scholarly journals Early versus late treatment of voiding dysfunction with pelvic neuromodulation

2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Magdy M. Hassouna ◽  
Mohamed S. Elkelini
Keyword(s):  
Retrospective Study ◽  
Voiding Dysfunction ◽  
Sacral Neuromodulation ◽  
Early Group ◽  
Established Method ◽  
Group 13 ◽  
Patient Response ◽  
Percutaneous Nerve Evaluation ◽  
Late Treatment ◽  
Late Group

Introduction: Pelvic neuromodulation is an established method of treating voidingdysfunction. Little is known about the pathophysiology associated with voiding dysfunction. Reports have suggested that a delay in treating patients with sacral neuromodulation therapy can impact the success rate of this type oftreatment in voiding dysfunction. We examined patient response to pelvic neuromodulationwhen it was applied early versus late in the postdiagnosis of voidingdysfunction.Methods: We conducted a retrospective study of 42 patients (38 women and4 men) with voiding dysfunction who underwent surgery for implant with the Interstim (Medtronic, Minneapolis, Minn.). Prior to implantation, patients wererequired to pass a percutaneous nerve evaluation (PNE) over a 1-week period. Patients were observed for 20–48 months postimplantation. All patients recorded their voiding parameters at baseline, after screening and every 6 months thereafter. Twenty patients (in the early group) underwent implant surgery withthe neurostimulator 2–4 weeks post-PNE, and 22 patients (the late group)had the device implanted 6–24 months post-PNE owing to local logisticalcircumstances.Results: In the early group, 16 of 20 patients (80%) maintained a good response.In the late group, 13 of 22 (59%) patients showed a good response. Groupswere well matched in terms of age, duration of voiding dysfunction and incidenceof comorbidity.Conclusion: Patients who were delayed more than 6 months in receiving the neurostimulatorimplant showed a worse response than did patients who had thedevice implanted soon after PNE. This indicates the possibility of disease progression,which may limit the response to sacral neuromodulation.

894: Incidence and Relative Risk of Sacral Neuromodulation Failure in Women with Voiding Dysfunction Status Post Hysterectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 289-289 ◽  
Author(s):  
Humphrey Atiemo ◽  
Ashwin A. Vaze ◽  
Courtenay K. Moore ◽  
Michael Aleman ◽  
Joseph Abdelmalak ◽  
...  
Keyword(s):  
Relative Risk ◽  
Voiding Dysfunction ◽  
Sacral Neuromodulation

Survival With Respect to Morphology in Pulmonary Atresia and Intact Ventricular Septum in Sweden

2021 ◽  
Vol 12 (1) ◽  
pp. 27-34
Author(s):  
Stina Manhem ◽  
Katarina Hanséus ◽  
Håkan Berggren ◽  
Britt-Marie Ekman-Joelsson
Keyword(s):  
Pulmonary Atresia ◽  
Early Time ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Early Group ◽  
Time Period ◽  
Medical Reports ◽  
One Year ◽  
Survival Risk ◽  
Late Group

Background: Patients born with pulmonary atresia and intact ventricular septum represent a challenge to pediatric cardiologists. Our objective was to study changes in survival with respect to morphology in all children born with pulmonary atresia and intact ventricular septum in Sweden during 36 years. Methods: A retrospective, descriptive study based on medical reports and echocardiographic examinations consisting of those born between 1980 and 1998 (early group) and those born between 1999 and 2016 (late group). Results: The cohort consists of 171 patients (early group, n = 86 and late group, n = 85) yielding an incidence of 4.35 and 4.46 per 100,000 live births, respectively. One-year survival in the early group was 76% compared to 92% in the late group ( P = .0004). For patients with membranous atresia, one-year survival increased from 78% to 98%, and for muscular pulmonary atresia, from 68% to 85%. In patients with muscular pulmonary atresia and ventriculocoronary arterial communications, there was no significant increase in survival. Risk factors for death were being born in the early time period hazard ratio (HR), 6; 95% CI (2.33-14.28) P = .0002, low birth weight HR, 1.26; 95% CI (1.14-1.4) P < .0001 and having muscular pulmonary atresia HR, 3.74; 95% CI (1.71-8.19) P = .0010. Conclusion: The incidence of pulmonary atresia and intact ventricular septum remained unchanged during the study period. Survival has improved, especially for patients with membranous pulmonary atresia, while being born with muscular pulmonary atresia is still a risk factor for death. To further improve survival, greater focus on patients with muscular pulmonary atresia and ventriculocoronary arterial communications is required.

scholarly journals Benefits of early intervention with catheter ablation in patients with atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Mohanty ◽  
C Trivedi ◽  
D G Della Rocca ◽  
C Gianni ◽  
B MacDonald ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Early Intervention ◽  
Catheter Ablation ◽  
Success Rate ◽  
Therapeutic Option ◽  
Superior Vena ◽  
Vena Cava ◽  
Posterior Wall ◽  
Early Group ◽  
Late Group

