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Objective: Retrospective analysis of the efficacy and influencing factors of bladder preservation integrated therapy for unresectable invasive bladder cancer confined to the pelvis was done, also including the bladder function preservation and adverse effects analysis. Methods: Sixty-nine patients with unresectable locally invasive bladder cancer who received radiotherapy-based combination therapy from March 1999 to December 2021 at our hospital were selected. Among them, 42 patients received concurrent chemoradiotherapy, 32 underwent neoadjuvant chemotherapyand 43 with transurethral resection of bladder tumors (TURBT) prior to radiotherapy. The late adverse effect of radiotherapy, preservation of bladder function, replase and metastasis and survival were followed-up. Cox proportional hazards models were applied for the multifactorial analysis. Results: The median age was 69 years. There were 63 cases (91.3%) of uroepithelial carcinoma, 64 of stage Ⅲ and 4 of stage Ⅳ. The median duration of follow-up was 76 months. There were 7 grade 2 late genito urinary toxicities, 2 grade 2 gastrointestinal toxicities, no grade 3 or higher adverse events occurred. All patients maintained normal bladder function, except for 8 cases who lost bladder function due to uncontrolled tumor in the bladder. Seventeen cases recurred locally. There were 11 cases in the concurrent chemoradiotherapy group with a local recurrence rate of 26.2% (11/42) and 6 cases in the non-concurrent chemoradiotherapy group with a local recurrence rate of 22.2% (6/27), and the difference in local recurrence rate between the two groups was not statistically significant (P=0.709). There were 23 cases of distant metastasis (including 2 cases of local recurrence with distant metastasis), including 10 cases in the concurrent chemoradiotherapy group with a distant metastasis rate of 23.8% (10/42) and 13 cases in the non-concurrent chemoradiotherapy group with a distant metastasis rate of 48.1% (13/27), and the distant metastasis rate in the non-concurrent chemoradiotherapy group was higher than that in the concurrent chemoradiotherapy group (P=0.036). The median 5-year overall survival (OS) time was 59 months and the OS rate was 47.8%. The 5-year progression-free survival (PFS) time was 20 months and the PFS rate was 34.4%. The 5-year OS rates of concurrent and non-concurrent chemoradiotherapy group were 62.9% and 27.6% (P<0.001), and 5-year PFS rates were 45.4% and 20.0%, respectively (P=0.022). The 5-year OS rates of with or without neoadjuvant chemotherapy were 78.4% and 30.1% (P=0.002), and the 5-year PFS rates were 49.1% and 25.1% (P=0.087), respectively. The 5-year OS rates with or without TURBT before radiotherapy were 45.5% and 51.9% (P=0.233) and the 5-year PFS rates were 30.8% and 39.9% (P=0.198), respectively. Multivariate Cox regression analysis results showed that the clinical stage (HR=0.422, 95% CI: 0.205-0.869) was independent prognostic factor for PFS of invasive bladder cancer. The multivariate analysis showed that clinical stages (HR=0.278, 95% CI: 0.114-0.678), concurrent chemoradiotherapy (HR=0.391, 95% CI: 0.165-0.930), neoadjuvant chemotherapy (HR=0.188, 95% CI: 0.058-0.611), and recurrences (HR=10.855, 95% CI: 3.655-32.638) were independent prognostic factors for OS of invasive bladder cancer. Conclusion: Unresectable localized invasive bladder cancer can achieve satisfactory long-term outcomes with bladder-preserving combination therapy based on radiotherapy, most patients can retain normal bladder function with acceptable late adverse effects and improved survival particularly evident in patients with early, concurrent chemoradiotherapy and neoadjuvant chemotherapy.
