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1.
Pathol Res Pract ; 240: 154222, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36413828

RESUMO

One of the most prevalent and lethal forms of gynecological cancer is ovarian cancer (OC), which is often diagnosed in its latter, deadly stages. The OC's high mortality and heterogeneity impede early identification and primary prevention. Thus, numerous studies have looked for biomarkers in OC tissue and blood samples to help early diagnosis and decrease the mortality rate using microRNAs (miRNAs). The miRNAs are short, noncoding RNAs (ncRNAs) that are typically approximately 22 nucleotides in length and act as oncogenic or tumor suppressors via degrading or impeding target mRNA translation. By regulating cellular activities and signaling pathways, miRNAs promote carcinogenesis and the invasiveness of OC cells. In this review, we explore the function of miRNAs in the pathophysiology of OC, their use as biomarkers, future implications, and the direction of future research. The review also underlines the involvement of miRNAs in the most significant pathways affecting the pathogenesis of OC and their relevance to treatment resistance.

2.
Arch Ital Urol Androl ; 94(2): 180-185, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35775343

RESUMO

INTRODUCTION: Novel laser technologies have been developed for the minimally invasive surgical management of benign prostatic hyperplasia (BPH). The objective of this study was to assess the safety and efficacy of MOSESTM technology versus the thulium fiber laser (TFL) in patients with BPH undergoing transurethral enucleation of the prostate. METHODS: We conducted a retrospective review of prospectively collected data of eighty-two patients who underwent transurethral enucleation of the prostate using MOSESTM or TFL technologies from August 2020 to September 2021. Preoperative and intraoperative parameters, in addition to postoperative outcomes, were collected and analyzed. RESULTS: Twenty patients underwent transurethral enucleation of the prostate with TFL, while 62 had MOSESTM HoLEP. No statistically significant difference in preoperative characteristics was observed between the groups. Patients in the TFL group had longer median enucleation, hemostasis, and morcellation times (p < 0.001) than those in the MOSESTM cohort. The longer morcellation time of TFL is mostly related to less visibility. The postoperative outcomes IPSS, QoL, Qmax, and post void residual (PVR), were comparable between the groups at 1, 3 and 6 months. The incidence of urge urinary incontinence (p = 0.79), stress urinary incontinence (p = 0.97), and hospital readmission rates (p = 0.1) were comparable between the two groups. CONCLUSIONS: A satisfactory safety and efficacy profile with comparable postoperative outcomes was demonstrated for both techniques; though, MOSESTM technology was superior to TFL in terms of shorter overall operative time.


Assuntos
Terapia a Laser , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Humanos , Terapia a Laser/métodos , Lasers , Masculino , Próstata/cirurgia , Hiperplasia Prostática/cirurgia , Qualidade de Vida , Tecnologia , Túlio , Ressecção Transuretral da Próstata/métodos , Resultado do Tratamento
3.
J Genet Eng Biotechnol ; 20(1): 70, 2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35543892

RESUMO

BACKGROUND: Several SARS-CoV-2 variants with increased transmissibility and/or potential immune escape have emerged and rapidly spread worldwide. Ongoing surveillance analyses are performed worldwide to designate new variants of concern (VOC) of coronavirus. MAIN TEXT: This report identifies the first Egyptian patient with a confirmed SARS-CoV-2 omicron variant. The patient showed positivity on reverse transcriptase-polymerase chain reaction and full genome sequencing was performed to confirm the variant. The mutations found in the variant were compared with the GISAID reference strain hCoV-19/Wuhan/WIV04/2019. Genome BLAST showed the highest similarity to omicron variants isolated in South Africa. Phylogenetic analysis revealed that the variant belongs to the 21K clade. CONCLUSIONS: The study indicates the importance of information-sharing among global public health partners. Moreover the importance of implementation of full genome sequencing to rapidly identify and track the new SARS-CoV-2 variants.

