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BMC Surgery May 2024To investigate whether simethicone expediates the remission of abdominal distension after laparoscopic cholecystectomy (LC).
OBJECTIVE
To investigate whether simethicone expediates the remission of abdominal distension after laparoscopic cholecystectomy (LC).
METHODS
This retrospective study involved LC patients who either received perioperative simethicone treatment or not. Propensity score matching (PSM) was employed to minimize bias. The primary endpoint was the remission rate of abdominal distension within 24 h after LC. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors affecting the early remission of abdominal distension after LC. Subsequently, a prediction model was established and validated.
RESULTS
A total of 1,286 patients were divided into simethicone (n = 811) and non-simethicone groups (n = 475) as 2:1 PSM. The patients receiving simethicone had better remission rates of abdominal distension at both 24 h and 48 h after LC (49.2% vs. 34.7%, 83.9% vs. 74.8%, respectively), along with shorter time to the first flatus (14.6 ± 11.1 h vs. 17.2 ± 9.1 h, P < 0.001) compared to those without. Multiple logistic regression identified gallstone (OR = 0.33, P = 0.001), cholecystic polyp (OR = 0.53, P = 0.050), preoperative abdominal distention (OR = 0.63, P = 0.002) and simethicone use (OR = 1.89, P < 0.001) as independent factors contributing to the early remission of abdominal distension following LC. The prognosis model developed for predicting remission rates of abdominal distension within 24 h after LC yielded an area under the curve of 0.643 and internal validation a value of 0.644.
CONCLUSIONS
Simethicone administration significantly enhanced the early remission of post-LC abdominal distension, particularly for patients who had gallstones, cholecystic polyp, prolonged anesthesia or preoperative abdominal distention.
TRIAL REGISTRATION
ChiCTR2200064964 (24/10/2022).
Topics: Humans; Retrospective Studies; Female; Male; Propensity Score; Middle Aged; Cholecystectomy, Laparoscopic; Simethicone; Postoperative Complications; Adult; Treatment Outcome; Aged; Abdomen
PubMed: 38811935
DOI: 10.1186/s12893-024-02460-w -
Arquivos Brasileiros de Oftalmologia 2024
Topics: Humans; Silicone Oils; Anterior Chamber; Male; Emulsions; Female; Vitrectomy
PubMed: 38808910
DOI: 10.5935/0004-2749.2024-0058 -
Ugeskrift For Laeger May 2024Around 2,500 women receive a breast augmentation with silicone-based implants yearly in Denmark. A number of these women report various uncharacteristic systemic... (Review)
Review
Around 2,500 women receive a breast augmentation with silicone-based implants yearly in Denmark. A number of these women report various uncharacteristic systemic symptoms, which they attribute to the breast implants, including impaired cognition, joint pain, etc. This condition has been termed "breast implant illness" and is currently not a recognised diagnosis. The correlation between the patient's self-reported symptoms and breast implants has not been established and there is limited evidence that surgery has any effect. In this review, the current literature on the topic has been reviewed.
Topics: Humans; Breast Implants; Female; Self Report; Arthralgia; Silicone Gels; Denmark; Breast Implantation
PubMed: 38808767
DOI: 10.61409/V12230801 -
Frontiers in Medicine 2024To investigate the efficacy and safety profile of T-shaped pars plana scleral incision technique in removing large intraocular foreign bodies, during 23-gauge pars plana...
AIM
To investigate the efficacy and safety profile of T-shaped pars plana scleral incision technique in removing large intraocular foreign bodies, during 23-gauge pars plana vitrectomy.
METHODS
Retrospective interventional case series that included patients diagnosed with a large intraocular foreign body (IOFB). Possible postoperative complications were recorded 24 h, 1 month, 3 and 6 months postoperatively.
RESULTS
Thirty eyes of 30 patients (48 ± 5 years old) were enrolled. All IOFBs were successfully removed: mean diameters of 7.8 ± 2.0 mm and 2.6 ± 0.3 mm. Silicone oil and sulfur hexafluoride were used in 27 and 3 eyes, respectively. Lensectomy was performed in 27 eyes. Intraocular lens was implanted at first attempt in 12 eyes; during a second operation in 12 eyes and 6 eyes remained aphakic. At any follow-up, no signs of postoperative complications were observed. Secondary retinal detachment occurred in 12 eyes. Mean preoperative corrected distance visual acuity was 0.04, on the Snellen scale; it increased to 0.07, at last follow-up. Mean intraocular pressure was 17.97 mmHg. All eyes were preserved.
