Treatment Methods Research Articles

Evaluation of junctional zone differential and ratio as possible markers of clinical efficacy in uterine artery embolisation of adenomyosis.

Uterine artery embolisation is a recommended method of adenomyosis treatment with good clinical results. Changes in uterine volume and maximal junctional zone thickness (JZmax) after embolisation are thoroughly analyzed in the literature. In contrast changes in other suggested morphological diagnostic markers of adenomyosis (junctional zone differential / JZdiff-and junctional zone ratio / JZratio) are rarely evaluated. This single-centre retrospective study aimed to analyse the changes in morphological parameters used for the MR imaging diagnosis of adenomyosis (including JZdiff and JZratio) after UAE. Clinical effectiveness and safety were also analysed. Patients who underwent UAE for pure adenomyosis from Jan 2008 to Dec 2021 were evaluated. Adenomyosis was diagnosed based on JZmax, JZdiff, and JZratio measured on MR imaging. To assess clinical efficacy, the numerical-analog-quality-of-life (QoL) score was routinely obtained from patients at our centre. MRI morphological data were analysed. Statistical analysis was conducted using Wilcoxon signed-rank test, uni- and multivariate regression models, Pearson product-moment correlation, and Kruskal-Wallis tests. From our database of 801 patients who underwent UAE between Jan 2008 to Dec 2021, preprocedural MR images were available in 577 cases and, 15 patients had pure adenomyosis (15/577, 2.6%). Uterine volume, JZmax, and JZdiff decreased significantly after UAE; QoL score increased significantly. A significant correlation was found between QoL change vs. JZmax and JZdiff change. Permanent amenorrhoea and elective hysterectomy 5years after UAE were both 7.1%. Change of JZdiff after UAE in adenomyosis is a potential marker of clinical success. UAE is a clinically safe and effective treatment for adenomyosis.

SODIS with hydrogen peroxide: an effective household water treatment option under sub-tropical climatic conditions of bangladesh.

Solar disinfection (SODIS) is an affordable and sustainable Household Water Treatment (HWT) method endorsed by WHO. However, its limitations include longer sunlight exposure requirements, incomplete microbial inactivation, and post-SODIS microbial regrowth during monsoon and winter seasons in subtropical climates. To address these limitations, the performance of SODIS with H2O2 for microbial inactivation during the monsoon and winter seasons in Bangladesh was evaluated following the WHO HWT protocols. Moreover, the process was verified using drinking water samples collected from restaurants, households, and slums. All SODIS experiments were conducted using reflective reactors with PET bottles and plastic bags, adding 10 mg/L of H2O2, and exposing them to sunlight for 6 h. The results showed that E. coli was completely inactivated within 2 h in plastic bags and within 3 h in PET bottles during the monsoon season, achieving an LRV of > 5. In winter, both achieved an LRV > 5 within 3 h and plastic bags showed more efficient in microbial inactivation than PET bottles. The microbial inactivation rates were 5 times higher than those of conventional SODIS. No regrowth of microorganisms was observed during the subsequent post-SODIS period of 12 h and 24 h at room temperature. The study findings suggest that SODIS with H2O2 has the potential for complete microorganism inactivation with shorter sunlight exposure in subtropical climates with moderate to low solar irradiation and can be adopted as a reliable disinfection option for rural and urban communities with unsafe drinking water supply.

Low meniscus reoperation rates following meniscus repair during anterior cruciate ligament reconstruction in Turkey: an in-depth national analysis of 8-years

