scholarly journals Testicular germ cells tumors in adolescents and young adults: Management and outcomes from a single-center experience

2021 ◽  
Vol 93 (3) ◽  
pp. 301-306
Author(s):  
Claudio Spinelli ◽  
Gianmartin Cito ◽  
Girolamo Morelli ◽  
Marco Ghionzoli ◽  
Alessia Bertocchini ◽  
...  
Keyword(s):  
Young Adults ◽  
Survival Rate ◽  
Active Surveillance ◽  
Germ Cells ◽  
Active Treatment ◽  
Age Groups ◽  
Retroperitoneal Lymphadenectomy ◽  
Group A ◽  
Group B

Objective: To investigate and compare the effectiveness of active surveillance versus post-surgical active treatment, in patients with testicular germ cells tumor (TGCT). Materials and methods: We retrospectively analyzed 52 patients who underwent surgery for TGCT from January 2009 to December 2014. All the patients were divided into two age groups: the Group A included children-adolescents from 18 months to 21 years old, while the Group B comprised young adults from 22 to 39 years old. Clinical, histopathological, therapeutic and follow-up data were collected. Results: Overall, 22 patients (42,3%) were enrolled in the Group A and 30 patients (57.7%) were categorized in the Group B. Inguinal orchiectomy was performed in all patients. Retroperitoneal lymphadenectomy was performed in 4 patients (7.7%). Post-surgical management differed based on clinical stage, resulting in active surveillance or adjuvant therapy. After an average 7 years follow-up period (range: 3.5-9.0 years), the overall survival rate is 100%. The relapse risk is significantly higher for the patients in the Group B, displaying a recurrence free-survival rate of 72% versus 95% (Group A); 11 relapses (21.1%) were recorded 2 years after surgery. Of these, 3 recurrences (12.0%) occurred in patients undergoing an active surveillance approach, while 8 (29.6%) in patients subjected to an active treatment. Conclusions: The excellent prognosis in both age groups confirms the high curability of this neoplasia. The active surveillance could represent an optimal option for low recurrence risk tumors. However, post-surgical treatments should be taken into consideration for TGCT with high risk factors, including tumor size, lymphovascular and rete testis invasion.

scholarly journals Active Surveillance in RET Gene Carriers Belonging to Families with Multiple Endocrine Neoplasia

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5554
Author(s):  
Alessandro Prete ◽  
Antonio Matrone ◽  
Carla Gambale ◽  
Valeria Bottici ◽  
Virginia Cappagli ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Thyroid Surgery ◽  
Multiple Endocrine Neoplasia ◽  
Ret Gene ◽  
Ret Mutation ◽  
Gene Carriers ◽  
Endocrine Neoplasia ◽  
Group A ◽  
Group B

Multiple Endocrine Neoplasia 2 (MEN2) is a hereditary cancer syndrome for developing medullary thyroid cancer (MTC) due to germline mutations of RET gene. Subjects harboring a germline RET mutation without any clinical signs of MTC are defined as gene carriers (GCs), for whom guidelines propose a prophylactic thyroid surgery. We evaluate if active surveillance of GCs, pursuing early thyroid surgery, can be safely proposed and if it allows safely delaying thyroid surgery in children until adolescence/adulthood. We prospectively followed 189 GCs with moderate or high risk germline RET mutation. Surgery was planned in case of: elevated basal calcitonin (bCT) and/or stimulated CT (sCT); surgery preference of subjects (or parents, if subject less than 18 years old); other reasons for thyroid surgery. Accordingly, at RET screening, we sub-grouped GCs in subjects who promptly were submitted to thyroid surgery (Group A, n = 67) and who were not (Group B, n = 122). Group B was further sub-grouped in subjects who were submitted to surgery during their active surveillance (Group B1, n = 22) and who are still in follow-up (Group B2, n = 100). Group A subjects presented significantly more advanced age, bCT and sCT compared to Group B. Mutation RETV804M was the most common variant in both groups but it was significantly less frequent in Group A than B. Analyzing age, bCT, sCT and genetic landscape, Group B1 subjects differed from Group B2 only for sCT at last evaluation. Group A subjects presented more frequently MTC foci than Group B1. Moreover, Group A MTCs presented more aggressive features (size, T and N) than Group B1. Accordingly, at the end of follow-up, all Group B1 subjects presented clinical remission, while 6 and 12 Group A MTC patients had structural and biochemical persistent disease, respectively. Thank to active surveillance, only 13/63 subjects younger than 18 years at RET screening have been operated on during childhood and/or adolescence. In Group B1, three patients, while actively surveilled, had the possibility to reach the age of 18 (or older) and two patients the age of 15, before being submitted to thyroid surgery. In Group B2, 12 patients become older than 18 years and 17 older than 15 years. In conclusion, we demonstrated that an active surveillance pursuing an early thyroid surgery could be safely recommended in GCs. This patient-centered approach permits postponing thyroid surgery in children until their adolescence/adulthood. At the same time, we confirmed that genetic screening allows finding hidden MTC cases that otherwise would be diagnosed much later.

