIMS ◽  
2009 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Aejaz A Baba ◽  
Bajpai Minu
Keyword(s):  
Bladder Neck ◽  
Posterior Urethral Valve ◽  
Posterior Urethral Valves ◽  
Blocker Therapy ◽  
Urethral Valve ◽  
Novel Method ◽  
Radiological Changes ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Background: We evaluated the effects of alpha-1 blocker therapy on clinical and radiological abnormalities in patients of posterior urethral valve with bladder neck hypertrophy. Materials and Methods: A total of 74 patients with posterior urethral valves were seen at our department between 2003 and 2007. Out of these 24 had radiological evidence of bladder neck hypertrophy. Those patients with bladder neck hypertrophy who were seen before June 2006 and did not receive alpha-1 blocker (prazocin) therapy after valve ablation were assigned to group 1 (n=10). Group 2 consisted of 14 age matched patients with bladder neck hypertrophy and comparable prognostic factors who received alpha-1 blocker therapy after valve ablation (n=14). Micturating cystourethrography (MCU) was done periodically and a novel method used to calculate bladder neck hypertrophy. Trends in symptoms and radiological changes were evaluated throughout follow-up. Results: Mean patient age at presentation was 3.02±2.68 years in group 1 and 3.12±3.4 years in group 2. Bladder neck hypertrophy decreased from 2.3±1.0 to 2.0±0.5 in a mean time of 52.0 (34-52) weeks in group 1 where as it decreased from 2.2±0.5 to 1.6±0.3 in a mean time of 32.0 (22-52) weeks. Symptomatically patients in group 2 who received alpha-1 blocker therapy after valve ablation were better and had quick resolution of bladder neck hypertrophy. Conclusions: Use of alpha-1 blocker therapy in patients of posterior urethral valve with bladder neck hypertrophy helps in quick resolution of bladder neck hypertrophy. J Med Sci 2009;12(1):3-7.

scholarly journals Can We Use the Silodosin as Second Line Treatment of Benign Prostate Hyperplasia?

2021 ◽  
Author(s):  
Bekir Voyvoda ◽  
Onur Memik ◽  
Onur Karslı ◽  
Murat Üstüner ◽  
Levent Özcan
Keyword(s):  
Surgical Treatment ◽  
Symptom Relief ◽  
Routine Practice ◽  
Prostate Hyperplasia ◽  
Blocker Therapy ◽  
Alpha Blocker ◽  
The Third ◽  
Voiding Symptoms ◽  
Group 2 ◽  
Group 1

Objective: We aimed to investigate the efficacy of silodosin in patients with lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) refractory to previous α-adrenergic receptor (AR) blocker therapy. Materials and Methods: Patients who did not benefit from alpha-blocker therapy but avoided surgical treatment constitute the population of our study. Seventy-five patients were studied in each group; Group 1 was given 8 mg of silodosin, while Group 2 continued the previous alpha-blocker treatment. Results: The initial mean international prostate symptom score (IPSS) was calculated as 20.81±0.97 in Group 1, in the third month there was a decrease of 17.12±1.25 (p<0.05). No significant change was observed in Group 2. In addition, a significant decrease was observed in IPSS subscores (storage and voiding symptoms) in Group 1 compared to baseline at the third month. There was an improvement in residual urine in the silodosin group and no improvement in the other group. Conclusion: In patients with BPH who refuse surgical treatment and could not achieve adequate symptom relief with other α-blockers in routine practice, silodosin was found superior in terms of LUTS recovery. Silodosin is also an effective option in patients who cannot undergo surgical treatment due to comorbidities.

scholarly journals Revisiting conventional adenoidectomy using technology

2020 ◽  
Vol 6 (7) ◽  
pp. 1232
Author(s):  
Kiran Gangadhar S. ◽  
Sonee Thingujam ◽  
Jayita Poduval
Keyword(s):  
Blood Loss ◽  
Paediatric Population ◽  
Lateral View ◽  
Respiratory Pathogens ◽  
Moderate Degree ◽  
Ventilation Tubes ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most frequently applied surgical procedures in the paediatric population, either alone or in conjunction with tonsillectomy and/or insertion of ventilation tubes. The main purpose of the adenoidectomy is to eliminate the nasopharyngeal respiratory pathogens and to remove nasal airway obstruction. Aim of the study was to compare the outcomes of conventional and endoscopic assisted curettage adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> In this comparative study, 50 patients were divided into 2 groups. Group 1 (25 patients) underwent endoscopic curettage adenoidectomy and group 2 (25 patients) underwent conventional curettage adenoidectomy. Intraoperative time, complications and postoperative pain were recorded.  </p><p class="abstract"><strong>Results:</strong> 72% in group 1 and 64% in group 2 had grade 2 adenoid hypertrophy. 68% in group 1 and 64% in group 2 had a moderate degree of obstruction in lateral view of soft tissue X-ray nasopharynx. The mean time taken for surgery in group 1 was 13.29±3.28 minutes, and in group 2,6.28±2.31 minutes. Minimal loss of blood was recorded in group 1 with less than 20 ml, whereas in group 2, the blood loss was high; 30% of patients had blood loss more than 30 ml. In group 1, the mean VAS was 3.25 and 2.55 in group 2 2.55. In group 1, 4% of patients had primary haemorrhage and in group 2, 8% of patients had primary haemorrhage. No patient had velopharyngeal dysfunction in either group.</p><p class="abstract"><strong>Conclusions:</strong> More operative time but less blood loss were noted in endoscopic adenoidectomy. Intraoperative visualisation of the nasopharynx in endoscopic procedures showed no significant advantage over conventional adenoidectomy.</p>

Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic

2021 ◽  
pp. 001857872110375
Author(s):  
Frank A. Fanizza ◽  
Jennifer Loucks ◽  
Angelica Berni ◽  
Meera Shah ◽  
Dennis Grauer ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Medication Adherence ◽  
Hcv Treatment ◽  
Clinical Pharmacists ◽  
The Mean ◽  
Group 2 ◽  
Cure Rates ◽  
The Impact ◽  
Mean Time ◽  
Group 1

Background: Modern hepatitis C virus (HCV) treatment regimens yield cure rates greater than 90%. However, obtaining approval for treatment through the prior authorization (PA) process can be time consuming and require extensive documentation. Lack of experience with this complex process can delay HCV medication approval, ultimately increasing the amount of time before patients start treatment and in some cases, prevent treatment altogether. Objectives: Assess the impact of incorporating clinical pharmacists into specialty pharmacy and hepatology clinic services on medication access, patient adherence, and outcomes in patients being treated for HCV. Methods: We performed a retrospective cohort exploratory study of patients seen in an academic medical center hepatology clinic who had HCV prescriptions filled between 8/1/15 and 7/31/17. Patients were categorized by whether they filled prescriptions prior to (Pre-Group) or after (Post-Group) the implementation of a pharmacist in clinic. The Post-Group was further divided according to whether the patient was seen by a pharmacist in clinic (Post-Group 2) or if the patient was not seen by the pharmacist, but had their HCV therapy evaluated by the pharmacist before seeking insurance approval (Post-Group 1). Results: The mean time from the prescription being ordered to being dispensed was longer in the Pre-Group (50.8 ± 66.5 days) compared to both Post-Groups (22.2 ± 27.8 days in Post-Group 1 vs 18.9 ± 17.7 days in Post-Group 2; P < .05). The mean time from when the prescription was ordered to when the PA was submitted was longer in the Pre-Group (41.6 ± 71.9 days) compared to both Post-Groups (6.3 ± 16 in Post-Group 1 vs 4.1 ± 9.7 in Post-Group 2; P < .05). Rates of medication adherence and sustained virologic response were similar between all groups. Conclusion: Incorporation of clinical pharmacists into a hepatology clinic significantly reduced the time patients waited to start HCV treatment. In addition to improving access to medications, implementation of the model helped to maintain excellent medication adherence and cure rates.

scholarly journals Effect of Timing of Ondansetron Administration on Incidence of Postoperative Vomiting in Paediatric Strabismus Surgery

2000 ◽  
Vol 28 (1) ◽  
pp. 27-30 ◽  
Author(s):  
R. Madan ◽  
T. Perumal ◽  
K. Subramaniam ◽  
D. Shende ◽  
S. Sadashivam ◽  
...  
Keyword(s):  
Muscle Relaxation ◽  
Demographic Data ◽  
Median Number ◽  
Strabismus Surgery ◽  
First Episode ◽  
Antiemetic Efficacy ◽  
Number Of Patients ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

This prospective, randomized, double-blinded study evaluated the effect of the timing of ondansetron administration on its antiemetic efficacy in children undergoing elective strabismus surgery. One hundred and twenty children aged one to 15 years, ASA physical status 1 or 2, were randomly allocated to receive intravenous ondansetron 100 μg/kg either at induction (Group 1) or at the end of the surgery (Group 2). All patients had general anaesthesia induced and maintained with nitrous oxide and halothane, muscle relaxation with vecuronium, endotracheal intubation, reversal with neostigmine and glycopyrrolate, and pethidine 0.5 mg/kg analgesia. Episodes of nausea and vomiting were evaluated at 0 to 2, 2 to 6 and 6 to 24 hour intervals by a blinded observer. Demographic data, duration of anaesthesia, type of surgery, incidence of previous postoperative nausea or vomiting and motion sickness and number of patients who developed oculocardiac reflex requiring atropine treatment were similar in both groups. The incidence of emesis in the first 24 hours following surgery was similar in both groups (35% Group 1, 33.3% Group 2, P=1.00). Severity of emesis (median number of emetic episodes, rescue antiemetic requirement and mean time to the onset of first episode of emesis) and mean time to discharge from the post anaesthesia care unit were also similar in the two groups. We conclude that the timing of ondansetron administration either before or after the surgical manipulation of extraocular muscles had similar antiemetic efficacy following strabismus surgery in children.

