It is a thematic review where the author's path in scientific research focused on enhancing the effectiveness of psychotherapeutic treatment of people with alcoholism or any other drug addiction and the results of published studies are exposed. The thematic review focuses on the neurotic level affective spectrum comorbidities in drug addictions from the progressive understanding of this author in the professional practice with Cuban and Latin American patients. The logic followed in scientific research and its outcome towards an effective professional practice in psychotherapy in this area of clinical psychology is narrated. The state of the art in the Cuban user population of these services is reported, the value of resources and psychotherapeutic strategies that give prestige to the work with the emotional area of users of the addiction service is based, since they seem to contain a greater potential for effectiveness to fulfill psychotherapeutics objectives.
{"title":"Emotional comorbidities in drug addictions. Recount and thematic review","authors":"Humberto Garcia Penedo","doi":"10.31579/2690-1919/284","DOIUrl":"https://doi.org/10.31579/2690-1919/284","url":null,"abstract":"It is a thematic review where the author's path in scientific research focused on enhancing the effectiveness of psychotherapeutic treatment of people with alcoholism or any other drug addiction and the results of published studies are exposed. The thematic review focuses on the neurotic level affective spectrum comorbidities in drug addictions from the progressive understanding of this author in the professional practice with Cuban and Latin American patients. The logic followed in scientific research and its outcome towards an effective professional practice in psychotherapy in this area of clinical psychology is narrated. The state of the art in the Cuban user population of these services is reported, the value of resources and psychotherapeutic strategies that give prestige to the work with the emotional area of users of the addiction service is based, since they seem to contain a greater potential for effectiveness to fulfill psychotherapeutics objectives.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The main risk factors are tobacco smoking, obesity, hypertension, horseshoe kidneys, acquired renal cysts and genetic factors especially von Hippel Lindau disease (VHL).
主要危险因素有吸烟、肥胖、高血压、马蹄肾、获得性肾囊肿和遗传因素，尤其是血管性林道病。
{"title":"Multiple Calculi and Clear Cell Carcinoma in Same Kidney Rare Condition with Remarkable Implications for Surgery","authors":"Henry K. YISA","doi":"10.31579/2690-1919/283","DOIUrl":"https://doi.org/10.31579/2690-1919/283","url":null,"abstract":"The main risk factors are tobacco smoking, obesity, hypertension, horseshoe kidneys, acquired renal cysts and genetic factors especially von Hippel Lindau disease (VHL).","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus (DM) is a chronic disease that occurs due to inadequate production of insulin or decreased effect of available insulin. Considered one of the most critical life-threatening diseases of the 21st century, the number of patients has been increasing over the past few decades. These patients suffer many problems such as neuropathy, nephropathy and rethinopathy which the first can decrease their life expectations. Diabetic peripheral neuropathy (DPN) is the most common complication in diabetic patients and more than one half of these patients develop nerve dysfunction through their life. The primary cause of diabetic foot disease is DPN which sleep disturbances, poor quality of life, depression and finally unemployment are the results of it. In this article, we are studying different biomarkers of diabetic neuropathy using related papers in order to consider them in diabetic patients and prevent further complications in them.
{"title":"Diagnostic Biomarkers of Diabetic Neuropathy","authors":"Mohammad Darvishi","doi":"10.31579/2690-1919/289","DOIUrl":"https://doi.org/10.31579/2690-1919/289","url":null,"abstract":"Diabetes mellitus (DM) is a chronic disease that occurs due to inadequate production of insulin or decreased effect of available insulin. Considered one of the most critical life-threatening diseases of the 21st century, the number of patients has been increasing over the past few decades. These patients suffer many problems such as neuropathy, nephropathy and rethinopathy which the first can decrease their life expectations. Diabetic peripheral neuropathy (DPN) is the most common complication in diabetic patients and more than one half of these patients develop nerve dysfunction through their life. The primary cause of diabetic foot disease is DPN which sleep disturbances, poor quality of life, depression and finally unemployment are the results of it. In this article, we are studying different biomarkers of diabetic neuropathy using related papers in order to consider them in diabetic patients and prevent further complications in them.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The schema of top peer pressure (TPP) consists of nine hierarchical cognitive taxa measured by the Top Peer Pressure Scale (TPPS): domain, kingdom, phylum, class, order, family, genus, species and word. The TPPS taken by undergraduate university students’ (UUSs) has shown that their TPP consists of eight taxa among which four, i.e., domain, kingdom, class, and family associate negatively with their university achievement. Objective: To find out what taxa constitute the TPP of junior high school students (JHSSs) and which taxa associate with the JHSSs’ English and school achievement. Methodology: The TPPS was administered to 304 male HSSs. Following the designers of the TPPS, JHSSs’ responses were subjected to Principal Axis Factoring and Varimax with Kaiser Normalization to extract and rotate the factors underlying the TPPS. The factors represented cognitive taxa other than the domain, species and word empirically. Results: Six rotated factors were extracted from JHSSs’ responses on the TPPS representing their cognitive taxa of kingdom, phylum, class, order, family and genus. Among these taxa the kingdom associated significantly with both English language and school achievement. The taxon of family associated significantly only with the English language achievement. Conclusion: The schema of TPP helps JHSSs achieve not only in English language but also in other courses offered in school at its kingdom taxon. UUSs pathologically manipulate the items comprising the schema not only at its kingdom taxon but also at the taxa of phylum, class and order to justify their low university achievement.
