Our objective is to describe a novel ligamentolysis approach using a subcoronal incision technique and to determine its safety and efficacy. During the last 7 years, 82 consecutive patients had penile augmentation sur...Our objective is to describe a novel ligamentolysis approach using a subcoronal incision technique and to determine its safety and efficacy. During the last 7 years, 82 consecutive patients had penile augmentation surgery. Ligamentolysis, through a lower abdominal incision （V-Y plasty） in the first 35 males, was performed （Group A）, followed by circumcision ligamentolysis in the next 47 males （Group B）. The operation time, complications, and the preoperative and postoperative values of penile length and girth along with the self-esteem and relations questionnaire score as well as satisfaction score was calculated before and after the surgery, and a comparison was conducted between the groups. The mean age at presentation was 32 years （range： 18-56 years）. Seventy-nine patients suffered from penile dysmorphophobia, and three patients had micropenises （length 〈7.5 cm）. The mean surgical times were 150.7 and 125.2 rain for Groups A and B, respectively （P=0.005）. Postoperatively, four Group A patients and three Group B patients （11% versus 6%, respectively） experienced penile retraction （P=0.453）. Hypertrophic scars were observed in 18 men （51%） in the former group. In the circumcision group, no major wound complications were recorded. The length and girth improvements between the groups were similar. In terms of satisfaction and SEAR improvement, the resulting difference for both variables favored the circumcision group （P=0.007 and 〈0.001, respectively）. With strict selection criteria, the circumcision ligamentolysis procedure compared to the V-Y plasty demonstrated improved results in terms of safety, operation time, retraction rate and cosmetic appearance without any compromise in the gained penile size.展开更多
BACKGROUND: Nasopharyngeal carcinoma (NPC) has a propensity to develop distant metastases at a high rate and with poor prognosis. Metastatic sites are usually multifocal and involve bones, lungs, liver and distant lym...BACKGROUND: Nasopharyngeal carcinoma (NPC) has a propensity to develop distant metastases at a high rate and with poor prognosis. Metastatic sites are usually multifocal and involve bones, lungs, liver and distant lymph nodes. Management of metastatic disease is essentially palliative and is based on chemotherapy. METHODS: A 50-year-old man with a solitary liver metastasis from a newly diagnosed NPC was treated by segmentectomy. Prior to surgery, neoadjuvant chemo therapy followed by concurrent chemoradiotherapy was administered. RESULTS: Complete remission of the primary disease was achieved, although the size of the hepatic lesion was increased. After resection of the liver metastasis, no signs of local or distant recurrence was noted during the 6-month follow up. CONCLUSION: Although surgical treatment has a limited role in metastatic NPC, there are rare cases of localized disease with a reasonable outcome after resection.展开更多
AIM:To investigate factors associated with breastfeeding duration(BD) in a sample of mothers living in Greece.METHODS:Four hundred and twenty-eight mothers(438 infants) were initially recruited in a tertiary Universit...AIM:To investigate factors associated with breastfeeding duration(BD) in a sample of mothers living in Greece.METHODS:Four hundred and twenty-eight mothers(438 infants) were initially recruited in a tertiary University Hospital.Monthly telephone interviews(1665in total) using a structured questionnaire(one for each infant) were conducted until the sixth postpartum month.Cox regression analysis was used to assess factors influencing any BD.RESULTS:Any breastfeeding rates in the first,third,and sixth month of the infant's life reached 87.5%,57.0%and 38.75%,respectively.In the multivariate analysis,maternal smoking in the lactation period[hazard-ratio(HR) = 4.20]and psychological status(HR = 1.72),and the introduction of a pacifier(HR =2.08),were inversely associated,while higher maternal education(HR_(university/college vs primary/high school) = 0.53,HR_(master's vs primary/high school) = 0.20),and being an immigrant(HR = 0.35) were positively associated with BD.CONCLUSION:Public health interventions should focus on campaigns against smoking during lactation,target women of lower educational status,and endorse the delayed introduction of pacifiers.展开更多
