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Gastroenterology Report 2014年第2期2卷 112-120页

作者： Andrew P.Zbar Department of Surgery and Transplantation Chaim Sheba Medical CenterRamat GanIsrael Assia Medical Colorectal Group Assuta private hospital Tel AvivIsrael

Sacral neuromodulation(SNM)therapy has revolutionized the management of many forms of anal incontinence,with an expanded use and a medium-term efficacy of 75%*** review discusses the technique of SNM therapy,along with its complications and troubleshooting and a discussion of the early data pertaining to peripheral posterior tibial nerve stimulation in incontinent *** work needs to define the predictive factors for neurostimulatory success,along with the likely mechanisms of action of their therapeutic action.

关键词： anal incontinence sacral neuromodulation peripheral nerve stimulation posterior tibial nerve stimulation

Boswellia resin extract and propolis derived polyphenols in patients with type III chronic prostatitis/chronic pelvic pain syndrome:An Italian prospective multicenter study

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Asian Journal of Urology 2022年第2期9卷 139-145页

作者： Fabrizio Presicce Francesco Barrese Andrea Cantiani Alessio Filianoti Domenico Tuzzolo Paolo Di Palma Stefano Lauretti Stefano Brunori Marco Martini San Filippo Neri hospital Department of UrologyRomeItaly Sant’Eugenio hospital Department of UrologyRomeItaly Casa del Sole Clinic Department of UrologyFormiaItaly Fabrizio Spaziani hospital Department of UrologyFrosinoneItaly Santa Caterina della Rosa Clinic Department of UrologyRomeItaly villa Stuart Clinic Department of UrologyRomeItaly

Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome(CP/CPPS).Methods:Patients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive *** were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),the International Prostate Symptom Scores(IPSS),International Index of Erectile Function(IIEF),four-glass test,uroflowmetry,and prostate-specific antigen assessments at baseline and at Week 4,and Week *** endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total *** outcomes included improvement of micturition and quality of life(QoL)domains of NIH-CPSI ***:A total of 61 males were *** adverse events were *** improvements from baseline to Day 30 were reported for NIH-CPSI total score(mean difference:-9.2;p<0.01),NIH-CPSI pain domain(mean difference:-5.5;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score(mean difference:-5.6;p<0.01).No significant changes from baseline in terms of IIEF score or maximum flow rate were *** final follow-up(Day 90),further significant improvements in terms of NIH-CPSI total score(mean difference:-12.2;p<0.01),NIH-CPSI pain domain(mean difference:-6.6;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score were ***:Rectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.

关键词： Boswellia serrata Chronic prostatitis Chronic pelvic pain syndrome Propolis Treatment

Review of Thoracic Endovascular Aneurysm Repair (TEVAR), Spinal Cord Ischemia (SCI), Cerebrospinal Fluid (CSF) Drainage and Blood Pressure (BP) Augmentation

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Surgical Science 2017年第2期8卷 73-81页

作者： R. Englund Department of Vascular Surgery St George Private Hospital Kogarah Australia

The object of this review is to examine the role of TEVAR in causing SCI. The anatomy and physiology of blood flow to the spinal cord is examined. The role of auto regulation of blood flow within the spinal cord is also examined. This review examines the reported results from the scientific literature of the effect of thoracic aortic aneurysm repair on spinal cord blood flow. In the light of the-se findings several conclusions can reasonably be reached. These conclusions are that the development of SCI can reasonably be predicted based on complexity and extent of the TEVAR procedure performed and BP augmentation and CSF drainage can significantly reduce the impact of SCI.

