Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SUCCESS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed1998

Endopyelotomy for primary ureteropelvic junction obstruction: risk factors determine the success rate.

PURPOSE: We prospectively assessed the feasibility, complications, and short-term and long-term results of endopyelotomy for primary ureteropelvic junction obstruction. MATERIALS AND METHODS: In 80 consecutive patients primary ureteropelvic junction obstruction was diagnosed by excretory urogram or nephrostomogram, retrograde pyelography, diuresis renography and the Whitaker test in ambiguous cases. In all patients antegrade endopyelotomy was performed with a cold knife and an indwelling stent was left for 6 weeks. At 6 and 24 months postoperatively results were assessed clinically by an excretory urogram and/or diuretic renography and later by questionnaire and ultrasound. RESULTS: The primary success rate was 89% (71 of 80 patients) after the first endopyelotomy and increased to 91% (73 of 80 patients) after 2 patients had a second endopyelotomy. After median followup of 26 months (range 1.5 to 72) 6 of the 73 initially successfully treated patients had relapse. Two were successfully re-treated by a second endopyelotomy, resulting in an overall success rate of 81% (65 of 80 patients) after 1 procedure and 86% (69 of 80 patients) after a second endopyelotomy in 4 patients. Mean preoperative pyelocaliceal volume decreased from 64 +/- 33 to 41 +/- 20 ml. (p = 0.0003) 6 months after endopyelotomy and did not change during the following 18 months. The probability of successful endopyelotomy was better in patients with a preoperative pyelocaliceal volume less than 50 ml. (87%) and worse in patients with a volume greater than 50 ml. (76%). A crossing vessel to the lower pole of the kidney causing persistent functional obstruction of the ureteropelvic junction was found in 6 of the 10 patients re-treated by open pyeloplasty (9) or nephrectomy (1). Preoperative mean renal function as determined by diuretic renography was significantly lower in patients with failed endopyelotomy than in successfully treated patients. Successfully treated patients showed no change in renal function 6 and 24 months postoperatively. CONCLUSIONS: Endopyelotomy in primary ureteropelvic junction obstruction is a safe, minimally invasive procedure with a high primary success rate and a low relapse rate. Open pyeloplasty could be avoided in 86% of our patients. Endopyelotomy is less invasive, has less functional and esthetic sequelae than open pyeloplasty and does not compromise open surgery if that becomes necessary. We recommend endopyelotomy as first line treatment for patients with primary ureteropelvic junction obstruction.

Adolescent↗
PubMed1997

The value of the cervical score in predicting successful outcome of labor induction.

OBJECTIVE: To compare cervical dilation and the Bishop score as correlates of successful labor induction and vaginal delivery and to determine whether the prognosis of post-ripening cervical characteristics varies with the method of ripening used. METHODS: Four hundred forty-three women with Bishop scores less than 9 who required induction of labor were assigned randomly to cervical ripening with prostaglandin E2 gel or hygroscopic dilation. The Bishop score and its component characteristics were evaluated as univariate correlates of successful induction of labor and vaginal delivery and then were assessed using logistic regression to adjust for other maternal and fetal factors. The differences in the association between method of ripening and successful labor induction were evaluated relative to pre-ripening and post-ripening cervical examination characteristics. RESULTS: Cervical dilation was a better correlate of successful labor induction and vaginal delivery than was the Bishop score, even after exclusion of patients with initial Bishop scores greater than 6 and dilation greater than 3.0. Both ripening methods yielded similar success in labor induction and vaginal delivery, but when categorized by post-ripening cervical examinations, patients undergoing hygroscopic ripening had lower rates of successful labor induction and vaginal delivery. CONCLUSION: Cervical dilation is a better predictor of successful labor induction and vaginal delivery than either the Bishop score or any other Bishop score component characteristic. The likelihood of successful labor induction and vaginal delivery based on post-ripening cervical characteristics varies by the ripening method used.

Cervix Uteri↗
PubMed1999

A practical approach to vascular access for hemodialysis and predictors of success.

