scholarly journals The effects of surgical treatment and sclerotherapy for intramuscular venous malformations: a comparative clinical study

2021 ◽  
Vol 48 (6) ◽  
pp. 622-629
Author(s):  
Yun Hyun Kim ◽  
Jeong Yeop Ryu ◽  
Joon Seok Lee ◽  
Seok Jong Lee ◽  
Jong Min Lee ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Clinical Outcomes ◽  
Vascular Malformations ◽  
Medical Center ◽  
Surgical Excision ◽  
Complication Rates ◽  
Venous Malformations ◽  
Treatment Groups ◽  
Comparative Clinical Study

Background Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision.Methods Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement.Results Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group.Conclusions Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.

Cost Comparison of Surgical and Endovascular Treatment of Unruptured Giant Intracranial Aneurysms

Neurosurgery ◽  
2015 ◽  
Vol 77 (5) ◽  
pp. 733-743 ◽  
Author(s):  
◽  
Pietro Familiari ◽  
Nicolai Maldaner ◽  
Adisa Kursumovic ◽  
Stefan A. Rath ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Direct Costs ◽  
Treatment Costs ◽  
Cost Comparison ◽  
Treatment Groups ◽  
Giant Intracranial Aneurysms ◽  
Hospital Stays

Abstract BACKGROUND: Giant intracranial aneurysms (GIAs), which are defined as intracranial aneurysms (IAs) with a diameter of ≥25 mm, are most likely associated with the highest treatment costs of all IAs. However, the treatment costs of unruptured GIAs have so far not been reported. OBJECTIVE: To examine direct costs of endovascular and surgical treatment of unruptured GIAs. METHODS: We retrospectively examined 55 patients with unruptured GIAs treated surgically (37 patients) or endovascularly (18 patients) between April 2004 and March 2014. We analyzed the costs of all hospital stays, interventions, and imaging with a median follow-up of 46 months. RESULTS: There was no difference in the costs of hospital stay between surgical and endovascular treatment groups ($10 565 vs $14 992; P = .37). Imaging costs were significantly higher in the surgical group than in the endovascular treatment group ($2890 vs $1612; P < .01), as were the costs of the intervention room and personnel involved in the intervention ($5566 vs $1520; P < .01). Implants used per patient were more expensive in the endovascular group than in the surgical treatment group ($20 885 vs $167). The total direct treatment costs were higher in the endovascular group ($52 325) than in the surgical treatment group ($20 619; P < .01). Treatment costs were associated with the type of treatment and GIA location but not with patient age, sex, or GIA size. CONCLUSION: Endovascular GIA treatment produced higher direct costs than surgical GIA treatment mainly due to higher implant costs. Reducing endovascular implant costs may be the most effective tool to decrease direct costs of GIA treatment.

scholarly journals SUN-LB92 The Importance of Early Diagnosis and Treatment of Primary Aldosteronism on the Progression of Chronic Kidney Disease, Compared With Essential Hypertension: A Retrospective Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jayoung Lim
Keyword(s):  
Essential Hypertension ◽  
Surgical Treatment ◽  
Primary Aldosteronism ◽  
Medical Center ◽  
Case Detection ◽  
Renal Protection ◽  
Treatment Groups ◽  
Endocrine Hypertension ◽  
Study Support ◽  
Better Than

