Coronectomy of High Risk Wisdom Teeth With Superficial Caries: A Case Series With 12-Month Follow-up

2016 ◽  
Vol 74 (9) ◽  
pp. e59-e60
Author(s):  
N. Patel ◽  
N. Thanabalan ◽  
T. Halai ◽  
K. Beneng
Keyword(s):  
High Risk ◽  
Case Series ◽  
Wisdom Teeth

Case Series Regarding Parastomal Variceal Bleeding: Presentation and Management

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
John Romano ◽  
Charles V. Welden ◽  
Jordan Orr ◽  
Brendan McGuire ◽  
Mohamed Shoreibah
Keyword(s):  
Portal Hypertension ◽  
High Risk ◽  
Literature Review ◽  
Variceal Bleeding ◽  
Coil Embolization ◽  
Case Series ◽  
Treatment Modalities ◽  
Post Procedure ◽  
Lost To Follow Up

Parastomal variceal bleeding (PVB) is a serious complication occurring in up to 27% of patients with an ostomy and concurrent cirrhosis and portal hypertension. The management of PVB is difficult and there are no clear guidelines on this matter. TIPS, sclerotherapy, and /or coil embolization are all therapies that have been shown to successful manage PVB. We present a case series with five different patients who had a PVB at our institution. The aim of this case series is to report our experience on the management of this infrequently reported but serious condition. We also conducted a systemic literature review focusing on the treatment modalities of 163 patients with parastomal variceal bleeds. In our series, patient 1 had embolization and sclerotherapy without control of bleed and expired on the day of intervention due to hemorrhagic shock. Patient 2 had TIPS in conjunction with embolization and sclerotherapy and had no instance of rebleed 441 days after therapy. Patient 3 did not undergo any intervention due to high risk for morbidity and mortality, the bleed self-resolved and there was no further rebleed, this same patient died of sepsis 73 days later. Patient 4 had embolization and sclerotherapy and had no instance of rebleed 290 days after therapy. Patient 5 had TIPS procedure and was discharged five days post procedure without rebleed, patient has since been lost to follow-up.

scholarly journals A277 DISCREPANCIES IN EUS-FNA CYTOPATHOLOGY AND SURGICAL SPECIMEN PATHOLOGY FOR HIGH RISK PANCREATIC MUCINOUS CYSTIC LESIONS: A CASE SERIES

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 155-156
Author(s):  
S Li ◽  
M Monachese ◽  
P James
Keyword(s):  
High Risk ◽  
Surgical Resection ◽  
Case Series ◽  
Surgical Pathology ◽  
Low Grade ◽  
Cystic Lesions ◽  
Cystic Neoplasms ◽  
Cross Sectional ◽  
Surgical Specimen

Abstract Background Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is the primary method of sampling pancreatic cystic lesions with reported specificity near 100% for diagnosing malignancy. Discrepant positive malignant cytopathology with final surgical pathology of pancreatic cystic lesions has not previously been described. Aims To present a case series and review the literature regarding the implications of positive malignant cytology with discrepant surgical pathology for high risk pancreatic mucinous cystic lesions. Methods Patient demographics, clinical history, procedure details, pathology evaluations and follow-up were collected. A thorough literature review was performed. Results Three patients with high-risk pancreatic cystic lesions on cross-sectional imaging underwent EUS-FNA evaluation. None of these patients had a history of pancreatitis. Cytology was reported as positive for adenocarcinoma in all patients by separate gastrointestinal cytopathologists. All patients underwent surgical resection. The pathology for all resected specimens were reported as intraductal papillary mucinous neoplasm. The resected cysts for two patients demonstrated foci of high-grade dysplasia and the third noted low grade dysplasia. All surgical pathology underwent consensus review by three separate gastrointestinal pathologists. None of the patients were treated with adjuvant chemotherapy. All patients have been followed post-operatively with surveillance magnetic resonance imaging with no evidence of recurrence to date (median follow-up time 239 days, range 133 – 447 days). Conclusions This phenomenon sheds light on the potential for variable interpretations of EUS-FNA cytopathology and surgical resection pathology for high risk pancreatic cystic neoplasms. EUS-FNA may identify foci of adenocarcinoma that is not seen on surgical pathology specimens. Further research is required to examine the long-term outcomes of these patients. Funding Agencies None

Open versus laparoscopic retroperitoneal lymph node dissection (RPLND) in clinical stage I nonseminomatous germ-cell tumors (NSGCTs): Two contemporary series from a single institution

