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1.
Ilana Sebbag Raymond Tang Vit Gunka JagPaul Sahota Himat Vaghadia Andrew Sawka 《Brazilian Journal of Anesthesiology》2018,68(3):280-284
Study objective
The purpose of this study was to assess whether application of dorsal table tilt and body rotation to a parturient seated for neuraxial anesthesia increased the size of the paramedian target area for neuraxial needle insertion.Setting
Labor and Delivery Room.Patients
Thirty term pregnant women, ASA I–II, scheduled for an elective C‐section delivery.Interventions
Lumbar ultrasonography was performed in four seated positions: (F) lumbar flexion; (FR) as in position F with right shoulder rotation; (FT) as in position F with dorsal table‐tilt; (FTR) as in position F with dorsal table‐tilt combined with right shoulder rotation.Measurements
For each position, the size of the ‘target area’, defined as the visible length of the posterior longitudinal ligament was measured at the L3‐L4 interspace.Main results
The mean posterior longitudinal ligament was 18.4 ± 4 mm in position F, 18.9 ± 5.5 mm in FR, 19 ± 5.3 mm in FT, and 18 ± 5.2 mm in FTR. Mean posterior longitudinal ligament length was not significantly different in the four positions.Conclusions
These data show that the positions studied did not increase the target area as defined by the length of the posterior longitudinal ligament for the purpose of neuraxial needle insertion in obstetric patients. The maneuvers studied will have limited use in improving spinal needle access in pregnant women. 相似文献2.
Bilade Cherqaoui Linda Rossi-Semerano Sophie Georgin-Lavialle Perrine Dusser Caroline Galeotti Maryam Piram Véronique Hentgen Isabelle Touitou Isabelle Koné-Paut 《Joint, bone, spine : revue du rhumatisme》2018,85(6):733-739
Objectives
Children with Familial Mediterranean fever may suffer from musculoskeletal involvement, somewhat difficult to distinguish from juvenile spondyloarthritis. The association of these two diseases has been scarcely reported in children. Objective of this work was to define the association of familial Mediterranean fever and juvenile spondyloarthritis in France.Methods
Three cohorts of children with familial Mediterranean fever, juvenile spondyloarthritis, familial Mediterranean fever related juvenile spondyloarthritis, were retrospectively identified in the French reference center of auto-inflammatory diseases. Familial Mediterranean fever was defined according to Tel-Hashomer or Turkish pediatric criteria with at least one exon-10 MEFV-gene mutation. Juvenile spondyloarthritis was defined according to ILAR criteria. Patients with familial Mediterranean fever or juvenile spondyloarthritis were respectively compared to familial Mediterranean fever related juvenile spondyloarthritis patients.Results
Sixteen children were identified as having familial Mediterranean fever related juvenile spondyloarthritis. The male/female-ratio was 0.6, with median age at spondyloarthritis onset of 7.5 years (3–16 years). All carried at least one M694V variant in MEFV gene; 16.7% were HLA-B27-carriers. Compared to 83 familial Mediterranean fever patients, familial Mediterranean fever related juvenile spondyloarthritis patients had less frequently fever (P < 0.01) and more frequently arthritis (P < 0.05), enthesitis (P < 0.001), inflammatory back pain (P < 0.001), inadequate response to colchicine (P < 0.05). Compared to 20 juvenile spondyloarthritis patients, familial Mediterranean fever related juvenile spondyloarthritis patients less often received non-steroidal anti-inflammatory drugs (P < 0.01) and anti-tumor necrosis factor drugs (P < 0.001).Conclusions
Familial Mediterranean fever may be associated with typical pattern of juvenile spondyloarthritis. These patients, with less response to colchicine, should be diagnosed earlier and treated as for jSpA. 相似文献3.