PURPOSE: The long-term results and predictors of success for vascular access at The Toronto Hospital were studied. This report describes the access program and emphasizes the role of the vascular access coordinator. METHODS: A total of 384 consecutive patients underwent 466 vascular access procedures. The access program is centered around a dedicated, full-time vascular access coordinator, who is a registered nurse and is responsible for all aspects of access care, including follow-up. Outcome variables were collected prospectively. Primary, primary-assisted, and secondary success was determined by means of Kaplan-Meier analysis, and the stepwise Cox proportional hazards model was used for multivariate analysis of the factors that were independently predictive of primary success. RESULTS: There were 235 autogenous arteriovenous fistulae (AVFs) and 231 arteriovenous grafts (AVGs). The cumulative primary, assisted-primary, and secondary success (patent and functional for effective dialysis) at 24 months for all 466 cases combined was 36% +/- 3%, 54% +/- 3%, and 66% +/- 3%, respectively. The primary success for AVFs and AVGs at 2 years was 54% +/- 4% and 18% +/- 4%, respectively (P <.001; log-rank test); the primary-assisted success for AVFs and AVGs at 2 years was 62% +/- 4% and 44% +/- 6%, respectively (P <.001; log-rank test); and the secondary success for AVFs and AVGs at 2 years was 70% +/- 4% and 60% +/- 5%, respectively (P =.331; log-rank test). Stratification of variables revealed significant benefit for AVFs (P =.001), the female sex (P =.014), and the absence of diabetes mellitus (P =.001). Multivariate analysis with Cox regression determined that access type (AVF vs AVG; P =.001) and diabetes mellitus (P =.024) were independently predictive of primary success. The improved clinical coordination of access patients with the initiation of the vascular access program resulted in a significant reduction in length of hospital stay before and after the program was organized (2.5 +/- 0.06 vs 1.1 +/- 0.03 days; P =.001). CONCLUSION: The organization of a vascular access program in a practical and cost-effective way for reduced length of hospital stay is streamlined through a dedicated access coordinator, who ensures an integrated, multidisciplinary approach. The results for the Cox model is useful when discussing the anticipated results of access procedures with individual patients.

Algorithms↗
PubMed1996

Criteria for successful breastfeeding: mothers' perceptions.

A descriptive study was conducted to determine the criteria Western Australian mothers use to decide whether their breastfeeding was successful. Successful breastfeeding tends to be measured by duration with minimal research examining breastfeeding success from mothers' perspectives. Telephone interviews were conducted with 183 mothers who were asked to classify their breastfeeding as successful or unsuccessful and identify criteria used as a basis for their decision. Nineteen women (10 unsuccessful, 9 successful) were then interviewed in depth. Content analysis revealed breastfeeding success or failure to be a personally defined experience. Four categories of criteria used to determine breastfeeding success emerged: giving, persistence, meeting expectations and accomplishing personal goals. Nurses play a significant role in promoting breastfeeding. Therefore, encouraging understanding of the mother's perspective values the uniqueness of each experience and allows nurses to assess, acknowledge and reinforce a mother's perceptions of success.

Adult↗
PubMed2002

Does breast tumor location influence success of sentinel lymph node biopsy?

BACKGROUND: Controversy exists regarding the influence of sentinel lymph node (SLN) mapping technique or patient variables on the success rate of SLN mapping. We undertook a prospective study in a single institution series to evaluate multiple variables that could adversely affect SLN identification rates. STUDY DESIGN: Data were collected on 174 patients who underwent 177 SLN mapping procedures followed by axillary dissection from October 1996 through January 2000. Patient demographics, body mass index (BMI), biopsy method, tumor size, palpability, and location were recorded. SLNs were identified by blue dye only (n = 31), Tc-99m sulfur colloid only (n = 34), or combined techniques (n = 112). Data were analyzed by logistic regression analysis and expressed as the probability of failure to map the SLN. RESULTS: SLNs were identified successfully in 150 of 177 procedures (85%) with a false negative rate of 3.7%. Mapping success reached 93% using combination blue dye and isotope. Variables found to adversely affect SLN mapping success and the odds ratio of failure (OR) included lower inner quadrant (LIQ) location (OR 35.6), blue dye only (OR 42.4), BMI >30 and upper outer quadrant (UOQ) location (OR 14.6), and nonpalpable UIQ location (OR 25). LIQ location adversely affects mapping success independent of technique, tumor size, or obesity. Obesity and nonpalpability were adverse factors when tumors were located in the UOQ and UIQ, respectively. Age, biopsy technique, and tumor diameter did not affect SLN mapping success. CONCLUSIONS: SLN mapping success is influenced by technique and tumor location, with best results achieved using combined techniques and for lesions located in quadrants other than the LIQ. Obesity and tumor palpability influence success in the context of tumor location.

