scholarly journals Does the duration of symptoms of anal fissure impact its response to conservative treatment? A prospective cohort study

2017 ◽  
Vol 44 ◽  
pp. 64-70 ◽  
Author(s):  
Sameh Hany Emile ◽  
Hesham Elgendy ◽  
Hossam Elfeki ◽  
Alaa Magdy ◽  
Ahmed Aly Abdelmawla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Conservative Treatment ◽  
Anal Fissure ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Duration Of Symptoms

scholarly journals IS THERE A PLACE FOR HIGH-RESOLUTION ANOSCOPY IN THE DIAGNOSTICS OF INFLAMMATORY CHANGES IN PATIENTS WITH CHRONIC HEMORRHOIDS?

2018 ◽  
pp. 58-65
Author(s):  
A. G. Khitaryan ◽  
A. Z. Alibekov ◽  
S. A. Kovalev ◽  
I. A. Shatov ◽  
O. A. Aluhanyan ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Resolution ◽  
Conservative Treatment ◽  
Diagnostic Accuracy ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Histological Study ◽  
Diagnostic Specificity ◽  
Inflammatory Changes ◽  
Grade Iii

AIM: to evaluate the significance of high-resolution anoscopy (HRA) in diagnostics of inflammatory and thrombotic changes in hemorrhoid piles and to assess the efficacy of micronized purified favonoid fraction (MPFF) in patients with inflammatory thrombotic changes of hemorrhoids according to HRA results in the preoperative conservative treatment of hemorrhoids. PATIENTS AND METHODS: a prospective cohort study included 77 patients with grade III chronic hemorrhoids. Patients were divided into 3 groups depending on the degree of development of inflammatory and thrombotic changes according to the HRA. The 3 group included patients with preoperative conservative treatment by MPFF. All patients underwent Milligan-Morgan procedure with further histological study of removed piles. RESULTS: it was found that the diagnostic sensitivity of the HRA in detection of inflammatory thrombotic changes was 91.3 % (CI=83.6-96.2 %), and diagnostic specificity - 40 % (CI=19-64 %). HRA diagnostic accuracy was 82.1 % (p=0.001). A 30 % decrease in the number of removed piles with moderate inflammatory thrombotic changes after MOFF therapy has also been revealed. CONCLUSION: HRA permits to determine the severity of thrombotic inflammatory changes, which is extremely importantfor the management of patients with acute hemorrhoids.

scholarly journals Rapid, early and accurate SARS-CoV-2 detection using RT-qPCR in primary care: a prospective cohort study (REAP-1)

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045225
Author(s):  
Werner Leber ◽  
Oliver Lammel ◽  
Monika Redlberger-Fritz ◽  
Maria Elisabeth Mustafa-Korninger ◽  
Reingard Christina Glehr ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Acute Infection ◽  
Sentinel Surveillance ◽  
Duration Of Symptoms ◽  
Targeted Testing ◽  
Test Specificity ◽  
National Sentinel Surveillance

ObjectivesWe explore the importance of SARS-CoV-2 sentinel surveillance testing in primary care during a regional COVID-19 outbreak in Austria.DesignProspective cohort study.SettingA single sentinel practice serving 22 829 people in the ski-resort of Schladming-Dachstein.ParticipantsAll 73 patients presenting with mild-to-moderate flu-like symptoms between 24 February and 03 April, 2020.InterventionNasopharyngeal sampling to detect SARS-CoV-2 using real-time reverse transcriptase-quantitative PCR (RT-qPCR).Outcome measuresWe compared RT-qPCR at presentation with confirmed antibody status. We split the outbreak in two parts, by halving the period from the first to the last case, to characterise three cohorts of patients with confirmed infection: early acute (RT-qPCR reactive) in the first half; and late acute (reactive) and late convalescent (non-reactive) in the second half. For each cohort, we report the number of cases detected, the accuracy of RT-qPCR, the duration and variety of symptoms, and the number of viral clades present.ResultsTwenty-two patients were diagnosed with COVID-19 (eight early acute, seven late acute and seven late convalescent), 44 patients tested SARS-CoV-2 negative and 7 were excluded. The sensitivity of RT-qPCR was 100% among all acute cases, dropping to 68.1% when including convalescent. Test specificity was 100%. Mean duration of symptoms for each group were 2 days (range 1–4) among early acute, 4.4 days (1–7) among late acute and 8 days (2–12) among late convalescent. Confirmed infection was associated with loss of taste. Acute infection was associated with loss of taste, nausea/vomiting, breathlessness, sore throat and myalgia; but not anosmia, fever or cough. Transmission clusters of three viral clades (G, GR and L) were identified.ConclusionsRT-qPCR testing in primary care can rapidly and accurately detect SARS-CoV-2 among people with flu-like illness in a heterogeneous viral outbreak. Targeted testing in primary care can support national sentinel surveillance of COVID-19.