4.
Biomark Med ; 16(8): 589-597, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35350852

RESUMO

Aim: To investigate the change in a serum level of copeptin, a neuroendocrine biomarker, in differentiating grades of COVID-19 severity on admission time and to find its diagnostic potential. Materials & Methods: 160 COVID-19 patients were classified according to disease severity into 80 mild to moderate and 80 severe patients. Serum copeptin level was assessed by ELISA on their admission time. Besides, serum CRP, ferritin and D-dimer were estimated. Results: Severe COVID-19 patients showed higher serum copeptin level in comparison to mild to moderate cases, with diagnostic potential to distinguish disease severity with 93.33% sensitivity and 100% specificity at cutoff value >18.5 Pmol/l. Conclusion: Serum copeptin was remarkably increased with COVID-19 severity with reasonable differentiation potential for recently admitted patients.


We conducted a biochemical study on the role of copeptin ­ a biomarker of acute stress due to COVID-19 infection ­ in classification of COVID-19 severity on admission over 160 adult patients. Copeptin was highly elevated in severe cases more than the mild to moderate ones. So, it may be an early marker in admission departments to ease early clinical decisions and medical intervention.


Assuntos
COVID-19 , Biomarcadores , COVID-19/diagnóstico , Glicopeptídeos , Humanos , Prognóstico , Índice de Gravidade de Doença
5.
J Pediatr Urol ; 18(3): 354.e1-354.e7, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35341671

RESUMO

INTRODUCTION: Classic bladder exstrophy (CBE) repair report wide variation in success. Given the complexity of CBE care, benefit would be derived from validation of reported outcomes. Using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) data, this manuscript evaluates surgical complications for bladder closure and advanced urologic reconstruction in CBE patients. AIM: The primary aim of this study was to determine complication rates in the CBE population for bladder closure and advanced urologic reconstruction in national studies compared to single-institutional studies. STUDY DESIGN: Pediatric cases and complications were identified in the 2012-2019 NSQIP-P database in CBE patients who had either bladder closure or advanced urologic reconstruction. Bladder closure was further defined as early (<7 days) or delayed (>7 days). Differences were assessed using Fisher's exact test and analysis was conducted using SPSS with significance defined as p-value <0.05. RESULTS: 302 patients were included; 152 patients underwent bladder closure, and 150 patients underwent advanced urologic reconstruction. The 30-day complication rate for bladder closure is 30.3% and for advanced urologic reconstruction is 24.0% in the CBC cohort. No differences were found in the rates of NSQIP complications between early and delayed bladder closure, though significant differences (p < 0.001) were found in the rates of blood transfusion (17.9 vs 65.3%). This may be due to the different rates of osteotomy (25.0 vs 48.3%) between early and delayed bladder closure. Rates of readmission are 14.7% and rates of reoperation are 8.0% for advanced urologic reconstruction procedures. Both bladder closure and advanced urologic reconstruction had infectious issues in greater than 10% of the population. DISCUSSION: CBE surgeries nationally carry a higher risk of complications than is reported in most institutional studies. Infectious complications occur greater than 10% of the time in both bladder closure and advanced urologic reconstruction, which should be the source of additional study given the inverse relationship infections pose to surgical success in BE patients. A limitation of this study is that the data is derived from Children's hospitals that elect to participate and includes only data from 30 days after a procedure. CONCLUSION: CBE complication data for both bladder closure and advanced urologic reconstruction may be underrepresented in the literature.


Assuntos
Extrofia Vesical , Extrofia Vesical/cirurgia , Criança , Humanos , Complicações Pós-Operatórias/epidemiologia , Melhoria de Qualidade , Estudos Retrospectivos , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/métodos
6.
Eye Vis (Lond) ; 8(1): 36, 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34600582

RESUMO

PURPOSE: Evaluation of the patency and position of perforated lacrimal punctal plugs implanted for treating punctal stenosis together with quantitative assessment of the precorneal tear film using anterior segment optical coherence tomography (AS-OCT). METHODS: In a prospective study, the lower punctum of 54 eyes of 29 patients implanted with perforated punctal plugs were examined using AS-OCT during the early postoperative period. Preoperative tear meniscus height (TMH) and tear meniscus area (TMA) were evaluated. Postoperatively, the patency of the plug, its position, TMH and TMA were evaluated, and the results were correlated with postoperative epiphora. Munk scale was used for epiphora grading. RESULTS: Using AS-OCT, 48 (88.9%) plugs were found in proper position while 6 (11.1%) were rotated. The lumen of the plugs was completely patent in 47 (87%) plugs, partially obstructed in 2 (3.7%) plugs and completely occluded in 5 (9.2%) plugs. There was a statistically significant postoperative decrease of TMH and TMA (P < 0.001) and postoperative epiphora Munk score (P < 0.001). CONCLUSION: AS-OCT is a valuable, reliable, and noninvasive investigative tool that can detect the proper positioning, patency, and contents of the implanted perforated lacrimal punctal plugs in addition to measurement of TMH and TMA. Trial registration ClinicalTrials.gov ID: NCT04624022, https://clinicaltrials.gov/ct2/show/NCT04624022.

