scholarly journals A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers

2021 ◽  
Vol 32 (2) ◽  
pp. 383-390
Author(s):  
Kaan Gürbüz ◽  
Yalçın Yontar
Keyword(s):  
Community Hospital ◽  
Functional Results ◽  
Clinical Results ◽  
Dominant Hand ◽  
Severity Scale ◽  
Cold Intolerance ◽  
Work Related ◽  
The Third ◽  
The Mean

Objectives: This study aims to evaluate the clinical results and experiences in a community hospital regarding procedures for the replantation and revascularization of fingers. Patients and methods: Between June 2015 and December 2019, a total of 58 patients (51 males, 7 females; mean age: 33.4±6.3 years; range, 23 to 46 years) who were followed after total and/or subtotal amputation and replantation were retrospectively analyzed. The patients were evaluated at nine months in terms of cold intolerance, static two-point discrimination, and functional results using the range of motion (ROM) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Results: The majority of the patients presented with work-related injuries (70%), most commonly by the mechanism of guillotine (64%), and to the dominant hand (76%) and the third finger (36%) most frequently. The overall success rate of digit salvage was 72.9% (n=51). Of 19 digits with unsuccessful surgical outcomes, seven were from total and 12 were from subtotal amputations. In the long-term, cold intolerance was observed in 14 patients (24.1%) according to the cold intolerance severity scale. The mean static two- point discrimination value was 6.0±0.7 mm and the mean QuickDASH score was 22.3±5.0. The mean ROM measured at nine months after surgery in the metacarpophalangeal and interphalangeal joints of the third and fourth digits was significantly lower than that in the others (p<0.05). Conclusion: The predictors of survival of a replanted digit indicated in this study can be used as a guide and decision-making aid for any attempts for replantation.

scholarly journals Short stump and high anastomosis pull-through (SHiP) procedure for delayed coloanal anastomosis with no protective stoma for low rectal cancer

2021 ◽  
Vol 73 (2) ◽  
pp. 495-502
Author(s):  
Francesco Bianco ◽  
Paola Incollingo ◽  
Armando Falato ◽  
Silvia De Franciscis ◽  
Andrea Belli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Coloanal Anastomosis ◽  
Functional Results ◽  
Anal Margin ◽  
Perioperative Mortality ◽  
The Mean ◽  
Pull Through ◽  
Protective Stoma

AbstractDespite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed ‘Short stump and High anastomosis Pull-through’ (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.

Contemporary Treatment for Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Mitova D
Keyword(s):  
Subretinal Fluid ◽  
Functional Results ◽  
Clinical Results ◽  
Long Term Results ◽  
Nanosecond Laser ◽  
Success Rates ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Short And Long Term

Aim: To study the short-and long-term results of 2RT nanosecond laser treatment for CSC. To compare clinical results with those with AntiVEGF. Methods: Nanosecond laser (2RT, Ellex) was used. Patients were followed by BCVA, FAF, OCT, Angio-OCT. Results: 90% of the patient treated with 2RT had improvement of visual acuity and contrast sensitivity. 19 % [1] patients showed no improvement. 81% of the 2RT treated patients had total resorbtion of subretinal fluid against 60% treated with AntiVEGF. Functional results correlated with the atrophy of RPE in the macula. 46% (19 patients) had resolution on the first month, 23% [2]-on the third and 12% [3]-on the sixth month. The time of resolution shows no relation to the baseline pigment epithelial atrophy. Four patients presented with a recurrency of the disease in the follow-up period. 19% [1] were non responders. 60% of AntiVEGF treated eyes were responders and 40% were non responders. Those who responded to treatment needed between 3 and 10 injections. Conclusion: 2 RT is a non-invasive treatment modality with no adverse effects and high success rates.

