scholarly journals Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2161
Author(s):  
Jae Yun Sung ◽  
Ju Mi Kim ◽  
Jae Yul Hwang ◽  
Kyoung Nam Kim ◽  
Jae Young Kim ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Surgical Outcomes ◽  
Timing Of Surgery ◽  
Secondary Outcome ◽  
Control Group ◽  
Optimal Timing ◽  
Secondary Outcome Measure ◽  
Success Rates ◽  
Endoscopic Dacryocystorhinostomy ◽  
And Gender

Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery. Methods: A retrospective review of medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and an age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were the surgical outcomes at the final follow-up examination. The secondary outcome measure was the clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing the outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days). Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery, respectively. In the subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stays, and the duration of antibiotic treatments were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the two groups (p = 1.000). Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR performed within 3 days leads to faster recovery and shortens the course of antibiotic treatment.

Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

2021 ◽  
Author(s):  
Jae Yun Sung ◽  
Ju Mi Kim ◽  
Jae yul Hwang ◽  
Kyoung Nam Kim ◽  
Jae young Kim ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Surgical Outcomes ◽  
Length Of Hospital Stay ◽  
Timing Of Surgery ◽  
Secondary Outcome ◽  
Control Group ◽  
Optimal Timing ◽  
Secondary Outcome Measure ◽  
Success Rates ◽  
Endoscopic Dacryocystorhinostomy

Abstract Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery.Methods: A retrospective review of the medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were surgical outcomes at the final follow-up examination. The secondary outcome measure was clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days).Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery. In subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stay, and the duration of antibiotics treatment were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the 2 groups (p = 1.000)Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR, performed within 3 days, leads to faster recovery and shortens the course of antibiotic treatment.

scholarly journals Effects of a person-centred telephone support on fatigue in people with chronic heart failure: Subgroup analysis of a randomised controlled trial

2019 ◽  
Vol 19 (5) ◽  
pp. 393-400 ◽  
Author(s):  
Sara Wallström ◽  
Lilas Ali ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Andreas Fors
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Usual Care ◽  
Subgroup Analysis ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Telephone Support

Introduction: Fatigue is a prevalent symptom that is associated with various conditions. In patients with chronic heart failure (CHF), fatigue is one of the most commonly reported and distressing symptoms and it is associated with disease progression. Person-centred care (PCC) is a fruitful approach to increase the patient’s ability to handle their illness. Aim: The aim of this study was to evaluate the effects of PCC in the form of structured telephone support on self-reported fatigue in patients with CHF. Method: This study reports a subgroup analysis of a secondary outcome measure from the Care4Ourselves randomised intervention. Patients ( n=77) that were at least 50 years old who had been hospitalized due to worsening CHF received either usual care ( n=38) or usual care and PCC in the form of structured telephone support ( n=39). Participants in the intervention group created a health plan in partnership with a registered nurse. The plan was followed up and evaluated by telephone. Self-reported fatigue was assessed using the Multidimensional Fatigue Inventory 20 (MFI-20) at baseline and at 6 months. Linear regression was used to analyse the change in MFI-20 score between the groups. Results: The intervention group improved significantly from baseline to the 6-month follow-up compared with the control group regarding the ‘reduced motivation’ dimension of the MFI-20 (Δ -1.41 versus 0.38, p=0.046). Conclusion: PCC in the form of structured telephone support shows promise in supporting patients with CHF in their rehabilitation, improve health-related quality of life and reduce adverse events. Trial registration ISRCTN.com ISRCTN55562827

Clinical Effects of Sensor AR40E Intraocular Lenses in Cataract Patients with Prominent Myopia

2020 ◽  
Vol 12 (4) ◽  
pp. 461-466
Author(s):  
Wenying Wang ◽  
Zhixue Wang ◽  
Yu Liu ◽  
Yuanyuan Zou ◽  
Xiangning Ji ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Group Treatment ◽  
Outcome Measure ◽  
Acupuncture Group ◽  
Intraocular Lenses ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Clinical Effects

