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Preventive Effect of Electrical Stimulation Biofeedback Combined With Family Individualized Pelvic Floor Rehabilitation Training on Postpartum Pelvic Floor Dysfunction
Huan Wang,
Hong Zhou,
Li Cheng
Issue:
Volume 8, Issue 2, April 2020
Pages:
43-47
Received:
1 February 2020
Accepted:
17 February 2020
Published:
6 March 2020
Abstract: Objective: To explore the preventive effect of electrical stimulation biofeedback combined with family individualized pelvic floor rehabilitation training on postpartum pelvic floor dysfunction (PFD). Methods: From June 2018 to June 2019, 124 women who underwent the first postpartum review (Postpartum4-6 weeks, lochia clean, no vaginal bleeding) in our hospital were randomly divided into observation group and control group, 62 cases in each group. The control group received routine pelvic floor muscle training intervention, while the observation group received family individualized pelvic floor rehabilitation training combined with electrical stimulation biofeedback intervention. Six months after the intervention, the pelvic floor muscular fibre strength and A3 reflex, pelvic organ prolapse quantitative (POP-Q) score, pelvic floor dysfunction questionnaire (PFDI20), pelvic floor disease quality of life questionnaire (PFIQ7) and pelvic organ prolapse, urinary incontinence function questionnaire (PISQ-12) were compared between the two groups. Results: After 6 months of intervention, there was no significant difference in the muscle strength of type I muscle fibers between the two groups (Z=-0.918, P=0.358), while the muscle strength of type II muscle fibers in the observation group was significantly better than that in the control group (Z=-2.372, P=0.018). There was no significant difference in A3 reflex between the two groups before and after treatment (before: χ2=0.387, P=0.534; after: χ2=0.683, P=0.409). The POP-Q score of the observation group was significantly better than that of the control group (Z=-2.073, P=0.038). There was no significant difference in PFDI20, PFIQ7 and PISQ-12 scores between the two groups before and after treatment (P > 005). In the observation group, there were 2 cases of vaginal relaxation, 1 case of mild uterine prolapse, no stress urinary incontinence and vaginal wall bulge, the incidence was 4.84%. In the control group, 4 cases had vaginal relaxation, 2 cases had mild uterine prolapse, 1 case had stress urinary incontinence and no vaginal wall bulge, the incidence was 11.29%. Conclusion: Electrical stimulation biofeedback combined with family individualized pelvic floor rehabilitation training has a better effect on pelvic floor muscle rehabilitation, which is helpful to prevent the occurrence of PFD.
Abstract: Objective: To explore the preventive effect of electrical stimulation biofeedback combined with family individualized pelvic floor rehabilitation training on postpartum pelvic floor dysfunction (PFD). Methods: From June 2018 to June 2019, 124 women who underwent the first postpartum review (Postpartum4-6 weeks, lochia clean, no vaginal bleeding) in...