{"title":"Does the Schema of top Peer Pressure and its Relationship with Achievement Change from Junior High School to University?","authors":"Ebrahim Khodadady","doi":"10.31579/2690-1919/291","DOIUrl":"https://doi.org/10.31579/2690-1919/291","url":null,"abstract":"Background: The schema of top peer pressure (TPP) consists of nine hierarchical cognitive taxa measured by the Top Peer Pressure Scale (TPPS): domain, kingdom, phylum, class, order, family, genus, species and word. The TPPS taken by undergraduate university students’ (UUSs) has shown that their TPP consists of eight taxa among which four, i.e., domain, kingdom, class, and family associate negatively with their university achievement. Objective: To find out what taxa constitute the TPP of junior high school students (JHSSs) and which taxa associate with the JHSSs’ English and school achievement. Methodology: The TPPS was administered to 304 male HSSs. Following the designers of the TPPS, JHSSs’ responses were subjected to Principal Axis Factoring and Varimax with Kaiser Normalization to extract and rotate the factors underlying the TPPS. The factors represented cognitive taxa other than the domain, species and word empirically. Results: Six rotated factors were extracted from JHSSs’ responses on the TPPS representing their cognitive taxa of kingdom, phylum, class, order, family and genus. Among these taxa the kingdom associated significantly with both English language and school achievement. The taxon of family associated significantly only with the English language achievement. Conclusion: The schema of TPP helps JHSSs achieve not only in English language but also in other courses offered in school at its kingdom taxon. UUSs pathologically manipulate the items comprising the schema not only at its kingdom taxon but also at the taxa of phylum, class and order to justify their low university achievement.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypoxia-inducible factors (HIF) plays a major role in the regulation of hypoxia. It occurs not only under normal physiological conditions but also under pathological conditions such as some inflammatory reactions and tumor diseases. Studies have shown that the mechanisms of hepatocarcinogenesis include cellular molecules signaling pathways and gene levels in which Hypoxia-inducible factors play an important role. At present, surgical resection liver transplantation and chemotherapy are still the main treatment methods in the clinical treatment of patients with liver cancer but conventional chemotherapy drugs have toxic side effects on human body and the prognosis is poor. HIF is not only involved in reducing the efficacy of radiotherapy chemotherapy and targeted therapy but also closely related to angiogenesis and immune escape. In this article, we will focus on the Hypoxia-inducible factors of liver cancer and discuss its relationship with the development and prognosis of liver cancer and provide new ideas for the precise treatment of malignant liver tumors.
