In-Patient Treatment of Chronic Varicose Venous Ulcers. A Randomized Trial of Cadexomer Iodine versus Standard Dressings

1988 ◽  
Vol 16 (6) ◽  
pp. 428-435 ◽  
Author(s):  
H. Laudanska ◽  
B. Gustavson
Keyword(s):  
Randomized Trial ◽  
Rural Area ◽  
Thyroid Function ◽  
Bed Rest ◽  
Economic Conditions ◽  
Patient Treatment ◽  
Serum Concentrations ◽  
Treatment Resistant ◽  
Venous Ulcers ◽  
The Mean

A total of 67 patients with treatment resistant chronic venous ulcers were admitted to hospital for 6 weeks of bed rest and daily dressings. The patients came from a rural area in Poland with poor socio-economic conditions. They were randomized to treatment with either standard dressings or with cadexomer iodine. After 6 weeks all but four patients had shown a clear reduction of ulcer area; the mean reduction was 54% within the former group and 71% with cadexomer iodine. The latter treatment was significantly more effective than the standard hospital dressings in debriding the ulcer, accelerating healing and reducing pain. Elevation of serum concentrations of protein-bound iodine occurred after treatment with cadexomer iodine in patients with large ulcers, but tests of thyroid function showed no changes associated with the use of cadexomer iodine. It is concluded that cadexomer iodine significantly accelerates the healing of chronic, infected, treatment-resistant, venous ulcers in hospitalized patients.

scholarly journals Efficacy and safety of radiofrequency ablation for benign thyroid nodules in patients with previous thyroid lobectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lin Yan ◽  
Mingbo Zhang ◽  
Fang Xie ◽  
Jun Ma ◽  
Jing Xiao ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Symptom Score ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Efficacy And Safety ◽  
Thyroid Lobectomy ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy. Methods From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22–74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40–69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated. Results During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA. Conclusions As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.

scholarly journals Plasma mineral (selenium, zinc or copper) concentrations in the general pregnant population, adjusted for supplement intake, in relation to thyroid function

2020 ◽  
Vol 125 (1) ◽  
pp. 71-78
Author(s):  
Victor Pop ◽  
Johannes Krabbe ◽  
Wolfgang Maret ◽  
Margaret Rayman
Keyword(s):  
Thyroid Function ◽  
Reference Range ◽  
First Trimester ◽  
Future Research ◽  
Thyroid Peroxidase ◽  
Reference Ranges ◽  
Lower Plasma ◽  
The Mean ◽  
The Impact ◽  
Supplement Intake

AbstractThe present study reports on first-trimester reference ranges of plasma mineral Se/Zn/Cu concentration in relation to free thyroxine (FT4), thyrotropin (TSH) and thyroid peroxidase antibodies (TPO-Ab), assessed at 12 weeks’ gestation in 2041 pregnant women, including 544 women not taking supplements containing Se/Zn/Cu. The reference range (2·5th–97·5th percentiles) in these 544 women was 0·72–1·25 µmol/l for Se, 17·15–35·98 µmol/l for Cu and 9·57–16·41 µmol/l for Zn. These women had significantly lower mean plasma Se concentration (0·94 (sd 0·12) µmol/l) than those (n 1479) taking Se/Zn/Cu supplements (1·03 (sd 0·14) µmol/l; P < 0·001), while the mean Cu (26·25 µmol/l) and Zn (12·55 µmol/l) concentrations were almost identical in these sub-groups. Women with hypothyroxinaemia (FT4 below reference range with normal TSH) had significantly lower plasma Zn concentrations than euthyroid women. After adjusting for covariates including supplement intake, plasma Se (negatively), Zn and Cu (positively) concentrations were significantly related to logFT4; Se and Cu (but not Zn) were positively and significantly related to logTSH. Women taking additional Se/Zn/Cu supplements were 1·46 (95 % CI 1·09, 2·04) times less likely to have elevated titres of TPO-Ab at 12 weeks of gestation. We conclude that first-trimester Se reference ranges are influenced by Se-supplement intake, while Cu and Zn ranges are not. Plasma mineral Se/Zn/Cu concentrations are associated with thyroid FT4 and TSH concentrations. Se/Zn/Cu supplement intake affects TPO-Ab status. Future research should focus on the impact of trace mineral status during gestation on thyroid function.