Cataracts are a complex group of eye disorders. Many studies suggest that blood circulation around the eyes, and a rise in intraocular pressure play important roles in glaucoma. Sensor AR40E artificial crystalline bodies can adjust intraocular pressure, improve activity in the optic nerve and increase blood flow to the eye fundus. BL1 can transport Yin and Yang. We designed a randomized, military blind, controlled clinical trial: Control group: (1) A Sensor only AR40E intraocular lens was applied to the skin of Qingming and retrobulbar acupoints on the rainy side, twice per week for 20 min every time, for two consecutive weeks; (2) acupuncture group: treatment was same as for the control group, but the eye was needled into Jingming and retrobulbar acupoints to achieve Qi; (3) Sensor AR40E intraocular lens group: treatment was the same as that for the acupuncture group, the main outcome measure was the change of intraocular pressure and the secondary outcome measure is the score change of WHOQOL ref (Taiwan version). Beneficial outcomes were realized in the right and left eye acupuncture groups and the Sensor AR40E intraocular lens group.

scholarly journals P585 Evaluation and comparison of the safety profiles of different intravenous iron preparations and oral iron for treatment of iron deficiency anaemia: Preliminary results from the IBD subgroup analysis

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S490-S490 ◽  
Author(s):  
A Aksan ◽  
H Işık ◽  
S Aksan ◽  
D Tuğal ◽  
A Dignass ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Outcome Measure ◽  
Oral Iron ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Preliminary Results ◽  
Increased Risk ◽  
Statistical Heterogeneity ◽  
Iv Iron

Abstract Background Current ECCO guidelines state that intravenous (IV) iron should be considered first-line treatment in patients with clinically active IBD, previous intolerance to oral iron, Hb below 100 g/l and patients who need erythropoiesis-stimulating agents. Several different IV iron products are available with differing therapeutic effectiveness and tolerability. In this ongoing study, we compare their safety profiles to establish whether any IV iron carries an increased risk compared with other IV iron products or with oral iron, and to determine which, if any, has a superior safety profile. We report preliminary results from an IBD subgroup analysis. Methods We performed a systematic review and network meta-analysis (NMA), searching PUBMED, SCOPUS, WoS and Cochrane Library up to July 2019. The primary outcome measure was the pooled total of drug-related adverse events (AEs) and serious AEs (SAEs) in proportion to the safety population. The secondary outcome measure was identification of the most common AEs. Results 8086 distinct publications were found. Of 171 relevant full-text articles on IBD, 5 RCTs (n = 1143) were eligible. Bayesian NMA was performed using a fixed effects model. Low statistical heterogeneity was determined (I2= 9%). AE rates did not differ significantly between the different IV iron products (ferric carboxymaltose/FCM; iron sucrose/IS; iron isomaltoside/IIM) or oral iron. Compared with oral iron; OR=0.69, 95% CrI [0.29;1.7] for FCM, OR=0.52, 95% CrI [0.22;1.2] for IS, OR=1.5, 95%CrI [0.80;3.1] for IIM. Compared with FCM; OR=0.74, 95% CrI [0.45;1.2] for IS, OR=2.2, 95% CrI [0.74;6.7] for IIM. Compared with IS; OR=0.1.3, 95% CrI [0.82;2.2] for IS, OR=3.0, 95% CrI [1.0;9.1] for ISM. Compared with IIM; OR=0.45, 95% CrI [0.15;1.3] for FCM, OR=0.33, 95% CrI [0.11;1.0] for IS. The most common AEs were headache (1.8%) and transient hyperferritinaemia (1.8%) for FCM; headache (1.5%), hyperferritinaemia and rigors (both 1.2%) for IS; flushing (2.7%), hypersensitivity and hepatic enzyme increase (both 1.8%) for IIM; diarrhoea (8.0%) and abdominal pain (7.7%) for oral iron. Hypophosphataemia was reported in only 1 RCT of FCM, here transient and clinically asymptomatic. Seven SAEs were recorded; 1/381 for FCM, 1/223 for IIM and 5/238 for oral iron. Conclusion None of the IV iron products was associated with an increased risk of AEs or SAEs compared with oral iron and all showed similarly low rates of AEs. However, their safety profiles differed: Whereas with FCM or IS, headaches were most commonly reported, IIM was more frequently associated with hypersensitivity reactions or increase in hepatic enzymes. On this evidence, while FCM, IS and IIM are all safe, their differing safety characteristics should be considered in therapeutic decision-making.

