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A randomized clinical trial comparing intralesional bone marrow and steroid injections for simple bone cysts Simple bone cysts are common benign lesions in growing children that predispose them to fracture and are sometimes painful. The purpose of this trial was to compare rates of healing of simple bone cysts treated with intralesional injections of bone marrow with rates of healing of those treated with methylprednisolone acetate.Of ninety patients randomly allocated to treatment with either (...) a bone-marrow or a methylprednisolone acetate injection, seventy-seven were followed for two years. The primary outcome, determined by a radiologist who was blind to the type of treatment, was radiographic evidence of healing. The cyst was judged to be either not healed (grade 1 [a clearly visible cyst] or grade 2 [a cyst that was visible but multilocular and opaque]) or healed (grade 3 [sclerosis around or within a partially visible cyst] or grade 4 [complete healing with obliteration of the cyst
Laparoscopic deroofing of simple renal cysts (IPG226) Overview | Laparoscopic deroofing of simple renal cysts | Guidance | NICE Laparoscopic deroofing of simple renal cysts Interventional procedures guidance [IPG226] Published date: July 2007 Share Save Guidance The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic deroofing of simple renal cysts. Description Solitary cysts (...) in the kidney are common, but rarely cause any symptoms. Multiple cysts are less common and are usually due to polycystic kidney disease, which is an inherited condition. Laparoscopic deroofing involves draining the cyst and removing part of the cyst wall, which is done through small cuts in the abdomen using a fine telescope to see inside the body ('keyhole surgery'). and for this guidance. Your responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence
Therapeutic percutaneous image-guided aspiration of spinal cysts (IPG223) Overview | Therapeutic percutaneous image-guided aspiration of spinal cysts | Guidance | NICE Therapeutic percutaneous image-guided aspiration of spinal cysts Interventional procedures guidance [IPG223] Published date: June 2007 Last updated: August 2007 Share Save Guidance The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland (...) on therapeutic percutaneous image-guided aspiration of spinal cord cysts. Description Image guided needle aspiration of cysts can be used as part of a diagnostic work up with aspirate analysed by laboratory testing. Aspiration can also be used as a therapeutic procedure with the intent of decreasing cyst volume to relieve symptoms caused by pressure on the spinal cord. The procedure is usually undertaken under local anaesthesia. A small gauge needle is inserted into the cysts using imaging guidance
Oral contraceptives for functional ovarian cysts. Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice (...) of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of studies.Two authors independently abstracted data from the articles and entered them into RevMan 4.2. We used Peto odds ratios with 95% confidence intervals for dichotomous outcomes.We identified four randomized controlled trials from three countries; the studies included a total of 227 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true
Percutaneous needle aspiration, injection, and reaspiration with or without benzimidazole coverage for uncomplicated hepatic hydatid cysts. Hepatic hydatid cyst is an important public health problem in parts of the world where dogs are used for cattle breeding. Management of uncomplicated hepatic hydatid cysts is currently surgical. However, the puncture, aspiration, injection, and re-aspiration (PAIR) method with or without benzimidazole coverage has appeared as an alternative to surgery over (...) the past decade.To assess the benefits and harms of PAIR with or without benzimidazole coverage for patients with uncomplicated hepatic hydatid cyst in comparison with sham/no intervention, surgery, or medical treatment.The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Controlled Trials Register in The Cochrane Library, MEDLINE, EMBASE, DARE, and ACP Journal Club and full text searches were combined (all searched October 2004). Reference lists of pertinent studies and other
Choroid plexus cysts in the mid-trimester fetus: practical application suggests superiority of an individualized risk method of counselling for trisomy 18 Choroid plexus cysts in the mid-trimester fetus: practical application suggests superiority of an individualized risk method of counselling for trisomy 18 Choroid plexus cysts in the mid-trimester fetus: practical application suggests superiority of an individualized risk method of counselling for trisomy 18 Bird L M, Dixson B, Masser-Frye D (...) for trisomy 18 in pregnant women, where at least one choroid plexus cyst (CPC) was detected in the second trimester foetus. The individualised risks were calculated by multiplying the prior risk of trisomy 18 (determined by maternal age or multiple-marker screening results) by the likelihood ratio of 9 (established by Gupta et al, see Other Publications of Related Interest) if the CPC was isolated (no other abnormalities were found on ultrasound). If the CPC was associated with other foetal ultrasound
Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts. Infection with the larval form of the pork tapeworm, Taenia solium, can lead to the development of cysts in the brain. Surgical removal of cysts has been the accepted treatment for neurocysticercosis characterized by giant cysts when there is associated intracranial hypertension.We describe 33 patients whom we treated medically for malignant forms of neurocysticercosis. All patients had evidence of intracranial (...) hypertension and subarachnoid cysts at least 50 mm in diameter. All patients received 15 mg of albendazole per kilogram of body weight per day for four weeks. Ten patients were also treated with 100 mg of praziquantel per kilogram per day for four weeks. Seventeen patients received a second course of albendazole, three received a third course, and one received a fourth course. During the first cycle of treatment, all patients also received dexamethasone. Five patients had previously undergone neurosurgery
Percutaneous drainage compared with surgery for hepatic hydatid cysts. In recent years percutaneous drainage has been used successfully to treat the hepatic hydatid cysts of echinococcal disease. We performed a controlled trial to compare the safety and efficacy of percutaneous drainage with those of surgical cystectomy, the traditional treatment.In a prospective study, we randomly assigned 50 patients with hepatic hydatidosis to treatment with percutaneous drainage (25 patients) or cystectomy (...) (25). Albendazole (10 mg per kilogram of body weight per day for eight weeks) was administered to the patients who underwent percutaneous drainage. Serial assessments included clinical and biochemical examinations, ultrasonography, and serologic tests of echinococcal-antibody titers.The mean (+/-SD) hospital stay was 4.2+/-1.5 days in the drainage group and 12.7+/-6.5 days in the surgery group (P<0.001). Over a mean follow-up period of 17 months, the mean cyst diameter decreased from 8.0+/-3.0
Cost-effectiveness analysis of treatment of E histolytica/E dispar cyst carriers Cost-effectiveness analysis of treatment of E histolytica/E dispar cyst carriers Cost-effectiveness analysis of treatment of E histolytica/E dispar cyst carriers Garduno-Espinosa J, Martinez-Garcia M C, Valadez-Salazar A, Padilla G, Cedillo-Rivera R, Munoz O Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Metronidazole for Entamoeba histolytica and Entamoeba dispar cyst carriers. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Asymptomatic carriers of E.histolytica Setting The practice setting was primary care. The economic analysis was carried out in an academic setting in Mexico. Dates to which
Role of puncture and aspiration in expectant management of simple ovarian cysts: a randomised study. To assess the potential of expectant management for simple ovarian cysts diagnosed by transabdominal or transvaginal ultrasonography. To compare the results of needle aspiration with those achieved with simple observation.Randomised trial.Hospital department of obstetrics and gynaecology.278 women with simple cysts randomly allocated to simple observation (143) or ultrasound guided fine needle (...) aspiration (135) between 1990 and 1994.Resolution of cyst or development of malignancy.After six months 269 were available for follow up. The rate of resolution was 46% (59/128) with aspiration and 44.6% (63/141) with observation. Only the diameter of the cyst (P < 0.0001) was a significant independent prognostic factor for resolution in a multivariate analysis. Age and treatment had no significant effect. One woman was subsequently found to have borderline malignant changes on histopathological
[Costs of video-laparoscopic surgery in the treatment of ovarian cysts] Costi della chirurgia video-laparoscopica nel trattamento delle cisti ovariche [Costs of video-laparoscopic surgery in the treatment of ovarian cysts] Costi della chirurgia video-laparoscopica nel trattamento delle cisti ovariche [Costs of video-laparoscopic surgery in the treatment of ovarian cysts] Saviano M S, Heydari A, Gelmini R, Piccoli M Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Cholecystectomy after introduction of video-laparoscopic surgery in the treatment of ovarian cysts. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Female patients undergoing video-laparoscopic surgery or laparotomic
Minilaparotomy for the ambulatory management of ovarian cysts Minilaparotomy for the ambulatory management of ovarian cysts Minilaparotomy for the ambulatory management of ovarian cysts Flynn M, Niloff J M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study (...) and the conclusions drawn. Health technology Minilaparotomy in patients less than 50 years old with complex or persistent ovarian cysts. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Patients less than 50 years old with complex or persistent ovarian cysts less than or equal to 10cm in maximum size, undergoing cystectomy or oophorectomy. Setting Hospital and primary care. The economic study was carried out in Boston, Massachusetts, USA. Dates to which data relate