7.
J Ophthalmic Inflamm Infect ; 11(1): 27, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34523045

RESUMO

PURPOSE: To document the presentation of unilateral combined endophthalmitis and orbital cellulitis in patients with COVID-19 infection and study their prognosis. PATIENTS AND METHODS: This interventional case series study included 9 patients referred to the Ophthalmology Department, Minia University Hospital with unilateral combined endophthalmitis and orbital cellulitis between April 2020 and March 2021. In addition to the COVID-19 work-up, all patients were subjected to full ophthalmological evaluation and managed according to their ophthalmic and systemic disease. RESULTS: The patients were 5 females and 4 males. They had clinical, laboratory and imaging findings that confirmed COVID-19 infection. All patients had unilateral endophthalmitis with orbital cellulitis and profound visual loss in the affected eye. Three patients died due to respiratory failure, while 6 patients recovered systemically. The survived patients developed atrophia bulbi in 4 patients and in 2 patients, the globe retained normal size but with complete visual loss. CONCLUSION: Combined endophthalmitis and orbital cellulitis can be one of the early presentations of patients with COVID-19 infection with poor visual prognosis. TRIAL REGISTRATION: Clinical registration: clinicaltrials.gov identifier: NCT04456556 .

8.
Saudi J Biol Sci ; 28(11): 6465-6470, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34305426

RESUMO

The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in coronavirus disease 2019 (COVID-19) patients has been claimed as associated with the risk of COVID-19 infection and its subsequent morbidities and mortalities. These claims were resulting from the possibility of upregulating the expression of angiotensin-converting enzyme 2 (ACE2), facilitation of SARS-CoV-2 entry, and increasing the susceptibility of infection in such treated cardiovascular patients. ACE2 and renin-angiotensin-aldosterone system (RAAS) products have a critical function in controlling the severity of lung injury, fibrosis, and failure following the initiation of the disease. This review is to clarify the mechanisms beyond the possible deleterious effects of angiotensin II (Ang II), and the potential protective role of angiotensin 1-7 (Ang 1-7) against pulmonary fibrosis, with a subsequent discussion of the latest updates on ACEIs/ARBs use and COVID-19 susceptibility in the light of these mechanisms and biochemical explanation.

9.
Curr Urol ; 15(2): 79-84, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34168524

RESUMO

BACKGROUND: This study aimed to compare the oncological and functional outcomes of primary whole gland cryoablation of the prostate using the variable ice cryoprobe (V-Probe®) and the conventional fixed-size ice probe. MATERIALS AND METHODS: We reviewed the Cryo On-Line Data Registry for men who were treated with primary whole gland prostate cryoablation from 2000 through 2017. A multivariate Cox proportional hazards model was used to compare timing to biochemical recurrence between the V-Probe® and fixed-size ice probe after adjusting for preoperative prostate-specific antigen (PSA), neoadjuvant androgen deprivation therapy, preoperative Gleason score, and preoperative T stage. RESULTS: A total of 1124 men were included. Median age, Gleason score, and pretreatment PSA were 70 years (interquartile range [IQR]: 65-74 years), 7 (IQR: 6-7) and 5.9 ng/mL (IQR: 4.6-8.1 ng/mL), respectively. The median follow-up time was 25.0 months (IQR: 11.2-48.6 months). V-Probes® were used in 269 (23.9%) cases and fixed-size ice probes in 858 (76.1%) cases. After adjusting for clinical T stage, PSA, neoadjuvant androgen deprivation therapy and preoperative Gleason score, on the multivariate Cox regression model, we found that there was no significant difference between the type of probe and timing to biochemical recurrence (p = 0.35). On multivariate logistic regression, using the V-Probe® was associated with a 91% increase in postoperative urinary retention compared to the fixed-size ice probe (p = 0.003). CONCLUSIONS: The use of the V-Probe® versus conventional fixed-size ice probe was not associated with a difference in biochemical recurrence in patients undergoing primary cryoablation of the prostate.

