scholarly journals Performance of Venous Port Catheter Insertion by a General Surgeon: A Prospective Study

2015 ◽  
Vol 100 (5) ◽  
pp. 827-835 ◽  
Author(s):  
Mehmet Aziret ◽  
Oktay İrkörücü ◽  
Cihan Gökler ◽  
Enver Reyhan ◽  
Süleyman Çetinkünar ◽  
...  
Keyword(s):  
Vascular Access ◽  
Catheter Insertion ◽  
Port Catheter ◽  
Insertion Procedure ◽  
Venous Port ◽  
Stay Time ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

As part of the vascular access procedures, venous ports, commonly referred to as catheters, are placed under the skin to enable safe and easy vascular access for administration of repeated drug treatments. 122 patients who had received a venous port catheter insertion procedure in the general surgery department between January 1012 and January 2014 were involved in this study. Patients were divided into two groups: those who had undergone a fluoroscopy (group 1) and those who had not undergone a fluoroscopy (group 2). Complications that emerged during and after the port catheter insertion procedure and successful insertion rates were recorded in the database. Data of these patients were presented in a prospective manner. There were 92 to 30 patients in groups 1 and 2, respectively. In group 1, the mean age was approximately 56.8, total catheter stay time was 20,631 days, and mean time of port use was 224.2 days. In group 2, the mean age was approximately 61.2, total catheter stay time was 13,575 days, and mean time of port use was 452.5 days. Successful insertion rate was 100% and 90% in groups 1 and 2, respectively (P < 0.05). The proper insertion of the port catheter accompanied by monitoring methods can decrease procedure-related complications. Statistical comparisons between the two groups in terms of malposition and successful insertion rates also support this view (P < 0.05). The findings support the view that in cancer patients, a venous port catheter insertion accompanied by a fluoroscopy can be safely performed by general surgeons.

scholarly journals Revisiting conventional adenoidectomy using technology

2020 ◽  
Vol 6 (7) ◽  
pp. 1232
Author(s):  
Kiran Gangadhar S. ◽  
Sonee Thingujam ◽  
Jayita Poduval
Keyword(s):  
Blood Loss ◽  
Paediatric Population ◽  
Lateral View ◽  
Respiratory Pathogens ◽  
Moderate Degree ◽  
Ventilation Tubes ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most frequently applied surgical procedures in the paediatric population, either alone or in conjunction with tonsillectomy and/or insertion of ventilation tubes. The main purpose of the adenoidectomy is to eliminate the nasopharyngeal respiratory pathogens and to remove nasal airway obstruction. Aim of the study was to compare the outcomes of conventional and endoscopic assisted curettage adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> In this comparative study, 50 patients were divided into 2 groups. Group 1 (25 patients) underwent endoscopic curettage adenoidectomy and group 2 (25 patients) underwent conventional curettage adenoidectomy. Intraoperative time, complications and postoperative pain were recorded.  </p><p class="abstract"><strong>Results:</strong> 72% in group 1 and 64% in group 2 had grade 2 adenoid hypertrophy. 68% in group 1 and 64% in group 2 had a moderate degree of obstruction in lateral view of soft tissue X-ray nasopharynx. The mean time taken for surgery in group 1 was 13.29±3.28 minutes, and in group 2,6.28±2.31 minutes. Minimal loss of blood was recorded in group 1 with less than 20 ml, whereas in group 2, the blood loss was high; 30% of patients had blood loss more than 30 ml. In group 1, the mean VAS was 3.25 and 2.55 in group 2 2.55. In group 1, 4% of patients had primary haemorrhage and in group 2, 8% of patients had primary haemorrhage. No patient had velopharyngeal dysfunction in either group.</p><p class="abstract"><strong>Conclusions:</strong> More operative time but less blood loss were noted in endoscopic adenoidectomy. Intraoperative visualisation of the nasopharynx in endoscopic procedures showed no significant advantage over conventional adenoidectomy.</p>

Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic

2021 ◽  
pp. 001857872110375
Author(s):  
Frank A. Fanizza ◽  
Jennifer Loucks ◽  
Angelica Berni ◽  
Meera Shah ◽  
Dennis Grauer ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Medication Adherence ◽  
Hcv Treatment ◽  
Clinical Pharmacists ◽  
The Mean ◽  
Group 2 ◽  
Cure Rates ◽  
The Impact ◽  
Mean Time ◽  
Group 1

Background: Modern hepatitis C virus (HCV) treatment regimens yield cure rates greater than 90%. However, obtaining approval for treatment through the prior authorization (PA) process can be time consuming and require extensive documentation. Lack of experience with this complex process can delay HCV medication approval, ultimately increasing the amount of time before patients start treatment and in some cases, prevent treatment altogether. Objectives: Assess the impact of incorporating clinical pharmacists into specialty pharmacy and hepatology clinic services on medication access, patient adherence, and outcomes in patients being treated for HCV. Methods: We performed a retrospective cohort exploratory study of patients seen in an academic medical center hepatology clinic who had HCV prescriptions filled between 8/1/15 and 7/31/17. Patients were categorized by whether they filled prescriptions prior to (Pre-Group) or after (Post-Group) the implementation of a pharmacist in clinic. The Post-Group was further divided according to whether the patient was seen by a pharmacist in clinic (Post-Group 2) or if the patient was not seen by the pharmacist, but had their HCV therapy evaluated by the pharmacist before seeking insurance approval (Post-Group 1). Results: The mean time from the prescription being ordered to being dispensed was longer in the Pre-Group (50.8 ± 66.5 days) compared to both Post-Groups (22.2 ± 27.8 days in Post-Group 1 vs 18.9 ± 17.7 days in Post-Group 2; P < .05). The mean time from when the prescription was ordered to when the PA was submitted was longer in the Pre-Group (41.6 ± 71.9 days) compared to both Post-Groups (6.3 ± 16 in Post-Group 1 vs 4.1 ± 9.7 in Post-Group 2; P < .05). Rates of medication adherence and sustained virologic response were similar between all groups. Conclusion: Incorporation of clinical pharmacists into a hepatology clinic significantly reduced the time patients waited to start HCV treatment. In addition to improving access to medications, implementation of the model helped to maintain excellent medication adherence and cure rates.

Comparison of power-free-chop and phaco-chop techniques for moderate nucleus

2020 ◽  
Author(s):  
Haiqing Bai ◽  
Lin Yao
Keyword(s):  
Healing Process ◽  
Corneal Thickness ◽  
Dissipated Energy ◽  
Thickness Variation ◽  
Negative Effects ◽  
Chi Square ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Abstract Background: To compare intraoperative and postoperative effects of power-free-chop and phaco-chop techniques for moderate nucleus in phacoemulsification sugery. Methods: Sixty patients were evaluated in 2 groups prospectively. The power-free-chop technique was performed in Group 1 (30 eyes) and the phaco-chop technique in Group 2 (30 eyes). There were no significant differerces between these 2 groups. The cumulative dissipated energy (CDE), time to achieve maximum vision, corneal thickness variation, and time to return to the preoperative values were collected. All parameters were statistically compared in these 2 groups by using the chi-square test and the independent-sample t test. Results: The CDE was 5.53±1.92J in Group 1 and 7.02±1.77J in Group 2. After the operation, the mean time to recover to the maximum vision was 2.80±1.42 days in Group 1 and 3.80±1.92 days in Group 2 respectively. The mean postoperative corneal thickness increased 36.9±14.74μm in Group1 and 46.20±20.67μm in Group 2. And the mean time to return to preoperative pachymetry values were 3.73±1.70 days and 4.83±2.11 days, in Group 1 and Group 2 respectively. There were significant differences in these parameters between both groups. Conclusions: The power-free-chop technique had fewer negative effects on the corneal endothelium as less ultrasound power was used for moderate nucleus cases. This can accelerate the functional healing process and the return to preoperative physiologic values.

scholarly journals Evaluation of Metachronous Breast and Endometrial Cancers: Preroutine and Postroutine Adjuvant Tamoxifen Use

