scholarly journals The Comparison of Double J Stent Insertion and Conservative Treatment Alone in Severe Pure Gestational Hydronephrosis: A Case Controlled Clinical Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kürşat Çeçen ◽  
Kahraman Ülker
Keyword(s):  
Conservative Treatment ◽  
Stone Disease ◽  
Stent Insertion ◽  
Management Options ◽  
Treatment Groups ◽  
Pain Scores ◽  
Double J Stent ◽  
The Right ◽  
Postpartum Pain ◽  
Controlled Clinical Study

Objective. Management options of gestational hydronephrosis are based on the coexisting stone disease, pyelonephritis, and renal disease. However, the management option and its consequences in the absence of a coexisting disease state are not clear. In this study we aimed to compare the effectiveness of conservative treatment and double J insertion in symptomatic pure gestational hydronephrosis.Material and Methods. The data of the women with severe pure gestational hydronephrosis over a nine-year period was collected retrospectively. The included women were grouped into two according to receiving double J stent insertion or conservative treatments.Results. Double J insertion and conservative treatment groups included 24 and 29 women, respectively. Hydronephrosis was demonstrated on the right, left, or both kidneys in 37 (70%), 13 (24%), and 3 (6%) women, respectively. None of the participants gave birth prior to the 37th week. The demographics, initial pain scores, the severity of the hydronephrosis during first admission, and pain scores one week after the interventions did not differ significantly between groups (P>0.05). Similarly, the rates of complications, postpartum pain scores, and permanent hydronephrosis did not differ between groups (P>0.05).Conclusion. Double J insertion in symptomatic pure gestational hydronephrosis adds no benefit to conservative treatment.

scholarly journals The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Fatih Asutay ◽  
Yusuf Atalay ◽  
Hilal Asutay ◽  
Ahmet Hüseyin Acar
Keyword(s):  
Retrospective Study ◽  
Botulinum Toxin ◽  
Visual Analogue Scale ◽  
Conservative Treatment ◽  
Analogue Scale ◽  
Single Injection ◽  
Botulinum Toxin A ◽  
Clinical Effects ◽  
Pain Scores ◽  
The Right

Objectives. Nocturnal bruxism can be managed by botulinum toxin (Botox®) in patients who have not responded to conservative treatment. The aim of this study was to evaluate the efficacy of botulinum toxin A (BTXA) in the treatment of nocturnal bruxism. Material and Methods. The retrospective study comprised 25 female patients, aged 23–55 years (mean 35.84±8.41 years). All patients received a single injection of BTXA in the right and left masseters. Evaluation was made by Visual Analogue Scale (VAS) values, complaint duration, onset of effect, and duration of effectiveness. Results. BTXA produced significant improvements in pain scores. Only 2 adverse events (8%) were recorded. Conclusion. BTX-A is effective in the treatment of nocturnal bruxism.

scholarly journals THE COMPARISON OF CONSERVATIVE TREATMENT AND DOUBLE J STENT INSERTION IN GESTATIONAL HYDRONEPHROSIS

2018 ◽  
Vol 6 (2) ◽  
pp. 94-100
Author(s):  
Uğurkan Erkayıran ◽  
Bülent Köstü ◽  
Alev Özer
Keyword(s):  
Conservative Treatment ◽  
Pregnancy Outcomes ◽  
University Hospital ◽  
Control Group ◽  
Stent Insertion ◽  
Conservative Approach ◽  
Double J Stent ◽  
Significant Difference ◽  
Gestational Week ◽  
The Difference

Background: To compare the pregnancy outcomes of patents determined with gestational hydronephrosis and treated with a conservative approach or Double J Stent (DJS) application. Method: The study included 113 patients diagnosed with gestational hydronephrosis at a university hospital between January 2011 and January 2014. Of the 113 patients, DJS was applied to 51 and a conservative approach was applied to 62 patients. A comparison was made of the pregnancy outcomes in both treatment arms. Results: No significant difference was determined between the patients in the DJS application group and the patients in the conservative treatment group in respect of age, gravida, parity, gestational week at the time of diagnosis, gestational week at birth, and renal calyx diameter. Although a higher rate of births was determined in the first 24 hours and the first week after placement of DJS in DJS group compared to control group, the difference was not statistically significant. None of the patients in the control group required DJS insertion during the follow-up period. Conclusion: In patients with gestational hydronephrosis, if conservative treatment is first tried, if the patient cannot overcome the symptoms and complications are present, DJS should be inserted.

