Longstanding overt ventriculomegaly in adults (LOVA): diagnostic aspects, CSF dynamics with lumbar infusion test and treatment options in a consecutive series with long-term follow-up.

A 9-year-old girl presented to the emergency department reporting intense pain and inability to bear weight on her left foot after a classmate tripped over it. Imaging studies confirmed a fracture of the cuboid bone due to compression of the lateral column of the foot (also known as nutcracker fracture). The patient was treated surgically, with direct reduction of the compression fracture and definitive fixation with two Kirschner wires. Cuboid nutcracker fracture is rare in children and adolescents, and potential consequences can occur if it is not correctly diagnosed and adequately managed. Literature on this type of fracture is scarce, along with information on treatment options and results over medium-term and long-term follow-up. We describe this case and review the literature on this particular topic.

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Angiolymphoid Hyperplasia with Eosinophilia (Histiocytoid Hemangioma): Evaluation of Treatment Options

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949310200410 ◽

1993 ◽

Vol 102 (4) ◽

pp. 303-308 ◽

Cited By ~ 24

Author(s):

Mack L. Cheney ◽

Samir Bhatt ◽

Paul Googe ◽

Patricia L. Hibberd

Keyword(s):

Treatment Options ◽

Clinical Problem ◽

Radical Excision ◽

Angiolymphoid Hyperplasia With Eosinophilia ◽

Angiolymphoid Hyperplasia ◽

Immunodeficiency Virus ◽

Long Term Follow Up ◽

Proliferative Lesion

Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular proliferative lesion of unknown cause. In this report, a case is presented of a patient who was confirmed to be positive for human immunodeficiency virus and in whom the lesion had shown rapid accelerated growth. The case is used to illustrate a variety of therapeutic techniques and to evaluate the effectiveness of the various alternatives in the treatment of this unusual clinical problem. Long-term follow-up after radical excision of the tumor mass is presented.

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RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v7.i12.2019.311 ◽

2020 ◽

Vol 7 (12) ◽

pp. 189-198

Author(s):

Zeynep Başağaoğlu Demirekin ◽

Yavuz Findik ◽

S. Süha Turkaslan ◽

Timuçin Baykul ◽

Merve Erken

Keyword(s):

Treatment Options ◽

Clinical Results ◽

Long Term Results ◽

Retrospective Evaluation ◽

Early Results ◽

Single Crown ◽

Long Term Follow Up ◽

Implant Therapy

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

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Abstract 165: Pial Synangiosis in Patients with Moyamoya less than 2 Years of Age

Stroke ◽

10.1161/str.43.suppl_1.a165 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Eric M Jackson ◽

Ning Lin ◽

Lissa Baird ◽

R. Michael Scott ◽

Edward R Smith

Keyword(s):

Late Complications ◽

High Risk Population ◽

Consecutive Series ◽

Ischemic Change ◽

Initial Surgery ◽

Long Term Follow Up ◽

Progression Of Disease ◽

Long Term Prognosis

Introduction: Moyamoya patients under two years of age represent a therapeutic challenge because of their frequent neurologic instability and concomitant anesthetic risks. We report our experience with pial synangiosis revascularization in this population. Methods: We reviewed the clinical and radiographic records of all patients with moyamoya syndrome in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results: During a 12-year period (1994-2005), thirty-four procedures (15 bilateral, 4 unilateral) were performed in 19 patients under two years of age (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or TIA. Average age at first surgery was 1.4 years (range 6 months to 1.9 years). Unanticipated staged operations occurred in three patients, two due to persistent EEG changes during the initial surgery and one due to brain swelling during the procedure requiring ventriculostomy. There were two perioperative strokes; both patients had post-operative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14). In long term follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures years later for frontal lobe ischemia (2), late infarction (1) and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre and post-operative angiography demonstrated progression of disease. Conclusions: Despite the challenges inherent to this population, the majority of children with moyamoya under 2 years of age have a good long-term prognosis. Our data support the use of pial synangiosis as a safe, effective and durable method for treatment of moyamoya for most children in this potentially high-risk population.

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Long-term outcome of social phobia treated by exposure

Psychological Medicine ◽

10.1017/s0033291701004020 ◽

2001 ◽

Vol 31 (5) ◽

pp. 899-905 ◽

Cited By ~ 39

Author(s):

G. A. FAVA ◽

S. GRANDI ◽

C. RAFANELLI ◽

C. RUINI ◽

S. CONTI ◽

...