BackgroundConcomitant knee injuries, such as meniscal tears, are observed in up to 80% of cases and can have a detrimental impact on outcomes following anterior cruciate ligament reconstruction (ACLR). Over recent decades, there has been a growing recognition of the importance of preserving meniscal tissue. Consequently, the prevalence of meniscal-preserving procedures has been on the rise.PurposeThe objective of this study was to examine the prevalence of concurrent meniscal procedures, assess the success rate, and identify factors associated with the failure of meniscal repair in patients undergoing ACLR.MethodsAll patients who underwent ACLR due to anterior cruciate ligament (ACL) injury between January 2015 and December 2022 were extracted from the Republic of Türkiye National health system using operation-specific procedure codes. Patients with multiple ligament injuries, revision ACL patients, and patients with missing data were excluded from the study. The treatment methods were grouped into the subsets of meniscectomy, meniscal repair, transplantation, and meniscectomy + repair. The distribution of ACLR and meniscus treatment methods according to years, age and sex groups, hospital characteristics, and geographical regions was examined. A secondary analysis was performed to assess the effect of patient demographics and hospital healthcare level on revision meniscal procedures in the ACLR + concomitant meniscal repair group.ResultsA total of 91,700 patients who underwent ACLR between 2015 and 2022 were included in the study. A concomitant meniscal procedure was noted in 19,951(21.8%) patients (16,130 repair,3543 meniscectomy). In the 8 years studied, meniscus repair rates increased from 76.3%to87.9%, while meniscectomy rates decreased from 23.7%to12.1% (p < 0.001). The revision meniscus surgery rate following ACLR + meniscal repair was 3.7%at a mean follow-up of 50 ± 26 months. The interval between primary and revision surgery was 20.5 ± 21.2 months. The meniscectomy rates were higher in community hospitals, while private hospitals showed the lowest revision meniscus surgery rates. Younger age was associated with increased meniscus repair failure rates.ConclusionThe propensity towards using repair techniques to treat meniscal tears during concurrent ACLR has significantly increased in Turkey. Age and the healthcare level of the treating hospital affect the success of meniscal repair.

Regional variations in incidence and treatment trends of Achilles tendon ruptures in Finland: a nationwide study.

The aim of our study was to assess the regional variations in Achilles tendon rupture incidence and treatment methods in Finland during the period 1997-2019. The Finnish National Hospital Discharge Register (NHDR) and the Finnish Register of Primary Health Care Visits (PHCR) were searched to identify all adult patients diagnosed with Achilles tendon rupture during our study period. The population-based annual incidence and incidences of surgically and non-surgically treated Achilles tendon ruptures were calculated for each hospital district. Achilles tendon rupture incidence increased from 17.3 per 105person-years in 1997 to 32.3 per 105in 2019. The mean incidence of Achilles tendon ruptures ranged from 26.4 per 105(North Savo) to 37.2 per 105(Central Ostrobothnia). The incidence of Achilles tendon ruptures increased in all areas. The proportion of non-surgical treatment of Achilles tendon ruptures ranged in 1997 from 7% (Vaasa) to 67% (Åland) and in 2019 from 73% (Southwest Finland) to 100% (East Savo, Kainuu, Länsi-Pohja, Åland). During the study period, a shift towards non-surgical treatment was evident in all hospital districts. Regional variations in Achilles tendon rupture incidence exist in Finland; however, the incidence increased in all areas during the follow-up period. More Achilles tendon rupture patients are currently being treated non-surgically throughout the country.

Laparoscopic Heller’s cardiomyotomy as the main method for treatment of achalasia cardia: an evaluation of treatment results

Laparoscopic Heller’s cardiomyotomy as the main method for treatment of achalasia cardia: an evaluation of treatment results

Macauba palm endocarps under compression forces considering the different treatments: A study about physical and mechanical properties for seed extraction

Macauba (Acrocomia aculeata) is a palm tree native to the tropical forests of North America and Brazil, with fruits that hold significant potential across agricultural and industrial sectors, including cosmetics, pharmaceuticals, food, and biofuels. The spherical, drupe-like fruit consists of a fibrous peel (epicarp), pulp (mesocarp), endocarp, and seed. The endocarp, housing the seeds, is a dense, mechanically robust triaxial spheroid with high caloric value. To harness macauba potential on an industrial scale, strategies incorporating high-performance machinery are necessary, replacing rudimentary extraction methods with more rational approaches to crop development. Understanding the physical and mechanical properties of such crops is crucial for designing machines and processes for agricultural product cultivation. This study focuses on the mechanical behavior of the macauba palm endocarp for seed extraction, evaluating its geometric and mechanical properties through compressive stress analysis. Geometric properties such as endocarp characteristics, circularity, sphericity, eccentricity, and surface area were examined, alongside the influence of different endocarp treatments on rupture strengths. Compression tests on macauba fruit endocarps revealed treatment methods (control, 24, 48, and 72-h water immersion, and 10-day sun exposure) influence on mechanical properties at various strain rates (100–600 mm.min-1).Results show the macauba palm endocarp behaves as a spheroid. Immersing macauba endocarps in water increased their rupture strength during compression. However, sun exposure for 10 days rendered the fruit more fragile and less tenacious, reducing rupture force by over 40 % compared to control samples. The Deformity Modulus of macauba fruit endocarp ranged from 30.1 GPa to 53.2 GPa depending on the treatment applied.

