scholarly journals Sacrocolpopexy with Polypropylene Tape as Valuable Surgical Modification during Cystectomy with Orthotopic Ileal Bladder: Functional Results

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Marcin Życzkowski ◽  
Bartosz Muskała ◽  
Zbigniew Kaletka ◽  
Piotr Bryniarski ◽  
Krzysztof Nowakowski ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Functional Results ◽  
Control Group ◽  
Study Group ◽  
Ileal Neobladder ◽  
Flow Test ◽  
Polypropylene Tape ◽  
Orthotopic Ileal Neobladder

Introduction. Urinary diversion is very often associated with urinary retention and urinary incontinence. In this study, a surgical modification during cystectomy with orthotopic ileal neobladder is presented.Material and Methods. Female patients enrolled in the study (n-24) were subjected to sacrocolpopexy during the operation. Apart from oncological control, the follow-up consisted of 1-hour inlay test and questionnaires (UDI-6 and IIQ-7) in the 3rd, 6th, and 12th month after the operation. In the 12th month after the surgery, the urodynamic pressure-flow test was performed. Outcomes were compared with the control group (n-18) in which sacrocolpopexy was not implemented.Results. The study group was characterised by reduced urinary retention and improved continence.Conclusion. Sacrocolpopexy during cystectomy with orthotopic ileal bladder is a valuable surgical method which provides patients with a better quality of life.

1753 QUALITY OF LIFE AND FUNCTIONAL RESULTS IN WOMEN WITH ORTHOTOPIC ILEAL NEOBLADDER: LONG-TERM FOLLOW-UP ASSESSMENT

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Guillaume Legrand ◽  
Mathieu Rouanne ◽  
Yann Neuzillet ◽  
Florence Cour ◽  
Adrien Vidart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Results ◽  
Ileal Neobladder ◽  
Long Term Follow Up ◽  
Orthotopic Ileal Neobladder

Patient-Reported Outcomes After Revision Surgery for Failed Medial Patellofemoral Ligament Reconstruction: A Matched-Pair Analysis Including Correction of Predisposing Factors

2020 ◽  
Vol 48 (14) ◽  
pp. 3566-3572
Author(s):  
Felix Zimmermann ◽  
Juliane Börtlein ◽  
Danko Dan Milinkovic ◽  
Peter Balcarek
Keyword(s):  
Revision Surgery ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Predisposing Factors ◽  
Control Group ◽  
Study Group ◽  
Joint Function ◽  
Patient Reported

Background: Complications and the need for revision surgery after medial patellofemoral ligament reconstruction (MPFLR) are evident in the current literature. However, there is a shortage of clinical data evaluating the results of revision surgery in individual patients after failed MPFLR. Purpose: To investigate the results of tailored revision surgery for failed MPFLR, including the correction of predisposing factors. Study Design: Cohort study; Level of evidence, 3. Methods: Between August 2015 and March 2019, 25 patients (male:female, n = 9:16; mean ± SD age, 25.9 ± 6.5 years) underwent revision surgery for failed MPFLR (study group). The Banff Patella Instability Instrument 2.0 (BPII 2.0) and a numerical analog scale (0-10) for patellofemoral pain and subjective knee joint function were used to assess patient-reported quality of life before and after revision surgery. The control group of 50 patients (male:female, n = 18:32; age, 22.8 ± 4.3 years) who underwent identical patellar-stabilizing procedures was matched 1:2 by the surgical procedure, predisposing factors, sex, age, and follow-up time. Results: Evaluation was performed postoperatively at a mean 27.8 ± 14.0 months (range, 12-54 months) in the study group and 26.1 ± 11.2 months (range, 12-56 months) in the control group ( P = .55). The BPII 2.0 score increased from 28.6 ± 17.9 points to 68.7 ± 22.3 points ( P < .0001) in the study group and from 43.8 ± 22.5 points to 75.5 ± 21.4 points ( P < .0001) in the control group from preoperatively to postoperatively, respectively. Before revision surgery, the BPII 2.0 scores in the study group were significantly inferior to those in the control group ( P = .0026). At the final follow-up, the BPII 2.0 score in the study group was not significantly lower ( P = .174), and a similar number of patients in the study group and the control group achieved the minimally clinically important difference ( P = .49). Patellofemoral pain and subjective knee joint function improved significantly in both groups ( P < .0001, P < .0001), without any significant difference between them at the final follow-up ( P = .85, P = .86). Conclusion: Revision surgery for MPFLR failure, including the correction of major anatomic risk factors, yielded a significant improvement in patient-reported quality-of-life outcome measures. Patients with failed MPFLR, however, were significantly more restricted before revision surgery than patients without previous interventions when evaluated with the BPII 2.0.