Long-Term Results After Policization for Congenital Hand Deformities

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 79-85 ◽  
Author(s):  
Toshihiko Ogino ◽  
Seiichi Ishii
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Pinch Strength ◽  
Cosmetic Results ◽  
Opposite Hand ◽  
Hand Deformities ◽  
The Mean ◽  
Congenital Hand Deformities

Thirteen patients — 18 hands — have been treated with pollicization and could be followed-up for 2 years to 19 years with an average of 7.9 years. Surgery was performed according to the Buck-Gramcko method. The mean age at the time of pollicization was 1.7 years. The parents were satisfied with the cosmetic results in all cases, and they were satisfied with the functional results in all except 4 hands. At follow-up, all patients could use the pollicized digit for pinch. Excellent pinch function has been achieved in 11 hands, good in 2, and fair in 1. The average percent pinch strength compared to the opposite hand was 55%. Association of a radial club hand and contracture of the pollicized digit and other fingers seemed to influence the postoperative pinch function.

Results of Ray Resection and Amputation for Ring Avulsion Injuries at the Proximal Interphalangeal Joint

2003 ◽  
Vol 28 (6) ◽  
pp. 578-581 ◽  
Author(s):  
E. NUZUMLALI ◽  
E. ORHUN ◽  
K. ÖZTÜRK ◽  
S. CEPEL ◽  
S. POLATKAN
Keyword(s):  
Grip Strength ◽  
Ring Finger ◽  
Functional Results ◽  
Proximal Interphalangeal Joint ◽  
Pinch Strength ◽  
Resection Group ◽  
The Mean ◽  
Ring Avulsion

We investigated the long-term functional results of ray resection (14 cases) and amputation (nine cases) for ring avulsion injuries of ring finger which could not be replanted or underwent failed replantation. The mean follow-up was 37 (range, 24–63) months in the ray resection group and 32 (range, 24–40) months in the amputation group. Grip strength, key pinch strength, chuck pinch strength, hand circumference and palmar volume were decreased in the ray resection group but only grip strength and pulp pinch strength were significantly decreased in the amputation group. These results suggest that ray resection should be avoided in patients with occupations that need strong key and chuck pinch functions.

The Italian Trial of Endovascular AAA Exclusion Using the Parodi Endograft

1997 ◽  
Vol 4 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Gioacchino Coppi ◽  
Roberto Moratto ◽  
Roberto Silingardi ◽  
Nicola Tusini ◽  
Roberto Vecchioni ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Covered Stents ◽  
The Third ◽  
Abdominal Aortic ◽  
The Mean ◽  
Distal Fixation

Purpose: To report the outcome of the prospective 11-center Italian Parodi Trial using straight and tapered endografts for the endovascular exclusion of abdominal aortic aneurysms (AAA). Methods: From April 1994 to July 1995, 27 patients were evaluated and selected for endovascular AAA exclusion. The Parodi devices were delivered through femoral arteriotomies using 18 to 22F introducers and deployed by balloon expansion of the terminal stents. Results: Of 27 cases attempted, 24 endografts (15 tube, 9 aortomonoiliac) were implanted (1 deployment and 2 access failures [11.1%] were converted). Three endoleaks (12.5%) were treated intraoperatively with covered stents, two successfully, and the third sealed within 30 days. Three (12.5%) of the 24 treated patients died in-hospital of device- (n = 2) and procedure-related (n = 1) causes; the remaining 21 patients were discharged within 8 days. Of the 8 aortomonoiliac grafts in follow-up, only 1 (12.5%) failed in the mean 23-month (range 18 to 30) follow-up; however, 4 (31%) of 13 tube graft patients were converted to surgery within 18 months. Of the 16 (66.7%) surviving endografts at 2 years, 6 (38%) showed no change in the AAA diameter, while 10 (62%) had shrunk. Conclusions: The tube graft was applicable in only about 5% of cases, and accurate endograft sizing and distal fixation were problematic. The aortomonoiliac design was not appealing to surgeons but fared better in the long term. Given the advent of newer endograft models, the Italian Parodi Trial has been terminated.

