Short-term Success Research Articles

Building an equitable future? BRAC’s STAR program and young women’s economic empowerment in Bangladesh

ABSTRACT Equitable futures depend upon better employment outcomes for young women. We use a skills ecosystems approach to explore how youth skills development programs can maximise their impact in highly gendered societies and labour markets. While improving employment outcomes and incomes for young women, BRAC’s STAR program cannot withstand Bangladesh’s deep-rooted and socially restrictive norms and practices. Short-term successes are diluted as family pressures and commitments take precedent over young women’s economic lives. Adding a temporal dimension to the concept of skills ecosystems, these findings highlight that maintaining these impacts requires constant renegotiation and advocacy to challenge the structural obstacles within households and labour markets and within national policies and investments that constrain their longer-term economic empowerment.

Long-term follow-up suggests high satisfaction rates for bulbomembranous radiation-induced urethral stenoses treated with anastomotic urethroplasty

PurposeTo analyze patients who underwent anastomotic urethroplasty for radiationinduced bulbomembranous urethral stricture/stenosis (RIS) due to prostate cancer treatment with up to 19 years of follow-up and assess long-term patient reported outcomes (PROMs). Long-term follow-up with the inclusion of urethroplasty specific PROMs is lacking in the available research.MethodsPatients who underwent anastomotic urethroplasty for RIS were identified from 2002 to 2020. Inclusion criteria included completion of 4-month post-operative cystoscopy and PROMs including IPSS, SHIM, MSHQ-EF, 6Q-LUTS, and global satisfaction queries at 4 months. PROMs were assessed annually thereafter, and cystoscopy was performed for adverse change in PROMs or worsening uroflow/PVR parameters. PROMs were compared at pre-op, post-op, and most recent follow-up.Results23 patients met inclusion criteria. Short-term anatomic success was 95.7%. At a mean follow-up of 73.1 months (9.1–228.9), one late recurrence occurred for an overall success of 91.3%. Significant and sustained objective improvement was identified in voiding scores, quality of life, and urethroplasty specific PROMs. Satisfaction was 91.3% despite sexual side effects, and 95.7% of patients stated they would have surgery again knowing their outcome at a mean of over 6 years’ follow up.ConclusionsRIS are challenging problems, but durable symptomatic relief is achievable in well-selected patients. Patients with bulbomembranous RIS should be appropriately counseled regarding the risk of urinary incontinence and sexual side effects after anastomotic urethroplasty. However, long-term success is high, and overall QoL will have sustained subjective improvement in most cases.

ID: 208410 Development of Machine Learning-Based Models to Predict Short Term Success in Substance Use Disorder treatment

Prescription opioids have resulted in large part to a substance use disorder (SUD) epidemic. Relapse rates for patients with SUD within 30 days of leaving an inpatient drug and alcohol treatment center are reported at 40-60%. When determining which therapy (e.g., opioids v. neuromodulation) is ideal for a person with chronic pain, understanding the factors that lead to treatment refractory SUD is essential. We aim to show proof of principle for machine learning (ML) and predictive analytics on short-term success or failure with SUD treatment.

Effectiveness of Different Types of Smoking Cessation Health Education for Preoperative Patents and the Factors Correlated with Cessation Success Rate

