Osteotomies Around the Knee for Older Active Patients

2021 ◽  
pp. 425-436
Author(s):  
Ryohei Takeuchi ◽  
Eiji Kondo ◽  
Takenori Akiyama ◽  
Akihiko Yonekura ◽  
Ryuichi Nakamura ◽  
...  
Keyword(s):  
2018 ◽  
Vol 14 (2) ◽  
Author(s):  
M.C. Ibarra

Abstract: To determine the frequency and distributionof dental anomalies of shape and numberin primary dentition. Methods: The study is retro-prolective, crosssectionaland descriptive. The sample was probabilistic,stratified for convenience by gender. Theclinical record of 1,568 patients was reviewed.These patients attended the Clinic of PediatricDentistry of FEBUAP during the period of 2012-2014, only 720 records of patients were includedin the study (321 girls and 399 boys) between theages of 1-10 years old, who provided complete,crisp radiographic studies with the presence ofdental anomalies of shape or number, the studywas divided into active and inactive patients.For inactive patients, photographs of x-rays withdental anomalies of shape and/or number weretaken. For cases with active patients, an interviewwith one of the parents was conducted andauthorization with informed consent was requested,also the child agreed to do a clinical examinationand take intraoral photographs. Results:A total of 63 children had anomalies (17girls and 46 boys). The total prevalence of dentalanomalies was 9%, of which 3.1% were (fusedand geminated teeth), 1.1% (agenesis) and 1.9%(supernumerary), 1.3% (supernumerary roots),0.27% (macrodontia), 0.11% (microdontia), andfinally 0.27% corresponded to (talon cusp). Conclusions: Although the prevalence of theseanomalies is not high, it is important to do a routineradiographic examination for early diagnosisand accordingly apply the correct preventivemeasures to establish the best treatment plan.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1207.2-1207
Author(s):  
A. García Fernández ◽  
A. Briones-Figueroa ◽  
L. Calvo Sanz ◽  
Á. Andreu-Suárez ◽  
J. Bachiller-Corral ◽  
...  

Background:Biological therapy (BT) has changed the treatment and perspectives of JIA patients but little is known about when is the best moment to start BT and the impact of this prompt iniciation.Objectives:To analyze the response to BT of Juvenile Idiophatic Arthritis (JIA) patients according to the time when the BT was started.Methods:A retrospective, descriptive study was conducted on JIA patients followed up in a referal hospital that started BT up to 24 months after diagnosis from 2000 to 2018. Disease activity was measured, at 2 years after diagnosis, according to Wallace criteria for remission (absence of: active arthritis, active uveitis, fever, rash or any other manifestation attributable to JIA, normal CRP and ESR, PGA indicating no active disease) for at least 6 months.Results:55 JIA patients that started BT up to 24 months from diagnosis were analyzed. 69,1% were girls with a median age at diagnosis of 8 years old IQR(3-13), median age at the start of BT of 9 years old IQR(3-13). Regarding JIA categories: 25,5% were Oligoarticular Persistent (OligP), 18,2% Systemic JIA (sJIA), 16,4% Entesitis related Arthritis (ERA), 12,7% Psoriatic Arthritis (APso) and Polyarticular RF- (PolyRF-), 5,5% Oligoarticular Extended (OligE) and Polyarticular RF+ (PolyRF+), 3,6% Undifferentiated (Und). 20% of patients had uveitis during followup. Conventional DMARD (cDMARD) was indicated in 83,6% of patients (95,7% Methotrexate) at diagnosis [median 0 months IQR(0-2,3)]. At the end of followup (2 years) only 30,9% of patients continued with cDMARDs. The main causes of discontinuation were: adverse events (46,7%), remission (36,7%). TNF inhibitors were precribed in 81,8% of patients and 18,2% of patients recieved two BT during the first 2 years from diagnosis. 54,5% of BT were indicated during the first 6 months from diagnosis, 27,3% from 7 to 12 months, 12,7% from 13 to 18 months, 5,5% from 19 to 24 months.After 2 years from diagnosis, 78,2% of patients were on remission and 21,8% active. Among patients with active disease: 75% had arthritis, 16,7% had uveitis and 8,3% had both. There were no differences regarding disease activity among patients with uveitis and neither taking cDMARDs. Regarding JIA categories: 66,7% of OligE, 57,1% of PolyRF- and 57,1% of APso patients were active at 2 years from diagnosis when compared to the other categories (p=0.004).Patients on remission at 24 months from diagnosis started sooner the BT than active patients [CI 95% (0,46-8,29) p=0,029]. The time when the BT was started was correlated to the activity at 2 years (K= 0,294 p=0,029). When the BT was prescribed after 7,5months from diagnosis it was correlated, in a COR curve, with a higher probability of active disease at 2 years (S= 0,67 E= 0,63). There was a correlation, among patients on remission at 2 years, between prompt start of BT and less time to reach remission (K= -0,345 p=0,024). Patients with active disease at 2 years, regardless of moment of BT iniciation, required more BT during follow-up (p=0,002).Conclusion:Prompt iniciation of BT was correlated with a better outcome. JIA patients that started BT early after diagnosis had a higher probability of remission after 2 years. Starting BT after 7,5 months was correlated with a higher probability of active disease at 2 years. Active disease at 24 months was correlated with persistent active disease during follow-up.Disclosure of Interests:None declared


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Sergio Pinto ◽  
Erica Loddo ◽  
Salvatore Paba ◽  
Agnese Favale ◽  
Fabio Chicco ◽  
...  