Axilla↗
PubMed2004

[Predictors of success at 6-month follow-up for smokers treated at a smoking cessation clinic].

OBJECTIVE: To identify the predictors of successful outcome in a smoking cessation program at 6-month follow-up. MATERIAL AND METHODS: Cross-sectional descriptive study of a sample of smokers who attended a smoking cessation clinic for combined medical and cognitive-behavioral group therapy. The independent variables assessed included age, sex, level of education, nicotine dependence (Fagerström test), prior attempts to quit smoking, medication prescribed, compliance with group therapy regimen, and success at one week and 3 months. Success was defined as self-reported abstinence, confirmed by CO-oximetry (carbon monoxide <10 ppm). Odds ratios (with 95% confidence intervals) were calculated for the categorical variables and a test of statistical significance of differences between means was performed for quantitative variables. Univariate logistic regression analysis was performed and significant variables were entered into a multivariate logistic regression model. RESULTS: The study population comprised 248 individuals, 67.7% male and 32.3% female, with a mean (SD) age of 43.1 (10.5) years. The mean score on the Fagerström test was 6.3 (2.1) points and 84.7% of the individuals complied with the treatment regimen. Success rates were as follows: 77% at one week, 30.2% at 3 months, and 31.9% at 6 months. Three variables--success at 3 months, age, and nicotine dependence--were entered into the multivariate logistic regression model; the only variable predictive of successful smoking cessation at 6 months was success at 3 months. CONCLUSIONS: Individuals who fully comply with treatment and abstain from smoking during the first weeks are more likely to be successful at 6 months.

Adult↗
PubMed2003

Vaginal birth after Caesarean section: review of antenatal predictors of success.

OBJECTIVE: To determine antenatal factors that may predict successful vaginal birth after Caesarean (VBAC). DATA SOURCES: The MEDLINE database was searched for all English-language articles describing the impact of various factors on outcomes when VBAC is attempted. Articles reviewed included published abstracts, retrospective and prospective studies, and meta-analyses. CRITERIA FOR STUDY SELECTION: Studies were included if they reported both a control group of pregnant women without the factor under evaluation and a study group with this factor, both undergoing a trial of labour (TOL). Other criteria included accountability for all individuals enrolled at study outset, and vaginal delivery rates in both study and control groups stated or easily calculated. RESULTS: A nonrecurrent indication for previous Caesarean section (CS), such as breech presentation or fetal distress, is associated with a much higher successful VBAC rate than recurrent indications, such as cephalopelvic disproportion (CPD). Even with a history of CPD, two-thirds of women will have successful VBAC, though rates decrease with increasing numbers of prior CS. Prior vaginal deliveries are excellent prognostic indicators of successful VBAC, especially if the vaginal delivery follows the prior CS. A low vertical uterine incision does not seem to adversely affect VBAC success rates as compared to a low transverse incision. Maternal obesity and diabetes mellitus adversely affect VBAC outcomes. Fetal macrosomia does not appear to be a contraindication to VBAC, as success rates exceeding 50% are achieved and uterine rupture rates are not increased. Twin gestation does not preclude VBAC. Post-dates pregnancies may deliver successfully by VBAC in greater than two-thirds of cases. CONCLUSION: There are few absolute contraindications to attempted VBAC. Attempted VBAC will be successful in the majority of attempted cases.

Adult↗
PubMedDate not supplied

Success and complication rates with prehospital placement of an esophageal-tracheal combitube as a rescue airway.

