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1.
An. psicol ; 37(2): 210-220, mayo-sept. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-202545

RESUMEN

BACKGROUND: Prison victimization has been a focus of attention by the scientific community with studies that indicate a high prevalence and negative effects on mental health and social reintegration of prisoners. However, there is few information on intervention responses, so it is relevant to obtain reliable data about intervention strategies that seeks to mitigate its consequences and provide support to victims. OBJECTIVE: accomplish a detailed description of the literature on psychological intervention that seeks to respond to victimization in prison and its consequences. METHOD: Systematic review (SR) using the PRISMA-P method. The research was carried out in 10 electronic databases and the data collection and analysis process carried out by two independent researchers. RESULTS: Five publications were included, three quantitative studies and two theoretical articles although none specifically focuses on intervention with individuals subject to prison victimization. This feature is addressed and theoretically analyzed throughout the discussion. CONCLUSION: There are few publications on intervention with victims of pris-on victimization and existing ones do not focus on specific intervention in the context of this type of victimization. However, important guidelines were obtained to be included into future intervention proposals. There is a consensus regarding the need to adopt empirically validated intervention models, referring to the Cognitive Behavior Therapy (CBT), specifically to the Trauma-Informed Treatment (TIT)


INTRODUCCIÓN: La victimización penitenciaria ha sido el foco de atención de la comunidad científica con estudios que indican una alta prevalencia y efectos negativos en la salud mental y en la reintegración social de los presidiarios. Sin embargo, existe poca información sobre las intervenciones, por lo que es relevante obtener datos confiables sobre estrategias de intervención que busquen mitigar sus consecuencias y ofrecer apoyo a las víctimas. OBJETIVO: realizar una descripción detallada de la literatura sobre intervención psicológica que busca dar respuesta a la victimización en prisión y sus consecuencias. MÉTODO: Revisión sistemática (RS) mediante el método PRISMA-P. La investigación se realizó en 10 bases de datos electrónicas y el proceso de recolección y análisis de datos fue realizado por dos investigadores independientes. RESULTADOS: Se incluyeron cinco publicaciones, tres estudios cuantitativos y dos artículos teóricos, aunque ninguno se centra específicamente en la intervención con personas sometidas a victimización penitenciaria. Este as-pecto se aborda y analiza teóricamente a lo largo de la discusión. CONCLUSIÓN: Existen pocas publicaciones sobre intervención con personas victimizadas en prisión y las existentes no enfocan en detalle en la intervención en este tipo de victimización. Sin embargo, se obtuvieron datos relevantes para ser incluidos en futuras propuestas de intervención. Existe consenso en cuanto a la necesidad de adoptar modelos de intervención valida-dos empíricamente, refiriéndose a la Terapia Cognitivo Conductual (TCC), específicamente al Tratamiento Informado por Trauma (TIT)


Asunto(s)
Humanos , Violencia/psicología , Prisioneros/psicología , Psicoterapia/métodos , Víctimas de Crimen/psicología , Prisiones , Salud Mental , Resultado del Tratamiento
2.
Kyobu Geka ; 74(7): 539-542, 2021 Jul.
Artículo en Japonés | MEDLINE | ID: mdl-34193790

RESUMEN

A right-sided classical Blalock-Taussig shunt was created in a 3-year-old male infant with hypoplastic left ventricle, common atrioventricular valve, transposition of the great arteries, and pulmonary stenosis. He was diagnosed with near Eisenmenger pulmonary hypertension at the age of 6 years. Surgery to achieve right heart bypass circulation was not conducted. At 33 years of age, he experienced hemoptysis. Pulmonary artery dissection, a life-threatening condition, was detected upon computed tomography performed when the patient was 35 years of age. After three weeks, surgery with cardiopulmonary bypass requiring pulmonary artery replacement using composite prosthetic conduits, closure of the pulmonary valve, and banding of the previously created Blalock-Taussig shunt was performed. Six years after the surgery, the patient's physical activity is maintained. Although intracardiac repair or definitive palliation with cardiopulmonary bypass is contraindicated in such patients, life-saving surgery with cardiopulmonary bypass that does not worsen pulmonary hypertension can be performed.


Asunto(s)
Hipertensión Pulmonar , Transposición de los Grandes Vasos , Niño , Preescolar , Disección , Ventrículos Cardíacos , Humanos , Hipertensión Pulmonar/complicaciones , Hipertensión Pulmonar/cirugía , Lactante , Masculino , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Resultado del Tratamiento
3.
Acta Biomed ; 92(3): e2021250, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34212899