关键词： Thoracic Endovascular Aortic Aneurysm Repair Spinal Cord Ischemia Means Systemic Arterial Blood Pressure Cerebrospinal Fluid Drainage Collateral Network

Long-term survival of a patient with advanced pancreatic cancer under adjunct treatment with Viscum album extracts: A case report

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World Journal of Gastroenterology 2019年第12期25卷 1524-1530页

作者： Paul G Werthmann Robert Kempenich Gerlinde Lang-Averous Gunver S Kienle Department of Methodology Institute for Applied Epistemology and Medical Methodology (IFAEMM) Center for Complementary Medicine Institute for Environmental Health Sciences and Hospital Infection Control Medical Center-University of Freiburg private Praxis General Practitioner with Specialization in Oncology Department of Pathology Hopital de Hautepierre University Hospital of Strasbourg

BACKGROUND Advanced pancreatic cancer(aPC) has a poor prognosis with limited survival benefit from current standard treatment. Viscum album extracts(VAE) are used by many cancer patients, showing immune-stimulating effects, improved quality of life, and a survival benefit in patients with *** SUMMARY A 59-year-old architect developed epigastric pain. A cystic lesion of the pancreas of 45-mm diameter was detected. In a follow-up magnetic resonance imaging,about one year later, multiple lesions were seen in the corpus and the tail of the pancreas; CA-19-9 was elevated to 58.5 U/mL. A distal pancreatectomy with splenectomy was performed, and a tumor of 7 cm × 5 cm × 3.5 cm was *** investigation showed an intraductal papillary mucinous neoplasmassociated invasive adenocarcinoma with invasion of the lymph vessels,perineural invasion, and positive nodes(2/27); surgical margins showed tumor cells, and the tumor was classified as pT3 N1 M0 R1. The patient was treated with radiation of the tumor bed and capecitabine/oxaliplatin followed by gemcitabine and FOLFIRINOX. Seven months after surgery, a liver metastasis was detected and treatment with FOLFIRINOX was started. Four months after detection of the metastasis, the patient opted for additional treatment with VAE. Another month later, the metastasis was treated with radiofrequency ablation(RFA). Eight months later, the hepatic lesion recurred and was again treated with RFA. Thecontinuous VAE treatment was increased in dose, and the patient stayed recurrence-free for the next 39 mo in good health and working full-time(as of the time this case report was written).CONCLUSION We present the case of a patient with aPC with R1-resection with development of liver metastasis during the course of treatment who showed an overall survival of 63 mo and a relapse-free survival of 39 mo under increasing VAE therapy. The possible synergistic effect on tumor control of RFA treatment and immunestimulatory effects of VAE

关键词： Pancreatic cancer Integrative medicine Viscum album extract Radiofrequency ablation Case report

Mechanical and cellular processes driving cervical myelopathy

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World Journal of Orthopedics 2016年第1期7卷 20-29页

作者： Roisin T Dolan Joseph S Butler John M O'Byrne Ashley R Poynton Department of Trauma and Orthopaedic Surgery Waterford Regional Hospital National Spinal Injuries Unit Department of Trauma and Orthopaedic Surgery Mater Misericordiae University Hospital Department of Trauma and Orthopaedic Surgery Royal College of Surgeons in Ireland Cappagh National Orthopaedic Hospital Department of Trauma and Orthopaedic Surgery Mater Private Hospital

Cervical myelopathy is a well-described clinical syndrome that may evolve from a combination of etiological mechanisms. It is traditionally classified by cervical spinal cord and/or nerve root compression which varies in severity and number of levels involved. The vast array of clinical manifestations of cervical myelopathy cannot fully be explained by the simple concept that a narrowed spinal canal causes compression of the cord, local tissue ischemia, injury and neurological impairment. Despite advances in surgical technology and treatment innovations, there are limited neuro-protective treatments for cervical myelopathy, which reflects an incomplete understanding of the pathophysiological processes involved in this disease. The aim of this review is to provide a comprehensive overview of the key pathophysiological processes at play in the development of cervical myelopathy.