2016 ◽  
Vol 26 (8) ◽  
pp. 1440-1447 ◽  
Author(s):  
Kassondra S. Grzankowski ◽  
J. Brian Szender ◽  
Chandra L. Spring-Robinson ◽  
Shashikant B. Lele ◽  
Kunle O. Odunsi ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Adjuvant Tamoxifen ◽  
Time Interval ◽  
Primary Tumors ◽  
Previous Diagnosis ◽  
Clinicopathologic Factors ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

BackgroundThe time interval between diagnoses of breast cancer (BC) and endometrial cancer (EC) is not well established in women with metachronous primary tumors. We sought to examine this interval and identify associations with treatment-related and clinicopathologic factors.MethodsWe identified 141 patients who developed both cancers during 1966 to 2013. Patients were divided into 2 groups: group 1, BC first, and group 2, EC first. Subanalysis performed of group 1 (59 patients) stratified around adjuvant tamoxifen use: pre-1990 BC diagnosis and post.ResultsFifty-nine and 82 patients were in groups 1 and 2, respectively. The mean time interval was comparable (76 vs 74 months,P= 0.861). Subanalysis divided group 1 into pre- (n = 27) and post- (n = 32) 1990 and resulted in different mean time intervals between diagnosis of metachronous cancers (106 vs 50 months, respectively [P= 0.042]). Median progression-free survival (PFS) and overall survival (OS) for EC were longer in the pre group (PFS, 51 vs 26 months [P= 0.169]; OS, 59 vs 27 months [P= 0.190]). Median PFS and OS for BC were also longer in this group (PFS, 147 vs 109 months [P= 0.005]; OS, 166 vs 114 months [P< 0.001]).ConclusionsOur data indicate the mean time interval between the diagnosis of EC and BC was approximately 6 years. Disease-specific EC survival was worse for patients with a previous diagnosis of BC. Stratification around implementation of tamoxifen use shows comparable grade and stage but different time interval and survival, suggesting resulting effects from adjuvant therapy for BC. These results are useful in counseling women at risk.

scholarly journals Comparison of power-free-chop and phaco-chop techniques for moderate nuclei

2020 ◽  
Author(s):  
Lin Yao ◽  
Haiqing Bai
Keyword(s):  
Healing Process ◽  
Corneal Thickness ◽  
Dissipated Energy ◽  
Thickness Variation ◽  
Negative Effects ◽  
Chi Square ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Group 1

Abstract Background: To compare the intraoperative and postoperative effects of power-free-chop and phaco-chop techniques for moderate nuclei in phacoemulsification surgery. Methods: Sixty patients were evaluated in 2 groups prospectively. The power-free-chop technique was performed in Group 1 (30 eyes), and the phaco-chop technique was performed in Group 2 (30 eyes). There were no significant differences between these 2 groups. The cumulative dissipated energy (CDE), time to achieve maximum vision, corneal thickness variation, and time to return to the preoperative values were collected. All parameters were statistically compared in these 2 groups by using the chi-square test and the independent-sample t -test. Results: The CDE was 5.53±1.92 J in Group 1 and 7.02±1.77 J in Group 2. After the operation, the mean time to recover to the maximum vision was 2.80±1.42 days in Group 1 and 3.80±1.92 days in Group 2. The mean postoperative corneal thickness increased 36.9±14.74 μm in Group 1 and 46.20±20.67 μm in Group 2. The mean time to return to preoperative pachymetry values was 3.73±1.70 days and 4.83±2.11 days in Group 1 and Group 2, respectively. There were significant differences in these parameters between the groups. Conclusions: The power-free-chop technique had fewer negative effects on the corneal endothelium, as less ultrasound power was used for moderate nucleus cases. This can accelerate the functional healing process and the return to preoperative physiologic values.

scholarly journals RATIONAITY AND INTERVENTION EFFICIENCY OF CLINICAL PHARMACIST IN USAGE PAINKILLERS AFTER OPERATION

2021 ◽  
Vol 62 (3) ◽  
Author(s):  
Bui Dang Phuong Chi ◽  
Bui Dang Minh Tri ◽  
Bui Tung Hiep ◽  
Tran Nhat Anh
Keyword(s):  
Adverse Effects ◽  
General Surgery ◽  
Pain Treatment ◽  
Pain Scores ◽  
Post Operative Pain ◽  
The Mean ◽  
Group 2 ◽  
Surgery Department ◽  
Mean Time ◽  
Group 1