RESUMEN

I am a professor and attending pharmacist in the field of pharmaceutical sciences and writer or co-author of at least 5 manuscripts about different aspects of COVID-19. More than 15 months from the first report of COVID-19, over 120 million people all over the world infected by this virus, and more than 2.5 million of them have died. Although different treatment approaches have been proposed, management of the COVID-19 patients is steal remained controversial. In this regard, I want to share my personal experience from the exposure to the coronavirus and the consequence of this infection on my health status. I am a 51 years old male, known case of hypertension, dyslipidemia, and chronic kidney disease. During working hours of colleagues in the Faculty of Pharmacy, I visited one of my colleagues in his office. After leaving the Faculty, my colleague declares that his RT-PCR test of COVID-19 is positive and it took 3 days for me to experience the first sign of the COVID-19 as fever. Many complications have occurred for me during the different stages of COVID-19 infection that I shared and explained in detail with the suggested pharmacotherapies. According to the pathophysiology of COVID-19 infection and my personal experience during COVID-19 infection, I want to emphasize the necessity of early initiation of anti-inflammatory agents including corticosteroids and colchicine in high-risk patients with mild-to-moderate COVID-19 pneumonia who shows respiratory system involvement, in order to prevent progression to the severe and critical stages of this disease.


Asunto(s)
COVID-19 , Antiinflamatorios , Humanos , Masculino , Persona de Mediana Edad , Farmacéuticos , SARS-CoV-2 , Resultado del Tratamiento
4.
BMC Infect Dis ; 21(1): 635, 2021 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-34215210

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has changed our lives. The scientific community has been investigating re-purposed treatments to prevent disease progression in coronavirus disease (COVID-19) patients. OBJECTIVE: To determine whether ivermectin treatment can prevent hospitalization in individuals with early COVID-19. DESIGN, SETTING AND PARTICIPANTS: A randomized, double-blind, placebo-controlled study was conducted in non-hospitalized individuals with COVID-19 in Corrientes, Argentina. Patients with SARS-CoV-2 positive nasal swabs were contacted within 48 h by telephone to invite them to participate. The trial randomized 501 patients between August 19th 2020 and February 22nd 2021. INTERVENTION: Patients were randomized to ivermectin (N = 250) or placebo (N = 251) arms in a staggered dose, according to the patient's weight, for 2 days. MAIN OUTCOMES AND MEASURES: The efficacy of ivermectin to prevent hospitalizations was evaluated as primary outcome. We evaluated secondary outcomes in relationship to safety and other efficacy end points. RESULTS: The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3-6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32-1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes. LIMITATIONS: Low percentage of hospitalization events, dose of ivermectin and not including only high-risk population. CONCLUSION: Ivermectin had no significant effect on preventing hospitalization of patients with COVID-19. Patients who received ivermectin required invasive MVS earlier in their treatment. No significant differences were observed in any of the other secondary outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT04529525 .


Asunto(s)
Antivirales/uso terapéutico , COVID-19/tratamiento farmacológico , Ivermectina/uso terapéutico , Adulto , Antivirales/efectos adversos , COVID-19/etiología , COVID-19/virología , Prueba de Ácido Nucleico para COVID-19 , Método Doble Ciego , Femenino , Hospitalización , Humanos , Ivermectina/efectos adversos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Placebos , Resultado del Tratamiento
5.
BMC Musculoskelet Disord ; 22(1): 605, 2021 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-34217257

RESUMEN

STUDY DESIGN: This is a prospective case-controlled study. BACKGROUND: To analyze the postoperative axial pain and cage subsidence of patients presenting with cervical spondylotic myelopathy (CSM) after a modified procedure of ACDF (mACDF). METHODS: Ninety patients with CSM were prospectively collected from 2014 to 2018. The patients were divided into spread group and non-spread group (48:42 ratio) according to the cage placement with or without releasing the Caspar cervical retractor after decompression. Spread group received conventional ACDF and non-spread group received mACDF. Patients were followed-up for at least 24 months after surgery. Radiologic data, including height of intervertebral space and Cobb Angle, were collected. Nervous system function was obtained using JOA scores, and level of pain was assessed using VAS scores. RESULTS: A total of 90 patients were enrolled and the patients were divided into spread group (n = 48) and none-spread group(n = 42). Cage subsidence of (spread group vs none-spread group) was (0.82 ± 0.68 vs 0.58 ± 0.81) mm, (0.64 ± 0.77 vs 0.34 ± 0.46) mm, (0.48 ± 0.43 vs 0.25 ± 0.28) mm, and (0.45 ± 0.47 vs 0.17 ± 0.32) mm at 3 months, 6 months, 12 months and 24 months, respectively. The period exhibiting the most decrease of the height of intervertebral space was 3 months postoperatively. However, there was no statistical difference in the height of intervertebral space, JOA or VAS scores at the final follow-up between the two groups. CONCLUSIONS: The mACDF can avoid excessive distraction by releasing the Caspar Cervical retractor, restore the "natural height" of cervical vertebra, relieve immediate pain after surgery, and prevent rapid Cage subsidence and the loss of cervical curvature.


