59 research outputs found
Free muscle transplantation for treatment of facial palsy
Facial palsy is treated by many different operative procedures. In addition, factors such as the varying degree of paralysis, make postoperative comparisons difficult. The limited number of patients treated by free muscle transplantation at any one center also complicates evaluation of alternative treatments. This limitation has been overcome by development of an International Muscle Transplant Registry for collection, storage and analysis of data from different centers. As of June 1, 1988, 137 patients from 6 countries have been entered into the Registry. Significantly more USA/European patients had a congenital deficit and significantly more Japanese patients had a deficit resulting from surgery. According to a modification of the paresis scoring system proposed by Stennert et al. [3], USA/European patients also had a higher degree of nonsurgical facial paresis than Japanese patients. The most frequent preoperative treatment used in Japan was electrostimulation in 24% of cases, only 6% of European and American patients received this treatment. Evaluation of surgical procedures performed by the 2 groups of surgeons showed similar dimensions of muscle grafts used in the face, with a length of about 8.5 cm and a width of 3.4 cm. The extensor digitorum brevis muscle was the most popular, being used in 58% of European and American cases, whereas the Japanese choice was the gracilis muscle in 94% of cases. The length of the nerve graft used by Japanese surgeons was 6 cm, longer than that used by European and American surgeons. At this time, these preliminary data suggest evidence for paresis improvement in 79% of patients overall. Ultimately, the Registry should permit evaluation of the efficacy of different operative techniques and should influence experimental research and clinical application of muscle transplantation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46675/1/238_2004_Article_BF00176632.pd
Evaluation of low intensity laser's action on silicone mammary implant pseudocapsules in rats
Bowel management for the treatment of pediatric fecal incontinence
Fecal incontinence is a devastating underestimated problem, affecting a large number of individuals all over the world. Most of the available literature relates to the management of adults. The treatments proposed are not uniformly successful and have little application in the pediatric population. This paper presents the experience of 30 years, implementing a bowel management program, for the treatment of fecal incontinence in over 700 pediatric patients, with a success rate of 95%. The main characteristics of the program include the identification of the characteristics of the colon of each patient; finding the specific type of enema that will clean that colon and the radiological monitoring of the process
Prolonged conservative treatment or 'early' surgery in sciatica caused by a lumbar disc herniation: rationale and design of a randomized trial [ISRCT 26872154]
BACKGROUND: The design of a randomized multicenter trial is presented on the effectiveness of a prolonged conservative treatment strategy compared with surgery in patients with persisting intense sciatica (lumbosacral radicular syndrome). METHODS/DESIGN: Patients presenting themselves to their general practitioner with disabling sciatica lasting less than twelve weeks are referred to the neurology outpatient department of one of the participating hospitals. After confirmation of the diagnosis and surgical indication MRI scanning is performed. If a distinct disc herniation is discerned which in addition covers the clinically expected site the patient is eligible for randomization. Depending on the outcome of the randomization scheme the patient will either be submitted to prolonged conservative care or surgery. Surgery will be carried out according to the guidelines and between six and twelve weeks after onset of complaints. The experimental therapy consists of a prolonged conservative treatment under supervision of the general practitioner, which may be followed by surgical intervention in case of persisting or progressive disability. The main primary outcome measure is the disease specific disability of daily functioning. Other primary outcome measures are perceived recovery and intensity of legpain. Secondary outcome measures encompass severity of complaints, quality of life, medical consumption, absenteeism, costs and preference. The main research question will be answered at 12 months after randomization. The total follow-up period covers two years. DISCUSSION: Evidence is lacking concerning the optimal treatment of lumbar disc induced sciatica. This pragmatic randomized trial, focusses on the 'timing' of intervention, and will contribute to the decision of the general practictioner and neurologist, regarding referral of patients for surgery
Characteristics of women with cosmetic breast augmentation surgery compared with breast reduction surgery patients and women in the general population of Sweden
To determine whether women with cosmetic breast implants have distinct demographic, lifestyle, and reproductive characteristics that put them at increased risk for subsequent morbidity, the authors compared 1,369 such women to 2,211 women who had undergone breast reduction surgery, and to a random sample of 49,262 women from the general population of Sweden. Information was collected through serf-administered questionnaires, and comparisons were made using the prevalence odds ratio. Women with cosmetic breast implants were significantly (
Experimental study of the role of the motor endplate zone in the transplantation of skeletal muscle autografts in rabbits
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