Introduction
Tamsulosin is an α-1A-specific blocker inducing selective relaxation of ureteral smooth muscle and inhibition of ureteral spasms leading to ureteral dilatation that can facilitates retrograde ureterorenoscopy (URS).Objective
To assess the efficacy of tamsulosin in improving the outcome of URS management of lower ureteral stones.Patients and methods
This prospective, randomised, controlled, clinical trial was carried out between June 2011 and December 2014. It included 98 patients with lower ureteral stones scheduled for treatment with URS. Before URS, patients were randomly divided into 2 groups; study group including 51 patients, in which pre-URS daily oral dose of tamsulosin 0.4 mg tab, for 1 week, was given and control group including 47 patients who received no additional therapy rather than standard analgesic on demand. The URS outcomes were evaluated and compared between both groups.Results
The demographic and stone characteristics were comparable between both groups. The mean URS time was significantly shorter in study group than in control group (52.0 ± 14.9 min vs. 71.0 ± 17.3 min; p = 0.039). Of the 98 patients, 89 (90.81%) had a successful URS procedures. The success rate was 94.1% (98/51) in study group compared 89.2% (58/65) in the control group, with statistically significant difference (p = 0.045). The major complications occurred in 4.25% of patients in control group but in only 1.96% of those received tamsulosin (p = 0.034).Conclusion
Post-tamsulosin ureteroscopy was easier and safer; leading to significantly increased stone-free rates and fewer complications. 相似文献4.
Thomas Seisen Malte W. Vetterlein Patrick Karabon Tarun Jindal Akshay Sood Luigi Nocera Paul L. Nguyen Toni K. Choueiri Quoc-Dien Trinh Mani Menon Firas Abdollah 《European urology》2018,73(3):452-461
Background
There is limited evidence supporting the use of local treatment (LT) for prostate cancer (PCa) patients with clinically pelvic lymph node-positive (cN1) disease.Objective
To examine the efficacy of any form of LT ± androgen deprivation therapy (ADT) in treating these individuals.Design, setting, and participants
Using the National Cancer Database (2003–2011), we retrospectively identified 2967 individuals who received LT ± ADT versus ADT alone for cN1 PCa. Only radical prostatectomy (RP) and radiation therapy (RT) were considered as definitive LT.Intervention
LT ± ADT versus ADT alone.Outcome measurements and statistical analysis
Instrumental variable analyses (IVA) were performed using a two-stage residual inclusion approach to compare overall mortality (OM)-free survival between patients who received LT ± ADT versus ADT alone. The same methodology was used to further compare OM-free survival between patients who received RP ± ADT versus RT ± ADT.Results and limitations
Overall, 1987 (67%) and 980 (33%) patients received LT ± ADT and ADT alone, respectively. In the LT ± ADT group, 751 (37.8%) and 1236 (62.2%) patients received RP ± ADT and RT ± ADT, respectively. In IVA, LT ± ADT was associated with a significant OM-free survival benefit (hazard ratio = 0.31, 95% confidence interval [CI] = 0.13–0.74, p = 0.007), when compared with ADT alone. At 5 yr, OM-free survival was 78.8% (95% CI: 74.1–83.9%) versus 49.2% (95% CI: 33.9–71.4%) in the LT ± ADT versus ADT alone groups. When comparing RP ± ADT versus RT ± ADT, IVA showed no significant difference in OM-free survival between the two treatment modalities (hazard ratio = 0.54, 95% CI = 0.19–1.52, p = 0.2). Despite the use of an IVA, our study may be limited by residual unmeasured confounding.Conclusions
Our findings show that PCa patients with clinically pelvic lymph node-positive disease may benefit from any form of LT ± ADT over ADT alone. While not necessarily curative by itself, the use of RP or RT could be the first step in a multi-modality approach aiming at providing the best cancer control outcomes for these individuals.Patients summary
We examined the role of local treatment for clinically pelvic lymph node-positive prostate cancer. We found that the delivery of radical prostatectomy or radiation therapy may be associated with an overall mortality-free survival benefit compared with androgen deprivation therapy alone. 相似文献5.