scholarly journals Orthotopic neobladder: A 22-year experience

2007 ◽  
Vol 54 (4) ◽  
pp. 33-35 ◽  
Author(s):  
J. Hadzi-Djokic ◽  
T. Pejcic ◽  
A. Vuksanovic ◽  
M. Acimovic ◽  
Z. Dzamic
Keyword(s):  
Operative Time ◽  
State Of The Art ◽  
Orthotopic Neobladder ◽  
Ileal Neobladder ◽  
Long Term Follow Up ◽  
The Mean ◽  
Orthotopic Ileal Neobladder

Objective: To analyze the outcome of orthotopic ileal neobladder related to complications and quality of life. Patients and methods: From 1985 to 2006, 75 patients with mean age of 57 years, (41-75) underwent radical cystectomy and orthotopic ileal neobladder substitution. The mean follow up was 72 months (6-144). Mean operative time was 240 minutes. Results: Intraoperative blood loss ranged from 250 to 2810 ml. Ureteral stents were removed on 14th postoperative day, and patients were discharged at 21st day, average. Complications appeared in 23 patients. There were two recurrent TCC in the neobladder. Three patients died from pulmonary embolism. Vesicoureteral reflux appeared in three patients, and it was bilateral in two patients. Total of 98% patients have daytime continence. Conclusion: Continent urinary reservoirs represent the state of the art in urinary diversion. Surgeons who perform these operations are urgent to institute requirements for careful long-term follow-up of these patients.

Orthotopic ileal bladder substitution in female patients: Our experience

1996 ◽  
Vol 63 (4) ◽  
pp. 534-537
Author(s):  
A. Cancrini ◽  
P. De Carli ◽  
H. Fattahi
Keyword(s):  
Functional Results ◽  
Urinary Continence ◽  
Ileal Neobladder ◽  
Female Patients ◽  
Clinical Complications ◽  
Bladder Substitution ◽  
Bladder Reconstruction ◽  
Continence Rate ◽  
Orthotopic Ileal Neobladder

Orthotopic bladder reconstruction in women was introduced to guarantee voluntary micturition via the urethra as already obtained in men. A meticulous urethra-sparing surgical procedure and a low-pressure reservoir allow urinary continence to be preserved. Careful selection of patients can reduce the already low risk of urethral relapse. An orthotopic ileal neobladder was performed in 8 women following radical cystectomy for infiltrating bladder carcinoma. Follow-up ranged from 10 to 47 months. There were no serious clinical complications. At 6 months the complete urinary continence rate was 100% during the day and 75% at night with 4-hour interval voiding. At 12 months neobladder capacity varied from 250 to 400 ml and pressure at maximum capacity from 8 to 25 cm water. Urodynamic parameters were stable over a period of time. Four patients died of distant metastasis and 4 are alive and disease-free. In our opinion an orthotopic ileal neobladder in women gives excellent functional results and is a satisfactory option in selected female patients.

scholarly journals Efficacy of Osteochondral Allograft Transplantation in the Knee in Adults Forty Years and Older

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0009
Author(s):  
Katlyn Robinson ◽  
Dennis C. Crawford
Keyword(s):  
Quality Of Life ◽  
International Knee Documentation Committee ◽  
Osteochondral Allograft ◽  
Control Group ◽  
Study Cohort ◽  
Study Group ◽  
Allograft Transplantation ◽  
Significant Difference

