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At least 1,135 records · Page 63Linked to original sources
PubMed2004

Management of patients with two consecutive ASC-US smears.

INTRODUCTION: To determine whether aggressive or expectative management of patients after two consecutive smears with atypical squamous cells of undetermined significance is preferable. To determine whether triage with high-risk human papillomavirus will identify all patients with cervical intraepithelial neoplasia grade 2 and 3. METHODS: 140 of 282 patients referred for colposcopy with two consecutive smears with atypical squamous cells of undetermined significance were only treated when abnormalities suggestive of high-grade cervical intraepithelial neoplasia were present at colposcopy. The other 142 patients underwent excision of all detected colposcopic abnormalities. Both groups were compared regarding the final cytological follow-up, the number of diathermy loop excisions, and the detection of cervical intraepithelial neoplasia. Retrospectively, the outcome of triage with high-risk human papillomavirus in the first group was investigated. RESULTS: There was no significant difference in final cytological follow-up between patients managed by expectative or by aggressive colposcopic management. Significantly less diathermy loop excisions (p < 0.001) are performed in case of expectative management. The sensitivity, specificity, negative- and positive predictive values of triage with high-risk human papillomavirus detection were comparable with those of colposcopy alone. CONCLUSIONS: Patients referred with two consecutive ASC-US smears may be followed with an expectative colposcopic management and cytological follow-up. Triage with high-risk human papillomavirus will reduce the number of referrals and colposcopies, but (cytological) follow-up remains necessary in all high-risk human papillomavirus negative patients as well.

Colposcopy↗
PubMed2005

Correlation between perceptual, visuo-spatial, and psychomotor aptitude to duration of training required to reach performance goals on the MIST-VR surgical simulator.

Given the dynamic nature of modern surgical education, determining factors that may improve the efficiency of laparoscopic training is warranted. The objective of this study was to analyze whether perceptual, visuo-spatial, or psychomotor aptitude are related to the amount of training required to reach specific performance-based goals on a virtual reality surgical simulator. Sixteen MS4 medical students participated in an elective skills course intended to train laparoscopic skills. All were tested for perceptual, visuo-spatial, and psychomotor aptitude using previously validated psychological tests. Training involved as many instructor-guided 1-hour sessions as needed to reach performance goals on a custom designed MIST-VR manipulation-diathermy task (Mentice AB, Gothenberg, Sweden). Thirteen subjects reached performance goals by the end of the course. Two were excluded from analysis due to previous experience with the MIST-VR (total n = 11). Perceptual ability (r = -0.76, P = 0.007) and psychomotor skills (r = 0.62, P = 0.04) significantly correlated with the number of trials required. Visuo-spatial ability did not significantly correlate with training duration. The number of trials required to train subjects to performance goals on the MIST-VR manipulation diathermy task is significantly related to perceptual and psychomotor aptitude.

Adult↗
PubMed1991

[Conservative endoscopic treatment of urothelial cystic dysplasia of the upper urinary tract].

We highlight the importance of the new diagnostic possibilities afforded by ureterorenoscopy and nephroscopy in the differential diagnosis of single or multiple cystic dysplasia of the upper excretory tract. Moreover, endoscopic treatment was performed in the two cases reported herein. In the first case the biopsy procedure was also therapeutic and in the second case cyst removal resolved the ureteral obstruction. Because the disease is detected infrequently and because treatment may be required even less frequently, several technical solutions have been applied to assess efficacy and reliability. Diathermy coagulation has proved to be the safest, fastest and the most effective. Follow-up has documented the absence of recurrence and good reepithelialization of the ureteral wall without progression to stricture. In those cases with single cyst, one-stage diathermy loop resection permits obtaining biopsy material and radical removal of the neoformation.

Carcinoma, Transitional Cell↗
PubMed1991

Laser surgery for cervical intraepithelial neoplasia.