Results of 115 Rubis II reverse thumb carpometacarpal joint prostheses with a mean follow-up of 10 years

2017 ◽  
Vol 42 (6) ◽  
pp. 592-598 ◽  
Author(s):  
M. Dehl ◽  
M. Chelli ◽  
S. Lippmann ◽  
S. Benaissa ◽  
V. Rotari ◽  
...  
Keyword(s):  
Clinical Results ◽  
Carpometacarpal Joint ◽  
Level Of Evidence ◽  
Thumb Carpometacarpal Joint ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
Joint Prostheses ◽  
Clinical And Radiological Results

The aim of this study was to assess the clinical and radiological results of the Rubis II thumb carpometacarpal joint reverse prosthesis, at a mean follow-up of 10 years. Between 1997 and 2008, 253 prostheses were implanted in 199 patients; 115 were reviewed. The survival after a mean of 10 years was 89%. At the last follow-up, 70% of prostheses were painless; the others reported moderate or intermittent pain. The satisfaction rate was 98%. The mean opposition was 9 on the Kapandji scale; the mean QuickDASH score was 30. Wrist, key and tip pinch strengths were comparable with the non-operated side. Of the 115 implants, one was radiologically loose (1%) and 15 had suffered dislocations (13%), 12 of which were caused by an injury. Eleven thumbs had revision surgery. This study confirms that the good clinical results of the Rubis II prosthesis are maintained in the medium and long term, and represents a useful alternative to trapeziectomy for selected patients. Level of evidence: IV

Long-Term Outcome of Microendoscopic Diskectomy for Lumbar Disk Herniation. A Clinical Study of Consecutive 112 Cases with More than 5-Year Follow-Up

2017 ◽  
Vol 78 (05) ◽  
pp. 446-452 ◽  
Author(s):  
Noriyuki Iesato ◽  
Yoshinori Terashima ◽  
Katsumasa Tanimoto ◽  
Tsuneo Takebayashi ◽  
Toshihiko Yamashita ◽  
...  
Keyword(s):  
Blood Loss ◽  
Recurrence Rate ◽  
Operative Time ◽  
Clinical Results ◽  
Improvement Rate ◽  
Long Term Outcome ◽  
Sf 36 ◽  
The Mean

Background Clinical results and recurrence rate after microendoscopic diskectomy (MED) with long-term follow-up is still unclear, in spite of its relatively long history. Materials and Methods A total of 112 who underwent MED participated in this study. Operative time, blood loss, serum C-reactive protein (CRP), creatine kinase (CK), and visual analog scale (VAS) were evaluated as indexes of surgical invasiveness. The 36-Item Short Form Survey Instrument (SF-36), Japanese Orthopaedic Association (JOA) score, patient satisfaction, and recurrence were also evaluated with a follow-up of at least 5 years. Results The mean operative time was 86.7 minutes, and the mean blood loss was 35.7 mL. The mean CRP on postoperative day 3 and CK on the first postoperative day was 0.72 mg/dL and 224.6 IU/L, respectively, and VAS to assess surgical site pain on the first postoperative day was 24.9 mm on average. The improvement rate in the JOA score was 68.7%. The physical component summary of SF-36 in norm-based scoring was improved from 23.4 to 48.6. Overall, 90.8% of patients evaluated their response to the surgery as extremely satisfied or satisfied. The recurrence rate was 10.5%, and reoperation was performed in 7.9% of patients. Conclusions MED is a technique that offers both reduced invasiveness and good long-term clinical results.

scholarly journals Fexofenadine Treatment of Atopic Dogs: Preliminary Clinical Results

2006 ◽  
Vol 75 (4) ◽  
pp. 549-555 ◽  
Author(s):  
A. Plevnik ◽  
T. Kotnik ◽  
S. Kobal
Keyword(s):  
Atopic Dermatitis ◽  
Severity Index ◽  
Clinical Results ◽  
Efficacy And Safety ◽  
Time Points ◽  
The Third ◽  
Study Results ◽  
Significant Difference ◽  
Severity Index Score ◽  
The Mean