10.
Diabetes Metab Syndr Obes ; 14: 1897-1908, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33958881

RESUMO

BACKGROUND: The link between immune system and type 2 diabetes mellitus (T2DM) pathogenesis attracted attention to demonstrate the role of immune cells and their secreted cytokines in T2DM development and its subsequent foot complications. OBJECTIVE: To investigate the relation between T Natural killer cell (TNK) %, Interleukin 4 (IL4) and Interferon gamma (IFN-γ) and diabetic foot infection (DFI) development in patients with diabetic foot ulcer (DFU). PATIENTS AND METHODS: Ninety patients with diabetes were included in this work, divided as T2DM group (n=30), DFU group (n=30), and DFI group (n=30). TNK% was detected using flow cytometry. Serum IL4 and IFN-γ were measured by ELISA. Diabetes biochemical parameters were also analyzed. RESULTS: Significant decrease was detected in TNK% and IFN-γ in DFI group compared to other 2 groups (P<0.001). Significant decrease was detected in serum levels of IL4 in DFI group compared to T2DM group (P=0.006). IFN-γ/IL4 was significantly decreased in DFI compared to DFU group (P=0.020). There was a significant correlation of TNK% with both IL4 and IFN-γ (r=0.385, P<0.001; r=0.534, P<0.001, respectively). Significant negative correlation of TNK% with HbA1c and LDL was revealed (r=-0.631, P<0.001; and r=-0.261, P=0.013, respectively), while a positive correlation was seen with HDL (r=0.287, P=0.006). A significant negative correlation of IL4 with HbA1c  was found (r=-0.514, P<0.001;. As for IFN-γ, a significant negative correlation with HbA1c and LDL was detected (r=-0.369, P< 0.001; r=-0.229, P=0.030). TNK % and IFN-γ level showed negative correlations with disease duration/year (r=-0.546, P< 0.001; r=-0.338, P=0.001,respectively). CONCLUSION: Decline in TNK frequency has essential role in T2DM pathogenesis and subsequent foot complications. Downregulation of TNK% and IFN-γ level have potential roles in predicting infection of diabetic ulcer and are correlated with disease duration.

12.
Saudi J Biol Sci ; 28(4): 2581-2590, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33911969

RESUMO

MicroRNA-567 (miR-567) plays a decisive role in cancers whereas its role in non-small cell lung cancer (NSCLC) is still unexplored. This study was therefore planned to explore the regulatory function of miR-567 in A549 NSCLC cells and investigate its possible molecular mechanism that may help in NSCLC treatment. In the current study, miR-567 expression was examined by quantitative real time-polymerase chain reaction (qRT-PCR) in different NSCLC cell lines in addition to normal cell line. A549 NSCLC cells were transfected by miR-567 mimic, miR-567 inhibitor, and negative control siRNA. Cell proliferation was evaluated by MTT and 5-bromo-2'deoxyuridine assays. Cell cycle distribution and apoptosis were studied by flow cytometry. Bioinformatics analysis programs were used to expect the putative target of miR-567. The expression of cyclin-dependent kinase 8 (CDK8) gene at mRNA and protein levels were evaluated by using qRT-PCR and western blotting. Our results found that miR-567 expressions decreased in all the studied NSCLC cells as compared to the normal cell line. A549 cell proliferation was suppressed by miR-567 upregulation while cell apoptosis was promoted. Also, miR-567 upregulation induced cell cycle arrest at sub-G1 and S phases. CDK8 was expected as a target gene of miR-567. MiR-567 upregulation decreased CDK8 mRNA and protein expression while the downregulation of miR-567 increased CDK8 gene expression. These findings revealed that miR-567 may be a tumor suppressor in A549 NSCLC cells through regulating CDK8 gene expression and may serve as a novel therapeutic target for NSCLC treatment.

