scholarly journals Stapled Hemorrhoidopexy: “Mucosectomy or Not Only Mucosectomy, This Is the Problem”

2021 ◽  
Vol 8 ◽  
Author(s):  
Chiara Eberspacher ◽  
Fabio M. Magliocca ◽  
Stefano Pontone ◽  
Pietro Mascagni ◽  
Lisa Fralleone ◽  
...  
Keyword(s):  
Rectal Wall ◽  
Muscularis Propria ◽  
Stapled Hemorrhoidopexy ◽  
Single Center Study ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Rectal Mucosectomy ◽  
Group B ◽  
Almost All

Introduction: Stapled hemorrhoidopexy was originally defined as a rectal mucosectomy. The aims of our retrospective, single-center study were to demonstrate if the excised specimen comprises only the mucosa or more wall rectal layers and if the latter excision should be considered a technical mistake with an increase in complications.Materials and Methods: We histopathologically analyzed surgical samples from patients who underwent stapled hemorrhoidopexy performed between 2014 and 2019. Patients were divided into three groups, according to the stapler used: Group A (single PPH®), Group B (double PPH®), and Group C (CPH34 HV™). We evaluated the actual wall layers included in the stapled rectal ring. For every specimen, we reconstructed the history of the corresponding patient and the incidence of complications.Results: Of the 137 histological slides available, 13 were only mucosectomies (9.5%), and 124 presented also the submucosa and muscularis propria (90.5%)−50/58 patients in Group A, 28/28 in Group B, and 46/51 in Group C. No statistically significant difference in the rate of complications was found when stratifying patients according to the thickness of the resection [mucosectomy (M) or “full thickness” (FT)].Discussion: Stapled hemorrhoidopexy is not a simple mucosectomy but a resection of the rectal wall with almost all its layers. This concept defines the entity of the surgical procedure and excludes a direct correlation with an increased rate of complications.

Pentraxin 3 and other inflammatory biomarkers related to atrial fibrillation in cardiac surgery

Perfusion ◽  
2016 ◽  
Vol 32 (4) ◽  
pp. 269-278 ◽  
Author(s):  
Zdenka Holubcova ◽  
Pavel Kunes ◽  
Jiri Mandak ◽  
Dana Vlaskova ◽  
Martina Kolackova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Serum Levels ◽  
Inflammatory Biomarkers ◽  
Surgical Patients ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Group B ◽  
New Onset

Objectives: The aim was to evaluate the association between perioperative inflammatory biomarkers and atrial fibrillation (AF) in cardiac surgical patients. Methods: Forty-two patients undergoing cardiac surgery were divided into three groups according to the occurrence of AF: Group A (n = 22) – patients with no AF, Group B (n = 11) – patients with new onset AF postoperatively and Group C (n = 9) – patients with preoperative history of atrial fibrillation. The serum levels of PTX3, CRP, TLR2, IL-8, IL-18, sFas, MMP-7 and MMP-8 were measured at the following time points: before surgery, immediately and 6 h after surgery and on the 1st, 3rd and 7th postoperative days (POD). Results: Serum levels of PTX3 showed a significant difference between Groups A and C on the 3rd POD (p<0.05) and on the 7th POD (p<0.0001). IL-8 levels were different between Groups A and C immediately after surgery (p<0.05), 6 hours after surgery (p<0.05) and on the 3rd POD (p<0.05). There was a difference between Groups B and C on the 1st POD in IL-8 levels (p<0.05). The sFas levels differed between Groups A and C on the 3rd POD (p<0.01) and the 7th POD (p<0.05). There was also a difference on the 7th POD (p<0.05) between the Groups B and C. No significant differences between the groups was seen for other biomarkers. Conclusion: This study demonstrates significantly different dynamics of PTX3, IL-8 and sFas levels after cardiac surgery in relation to AF.

scholarly journals Properties and composition of carcass of domestic spotted young cattle of two preslaughter weights

2011 ◽  
Vol 27 (4) ◽  
pp. 1443-1450 ◽  
Author(s):  
M. Petricevic ◽  
N. Stanisic ◽  
Lj. Sretenovic ◽  
M.M. Petrovic ◽  
S. Stajic ◽  
...  
Keyword(s):  
Muscle Tissue ◽  
Carcass Composition ◽  
Fat Tissue ◽  
Significant Difference ◽  
Kidney Fat ◽  
Group A ◽  
Young Cattle ◽  
Group B ◽  
Almost All ◽  
A Share