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5084-5084
Author(s):  
N. Nicolai ◽  
D. Biasoni ◽  
J. Piedra Aguilera ◽  
A. Necchi ◽  
L. Piva ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Stage ◽  
Operating Time ◽  
Case Series ◽  
Median Number ◽  
Low Risk ◽  
Stage I ◽  
Nodal Metastases ◽  
Risk Patients

5084 Background: Primary RPLND is our choice for clinical stage I (CSI) NSGCTs. Open RPLND (O-RPLND) has been our standard policy since 1985, while laparoscopic RPLND (L-RPLND) has been introduced since the late-1990s. Methods: Between June 2003-March 2008, 150 consecutive CSI NSGCT patients (pts) have been submitted to O-RPLND (n = 91) or L-RPLND (n = 59). Pts with high risk disease (vascular invasion/embryonal carcinoma > 90% in the primary tumor) were more frequently offered O-RPLND, while pts with low risk disease (none of the 2 above) were usually considered for L-RPLND. We reviewed our data focusing on: complications, operating time (OT), hospital stay (HS), number of removed nodes, occurrence of nodal metastases as well as of metastasis during follow-up and global need of chemotherapy (CT). Results: O-RPLND (91). 59/91 (64.8%) were high-risk patients. Median OT was 140 min (IQR 110–150). Five (5.5%) complications occurred: 4 lymphorrea and 1 hemorrhage. Median HS was 6 days (IQR 5–7). Nodal metastases were found in 24 (26.4%) pts. Median number of removed nodes was 20 (IQR 14–25). L-RPLND (59). 54/59 (91.2%) were low-risk patients. Median OT was 210 min (IQR 180–240). Ten (16.9%) complications occurred: 5 required conversions to open procedure due to intraoperative bleeding (4) or technical impossibility to conclude the procedure (1). Median HS was 4 days (IQR 4–5). Nodal metastases were found in 5 (8.5%) pts: 2 of them received immediate adjuvant CT. Median number of removed nodes was 14 (IQR 11–20). OT and HS were significantly better in O-RPLND and L-RPLND series, respectively (p.0001 at Mann Whitney test). After a median follow-up of 15.1 months (1–52), distant metastases were observed in 10 (0.7%) pts: 7/91 (7.7%) following O-RPLND and 1/59 (1.7%) following L-RPLND. CT was administered to 7 (7.7%) pts following O-RPLND and to 3 (5.1%) pts following L-RPLND. Conclusions: In this large case-series, no excess of recurrences but a higher rate of complications were recorded in L-RPLND pts. O-RPLND had a significant better OT while HS was shorter in L-RPLND series. Both procedures are still being applied: pts are currently offered one of the 2 modalities after counseling. No significant financial relationships to disclose.

scholarly journals Coronectomy of Mandibular Third Molar: Four Years of Follow-Up of 130 Cases

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 654
Author(s):  
Saverio Cosola ◽  
Young Sam Kim ◽  
Young Min Park ◽  
Enrica Giammarinaro ◽  
Ugo Covani
Keyword(s):  
Correct Diagnosis ◽  
Extraction Procedure ◽  
Third Molar ◽  
Case Series ◽  
Mandibular Third Molar ◽  
Wisdom Teeth ◽  
Oral Surgical Procedure ◽  
Teeth Extraction

Inferior wisdom teeth extraction surgery may have some complications that, in some cases, could be prevented by a correct diagnosis and minimal surgery. Coronectomy is a technique used for wisdom teeth surgery where only the crown is extracted and the root/roots are left in situ. This procedure may be controversial, but it could limit the common risks of the extraction procedure. Nowadays, the indication and contraindication of this technique are debated, and clinicians normally extract the entire tooth. The following case series includes the data and follow-up radiographs of 130 patients who received a coronectomy, reporting the safety of the procedure. After a mean follow-up period of four years, no complications occurred. A total of 13 patients showed mobile roots but had no complications or symptoms. The roots migrated in a mesial or coronal direction in 31 patients; in 4 cases, they were removed because of patient preference. Coronectomy is a useful oral surgical procedure in certain complicated cases of mandibular wisdom tooth extraction.

scholarly journals Minimally Invasive Posterior Cervical Fusion With Facet Cages to Augment High-Risk Anterior Cervical Arthrodesis: A Case Series