Asunto(s)
Fusión Vertebral , Espondilosis , Vértebras Cervicales/cirugía , Discectomía , Estudios de Seguimiento , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Espondilosis/cirugía , Resultado del Tratamiento
6.
BMC Surg ; 21(1): 249, 2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34218794

RESUMEN

OBJECTIVE: Proximal gastrectomy acts as a function-preserving operation for upper-third gastric cancer. The aim of this study was to compare the short-term surgical outcomes between proximal gastrectomy with gastric tube reconstruction and proximal gastrectomy with jejunal interposition reconstruction in upper-third gastric cancer. METHODS: A retrospective review of 301 patients who underwent proximal gastrectomy with jejunal interposition (JI) or gastric tube (GT) at Harbin Medical University Cancer Hospital between June 2007 and December 2016 was performed. The Gastrointestinal Symptom Rating Scale (GSRS) and Visick grade were used to evaluate postgastrectomy syndromes. Gastrointestinal fiberoscopy was used to evaluate the prevalence and severity of reflux esophagitis based on the Los Angeles (LA) classification system. RESULTS: The JI group had a longer operation time than the GT group (220 ± 52 vs 182 ± 50 min), but no significant difference in blood loss was noted. Compared to the GT group, the Visick grade and GSRS score were significantly higher. Reflux esophagitis was significantly increased in the GT group compared with the JI group. CONCLUSION: Proximal gastrectomy is well tolerated with excellent short-term outcomes in patients with upper-third gastric cancer. Compared with GT construction, JI construction has clear functional advantages and may provide better quality of life for patients with upper-third gastric cancer.


Asunto(s)
Neoplasias Gástricas , Gastrectomía , Humanos , Yeyuno , Calidad de Vida , Estudios Retrospectivos , Neoplasias Gástricas/cirugía , Resultado del Tratamiento
7.
World J Surg Oncol ; 19(1): 198, 2021 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-34218803

RESUMEN

OBJECTIVES: This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng's multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). METHODS: We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. RESULTS: The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. CONCLUSIONS: We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.


Asunto(s)
Laparoscopía , Neoplasias Hepáticas , Pérdida de Sangre Quirúrgica , Estudios de Casos y Controles , Hepatectomía , Humanos , Tiempo de Internación , Neoplasias Hepáticas/cirugía , Tempo Operativo , Pronóstico , Resultado del Tratamiento
8.
Front Endocrinol (Lausanne) ; 12: 649405, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34220705

RESUMEN

The finding that high-dose dexamethasone improves survival in those requiring critical care due to COVID-19 will mean much greater usage of glucocorticoids in the subsequent waves of coronavirus infection. Furthermore, the consistent finding of adverse outcomes from COVID-19 in individuals with obesity, hypertension and diabetes has focussed attention on the metabolic dysfunction that may arise with critical illness. The SARS coronavirus itself may promote relative insulin deficiency, ketogenesis and hyperglycaemia in susceptible individuals. In conjunction with prolonged critical care, these components will promote a catabolic state. Insulin infusion is the mainstay of therapy for treatment of hyperglycaemia in acute illness but what is the effect of insulin on the admixture of glucocorticoids and COVID-19? This article reviews the evidence for the effect of insulin on clinical outcomes and intermediary metabolism in critical illness.


Asunto(s)
COVID-19/tratamiento farmacológico , Glucocorticoides/efectos adversos , Insulina/uso terapéutico , Enfermedades Metabólicas/inducido químicamente , Enfermedades Metabólicas/prevención & control , COVID-19/complicaciones , Cuidados Críticos/métodos , Enfermedad Crítica/terapia , Dexametasona/efectos adversos , Dexametasona/uso terapéutico , Complicaciones de la Diabetes/diagnóstico , Complicaciones de la Diabetes/tratamiento farmacológico , Complicaciones de la Diabetes/mortalidad , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/mortalidad , Diabetes Mellitus/virología , Glucocorticoides/uso terapéutico , Humanos , Hiperglucemia/complicaciones , Hiperglucemia/tratamiento farmacológico , Hiperglucemia/mortalidad , Enfermedades Metabólicas/etiología , Obesidad/complicaciones , Obesidad/tratamiento farmacológico , Obesidad/mortalidad , SARS-CoV-2/fisiología , Resultado del Tratamiento
9.
Artículo en Ruso | MEDLINE | ID: mdl-34223752

