scholarly journals Anatomical and functional outcome after bilateral scrotal flap in penile reconstruction

2014 ◽  
Vol 8 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Pornthep Pungrasmi ◽  
Anon Chayasadom ◽  
Apichai Angspatt
Keyword(s):  
Foreign Body ◽  
Sexual Activity ◽  
Functional Outcome ◽  
Surgical Excision ◽  
Foreign Body Granuloma ◽  
Surgical Removal ◽  
Penile Skin ◽  
One Stage ◽  
Before And After ◽  
The Mean

Abstract Background: Injection of alloplastic material underneath the penile skin for penile augmentation causes many complications such as inflammation, infection, ulceration, and pain during sexual activity. One of the treatments for complications after these penile augmentation procedures is surgical excision of the foreign body granuloma followed by penile skin coverage with bilateral scrotal flaps. There are no prior prospective studies published about anatomical and functional outcomes. Objective: To study the anatomical and functional outcome of one-stage bilateral scrotal flap reconstruction in patients after surgical removal of paraffinoma from penile shafts. Methods: Patients who suffered from complications of penile foreign body granuloma were treated by surgical excision and reconstruction with bilateral scrotal flaps. The penile lengths and circumferences when flaccid and erect were recorded preoperatively and postoperatively. The patients were interviewed using questionnaires and satisfaction scored to determine their sexual experiences were recorded before and after surgery. Results: Thirteen patients were enrolled in this study. The mean follow-up time was 23.5 (11.5-40.5) weeks. The mean erectile length and the maximal circumference were 11.8 (9-15) cm, 14.5 (11.5-17) cm preoperatively, and 11.7 (10-14) cm, 11.8 (10-13) cm postoperatively. Satisfaction scores of sexual activity is 6.84 (0-9) preoperatively, and 8.38 (5-10) postoperatively. Conclusion: One-stage bilateral scrotal flap coverage is a good option for penile skin reconstruction. This technique can achieve satisfactory results both anatomically and functionally.

scholarly journals Do Intraoperative Neurophysiological Changes During Decompressive Surgery for Cervical Myeloradiculopathy Affect Functional Outcome? A Prospective Study

2020 ◽  
pp. 219256822095177
Author(s):  
Keyur Kantilal Akbari ◽  
Vigneshwara Badikillaya ◽  
Muralidharan Venkatesan ◽  
Sajan K. Hegde
Keyword(s):  
Functional Outcome ◽  
Evoked Potential ◽  
Japanese Orthopaedic Association ◽  
Motor Evoked Potential ◽  
Functional Improvement ◽  
Cervical Compressive Myelopathy ◽  
Before And After ◽  
Group A ◽  
The Mean ◽  
Compressive Myelopathy

Study Design: Prospective cohort. Objective: To investigate whether intraoperative neuromonitoring (IONM) positive changes affect functional outcome after surgical intervention for myeloradiculopathy secondary to cervical compressive pathology (cervical compressive myelopathy). Methods: Twenty-eight patients who underwent cervical spine surgery with IONM for compressive myeloradiculopathy were enrolled. During surgery motor-evoked potential (MEP) and somatosensory evoked potential (SSEP) at baseline and before and after decompression were documented. A decrease in latency >10% or an increase in amplitude >50% was regarded as a “positive changes.” Patients were divided into subgroups based on IONM changes: group A (those with positive changes) and group B (those with no change or deterioration). Nurick grade and modified Japanese Orthopaedic Association (mJOA) score were evaluated before and after surgery. Results: Nine patients (32.1%) showed improvement in MEP. The mean preoperative Nurick grade and mJOA score of group A and B were (2.55 ± 0.83 and 11.11 ± 1.65) and (2.47 ± 0.7 and 11.32 ± 1.24), respectively. The mean postoperative Nurick grade of groups A and B at 6 months was 1.55 ± 0.74 and 1.63 ± 0.46, respectively, and this difference was not significant. The mean postoperative mJOA score of groups A and B at 6 months was 14.3 ± 1.03 and 12.9 ± 0.98, respectively, and this difference was statistically significant ( P = .011). Spearman correlation coefficient showed significant positive correlation between the IONM change and the mJOA score at 6 months postoperatively ( r = 0.47; P = .01). Conclusion: Our study shows that impact of positive changes in MEP during IONM reflect in functional improvement at 6 months postoperatively in cervical compressive myelopathy patients.