{"title":"Advances In the Study of Hypoxia Inducible Factors and Prognosis of Hepatocellular Carcinoma Development","authors":"Weichen Si","doi":"10.31579/2690-1919/290","DOIUrl":"https://doi.org/10.31579/2690-1919/290","url":null,"abstract":"Hypoxia-inducible factors (HIF) plays a major role in the regulation of hypoxia. It occurs not only under normal physiological conditions but also under pathological conditions such as some inflammatory reactions and tumor diseases. Studies have shown that the mechanisms of hepatocarcinogenesis include cellular molecules signaling pathways and gene levels in which Hypoxia-inducible factors play an important role. At present, surgical resection liver transplantation and chemotherapy are still the main treatment methods in the clinical treatment of patients with liver cancer but conventional chemotherapy drugs have toxic side effects on human body and the prognosis is poor. HIF is not only involved in reducing the efficacy of radiotherapy chemotherapy and targeted therapy but also closely related to angiogenesis and immune escape. In this article, we will focus on the Hypoxia-inducible factors of liver cancer and discuss its relationship with the development and prognosis of liver cancer and provide new ideas for the precise treatment of malignant liver tumors.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare workers are exposed to various violent behaviors, such as physical violence, threats, and psychological violence at their work. The experience of workplace violence is associated with various serious health outcomes including depression, loss of self-esteem, sleep disorders, anxiety, and Lack of concentration. Therefore, this editorial is conducted to stress the worldwide predictores of violence in acute health care settings and recommendations for action
{"title":"Worldwide predictors of violence in acute health care settings and recommendations for action","authors":"Nahla Shaaban Khalil","doi":"10.31579/2690-1919/277","DOIUrl":"https://doi.org/10.31579/2690-1919/277","url":null,"abstract":"Healthcare workers are exposed to various violent behaviors, such as physical violence, threats, and psychological violence at their work. The experience of workplace violence is associated with various serious health outcomes including depression, loss of self-esteem, sleep disorders, anxiety, and Lack of concentration. Therefore, this editorial is conducted to stress the worldwide predictores of violence in acute health care settings and recommendations for action","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43636810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Douglas E. Rappaport, Kartik Mangipudi, Thomas M. Polveroni, Wayne Martini
Closed head trauma in anticoagulated patients is an increasing common presentation to Emergency Department (ED). Within this population, there is a subset of patients who present with delayed intracranial haemorrhage, typically resulting in subdural or parenchymal bleeds, with negative initial non-contrast head CT.
{"title":"Delayed Subarachnoid Hemorrhage in A Patient on Warfarin with Blunt Head Trauma","authors":"Douglas E. Rappaport, Kartik Mangipudi, Thomas M. Polveroni, Wayne Martini","doi":"10.31579/2690-1919/280","DOIUrl":"https://doi.org/10.31579/2690-1919/280","url":null,"abstract":"Closed head trauma in anticoagulated patients is an increasing common presentation to Emergency Department (ED). Within this population, there is a subset of patients who present with delayed intracranial haemorrhage, typically resulting in subdural or parenchymal bleeds, with negative initial non-contrast head CT.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46359725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:Overcrowding in Emergency Departments is associated with poor patient outcomes and low patient satisfaction; overcrowding has been exacerbated by the ongoing Covid-19 pandemic. One intervention used in both the H1N1 pandemic and the current Covid-19 pandemic is the deployment of temporary structures such as surge tents. Data on the effectiveness of such interventions is currently lacking. Methods:In this retrospective study, we assess ED length of stay (LOS), percent of patients leaving without being seen, and 72-hour return rate in the time period during tent operation with equivalent time periods before and after tent use. Differences in outcomes were modeled and tested using Generalized Estimating Equations (GEEs) methodology and controlled for emergency severity index (ESI). Results:Deployment of a Covid tent was associated with reduced LOS (227.5 vs. 214.5 min, ESI-adjusted p = 0.02). Additionally, we observed a significantly reduced rate of patients leaving without being seen (0.8% vs. 0.2%, ESI-adjusted p < 0.001) without any increase in the 72-hour return rate (4.2% vs 4.2%, ESI-adjusted p = 0.98) during the period of Covid tent operations. Conclusion:This data suggests that the deployment of temporary structures such as tents is an effective means of decompressing EDs in the setting of the Covid-19 pandemic.