Abstract <META NAME=“author” CONTENT=“Windows 사용자”>Introduction: Primary aldosteronism(PA) has few clinical phenotypes and features, compared with other endocrine hypertension(HTN). Even though hypokalemia is a typical sign of PA, most of PA reveals normal potassium concentration. For that reason, PA is likely to undetected and underestimated and it may account for larger proportion of total HTN than we expected. However, it has known that PA has higher risk of renal complications than essential hypertension(EH) and has been controversy which treatment between medication and operation is better for renal protection of PA. Methods: We retrospectively reviewed the medial records of patients with PA and EH of a single medical center from January, 2009 to December, 2019. PA patients were divided into medical and surgical treatment groups. EH patients were distinguished from one that satisfied with case detection test, called non-confirmed PA. We excluded cases with other secondary HTN and baseline eGFR < 60 mL/min/1.73m2. Results: Patients with PA(N=66) and patients with EH(N=514) were selected for analysis. Each baseline mean eGFR of patients with PA and EH indicated 91.2 ± 74.5 and 87.1 ± 19.7 mL/min/1.73m2 and statistically insignificant differences(P = 0.1688) as well as baseline SBP(P = 0.5403) and DBP(P = 0.8691). However, in spite of treatment of PA and controlled BP, mean eGFR of PA patients was lower than one of EH patients and its difference was statistically significant showing 66.5 ± 14.2 and 94.6 ± 195.9 mL/min/1.73m2 (P < .0001) at 2~ 5 years, 52.4 ± 17.9 and 77.6 ± 20.6 mL/min/1.73m2 (P < 0.0004) at 6~10 years. Baseline mean eGFR of PA with normokalemia and hypokalemia respectively were 77.7 ± 11.6 and 98.9 ± 92.5 mL/min/1.73m2 (P = 0.0269). Baseline mean eGFR of non-confirmed PA and EH were 82.5 ± 13.2 and 88.4 ± 21.1 mL/min/1.73m2 (P = 0.0240). Although baseline mean eGFR of PA with surgical treatment was better than one with medical treatment, it was reversal after 2~5 years indicating mean eGFR of PA patients treated with operation, 62.9 ± 16.1 mL/min/1.73m2 and one treated with spironolactone, 70.5 ± 12.6 mL/min/1.73m2 (P = 0.0010). Conclusions: This study support PA has worse effects on renal function than EH. PA is frequently unsuspected and undiagnosed because it hardly shows symptoms and signs. Many cases do not reveal main characteristics such as uncontrolled HTN and hypokalemia, so that patients with PA maybe have longstanding exposure to risk of CKD. Therefore it is necessary to do case detection test and rule out PA in initial hypertensive patients. In addition, more longitudinal study and research should be performed to decide personalized and adequate treatments for PA patients.

scholarly journals Sporadic Multifocal Venous Malformations of the Head and Neck

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Michael V. Amato ◽  
Neha A. Patel ◽  
Shirley Hu ◽  
Harry Pantelides
Keyword(s):  
Head And Neck ◽  
Vascular Malformations ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
International Normalized Ratio ◽  
Neck Mass ◽  
Venous Malformations ◽  
Heparin Administration ◽  
Increased Risk ◽  
D Dimer

Objective. To report a case of unusually widespread sporadic venous malformations of the head and neck associated with normal D-dimer levels and, due to the protean clinical manifestations and increased risk of coagulopathy of these lesions, to review their diagnosis and clinical management.Case Report. A 25-year-old man presented with a one-year history of intermittent right-sided neck swelling and tongue swelling. Physical exam revealed additional lesions present throughout the head and neck. There was no family history suggestive of heritable vascular malformations. Radiographic imaging demonstrated 15 lesions located in various tissue layers consistent with venous malformations. A coagulation screen showed a normal prothrombin time, activated partial thromboplastin time, international normalized ratio, D-dimer level, and fibrinogen level. It was determined that the patient was not at increased risk for intraoperative coagulopathy and preoperative heparin administration would not be necessary. The patient’s buccal and tongue lesions were subsequently excised with no complications. The patient also underwent sclerotherapy evaluation for his neck mass.Conclusion. This case describes a unique presentation of sporadic multifocal venous malformations. It also emphasizes the importance of prompt diagnosis and workup when multiple venous malformations are present to prevent morbidity during surgical excision secondary to intravascular coagulopathy.