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Humans , Aged , Treatment Outcome , Retrospective Studies , Combined Modality Therapy , Chemoradiotherapy/methods , Urinary Bladder Neoplasms/radiotherapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasm StagingABSTRACT
Objective:To evaluate the efficacy and long-term effect of functional electrical stimulation (FES) on cerebral palsy. Methods:Literature retrieval was carried out in the electronic databases of PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine Disc (CBM), CNKI, Wanfang Database and VIP. The time limit was from the establishment of these databases to March 26th, 2020. According to the inclusion and exclusion criteria, randomized controlled trials about FES for children with cerebral palsy were included. At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies. The data was analyzed with Review Manager 5.3 software. Results:A total of eleven studies with 513 children were included. The Gross Motor Function Measure-88 (GMFM-88) D/E scores (MD = 8.14, 95%CI 6.26 to 10.02, P < 0.001), GMFM-88 B score (MD = 8.77, 95%CI 4.00 to 13.53, P < 0.001), modified Ashworth Scale (MAS) score (MD = -1.05, 95%CI -1.25 to -0.84, P < 0.001), Kyphosis angle (MD = -10.67, 95%CI -12.21 to -9.13, P < 0.001), Cobb's angle (MD = -2.66, 95%CI -3.38 to -1.93, P < 0.001), step length (MD = 3.35, 95%CI 1.81 to 4.90, P < 0.001), walking speed (MD = 0.09, 95%CI 0.05 to 0.14, P < 0.001) and GMFM score at six weeks follow-up (MD = 4.84, 95%CI 1.90 to 7.77, P = 0.001) were better in FES group than in the control group. There was no significant difference in MAS score between two groups after six weeks of follow-up (MD = 0.04, 95%CI -0.30 to 0.37, P = 0.84). Conclusion:FES could improve the lower-limb and trunk function of children with cerebral palsy, however, the long-term effect of relieving muscle spasm was not significant.
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Objective:To explore the effect of sling-massage exercise on neck type cervical spondylopathy (NTCS). Methods:From June, 2020 to February, 2021, 68 patients with NTCS from the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group (n = 34) and observation group (n = 34). The control group accepted routine massage, while the observation group accepted sling exercise and massage based on weak link test, for four weeks. They were assessed with McGill Pain Qusetionnaire (MPQ) and Neck Disability Index (NDI) before and after treatment, and measured median frequency (MF) of the upper trapezius muscle on the affected side with electromyography biofeedback before treatment, after treatment, two weeks after treatment and 4 weeks after treatment. Results:Four cases in the control group and three cases in the observation group dropped down. The scores of MPQ and NDI decreased in both groups after treatment (|Z| > 4.879, P < 0.001), while MF increased (P < 0.001). There was no significant difference in scores of MPQ and NDI between the two groups after treatment (|Z| < 1.100, P > 0.05), while MF was less in the control group than in the observation group (t = 2.184, P < 0.05). MF decreased more in the control group than in the observation group, and was continually less in the control group than in the observation group after treatment (t > 3.770, P < 0.001). Conclusion:Sling-massage exercise is as effective as massage on NTCS immediately, and for more time.
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@#Through a review of the literature on surface treatment of superhydrophilic implants and its clinical application, this paper discusses the shortening of load time, the improvement of the planting success rate and its long-term effect. Additionally, attention should be paid to the nonindication of superhydrophilic implants and issues requiring attention. The literature review showed that healthy patients could carry out an early load 21 days after implantation of superhydrophilic implants, and the load could be completed as soon as 6 weeks after implantation with superhydrophilic short implants when the residual alveolar bone height of the posterior dental area was repaired. Even if the residual alveolar bone density of the patient is low, the application of superhydrophilic implants can shorten the healing period to 8 weeks. Notably, some studies have reported that superhydrophilic implants have no significant effect on patients with a history of radiotherapy and the use of anticoagulants. Because the adhesion of the superhydrophilic implant to the bacteria is also improved to some extent, it is very important to prevent the use of antibiotics when using the superhydrophilic implant. Finally, this paper discusses and anticipates the future research direction of superhydrophilic implants: longer periodic follow-up and more in-depth molecular mechanism studies.
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OBJECTIVE@#To compare the efficacy between acupoint selection of meridian diagnosis and regular acupoint selection for chronic atrophic gastritis (CAG).@*METHODS@#A total of 70 cases of CAG were randomly divided into an observation group (35 cases, 5 cases dropped off) and a control group (35 cases, 5 dropped off). In the observation group, according to the hand diagnosis of meridians and the results of 80-channels energy determinator, based on the principle of child-mother relation acupoint combination, the -connecting point and back- points were added for excess syndrome, and the -primary point, front- points and -sea point of foot meridians were added for deficiency syndrome; in addition, the acupoints of the eight extraordinary meridians were added based on the nature of acupoints. In the control group, Zhongwan (CV 12), Neiguan (PC 6), Zusanli (ST 36) and Gongsun (SP 4) were selected as the primary acupoints, and additional acupoints were added according to syndrome differentiation. The two groups were treated twice a week (Tuesday and Thursday, respectively), totally for 6 months. Six months after treatment, the follow-up was conducted. The clinical symptom score, gastroenteropathy patient reported outcomes (PRO) scale score before treatment, after treatment and during follow-up as well as the score of pathological changes of gastric mucosa before and after treatment were compared between the two groups.@*RESULTS@#After treatment and during follow-up, the clinical symptom scores and gastroenteropathy PRO scale scores were decreased in the two groups (<0.01, <0.001); at the follow-up, the gastroenteropathy PRO scale score in the observation group was lower than that in the control group (<0.01). After treatment, the scores of pathological changes of gastric mucosa in the two groups were decreased (<0.01), and the score in the observation group was lower than that in the control group (<0.05).@*CONCLUSION@#The acupoint selection of meridian diagnosis is superior to regular acupoint selection for CAG, which has better efficacy, more significant improvement on gastric mucosa pathology, and more stable long-term effect.
