1,721,010 research outputs found
HIV screening in patients with anal condylomatosis. An overview about ethical and legal issues
Get PDF: Although there is a strong evidence of prevalence of condylomata in the HIV-positive population, literature on HIV prevalence in HIV-unscreened population diagnosed with condylomata is still unconclusive. Our aim is to review literature about HIV screening and diagnosis of anal condylomata in order to evaluate medical aspects, ethical and legal issues concerning the management of this disease. We undertook an online search on Pubmed for the keywords "HIV", "screening" and "anal condylomata" and 23 papers were analysed, 2 being randomized controlled trial, 11 comparative studies and 10 reviews. A total of 1270 patients were reviewed. All authors strongly recommend HIV testing in patients with clinical evidence of anal condylomata. In undeveloped countries with high prevalence of HIV, a proctological evaluation could be a could represent an unexpected therapeutic option for HIV infected male patients to prevent anal cancer. Clinical trials and prospective studies are necessary to validate this interesting hypothesis. KEY WORDS: Anal condylomatosis, HIV screening, Papilloma virus
Comment on Wijnia, J.W. A Clinician’s View of Wernicke-Korsakoff Syndrome. J. Clin. Med. 2022, 11, 6755
Get PDFWe have read with great interest the article by Wijnia [...
Optical coherence tomography angiography versus fluorescein angiography in the diagnosis of ischaemic diabetic maculopathy
No full textTo evaluate the efficacy of optical coherence tomography (OCT) angiography versus fluorescein angiography (FA) in terms of retinal vessel imaging in ischaemic diabetic maculopathy defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification
Lateral internal sphincterotomy (LIS) for chronic anal fissure by LigaSureTM Small Jaws: a comparison with traditional technique
Get PDFBACKGROUND: An anal fissure is a small laceration in the tissue (mucosa) that lines the anus. Anal fissures can cause pain and bleeding with bowel movements. Anal fissures can be attributed to constipation or repeated straining: a hard-fecal bolus cut the mucosa of anal canal that is relatively soft at sphincter level. Management and treatment of the disease are controversial. Many studies recommend conservative and medical treatment modalities as the initial options, since they are noninvasive and do not have risks of sphincter injury. Lateral internal sphincterotomy (LIS) is considered the gold standard for treatment of chronic anal fissure. Nonetheless, anal incontinence is one of the worrisome complications of LIS. LigaSureTM (Medtronic, Dublin, Ireland) is a bipolar electrosurgical device designed to deliver high current and very low voltage to tissue. It monitors tissue impedance between the jaws of the instrument and continuously adjusts the delivery of energy. We have applied the use of this device to a group of patients complaining about chronic anal fissure in order to verify if there is any advantage in performing it, compared to traditional technique (blade, scissors, electrocautery).
METHODS: A group of 436 patients were treated in our institution as proctological day-surgery patients from January 2016 to January 2021. Three hundred fifty-one underwent lateral internal sphincterotomy. As comparative group (CG), we considered the results of the systematic review of Boland et al. whose sphincterotomy group consisted of 349 patients (45% of 775patients) from 9 studies included.
RESULTS: Of 351 patients who underwent to LIS pile excision, 322 healed within 9 weeks from treatment (91.73%) compared to 332 (95.1%) of the CG. Sixty-three out 85 (74.1%) of patients with AF + other treatments. In the LIS group the overall recurrence over a period of 6 months for all patients was 17 patients (4.84%) compared with 6.9% (24/349) over a period of 2-6 months follow-up.
CONCLUSIONS: The use of LigaSureTM Small Jaw (SJ) (Medtronic) was never reported for anal fissures in literature. LigaSureTM SJ (Medtronic) is a bipolar device which allows to perform the procedure in a reduced time and in a safer way even if differences with traditional techniques are not significant. The costs of the operation are higher in LigaSure group. Literature up today does not report any article about the use of LigaSureTM (Medtronic) for treatment of anal fissures. It could be controversial for the cost of the device but is safer and quicker compared to traditional knife or scissors
Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab
Get PDFPURPOSE::
To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy.
METHODS::
Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners.
RESULTS::
Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = -2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = -1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = -3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05).
CONCLUSION::
Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab
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