Truncular vascular malformations in a varicose vein surgery patient cohort

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 54-58
Author(s):  
Mouton ◽  
Klippert ◽  
Wenning ◽  
Naef ◽  
Wagner
Keyword(s):  
Surgical Treatment ◽  
Varicose Vein ◽  
Vascular Malformations ◽  
Venous Malformation ◽  
Venous Disease ◽  
Venous Malformations ◽  
Varicose Vein Surgery ◽  
Patient Cohort ◽  
Surgery Patient ◽  
Hands And Feet

Background: To determine the incidence and significance of vascular malformations in a varicose vein surgery patient cohort in a prospective cohort study. Patients and methods: During a ten year time span we prospectively searched for patients with vascular malformations within a varicose vein surgery cohort. All patients underwent colour duplex sonography and surgery for symptomatic chronic venous disease or chronic venous insufficiency corresponding to clinical classes C2 to C6 according to CEAP. Results: Five out of 1488 patients had truncular vascular malformations. One patient had an arterio-venous malformation in the groin. Venous malformations were found in three marginal veins and one bone perforating vein. Two of these five patients had a mitral valve prolapse syndrome, one a persistent foramen ovale, one had a bone cyst in a finger and one ectromelia of the hands and feet, respectively. No complications occurred following surgical treatment of these five malformations. Conclusions: Truncular arterio-venous and venous malformations in a varicose vein surgery patient cohort are rare. In our cohort the hemodynamic impact of the vascular malformations was low, the surgical treatment combined with varicose vein surgery resulted in technical and clinical success.

scholarly journals Clinical Characteristics and Treatment Outcomes Among Patients With Gastrointestinal Phytobezoars: A Single-Institution Retrospective Cohort Study in Korea

2021 ◽  
Vol 8 ◽  
Author(s):  
Songsoo Yang ◽  
Min Jeng Cho
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Postoperative Complications ◽  
Treatment Outcomes ◽  
Multivariate Logistic Regression Analysis ◽  
Gastric Surgery ◽  
Treatment Groups ◽  
Significant Difference ◽  
Small Intestinal

Purpose: To describe our experience with phytobezoars, evaluate risk factors on treatment, and analyze whether previous gastric surgery affects treatment outcomes.Methods: Medical records of 51 patients with phytobezoars between 2000 and 2019 were retrospectively evaluated. We compared endoscopic and surgical treatment groups and evaluated risk factors using multivariate logistic regression analysis. And we compared patients with and without previous gastric surgery in the surgical treatment group.Results: The median patient age was 62.9 (range: 27–89) years. The endoscopic and surgical treatment groups included 26 (51%) and 25 (49%) patients, respectively. Patients aged ≥65 years, diabetes, and small intestinal phytobezoars were more frequent in the surgical treatment group. Previous gastric surgery (n = 16, 31.4%) was the most common predisposing risk factor, but without a significant difference between the groups. Enterotomy was performed for 20 patients (80%), segmental resection was performed for five patients (20%). Five patients (20%) had postoperative complications; there was one death. There were no significant differences in age, preoperative diagnosis, operation method, operative time, or postoperative stay between patients with and without previous gastric surgery, but postoperative complications were significantly more common in patients with previous gastric surgery.Conclusions: Phytobezoar should be suspected early in patients with previous gastric surgery or a specific food intake history. Early diagnosis and treatment are important for avoiding surgical intervention and complications, especially in elderly patients. Surgery is required in most patients with small intestinal phytobezoars, safe removal can be achieved mainly via enterotomy.

scholarly journals Comparing the Outcomes of Adults with Enterobacteriaceae Bacteremia Receiving Short-Course vs Prolonged-Course Antibiotic Therapy

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S31-S31
Author(s):  
Darunee Chotiprasitsakul ◽  
Jennifer H Han ◽  
Anna T Conley ◽  
Sara E Cosgrove ◽  
Anthony D Harris ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Outcomes ◽  
Antibiotic Treatment ◽  
Medical Center ◽  
Johns Hopkins Hospital ◽  
Treatment Groups ◽  
Short Course ◽  
All Cause Mortality ◽  
The University