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Objective@#To explore the long-term effects of radiation injury and to provide scientific basis for the evaluation of the effects of ionizing radiation injury by carrying out medical follow-up of patients involved in the " 5.7" radiative source accident in Nanjing in 2014.@*Methods@#Through interviewing and investigating, we inquired about the new disease history of the exposed patients from rehabilitation treatment to medical follow-up peroid. Physical and laboratory examinations were carried out. According to relevant standards, physiological and biochemical indexes such as hematopoietic system, immune system, endocrine system, ophthalmology, circulatory system, digestive system, urinary system and bone mineral density were systematically evaluated, with the long-term effects being evaluated.@*Results@#The patient′s vital signs were good without new diseases. The indexes of hematopoietic system, immune system and endocrine system tended to be normal, the circulatory system, digestive system and urinary system showed degenerative changes, the ophthalmic examination showed visual acuity continue to decline, and bone mineral density examination indicated low bone mass.@*Conclusions@#Physiological and biochemical indicators of the patients gradually returned to normal without obvious symptoms of radiation damage. Further medical follow-up observation still needs to continue.
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Objective@#To explorea long-term effect of in situ artificial anal reconstruction using five-combined-operation technique after lower rectal cancer resection.@*Methods@#After miles operation, 60 patients suffered with lower rectal cancers underwent in situ artificial anal reconstruction using five-combined-operation technique, which included internal and external anal sphincter, rectal flap, rectal angle, and anoperineal reconstruction.@*Results@#All cases in this study were performed successfully, with primary healing in the wounds. Awareness of defecation had reoccurred in all cases since 1 week postoperatively and self-control of defecation had been regained since 3 weeks postoperatively with formed stool excreted once or twice a day. Long-term follow-ups: ①In 95% cases, rectal controlled discharge time was longer than 2 minutes, which was significantly higher than that of sphincter reconstruction group as a control(P<0.05). ② Five-year survival rate reached to 88%, which was significantly higher than that of the control group(P<0.05).@*Conclusions@#Anal reconstruction using five-combined operation method after Miles operation could be a safe and effective surgical procedure, which could completely cure tumor, and improve patients′ life quality and long-term survival rate.
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Objective To explore the nursing effects of cognitive behavior nursing model in glaucoma patients and its influence on self-management behavior and long-term efficacy. Methods 102 cases of glaucoma patients who were admitted to the Department of-2017 in June 2014 July were randomly divided into the control group (n=51 cases) and the observation group (n=51 cases) . The control group received conventional nursing, the observation group with cognitive behavioral nursing mode. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to evaluate the 2 groups members' psychological and emotional factors. Self Management Behavior Scale was used in the 2 groups at different time points to intervene patients's self responsibility, health knowledge,self care skills,general grading and self-managing ability, so as to compare the nursing effect of the 2 groups and the long-term curative effects. Results the Self-rating Anxiety Scale and Self-rating Depression Scale scores of the observation group were lower than those of the control group (P＜0.05);the Self Management Behavior Scores of the observation group after nursing were higher than that of the control group (P＜0.05);the visual acuity of both groups before nursing was not statistically significant (P＞0.05); the visual acuities with nursing in the observation group after 3 months, 6 months were higher than the control group (P＜0.05) . Conclusion the cognitive behavior nursing model used in the treatment of glaucoma patients can improve the self-management behavior ability, improve the long-term effect of patients, and is worthy of popularization and application.