Hypofractionation vs. conventional radiotherapy fractionation in the conservative treatment of T1 glottic cancer: a prospective cohort study

2019 ◽  
Vol 22 (1) ◽  
pp. 151-157
Author(s):  
B. G. Salas-Salas ◽  
D. J. Domínguez-Nuez ◽  
R. Cabrera ◽  
L. Ferrera-Alayón ◽  
M. Lloret ◽  
...  
Keyword(s):  
Cohort Study ◽  
Conservative Treatment ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Glottic Cancer ◽  
Conventional Radiotherapy

scholarly journals Relationship between microbiology of throat swab and clinical course among primary care patients with acute cough: a prospective cohort study

2019 ◽  
Vol 37 (3) ◽  
pp. 332-339
Author(s):  
José M Ordóñez-Mena ◽  
Thomas R Fanshawe ◽  
Chris C Butler ◽  
David Mant ◽  
Denise Longhurst ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Acute Cough ◽  
Severe Problem ◽  
Duration Of Symptoms ◽  
Presenting Symptoms ◽  
Severity Scores ◽  
Tract Infections

Abstract Background Acute lower respiratory tract infections (ALRTIs) account for most antibiotics prescribed in primary care despite lack of efficacy, partly due to clinician uncertainty about aetiology and patient concerns about illness course. Nucleic acid amplification tests could assist antibiotic targeting. Methods In this prospective cohort study, 645 patients presenting to primary care with acute cough and suspected ALRTI, provided throat swabs at baseline. These were tested for respiratory pathogens by real-time polymerase chain reaction and classified as having a respiratory virus, bacteria, both or neither. Three hundred fifty-four participants scored the symptoms severity daily for 1 week in a diary (0 = absent to 4 = severe problem). Results Organisms were identified in 346/645 (53.6%) participants. There were differences in the prevalence of seven symptoms between the organism groups at baseline. Those with a virus alone, and those with both virus and bacteria, had higher average severity scores of all symptoms combined during the week of follow-up than those in whom no organisms were detected [adjusted mean differences 0.204 (95% confidence interval 0.010 to 0.398) and 0.348 (0.098 to 0.598), respectively]. There were no differences in the duration of symptoms rated as moderate or severe between organism groups. Conclusions Differences in presenting symptoms and symptoms severity can be identified between patients with viruses and bacteria identified on throat swabs. The magnitude of these differences is unlikely to influence management. Most patients had mild symptoms at 7 days regardless of aetiology, which could inform patients about likely symptom duration.

scholarly journals Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study

BMJ Open ◽  
2016 ◽  
Vol 6 (12) ◽  
pp. e012938 ◽  
Author(s):  
Marinella Gugliotta ◽  
Bruno R da Costa ◽  
Essam Dabis ◽  
Robert Theiler ◽  
Peter Jüni ◽  
...  
Keyword(s):  
Cohort Study ◽  
Conservative Treatment ◽  
Prospective Cohort Study ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Prospective Cohort ◽  
Lumbar Disc

scholarly journals 889 Management of Paediatric Appendicitis During the First Wave of COVID-19: Comparison of Our Centre to National Practice

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Darbyshire ◽  
J Miles ◽  
A Towers ◽  
C Tan ◽  
S Toh
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
National Level ◽  
Perforated Appendicitis ◽  
Duration Of Symptoms ◽  
Ultrasound Findings ◽  
Negative Appendicectomy ◽  
The Uk

Abstract Aim Our hospital took part in a multi-centre prospective cohort study “the CASCADE study” investigating the management and early outcomes of children with appendicitis in the UK and Ireland during the first wave of the COVID-19 pandemic (1). The aim of this study was to compare our local outcomes to those at a national level. Method This was a prospective cohort study with data collected from 01/04/2020 to 31/05/2020. Primary outcome was treatment strategy for appendicitis. Secondary outcomes were duration of symptoms, ultrasound findings, rate of simple vs perforated appendicitis and complications. Results Overall, only a minority (2/24 [8%]) were initially treated non-operatively, with both proceeding to appendicectomy due to pain. Remaining children (24/26 [92%]) were primarily treated with appendicectomy. All were performed laparoscopically with no conversions to open. Ultrasound was performed for most children (23/26 [88%]) which accurately identified appendicitis (22/23 [95%]) and negative appendicectomy rate of zero. Rates of complex appendicitis were not higher than expected (10/26 [38%]) but had a longer duration of symptoms (median 66.0h [IQR21.5] vs 30.0h [27.2], p = 0.008) and more complications (4 vs 1). Post-operative length of stay was significantly shorter for simple appendicitis than complicated (median 1.0d [IQR0.0] vs 4.0 [IQR2.8], p = 0.001). Conclusions Practice in our centre contrasts with the CASCADE study's National findings where 39% were treated non-operatively, only 48% of appendicectomies were performed laparoscopically, only 53% of children had diagnostic imaging and negative appendicectomy rate was 4.5%. Rates of complications for simple and complex appendicitis were similar, but post-operative length of stay shorter in our centre.

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