scholarly journals Technical and clinical outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures performed in patients with COVID-19

2020 ◽  
Vol 13 ◽  
pp. 175628482098067
Author(s):  
Theodor Voiosu ◽  
Andrei Voiosu ◽  
Ivo Boškoski ◽  
Marianna Arvanitakis ◽  
Michiel Bronswijk ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Multivariable Analysis ◽  
Secondary Outcome ◽  
Control Group ◽  
Minimal Risk ◽  
Technical Failure ◽  
Success Rates ◽  
Technical Success ◽  
Endoscopic Retrograde

Background: The unprecedented situation caused by the coronavirus disease 2019 (COVID-19) pandemic has profoundly affected endoscopic practice in regard to access, volume, and workflow. We aimed to assess the potential changes in the technical outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures carried out in patients with confirmed SARS-CoV-2 infection. Methods: We conducted an international, multicenter, retrospective, matched case-control study of ERCP procedures carried out in patients with confirmed COVID-19. The main outcome was technical success of the procedure as assessed by the endoscopist, and the secondary outcome was the development of procedure-related adverse events. Each case was matched in a 1:4 ratio with controls extracted from each center’s database in order to identify relevant changes in outcome measures compared with the pre-pandemic era. Results: Eighteen procedures performed in 16 COVID-19 patients [14 men, 65 years (9–82)] and 67 controls were included in the final analysis. Technical success was achieved in 14/18 COVID-19 cases, which was significantly lower as compared with the control group (14/18 versus 64/67, p = 0.034), with an endoscopic reintervention required in 9/18 cases. However, the rate of procedure-related adverse events was low in both groups (1/18 versus 10/67, p = 0.44). On multivariable analysis, COVID-19 status remained the only risk factor for technical failure of the procedure [odds ratio of 19.9 (95% confidence interval 1.4–269.0)]. Conclusions: The COVID-19 pandemic has affected the volume and practice of ERCP, resulting in lower technical success rates without significantly impacting patient safety. Prioritizing cases and following recommendations on safety measures can ensure good outcome with minimal risk in dedicated centers.

scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY COMPARING CLINICAL OUTCOME OF IUGR NEONATES WITH NORMAL AND ABNORMAL UMBILICAL ARTERY FLOW DOPPLER

2020 ◽  
pp. 1-3
Author(s):  
Aarti Panchal ◽  
Sucheta Munshi ◽  
Halak Chauhan
Keyword(s):  
Umbilical Artery ◽  
Outcome Measure ◽  
Perinatal Asphyxia ◽  
Secondary Outcome ◽  
Control Group ◽  
Case Group ◽  
Secondary Outcome Measure ◽  
Perinatal Complications ◽  
Umbilical Artery Doppler ◽  
Artery Flow

Background: Intrauterine growth restriction (IUGR) is one of the causes of perinatal mortality and morbidity which affects approximately 9.65% of pregnancies worldwide. Doppler indices from the fetal circulation can reliably predict adverse perinatal outcome. Aims &objectives: To compare perinatal complications and outcome between term and preterm IUGR neonates having normal and abnormal umbilical artery flow Doppler. Methodology: 140 IUGR Neonates with abnormal and normal antenatal umbilical artery Doppler scan admitted in NICU of Civil Hospital, Ahmedabad were included in the study. Amongst them 52 were preterm and 88 were term neonates. Study was conducted between October 2019 to December 2019. Primary outcome measure is neonatal mortality and secondary outcome measure is neonatal morbidities like perinatal asphyxia, hypoglycemia, NEC, hyperbilirubinemia etc. Results: Amongst140 IUGR neonates Preterm were more in case group 36(51.4%) compared to control group 16(22.8 %.) Hypoglycaemia and NEC was observed more in preterm 19 (36.5%) and 14(26.9%) compared to 16(18.2%) and 11(12.5%) in term respectively. Birth asphyxia was observed more in term 26(29.5%) than preterm 7(13.5%). At birth perinatal asphyxia was observed more in case group, 27 out of 70 (38.5%), as compared to 6 out of 70 (8.5%) in control group (P <0.05). Hypoglycemia and NEC was noticed in 30(42.8%) and 24(34.2%) neonates in case group, as compared to 5(7.1%) and 2(2.8%) neonates in control group respectively. (P < 0.05) Conclusion: Neonates with abnormal Umbilical Artery Doppler flow are at increased risk of perinatal complications and needs extra care during this period.