Abstract Background The recommended duration of antibiotic treatment for Enterobacteriaceae bacteremia is between 7 and 14 days. We compared the clinical outcomes of patients receiving short-course (6–10 days) vs prolonged-course (11–15 days) antibiotic therapy for Enterobacteriaceae bacteremia. Methods A retrospective cohort study was conducted at The Johns Hopkins Hospital, The University of Maryland Medical Center, and The Hospital of the University of Pennsylvania including patients with monomicrobial Enterobacteriaceae bacteremia treated with in vitro active antibiotic therapy in the range of 6–15 days between 2008 and 2014. 1:1 nearest neighbor propensity score matching without replacement was performed, prior to regression analysis, to estimate the risk of all-cause mortality within 30 days after the end of antibiotic treatment for patients receiving short vs. prolonged durations of antibiotic therapy. Secondary outcomes included Clostridium difficile infection (CDI) and the emergence of multidrug-resistant Gram-negative (MDRGN) bacteria within 30 days after the end of antibiotic therapy. Results A total of 1,769 patients met eligibility criteria. There were 385 matched pairs who were well-balanced on baseline characteristics. The median duration of therapy in the short-course group and prolonged-course group was 8 days (interquartile range (IQR) 7–9 days) and 15 days (IQR 13–15 days), respectively. No difference in all-cause mortality between short- and prolonged-course treatment groups was observed (adjusted hazard ratio [aHR] 1.00; 95% CI 0.62–1.63). Rates of CDI were similar between the treatment groups (OR 1.17; 95% CI 0.39–3.51). There was a non-significant protective effect of short-course antibiotic therapy on the emergence of MDRGN bacteria (OR 0.59; 95% CI 0.32–1.09 P = 0.09). Conclusion Short courses of antibiotic therapy yields similar clinical outcomes to prolonged courses of antibiotic therapy for Enterobacteriaceae bacteremia, and may protect against subsequent MDRGN emergence. Disclosures All authors: No reported disclosures.

scholarly journals The impact of delayed surgical intervention following high velocity maxillofacial injuries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniel Oren ◽  
Amiel A. Dror ◽  
Adeeb Zoabi ◽  
Adi Kasem ◽  
Lior Tzadok ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
High Velocity ◽  
Medical Center ◽  
Complication Rates ◽  
Maxillofacial Injuries ◽  
Delayed Treatment ◽  
Syrian Civil War ◽  
The Mean ◽  
The Impact

AbstractOur study compares the number of postoperative complications of Syrian patients admitted to the Galilee Medical Center (GMC) over a 5-year period (May 2013–May 2018) for treatment after initial high-velocity maxillofacial injuries sustained during the Syrian civil war. Specifically, we evaluated complication rates of patients arriving “early,” within 24 h, to the GMC versus those who arrived “late,” or 14–28 days following high-velocity maxillofacial injuries. Both groups of patients received definitive surgical treatment within 48 h of admission to our hospital with a total of 60 patients included in this study. The mean age was 26 ± 8 years (range: 9–50) and all except one were male. Postoperative complications in the early group were found to be significantly higher compared to the delayed arrival group (p = 0.006). We found that unintentionally delayed treatment may have contributed to a critical revascularization period resulting in improved healing and decreased postoperative morbidity and complications. We discuss potential mechanisms for complication rate variations, including critical vascularization periods. Our study may add to a growing body of work demonstrating the potential benefit of delayed surgical treatment for high-velocity maxillofacial injuries.