scholarly journals Performance of Venous Port Catheter Insertion by a General Surgeon: A Prospective Study

2015 ◽  
Vol 100 (5) ◽  
pp. 827-835 ◽  
Author(s):  
Mehmet Aziret ◽  
Oktay İrkörücü ◽  
Cihan Gökler ◽  
Enver Reyhan ◽  
Süleyman Çetinkünar ◽  
...  
Keyword(s):  
Vascular Access ◽  
Catheter Insertion ◽  
Port Catheter ◽  
Insertion Procedure ◽  
Venous Port ◽  
Stay Time ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

As part of the vascular access procedures, venous ports, commonly referred to as catheters, are placed under the skin to enable safe and easy vascular access for administration of repeated drug treatments. 122 patients who had received a venous port catheter insertion procedure in the general surgery department between January 1012 and January 2014 were involved in this study. Patients were divided into two groups: those who had undergone a fluoroscopy (group 1) and those who had not undergone a fluoroscopy (group 2). Complications that emerged during and after the port catheter insertion procedure and successful insertion rates were recorded in the database. Data of these patients were presented in a prospective manner. There were 92 to 30 patients in groups 1 and 2, respectively. In group 1, the mean age was approximately 56.8, total catheter stay time was 20,631 days, and mean time of port use was 224.2 days. In group 2, the mean age was approximately 61.2, total catheter stay time was 13,575 days, and mean time of port use was 452.5 days. Successful insertion rate was 100% and 90% in groups 1 and 2, respectively (P &lt; 0.05). The proper insertion of the port catheter accompanied by monitoring methods can decrease procedure-related complications. Statistical comparisons between the two groups in terms of malposition and successful insertion rates also support this view (P &lt; 0.05). The findings support the view that in cancer patients, a venous port catheter insertion accompanied by a fluoroscopy can be safely performed by general surgeons.

scholarly journals Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study

2004 ◽  
Vol 59 (5) ◽  
pp. 262-265 ◽  
Author(s):  
Carlos Ary Vargas Souto ◽  
Ernani Luis Rhoden ◽  
Rafael De Conti ◽  
Mário Chammas Jr. ◽  
Sandro Eduardo Laste ◽  
...  
Keyword(s):  
Bladder Neck ◽  
Randomized Study ◽  
Radical Retropubic Prostatectomy ◽  
Urethral Catheter ◽  
Catheter Removal ◽  
Indwelling Catheter ◽  
Retropubic Prostatectomy ◽  
Group 2 ◽  
Continence Rate ◽  
Group 1

PURPOSE: To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy is effective and safe without the need of performing cystography. METHODS: In the period from January of 2000 to July of 2002, 73 patients underwent radical retropubic prostatectomy, and these patients were prospectively randomized in 2 groups: Group 1-37 patients who had the urethral catheter removed 7 days after the procedure, and Group 2-36 patients who had the catheter removed 14 days after the surgery. The 2 groups were similar, the surgeons and the technique were the same, and no cystography was performed to evaluate the presence of leaks. RESULTS: Two patients in Group 1 had bleeding and clot retention after having the catheter taken out in the seventh postoperative day and were managed by putting the catheter back in for 7 more days. Two patients in Group 2 developed bladder neck stricture and were treated by bladder neck incision with success. The continence rate was the same, with 2 cases of incontinence in each group. About 2 pads a day were used by the patients with incontinence. The average follow-up was 17.5 months (12-36 months). No urinary fistula, urinoma, or pelvic abscesses developed after catheter removal. Two patients were excluded from the analysis of this series: 1 died with a pulmonary embolus in the third postoperative day, and 1 developed a urinary suprapubic fistula before catheter withdrawal, which was maintained for 16 days. CONCLUSION: Withdrawal of the urethral catheter 7 days after radical retropubic prostatectomy, without performing cystography, has a low rate of short-term complications that are equivalent to withdrawal 14 days after the surgery.