scholarly journals Intrauterine lidocaine and naproxen for analgesia during intrauterine device insertion: randomized controlled trial

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Shana M. Miles ◽  
Katerina Shvartsman ◽  
Susan Dunlow
Keyword(s):  
Pain Assessment ◽  
Controlled Trial ◽  
Intrauterine Device ◽  
Self Medication ◽  
Double Blind ◽  
Clinical Trial Registration ◽  
Treatment Groups ◽  
Pain Scores ◽  
Post Procedure ◽  
Treatment Medication

Abstract Background This study evaluates oral naproxen and intrauterine instillation of lidocaine for analgesia with intrauterine device (IUD) placement as compared to placebo. Methods This was a randomized, double-blind, placebo-controlled trial. Patients desiring levonorgestrel 52 mg IUD or Copper T380A IUD were randomized into treatment groups. Patients received either oral naproxen 375 mg or placebo approximately 1 h prior to procedure in conjunction with 5 mL of 2% lidocaine or 5 mL of intrauterine saline. The primary outcome was pain with IUD insertion measured on a visual analog scale immediately following the procedure. Prespecified secondary outcomes included physician pain assessment, post procedure analgesia, satisfaction with procedure, satisfaction with IUD, and pain assessment related to IUD type. Results From June 4, 2014 to October 28, 2016 a total of 160 women desiring Copper T380A or levonorgestrel 52 mg intrauterine device insertion and meeting study criteria were enrolled and randomized in the study. Of these, 157 (78 in the Copper T380A arm, 79 in the levonorgestrel 52 mg) received study treatment medication. There were 39 in naproxen/lidocaine arm, 39 in placebo/lidocaine arm, 40 in naproxen/placebo arm, and 39 in placebo/placebo arm. There were no differences in the mean pain scores for IUD placement between treatment groups (naproxen/lidocaine 3.38 ± 2.49; lidocaine only 2.87 ± 2.13; naproxen only 3.09 ± 2.18; placebo 3.62 ± 2.45). There was no difference in self-medication post procedure or in satisfaction with the procedure and IUD among women in the treatment arms or by type of IUD. Conclusion Naproxen with or without intrauterine lidocaine does not reduce pain with IUD placement. Clinical trial registration Clinicaltrials.gov, NCT02769247. Registered May 11, 2016, Retrospectively registered

scholarly journals Hyperthermia in a pediatric patient with neuroblastoma during anesthesia: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chuan Wang ◽  
Wenqiong Xin ◽  
Yi Ji
Keyword(s):  
Tumor Resection ◽  
Neuron Specific Enolase ◽  
Tracheal Extubation ◽  
Posterior Mediastinum ◽  
Gas Analysis ◽  
Vanillylmandelic Acid ◽  
Management Options ◽  
Paravertebral Space ◽  
Tissue Mass ◽  
The Right

Abstract Background Neuroblastoma is the most common malignant extracranial solid tumor in pediatrics patients. Intraoperative hyperthermia is extremely rare in patients with neuroblastoma and can cause a series of complications. Here, we represent a case of neuroblastoma accompanied by hyperthermia during anesthesia, and propose a rational explanation and management options. Case presentation The patient had gait disturbance and sitting-related pain without fever. Magnetic resonance imaging revealed a soft tissue mass located in the right posterior mediastinum, paravertebral space and canalis vertebralis. Serum tumor marker screening showed that the patient had increased epinephrine, norepinephrine and neuron specific enolase levels, with an increased 24 hour urine vanillylmandelic acid level. Intraspinal tumor resection was conducted. The temperature of the patient rapidly arose to 40.1 °C over 10 minutes when waiting for tracheal extubation. The arterial gas analysis results indicated malignant hyperthermia was less likely, and dantrolene was not administered. Physical cooling methods were used, and the temperature dropped to 38.6 ℃. The trachea was successfully extubated. Histological results confirmed the diagnosis of neuroblastoma. Conclusions Hyperthermia during anesthesia is a serious adverse event. Catecholamines secreted from neuroblatoma cells can lead to hypermetabolism and hyperthermia. Surgeons and anesthesiologists should be aware of the possibility of hyperthermia in patients with neuroblastoma.