RESUMEN

Pelvic floor surgery is currently recognized as the only effective method for treating genital prolapse but it is not able to restore fully the qualitative characteristics of perineal tissues. The risk of recurrence of the pathological process in the long-term period remains a serious negative aspect. Optimization of pelvic floor rehabilitation after surgical correction of perineal ptosis remains an urgent problem in the female population. The validated method of questioning is a priority in assessing the dynamics of clinical manifestations of failure of the anatomical and functional structures of the pelvic floor, their impact on the life quality of patients before and after the biofeedback method (BFB therapy) and electrical impulse stimulation (EIS) of muscles. Multi-parametric ultrasound diagnostics of perineal tissues can confirm the improvement of the echo-structure of the anatomical and functional elements of the pelvic floor after the complex application of physiotherapeutic effects using modern high-tech hardware systems through an external feedback channel by means of acoustic, visual and tactile perception. OBJECTIVE: To evaluate the effectiveness of biofeedback therapy and EIS of the neuromuscular apparatus of the pelvic floor in patients operated on for stage III, IV of genital prolapse using mesh implants by means of validated questionnaire survey and measuring the parameters of perineal tissues by the method of multi-parametric ultrasound. MATERIAL AND METHODS: The study included 187 women after surgical correction of stage III and IV genital prolapse according to POP-Q using mesh technologies. The 149 women underwent the observation program; 36 patients of the control group were recommended to modify their lifestyle; 113 patients of the main group - biofeedback therapy and EIS. The indicators of validated questionnaires (determination of the of perineal structures failure influence index on the life quality, ILQ) and ultrasound multi-parametric examination were assessed at baseline, 6 months and 1 year after the program of observation and rehabilitation. RESULTS: The clinical effectiveness of biofeedback therapy and EIS was confirmed by validated questionnaire: after 1 year, the ILQ in the control group decreased by 7.7%, in the main group - by 43.3% (p<0.05). Multi-parametric ultrasound assessment of perineal tissues after surgical correction of stages III and IV of genital prolapse showed a positive effect of conservative rehabilitation on the anatomical and functional structures of the pelvic floor. The diagnostic advantage of endo-anal sonography in the analysis of the echo-structure of the pelvic floor elements, detection of pathologies that cannot be scanned endo-vaginally and trans-perineally has been established. There were 2 (5.5%) cases of recurrence of genital prolapse in the control group; there were no relapsesamong the patients of the main group. CONCLUSION: The validated questioning for the ILQ and ultrasound multi-parametric study by measuring the parameters of perineal tissues confirmed the effectiveness of biofeedback therapy and EIS after surgical correction of stage III and IV genital prolapse using mesh technologies. Endo-anal sonography is essential in the examination of gynecological patients. The adherence to the monitoring and rehabilitation program was 79.6%.


Asunto(s)
Diafragma Pélvico , Prolapso de Órgano Pélvico , Biorretroalimentación Psicológica , Femenino , Genitales , Humanos , Diafragma Pélvico/diagnóstico por imagen , Diafragma Pélvico/cirugía , Prolapso de Órgano Pélvico/diagnóstico por imagen , Prolapso de Órgano Pélvico/cirugía , Calidad de Vida , Encuestas y Cuestionarios , Resultado del Tratamiento
10.
Zhonghua Yi Xue Za Zhi ; 101(25): 1978-1984, 2021 Jul 06.
Artículo en Chino | MEDLINE | ID: mdl-34225419

RESUMEN

Objectives: To compare the clinical effect of alternative-level and all-level Arch mini-plate fixation in patients undergoing unilateral open-door laminoplasty. Methods: Clinical data of 134 patients administrated in the Peking University International Hospital for multistage cervical spondylotic myelopathy from March 2015 to March 2019 were reviewed retrospectively. There were 63 males and 71 females with an average age of (62±8) years and a mean disease course of (18±7) months (3-37 months). All the patients underwent posterior cervical unilateral open-door laminoplasty with Arch titanium plate fixation. All the patients were divided into two groups according to the different amount of titanium plates used during operation as follow: group A, Arch plates were fixed at the door sides of C3, C5 and C7 (n=68) and group B, Arch plates were fixed at the door sides of C3, C4, C5, C6 and C7 (n=66). Operation time, intraoperative blood loss, postoperative hospitalization days and the cost of consumables, the Japanese orthopaedic association (JOA) score, cervical dysfunction index (NDI), the rates of improved JOA score, cervical curvature index, C2-7 Cobb angle, cervical range of motion, sagittal diameter of vertebral canal, opening angle of laminar, hinges bone healing and surgery related complications (axial symptoms, C5 nerve root palsy, screw loosening, laminar re-closing, cervical kyphosis, etc.) were recorded and compared between the two groups. Results: There was no complications during the operation, and the mean follow-up was (20±8) months (14-48 months). There was no statistically significant difference between the two groups in terms of gender, age, course of disease and compression segments (all P>0.05). There was no statistically significant differences between the two groups in operation time, intraoperative blood loss and postoperative hospital stay too (all P>0.05). The cost of consumables in group A was (34 970±1 325) yuan, and it was (57 450±2 161) yuan in group B, the difference between the two groups was statistically significant (P<0.01). The JOA and NDI score were significantly improved 3 months and 1 year after operation in both groups (both P<0.05). The sagittal diameter of each segment of the spinal canal at C3, C4, C5, C6 and C7 were all significantly increased in both groups 3 months and 1 year after surgery (all P<0.05). The C2-7 Cobb angle and cervical curvature index were all significantly reduced in both groups 3 months and 1 year after surgery (all P<0.05). The cervical range of motion in both groups was significantly reduced 3 months and 1 year after surgery compared with that before surgery (both P<0.05). The range of motion of the cervical spine in group A was significantly higher than that in group B (P<0.05). The opening angles of C4 and C6 segment lamina in group A 3 months and 1 year after operation were significantly lower than those in group B (all P<0.05). At 3 months after the operation, the hinges healing rate of C4 and C6 in group B was significantly better than that of group A (both P<0.05). At 1 year after the operation, there was no difference in the hinges healing rate of C4 and C6 in the two groups (both P>0.05). There was no statistically significant difference in postoperative complications between the two groups (P>0.05). Conclusions: The safety and early clinical efficacy of alternative-level and all-level Arch titanium plate fixation in posterior cervical unilateral open-door laminoplasty are comparable, alternative-level fixation can effectively reduce the cost of hospitalization. The open Angle loss and lower early hinges healing rate of the non-fixed segment in the alternative-level fixed group does not lead to laminar re-closing in early period of post operation.


