Endoscopic treatment of ureterovesical junction obstructive pathology: A description of the oblique meatotomy technique and results

Background: Benign obstructive pathology of the ureterovesical junction includes congenital and acquired illnesses. The objective of this study was to describe the endoscopic oblique meatotomy technique using scissors and cold cutting to treat benign obstructive pathology of the ureterovesical junction.Methods: From 2007 to 2012, we treated 18 patients with obstructive pathology of the ureterovesical junction (5 megaureters [3 with lithiasis], 4 iatrogenic stenoses, and 9 ureteroceles with lithiasis). In all cases, oblique meatotomy was performed using endoscopic scissors through an 8.5 Ch ureteroscope. The mean follow-up for all patients was 3 years. Pain, grade of hydronephrosis, and occurrence of vesicoureteral reflux were evaluated before and after treatment.Results: The mean endoscopic treatment time was 13.4 minutes. The procedure was performed on an outpatient basis with 6 hours of hospital admission, and a double J stent was inserted for 6 weeks. We achieved treatment success in 94.5% of patients after 3 years of follow-up. Only 1 patient presented with vesicoureteral reflux at 12 months after treatment; however, this condition did not require further treatment. Overall, 100% of patients remained free from lithiasis. There are 2 main limitations: the small number of patients and the lack of another group to compare the results of this technique; however, the aim of this work was to communicate a new technique to treat ureterovesical junction stricture.Interpretation: Oblique ureteral meatotomy is a safe and effective treatment for benign obstructive pathology of the ureterovesical junction and has a low index of complications.

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Behavior of partially formed roots of teeth submitted to orthodontic movement

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.28.2.56n643558770p763 ◽

2005 ◽

Vol 28 (2) ◽

pp. 147-154 ◽

Cited By ~ 5

Author(s):

Omar Gabriel da Silva Filho ◽

Olívia de Freitas Mendes ◽

Terumi Okada Ozawa ◽

Flávio Mauro Ferrari Junior ◽

Tatiana Mattosinho Correa

Keyword(s):

Root Formation ◽

Root Resorption ◽

Treatment Time ◽

Mixed Dentition ◽

Orthodontic Movement ◽

Before And After ◽

The Mean

The occurrence of root resorption in orthodontically treated permanent incisors with partially formed roots was investigated using periapical radiographs taken before and after the orthodontic leveling in the mixed dentition. The mean age at the beginning of treatment was 9 years and the mean treatment time was 7.1 months. The findings showed that the orthodontic movement during root formation causes no root resorption. The longitudinal follow-up showed that incompletely formed roots developed normally.

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Evaluation of the French National Program on Home Return of Patients with Chronic Heart Failure (PRADO-IC): Pilot Study of 91 Patients During Its Deployment in the Bas Rhin Area

Journal of Clinical Medicine ◽

10.3390/jcm9041222 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1222

Author(s):

Mylène Radreau ◽

Noel Lorenzo-Villalba ◽

Samy Talha ◽

Jean-Jacques Von Hunolstein ◽

Michel Hanssen ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Controlled Study ◽

National Program ◽

Number Of Patients ◽

Before And After ◽

The Mean

Objective: The main objective of this study was to evaluate the impact of the French national program on home return of chronic heart failure patients (PRADO-IC) in terms of re-hospitalizations for heart failure (HF) during its deployment in the Bas-Rhin (France). Patients and methods: This was a pilot, descriptive, quantitative, retrospective, and bi-centric study (University Hospitals of Strasbourg and Haguenau Hospital Center, France). It included all patients included in the PRADO-IC program from these centers between January 1, 2015 and December 31, 2015. The primary endpoint of our study was the evaluation of the number of 1-year, 6-month, and 30-day re-admissions to the hospital in relation to an acute HF episode, before and after the inclusion of patients in the PRADO-IC program. The secondary endpoints were the number of overall re-hospitalizations (all-cause); the number of days of hospitalization for HF; the time to first re-hospitalization and the average length of hospital stay, before and after inclusion in PRADO-IC; and the overall and cardiovascular mortality rates. Results: 91 patients out of 271 (33,6%) with a mean age of 79.2 years (67–94) were included. They all had chronic HF, essentially class II-III NYHA (90.1%), mostly of ischemic origin (41.9%), with altered left ventricular ejection fraction in 71.4% of cases. A reduction in the mean number of hospitalizations for HF per patient at 30 days, 6 months and 1 year was observed, respectively, from 0.18 ± 0.42 per patient before inclusion to 0.15 ± 0.36 after inclusion (p = 0.56); 0.98 ± 1.04 hospitalizations to 0.53 ± 0.81 at 6 months (p < 0.01); and 1.64 ± 1.14 hospitalizations 1.04 ± 1.05 at 1 year (p < 0.001). Patients were hospitalized less overall after inclusion in the PRADO-IC program. The number of days of hospitalization for HF was reduced after inclusion of patients from 18.02 ± 7.78 days before inclusion to 14.28 ± 11.57 days for the 6 month follow-up (p = 0.006), and from 22.07 ± 10.33 days before inclusion to 16.39 ± 15.94 days for the 1 year follow-up (p < 0.001). In contrast, inclusion in PRADO-IC statistically increased the mean time to first re-hospitalization for HF from mean 99.36 ± 72.39 days before inclusion to 148.11 ± 112.77 days after inclusion (p < 0.001). Conclusion: This study seems to demonstrate that the PRADO-IC program could improve the management of chronic HF patients in ambulatory care, particularly regarding HF re-hospitalization. However, due to the limitations of the methodology used and the small number of patients, it is advisable to consolidate its initial results with a randomized controlled study on a larger number of patients. In our opinion, its results need to be communicated because, to our knowledge, no equivalent study exists.