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Accelerated Wound Healing by a Topical Wound Healing Lipogel in Patients Undergoing Catheter De-placement - Evidence from a Randomized, Controlled Clinical Study
Thomas Eberlein,
Sami Siam
Issue:
Volume 8, Issue 2, April 2020
Pages:
48-55
Received:
31 January 2020
Accepted:
21 February 2020
Published:
17 March 2020
Abstract: Objective: The purpose of this clinical study was to assess a novel wound model and to compare the wound healing properties of a topical wound healing hydroactive lipogel (MediGel®) promoting moist wound environment versus standard treatment by a standard plaster und dry environmental conditions in patients undergoing catheter de-placement as a model for non-acute wounds affecting all skin layers in real life conditions (moist environment does improve granulation & epithelialization supported by Lipogel – the MEDIGEL trial). Methods: Patients (n=69) admitted to the dialysis ward of a tertiary care institution with acute or chronic renal insufficiency and in need for dialysis were enrolled into a prospective, observer-blind, randomized, controlled, inter-individual experimental comparison study. Patients enrolled were undergoing placement of Sheldon multi-lumen catheter (11 French diameter) in the external jugular vein at the neck by Seldinger technique to enable access for hemodialysis. One group of patients which had catheter displaced after one session of hemodialysis was regarded as acute wound group. A different group of patients had catheter withdrawn after 14 (+/- 2 days) and was classified as non-acute wound group. Topical treatments were randomly allocated, i.e. traditional care with standard plaster (control group) or investigational product (promoting moist environment) beneath a standard plaster (investigational product). Wound healing was assessed (digital photography, visual scoring) and analyzed via comparison of area under curve at day 0, 3 and 7 after displacement of catheter. Results: Evaluation showed significantly faster wound healing results for the investigational product in comparison to standard (all time points) and with significant AUC difference in both patient groups, acute and non-acute. Visible re-epithelialization was recorded from day 3 to day 7 in acute wounds, delayed in non-acute wounds. Standard plaster-treated wounds remained open and had markedly larger wound area. Formation of fibrous scar tissue was minimal but less prominent in patients treated with the hydroactive lipogel in the non-acute group due to faster epithelialization promoted by moist environment. Conclusion: Clinically relevant accelerated epithelialization and faster wound healing were observed for the investigational product compared to traditional treatment indicating superiority of moist wound environmental conditions both in acute and non-acute wounds after displacement of catheter placed into the jugular vein for 5 hours or 2 weeks in patients undergoing hemodialysis. The model is an innovative approach to study acute and non-acute wounds affecting all three skin layers and should be further investigated.
Abstract: Objective: The purpose of this clinical study was to assess a novel wound model and to compare the wound healing properties of a topical wound healing hydroactive lipogel (MediGel®) promoting moist wound environment versus standard treatment by a standard plaster und dry environmental conditions in patients undergoing catheter de-placement as a mod...
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Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly
Liu Rui Jia,
Meng Qing Qi,
Li Si Ming
Issue:
Volume 8, Issue 2, April 2020
Pages:
56-61
Received:
18 February 2020
Accepted:
3 March 2020
Published:
18 March 2020
Abstract: Background: The incidence of proximal humeral fracture is increasing gradually. Many patients choose open reduction and internal fixation. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complications and fast postoperative recovery. However, due to the complexity of shoulder anatomy, scholars have created different surgical approaches from different perspectives. Objective: Although the effect of open reduction and internal fixation is confirmed, there are still some differences in the effect of different surgical approaches. We need to study the summary and research progress of surgical approach for proximal humeral fracture, which is conducive to the selection of the optimal approach for incision, so as to improve the prognosis. Method: Selective literature review. Result: At present, common surgical approaches include lateral approach, anteromedial approach, anterolateral approach, small incision approach and other approaches. This paper describes and compares the advantages and disadvantages of each approach, so as to choose the best approach for different fracture types. Conclusion: Based on the complexity of the anatomical relationship of the shoulder joint, the displacement, classification of the fracture, the proximal humerus are opened and exposed from different perspectives. Choosing a safe surgical approach is one of the key links of the whole operation and plays an important role in the postoperative effect. In this paper, the common approaches and new approaches of open reduction and internal fixation for proximal humeral fracture are reviewed, which provides new ideas for the design of surgical scheme.
Abstract: Background: The incidence of proximal humeral fracture is increasing gradually. Many patients choose open reduction and internal fixation. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complica...