Objectives: Fresh osteochondral allograft transplantation (FOCA) have been used successfully to treat large chondral and osteochondral defects of the knee. The purpose of the present study was to determine the efficacy of this treatment in patients older than 40, in comparison to a cohort 39 and younger. Methods: We utilized a prospective database of 107 consecutive patients, with baseline PRO data receiving osteochondral allograft transplantation to the knee from a single surgeon practice over 8 years (March 2007-July 2015). Patient and donor characteristics were routinely collected, as were patient annual PRO measures, principally International Knee Documentation Committee (IKDC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Table 1 summarizes cohort demographics; 68 patients completed surveys at a minimum of 24 month follow-up and were categorized into two cohorts based on age at surgery. Group A (study group) consisted of 33 patient’s forty years of age and greater, 8 women and 25 men, with a mean age of 52.8 years (40-68) and average final up of 3.5 years. Group B (control group) consisted of 35 patient’s less than forty years, 12 women and 23 men, with a mean age of 27.8 years (15-39) and average final follow up of 2.6 years. Results: Both groups showed a significant improvement in outcome KOOS and IKDC scores at 12 months, 24 months and final follow up. 11 patients (31%) in the control cohort and 8 patients (24%) in study cohort underwent a second surgery on the index knee after the OCA transplantation. A statistically significant improvement in the study group from baseline to final follow-up (p<.02) was seen for all KOOS subscores (Symptom:+ 4.83, Pain: +13.05, ADL: +17.44, Sports: +14.48, QOL: +25.3) and IKDC (+22.46). A statistically significant improvement in the control group from baseline to final follow-up (p<.02) was seen for all 5 KOOS subscores; (Symptom:+15.22, Pain: +8.68, ADL: +18.52, Sports: +30, QOL: +32.71) and IKDC (+32.9). In the study group, the maximum improvements (112% of baseline, 45% of baseline) were seen in the KOOS QOL and sports respectively. Similar changes in the control group included 138% improvement from baseline KOOS QOL and 83.3% for sports. Despite this, there was no significant difference between the two groups with respect to any average KOOS subscore or IKDC score, at any time during the observation period. Conclusion: There was no significant difference between the group’s outcomes data at final follow up. This implies the efficacy of OCA transplantation in adults forty years of age and older is similar to that of younger adults. Interestingly, we saw the greatest improvement in each of the two cohorts in the quality of life subscale of the KOOS. Significant sustained improvements in the symptom, ADL and pain subscales of the KOOS and IKDC were also observed in both groups. Overall, patients over 40 years benefit in a similar manner to younger patients after FOCA and these benefits appear greatest for Quality of Life. [Table: see text]

scholarly journals A CLINICAL COMPARATIVE STUDY TO EVALUATE THE EFFECTIVENESS OF RASNA SWADAMSTRADI KSHEERAPAKA WITH SUKUMARAM KASHAYAM IN SPASMODIC DYSMENORRHOEA

2021 ◽  
pp. 18-27
Author(s):  
Shahina Mole.S ◽  
Anisha A
Keyword(s):  
Control Group ◽  
Study Group ◽  
Low Back ◽  
Control Drug ◽  
Sustained Action ◽  
Back Ache ◽  
And Control ◽  
Research Drug

Many women are familiar with the experience of spasmodic dysmenorrhoea, one of the commonest gynaecological conditions that affects the quality of life of many in their reproductive years. This condition manifested as painful menstruation, is the most frequently encountered gynaecological complaint and it can be included under Udavartha yonivyapat, caused by Apana vata vaigunya described in Ayurvedic classics. As the condition has significant effect on quality of life, personal health, and working hours and there are several limitations and adverse effects in modern medicine, its Ayurvedic management is of great importance. Randomized clinical study was conducted in Govt. Ayurveda College Hospital for Women and Children, Poojappura to evaluate the effectiveness of Rasna swadamstraadi ksheerapaaka in spasmodic dysmenorrhoea and to compare its result with that of Sukumaram kashayam. Total 30 patients between the age group 15-35 yrs were taken in to the study who had complaints of severe or moderate lower abdominal pain and associated complaints such as low back ache, nausea, vomiting, diarrhoea, and allocated them into two groups. Study group were treated with Rasna swadamstraadi ksheerapaaka and control group with Sukumaram kashayam. Administration of drug started10 days before menstruation and continued till 4th day of menstruation for 3 consecutive cycles for study group and control group. Follow up without medicine was done for next 3 consecutive cycles for both the groups. Results were analyzed and compared statistically. The research drug Rasna swadamstraadi ksheerapaaka had shown effectiveness in controlling pain in spasmodic dysmenorrhoea and associated symptoms like low back ache and nausea, but in the case of vomiting, and diarrhoea it showed less sustained action in follow up period. The control drug Sukumaram kashayam had also shown effectiveness in controlling pain in spasmodic dysmenorrhoea and associated complaints nausea and low back ache. But in the case of vomiting, and diarrhoea this medicine also showed less sustained action in follow up period. On conclusion the study revealed that the research drug Rasna swadamstraadi ksheerapaaka and control drug Sukumaram kashayam are equally effective in treating spasmodic dysmenorrhoea, without any side effects.