INTRODUCTION: Previous studies have proven the success of the Esophageal-Tracheal Combitube (ETC) as a primary airway, but not as a rescue airway. OBJECTIVE: The object of this study was to observe success and complication rates of paramedic placement of an ETC as a rescue airway, and to compare success rates with endotracheal tube (ETT) intubation. The primary outcome indicator was placement with successful ventilation. Complication rates, esophageal placement, and return of spontaneous circulation (ROSC) were secondary measures. METHODS: A retrospective review of the records of patients who had ETC attempts by Emergency Medical Services (EMS) was conducted for a period of three years. Complications were defined a priori. The ETC is used primarily as rescue airway for a failed attempt at an endotracheal tube (ETT) intubation. A control group for ETT placements was drawn from the EMS quality assurance (QA) database for the same period. RESULTS: Esophageal-Tracheal Combitube insertion was attempted on 162 patients, of which, 113 (70%) were successful, 46 (28%) failed, and the outcome of three (2%) was not recorded. Inability to place the ETC occurred in 29 (18%) patients, and accounted for 48% (22/46) of failures. The use of the ETC caused dental trauma in one patient, and one placement of the ETC was related to the onset of subcutaneous emphysema. Blood in the ETC from active upper gatrointestinal bleeding occurred in nine patients (6%), and four tubes (3%) became dislodged en route to the hospital. The apriori complication rate was 44/162 (27%). Inability to determine placement of the ETC due to emesis from both ports occurred in 21 cases. Combining these problems with the apriori complications, the overall rate was 40% (65/162). Esophageal-Tracheal Combitube location was noted in a subset of 90 charts, of which, 76 (84%) were esophageal, and 14 (16%) were tracheal. Thirteen of 126 (10%) patients in cardiac arrest had return of spontaneous circulation (ROSC) in the field after placement of the ETC. An ETT was attempted in 128 control patients, of which, 107 (84%) were successful, 21 (16%) failed (odds ratio (OR) for ETT vs. ETC = 2.1; 95% CI = 1.12-3.86). CONCLUSION: Despite a low ROSC rate, the complication and success rates of ETC are acceptable for a rescue airway device. Tracheal placement of the Combitube is uncommon, but requires fail-safe discrimination. Similar to previous reports, the success ratio for ETT was greater than for the ETC.

California↗
PubMed2002

Clinical predictors of successful cephalic vein access for implantation of endocardial leads.

BACKGROUND: The purpose of this study was to determine whether there are any patient characteristics that predict successful use of the cephalic vein for endocardial lead implantation. METHODS: One-hundred fifty consecutive patients who underwent implantation of one or more endocardial pacemaker (N = 63) or defibrillator (N = 87) leads using a cephalic vein approach were included in this prospective study. The mean age of the patients was 63 +/- 14 years, and 115 (77%) were men. Ninety-one patients (61%) had coronary artery disease, 77 patients (51%) had hypertension, and 42 patients (28%) had diabetes. The mean ejection fraction was 0.34 +/- 0.17. RESULTS: At least one lead was successfully implanted using a cephalic vein approach in 96 patients (64%). The most common reason for failure of the cephalic vein approach was a small cephalic vein, found in 25 patients (17%). Independent predictors of successful cephalic vein use were diabetes (p < 0.001), ejection fraction < or = 0.40 (p < 0.05), and male gender (p < 0.05). At least one endocardial lead was implanted in 19 of the 24 (79%) men who had an ejection fraction < or = 0.40 and diabetes, compared to 4 of the 11 (36%) women who had an ejection fraction > 0.40 and did not have diabetes. The only independent predictor of successful cephalic vein implantation among nondiabetics was an ejection fraction < or = 0.40 (p < 0.01). Body size was not an independent predictor of successful cephalic vein use. CONCLUSION: Baseline patient characteristics influence the likelihood of successful endocardial lead implantation using a cephalic vein approach. Diabetes, ventricular dysfunction, male gender and are associated with an increased likelihood of a successful implant using the cephalic vein. Smaller leads and and better techniques are needed to improve the success rate of cephalic vein implantation in all patients.

Aged↗
PubMed2003

The impact of committee characteristics on the success of healthcare ethics committees.

