Nasal Planum Vasculopathy in a Scottish Terrier Dog Treated with Ciclosporin and Endonasal Stents

A two-year-old, intact female Scottish Terrier presented with one-and-a-half-year history of erosive and ulcerative lesions affecting the nasal planum. Clinical appearance, history, histopathology, and response to therapy were suggestive of a rare vasculopathy of the nasal planum that has been previously described in Scottish Terrier dogs. In previously published reports, medical treatments of the disease had failed, leading to euthanasia of five dogs, while a short-term follow-up was available for one case that was controlled with prednisolone and ciclosporin. The dog reported herein was successfully treated with medical therapy consisting initially of a combination of ciclosporin and prednisolone and endonasal stents applied over the first six months. Stents were inserted in order to prevent abnormal scarring and nostril stenosis. More than one and a half years after diagnosis, the dog is still being administered ciclosporin once daily, breathes normally, and has an optimal quality of life.

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Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽

10.1027//0227-5910.24.2.73 ◽

2003 ◽

Vol 24 (2) ◽

pp. 73-78 ◽

Cited By ~ 21

Author(s):

Yves Sarfati ◽

Blandine Bouchaud ◽

Marie-Christine Hardy-Baylé

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Personality Traits ◽

Rating Scales ◽

Suicide Attempts ◽

World Health ◽

Life Questionnaire ◽

Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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Do We Have Another Option to Treat Bleeding Hemorrhoids? The Emborrhoid Technique: Experience in 16 Patients

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200313102246 ◽

2020 ◽

Vol 15 ◽

Cited By ~ 1

Author(s):

Elisabetta Moggia ◽

Giuseppina Talamo ◽

Gaetano Gallo ◽

Matteo Barattini ◽

...

Keyword(s):

Rectal Bleeding ◽

Hemorrhoidal Disease ◽

Severe Bleeding ◽

Conventional Surgery ◽

Short Term ◽

Selective Embolization ◽

Invasive Techniques ◽

Bleeding Hemorrhoids

Background: Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain. Objective: The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia. Many categories of patients might benefit from this treatment, such as patients not eligible for conventional surgery, patients not responding to conventional treatment and fit patients with severe bleeding who refused endorectal surgical therapy. Method: From May 2017 to November 2018 a total of 16 patients with chronic rectal bleeding due to hemorrhoids underwent super-selective embolization of the superior rectal arteries at the department of General Surgery in La Spezia, S. Andrea Hospital, Italy. Median age was 59 years. 14 patients were males (87.5 %). Results: No post-procedural and short-term complications were observed at maximum follow up (12 months). The reduction of rectal bleeding with improvement of the quality of life was obtained in 14 patients (87.5%). Conclusion: Our study, although small in number, demonstrates that embolization of superior rectal arteries with coils to treat severe bleeding due to hemorrhoids is safe and effective and does not lead to immediate complications.

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Does a missed obstetric anal sphincter injury at time of delivery affect short-term functional outcome?

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0140 ◽

2018 ◽

Vol 100 (1) ◽

pp. 26-32 ◽

Cited By ~ 6

Author(s):

L Ramage ◽

C Yen ◽

S Qiu ◽

C Simillis ◽

C Kontovounisios ◽

...

Keyword(s):

Quality Of Life ◽

Anal Sphincter ◽

Short Form ◽

Primary Repair ◽

Obstetric Anal Sphincter Injury ◽

Short Term ◽

Sphincter Injury ◽

Anal Sphincter Injury

Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment. Outcomes compared included Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score, Short Form-36, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and anorectal physiology results. Results Thirty-two missed anal sphincter injuries were matched two to one with sixty-two patients who underwent primary repair of an anal sphincter defect. Mean time to follow-up was 9.31 ± 6.79 months. Patients with a missed anal sphincter injury had suffered more incontinence, as seen in higher the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ; 30.56% ± 14.41% vs. 19.75% ± 15.65%, P = 0.002) and Wexner scores (6.00 ± 3.76 vs. 3.67 ± 4.06, P = 0.009). They also had a worse BBUSQ urinary domain score (28.25% ± 14.9% vs. 17.01 ± 13.87%, P = 0.001) and worse physical functioning as measured by the Short Form-36 questionnaire (P = 0.045). There were no differences in other outcomes compared, including anorectal physiology and sexual function. Discussion In the short-term, patients with a missed obstetric anal sphincter injury had significantly worse faecal incontinence and urinary function scores, however quality of life and sexual function were largely comparable between groups. Conclusions Longer-term follow-up is needed to assess the effects of missed obstetric anal sphincter injury over time.