Asunto(s)
Laminoplastia , Anciano , Placas Óseas , Vértebras Cervicales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rango del Movimiento Articular , Estudios Retrospectivos , Resultado del Tratamiento
11.
Zhonghua Yi Xue Za Zhi ; 101(25): 1985-1990, 2021 Jul 06.
Artículo en Chino | MEDLINE | ID: mdl-34225420

RESUMEN

Objective: To investigate the efficacy and tolerability of Polatuzumab vedotin+rituximab±bendamustine (Pola-(B)R) in relapse/refractory diffuse large B cell lymphoma (R/R DLBCL) patients. Methods: The clinical data of 21 patients enrolled in Chinese Pola compassionate use program (CUP) in 4 centers from November 2019 to August 2020 were collected. There were 15 males and 6 females, and the median age was 56 years (ranged 25-76 years). Of the patients, 10 cases received Pola-BR regimen and the other 11 received Pola-R. Their clinical features, regimens, efficacy, and adverse events (AEs) were retrospectively analyzed. Results: Twenty-one patients with at least one efficacy evaluation were included. At data analysis cut-off point (12 Aug. 2020), the best overall response (BOR) rate was 81.0% (17/21) and the complete response (CR) rate was 19.0% (4/21). Kaplan-Meier survival estimation was performed, at a median follow-up of 54 days, three patients (14.3%) had disease progressed, and 18 patients (85.7%) were censored; the median progression-free survival (mPFS) was estimated to be 148 days. The incidence of adverse effects (AEs) of any grade was higher in Pola-BR group than Pola-R group (80.0% vs 63.6%). However, the incidence of grade 3-4 AEs were close in the two groups (30.0% vs 29.3%). The most common hematological toxicities were thrombocytopenia (28.6%, 6/21), neutropenia (28.6%, 6/21) and anemia (14.3%, 3/21), respectively. One patient with pneumonia and 1 patient with hemophagocytic syndrome recovered after symptomatic treatment. No peripheral neuropathy of grade≥2 was observed. Conclusions: The preliminary data suggested that, for heavily treated Chinese R/R DLBCL, the Pola-(B)R regimen still achieves promising efficacy and tolerable safety.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Linfoma de Células B Grandes Difuso , Adulto , Anciano , Anticuerpos Monoclonales , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estudios de Cohortes , Femenino , Humanos , Inmunoconjugados , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Rituximab/uso terapéutico , Resultado del Tratamiento
12.
Zhonghua Yi Xue Za Zhi ; 101(25): 1991-1993, 2021 Jul 06.
Artículo en Chino | MEDLINE | ID: mdl-34225421

RESUMEN

The clinical data of 22 patients with giant renal hamartoma in Zhejiang Provincial People's Hospital who underwent robot-assisted laparoscopic nephron-sparing surgery from October 2014 to January 2020 were retrospectively analyzed. All the patients successfully completed the operation. The operation time and renal artery occlusion time was (179±34) min and (19.8±2.5) min, respectively. The intraoperative blood loss was (117±62) ml, and the postoperative hospital stay was (9.0±1.5) d. All cases were confirmed as renal angiomyolipoma by postoperative pathology. No urine leakage, postoperative bleeding and other complications occurred. Postoperative telephone follow-up was performed for 6 to 52 months, and no tumor recurrence on the surgical side was reported.


Asunto(s)
Angiomiolipoma , Hamartoma , Neoplasias Renales , Laparoscopía , Robótica , Angiomiolipoma/cirugía , Hamartoma/cirugía , Humanos , Neoplasias Renales/cirugía , Recurrencia Local de Neoplasia , Nefrectomía , Nefronas , Estudios Retrospectivos , Resultado del Tratamiento
13.
Zhonghua Gan Zang Bing Za Zhi ; 29(6): 575-579, 2021 Jun 20.
Artículo en Chino | MEDLINE | ID: mdl-34225434