The laser has provided a relatively easy and safe method for treating all types of CIN. The advantages of lasers include great conservatism due to tissue sparing, great precision because of microsurgical method, combination of excisions and vaporization possible, suitable for therapy of multifocal disease, uncluttered field, and good hemostasis. Although other modalities have also been used successfully in the therapy of this disease, it appears that none are so versatile as CO2 laser or possess its ability to accurately treat the multifocal disease that may involve large surface areas of the lower reproductive tract. It seems unlikely that any of the cervical ablation methods--chemical destruction, hot cautery, diathermy electrode, cryoprobe, laser, and diathermy loop--will completely disappear from use in the near future. Ablation is an attractive alternative to cold-knife excision in properly triaged patients, since it is almost always an outpatient procedure done without anesthesia or with only local anesthesia. Most importantly, a large number of patients have completely visible lesions of a severity less than that of in situ cancer; they really do not need excisional conization by any technique and benefit by quick ablation of the transformation zone. A conization, to be diagnostic and therapeutic, must remove the entire transformation zone to the proper depth. This procedure is almost always attended by a higher morbidity rate than is simple ablation. Laser excisional conization and the large loop excision of the transformation zone procedure are similar in a number of respects, because the operator must have certain capabilities and a through understanding of the disease to be treated to perform the operation correctly.

Carcinoma in Situ↗
PubMed1987

[Carcinoma in situ of the conjunctiva bulbi. Clinical and histopathologic findings].

The present paper communicates clinical and pathohistologic findings in a case of carcinoma in situ of the conjunctiva (Bowen's disease) with a five-year course. Initially, there are clinical similarities between Bowen's disease and Mooren's ulcer; the diagnosis can be established on the basis of the histologic findings. In this case the clinical picture at first resembled that of Mooren's ulcer. An epithelial dysplasia was confirmed histologically following perilimbal conjunctivectomy. A year later the dysplasia was found to have progressed and was treated by diathermy coagulation. At the check-up examination three months later the tumor had diminished in size. Four years later, however, it had redeveloped. As a rule, tumor excision is the treatment of choice. In the case described here it was first coagulated by diathermy because of its great extent, but this only brought the tumor to a temporary standstill.

Basement Membrane↗
PubMed1984

[Critical review of the therapy of juvenile laryngeal papillomas].

At present no causal method is known for the treatment of juvenile papillomatosis of the larynx, which is probably caused by a virus. The data of 627 patients compiled between 1944-1982 and published in 32 reports, showed no significant preponderance of any of the three most frequently applied methods of treatment (excision including suction diathermy, destruction via laser beams and ultrasonic application). Our own observations showed that after an average of three operations by means of suction diathermy, a recurrence-free period of more than three years was achieved in 54.4% of the children (n = 16) and in 72.2% of the adults (n = 30). Improvement in the treatment of papillomas is due only to the definite reduction in tracheotomies and in cicatrization of the larynx.

Adolescent↗
PubMed1984

[Endocavitary fulguration. A new method of treating arrhythmia?].

Endocavitary diathermy consists of transmitting the energy of a defibrillator shock to the tip of an intracardiac catheter. The circuit is completed via a neutral plate placed under the patient's back. Energies in the order of 200 to 300 joules produce an electric arc at the catheter tip which causes an abrupt variation in pressure and the creation of a shock wave which modifies the myocardial structures directly in contact with the catheter. This method, which was originally used to treat supraventricular arrhythmias by interrupting the conduction in the His bundle, has recently been extended to the treatment of resistant ventricular tachycardia, and has even been used to interrupt the accessory pathway in certain cases of Wolff-Parkinson-White syndrome. The authors report the basic experimental data and the clinical results obtained with this method in the treatment of 20 cases of arrhythmia, especially in various types of ventricular tachycardia. The very promising results obtained, particularly in cases of ventricular tachycardia, suggest that this is a radical method which can be extended to patients unable to support a surgical operation. Although the follow-up period is only short, these results are encouraging. They confirm the basic principle of diathermy in the treatment of supraventricular tachycardia by interruption of the conduction in the His bundle and for the radical treatment of chronic ventricular tachycardia unresponsive to medical treatment. However, a longer follow-up period is required before we can demonstrate the long term effectiveness of this new therapeutic method.