CONCLUSION
T-shaped scleral incision could be an effective, safe and easy-to-perform standard procedure to remove large IOFBs during pars plana vitrectomy, without increasing the risk of surgical complications and additional damage to the ocular tissues.
PubMed: 38808133
DOI: 10.3389/fmed.2024.1399321 -
BMC Oral Health May 2024The aim of this in vitro study was to evaluate the changes the rheological properties of some soft lining materials, to compare the rheological properties and... (Comparative Study)
Comparative Study
PURPOSE
The aim of this in vitro study was to evaluate the changes the rheological properties of some soft lining materials, to compare the rheological properties and viscoelastic behaviour at different temperatures.
MATERIALS AND METHODS
Five soft lining materials (acrylic and silicone based) were used. the storage modulus (G'), loss modulus (G"), tan delta (tan δ) and complex viscosity (η') were chosen and for each material, measurements were repeated at 23, 33 and 37 °C, using an oscillating rheometer. All data were statistically analyzed using the Mann Whitney U test, Kruskal Wallis test and Conover's Multiple Comparison test at the significance level of 0.05.
RESULTS
Soft lining materials had different viscoelastic properties and most of the materials showed different rheological behavior at 23, 33 and 37 °C. At the end of the test (t¹5), at all the temperatures, Sofreliner Tough M had the highest storage modulus values while Visco Gel had the highest loss Tan delta values.
CONCLUSIONS
There were significant changes in the rheological parameters of all the materials. Also temperature affected the initial rheological properties, and polymerization reaction of all the materials, depending on temperature increase.
CLINICAL IMPLICATIONS
Temperature affected the initial rheological properties, and polymerization reaction of soft denture liner materials, and clinical inferences should be drawn from such studies conducted. It can be recommended to utilize viscoelastic acrylic-based temporary soft lining materials with lower storage modulus, higher tan delta value, and high viscosity in situations where pain complaint persists and tissue stress is extremely significant, provided that they are replaced often.
Topics: Rheology; Viscosity; Temperature; Materials Testing; Acrylic Resins; Elasticity; Denture Liners; Elastic Modulus; Dental Cavity Lining; Silicones; Polymerization; Humans; Oscillometry
PubMed: 38807138
DOI: 10.1186/s12903-024-04393-5 -
European Journal of Dentistry May 2024This study evaluated the linear dimensional change of polymerization of three materials and two techniques of the union of molding transfers for implant-supported...
OBJECTIVES
This study evaluated the linear dimensional change of polymerization of three materials and two techniques of the union of molding transfers for implant-supported prostheses used in the open-tray technique.
MATERIALS AND METHODS
A nylon maxilla-shaped matrix was made, two osseous integrated implants were installed, and, over these two, straight conical mini-pillars were installed. Open-tray impression transfers were attached to the mini-pillars, and a silicone guide was made to standardize the connections between the transfers. The samples were divided into six groups ( = 20): PA (Pattern Resin LS, chemically activated acrylic resin in the single step technique); DU (Durallay, chemically activated acrylic resin in the single step technique); BI (Protemp4, bisacrylic resin in the single step technique); PAC (Pattern Resin LS in sectioning and joining of segments technique); DUC (Durallay, in sectioning and joining of segments technique); and BIC (Protemp4, in sectioning and joining of segments technique). The linear dimensional change values that occurred among these transfers were measured in a profile projector (VB300; Starret) coupled to the Quadra Check device, with a resolution of 0.001 mm, performed by a single calibrated operator.
STATISTICAL ANALYSIS
Data were submitted to a two-way analysis of variance and Tukey's test ( < 0.01).
RESULTS
Statistically significant mean values were found in all comparisons. The PA showed the lowest mean values (µm) of linear dimensional change, both in the single-step technique and in the sectioning and joining technique, in the following order: BI 255.73 (3.81), DU 173.75 (2.30), PA 95.97 (3.20), BIC 23.82 (1.71), DUC 20.85 (2.53), and PAC 13.27 (2.09). The single-step technique showed the worst results, regardless of the material.
