Management of Lipedema with Ketogenic Diet: 22-Month Follow-Up

Lipedema is a pathology of adipose tissue, still of unclear etiology and challenging to diagnose. For these reasons, a therapeutic approach is also complex and sometimes controversial. The inflammation state present in lipedema can be limited by controlling the glycemic peaks. Specifically, the ketogenic diet (KD) seems to have the right conditions to be effective. Herein, we reported a subject diagnosed with lipedema who, with only KD nutritional intervention, achieved a significant weight loss (−41 Kg), with a net decrease in body circumferences, and also reporting an improvement in pain, and therefore in the overall quality of life. She refused other types of intervention and kept KD for two years. This case could represent the first step to organize a KD nutritional protocol specifically applied to lipedema.

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Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale Follow-Up

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.751178 ◽

2021 ◽

Vol 8 ◽

Author(s):

Quentin Senechal ◽

Perrine Echegut ◽

Marine Bravetti ◽

Marie Florin ◽

Lamia Jarboui ◽

...

Keyword(s):

Quality Of Life ◽

Lower Limb ◽

Iliac Vein ◽

Pelvic Vein ◽

Internal Iliac Vein ◽

Internal Iliac ◽

The Right ◽

Pelvic Congestion

Purpose: To evaluate medium-term clinical outcomes of transcatheter embolization and stenting in women with several pelvic venous disorders responsible for chronic pelvic pain and varicose veins of the lower limbs.Materials and Methods: The study population included 327 consecutively recruited patients referred to the interventional radiology unit from January 2014 to December 2019 due to chronic pelvic congestion (91; 27.83%), lower limb varices (15; 4.59%), or a combination of both the symptoms (221; 67.58%). Preprocedural pelvic, transvaginal Doppler ultrasound (US), and MRI were conducted in all the patients and revealed anatomical varicosities and incompetent pelvic veins in 312 patients. In all the patients, selective catheterization demonstrated uterine venous engorgement, ovarian plexus congestion, or pelvic vein filling. Retrograde flow was detected on catheter venography in the left ovarian vein (250; 78%), the right ovarian vein (85; 26%), the left internal iliac vein (222; 68%), and the right internal iliac vein (185; 57%). Patients were followed-up at 1, 6, and 12 months, and years thereafter systematically by the referring angiologist and the interventional radiologist of center. They were contacted by telephone in November and December 2020 to assess pain perception and quality of life by using the visual analog scales from 0 to 10 with assessments made at the baseline and last follow-up. Of the 327 patients (mean age, 42 ± 12 years), 312 patients were suffering from pelvic congestion syndrome and 236 patients was suffering from lower limb varices. All underwent embolization by using ethylene vinyl alcohol copolymer (Onyx®). Eighty-five right ovarian veins, 249 left ovarian veins, 510 tributaries of the right internal iliac vein, and 624 tributaries of the left internal iliac vein were embolized. A cohort of patients also underwent nutcracker syndrome angioplasty (6.7%) and May–Thurner syndrome angioplasty (14%) with a stent placement.Results: The initial technical success rate was 80.9% for embolization of pathological veins and 100% for stenting of stenoses. Overall, 307 patients attended 12-month follow-up visits and 288 (82%) patients completed the telephone survey at mean 39 (±18)-month postintervention. Main pelvic pain significantly improved from 6.9 (±2.4) pre- to 2.0 (±2.4) postembolization (p < 0.001), as did specific symptoms in each category. Improvement or disappearance of pain was achieved in 266/288 (92.36%) patients with improved quality of life in 276/288 (95.8%) patients. There were 16 minor and 4 major adverse events reported on the follow-up.Conclusion: Pelvic vein embolization (Onyx®) is an effective and safe procedure with high clinical success and quality of life improvement rates.

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Surgical Interventions Are Effective for Treating Unruptured Sinus of Valsalva Aneurysms

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.707147 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juntao Qiu ◽

Enzehua Xie ◽

Yuetang Wang ◽

Wei Wang ◽

Cuntao Yu ◽

...

