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Immediate Results (immediate + result)
Selected AbstractsImproving homework compliance in the treatment of generalized anxiety disorderJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2002Robert L. Leahy Generalized anxiety disorder is a chronic condition characterized by beliefs that worry prepares and protects, but that excessive worry is out of control. In this article, I review the cognitive-behavioral model of generalized anxiety, focusing specifically on problems related to excessive worrying. Noncompliance in self-help homework is reflected in the patient's excessive focus on negative feelings, difficulty identifying automatic thoughts, demand for immediate results, and the belief that worries are realistic. Interventions for these problems are illustrated in the case of the treatment of a patient characterized by persistent worries, low self-confidence, procrastination, and avoidance. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 499,511, 2002. [source] Medical rhinoplasty with hyaluronic acid and botulinum toxin A: a very simple and quite effective techniqueJOURNAL OF COSMETIC DERMATOLOGY, Issue 3 2008Alessio Redaelli MD Summary Objective, The management of nasal deformities, and in particular those with "plunging" tip, has always been a typical area of interest in surgery. In the author's experience many of these problems can be successfully approached with a new medical technique, which consists of using only hyaluronic acid for the correction of nasal angles and botulinum toxin for patients with hyperactivity of the depressor septi nasi muscle. The present study aims to illustrate this new technique and evaluates safety and results. Materials and methods, Ninety-five patients were treated between January 2006 and July 2007. The average age of the patients was 42.7 years. In 45% of the cases, botulinum toxin was employed. In all of the cases, the treatment was conducted with hyaluronic acid (24 mg/mL), the same substance used for face rejuvenation. The amount varied from 0.6 to 1.4 mL. Results Results were evaluated using a definitive graduated score calculated by patient's and doctor's satisfaction score (range, 1,10) and by photographs' score at time 0, after 30 days, and after 180 days. It ranged from 8 to 10 (average of 9.1). No significant side effects were reported. Conclusion, The medical rhinoplasty for a "plunging" nose is a simple and very effective technique with immediate results. It can be used in those cases where patients are reluctant to undergo surgery, or as primary indication in the correction of minor nose defects. Results are satisfactory and no side effects have been reported so far. Results will last for a long time. [source] Cutting Balloon for In-Stent Restenosis:JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 4 2004Acute, Long-Term Results Introduction: Conventional percutaneous coronary intervention for the treatment of in-stent restenosis (ISR) has shown a high rate of ISR (30,55%). Considering the need for both extrusion of hyperplastic intima and additional stent expansion, a cutting balloon might be more effective for the treatment of ISR. Methods: We prospectively assessed the immediate and 8-month outcome of balloon angioplasty using the Barath Cutting Balloon in 100 consecutive patients (mean age: 60.5 ± 10.8 years, 71% male). Results: In 73 lesions (73%), a good result was reached with the cutting balloon only. In 21 lesions (21%) postdilatation and in 6 lesions (6%) predilatation with a conventional balloon was necessary. The mean inflation pressure was 8.7 ± 2.0 (range: 6.0,18.0) atm. Before the procedure the mean minimal luminal diameter (MLD) was 0.95 ± 0.45 mm. Quantitative coronary analysis showed a mean diameter stenosis of 65%± 16%. Immediately after the procedure the mean MLD was 2.42 ± 0.54 mm with a mean diameter stenosis of 19%± 13%. Two patients died during the follow-up period (1 stroke, 1 nonvascular). At 8-month follow-up 26 patients (26%) reported to have anginal complaints CCS class II,IV of whom 16 (16%) needed target lesion revascularization. Conclusion: Treatment of ISR using the Barath Cutting Balloon can be performed safely with good immediate results and a relatively low need for repeated target lesion revascularization at 8-month follow-up. [source] Stenting of Bifurcation Lesions: A Rational ApproachJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2001FSCAI, THIERRY LEFÈVRE M.D. The occurrence of stenosis in or next to coronary bifurcations is relatively frequent and generally underestimated. In our experience, such lesions account for 15%,18% of all percutaneous coronary intervention > (PCI). The main reasons for this are (1) the coronary arteries are like the branches of a tree with many ramifications and (2) because of axial plaque redistribution, especially after stent implantation, PCI of lesions located next to a coronary bifurcation almost inevitably cause plaque shifting in the side branches. PCI treatment of coronary bifurcation lesions remains challenging. Balloon dilatation treatment used to be associated with less than satisfactory immediate results, a high complication rate, and an unacceptable restenosis rate. The kissing balloon technique resulted in improved, though suboptimal, outcomes. Several approaches were then suggested, like rotative or directional atherectomy, but these techniques did not translate into significantly enhanced results. With the advent of second generation stents, in 1996, the authors decided to set up an observational study on coronary bifurcation stenting combined with a bench test of the various stents available. Over the last 5 years, techniques, strategies, and stent design have improved. As a result, the authors have been able to define a rational approach to coronary bifurcation stenting. This bench study