ObjectiveTo evaluate the long-term results of repairing long anterior urethral strictures with lingual mucosa onlay grafts.Patients and methodsThis study included 23 patients (mean age 36.3 years, range 21–62) who had a lingual mucosa onlay graft for managing a long anterior urethral stricture, and who were followed up for ⩾5 years. The mean length of the stricture was 4.6 cm. The International Prostate Symptom Score and uroflowmetry values were obtained before surgery, and at 3, 6 and 12 months afterwards, and annually thereafter. A retrograde urethrogram with a voiding cysto-urethrogram was taken before surgery, at catheter removal, after 3 and 6 months, and selectively thereafter.ResultsThe mean (range) follow-up was 66 (60–72) months. The cause of the stricture was trauma in nine patients, instrumentation in seven, idiopathic in four, urethritis in two and previous hypospadias repair in one. The surgery was successful in 20 of the 23 patients (87%), and a recurrent stricture developed in the remaining three. There were no fistulae or clinically perceptible graft sacculations, and no long-term donor-site complications.ConclusionsWith a long-term follow-up, our series confirms the durability of lingual mucosal onlay grafts for treating long anterior urethral strictures. This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.
this paper aims to provide an overview of the development and provision of educational services for children with intellectual disabilities in Egypt. Intellectual disability is a significant sub-average general intellectual functioning existing concurrently with deficits in adaptive behaviour and manifested during the developmental period. The education of children with intellectual disabilities is a right endowed and authorised by the Egyptian government. The Ministry of Education in Egypt is keen to provide those children who have intellectual disabilities, along with other children with special needs, with an appropriate education that addresses their needs and allows them to live in society using their full potential, as typically developing children. Observations and interviews were carried out to collect further information about the educational services the children with intellectual disabilities receive in Egypt. The findings of this study indicated that, despite the efforts exerted by the Ministry of Education, to provide advanced and new services for children with intellectual disabilities, the provision may still need improvements. A series of recommendations was suggested to improve the services that children with intellectual disabilities receive in Egypt. KEYWORDS:Intellectual Disability; Special Education; Inclusion.RESUMO: este artigo visa fornecer uma visão geral do desenvolvimento e prestação de serviços educacionais para crianças com deficiência intelectual no Egito. Deficiência intelectual é um prejuízo significante do funcionamento intelectual, concomitantemente a déficits no comportamento adaptativo, e que se manifesta durante o período de desenvolvimento. A educação das crianças com deficiência intelectual é um direito garantido e legitimado pelo governo egípcio. O Ministério da Educação no Egito está empenhado em fornecer a essas crianças, que têm deficiência intelectual, junto com outras crianças com necessidades especiais, uma adequada educação que atenda as suas necessidades e lhes permita viver em sociedade utilizando todo o seu potencial, como crianças com desenvolvimento típico. Observações e entrevistas foram realizadas para coletar informações adicionais sobre os serviços educacionais destinados a crianças com deficiência mental no Egito. Os resultados deste estudo indicaram que, apesar dos esforços promovidos pelo Ministério da Educação, para proporcionar serviços novos e avançados para crianças com deficiência intelectual, a prestação ainda precisa de melhorias. Uma série de recomendações foi sugerida para melhorar os serviços que as crianças com deficiência intelectual recebem no Egito. PALAVRAS-CHAVE: deficiência intelectual; educação especial; inclusão.
ObjectivesTo compare the efficacy and safety of ethanolamine oleate (EO) as a sclerosing agent, vs. absolute ethanol (AE), in the treatment of symptomatic simple renal cysts.Patients and methodsBetween November 2009 and October 2012, 46 patients were prospectively randomised into two groups. All patients presented with a simple renal cyst underwent ultrasonographic aspiration and injection of a sclerosing agent. In group 1, 25 patients had the cyst injected with EO, and in group 2, 21 were treated with AE. One injection was used in cysts of <200 mL and two injections were used in larger cysts. Complete and partial success were defined as complete cyst ablation or a >50% reduction in cyst volume with symptomatic relief, respectively. Patients were followed up using semi-annual ultrasonography and computed tomography for 2 years.ResultsSclerotherapy was technically successful in all patients. There was no significant difference in cyst volume between the groups. After ≈2 years of follow-up there was complete symptomatic relief in both groups, and the overall radiological success rate was 100% of both groups, at 79% complete and 21% partial in group 1, and 83% complete and 17% partial in group 2. The frequency of transient complications in the form of microscopic haematuria was 7% and 13%, and of low-grade fever in 4% and 10% in groups 1 and 2, respectively.ConclusionEO can replace AE as a sclerosing agent for symptomatic simple renal cysts, as it has comparable efficacy with higher safety and tolerance.
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