<p>目的：探討預計接受手術之病人接受不同戒菸衛教方式之戒菸成功率與影響因子分析。</p> <p>方法：本研究為臨床介入前瞻性隨機分配研究。研究對象為2016年10月至2020年1月某醫學中心預計進行常規手術的吸菸病人，隨機分配為影片衛教組及單張衛教組，進行戒菸衛教介入，並分別於戒菸衛教介入後三個月、六個月、十二個月以電話追蹤個案的吸菸狀況，監測點戒菸成功率。以統計方式分析兩組類別變項差異，以及與點戒菸成功率之相關性。</p> <p>結果：本研究共收案79人（接受單張衛教組為44人，男性佔95.5%，平均年齡為49.47±13.52歲；接受影片衛教組為35人，男性佔100%，平均年齡為49.25±12.96歲）。結果顯示戒菸成功率，在3個月點戒菸成功率中，影片衛教組顯著高於單張衛教組，但在6個月及12個月點戒菸成功率則無顯著差異。進一步以羅吉斯迴歸分析發現有使用戒菸藥物者其手術前戒菸衛教3個月點戒菸成功率較高，有糖尿病者手術前戒菸衛教3個月點戒菸成功率較低。而術前接受單張衛教介入者3個月點戒菸成功率較接受影片衛教者低。12個月點戒菸成功率部分則發現罹患心血管疾病者、罹患癌症者其手術前戒菸衛教12個月點戒菸成功率較高；吸菸時間較長者其手術前戒菸衛教12個月點戒菸成功率較低。</p> <p>結論：手術前接受戒菸衛教能提升戒菸意願，增加戒菸成功率，其中使用傳統衛教單張作為戒菸衛教的媒材相較於衛教影片的戒菸成功率低，故也許能嘗試使用衛教影片作為媒材以期提升短期戒菸成功率。</p> <p> </p><p>Purpose: To explore the success rates and influencing factors of different smoking cessation education methods among patients scheduled for surgery.</p> <p>Methods: This study is a clinical intervention prospective randomized controlled trial. The study population consisted of smokers scheduled for elective surgery at a medical center between October 2016 and January 2020. Participants were randomly assigned to either a video education group or a pamphlet education group for smoking cessation intervention. Follow-ups were conducted via phone at three months, six months, and twelve months after the intervention to monitor smoking status and assess point cessation success rates. Statistical analyses were performed to compare categorical variables between the two groups of participants and assess correlations with point cessation success rates.</p> <p>Results: A total of 79 participants were enrolled (44 in the pamphlet education group, 95.5% male, mean age 49.47±13.52 years; 35 in the video education group, 100% male, mean age 49.25±12.96 years). Results indicated that, at the 3-month follow-up, the video education group exhibited a significantly higher smoking cessation success rate than the pamphlet education group. However, no significant differences were observed at the 6-month and 12-month follow-ups. Further analysis using logistic regression revealed that individuals using smoking cessation medication reported a higher smoking cessation success rate at the 3-month follow-up after preoperative smoking cessation education; the success rate, however, was lower for diabetes patients. Moreover, the success rate at the 3-month follow-up remained lower in those receiving pamphlet education as compared to those receiving video education. At the 12-month follow-up, the success rate after operative smoking cessation education was higher among participants with cardiovascular disease and cancer but lower in those with a longer smoking history. </p> <p>Conclusion: Preoperative smoking cessation education enhances the motivation and success rates of smoking cessation for patients scheduled for surgery, and traditional health education pamphlets appear to be less effective than health education videos. Therefore, it may be worth trying health education videos as a medium to enhance short-term smoking cessation success rates.</p> <p> </p>

ID: 199431 Sex Differences in Variables Affecting Short Term Success in Substance Use Disorder Treatment

Because of stigma surrounding patients with substance use disorder (SUD) and difficulties with follow-up, data on acute and long-term outcomes is limited. Here we explore real-word data from a prospectively collected database to determine patient phenotypes which are more likely to complete acute SUD treatment.

Clinical outcome of endoscopic treatment of symptomatic Hepaticojejunal anastomotic strictures after pancreatoduodenectomy

BackgroundHepaticojejunostomy anastomotic stricture (HJAS) is an adverse event after pancreatoduodenectomy (PD) which can result in jaundice and/or cholangitis. With endoscopy, HJAS can be managed. However, few studies report the specific success and adverse event rates of endoscopic therapy after PD. MethodsPatients with symptomatic HJAS, who underwent an endoscopic retrograde cholangiopancreatography at the Erasmus MC between 2004-2020, were retrospectively included. Primary outcomes were short-term clinical success defined as no need for re-intervention <3 months and long-term <12 months. Secondary outcome measures were cannulation success and adverse events. Recurrence was defined as symptoms with radiological/endoscopic confirmation. ResultsA total of 62 patients were included. The hepaticojejunostomy was reached in 49/62 (79%) of the patients, subsequently cannulated in 42/49 (86%) and in 35/42 patients (83%) an intervention was performed. Recurrence of symptomatic HJAS after technically successful intervention occurred in 20 (57%) patients after median time to recurrence of 7.5 months [95%CI, 7.2–NA]. Adverse events were reported in 4% of the procedures (8% of patients), mostly concerning cholangitis. DiscussionEndoscopic treatment for symptomatic HJAS after PD has a moderate technical success rate and a high recurrence rate. Future studies should optimize endoscopic treatment protocols and compare percutaneous versus endoscopic treatment.