Despite the increase in number and importance of healthcare ethics committees (HECs), little is known about how successful HECs are and what characteristics contribute to their success. The current study attempted: (1) to examine the effect of respondent backgrounds on the self-reported success and characteristics of HECs, (2) to describe the current success status of HECs, and (3) to explore how committee characteristics are related with the success. Questionnaires on characteristics of respondents and committees as well as the rating of success were distributed to 962 acute care hospitals with 300 beds or more across the United States in the calendar year 2000. A total number of 294 chairpersons and 223 members from 334 ethics committees responded to the survey, yielding a 35% response rate. Statistical analyses on the survey data found that the length of services on committees (seniority) and the size of committees were significant contributors to the perceived success of committees. The significant association of seniority suggests that future studies should control for the effect of seniority, possibly using multivariate modeling methods. The more success perceived by large committees indicates a need for small committees to increase the size of their committees so that they can expand their expertise to resolve the wide variety of current issues.

Cross-Sectional Studies↗
PubMed2001

The influence of male parr body size and mate competition on fertilization success and effective population size in Atlantic salmon.

Alternative mating strategies in male Atlantic salmon, Salmo salar, are characterized by variability in body size and mate competition. Controlling breeding numbers of larger, older anadromous males, we examined whether body size of mature male parr influenced fertilization success and whether such an association was affected by mate competition among parr. Variation at three to four hypervariable microsatellite loci was used to determine individual paternity of 53-60 offspring from two or three nests from each experimental treatment. Although individual and total parr reproductive success differed significantly among nests within treatments, there was no relationship between parr size and individual reproductive success at any level of competition when anadromous males were involved. However, in a single treatment having no anadromous male, the influence of body size on parr fertilization success was highly significant. Combining data from all treatments, parr body size was an important predictor of the probability of an individual being involved in spawning. We found a negative relationship between total parr reproductive success and intensity of anadromous male competition. To our knowledge, the present study is the first to estimate the effective number of males from individual fertilization success in fish. Our estimates of Ne should not be taken as absolute and may have a downward bias because we did not sample all nests and we used a proxy for lifetime reproductive success. They do, however, illustrate how mature male parr can greatly increase the effective number of males when the latter is estimated from anadromous individuals alone. Although reproductive success by mature male parr increases the effective number of males, this increase seems likely to be most pronounced in natural populations when the number of anadromous males is low.

Animals↗
PubMed2002

Reproductive success in reindeer males in a herd with varying sex ratio.

In polygynous species, male reproductive success is often correlated with dominance status of individual males and sex ratio in the population. Reindeer, Rangifer tarandus, is a polygynous species, and here we compared the variation in male reproductive success and dominance status during two successive years in a herd with a male:female sex ratio of 1:7 and 1:3. Copulations were recorded, together with data on male dominance hierarchy and size of mating groups. Male reproductive success was estimated by paternity analysis of calves using microsatellite DNA markers. The distribution of reproductive success among the males was highly skewed for both years with the most dominant male also being the most successful. The largest mating group was established in the herd with the least skew in sex ratio. In this herd some of the adult males present were less reproductively successful than some of the more subordinate younger males. Estimates of the mating group size of males, correcting for dominance status when more than one male is present in the groups, gave good prediction of individual males' reproductive success.

Animals↗
PubMed2003

High-energy transurethral microwave thermotherapy: symptomatic vs urodynamic success.