Risk Factors for Thrombosis Vary According to Age in Patients with Essential Thrombocythemia: a Retrospective Analysis of 1090 Patients from the “Gruppo Laziale SMPC Ph Negative “,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3854-3854
Author(s):  
Marco Montanaro ◽  
Roberto Latagliata ◽  
Michele Cedrone ◽  
Nicoletta Villivà ◽  
Raffaele Porrini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Thrombotic Event ◽  
Age Groups ◽  
Thrombotic Risk ◽  
Mutational Status ◽  
Group A ◽  
Group B

Abstract Abstract 3854 Increasing age is a well-recognised risk factor for thrombotic events in patients with Essential Thrombocythemia (ET): however, few data exist on the role of other clinical and biological features in different age groups. To address this issue, we analysed retrospectively 1090 ET patients (M/F 403/687, median age 63 years, IR 17 – 96) diagnosed at 11 Hematological Institutions in the Lazio region from 1980 to 2010 and with a median period of follow-up of 84 months (IR 1 – 371). Based on the commonly adopted age threshold, 480 patients (44 %) were < 60 years (Group A) and 610 (56 %) were ≥ 60 years (Group B). Clinical and biological features as well as cardiovascular risk factors analyzed for the impact on the thrombotic risk in the two age groups are reported in the Table.Group A < 60 yearsGroup B ≥ 60 yearsPutative risk factorsRisk ratio (95% CI)P valueRisk ratio (95% CI)P valueM/F167/3132.68 (1.03–6.94)0.0029236/3741.12 (0.17–2.59)0.73WBC median (range) x 109/l8.9 (4.29–22.35)0.387 (0.149–1,004)0.06458.9 (1.2–57.7)0.79 (0.41–1.47)0.445PLTS median (range) x 109/l837 (451–3582)0.37 (0.258–1.70)0.66802 (450–3104)0.52 (0.28–0.99)0.0052Hb median, g/dL (range)14.1 (6.0–18.4)0.86 (0.33–2.24)0.76914.0 (7.0–17.8)0.87 (0.45–1.67)0.674*JAK-2 mutational status: wild type/mutated (%)53.2/46.81.57 (0.50–4.87)0.4434.1/65.90.498 (0.17–1.48)0.209Previous thrombotic events: n° (%)· All events72 (15)2.18 (0.59–7.96)0.12149 (24.4)3.01 (1.38–6.57)0.0004· within 24 months from diagnosis48 (10)1.43 (0.19–10.4)0.7464 (10.5)0.506 (0.18–1.39)0.189· within 60 months from diagnosis60 (12.5)NA0.5191 (14.9)0.323 (0.11–0.95)0.023Cardiovascular risk factors: Y/N %○ Arterial hypertension41.7/58.31.68(0.64–4.36)0.2880.7/19.30.96 (0.36–2.57)0.935○ Diabetes10.2/89.81.11 (0.23–5.15)0.8925.0/75.01.09 (0.38–3.11)0.86○ Smoking attitude45.6/54.42.78 (1.01–7.65)0.06758.3/41.71.04 (0.35–3.09)0.94○ Hyperlipidemia31.0/69.03.11(0.917–10.592)0.03951.6/48.42.31 (0.70–7.55)0.203 In Group A, 39 patients (8.1%) had at least one thrombotic event during follow-up; there were 20 (51.3%) arterial thrombosis and 19 (48.7%) venous thrombosis. In Group B, 63 patients (10.3%) had at least one thrombotic event during follow-up; there were 38 (69.4%) arterial thromboses and 25 (39.6%) venous thromboses. In group A univariate analysis for thrombosis-free survival performed by Kaplan-Meier method, disclosed a significant impact of male gender (p=0.0029, CI 1.03–6.94, HR 2.68), > 2 cardiovascular risk factors (p=0.0002, CI 1.87 – 190, HR 18.94) and isolated hyperlipidemia (p=0.039, CI 0.917 – 10.59, HR 3.11), while previous thrombotic events had no significant impact (p=0.27). By contrast, the presence of a previous thrombotic event was the only feature with a significant impact on thrombotic risk in Group B (p=0.0004, CI 1.38 – 6.55, HR 3.01). WBC and PLTS values at different cut-off levels as well as JAK-2 mutational status did not have any impact on thrombosis in either age groups. However, in group B, we observed a trend (p=0.052, CI 0.28–0.99, HR 0.52) towards a protective effect of higher PLTS values (> 800 × 109/l). In conclusion, our data seem to reinforce the need of a different thrombotic risk assessment in distinct age groups: in particular, younger patients could benefit from early recognition and treatment of well-known cardiovascular risk factors. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Immediate and early loading of hydrothermally treated, hydroxyapatite-coated dental implants: a 7-year prospective randomized clinical study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Afarin Arghami ◽  
David Simmons ◽  
Jeanne St. Germain ◽  
Pooja Maney
Keyword(s):  
Survival Rate ◽  
Bone Loss ◽  
Age Distribution ◽  
Implant Survival ◽  
Randomized Clinical Study ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Plasma Sprayed