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The effectiveness of M-Health associated with cardiac rehabilitation on functional capacity and cardiovascular risk factors: a systematic review and meta-analysis

European Heart Journal ◽

10.1093/eurheartj/ehab724.3118 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A C Campagnolo Goncalves Toledo ◽

N Soares De Almeida ◽

A Pierucci ◽

A Straioto Salomao ◽

I Ribeiro Lemes ◽

...

Keyword(s):

Functional Capacity ◽

Meta Analysis ◽

Medium Term ◽

Short Term ◽

High Quality ◽

Quality Of Evidence ◽

High Quality Evidence ◽

Quality Evidence

Abstract Introduction Smartphone applications for health (M-Health) seem to overcome barriers to access Cardiovascular Rehabilitation Programs (CRP), because of their high degree of acceptance and also their potential to influence the frequency of physical exercise in weight loss. Objective To analyze the effectiveness of the combination of M-Health and CRP compared to CRP alone on functional capacity, adherence to CRP, management of cardiovascular risk factors in cardiac patients. Design Systematic Review and Meta-Analysis. Methods The following databases were used Medline via Ovid, EMBASE, Central, PEDro and SPORTDiscus via EBSCOhost from their inception until July/2020. We included randomized controlled trials investigating the effects of M-Health in combination with CRP compared to CRP alone in adults with heart disease, and the interventions with M-Health consisted of text messages, e-mails, and applications. The primary outcome of this review was functional capacity, measured by VO2peak, or self-reported physical activity (METs.min/week). PEDro scale was used to assess the methodological quality of the studies and the GRADE approach to assess the overall quality of evidence. Pooled estimates were calculated using a random effect model to obtain mean difference (MD) or standardized mean differences (SMD) and their respectives 95% confidence intervals (CI). Results Nineteen RCTs were eligible, the median risk of bias was 7 out of 10 points. The primary endpoint was analyzed by subgroups, time of intervention and kind of type CRP, eigthteen of these studies assessed functional capacity. CRP in combination with a m-health intervention was more effective than CRP alone in improving VO2peak, ml/min/kg, (MD: 0.84, CI: 0.30 to 1.38; I2=0%, high quality evidence, 12 trials, n=1889) at short-term follow-up, but at medium-term follow-up (MD: 0.84, CI: −0.26 to 1.41; I2=0%, high quality evidence, 8 trials, n=927,). Similarly, CRP associated with m-health was superior to CRP alone in increasing self-reported at short-term, METs.min/week, (MD:1.31, CI: −0.24 to 2.37; I2 = not aplicable, very low quality evidence, 1 trial, n=18), and at medium-term follow-up (MD: 0.18, CI: −0.01 to 0.36; I2=56%, moderate quality evidence, 4 trials, n=1107). Conclusion High quality of evidence shows that M-Health improves cardiorespiratory fitness at short-term follow-up. In addition, supervised program showed to be more effective than non-supervised. Funding Acknowledgement Type of funding sources: None.

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Short-term health-related quality of life in patients with ischaemic stroke after PFO closure

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvab060.028 ◽

2021 ◽

Vol 20 (Supplement_1) ◽

Author(s):

G Christopoulou ◽

E Sigala ◽

D Aragiannis ◽

E Stamatopoulou ◽

P Manthou ◽

...

Keyword(s):