OBJECTIVE: To evaluate the subjective and objective treatment results of high-energy transurethral microwave thermotherapy (TUMT) for symptomatic benign prostatic hyperplasia (BPH), and investigate the possible variables for predicting symptomatic and/or urodynamic success. PATIENTS AND METHODS: Between October 1998 and October 2000, 40 men with BPH underwent high-energy TUMT using the Targis device (Urologix, Inc., Minneapolis, MN, USA). Evaluation after treatment included a clinical determination of the symptom score, a urodynamic assessment by peak flow rate and pressure-flow, magnetic resonance imaging (MRI), transrectal ultrasonography and endoscopy. The objective and subjective success was correlated with several variables before, during and after treatment. RESULTS: All patients completed at least 1 year of follow-up after TUMT as monotherapy. The symptom score improved from a median (range) of 20.5 (11-28) initially to 9 (0-28) (P < 0.001). Twenty-two patients (55%) had a marked and 11 (28%) a moderate response, giving an overall subjective success rate of 83%. Similarly, there was a significant improvement in peak flow rate, from 9.2 (4.4-13.4) to 15 (3.3-22.9) mL/s (P < 0.001). Twenty-one patients (53%) had a maximum flow rate of > 15 mL/s while in eight (20%) it was 10-15 mL/s. Only 20 patients changed from unobstructed on the pressure-flow nomogram, i.e. an overall objective success rate of 50%. Gadolinium-enhanced T1-weighted MRI 1 week after treatment showed a median (range) perfusion defect of 20.7 (5.5-76.6)% of the total gland volume. Despite this persisting in all patients, a well-defined cavity was apparent in only in seven (18%) at the final evaluation. Cystoscopy 1 month after therapy showed evidence of necrotic tissue occupying the prostatic fossa in all patients. Younger patients were more likely to be urodynamically successful, and a higher grade of obstruction predicted symptomatic success. CONCLUSION: High-energy TUMT can induce considerable necrosis of the prostate, as shown by MRI and cystoscopy. Although there was an adequate improvement in most patients' symptoms, there was a successful urodynamic change to unobstructed in only half the patients. Younger patients and those with a higher grade of obstruction were more likely to have urodynamic and symptomatic success, respectively.

Aged↗
PubMedDate not supplied

Successful interscalene block with a nerve stimulator may also result after a pectoralis major motor response.

BACKGROUND AND OBJECTIVES: Interscalene block of the brachial plexus is a well-established anesthetic and analgesia technique for shoulder surgery. The endpoint for successful block using the nerve stimulator has been described by previous authors as a bicep motor response (twitch) and recently by a deltoid motor response. This retrospective observational case study of regular clinical practice examined the efficacy of using the pectoralis major motor response as an endpoint for a successful block. METHODS: A total of 120 patients who were scheduled for elective ambulatory shoulder surgery were retrospectively studied. All interscalene blocks were performed with aid of a nerve stimulator. Patients were categorized into 3 groups of 40 patients. Group 1 (biceps twitch), group 2 (deltoid twitch), and group 3 (pectoralis major twitch) were compared on success of the block. This retrospective study was conducted by reviewing interscalene block data sheets from the last 40 patients consecutively receiving interscalene block from either a bicep, deltoid, or pectoralis major motor response. A successful block was defined by the inability of the patient to raise their arm against gravity 20 minutes after injection of the local anesthetic. RESULTS: Pectoralis major motor response as an endpoint for local anesthetic injection was examined. Of 40 patients studied in this group, 38/40 were judged successful. This was comparable to the success rate in biceps (38/40 successful) and deltoid groups (37/40 successful). CONCLUSIONS: This retrospective observational case study of regular clinical practice suggests that a pectoralis major motor response can be a satisfactory endpoint for interscalene block.

Adult↗
PubMed2006

Creativity enhancement: possibilities for successful aging.

Successful aging is of growing importance in the U.S. Many researchers have explored the phenomenon using various approaches, yet we are still lacking practical guidelines on how to promote successful aging in older adults. The Roy Adaptation Model supports the promotion of adaptation to chronic health problems at a time when one's overall health may be declining and is a useful guide for understanding successful aging. Current literature also suggests that functional performance and creativity are important in order to age successfully. This study examined the relationships between functional performance, creativity, and successful aging within the context of the Roy Adaptation Model. Although creativity was not significantly predictive of successful aging, functional performance was a statistically significant predictor of a successful aging indicator, purpose in life. The study was a pretest-posttest experimental design investigating the effects of a creativity enhancement intervention in older adults. Although the intervention did not appear to increase creativity or successful aging, there were some statistically significant results and valuable findings about the possibilities for creativity enhancement.

Activities of Daily Living↗
PubMed2005

Long-term follow-up of external dacryocystorhinostomy and the factors affecting its success.