Abstract Background Existing research on marginal bone stability around hydroxyapatite (HA)-coated implants often lacks adequate long-term follow-up. The purpose of this randomized prospective study was to evaluate the 7-year outcome of patients with immediate and early loaded single-tooth restorations supported by implants with plasma-sprayed, partially HA-coated surfaces. Forty-two patients in need of 50 single implants were treated in in the Postgraduate Periodontics Clinic of Louisiana State University School of Dentistry. Implants were randomly divided into 2 groups: Group A was immediately loaded, and Group B was early loaded. Continuous follow-up with periodic maintenance care and radiographic evaluations was performed. The primary outcome of interest was implant survival, characterized using the Kaplan–Meier method. Secondary study outcome consisted of peri-implant crestal bone level changes. Data on age, sex, bone quality, implant location, length and diameter, and prior augmentation of the site were collected. Multiple regression analyses were conducted to determine whether the independent variables were associated with bone loss. Results One implant failed to maintain stability and was removed at 3 weeks. Thirty-four patients (14 males, 20 females with a total of 42 implants) completed the 7-year follow-up visit. Average age of evaluable patients was 52 in Group A and 55 in Group B. No significant difference was observed regarding sex and age distribution between the 2 groups. No significant difference was detected in the distribution of implant locations, types of bone, implant length, implant diameter, and augmentation status of the bone between the 2 groups. After 7 years of functioning for the 42 implants examined, implant survival rate was 100% for Group A and 95.5% for Group B. The results from this study of 50 implants showed that HA-coated Zimmer Tapered Screw-Vent Implants were clinically effective, with an overall cumulative 7-year survival rate of 98.0%. When comparing radiographic bone levels between 2-year and 7-year follow-ups, no significant differences in bone loss were found between Group A and Group B. Conclusions After 7 years in function, implants partially coated with plasma-sprayed and hydrothermally treated HA were clinically predictable when restored in occlusion immediately after or 3 weeks after implant placement.

scholarly journals Catheter ablation of atrial fibrillation in patients under 45 years of age. Longterm outcome

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Calero Nunez ◽  
V.M Hidalgo-Olivares ◽  
M Cubells-Pastor ◽  
A Prieto-Lobato ◽  
S Gil-Gomez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Young Adults ◽  
Catheter Ablation ◽  
Young Patients ◽  
Older Population ◽  
Af Ablation ◽  
Group A ◽  
Group B

