Selection of Appropriate Treatment Options for Hand Fractures

Hand Clinics ◽  
2013 ◽  
Vol 29 (4) ◽  
pp. 501-505 ◽  
Author(s):  
Douglas M. Sammer ◽  
Tarik Husain ◽  
Rey Ramirez
Keyword(s):  
Treatment Options ◽  
Appropriate Treatment ◽  
Hand Fractures ◽  
Selection Of

scholarly journals Proposed Algorithm for Management of Meibomian Gland Dysfunction Based on Noninvasive Meibography

2020 ◽  
Vol 10 (1) ◽  
pp. 65
Author(s):  
Reiko Arita ◽  
Shima Fukuoka ◽  
Motoko Kawashima
Keyword(s):  
International Workshop ◽  
Treatment Options ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Ocular Symptoms ◽  
Appropriate Treatment ◽  
Stage Classification ◽  
Surface Staining ◽  
Selection For ◽  
Selection Of

Although the pathophysiology of meibomian gland dysfunction (MGD) remains incompletely understood, many treatment options have recently become available. According to an international workshop report, treatment selection for MGD should be based on a comprehensive stage classification dependent on ocular symptoms, lid margin abnormalities, meibum grade, and ocular surface staining. However, it is often difficult to evaluate all parameters required for such classification in routine clinical practice. We have now retrospectively evaluated therapeutic efficacy in MGD patients who received five types of treatment in the clinic setting: (1) meibocare (application of a warm compress and practice of lid hygiene), (2) meibum expression plus meibocare, (3) azithromycin eyedrops plus meibocare, (4) thermal pulsation therapy plus meibocare, or (5) intense pulsed light (IPL) therapy plus meibocare. Patients in each treatment group were classified into three subsets according to the meiboscore determined by noncontact meibography at baseline. Eyes in the IPL group showed improvement even if the meiboscore was high (5 or 6), whereas meibocare tended to be effective only if the meiboscore was low (1 or 2). The meiboscore may thus serve to guide selection of the most appropriate treatment in MGD patients. Prospective studies are warranted to confirm these outcomes.

scholarly journals Selection of treatment for hepatic epithelioid hemangioendothelioma: a single-center experience

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Linping Cao ◽  
Jiawei Hong ◽  
Lingfeng Zhou ◽  
Yufu Ye ◽  
Yuanxing Liu ◽  
...  
Keyword(s):  
Treatment Options ◽  
Needle Aspiration ◽  
Epithelioid Hemangioendothelioma ◽  
Multiple Strategies ◽  
Single Center Experience ◽  
Appropriate Treatment ◽  
Significant Disease ◽  
Selection Of ◽  
Observation Period

Abstract Background Hepatic epithelioid hemangioendothelioma (HEHE) is a rare angiogenic tumor with no recognized effective treatment. Treatment options used worldwide include liver transplantation (LT), liver resection (LR), radiofrequency ablation (RFA), chemotherapy, and observation. The aim of this study was to describe the efficacy of different treatment options used for HEHE at our center. Methods The medical charts of 12 patients with HEHE (9 women and 3 men) who were diagnosed and treated at the First Affiliated Hospital of Zhejiang University, China, between January 2011 and December 2017 were retrospectively reviewed. Results The patients were diagnosed by postoperative histopathology or fine needle aspiration biopsy. Two patients with diffuse lesions received LT and were alive without recurrence at the last follow-up. Three patients received LR as the initial treatment, and all of them developed recurrence during the follow-up period. One patient received RFA and remained free of disease, while the remaining six patients opted for simple observation rather than treatment. One of the patients who received LR passed away because of tumor recurrence within 32 months after surgery; the other patients showed no significant disease activity after treatments for their recurrent lesions. As of April 2018, the mean follow-up duration was 39.6 ± 20.1 months (15–82 months). Conclusions There are multiple strategies for HEHE. Considering its indolent course, initial observation for assessment of the lesion behavior may aid in the selection of appropriate treatment. Surgery or LT is suitable for patients with disease progression during the observation period. However, our sample size was small, and further studies are required to gather more information that can aid in optimal treatment selection.

scholarly journals Open surgery retrieval of a missing guidewire causing cerebral infarctions after cerebral angiography: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Cerebral Angiography ◽  
Open Surgery ◽  
Foreign Bodies ◽  
Treatment Options ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Long Time ◽  
Multiple Cerebral Infarctions ◽  
Selection Of