A paradigm shift in diagnosis and treatment innovation for mucinous cystic neoplasms of the liver

This study comprehensively explores the clinical characteristics, diagnostic approaches, and treatment methods for liver mucinous cystic neoplasms (MCN). A retrospective analysis was conducted on seven individuals diagnosed with MCN, admitted to the Fifth Medical Center of the PLA General Hospital between October 2016 and May 2023. Preoperative AFP was negative, while CA19-9 was elevated in two cases. Surgical resection was performed for all patients. The patients showed favorable postoperative recovery. Follow-up revealed an excellent overall survival rate, except for one case of invasive carcinoma resulting in tumor recurrence and metastasis 6 months after surgery. MCN poses a diagnostic challenge due to the absence of distinct clinical and radiological features, leading to potential misdiagnosis and inappropriate treatment. Patients with suspected liver cystic diseases should consider the possibility of MCN. Surgical resection has proven to be a practical approach with satisfactory therapeutic outcomes.

Social media use as a source of information by acne vulgaris patients.

Social media and internet usage is undeniably high. Misinformation obtained from the internet and wrong treatment methods can cause serious problems in patients with acne vulgaris (AV). In this study, the sociodemographic data of AV patients, their frequency of using the internet as an information source, the relationship between them, and their attitudes and behaviors regarding their disease due to these programs were examined. 481 patients aged 14 and over diagnosed with AV were included in the study. It was conducted in a descriptive cross-sectional type. Acne severity of all patients included in the study was determined using the Global Acne Grading System. 78.3 percent of participants use social media to get information about AV. It was determined that men and single people used social media about their illnesses at a statistically significantly higher rate than women and married people (p = 0.004). In addition, patients aged 13-18 and high school graduates use social media as a source of information about their diseases, and this rate is statistically significantly higher (p < 0.001). Especially in the last decade, the use of social media tools to spread health messages has increased significantly. Because it has a chronic course and can cause cosmetic problems, AV patients may frequently resort to communication sources such as social media. Considering the possibility of social media misinforming patients, physicians should be aware that their patients with AV frequently use social media and should improve themselves in creating correct awareness on this issue.

Clinical management controversy caused by a rare case of silver clip detachment and displacement after tubal sliver clip sterilization

Introduction and importance: The treatment of rare long-term complications such as ectopic silver clips after tubal silver clip sterilization, still follows the principle of removing metal foreign body(MFB) in the abdominal cavity: first choice removal, which seems to be a habitual treatment method by clinical gynecologists. However, this measure has recently been greatly questioned. Case presentation: A 54-year-old postmenopausal woman who had undergone tubal sterilization with a sliver clip 32 years ago, presented to emergency department(ED) with severe left upper abdominal colic, paroxysmal, accompanied by vomiting and radiating pain. Her vital signs were stable and emergency routine urine test showed microscopic hematuria. Preliminary consideration was given to ureteral stones and abdominal pain was relieved after treatment. Abdominal CT confirmed the previous consideration, but unexpectedly found that the left tubal sterilization metal clip disappeared and was ectopic in the perihepatic space. Clinical discussion: This traditional conception of removing metal foreign body(MFB) in the abdominal cavity is often accepted by many surgeons. Based on the management measures of this case and the systematic review of literature, we found that the detached ectopic silver clip did not cause serious long-term complications, possibly due to its good tissue receptivity and other characteristics. Conclusion: Although an ectopic silver clip is a MFB in the abdominal cavity, it has been increasingly shown that removing the silver clip is not necessary because of the good receptivity of silver to human tissue and uncertainty of long-term side effects on human body.