Management of intended durotomy in minimally invasive intradural spine surgery

2014 ◽  
Vol 21 (2) ◽  
pp. 279-285 ◽  
Author(s):  
Lee A. Tan ◽  
Ippei Takagi ◽  
David Straus ◽  
John E. O'Toole
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Length Of Hospital Stay ◽  
Bed Rest ◽  
Tubular Retractor ◽  
Specific Patient ◽  
Dural Closure ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Operative Notes

Object Minimally invasive surgery (MIS) has been increasingly used for the treatment of various intradural spinal pathologies in recent years. Although MIS techniques allow for successful treatment of intradural pathology, primary dural closure in MIS can be technically challenging due to a limited surgical corridor through the tubular retractor system. The authors describe their experience with 23 consecutive patients from a single institution who underwent MIS for intradural pathologies, along with a review of pertinent literature. Methods A retrospective review of a prospectively collected surgical database was performed to identify patients who underwent MIS for intradural spinal pathologies between November 2006 and July 2013. Patient demographics, preoperative records, operative notes, and postoperative records were reviewed. Primary outcomes include operative duration, estimated blood loss, length of bed rest, length of hospital stay, and postoperative complications, which were recorded prospectively. Results Twenty-three patients who had undergone MIS for intradural spinal pathologies during the study period were identified. Fifteen patients (65.2%) were female and 8 (34.8%) were male. The mean age at surgery was 54.4 years (range 30–74 years). Surgical pathologies included neoplastic (17 patients), congenital (3 patients), vascular (2 patients), and degenerative (1 patient). The most common spinal region treated was lumbar (11 patients), followed by thoracic (9 patients), cervical (2 patients), and sacral (1 patient). The mean operative time was 161.1 minutes, and the mean estimated blood loss was 107.2 ml. All patients were allowed full activity less than 24 hours after surgery. The median length of stay was 78.2 hours. Primary sutured dural closure was achieved using specialized MIS instruments with adjuvant fibrin sealant in all cases. The rate of postoperative headache, nausea, vomiting, and diplopia was 0%. No case of cutaneous CSF fistula or symptomatic pseudomeningocele was identified at follow-up, and no patient required revision surgery. Conclusions Primary dural closure with early mobilization is an effective strategy with excellent clinical outcomes in the use of MIS techniques for intradural spinal pathology. Prolonged bed rest after successful primary dural closure appears unnecessary, and the need for watertight dural closure should not prevent the use of MIS techniques in this specific patient population.

Abstract 3016: Spirituality and Medication Adherence in Older African American Adults Diagnosed with Hypertension: A Qualitative Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Lisa M Lewis
Keyword(s):  
African American ◽  
Medication Adherence ◽  
Qualitative Study ◽  
Antihypertensive Medication ◽  
Demographic Data ◽  
Patient Treatment ◽  
List Type ◽  
Medication Regimen ◽  
Antihypertensive Medications ◽  
The Mean

Background : Medication adherence (ADH) is key to decreasing hypertension (HTN)-related morbidity and mortality in older African-American (AA) adults. However, older AA adults have poorer ADH to prescribed antihypertensive medications when compared to their younger and Caucasian-American counterparts. Patient beliefs and cultural concepts about their medications influence their medication ADH. An important cultural concept in this regards is spirituality, which is a significant resource in the AA community. Thus, the purpose of this qualitative study was to explore the role of spirituality in ADH to antihypertensive medications for older AA adults. Methods: Older AA adults who were members of a Program of All Inclusive Care for the Elderly (PACE) and who were (a) diagnosed with HTN; (b) prescribed at least one antihypertensive medication; (c) self-identified as African-American or Black; and (d) self-identified as spiritual completed one in-depth individual face-to-face in this qualitative descriptive study informed by grounded theory. Demographic data were also collected. Results : Twenty-one PACE members completed the study. All of the participants were female. The mean age of participants was 73 years with most completing high school (67%). The mean HTN diagnosis was16.7 years and mean number of prescriptions for antihypertensives was 3.3. Participants indicated that their spirituality was used in a collaborative process with formal health care to manage their ADH to antihypertensive medications. This process was identified as Partnering with God to Manage My Medications. Partnering with God to Manage My Medications indicated that the PACE members acknowledged personal responsibility for adhering to their antihypertensive medication regimen but used their spirituality as a resource for making decisions to remain adherent; coping with medication side effects; and increasing their self-efficacy to deal with barriers to ADH . Conclusions : Spirituality played a positive role in medication adherence for the PACE members. Incorporating individual beliefs, such as spirituality, into patient treatment for HTN may capitalize on their inner resources for medication ADH and demonstrates culturally appropriate care.

