Complications of occipitocervical fixation: retrospective review of 128 patients with 5-year mean follow-up

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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Evaluation of Aortic Zone 2 Proximal Landing Accuracy During Thoracic Endovascular Aortic Repair Following Carotid-Subclavian Revascularization

Vascular and Endovascular Surgery ◽

10.1177/1538574421989851 ◽

2021 ◽

Vol 55 (4) ◽

pp. 355-360

Author(s):

Sally H. J. Choi ◽

Gary K. Yang ◽

Keith Baxter ◽

Joel Gagnon

Keyword(s):

Carotid Artery ◽

Common Carotid Artery ◽

Retrospective Review ◽

Average Distance ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Aortic Repair ◽

Technical Accuracy ◽

Corrective Procedures

Background: Adequate seal for thoracic endovascular aortic repair (TEVAR) commonly requires landing in zone 2, but can prove to be challenging due to the tortuous and angulated anatomy of the region. Objectives: Our objective was to determine the proximal landing accuracy of zone 2-targeted TEVARs following carotid-subclavian revascularization (CSR) and its impact on clinical outcomes. Methods: Retrospective review of patients that underwent CSR for zone 2 endograft delivery at a tertiary institute between January 2008 and March 2018 was conducted. Technical outcomes were assessed by examining the incidence of intraoperative corrective maneuvers, 1a endoleaks and reinterventions. Distance to target and incidence of LSA stump filling were examined as radiographic markers of landing accuracy. Results: Zone 2-targeted TEVAR with CSR was performed in 53 patients for treatment of dissections (49%), aneurysms (30%) or trauma (21%). Nine (17%) cases required intraoperative corrective procedures: 5 (9%) proximal cuffs due to type 1a endoleak and 4 (8%) left common carotid artery (LCCA) stenting due to inadvertent coverage. Cases performed using higher resolution hybrid fluoroscopy machine compared to mobile C-arm were associated with increased proximal cuff use (OR 8.8; 95% CI 1.2-62.4). Average distance between the proximal edge of the covered graft to LCCA was 8 ± 1 mm and larger distances were not associated with higher rates of 1a endoleak. Twenty-eight (53%) cases of antegrade LSA stump filling were noted on follow-up imaging, but were not associated with higher rates of reinterventions (OR 0.8, 95% CI [0.2-4.6]). Three (6%) patients had a stroke within 30 days and 4 (8%) patients expired within 1 month. Intraoperative corrective maneuvers, post-operative 1a endoleak and reinterventions were not associated with higher rates of stroke or mortality. Conclusion: Using current endografts and imaging modalities, zone 2-targeted TEVARs have suboptimal technical accuracy.

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Spinal artery aneurysms: clinical presentation, radiological findings and outcome

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2017-013687 ◽

2018 ◽

Vol 10 (7) ◽

pp. 644-648 ◽

Cited By ~ 3

Author(s):

Leonardo Renieri ◽

Eytan Raz ◽

Giuseppe Lanzino ◽

Timo Krings ◽

Maksim Shapiro ◽

...

Keyword(s):

Back Pain ◽

Retrospective Review ◽

Clinical Presentation ◽

Treated Patient ◽

Demographic Data ◽

Treatment Options ◽

Treatment Strategies ◽

Imaging Characteristics ◽

Arterial Aneurysms

Background and purposeSpinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.Materials and methodsWe performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.Results11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.ConclusionsSpinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.

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SR and LR Union Suture for the Treatment of Myopic Strabismus Fixus: Is Scleral Fixation Necessary?

BioMed Research International ◽

10.1155/2015/470473 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Carol P. S. Lam ◽

Jason C. S. Yam ◽

Flora H. S. Lau ◽

Dorothy S. P. Fan ◽

C. Y. Wong ◽

...

Keyword(s):

Hong Kong ◽

Retrospective Review ◽

Surgical Outcome ◽

Surgical Techniques ◽

Effective Procedure ◽

Successful Outcome ◽

Range Of Movement ◽

Scleral Fixation ◽

Fixation Group

Purpose. To evaluate and compare the effectiveness of scleral fixation SR and LR union suture and nonscleral fixation union suture for the treatment of myopic strabismus fixus.Methods. Retrospective review of 32 eyes of 22 patients with myopic strabismus fixus who had undergone union suture of superior rectus (SR) and lateral rectus (LR) with or without scleral fixation, and follow-up longer than 6 months at Hong Kong Eye Hospital from 2006 to 2013. Surgical techniques and outcomes in terms of ocular alignment are analyzed.Results. There is significant overall improvement both in postoperative angle of esodeviation (P<0.01) and postoperative range of movement (P=0.042). Comparing between the sclera fixation group (11 eyes) versus nonscleral fixation group (21 eyes), the postoperative horizontal deviation, the postoperative vertical deviation, successful outcome, and the change in horizontal deviation were not significantly different (P>0.05).Conclusions. Union suture of SR and LR is an effective procedure in correcting myopic strabismus fixus. Fixation of the union suture to the sclera does not improve surgical outcome.