RESUMEN

Objective: To analyze the factors influencing radiation-induced liver injury after receiving Cyberknife stereotactic radiotherapy in patients with primary hepatocellular carcinoma. Methods: 278 cases with primary hepatocellular carcinoma from July 2016 to April 2019 were prospectively enrolled. Stereotactic radiosurgery with a prescription dose of 48-55gy/5-8 times were given. Liver function, coagulation function, Child-Pugh score, and liver imaging changes were dynamically observed before and after treatment to evaluate the occurrence of radiation-induced liver injury. Logistic regression model was used to analyze the factors influencing radiation-induced liver injury. Results: Among 278 cases, 3 cases of tumor progression were excluded, and a total of 275 cases were included for analysis. The overall survival rate after 8 months of treatment was 100%. Among them, 22 cases were diagnosed as radiation-induced liver injury, with an incidence rate of 8%, and all cases were recovered after symptomatic treatment. Multivariate analysis result suggested that the peripheral white blood cell count was factors influencing the occurrence of radiation-induced liver injury. Conclusion: Cyberknife stereotactic radiotherapy has a low incidence of radiation-induced liver injury in patients with liver cancer, and it is a relatively safe treatment method. Patients with low peripheral white blood cell counts before treatment should be closely monitored for early detection and treatment.


Asunto(s)
Carcinoma Hepatocelular , Enfermedad Hepática Crónica Inducida por Sustancias y Drogas , Neoplasias Hepáticas , Radiocirugia , Carcinoma Hepatocelular/cirugía , Humanos , Neoplasias Hepáticas/cirugía , Radiocirugia/efectos adversos , Estudios Retrospectivos , Resultado del Tratamiento
14.
Mymensingh Med J ; 30(3): 644-650, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34226450

RESUMEN

Danis-Weber type-B ankle fracture is one of the most common injuries in young and active individual. This fracture offers a considerable challenge to orthopedic surgeon. Though there are several options for treating such type of fracture, ORIF by Pre-contoured Distal Fibular Locking Plate is the preferred option in the recent years. This descriptive type of observational study was performed from July 2017 to June 2019 in NITOR. Thirty (30) patients, 22 male and 8 female with an average age of 39 years with Danis-Weber type-B ankle fracture underwent ORIF by Pre-contoured Distal Fibular Locking Plate for fractured fibula and ORIF by 4.0mm cannulated cancellous screw for fractured medial malleolus. All the patients were initially managed by analgesic and short leg posterior slab. Average follow up was 24 weeks. Final outcome was assessed by AOFAS score. The main cause of injury was RTA (56.67%). Mean operation time was 1.2 hours. Mean duration of Hospital stay was 16.43±1.73 days. Superficial infection was in 3.33% and skin necrosis in 3.33% patient. Mean duration of radiological healing was 12.73±0.39 weeks. At final follow up, mean dorsi flexion was 10.93°±0.357° and plantar flexion was 50.93°±0.357°. Ninety percent (90%) patient had no difficulties in walking on any surface; 96.67% patient had stable ankle hind foot; 86.67% patient had good. Ten percent (10%) had fair and 3.33% patient had poor alignment of foot. The mean score in this study was 88.67±2.31. Satisfactory outcome was observed in 86.67% patients and 13.33% had unsatisfactory results. On the basis of results in the present study, it can be concluded that treatment of Danis-Weber type-B ankle fracture by Pre-contoured Distal Fibular Locking Plate is an effective and reliable method.


Asunto(s)
Fracturas de Tobillo , Peroné , Adulto , Tobillo , Fracturas de Tobillo/diagnóstico por imagen , Fracturas de Tobillo/cirugía , Placas Óseas , Femenino , Peroné/cirugía , Fijación Interna de Fracturas , Humanos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento
15.
Mymensingh Med J ; 30(3): 657-665, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34226452

RESUMEN

Intramedullary nailing is a pillar in the treatment of femoral shaft fractures. But it is not possible in all cases especially in comminuted fractures. This study has been designed to explain the importance of Minimally Invasive Plate Osteosynthesis (MIPO) with the locking plate in the treatment of comminuted Femoral Shaft Fracture. Twenty (20) such patients were treated by MIPO and analysis has been done in this study to get fruitful result and to find out the effectiveness of this procedure who were admitted at Mymensingh Medical College Hospital, Mymensingh, a tertiary level hospital of Bangladesh from February 2018 to January 2019. Mean age of the patients were 49.20±14.41 years. Based on AO classification, there were 4, 8 and 8 patients belong to type A, B and C respectively. The union period for all the patients was in between 12 to 14 weeks. The mean union period was 12.90±1.997 weeks. Mean follow up period was 19.70±2.77 weeks. Mean full weight bearing period was 16.50±1.10 weeks. In Thoresen scoring system excellent result was 9(45%), good result was 10(20%) and fair result was 01(5%). Mal-alignment happened in two cases. However, delayed union and broken screws were found in two cases each of which was treated accordingly. Comminuted Femoral shaft fracture with MIPO procedure is more effective treatment than intramedullary nailing. Furthermore, mal-alignment is the basic complexity that must be taken away intraoperatively.


