scholarly journals SACRAL NEUROMODULATION FOR THE TREATMENT OF FAECAL INCONTINENCE: FIRST STEPS IN LITHUANIA

2015 ◽  
Vol 26 (2) ◽  
pp. 91-95
Author(s):  
Saulius Švagždys ◽  
Mantas Vilčinskas ◽  
Justinas Vencius ◽  
Andrius Radžiūnas
Keyword(s):  
Functional State ◽  
Faecal Incontinence ◽  
Nerve Stimulation ◽  
Sacral Neuromodulation ◽  
Statistical Significance ◽  
Sacral Nerve ◽  
Before And After ◽  
First Results ◽  
Faecal Urgency ◽  
The Impact

Two female patients with faecal incontinence resistant to conservative treatment but improved after percutaneous tibial nerve neuromodulation were treated with sacral nerve neuromodulation in 2014. Quality of Life questionnaires were used in order to determine the impact of faecal incontinence on everyday life before and after the implantation of the stimulator. To evaluate the functional state, Wexner’s questionnaires were applied. Bowel movement diary was used to detect the improvement of faecal continence before and after temporary and permanent neuromodulation. The data were analyzed using a Statistical Package for Social Sciences program (SPSS, version 22.0). All values were given as mean ± SD. P-values less than 0.05 were accepted to indicate statistical significance. Both patients had a reduction in episodes of incontinence and soiling during a 3 week temporary nerve stimulation period as well as during 3 week followup after permanent stimulator implantation. Statistically significant elevation of faecal urgency frequency (p=0.031) was observed during temporary nerve stimulation. Reduction of episodes of faecal incontinence (p=0.001) and soiling (p=0.000) was observed after permanent stimulator implantation. Both patients presented an improvement in lifestyle, coping, depression and embarrassment as well as an improvement in functional state 3 weeks after the beginning of sacral nerve stimulation. Conclusions: The first results of sacral neuromodulation in patients with faecal incontinence are excellent and very promising. What does this paper add to the literature? The article describes the first Lithuanian experience applying the sacral nerve neuromodulation to treat faecal incontinence.

Effects of use of an eHealth platform e-Vita for COPD patients on disease specific quality of life domains

2020 ◽  
Keyword(s):  
Quality Of Life ◽  
Functional State ◽  
Mental State ◽  
Self Management ◽  
Copd Patients ◽  
Before And After ◽  
Ehealth Intervention ◽  
The Impact ◽  
Disease Specific

Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings. Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients. Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention. Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0,20% before the intervention and 0,27% after the intervention; this difference was statistically significant (P=0.027). The decrease of CCQ-mental was 0,97% before the intervention and after the intervention there was an increase of 0,017%; this difference was statistically significant (P=0,01). No significant difference was found in the slopes of CCQ (P=0,12) and CCQ-function (P=0,11) before and after the intervention. Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.

scholarly journals Treatment of HIV-associated facial lipoatrophy: impact on infection progression assessed by viral load and CD4 count

2013 ◽  
Vol 88 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Flávia Machado Gonçalves Soares ◽  
Izelda Maria Carvalho Costa
Keyword(s):  
Viral Load ◽  
Disease Progression ◽  
Statistical Significance ◽  
Undetectable Viral Load ◽  
Fat Distribution ◽  
Cd4 Count ◽  
Before And After ◽  
Facial Lipoatrophy ◽  
A Prospective Study ◽  
The Impact

BACKGROUND: HIV/AIDS-Associated Lipodystrophy Syndrome includes changes in body fat distribution, with or without metabolic changes. The loss of fat from the face, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome.OBJECTIVES:To evaluate the effect of FL treatment using polymethylmethacrylate (PMMA) implants on disease progression, assessed by viral load and CD4 cell count.METHODS: This was a prospective study of 44 patients treated from July 2009 to December 2010. Male and female patients, aged over 18 years, with clinically detectable FL and who had never been treated were included in the study. PMMA implantation was done to fill atrophic areas. Laboratory tests were conducted to measure viral load and CD4 count before and after treatment.RESULTS: Of the 44 patients, 72.72% were male and 27.27% female, mean age of 44.38 years. Before treatment, 82% of patients had undetectable viral load, which increased to 88.6% after treatment, but without statistical significance (p = 0.67). CD4 count before treatment ranged from 209 to 1293, averaging 493.97. After treatment, the average increased to 548.61. The increase in CD4 count after treatment was statistically significant with p = 0.02.CONCLUSION: The treatment of FL with PMMA implants showed a statistically significant increase in CD4 count after treatment, revealing the impact of FL treatment on disease progression. Viral load before and after treatment did not vary significantly.