Flawless victory! Investigating search and experience qualities as antecedent predictors of video game success

In recent years, video games have been on the rise as entertainment goods, leading to a growing interest by practitioners, researchers, and, of course, consumers alike. While a few unusually successful video games produce overall high revenues, most released games struggle to break even. Hence, there is an urgent need to better understand what distinguishes financially successful games from nonsuccessful video games. Accordingly, several researchers have called for investigations into the drivers of the financial success of video games. However, empirical studies within this respect are still lacking. Based on longitudinal data of 351 video games, the current study strives to fill this research gap by investigating the relative importance of potential success factors for the short-term and long-term financial success of video games. The results of multiple regression analyses confirm that search qualities such as brand popularity, reviews, and awards as well as experience qualities such as graphics, sound, and game duration significantly drive financial success in terms of the total number of sold video games in Europe. Consequently, managers in the video game industry can boost their chances for the production of a successful video game by focusing on these factors.

Feasibility of single-port laparoscopic partial adrenalectomy with selective adrenal venous sampling and high-resolution ultrasound for unilateral aldosterone-producing adenomas

BackgroundThe surgical and endocrinological outcomes of single-port laparoscopic partial adrenalectomy for patients with aldosterone-producing adenomas are unknown. Precise diagnosis of intra-adrenal aldosterone activity and a precise surgical procedure may improve outcomes. In this study, we aimed to determine the surgical and endocrinological outcomes of single-port laparoscopic partial adrenalectomy with preoperative segmental selective adrenal venous sampling and intraoperative high-resolution laparoscopic ultrasound in patients with unilateral aldosterone-producing adenomas. We identified 53 patients with partial adrenalectomy and 29 patients with laparoscopic total adrenalectomy. Single-port surgery was performed for 37 and 19 patients, respectively. MethodsA single-center, retrospective cohort study. All patients with unilateral aldosterone-producing adenomas diagnosed by selective adrenal venous sampling and treated surgically between January 2012 and February 2015 were included. Follow-up with biochemical and clinical assessments was set at 1 year after surgery for short-term outcomes and was performed every 3 months after surgery. ResultsWe identified 53 patients with partial adrenalectomy and 29 patients with laparoscopic total adrenalectomy. Single-port surgery was performed for 37 and 19 patients, respectively. Single-port surgery was associated with shorter operative and laparoscopic times (odds ratio, 0.14; 95% confidence interval, 0.039–0.49; P = .002 and odds ratio, 0.13; 95% confidence interval, 0.032–0.57; P = .006, respectively). All single-port and multi-port partial adrenalectomy cases showed complete short-term (median 1 year) biochemical success, and 92.9% (26 of 28 patients) who underwent single-port partial adrenalectomy and 100% (13 of 13 patients) who underwent multi-port partial adrenalectomy showed complete long-term (median 5.5 years) biochemical success. No complications were observed with single-port adrenalectomy. ConclusionSingle-port partial adrenalectomy is feasible after selective adrenal venous sampling for unilateral aldosterone-producing adenomas, with shorter operative and laparoscopic times and a high rate of complete biochemical success.

‘Lately Gone into Germany’: Thomas Tillam and his Treatises on Marriage, Divorce and Polygamy

ABSTRACT Thomas Tillam lived in the middle of the seventeenth century and stands out as one of the most intriguing figures among the religious dissenters of the time. Having had short-term success establishing Baptist churches at Hexham and Colchester, he encouraged 100–200 families to emigrate to Southern Germany and set up a Judaeo-Christian community. In 1660–1665 his publications entitled Temple of Lively Stones and The Unequal Yoke Unloosed, reveal his attitude to marriage and divorce. He seems to have moved from his declaration that ‘I know not any door of divorce (opened in the Gospel) except adultery’ to defending the divorce of ‘unacceptable wives’ and supporting polygamy by Old Testament precedents. The reason for this change of belief is considered in the light of rumours and accusations from contemporary commentators and the marital situation of his benefactor, Karl I Ludwig.

Temperature-Related Short-Term Succession Events of Bacterial Phylotypes in Potter Cove, Antarctica.