Efficacy of cystone versus tamsulosin in treatment of stent-related lower urinary tract symptoms

2021 ◽  
pp. 205141582110002
Author(s):  
Mohammad Ali Ghaed ◽  
Reza Rezaei ◽  
Amineh Shafeinia ◽  
Robab Maghsoudi
Keyword(s):  
Urinary Tract ◽  
Symptom Score ◽  
Lower Urinary Tract Symptoms ◽  
International Prostate Symptom Score ◽  
Lower Urinary Tract ◽  
Visual Analogue Score ◽  
Stent Insertion ◽  
Double J Stent ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Objective: Double-J stent is a common tool used in urological procedures that is inserted for 2–6 weeks, but it may induce abdominal and flank pain, incontinence and irritative urinary symptoms. Alleviation of such symptoms would be useful to improve the patients’ quality of life. Accordingly, in this study, the efficacy of cystone versus tamsulosin in the treatment of double-J stent-related lower urinary tract symptoms was determined. Materials and methods: In this randomised clinical trial, 128 patients who required double-J stent insertion after transureteral lithotripsy during 2018–2019 were enrolled. They were randomly assigned to receive either cystone, tamsulosin, both, or placebo. The international prostate symptom score and visual analogue score data were recorded at baseline, after 2 and 4 weeks across the groups. Results: The international prostate symptom score and visual analogue score factors were statistically different across the case groups receiving cystone, tamsulosin and both drugs versus placebo ( P=0.001). Two weeks after drug administration, the visual analogue score and international prostate symptom score were not statistically different in the tamsulosin, cystone and dual therapy groups; however, after 4 weeks the cystone group had the lowest symptoms. Conclusion: Both tamsulosin and cystone are efficient drugs which would relieve stent-related lower urinary tract symptoms. The administration of cystone with or without tamsulosin for 4 weeks may have the best result in reducing the visual analogue score and international prostate symptom score. Level of evidence: Level I, 1b, therapeutic study, randomised controlled trial

scholarly journals May-Thurner Syndrome Is Aggravated by Pregnancy

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 222
Author(s):  
Kuntharee Traisrisilp ◽  
Manatsawee Manopunya ◽  
Tanop Srisuwan ◽  
Wisit Chankhunaphas ◽  
Theera Tongsong
Keyword(s):  
Conservative Treatment ◽  
Renal Agenesis ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Left Lower Extremity ◽  
Asymptomatic Patients ◽  
Pregnancy And Postpartum ◽  
Anticoagulant Prophylaxis ◽  
The Right ◽  
Deep Vein

This study aims to emphasize that asymptomatic patients with undiagnosed and asymptomatic May-Thurner syndrome (MTS) may firstly develop severe compression during pregnancy. A 40-year-old woman, G1P0, at 22 weeks of twin gestation presented with left lower extremity edema and pain. One twin was structurally normal while the other had bilateral renal agenesis with oligohydramnios. Magnetic resonance venography (MRV) revealed severe compression of the left iliac vein by the right iliac artery without evidence of deep vein thrombosis (DVT). Conservative treatment with anticoagulant prophylaxis was instituted throughout the rest of pregnancy and postpartum period. She was also complicated with severe pre-eclampsia, a cesarean section was performed due to a prolapsed cord at 27 weeks of gestation, and she gave birth to a surviving baby weighing 1100 g. In conclusion, this case report provides evidence that pregnancy can disclose a subtle May-Thurner anatomy to be symptomatic without DVT. Successful pregnancy outcomes could be achieved with conservative treatment and anticoagulant prophylaxis.