analyzed the behavior of stents and allowed stents to be discarded that are not compatible with the treatment of coronary bifurcations. Most importantly, this study revealed that stent deformation due to the opening of a strut is a constant phenomenon that must be corrected by kissing balloon inflation. Moreover, it was observed that the opening of a stent strut into a side branch could permit the stenting, at least partly, of the side branch ostium. This resulted in the provocative concept of "stenting both branches with a single stent." Therefore, a simple approach is currently implemented in the majority of cases: stenting of the main branch with provisional stenting of the side branch, The technique consists of inserting a guidewire in each coronary branch. A stent is then positioned in the main branch with a wire being "jailed" in the side branch. The wires are then exchanged, starting with the main branch wire that is passed through the stent struts into the side branch. After opening the stent struts in the side branch, kissing balloon inflation is performed. A second stent is deployed in the side branch in the presence of suboptimal results only. Over the last 2 years, this technique has been associated with a 98% angiographic success rate in both branches. Two stents are used in 30%,35% of cases and final kissing balloon inflation is performed in > 95% of cases. The in-hospital major adverse cardiac events (MACE) rate is around 5% and 7-month target vessel revascularization (TVR) is 13%. Several stents specifically designed for coronary bifurcation lesions are currently being investigated. The objective is to simplify the approach for all users. In the near future, the use of drug-eluting stents should reduce the risk of restenosis. [source] A Thin Tracheal Silicone Washer to Solve Periprosthetic Leakage in Laryngectomies: Direct Results and Long-Term Clinical Effects,THE LARYNGOSCOPE, Issue 4 2008Frans J. M. Hilgers MD Abstract Objectives: Assessment of the immediate results and long-term clinical effects of a thin silicone washer placed behind the tracheal flange of voice prostheses to treat periprosthetic leakage. Patients and Methods: Three year retrospective analysis of 32 laryngectomized patients with 107 periprosthetic leakage events (PLEs). Custom-made silicone washers (outer diameter 18 mm, inner diameter 7.5 mm, thickness 0.5 mm) were placed behind the tracheal flange either in combination with prosthesis replacement or later. Results: There was immediate resolution of periprosthetic leakage in 88 PLEs (median, 38 d; mean, 53 d; range, 8,330 d) and in 6 PLEs with the washer still in situ at the date of analysis (median, 75; mean, 97 d; range, 38,240 d). There was no resolution for periprosthetic leakage in 13 PLEs. Thus, in total, 94 of 107 PLEs (88%) were successfully resolved. In 29 of 32 (91%) patients, the washer resolved the problem at least in one PLE successfully. Twelve of 32 patients, including all 3 with washer failures, also required other interventions to ultimately solve the problem. The vast majority of patients (80%) did not consider placement of the washer to be inconvenient. Conclusions: In consideration of the high success rate and limited inconvenience for patients, this simple thin silicon washer application provides a good first option for the treatment of periprosthetic leakage. [source] Rethinking Caretaker Conventions for Australian GovernmentsAUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 3 2001Glyn Davis Australia has well-established conventions for caretaker governments. These conventions regulate how a government should operate once an election is called, and have been documented for some decades. Yet the current conventions date from an era when elections usually produced clear and immediate results. Can our caretaker conventions cope with the emerging reality of indecisive elections and long delays before a new government is confirmed? This paper canvasses the state of Australia's caretaker conventions and offers suggestions for an expanded, contemporary code. [source] Surgical treatment of haemorrhoidal disease with CO2 laser and Milligan,Morgan cold scalpel techniqueCOLORECTAL DISEASE, Issue 7 2006L. C. Pandini Abstract Objective, To prospectively compare immediate postoperative results of the surgical treatment of haemorrhoidal disease (HD) by Milligan,Morgan technique using either the CO2 laser or cold scalpel. Methods, Forty patients with grade III/IV HD were prospectively randomized to undergo surgical treatment (Milligan,Morgan) using either the CO2 laser (group A) or the cold scalpel method (group B). Data were compared regarding postoperative pain, complications, healing time, return to normal activity and patient satisfaction. Patients were blinded to treatment method until the completion of the study. Postoperative outcomes were assessed by patient questionnaire and outpatient follow-up visits. Pain was assessed by Visual Analogue Scale and analgesic consumption. Results, Twenty patients were randomized into each group and were comparable relative to mean age, gender and grade of HD. There were no statistically significant differences regarding postoperative pain measured (P =0.17) or consumption of oral (P = 0.741) and parenteral analgesics (P = 0.18) between the two groups. Mean pain score at the first bowel movement was significantly higher in group A (P = 0.035), although the use of analgesics was similar in both the groups. There were no differences regarding complications, mean healing time, return to normal activities and patient satisfaction. Conclusion, There were no differences in the immediate results after Milligan,Morgan haemorrhoidectomy using either the CO2 laser or cold scalpel regarding postoperative pain, complications, healing time, return to normal activities or patient satisfaction. [source] | ||||||||||