{"title":"The Effect of A ‘Covid Tent’ On Emergency Department Efficiency and Patient Satisfaction: A Single Site Retrospective Study","authors":"Douglas E. Rappaport","doi":"10.31579/2690-1919/294","DOIUrl":"https://doi.org/10.31579/2690-1919/294","url":null,"abstract":"Background:Overcrowding in Emergency Departments is associated with poor patient outcomes and low patient satisfaction; overcrowding has been exacerbated by the ongoing Covid-19 pandemic. One intervention used in both the H1N1 pandemic and the current Covid-19 pandemic is the deployment of temporary structures such as surge tents. Data on the effectiveness of such interventions is currently lacking. Methods:In this retrospective study, we assess ED length of stay (LOS), percent of patients leaving without being seen, and 72-hour return rate in the time period during tent operation with equivalent time periods before and after tent use. Differences in outcomes were modeled and tested using Generalized Estimating Equations (GEEs) methodology and controlled for emergency severity index (ESI). Results:Deployment of a Covid tent was associated with reduced LOS (227.5 vs. 214.5 min, ESI-adjusted p = 0.02). Additionally, we observed a significantly reduced rate of patients leaving without being seen (0.8% vs. 0.2%, ESI-adjusted p < 0.001) without any increase in the 72-hour return rate (4.2% vs 4.2%, ESI-adjusted p = 0.98) during the period of Covid tent operations. Conclusion:This data suggests that the deployment of temporary structures such as tents is an effective means of decompressing EDs in the setting of the Covid-19 pandemic.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":"27 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41273038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dilara Bas, Emre Burak Erkal, Melis Korkmaz, A. Recepoglu, Hazal Elitas, Deniz Baycin Demirhan
Monoclonal antibodies have been established as a major product class of biotechnology-based drugs. The increasing demand of monoclonal antibodies has led pharmaceutical companies to adopt efficient production processes. Transferring monoclonal antibody production to the industrial manufacturing requires adequate effort in process development. The strategy to reduce development time and cost comprises high-throughput process development which is especially central for the rapid optimization of the purification process. Chromatography process is the backbone of the purification process that can deliver high purity but it requires significant resources. Combined with high-throughput process development approach, the chromatography process is easy to develop and scale-up from laboratory to manufacturing scale. Design of experiments helps high-throughput process development workflow to provide decision-support techniques. This approach ensures significantly decreased time and material needs while improving the chromatography process. Protein A affinity chromatography is one of the most important chromatographic steps because of its great performance and capabilities. Most of the working parameters can be predefined and are identical for several monoclonal antibodies. However, some parameters like elution pH, loading capacity, resin type need further optimization for each monoclonal antibody. In this study, the loading and elution parameters were screened for Protein A chromatography to identify the best purification conditions using the combination of Design of Experiments and high-throughput process development approach in micro-volume columns. Developed working parameters were used for scale-up and tested under robust process conditions. Specific chromatography conditions were applied in pilot-scale and data comparison was done with micro-volume columns, lab-column scale to validate high-throughput strategy approach
{"title":"Protein A Chromatography Purification for a Monoclonal Antibody from Process Development to Scale-up","authors":"Dilara Bas, Emre Burak Erkal, Melis Korkmaz, A. Recepoglu, Hazal Elitas, Deniz Baycin Demirhan","doi":"10.31579/2690-1919/285","DOIUrl":"https://doi.org/10.31579/2690-1919/285","url":null,"abstract":"Monoclonal antibodies have been established as a major product class of biotechnology-based drugs. The increasing demand of monoclonal antibodies has led pharmaceutical companies to adopt efficient production processes. Transferring monoclonal antibody production to the industrial manufacturing requires adequate effort in process development. The strategy to reduce development time and cost comprises high-throughput process development which is especially central for the rapid optimization of the purification process. Chromatography process is the backbone of the purification process that can deliver high purity but it requires significant resources. Combined with high-throughput process development approach, the chromatography process is easy to develop and scale-up from laboratory to manufacturing scale. Design of experiments helps high-throughput process development workflow to provide decision-support techniques. This approach ensures significantly decreased time and material needs while improving the chromatography process. Protein A affinity chromatography is one of the most important chromatographic steps because of its great performance and capabilities. Most of the working parameters can be predefined and are identical for several monoclonal antibodies. However, some parameters like elution pH, loading capacity, resin type need further optimization for each monoclonal antibody. In this study, the loading and elution parameters were screened for Protein A chromatography to identify the best purification conditions using the combination of Design of Experiments and high-throughput process development approach in micro-volume columns. Developed working parameters were used for scale-up and tested under robust process conditions. Specific chromatography conditions were applied in pilot-scale and data comparison was done with micro-volume columns, lab-column scale to validate high-throughput strategy approach","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44049676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Charalampopoulos, G. Bagias, Dimitri Papaconstantinou, N. Koliakos, N. Zavras, Kostantinos Nastos, S. Papagrigoriadis
