scholarly journals Conservative Management in Congenital Bilateral Upper Eyelid Eversion

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Viola Andin Dohvoma ◽  
Alice Nchifor ◽  
Aronette Nana Ngwanou ◽  
Elisabeth Attha ◽  
Faustin Ngounou ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Hypertonic Saline ◽  
Conservative Management ◽  
Healthcare Professionals ◽  
Upper Eyelid ◽  
Benign Condition ◽  
The Third ◽  
Upper Lid ◽  
Male Neonate ◽  
Antibiotic Ointment

Aim. To report the case of congenital bilateral upper eyelid eversion with severe chemosis that was successfully managed conservatively.Report. The patient was a six-hour-old male neonate with bilateral congenital upper eyelid eversion and severe chemosis, following uneventful delivery. Conservative management consisted of the application of antibiotic ointment and padding the exposed conjunctiva with 5% hypertonic saline-soaked gauze. The eyelids reverted spontaneously on day 3 and the condition was completely resolved by the third week.Conclusion. Congenital upper lid eversion is usually a benign condition which responds well to conservative treatment. Creating awareness amongst healthcare professionals is essential.

scholarly journals Successful Conservative Management of Neonatal MRSA Associated Tricuspid Valve Infective Endocarditis

2013 ◽  
Vol 33 (1) ◽  
pp. 70-73
Author(s):  
MK Sodhi ◽  
GS Chhabra ◽  
SS Sarin
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Conservative Treatment ◽  
Early Diagnosis ◽  
Effective Treatment ◽  
Tricuspid Valve ◽  
Conservative Management ◽  
Current Case ◽  
The Status ◽  
Male Neonate

Prognosis in neonatal endocarditis depends on early diagnosis and the status of the patient at the time of diagnosis, and effective treatment with appropriate antibiotics. The current case report describes a case of successful conservative treatment of endocarditis in a 26 day old male neonate, previously inadequately treated for septicaemia in another hospital. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7045 J Nepal Paediatr Soc. 2013;33(1):70-73

scholarly journals VATAHATA VARTMA (PTOSIS) AYURVEDIC MANAGEMENT: A CASE STUDY

2019 ◽  
pp. 145-148
Author(s):  
Aswathy Narayanan ◽  
Ashwini M J
Keyword(s):  
Present Article ◽  
Male Patient ◽  
Conservative Management ◽  
Double Vision ◽  
Effective Management ◽  
Upper Eyelid ◽  
Treatment Principles ◽  
Upper Lid

Vatahata vartma is a vataja vartmagata roga where there is drooping of the eyelids. Ptosis is an abnormal low position of the upper lid; it may be congenital or acquired.The condition can be either uniocular or binocular. The present article discusses a case of Vatahata vartma (uniocular involutional ptosis) where a male patient of 59 years visited opd with complaints of drooping of left upper eyelid associated with double vision of near objects since 1 month. Initially the patient was treated with amapachana chikitsa followed by bruhmana and vata shamana chikitsa along with eye exercise of ocular muscles. After 2 weeks of treatment there was improvement in the grade of ptosis. Eventhough acharya explained the disease as asadhya in nature; conservative management can be done using ayurvedic principles in particular types of ptosis.This case study helps in exploring the effective management of vatahata vartma(involutional ptosis) by applying vatahara treatment principles. KEYWORDS: vatahata vartma,involutional ptosis,vatahara chikitsa

Expert consensus on the conservative management of patients with chronic venous disease in CEAP clinical classes C0s-C3 in Italy

2019 ◽  
Vol 35 (5) ◽  
pp. 316-324
Author(s):  
Cristiana Vitale ◽  
Massimo Lucchi ◽  
Daniele Bissacco ◽  
Salvino Bilancini ◽  
Fabrizio D’Abate ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Steering Committee ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Second Phase ◽  
Delphi Consensus ◽  
The Third ◽  
Two Phases ◽  
Consensual Approach

