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This study aimed to evaluate the effect of sono-scintigraphic correlation on the success of minimal invasive parathyroidectomy (MIP) via surgeon performed continuous intraoperative sonographic guidance in patients operated for primary hyperparathyroidism(PHPT) without intact parathormone (PTH) measurement.
A retrospective analysis of a prospective database was conducted to review patients who underwent MIP (July 2017-October 2019). The screened parameters were preoperative PTH level, preoperative ultrasonography (US), preoperative scintigraphy, intraoperative US, intraoperative frozen section analysis, postoperative PTH level and permanent pathology report. Intraoperative intact PTH measurement was not employed due to institutional policy.
Preoperative US alone localized the specific side (right/left, inferior/superior) of abnormality in 54 out of 74 (72.97%) cases. Scintigraphy alone localized the specific side in 58 (78.37%) cases. The sensitivity of preoperative US and scintigraphy alone was 76.05% and 86.56%, respectively. Sono-scintigraphic discordance was present in 6 cases (8.1%) and intraoperative real-time US predicted accurate localization of adenoma in 4 (66.6%) and scintigraphy in 2 (44.4%) patients. The frozen section analysis confirmed parathyroid cells in all cases evaluated.
Sono-scintigraphic concordance with intraoperative real-time imaging increases surgical success rates in cases where MIP is planned under the circumstances of limited resources regarding unavailability of intact PTH measurement.
Sono-scintigraphic concordance with intraoperative real-time imaging increases surgical success rates in cases where MIP is planned under the circumstances of limited resources regarding unavailability of intact PTH measurement.
The criteria for surgical management of ureteropelvic junction obstruction are not well-defined, and there is a risk for loss of renal function before the operation. In this context, certain changes in contralateral kidney had been investigated in order to increase the sensitivity of diagnosis. In this study we aimed to investigate whether contralateral transient minimal hydronephrosis (CTMH) can be considered as an ?early alarm? sign for worsening of the affected kidney in infants with hydronephrosis.
A total of 182 infants (92 surgically treated and 90 conservatively followed-up) with unilateral hydronephrosis were retrospectively analyzed. Ultrasonography and renal scan findings were evaluated. Correlation between the appearance of CTMH, contralateral compensatory hypertrophy (CCH) on ultrasonography, and prognosis of the affected kidney were evaluated.
Among the surgically treated patients; 18 (19.6%) patients developed CTMH on average 7 months (0-13 months) before surgery. Among these 18 patients wrioration in the affected kidney and poor prognosis in infants followed-up with isolated unilateral hydronephrosis. Additionally, CTMH can be considered as an ?early alarm? sign for worsening of the affected kidney and the need for surgical intervention.
There is limited literature on the knowledge, attitude, and perceptions (KAP) of botulinum toxin (BoNT) treatment among patients and caregivers. The objective of this study was to assess the KAP in patients undergoing BoNT treatment for movement disorders.
One hundred patients with movement disorders from National Institute of Mental Health and Neurosciences Hospital in Bengaluru, South India, were recruited. The patients underwent demographic, clinical, and Patient Knowledge Questionnaire on Botulinum Toxin Use in Movement Disorders (PKQ-BMD)-based evaluations.
The mean age of patients at the time of presentation was 47.97 ± 14.19 years (range, 12-79). Of all the patients, 26 (28%) patients were anxious, and 86% of these patients were reassured after appropriate counseling. There were 83 (89%) patients who found BoNT to be a costlier option. Education and previous Internet searches influenced positive performance in the "knowledge" domain and overall PKQ-BMD scores. The "number of injections" was also positively correlated with KAP performance.
This study showed that knowledge and perceptions about BoNT treatment need to be further improved. Wider availability of the Internet has provided a positive impact on patients' and carers' KAP. Internet-based information, higher educational qualifications of the patients, and a higher number of BoNT injection sessions are the most important predictors of satisfactory KAP related to BoNT injection treatment in patients with movement disorders.
This study showed that knowledge and perceptions about BoNT treatment need to be further improved. Wider availability of the Internet has provided a positive impact on patients' and carers' KAP. Internet-based information, higher educational qualifications of the patients, and a higher number of BoNT injection sessions are the most important predictors of satisfactory KAP related to BoNT injection treatment in patients with movement disorders.In the process of repairing of bone defects, bone scaffold materials need to be implanted to restore the corresponding tissue structure at the injury. At present, the repair materials used for bone defects mainly include autogenous bone, allogeneic bone, metal materials, bioceramics, polymer materials and various composite materials. Bisindolylmaleimide I Different materials have demonstrated strong reconstruction ability in bone repair, but the ideal bone implants in the clinic are still yet to be established. Except for autogenous bone, other materials used in bone defect repair are unable to perfectly balance biocompatibility, bone formation, bone conduction and osteoinduction. Combining the latest advances in materials sciences and clinical application, we believe that composite materials supplementedwith Chinese medicine, tissue cells, cytokines, trace elements, etc. and manufactured using advanced technologies such as additive manufacturing technology may have ideal bone repair performance, and may have profound significance in clinical repair of bone defects of special type. This article reviewed to the domestic and foreign literature in recent years, and elaborates the current status of bone defect repair materials in clinical application and basic research in regard to the advantages, clinical options, shortcomings, and how to improve the autogenous bone, allogeneic bone and artificial bone materials, in order to provide a theoretical basis for clinical management of bone defects.