BACKGROUND Balloon aortic valvuloplasty(BAV)is a well-established treatment modality for congenital aortic valve stenosis.AIM To evaluate the role of rapid right ventricular pacing(RRVP)in balloon stabilization during...BACKGROUND Balloon aortic valvuloplasty(BAV)is a well-established treatment modality for congenital aortic valve stenosis.AIM To evaluate the role of rapid right ventricular pacing(RRVP)in balloon stabilization during BAV on aortic regurgitation(AR)in pediatric patients.METHODS A systematic review of the MEDLINE,Cochrane Library,and Scopus databases was conducted according to the PRISMA guidelines(end-of-search date:July 8,2020).The National Heart,Lung,and Blood Institute and Newcastle-Ottawa scales was utilized for quality assessment.RESULTS Five studies reporting on 72 patients were included.The studies investigated the use of RRVP-assisted BAV in infants(>1 mo)and older children,but not in neonates.Ten(13.9%)patients had a history of some type of aortic valve surgical or catheterization procedure.Before BAV,58(84.0%),7(10.1%),4(5.9%)patients had AR grade 0(none),1(trivial),2(mild),respectively.After BAV,34(49.3%),6(8.7%),26(37.7%),3(4.3%),patients had AR grade 0,1,2,and 3(moderate),respectively.No patient developed severe AR after RRVP.One(1.4%)developed ventricular fibrillation and was defibrillated successfully.No additional arrhythmias or complications occurred during RRVP.CONCLUSION RRVP can be safely used to achieve balloon stability during pediatric BAV,which could potentially decrease AR rates.展开更多
Non-A non-B aortic dissection(AAD)is an infrequently documented condition,comprising of only a small proportion of all AADs.The unique anatomy of the aortic arch and the failure of the existing classifications to adeq...Non-A non-B aortic dissection(AAD)is an infrequently documented condition,comprising of only a small proportion of all AADs.The unique anatomy of the aortic arch and the failure of the existing classifications to adequately define individuals with non-A non-B AAD,have led to an ongoing controversy around the topic.It seems that the clinical progression of acute non-A non-B AAD diverges from the typical type A and B dissections,frequently leading to serious complications and thus mandating early intervention.Currently,the available treatment methods in the surgical armamentarium are conventional open,endovascular techniques and combined hybrid methods.The optimum approach is tailored in every individual case and may be determined by the dissection’s location,extent,the aortic diameter,the associated complications and the patient’s status.The management of non-A non-B dissections still remains challenging and a unanimous consensus defining the gold standard treatment has yet to be reached.In an attempt to provide further insight into this perplexing entity,we performed a minireview of the literature,aiming to elucidate the epidemiology,clinical course and the optimal treatment modality.展开更多
Myxoid degeneration of ovarian tumors represents a rare distinctive benign ovarian stromal neoplasm that occurs predominantly in young women and is hormonally inactive.According to recent bibliography,pathogenesis rem...Myxoid degeneration of ovarian tumors represents a rare distinctive benign ovarian stromal neoplasm that occurs predominantly in young women and is hormonally inactive.According to recent bibliography,pathogenesis remains controversial.Many conducted studies express the strong belief adjusting myxoid ovarian tumors with genetic abnormalities.Therapeutic mapping is associated with histologic confirmation of the lesion.In cases of premenopausal patients,fertility preservation consists of ultimate scope.Abdominal MRI(magnetic resonance imaging)along with transvaginal ultrasound can differentiate and depict all preoperative imaging findings.Myxoid degenerated ovarian tumors can be malignant transformed into myxoid leiomyosarcomas with extremely metastatic possibilities.Meticulous atomic history,proper laboratory and imaging findings reflect successful key concerning ultimate diagnosis and treatment.展开更多
文摘Our objective is to describe a novel ligamentolysis approach using a subcoronal incision technique and to determine its safety and efficacy. During the last 7 years, 82 consecutive patients had penile augmentation surgery. Ligamentolysis, through a lower abdominal incision （V-Y plasty） in the first 35 males, was performed （Group A）, followed by circumcision ligamentolysis in the next 47 males （Group B）. The operation time, complications, and the preoperative and postoperative values of penile length and girth along with the self-esteem and relations questionnaire score as well as satisfaction score was calculated before and after the surgery, and a comparison was conducted between the groups. The mean age at presentation was 32 years （range： 18-56 years）. Seventy-nine patients suffered from penile dysmorphophobia, and three patients had micropenises （length 〈7.5 cm）. The mean surgical times were 150.7 and 125.2 rain for Groups A and B, respectively （P=0.005）. Postoperatively, four Group A patients and three Group B patients （11% versus 6%, respectively） experienced penile retraction （P=0.453）. Hypertrophic scars were observed in 18 men （51%） in the former group. In the circumcision group, no major wound complications were recorded. The length and girth improvements between the groups were similar. In terms of satisfaction and SEAR improvement, the resulting difference for both variables favored the circumcision group （P=0.007 and 〈0.001, respectively）. With strict selection criteria, the circumcision ligamentolysis procedure compared to the V-Y plasty demonstrated improved results in terms of safety, operation time, retraction rate and cosmetic appearance without any compromise in the gained penile size.