Development of an Automated Computer-Controlled Islet Isolation System

1997 ◽  
Vol 6 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Jonathan R.T. Lakey ◽  
Garth L. Warnock ◽  
Mark Brierton ◽  
Ziliang Ao ◽  
Bernhard J. Hering ◽  
...  
Keyword(s):  
Computer Control ◽  
Fold Increase ◽  
Pancreatic Tissue ◽  
Extraction System ◽  
Diabetic Patients ◽  
Clinical Islet Transplantation ◽  
Novel Method ◽  
Group 2 ◽  
Group 1

Before clinical islet transplantation can become an effective and reliable treatment for type 1 diabetic patients, there must be significant improvements in the methods employed for the isolation of islets of Langerhans. We have developed an automated cell extraction system (ACES), which allows computer control of the isolation process. As well, it incorporates a novel method of recombining dissociated pancreatic tissue. Following initial system design and testing to determine the optimal system configuration, a series of 12 consecutive canine islet isolations were performed. Pancreases were perfused with collagenase via the duct and dissociated and recombined using either the standard Ricordi-based protocol (group 1, n = 6) or dissociated and recombined using the ACES system (group 2, n = 6). A total of 90.8 ± 21 x 103 islet equivalents (IE) (mean ± SEM) were recovered in group 1 vs. 99 ± 14 x 103 IE in group 2 (p = NS, student unpaired t-test). Following Ficoll purification the recovery was 56.2 ± 14 x 103 IE for group 1 vs. 54.7 ± 11 x 103 IE for group 2 (p = NS). Viability was equivalent with an 8.6-fold increase in insulin secretion for group 1 and an 8.8-fold increase for group 2 when the islets were exposed to high glucose solution supplemented with IBMX (3-isobutyl-1-methylxanthine) during static incubation. In vivo function was equivalent following transplantation of 2000 IE under the kidney capsule of alloxan-induced diabetic nude mice with five of six and five of seven mice surviving long-term (>50 days posttransplant) (groups 1 and 2, respectively). This data shows that an entirely automated pancreatic islet extraction system can result in effective canine islet recovery without compromising islet yields and viability. The ACES system has several ad van tages over the standard isolation protocol. These include: 1) computer control and monitoring over all phases of the isolation, 2) a single-use sterile disposable tubing set, and 3) a novel method of tissue recombination. Copyright © 1997 Elsevier Science Inc.

Comparison of power-free-chop and phaco-chop techniques for moderate nucleus

2020 ◽  
Author(s):  
Haiqing Bai ◽  
Lin Yao
Keyword(s):  
Healing Process ◽  
Corneal Thickness ◽  
Dissipated Energy ◽  
Thickness Variation ◽  
Negative Effects ◽  
Chi Square ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Abstract Background: To compare intraoperative and postoperative effects of power-free-chop and phaco-chop techniques for moderate nucleus in phacoemulsification sugery. Methods: Sixty patients were evaluated in 2 groups prospectively. The power-free-chop technique was performed in Group 1 (30 eyes) and the phaco-chop technique in Group 2 (30 eyes). There were no significant differerces between these 2 groups. The cumulative dissipated energy (CDE), time to achieve maximum vision, corneal thickness variation, and time to return to the preoperative values were collected. All parameters were statistically compared in these 2 groups by using the chi-square test and the independent-sample t test. Results: The CDE was 5.53±1.92J in Group 1 and 7.02±1.77J in Group 2. After the operation, the mean time to recover to the maximum vision was 2.80±1.42 days in Group 1 and 3.80±1.92 days in Group 2 respectively. The mean postoperative corneal thickness increased 36.9±14.74μm in Group1 and 46.20±20.67μm in Group 2. And the mean time to return to preoperative pachymetry values were 3.73±1.70 days and 4.83±2.11 days, in Group 1 and Group 2 respectively. There were significant differences in these parameters between both groups. Conclusions: The power-free-chop technique had fewer negative effects on the corneal endothelium as less ultrasound power was used for moderate nucleus cases. This can accelerate the functional healing process and the return to preoperative physiologic values.

A rare clinical finding of posterior urethral valve: Recurrent epididymo-orchitis

2020 ◽  
Author(s):  
Serdar Mollaoğlu ◽  
Sırma Mine Tilev ◽  
Okyav Bosnalı ◽  
Ayşenur Celayir
Keyword(s):  
Clinical Finding ◽  
Rare Condition ◽  
Posterior Urethral Valve ◽  
Posterior Urethral Valves ◽  
Diagnosis And Treatment ◽  
Urinary System ◽  
Urethral Valves ◽  
Urethral Valve

Recurrent epididymo-orchitis is a rare condition in children. Considering that obstructive infravesical pathologies, such as posterior urethral valves, may cause recurring epididymo-orchitis in children, a thorough examination of the genito-urinary system will prove essential for the diagnosis and treatment of the main pathology. We herein present a case of posterior urethral valve presenting with recurrent episodes of epididymo-orchitis.

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