scholarly journals Foreign Body Granuloma in the Tongue by a Pequi Spine

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Rafael Martins Afonso Pereira ◽  
Patrícia Cristine de Oliveira Afonso Pereira ◽  
Vitor Carvalho Rodrigues ◽  
Luiz Fernando Braga de Andrade ◽  
Elisa Morais de Carvalho ◽  
...  
Keyword(s):  
Foreign Body ◽  
Inflammatory Response ◽  
Histopathological Examination ◽  
Foreign Body Granuloma ◽  
Human Organism ◽  
Surgical Removal ◽  
Histopathological Analysis ◽  
Anatomical Structures ◽  
Local Trauma ◽  
Diagnostic Hypothesis

Substances considered foreign to the human organism can penetrate it due to local trauma, initially causing an acute inflammatory response against these substances, involving a neutrophilic infiltrate that, when it fails to deal with these foreign bodies, ends up generating a granulomatous inflammatory response. Granuloma formation has been associated with a variety of conditions. The correct clinical and imaging diagnoses are extremely important for the dentist to choose an appropriate therapeutic approach, aiming at the best possible treatment. This work is aimed at describing a case report of a foreign body granuloma, formed on the tongue, from the penetration of a pequi spine, in a 76-year-old patient, in whom, after an imaging diagnosis with ultrasound, surgical removal of the lesion was performed, and the piece was sent for histopathological examination, which confirmed the initial diagnostic hypothesis of a foreign body granuloma. The initial diagnosis of foreign body granulomas is challenging. For this reason, more sophisticated means of diagnosis such as tomography and magnetic resonance become important in the diagnosis, as they can show with greater clarity and reliability the nature of the lesion and its relationship with adjacent anatomical structures. In the case in question, an ultrasound examination was chosen, which was extremely important as an aid to diagnosis, considerably improving surgical planning. In addition, after surgical removal, the result of the histopathological analysis is essential to determine the definitive diagnosis, as it determines the granulomatous characteristic of the lesion.

scholarly journals Functional outcome of surgical management of calcaneal spur by excision and autologous platelet-rich plasma injection

2021 ◽  
Vol 7 (1) ◽  
pp. 34-37
Author(s):  
Parvez Ahmad Ganie ◽  
Arun Gulati ◽  
Rajendra Pranav Prasad ◽  
Anvith S Shetty
Keyword(s):  
Functional Outcome ◽  
Platelet Rich Plasma ◽  
Plantar Fascia ◽  
Surgical Excision ◽  
Alternative Methods ◽  
Surgical Removal ◽  
Calcaneal Spur ◽  
Plasma Injection ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

The calcaneal spur is also known as an enthesophyte which is a bony outgrowth from the calcaneum at the plantar fascia insertion. Treatment aspect ranges from initial conservative methods, invasive techniques to surgical excision of the spur in cases which are not responding to any other alternative methods. This article aims in evaluating the functional outcome of calcaneal spur excision coupled with a dose of autologous platelet-rich plasma injection in recalcitrant cases of the calcaneal spur. A total of 42 cases of confirmed calcaneal spur cases were recruited for the study. All participants were offered with calcaneal excision with a dose of autologous platelet-rich plasma injection. All patients were evaluated preoperatively and post-operatively with VAS and FFI scores at the end of the 1, 3 and 6 months. The patients who received calcaneal spur excision along with a single dose of autologous platelet-rich plasma injection reported statistically significant pain relief at the end of 6 months while comparing with the pre-operative VAS score (p = 0.003) and FFI score showed a statistically significant functional outcome between both groups at the end of 6 months (p <0.001). Surgical removal of calcaneal spur along with a dose of an autologous platelet-rich plasma injection serve the better management for calcaneal spur and improves the functional quality of life.

scholarly journals Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Pradnya Suhas Bendre ◽  
Parag Janardhan Karkera ◽  
Monita Nanjappa
Keyword(s):  
Functional Outcome ◽  
Safe Procedure ◽  
Drainage Pattern ◽  
Fetal Hydronephrosis ◽  
Renal Scan ◽  
Antenatal Ultrasonography ◽  
Before And After ◽  
The Mean ◽  
Grade 3 ◽  
Parenchymal Thickness