Evaluation of unconventional poultry feed in broilers

2019 ◽  
Vol 17 (1) ◽  
Keyword(s):  
Body Weight ◽  
Treatment Group ◽  
Blood Meal ◽  
Feed Consumption ◽  
Trial Period ◽  
Feed Ingredients ◽  
Treatment Groups ◽  
Broiler Production ◽  
Group I ◽  
Unconventional Feed

Background: Commercial broiler is a rapidly growing sector in Bangladesh. The broilers are supplied with the balanced ration prepared from a number of ingredients which are not available uniformly throughout the years. On the other hands, manufactured feeds are costly and inconvenient for the rural farmers. This study is undertaken to use unconventional feed ingredients aiming to decrease the broiler production cost. Method: A total of ninety-nine day- old broiler chicks (Hubbard) of either sex were used in this study in 3 treatment groups to assess processed unconventional feed item (shoti, blood meal, poultry dropping and molasses) on growth and profitability upon rearing for 60 days. Broilers were reared in dip litter system and were fed ad libitum on conventional and unconventional diet dividing into 3 treatment diets namely, treatment diet 1 (T1: Conventional as control), treatment diet 2 (T2: unconventional with blood meal and shoti), and treatment diet 3 (T3: unconventional with blood meal, shoti, poultry droppings and molasses) throughout the trial period. Treatment group 1 (T1) was used as control. Results: Broilers fed on control diet (conventional feed) achieved higher (P<0.01) body weight, while the broilers offered diets with the highest amount of unconventional feed had the lowest body weight. Increased (P<0.01) feed intake was observed during 21days and 49 days of age when broilers fed diets with the supplementation, but no significant differences were found among the groups in terms of feed consumption during 33 day of age. FCR differed significantly (P<.01) throughout the trial period with the broilers fed diets without supplementation of unconventional feed item had the superior FCR than the others. Mortality rate was 6.06%,9.09%, and 9.09% in treatment group I, treatment group II, and treatment group III respectively while live weights, feed conversion and feed consumption was unaffected by all the dietary groups with/without incorporation of unconventional feed item up to day 60 days of age. Statistically significant (P<0.01) decreased live weight was observed among the treatment groups in 60-day-old birds. Productivity and cost-benefit analysis were performed. Conclusion: Use of unconventional feed ingredients in broiler production greatly reduces the feed cost with little hampering the growth rate and hence, it is profitable for the farmers.

TERATOGENIK EKSTRAK ETANOL UWI BANGGAI UNGU (Dioscorea alata L.) PADA MENCIT BETINA (Mus musculus)

2020 ◽  
Vol 5 (2) ◽  
pp. 309-318
Author(s):  
Ihwan Ihwan ◽  
◽  
Rahmatia Rahmatia ◽  
Khildah Khaerati ◽  
Keyword(s):  
Treatment Group ◽  
Embryo Development ◽  
Mus Musculus ◽  
Birth Defect ◽  
Abnormal Development ◽  
Dioscorea Alata ◽  
Treatment Groups ◽  
Study Results ◽  
Pregnant Mice ◽  
Ethanol Extracts

Teratogenic is an abnormal development on embryo and is the cause of congenital defect or birth defect. This study aims to determine the effect of the addition of Dioscorea alata L. ethanol extracts to the embryo development on pregnant mice whose given orally to 24 mice which divided to 4 treatment groups, they are the normal group (NG) with NaCMC 0.5%; 28 mg/KgBB treatment group; 35 mg/KgBB; 42 mg/Kg BB. The addition of Dioscorea alata L ethanol extracts was done on the sixth day until the 15th day of pregnancy. On the 18th day of pregnancy, Laparaktomi was done to the pregnant mice and the embryo was taken out of the uterus. The observation was done to the fetus numbers, weight weighing of the fetus's body, dan length measurement of the fetus's body. Another observation is the observation of the external organ defect of the embryo. The study results that the addition of Dioscorea alata L ethanol extracts with various doses have no significant effect (P>0.5) to the mice external fetus development. On the examination of the fetus, we can conclude that Dioscorea alata L ethanol extracts don’t give any effect that may cause the defect of the fetus’ external organ.

Sign in / Sign up

Export Citation Format

Share Document