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Objective To analyze the long term efficacy of sodium hyaluronate on the treatment of moderate knee osteoarthritis. Methods From January 2015 to December2016 year in our hospital , 84 patients with moderate knee osteoarthritis were participated in the study, and were randomly divided into two groups, 42 cases in each group. The control group were given oral glucosamine sulfate . Based on the treatment of the control group, the observation group were received sodium hyaluronate . The long-term effect in the two groups were compared. Results The excellent rate of knee joint function recovery was 80.95% in the observation group, and 54.76% in the control group, the difference in the two groups had statistically significant, P<0.05; Three months, nine months, and one years after treatment, the knee joint function Lysholm scores in the observation group were significantly higher than those in the control group; Three months, nine months, and one years after treatment, AIMS quality of life score in the observation group was significantly lower than those in the control group. Conclusion The long-term effect of sodium hyaluronate in the treatment of moderate knee osteoarthritis is obvious. It can help the knee joint function to be improved significantly, and promote the quality of life of patients significantly improved. It is worth to be widely applied.
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Objective To investigate the long term effect of stent implantation for severe carotid stenosis. Methods The clinical data of 66 patients with severe carotid artery stenosis who were hospitalized from January 2009 to December 2015 were retrospectively reviewed.40 patients underwent carotid artery stenosis stent implanta-tion(as study group)and 26 patients were treated with conventional drug theraphy(as control group).All patient were followed up for 36 months.and the quality of life of the patients was evaluated by SF-36 and the incidence of cerebrovascular events was recorded by following up.Results The quality of life score of the study group were sig-nificantly higher than those of the control group at 3 months,12 months,24 months and 36 months after operation (P<0.05);the incidence of cerebrovascular events after 12 months,24 months and 36 months in the study group was lower than in the control group,and the difference was significant(P<0.05).Conclusions There is obvious long-term effect of carotid artery stenting in the treatment of severe carotid stenosis,in which the quality of life can be effectively improved and the incidence of cerebrovascular events can be reduced in patients with carotid stenosis.
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Objective To investigate the clinical effect of porcelain fused for metal crown restoration after root canal therapy.Methods Totally 90 patients with pulpitis or periapical periodontitis from December 2013 to December 2015 had their clinical data analyzed,who underwent root canal therapy and were divided equally into an observation group and a control group.The observation group took porcelain endocrowns repair and the control group applied ceramic crown.The two groups were compared on the restoration integrity,edge sealing,residual rate,gum,food impaction and color 3 months,6 months and 1 a after treatment.Results The observation group behaved significantly better than the control group in the edge sealing and restoration integrity (P＜0.05).There were significant differences between the residual rates,gum and food impaction in the two groups (P＜0.05).Conclusion Porcelain endocrowns repair gains advantages over ceramic crown repair in edge sealing,integrity,gum,food impaction and color after root canal therapy,though its long-term effect needs further investigation.
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Objective To compare the long-term outcomes of the retropubic tension-free vaginal tape (TVT) versus the transobturator tension-free vaginal tape (TVT-O) for women with stress urinary incontinence (SUI).Methods From July 2001 to June 2011,data of 120 female patients with SUI were retrospectively reviewed,of which 45 patients received TVT treatment,while 75 patients received TVT-O.The median age in TVT group was 45.1 years (range 35-72 years),and the median age in TVT-O group was 50.5 years (range 39-76 years).We retrospectively analyzed the long-term subjective effect,objective effect and the rate of complications in the two groups.Results Median follow-up period was 121 months (range 72-192 months).The complete satisfaction rate was 89％ (40/45) in TVT group,and 92％(69/75) in TVT-O group,with no statistical difference between the two groups.The negative rate of cough test was 84.4％ (38/45) in TVT group,and 76.0％ (57/75)in TVT-O group,with a statistically significant difference.The rate of urinary tract injury was 8.9％ (4/45) in TVT group,and 4.0％ (3/75) in TVT-O group.The rate of thigh pain was 0 in TVT group,and 6.7％ (3/45) in TVT-O group.The rate of micturition frequency and urinary incomplete emptying after operations was 6.7％ (5/75) in TVT group,and 5.3％ (4/75) in TVT-O group.Conclusions The long-term subjective effect between TVT and TVT-O groups was similar.The objective effect in TVT group was better.There was no statistical difference in complication rate between the two groups,which showed different types of complications in different procedures.