Objectives To define a consensual approach for the conservative treatment of patients C0s-C3. Method The project was structured into two phases. The first one involved a group of Italian specialists in angiology and/or vascular surgery with the aim to compare their therapeutic choices in the management of patients in CEAP C0s-C3. The second phase used a Delphi consensus in order to elaborate practical statements on the conservative management of these patients. Results The first phase involved a group of 166 Italian specialists while the second phase involved a Steering Committee of 6 specialists and a panel of 20 specialists. At the end of the third round, a consensus >80% was reached on seven assertions. Conclusion Seven statements have been drafted by a group of Italian specialists to provide physicians with practical guidance for the conservative treatment of C0s-C3 patients. Outstanding issues on the management of these patients were identified, confirming the urgent need of further research.

scholarly journals Relative Efficacy of Three of Nonsurgical Treatments for Calcific Tendinitis: Physical Therapy vs Steroid Injection vs Ultrasound-Guided Aspiration

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Mauricio Drummond ◽  
Caroline Ayinon ◽  
Albert Lin ◽  
Robin Dunn
Keyword(s):  
Physical Therapy ◽  
Rotator Cuff ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Ultrasound Guided ◽  
Calcium Deposits

Objectives: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC) that accounts for up to 7% of cases of shoulder pain1. The most common conservative treatments typically include physical therapy (PT), corticosteroid injection (CSI), or ultrasound-guided aspiration (USA). When conservative management fails, the patient may require arthroscopic surgery to remove the calcium with concomitant rotator cuff repair. The purpose of this study was to characterize the failure rates, defined as the need for surgery, of each of these three methods of conservative treatment, as well as to compare post-operative improvement in patient-reported outcomes (PROs) – including subjective shoulder values (SSV) and visual analog scale (VAS) pain scores – based on the type of pre-operative conservative intervention provided. A secondary aim was to compare post-operative range of motion (ROM) outcomes between groups that failed conservative management. We hypothesized that all preoperative conservative treatments would have equivalent success rates, PROs, and ROM. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA. 1941;116(22):2477-2489. Methods: A retrospective review of all patients who were diagnosed with calcific tendinitis at our institution treated among 3 fellowship trained orthopedic surgeons between 2009 and 2019 was performed. VAS, SSV, and ROM in forward flexion (FF) and external rotation (ER) was abstracted from the medical records. Scores were recorded at the initial presentation as well as final post-operative follow-up visit for those who underwent surgery. The conservative treatment method utilized by each patient was recorded and included PT, CSI, or USA. Failure of conservative management was defined as eventual progression to surgical intervention. Statistical analysis included chi-square, independent t test and ANOVA. Descriptive statistics were used to report data. A p<0.05 was considered to be statistically significant. Results: 239 patients diagnosed with calcific tendinitis were identified in the study period with mean age of 54 years and follow up of at least 6 months. In all, 206 (86.2%) patients underwent a method of conservative treatment. Of these patients, 71/239 (29.7%) underwent PT, 67/239 (28%) attempted CSI, and 68/239 (28.5%) underwent USA. The overall failure rate across all treatment groups was 29.1%, with injections yielding the highest success rate of 54/67 (80.6%). Physical therapy saw the highest failure rate, with 26/71 (36.7%) proceeding to surgical intervention. Patients undergoing physical therapy were statistically more likely to require surgery compared to those undergoing corticosteroid injection (RR 1.88, p= 0.024). Of all 93 patients who underwent surgery, VAS, SSV, ROM improved significantly in all groups. On average, VAS decreased by 4.02 points (6.3 to 2.3), SSV increased by 33 points (51 to 84), FF improved by 13.8º, and ER improved 8.4º between the pre- and post-operative visits (p<0.05). The 33 patients who did not attempt a conservative pre-operative treatment demonstrated the largest post-operative improvement in VAS (-6.00), which was significantly greater than those who previously attempted PT (-3.33, p<0.05). There was a trend towards greater improvement in SSV in the pre-operative PT group (45 to 81) compared to others, but this did not reach statistical significance (p=0.47). Range of motion was not significantly affected by the method of pre-operative conservative intervention. Conclusions: Conservative treatment in the form of physical therapy, corticosteroid injection, and ultrasound-guided aspiration is largely successful in managing calcific tendinitis of the shoulder. Of these, PT demonstrated the highest rate of failure in terms of requiring surgical management. PRO improvement varied among the conservative modalities used, however patients who did not attempt conservative management experienced the greatest improvements following surgery. If surgery is necessary following failed conservative treatment, excellent outcomes can be expected with significant improvements in ROM and PROs. This information should be considered by the surgeon when deciding whether to recommend conservative treatment for the management of calcific tendinitis, as well as which specific method to employ.

Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

2020 ◽  
Vol 28 (2) ◽  
pp. 119-133
Author(s):  
Nicola Davies ◽  
Teresa Burdett
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Integrated Approach ◽  
Pelvic Organ ◽  
Social Implications ◽  
Content Type ◽  
Practical Implications

PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

scholarly journals Concordance of a point mutation 5' to the G gamma globin gene with G gamma beta +. Hereditary persistence of fetal hemoglobin in the black population

Blood ◽  
1984 ◽  
Vol 64 (6) ◽  
pp. 1292-1296 ◽  
Author(s):  
FS Collins ◽  
CD Boehm ◽  
PG Waber ◽  
CJ Jr Stoeckert ◽  
SM Weissman ◽  
...  
Keyword(s):  
Point Mutation ◽  
Globin Gene ◽  
Fetal Hemoglobin ◽  
Black Population ◽  
Globin Genes ◽  
Beta Globin ◽  
Restriction Endonuclease Site ◽  
Benign Condition ◽  
The Third ◽  
Hereditary Persistence

Abstract Hereditary persistence of fetal hemoglobin (HPFH) is a genetically heterogeneous and clinically benign condition characterized by persistent expression of fetal hemoglobin (Hb F) into adulthood. In the G gamma beta + type, no major deletions in the globin gene cluster occur; adult heterozygotes produce approximately 20% Hb F, which results from overproduction of G gamma chains, with no apparent increase in production from the adjacent A gamma gene. We have recently described a point mutation 202 base pairs 5′ to the cap site of the G gamma gene in an individual with G gamma beta + HPFH. This mutation abolishes a normal ApaI restriction endonuclease site, and thus can be detected by blotting of genomic DNA. We present here further data on the ApaI mutation: (1) It occurs in six of seven families with G gamma beta + HPFH. (2) In three families, detailed haplotype analysis using 11 polymorphic restriction sites in the beta globin cluster has been done. The two that carry the missing ApaI site are identical but the third, which has a normal ApaI pattern, differs from the other two in at least two sites, one of which is a new polymorphic Nco I site between the delta and beta globin genes. This suggests the possibility of a different HPFH mutation in the third family. (3) The haplotype of the G gamma beta + HPFH chromosome carrying the ApaI mutation is different from that of 108 beta A chromosomes of black individuals that have been tested. (4) The G gamma ApaI site is normal in 61 beta A and 109 beta S alleles from non-HPFH black individuals, including 22 who share the same haplotype for the intragenic G gamma, A gamma HindIII polymorphisms. These data add support to the possibility that the -202 mutation is actually causative of the G gamma beta + HPFH phenotype.

Surgical Management of the Paralyzed Eyelid

1993 ◽  
Vol 72 (10) ◽  
pp. 692-701 ◽  
Author(s):  
Monte S. Keen ◽  
John D. Burgoyne ◽  
Scott L. Kay
Keyword(s):  
Critical Analysis ◽  
Lower Eyelid ◽  
Facial Nerve Paralysis ◽  
Upper Eyelid ◽  
Nerve Paralysis ◽  
Eyelid Closure ◽  
Corneal Abrasion ◽  
Tarsal Plate ◽  
Analysis Of Results ◽  
Upper Lid

