The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volumetric reduction of the nodule with significant improvement in the quality of life. The trans-isthmic approach and the moving shot technique are the two basic techniques; however, an advanced technique, artery-first feeding radiofrequency ablation, has been developed and validated. We have prospectively included 29 consecutive patients who have undergone radiofrequency ablation (Group A) or artery- first vRFA (Group B). All included patients had a diagnosis of benign nodular goiter and they underwent a single session of radiofrequency ablation. All patients followed a follow-up program at 1 month, 3 months, and 6 months. Continuous variables (age, TSH value, basal volume of nodule, used Joule, time in second of the procedure, nodules’ volume at 1-, 3-, and 6- months of follow-up and percentage of volume reduction at 1-, 3-, and 6- months of follow-up) were described as mean, standard deviation and range, while categorical variables (gender, nodule structure and nodule vascularization) were described as number of cases and percentage. Independent samples t-test were performed to compare the continuous variables. A Test of Proportions was applied to the categorical variables. The Fisher’s exact test was used to analyze the gender. Statistical significance was considered in case of p-value <0.05. Solid structure and spongiform structure showed statistic differences with p-values of 0.022 and 0.023 respectively between two groups. The percentage of reduction at 1 month did not show a significant difference between two groups; instead, the percentage of volume reduction was decreased mostly in the Group B at 3 months and 6 months of follow-up with a p-value of 0.003 and 0.013, respectively. The Joules/energy used showed a statistically significant difference (p-value=0.05), more energy must be used in vascular radiofrequency ablation. These data allow us to hypothesize that vRFA may improve the effectiveness of the procedure, allowing for a reduction in volume more quickly. They were preliminary but promising results, clearly a larger series of cases and prolonged follow-up are needed to clarify and confirm our observations.

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617 Who Benefits the Most from Burn Camps?

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.267 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S162-S163

Author(s):

Jennifer B Radics-Johnson ◽

Daniel W Chacon ◽

Li Zhang

Keyword(s):

Retrospective Review ◽

Burn Injury ◽

Statistical Significance ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Self Evaluation ◽

Significant Difference ◽

Return Home ◽

The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value< 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

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Fistula first, graft on arterialized vein second

Vascular ◽

10.1177/1708538114542479 ◽

2014 ◽

Vol 23 (3) ◽

pp. 265-269

Author(s):

Giuseppe Galzerano ◽

Michele Giubbolini ◽

Francesco Setacci ◽

Gianmarco de Donato ◽

Pasqualino Sirignano ◽

...

Keyword(s):

Patency Rate ◽

Rank Test ◽

P Value ◽

Secondary Patency ◽

Kaplan Meier ◽

Significant Difference ◽

Group A ◽

Group B ◽

Vein Stenosis

Objectives Arterovenous grafts (AVGs) present a feasible solution for creating a vascular access in patients who are unsuitable for autogenous fistula (AVF). The aim of this study is to assess the prevention rate of vein stenosis, placing a graft on an arterialized vein (GAV) instead of an anastomized AVG in a native vein (GNV). Methods This was a cohort study conducted from January 2009 to November 2012. All consecutive patients who underwent AVG in our institution were included. All patients requiring a secondary intervention were also referred to our centre. Patients underwent ultrasound follow up at first and the every month. A Kaplan–Meier method was used; a Log-rank test was used to identify whether significant difference existed between GAV and GNV ( p < 0.05). Results Forty-six grafts were placed. Twenty patients had arterialized receiving veins (group A), while 26 patients received an AVG immediately because they lacked autogenous veins suitable for fistula (group B).The average follow-up period was 16.1 months (range 0–41). The group A 41 months-patency rate was 84.3%, while group B was 43.7% ( p = 0.06). Secondary patency was similar in the two groups. Conclusions Vein arterialization seems to prevent venous stenosis improving AVG-patency rate. More data are needed; however, the borderline p value encourages new studies.

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Outcomes following operative vs. non-operative management of blunt traumatic pancreatic injuries: a retrospective multi-institutional study

Burns & Trauma ◽

10.1186/s41038-016-0065-5 ◽

2016 ◽

Vol 4 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Poppy Addison ◽

Toni Iurcotta ◽

Leo I. Amodu ◽

Geoffrey Crandall ◽

Meredith Akerman ◽

...

