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The Ligation of Intersphincteric Fistula Tract Technique: A Preliminary Experience
Pasquale Cianci,Nicola Tartaglia,Alberto Fersini,Libero Luca Giambavicchio,Vincenzo Neri,Antonio Ambrosi 대한대장항문학회 2019 Annals of Coloproctolgy Vol.35 No.5
Purpose: Surgery is the only treatment for anal fistula. Many surgical techniques have been described. The aim of this study was to communicate the authors’ preliminary experience in the use of a recently proposed, simplified technique. Methods: This was a prospective study of 28 patients admitted from January 13, 2016 through July 20, 2017. Patients were managed with the ligation of intersphincteric fistula tract (LIFT) technique and results were observed and documented, including recurrence rate, incontinence rate, and other postoperative complications. Results: A total of 28 patients were studied. The mean operation time was 31 minutes (range, 23–44 minutes), and there were no intra- and postoperative complications. The overall complete healing rate was 85.7%, and the recurrence rate was 14.2%. Follow-up was conducted at 1, 3, and 6 months. Conclusion: Many surgical techniques have been described for the treatment of anal fistula. The correct choice of surgical technique out of available procedures is the most important factor for proper treatment and reducing the risk of recurrence or incontinence. In the authors’ experience, the LIFT technique is simple and easy to learn, and is a good choice for the treatment of simple anal fistula; however, a tailored surgery remains the gold standard for this condition.
Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series
Gabriele Sani,Georgios D. Kotzalidis,Isabella Panaccione,Alessio Simonetti,Lavinia De Chiara,Antonio Del Casale,Elisa Ambrosi,Flavia Napoletano,Delfina Janiri,Emanuela Danese,Nicoletta Girardi,Chiara 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.1
The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do notrespond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergictransmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder andone with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergicmechanisms may be involved in counteracting PMDD symptoms.