Abstract Background With routine antenatal ultrasonography, fetal hydronephrosis is commonly diagnosed. This leads to early detection of postnatal uretero-pelvic junction obstruction which may require surgical intervention. But, there is no clear consensus in the benefits of operating these patients in the neonatal age. Methods Aim—To study the functional outcome after pyeloplasty in neonates with antenatally diagnosed unilateral uretero-pelvic junction obstruction (UPJO). Records of all neonates (N = 48) who presented between 2016 and 2018 with prenatal diagnosis of unilateral UPJO and underwent a Anderson-Hyne’s Pyeloplasty were retrospectively analyzed. Indications for surgery were SFU grade 3 or 4, a split renal function (SRF) < 40% on a diuretic renal scan and antero-posterior renal pelvic diameter (APD) > 2.5 cm with parenchymal thinning. Parenchymal thickness (PT) and APD measured by ultrasonography, and SRF measured by 99 m Tc-EC renal scan were compared before and after surgery. Results Our study comprised of 48 patients with 79.2% males (n = 38). UPJO affected the left side more (n = 30, 62.5%). The mean age at pyeloplasty was 28 days (range 26–30). The outcome was considered successful in 46 (95.84%) patients. The APD decreased from a mean of 3.5 cm APD preoperatively to 1.38 cm 1 year later which was statistically significant (p < 0.001). The PT increased from 3.95 to 7.1 mm 1 year postoperatively which was significant (p < 0.001). The drainage pattern and SRF improved in 46 (95.84%) patients. The SRF improved from a mean of 35.48–44.7% 1 year postoperatively which was significant (p < 0.001). Conclusion Pyeloplasty done in the neonatal age for prenatally diagnosed UPJO, having SFU grade 3–4 UPJO, leads to significant improvement of SRF and PT with minimal complications. Neonatal Pyeloplasty for significant UPJO is a safe procedure which provides the kidney maximum opportunity to improve function.

scholarly journals Proximal tibia stress fracture with Osteoarthritis of knee − Radiological and functional analysis of one stage TKA with long stem

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 13 ◽  
Author(s):  
Dhanasekaran Soundarrajan ◽  
Natesan Rajkumar ◽  
Palanisamy Dhanasekararaja ◽  
Shanmuganathan Rajasekaran
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Outcome ◽  
Stress Fracture ◽  
Proximal Tibia ◽  
Fracture Site ◽  
Stress Fractures ◽  
One Stage ◽  
The Mean ◽  
Long Stem

Introduction: Proximal tibia stress fractures with knee osteoarthritis pose a challenging situation. We evaluated the radiological and functional outcome of one-stage total knee arthroplasty (TKA) and long stem for patients with varied grades of knee arthritis and proximal tibia stress fractures.  Methods: We analysed 20 patients from April 2012 to March 2017 with proximal tibia stress fractures associated with knee osteoarthritis of varied grades. Out of 20 patients, five were acute fresh fractures. The mean age was 64 years (range, 52–78) which includes three men and 17 women. Previous surgery in the same limb, rheumatoid arthritis, valgus deformity were excluded. All patients were treated with posterior stabilised TKA with long stem, of which, four patients had screw augmentation for medial tibial bone defect and two patients with malunited fracture at stress fracture site required osteotomy, plating and bone grafting. Two patients had two level stress fracture of tibia in the same leg. Results: The mean follow-up period was 28 (range, 6–60) months. The mean tibiofemoral angle improved from 18.27° varus to 1.8° valgus. The mean knee society score improved from 21.9 (range, −10 to 45) to 82.8 (range, 15–99) [p < 0.05]. The mean Knee Society functional score improved from 15.5 (range, −10 to 40) to 76.8 (range, 10–100) [p < 0.05]. All fractures got united at the last follow-up. One patient had infection and wound dehiscence at six months for which debridement done and had poor functional outcome. Conclusion: TKA with long stem gives excellent outcome, irrespective of severity of arthritis associated with stress fracture. By restoring limb alignment and bypassing the fracture site, it facilitates fracture healing. Early detection and prompt intervention is necessary to prevent the progression to recalcitrant non-union or malunion.