scholarly journals Eosinophilic Esophagitis in Brazilian Pediatric Patients

2013 ◽  
Vol 7 ◽  
pp. CMPed.S12733 ◽  
Author(s):  
Mayra Isabel Correia Pinheiro ◽  
Luciano Pamplona De Góes Cavalcanti ◽  
Rodrigo Schuler Honório ◽  
Luïs Hélder De Alencar Moreno ◽  
Mayara Carvalho Fortes ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Topical Corticosteroid ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients ◽  
Erosive Esophagitis ◽  
Normal Mucosa ◽  
Patient Treatment ◽  
Therapeutic Approaches ◽  
Endoscopic Findings ◽  
The Mean

We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils.

scholarly journals Comparing cluster-level dynamic treatment regimens using sequential, multiple assignment, randomized trials: Regression estimation and sample size considerations

2017 ◽  
Vol 26 (4) ◽  
pp. 1572-1589 ◽  
Author(s):  
Timothy NeCamp ◽  
Amy Kilbourne ◽  
Daniel Almirall
Keyword(s):  
Randomized Trial ◽  
Randomized Trials ◽  
Treatment Regimens ◽  
Patient Level ◽  
Multiple Assignment ◽  
Dynamic Treatment ◽  
The Mean ◽  
Cluster Randomized ◽  
The Individual ◽  
Cluster Level

Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens. In a cluster-randomized sequential multiple assignment randomized trial, sequential randomizations occur at the cluster level and outcomes are observed at the individual level. This manuscript makes two contributions to the design and analysis of cluster-randomized sequential multiple assignment randomized trials. First, a weighted least squares regression approach is proposed for comparing the mean of a patient-level outcome between the cluster-level dynamic treatment regimens embedded in a sequential multiple assignment randomized trial. The regression approach facilitates the use of baseline covariates which is often critical in the analysis of cluster-level trials. Second, sample size calculators are derived for two common cluster-randomized sequential multiple assignment randomized trial designs for use when the primary aim is a between-dynamic treatment regimen comparison of the mean of a continuous patient-level outcome. The methods are motivated by the Adaptive Implementation of Effective Programs Trial which is, to our knowledge, the first-ever cluster-randomized sequential multiple assignment randomized trial in psychiatry.

scholarly journals Systolic blood pressure of dogs at hospital and domestic environment

2012 ◽  
Vol 42 (7) ◽  
pp. 1242-1248
Author(s):  
Frederico Aécio Carvalho Soares ◽  
Elisa Barp Neuwald ◽  
Verônica Santos Mombach ◽  
Ana Elize Ribeiro D'Avila ◽  
Francisco de Oliveira Conrado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Doppler Ultrasonography ◽  
Serum Cortisol ◽  
Serum Concentrations ◽  
Pathological Conditions ◽  
Healthy Dogs ◽  
The Mean ◽  
Veterinary Hospital ◽  
At Home

The measurement of blood pressure (BP) is an important assessment of the cardiovascular system, being influenced by physical and pathological conditions. Certain situations of stress and anxiety during BP measurement can lead to elevated values in small animals, known in medicine as "white coat effect". The aim of this research was to compare systolic blood pressure (SBP) measurement using Doppler ultrasonography in 45 adult healthy dogs in two environments, at a veterinary hospital and at home. Comparison of heart rate, serum concentrations of cortisol and glucose intended to help the evaluation of the stress level of the animals. The mean of SBP at the veterinary hospital was 154.7mmHg and it was significantly (P<0.01) higher than at home (136.3mmHg). It was also observed that HR (mean=122.7bpm), and serum cortisol (median=4.5µg dL-1) and glucose (mean=95.9mg dL-1) concentrations were significantly higher (P<0.01) at the hospital, when compared with values obtained at home (109.6bpm; 1.5µg dL-1 and 85.5mg dL-1, respectively). In conclusion, the environment can influence SBP in dogs, due to factors related to stress.