In recent years, our understanding of the roles of bacterial communities in the Antarctic Ocean has substantially improved. It became evident that Antarctic marine bacteria are metabolically versatile, and even closely related strains may differ in their functionality and, therefore, affect the ecosystem differently. Nevertheless, most studies have been focused on entire bacterial communities, with little attention given to individual taxonomic groups. Antarctic waters are strongly influenced by climate change; thus, it is crucial to understand how changes in environmental conditions, such as changes in water temperature and salinity fluctuations, affect bacterial species in this important area. In this study, we show that an increase in water temperature of 1 °C was enough to alter bacterial communities on a short-term temporal scale. We further show the high intraspecific diversity of Antarctic bacteria and, subsequently, rapid intra-species succession events most likely driven by various temperature-adapted phylotypes. Our results reveal pronounced changes in microbial communities in the Antarctic Ocean driven by a single strong temperature anomaly. This suggests that long-term warming may have profound effects on bacterial community composition and presumably functionality in light of continuous and future climate change.

Coercion versus self-selection when treating issues of overfatness: A narrative review

The use of diet and exercise has become the cornerstone to treatment of overfatness issues. Yet, the implementation of such factors into lifestyle changes has not been able to meet intrinsic expectations or desires and has led to continuous repetition of short-term success within a coercive environment that is followed by rebound leading to secondary short-term success, that is yo-yo’ing. Even though this has become common, there has been little insight into how we might be able to improve suggestions for diet and exercise to better encourage long-term success as opposed to the short-term gains that are regularly met. In this commentary, we offer a narrative review describing how the use of behavioural analytic methodologies and techniques might allow for the development of self-selective lifestyle modifications (e.g. changes to diet, use of exercise) and choices in behaviour that better serve individuals attempting to reverse the health issues associated with overfatness, without the sense of their being coerced into their choices.

Double Device Approach for Percutaneous Closure of Postmyocardial Infarction Ventricular Septal Defect

The benefit related to the use of preprocedural computed tomography angiography (CCTA) on top of periprocedural echocardiography to plan percutaneous left atrial appendage closure (LAAC) procedures is still unclear.The authors sought to evaluate the impact of preprocedural CCTA on LAAC procedural success.In the investigator-initiated SWISS-APERO (Comparison of Amplatzer Amulet and Watchman Device in Patients Undergoing Left Atrial Appendage Closure) trial, patients undergoing echocardiography-guided LAAC were randomly assigned to receive the Amulet (Abbott) or Watchman 2.5/FLX (Boston Scientific) device across 8 European centers. According to the study protocol ongoing at the time of the procedure, the first operators had (CCTA unblinded group) or did not have (CCTA blinded group) access to preprocedural CCTA images. In this post hoc analysis, we compared blinded vs unblinded procedures in terms of procedural success defined as complete left atrial appendage occlusion as evaluated at the end of LAAC (short-term) or at the 45-day follow-up (long-term) without procedural-related complications.Among 219 LAACs preceded by CCTA, 92 (42.1%) and 127 (57.9%) were assigned to the CCTA unblinded and blinded group, respectively. After adjusting for confounders, operator unblinding to preprocedural CCTA remained associated with a higher rate of short-term procedural success (93.5% vs 81.1%; P = 0.009; adjusted OR: 2.76; 95% CI: 1.05-7.29; P = 0.040) and long-term procedural success (83.7% vs 72.4%; P = 0.050; adjusted OR: 2.12; 95% CI: 1.03-4.35; P = 0.041).In a prospective multicenter cohort of clinically indicated echocardiography-guided LAACs, unblinding of the first operators to preprocedural CCTA images was independently associated with a higher rate of both short- and long-term procedural success. Further studies are needed to better evaluate the impact of preprocedural CCTA on clinical outcomes.

Impact of Preprocedural Computed Tomography on Left Atrial Appendage Closure Success: A Swiss-Apero Trial Subanalysis