Abstract Introduction Young patients (p) with atrial fibrillation (AF) tend to be more symptomatic and more reluctant to take long-term antiarrhythmic drugs. However, AF ablation (especially when persistent) is often used as second-line treatment regardless of age. Purpose The aim is to compare clinical outcome and safety of catheter ablation of atrial fibrillation in young adults in comparison to older adults. Secondary endpoints were to compare the influence of other comorbidities in AF ablation outcomes. Methods From 2012–2019, consecutive patients (mean age 56±9,4 years; 72,8% men) with symptomatic paroxysmal AF (PAF 68,8%) and persistent (Pers) AF (31,2%) underwent PVI through radiofrequency (91%) or cryoballoon (9%) at our centre. Two groups were defined (group A ≤45 years, group B &gt;45 years). Follow-up was based on outpatient visits including 24h Holter-ECG at 3, 6 and, 12 months post ablation, and every 12 months thereafter. Results A total of 202 patients undergoing AF ablation were included (group A: 35, 17,3%; group B: 167, 82,7%). Male gender (91,4 vs 68,9%, p=0,006) and smoking (37,1% vs 13,2%, p=0,001) were significantly more often present in group A. HTA (50,9% vs 22,9%, p=0,002) and CHA2DS2-VASc score (1,3±1 vs 0,4±0,6; p=0,01) were higher in the older population group. Median follow-up was 29±18 months. After 12 months AF recurrence were less common in group A: 1-year arrhythmia-free survival was 88,6% (31/35) vs 73,7% (123/167) in the older group [P 0.049]. However, outcomes at the end of follow up were similar between the two groups, the freedom from AF was 57.1% (20/35) in young patients vs 65,3% (109/167) in older group, p=0,42. Multivariate analysis demonstrated that left atrial volume was a predictor of being freedom from AF recurrent [HR 0,96 (95% IC 0,95–0,99), p=0.003]. Major complications occurred more frequently in older patients, although without reaching statistical significance (4.8% (8) vs 2.9% (1); p=0.61), in the young there was only one complication that was pulmonary vein stenosis. Redo AF ablation rate was comparable between the two groups. Conclusion(s) Catheter ablation of AF in young adults is associated with higher 1-year success rates but similar long-term outcomes. The young patients tended to have lower rates of complications in comparison to the older population. These findings suggest that it may be appropriate to consider ablative therapy as first-line therapy in this age group, but further study may be needed to confirm this FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Table 1

scholarly journals Severe Ankle Varus Malalignment Management with a Fix-Bearing Total Ankle Replacement Implant

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0019
Author(s):  
Claudia A. Di Silvestri ◽  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Cristian Indino ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Survival Rate ◽  
Total Ankle Replacement ◽  
Fracture Dislocation ◽  
Ankle Arthritis ◽  
Varus Malalignment ◽  
Ankle Replacement ◽  
Group A ◽  
Group B ◽  
End Stage

Category: Ankle Arthritis; Ankle Introduction/Purpose: Despite Total ankle replacement (TAR) is currently considered a safe procedure and an optimal alternative to ankle fusion in end-stage ankle arthritis, still the precise indications and the limits of TAR are a highly controversial topic. Coronal malalignment correction with TAR is also a widely debated point. Purpose of this work was to confront two patient groups undergoing Total Ankle Replacement (a group of patients with a pre-operative ankle varus misalignment on coronal plane, versus a group of patients with neutral pre-operative ankle alignment) comparing clinical and radiographic results, complications and survival rate of the implant. Methods: 171 patients, all affected by end-stage ankle arthritis and all treated with total ankle replacement with fix-bearing Trabecular Metal Total Ankle System (Zimmer-Biomet, Warsaw IN, USA), were divided in two groups. Group ‘A’ included 159 patients having a normal alignment or a slight valgus or valgus misalignment within 10°. Group ‘B’ included 12 patients with a pre- operative varus malalignment >10°. Each patient of the study was evaluated, clinically and radiologically, before and after surgery, and subsequently at 6 and 12 months follow-up, then once every year. Clinical evaluation comprised some score: visual analogue scale (VAS); American Foot and Ankle Society Score (AOFAS); and the Short Form (SF)-12 Quality of Life, in both of its ‘physical’ (PCS) and ‘mental’ (MCS) components. Radiological evaluated parameters were: tibio-talar surface angle (TTS), lateral distal tibial angle (LDTA-α), and anterior distal tibial angle (ADTA-β). Complications and implant survival rate were evaluated for both groups. Results: At a mean follow up of 2,75 years (range 2.09-5.66 years), improvement was found in all clinical and radiological evaluated parameters of two groups, without statistically significant differences between two groups at last follow-up. In group A most frequent reported complication was the presence of a fibular symptomatic hardware. Major complication were a deep arthroplasty infection and a 3 months post-operative ankle fracture-dislocation/periprostethic fracture. In group B there were 2 delayed wound healing, and one case of loosening of correction. No significant difference in complication and revision rate comparison between two groups was founded. Conclusion: Mid-term results reported in the present show that in patients with varus greater than 10 ° it is possible to obtain a post-operative alignment similar to pre-operative neutral ankles and that the complication rate is not greater. Despite this, is Authors opinion that major and complex misalignment should be approached by skilled surgeons, with an adequate learning curve experience, with a wide range of cases and in highly specialized centers.