Adolescent↗
PubMed1978

[Forty years' contemporary retinal detachment surgery (author's transl)].

A survey is given on the evolution of retinal detachment surgery during the past four decades. Contributions of the ophthalmological school of Vienna are particularly considered. The review includes simple diathermy-coagulation with subretinal drainage, the undermining operation of Lindner and his eye ball shortening procedure, the combined operation (sealing of retinal breaks by diathermy plus scleral resection), and vitreous tamponade using sodium hyaluronate. All these methodes have been widely replaced during the past years by cryopexy with plombage, and by encircling procedures. Though the rate of success could not be definitely increased, the introduction of the modern methods implies technical facilities for the eye surgeon, and advances for the treated patients. The evolution of retinal detachment surgery is not yet terminated, and further progress can be taken as granted. Retinal detachment surgery with very short hospitalization may become practicable in near future.

Austria↗
PubMedDate not supplied

[Changes in pacemakers and the wearers of pacemakers as a result of the use of different electromagnetic energy sources].

Over the past decade there have been considerable advances in cardiac electrostimulation technologies. However, there are still reports of electromagnetic interference with pacemakers and pacemaker patients. We have studied the effects of various electromagnetic sources (short-wave diathermy, electrosurgical knives, electrotherapy and radiofrequencies) on both humans and animals. The results of the studies were completely negative and, therefore, we are convinced that today's pacemakers are much more reliable and hence less subject to interference from external electromagnetic sources. We performed the following tests: (a) Short-wave diathermy: various electrode positions in pigs and 8 patients with pacemakers. (b) Electrosurgical knives: several tests on pigs with unipolar electrosurgical knife; 6 tests on humans during automatic defibrillator implantation using two-pole electrosurgical knives; 23 pacemaker patients underwent abdominal surgery (3 inguinal hernias, 12 gastric resections; 6 cholecystotomies, 2 aortic aneurysms-with two-pole electrosurgical knives). (c) Electrotherapy (TENS): on pigs. (d) Radiofrequency (RF) for transcatheter ablation-several tests on pigs.

Animals↗
PubMed1994

Physical modalities in rheumatological rehabilitation.

Physical modalities continue to be a part of the rehabilitation treatment of patients with arthritis. Databases Medline (1980-1992) and National Rehabilitation Information Center, Rehabdata (1956-1992), were searched for "arthritis" and (1) diathermy, (2) massage, (3) transcutaneous electrical nerve stimulation (TENS), (4) hydrotherapy, (5) counter-irritants, (6) topical ointments, (7) compression gloves, (8) superficial heat, and (9) acupuncture. The results suggest that scientific publication related to the treatment of arthritis with physical modalities has been recently less frequent. The literature reviewed suggested that ablative diathermy may be fruitful for wider trials for persistently inflamed joints, and TENS and capsaicin can provide pain relief in osteoarthritis if it is possible to deliver the treatment fully and persistently.

Acupuncture Therapy↗
PubMed1993

A randomized clinical trial of manual therapy and physiotherapy for persistent back and neck complaints: subgroup analysis and relationship between outcome measures.