13.
Prostate Cancer Prostatic Dis ; 24(2): 507-513, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33483626

RESUMO

BACKGROUND: To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation. METHODS: Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we identified 160 with a history of prior BPH interventional therapy including transurethral needle ablation (n = 6), transurethral microwave thermotherapy (n = 9), or transurethral resection of the prostate (n = 145). Patients with a history of medically treated or unspecified BPH therapy were excluded from the study. Oncological and functional outcomes were compared between men with and without prior BPH interventional therapy. RESULTS: In unadjusted analyses, prior interventional BPH therapy was associated with higher risks of postoperative urinary retention (17.5% vs. 9.6%, p = 0.001) and new-onset urinary incontinence (39.9% vs. 19.4%, p > 0.001) compared with no prior therapy. Interventional BPH therapy was not correlated with the risk of developing a rectourethral fistula (p = 0.84) or new-onset erectile dysfunction (ED) at 12 months (p = 0.08) following surgery. On multivariable regression, prior interventional BPH therapy was associated with increased risk of urinary retention (OR 1.9, 95%, p = 0.015) and new-onset urinary incontinence (OR 2.13, p < 0.001). The estimated 5 years Kaplan-Meier survival analysis showed no statistically significant difference (p = 0.3) in biochemical progression free survival between those who underwent interventional BPH therapy compared with those who did not. Local disease recurrence assessed by post cryoablation positive for-cause prostate biopsy showed no significant difference between the two groups (25.4% vs. 28.7%, p = 0.59). CONCLUSIONS: Prior interventional BPH therapy did not affect the oncologic outcomes nor did it increase the risk of rectourethral fistula or ED in sexually performing patients prior to cryosurgery. Prior interventional BPH therapy was associated with increased risk of urinary retention and incontinence after primary whole-gland prostate cryoablation for prostate cancer.


Assuntos
Criocirurgia/métodos , Cuidados Pré-Operatórios , Hiperplasia Prostática/cirurgia , Neoplasias da Próstata/cirurgia , Ressecção Transuretral da Próstata/métodos , Idoso , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Hiperplasia Prostática/patologia , Neoplasias da Próstata/patologia , Taxa de Sobrevida
14.
BMC Res Notes ; 14(1): 36, 2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33499929

RESUMO

OBJECTIVE: Ficolin-3 is one of the innate immunity molecules that was thought to play a pivotal role in Streptococcus pyogenes autoimmunity and its complications; rheumatic fever (RF) and rheumatic heart disease (RHD). We aimed to disclose if there is an association between ficolin-3 (FCN3) gene polymorphisms (rs4494157 and rs10794501) and RF with or without RHD for the first time in Egyptian adolescents. RESULTS: Serum ficolin-3 level was significantly elevated in patients suffering from RF with and without RHD in comparison with control. Regarding FCN3 gene (rs4494157) polymorphism, a significant correlation was found between the A allele and the susceptibility to RF with or without RHD (OR = 2.93, P = 0.0002 and OR = 2.23, P = 0.008 respectively). Besides, AA homozygous genotype showed a significant association with RHD risk (OR = 3.47, P = 0.026). Patients carrying the A allele (CA + AA) had significantly higher serum ficolin-3 than those carrying the CC genotype (P ˂ 0.0001). While the frequency of (rs10794501) polymorphism revealed no significant differences between the controls and RF patients with or without RHD (OR = 1.43, P = 0.261 and OR = 1.48, P = 0.208 respectively).


Assuntos
Lectinas/genética , Febre Reumática , Cardiopatia Reumática , Adolescente , Egito , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único , Cardiopatia Reumática/genética
15.
Eur J Ophthalmol ; 31(2): 796-803, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32429697