CONCLUSION
The sectioning and joining technique reduced the dimensional change in all materials, and the Pattern Resin LS showed the lowest shrinkage mean values, followed by Durallay and Protemp4.
PubMed: 38806161
DOI: 10.1055/s-0044-1779422 -
Indian Journal of Ophthalmology Jun 2024Submacular hemorrhage (SMH) is a sight-threatening disorder. Choroidal neovascularization secondary to age-related macular degeneration, polypoidal choroidal...
BACKGROUND
Submacular hemorrhage (SMH) is a sight-threatening disorder. Choroidal neovascularization secondary to age-related macular degeneration, polypoidal choroidal vasculopathy, trauma, angioid streaks, and pathological myopia are a few important causes. The conventional treatment of massive SMH is vitrectomy with manual removal of the clot with extensive retinectomy with/without tissue plasminogen activator (tPA). The usual dose of subretinal tPA is 10-25 µg.
PURPOSE
To describe a new surgical approach in a case of massive SMH with retinal detachment without retinectomy.
SYNOPSIS
In our case of near total hemorrhagic retinal detachment due to subretinal hemorrhage caused by trauma (road traffic accident), the patient presented with a visual acuity of counting fingers. Core vitrectomy was performed and posterior vitreous detachment was induced. The locations for retinotomy to inject and aspirate subretinal blood were selected at the maximum height of retinal elevation near the arcades. Recombinant tPA (10 µg/0.1 ml concentration; 0.3 ml injected in two locations) was injected subretinally with a 23-G soft tip cannula in the superotemporal and inferonasal quadrant causing subretinal bleb formation. Subsequently, the surgeon waited for approximately 20 min on the table for the liquefaction of the clot. The liquefied blood and tPA were drained with a silicone soft tip. Endolaser was performed at the retinotomy site and 1000cs silicone oil was injected. No signs of toxicity such as vitritis, vasculitis, or retinal necrosis were noted.
HIGHLIGHTS
Our unique technique of high-dose intraoperative subretinal tPA (60 µg) is safe and helpful in rapid clot lysis and recovery of visual acuity. The patient gained a visual acuity of 20/80 from counting fingers after 1 month of surgery and 20/60 after silicone oil removal. A high dose of tPA aids in the immediate aspiration of blood from a small retinotomy. A 23-G soft tip was used instead of a 41-G subretinal cannula to inject a large quantity of subretinal tPA.
VIDEO LINK
https://youtu.be/JzZBDUfa3NA.
Topics: Humans; Tissue Plasminogen Activator; Retinal Hemorrhage; Vitrectomy; Fibrinolytic Agents; Visual Acuity; Tomography, Optical Coherence; Male; Fundus Oculi; Fluorescein Angiography; Dose-Response Relationship, Drug
PubMed: 38804808
DOI: 10.4103/IJO.IJO_2295_23 -
Scientific Reports May 2024Colonoscopy is the standard procedure for screening, and surveillance of colorectal cancer, including the treatment for colonic lesions. Colonic spasm is an important... (Randomized Controlled Trial)
Randomized Controlled Trial
Colonoscopy is the standard procedure for screening, and surveillance of colorectal cancer, including the treatment for colonic lesions. Colonic spasm is an important problem from colonoscopy that affects both surgeons and patients. The spasm also might be the cause of longer cecal intubation time, difficulty of the procedure, and increased pain. Previous reports indicated that antispasmodic agents can decrease such symptoms. Therefore, we conducted this study to investigate the cecal intubation time of antispasmodic agents. A single blinded randomized controlled trial was conducted from 01/11/2020 to 31/08/2021. One hundred four patients were allocated to antispasmodic agent group and control group, in 1:1 ratio. The efficacy of median (range) cecal intubation time showed similar results of 5 (2, 14) and 5 (2, 15) minutes with no statistically significant difference. The mean scores of all domains i.e., pain, spasm, cleanliness, and difficulty were better in the antispasmodic agent group about 2.6 (1.4), 1.8 (0.8), 2.4 (0.9), and 2.0 (0.9), respectively, than control group but there were spasm and cleanliness showed statistically significant difference. Moreover, the satisfaction scores showed better efficacy in decreased spasm, decreased difficulty, and increased cleanliness than control group. Prescribing of antispasmodic drugs before colonoscopy might be the choice of treatment for the patients. The antispasmodic drugs will be beneficial to both of the patient and the doctor.