Abstract Background Intra-aortic foreign body (IAFB) is uncommon, which is usually caused by a rupture of the catheter or guidewire. IAFB can cause catastrophic complications, including arrhythmia, embolization of guidewire fragments, intravascular clipping of the guidewire and vascular perforation. However, there are still no guidelines on removal and management of IAFB. Here, we present a rare case of fractured cerebral angiographic guidewires in the aorta that resulted in multiple cerebral infarctions. Case presentation A 50-year-old man experienced new cerebral infarction after cerebral angiography. Computed tomography and echocardiography demonstrated foreign bodies in his ascending aorta and aortic arch. Open surgery was successfully performed to retrieve the guidewires. The postoperation and follow-up was uneventful. Conclusion It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent IAFB. Additionally, the effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up.

scholarly journals Open Surgery Retrieval Of A Missing Guidewire Causing Cerebral Infarctions After Cerebral Angiography: A Case Report

2021 ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Cerebral Angiography ◽  
Open Surgery ◽  
Guide Wire ◽  
Treatment Options ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Long Time ◽  
Multiple Cerebral Infarctions ◽  
Selection Of

Abstract Background: Intra-aortic foreign body (IAFB) is uncommon, which is usually caused by a rupture of the catheter or guidewire. IAFB can cause catastrophic complications, including arrhythmia, embolization of guide wire fragments, intravascular clipping of the guide wire and vascular perforation. However, there are still no guidelines on removal and management of IAFB. Here, we present a rare case of fractured cerebral angiographic guidewires in the aorta that resulted in multiple cerebral infarctions.Case presentation: A 50-year-old man experienced new cerebral infarction after cerebral angiography. Computed tomography and echocardiography demonstrated foreign bodies in his ascending aorta and aortic arch. Open surgery was successfully performed to retrieve the guidewires. The postoperation and follow-up was uneventful.Conclusion: It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent IAFB. Additionally, the effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up.

scholarly journals Completion of the Updated Caprini Risk Assessment Model (2013 Version)

2019 ◽  
Vol 25 ◽  
pp. 107602961983805 ◽  
Author(s):  
MaryAnne Cronin ◽  
Nancy Dengler ◽  
Eugene S. Krauss ◽  
Ayal Segal ◽  
Nicole Wei ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Clinical Trials ◽  
Venous Thromboembolism ◽  
Treatment Options ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Postoperative Course ◽  
Appropriate Treatment ◽  
Presurgical Assessment ◽  
Selection Of

The Caprini risk assessment model (RAM) has been validated in over 250 000 patients in more than 100 clinical trials worldwide. Ultimately, appropriate treatment options are dependent on precise completion of the Caprini RAM. As the numerical score increases, the clinical venous thromboembolism rate rises exponentially in every patient group where it has been properly tested. The 2013 Caprini RAM was completed by specially trained medical students via review of the presurgical assessment history, medical clearances, and medical consults. The Caprini RAM was completed for every participant both preoperatively and predischarge to ensure that any changes in the patient’s postoperative course were captured by the tool. This process led to the development of completion guidelines to ensure consistency and accuracy of scoring. The 2013 Caprini scoring system provides a consistent, thorough, and efficacious method for risk stratification and selection of prophylaxis for the prevention of venous thrombosis.

scholarly journals Chest Computed Tomography (CT) Findings and Semiquantitative Scoring of 60 Patients with Coronavirus Disease 2019 (COVID-19): A Retrospective Imaging Analysis Combining Anatomy and Pathology

2020 ◽  
Author(s):  
Hao Zhang ◽  
Xu-jing Jiang ◽  
Xiao-hua Liu ◽  
Hong Ma ◽  
Ya-hong Zhang ◽  
...  
Keyword(s):  
Disease Severity ◽  
Healthcare Workers ◽  
Treatment Options ◽  
Chest Ct ◽  
Ct Findings ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Ct Data ◽  
Severity Of The Disease ◽  
Selection Of

Abstract In this study, we ascertained the chest CT data of 60 patients admitted to 3 hospitals in Chongqing with confirmed COVID-19. We conducted anatomical and pathological analyses to elucidate the possible reasons for the distribution, morphology, and characteristics of COVID-19 in chest CT. We also shared a semiquantitative scoring of affected lung segments, which was recommended by our local medical association. This scoring system was applied to quantify the severity of the disease. The most frequent imaging findings of COVID-19 were subpleural ground glass opacities and consolidation; there was a significant difference in semiquantitative scores between the early, progressive, and severe stages of the disease. We conclude that the chest CT findings of COVID-19 showed certain characteristics because of the anatomical features of the human body and pathological changes caused by the virus. Therefore, chest CT is a valuable tool for facilitating the diagnosis of COVID-19 and semiquantitative scoring of affected lung segments may further elucidate diagnosis and assessment of disease severity. This will assist healthcare workers in diagnosing COVID-19 and assessing disease severity, facilitate the selection of appropriate treatment options, which is important for reducing the spread of the virus, saving lives, and controlling the pandemic.