scholarly journals One-Bone Forearm Reconstruction and Distal Radioulnar Joint Fusion for Emergency One-stage Operation in Traumatic Major Bone Defect of Forearm

2020 ◽  
Author(s):  
Yapeng Wang ◽  
Ming Zhou ◽  
Yongwei Wu ◽  
Yunhong Ma ◽  
Jun Liu ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Bone Defects ◽  
Severe Trauma ◽  
Distal Radioulnar Joint ◽  
Difficult Situation ◽  
Radioulnar Joint ◽  
One Stage ◽  
Joint Fusion ◽  
The Mean

Abstract Background: Major bone defects in forearm caused by severe trauma is a real challenge for orthopedic surgeons. This study aimed to evaluate the role of one-bone forearm (OBF) reconstruction combined with distal radioulnar joint fusion (DRUJF) as a rescue option under this difficult situation.Methods: In total, 18 patients with major bone defects in forearm caused by severe trauma were selected from 2003 to 2017 and followed up for 2 to 16 years. All patients were managed in the Emergency Department and received emergency one-stage OBF combined with DRUJF. In addition, patient demographics, surgical techniques, clinical outcomes and complications were collected from the medical records.Results: The mean age of patients was 41.5 years (ranging from 23 to 58 years), with 11 males and 7 females. The mean time to union was 5.8 months; 17 patients had complete union, and 1 patient had infection with nonunion requiring secondary procedures. According to the criteria of Chen, 3 patients had a grade-I functional outcome, 14 patients had a grade-II functional outcome, and 1 patient had a grade-III functional outcome. Based on the Peterson scoring system, the outcome was excellent for 3 patients, good for 13 patients, fair for 1 patient, and poor for 1 patient.Conclusion: OBF construction combined with DRUJF was an alternative surgical procedure as the emergency stage-one intervention for the treatment of traumatic major bone defects in forearm, which may be more functionally and cosmetically superior than forearm amputation.

scholarly journals Vaginal cytokine profile and microbiota before and after lubricant use compared with condomless vaginal sex: a preliminary observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Susan Tuddenham ◽  
Christina A. Stennett ◽  
Richard A. Cone ◽  
Jacques Ravel ◽  
Andrew N. Macintyre ◽  
...  
Keyword(s):  
Sexual Activity ◽  
Relative Abundance ◽  
Mixed Effects ◽  
Vaginal Microbiota ◽  
Reproductive Age ◽  
Control Analysis ◽  
Cytokine Profiles ◽  
Before And After ◽  
Vaginal Sex ◽  
The Mean

Abstract Background Limited data suggest that personal lubricants may damage the vaginal mucosal epithelium, alter the vaginal microbiota, and increase inflammation. We compared vaginal cytokine profiles and microbiota before and after vaginal lubricant use and condomless vaginal sex. Methods Reproductive-age women were recruited to a 10-week observational cohort study and were asked to self-collect vaginal samples and behavioral diaries daily. This nested case–control analysis utilized samples collected before and after self-reported condomless sexual activity with lubricants (22 case participants) and without lubricants (22 control participants). Controls were matched to cases on race/ethnicity. Microbiota composition was characterized by sequencing amplicons of the 16S rRNA gene V3–V4 regions. Cytokine concentrations were quantified using a magnetic bead 41-plex panel assay and read using a Bio-Plex 200 array reader. Wilcoxon signed-rank tests were used to assess baseline differences in vaginal cytokines between cases and controls as well as differences pre- and post-exposure. Linear mixed effects models were used to examine differences in relative post-to-pre change in each individual cytokine between matched cases and controls. Similar analyses were conducted for the microbiota data. Results Mean age was 29.8 years (SD 6.8), and 63.6% were African American. There were few statistically significant changes in cytokines or microbiota before and after exposure in cases or controls. In mixed-effects modeling, the mean relative post-to-pre change of cytokines was higher in cases vs. controls for macrophage derived chemokine (MDC) (p = 0.03). The microbiota data revealed no significant changes when measured by similarity scores, diversity indexes and descriptive community state types (CST) transition analyses. However, post sexual activity, the mean relative abundance of L. crispatus decreased for those who used lubricants (particularly those who were L. iners-dominated prior to exposure). Conclusions Although there were overall few differences in the vaginal microbiota and cytokine profiles of lubricant users and controls before and after condomless vaginal sex, there was a trend toward decreases in relative abundance of L. crispatus following use of lubricant. Future larger studies that take into account osmolarity and composition of lubricants may provide additional insights.