BackgroundThe benefit related to the use of preprocedural computed tomography angiography (CCTA) on top of periprocedural echocardiography to plan percutaneous left atrial appendage closure (LAAC) procedures is still unclear. ObjectivesThe authors sought to evaluate the impact of preprocedural CCTA on LAAC procedural success. MethodsIn the investigator-initiated SWISS-APERO (Comparison of Amplatzer Amulet and Watchman Device in Patients Undergoing Left Atrial Appendage Closure) trial, patients undergoing echocardiography-guided LAAC were randomly assigned to receive the Amulet (Abbott) or Watchman 2.5/FLX (Boston Scientific) device across 8 European centers. According to the study protocol ongoing at the time of the procedure, the first operators had (CCTA unblinded group) or did not have (CCTA blinded group) access to preprocedural CCTA images. In this post hoc analysis, we compared blinded vs unblinded procedures in terms of procedural success defined as complete left atrial appendage occlusion as evaluated at the end of LAAC (short-term) or at the 45-day follow-up (long-term) without procedural-related complications. ResultsAmong 219 LAACs preceded by CCTA, 92 (42.1%) and 127 (57.9%) were assigned to the CCTA unblinded and blinded group, respectively. After adjusting for confounders, operator unblinding to preprocedural CCTA remained associated with a higher rate of short-term procedural success (93.5% vs 81.1%; P = 0.009; adjusted OR: 2.76; 95% CI: 1.05-7.29; P = 0.040) and long-term procedural success (83.7% vs 72.4%; P = 0.050; adjusted OR: 2.12; 95% CI: 1.03-4.35; P = 0.041). ConclusionsIn a prospective multicenter cohort of clinically indicated echocardiography-guided LAACs, unblinding of the first operators to preprocedural CCTA images was independently associated with a higher rate of both short- and long-term procedural success. Further studies are needed to better evaluate the impact of preprocedural CCTA on clinical outcomes.

THE RESULTS OF THE SECOND WORLD WAR AND THE ESTABLISHMENT OF THE TRIPOLAR SYSTEM OF INTERNATIONAL RELATIONS IN THE WORLD

During the 20 months since the beginning of the Second World War, German troops occupied all the small states of North-Western Europe, captured the Balkans, Poland, Czechoslovakia, Belgium, the Netherlands, Denmark, Norway, Bulgaria, Albania, Yugoslavia, and took Hungary, Romania and Finland under their sphere of influence. , forced France to surrender. Economic, territorial, human, etc. of all these countries. resources were in the hands of the German military machine. In 1941, the USSR and England were already waiting for German attacks. Although the United States was protected by oceans and distance from the German threat, it was nevertheless deeply alarmed by Hitler's short-term success. All the progressive humanity, the peoples of the world facing the threat of Hitlerism, stood together to get rid of this scourge of the 20th century. The determination to fight against fascism soon overcame all class and ideological barriers and led to the creation of an anti-fascist coalition and the organization of a joint struggle against the German-Italian-Japanese occupation. Although the main goal during the war was to liberate Europe and the world from the German invaders and their allies, the post-war interstate relations and relations, the restoration of norms of civil coexistence and the creation of a collective security system became the main topic of discussion in the international community. Of course, everything depended on the position of the USSR, England and the United States, which were at the forefront of the fight against Germany, and the relations between them. Keywords: World Second War, Tripolar International Relations, Coalision blocks.

The "banana splitting DREZotomy": an atraumatic method to improve pain relief after dorsal root entry zone lesioning in brachial plexus injuries. Case series and tenets for the treatment.

The treatment of neuropathic deafferentation pain due to avulsion injuries of the brachial plexus is a major problem, albeit rare, in the neurosurgical practice. The aim of the paper is to present step-by-step the main principles of a surgical upgrade of the well-known Dorsal Root Entry Zone lesioning, that we named banana splitting DREZotomy. A comparison is made among three groups of patients, two of which were treated following the classic techniques, while in the third no physical agent is applied to the spinal cord during surgery. The patients operated on following the well-established surgical procedures showed a short-term success rate around 70%, online with the data of the ongoing literature. The results with the banana-splitting technique, instead, have been astonishing both in terms of resolution of pain, absence of true complications and of unpleasant side effects. A purely dissective technical variant of the surgical procedure called DREZ lesioning has shown better results overcoming the 30% failures of all the reported series. The profound and permanent splitting of the posterior horn and the absence of any other component (heat propagation, radiofrequency, or dotted coagulation) are the major factors which may explain such outstanding results.