Characteristics of Polycystic Ovarian Syndrome in Sub-fertile Woman Attending to GOPD in ShSMCH

2019 ◽  
Vol 11 (1) ◽  
pp. 17-23
Author(s):  
Jinnat Ara Islam ◽  
Fatema Ashraf ◽  
Eva Rani Nandi
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovaries ◽  
Cross Sectional ◽  
Medical College ◽  
Appropriate Treatment ◽  
Pcos Group ◽  
Symptom Complex ◽  
Ovarian Syndrome ◽  
Selection Of ◽  
Fertile Women

Background: Polycystic ovarian syndrome (PCOS) is a condition characterized by menstrual abnormalities (oligo/amenorrhea) and clinical or biochemical features of hyperandrogenism and may manifest at any age. It is a common cause of female subfertility. All the dimensions of PCOS have not been yet completely explored. Methods: It was a cross sectional comparative study carried out at-GOPD of Shaheed Suhrawardy Medical College & Hospital from January, 2016 to December 2016 on 162 subfertile women. Among them 54 were PCOS group and 108 were non PCOS group. PCOS was diagnosed by (Rotterdam criteria 2003) (i) Oligo or anovulation (ii) hyperandrogenism (iii) Polycystic ovaries. Study was done to evaluate and compare the demographic characteristics, clinical, biochemical and ultrasoundgraphic features of sub-fertile women with and without PCOS. Results: A total of 162 sub-fertile women aged 16-36 years. Mean age was 29.5±5.4. There were significant differences between the two groups in terms of (oligo/amenorrhea), hirsutism, WHR and ovarian ultrasound features. There were no significant differences between two groups in correlations between the level of obesity with the incidence of anovulation, hyperandrogenism or with hormonal features. Conclusion: PCOS is one of the important factors causing Infertility. It is an ill-defined symptom complex needed due attention. There is a need to increase awareness regarding. The clinical features of PCOS are heterogenous thus can be investigated accordingly of selection of appropriate treatment modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 17-23

Candida albicans endocarditis involving a normal native aortic valve in an immunocompetent patient

2020 ◽  
Vol 13 (11) ◽  
pp. e236902
Author(s):  
Taha Sheikh ◽  
Jeremy C Tomcho ◽  
Mohammed T Awad ◽  
Syeda Ramsha Zaidi
Keyword(s):  
Candida Albicans ◽  
Mortality Rate ◽  
Aortic Valve ◽  
High Mortality ◽  
Treatment Options ◽  
Immunocompetent Patient ◽  
Fungal Endocarditis ◽  
Appropriate Treatment ◽  
Mechanical Valves ◽  
Serious Infection

Fungal endocarditis, specifically from Candida species, is a rare but serious infection with a high mortality rate. Most cases occur in bioprosthetic or mechanical valves and are uncommon in native, structurally normal valves. When Candida endocarditis is detected and appropriate treatment is initiated earlier, there is an improvement in mortality. While the recommendation is usually to treat with a combination of surgery and antifungal medications, patient comorbidities may limit treatment options.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

Endoleaks: current concepts and treatments

2021 ◽  
Author(s):  
Zia Ur Rehman
Keyword(s):  
Stent Graft ◽  
Treatment Options ◽  
Endovascular Aneurysm Repair ◽  
Aneurysm Rupture ◽  
Special Situation ◽  
Type V ◽  
Aneurysm Repair ◽  
Benign Course ◽  
Selection Of

Endoleaks are the most common complications following endovascular aneurysm repair. Depending upon their origin, there are five types of endoleaks, types I-V, which can also be classified as direct and indirect endoleaks. Direct endoleaks type 1 and III have higher risk of aneurysm rupture due to rapid sac expansion, and require immediate correction.  Indirect endoleaks types II, IV and V have a relatively benign course compared to direct endoleaks. Most of them resolve with time and very few of them need interventions upon sac enlargement. Type V endotension is a special situation where there is sac enlargement despite no demonstrable endoleak. Proper planning and appropriate selection of stent-graft can prevent most of these endoleaks. With improvement in stent-graft technology, the incidence of endoleaks has been reduced. The current narrative review was planned to describe the pathophysiology, risk factors and treatment options for each type of endoleak. Continuous...

Sign in / Sign up

Export Citation Format

Share Document