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Randers, Denmark

Sommer T.,Randers Regional Hospital | Friis-Andersen H.,Horsens Regional Hospital
Hernia | Year: 2013

Purpose: To investigate mesh-related complications in patients undergoing laparoscopic ventral hernia repair using DynaMesh®. Methods: In the period 1 January 2005 through 31 December 2010, 181 consecutive patients undergoing laparoscopic ventral hernia repair in our day surgery unit using DynaMesh® were entered prospectively in the National Danish Hernia Database. Data concerning abdominal reoperations after hernia repair were later collected on all 181 patients from the National Danish Health Registry. Postoperative telephone interviews were conducted estimating postoperative pain and patient satisfaction. Results: Six % (11 patients) were reoperated because of mesh-related complications. Three had small bowel obstruction and one had a colonic fistula with mesh infection, all causing bowel resection and mesh removal. Mesh-related cutaneous fistula was seen in one patient. Six patients had a symptomatic recurrence requiring reoperation. Abdominal wall hematomas were seen in two cases, while two other patients had symptomatic large seromas, of which one was drained surgically. After a median follow-up of 34 months (range 12-63) in 140 patients, 66 % were pain free (0 on the Numeric Rating Scale (NRS)). Of 26 patients with moderate to severe pain (NRS > 3) at follow-up, only 4 regretted the operation. Sixteen patients thought they had a recurrence, of these only 3 regretted the operation. Conclusion: The use of DynaMesh® in laparoscopic ventral hernia repair was associated with a 6 % risk of mesh-related reoperation in a high volume setting. Despite chronic pain in 19 %, after 34 months follow-up patient satisfaction was high. © 2013 Springer-Verlag France.

Kainsbak J.,Randers Regional Hospital | Hansen E.S.,Aarhus University Hospital | Dueholm M.,Aarhus University Hospital
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2015

Objective To describe the early and late outcomes of uterine smooth muscle tumors that are either malignant or have the potential for recurrence (MRUSMTs) after uterine artery embolization (UAE). Design Literature review of MRUSMTs in case reports and in studies on patient outcome after UAE and reports of one case of leiomyosarcoma (LMS) and 2 cases of bizarre leiomyoma (BL) after UAE. Setting University hospital. Intervention(s) Main outcome measure(s) and clinical outcome of UAE and prevalence of MRUSMT. Result(s) In the review of clinical trials, six cases of sarcomas were reported after UAE treatment in 8084 procedures. One of the six sarcoma cases and one case of intravenous leiomyomatosis occurred more than two years after the UAE. Thirteen cases of LMS, two cases of BL and no cases of MRUSMTs after UAE were identified in the published case reports. Six of the thirteen patients with sarcomas exhibited a good initial clinical response, but their symptoms relapsed after six months. UAE had a failed outcome in the two BL cases. Conclusion(s) MRUSMTs are rarely treated using UAE; late malignant transformation is infrequent but may be underreported. UAE treatment of leiomyosarcomas does not seem to spread the disease, but this approach may impair prognosis by delaying diagnosis. Tumors with low malignant potential may initially exhibit volume reduction and a good clinical response, but these tumors may exhibit persistent enhancement with contrast-enhanced magnetic resonance imaging (MRI). Special attention is required in cases with or without a limited response to UAE. © 2015 Elsevier Ireland Ltd. All rights reserved.

The aims of this study were to demonstrate a case of bilateral intravesical ureterocele associated with megacystis and mega-ureters, unilateral partial duplication of the ureter and unilateral segmental renal dysplasia of the upper pole and an accessory spleen and to propose an addition of the new variant to the classification of ureteroceles. A perinatal necropsy was conducted on the 21-week fetus by employing the Rokitansky procedure with evisceration performed in blocks. The autopsy revealed the aforementioned abnormalities without cardiac or neural anomalies. The amniocentesis report was normal. Ureterocele is a saccular expansion of the distal ureter. It is most commonly observed in females and children and usually affects the upper moiety of a complete pyeloureteral duplication. Four types of ureteroceles are described: (A) ureterocele with single ureter (10%); (B) ureterocele with total duplication and intravesical development (10%); (C) ureterocele with total duplication and extravesical development (62%); and (D) ureterocele with ectopic ureter (3%). One case in a new born with bilateral intravesical ureterocele associated with hydrouretero-nephrosis and hyperechogenic spots in kidneys has been reported, but bilateral intravesical ureterocele with unilateral incomplete pyeloureteral duplication has never been described in the literature. © 2010 APMIS.

Purpose: To provide a theoretical approach for combining refractive and topographic data in the planning of corneal laser refractive surgery for astigmatism. Methods: Refractive and topographic data for astigmatism were transformed to the corneal plane. Net astigmatisms were converted to polar values. An optimization process was performed with the use of differential calculus. Results: With this method, the magnitude of the corneal astigmatism is reduced or unaltered, while its orientation is maintained. The method identifies the reduction in corneal astigmatism, which will yield the largest reduction in refractive astigmatic magnitude. Conclusions: The advantage of the optimization method described in this article is a consistent reduction in corneal astigmatism towards sphericity. No new corneal astigmatism is carved on the cornea, and probably less tissue is ablated. The optimization method may also be used to combine refractive and topographic data for higher order aberrations with sinusoidal components. However, compared to the traditional purely refractive driven treatment, more refractive astigmatism will remain in the eye in most cases. A controlled clinical trial is necessary for comparing these two treatment modalities. © 2011 The Author. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

Oord T.,University of Aarhus | Hornung N.,Randers Regional Hospital
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2014

Calprotectin is a protein found in the cytosol of inflammatory cells and is a marker of the presence and the degree of inflammation in the bowel system. Calprotectin in feces has great diagnostic value in the matter of inflammatory bowel disease (IBD). In feces, the protein is stable up to seven days, and since the protein can easily be measured with an ELISA, the use of fecal calprotectin (FC) means no invasive measures. For adults and children over 4 years, a cut-off level of 50 mg/kg has been well established for diagnostic purposes. Because previous studies have proven that children under the age of four in general have higher FC values than older children and adults, there is a need for a cut-off level for this age group. In order to establish that, the normal values for FC in children from 0-4 years were investigated. Some 75 stool samples from healthy children were collected and the levels of FC were analyzed. The results were compared to 157 pediatric cases where FC analysis had been performed for diagnostic purposes. As a result, three cut-off levels were established based on the 97.5% percentiles of FC in different age groups: 538 mg/kg (1 < 6 months), 214 mg/kg (6 months < 3 years) and 75 mg/kg (3 < 4 years). © 2014 Informa Healthcare.

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