关键词： Cervical myelopathy Cervical spine Neck pain

Endovascular Repair of Abdominal Aortic Aneurysm May Not Provide Long-Term Survival Benefit

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Surgical Science 2016年第7期7卷 316-320页

作者： R. Englund N. Katib Department of Vascular Surgery St George Private Hospital Kogarah Australia

Purpose: To investigate the long term survival benefit for the treatment of abdominal aortic aneurysmal (AAA) disease with Endovascular Aneurysm Repair (EVAR). Our hypothesis is that patients undergoing EVAR have an equivalent survival to an age matched population. Methods: Between 1997 and 2014 all patients treated for an AAA with EVAR by a single surgeon were prospectively followed and at 12 monthly intervals ultrasonography was utilised to assess the size of the aorta after treatment. Data from the Births, Deaths and Marriages was also collected regarding the survival of these patients. As of 2003 all patients with AAA were treated electively with EVAR. Results: There were a total of 145 patients treated with EVAR for AAA during the study period, 143 who survived the 30-day post-operative period. The long-term survival following EVAR at one year was 95% (95% C.I.: 88% to 97%), at 5 years 56% (95% C.I.: 42% to 64%), and at 10 years 28% (95% C.I.: 17% to 42%). Compared to an age-matched population the EVAR group had a lower than expected long term survival (P < 0.0001). Discussion: EVAR for the treatment of abdominal aortic aneurysms can be achieved with acceptable 30 day survival and freedom from aneurysm related death. However selection of patients for EVAR may significantly effect long-term survival if patients are fit for EVAR but not open operation. The question arises as to whether EVAR should be performed in patients with questionable long-term survival, even if they are fit for this procedure.

关键词： Endovascular Abdominal Aortic Aneurysm Survival

Reducing Paediatric Outpatient Waitlists—A Proposed Allied Health Multidisciplinary Approach

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Open Journal of Preventive Medicine 2021年第2期11卷 63-70页

作者： Hsien-Jin Teoh Millie Darvell Redcliffe hospital Metro North Hospital and Health Service Queensland Australia private Practice Queensland Australia

Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children may benefit from allied health input, in addition to being seen by the paediatrician. This paper provides an organisational strategy that involves streamlining Allied Health clinical services in an effort to assist with bringing down a Paediatric Out-patient waitlist. The paper describes principles to guide the formation of a Paediatric Allied Health Multi-Disciplinary team that proposes assessment and brief interventions. The service would focus on supporting the paediatricians through the use of structured procedures, telephone intakes, multidisciplinary triage, shared and standardised assessments, collaborative formulations and reports, brief interventions, clinical-community linkages, and allied health student support. A variety of additional important organisational principles are proposed to facilitate patient flow from the perspective of streamlining administrative processes, having adequate administrative support, shared responsibilities, teamwork, flexibility, carrying out intake assessments, determining which referrals were appropriate for allied health, and working closely with medical staff.

关键词： Paediatric Out-Patient Allied Health Multi-Disciplinary Waiting Lists

Defective Expression of the Gap Junction Protein Pannexin-1 Channel Contributes to the Formation of PCOS-Realted Androgenetic Alopecia

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Advances in Reproductive Sciences 2023年第4期11卷 86-92页

作者： Sule Gencoglu Fatma Tanilir Cagiran Zercan Kali Dermatology Private G&oumlzde Akademi Hospital Malatya Turkiye private Clinic Obstetrics and Gynecology Diyarbakir Turkey Gozde Academy hospital Obstetrics and Gynecology Malatya Turkey