Review of the monograph by Nikita I. Sasaev "The Russian Gas Industry Strategizing: The Far Eastern Vector"

In an unsteady economic environment, the Far Eastern Federal District, as one of the most promising macro-regions of Russia, has the necessary resource and technological capacities to make a breakthrough in socio-economic development. In the Russian Far East, the gas industry can be a potential driver of economic development, as on its functioning and growth the whole range of interests and large-scale strategic opportunities are concentrated. Implementation of strategic opportunities by individual projects in most cases will bring only targeted short-term success. Therefore, it is crucial to apply an integrated approach, which involves elaboration and further implementation of a full-fledged industry strategy incorporated into the overall strategy system. The monograph The Russian Gas Industry Strategizing: The Far Eastern Vector continues the book series of the Strategy of the Russian Far East Library and is aimed at developing a strategy concept for the Far Eastern gas industry that takes into account the full range of interests, strategic trends and opportunities. The author of the monograph formulates effective theoretical and methodological provisions for elaboration and implementation of such strategies, underpins strategic priorities and practical solutions for long-term development of the gas industry of the Far East. The book will be useful for scientists, teachers, and students studying the theory of strategy and the practice of strategizing.

Evaluating translocation success of wild eastern hellbenders (Cryptobranchus alleganiensis alleganiensis) in Blue Ridge Ecoregion streams using pre- and post-translocation home range sizes and movement metrics.

Translocations of freshwater species have become a widespread conservation strategy to mitigate the impacts of habitat fragmentation, yet they are not often rigorously monitored using animal movement data to determine their success. We demonstrate the value of monitoring pre- and post-translocation movements and home-range sizes of a fully-aquatic, benthic stream salamander, the eastern hellbender (Cryptobranchus a. alleganiensis) to determine translocation success. We studied the home range sizes, movements, and habitat use of individuals (n = 27) in two self-sustaining populations (S1 & S2) for one year, and then subsequently collected similar data from a subset of these individuals (n = 17) that were translocated into two nearby streams (T1 & T2) with dam-isolated, declining populations in the Blue Ridge Ecoregion of Tennessee. We collected 1,571 location data points (869 pre-translocation and 715 post-translocation) from four study sites, and evaluated effects of mass, sex, and pre-translocation home range size/sedentariness, as well as habitat covariates on home range size and movements. Hellbender home range sizes increased from pre-translocation estimates at both sites, but response depended primarily on physical characteristics of release sites. Home range and fine-scale movement metrics indicated that hellbenders translocated from S1 to T1 settled in more quickly, had greater site fidelity, and smaller home ranges than hellbenders translocated from S2 to T2. Hellbender movements were influenced by cover rock size and density rather than individual characteristics. Study-long survival rates of translocated hellbenders increased from S1 to T1 (80% to 100%) and decreased from S2 to T2 (76% to 33%). Monitoring pre- and post-translocation movements was a valuable method for evaluating short-term translocation success in a freshwater environment. For future hellbender translocations, managers should prioritize selecting suitable release sites with contiguous boulder-dense areas (1-2 per m2), adequate prey (crayfish) densities (>1/m2), and habitats with low risk of predation.

Infiltration therapies for lateral epicondylopathy

The therapy of the lateral epicondylopathy (tennis elbow) includes drug injection into the extensor tendon insertion in chronic cases. The choice of medication and the type of injection is decisive for the success of therapy. Furthermore, accurate application is indispensable for therapy success (e.g. peppering injection technique, ultrasound-supported injection technique). Corticosteroid injection is often associated with short-term success, so that other options have found their way into everyday practice. Objectification of treatment success is usually defined by Patient-Reported Outcome Measurements (PROM). With the introduction of Minimal Clinically Important Differences (MCID), statistically significant results are put into perspective in terms of clinical significance. Therapy for lateral epicondylopathy was considered effective if the mean difference in score results between baseline and follow-up exceeded 1.5points for the Visual Analogue Scale (VAS), 16points for Disabilities of Arm, Shoulder and Hand Score (DASH), 11points for Patient-Rated Tennis Elbow Evaluation (PRTEE), and 15points for Mayo Elbow Performance Score (MEPS). However, the effectiveness must still be critically questioned according to meta-analytical evaluations, in which healing within 12months was found in 90% of the cases of untreated chronic tennis elbow in the placebo groups. The use of substances, such as Traumeel (Biologische Heilmittel Heel GmbH, Baden-Baden, Germany), hyaluronic acid, botulinum toxin, platelet rich plasma (PRP), autologous blood or polidocanol, are based on various mechanisms. In particular, the use of PRP or autologous blood for the treatment of musculotendinous and degenerative articular pathologies has become popular, although the studies regarding effectiveness are inconsistent. PRP can be divided into leukocyte-rich (LR-PRP) and leukocyte-poor plasma (LP-PRP) according to its preparation. In contrast to LP-PRP, LR-PRP incorporates the middle and intermediate layers, but there is no standardized preparation described in the literature. Conclusive data regarding effective efficacy are still pending.

