scholarly journals Endoscopic treatment of intraluminal ureteral suture with holmium laser

2021 ◽  
Vol 93 (2) ◽  
pp. 248-249
Author(s):  
Jorge Panach-Navarrete ◽  
María Negueroles-García ◽  
José María Martínez-Jabaloyas
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Ureteral Injury ◽  
Holmium Laser ◽  
Central Position ◽  
Promising Technique ◽  
Intense Pain ◽  
Ureteral Trauma ◽  
Open Reconstruction

Although reconstructive surgery is the most accepted treatment for ureteral injury, there are reports of cases where endourologic treatment led to correct resolution of the problem. We present the case of a female patient aged 72-year-old who was previously underwent sacralcolpopexy because of anterior vaginal compartment prolapse. The patient underwent surgery to remove the mesh, due to the pain she had had since it was placed. A mid-line laparotomy was performed removing completely the mesh. At 48 hours after intervention, the patient started feeling an intense pain in the left renal fossa that was not relieved with anti-inflammatories and morphic drugs. In the diagnostic ureteroscopy, it was found iatrogenic suture of the ureter. Due to the availability of holmium laser, an endoureterotomy was performed in the 12h central position on the tip, with laser parameters of 1J-10Hz. A 6F ureteral stent was maintained for one month. During follow-up, the patient remained asymptomatic and without dilation of the left system on imaging tests. Although we accept that open reconstruction is the gold standard treatment for ureteral trauma, we describe holmium laser endoureterotomy as a promising technique to consider in the event of ureteral intraluminal ligation.

scholarly journals Whether Hemiarthroplasty Remains a Gold Standard Treatment for Patients With Displaced Femoral Neck Fractures? - A 20-year Sample of 4516 Patients From a Single Institute

2020 ◽  
Author(s):  
Chi-Yung Yeung ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Cheng-Fong Chen ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Revision Rate ◽  
Femoral Stem ◽  
Recurrent Dislocation ◽  
Geriatric Population ◽  
Displaced Femoral Neck Fractures ◽  
Neck Fracture ◽  
Therapeutic Study

Abstract BackgroundFemoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. This study analysed the causes of HA failure and reevaluated whether HA remains a gold standard treatment for patients with displaced FNFs.MethodsA total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients were enrolled who received the diagnosis of a displaced FNF, underwent primary HA initially, required second revision procedures, and were followed up for a minimum of 36 months. Data were collected and comprehensively analysed.ResultsIn 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.ConclusionHA has an extremely low revision rate and remains a gold standard treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study

scholarly journals Posterior Percutaneous Endoscopic Cervical Diskectomy as a treatment for cervical radiculopathy

2019 ◽  
pp. 1-2
Author(s):  
Hao Wu
Keyword(s):  
Nerve Root ◽  
Gold Standard ◽  
Standard Treatment ◽  
Cervical Radiculopathy ◽  
Endoscopic Technique ◽  
Spinal Instability ◽  
Adjacent Segment ◽  
Less Invasive ◽  
Symptom Relapse

Anterior cervical diskectomy and fusion (ACDF) is the gold standard treatment for patients with cervical radiculopathy. However, the use of ACDF for patients with cervical radiculopathy can result in several disadvantages, such as limitation of motion and accelerating degeneration of adjacent segment. An alternative, less invasive endoscopic technique, posterior percutaneous endoscopic cervical diskectomy (PPECD), was applied to address the above problems associated with ACDF. The patient presented with pain and weakness of the left arm for 2 years. P-PECD was applied and complete decompression of the nerve root was achieved. The symptoms were relieved after surgery. Postoperative MR showed the ruptured disk fragment was successful removed. No spinal instability or symptom relapse was observed in follow-up. PPECD may be an option for patients with cervical radiculopathy.

scholarly journals Laser for the treatment of twin to twin transfusion syndrome

2005 ◽  
Vol 20 (6) ◽  
pp. 478-481 ◽  
Author(s):  
Denise Araújo Lapa Pedreira ◽  
Gregório Lorenzo Acácio ◽  
Carolina Leite Drummond ◽  
Rita de Cássia Sanchez e Oliveira ◽  
Alice D'Agostini Deustch ◽  
...  
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Neonatal Period ◽  
Uterine Cavity ◽  
Initial Experience ◽  
Therapeutic Technique ◽  
Surface Vessels ◽  
Proper Training ◽  
A New Technique

PURPOSE: To report the initial experience in our country with a new technique for twin to twin transfusion syndrome (TTTS) treatment, using laser to coagulate the placental vessels responsible for the twin transfusion during gestation. METHODS: Prospective study of eight cases diagnosed with TTTS evaluated in our service from january 2001 to june 2005. Through percutaneous introduction of a 2,0mm diameter fetoscope in the uterine cavity, placental surface vessels where directly visualized. Those identified as responsible for the transfusion were laser coagulated. The procedure combines ultrasonography and fetoscopy, in a so-called sonoendoscopic technique (FETENDO). RESULTS: Among the eight pregnancies evaluated, five cases were submitted to the procedure (10 fetuses). All fetuses survived for at least five weeks after surgery. A total of eight fetuses were born alive and five survived the neonatal period. In a 18 months follow-up after birth, all five are still alive and well and their mean age is now 10,6 months. The total survival rate was 50% and in three pregnancies, at least one fetus survived. CONCLUSIONS: Laser fetoscopy is actually the "gold-standard" treatment of TTTS. Nevertheless is a sophisticated technique that epends of proper training. Our service is the first in our country to offer this therapeutic technique. Our success rate is comparable with the international literature.