2020 ◽  
Vol 10 (2_suppl) ◽  
pp. 56S-60S
Author(s):  
Sterling Kramer ◽  
Mohamed F. Albana ◽  
John B. Ferraro ◽  
Rahul V. Shah
Keyword(s):  
High Risk ◽  
Minimally Invasive ◽  
Patient Outcomes ◽  
Case Series ◽  
Cervical Fusion ◽  
Anterior Cervical Decompression ◽  
Average Improvement ◽  
Vas Scores ◽  
Posterior Cervical Fusion

Study Design: Retrospective case series. Objectives: To evaluate the efficacy and results of minimally invasive posterior cervical fusion with facet cages as an augment to high-risk patients and patients status post multilevel anterior cervical decompression and fusion. Methods: Thirty-five patients with symptomatic cervical stenosis with high risk for pseudoarthrosis underwent circumferential cervical decompression and fusion via staged anterior and posterior approach. Anterior cervical decompression and fusion was performed first by means of the standard anterior approach, with the patient supine on the operating table. The patients were subsequently flipped into a prone position and minimally invasive posterior cervical facet fusion with DTRAX was performed. The patients were then followed in the outpatient clinic for an average of 312.71 days. Postoperative patient satisfaction scores were obtained via the visual analogue scale (VAS). Preoperative VAS scores were compared with postoperative VAS scores in order to evaluate patient outcomes. Results: Of the 35 patients evaluated, minimum follow-up was 102 days, with a maximum follow-up of 839 days. Average preoperative and postoperative VAS scores were 7.6 and 2.8, respectively ( P < .0001), with an average improvement of 4.86 points. This was an average improvement of 64.70% from preoperative to postoperative. Seventeen patients had excellent outcomes, with a postoperative VAS score ≤2. Seven patients achieved a postoperative VAS score of 0, with 100% improvement of preoperative pain and symptoms. Average blood loss was 70.38 mL. Average length of stay was 1.03 days. Conclusions: The results indicate that minimally invasive posterior cervical decompression and fusion with facet cages, when combined with standard anterior cervical decompression and fusion, is an effective means of obtaining circumferential cervical fusion while simultaneously improving patient outcomes.

scholarly journals Closure or medical therapy of patent foramen ovale in cryptogenic stroke: prospective case series

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sven Poli ◽  
Elisabeth Siebert ◽  
Joshua Mbroh ◽  
Khouloud Poli ◽  
Markus Krumbholz ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Therapy ◽  
Intracranial Hemorrhage ◽  
Patent Foramen Ovale ◽  
Case Series ◽  
Low Risk ◽  
Foramen Ovale ◽  
Prospective Case Series ◽  
Pfo Closure

Abstract Background Results of randomized controlled trials (RCT) do not provide definite guidance for secondary prevention after ischemic stroke (IS)/transient ischemic attack (TIA) attributed to patent foramen ovale (PFO). No recommendations can be made for patients > 60 years. We aimed to compare interventional and medical PFO-management in cryptogenic IS/TIA patients, including patients > 60 years. Methods Prospective case series including consecutive cryptogenic IS/TIA patients with PFO at Tuebingen university stroke unit, Germany. ‘PFO-closure’ was recommended in patients ≤70 years when featuring high-risk PFO (i.e., with atrial septal aneurysm, spontaneous, or high-grade right-to-left shunt during Valsalva). Primary (recurrent IS/intracranial hemorrhage) and secondary endpoints (e.g., disability) were assessed during ≥1-year follow-up; planned subgroup analyses of patients ≤60/> 60 years. Results Among 236 patients with median age of 58 (range 18–88) years, 38.6% were females and median presenting National Institutes of Health Stroke Scale score was 1 (IQR 0–4). Mean follow-up was 2.8 ± 1.3 years. No intracranial hemorrhage was observed. Recurrent IS rate after ‘PFO-closure’ was 2.9% (95%CI 0–6.8%) and 7% (4–16.4) in high-risk PFO patients ≤60 (n = 103) and > 60 years (n = 43), respectively, versus 4% (0–11.5) during ‘medical therapy alone’ MTA (n = 28). 42 low-risk PFO patients treated with MTA experienced no recurrent IS/TIA. Conclusions In our real-world study, IS recurrence rate in ‘PFO-closure’ high-risk PFO patients ≤60 years was comparable to that observed in recent RCT. High-risk PFO patients > 60 years who underwent PFO-closure had similar IS recurrence rates than those who received MTA. MTA seems the appropriate treatment for low-risk PFO. Trial registration ClinicalTrials.gov, registration number: NCT04352790, registered on: April 20, 2020 – retrospectively registered.