Knowledge and Attitude Toward Sciatica Pain and Treatment Methods Among the Population of Qassim in Saudi Arabia: A Cross-Sectional Study

Knowledge and Attitude Toward Sciatica Pain and Treatment Methods Among the Population of Qassim in Saudi Arabia: A Cross-Sectional Study

Achilles tendon rupture: etiology, diagnosis, prevention, repair, complications and their relation to future sports performance in the athletic population

The Achilles tendon is the most powerful and longest in our body. 20% of all serious tendon ruptures involve the Achilles tendon (AT). An AT rupture can be a career-ending injury. Proven risk factors predisposing and preventing tendon rupture are presented, as well as epidemiological data on the incidence of this disease in the population. In addition, it illustrates currently used diagnostic methods and presents the benefits they bring. Achilles tendon ruptures have a detrimental impact on athletic performance, and the most appropriate treatment method and return-to-play recommendations remain controversial. Recent studies show that operative intervention improves strength and functional results and is more effective compared to non-operative treatment combined with rehabilitation. Currently, according to the latest research, surgical intervention should be used, especially in athletes and very physically active people, because it shortens the time to return to full fitness and allows for better sports achievements in the future. However, you should remember about the complications that may result from such treatment. Nevertheless, the benefits of surgery outweigh the possible losses, especially to the athletic population. The purpose of this study is to comprehensively review the relationship between surgical repair of a ruptured AT and future athletic performance in an athlete population. The available research shows the effectiveness, side effects, complications, and benefits of surgical correction of a ruptured tendon in the athlete population, as well as the quality of performance they are able to achieve after recovery. Materials and methods: Materials used in this study were found in the PubMed database, using the following keywords: Achilles tendon”, Achilles tendon rupture”, Return to play’’, Athletes injury”, Athletic population”.

GREEN SYNTHESIS, CHARACTERIZATION AND PHOTOCATALYTIC ACTIVITY OF NEW PHOTOCATALYST SrCo2O4 UNDER VISIBLE LIGHT IRRADIATION

In order to reduce the enormous costs of photocatalytic processes, the development of new photocatalysts sensitive to visible light constitutes a promising strategy to boost the efficiency of this method in water treatment. In this paper, strontium cobaltite nanoparticles (SrCo2O4 NPs) were shaped by simple, ecological and economical methods using cobalt and strontium nitrates as precursor and freshly isolated chicken egg white as capping agents. The crystalline product SrCo2O4 NPs was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Ultraviolet–Visible (UV–Vis) spectroscopy studies. The SrCo2O4-catalyzed Congo red (CR) degradation under visible light is investigated. XRD analysis showed that the sample was indeed crystallized in the cubic spinel structure (space group Fd3m). The average size of the nanoparticles was estimated to be ∼28[Formula: see text]nm. The FT-IR spectrum shows two bands at 620 and 573[Formula: see text][Formula: see text], which are characteristic of the spinel strontium cobaltite crystalline structure. The two optical band gap energy of synthesized photocatalyst estimated from UV–Visible spectrum is 2.07 and 3.48[Formula: see text]eV. The developed photocatalyst exhibits significant photocatalytic degradation of RC in an acidic medium with 97% of the dye mineralized after 5[Formula: see text]h.

Diffuse large B-cell lymphoma in the uterus with unexpected manifestations: a case report

BackgroundLymphoid neoplasm is a common disease, arising from lymphoid cells. It is divided into Hodgkin lymphoma and non-Hodgkin lymphoma. Non-Hodgkin lymphoma can be intranodular or extranodular, which happens in 25% of primary cases. The most common locations of extranodular non-Hodgkin lymphoma are the skin and gastrointestinal tract. The genital tract is a rare location; most lymphomas arise from the cervix and vagina, while the uterine corpus is an extremely rare location. In our case, the patient was diagnosed with primary extranodular non-Hodgkin lymphoma in different locations of her genital tract.Case presentationA 48-year-old nonparous Syrian woman complained of diffuse abdominal pain, fatigue, debility, high fever, vomiting, and urinary retention for a week. The last menstrual period of the patient was 5 years previously. The physical examination showed periodic abdominal pain with severe fatigue and increased abdominal size. The laboratory investigations were within normal limits except for a low level of hemoglobin and a high level of cancer antigen 125. The radiological investigations showed a uterine sizable lobulated mass with irregular borders and high and heterogeneous density, extending to the right and left ovaries, enlargement lymph nodes around the abdominal aortic and right iliac vessels, and severe right pleural effusion with right inferior lobe atelectasis. A total hysterectomy and oophorectomy were done. The histopathological examination showed that the patient had non-Hodgkin lymphoma (primary tumor).ConclusionPrimary non-Hodgkin lymphoma in the female genital tract is an extremely rare disease. Fast diagnosis and treatment can improve the outcomes, so this differential diagnosis should be in our minds even in the absence of systematic manifestations of lymphoma. More studies are needed to explain the pathology of this disease and to put guidelines that determine the perfect methods for diagnosis and treatment.