Quality Of Life ◽

Ischaemic Stroke ◽

Physical Function ◽

Health Related Quality ◽

Short Term ◽

Related Quality ◽

Health Related ◽

Pfo Closure

Abstract Funding Acknowledgements Type of funding sources: None. Introduction/Purpose: Patent foramen ovale (PFO) is common in asymptomatic adults and is associated with cryptogenic stroke (CS). We sought to evaluate the impact of PFO closure in health-related quality of life (HRQoL) in PFO patients with CS. Method In this pilot study, 19 patients (mean age 47 ± 7.7; 13 male) who underwent PFO closure at our center were invited to a short-term clinical follow up (mean follow-up period 6-10 months). All patients had suffered an ischaemic stroke and their disability level was assessed using the Modified Rankin Scale (MRS, no significant disability 63%). HRQoL was assessed using the 36-Item Short Form Survey (SF-36) and the European Quality of Life-5 Dimensions Questionnaire (EQ-5D) preoperatively and at follow-up. Results Both SF36 and EQ-5D scores improved after the operation as shown by the self-rating scores (20,67% and 40,52% higher scores, respectively). Patients with major mobility problems were more likely to be current smokers (r = 0.481) and those who had lower scores on the MRS scale (r=-0.571) rated higher their scale diagram. The categories of energy/fatigue (r = 0.459; p = 0.048), social functioning (r = 0.547; p = 0.015) and pain (r = 0.550; p = 0.015) were positively correlated with physical function. Finally, there was a positive correlation between role limitations due to emotional problems and energy/fatigue (r = 0,519; p = 0.023), and between energy/fatigue and emotional well-being (r = 0.519; p = 0,023). Conclusions The results of our study indicate that shortly after PFO, subjects perceive improvements in their QoL. However, it seems that poorly rated physical function was more common in active smokers, and affects patients" social life and their emotional state. Health care professionals should encourage these patients to participate in rehabilitation and psychological support programs postoperatively.

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The Impact of Emergency Surgery versus Self-expanding Metallic Stents on Anal Function and Quality of Life in Patients with Complete Obstructing Left-sided Colon Cancer

10.21203/rs.3.rs-208724/v1 ◽

2021 ◽

Author(s):

GanBin Li ◽

Tao Yu ◽

Hao-Yu Zhang ◽

Zhen-Jun Wang ◽

Guang-Hui Wei ◽

...

Keyword(s):

Quality Of Life ◽

Colon Cancer ◽

Regression Analysis ◽

Short Term ◽

Anal Function ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Better Than

Abstract Background: Emergence surgery (ES) and self-expanding metallic stents (SEMS) are traditional approaches for complete obstructing left-sided colon cancer. A strategy of “stents-chemotherapy-surgery” was applied in our center recently. Studies assessing the anal function and quality of life of patients with complete obstructing left-sided colon cancer are still lacking.Methods: Patients with complete obstructing left-sided colon cancer were included, and three treatment strategies were used, including ES, SEMS, and SEMS followed by neoadjuvant chemotherapy (NAC) for patients with complete obstructing left-sided colon cancer. The Wexner, Vaizey, and low anterior resection syndrome (LARS) scores were used to assess anal function and the EORTC QLQ C30 score was used to assess quality of life. Logistic regression analysis was used to detect risk factors affecting short-term anal function of patients.RESULTS: The Wexner scores were similar among the groups during the follow-up period. The Vaizey (H=18.415, P=0.001) and LARS scores (H=3.660, P=0.04) both revealed that anal function among patients receiving SEMS and NACwas significantly better than patients who underwent ES at the 1-month post-operative follow-up evaluation; no significant difference existed at the 6- and 12-month follow-up evaluations. The EORTC QLQ C30 score revealed that social function of patients receiving SEMS and NAC was also significantly better than patients undergoing ES (H=7.035, P=0.03). Logistic regression analysis suggested that a one-stage stoma in an emergent setting is an independent risk factor for short-term reduction of anal function among patients with complete obstructing left-sided colon cancer (OR=5.238, 95% CI: 1.569~17.484, P=0.007).Conclusion: Compared to ES, SEMS might be able to improve the quality of life and short-term anal function in patients with complete obstructing left-sided colon cancer.

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Asystole in an older patient with recurrent falls. Case report

Case reports ◽

10.15446/cr.v6n1.82558 ◽

2020 ◽

Vol 6 (1) ◽

pp. 77-83

Author(s):

William Fernando Bautista-Vargas

Keyword(s):

Case Report ◽

Older Patients ◽

Implantable Devices ◽

Loop Recorder ◽

General Terms ◽

Recurrent Falls ◽

History Of ◽

Rule Out

Introduction: Recurrent falls are a usual problema in older patients. It is therefore important to learn how to differentiate a pathological or syncopal episode from a simple stumbling fall, especially in patients who have limitations for communicating clearly and are poorly understood, in general terms, during the medical consultation. Implantable loop recorders (ILR) have been used as an investigation tool in selected cases of recurrent falls in older patients. Consequently, this case report aims to describe its usefulness in this type of patients.Case presentation: An 87-year-old female patient, hypertensive, with a history of recent stroke and frequent falls —referred to as stumbling—, received an implantable loop recorder due to atrial fibrillation. During one follow-up appointment, a 36-second pause related to a fall was documented, so a bicameral pacemaker was implanted.Conclusions: Evaluating repeated falls in older patients is complex; it must be done in detail to rule out syncopal episodes. Implantable devices to diagnose arrhythmic causes are useful and allow achieving accurate diagnoses and establish specific behaviors aimed at improving the quality of life of patients.