Keyword(s):

Quality Of Life ◽

Coronary Sinus ◽

Surgical Repair ◽

Heart Function ◽

Early Death ◽

Sinus Of Valsalva ◽

Surgical Interventions ◽

The Right

Background: This study investigates the optimal management for unruptured sinus of Valsalva aneurysms (USVAs) combined with other cardiovascular lesions.Methods: This retrospective study examined 33 USVA patients who underwent surgical repair from February 1, 2007 to January 31, 2012. We analyzed the surgical procedures and the patients' quality of life after surgery. Additionally, echocardiography follow-up was performed before and after the operation.Results: Most USVAs (87.8%) originated in the right coronary sinus. Aside from one patient who was preoperatively misdiagnosed as having a ruptured sinus of Valsalva aneurysm (SVA). USVAs of the right coronary sinus were addressed by reinforcing this sinus with a Dacron patch through the right ventricle. USVAs were corrected by aortotomy using an autogenous pericardium patch when they originated in the non-coronary or left coronary sinus. Thirty patients (90.9%) were followed up for 22–119 months. No early death, residual fistula or SVA recurrence were found during the follow-up period. They all had a good quality of life and good heart function (New York Heart Association class I–II).Conclusions: Active surgical repair of an USVA can be achieved with satisfactory results in patients combined with other cardiovascular lesions.

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Lágyéksérvet utánzó gigantikus méretű myxoid leiomyoma

Orvosi Hetilap ◽

10.1556/650.2016.30374 ◽

2016 ◽

Vol 157 (10) ◽

pp. 392-395

Author(s):

Orsolya Huszár ◽

Attila Zaránd ◽

Gyöngyi Szántó ◽

Viktória Juhász ◽

Eszter Székely ◽

...

Keyword(s):

Quality Of Life ◽

Smooth Muscle ◽

Soft Tissue Mass ◽

Smooth Muscle Tumour ◽

Tissue Mass ◽

Abdominal Symptoms ◽

History Of ◽

The Right

Leiomyoma is a rare, smooth muscle tumour that can occur everywhere in the human body. The authors present the history of a 60-year-old female, who had a giant, Mullerian type myxoid leiomyoma in the inguinal region mimicking acute abdominal symptoms. After examination the authors removed the soft tissue mass in the right femoral region reaching down in supine position to the middle third of the leg measuring 335 × 495 × 437 mm in greatest diameters in weight 33 kg. Reconstruction of the tissue defect was performed using oncoplastic guidelines. During the follow-up time no tumour recurrence was detected and the quality of life of the patient improved significantly. Orv. Hetil., 2016, 157(10), 392–395.

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Intraosseous Stab Wound of Scapula: A Case Report

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v5i4.4383 ◽

2020 ◽

Author(s):

Mohsen Rezaei Nosrati ◽

Salar Baghbani ◽

Yousef Fallah ◽

Babak Siavashi ◽

Mohammad Reza Golbakhsh

Keyword(s):

Quality Of Life ◽

Case Report ◽

Physical Examination ◽

Stab Wound ◽

Stab Wounds ◽

Iatrogenic Injuries ◽

Physical Examinations ◽

The Right

Background: Intraosseous stab wounds are extremely rare. Only a few cases have been reported in the upper extremity. Case Report: In this report, we presented a case of stab wound to the right shoulder with penetration to the scapula. The patient was successfully managed in a team-based approach. During a 12-month follow-up, he showed no abnormality in passive and active movements or physical examination. Conclusion: Relying on the physical examinations and paraclinical studies may be an appropriate substitution for exploration surgery when possible iatrogenic injuries may affect the patient's quality of life.

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PP443 Effectiveness And Safety Of Transcatheter Therapy Interventions Devices For Treatment Of Tricuspid Regurgitation

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320001774 ◽

2020 ◽

Vol 36 (S1) ◽

pp. 35-36

Author(s):

Esther Elena Garcia_Carpintero ◽

Jordi Gol Freixa ◽

Luis María Sánchez Gómez

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Adverse Events ◽

Mortality Rates ◽

Transcatheter Therapy ◽

Procedural Success ◽

Therapy Interventions ◽

The Right

IntroductionTricuspid regurgitation (TR) is defined as incompetence of the tricuspid valve (TV), which produces the movement of blood flow from the right ventricle (RV) to the right atrium during systole. Pathological TR is functional in nearly 80–90 percent of cases, secondary to volume and/or pressure overload in the RV. Surgical intervention of TR is associated with mortality rates of 10 percent. Transcatheter therapy interventions (TTI) can be an alternative for severe TR. The aim of this study is to assess effectiveness and safety of TTI.MethodsA systematic review was carried out. The scientific literature search was performed in major medical databases. Studies analyzing the efficacy and safety of the devices were included. Outcomes related with mortality rates, TR volume reduction, echocardiographic findings and adverse events were analyzed. The methodological quality of the studies was analyzed with the Canadian Institute of Health Economics Quality Appraisal Checklist.ResultsNine studies comprising 557 patients were included (two first-in-human studies, one retrospective, five single arm prospective studies and one international registry). The studies were small with short follow up. The outcome of procedural success ranged from 80 to 100 percent. Mortality rates at 30 days were lower than 5 percent. Improvements in reduction of TR, European System for Cardiac Operative Risk Evaluation (EuroSCORE), heart failure symptoms or quality of life scores were observed in all studies.ConclusionsTTI for moderate-severe TR show significant reduction of annulus dimension, improvements in heart failure symptoms and quality of life, which are maintained in mid-term follow up. TTI present lower rates of major serious adverse events. No differences were observed between different TTI devices in terms of procedural success, mortality or safety. Randomized studies comparing TTI with optimal medical therapy are needed to confirm the preliminary clinical impact in patients with severe TR, and define aspects such as patient selection, risk factors associated with procedural success or mortality rates.