Objective of this research was to determine the slaughter properties and carcass composition of carcass sides derived from young cattle of Domestic Spotted breed, of pre-slaughter weights of 500 (group A) and 600 kg (group B). Heavier cattle had higher share of kidney fat in carcass, whereas the share of offals showed no significant differences. Statistically significant difference was registered only in share of toungue (P<0.05), that was higher in cattle of group A. Share of extra/premium (tenderloin), I category (round) and II category (loin, back, shoulder) showed no significant differences between groups of cattle. Statistically significant difference (P<0.05) was established in the share of III category carcass parts. Share of forearm and chest was significantly higher in lighter cattle (3.55% and 7.95%) compared to heavier animals (2.89% and 6.33%), whereas the share of subshoulder was considerably lower in group A (6.89%) compared to cattle of group B (9.73%). Data obtained by dissection of main carcass side parts differed significantly in regard to the share of muscle tissue in round and belly, that was significantly higher in cattle of group A (P<0.05). Share of fat tissue (subcutaneous and intermuscular) was higher in cattle of group B in almost all carcass side parts, however, statistically significant difference between groups was determined only in round, back, neck and subshoulder. Also, share of bones in chest differed statistically significantly (P<0.05) and it was higher in group A (20.09%) compared to cattle of group B (15.52%).

Seroepidemiology ofStrongyloides stercoralisin Dhaka, Bangladesh

Parasitology ◽  
2012 ◽  
Vol 139 (11) ◽  
pp. 1513-1520 ◽  
Author(s):  
YASMIN SULTANA ◽  
GWENDOLYN L. GILBERT ◽  
BE-NAZIR AHMED ◽  
ROGAN LEE
Keyword(s):  
Strongyloides Stercoralis ◽  
Epidemiological Studies ◽  
Igg Subclasses ◽  
Personal Hygiene ◽  
Individual Risk ◽  
Slum Dwellers ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Group B

SUMMARYHuman strongyloidiasis is a neglected tropical disease with global distribution and this infection is caused by the parasitic nematodeStrongyloides stercoralis. The aim of this study was to determine the prevalence of strongyloidiasis in Dhaka, Bangladesh. Sera from 1004 residents from a slum (group A) and 299 from city dwellers (group B) were tested for total IgG and IgG subclasses toStrongyloidesantigen. There was a significant difference (P < 0·001) in IgG seroprevalence between group A (22%) and group B (5%). Reactive IgG subclasses (IgG1 and IgG4) were also higher in group A (P < 0·05). The seroprevalence of strongyloidiasis in group A increased with age but was unrelated to sex. The presence of reactive IgG toStrongyloidesantigen had no correlation with either socio-economic or personal hygiene factors. However, a history of diarrhoea in a family member, in the past 6 months, but not in the respondents was associated with detection of antibodies toS. stercoralis(P < 0·01). None of the sera from either group had an HTLV-I reaction. This study demonstrates that strongyloidiasis is prevalent in Dhaka, especially among slum dwellers, but concurrent infection with HTLV-I was not found. Future epidemiological studies should identify individual risk factors and other communities at risk so that appropriate interventions can be planned.

scholarly journals ED50 of Intranasal Dexmedetomidine Sedation for Transthoracic Echocardiography in Children with or without a History of Cardiac Surgery for Cyanotic Congenital Heart Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
HongBin Gu ◽  
YunAn Song ◽  
Jie Bai
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Congenital Heart ◽  
Onset Time ◽  
Cyanotic Congenital Heart Disease ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Correction Surgery ◽  
Group B

Background and Objective. Dexmedetomidine (DEX) can provide adequate sedation during short procedures. However, the median effective dose (ED50) of intranasal DEX sedation has not been well established in children with a history of correction surgery for cyanotic congenital heart disease (cCHD). This study was to determine ED50 of intranasal DEX sedation for transthoracic echocardiography (TTE) in young children with a history of correction surgery for cCHD. Methods. This prospective single-blinded clinical trial included 72 ASA I-II stage children aged 1-36 months with cCHD who were scheduled to undergo TTE under sedation. Children were assigned to group A ( n = 37 ) with a previous history of cardiac surgery and group B ( n = 35 ) with no history of cardiac surgery. Doses of intranasal DEX were analyzed by up-down sequential allocation at an initial dose of 2.3 μg/kg and an increase in steps of 0.2 μg/kg. Intranasal DEXED50 values were analyzed by the up-and-down method of Dixon-Massey and probit regression to determine ED50 and 95% confidence interval (CI) for sedation. The time to effective sedation, time to regaining consciousness, vital signs, oxygen saturation, time of performing TTE, clinical adverse effects, and characteristics of regaining consciousness were compared between the two groups. Results. ED50 of intranasal DEX sedation was 2.530 μg/kg (95% CI, 1.657-4.156) in group A and 2.500 μg/kg (95% CI, 1.987-3.013) in group B. There was no significant difference in sedation onset time and time to regaining consciousness between the two groups. Additionally, no significant adverse hemodynamic or hypoxemic effect was observed. There was no significant difference in sedation-onset time and wake-up time between the two groups ( 15 ± 4  min vs. 16 ± 5  min; 50 ± 11  min vs. 48 ± 10  min). This trial is registered with the China Clinical Trials Registry (ChiCTR-IOR-1800015038). Conclusions. ED50 of intranasal DEX sedation for TTE is similar in children with and without a history of cardiac surgery for cCHD.