RESUMO

PURPOSE: To compare rectangular three-snip punctoplasty and polyvinylpyrrolidone-coated perforated punctal plugs for treatment of acquired lacrimal punctal stenosis. PATIENTS AND METHODS: In a prospective comparative non-randomized interventional study, 80 eyes with acquired lacrimal punctal stenosis were classified into two groups. Group A was treated by insertion of polyvinylpyrrolidone-coated perforated punctal plugs (FCI ophthalmics)™ and Group B was treated by rectangular three-snip punctoplasty. The study was done in Minia University Hospital between January 2018 and April 2019. Exclusion criteria included allergic punctal stenosis, lid malposition, and lacrimal obstruction distal to the punctum. All patients were subjected to complete history taking, slit lamp examination of tear meniscus height, fluorescein dye disappearance test, punctal position, shape, size, grading of stenosis, and grading of epiphora. RESULTS: The mean age of the patients was 43.85 ± 14.93 years. They were 30 females and 10 males. Eepiphora Grade 3 or 4, improved postoperatively to Grade 0 or 1 in 97.5% of eyes in Group A versus 55% of eyes in Group B. All eyes (100%) in Group A versus 21 eyes (52.5%) in Group B improved regarding fluorescein dye disappearance test grade (p < 0.001). Restenosis did not occur after plug removal, while it occurred in 10% of eyes subjected to three-snip punctoplasty. CONCLUSION: Perforated punctal plugs and three-snip punctoplasty are safe and effective in treatment of punctal stenosis. However, perforated plugs are less invasive, better tolerated, and have more stable results compared to three-snip punctoplasty.


Assuntos
Dacriocistorinostomia/métodos , Aparelho Lacrimal/cirurgia , Obstrução dos Ductos Lacrimais/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
16.
Eur J Ophthalmol ; 31(3): 1384-1390, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32476460

RESUMO

PURPOSE: To evaluate the use of the resorbable polylactic acid polymer implants (Resorb X) in the management of orbital floor blow-out fractures as regards safety, cosmetic, and functional results. METHODS: In a prospective, interventional case series, 22 patients with traumatic blow-out floor fractures underwent lower fornix transconjunctival repair using polylactic acid implant insertion over the defect without fixation. Orbital imaging was done preoperatively, at 1 month and 1 year postoperatively with orbital computed tomography with 2 mm cuts of axial, sagittal, and coronal scans. Outcome measures included the maximum vertical height of the orbit at the fracture plane and its changes over time. RESULTS: At the final follow-up, both limitation of elevation and diplopia improved in 82% of cases, while 63.6% of cases showed improvement of enophthalmos. Radiological restoration of the orbital vertical height was recorded in 100% of cases without implant displacement at 1 month. However, after 1 year, a significant floor bowing was found in 45.5% of cases, which showed a strong positive correlation with preoperative defect size (r = 0.820). CONCLUSIONS: Resorb X mesh plates can be a good option for the safe reconstruction of orbital floor blow-out fractures. Good anatomical and functional results were obtained in small orbital floor defects. Late bowing under pressure may limit their use in medium-sized floor defects.


Assuntos
Enoftalmia , Fraturas Orbitárias , Procedimentos Cirúrgicos Reconstrutivos , Humanos , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Poliésteres , Estudos Prospectivos , Resultado do Tratamento
17.
Urology ; 147: 299-305, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32916190

RESUMO

OBJECTIVE: To validate the Martini staging system for postoperative rectourethral fistula (RUF) utilizing data from previous studies to determine whether it can accurately predict postoperative success rate. METHODS: A systematic search of peer-reviewed studies was conducted through January, 2020. The primary inclusion criteria for the studies were studies that evaluated outcomes based on the etiology of the fistula (ie, radiotherapy/ablation [RA] vs nonradiotherapy/ablation [NRA]). Martini RUF classification was utilized for the subgroup analysis. RESULTS: Out of 1948 papers, 7 studies with a total of 490 patients (251 in RA vs 239 NRA) were included in this study. Receiving RA increased the risk of permanent bowel diversion by 11.1 folds, eventual fistula recurrence by 9.1 folds, and post-op urinary incontinence (UI) by 2.6 folds. Similarly, compared to a Grade 0 fistula, a Grade I fistula increased the risk of permanent bowel diversion by 9.1 folds, fistula recurrence by 20 folds, and post-op UI by 2.7 folds. There were some valuable variables that were not captured by the Martini classification. CONCLUSION: Overall, the Martini classification system is efficacious in stratifying post-op complications from RUF repair based on the grade and etiology; however, it is limited in application. There is an opportunity for the development of more comprehensive staging systems in this domain.