文摘BACKGROUND: Nasopharyngeal carcinoma (NPC) has a propensity to develop distant metastases at a high rate and with poor prognosis. Metastatic sites are usually multifocal and involve bones, lungs, liver and distant lymph nodes. Management of metastatic disease is essentially palliative and is based on chemotherapy. METHODS: A 50-year-old man with a solitary liver metastasis from a newly diagnosed NPC was treated by segmentectomy. Prior to surgery, neoadjuvant chemo therapy followed by concurrent chemoradiotherapy was administered. RESULTS: Complete remission of the primary disease was achieved, although the size of the hepatic lesion was increased. After resection of the liver metastasis, no signs of local or distant recurrence was noted during the 6-month follow up. CONCLUSION: Although surgical treatment has a limited role in metastatic NPC, there are rare cases of localized disease with a reasonable outcome after resection.
文摘AIM:To investigate factors associated with breastfeeding duration(BD) in a sample of mothers living in Greece.METHODS:Four hundred and twenty-eight mothers(438 infants) were initially recruited in a tertiary University Hospital.Monthly telephone interviews(1665in total) using a structured questionnaire(one for each infant) were conducted until the sixth postpartum month.Cox regression analysis was used to assess factors influencing any BD.RESULTS:Any breastfeeding rates in the first,third,and sixth month of the infant's life reached 87.5%,57.0%and 38.75%,respectively.In the multivariate analysis,maternal smoking in the lactation period[hazard-ratio(HR) = 4.20]and psychological status(HR = 1.72),and the introduction of a pacifier(HR =2.08),were inversely associated,while higher maternal education(HR_(university/college vs primary/high school) = 0.53,HR_(master's vs primary/high school) = 0.20),and being an immigrant(HR = 0.35) were positively associated with BD.CONCLUSION:Public health interventions should focus on campaigns against smoking during lactation,target women of lower educational status,and endorse the delayed introduction of pacifiers.
文摘BACKGROUND Balloon aortic valvuloplasty(BAV)is a well-established treatment modality for congenital aortic valve stenosis.AIM To evaluate the role of rapid right ventricular pacing(RRVP)in balloon stabilization during BAV on aortic regurgitation(AR)in pediatric patients.METHODS A systematic review of the MEDLINE,Cochrane Library,and Scopus databases was conducted according to the PRISMA guidelines(end-of-search date:July 8,2020).The National Heart,Lung,and Blood Institute and Newcastle-Ottawa scales was utilized for quality assessment.RESULTS Five studies reporting on 72 patients were included.The studies investigated the use of RRVP-assisted BAV in infants(>1 mo)and older children,but not in neonates.Ten(13.9%)patients had a history of some type of aortic valve surgical or catheterization procedure.Before BAV,58(84.0%),7(10.1%),4(5.9%)patients had AR grade 0(none),1(trivial),2(mild),respectively.After BAV,34(49.3%),6(8.7%),26(37.7%),3(4.3%),patients had AR grade 0,1,2,and 3(moderate),respectively.No patient developed severe AR after RRVP.One(1.4%)developed ventricular fibrillation and was defibrillated successfully.No additional arrhythmias or complications occurred during RRVP.CONCLUSION RRVP can be safely used to achieve balloon stability during pediatric BAV,which could potentially decrease AR rates.
文摘Non-A non-B aortic dissection(AAD)is an infrequently documented condition,comprising of only a small proportion of all AADs.The unique anatomy of the aortic arch and the failure of the existing classifications to adequately define individuals with non-A non-B AAD,have led to an ongoing controversy around the topic.It seems that the clinical progression of acute non-A non-B AAD diverges from the typical type A and B dissections,frequently leading to serious complications and thus mandating early intervention.Currently,the available treatment methods in the surgical armamentarium are conventional open,endovascular techniques and combined hybrid methods.The optimum approach is tailored in every individual case and may be determined by the dissection’s location,extent,the aortic diameter,the associated complications and the patient’s status.The management of non-A non-B dissections still remains challenging and a unanimous consensus defining the gold standard treatment has yet to be reached.In an attempt to provide further insight into this perplexing entity,we performed a minireview of the literature,aiming to elucidate the epidemiology,clinical course and the optimal treatment modality.
文摘Myxoid degeneration of ovarian tumors represents a rare distinctive benign ovarian stromal neoplasm that occurs predominantly in young women and is hormonally inactive.According to recent bibliography,pathogenesis remains controversial.Many conducted studies express the strong belief adjusting myxoid ovarian tumors with genetic abnormalities.Therapeutic mapping is associated with histologic confirmation of the lesion.In cases of premenopausal patients,fertility preservation consists of ultimate scope.Abdominal MRI(magnetic resonance imaging)along with transvaginal ultrasound can differentiate and depict all preoperative imaging findings.Myxoid degenerated ovarian tumors can be malignant transformed into myxoid leiomyosarcomas with extremely metastatic possibilities.Meticulous atomic history,proper laboratory and imaging findings reflect successful key concerning ultimate diagnosis and treatment.