scholarly journals Dental Implants with Different Neck Design: A Prospective Clinical Comparative Study with 2-Year Follow-Up

Materials ◽  
2020 ◽  
Vol 13 (5) ◽  
pp. 1029 ◽  
Author(s):  
Pietro Montemezzi ◽  
Francesco Ferrini ◽  
Giuseppe Pantaleo ◽  
Enrico Gherlone ◽  
Paolo Capparè
Keyword(s):  
Survival Rate ◽  
Bone Loss ◽  
Dental Implants ◽  
Survival Rates ◽  
Marginal Bone Loss ◽  
Probing Depth ◽  
Group A ◽  
Group B ◽  
Wide Neck

The present study was conducted to investigate whether a different implant neck design could affect survival rate and peri-implant tissue health in a cohort of disease-free partially edentulous patients in the molar–premolar region. The investigation was conducted on 122 dental implants inserted in 97 patients divided into two groups: Group A (rough wide-neck implants) vs. Group B (rough reduced-neck implants). All patients were monitored through clinical and radiological checkups. Survival rate, probing depth, and marginal bone loss were assessed at 12- and 24-month follow-ups. Patients assigned to Group A received 59 implants, while patients assigned to Group B 63. Dental implants were placed by following a delayed loading protocol, and cemented metal–ceramic crowns were delivered to the patients. The survival rates for both Group A and B were acceptable and similar at the two-year follow-up (96.61% vs. 95.82%). Probing depth and marginal bone loss tended to increase over time (follow-up: t1 = 12 vs. t2 = 24 months) in both groups of patients. Probing depth (p = 0.015) and bone loss (p = 0.001) were significantly lower in Group A (3.01 vs. 3.23 mm and 0.92 vs. 1.06 mm; Group A vs. Group B). Within the limitations of the present study, patients with rough wide-neck implants showed less marginal bone loss and minor probing depth, as compared to rough reduced-neck implants placed in the molar–premolar region. These results might be further replicated through longer-term trials, as well as comparisons between more collar configurations (e.g., straight vs. reduced vs. wide collars).

scholarly journals Mandibular fractures in different pediatric age groups and their current management modalities

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Muhammad Usman Akhtar ◽  
Rafique Chatha ◽  
Adnan Ali Shah ◽  
Muhammad Anwaarul Haq
Keyword(s):  
Age Groups ◽  
Deciduous Teeth ◽  
Mandibular Fractures ◽  
Rigid Fixation ◽  
Arch Bar ◽  
Group A ◽  
Group B ◽  
Condylar Fractures ◽  
Group D