scholarly journals Effects of medetomidine and atipamezole on serum glucose and cortisol levels in captive reindeer (Rangifer tarandus tarandus)

Rangifer ◽  
1999 ◽  
Vol 19 (2) ◽  
pp. 85 ◽  
Author(s):  
Jon M. Arnemo ◽  
Birgit Ranheim
Keyword(s):  
Rangifer Tarandus ◽  
Fold Increase ◽  
Serum Glucose ◽  
Serum Concentrations ◽  
Seasonal Differences ◽  
Blood Concentrations ◽  
Rangifer Tarandus Tarandus ◽  
Adrenoceptor Agonists ◽  
The Mean ◽  
Baseline Levels

<p>Serum concentrations of glucose and Cortisol were measured in five adult captive reindeer (Rangifer tarandus tarandus) at 24 h and 10 min before, and at 0.5, 1,2,4, 8, 12 and 24 h after, treatment with 60 p.g/kg of medetomidine i.v. followed by 300 jig/kg of atipamezole i.v. 60 min later. The experiments were performed in January and repeated in July-August. The animals were used as their own controls and treated with saline in July-August. The wash-out period between experiments in summer was 2 weeks or more. No obvious seasonal differences were observed. Mederomidine induced a 2.5-fold increase in glucose (mean &plusmn; standard error of the mean being 15.4 &plusmn; 0.6 mmol/1 at 1 h) and a 3.5-fold increase Cortisol (349 &plusmn; 28 nmol/1 at 0.5 h). Serum glucose reached control levels within 12 h, and Cortisol declined to baseline levels within 4 h after injection og medetomidine. The use of blood concentrations of glucose and Cortisol to assess nutritonal status, body condition and stress may be significantly biased in animals chemically immobilized with medetomidine or other alpha-2 adrenoceptor agonists.</p>

scholarly journals Circulating concentrations of insulin like growth factor-1 in female dogs with spontane-ous mammary tumours

2018 ◽  
Vol 74 (1) ◽  
pp. 6054-2018
Author(s):  
MAREK SZCZUBIAŁ ◽  
ROMAN DABROWSKI ◽  
WOJCIECH ŁOPUSZYŃSKI ◽  
MARIOLA BOCHNIARZ ◽  
MAGDALENA KRAWCZYK ◽  
...  
Keyword(s):  
Mammary Gland ◽  
Cell Differentiation ◽  
Growth Factor ◽  
Healthy Controls ◽  
Serum Concentrations ◽  
Elisa Kit ◽  
Mammary Tumours ◽  
The Mean ◽  
Grade 3 ◽  
Mean Concentration

The aim of this study was the investigation of the circulating concentration of IGF-1 in female dogs with spontaneous mammary tumours. The study was performed on 34 female dogs undergoing surgery due to spontaneously occurring mammary gland tumours (24 malignant and 10 benign) and 10 clinically healthy fe-male dogs. The serum concentrations of IGF-1 were determined by specific ELISA Kit assay. The mean con-centrations of IGF-1 were significantly higher (P < 0.05) both in dogs with malignant (173.35 ± 120.45 ng/ml) and benign (130.58 ± 59.0 ng/ml) mammary tumours than in healthy controls (117.45±71.0 ng/ml). In the group of female dogs with mammary carcinomas, the mean concentration of IGF-1 gradually increased from 132.85 ± 65.64 ng/ml in dogs with grade 1 tumours to 317.74 ± 119.25 ng/ml in those with grade 3 tumours, and significant differences (P < 0.05) were found among dogs with various grade tumours. These findings suggest that circulating IGF-1 may play an important role in the pathogenesis of canine mammary tumour. Moreover, high IGF-1 levels may reflect tumour cell differentiation into a more aggressive phenotype. .

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