Clinical evaluation of cemented and adhesively resin-bonded monolithic and partially layered zirconia and lithium disilicate crowns

PurposeZirconia and lithium disilicate crowns are very popular dental restorations. The cement type and layering technique used can profoundly affect the clinical performance of these crowns.This retrospective study is designed to investigate the success rate of cemented and adhesively bonded monolithic and partially layered zirconia and lithium disilicate crowns placed in faculty practice settings. Materials and MethodsPatients who had received zirconia or lithium disilicate crowns at the faculty practice were invited for clinical examination. The examiner used the modified United States Public Health Service (MUSPHS) evaluation criteria to evaluate the crowns. The crowns were either glass ionomer cemented zirconia (GIC-Zr), resin-bonded zirconia (Adh-Zr), or resin-bonded lithium disilicate (Adh-LD). The crowns were also divided into monolithic and layered groups. Inferential analysis was used to examine the differences through bivariate analysis using t-testing and one-way ANOVA. ResultsThirty-five patients, with a combined total of 218 single crowns, agreed to participate in the study. No statistically significant differences in the quality outcome variables considered were found between the groups, except for marginal adaptation, where Adh-Zr achieved significantly higher scores compared to GIC-Zr and Adh-LD. Layered zirconia and lithium disilicate crowns have significantly higher quality outcomes in terms of anatomic form, marginal adaptation, and color match compared to monolithic zirconia and lithium disilicate crowns. ConclusionsConventionally cemented zirconia and adhesively bonded zirconia and lithium disilicate crowns are reliable treatment options with high short-term success rates. Clinical studies with longer follow-up times are needed to investigate their long-term success rates.

Outcomes of colon self-expandable metal stents for malignant vs benign indications at a tertiary care center and review of literature.

Endoscopic placement of a self-expandable metal stent (SEMS) is a minimally invasive treatment for use in malignant and benign colonic obstruction. However, their widespread use is still limited with a nationwide analysis showing only 5.4% of patients with colon obstruction undergoing stent placement. This underutilization could be due to perceived increase risk of complications with stent placement. To review long- and short-term clinical success of SEMS use for colonic obstruction at our center. We retrospectively reviewed all the patients who underwent colonic SEMS placement over a eighteen year period (August 2004 through August 2022) at our academic center. Demographics including age, gender, indication (malignant and benign), technical success, clinical success, complications (perforation, stent migration), mortality, and outcomes were recorded. Sixty three patients underwent colon SEMS over an 18-year period. Fifty-five cases were for malignant indications, 8 were for benign conditions. The benign strictures included diverticular disease stricturing (n = 4), fistula closure (n = 2), extrinsic fibroid compression (n = 1), and ischemic stricture (n = 1). Forty-three of the malignant cases were due to intrinsic obstruction from primary or recurrent colon cancer; 12 were from extrinsic compression. Fifty-four strictures occurred on the left side, 3 occurred on the right and the rest in transverse colon. The total malignant case (n = 55) procedural success rate was 95% vs 100% for benign cases (P = 1.0, NS). Overall complication rate was significantly higher for benign group: Four complications were observed in the malignant group (stent migration, restenosis) vs 2 of 8 (25%) for benign obstruction (1-perforation, 1-stent migration) (P = 0.02). When stratifying complications of perforation and stent migration there was no significant difference between the two groups (P = 0.14, NS). Colon SEMS remains a worthwhile option for colonic obstruction related to malignancy and has a high procedural and clinical success rate. Benign indications for SEMS placement appear to have similar success to malignant. While there appears to be a higher overall complication rate in benign cases, our study is limited by sample size. When evaluating for perforation alone there does not appear to be any significant difference between the two groups. SEMS placement may be a practical option for indications other that malignant obstruction. Interventional endoscopists should be aware and discuss the risk for complications in setting of benign conditions. Indications in these cases should be discussed in a multi-disciplinary fashion with colorectal surgery.