The most devastating sequelae of the facial nerve paralysis is the loss of eye lid function. The inability to blink, lubricate and protect the globe can lead to exposure keratitis, corneal abrasion and even the loss of vision. Eyelid closure is approximately 85% upper eyelid and 15% lower eyelid. In order to ensure adequate protection of the globe, deficiencies of both eyelids must be addressed. We report our experience with 20 patients with eyelid paralysis. Upper lid reanimation was performed by the placement of gold lid weights on the tarsal plate. Lower lid reanimation procedures included lateral canthopexy and horizontal lid shortening. A discussion of the above-mentioned procedures, the timing of the procedures and a critical analysis of results will be included. A comprehensive approach to the management of the paralyzed eye will be presented.

scholarly journals Action after Adverse Events in Healthcare: An Integrative Literature Review

2020 ◽  
Vol 17 (13) ◽  
pp. 4717
Author(s):  
Mari Liukka ◽  
Alison Steven ◽  
M Flores Vizcaya Moreno ◽  
Arja M Sara-aho ◽  
Jayden Khakurel ◽  
...  
Keyword(s):  
Adverse Event ◽  
Literature Review ◽  
Adverse Events ◽  
Healthcare Professionals ◽  
Open Communication ◽  
The Third ◽  
Knowledge Theory ◽  
Victim Support ◽  
Second Victim ◽  
And Training

Adverse events are common in healthcare. Three types of victims of patient-related adverse events can be identified. The first type includes patients and their families, the second type includes healthcare professionals involved in an adverse event and the third type includes healthcare organisations in which an adverse event occurs. The purpose of this integrative review is to synthesise knowledge, theory and evidence regarding action after adverse events, based on literature published in the last ten years (2009–2018). In the studies critically evaluated (n = 25), key themes emerged relating to the first, second and third victim elements. The first victim elements comprise attention to revealing an adverse event, communication after an event, first victim support and complete apology. The second victim elements include second victim support types and services, coping strategies, professional changes after adverse events and learning about adverse event phenomena. The third victim elements consist of organisational action after adverse events, strategy, infrastructure and training and open communication about adverse events. There is a lack of comprehensive models for action after adverse events. This requires understanding of the phenomenon along with ambition to manage adverse events as a whole. When an adverse event is identified and a concern expressed, systematic damage preventing and ameliorating actions should be immediately launched. System-wide development is needed.

Identifying Aesthetically Appealing Upper Eyelid Topographic Proportions

2019 ◽  
Vol 39 (8) ◽  
pp. 824-834 ◽  
Author(s):  
Elbert E Vaca ◽  
Jonathan T Bricker ◽  
Irene Helenowski ◽  
Eugene D Park ◽  
Mohammed S Alghoul
Keyword(s):  
Likert Scale ◽  
Upper Eyelid ◽  
Topographic Features ◽  
Public Media ◽  
Adobe Illustrator ◽  
Upper Lid ◽  
Caucasian Female ◽  
The Ideal

AbstractBackgroundThe goal of upper eyelid procedures is to restore or create the ideal proportions between the pretarsal space and the upper lid fold.ObjectivesThe aim of this study was to define the topographic features of the attractive upper lid.MethodsCaucasian female frontal facial photographs were obtained from public media and periorbital areas were cropped. A total of 294 photographs of eyes were rated by 6 evaluators using a 4-point Likert scale. Eyes rating an average ≥3.5 were defined as “attractive,” whereas those rated ≤2.0 were defined as “unattractive” and analyzed using Adobe Illustrator.ResultsFifty-one and 19 eyes were included in the attractive and unattractive cohorts, respectively. (Upper lid foldPretarsal) shows ratios averaged between 1.8 and 3.0 among attractive eyes, and larger ratios were observed laterally. These ratios were significantly larger laterally among attractive vs unattractive eyes (P ≤ 0.003). The lash line peak (P < 10–4), lid crease peak (P < 10–3), and brow peak (P < 0.05) were significantly more lateralized in attractive eyes.ConclusionsAttractive eyes tend to exhibit decreased pretarsal show. However, there is pronounced variability in these ratios among attractive eyes, suggesting the importance of other features. Interestingly, progressive lateralization of the lash line, lid crease, and brow peaks appears to be an undescribed feature common to attractive eyes. Knowledge of attractive eyelid features may be an important consideration for planning and optimization of upper lid rejuvenation procedures.

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