Background: A number of cases of growing age trauma within oro-facial region have been observed in Pakistan, unlike developed countries of world. Mandibular fractures occur in greater frequency than those of the middle third of the face in children, later being very small and plastic comparative to mandible. These fractures of mandible do not demonstrate different clinical features as compared to adults but there is relative difference in treatment management due to, different patterns and plasticity of the facial bones in children, developing tooth buds at different levels in the jaws, mixed dentition, shedding deciduous teeth and incomplete roots of anterior teeth. The causes and patterns of fracture in children older than 12 years resemble to those found in adults. Mandibular fractures are common in Pakistan and commonly related etiology is accidental fall. Method: 57 patients presented with mandibular fractures at Oral and Maxillofacial Surgery department of Punjab Dental Hospital and Children Complex Hospital, Lahore from September 2003 to September 2005. The age of the patients ranged from infancy to early teenage (6 month to 15 years). After confirming diagnosis, the children were divided into following four groups; Group "A" (Infants), Group "B" (Pre-school), Group "C" (School) and Group "D" (Teenage). All patients were treated with one of the following treatment modalities, depending upon the site of fracture and age group of the patients; Micro and miniplates, Eric arch bar splints, Acrylic splints, Ivy eyelet wires, Trans-osseous wiring and Conservative treatment. Results: Group "A" of only 3 patients was managed with open reduction and microplate rigid fixation. Six months follow up showed healing without any complications. Group `B` with 60% males, had mostly body fractures, was treated with acrylic splints and circummandibular wires. Two bilateral body fractures, with avulsed few teeth, were fixed with rigid fixation. Five patients of about age 3 with minimally displaced body fractures were man aged with Eric arch bar fixation alone. Two bilateral condylar bowing fractures were treated conservatively (no active treatment) with no TMJ complications during follow up. The mandibular trauma was noticed exceedingly high in group `C` with overall 50.87% and exclusively in males (90%). Acrylic splints were utilized to treat either condyle with body fractures or condyles alone. Two children had postoperative ipsilateral jaw deviation on opening, which was improved with reverse elastic exercises during follow up. Five patients of high condylar fractures with either no or minimum occlusal disturbance, were conservatively managed. Early mobilization was the prime concern in them to avoid late complications. 17.54 % patients were of group `D` with again high male (90%) ratio. Two horizontally unfavorable angle fractures were managed by trans-osseous wires. Five with minimum displacement were managed with miniplates rigid fixation. All others` with associated condylar fractures were treated with Eric arch bar splint with one plate at body and intermaxillary fixation for two weeks. Conclusion: The patterns and management modalities of pediatric mandibular fractures vary in different age groups. The pediatric fractures should be managed as early as possible to avoid complications. Majority of trauma results in school going and teenage groups with definite high male proportion. High condylar fractures should be treated with extra care, keeping in mind of post traumatic TMJ ankylosis. Acrylic splints showed ideal results in body and condylar fractures, whereas, microplates may be the treatment of choice in infants with no or few deciduous teeth. No serious complications were observed during 6 months follow up.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Hypercoagulable State in the Watanabe Heritable Hyperlipidemic Rabbit, an Animal Model for the Progression of Atherosclerosis

1989 ◽  
Vol 61 (01) ◽  
pp. 140-143 ◽  
Author(s):  
Yoshitaka Mori ◽  
Hideo Wada ◽  
Yutaka Nagano ◽  
Katsumi Deguch ◽  
Toru Kita ◽  
...  
Keyword(s):  
Vitamin K ◽  
Fibrinogen Level ◽  
Plasma Cholesterol ◽  
Age Groups ◽  
Clotting Factor ◽  
Clotting Factors ◽  
Group A ◽  
Hyperlipidemic Rabbit ◽  
Group B ◽  
Progression Of Atherosclerosis

SummaryBlood coagulation in a strain of rabbits designated as Watanabe heritable hyperlipidemic (WHHL) rabbits was examined. The activities of vitamin K-dependent clotting factors, contact factors and clotting factor VIII (F VIII) and the fibrinogen level were significantly higher in WHHL rabbits than in normolipidemic rabbits (all age groups). Values for vitamin Independent clotting factor were already higher at 2 months of age. Contact factors and fibrinogen levels increased age after 5 to 8 months. F VIII increased between 5 and 8 months and then decreased. At 2 months of age, WHHL rabbits were divided into two groups. Group A was fed standard rabbit chow and group B standard rabbit chow containing 1% probucol. Probucol prevented the progression of atherosclerosis in group B in the absence of a significant reduction in plasma cholesterol level. F VIII and fibrinogen levels were statistically decreased in all rabbits at all ages in group B (P<0.05). These differences in clotting factors between the two groups were most obvious at 8 months (P<0.02).We conclude that vitamin K-dependent clotting factors may increase with hyperlipemia and that increases in F VIII and fibrinogen may be closely related to the progression of throm- boatherosclerosis.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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