Objectives: To evaluate the rationality and effectiveness of clinical pharmacist’s intervention in the use of painkillers for post-operative pain treatment at the General Surgery Department of Cai Nuoc General Hospital. Objects and methods: Cross-sectional descriptive study on 172 patients (patients) undergoing surgery at General Surgery Department, Cai Nuoc General Hospital. Results: There were 38.95% of patients studied with adverse effects when using painkillers. The average duration of painkiller use after surgery was 5.6 ± 4.0 days. The differences in the mean time to take the drug between the 2 groups were statistically significant. VAS pain scores of the study samples tended to decrease gradually over 1, 3, 5, 7 days after surgery. On 2 research groups, in general, the average VAS score after 1 day surgery was 4.2 ± 1.9 points and after 7 days was 1.1 ± 0.8 points. Increase the reasonable rate in choosing drugs group 2 with reasonable rate was had a reasonable rate of 68.18%, much higher than group 1 with 46.43%. Conclusion: The incidence of adverse effects was low. The differences in the mean time to take the drug 70.45%, much higher than group 1 with 42.86%; drug dose, group 2 had reasonable rate was 82.95%, much higher than group 1 with 55.95%; the rationality of drug use, group 2 between the 2 groups were statistically significant. VAS pain scores of the study samples tended to decrease gradually over 1, 3, 5, 7 days after surgery. Increase the rationality of drug selection, drug dosage, and general rationality of post-operative pain treatment.

A Ruler for Abdominoplasty Preoperative Markings: The Potential of Best Scar Symmetry

2021 ◽  
pp. 155335062110331
Author(s):  
Ricardo Horta ◽  
Cátia S. Domingues ◽  
Cláudia C. Dias ◽  
Diogo Barreiro
Keyword(s):  
Patient’S Satisfaction ◽  
Preoperative Marking ◽  
Classic Technique ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Postoperative Scar ◽  
Surgeon Satisfaction ◽  
Group 1

Background. Scar appearance is an important outcome in abdominoplasty surgery, and its asymmetry can have a significant impact on patient and surgeon satisfaction. Here, we compared the scar symmetry reached with a ruler specially designed for the preoperative marking in abdominoplasty to the classic preoperative incision marking. Methods. In this randomized, uni-blind study, 42 patients were allocated to 2 different groups. Group 1 patients had their preoperative marking made by a group of surgeons that used the classic technique as described by Baroudi (n = 21), and Group 2 patients received their preoperative marking by another group of surgeons, using a ruler specially designed to fit the abdominal contour (n = 21). Patients were evaluated using a standard questionnaire that collected information about general patient’s characteristics. On the follow-up period, we evaluated the presence of late surgical complications, need for revision surgery, patient’s satisfaction concerning the postoperative scar, and 4 distances were measured in both groups to assess symmetry. Statistical analysis was made. Results. A total of 42 patients underwent abdominoplasty and were evaluated on the follow-up period (mean time: 4 months). The mean difference of corresponding measures on each side (A-B vs. A-B’ and A-C vs. A-C’) was higher in Group 1 comparing to Group 2. The level of correlation between corresponding measurements was higher in Group 2. Better satisfaction regarding the scar symmetry was achieved in Group 2, being this result statistically significant ( P = .004). Conclusions. The use of the specialized ruler may help surgeons achieve a better scar symmetry with higher patient satisfaction.

