METHODS: High-frequency ultrasound (HFU) images of 30 wounds were acquired in a controlled environment on post-debridement days 7, 14, 21, and 28. Meaningful features portraying changes in structure and intensity of echoes during healing were extracted from the images, their relevance and discriminatory power being verified by analysis of variance. Relative analysis of tissue healing was conducted by developing a features-based healing function, optimised using the pattern-search method. Its performance was investigated through leave-one-out cross-validation technique and reconfirmed using principal component analysis.
RESULTS: The constructed healing function could depict tissue changes during healing with 87.8% accuracy. The first principal component derived from the extracted features demonstrated similar pattern to the constructed healing function, accounting for 86.3% of the data variance.
CONCLUSION: The developed wound analysis technique could be a viable tool in quantitative assessment of diabetic foot ulcers during healing.
METHODS: A prospective quasi experimental study was conducted by enrolling 450 patients from tertiary care hospital of Lahore, Pakistan, 225 patients in each, control and intervention, arm using non-random convenient sampling. The study parameters included antibiotic indication, choice, dose, frequency, duration and associated costs. This study is registered with Chinese Clinical Trial Registry # ChiCTR-OON-17013246.
RESULTS AND CONCLUSION: After educational intervention, in post-intervention arm, total compliance in terms of correct antibiotic choice, dose, frequency and duration increased from 1.3% to 12.4%. The rate of inappropriate antibiotic choice did not change significantly. After intervention only metronidazole utilization decreased (16%) significantly (p=0.011). Significant reductions were observed in mean duration of antibiotic prophylaxis (17%, p=0.003), average number of prescribed antibiotics (9.1%, p=0.014) and average antibiotic cost (25.7%, p=0.03), with reduction in mean hospitalization cost (p=0.003) and length of stay (p=0.023). Educational intervention was significantly associated (OR; 2.4, p=0.005) with appropriate antibiotic prophylaxis. The benefit of pharmacist intervention, mean antibiotic cost savings to mean cost of pharmacist time, was 4.8:1. Thus, the educational intervention resulted in significant reductions in the duration and average number of antibiotic use having considerable effect on therapy and hospitalization cost.
SETTING: An academic medical center.
METHODS: Weight changes of patients who received weight loss medications after bariatric surgery from 2012 to 2015 at a single center were studied.
RESULTS: Weight loss medications prescribed for 209 patients were phentermine (n = 156, 74.6%), phentermine/topiramate extended release (n = 25, 12%), lorcaserin (n = 18, 8.6%), and naltrexone slow-release/bupropion slow-release (n = 10, 4.8%). Of patients, 37% lost>5% of their total weight 1 year after pharmacotherapy was prescribed. There were significant differences in weight loss at 1 year in gastric banding versus sleeve gastrectomy patients (4.6% versus .3%, P = .02) and Roux-en-Y gastric bypass versus sleeve gastrectomy patients (2.8% versus .3%, P = .01).There was a significant positive correlation between body mass index at the start of adjuvant pharmacotherapy and total weight loss at 1 year (P = .025).
CONCLUSION: Adjuvant weight loss medications halted weight regain in patients who underwent bariatric surgery. More than one third achieved>5% weight loss with the addition of weight loss medication. The observed response was significantly better in gastric bypass and gastric banding patients compared with sleeve gastrectomy patients. Furthermore, adjuvant pharmacotherapy was more effective in patients with higher body mass index. Given the low risk of medications compared with revisional surgery, it can be a reasonable option in the appropriate patients. Further studies are necessary to determine the optimal medication and timing of adjuvant pharmacotherapy after bariatric surgery.
METHODS: A retrospective study was performed of all histopathology reports for cholecystectomies (laparoscopic and open) undertaken over a period of 12 years (1997-2008) in a single teaching hospital.
RESULTS: A total of 1,375 gallbladder specimens were sent for histopathological analysis, with 7 (0.5%) being reported as malignant while only three (0.2%) were found to contain primary gallbladder carcinoma. Other premalignant findings included two specimens with dysplastic changes of the mucosa and one tubulovillous adenoma with a dysplastic epithelium. From the ten malignant and premalignant specimens, seven were diagnosed pre-operatively, two were suspected intra-operatively and one was diagnosed with dysplastic changes on the histopathology report post-operatively.
CONCLUSIONS: This study supports earlier research carried out in the UK and the demographic difference does not affect the impact of the histology examination on cholecystectomy specimens in diagnosing this disease. A selective policy is recommended in Malaysia.