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Surface Replacement Proximal Interphalangeal Joint Arthroplasty: A Case Series

Hand ◽

10.1177/1558944718760035 ◽

2018 ◽

Vol 14 (5) ◽

pp. 669-674

Author(s):

Pieter W. Jordaan ◽

Duncan McGuire ◽

Michael W. Solomons

Keyword(s):

Patient Satisfaction ◽

Range Of Motion ◽

Retrospective Review ◽

Case Series ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint ◽

Surface Replacement ◽

Significant Difference

Background: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. Methods: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up. Results: A total of 43 joints were included with an average follow-up of 26.5 months. There was a significant ( P = .02) improvement in arc of motion with an average satisfaction score of 3.3 (satisfied patient). Subsidence was noted in 26% of joints with a significant difference in range of motion ( P = .003) and patient satisfaction ( P = .001) between the group with and without subsidence. Conclusions: The change to a cemented implant resulted in satisfied patients with an improvement in range of motion. The rate of subsidence improved but remains unacceptably high.

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Nasal Reconstruction of a Frontonasal Dysplasia via Septal L-Strut Reconstruction Using Costal Cartilage

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211036614 ◽

2021 ◽

pp. 105566562110366

Author(s):

Yong Bae Kim ◽

Seung Min Nam ◽

Eun Soo Park ◽

Chang Yong Choi ◽

Han Gyu Cha ◽

...

Keyword(s):

Postoperative Complications ◽

General Anesthesia ◽

Retrospective Review ◽

Costal Cartilage ◽

Point Of View ◽

Nasal Reconstruction ◽

Open Rhinoplasty ◽

Frontonasal Dysplasia ◽

Congenital Condition

Objective Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. Design Retrospective review from June 2008 and August 2017. Methods Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. Results The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. Conclusions Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.

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CD161 Is Expressed in a Subset of T-Cell Prolymphocytic Leukemia Cases and Is Useful for Disease Follow-up

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz060 ◽

2019 ◽

Vol 152 (4) ◽

pp. 471-478

Author(s):

Scott R Gilles ◽

Sophia L Yohe ◽

Michael A Linden ◽

Michelle Dolan ◽

Betsy Hirsch ◽

...

Keyword(s):

Flow Cytometry ◽

T Cell ◽

Nk Cells ◽

Retrospective Review ◽

T Cell Subsets ◽

Prolymphocytic Leukemia ◽

Flow Cytometry Data ◽

Flow Cytometric ◽

Flow Cytometric Evaluation

AbstractObjectivesCD161 (NKRP1) is a lectin-like receptor present on NK cells and rare T-cell subsets. We have observed CD161 expression in some cases of T-cell prolymphocytic leukemia (T-PLL) and found it to be useful in follow-up and detection of disease after treatment.MethodsRetrospective review of T-PLL cases with complete flow cytometry data including CD161.ResultsWe identified 10 cases of T-PLL with flow cytometric evaluation of CD161 available. Six of these cases were positive for CD161 expression. All CD161-positive cases were positive for CD8 with variable CD4 expression, whereas all CD161-negative cases were negative for CD8. In a case with two neoplastic subsets positive and negative for CD8, only the former expressed CD161.ConclusionsThese novel results suggest that CD161 is often aberrantly expressed in a defined subset of T-PLL positive for CD8. We are showing the utility of this immunophenotype in diagnosis and follow-up.

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Following Mixed Tree Nut Biscuit Challenge, Are the Nuts Still Included in the Diet?

