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Segment Disease (segment + disease)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Long-term continence after surgery for Hirschsprung's disease

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 12 2007
Anthony G Catto-Smith
Abstract Aim:, Our aim was to examine the long-term bowel dysfunction that followed surgery for Hirschsprung's disease. Methods:, Of 414 patients diagnosed with Hirschsprung's disease between 1974 and 2002, 98 were interviewed using a structured questionnaire to provide an assessment of bowel function, medication, diet, physical and social limitations. Forty-two completed a prospective 4-week toileting diary and 16 underwent anorectal manometry. Results:, Four of the 98 patients had permanent stomas and 10 had Down's syndrome. Of the remaining 84 patients (mean age 12 ± 8 years, range 1.9,41.9 years), 13% (11/84) had heavy soiling by day and 17% (14/84) by night. Fifty percent reported episodic urgency, but 36% also reported episodic constipation. Stool consistency was looser in patients with a history of long segment disease. Some aspects of bowel function improved with age. Enuresis was much more frequent than expected. Sixty-four percent reported adverse reactions to foods, particularly to fruit, vegetables, fats and diary products, and 15% limited their social activities because of fecal incontinence. There were no significant differences in manometric parameters between those patients who soiled and those who did not. Conclusions:, Fecal incontinence is common after surgery for Hirschsprung's disease and has a significant impact on social activities. Some aspects of bowel function did improve with age. Adverse reactions to food were unexpectedly frequent and need to be further studied. [source]

Clinical decision paths in KPro Surgery

ACTA OPHTHALMOLOGICA, Issue 2009
G GRABNER
Purpose To analyse the currently available methods for treating very severe anterior segment disease, such as stem cell transplantation with amniotic membrane transplantation, lamellar and penetrating keratoplasty techniques, and the different Kpro´s currently available, in regard to the initial clinical findings, the potential complications encountered and the surgical requirements needed for the different techniques. Factors considered are: uni- or bilaterality, limbal stem cell status, dry eye status and availability of healthy teeth. Methods A systematic analysis of surgical options available for different stages of a variety of anterior segment diseases and currently published results of VA and complications Results With a systematic approach it becomes clear that some popular reconstructive surgical techniques should be avoided in cases where a very low chance of success is to be expected (e.g. amniotic membrane and stem cell transplantation and /or PKP in very dry eyes ,> these would have to be treated with OOKP). Conclusion Following a simple the clinical decision path the anterior segment surgeon will be presented with standardized guidelines for treating those patients where conventional surgical procedures have to be avoided and replaced by rather rarely performed KPro techniques. [source]

The key role of electrophysiology in the diagnosis of visually impaired children

ACTA OPHTHALMOLOGICA, Issue 6 2006
Maria Van Genderen
Abstract. Purpose:, To describe the outcome of specialized electrophysiology in visually impaired children. Methods:, We carried out a retrospective evaluation of 340 electrophysiological examinations performed in 298 children over a 3-year period (2001,2003), with regard to demographic data, referral pattern, degree of compliance, and diagnostic results. Electrophysiology was performed without sedation or anaesthesia. In electroretinograms, DTL electrodes were used in combination with online selection of responses. Visual evoked potentials testing was performed with seven active occipital electrodes. Results:, The mean age of the children was 7 ± 5 years; 72 (24%) of the children were mentally as well as visually impaired. Main reasons for referral were suspected posterior segment disease, abnormal visual development, unexplained low vision, high myopia, and suspected albinism. Compliance was good in 302/340 (88%), partial in 24/340 (7%), and absent in 14/340 (4%) of the examinations. Of the 326 successful procedures, 215 (66%) showed abnormal results. Tapetoretinal dystrophy (22%), opticopathy (16%), congenital stationary night blindness (13%), and cone dystrophy (11%) were the most frequently established diagnoses. Albinism was confirmed in 14 of 24 suspected patients; additionally, unsuspected misrouting was found in six. In 26 (9%) of the patients, a previously established diagnosis was changed. Conclusions:, In a specialized setting, electrophysiological examinations can be performed successfully in visually impaired children. The results are essential for the final ophthalmological diagnosis and have important consequences for rehabilitation. [source]