scholarly journals To compare the perinatal outcome of IUGR infants with abnormal and normal antenatal umbilical artery Doppler flow in the immediate neonatal period

2017 ◽  
Vol 6 (4) ◽  
pp. 1449 ◽  
Author(s):  
Shivaprasad B. ◽  
Devendrakumar Sharma
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Outcome Measure ◽  
Perinatal Asphyxia ◽  
Secondary Outcome ◽  
Control Group ◽  
Case Group ◽  
Secondary Outcome Measure ◽  
Doppler Flow ◽  
Umbilical Artery Doppler

Background: Intrauterine growth restriction (IUGR) is one of the cause of perinatal mortality and morbidity and affects approximately 7-15% of worldwide pregnancies. IUGR is the failure of the fetus to achieve intrinsic growth potential, due to disorders and diseases in the feto–placental–maternal unit. Doppler indices from the fetal circulation can reliably predict adverse perinatal outcome. Aim of the study was to determine perinatal outcome of IUGR infants with abnormal antenatal umbilical artery Doppler flow versus IUGR infants with normal Doppler flow.Methods: All Preterm and term IUGR infants with abnormal and normal antenatal umbilical artery Doppler scan admitted in NICU of St Martha’s Hospital were included in the study. 30 in each group with total sample size of 60. Study was conducted from March 2015 to February 2016. Primary outcome measure will be neonatal mortality and secondary outcome measure will be neonatal morbidities like perinatal asphyxia, hypoglycemia, NEC, polycythemia, sepsis, hyperbilirubinemia etc.Results: IUGR infants with abnormal antenatal umbilical artery Doppler scan were included as cases and those with normal antenatal umbilical artery Doppler scan as control. At birth resuscitation rate and therefore perinatal asphyxia was observed more in case group, 11 out of 30 (36.6%), compared to 1 out of 30 (3.3%) in control group, statistically significant (P <0.05). Hypoglycemia was noticed in 19 infants in case group (63.3%) compared to 2 infants (6.6%) in control group, statistically significant. NEC, polycythemia, sepsis was noticed more in case group, but statistically not significant.Conclusions: Infants with abnormal antenatal Doppler flow are at increased risk of perinatal complications than infants with normal antenatal umbilical artery Doppler and needs extra care during this period.

scholarly journals Meta-Analysis of the Clinical Effectiveness and Safety of Ligustrazine in Cerebral Infarction

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Tian Yu ◽  
Xiaoheng Guo ◽  
Zhen Zhang ◽  
Rong Liu ◽  
Liang Zou ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cerebral Infarction ◽  
Clinical Efficacy ◽  
Large Scale ◽  
Meta Analysis ◽  
Blood Rheology ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Clinical Effects