Abstract Background and aims The COVID-19 pandemic has led to a deep reorganization of hospital services including inflammatory bowel disease (IBD) units. In this situation, conversion of in-person routine follow-up visits into phone consultations might be necessary. Here we explored the feasibility of using the validated Crohn’s Disease (CD) or Ulcerative Colitis (UC) Patient-Reported Outcomes Signs and Symptoms (CD- and UC-PRO/SS) to collect data about abdominal symptoms (abdominal/S) and bowel signs and symptoms (bowel/SS) remotely. Methods CD- and UC-PRO/SS were collected during phone consultations and compared among patients with active and inactive disease. The effectiveness of therapeutic intervention in patients with active disease was assessed by PRO/SS variation. Results Twenty-one CD and 56 UC patients were evaluated by phone. Six (28.6%) CD and 15 (26.8%) UC patients were considered to have active disease. In CD the bowel/SS but not the abdominal/S module was significantly higher in active patients (mean bowel/SS 2.50 [SE ± 0.44] active vs 0.76 [SE ± 0.18] remission, p = 0.008, AUC 0.87; mean abdominal/S 1.11 [SE ± 0.38] active vs 0.24 [SE ± 0.13] remission, p = 0.066). UC-PRO/SS measures were significantly higher in active patients as compared to patients in remission (median bowel/SS 1.63 [SE ± 0.24] active vs 0.33 [SE ± 0.04] remission; p < 0.0001, AUC 0.91; mean abdominal/S 1.03 [SE ± 0.24] vs 0.37 [SE ± 0.12]; p = 0.009, AUC 0.71). Therapy was escalated in 12 patients (3 CD and 9 UC) due to disease relapse. Therapy escalation resulted in the reduction of PRO/SS as evaluated at the subsequent phone consultation. Conclusions PRO/SS might represent a feasible tool to evaluate disease activity and therapy outcome in IBD patients during periods of limited access to outpatient clinics.


Author(s):  
Vishu Madaan ◽  
Aditya Roy ◽  
Charu Gupta ◽  
Prateek Agrawal ◽  
Anand Sharma ◽  
...  

AbstractCOVID-19 (also known as SARS-COV-2) pandemic has spread in the entire world. It is a contagious disease that easily spreads from one person in direct contact to another, classified by experts in five categories: asymptomatic, mild, moderate, severe, and critical. Already more than 66 million people got infected worldwide with more than 22 million active patients as of 5 December 2020 and the rate is accelerating. More than 1.5 million patients (approximately 2.5% of total reported cases) across the world lost their life. In many places, the COVID-19 detection takes place through reverse transcription polymerase chain reaction (RT-PCR) tests which may take longer than 48 h. This is one major reason of its severity and rapid spread. We propose in this paper a two-phase X-ray image classification called XCOVNet for early COVID-19 detection using convolutional neural Networks model. XCOVNet detects COVID-19 infections in chest X-ray patient images in two phases. The first phase pre-processes a dataset of 392 chest X-ray images of which half are COVID-19 positive and half are negative. The second phase trains and tunes the neural network model to achieve a 98.44% accuracy in patient classification.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Sanket Kalpande ◽  
P. R. Saravanan ◽  
K. Saravanan

Abstract Background Long-term catheterisation is frequently necessary for patients with retention of urine or intractable incontinence who are unfit for definitive treatment or being evaluated for definitive treatment. In this study, the important factors influencing the encrustation of indwelling catheters are analysed. Methods A total of 52 patients on catheter drainage for a period ranging from 1 month to 1 year were taken in the study. Patients reported either for problems like catheter block or routine changing of catheter. The catheters were removed, and encrustation was subjected to chemical analysis. Urine was examined for pH, specific gravity, culture sensitivity and appearance. Blood samples were taken for estimation of calcium, phosphorus and uric acid. Results Out of 52 patients, 28 with urea splitting and 15 with non-urea splitting had positive urine culture (43 out of 52). Amongst 28, 27 (96%) had encrustation compared to 10 (50%) out of 15 with non-urea splitting bacteria (p value < .05). Amongst 24 patients having pH > 6, 22 (92%) had encrustation (p value < .05). The encrustation was found to be more common in bedridden patients (91%) when compared to physically active patients (54%) (p value < .05). The encrustation was more common in patients having single catheter for more than 15 days (86%) when compared to patients having catheter for shorter period (43%) (p value < .05). Conclusion This study showed definitive influence of the following factors in encrustation formation: infection with urea splitting organism, alkaline pH, physical activity of patient and duration of keeping a particular catheter.


2017 ◽  
Vol 06 (04) ◽  
pp. 329-333 ◽  
Author(s):  
Sidney Jacoby ◽  
Paul Marchetto ◽  
Peter DeLuca ◽  
Randall Culp ◽  
Michael Gaspar

Abstract Background No consensus treatment option for focal osteochondral defects of the proximal lunate exist in the literature. Surgical management has thus far been limited to salvage procedures such as proximal row carpectomy and partial arthrodesis. Case Description We report our experience using the osteochondral autograft transplantation surgery (OATS) procedure in two young, active patients with focal osteochondral defects of the proximal lunate. At mean follow-up of 6 years, sustained improvements in pain, motion, and function were observed. Both patients reported high levels of satisfaction and neither experienced any complications. Literature Review To our knowledge, this is the first report describing the use of OATS to treat proximal lunate defects. Clinical Relevance OATS is a valuable surgical option for treating focal chondral defects of the proximal lunate, with positive outcomes at greater than 5 years postoperatively. This may be an especially useful technique for younger, active patients, and those wishing to maintain maximum functionality.


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