Extension block technique for mallet fractures: a comparison of one and two dorsal pins

2016 ◽  
Vol 41 (7) ◽  
pp. 701-706 ◽  
Author(s):  
U. Akgun ◽  
T. Bulut ◽  
E. C. Zengin ◽  
M. Tahta ◽  
M. Sener
Keyword(s):  
Controlled Study ◽  
Randomized Controlled ◽  
Outcome Scores ◽  
Level 3 ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Extensor Lag ◽  
Group 1

The aim of this study was to compare the clinical and radiological outcomes of one or two dorsal pins for extension blocking of mallet fractures. We treated 36 mallet fractures with the extension block technique. A single pin was used in 19 fractures (Group 1) and two pins in 17 fractures (Group 2). The mean age was 33.6 years and the mean follow-up time was 12.2 months. All patients were assessed by the Crawford outcome score. Extensor lag and other complications were noted. All fractures united with a mean time of 6.0 weeks (4–9) in Group 1, and 6.1 weeks (4–7) in Group 2. We obtained 74% and 71% excellent and good outcome scores in Group 1 and in Group 2, respectively. The final extension lag was 6° in Group 1, and 7° in Group 2. No difference was found between the two groups in terms of clinical outcomes, radiological values and complications. Level 3 non-randomized controlled study.

scholarly journals Vascular access for hemodialysis: creation, functioning, and complications (Data of the Hospital of Kaunas University of Medicine)

Medicina ◽  
2010 ◽  
Vol 46 (8) ◽  
pp. 550 ◽  
Author(s):  
Sondra Kybartienė ◽  
Inga Skarupskienė ◽  
Edita Žiginskienė ◽  
Vytautas Kuzminskis
Keyword(s):  
Renal Failure ◽  
Vascular Access ◽  
Ischemic Brain ◽  
End Stage Renal Failure ◽  
Arteriovenous Fistulas ◽  
The Mean ◽  
Group 2 ◽  
End Stage ◽  
Complications Rate ◽  
Mean Time

Background. There are no data about arteriovenous fistulas (AVF) formation, survival, and complications rate in patients with end-stage renal failure in Lithuania. Material and methods. We analyzed the data of patients (N=272) with end-stage renal failure, dialyzed at the Hospital of Kaunas University of Medicine from January 1, 2000, until March 30, 2010, and identified 368 cases of AVF creation. The patients were divided into two groups: group 1 included the patients with an AVF that functioned for <15 months (n=138) and group 2 included patients with an AVF that functioned for ≥15 months (n=171). Results and conclusions. Less than half (47%) of the patients started planned hemodialysis and 51% of the patients started hemodialysis urgently. The mean time of AVF functioning was 15.43±8.67 months. Age, gender, the kidney disease, and time of AVF maturation had no influence on AVF functioning time. AVFs of the patients who started planned hemodialysis functioned longer as compared to AVFs of the patients who started hemodialysis urgently (P<0.05). Hospitalization time of the patients who started hemodialysis urgently was longer as compared that of the patients who had a matured AVF (37.63±20.55 days vs. 16.54±9.43 days). The first vascular access had better survival than repeated access. AVF survival in patients with ischemic brain vascular disease was worse than in patients without this comorbidity.

Radiotherapy and CCNU in the treatment of high-grade supratentorial astrocytomas

1976 ◽  
Vol 45 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Bryce Weir ◽  
Pierre Band ◽  
Raul Urtasun ◽  
Gilles Blain ◽  
Don McLean ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Content Type ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
To Receive ◽  
Mean Time ◽  
Grade Iii ◽  
Group 1

✓ Forty-one consecutive patients with supratentorial primary brain tumors (38 Grade III and IV astrocytomas, one giant-cell astrocytoma, and two cases with insufficient tissue for diagnosis) were randomly allocated within 2 weeks of surgery to one of three therapeutic groups. Group 1 (15 patients) received radiation therapy totaling 4000 to 4500 rads in 4 to 5 weeks. Group 2 (13 patients) received 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) 130 mg/sq m orally every 6 weeks. Group 3 (13 patients) received radiation therapy plus CCNU as for Groups 1 and 2. When the disease progressed, patients in Groups 1 and 2 were crossed over to receive CCNU and irradiation respectively. The median survival time in these groups was 188, 259, and 252 days, and the mean survival 263, 262, and 329 days. The median time from diagnosis to crossover (Groups 1 and 2) or to progression (Group 3) was 163, 99, and 220 days, and the mean time was 172, 108, and 231 days. There was no statistically significant difference between the means or medians in any of these situations.

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