Objectives. To evaluate the efficacy and safety of ligustrazine in the treatment of cerebral infarction.Methods. A systematic literature search was conducted in 6 databases until 30 June 2016 to identify randomized controlled trials (RCTs) of ligustrazine in the treatment of cerebral infarction. The quality of all the included studies was evaluated. All data were analyzed by Review Manager 5.1 Software.Results. 19 RCTs totally involving 1969 patients were included. The primary outcome measures were Neurological Deficit Score (NDS) and clinical effective rate. The secondary outcome measure was adverse events. Meta-analysis showed that ligustrazine could improve clinical efficacy and NDS of cerebral infarction with [OR = 3.60, 95% CI (2.72, 4.78),P<0.00001] and [WMD = −3.87, 95% CI (−4.78, −2.95),P<0.00001]. Moreover, ligustrazine in treatment group exerted better clinical effects in improving the Blood Rheology Index (BRI) in patients compared with control group. Ten trials contained safety assessments and stated that no obvious side effects were found.Conclusions. Ligustrazine demonstrated definite clinical efficacy for cerebral infarction, and it can also improve NDS in patients without obvious adverse events. However, due to the existing low-quality research, more large-scale and multicentric RCTs are required to provide clear evidence for its clinical efficacy in the near future.

scholarly journals Double blinded randomized placebo-controlled comparative study between sucralfate ointment and lidocaine ointment after Milligan Morgan hemorrhoidectomy

2017 ◽  
Vol 4 (12) ◽  
pp. 3822
Author(s):  
Yahia Alkhateep ◽  
Abdelmieniem Fareed
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Lidocaine Group ◽  
Significant Difference ◽  
Double Blinded

Background: Post haemorrhoidectomy pain and delayed wound healing are the most annoying drawbacks to the patients and the surgeons. Topical application of sucralfate or lidocaine may help in reducing postoperative pain and promoting wound healing after Milligan Morgan hemorrhoidectomy.Methods: This study was designed as a single-center double blinded randomized placebo controlled trial at the Department of general Surgery Menoufia University, immediately after Milligan Morgan Hemorrhoidectomy, a total of 150 patients were randomly assigned to receive either 10% Sucralfate ointment, 5% lidocaine ointment or placebo ointment (control group). The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy and the secondary outcome measure was wound healing.Results: There was no significant difference in age, gender, and number of excised hemorrhoid piles between the two groups. At the 1st ,3rd and 7th days after surgery pain intensity was significantly lower in sucralfate group (4.18±0.82, 3.92±0.72, 3.56±0.67) when compared to lidocaine group (5.06±1.11, 4.70±0.84, 3.93±0.75) and placebo group (6.17±1.26, 5.42±0.98, 4.55±0.84). At the 21st and 28th days no significant difference in pain intensity between groups (p > 0.05) with better wound healing in sucralfate group (P<0.05).Conclusions: Sucralfate was able to reduce the acute postoperative pain and improve wound healing after hemorrhoidectomy, local anesthetic lidocaine could help in pain control but without effect on healing.

Comparison of Surgical Outcomes in Primary Endoscopic Dacryocystorhinostomy with and without Silicone Intubation

2002 ◽  
Vol 111 (8) ◽  
pp. 704-709 ◽  
Author(s):  
H. Halis Unlu ◽  
Asim Aslan ◽  
Baris Toprak ◽  
Cenap Guler
Keyword(s):  
Granulation Tissue ◽  
Surgical Outcomes ◽  
Surgical Outcome ◽  
Success Rates ◽  
Endoscopic Endonasal ◽  
Silicone Tubing ◽  
Surgical Success ◽  
Patient Discomfort ◽  
Endoscopic Dacryocystorhinostomy ◽  
Silicone Intubation

The surgical outcome of endoscopic endonasal dacryocystorhinostomy was analyzed in 30 cases of postsaccal stenosis. Intubation with silicone tubing was used in 14 cases (46.7%) and not used in 16 cases (53.3%). Surgical success was evaluated subjectively and objectively. The patients' complaints were improved in 85.7% of cases in the intubation group, and in 81.3% of the group in which no stent was used. Postoperative endoscopic examinations revealed that the rhinostomy opening was visible in 11 cases without intubation (68.8%) and 9 cases with intubation (64.3%). Six patients in the intubation group (42.9%) had granulation tissue at the rhinostomy site. Four patients (28.6%) had complaints regarding the intubation. Considering the similar surgical success rates, and the granulation formation, patient discomfort, and cost related to intubation, we recommend endoscopic dacryocystorhinostomy without intubation as the treatment of choice in cases of chronic epiphora due to postsaccal stenosis of the lacrimal canal.

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