scholarly journals Implantable loop recorders in patients with a structural or electrical heart disease: comparison of the clinical value in patients with and without a history of syncope

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Assaf ◽  
R Sakhi ◽  
M Michels ◽  
JW Roos-Hesselink ◽  
JMA Verhagen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Primary Endpoint ◽  
Clinical Value ◽  
Loop Recorder ◽  
Increased Risk ◽  
Significant Difference ◽  
Electrical Heart Disease ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Funding Acknowledgements Type of funding sources: None. Background Patients with structural and electrical heart disease are at increased risk for sudden cardiac death. Guidelines recommend the use of an implantable loop recorder (ILR) in symptomatic patients when symptoms are sporadic and suspected to be related to arrhythmias. In clinical practice, an ILR is mainly used in patients with unexplained syncope. Purpose To compare the clinical value of an ILR in patients with a heart disease and a history of syncope versus those with non-syncopal suspected arrhythmia-related symptoms. Methods In this observational single-center study we included symptomatic patients with structural or electrical heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to implantation of a pacemaker or implantable cardioverter-defibrillator (ICD). Results A total of 120 patients (mean age 47 ± 17 years, 49% men) were included. Underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%), and other structural heart disease (18%).There were 43 patients with a history of syncope (group A) and 77 patients with non-syncopal symptoms (group B) such as palpitations, dizziness and/or near-syncope at baseline. During a median follow-up of 19 months (IQR 8-36), a primary endpoint was reached in 14 patients (33%) of group A, and in 28 patients (36%) of group B (logrank P = 0.54, Figure A). There was also no significant difference in the cumulative rate of cardiac device implantation between group A and B, 14% versus 10%, respectively (logrank P = 0.97, Figure B). Conclusion Our results show no differences in ILR yield in patients with structural or electrical heart disease who present with any suspected arrhythmia-related symptom, including those with non-syncopal symptoms. Abstract Figure.

scholarly journals Comparison of Early Interventions in the Prevention of Alzheimer’s Disease in Patients with Down Syndrome: A Systematic Review

2021 ◽  
Author(s):  
Yago Ricardo Pedrosa ◽  
Jossielly Rodrigues Pinheiro
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Down Syndrome ◽  
Controlled Trial ◽  
Early Interventions ◽  
Significant Difference ◽  
Group A ◽  
The Subject ◽  
Group B ◽  
Almost All

Background: Down Syndrome (DS) is the most common chromosomal abnormality with an incidence of 1:700 live births. Alzheimer’s disease (AD) affects almost all of these individuals from the age of 30, whose susceptibility is on the rise with increasing life expectancy. However, interventions can limit or improve cognitive decline. Objectives: To compare early interventions in the prevention of AD in patients with DS. Methods: Randomized Controlled Trial published in English, in the last 5 years, in humans, at PUBMED. Were included studies involving participants over 18 years old, diagnosed with DS and those with unclear interventions were excluded. Six articles were found and after applying the criteria, two studies were part of this review. The PRISMA scale was used. Results: Ptomey et al. (2018) intervened with online exercise, selecting 27 participants divided into two groups: A) one session/week; B) two sessions/ week. After 12 weeks it was observed that group B showed improvement in learning compared to group A. Sano et al. (2016) performed an intervention with Vitamin E (VE) for three years in 337 individuals, segregated in: A) 1,000 IU, orally, twice/day; B) placebo. There was no significant difference in the progression of cognitive, functional, behavioral and clinical deterioration between the groups. Conclusions: The practice of physical exercise proved to be promising in the prevention of AD, however the use of VE did not show significant results. Further studies on the subject are needed.

scholarly journals Comparison of efficacy of duloxetine with amitriptyline in terms of reduction in frequency of pain in the patients of diabetic neuropathy.