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Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center

European Journal of Ophthalmology ◽

10.1177/11206721211023727 ◽

2021 ◽

pp. 112067212110237

Author(s):

Ilkay Kilic Muftuoglu ◽

Ecem Onder Tokuc ◽

V Levent Karabas

Keyword(s):

Optic Disc ◽

Case Series ◽

Internal Limiting Membrane ◽

Maximum Height ◽

Optic Disc Pit ◽

Tertiary Referral Center ◽

Number Of Patients ◽

The Mean ◽

Foveal Center

Purpose: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Methods: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Results: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9–53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80–78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up ( p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery ( p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1–12 months) after the surgery. Conclusion: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

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The Effect of Q-Switched Nd:YAG 1064 nm/532 nm Laser in the Treatment of Onychomycosis In Vivo

Dermatology Research and Practice ◽

10.1155/2013/379725 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 23

Author(s):

Kostas Kalokasidis ◽

Meltem Onder ◽

Myrto-Georgia Trakatelli ◽

Bertrand Richert ◽

Klaus Fritz

Keyword(s):

Clinical Study ◽

Treatment Time ◽

Prospective Clinical Study ◽

Self Evaluation ◽

Time Period ◽

Level Of Satisfaction ◽

Before And After ◽

532 Nm

In this prospective clinical study, the Q-Switched Nd:YAG 1064 nm/532 nm laser (Light Age, Inc., Somerset, NJ, USA) was used on 131 onychomycosis subjects (94 females, 37 males; ages 18 to 68 years). Mycotic cultures were taken and fungus types were detected. The laser protocol included two sessions with a one-month interval. Treatment duration was approximately 15 minutes per session and patients were observed over a 3-month time period. Laser fluencies of 14 J/cm2were applied at 9 billionths of a second pulse duration and at 5 Hz frequency. Follow-up was performed at 3 months with mycological cultures. Before and after digital photographs were taken. Adverse effects were recorded and all participants completed “self-evaluation questionnaires” rating their level of satisfaction. All subjects were well satisfied with the treatments, there were no noticeable side effects, and no significant differences were found treating men versus women. At the 3-month follow-up 95.42% of the patients were laboratory mycologically cured of fungal infection. This clinical study demonstrates that fungal nail infections can be effectively and safely treated with Q-Switched Nd:YAG 1064 nm/532 nm laser. It can also be combined with systemic oral antifungals providing more limited treatment time.

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Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children

BMC Ophthalmology ◽

10.1186/s12886-020-01778-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Oriel Spierer ◽

Abraham Spierer

Keyword(s):

Young Children ◽

Success Rate ◽

Lateral Rectus ◽

Intermittent Exotropia ◽

Age At Surgery ◽

Surgical Methods ◽

Before And After ◽

The Mean ◽

Consecutive Esotropia

Abstract Background Different surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Methods The charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented. Results Mean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years. Conclusions In children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.

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Renal functional improvement after pediatric pyeloplasty in kidneys with split renal function less than 20%: a single institute experience

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00084-w ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Elsayed Salih ◽

Ibrahim Abdelmaksoud ◽

Mohamed Elfeky ◽

Gamal Selmy ◽

Hussein Galal ◽

...