Keyword(s):

Social Phobia ◽

Consecutive Series ◽

Term Outcome ◽

Long Term Outcome ◽

Concurrent Use ◽

Complete Treatment ◽

Long Term Follow Up ◽

Dsm Iv

Background. There is very little information on long-term follow-up of social phobia.Methods. A consecutive series of 70 patients satisfying the DSM-IV criteria for social phobia was treated in an out-patient clinic with behavioural methods based on exposure homework. Forty-five patients were judged to be remitted after eight individual sessions of psychotherapy. A 2 to 12 year (median = 6 years) follow-up was performed. Survival analysis was selected to characterize the clinical course of patients. Assessments were performed before treatment, at the end of therapy, after 1 year, and subsequently on a yearly basis, and utilized selected items of Paykel's Clinical Interview for Depression.Results. Six of the 45 patients (13%) had a relapse of social phobia at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 98 after 2 years, 85 after 5 years and 85 after 10 years. Such probabilities increased in the absence of a personality disorder, of residual social phobic avoidance after exposure, and of concurrent use of benzodiazepines.Conclusions. The findings suggest that, even though one patient out of three is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting effects to the majority of patients with social phobia. Disappearance of residual, subclinical social phobic avoidance appears to be the target of treatment.

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Management and outcome of acute and recurrent pericarditis during pregnancy

European Heart Journal ◽

10.1093/ehjci/ehaa946.2157 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D Lotan ◽

Y Wasserstrum ◽

E Itelman ◽

M Nir-Simchen ◽

M Arad ◽

...

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Q Fever ◽

Treatment Options ◽

Subsequent Treatment ◽

High Recurrence Rate ◽

Recurrent Pericarditis ◽

Long Term Follow Up

Abstract Background Pericarditis in pregnancy is uncommon. Treatment options, including NSAIDs and long term gluco-corticosteroids (CS) have extensive side-effects, while data on the use of Colchicine in pregnant women who suffer from pericarditis is limited. Objective To evaluate the management and outcome of active pericarditis during pregnancy in both acute (AP) and recurrent pericarditis (RP) patients. Methods and results Twelve pregnant women (14 pregnancies) with active pericarditis were followed prospectively in our cardiology-pregnancy clinic; 6 with AP and 8 with RP. Etiology: 11 idiopathic, 2 post-pericardiotomy syndrome and 1 Q fever. Maternal age on presentation was 27±4y vs. 33±3y in RP vs AP respectively. Average gestational age upon diagnosis was lower in RP than in AP (18 weeks, range 6–30 vs 26 weeks, range 5–35). In the RP group, 7/8 women (87%) were treated with CS compared with 2/6 women (33%) in the AP group; 3 women in RP group (37%) failed to respond to subsequent treatment with azathioprine and 1 patient was treated successfully with Anakinra. Colchicine was prescribed in 13/14 (93%) of pregnancies, average colchicine exposure during pregnancy was 25±15 weeks. Recurrence during pregnancy: 6/8 (75%) of RP; 2/6 (33%) of the AP, all of them on CS. All pregnancies culminated in a live birth with a mean gestational age on delivery of 37±1.4 weeks. Average birthweight was 3267±507 grams. There were no fetal anomalies or developmental delays after a mean follow-up of 2.7 years. All newborns and maternal outcomes were normal. On long term follow-up after delivery RP patients treated with colchicine developed less recurrences. Conclusion Active pericarditis is associated with a high recurrence rate during pregnancy despite treatment with CS. Colchicine use in pregnant women with active pericarditis appears to be safe. Funding Acknowledgement Type of funding source: None

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What non-pharmacological treatments do people with polymyalgia rheumatica try: results from the PMR Cohort Study

Rheumatology International ◽

10.1007/s00296-021-05036-6 ◽

2021 ◽

Author(s):

Jake Weddell ◽

Samantha L. Hider ◽

Christian D. Mallen ◽

Sara Muller

Keyword(s):

Cohort Study ◽

Polymyalgia Rheumatica ◽

Treatment Options ◽

Complementary Therapy ◽

Evidence Base ◽

Pharmacological Therapy ◽

Pharmacological Treatments ◽

Long Term Follow Up

AbstractPolymyalgia rheumatica (PMR) is common. The mainstay of treatment, glucocorticoids, are associated with significant adverse effects and many patients remain on high doses for a number of years. Little is known about the use of other, non-pharmacological therapies as adjuncts in PMR. The PMR Cohort Study is an inception cohort study of patients diagnosed with PMR in primary care. This analysis presents data on the use and perceived impact of non-pharmacological therapies from a long-term follow-up survey. Non-pharmacological treatments were classified as either diet, exercise, or complementary therapies. Results are presented as adjusted means, medians, and raw counts where appropriate. One hundred and ninety-seven participants completed the long-term follow-up questionnaire, of these 81 (41.1%) reported using non-pharmacological therapy. Fifty-seven people reported using a form of complementary therapy, 35 used exercise and 20 reported changing their diet. No individual non-pharmacological therapy appeared to be associated with long-term outcomes. The use of non-pharmacological therapies is common amongst PMR patients, despite the paucity of evidence supporting their use. This suggests that people perceive a need for treatment options in addition to standard glucocorticoid regimens. Further research is needed to understand patients’ aims when seeking additional treatments and to strengthen the evidence base for their use so that patients can be guided towards effective options.