scholarly journals Carpal tunnel release by mini palmar incision

2011 ◽  
Vol 5 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Kawee Pataradool ◽  
Pravit Kitidumrongsook ◽  
Adisorn Patradul
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Gold Standard ◽  
Standard Treatment ◽  
Carpal Tunnel Release ◽  
Small Series ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Mini Incision

Abstract Background: Open carpal tunnel release is the gold standard treatment for carpal tunnel syndrome. However, there are complications related to the long incision. Method: We report the results from a mini-incision open carpal tunnel release with simple instruments. Results: There were no complications in our small series, improvement of scores was shown at four-week follow-up, and cosmetic results were satisfactory. Conclusions: Mini-incision carpal tunnel release is one option to treat carpal tunnel syndrome.

scholarly journals Paraganglioma of the Thyroid Gland: A Case Report and a Review of the Literature

2021 ◽  
pp. 014556132110345
Author(s):  
Massimo Campagnoli ◽  
Michele Cerasuolo ◽  
Giorgio Arena ◽  
Valeria Dell’Era ◽  
Annalisa Andorno ◽  
...  
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Gold Standard ◽  
Standard Treatment ◽  
Incidental Finding ◽  
Definitive Diagnosis ◽  
Review Of The Literature ◽  
Staining Techniques ◽  
Histological Staining

Paragangliomas of the thyroid gland are rare and usually they originate from the inferior laryngeal paraganglia. In this case report, we describe the case of a 78-year-old woman who presented with an incidental finding of thyroid nodule dislocating the trachea. After a systemic and radiological evaluation, right lobo-isthmectomy was performed, and the definitive diagnosis of paraganglioma was reached. Diagnosis of these thyroidal lesions could be difficult due to their rarity, to their specific radiological aspects and the need of employing specific histological staining techniques. Once the definitive diagnosis is reached, patients should undergo a systemic and genetic evaluation. Surgery is the gold standard treatment; radiotherapy should be considered when aggressive behavior is suspected. Regular long-lasting follow-up should be proposed to these patients considering the unpredictable behavior of these lesions.

Multislice imaging of gastrointestinal stromal tumors

2018 ◽  
pp. 3-14
Keyword(s):  
Computed Tomography ◽  
Key Words ◽  
Gold Standard ◽  
Gastrointestinal Stromal Tumors ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Preferential Localization ◽  
Multislice Imaging ◽  
Computed Tomography Diagnosis

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Detection of adverse drug events in e-prescribing and administrative health data: a validation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bettina Habib ◽  
Robyn Tamblyn ◽  
Nadyne Girard ◽  
Tewodros Eguale ◽  
Allen Huang
Keyword(s):  
Administrative Data ◽  
Gold Standard ◽  
Adverse Drug Events ◽  
Study Drug ◽  
Health Data ◽  
Diagnostic Code ◽  
Administrative Health Data ◽  
Potential Ades ◽  
Patient Reported

Abstract Background Administrative health data are increasingly used to detect adverse drug events (ADEs). However, the few studies evaluating diagnostic codes for ADE detection demonstrated low sensitivity, likely due to narrow code sets, physician under-recognition of ADEs, and underreporting in administrative data. The objective of this study was to determine if combining an expanded ICD code set in administrative data with e-prescribing data improves ADE detection. Methods We conducted a prospective cohort study among patients newly prescribed antidepressant or antihypertensive medication in primary care and followed for 2 months. Gold standard ADEs were defined as patient-reported symptoms adjudicated as medication-related by a clinical expert. Potential ADEs in administrative data were defined as physician, ED, or hospital visits during follow-up for known adverse effects of the study medication, as identified by ICD codes. Potential ADEs in e-prescribing data were defined as study drug discontinuations or dose changes made during follow-up for safety or effectiveness reasons. Results Of 688 study participants, 445 (64.7%) were female and mean age was 64.2 (SD 13.9). The study drug for 386 (56.1%) patients was an antihypertensive, and for 302 (43.9%) an antidepressant. Using the gold standard definition, 114 (16.6%) patients experienced an ADE, with 40 (10.4%) among antihypertensive users and 74 (24.5%) among antidepressant users. The sensitivity of the expanded ICD code set was 7.0%, of e-prescribing data 9.7%, and of the two combined 14.0%. Specificities were high (86.0–95.0%). The sensitivity of the combined approach increased to 25.8% when analysis was restricted to the 27% of patients who indicated having reported symptoms to a physician. Conclusion Combining an expanded diagnostic code set with e-prescribing data improves ADE detection. As few patients report symptoms to their physician, higher detection rates may be achieved by collecting patient-reported outcomes via emerging digital technologies such as patient portals and mHealth applications.

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