Keyword(s):

Renal Function ◽

Statistical Significance ◽

Functional Improvement ◽

Renal Unit ◽

Poor Renal Function ◽

Split Renal Function ◽

Renal Function Deterioration ◽

Number Of Patients ◽

The Mean

Abstract Background Pediatric pyeloplasty in ureteropelvic junction obstruction (UPJO) is indicated in renal impaired drainage or renal function deterioration. The improvement of renal function after pediatric pyeloplasty is still controversial in poorly functioning kidneys. Past studies on poorly functioning kidneys had a variable SRF specification, and these studies often had a limited number of patients so that they did not achieve statistical significance. The study aims to detect the renal functional improvement after pediatric Anderson-Hynes pyeloplasty (AHP) with split renal function (SRF) less than 20% (poor renal function). Results A retrospective study included 46 pediatric patients with unilateral UPJO who underwent open AHP with SRF < 20% on a renal isotope scan from August 2012 to October 2018. Success was defined based on either improvement in symptoms, improvement in drainage on postoperative renography, and/or improvement or stability in SRF on the renal scan done 6 months postoperatively and yearly thereafter. Deterioration of SRF by more than 5% was deemed to be deterioration. An increase in SRF of more than 5% was deemed to be an improvement. A total of 46 patients with a mean age of 32 months with poor renal function on isotope renogram (SRF < 20%) were included. All patients had an obstructive pattern on the preoperative radionuclide scans. The median preoperative SRF was 9.26%. The mean (range) follow-up was 30 months. The success rate was 91.3%. Three patients underwent redo pyeloplasty, whereas a secondary nephrectomy was necessary for one. The remaining (42) patients showed stability or improvement of SRF with no further symptoms. Renal scintigraphy at 6 and 12 months after surgery revealed significantly increased SRF compared to preoperative one. Conclusion Poorly functioning renal unit with SRF < 20% can show functional improvement and recoverability after pediatric pyeloplasty.

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Selective Arterial Embolization of Renal Angiomyolipomas with a N-Butyl Cyanoacrylate-Lipiodol Mixture: Efficacy, Safety, Short- and Mid-Term Outcomes

Journal of Clinical Medicine ◽

10.3390/jcm10184062 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4062

Author(s):

François-Victor Prigent ◽

Kévin Guillen ◽

Pierre-Olivier Comby ◽

Julie Pellegrinelli ◽

Nicolas Falvo ◽

...

Keyword(s):

Arterial Embolization ◽

Volume Reduction ◽

Renal Angiomyolipoma ◽

Cyanoacrylate Glue ◽

Selective Arterial Embolization ◽

Before And After ◽

The Mean ◽

Magnetic Resonance Imaging Mri ◽

Postembolization Syndrome

Selective arterial embolization (SAE) for renal angiomyolipoma (rAML) is effective to treat or prevent bleeding. We report our experience using a cyanoacrylate–Lipiodol mixture. We performed a single-center retrospective review of all rAMLs embolized with cyanoacrylate glue between July 2014 and June 2020. Demographics, tuberous sclerosis complex (TSC) status, clinical presentation, angiography features, and follow-up data were recorded. Pre- and post-procedure rAML sizes and volumes were estimated from computed tomography (CT) or magnetic resonance imaging (MRI) studies. Kidney function was assessed before and after the procedure. We identified 24 patients (22 females and 2 males, mean age 51 years) treated for 27 AMLs, either prophylactically (n = 20) or as an emergency (n = 4). Technical success was achieved for 25/27 AMLs; two patients, each with a single AML, required nephrectomy and repeated embolization, respectively. Major complications occurred in three patients and minor complications such as postembolization syndrome in 15 patients. AML volume reduction after embolization was 55.1% after a mean follow-up of 15 months (range, 1–72 months). Factors associated with greater volume reduction were a smaller percentage of fat (p = 0.001), larger initial rAML volume (p = 0.014), and longer follow-up (p = 0.0001). The mean creatinine level did not change after SAE. Embolization of rAMLs with a mixture of cyanoacrylate and Lipiodol is feasible, safe, and effective in significantly decreasing tumor volume.

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SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

British Journal of Surgery ◽

10.1093/bjs/znab361.165 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Hannah Elkadi ◽

Eleanor Dodd ◽

Theodore Poulton ◽

William Bolton ◽

Joshua Burke ◽

...