Objective: To determine serum pannexin-1 channel levels and their association with hair loss in women with PCOS diagnosed with female androgenetic alopecia (FAGA). Materials and Methods: Thirty-five women with PCOS who presented with diffuse and treatment-resistant progressive hair loss and were diagnosed with FAGA were included in the study. 25 patients who were diagnosed with female androgenetic alopecia but did not have PCOS were considered as the control group. PCOS and control groups were matched by age. Follicular miniaturization, displacement of terminal hairs with vellus hairs, and a diffuse decrease in hair density were accepted as FAGA in the trcihoscopy examination of the vertex and bitempoaral area. On the third day of the menstrual cycle serum FSH, LH, testosterone, PRL and insulin levels were measured. Insulin resistance was calculated with HOMA-IR. Serum pannexin-1 channel levels of each group were mesured with ELISA. Results: Serum pannexin 1 channels levels of FAGA group due to PCOS were found to be significantly higher than FAGA patients in the control group (2.72 ± 1.09 ng/mL vs 1.65 ± 0.97 ng/mL, p 2.5 in the PCOS group compared to the controls. PRL values were similar except for one patient with elevated PRL. Serum FSH values were the same in both groups. A positive and significant correlation was found between pannexin 1 channels levels and HOMA-IR and serum testosterone levels (r = 0.650, p Conclusions: In addition to hyperandrogenemia, increased pannexin 1 channel levels may play a role in the etiology of PCOS associated FAGA, as it impairs the communication between the skin and hair follicle.

关键词： Androgenetic Alopecia PCOS Androgen Pannexin-1 Channel Inflammation

Exit strategies in inflammatory bowel disease:Looking beyond antitumor necrosis factors

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World Journal of Clinical Cases 2023年第12期11卷 2657-2669页

作者： Federica Crispino Andrea Michielan Mauro Grova Chiara Tieppo Marta Mazza Teresa Marzia Rogger Franco Armelao Azienda Provinciale per i Servizi Sanitari Gastroenterology and Digestive Endoscopy UnitSanta Chiara HospitalTrento 38122Italy Inflammatory Bowel Disease Unit Department of MedicineAzienda Ospedaliera Ospedali RiunitiVilla Sofia-CervelloPalermo 90146Italy

The long-term management of patients with inflammatory bowel disease(IBD)is still a matter of debate,and no clear guidelines have been *** clinical practice,gastroenterologists often have to deal with patients in prolonged remission after immunomodulatory or immunosuppressive *** planning an exit strategy for drug withdrawal,the risk of disease relapse must be balanced against the risk of drug-related adverse events and healthcare ***,there is still a dearth of data on the withdrawal of novel biologics,such as the anti-α4β7 integrin antibody(vedolizumab)and anti-IL12/23 antibody(ustekinumab),as well as the small molecule *** for estimating the risk of disease relapse and the efficacy of retreatment should be evaluated according to the patient's age and IBD *** models should guide clinicians in programming a temporary drug withdrawal after discussing realistic outcomes with the *** would shift the paradigm from an exit strategy to a holiday strategy.

关键词： Exit strategy Biologic withdrawal Drug holiday Vedolizumab Ustekinumab Tofacitinib

Intraoperative Fracture of the Femur in Revision Total Hip Arthroplasty with a Fully HA-Coated Stem

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Open Journal of Orthopedics 2014年第3期4卷 70-76页

作者： David E. Rothem Lilah Rothem Alexander Lerner Tal Salamon Richard Hiscock Neil Bergman Warringal private hospital Heidelberg Australia Ziv Medical Center Zefad Israel

A retrospective review was made of intraoperative femoral fracture prevalence in seventy nine consecutive, cementless, fully HA-coated stems used for revision hip arthroplasty. Three patients were lost to follow up. Intraoperative fracture occurred in 15 (20%) femurs. Fractures occurred during cement removal (3/15) or insertion of the implant (12/15). All fractures were identified using intraoperative biplane X-ray, and were treated during the same operation. The clinical outcome of both groups (with or without fractures) was similar. The risk of intraoperative fracture was not statistically related to any demographic features or operative technique. Intraoperative radiographs are therefore mandatory in revision hip arthroplasty in order to diagnose and treat the common complication of femur fracture appropriately.

关键词： Revision Hip Arthroplasty Intraoperative Fracture Fully Coated HA Stem Femoral Periprosthetic Fracture