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

scholarly journals Patients with recurrent syncope and implantable loop recorder exhibit better survival than the control group without implantable loop recorder

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Perings ◽  
C Wolff ◽  
A Wilk ◽  
A Witthohn ◽  
R Voss ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Control Group ◽  
Funding Source ◽  
Implantable Loop Recorder ◽  
Loop Recorder ◽  
Cardiac Device ◽  
Unexplained Syncope ◽  
Care Costs

Abstract Introduction In 30% of patients with syncope, the underlying cause remains unexplained after clinical investigations. Unexplained syncope tends to recur, significantly impacting patients' quality of life of patients and mortality. Thus, there is a need for timely and more accurate diagnosis to initiate treatment. Dedicated care pathways are recommended by ESC guidelines. Purpose Patients with recurrent syncope were followed over time and patient outcomes with ILR were compared to patients with the same syncope burden, age, gender and mortality risk score who did not receive an ILR. Method A representative database of 4.9 million patients insured by German company statuary health insurances (BKK) was analysed over a time period of 10 years, 2007–17. Patients with recurrent syncope (two times ICD-10 GM diagnosis codes R55), age between 45–84 and no diagnosis code for the syncope were included in the analysis and followed for at least 2 years. Patients with ILR were matched to patients without ILR based on age, gender and Charlson Comorbidity index (CCI) using mahalanobis distances. The index event was the device implant in the ILR group and the second syncope event in the control group. Life expectancy, syncope hospitalisations, fall related injuries, health care costs, diagnoses and treatment rates were compared between the groups. Results A total of 412 patients with ILR for recurrent unexplained syncope were matched to the control group. Overall mean age was 68, mean was CCI 2.7, 42% were females. The risk of death was 2.35 times higher in the control group during follow up as shown in Figure 1 (p-value logrank test &lt;0.0001). Cardiovascular related diagnosis and treatment rates were higher in the ILR group with 69% of patients having a cardiology diagnosis compared to 41% in the control group. Over a quarter (27%) of ILR patients received an implantable cardiac device compared to 5% in the control group. Ablation rates were 7% in the ILR group compared to 0% in the control group. Median health care costs were € 3,847 higher in the ILR group including the costs of the ILR implant, follow up and higher rates of cardiac treatments. These extra costs appear moderate given the substantially higher mortality risk in the control group. Conclusion This study of patients with recurrent unexplained syncope shows a remarkable difference in life expectancy in patients with ILR compared to a matched control group. Two large claim data analysis have recently shown higher rates of cardiovascular death as well as all-cause mortality in patients with unexplained syncope. A more vigilant cardiac workup might be needed to identify a possible underlying cardiac condition. Higher rates of cardiac device therapy in the ILR group were likely to play an important role for their better life expectancy. Cardiac therapies such as pacemakers, defibrillators and ablation have also been shown to significantly improve patients' quality of life. Life Expectancy Comparison Funding Acknowledgement Type of funding source: Private company. Main funding source(s): The data analysis was funded by Medtronic

scholarly journals A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3007
Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Positive Effects ◽  
Therapy Program

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.

scholarly journals Engineered Fat Graft Enhanced with Adipose-Derived Stromal Vascular Fraction Cells for Regenerative Medicine: Clinical, Histological and Instrumental Evaluation in Breast Reconstruction

2019 ◽  
Vol 8 (4) ◽  
pp. 504 ◽  
Author(s):  
Pietro Gentile ◽  
Donato Casella ◽  
Enza Palma ◽  
Claudio Calabrese
Keyword(s):  
Breast Reconstruction ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Stromal Vascular Fraction ◽  
Fat Graft ◽  
Control Group ◽  
Study Group ◽  
Fat Tissue ◽  
Calvarial Defects

The areas in which Stromal Vascular Fraction cells (SVFs) have been used include radiotherapy based tissue damage after mastectomy, breast augmentation, calvarial defects, Crohn’s fistulas, and damaged skeletal muscle. Currently, the authors present their experience using regenerative cell therapy in breast reconstruction. The goal of this study was to evaluate the safety and efficacy of the use of Engineered Fat Graft Enhanced with Adipose-derived Stromal Vascular Fraction cells (EF-e-A) in breast reconstruction. 121 patients that were affected by the outcomes of breast oncoplastic surgery were treated with EF-e-A, comparing the results with the control group (n = 50) treated with not enhanced fat graft (EF-ne-A). The preoperative evaluation included a complete clinical examination, a photographic assessment, biopsy, magnetic resonance (MRI) of the soft tissue, and ultrasound (US). Postoperative follow-up took place at two, seven, 15, 21, 36 weeks, and then annually. In 72.8% (n = 88) of breast reconstruction treated with EF-e-A, we observed a restoration of the breast contour and an increase of 12.8 mm in the three-dimensional volume after 12 weeks, which was only observed in 27.3% (n = 33) of patients in the control group that was treated with EF-ne-A. Transplanted fat tissue reabsorption was analyzed with instrumental MRI and US. Volumetric persistence in the study group was higher (70.8%) than that in the control group (41.4%) (p < 0.0001 vs. control group). The use of EF-e-A was safe and effective in this series of treated cases.

Sign in / Sign up

Export Citation Format

Share Document