Asunto(s)
Fracturas del Fémur , Fracturas Conminutas , Adulto , Bangladesh , Placas Óseas , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/cirugía , Fijación Interna de Fracturas , Fracturas Conminutas/diagnóstico por imagen , Fracturas Conminutas/cirugía , Humanos , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Resultado del Tratamiento
16.
Mymensingh Med J ; 30(3): 760-768, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34226466

RESUMEN

Transpedicular screw fixation is a challenging procedure for the correction of deformity of Adolescent Idiopathic Scoliosis (AIS) in the dorso-lumbar spine. The inadvertently misplaced screws have a high risk of complications. The exactness of the pedicle screws is normally distinct as the screws axis being fully enclosed within the cortices of the pedicle. Evaluation of the surgical correction of adolescent idiopathic scoliosis by transpedicular screws and rods was done in single posterior dynamic approach. This prospective observational study was conducted in the National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka and different Hospitals in Dhaka, Bangladesh from July 2015 to March 2017. Ten patients at the age >9 years and <19 years who were admitted with a diagnosis of AIS during the period of study. The pedicle is a power nucleus of the vertebra and offers a secure grip of all 3 columns. Pedicle screw instrumentation has advantages of rigid fixation with improved 3D correction and it has been accepted as a reliable method with a high margin of safety. Accurate placement of the pedicle screws is important to reduce possible irreversible complication. So, all cases were corrected by transpedicular screws and rods in single posterior approach. In every case fusion was done in selected segments. In this study out of 10 patients 7(70.0%) were 10 to 14 years of age and 3(30.0%) were 15 to 18 years. Mean age 9.51±2.13 years. Minimum 10 years and maximum 18 years. Majority 7(70.0%) of the patients were female and the rest 3(30.0%) male. Five (50.0%) presented with level of involvement, 3(30.0%) patients thoracic and 2(20.0%) patients had lumbar. Maximum 7(70.0%) presented right sided involvement and rest 3(30.0%) left sided involvement. Before surgical intervention 100% patients had rib hump and positive Adams forward bending test, 70.0% patients had asymmetry of shoulder and uneven hip and also 50% patients had pain. After surgical treatment with transpedicular screws and rods through posterior approach, 70% of patients improved in terms of deformity. The average major curve deformity as defined by Cobb angle measurements was measured to be 54.9°±9.9° (40°-68°) in pre-surgery. After surgery this deformity corrected to 16.0°±4.9° (10°-24°) on average as measured in erect posture posterior anterior and lateral view. This represents significant improvement average of 71.4±4.3% (64.6-75.09) (p<0.001). This correction was maintained at 24 months after surgery. Functional results assessed by Modified Macnab criteria, significant number of 7(70.0%) patients had excellent outcome, 2(20.0%) patients had good outcome, 1(10.0%) patients had fair outcome and no poor outcome. Ninety percent (90%) patients had satisfactory results. No patient deteriorates neurologically after surgery. It is concluded that satisfactory curve correction and maintenance thereof is possible in adolescent idiopathic scoliosis, with posterior instrumentation by transpedicular screw and rods with effective reduction of cost and associated risks.


Asunto(s)
Escoliosis , Fusión Vertebral , Adolescente , Bangladesh , Niño , Preescolar , Femenino , Humanos , Masculino , Estudios Retrospectivos , Escoliosis/diagnóstico por imagen , Escoliosis/cirugía , Vértebras Torácicas , Resultado del Tratamiento
17.
Mymensingh Med J ; 30(3): 780-788, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34226468

RESUMEN

LASER Haemorrhoidoplasty (LH) is a novel procedure in modern medical science. It is a no cut, painless and bloodless clinical procedure with comparatively fewer complications in comparison to Stapler Haemorrhoidopexy (SH) for the treatment of grade III-IV haemorrhoids. It is very applicable surgical procedure at shrinking the terminal branches of haemorrhiodal arteries with fewer complications than Stapler Haemorrhoidopexy (SH). The aim of the study was to compare LASER Haemorrhoidoplasty (LH) with Stapler Haemorrhoidopexy (SH). The comparative study was performed in Bangabandhu Sheikh Mujib Medical University (BSMMU), Anower Khan Modern Medical College and Hospital and Care Medical College and Hospital, Dhaka, Bangladesh from August 2019 to July 2020. A total of 84 patients with grade III-IV haemorrhoids were allocated into two groups: LASER Haemorrhoidoplasty (LH) and Stapler Haemorrhoidopexy (SH) with 42 patients in each group prospectively. Comparative results and post-operative follow up periods were 4 months. The mean operative time was 28.6min (LH) and 36.2min (SH) (p=0.0006). The average blood loss was 6.42ml (LH) and 12.6ml (SH) (p<0.05). The mean hospital stay 18.36 hours (LH) and 28.40 hours (SH) (p<0.05). Mean postoperative pain score (VAS) at 12 hours was 3.8 (LH) and 6.81 (SH) (p<0.05), at 24 hours was 2.6 (LH) and 4.6 (SH) (p<0.05), at 1 week was 0.46 (LH) and 0.88 (SH) (p=0.05) and at 3 months 0.04 (LH) and 0.10 (SH) (p=0.401). Complications were found in (2.4%) patients ≤1 week in the (LH) group 7(16.7%) in the (SH) group which was statistically significant (p<0.05) between the two groups. Patients with haemorrhoids treated with LASER Haemorrhoidoplasty had a better outcome than stapler haemorrhoidopexy in terms of early postoperative pain as well as complications and was associated with a shorter hospital stay and early return to work. LASER Haemorrhoidoplasty was most effective and alternative to the popular stapler Haemorrhoidopexy for grade III-IV haemorrhoids.