An Overview of Multiple Sclerosis In Vitro Models

Multiple sclerosis (MS) still poses a challenge in terms of complex etiology, not fully effective methods of treatment, and lack of healing agents. This neurodegenerative condition considerably affects the comfort of life by causing difficulties with movement and worsening cognition. Neuron, astrocyte, microglia, and oligodendrocyte activity is engaged in multiple pathogenic processes associated with MS. These cells are also utilized in creating in vitro cellular models for investigations focusing on MS. In this article, we present and discuss a summary of different in vitro models useful for MS research and describe their development. We discuss cellular models derived from animals or humans and present in the form of primary cell lines or immortalized cell lines. In addition, we characterize cell cultures developed from induced pluripotent stem cells (iPSCs). Culture conditions (2D and 3D cultures) are also discussed.

The Effect of Age on High-Dose Therapy with Autologous Stem Cell Support in Multiple Myeloma: A Single-Center Experience

Background: This retrospective one-center study demonstrates the complications related to high-dose therapy with autologous stem cell support (HDT) and the survival of multiple myeloma (MM) patients according to age groups. Methods: We categorized the patients into two groups: those who were ≤65 years old (group 1) (N = 115) and those who were &gt;65 years old (group 2) (N = 26). The mean duration of follow-up was 48 (1–125) months. Results: In group 2 patients, the use of a reduced dosage of melphalan (12 [46%] versus 30 [26%]) was more frequent in comparison to group 1 (p = 0.046). There was a statistically significant difference between the two groups regarding the neutrophil engraftment days (p = 0.001) and the median progression-free survival (PFS) (p = 0.02). The PFS was 44 months for group 1 and 30 months for group 2. There was no statistically significant difference between the groups in relation to the median duration of hospitalization, presence of bacteremia, intravenous antibiotic administration, and overall survival (OS). Conclusions: The study’s results indicate that HDT is a reliable method of treatment for older patients with MM, provided that they obtain a suitable conditioning regimen and, furthermore, these patients achieved a comparable OS rate to that of younger patients.

EFFECTIVENESS OF TREATMENT BY METHOD OF INTRAVITREAL INJECTION OF VASCULAR ENDOTHELIAL GROWTH FACTOR INHIBITORS

Purpose of the study. To assess demographic and clinical characteristics of patients with diabetic retinopa-thy treated with anti-VEGF therapy. Materials and methods of the study. 129 patients with diabetic retinopathy treated by the method of intrav-itreal administration of anti-VEGF therapy. Information about age, gender, diagnosis, activity of patients, dia-betes and the result of examination and treatment was collected. Achieved results. For treatment of diabetic retinopathy in clinics of AMU intravitreal administration of anti-VEGF is used in 25.8±1.9% of cases. Women p (68.2%) and patients older than 40 years (6,6%) revailed among these patients. Conclusion. Intravitreal administration of anti-VEGF is highly effective method for treatment of diabetic retinopathy. Patients, involved to this method of treatment mostly are women and people older than 40 years. They often have a non-proliferative stage of retinopathy, exudative and edematous maculopathy.

Systematic review of the comparison between simultaneous and staged surgical interventions for proximal hypospadias in children: Duckett’s procedure versus Bracka’s procedure

Selecting a treatment method for proximal hypospadias in children remains challenging. This systematic review compares the outcomes of treating proximal hypospadias with the Duckett and Bracka techniques. Literature sources published between 2008 and 2023 were searched through PubMed, Google Scholar, and eLibrary using the following keywords in English: “proximal hypospadias,” “repair OR urethroplasty,” and “outcomes OR complications.” For Russian-language sources, the keywords were “proximal hypospadias,” “urethroplasty,” “complications,” “Duckett operation,” and “Bracka operation,” After screening, four full-text articles met the inclusion criteria and were included in this review. Data from 385 patients was analyzed: 218 underwent Duckett repair and 167 underwent Bracka repair. The overall complication rate in the postoperative period was 31.11% and 10.18% for Duckett and Bracka operation, respectively. No study has been performed at a high methodological level. Currently, studies comparing single-stage and staged surgeries for proximal hypospadias are lacking. It is crucial to conduct multicenter or comparative studies that involve closer collaboration between clinics, include a larger number of patients, and have a longer followup period.