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Preserved Tibial Attachment of Hamstring Graft Versus Detached Graft in Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Study
Patricio Espinoza Dumlao III,
Lyndon Lovina Bathan,
Patrick Mia Dizon
Issue:
Volume 8, Issue 2, April 2020
Pages:
62-66
Received:
5 March 2020
Accepted:
20 March 2020
Published:
31 March 2020
Abstract: Background: Anterior cruciate ligament (ACL) reconstruction is one of the most frequent procedures done by orthopedic surgeons. Successful reconstruction is founded on fast healing and incorporation of tendon graft which translates to earlier and aggressive rehabilitation and faster return to dynamic activities. Recent studies highlighted the importance of biologic strategies in the enhancement of the recuperation process of autologous grafts for reconstruction. Current literature theorized the concept of maintaining the hamstring graft (HG) insertion but was unable to explicitly conclude an advantage of maintaining the attachment of the hamstring graft. Method: A prospective, double-blinded, randomized controlled study was done comparing graft integration through MRI (Figueroa) scoring system, and clinical outcomes through IKDC scores between the detached HG (control group) versus preserved tibial attachment of HG (test group) both augmented with interference screw fixation for ACL reconstruction. Results and Conclusion: A total of 32 patients were enrolled, 18 for the control group, 14 for the test group. Preoperative IKDC scores were similar for both groups. Post-operatively, a significant earlier peak at 3 months and continued improvement at 6 months is in favor of the test group. Consistently, there is also a 2.78-fold increased likelihood of graft healing and its constituent graft integration and ligamentization in the test group. This suggests that preservation of the neurovascular attachment of the HG is a contributory factor for efficient ligamentization and subsequent pain control, activities of daily living and functional capacity.
Abstract: Background: Anterior cruciate ligament (ACL) reconstruction is one of the most frequent procedures done by orthopedic surgeons. Successful reconstruction is founded on fast healing and incorporation of tendon graft which translates to earlier and aggressive rehabilitation and faster return to dynamic activities. Recent studies highlighted the impor...
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Intussusception Induced by Burkitt Lymphoma in an Adult Patient
Olivia Makenzie Boyette,
Bradley Casey III,
Stephanie Khadeejah Tom,
Todd Nicholas Tom
Issue:
Volume 8, Issue 2, April 2020
Pages:
67-70
Received:
30 January 2020
Accepted:
31 March 2020
Published:
14 April 2020
Abstract: Intussusception is defined as the telescoping of an intestinal region into an adjacent region of intestine. We present an interesting case of a retrograde intussusception due to an underlying Burkitt lymphoma. Case Presentation: We have a 41-year-old Caucasian male who presented to the Emergency Department (ED) with complaints of left sided periumbilical abdominal pain that began several months prior. Computed tomography (CT) scan of the abdomen and pelvis with oral and IV contrast showed a colonic mass in the region of the ileocecal valve. Patient denied any fever, vomiting, melena, or hematochezia. He was scheduled for a colonoscopy with surgical services. Upon colonoscopy, intussusception in the region of the ileocecal valve was discovered and cecectomy was scheduled for the same day. Intussusception was removed via hand assisted laparoscopic cecectomy with functional end-to-end anastomoses. Gross dissection of the specimen post cecectomy revealed a 5cm by 5cm mass as the lead point for intussusception (Figures 4, 5). The mass was sent for pathology which revealed Burkitt lymphoma. Conclusion: Intussusception is a rare cause of abdominal pain in adults but should be considered because it may be an indicator of underlying malignancy. Unlike intussusception in the pediatric patient, which can be managed non-operatively, treatment in adults is usually surgery.
Abstract: Intussusception is defined as the telescoping of an intestinal region into an adjacent region of intestine. We present an interesting case of a retrograde intussusception due to an underlying Burkitt lymphoma. Case Presentation: We have a 41-year-old Caucasian male who presented to the Emergency Department (ED) with complaints of left sided periumb...