K.A. Gautam A.N. Singh A.N. Srivastav S.N. Sankhwar 《The African Journal of Urology》2018,24(2):98-103
Introduction
Prostate carcinoma is still a dreaded disease wanting more effective treatment and definitive early detection for a better prognosis and cure of life.Objective
The present study was planned to investigate the correlation of vascular endothelial growth factor (VEGF) expression level and microvessel density (MVD) between the BPH and prostate cancer subjects to analyze their diagnostic and prognostic value.Subjects and methods
Freshly diagnosed histopathologically confirmed 50 cases of prostate cancer and 50 cases of BPH were included. Expression level of VEGF was measured using Immunohistochemistry (IHC), while MVD was determined via CD34 endothelium-specific antibodies. In the case group, we have also recorded the Gleason's score of prostate cancer and investigated its correlation with angiogenic factor VEGF and MVD CD34.Results
The study showed a statistically significant difference value of VEGF expression level between the prostate cancer and BPH group (p < 0.001). The mean MVD CD34 in the prostate cancer and BPH groups were 29.66 ± 0.21 and 9.96 ± 0.25, respectively. The difference of MVD CD34 expression between the groups was also found significant (p < 0.001). VEGF scoring was significantly correlated with Gleason's scores of prostate cancer (p = 0.005).Conclusions
The present findings may support the assumption that VEGF and CD34 expression level might have an important role in the prediction of prostate cancer as it was significantly differed with BPH. In addition, VEGF expression level showed intense staining in the tissue samples with higher grading of prostate cancer which reveals its importance as prognostic marker. 相似文献6.
Grace C. Kunas William Probasco Amgad M. Haleem Jayme C. Burket Emilie R.C. Williamson Scott J. Ellis 《Foot and Ankle Surgery》2018,24(6):495-500
Background
The aim of this study was to assess the inferior talus-superior talus (inf-tal-sup-tal) angle (previously proven reliable in multiplanar-weight bearing imaging (MP-WB)) on both computed tomography (CT) and MP-WB scans. We sought to compare the angle between the two modalities in both AAFD and control groups, as well as to compare the groups to each other.Methods
Inf-tal-sup-tal angles were compared between a stage II AAFD group (n = 38) with routine MP-WB and CT scans and a control group (n = 20) with preoperative CT scans for lisfranc injuries and normal hindfoot alignment after healing.Results
The CT inf-tal-sup-tal angle was significantly greater in AAFD compared to control (AAFD, 12 ± 6; control, 5 ± 4; p < 0.001), but was even greater with MP-WB. There was no significant correlation between inf-tal-sup-tal angles on MP-WB and CT (Pearson’s = 0.29, p = 0.08).Conclusions
MP-WB imaging proved to be correlated more strongly with AAFD than CT by revealing greater hindfoot valgus. This confirmed that CT scans are useful in predicting AAFD, but cannot be used as a surrogate for MP-WB scans. 相似文献7.
Pierre Gazeau Divi Cornec Marie Agnes Timsit Maxime Dougados Alain Saraux 《Joint, bone, spine : revue du rhumatisme》2018,85(1):85-91
Objective
To assess agreement among methods for classifying patients with inflammatory back pain (IBP) after a 2-year follow-up.Methods
Patients with IBP in the French nationwide, longitudinal, prospective cohort DESIR were classified after 2 years based on imaging findings, rheumatologist's confidence in a diagnosis of spondyloarthritis, three classification criteria sets (axial Assessment of Spondyloarthritis international Society [ASAS], European Spondylarthropathy Study Group [ESSG], and Amor) and treatment (TNFα antagonists). Agreement among these methods was assessed by computing the percentage of concordant classifications and Cohen's kappa coefficient. Using logistic regression, we identified the items most strongly associated with rheumatologist's confidence.Results
Agreement among criteria sets was poor (kappa < 0.6), even in the group with inflammation by magnetic resonance imaging. Of 708 patients, 541 had all available data including rheumatologist's confidence after 2 years, which was 0/10 for 31 (5.7%) patients, 1/10 to 7/10 for 158 (29.2%) patients, 8/10 or 9/10 for 167 (30.9%) patients, and 10/10 for 185 (34.2%) patients. TNFα antagonists were used in 156/356 (43.8%) patients in the two highest confidence groups versus 53/188 (28.2%) patients in the two lowest confidence groups. Factors independently associated with confidence ≥ 8/10 were fulfilment of ASAS, ESSG, and Amor criteria.Conclusion
Confidence of rheumatologists in the diagnosis of spondyloarthritis in patients with recent-onset IBP shows limited agreement with classification criteria. The best way to currently classify spondyloarthritis should be the association of both at least one classification criteria and a diagnosis of spondyloarthritis according to the rheumatologist. 相似文献8.