Keyword(s):

Wound Healing ◽

Local Anaesthetic ◽

Surrogate Endpoints ◽

Incision And Drainage ◽

Number Of Patients ◽

Significant Difference ◽

Patient Reported ◽

Before And After ◽

The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p < 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

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Factors associated with early and late failure after goniotomy for primary pediatric glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672118805872 ◽

2018 ◽

Vol 30 (1) ◽

pp. 162-167 ◽

Cited By ~ 2

Author(s):

Dina H Hassanein ◽

Ahmed Awadein ◽

Hala Elhilali

Keyword(s):

Risk Factors ◽

Intraocular Pressure ◽

First Year ◽

Failure Rates ◽

Factors Associated ◽

Pediatric Glaucoma ◽

Late Failure ◽

Before And After ◽

The Mean

Purpose: To analyze the risk factors associated with early and late failure after goniotomy for primary pediatric glaucoma. Methods: A retrospective study was done on infants who underwent goniotomy as the initial surgical procedure for primary pediatric glaucoma, and had a follow-up period ⩾48 months after surgery. Early and late failures were defined as intraocular pressure ⩾18 mmHg or signs of glaucoma progression before and after the end of first year, respectively. Results: A total of 81 eyes of 47 children were included. The mean age at the time of surgery was 6.1 ± 6.7 months, 34 children (72.3%) were bilateral. The mean follow-up was 5.9 ± 2.8 years. Of the included eyes, 41 eyes (50.6%) showed success, 25 eyes (30.9%) showed an early failure, and 15 eyes (18.5%) showed a late failure. The mean survival time was 43 months. However, only surgery before the end of the first month and positive consanguinity of the parents (P < 0.01 for both) were independent risk factors for early and late failure of goniotomy for primary pediatric glaucoma. Patients with late failure showed a statistically significant lower preoperative intraocular pressure (P = 0.02). A larger preoperative corneal diameter and a male gender were associated with higher but statistically insignificant failure rates. There were no differences in the early or late failure rates between unilateral and bilateral cases. Conclusion: A positive consanguinity of the parents and surgery before the end of the first month are the major predictors of failure of goniotomy.

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Significantly lower annual rates of neoplastic progression in short- compared to long-segment non-dysplastic Barrett’s esophagus: a systematic review and meta-analysis

Endoscopy ◽

10.1055/a-0869-7960 ◽

2019 ◽

Vol 51 (07) ◽

pp. 665-672 ◽

Cited By ~ 8

Author(s):

Viveksandeep Thoguluva Chandrasekar ◽

Nour Hamade ◽

Madhav Desai ◽

Tarun Rai ◽

Venkata Subhash Gorrepati ◽

...

Keyword(s):

Systematic Review ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Meta Analysis ◽

Significant Heterogeneity ◽

Neoplastic Progression ◽

Number Of Patients ◽

The Mean ◽

Surveillance Endoscopy

Abstract Background Although shorter lengths of Barrett’s esophagus (BE) have been associated with a lower risk of neoplastic progression, precise estimates have varied, especially for non-dysplastic BE (NDBE) only. Therefore, current US guidelines do not provide specific recommendations on surveillance intervals based on BE length. We performed a systematic review and meta-analysis of the published literature to examine neoplastic progression rates of NDBE based on BE length. Methods PubMed, Cochrane, Google Scholar, and Embase were comprehensively searched. Studies reporting progression rates in patients with NDBE and > 1 year of follow-up were included. The number of patients progressing to esophageal adenocarcinoma (EAC) and high grade dysplasia (HGD)/EAC in individual studies and the mean follow-up were recorded to derive person-years of follow-up. Pooled rates of progression to EAC and HGD/EAC based on BE length (< 3 cm vs. ≥ 3 cm) were calculated. Results Of the 486 initial studies identified, 10 met the inclusion/exclusion criteria. These included a total of 4097 NDBE patients; 1979 with short-segment BE (SSBE; 10 773 person-years of follow-up) and 2118 with long-segment BE (LSBE; 12 868 person-years). The annual rates of progression to EAC were significantly lower for SSBE compared with LSBE: 0.06 % (95 % confidence interval 0.01 % – 0.10 %) vs. 0.31 % (0.21 % – 0.40 %), respectively; odds ratio (OR) 0.25 (0.11 – 0.56); P < 0.001, as were the rates for the combined endpoint (HGD/EAC): 0.24 % (0.09 % – 0.32 %) vs. 0.76 % (0.43 % – 0.89 %), respectively; OR 0.35 (0.21 – 0.58); P < 0.001. There was no significant heterogeneity among studies. Conclusion The results demonstrate significantly lower rates of neoplastic progression in NDBE patients with SSBE compared with LSBE. BE length can easily be used for risk stratification purposes for NDBE patients undergoing surveillance endoscopy and consideration should be given to tailoring surveillance intervals based on BE length in future US guidelines.

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