AIM: To evaluate the long-term follow-up results of external dacryocystorhinostomy (Ex-DCR) and to assess the role of some factors in its success. PATIENTS AND METHODS: Between January 1990 and November 2002, 437 nasolacrimal systems of 387 patients were operated on and included in the study. The success rates were determined on the basis of the last examinations of the patients, and the correlations between success rates and factors such as age, gender, the duration of obstruction, history of acute dacryocystitis, the side of obstruction, and the postoperative follow-up period were calculated. RESULTS: The mean follow-up period was 5.9 +/- 2.5 years. Fifty cases (12.9%) were operated bilaterally. The initial success rate was 91.5% and the last success rate was 98.4% after reoperations. We found meaningful correlations between success and duration of obstruction, age of the patient, and the duration of postoperative follow-up (r = 0.18, 0.17 and -0.14, p = 0.036, 0.001 and 0.002, respectively). DISCUSSION: In comparison to newly developed surgical techniques for the treatment of nasolacrimal duct obstruction, Ex-DCR still appears to offer higher success rates, even after long-term follow-up. In addition to being a cost-effective procedure, it requires no sophisticated instruments. In our opinion, the high success rates may be explained by the nature of the operation, which creates a fistula between the sac and the nasal mucosa.

Adolescent↗
PubMed2000

Recanalization of chronic total coronary occlusions: the impact of a new specific guidewire on primary success rate.

BACKGROUND: Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has yet to be devised. Various new guidewires have been designed in an attempt to negotiate chronic occlusions successfully. The authors have analysed the impact of the Athlete guidewire on procedural success in this lesion subset. METHODS: Sixty-two consecutive patients undergoing percutaneous intervention for chronic total occlusions over a two-year period were retrospectively studied. For the initial attempt, conventional guidewires were used. In case of failure, further attempts were made using the Athlete guidewire. Procedural success rates with the use of conventional and Athlete guidewires were assessed. RESULTS: Failure of the first attempt with the conventional guidewire occurred in 32 (51.6%) patients and success was achieved in 30 (48.4%) patients. In the former patients, a second attempt was made using the Athlete guidewire to cross the occlusion. The second attempt was successful in 20 patients (60%) in whom the first attempt was unsuccessful, while in the remaining 12 (40%) patients the occlusion could not be crossed even during the second attempt and the procedure was then terminated. Following the use of the Athlete guidewire, the success rate increased to 62% (p < 0.001). No complication occurred during the first attempt, while one patient had a coronary perforation using the Athlete guidewire, which was managed successfully without the need for bypass surgery. CONCLUSION: The use of the Athlete guidewire is feasible and safe, and enhances the chances of successfully treating chronic total occlusions during percutaneous coronary revascularization procedures.

Journal Article↗
PubMed2006

Long-term success of antegrade endopyelotomy compared with pyeloplasty at a single institution.

BACKGROUND AND PURPOSE: The classic standard for surgical repair of ureteropelvic junction (UPJ) obstruction has been open pyeloplasty, with a 95% success rate. Antegrade endopyelotomy is a less-invasive option with a slightly lower success rate. However, recent data call into question the long-term durability of UPJ repair. We present the long-term success of treatment of UPJ obstruction comparing these two modalities. PATIENTS AND METHODS: We reviewed the medical records of patients undergoing percutaneous antegrade endopyelotomy or open and laparoscopic pyeloplasty for UPJ repair in our practice from 1988 to 2004. Success was defined as both radiographic and symptomatic improvement. We evaluated the impact of preoperative factors, including prior surgical repair, crossing vessels, renal function, and calculi, on success. RESULTS: The estimated 3-, 5-, and 10-year recurrence-free survival rates for the endopyelotomy group (N = 182) were 63%, 55%, and 41%, respectively, compared with 85%, 80%, and 75% for the pyeloplasty group (N = 175; P < 0.001). Of the failed endopyelotomies undergoing salvage open repair, 8 of 26 (31%) had crossing vessels. Poor renal function and previous failed pyeloplasty decreased success in the pyeloplasty group. Variation from standard cold-knife incision adversely affected endopyelotomy success. CONCLUSIONS: Long-term success rates after both endopyelotomy and pyeloplasty are worse than previously reported. Although most failures in both groups occurred within 2 years, failures continue to appear after 5 and 10 years, and patients should be followed accordingly. In view of these results of endopyelotomy, laparoscopic pyeloplasty may prove to be the preferred minimally invasive approach to repair UPJ obstruction.

Adolescent↗