Topics: Humans; Colonoscopy; Male; Female; Middle Aged; Simethicone; Parasympatholytics; Aged; Adult; Single-Blind Method; Propylamines
PubMed: 38802518
DOI: 10.1038/s41598-024-62922-2 -
Journal of Cutaneous and Aesthetic... 2024Keloids are less responsive to any single treatment modality; hence, there is a need for combination therapy that can yield satisfactory outcomes.
BACKGROUND
Keloids are less responsive to any single treatment modality; hence, there is a need for combination therapy that can yield satisfactory outcomes.
OBJECTIVE
The present study assessed efficacy and safety of combination therapy-surgical excision or cryotherapy and intralesional corticosteroids along with 5-fluorouracil [IL (S + 5-FU)] injection, followed by silicone gel sheet (SGS) under compression therapy in the treatment of keloids.
MATERIALS AND METHODS
This was a retrospective, observational study comprising 21 clinically diagnosed keloid patients. All patients were treated with the stated combination therapy. Data about demographic, lesions, procedural characteristics, and treatment outcomes were reported.
RESULTS
Of 21, 11 (52.4%) patients were treated with liquid nitrogen (LN) cryotherapy, and 10 (47.6%) patients were treated with surgical excision. Mean age was 30.8 ± 7.6 (range: 14-44) years with slight male (52.4%) predominance. A mean surface area of keloid lesion was 96.8 ± 170.5 cm. The most frequently involved site was auricle (8 [38.1%] patients). Patients received the following types of treatments: intralesional LN cryotherapy (6 [28.6%]), intralesional excisional surgery (6 [28.6%]), surface LN cryotherapy (5 [23.8%]), and extralesional excisional surgery (4 [19.0%]). Complications of recurrence (2 [9.5%]), secondary infections (2 [9.5%]), persistent postinflammatory hypopigmentation (1 [4.8%]), and atrophic scarring with postinflammatory hyperpigmentation (1 [4.8%]) were reported. After a study period of 2.5 years, 100% cure rate was achieved.
CONCLUSION
Combination therapy of surgical excision or cryotherapy and IL (S + 5-FU), followed by SGS under compression, was safe and effective in treating keloids.
PubMed: 38800820
DOI: 10.4103/JCAS.JCAS_40_23 -
ACS Omega May 2024Hydrophilic-coated intermittent catheters have improved the experience of intermittent urinary catheterization for patients compared to conventional gel-lubricated...
Hydrophilic-coated intermittent catheters have improved the experience of intermittent urinary catheterization for patients compared to conventional gel-lubricated uncoated catheters. However, the incorporation of polyvinylpyrrolidone (PVP) within hydrophilic coatings can lead to significant issues with coating dry-out. Consequently, increased force on catheter withdrawal may cause complications, including urethral microtrauma and pain. Standard methods of evaluating catheter lubricity lack physiological relevance and an understanding of the surface interaction with the urethra. The tribological performance and urethral interaction of commercially available hydrophilic PVP-coated catheters and a coating-free integrated amphiphilic surfactant (IAS) catheter were evaluated by using a biomimetic urethral model designed from a modified coefficient of friction (CoF) assay. T24 human urothelial cells were cultured on customized silicone sheets as an alternate countersurface for CoF testing. Hydrophilic PVP-coated and coating-free IAS catheters were hydrated and the CoF obtained immediately following hydration, or after 2 min, mimicking in vivo indwell time for urine drainage. The model was observed for urethral epithelial cell damage postcatheterization. The majority of hydrophilic PVP-coated catheters caused significantly greater removal of cells from the monolayer after 2 min indwell time, compared to the IAS catheter. Hydrophilic PVP-coated catheters were shown to cause more cell damage than the coating-free IAS catheter. A biomimetic urethral model provides a more physiologically relevant model for understanding the factors that govern the frictional interface between a catheter surface and urethral tissue. From these findings, the use of coating-free IAS catheters instead of hydrophilic PVP-coated catheters may help reduce urethral microtrauma experienced during catheter withdrawal from the bladder, which may lead to a lower risk of infection.
PubMed: 38799332
DOI: 10.1021/acsomega.4c02109