Benefit of a nurse-led telephone-based intervention prior to the first urogynecology outpatient visit: a randomized-controlled trial.

INTRODUCTION AND HYPOTHESIS: Triage has become a valid tool to reduce workload during the first consultation in a specialized clinic. A nurse-led telephone intervention prior to the first urogynecologic visit reduces visit duration and increases patients' and physicians' satisfaction. METHODS: All patients scheduled for their very first visit were recruited. They were randomized into an intervention group (prior contact by a specialized urogynecology nurse) and a control group (no contact). The intervention included a questionnaire about history and symptoms. Patients were prompted to complete a bladder diary. Primary outcome was duration of the consultation; secondary outcomes were patients' and physicians' satisfaction with the intervention. RESULTS: Fifty-five patients were allocated to the intervention group and 53 to the control group with no difference regarding age, BMI, parity, menopausal status and primary diagnosis. Mean duration of the telephone call was 10.8 min (SD 4.4). The consultation was significantly shorter in the intervention group than in the control group (mean difference: 4 min and 8 s, p = 0.017). In the intervention group, 79% of the patients found the consultation quality "excellent," 86% would return, and 77% would recommend our clinic to a relative or friend compared with 68%, 67% and 66%, respectively, in the control group. Physicians were "very satisfied" or "satisfied" with the patient preparation. CONCLUSIONS: A nurse-led intervention reduces the duration of the first uroynecologic consultation and is associated with high patient and physician satisfaction. Further research should evaluate whether it also decreases the number of follow-up visits and further referrals.

Topical curcumin for the healing of carbon dioxide laser skin wounds in mice.

OBJECTIVE: The purpose of this study was to evaluate the effect of topical curcumin on the healing of skin wounds produced by the CO(2) laser in an animal model. METHODS: A prospective, randomized study was made of 90 mice assigned to three groups (30 animals per group), with the creation of 6-mm incisions in the skin of the dorsal region by means of the CO(2) laser. A total of 270 wounds were made (3 wounds by animal). No product was applied to the resulting wound in group I (control group); vehicle was applied in group II (5 mg/day by wound); and topical curcumin was applied to the mice in group III (5 mg/day by wound). Re-epithelialization and inflammation of the wounds were measured from histological sections of wounds, after 2, 7, and 14 days. RESULTS: Two days after production of the wounds, most of the latter showed incomplete re-epithelialization. After 7 days, 73.33% of the wounds treated with curcumin presented re-epithelialization covering the entire wound, with irregular thickness; nevertheless, only 37.50% of the wounds in control group and 41.67% in the vehicle group showed this degree ot re-epithelialization. After 14 days, all the wounds had completed re-epithelization. No significant differences were observed regarding resolution of the inflammatory process in any of the study groups after 2, 7, and 14 days. CONCLUSIONS: This study shows that topical curcumin applied to CO(2) laser-induced skin wounds may be useful, because improved re-epithelialization is observed after 7 days.

Wound healing with PRGF infiltration in CO(2) laser lesions of the tongue: an animal study.

OBJECTIVE: This study was done of the effects of plasma rich in growth factors (PRGF) on the healing of tongue wounds induced by the CO(2) laser. MATERIALS AND METHODS: A prospective blind study was made of 60 Sprague-Dawley rats divided into two groups after the creation of tongue lesions using the CO(2) laser. Nothing was applied to the resulting wounds in the first group, while PRGF was applied to the 30 wounds in the second group. Wound re-epithelialization and inflammation were measured after 7, 14, and 28 d. RESULTS: No significant differences were seen between the two groups in relation to wound re-epithelialization, and the group without PRGF actually showed significantly better resolution of the inflammatory process after 14 d (p = 0.036). CONCLUSIONS: After 28 d, the rat tongue wounds produced by the CO(2) laser showed complete healing, independently of PRGF application.

Analysis of the histopathological artefacts in punch biopsies of the normal oral mucosa.

OBJECTIVES: To study the most frequent artifacts of punch biopsies of the healthy oral mucosa, distinguishing between those attributable to the surgical technique and those resulting from sample processing in the laboratory. STUDY DESIGN: A total of 186 samples of oral mucosa (dorsal lingual mucosa) were obtained from 186 adult albino rats by the experienced oral surgeons, evaluating the presence of artifacts attributable to the surgical technique (crush, splits, fragmentation, pseudocysts and haemorrhage) and those attributable to sample processing in the laboratory (orientation). RESULTS: The distribution of artifacts attributable to the surgical procedure was as follows: crush 16.67%, splits 0%, fragmentation 0%, pseudocysts 1.08% and hemorrhage 0%. The artifacts corresponding to sample processing in the laboratory (orientation) represented 37.63%. CONCLUSIONS: The present study shows use of the punch for obtaining biopsies of the healthy oral mucosa to produce few artifacts. In addition, good or poor orientation of the samples is not attributable to the surgical technique but to processing of the samples in the laboratory.

Analysis of the histopathological artifacts in punch biopsies of the normal oral mucosa

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Objectives: To study the most frequent artifacts of punch biopsies of the healthy oral mucosa, distinguishing between those attributable to the surgical technique and those resulting from sample processing in the laboratory. Study design: A total of 186 samples of oral mucosa (dorsal lingual mucosa) were obtained from 186 adult albino rats by the experienced oral surgeons, evaluating the presence of artifacts attributable to the surgical technique (crush, splits, fragmentation, pseudocysts and haemorrhage) and those attributable to sample processing in the laboratory (orientation).Results: The distribution of artifacts attributable to the surgical procedure was as follows: crush 16.67%, splits 0%, fragmentation 0%, pseudocysts 1.08% and hemorrhage 0%. The artifacts corresponding to sample processing in the laboratory (orientation) represented 37.63%. Conclusions: The present study shows use of the punch for obtaining biopsies of the healthy oral mucosa to produce few artifacts. In addition, good or poor orientation of the samples is not attributable to the surgical technique but to processing of the samples in the laboratory (AU)

Biopsy of the buccal mucosa in oral lichen planus: the traditional method versus the use of a new pressure forceps.

BACKGROUND: The authors designed a pressure forceps, called the "B forceps," for use in performing biopsies. They compared biopsy specimens taken with and without the aid of the B forceps from buccal mucosa of 84 patients divided equally into two groups, all of whom satisfied the World Health Organization's diagnostic criteria for oral lichen planus. They analyzed the advantages and disadvantages of using this instrument. MATERIALS AND METHODS: The 42 patients in group A underwent a conventional biopsy (29 with a scalpel and 13 with a punch). The 42 patients in group B underwent a biopsy performed with the B forceps and a punch. The authors studied artifacts of fragmentation, pseudocysts, crushing, fissures and hemorrhages histologically in both groups. RESULTS: There were no significant differences within group A between the subjects who had undergone either the scalpel or the punch biopsy. There were, however, significant differences between groups A and B. Group B experienced less fragmentation (P = .021), fewer fissures (P = .001) and fewer hemorrhages (P = .001). CONCLUSIONS: The new B forceps was a useful aid in the performance of biopsies. It improved visibility and reduced the time needed for the procedure. Biopsy specimens taken with the B forceps also had histologically fewer artifacts than did those taken without the B forceps. CLINICAL IMPLICATIONS: This technique using the B forceps has several advantages, including speed, because the ischemia produced by the clamp stabilizes the tissue and increases visibility, facilitating dissection. The time needed for surgical removal thus is shortened.