scholarly journals The Prevalence of Hjortsjo Crook Sign of Right Posterior Sectional Bile Duct and Bile Duct Anatomy in ERCP

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hanan M. Alghamdi ◽  
Afnan F. Almuhanna ◽  
Bander F. Aldhafery ◽  
Raed M. AlSulaiman ◽  
Ahmed Almarhabi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Middle Eastern ◽  
Stone Disease ◽  
Positive Sign ◽  
Anatomical Variant ◽  
Female Ratio ◽  
Bile Duct Anatomy ◽  
Therapeutic Ercp ◽  
The Right

Aim. The frequency of the Right Posterior Sectional Bile Duct (RPSBD) hump sign in cholangiogram when it crosses over the right portal vein known as Hjortsjo Crook Sign and the bile duct anatomy are studied. Knowledge of the implication of positive sign can facilitate safe resection for both bile duct and portal vein. Methods. Prospectively, we included 237 patients with indicated ERCP during a period from March 2010 to January 2015. Results. The mean age (±SD) and male to female ratio were 38.8 (±19.20) and 1 : 1.28, respectively. All patients are Arab from Middle Eastern origin, had biliary stone disease, and underwent diagnostic and therapeutic ERCP. Positive Hjortsjo Crook Sign was found in 17.7% (42) of patients. The sign was found to be equally more frequent in Nakamura’s RPSBD anatomical variant types I, II, and IV in 8.4% (20), 6.8% (16), and 2.1% (5), respectively, while rare anatomical variant type III showed no positive sign. Conclusion. Hjortsjo Crook Sign frequently presents in RPSBD variation types I, II, and IV in our patients.

scholarly journals Internal jugular phlebectasia: A systematic review

2019 ◽  
Vol 10 ◽  
pp. 106 ◽  
Author(s):  
Jose A. Figueroa-Sanchez ◽  
Ana S. Ferrigno ◽  
Mario Benvenutti-Regato ◽  
Enrique Caro-Osorio ◽  
Hector R. Martinez
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Conservative Treatment ◽  
Literature Search ◽  
Jugular Vein ◽  
Adult Patients ◽  
Therapeutic Approaches ◽  
Jugular Phlebectasia ◽  
The Right ◽  
Meta Analyses

Background: Internal jugular phlebectasia (IJP), the abnormal dilatation of internal jugular vein, is generally considered a benign anomaly. However, because IJP is uncommon, little is known about its natural history, and currently, no consensus on the best treatment modality is available. Methods: The purpose of this article is to conduct a systematic review of available literature on recently reported IJP cases to understand the main characteristics of IJP and its most frequent therapeutic approaches. Following the preferred reporting items for systematic reviews and meta-analyses guidelines, literature search for IJP cases was conducted in the COCHRANE, PUBMED, EBSCOHOST, SCOPUS, OVID, and SCIELO databases. Results: A total of 97 original articles were found, with a total of 247 IJP cases reported including both pediatric and adult patients. Conclusions: To the best of our knowledge, this study is the largest systematic review analyzing all the reported cases of IJP. IJP is considered by most authors as a benign abnormality that predominantly affects the right jugular vein. It is most commonly diagnosed in children. At present, conservative treatment is preferred for pediatric but not for adult patients. Multicenter randomized prospective studies are required to further understand this rare anomaly.

scholarly journals Progression of Aortic Calcification in Stage 4–5 Chronic Kidney Disease Patients Transitioning to Dialysis and Transplantation

2021 ◽  
pp. 1-8
Author(s):  
Roosa Lankinen ◽  
Markus Hakamäki ◽  
Tapio Hellman ◽  
Niina S. Koivuviita ◽  
Kaj Metsärinne ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conservative Treatment ◽  
Left Ventricular ◽  
Waiting List ◽  
Aortic Calcification ◽  
Transplant Recipients ◽  
Treatment Groups ◽  
In The Beginning