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-020-00484-w ◽

2020 ◽

Vol 2 (11) ◽

pp. 2208-2213

Author(s):

Benedicta Itotoh ◽

Ingrid Roche ◽

Catherine Power

Keyword(s):

Western Australia ◽

Retrospective Review ◽

Food Challenge ◽

Oral Food Challenge ◽

Princess Margaret Hospital ◽

Tree Nuts ◽

Phone Calls ◽

Tree Nut

AbstractWe studied the introduction rate after a negative challenge to mixed tree nut biscuit. This is a retrospective review of patients who underwent and passed mixed tree nut biscuit challenges performed at Princess Margaret Hospital (PMH) between 2016 and 2018. Follow-up phone calls were made to families to ascertain if the tree nuts included in the tree nut biscuit were still included in the child’s diet 1 to 3 years following negative oral food challenge (OFC). A total of 162 children underwent mixed tree nut biscuit challenge between 2016 and 2018 at Princess Margaret Hospital, Perth, Western Australia. A total of 141 (87%) passed mixed tree nut biscuit challenge. Of the 133 children that were contacted (8 children could not be contacted), 104 children still included some or all of the challenge nuts in the child’s diet; with 24 children completely eliminating the challenge nuts (18%), 5 children eliminated some of the challenge nuts (3.5%). We found a high introduction rate (82%); however, some families may require more support to maintain the tree nuts in the child’s diet following a negative OFC.

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Intravitreal methotrexate for the treatment of proliferative vitreoretinopathy

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000293 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000293 ◽

Cited By ~ 6

Author(s):

Jeffrey David Benner ◽

David Dao ◽

John W Butler ◽

Kelli I Hamill

Keyword(s):

Adverse Effect ◽

Intraocular Pressure ◽

Retrospective Study ◽

Retinal Detachment ◽

Retrospective Review ◽

Proliferative Vitreoretinopathy ◽

Visual Recovery ◽

Perfluorocarbon Liquid ◽

Superficial Punctate Keratopathy

Background/aimsPreventing and treating proliferative vitreoretinopathy (PVR) remain a serious challenge for vitreoretinal surgeons. PVR is a devastating complication of retinal detachment that results in recurrent detachment and limits visual recovery. At present, there is no effective treatment for PVR.Materials and methodsA retrospective review was performed on a cohort of five consecutive eyes with severe PVR and recurrent retinal detachment that were treated with relaxing retinectomy, extended perfluorocarbon liquid tamponade (4–5 weeks) and a series of intravitreal methotrexate (MTX) injections (100–200 µg/0.05 mL for 10 weeks).ResultsAll five patients remained reattached (100%) with 11–27 months of follow-up (mean = 17.4). 4 eyes recovered ambulatory vision (>20/200) with normal intraocular pressure and non-fibrotic laser scars along with the relaxing retinectomy. The initial patient remained reattached, but only had hand motions vision. The only adverse effect noted was mild superficial punctate keratopathy in one patient.ConclusionThis small, retrospective study suggests that a series of MTX injections may be beneficial for treating complex retinal detachment caused by PVR. Further study is indicated.

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Proposal for the management of myopic traction maculopathy based on the new MTM staging system

European Journal of Ophthalmology ◽

10.1177/1120672120980943 ◽

2020 ◽

pp. 112067212098094

Author(s):

Barbara Parolini ◽

Michele Palmieri ◽

Alessandro Finzi ◽

Rino Frisina

Keyword(s):

Retrospective Review ◽

Surgical Complications ◽

Pars Plana Vitrectomy ◽

Staging System ◽

Combined Surgery ◽

Primary Surgery ◽

Myopic Traction Maculopathy ◽

Pars Plana ◽

Phakic Eyes

Purpose: To propose the Myopic Traction Maculopathy (MTM) management Table, based on the MTM Staging System (MSS). Methods: A retrospective review of 157 eyes affected by MTM, operated with pars plana vitrectomy (PPV), or macular buckle (MB) or combined surgery (MB + PPV). Each case was classified according to the MSS. Anatomical results were evaluated with OCT at an intermediate follow-up (3–6 months) and at a final follow-up (2–8 years), considering changes both in the foveal and in the retinal pattern. The number and type of operations needed were noted. The surgical complications were reported. Results: Primary surgery was MB for 83 eyes (52%), PPV for 36 (23%) and MB + PPV for 38 (24%). At intermediate follow-up, the retinal pattern was restored in 55.41% and foveal in 42.68%. Further surgery was indicated as PPV in 25.48%, MB in 14.65%. At the final follow-up, the retinal pattern was restored in 96.16% and the foveal pattern in 87.90%. BCVA improved at the final follow-up ( p < 0.05). The complications of MB were not sight-threatening. The complications of PPV were FTMH in 67% cases in stages 2, 3, and 4. Cataract developed in 60% of phakic eyes. The complications of combined MB+PPV were cataract (56%) and PVR (5%). Conclusions: Both PPV and MB may be used to treat MTM. PPV addresses the changes in the foveal pattern while MB addresses the changes in the retinal pattern. The MTM management table offers a proposal for the choice of type and timing of treatment customized per each stage of MTM.

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