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Objective To investigate the clinical effect of porcelain fused for metal crown restoration after root canal therapy.Methods Totally 90 patients with pulpitis or periapical periodontitis from December 2013 to December 2015 had their clinical data analyzed,who underwent root canal therapy and were divided equally into an observation group and a control group.The observation group took porcelain endocrowns repair and the control group applied ceramic crown.The two groups were compared on the restoration integrity,edge sealing,residual rate,gum,food impaction and color 3 months,6 months and 1 a after treatment.Results The observation group behaved significantly better than the control group in the edge sealing and restoration integrity (P＜0.05).There were significant differences between the residual rates,gum and food impaction in the two groups (P＜0.05).Conclusion Porcelain endocrowns repair gains advantages over ceramic crown repair in edge sealing,integrity,gum,food impaction and color after root canal therapy,though its long-term effect needs further investigation.
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Objective To compare the long-term outcomes of the retropubic tension-free vaginal tape (TVT) versus the transobturator tension-free vaginal tape (TVT-O) for women with stress urinary incontinence (SUI).Methods From July 2001 to June 2011,data of 120 female patients with SUI were retrospectively reviewed,of which 45 patients received TVT treatment,while 75 patients received TVT-O.The median age in TVT group was 45.1 years (range 35-72 years),and the median age in TVT-O group was 50.5 years (range 39-76 years).We retrospectively analyzed the long-term subjective effect,objective effect and the rate of complications in the two groups.Results Median follow-up period was 121 months (range 72-192 months).The complete satisfaction rate was 89％ (40/45) in TVT group,and 92％(69/75) in TVT-O group,with no statistical difference between the two groups.The negative rate of cough test was 84.4％ (38/45) in TVT group,and 76.0％ (57/75)in TVT-O group,with a statistically significant difference.The rate of urinary tract injury was 8.9％ (4/45) in TVT group,and 4.0％ (3/75) in TVT-O group.The rate of thigh pain was 0 in TVT group,and 6.7％ (3/45) in TVT-O group.The rate of micturition frequency and urinary incomplete emptying after operations was 6.7％ (5/75) in TVT group,and 5.3％ (4/75) in TVT-O group.Conclusions The long-term subjective effect between TVT and TVT-O groups was similar.The objective effect in TVT group was better.There was no statistical difference in complication rate between the two groups,which showed different types of complications in different procedures.
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Objective To analyze tumor-free survival rate and recurrence rate of radiofrequency ablation (RFA) versus surgical resection(SR) for small hepatocellular carcinoma. Methods Clinical data of 64 patients (hospitalized from October 2008 to October 2010) with small hepatocellular carcinoma(≤ 5 cm) in our hospital were retrospectively analyzed. 29 cases among them underwent RFA, and the 35 cases underwent SR, then they were further divided into two groups according to the tumor diameter (≤ 3 cm vs. ≤ 3 ~ 5 cm). The rate of complete elimination of tumor , complications , recurrence and metastasis , and survival rate out of tumor-free at year 1, 3, and 5 were compared. Accumulated survival rate of the two groups at year 1, 3, and 5 were compared. Results The rate of complete elimination of tumor, and complications in the RFA group were 89.66% and 6.9% respectively, and no statistically significant difference was found compared with the SR group (100% and 14.29%, respectively) . The rate of recurrence and metastasis and 1, 3, 5- year tumor-free rate in RFA and SR group with tumor diameter 0.05) respectively, and for the cases with tumor diameter in 3 ~ 5 cm, these data showed no significant difference between groups (P > 0.05). No significant difference were found in tumor-free survival rate within groups, while rate of recurrence and metastasis was significantly lower in the 0.05). Conclusions RFA and SR had similar medium and long term clinical effect for small hepatocellular carcinoma with tumor diameter≤ 5 cm. The larger in size of the tumor, the higher rate of recurrence and metastasis. RFA is less invasive and can avoid complications and should be considered an eligible treatment for small hepatocellular carcinoma with tumor diameter ≤ 5 cm.