Background: The success rate of surgery for anal fistulas in the literature is variable, ranging between 30-90% due to differences in etiology, risk factors for recurrences and variety of surgical and innovative techniques used in therapy of anal fistulas. Aim: We try to evaluate the surgical outcomes in patients without any known risk factor for recurrence. Materials and Methods: A retrospective study with 148 patients was performed. Fistulas were classified according to: Parks system, the modified Parks’s and the St James’s University Hospital system. MRI, TRUS and EUA were the most useful examinations. The age, duration of symptoms, location of the fistula according to the transvers anal line, the grade of complexity of AF were studied. Only patients with cryptoglandular anal infection were enrolled excluding patients with acute, subacute phase of inflammation and risk factors for recurrence. Operations performed in treatment of AF were registered. Various parameters studied underwent statistical analysis; Student t test and chi-square or Fisher exact test were used for comparisons between continuous and categorical data respectively Results: 148 patients (112 males,36 females, age range 21-74yrs, mean age 44±13, male to female ratio 3.1/1) were studied; 52(52/148, 35%) with simple and 96(96/148, 65%) with complex fistulas. MRI was necessary for classification of anal fistulas and identified the internal opening of fistula in134 patients (134/148, 93%) and in 14 inconclusive cases was identified by TRUS. LIFT was performed in complex fistulas and low intersphinceric fistulas in 102 patients (102/148, 68.6%). Fistulotomy in 41(41/148, 27.7%) with simple linear intersphincteric fistulas and laser therapy in 5(5/148, 3.4%) with simple low intersphincteric fistulas. A successful surgical outcome was achieved in 51 patients with simple (51/52, 98%) and 91(91/96, 94.8%) with complex fistulas.6 recurrences were detected (6/148, 4.05%). Conclusion: Chronic anal fistulas, in selected patients present postoperative healing rates at 98% and 94.8% for simple and complex fistulas respectively and recurrence rate at 4.05%. The most common operations were LIFT and fistulotomy.
{"title":"Chronic Cryptoglandular Anal Fistulas: Surgical Outcomes; A Retrospective Case Control Study In 148 Patients with No Risk Factors for Recurrence","authors":"A. Charalampopoulos, G. Bagias, Dimitri Papaconstantinou, N. Koliakos, N. Zavras, Kostantinos Nastos, S. Papagrigoriadis","doi":"10.31579/2690-1919/271","DOIUrl":"https://doi.org/10.31579/2690-1919/271","url":null,"abstract":"Background: The success rate of surgery for anal fistulas in the literature is variable, ranging between 30-90% due to differences in etiology, risk factors for recurrences and variety of surgical and innovative techniques used in therapy of anal fistulas. Aim: We try to evaluate the surgical outcomes in patients without any known risk factor for recurrence. Materials and Methods: A retrospective study with 148 patients was performed. Fistulas were classified according to: Parks system, the modified Parks’s and the St James’s University Hospital system. MRI, TRUS and EUA were the most useful examinations. The age, duration of symptoms, location of the fistula according to the transvers anal line, the grade of complexity of AF were studied. Only patients with cryptoglandular anal infection were enrolled excluding patients with acute, subacute phase of inflammation and risk factors for recurrence. Operations performed in treatment of AF were registered. Various parameters studied underwent statistical analysis; Student t test and chi-square or Fisher exact test were used for comparisons between continuous and categorical data respectively Results: 148 patients (112 males,36 females, age range 21-74yrs, mean age 44±13, male to female ratio 3.1/1) were studied; 52(52/148, 35%) with simple and 96(96/148, 65%) with complex fistulas. MRI was necessary for classification of anal fistulas and identified the internal opening of fistula in134 patients (134/148, 93%) and in 14 inconclusive cases was identified by TRUS. LIFT was performed in complex fistulas and low intersphinceric fistulas in 102 patients (102/148, 68.6%). Fistulotomy in 41(41/148, 27.7%) with simple linear intersphincteric fistulas and laser therapy in 5(5/148, 3.4%) with simple low intersphincteric fistulas. A successful surgical outcome was achieved in 51 patients with simple (51/52, 98%) and 91(91/96, 94.8%) with complex fistulas.6 recurrences were detected (6/148, 4.05%). Conclusion: Chronic anal fistulas, in selected patients present postoperative healing rates at 98% and 94.8% for simple and complex fistulas respectively and recurrence rate at 4.05%. The most common operations were LIFT and fistulotomy.","PeriodicalId":93114,"journal":{"name":"Journal of clinical research and reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47972665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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