Keyword(s):

Retrospective Review ◽

Injury Severity ◽

Univariate Analysis ◽

Operative Management ◽

Morbidity And Mortality ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Pancreatic Injuries ◽

Significant Difference

Abstract Background Traumatic pancreatic injuries are rare, and guidelines specifying management are controversial and difficult to apply in the acute clinical setting. Due to sparse data on these injuries, we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic injuries. We hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated non-surgically. Methods We performed a retrospective review of data from four trauma centers in New York from 1990–2014, comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed non-operatively. We compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher’s exact tests. Univariate analysis was performed to determine the possible confounding factors associated with mortality in both treatment groups. Results Twenty nine patients were managed operatively and 32 non-operatively. There was a significant difference between the operative and non-operative groups in median age (37.0 vs. 16.2 years, P = 0.016), grade of pancreatic injury (grade I; 30.8 vs. 85.2%, P value for all comparisons <0.0001), median injury severity score (ISS) (16.0 vs. 4.0, P = 0.002), blood transfusion (55.2 vs. 15.6%, P = 0.0012), other abdominal injuries (79.3 vs. 38.7%, P = 0.0014), pelvic fractures (17.2 vs. 0.00%, P = 0.020), intensive care unit (ICU) admission (86.2 vs. 50.0%, P = 0.003), median length of stay (LOS) (16.0 vs. 4.0 days, P <0.0001), and mortality (27.6 vs. 3.1%, P = 0.010). Conclusions Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated non-operatively. The greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.

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Comparison of Visuospatial Skill Development Between Preclinical and Clinical Undergraduate Students Using Dentinal Pin Placement Exercise

Journal of The Pakistan Dental Association ◽

10.25301/jpda.303.147 ◽

2021 ◽

Vol 30 (03) ◽

pp. 147-151

Author(s):

Alia Ahmed ◽

◽

Usman Anwer Bhatti

Keyword(s):

Undergraduate Students ◽

Dental Students ◽

Two Dimensions ◽

Categorical Variables ◽

P Value ◽

Psychomotor Skills ◽

Continuous Variables ◽

Chi Square ◽

Significant Difference ◽

Second Year

OBJECTIVE: The objective of this study was to compare visuospatial and psychomotor skills of second year pre-clinical dental students with final year dental students using an exercise in dentinal pin placement. METHODOLOGY:A total of 120 BDS undergraduate students who had completed second or final year Operative dentistry rotation were included. While students from second and final year who had not consented to participate or had missed the practical demonstration or whose dentinal pins were misplaced after becoming loose from the tooth were excluded. Participating students placed the dentinal pins, following which Adobe Photoshop (version CC 2014) was used to analyze the photographs of the taken radiographs in two dimensions. Parameters assessed were pulpal perforations, periodontal perforations and pin angulation. Independent sample t-test was used to compare continuous variables while chi-square test was used for testing association for categorical variables. RESULTS: Final year students fared better in all categories of pin placement except periodontal perforation which was the same for both years. Statistically significant difference in the angulation for pin placement were observed between the two student groups in mesiodistal direction (p value =0.001) and in buccolingual direction (p value <.001). CONCLUSION: There is a significant difference in the psychomotor and visuospatial skill of second year pre-clinical when compared with the final year clinical undergraduate students. KEYWORDS: curriculum, dental, learning, operative, students.

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Modified technique of end to side distal radio-cephalic shunt to overcome juxta-anastomotic stenosis

International Surgery Journal ◽

10.18203/2349-2902.isj20191060 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1029

Author(s):

Haitham Atif ◽

Nehad Abdou Zaid ◽

Abd El-Mieniem Fareed Mohamed ◽

Yehia Mohamed Alkhateep

Keyword(s):