OBJECTIVE: To study the efficacy of manual therapy and physiotherapy in subgroups of patients with persistent back and neck complaints. The second objective was to determine the correlation between three important outcome measures used in this trial. DESIGN: Randomized clinical trial (subgroup analysis). SETTING: Primary health care in the Netherlands. PATIENTS: Two hundred fifty-six patients with nonspecific back and neck complaints of at least 6 wk duration who had not received physiotherapy or manual therapy in the past 2 yr. INTERVENTIONS: At the discretion of the manual therapists, physiotherapists and general practitioners. Physiotherapy consisted of exercises, massage and physical therapy (heat, electrotherapy, ultrasound, shortwave diathermy). Manual therapy consisted of manipulation and mobilization of the spine. Treatment by the general practitioner consisted of drugs (e.g., analgesics), advice about posture, home exercises and (bed)rest. Placebo treatment consisted of detuned shortwave diathermy (10 min) and detuned ultrasound (10 min). MAIN OUTCOME MEASURES: Changes in severity of the main complaint and limitation of physical functioning measured on 10-point scales by a blinded research assistant and global perceived effect measured on a 6-point scale by the patients. RESULTS: Improvement in the main complaint was larger with manual therapy (4.3) than with physiotherapy (2.5) for patients with chronic conditions (duration complaint of 1 yr or longer). Also, improvement in the main complaint was larger with manual therapy (5.5) than with physiotherapy (4.0) for patients younger than 40 yr (both were measured after 12-mo follow-up). Labeling of patients by the treating manual therapists as "suitable" or "not suitable" for treatment with manual therapy did not predict differences in outcomes. Generally, there was a moderate to strong correlation between the three outcome measures, although a considerable number of patients gave a relatively low score for perceived benefit, while the research assistant gave a high improvement score for the main complaint and physical functioning. CONCLUSIONS: The subgroup analysis suggests better results of manual therapy compared to physiotherapy in chronic patients (duration of present complaints of 1 yr or longer) and in patients younger than 40 yr old). Differences for other subgroups were less clear. The explorative findings of these subgroup analyses have to be investigated in future research.

Adult↗
PubMed1993

[Use of diode laser in transcleral retinal photocoagulation].

Transscleral retinal photocoagulation using a diode laser emitting infrared radiation (810 nm) was performed on 8 rabbits. Examination was performed at 2 days, one month and three months after photocoagulation. The retinal burns were examined by light and electron microscopy and were found to be similar to those produced by argon and krypton photocoagulations. Histopathologic evaluation of the lesions demonstrated an intact sclera overlying the chorioretinal lesions. The results of the present experimental study support the hypothesis that transsccleral retinal photocoagulation using diode laser in selected indications may be a valuable alternative to cryotreatment and diathermy in the human eye. The absence of scleral damage and pigmented epithelium cell dispersion as well as the decreased break down of the blood ocular barrier after transscleral diode laser photocoagulation are the main advantages of the technique as compared to transscleral diathermy and cryotreatment.

Animals↗
PubMed1995

[The use of pulsed and continuous UHF electrical fields in the rehabilitation of patients with the Guillain-Barré syndrome and other peripheral myelinopathies].

120 patients with Guillain-Barre syndrome and other peripheral myelinopathies were randomly assigned to three treatment groups. One of the group was exposed to pulsed high frequency electric field (47 patients), the other group to continuous current (52 patients), and the third group received the imitation of therapy (21 patients). Pulsed current therapy caused the greatest regress of the neurological deficit (45 from 47 cases). The electroneuromyography of paretic limbs nerves showed that the acceleration of remyelinization process turn to be the background of pulsed high frequency electric field medical action. Both the rheovasography and isotope muscle flow measurements did not confirm the hypothesis about preferential mediation of the healing potency of pulsed short wave diathermy through vascular mechanism. It was suggested the direct influence of pulsed short wave diathermy on protein synthesis process in the spinal alpha-motoneurone and myocyte.

Adolescent↗
PubMed1996

New application of bipolar coagulation in laparoscopic surgery.

Bipolar electrocautery is associated with a lower risk of tissue injury from an inadvertent energy transfer compared with monopolar diathermy, and bipolar coagulation has been effectively employed in obstetric and gynecologic procedures. The present report describes the successful use of bipolar diathermy during general laparoscopic surgery. Hemostasis and closure of even large vessels was possible with the use of bipolar forceps during laparoscopic cholecystectomy, fundoplication, appendectomy, and highly selective vagotomy procedures. No intraoperative complications resulting from bleeding were apparent in this series of 296 laparoscopic operations, nor were any postoperative complications suggestive of inadvertent tissue damage, such as peritonitis, apparent. Thus, these results suggest that bipolar coagulation can be used safely and without difficulty in laparoscopic surgical procedures.