Investigating the efficiency of electrocoagulation using similar/dissimilar electrodes for the detoxification of Coralene Rubine dye: a cost effective approach.

Efficient treatment of textile dyeing wastewater can be achieved through electrocoagulation (EC) with minimal sludge production; however, the selection of the appropriate electrode is essential in lowering overall costs. Also, the reuse of the treated aqueous azo dye solution from this process has not been explored in detail. With these objectives, this study aims to treat synthetic azo dye solutions and achieve high colour removal efficiency (CRE%) using similar (Ti-Ti) and dissimilar (Ti-Cu) metal electrodes through EC with an attempt to reduce the cost. The aqueous Coralene Rubine GFL azo dye was used to examine the efficiency and cost of the EC process. X-Ray Photoelectron Spectroscopy was used to study the EC mechanism, while High Performance Liquid Chromatography was used to analyse the degradation of the dye and the formation of intermediate compounds. The concentration of metal ions in the treated dye solution was quantified using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES), with Ti-Ti treated solution having 14.20mg/L concentration of Ti and Ti-Cu treated solution having 0.078mg/L of Ti and 0.001mg/L of Cu, respectively. Colour removal efficiency of 99.49% was obtained for both electrode sets, with a lower operating time and voltage for dissimilar metal combination. Ecotoxicity studies showed negligible toxicity of Ti-Cu treated dye samples compared to untreated solutions. Survival rate, protein estimation, and catalase activity was used to validate the treatment method's efficacy. The study found that the dissimilar electrode material exhibited reduced toxicity due to the presence of heavy metals below the permissible limit.

Metastatic melanoma of the gallbladder: A case report and systematic review.

We report a case of metastatic melanoma of the gallbladder diagnosed by contrast-enhanced ultrasound and systematically review the characteristics of transabdominal ultrasound, clinical manifestations, and treatment methods of gallbladder metastatic melanoma in order to provide reference ideas for the diagnosis and treatment of metastatic melanoma of gallbladder.

Treatment of the Buried Bumper Syndrome​​​​​: A Retrospective Multicenter Study With Inclusion of 160 Cases.

The therapy of buried bumper syndrome (BBS) is difficult. The aim of this retrospective multicenter study was to analyze the treatment methods with focus on effectiveness and safety of endoscopic techniques. The analysis of all therapies and a comparison of the papillotome technique (PT) and needle knife-based nonpapillotome technique (NPT) were performed. Primary endpoint was technical success in one session, secondary endpoints overall technical success, number and duration of treatment sessions, SAE, and mortality. The primary treatment of 160 BBS cases, diagnosed between 2003 and 2021, was NPT in 60 (37.5%), PT in 43 (26.9%), push/pull technique (PPT) in 40 (25.0%), no removal in 9 (5.6%), laparotomy in 7 (4.4%) cases, and external incision in 1 (0.6%) case. For PT and NPT rates of technical success in one session were 95.5% and 45.0% (P<0.01), rates of overall technical success 100% and 88.3% (P=0.02), and mean number and duration of treatment sessions 1.05 (±0.21) versus 1.70 (±0.91) (P<0.01) and 32.17 (±21.73) versus 98,00 (±62.28) minutes (P<0.01), respectively. No significant differences between PT and NPT were found for SAE (15.9% vs. 25.0%) and mortality (2.3% vs. 1.7%). For PPT, laparotomy and external incision rates of technical success in one session and overall technical success were 100%, rates of SAE 2.5%, 50.0%, and 0% and mortality 0%, 10.0%, and 0%. Endoscopic therapy of BBS is treatment of choice in most cases with removal of incomplete BB by PPT. In case of complete BB PT appears more effective than NPT.