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Resumo Introdução: O número de pacientes idosos portadores de doença renal crônica aumenta progressivamente, desafiando os algoritmos de alocação, em um cenário de escassez de órgãos para transplante. Objetivo: Avaliar o impacto da idade sobre os resultados do transplante renal. Métodos: Foram analisados todos os 366 pacientes > 60 anos transplantados entre 1998-2010 versus um grupo controle de 366 pacientes mais jovens pareados por gênero, tipo de doador (vivo/falecido) e ano do transplante. Resultados: Diabetes mellitus (HR 1,5; IC 1,0-2,2; p = 0,031) e doador falecido (HR 1,7; IC 1,2-2,7; p = 0,013) se associaram independentemente a maior risco de óbito. Diabetes mellitus (HR 1,8; IC 1,2-2,6; p = 0,003) e priorização por acesso vascular (HR 2,9; IC 1,2-2,6; p < 0,001), mas não idade, foram fatores independentes de perda do enxerto renal. Conclusão: A idade avançada não teve impacto negativo no resultado do transplante quando excluído óbito do paciente como causa de perda do enxerto. A maior mortalidade entre a população senil esteve associada à maior frequência de comorbidades, em especial diabetes mellitus. .
Abstract Introduction: The number of elderly patients with chronic kidney disease increases progressively, challenging the allocation algorithms in a scenario of organ shortage for transplantation. Objective: To evaluate the impact of age on patient and graft survival. Methods: Evolution of all 366 patients greater than 60 years transplanted between 1998 and 2010 was analyzed versus a control group of 366 younger patients matched for gender, type of donor (living or deceased) and year of transplantation. Results: Diabetes mellitus (HR 1.8; IC 1.2-2.6; p = 0,003) and prioritization (HR 2.9; IC 1.2-2.6; p < 0,001), but not age, were independent factors for kidney graft loss. Conclusion: Advanced age was not related to negative outcomes after kidney transplantation, after excluding recipient death as a cause of allograft loss. Higher mortality rate in this group was associated to a higher frequency of comorbidities, especially diabetes mellitus. .
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Kidney Transplantation , Age Factors , Cohort Studies , Graft Survival , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
Introducción: La ablación o mutilación genital femenina incluye una amplia variedad de prácticas que suponen la extirpación total o parcial de los genitales externos o su alteración por razones que no son de índole médica. Causa daños irreversibles y pone en peligro la salud, e incluso la vida de la mujer o niña afectada. Objetivo: Caracterizar la mutilación genital femenina y sus complicaciones a largo plazo en la comunidad de Fajikunda, Gambia, entre marzo y septiembre de 2012. Método: Se realizó un estudio descriptivo prospectivo a 117 mujeres que asistieron al centro de salud por cualquier motivo que requiriera examen ginecológico y se estudiaron las variables grupo de edades, tipo de mutilación, grupo étnico y complicaciones. Resultados: Del total, 98 mujeres eran de 45 años de edad o menos; la clitoridectomía (tipo I) fue la práctica más frecuente; la inflamación pélvica crónica y el dolor en los genitales fueron las complicaciones a largo plazo que mayor asociación estadística demostraron con relación a la mutilación. La anorgasmia presentó una alta incidencia en la población estudiada. Conclusiones: La prevalencia de la mutilación genital femenina en Fajikunda es aproximadamente la misma que en Gambia, la tipo I es la más practicada y generalmente en jóvenes de la etnia Mandinga.
Introduction: The ablation or female genital mutilation includes a wide variety of practices dealing with total or partial extirpation of the external genitalia or its alterations for reasons other than of medical nature. It causes irreversible damages and puts in danger the health or even the life of the woman or child involved. Objective: The aim of the present study is to characterize female genital mutilation and its long-term complications in Fajikunda community, Gambia, between March and September 2012. Method: A descriptive prospective study was performed to 117 women that attended the health unit for reasons requiring gynecological examination and the variables age group, mutilation type, ethnic group and complications were studied. Results: Of the total, 98 women were 45 years old or less; the clitoridectomy (type I) was the most frequent practice; cronical pelvic and genital pains were the long-term complications that showed a major statistical association with relation to mutilation. Conclusions: The prevalence of female genital mutilation in Fajikunda is approximately the same as in Gambia, the type I is the most performed and generally within young women belonging to Mandinga ethnic group.