scholarly journals PTH-024 A Multicentre Experience of Sacral Nerve Stimulation (SNS) In Scleroderma Faecal Incontinence: Abstract PTH-024 Table 1

Gut ◽  
2013 ◽  
Vol 62 (Suppl 1) ◽  
pp. A221.1-A221
Author(s):  
S K Butt ◽  
A Alam ◽  
K Krogh ◽  
S Buntzen ◽  
A Emmanuel
Keyword(s):  
Faecal Incontinence ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Sacral Nerve

scholarly journals Impact of High Temperature on Post-Exercise Albuminuria in Dogs

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1988
Author(s):  
Urszula Pasławska ◽  
Barbara Szczepankiewicz ◽  
Aleksandra Bednarska ◽  
Robert Pasławski
Keyword(s):  
High Temperatures ◽  
Healthy Adult ◽  
Statistical Significance ◽  
Abdominal Ultrasound ◽  
Strenuous Exercise ◽  
Movement Activity ◽  
Post Exercise ◽  
Intensive Exercise ◽  
Before And After ◽  
The Impact

The literature suggests that strenuous exercise and exposure to high temperatures may cause physiologic proteinuria, but to our knowledge there have been no studies that have assessed the effect of high temperatures on the occurrence of post-exercise albuminuria in dogs. The goal of the study was to assess the impact of high temperatures on the occurrence of albuminuria. Thirteen healthy adult dogs—eight female (62%) and five male (38%) had to run 5 km at a temperature of 25 °C in grasslands which took about 30–40 min. Dogs underwent clinical examinations: echocardiography, abdominal ultrasound, blood hematology and biochemistry and urinalysis, including the ratio of albumin to creatinine (UAC). Baseline UAC was on the borderline of statistical significance for female dogs, but not for male dogs, before and after exercise. UAC was 0.31 ± 0.56 mg/mmol for female dogs and 0.36 ± 0.60 mg/mmol in male dogs before exercise. Immediately after exercise, UAC was 0.51 ± 0.58 mg/mmol in female dogs and 0.31 ± 0.40 mg/mmol in male dogs. Thus, a period of about 30–40 min of intensive exercise at high temperatures (25 °C) did not lead to increased albuminuria. This suggests that there is no need to limit the movement activity before urine tests in dogs, even at high temperatures, before urinalysis.

Sacral nerve stimulation reduces corticoanal excitability in patients with faecal incontinence

2005 ◽  
Vol 92 (11) ◽  
pp. 1423-1431 ◽  
Author(s):  
R. Sheldon ◽  
E. S. Kiff ◽  
A. Clarke ◽  
M. L. Harris ◽  
S. Hamdy
Keyword(s):  
Faecal Incontinence ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Sacral Nerve

scholarly journals Prospective comparison of faecal incontinence grading systems

Gut ◽  
1999 ◽  
Vol 44 (1) ◽  
pp. 77-80 ◽  
Author(s):  
C J Vaizey ◽  
E Carapeti ◽  
J A Cahill ◽  
M A Kamm
Keyword(s):  
Faecal Incontinence ◽  
Clinical Impression ◽  
Clinical Validity ◽  
Diary Card ◽  
Medical Systems ◽  
Prospective Comparison ◽  
Grading Systems ◽  
Before And After ◽  
Faecal Urgency ◽  
Level Of Significance

BackgroundExisting scales for assessing faecal incontinence have not been validated against clinical assessment, or with regard to reproducibility. They also fail to take into account faecal urgency, and the use of antidiarrhoeal medications.AimsTo establish the validity, and sensitivity to change, of existing scales and a newly designed incontinence scale.Methods(1) Twenty three patients (21 females, median age 57 years) were prospectively evaluated by two independent clinical observers, using three established scales (Pescatori, Wexner, American Medical Systems), a newly devised scale which also includes details about urgency and antidiarrhoeal drugs, and by a 28 day diary. (2) A further 10 female patients were assessed by the same scales before and after surgery for faecal incontinence.Results(1) Assessments by two independent clinicians correlated well. All four scales and a diary card correlated highly and significantly with the clinical impression, with the new scale reaching the highest correlation (r=0.79, p<0.001). (2) All except one score changed significantly in response to surgical treatment; the new scale showed the greatest change, at the highest level of significance (p=0.004), and correlated best with the clinicians’ assessment of change (r=0.94, p<0.001).ConclusionsExisting scales for the assessment of faecal incontinence correlate well with careful clinical impression of severity, and serve as useful and reproducible measures for comparison of patients and treatments. A newly devised scale has shown high clinical validity and utility.

Sign in / Sign up

Export Citation Format

Share Document