Rosana C. Gomes Elaine C.O. Guirro Adriana C. Gonçalves Jayme A. Farina Junior Luiz O. Murta Junior Rinaldo R.J. Guirro 《Burns : journal of the International Society for Burn Injuries》2018,44(3):636-645
Introduction
Severe burns benefit from skin grafting, and grafting surgery is of great importance in the treatment of these injuries. As a result, there is formation of an additional wound at the donor site, which is painful and susceptible to infection. However, the therapeutic approach to these problems at donor sites for skin grafting is insufficiently explored in the literature.Aim
To evaluate electrical stimulation of the donor sites of burn patients treated by grafting surgery.Methods
This work evaluated 30 donor sites of cutaneous graft burn patients treated with high-voltage electrical stimulation. Subjects were randomized into two groups: electrical stimulation (GES), treated with electrostimulation (50 min, 100 Hz, twin pulses 15 us, monophasic), and the sham group (GS), treated by the same procedures but without current. Pain was assessed by visual analog scale daily before and after the electrical stimulation. The time elapsed until complete epithelization was evaluated (time of primary dressing detached spontaneously). Skin temperature was measured by thermography. The characteristics of donor sites were qualitatively evaluated using images and the plug-in CaPAS® (Carotid Plaque Analysis Software).Results
The results showed a significant decrease in pain, which was absent on the third day in the GES and the sixth day in the GS. The time the primary dressing detached spontaneously in days decreased (p < 0.05) (4.7 ± 0.2) compared to the GS group (7.0 ± 1.3). Donor site healing characteristics such as vascularization, pigmentation, height, the quantity of crust formed, irregularities, and the quality of healing was better in the GES; moreover, homogeneity and inertia of the images confirmed higher healing quality.Conclusion
As a result of the study, the technology shows promise and merits a larger study with objective assessments and different physical variables. 相似文献9.
Background
This study compared outcomes after treatment of acute Achilles tendon (AT) rupture via percutaneous suturing, with those after chronic AT rupture treated via open reconstruction.Methods
This retrospective study included 30 patients who underwent either percutaneous suturing for acute AT rupture (group AR, n = 16) or open reconstruction for chronic AT rupture (group CR, n = 14). Function was evaluated by calf muscle circumference, and endurance through isokinetic measurement and single-leg heel-rise test. Score evaluation included AT Total Rupture Score, Victorian Institute of Sports Assessment-Achilles questionnaire, and visual analogue scale pain score. Postoperative tendon thickness was measured using ultrasonography and MRI.Results
Follow-up was conducted 4.97 ± 1.79 years postoperatively. The groups were similar in age and body mass index. There was no significant difference between groups in calf circumference, isokinetic measurement, heel-rise test, and score evaluation. There was significantly less mediolateral tendon thickening in group AR compared with group CR on ultrasonography (p = 0.01) and MRI (p = 0.001).Conclusions
Open reconstruction for chronic AT rupture may result in comparable clinical and functional outcomes, but a thicker tendon compared with percutaneous suturing after acute AT rupture. 相似文献10.