Outcomes of stent-graft repair for anastomotic femoral pseudoaneurysm. A case series

Vascular ◽  
2021 ◽  
pp. 170853812110451
Author(s):  
Marco Franchin ◽  
Federico Fontana ◽  
Luca Luzzani ◽  
Michela Lanza ◽  
Gabriele Piffaretti ◽  
...  
Keyword(s):  
High Risk ◽  
Stent Graft ◽  
Case Series ◽  
Common Femoral Artery ◽  
Related Complication ◽  
Stent Grafting ◽  
Stent Graft Repair ◽  
Novel Coronavirus ◽  
Post Hoc

Objective This study aims to report a case series of anastomotic femoral pseudoaneurysms (PSA) treated with stent-grafting (SG) in patients at high-risk for the open surgical approach. Methods It is a retrospective, observational cohort study. Between 1 January 2002 and 1 April 2020, post-hoc analysis of the database including patients who received repair for femoral PSA identified those treated with SG. All but one patient were approached through a contralateral percutaneous transfemoral access, and the SG was always deployed from the common femoral artery to the profunda femoris artery. For this study, primary outcomes of interest were early (≤ 30 days) survival and patency rate. Results We identified 10/823 cases of the entire PSA cohort (1.2%). There were 9 men and 1 woman: the mean age was 76 years ± 9 (range: 64–92). Urgent intervention was performed in 4 patients. The median operative time was 30 min (IQR: 25–36). Access-related complication was never observed. In-hospital mortality occurred in 1 patient due to novel coronavirus-19–related pneumonia. Median follow-up was 24 months (IQR: 12–37); 5 patients died. At the last radiologic follow-up available, all SGs were patent without necessity of reintervention. Conclusion Stent-graft repair for anastomotic femoral PSA may be considered a reasonable alternative for patients at high-risk for open surgical repair.

Clinical outcomes following selective laser trabeculoplasty in Afro-Caribbean patients with glaucoma at high risk for progression

2021 ◽  
pp. bjophthalmol-2020-317117
Author(s):  
Tony Realini ◽  
Hazel Shillingford-Ricketts ◽  
Darra Burt ◽  
Goundappa K Balasubramani
Keyword(s):  
High Risk ◽  
Clinical Outcomes ◽  
Open Angle Glaucoma ◽  
Medication Use ◽  
Case Series ◽  
Patient Specific ◽  
Selective Laser Trabeculoplasty ◽  
Time Points ◽  
Laser Trabeculoplasty

AimTo characterise clinical outcomes following selective laser trabeculoplasty (SLT) in eyes of Afro-Caribbean patients with open-angle glaucoma (OAG) at high risk for progression.MethodsIn a prospective interventional case series, patients meeting high-risk criteria (advanced disease, unilateral glaucoma blindness, inadequate intraocular pressure (IOP) on >2 medications, recent progression on medications, inability to administer, afford or tolerate medications) underwent bilateral 360° SLT and managed based on their subsequent clinical course. Patient-specific indications for SLT—IOP reduction (IOP group) or reduced reliance on medical therapy (MED group)—were recorded before treatment. IOP and medication use were recorded every 3–4 months through up to 24 months of follow-up. Outcomes were analysed separately in the IOP and MED groups.ResultsAmong 33 right eyes (left eye outcomes were similar) in the IOP group, mean (SD) IOP was significantly reduced from 21.7 (7.5) mm Hg to 16.2–17.1 mm Hg over follow-up (p<0.0177); medication use remained unchanged (p>0.05) at all time points. Among 36 right eyes in the MED group, mean medication use was 1.9 (0.9) at baseline and ranged from 1.2 to 1.4 medications per eye through follow-up (p<0.0033), and mean IOP was significantly reduced at months 1–6 (to 13.1 (2.3) mm Hg, p=0.0013), months 13–18 (to 14.3 (2.8), p=0.0136) and unchanged at other time points. No vision-threatening adverse events occurred.ConclusionsAfro-Caribbean patients with OAG at risk for progression can achieve clinically and statistically significant reductions in IOP or medications through up to 24 months following a single 360° SLT treatment.Trial registration numberNCT02375009.

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