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Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients

Cancer Imaging ◽

10.1186/s40644-019-0275-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Min-hao Wu ◽

Ling-fei Xiao ◽

Fei-fei Yan ◽

Shi-Liang Chen ◽

Chong Zhang ◽

...

Keyword(s):

Quality Of Life ◽

Retrospective Study ◽

Pain Relief ◽

Microwave Ablation ◽

Bone Tumors ◽

Short Term ◽

Sf 36 ◽

Percutaneous Microwave Ablation

Abstract Objective The present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors. Methods This single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding clinical efficacy, including pain relief, quality of life, and intervention-related complications, were evaluated before and after MWA using the visual analog scale (VAS) and the 36-item Short-Form Health Survey (SF-36) scoring system. Results Of the 47 patients included in this study, all of them completed follow-up examinations, with a mean follow-up duration of 4.8 ± 1.6 months (range, 2–9 months). Significantly improved VAS and SF-36 scores were recorded after the initial treatment (P<0.001), suggesting that almost 100% of patients experienced pain relief and an improved quality of life following surgery. No major intervention-related complications (e.g., serious neurovascular injury or infection) occurred during or after the treatment. We recorded only three minor posttreatment complications (6.4%, 3/47), which were related to thermal injury that caused myofasciitis and affected wound healing. Conclusion In our study, the short-term efficacy of MWA was considerably favorable, with a relatively low rate of complications. Our results also showed that MWA was effective for pain relief and improved patients’ quality of life, making it a feasible treatment alternative for bone tumors.

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Mid-term Outcomes of Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00444 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0044

Author(s):

Yoshiharu Shimozono ◽

Eoghan Hurley ◽

John Kennedy

Keyword(s):

Systematic Review ◽

Clinical Outcomes ◽

Osteochondral Transplantation ◽

Autologous Osteochondral Transplantation ◽

Short Term ◽

Level Of Evidence ◽

Quality Of Evidence ◽

Current Systematic Review

Category: Ankle Introduction/Purpose: Autologous osteochondral transplantation (AOT) is an established treatment for large-sized OLT, typically greater than 107mm2. Several studies have demonstrated favourable outcomes following AOT at short- and mid-term follow-up. However, the majority of the literature on AOT has short-term follow-up and little evidence exists on the mid-term and longer-term follow-up. Additionally, few studies include a large number of patients or have a high level of evidence, limiting the ability to draw broad and meaningful conclusions about the effectiveness of the AOT procedure for the treatment of OLT beyond short-term follow-up. The purpose of the current systematic review was to evaluate the clinical outcomes analysing level and quality of evidence of the AOT procedure in the treatment of OLT at mid-term and long-term follow-up. Methods: A systematic search of the MEDLINE, EMBASE and Cochrane Library databases was performed in October 2017 based on the PRISMA guidelines. Included studies were evaluated with regard to level of evidence (LOE) and quality of evidence (QOE) using the Coleman Methodology Score. Clinical outcomes, and complications were also evaluated. Results: Eleven studies, with 500 ankles were included at a mean 62.8 months follow-up. There were 3 studies of LOE III, and 8 studies of LOE IV. There were 3 studies of fair quality and 8 studies of poor quality. The weighted mean preoperative AOFAS score was 55.1 ± 6.1, and the postoperative score was 86.2 ± 4.5, with 87.4% of patients being reported as excellent or good results. In total, 54 of the 500 patients (10.8%) had complications. The most common complication was donor site morbidity with 18 patients (3.6%) at final follow-up. Thirty-one patients (6.2%) underwent reoperations, and the authors deemed a total of 5 ankles (1.0%) failures. Only 5 studies (45.5%) used MRI for follow-up evaluation. Conclusion: The current systematic review demonstrated that good clinical and functional outcomes can be expected following AOT procedure for the treatment of OLT, with a failure rate of only 1.0% at 63 months follow-up. MRI and radiographs showed restoration of articular surface as well as a minimal presence of osteoarthritis at mid-term follow-up. However, there is still lack of data from high LOE and QOE studies, and further high quality studies are necessary.

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