2020 ◽  
Vol 27 (09) ◽  
pp. 1891-1894
Author(s):  
Asif Javeed ◽  
Muhammad Absar Alam ◽  
Atif Maqsood ◽  
Amna Azher ◽  
Muhammad Arif ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Pain Score ◽  
Base Line ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Reduction Of Pain ◽  
History Of ◽  
Group A ◽  
Group B

Objectives: To compare the efficacy of Duloxetine with Amitriptyline in Terms of Reduction in Frequency of Pain in The Management of Patients of Diabetic Neuropathy. Study Design: Randomized Control Trial. Setting: Medical OPD of ABWA Medical College Hospital Faisalabad. Period: Six Months from 01-01-2019 to 30-06-2019. Material & Methods: A total of 200 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5 years history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included. Two groups were formed Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. After 3 weeks, an additional three weeks supply of medication was dispensed and patient were scheduled to return at week 6 for the final evaluation that recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Results: 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: The duloxetine was more effective than amitriptyline in terms of reduction of pain in diabetic neuropathy.

Blood Viscosity and Platelet Aggregation in Male and Female Patients with Transient Ischaemic Attacks (TIA)

1979 ◽  
Author(s):  
G. Palareti ◽  
M. Poggi ◽  
G. Fortunato ◽  
S. Coccheri
Keyword(s):  
Platelet Aggregation ◽  
Blood Viscosity ◽  
Indirect Evidence ◽  
Vascular Lesions ◽  
Transient Ischaemic Attacks ◽  
Group A ◽  
Circulating Platelet Aggregates ◽  
Male Patients ◽  
Group B ◽  
Almost All

A series of 40 patients with TIA (25 males and 15 females) was thoroughly investigated by means of angiography and computerized tomography, and divided into a group (A) of 15 “sine materia”, and a group (B) of 25 with direct or indirect evidence of vascular occlusive or stenotic changes. Blood viscosity at 230 sec-1 37° was cp 4.2 ± 0.3 in the controls, cp 4.7 ± 0.7 in all patients (p < 0.05) cp 4.98 ± 0.7 in all male patients (p < 0.01 versus male controls), and cp 4.75 ± 0.8 in group B (p < 0.02). Haematocrit and Fibrinogen were also significantly increased in all male patients and in group B. Circulating platelet aggregates (CPA) were increased in 40% of the patients. Almost all patients with elevated CPA were males, with a slight prevalence in group B. Changes in blood viscosity parameters and in platelet aggregation in TIA patients were therefore related both to evidence of vascular lesions, and to sex, since they were found to prevail in male patients of both groups.

Appreciation of the importance of pregravid preparation and reproductive attitudes of women of childbearing age in the city of Omsk

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 48-52
Author(s):  
E N Kravchenko ◽  
R A Morgunov
Keyword(s):  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Pregnancy And Childbirth ◽  
Perinatal Center ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Complicated Pregnancy ◽  
The Relationship ◽  
The City

The aim of the study. Assess the importance of pregravid preparation and outcomes of pregnancy and childbirth, depending on the reproductive attitudes of women in the city of Omsk. Materials and methods. The study included 92 women who were divided into groups: group A (n=43) - women whose pregnancy was planned; group B (n=49) - women whose pregnancy occurred accidentally. Each group was divided into subgroups depending on age: from 18 to 30 and from 31 to 49 years. For each patient included in the study, a specially designed map was filled out. These patients were interviewed at the City Clinical Perinatal Center. Results. Comparative analysis revealed the relationship between the reproductive settings of women of childbearing age and the peculiarity of the course of pregnancy and childbirth in these patients. Summary. The majority of women of fertile age are married: in subgroup AA - 25 (96.2%), AB - 13 (76.5%), BA - 25 (92.6%), BB - 20 (91.0%). The predominant number of women of fertile age have one or more abortions: in subgroup AA - 12 (46.2%), AB - 6 (35.3%), in subgroups of comparison BA - 8 (29.6%), BB - 6 (27.3%). More than half of the women of fertile age surveyed have a history of untreated cervical pathology (from 40.8% to 64.7%). The course of pregnancy in women planning pregnancy in most cases proceeded without complications: in subgroup AA - 13 (50.0%), AB - 11 (64.7%). The most common cause of complicated pregnancy in women whose pregnancy occurred accidentally is the threat of spontaneous miscarriage: in subgroup BA - 15 (55.6%), BB - 16 (72.7%). The uncomplicated course of labor more often [subgroup AA - 19 (73.0%), AB - 12 (70.6%)] was observed in women whose pregnancy was planned and they were motivated to give birth to a healthy child.

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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