Patency Rate ◽

Intervention Group ◽

Anastomotic Stenosis ◽

Control Group ◽

P Value ◽

Modified Technique ◽

Significant Difference ◽

Group A ◽

Group B

Background: Juxta-anastomotic stenosis (JAS) is one of the predominant causes of arteriovenous fistula (AVF) failure, with the reported incidence of 65%, so that technical modification to alter the outflow vein configuration using the modified technique has been applied to prevent JAS and improve AVF maturation. The aim of the study to evaluate the modified technique of end-to-side distal radiocephalic A-V fistula regarding maturation, patency rate and the resultant juxta-anastomotic stenosis.Methods: This prospective study was carried out on 80 patients with end stage renal disease (ESRD) at vascular surgery unit in general surgery department, Menoufia university hospital that prepared for dialysis. 40 patients "intervention group" underwent the modified technique to establish a functioning radiocephalic fistula; the other group (40 patients, control group) had the conventional technique of end to side radiocephalic fistula. Follow up of patients was over 6 months regarding function, patency rate and development of juxta-anastomotic stenosis.Results: There was statistically significant difference between 2 groups regarding primary failure, patency and JAS. Primary failure was detected in 2 patients in group A and in 5 patients in group B (p-value is 0.04). Considering patency rate, after 3 months the ratio between group A and group B was 37:34 with significant P value of 0.02, and after 6 months the ratio was 35:33 with P value of 0.03. Regarding JAS, by the end of follow up period, 4 patients diagnosed with JAS in group A, while group B had 8 patients, with p value of 0.01.Conclusions: Modified technique of end to side anastomosis for primary radio-cephalic fistula creation has better patency rate and low incidence of JAS than conventional method.

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A study of meibomian gland and tear film changes in patients with pterygium in a tertiary care centre

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.068 ◽

2021 ◽

Vol 11 (2) ◽

pp. 336-340

Author(s):

Piyali Sarkar ◽

Shilpi Sharma ◽

Partha Pratim Pal ◽

Pinaki Sengupta

Keyword(s):

Pearson Correlation ◽

Tertiary Care ◽

Tear Film ◽

Meibomian Gland ◽

Categorical Variables ◽

Control Group ◽

P Value ◽

Continuous Variables ◽

Significant Difference ◽

Expression Score

To find out the correlation of Meibomian gland and Tear film dysfunction with pterygium. Institution based prospective cross sectional study. 70 (seventy) patients with unilateral primary progressive nasal Pterygium and 70 healthy adults without any ocular pathology were selected as comparison group from the Ophthalmology outpatient department of Calcutta National Medical College and hospital, Kolkata for a duration of 6 months from January 2020 to June 2020. Meibomian gland dysfunction was measured by meibomian gland expression score and lid margin abnormality score. Tear film changes were measured by Ocular Surface Disease Index (OSDI) Score , Tear break up time (TBUT), Tear meniscus height(TMH), Schirmer’s test 1 (ST1) and Corneal flourescein staining in both pterygium and control group and comparisons were done to find out the significance in differences. The Categorical variables were analyzed with the help of Pearson Chi square test, Spearman rho Correlation, Man Whitney U Test and the continuous variables were analyzed with the help of Independent T test and Pearson Correlation coefficient. The level of significance was considered as 95% of confidence interval i.e. P value <0.05. OSDI score, TBUT, meibomian gland expression score, lid margin abnormality score and corneal fluoresce in staining were significantly higher in pterygium group than others (p<0.05) whereas TMH values although showed differences between the two groups but were not statistically significant. ST1 were normal in pterygium group though had significant difference with control. Meibomian gland function was altered in patient with Pterygium which is also associated with uncomfortable ocular symptoms due to tear film abnormalities.

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Depressive factors associated with breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e13091 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e13091-e13091

Author(s):

Alexandre Alberto Mendes Tostes ◽

Carla Simone Moreira de Freitas ◽

Aleida Nazareth Soares

Keyword(s):