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Background: Drug-eluting stents have been used in daily practice since 2002, with the clear advantages of reducing the risk of target vessel revascularization and an impressive reduction in restenosis rate by 50%-70%. However, the occurrence of a late thrombosis can compromise long-term results, particularly if the risks of this event were sustained. In this context, a registry of clinical cases gains special value. Objective: To evaluate the efficacy and safety of drug-eluting stents in the real world. Methods: We report on the clinical findings and 8-year follow-up parameters of all patients that underwent percutaneous coronary intervention with a drug-eluting stent from January 2002 to April 2007. Drug-eluting stents were used in accordance with the clinical and interventional cardiologist decision and availability of the stent. Results: A total of 611 patients were included, and clinical follow-up of up to 8 years was obtained for 96.2% of the patients. Total mortality was 8.7% and nonfatal infarctions occurred in 4.3% of the cases. Target vessel revascularization occurred in 12.4% of the cases, and target lesion revascularization occurred in 8% of the cases. The rate of stent thrombosis was 2.1%. There were no new episodes of stent thrombosis after the fifth year of follow-up. Comparative subanalysis showed no outcome differences between the different types of stents used, including Cypher®, Taxus®, and Endeavor®. Conclusion: These findings indicate that drug-eluting stents remain safe and effective at very long-term follow-up. Patients in the "real world" may benefit from drug-eluting stenting with excellent, long-term results. .
Fundamento: Stents eluidores de drogas têm sido utilizados na prática médica desde 2002, e apresentam grande eficácia na redução do risco de revascularização do vaso-alvo, e notável redução da taxa de reestenose de 50%-70%. No entanto, a ocorrência de trombose tardia pode comprometer os resultados a longo prazo, especialmente se o risco de trombose for mantido ao longo dos anos. Neste contexto, o registro da prática clínica assume grande importância. Objetivo: Avaliar a eficácia e segurança de stents eluidores de drogas no mundo real. Métodos: Relatamos os resultados de todos os pacientes que foram submetidos à intervenção coronária percutânea com stent eluidor de drogas no período entre janeiro de 2002 a abril de 2007, e que foram acompanhados por 8 anos. Os stents eluidores de drogas foram utilizados de acordo com as recomendações clínicas do cardiologista intervencionista e a disponibilidade do stent. Resultados: Um total de 611 pacientes foram avaliados, com acompanhamento clínico de 96,2% destes pacientes por até 8 anos. A mortalidade total foi de 8,7%. Infarto não-fatal ocorreu em 4,3% dos casos. A taxa de revascularização do vaso-alvo foi de 12,4% e a da lesão-alvo foi de 8,0%. A taxa de trombose de stent foi de 2,1%. Não houve novos episódios de trombose de stent após o quinto ano de acompanhamento. Uma subanálise comparativa indicou não haver diferenças nos desfechos clínicos apos a utilização dos stents Cypher, Taxus e Endeavor. Conclusão: Estes resultados indicam que stents eluidores de drogas são seguros e eficazes em acompanhamentos de longo prazo, e que pacientes no mundo real podem beneficiar destes stents, com excelentes resultados a longo prazo. .
Subject(s)
Aged , Female , Humans , Drug-Eluting Stents/adverse effects , Percutaneous Coronary Intervention/methods , Coronary Angiography , Coronary Artery Disease/surgery , Coronary Thrombosis/etiology , Follow-Up Studies , Percutaneous Coronary Intervention/adverse effects , Percutaneous Coronary Intervention/mortality , Risk Factors , Statistics, Nonparametric , Time Factors , Treatment OutcomeABSTRACT
Objective To investigate the long-term effect of angioplasty of patients with symptomatic vertebrobasilar artery stent.Methods Thirty-three patients with symptomatic vertebral artery stenosis who underwent endovascular treatment stent.The clinical symptoms and stent restenosis were recorded.Results The clinical symptoms of 33 cases with angioplasty were improved significantly.The preoperative stenosis rate was (92.36 ±3.23)％ before operation and the average postoperative residual stenosis rate was (9.13 ±2.57)％ after operation.Clinical symptoms of 23 patients disappeared completely after operation,and 10 cases improved significantly.As to complications,1 case with severe basilar artery stenosis had a side numbness of extremities,1 case showed postoperative cerebral embolism,and return to normal after 3 days.When follow up periods lasted for 6-24 months,9 cases were with dizziness or other symptoms.Of which,29 cases were performed DSA imaging,the residual stenosis rate was (19.27 ± 5.62)％,3 cases of vertebral artery in-stent restenosis were reached over 50％.Those 3 cases were give stent angioplasty again and the uncomfortable symptoms disappeared.Conclusion Stenosis opeation can significantly alleviate the symptoms of cerebral ischemia and symptomatic vertebrobasilar artery,and improve the quality of life of patients.However,restenosis should paid more attention.
ABSTRACT
10.3969/j.issn.1008-9691.2013.03.011