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Ovarian Conservation in Patients with Early Stage Endometrial Carcinoma (EC) as a Safe Alternative to Oophorectomy
Walid A. Abdelsalam,
Mohamed Fathy Abohashim,
Doaa Mandour,
Taha A. Baiomy,
Ibrahim Heggy
Issue:
Volume 8, Issue 2, April 2020
Pages:
71-75
Received:
25 February 2020
Accepted:
6 March 2020
Published:
17 April 2020
Abstract: Background: Premenopausal females having early-stage EC have a favorable prognosis. The guidelines of surgical treatment of EC have not been modified and it consists of total hysterectomy, bilateral salpingo-oophrectomy, pelvic and para-aortic lymphadenectomy, regardless of patients’ age or EC stage. The drawbacks of performing bilateral BSO are induction of surgical premature menopause which subsequently disturbs physical and psychosexual life in addition to increasing risk of diseases of the cardiovascular system and bone fractures. The aim of our study was to demonstrate if performing BSO in premenopausal females patients with early stage EC had survival benefits and improving long-term outcomes or not. Patients and methods; we included sixty EC patients and we have performed ovarian conservation in 30 (50%) of them, and performed BSO in the remaining 30 patients we have followed our patients for 5 years from December 2014 to December 2019. Results: Age of patients with ovarian conservation was younger than patients with BSO (p=0.032), have smaller tumor size (p=0.02), higher degree of tumor differentiation (p=0.025), less incidence of myomertrial invasion (p=0.004), less liability of lymphovascular invasion (p=0.001), more liability to endometrioid histopathological subtype (p=0.003), and earlier stage (p=0.009) than patients with BSO. There were no significant differences between both studied groups regarding recurrence of the tumor, recurrence free survival and overall survival rates. Conclusion: The current study tried to highlight the benefits of a more conservative approach by ovarian preservation in surgical management and staging of EC patients diagnosed in the early stage in young premenopausal women.
Abstract: Background: Premenopausal females having early-stage EC have a favorable prognosis. The guidelines of surgical treatment of EC have not been modified and it consists of total hysterectomy, bilateral salpingo-oophrectomy, pelvic and para-aortic lymphadenectomy, regardless of patients’ age or EC stage. The drawbacks of performing bilateral BSO are in...
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Effect of a Seamless Device for Instillation on Bladder Instillation of Drug After Transurethral Resection of Bladder Tumor
Issue:
Volume 8, Issue 2, April 2020
Pages:
76-80
Received:
29 March 2020
Accepted:
16 April 2020
Published:
29 April 2020
Abstract: Objective: We aim to explore the effect of a seamless device for instillation on bladder instillation of drug after transurethral resection of bladder tumor. Methods: There were 24 patients undergoing transurethral resection of bladder tumor in the department of urinary surgery from January 2019 to December 2019, and 150 person-times of bladder instillation of drug in follow-up. We adopted random number table to averagely divide the 150 person-times into experimental group, control group A and control group B. In the experimental group, before bladder instillation of drug, a 50ml injector was used for dissolution and suction of drug. During instillation of drug, we used heparin cap to connect the injector and catheter to make a seamless device for instillation. In the control group A, before instillation, a 50ml injector was also used for dissolution and suction of drug, but at the same time, the syringe nozzle was inserted into the horn-shaped catheter orifice to inject the drug. In the control group B, we used a 50 ml injector for dissolution and suction of drug before instillation and then injected to drug into an aseptic bowel. After that, we used a 50 ml medical irrigator to draw in the liquid in the bowl and inserted the irrigator nozzle into the horn-shaped catheter orifice to inject the liquid. We compared operator’s satisfaction during instillation, drug leakage and time consumption between the three groups. Results: Operator’s satisfaction in the experimental group, control group A and control group B was 100%, 12% and 84% respectively and there was a significant difference in that between the three groups (χ2=57.576, P=0.000). In terms of drug leakage, there was no leakage in the experimental group, and an average of 11.44±2.13 ml of leakage in the control group A and an average of 0.77±1.14 ml of leakage in the control group B. The one-way analysis of variance showed that there was a significant difference in that (F=1041.089, P=0.000). At last, the time consumption in the experimental group was 9.28±1.21min, and the control group A took the longest time 11.58±1.81 min. The one-way analysis of variance showed that there was a significant difference in time consumption between the three groups (F=32.947, P=0.000). Conclusions: the self-designed seamless device for instillation in the bladder instillation of drug for patients who underwent transurethral resection of bladder tumor can not only ensure the dosage of drug, avoid iatrogenic exposure but also reduce time consumption and improve medical staff’s satisfaction. Hence, the seamless device is worth clinical application.
Abstract: Objective: We aim to explore the effect of a seamless device for instillation on bladder instillation of drug after transurethral resection of bladder tumor. Methods: There were 24 patients undergoing transurethral resection of bladder tumor in the department of urinary surgery from January 2019 to December 2019, and 150 person-times of bladder ins...
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