scholarly journals Perineal Rectosigmoidectomy Revisited

2020 ◽  
Author(s):  
Deepa Taggarshe ◽  
Bashir Attuwaybi
Keyword(s):  
Operating Time ◽  
The Elderly ◽  
Long Term Results ◽  
Ultrasonic Scalpel ◽  
Perineal Rectosigmoidectomy ◽  
Estimated Blood Loss ◽  
Surgical Options ◽  
Perineal Abscess

Objective: The aim of this study was to evaluate the long-term results of perineal rectosigmoidectomy. Background: Multiple surgical options are available for rectal prolapse Perineal rectosigmoidectomy (Altemeier's procedure) is the procedure of choice in elderly patients and those with multiple comorbidities. Methods: Retrospective review was performed of all patients undergoing perineal rectosigmoidectomy from 1998-2008. Results: Of 128 patients, 125(98%) were women; with mean age 74 yrs. Mean operating time was 76 minutes. Hemostasis was achieved using Ultrasonic scalpel or clamp and tie technique in equal numbers. Ultrasonic scalpel use resulted in shorter operative times (57.9 vs. 94.7 minutes, respectively, p< 0.0001,) and estimated blood loss (18.8 vs. 73 ml, respectively, p <0.0001,) compared to clamp-tie technique. Recurrence was seen in 23(18%) patients. Recurrence was more after a hand-sewn anastomosis compared to a stapled anastomosis. Complications occurred in 3 patients (2%)(1-major bleeding, 1-perineal abscess, and 1-post-operative ileus). Conclusions: Perineal rectosigmoidectomy is associated with low morbidity and mortality. In addition the minimal discomfort to patient, short length of stay and improvement in quality of life makes this a suitable operation for the elderly.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

The Quality of Life of Long Term Survivors of Patients with Biliary Atresia

2021 ◽  
Author(s):  
Melanie Le ◽  
Konrad Reinshagen ◽  
Christian Tomuschat
Keyword(s):  
Quality Of Life ◽  
Liver Transplantation ◽  
Biliary Atresia ◽  
Long Term Results ◽  
Cochrane Library ◽  
Healthy Controls ◽  
Term Care ◽  
Associated Malformations

Abstract Purpose: Advances in surgical techniques and perioperative care have improved patients' short-and mid-term postoperative outcomes with Biliary Atresia (BA). However, the long-term results of these patients have not been thoroughly investigated. This systematic review aims to determine the long-term outcomes and the patients' health-related Quality of life (HrQoL) with their native livers or liver transplantation. Methods: A systematic literature-based search for relevant cohorts was performed using Pubmed/Medline, Cochrane Library from its inception to August 2021. Original studies reporting on BA, Hepatoportoenterostomie, portoenterostomy, Kasai, Liver transplantation, Quality of life, or HrQoL were included. Pooled prevalence has been calculated for cholangitis, secondary liver transplantation, or associated malformations using MetaXL (version 5.3). Subgroup analysis on HrQoL followed surgical treatment after BA was calculated by using RevMan (version 5.4).Results: 12 articles were considered for data synthesis. Nine studies compared biliary atresia patients to an age-matched healthy reference group. 4/9 (n = 338) of these studies indicated lower scores for biliary atresia patients; 5/9 (n = 127) stated similar health status. A Forest plot analysis including all studies with total HrQoL showed a tendency of higher scores towards healthy controls (MD -0.79, 95% CI: -6.00-4.41). Comparing patients after Kasai Hepatoportoenterostomy with healthy controls demonstrated favorable outcomes for the control group (MD -3.22, 95% CI: -7.20-0.75) with no statistical significance (p = 0.11). The pooled estimation of the prevalence of cholangitis, secondary liver transplantation and associated malformations are 0.33 (95% CI: 0.06–0.66), 0.59 (95% CI: 0,42–0.75) and 0.13 (95% CI: 0,01–0.33).Conclusion: Biliary atresia patients have an overall high prevalence of progressive liver-related complications and risk of lower HrQoL compared to their healthy peers. Furthermore, those patients who received liver transplantation appear to have the same Quality of life as those living with their native livers. Targeted and evidence-based follow-up procedures and transitional care are essential to meet these patients' long-term care needs. Prospective and multicenter research das focuses on the attributes and predictors of the long-term prognosis of patients with biliary atresia are necessary.

Long-term Results, Late Complications and Quality of Life in a Series of Adjustable Gastric Banding

2004 ◽  
Vol 14 (5) ◽  
pp. 648-654 ◽  
Author(s):  
Tarja Martikainen ◽  
Elina Pirinen ◽  
Esko Alhava ◽  
Eero Poikolainen ◽  
Matti Pääkkönen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Banding ◽  
Adjustable Gastric Banding ◽  
Late Complications ◽  
Long Term Results

scholarly journals Long-term results of tonsillectomy in professional opera singers: a pilot study

2020 ◽  
Vol 6 (5) ◽  
pp. 815
Author(s):  
Pedro Clarós ◽  
Aleksandra Sobolewska ◽  
María Del Carmen Pujol ◽  
Astrid Clarós-Pujol ◽  
Andrés Clarós
Keyword(s):  
Survey Study ◽  
Long Term Results ◽  
Long Term Effects ◽  
Recurrent Tonsillitis ◽  
Voice Performance ◽  
The Moment ◽  
Opera Singers ◽  
The Voice