Breast Cancer ◽

Categorical Variables ◽

Continuous Variables ◽

Cross Sectional ◽

Parametric Test ◽

Cancer Hospital ◽

Treatment Type ◽

Health Council ◽

Significant Difference ◽

Group B

e13091 Background: In Brazil, the estimated cancer for the 2019 was approximately 420 thousand new cases. In Minas Gerais, the estimate was 5,360 new cases. Objective is to relate comorbid humor disorders with breast cancer in patients treated at a cancer hospital. Methods: Cross-sectional and descriptive study with a sample of 100 patients with Breast Cancer (BC), chosen at random. Data were collected at a Muriaé cancer hospital in, from January to June 2019. Semi-structured sociodemographic and clinical suervey and the Beck Depression Inventory (BDI-II) to check for signs and symptoms of depression. Data analysis was performed using the statistical packages SPSS. To check if there was a difference between groups in continuous variables, Shapiro-Wilk test; the data considered normal the Student's t test (parametric test) and the data considered non-normal the Mann Whitney test (non-parametric test). For categorical variables, the chi-square test, Fisher's exact test or Monte Carlo simulation. As for the interpretation of Beck's inventory, the scores were analyzed and demonstrated according to the standardized by the inventory, that is, the result obtained was the sum of the individual items, reaching a maximum score of 63 points. The classification of the levels of depression varies between minimum, mild, moderate and severe, thus indicating the intensity of the depression. The study was developed according to Resol. 466/12, of the National Health Council. Results: Average age of women with BC in both groups was 55 years, with low education (43%), married (48%), and, 50% of them have one or more children and, 70% do not work. Regarding the use of drugs and/or medication and smoking, it was higher in group B (with depression) (64.6%). In the other variables (family relationship, self-preservation of health, affected daily life, family/social isolation, living with other women with BC, perspective of life after treatment, type of follow-up), the proportion was always higher in group B compared to group A (without depression). The time of diagnosis, staging, type of surgery and edema in the upper limb did not show significant difference between the two groups analyzed. Regarding the type of treatment, there was a significant difference, mainly showing that proportionally the Surgery + Chemotherapy treatment is higher in the group without depression while the and Surgery + Chemotherapy + Radiotherapy + Hormone therapy are proportionally higher in the group with depression. Conclusions: Women with BC have depressive symptoms frequently and should be investigated and treated so that the negative impacts can be minimized.

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Astigmatism Correction in Cataract Surgery with Foldable Toric IOL

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2014/v1/i2/824 ◽

2014 ◽

Vol 1 (2) ◽

pp. 93

Author(s):

Mrunal Suresh Patil ◽

Dhiraj Namdeo Balwir ◽

Sonal Dua ◽

Swapnil Shivaji Vidhate

Keyword(s):

Visual Acuity ◽

Statistical Analysis ◽

Cataract Surgery ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Toric Iol ◽

Iol Implantation ◽

Astigmatism Correction ◽

Significant Difference

Aim: To evaluate correction of pre-existing astigmatism after foldable Toric IOL implantation in patients undergoing cataract surgery.Materal & Methods: In this prospective observational study we included 10 eyes of 10 patients with astigmatism between 2.00D to 6.00D &undergoing cataract surgery. Phacoemulsification was performed with Toric IOL implantation through 2.8mm clear corneal temporal incision. Patients were examined post operatively for Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA) & residual refractive astigmatism.Statistical Analysis: Statistical analysis was performed by the SPSS program for Windows, ver.16.0.Continuous variables are expressed as mean ± SD, and categorical variables are presented as absolute numbers and percentage. For the statistical test, a p value less than 0.05 was taken to indicate a significant difference.Results: The UCVA was 6/9 or better in 90% of eyes. 80% eyes achieved 6/6 BCVA. The mean refractive cylinder corrected from -3.4 ± 1.4 D to -0.60 ± 0.27 D which was statistically significant. (p value=0.0001).Conclusion: Toric IOL implantation is an effective, safe surgical option to manage pre-existing corneal astigmatism during cataract surgery.

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Comparative Efficacy of the Combination of Topical Betamethasone Dipropionate and Calcipotriene with Betamethasone Dipropionate and Calcipotriene Alone in the Treatment of Localized Vitiligo

Medicine Today ◽

10.3329/medtoday.v26i1.21310 ◽

2014 ◽

Vol 26 (1) ◽

pp. 31-35

Author(s):

Mohd Nurul Alam ◽

Md Abdul Wahab ◽

Md Anwar Husain ◽

Lubna Khondker ◽

Gulam Kazem Ali Ahmad ◽

...