Assuntos
Fístula Retal/classificação , Doenças Uretrais/classificação , Fístula Urinária/classificação , Humanos
19.
Int J Retina Vitreous ; 6(1): 63, 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-33292788

RESUMO

BACKGROUND: To compare the therapeutic effects of subthreshold micropulse laser (SML) versus intravitreal injection of ranibizumab in treatment of diabetic macular edema (DME) both anatomically using optical coherence tomography (OCT) and functionally using best corrected visual acuity (BCVA) and multifocal electroretinogram (mfERG). METHODS: his study was an interventional prospective randomized comparative study. The study included 120 eyes classified into 3 groups: Group 1 included 40 eyes of 28 patients treated by SML laser, group 2 included 40 eyes of 32 patients treated by intravitreal injection of ranibizumab, and group 3 (control group for mfERG) included 40 eyes of 20 patients with diabetes mellitus (DM) of more than 10 year duration with no signs of diabetic retinopathy (DR). BCVA measurements, OCT and mfERG were done for the cases before and after interference and were followed up for 6 months RESULTS: By the end of the follow up period, BCVA significantly improved by 31% in group 1 vs 93% in group 2 with a statistically highly significant difference between the two groups (p value < 0.001). There was also a significant decrease in central subfield thickness in both groups with more reduction in group 2 compared with group 1 (p value < 0.001). There was a significant improvement in P1 amplitude of mf-ERG in group 2 (p value < 0.002) with no significant improvement in group 1. There was a significant decrease in P1 implicit time in group 2 (p value < 0.001) while there was no significant decrease in group1. CONCLUSIONS: Intravitreal injection of ranibizumab is a superior treatment modality for DME compared with SML regarding both anatomical and functional outcomes. TRIAL REGISTRATION:  This study has been approved by the local ethical committee of faculty of medicine of Minia University and retrospectively registered at the clinical trial gov. with Identifier: NCT04332133.

20.
Clin Genitourin Cancer ; 18(3): e260-e265, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31892490

RESUMO

BACKGROUND: We compared the short-term oncologic and functional outcomes of salvage focal cryotherapy (SFC) with those of salvage total cryotherapy (STC) for radiotherapy (RT)-persistent/recurrent prostate cancer. MATERIALS AND METHODS: We queried the Cryo On-Line Database registry for men who had undergone SFC and STC of the prostate for RT-persistent or recurrent disease. Propensity score weighting was used to match age at treatment, presalvage therapy prostate-specific antigen level, Gleason sum, and presalvage cryotherapy androgen deprivation therapy status. The primary outcome was progression-free survival. RESULTS: A total of 385 men with biopsy-proven persistent or recurrent prostate cancer after primary RT were included in the present study. The median follow-up, age, prostate-specific antigen, and Gleason sum before salvage cryotherapy was 24.4 months (first and third quartile, 9.8 and 60.3), 70 years (first and third quartile, 66 and 74 years), 4 ng/dL (first and third quartile, 2.7 and 5.6 ng/dL), and 7 (first and third quartile, 6 and 8), respectively. After propensity score weighting, the difference in progression-free survival was not statistically significant between the patients who had undergone STC and those who had undergone SFC (79.8% vs. 76.98%; P = .11 on weighted log-rank test). SFC was associated with a lower probability of post-treatment transient urinary retention (5.6% vs. 22.4%; P < .001). No significant differences were found in the incidence of rectal fistula (1.4% vs. 3.8; P = .30), new-onset urinary incontinence within 12 months (9.3% vs. 15.1%; P = .19), or new-onset erectile dysfunction within 12 months (52.6% vs. 59.6%; P = .47) between the SFC and STC groups, respectively. CONCLUSIONS: STC resulted in similar 2-year oncologic outcomes compared with SFC in the RT-persistent/recurrent disease population. However, the patients who had undergone SFC had a lower urinary retention rate compared with those who had undergone STC.


Assuntos
Crioterapia/métodos , Recidiva Local de Neoplasia/cirurgia , Neoplasias da Próstata/cirurgia , Tolerância a Radiação , Terapia de Salvação , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Prognóstico , Estudos Prospectivos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Estudos Retrospectivos , Taxa de Sobrevida
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