Abstract Background Radiofrequency catheter ablation, a widely recognized therapeutic option for atrial fibrillation (AF) has limited success rate as it is influenced by several factors including duration of AF. Purpose We evaluated the ablation success in AF patients intervened early versus late in the disease course. Methods Consecutive AF patients undergoing their first catheter ablation in 2015–16 at our center were included in the analysis. Patients were classified into two groups based on the time to ablation after AF diagnosis; 1) early: ≤12 months and 2) late: &gt;12 months. All received PV isolation plus isolation of posterior wall and superior vena cava. Additionally, in non-paroxysmal AF cases, non-PV triggers were identified with isoproterenol-challenge and ablated. Patients were prospectively followed up for 3 years with regular rhythm monitoring. Results A total of 752 and 1248 patients were included in the “early” and “late” group respectively. Baseline characteristics of the study population is provided in Table 1 A. At 4 years of follow-up, overall success rate off-antiarrhythmic drugs was significantly higher in the “early” group (65.4% vs 57%, p&lt;0.001). After stratification by AF type, “early” group was still associated with significantly higher success rate compared to the “late” group (Table 1B). Conclusion In this large series with standardized ablation strategy, early intervention with catheter ablation was associated with higher success rate in all AF types. FUNDunding Acknowledgement Type of funding sources: None. Table 1

An Early View of Real-World Patient Response to Sacubitril/Valsartan: A Retrospective Study of Patients with Heart Failure with Reduced Ejection Fraction

2018 ◽  
Vol 35 (6) ◽  
pp. 785-795 ◽  
Author(s):  
Dana Drzayich Antol ◽  
Adrianne Waldman Casebeer ◽  
Richard W. DeClue ◽  
Stephen Stemkowski ◽  
Patricia A. Russo
Keyword(s):  
Heart Failure ◽  
Retrospective Study ◽  
Ejection Fraction ◽  
Real World ◽  
Patient Response ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Early View

Delaying an Appendectomy: Is it Safe?

2012 ◽  
Vol 78 (8) ◽  
pp. 897-900 ◽  
Author(s):  
Kamal Nagpal ◽  
Navalkishor Udgiri ◽  
Niraj Sharma ◽  
Ernesto Curras ◽  
John Morgan Cosgrove ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Patient Outcomes ◽  
Early Group ◽  
Perforation Rate ◽  
Exclusion Criteria ◽  
Open Conversion ◽  
Urgent Operation ◽  
The Mean ◽  
The Relationship ◽  
Late Group

Appendicitis has always been an indication for an urgent operation, as delay is thought to lead to disease progression and therefore worse outcomes. Recent studies suggest that appendectomy can be delayed slightly without worse outcomes, however the literature is contradictory. The goal of our study was to examine the relationship between this delay to surgery and patient outcomes. We reviewed all patients that underwent an appendectomy in our institution from January 2009 to December 2010. We recorded the time of surgical diagnosis from when both the surgical consult and the CT scan (if done) were completed. The delay from surgical diagnosis to incision was measured, and patients were divided into two groups: early (≤6 hours delay) and late (>6 hours delay). Outcome measures were 30-day complication rate, length of stay, perforation rate, and laparoscopic to open conversion rate. Three hundred and seventy-seven patients had appendectomies in the study period, and 35 patients were excluded as per the exclusion criteria leaving 342 in the study: 269 (78.7%) in the early group and 73 (21.3%) in the late group. Complications occurred in 21 patients (6.1%) with no difference between the groups: 16/253 (5.9%) in the early group and 5/73 (6.8%) in the late group ( P = 0.93, χ2). The mean (± standard deviation) length of stay was 86.1 ± 67.1 hours in the early group, and 95.9 ± 73.0 hours in the late group. This difference was not significant ( P = 0.22). Delaying an appendectomy more than 6 hours, but less than 24 hours from diagnosis is safe and does not lead to worse outcomes. This can help limit the disruption to the schedules of both the surgeon and the operating room.

Inhibition of liver protein synthesis during laparoscopic surgery

1999 ◽  
Vol 277 (4) ◽  
pp. E591-E596 ◽  
Author(s):  
Hans Barle ◽  
Björn Nyberg ◽  
Stig Ramel ◽  
Pia Essén ◽  
Margaret A. McNurlan ◽  
...  
Keyword(s):  
Protein Synthesis ◽  
Laparoscopic Surgery ◽  
Synthesis Rate ◽  
Protein Synthesis Rate ◽  
Liver Protein ◽  
Early Group ◽  
Total Liver ◽  
Elective Laparoscopic Cholecystectomy ◽  
Absolute Synthesis ◽  
Late Group

Previous studies have indicated that laparoscopic surgery is associated with a decline in liver protein synthesis. In this study, the fractional synthesis rate (FSR) of total liver protein and albumin was measured in patients undergoing elective laparoscopic cholecystectomy at different times after commencing the procedure ( n = 8 + 8). Liver biopsy specimens were taken after 15 min of surgery in an “early” group and after 49 min of surgery in a “late” group. The liver FSR was higher in the early group (24.1 ± 4.7%/day) compared with the late group (19.0 ± 2.8%/day, P < 0.02). The fractional and absolute synthesis rates of albumin were similar in the two groups, 6.4 ± 1.5 vs. 6.5 ± 1.0%/day and 97 ± 19 vs. 96 ± 18 mg ⋅ kg−1⋅ day−1for the early and late groups, respectively. It is concluded that laparoscopic surgery was accompanied by a decrease in total liver protein synthesis rate, which developed rapidly during surgery. In contrast, no change in the synthesis rate of albumin was apparent during the course of surgery.

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