The purpose of our study was to investigate the efficacy and safety of the antihistamine fexofenadine versus methylprednisolone in dogs with atopic dermatitis. Eight dogs were included in the study and randomly allocated to two groups of four animals. The first group (F) received oral fexofenadine and the second group (M) received methylprednisolone. Over a period of 6 weeks, we evaluated the CADESI (Canine Atopic Dermatitis Extent Severity Index) score and the pruritus score and made measurements of biochemical blood indicators (AP, ALT, AST, urea, creatinine) on three occasions. The study results did not reveal any statistically significant differences compared to baseline in AST, ALT, AP, urea and creatinine values in any of the treated groups and at any of the time points during the treatment (p > 0.112). The mean CADESI values and the severity of pruritus were reduced by more than 50% in both groups during the treatment course. There were no statistically significant differences between group M and group F. A statistically significant difference compared to the baseline was found in the reduction of the CADESI score in group F in the sixth week of treatment (p = 0.011). There was also a significant reduction compared to the baseline in the severity of pruritus ingroup M in the third (p = 0.004) and sixth week of treatment (p = 0.022). Our results indicate the possible use of fexofenadine in the treatment of atopic dermatitis in dogs, as it was demonstrated safe and effective in comparison with methylprednisolone.

scholarly journals Burnout Among ENT Residents During Covid-19 Pandemic: What Are The Contributing Factors?

2022 ◽  
Vol 2 (2) ◽  
pp. 258-268
Author(s):  
Andrey Dwi Anandya ◽  
Abla Ghanie ◽  
Ahmad Hifni
Keyword(s):  
Female Gender ◽  
Medical Faculty ◽  
Burnout Syndrome ◽  
Medical Residents ◽  
Contributing Factors ◽  
Work Time ◽  
Work Related ◽  
Study Population ◽  
The Mean

Introduction. Resident doctors are susceptible to burnout syndrome, which are the combination of physical and psychological fatigue, that may affect their performance. Long-term pandemic of Covid-19 may also contribute to increase the severity of burnout among residents doctor, might be because the increasing of work time and effort to treat the patients during the time while maintaining prevention against the possible exposure that may harm themselves. This study was aimed to evaluate burnout prevalence among ENT (Ear-Nose-Throat) medical residents in Covid-19 pandemic, and its relation to certain factors of demographic and wellness. Methods. Thirty ENT medical residents of Medical Faculty of Sriwijaya University were enrolled as study population. Burnout was measured by Copenhagen Burnout Inventory (CBI) and divided by three parameters (personal,work-related, patient-related). Results. Among 30 ENT resident doctors at Rumah Sakit Moh. Hoesin, the mean level of personal burnout was 53.056 (SD 17.125), work-related burnout was 47.975 (SD 17.663), and patient-related burnout was 34.861 (SD 20.746). Conclusion. Marriage, female gender, and inadequacy of PPE may contribute to the development of burnout. The burnout among resident doctors is a serious matter regarding their role as a frontline doctor during the pandemic era, because it may affect not only their performance at work, but toward their life as well.

Obstetrical brachial plexus injuries: Late functional results of the Steindler procedure

2014 ◽  
Vol 39 (8) ◽  
pp. 868-875 ◽  
Author(s):  
A. Gilbert ◽  
S. Valbuena ◽  
C. Posso
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Elbow Flexion ◽  
Functional Results ◽  
Obstetrical Brachial Plexus Palsy ◽  
Long Term Follow Up ◽  
The Mean ◽  
Extensor Lag

We reviewed late functional results of a modified Steindler procedure in patients with obstetrical brachial plexus palsy and poor active elbow flexion. From 1982 to 2005, we reviewed final functional results and complications of 27 cases with flexion weakness of the elbow secondary to obstetrical brachial plexus injury, treated with a modified Steindler procedure. At the end of the follow-up, the mean active elbow flexion was 97° and the mean extensor lag was 10°. In the long-term follow-up, the modified Steindler procedure maintained good results in 67% of the cases in our series, and this percentage raised by 82% when the wrist extensor was present or restored before the Steindler procedure. There were poor results in 19% of the patients, but no major complications.

Sign in / Sign up

Export Citation Format

Share Document