<p class="abstract"><strong>Background:</strong> The primary goal of this study was to evaluate the long-term influence of tonsillectomy on the quality of life and voice performance of opera singers. Survey study which was reviewing the long-term effects of tonsillectomy.  </p><p class="abstract"><strong>Methods:</strong> Retrospective review of patients’ records and surveys in which patients have answered the questions about the influence of tonsillectomy on their voice. A total group of 30 singers was included in the study. They answered the questions about the indications for surgery, symptoms, and changes in their voice after surgery. The study group consisted of 19 women and 11 men. Mean age was 18.53 years old at the moment of surgery. The group included eleven sopranos, six mezzos, two contraltos, four tenors, five baritones, and one bass singer.  </p><p class="abstract"><strong>Results:</strong> A most common indication for tonsillectomy in opera singers was recurrent tonsillitis and was present in over 83% of cases. After surgery, the voice performance was better in 60% of cases, breathing improved in 50% of cases, voice emission was higher in 53% of cases. Over 80% of singers would recommend that surgery to another opera singer.</p><p class="abstract"><strong>Conclusions:</strong> Singers evaluated long-term influence of tonsillectomy as positive. Over 80% admitted improved effect on emission and the function of voice.</p>

scholarly journals Manajemen Perioperatif Gejala Ekstrapiramidal (EPS) pada Hidrocephalus Tekanan Normal (NPH)

2020 ◽  
Vol 9 (2) ◽  
pp. 183-190
Author(s):  
Agus Baratha Suyasa ◽  
◽  
Ni Putu Dharmi Lestari ◽  
Keyword(s):  
Dopamine Receptor ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Extrapyramidal Symptoms ◽  
Medical Rehabilitation ◽  
Long Term Results ◽  
Shunt Operation ◽  
Receptor Blocking

Extrapyramidal symptoms (EPS) are movement disorders due to side effects of dopamine receptor blocking agents. Symptoms of EPS include dystonia, akathisia, and parkinsonism. Symptoms of EPS in this case are found in normal pressure hydrocephalus (NPH) which does not consume dopamine receptor blocking drugs. Normal pressure hydrocephalus is hydrocephalus which does not coincide with intracranial pressure (ICT) elevation. Reported a case of a 57-year-old male with decreased consciousness and extrapyramidal symptoms and Normo pressure hydrocephalus (NPH), a V-P Shunt operation was performed. The operation was carried out under general anesthesia, using a non-kinking ETT no. 7.5, controlled ventilation. Premedication given midazolam 2 mg iv, Co induction with oxycodon 10 mg iv. Induction with propofol 150 mg iv, intubation facilities with rocketuronium 30 mg iv, maintenance with O2: Air (50: 50), sevoflurane, propofol continuous 100 mg/hour, rokuronium 20 mg/hour. Stable hemodynamics, SBP 130–150 mmHg, DBP 80–90 mmHg, HR 50–70 x/min, O2 saturation 99–100%, etCO2 35–37. After surgery the patient was treated in the intensive care unit (ICU) for monitoring blood pressure and extrapyramidal symptoms. The main goal of treatment should not be solely for the treatment of acute symptoms of EPS but also for the management of basic disease causing EPS related to morbidity and maintaining quality of life. Multidisciplinary management (neurosurgery, neurosurgery, intensive anesthesia and medical rehabilitation) are needed for better long-term results.

scholarly journals Long-Term Results of Kidney Transplantation in the Elderly: Comparison between Different Donor Settings

2021 ◽  
Vol 10 (22) ◽  
pp. 5308
Author(s):  
Renana Yemini ◽  
Ruth Rahamimov ◽  
Ronen Ghinea ◽  
Eytan Mor
Keyword(s):  
Graft Survival ◽  
Cox Regression ◽  
Survival Rates ◽  
The Elderly ◽  
Long Term Results ◽  
Live Donor ◽  
Allocation Policy ◽  
Cox Regression Analysis ◽  
Factors Associated

With scarce organ supply, a selection of suitable elderly candidates for transplant is needed, as well as auditing the long-term outcomes after transplant. We conducted an observational cohort study among our patient cohort >60 years old with a long follow up. (1). Patients and Methods: We used our database to study the results after transplant for 593 patients >60 years old who underwent a transplant between 2000–2017. The outcome was compared between live donor (LD; n = 257) recipients, an old-to-old (OTO, n = 215) group using an extended criteria donor (ECD) kidney, and a young-to-old (YTO, n = 123) group using a standard-criteria donor. The Kaplan−Meir method was used to calculate the patient and graft survival and Cox regression analysis in order to find risk factors associated with death. (2). Results: The 5- and 10-year patient survival was significantly better in the LD group (92.7% and 66.9%) compared with the OTO group (73.3% and 42.8%) and YTO group (70.9% and 40.6%) (p < 0.0001). The 5- and 10-year graft survival rates were 90.3% and 68.5% (LD), 61.7% and 30.9% (OTO), and 64.1% and 39.9%, respectively (YTO group; p < 0.0001 between the LD and the two DD groups). There was no difference in outcome between patients in their 60’s and their 70’s. Factors associated with mortality included: age (HR-1.060), DM (HR-1.773), IHD (HR-1.510), and LD/DD (HR-2.865). (3). Conclusions: Our 17-years of experience seems to justify the rational of an old-to-old allocation policy in the elderly population. Live-donor transplant should be encouraged whenever possible. Each individual decision of elderly candidates for transplant should be based on the patient’s comorbidity and predicted life expectancy.

scholarly journals Sarcopenia, obesity, osteoporosis and old age

2021 ◽  
Vol 11 (4) ◽  
pp. 23-35
Author(s):  
S. V. Topolyanskaya
Keyword(s):  
Body Composition ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Mineral Density ◽  
Term Care ◽  
Visceral Fat Accumulation ◽  
Age Related ◽  
Diagnostic Approaches

Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.

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