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Long-term outcomes in Primary congenital glaucoma, aniridia and anterior segment dysgenesis

European Journal of Ophthalmology ◽

10.1177/11206721211073208 ◽

2022 ◽

pp. 112067212110732

Author(s):

Tejal Magan ◽

Alexander Tanner ◽

Julia Fajardo-Sanchez ◽

Kin Sheng Lim ◽

Saurabh Goyal ◽

...

Keyword(s):

Anterior Segment ◽

Congenital Glaucoma ◽

Consecutive Series ◽

Long Term Outcomes ◽

Primary Congenital Glaucoma ◽

Anterior Segment Dysgenesis ◽

Long Term Follow Up ◽

Advanced Glaucoma

Aim To determine the long-term outcomes of a cohort of complex patients with primary congenital glaucoma, aniridia and anterior segment dysgenesis. Methods Retrospective consecutive series between 1990–2021 in two UK tertiary centres: Guy's and St Thomas’ NHS Foundation Trust and King's College Hospital NHS Foundation Trust. We recorded the number and types of surgical and laser treatments along with preoperative and postoperative data, including intraocular pressures (IOP) and anti-glaucoma medications. Results A total of 41 eyes of 21 patients were included. Primary diagnoses were primary congenital glaucoma in 16 eyes (39.0%), aniridia in 14 eyes (34.2%), and anterior segment dysgenesis in 8 eyes (19.5%). Sixteen eyes (39.0%) had one or more glaucoma surgery or laser procedures for advanced glaucoma, and the long-term follow-up was 12.8 ± 3.6 years. There was a significant decrease in postoperative IOP (mmHg) at 3 months (16.5 ± 1.6; p = 0.0067), 6 months (18.7 ± 2.1; p = 0.0386), 12 months (18.6 ± 1.7; p = 0.0229), 3 years (14.7 ± 1.2; p = 0.0126), 5 years (15.5 ± 1.8; p = 0.0330) and 10 years (15.4 ± 2.3; p = 0.7780), compared to preoperatively (24.1 ± 2.6). Surgical success (complete and qualified) was 62.5%, 50.0%, 43.8%, 46.2%, 45.5% and 28.6% at 3 months, 6 months, 12 months, 3 years, 5 years and 10 years, respectively. There was no significant change in the number of anti-glaucoma drugs postoperatively ( p > 0.05). Four eyes (25.0%) had postoperative complications (hyphaema, hypotony) that resolved after conservative management. Conclusions Surgical management of these complex eyes with advanced glaucoma is challenging. Overall, the cohort had good surgical outcomes with a significant decrease in IOP by 36.1% after long-term follow-up.

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Clinical Features and Long-Term Follow-Up of Patients with Retinoblastoma in Turkish Children Older Than 5 Years of Age

Journal of Ophthalmology ◽

10.1155/2020/8148013 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Zafer Cebeci ◽

Samuray Tuncer ◽

Rejin Kebudi

Keyword(s):

Clinical Features ◽

Treatment Options ◽

Older Children ◽

Long Term Outcomes ◽

Turkish Children ◽

Turkish Patient ◽

Long Term Follow Up ◽

Salvage Rate

Purpose. The diagnosis and management of retinoblastoma can be difficult in older children. This study reports the clinical features and long-term outcomes of such patients in a Turkish patient population. Methods. Medical records of 18 patients, between January 1992 and December 2017, were reviewed retrospectively. Results. Of 298 consecutive patients with retinoblastoma, 18 (6%) were at the age of 5 years and older. The median age at diagnosis was 9 years (range, 5–18 years). Misdiagnosis was noted in 8 patients (44.4%). Treatment options included enucleation in 16 patients (88.8%), adjuvant systemic chemotherapy in 3 (16.6%), intra-arterial chemotherapy in one (5.5%), and additional orbital irradiation in one (5.5%). After a median follow-up of 97 months (range, 6–252 months), all patients survived without any recurrence. Conclusions. Our series showed that 6% of patients with retinoblastoma were 5 years of age and older. Over a 15-year period, ocular salvage rate of 11.2% and survival rate of 100% were attained.

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