Asunto(s)
Hemorroides , Bangladesh , Hemorroides/cirugía , Humanos , Rayos Láser , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Complicaciones Posoperatorias , Estudios Prospectivos , Grapado Quirúrgico , Resultado del Tratamiento
18.
Mymensingh Med J ; 30(3): 816-825, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34226473

RESUMEN

Keloids always remain a great challenge due to limited surgical treatment options. Most treatments e.g. surgery, drug therapy, radiotherapy, laser therapy, and cryotherapy for managing keloids have very limited effectiveness, for keloids grow slowly but progressively and the recurrence rate is inappreciably high. Skin expansion constitutes a potential treatment option in the treatment of large keloid. This study was intended to determine the clinical outcome of 'Tissue Expander beneath the Keloid Surgery' for repair of wound formed as a result of excision of relatively large keloids. This retrospective study was done in the Department of Dermatology and Venereology of Nantong University-affiliated Hospital, China. Using a quasi-experimental design, from August 2006 to August 2017, 75 keloids in 70 patients were implanted with tissue expanders, the capacity of which was 70-600ml. After 50-126 days of implantation, the intralesional excision with flap advancement surgery was carried out. During intraoperative period, keloid lesions were treated with beta methasone injection as 0.2ml per sq. cm of lesion and the total dose should not normally over 1-2ml per dose and postoperative superficial electron beam irradiation. Post-operative follow-up ranged from 12 to 50 months. All patients underwent keloid resection followed by radiation at postoperative day 1 and 8 with a total dose 16-18 Gy. The patient and observer scar assessment scales (POSAS) were used to evaluate changes in keloids pre- and post-operatively. Among 75 keloids, 71(94.7%) (Including 11 keloids combined with the infected site) demonstrated successful outcome, 4(5.3%) expanders in the chest failed. Infection occurred in 4(5.3%) keloids during expansion process which led to early removal of expander resulting in failure of the operation, while in the remaining 71 sites, the entire treatment process was successfully completed. Follow-up was done for more than 12 months, when 14 sites (all anterior chest) exhibited local recurrence. There was no recurrence in the 14 sites of pubic region. The total POSAS scores before surgery were 59.3±13.6 which significantly reduced to 17.7±9.1 after 12 months of surgery (p<0.001). Soft tissue expanders implantation beneath the keloid is one of the ideal methods to treat relatively large keloids, formed as a result of excision of relatively large keloids, provided the patients are carefully selected based on knowledge about possible complications.


Asunto(s)
Queloide , China , Humanos , Queloide/patología , Queloide/cirugía , Recurrencia , Estudios Retrospectivos , Dispositivos de Expansión Tisular , Resultado del Tratamiento
19.
Biol Pharm Bull ; 44(7): 1019-1023, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34193684

RESUMEN

To prevent cognitive decline, non-pharmacological therapies such as reminiscence for mild cognitive impairment (MCI) are required, however, the use of nursing homes was limited due to coronavirus disease 2019 (COVID-19). Therefore, the demand for remote-care is increasing. We hypothesized that immersive virtual reality (iVR) could be used more effectively than conventional reminiscence for anxiety. We first examined the effectiveness and safety of reminiscence using iVR (iVR reminiscence session) in patients with MCI. After COVID-19 imposed restriction on visiting nursing homes, we conducted online iVR reminiscence session (remote iVR reminiscence session) and compared its effectiveness with that of interpersonal iVR reminiscence session (face-to-face iVR reminiscence session). The results of two elderly with MCI suggested that iVR reminiscence could reduce anxiety and the burden of care without serious side effects. The effects of remote iVR reminiscence might be almost as effective as those of face-to-face one.


Asunto(s)
Ansiedad/terapia , Disfunción Cognitiva/terapia , Imágenes en Psicoterapia/métodos , Telemedicina/métodos , Realidad Virtual , Anciano de 80 o más Años , Ansiedad/diagnóstico , Ansiedad/psicología , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/psicología , Femenino , Humanos , Masculino , Aplicaciones Móviles , Casas de Salud , Satisfacción del Paciente , Telemedicina/instrumentación , Resultado del Tratamiento
20.
Medicina (Kaunas) ; 57(6)2021 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-34198541

RESUMEN

The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management.


Asunto(s)
Aneurisma Infectado , Aneurisma de la Aorta Abdominal , Implantación de Prótesis Vascular , COVID-19 , Procedimientos Endovasculares , Anciano , Aneurisma Infectado/cirugía , Aneurisma de la Aorta Abdominal/cirugía , Prótesis Vascular , Humanos , Masculino , SARS-CoV-2 , Stents , Resultado del Tratamiento
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