scholarly journals Foreign body ingestion in children

2019 ◽  
Vol 98 (9) ◽  
pp. 370-374
Keyword(s):  
Foreign Body ◽  
Digestive Tract ◽  
Foreign Bodies ◽  
Outpatient Setting ◽  
University Hospital ◽  
Surgical Removal ◽  
Tract Perforation ◽  
The Mean ◽  
The University ◽  
Swallowed Foreign Bodies

Introduction: Evaluation of results of the group of paediatric patients treated for swallowed foreign bodies in the digestive tract. Methods: Retrospective analysis of patients treated for foreign bodies in the digestive tract, managed at the University Hospital of Hradec Králové between 2011–2018. Results: 365 patients (182 boys, 183 girls) with a foreign body in the digestive tract have been evaluated. The mean age was 2.4 years. Most of the children were treated as outpatients (280 children, 76.7%) and only 85 children (23.3%) were hospitalized. The most commonly swallowed frequent bodies included coins (26%) and batteries (14.5%); sharp objects occurred in 5.2%. Unusual foreign bodies were noticed, too. We can mention for example a pen or a plant nutrition product. In 302 cases (82.7%) the foreign bodies passed easily per vias naturales. Endoscopy was necessary in 63 cases (17.2%) – in 51 children the object had to be removed from the oesophagus and in 12 children the object had to be removed from the stomach. None of the swallowed bodies caused complications such as digestive tract perforation or bowel obstruction. No patient in the group was indicated for laparotomy to remove the foreign body. Conclusion: Foreign bodies entrapped in the oesophagus have to be removed endoscopically. In most cases, foreign bodies in the stomach require only observation in the outpatient setting because they leave the stomach easily, without complications, per vias naturales. If a battery remains at the same place of the digestive tract for more than 24 hours, endoscopic removal is indicated at our department. In addition, endoscopy is done in cases of swallowed multiple magnets or bodies that are too large and remain in stomach for several weeks or months. Surgical removal of foreign bodies should be reserved only for complicated cases.

scholarly journals One-Bone Forearm Reconstruction and Distal Radioulnar Joint Fusion for Emergency One-stage Operation in Traumatic Major Bone Defect of Forearm

2020 ◽  
Author(s):  
Yapeng Wang ◽  
Ming Zhou ◽  
Yongwei Wu ◽  
Yunhong Ma ◽  
Jun Liu ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Bone Defects ◽  
Severe Trauma ◽  
Distal Radioulnar Joint ◽  
Difficult Situation ◽  
Radioulnar Joint ◽  
One Stage ◽  
Joint Fusion ◽  
The Mean

Abstract B ackground : Major bone defects in forearm caused by severe trauma is a real challenge for orthopedic surgeons. This study aimed to evaluate the role of one-bone forearm (OBF) reconstruction combined with distal radioulnar joint fusion (DRUJF) as a rescue option under this difficult situation. Methods: In total, 18 patients with major bone defects in forearm caused by severe trauma were selected from 2003 to 2017 and followed up for 2 to 16 years. All patients were managed in the Emergency Department and received emergency one-stage OBF combined with DRUJF. In addition, patient demographics, surgical techniques, clinical outcomes and complications were collected from the medical records. Results: The mean age of patients was 41.5 years (ranging from 23 to 58 years), with 11 males and 7 females. The mean time to union was 5.8 months; 17 patients had complete union, and 1 patient had infection with nonunion requiring secondary procedures. According to the criteria of Chen, 3 patients had a grade-I functional outcome, 14 patients had a grade-II functional outcome, and 1 patient had a grade-III functional outcome. Based on the Peterson scoring system, the outcome was excellent for 3 patients, good for 13 patients, fair for 1 patient, and poor for 1 patient. Conclusion: OBF construction combined with DRUJF was an alternative surgical procedure as the emergency stage-one intervention for the treatment of traumatic major bone defects in forearm, which may be more functionally and cosmetically superior than forearm amputation.

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