<b><i>Background and Aims:</i></b> Abdominal aortic calcification (AAC) is common in chronic kidney disease (CKD) patients and associated with increased mortality. Comparative data on the AAC score progression in CKD patients transitioning from conservative treatment to different modalities of renal replacement therapy (RRT) are lacking and were examined. <b><i>Methods:</i></b> 150 study patients underwent lateral lumbar radiograph to study AAC in the beginning of the study before commencing RRT (AAC1) and at 3 years of follow-up (AAC2). We examined the associations between repeated laboratory tests taken every 3 months, echocardiographic and clinical variables and AAC increment per year (ΔAAC), and the association between ΔAAC and outcomes during follow-up. <b><i>Results:</i></b> At the time of AAC2 measurement, 39 patients were on hemodialysis, 39 on peritoneal dialysis, 39 had a transplant, and 33 were on conservative treatment. Median AAC1 was 4.8 (0.5–9.0) and median AAC2 8.0 (1.5–12.0) (<i>p</i> &#x3c; 0.0001). ΔAAC was similar across the treatment groups (<i>p</i> = 0.19). ΔAAC was independently associated with mean left ventricular mass index (LVMI) (log LVMI: β = 0.97, <i>p</i> = 0.02) and mean phosphorus through follow-up (log phosphorus: β = 1.19, <i>p</i> = 0.02) in the multivariable model. Time to transplantation was associated with ΔAAC in transplant recipients (per month on the waiting list: β = 0.04, <i>p</i> = 0.001). ΔAAC was associated with mortality (HR 1.427, 95% confidence interval 1.044–1.950, <i>p</i> = 0.03). <b><i>Conclusion:</i></b> AAC progresses rapidly in patients with CKD, and ΔAAC is similar across the CKD treatment groups including transplant recipients. The increment rate is associated with mortality and in transplant recipients with the time on the transplant waiting list.

The Effectiveness of Lavender (Lavendula Augustfolia) and Neroli (Citrus Aurantium) Aromatherapy Inhalation to Decrease Pain Labor

2020 ◽  
Vol 6 (1) ◽  
pp. 26-31
Author(s):  
Nurul Azizah ◽  
Rafhani Rosyidah ◽  
Hanik Machfudloh
Keyword(s):  
Labor Pain ◽  
P Value ◽  
Citrus Aurantium ◽  
Uterine Contractions ◽  
Pain Scores ◽  
Quasi Experimental ◽  
The Mean ◽  
Group 2 ◽  
Almost All ◽  
Postpartum Pain

Maternal labor will experience almost all body pain, such as painful ribs, stitches, abdominal pain due to uterine contractions, and discomfort in the back due to epidural needles, and this discomfort will last several days and can be overcome by prescription for painkillers. In this study aimed at carrying out non-famacological pain relief therapy, namely by using aromatherapy which is believed to reduce pain, this study tried to compare the effectiveness of lavender and neroli aromatherapy inhalation to decrease post-labor pain. The research method used quasi-experimental that is given aromatherapy lavender (Lavendula Augustfolia) and neroli (Citrus Aurantium) inhalation treatments. The number of respondents was 60 with 1-2 days of normal and postpartum criteria, each group consisted of 30 respondents. Group 1 was held at the Pearl Delta Clinic RB and group 2 in the Karunia RB Clinic. Data were analyzed by univariable by using mean and standard deviation, bivariable with statistical test independent sample T test. The results of this study showed a mean reduction in pain scores on lavender aromatherapy inhalation of 2.36 ± 0.15, whereas in the aromatherapy neroli inhalation group the mean reduction in pain score was 3.03 ± 0.067 with a P value <0.002 indicating a significant relationship. The conclusion of this study is the inhalation of lavender aromatherapy (LavendulaAugustfolia) and neroli (Citrus Aurantium) can reduce the intensity of postpartum pain, but in the aromatherapy neroli inhalation group has a greater pain reduction score than the lavender group. 

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