Keyword(s):

Betamethasone Dipropionate ◽

Ordinal Scale ◽

P Value ◽

Base Line ◽

Anova Test ◽

Global Estimate ◽

Significant Difference ◽

Group A ◽

Group B

Vitiligo is an acquired skin disorder characterized by welldefined white patches that are often symmetrically distributed. The study was conducted to compare the efficacy of the combination of topical betamethasone dipropionate and calcipotriene with betamethasone dipropionate and calcipotriene alone in the treatment of localized vitiligo. A clinical trial was carried out with the patients of vitiligo from January 2012 to August 2012. In group A, 20 patients were applied betamethasone dipropionate cream 0.05% and topical calcipotriene ointment (0.005%), in group B, 20 patients were applied betamethasone dipropionate cream 0.05% only; In group C, 20 patients were applied calcipotriene ointment 0.005% alone. From base line percentage reduction of total lesion in 1st follow up in group A, group B and group C were 20%, 15% and 10% respectively. At 3rd follow up in group A, group B and group C it was 50%, 37% and 30% and at 5th follow up, it was 80%, 75% and 65% respectively. ANOVA test was done and found significant difference of reduction of total lesion of vitiligo among the groups (p< 0.05). At the completion of the study, each patient was separately graded the treated sides on a 6-point ordinal scale based on a global estimate of the change in vitiligo and found that, the very much improvement were 70%, 55% and 45%, much improvement were 20%, 30% and 35% and improvement were 10%, 15% and 20% in group A, group B and group C respectively. ANOVA test was found significant difference of success rate of patients of localized vitiligo among the groups (p value 0.005). Both the drugs, calcipotriene and betamethasone dipropionate when used individually, were found to be equally effective in the treatment of vitiligo, but the combination of the two was found to be superior in efficacy. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21310 Medicine Today 2014 Vol.26(1): 31-35

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288. Follow-Up Blood Cultures in Gram-Negative Bacteremia: How Do They Impact Outcomes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.331 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S144-S144

Author(s):

Azza Elamin ◽

Faisal Khan ◽

Ali Abunayla ◽

Rajasekhar Jagarlamudi ◽

aditee Dash

Keyword(s):

Clinical Outcomes ◽

Antibiotic Treatment ◽

Readmission Rate ◽

Blood Cultures ◽

Categorical Variables ◽

Gram Negative ◽

Number Of Patients ◽

Significant Difference ◽

The Impact

Abstract Background As opposed to Staphylococcus. aureus bacteremia, there are no guidelines to recommend repeating blood cultures in Gram-negative bacilli bacteremia (GNB). Several studies have questioned the utility of follow-up blood cultures (FUBCs) in GNB, but the impact of this practice on clinical outcomes is not fully understood. Our aim was to study the practice of obtaining FUBCs in GNB at our institution and to assess it’s impact on clinical outcomes. Methods We conducted a retrospective, single-center study of adult patients, ≥ 18 years of age admitted with GNB between January 2017 and December 2018. We aimed to compare clinical outcomes in those with and without FUBCs. Data collected included demographics, comorbidities, presumed source of bacteremia and need for intensive care unit (ICU) admission. Presence of fever, hypotension /shock and white blood cell (WBC) count on the day of FUBC was recorded. The primary objective was to compare 30-day mortality between the two groups. Secondary objectives were to compare differences in 30-day readmission rate, hospital length of stay (LOS) and duration of antibiotic treatment. Mean and standard deviation were used for continuous variables, frequency and proportion were used for categorical variables. P-value < 0.05 was defined as statistically significant. Results 482 patients were included, and of these, 321 (67%) had FUBCs. 96% of FUBCs were negative and 2.8% had persistent bacteremia. There was no significant difference in 30-day mortality between those with and without FUBCs (2.9% and 2.7% respectively), or in 30-day readmission rate (21.4% and 23.4% respectively). In patients with FUBCs compared to those without FUBCs, hospital LOS was longer (7 days vs 5 days, P < 0.001), and mean duration of antibiotic treatment was longer (14 days vs 11 days, P < 0.001). A higher number of patients with FUBCs needed ICU care compared to those without FUBCs (41.4% and 25.5% respectively, P < 0.001) Microbiology of index blood culture in those with and without FUBCs Outcomes in those with and without FUBCs FUBCs characteristics Conclusion Obtaining FUBCs in GNB had no impact on 30-day mortality or 30-day readmission rate. It was associated with longer LOS and antibiotic duration. Our findings suggest that FUBCs in GNB are low yield and may not be recommended in all patients. Prospective studies are needed to further examine the utility of this practice in GNB. Disclosures All Authors: No reported disclosures

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