Electrocoagulation↗
PubMed1997

Treatment of chronic cervicitis: the loop electrosurgical excision procedure.

The effectiveness and morbidity of excisional biopsy of cervical tissue using the electrosurgical excision procedure for the treatment of chronic cervicitis was investigated. In this study, loop diathermy was used in the treatment of one hundred patients with chronic cervicitis. Before the procedure, cervical smear and colposcopic examination were done. Then the loop diathermy was performed under local anesthesia. All the removed specimens were evaluated histopathologically. The mean operation time was 6.34 +/- 1.37 minutes. The complication of bleeding and secondary infection were 5% and 4%, respectively. All the patients had normal cervical smear (Papanicolaou class I or II). In the microscopic evaluation, thermal damage of the removed specimens were negligible. Six cases (6%) with CIN (CIN I = 4, CIN II = 2) were determined and the others (94%) were reported as chronic cervicitis in the histopathologic examinations of the removed specimens. After the operation, these cases with CIN were followed up for one year with cervical smears and colposcopic examinations. One of the six patients with CIN had recurrence and underwent cold-knife conization. This new technique is simple, quick and cheap. It can be used confidently to provide both diagnosis and treatment with minimal thermal tissue injury in cases with chronic cervicitis.

Biopsy↗
PubMed1976

Traumatic hyphema: treatment of secondary hemorrhage with cyclodiathermy.

Four patients were treated with diathermy applications to the ciliary body for recurrent hemorrhage and elevated intraocular pressure following traumatic hyphema. In all cases, the hemorrhage and intraocular pressure were controlled without major complications. Indications for use of diathermy include a patient with recurrent secondary hemorrhage or a clotted hyphema, with elevated intraocular pressure or corneal blood-staining, in whom a site of bleeding can be identified during surgical intervention.

Adult↗
PubMed1964

A NEW DIAGNOSTIC SIGN IN NECK INJURIES.

The aggravation of neck pain and headache as a result of the use of diathermy or other forms of energy in the treatment of neck sprain may represent a diagnostic sign by which to distinguish severe injury of the neck from simple sprain. In the case of simple neck sprain, the patient's complaints may be inadvertently continued more or less indefinitely by the use of high frequency energy or even locally applied heat. That recovery sometimes follows settlement of litigation in such cases may be due not to the award of money but to discontinuance of an aggravating medical treatment.

Accidents, Traffic↗
PubMed1978

Indirect traumatic rupture of the globe.

Indirect rupture of the globe was found to be a rare injury, more common in males (P less than .01), and having a tendency to involve the left eye. Severe chemosis, a hyphema, and hypotony were usually present, but the intraocular pressure was elevated in three eyes. Of the 50 ruptures in this study, 41 were at the equator or anterior to it (P less than .01), and 37 were parallel to the equator. Thirty-three of the 41 anterior ruptures were located in the superior half of the eye. The nasal-superior quadrant between the limbus and spiral of Tillaux, the temporosuperior quadrant between the spiral of Tillaux and 5 mm posterior to the equator, and the temporosuperior quadrant between the limbus and spiral of Tillaux were the three most common areas involved, in decreasing order of frequency. A theory has been described to explain this distribution. The absence of a hyphema (P less than .001), the presence of a rupture of 9 mm or less (P less than .01), and the use of cryotherapy or diathermy at the wound edge at the time of closure of the rupture (P less than .01) were all good prognostic signs. The visual outcome was light perception or worse in 45 of the 50 ruptures, but every effort must be made to preserve the eye rather than to remove it.

Adolescent↗