Introduction
Incidence of lower ureteric injuries has increased due to proliferation of complex pelvic laparoscopic and ureteroscopic procedures.Objective
To describe our experience of laparoscopic ureteric reimplantation for lower ureteric strictures and ureterovaginal fistulas due to different aetiologies.Patients and methods
A total of 42 patients underwent laparoscopic ureteric reimplantation from January 2007 to December 2013 after preoperative evaluation by intravenous urography or CT urogram to delineate the site and length of stricture or ureterovaginal fistula. All the patients were followed up with ultrasonography and micturating cystourethrogram at 3 months. Out of the total 42 patients, 22 patients (group 1) underwent laparoscopic ureteric reimplant for lower ureteric stricture and 20 patients (group 2) underwent laparoscopic ureteric reimplant for ureterovaginal fistula.Results
There were 5 male and 37 female patients. The mean patient age was 43.5 ± 12 (range 24–62 yrs), mean operating time was 129 ± 11 (range 110–160) minutes, mean hospital stay was 2.8 (range 2–6) days and mean follow up period of 16 months (range 6–70). Two procedures had to be converted to open (one each in both groups). There were no major (Clavien grade III and above) intra-operative or post-operative complications. One of the failures in lower ureteric stricture group was managed by open reconstruction with boari flap.Conclusion
Laparoscopic ureteric reimplantation is an excellent modality for both lower ureteric strictures and ureterovaginal fistulas with long term good outcomes in addition to the advantage of lesser hospital stay and lesser comorbidities. 相似文献11.
Background
Soft tissue release for hallux valgus correction is traditionally performed through a dorsal first web space incision. We performed a single surgeon series review of hallux valgus correction with Scarf ± Akin osteotomy and lateral release using a single medial incision.Methods
192 feet were included. Patient satisfaction survey was conducted at the time of study. Pre-operative and final post-operative radiographic data obtained.Results
All radiological parameters had statistically significant improvement [p < 0.05 for each variable]. Response rate was 71% (completely satisfied 69%, satisfied with minor reservation 14%, satisfied with major reservation 11%, dissatisfied 6%). There was no correlation of any preoperative or postoperative radiographic measure with satisfaction grade. No patient required revision procedure.Conclusions
Single medial incision surgery for hallux valgus correction is a simple, safe and effective technique with very high satisfaction. The results are comparable to traditional two-incision surgery. 相似文献12.
Overview of literature
Elderly patients sustaining a trivial fall may develop vertebral compression fractures if they are predisposed to any factor that leads to decreased bone mineral density. Such patients suffer with severe pain and disability during the early healing stages. Percutaneous Vertebroplasty is mainly done to provide immediate pain relief and also believed to offer stability to the compressed vertebra by preventing further collapse.Methods
Selected patients [n = 20; Age = 57.9 ± 7.9 years] with osteoporotic vertebral compression fracture of a single dorsolumbar vertebra were treated with percutaneous vertebroplasty after 2–3 weeks of conservative trail. Their Pain score was noted using numeric rating scale (NRS) before and after the procedure. Functional outcomes were analysed using Roland Morris Disability Questionnaire (RMDQ) score.Results
NRS pain score before procedure was 8.3 ± 0.6. RMDQ score before procedure was 21.6 ± 0.5. Third post procedural day NRS pain score was 4.7 ± 1.2 (p < 0.0001), denoting significant decrease in pain. Functional outcome analysis using RMDQ score showed an average of 87 ± 6.1 percent improvement (p < 0.0001), by 6 weeks following procedure. Considering pre-injury status all patients were in their best possible functional state by 6 weeks.Conclusions
Percutaneous Vertebroplasty serves its purpose adequately and economically. Under controlled circumstances, it offers immediate pain relief and stability, leading to early recovery in selective patients. Yet, underlying poor bone mineral density status needs to be treated.Study design
Observational Case Series (Level 4). 相似文献13.