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Eliminating the Burden of Lymphedema in Cancer Patients Requiring Nodal Dissections Using Prophylactic Immediate Lymphatic Reconstruction – A Case Report and Review of the Literature

Plastic Surgery Case Studies ◽

10.1177/2513826x211028930 ◽

2021 ◽

Vol 7 ◽

pp. 2513826X2110289

Author(s):

Abiye Mussie ◽

Maria C. Medor ◽

Sylia Mohand-Said ◽

Andrea M. Ibrahim ◽

Carolyn Nessim ◽

...

Keyword(s):

Quality Of Life ◽

Standard Of Care ◽

Life Questionnaire ◽

Review Of The Literature ◽

Quality Of Life Questionnaire ◽

Novel Approach ◽

Nodal Dissection ◽

The Right

Immediate lymphatic reconstruction (ILR), performed concurrently with nodal dissection, has shown promise in reducing the rates of lymphedema in patients with various types of cancers. Herein, we detail the case of a 42-year-old patient who underwent nodal dissection in the management of their melanoma. This patient underwent ILR at the time of lymph node dissection of the right axilla and was followed for 24 months. Circumferential measurements of both the operative and non-operative limbs, as well as lymphedema-specific quality of life questionnaire (LYMQOL) data, were collected at each appointment. Our patient developed lymphedema transiently at 3 months which had resolved by the 6-month follow-up and maintained favorable measures of quality of life over the course of 2 years. This novel approach has yet to be implemented as a standard of care in Canada. Such an outcome would be overwhelmingly positive for our cancer population, and on our health-care system overall.

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Cementless Femoral Neck Endoprosthesis Spiron in Men in Aspects of Clinical Status and Quality of Life in Average a 5-year Follow-up

10.21203/rs.3.rs-39182/v1 ◽

2020 ◽

Author(s):

Tomasz Stołtny ◽

Jarosław Pasek ◽

Michał Pyda ◽

Daniel Spyrka ◽

Michał Białek ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Femoral Neck ◽

Clinical Condition ◽

Clinical Status ◽

Steroid Drugs ◽

The Right ◽

Observation Period

Abstract Background: Hip arthroplasty is increasingly performed in young people actively playing sports, professionally active, or treated with steroid drugs in the course of autoimmune diseases. Significantly more often in this group of patients the cause of osteoarthritis is sterile femoral head necrosis. Femoral neck endoprosthesis can be an alternative to pituitary or classical cementlessarthroplastyin the surgical treatment of osteoarthritis.Material and methods: The study group consisted of 27 men aged 32 to 65 years (average 46 years) in whom femoral neck endoprosthesis was implanted (16 on the left side, 11 on the right side).The most common indications for surgical treatment were idiopathic osteoarthritis of the hip (19 patients) and arthrosis due to sterile femoral osteonecrosis (8 patients).Operational access according to Hardinge in the patient's position on the back by embedding a uncemented femoral neck endoprosthesis in ceramic articulation was applied.In the studied group of patients, clinical condition was assessed using the HHS, WOMAC-HIP classification. An assessment of the quality of life was also carried out on the SF-12 scale and pain assessment on the VAS scale.Analyzes were performed before surgery, while the control test was carried out on average over a 5-year observation period.Results: The clinical condition of the examined men on the HHS (49.81 vs 84.05) and WOMAC-HIP (40.59 vs 13.5) scale significantly improved (p <0.05) in relation to the value before surgery.Similar results were obtained in the assessment of quality of life on the SF-12 scale (9.89 points vs. 32 points); (p <0.05) and pain on the VAS scale (6.74 vs 0.58); (p <0.05) during follow-up.Conclusions: The use of femoral neck endoprosthesis in men with hip arthrosis in the mean follow-up of 5 years improved both the clinical condition and the quality of life of the operated patients while reducing the pain.

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