Lin Li Xiao-lei Wu Le Xu 《Burns : journal of the International Society for Burn Injuries》2018,44(8):2064-2073
Objective
This study aimed to evaluate self-perceived participation and autonomy in patients with burns in Fujian, China, and to identify key factors influencing these parameters.Methods
We investigated 212 patients admitted to the burns unit 1 and 3 months after discharge using the Impact on Participation and Autonomy (IPA), Acceptance of Disability Scale-Revised, Herth Hope Index, Modified Barthel Index Rating Scale, Visual Analogue Scale, and a self-designed demographic data and disease condition questionnaires. Influencing factors were identified using multivariable linear regression.Results
The general IPA questionnaire scores were 2.13 ± 0.74 and 2.03 ± 0.72 at 1 and 3 months post-discharge, respectively. Acceptance of disability, hope, and social participation were significantly correlated (P < 0.01). Financial situation, pain level, activities of daily living, acceptance of disability, and hope were major factors affecting self-perceived participation and autonomy 3 months post-discharge, accounting for a variance of 77.5%.Conclusion
Medium-to-low levels of self-perceived participation and autonomy were observed 1 and 3 months post-discharge. Clinicians should adopt specific measures to help patients (including those from poor economic backgrounds) successfully reintegrate into their families/societies. These include alleviating their pain, encouraging participation in daily activities while accepting their disabilities, and offering hope. 相似文献14.
D.E. Orakwe K.H. Tijani E.A. Jeje M.A. Ogunjimi R.W. Ojewola 《The African Journal of Urology》2017,23(2):105-108
Objectives
To compare serum testosterone and prostate specific antigen (PSA) levels of patients diagnosed of prostate cancer to those with benign prostatic hyperplasia (BPH).Subjects and methods
One hundred and thirteen male patients with or without LUTS who had indication(s) for prostate biopsies were recruited. Blood samples were analysed for serum testosterone and serum PSA. Prostate sizes were measured and PSA densities calculated before trans-rectal prostate biopsies were performed.Results
On histology of prostate biopsy specimens, 54 patients (47.8%) had prostate adenocarcinoma while 59 patients (52.2%) had BPH. Serum testosterone levels were lower in the prostate cancer group (23.09 ± 2.31 nmol/L versus 24.37 ± 1.94 nmol/L in the BPH group) but this difference was not statistically significant (p = 0.671). Serum testosterone also did not differ significantly with Gleason grade and Gleason score in patients with prostate cancer.Serum PSA and PSA density (PSAD) values were significantly higher in men with prostate cancer, and also in prostate cancer patients with high grade disease.Conclusion
Serum testosterone levels of patients with prostate cancer did not significantly differ from those of patients with BPH and were not related to grade in prostate cancer patients. 相似文献15.
Brent K. Hollenbeck Samuel R. Kaufman Phyllis Yan Lindsey A. Herrel Tudor Borza Florian R. Schroeck Bruce L. Jacobs Ted A. Skolarus Vahakn B. Shahinian 《European urology》2018,73(4):491-498
Background
Prostate cancer treatment is a significant source of morbidity and spending. Some men with prostate cancer, particularly those with significant health problems, are unlikely to benefit from treatment.Objective
To assess relationships between financial incentives associated with urologist ownership of radiation facilities and treatment for prostate cancer.Design, setting, and participants
A retrospective cohort of Medicare beneficiaries with prostate cancer diagnosed between 2010 and 2012. Patients were further classified by their risk of dying from noncancer causes in the 10 yr following their cancer diagnosis by using a mortality model derived from comparable patients known to be cancer-free.Intervention
Urologists were categorized by their practice affiliation (single-specialty groups by size, multispecialty group) and ownership of a radiation facility.Outcome measurements and analysis
Use of intensity-modulated radiation therapy (IMRT) and use of any treatment within 1 yr of diagnosis. Generalized estimating equations were used to adjust for patient differences.Results
Among men with newly diagnosed prostate cancer, use of IMRT ranged from 24% in multispecialty groups to 37% in large urology groups (p < 0.001). Patients managed in groups with IMRT ownership (n = 5133) were more likely to receive IMRT than those managed by single-specialty groups without ownership (43% vs 30%, p < 0.001), regardless of group size. Among patients with a very high risk (> 75%) of noncancer mortality within 10 yr of diagnosis, both IMRT use (42% vs 26%, p < 0.001) and overall treatment (53% vs 44%, p < 0.001) were more likely in groups with ownership than in those without, respectively.Conclusions
Urologists practicing in single-specialty groups with an ownership interest in radiation therapy are more likely to treat men with prostate cancer, including those with a high risk of noncancer mortality.Patient summary
We assessed treatment for prostate cancer among urologists with varying levels of financial incentives favoring intervention. Those with stronger incentives, as determined by ownership interest in a radiation facility, were more likely to treat prostate cancer, even when treatment was unlikely to provide a survival benefit to the patient. 相似文献16.
Farrukh Aslam Khalid Usman Khalid Farooq Muhammad Saleem Jibran Rabbani Muhammad Amin Kamal Uddin Khan Younas Mehrose Moazzam N. Tarar 《Burns : journal of the International Society for Burn Injuries》2018,44(6):1489-1495
Background
The ear is the common site for keloid formation especially in women after ear piercing. Surgery is the main stay of treatment in these lesions but there are large numbers of treatment failures in surgery alone.Objective
The objective of this study was to compare the efficacy of post-excision intralesional 5-fluorouracil/triamcinolone acetonide (5-FU/TAC) and post-excision radiotherapy in the treatment of ear keloids.Study design
A randomized controlled trial.Setting
The study was conducted from May 2014 to January 2015 at Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, Lahore.Subject & methodology
After approval from the hospital ethical committee, 60 patients presented in the outpatient department fulfilling the inclusion criteria were selected and randomly assigned in two groups with the help of the random number table. Patients in group A had excision followed by intralesional 5-FU/TAC injections while patients of group B had excision followed by radiotherapy.Patients were assessed at 6 months after completion of treatment for efficacy (no recurrence within 6 months of treatment).Results
In our study total of 60 patients completed the study, with 30 patients in each group. 7 patients (23.34%) in Group-A and 9 patients (30%) in Group-B were males while 23 patients (76.67%) in Group-A and 21 patients (70%) in Group-B were females i.e. male to female ratio is 1:2.75. Mean age was 31.8 + 6.48 years. The comparison of frequency of efficacy in both groups showed that 73.33% (n = 22) in Group-A and 43.33% (n = 13) in Group-B had efficacy, p value was calculated as 0.01, showing a significant statistical difference.Conclusion
Excision and intralesional 5-FU/TAC is an effective treatment for keloids on the ears. 相似文献17.
Zhangqun Ye Guohua Zeng Huan Yang Kun Tang Xiaochun Zhang Hong Li Weibing Li Zhong Wu Lingwu Chen Xingfa Chen Xiankui Liu Yaoliang Deng Tiejun Pan Jinchun Xing Shusheng Wang Yue Cheng Xiaojian Gu Wenxi Gao Hua Xu 《European urology》2018,73(3):385-391
Background
Recent large high-quality trials have questioned the clinical effectiveness of medical expulsive therapy using tamsulosin for ureteral stones.Objective
To evaluate the efficacy and safety of tamsulosin for distal ureteral stones compared with placebo.Design, setting, and participants
We conducted a double-blind, placebo-controlled study of 3296 patients with distal ureteral stones, across 30 centers, to evaluate the efficacy and safety of tamsulosin.Intervention
Participants were randomly assigned (1:1) into tamsulosin (0.4 mg) or placebo groups for 4 wk.Outcome measurements and statistical analysis
The primary end point of analysis was the overall stone expulsion rate, defined as stone expulsion, confirmed by negative findings on computed tomography, over a 28-d surveillance period. Secondary end points included time to stone expulsion, use of analgesics, and incidence of adverse events.Results and limitations
Among 3450 patients randomized between September 1, 2011, and August 31, 2013, 3296 (96%) were included in the primary analysis. Tamsulosin benefits from a higher stone expulsion rate than the placebo (86% vs 79%; p < 0.001) for distal ureteral stones. Subgroup analysis identified a specific benefit of tamsulosin for the treatment of large distal ureteral stones (>5 mm). Considering the secondary end points, tamsulosin-treated patients reported a shorter time to expulsion (p < 0.001), required lower use of analgesics compared with placebo (p < 0.001), and significantly relieved renal colic (p < 0.001). No differences in the incidence of adverse events were identified between the two groups.Conclusions
Our data suggest that tamsulosin use benefits distal ureteral stones in facilitating stone passage and relieving renal colic. Subgroup analyses find that tamsulosin provides a superior expulsion rate for stones >5 mm, but no effect for stones ≤5 mm.Patient summary
In this report, we looked at the efficacy and safety of tamsulosin for the treatment of distal ureteral stones. We find that tamsulosin significantly facilitates the passage of distal ureteral stones and relieves renal colic. 相似文献18.
Objective
Flexible cystoscopy (FC) has become a frequently applied outpatient prosedure. Dysuria with an incidence of 30–54% is the main complaint of patients. As our hypothesis was, lower pain scores during and after cystoscopy would be achieved with bupivacaine application we aimed to compare the analgesic efficacy of intraurethral bupivacaine and lidocaine.Subjects and methods
Files of 90 patients who underwent FC in our clinic, between August 2015 and November 2015 were retrospectively scanned. Patients were evaluated in 2 groups according to the local anesthetic they were applied intraurethrally. The first group consisted of 45 patients who received 10 mL of %2 lidocaine gel; the second group consisted of 45 patients who received 10 mL of 0.5% bupivacaine. A numerical visual analog scale (VAS) from 0 to 10 was used to assess pain scores during and after the procedure.Results
During the procedure the mean VAS was 4.09 (±1.95) in the %2 lidocaine group and 4.3 (±1.58) in the 0.5% bupivacaine group (p = .5). Therefore, during the first micturition after the procedure the mean VAS was 3.4 (±1.86) in the %2 lidocaine group and 2.09 (±1.19) in the 0.5% bupivacaine group (<0.001).Conclusions
With the reason that dyuria is the most annoying complication for the patients undergoing FC, it is worth trying to overcome this issue. By providing significantly decreased levels of dysuria, 0.5% bupivacaine was superior to %2 lidocaine gel for local analgesia especially during first micturiation after out-patient FC in males patients. 相似文献19.
S. Gandolfi R. Carloni N. Bertheuil J.L. Grolleau I. Auquit-Auckbur B. Chaput 《Burns : journal of the International Society for Burn Injuries》2018,44(6):1602-1609
Introduction
Burns to the cephalic extremities are particularly implicated in problems of self-image and alterations to personal social relations. The aim of this study was to objectively assess the quality-of-life (QoL) of patients suffering from face-and-neck burns through our newly created scale: The Burn-Specific Health Scale for Face and Neck (BSHS-FN).Methods
After constructing the BSHS-FN, we compared QoL of patients with or without face-and-neck burns. SF-36, the French version of the BSHS-B (Burn Specific Health Scale-Brief), and the BSHS-FN were administrated to 53 patients divided into two groups: GB group (general burns, 26 patients) and FN group (face-neck burns, 27 patients).Results
QoL evaluated using the SF-36 had a higher average total score in GB patients compared to FN patients, but there were no significant difference between the two groups (54.3 ± 18.5 vs. 47.0 ± 17.3, respectively, p = 0.11). In contrast, in BSHS-B the total score was significantly different between the two groups with a higher score recorded for the GB group (71.9 ± 13.4 [median: 72.8] in the GB group vs. 62.2 ± 14.4 [median: 64.4] in the FN group). In percentage terms, total score of BSHS-FN for GB group was 79.1 ± 10.1, while total score for FN group was 53.6 ± 13.1 (p < 0.001), with the highest score for the Face and Neck domain in GB group (99.7 ± 1.1, p < 0.001)Conclusion
The BSHS-FN seemed to be more appropriate to assess QoL for FN burn patients. This study supports its application in routine clinical practice and in international studies. 相似文献20.
Sophie Maria Pierrette Nieuwendijk Iris Johanne de Korte Mereille Marren Pursad Monique van Dijk Heinz Rode 《Burns : journal of the International Society for Burn Injuries》2018,44(5):1151-1158