Efficacy of gastric electrical stimulation for gastroparesis refractory to medical therapy; a single center experience

OBJECT Encephaloduroarteriosynangiosis (EDAS) is a form of revascularization that has shown promising early results in the treatment of adult patients with moyamoya disease (MMD) and more recently in patients with intracranial atherosclerotic steno-occlusive disease (ICASD). Herein the authors present the long-term results of a single-center experience with EDAS for adult MMD and ICASD. METHODS Patients with ischemic symptoms despite intensive medical therapy were considered for EDAS. All patients undergoing EDAS were included. Clinical data, including recurrence of transient ischemic attack (TIA) and/or stroke, functional status, and death, were collected from a retrospective data set and a prospective cohort. Perren revascularization and American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grades were recorded from angiograms. RESULTS A total of 107 EDAS procedures were performed in 82 adults (36 with ICASD and 46 with MMD). During a median follow-up of 22 months, 2 (2.4%) patients had strokes; both patients were in the ICASD group. TIA-free survival and stroke-free survival analyses were performed using the product limit estimator (Kaplan-Meier) method. The probability of stroke-free survival at 2 years in the ICASD group was 94.3% (95% CI 80%–98.6%). No patient in the MMD group suffered a stroke. The probability of TIA-free survival at 2 years was 89.4% (95% CI 74.7%–96%) in ICASD and 99.7% (95% CI 87.5%–99.9%) in MMD. There were no hemorrhages or stroke-related deaths. Angiograms in 85.7% of ICASD and 92% of MMD patients demonstrated Perren Grade 3 and improvement in ASITN/SIR grade in all cases. CONCLUSIONS EDAS is well tolerated in adults with MMD and ICASD and improves collateral circulation to territories at risk. The rates of stroke after EDAS are lower than those reported with other treatments, including intensive medical therapy in patients with ICASD.

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Empiric treatment for peritonsillar abscess: A single-center experience with medical therapy alone

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2021.102954 ◽

2021 ◽

Vol 42 (4) ◽

pp. 102954

Author(s):

Aaron L. Zebolsky ◽

John Dewey ◽

Emma Jane Swayze ◽

Seth Moffatt ◽

Corbin D. Sullivan

Keyword(s):

Medical Therapy ◽

Peritonsillar Abscess ◽

Single Center ◽

Empiric Treatment ◽

Single Center Experience

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Severe Gastroparesis: Medical Therapy or Gastric Electrical Stimulation

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2009.09.010 ◽

2010 ◽

Vol 8 (2) ◽

pp. 117-124 ◽

Cited By ~ 7

Author(s):

Savio C. Reddymasu ◽

Irene Sarosiek ◽

Richard W. McCallum

Keyword(s):

Electrical Stimulation ◽

Medical Therapy ◽

Gastric Electrical Stimulation

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Clinical Correlates of Infliximab (IFX) Failure in Pediatric Patients With Inflammatory Bowel Disease (IBD): A Single Center Experience of Patient Characteristics, Concomitant Medical Therapy and Outcomes

Gastroenterology ◽

10.1016/s0016-5085(11)62110-0 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-509

Author(s):

Lina M. Felipez ◽

Ranjana Gokhale ◽

Kristen Wroblewski ◽

Anna Godick ◽

Barbara S. Kirschner

Keyword(s):

Inflammatory Bowel Disease ◽

Medical Therapy ◽

Bowel Disease ◽

Pediatric Patients ◽

Patient Characteristics ◽

Single Center ◽

Clinical Correlates ◽

Single Center Experience ◽

Inflammatory Bowel

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Efficacy and Safety of Stereotactic Radiotherapy in Cushing’s Disease: A Single Center Experience

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-1217-7365 ◽

2020 ◽

Author(s):

Tugce Apaydin ◽

Hande Mefkure Ozkaya ◽

Sebnem Memis Durmaz ◽

Rasim Meral ◽

Pinar Kadioglu

Keyword(s):

Medical Therapy ◽

Cushing’S Disease ◽

Remission Rate ◽

Gamma Knife Radiosurgery ◽

Cushing's Disease ◽

Efficacy And Safety ◽

Single Center ◽

Biochemical Control ◽

Single Center Experience ◽

Free Cortisol

Abstract Objective To determine the efficacy and safety of stereotactic RT in patients with Cushing’s disease (CD). Methods The study included 38 patients [31 patients who received gamma knife radiosurgery (GKS) and 7 patients who received cyberknife hypofractionated RT (HFRT)] with CD. Hormonal remission was considered if the patient had suppressed cortisol levels after low dose dexamethasone, normal 24-hour urinary free cortisol (UFC), and lack or regression of clinical features. Results Biochemical control after RT was observed in 52.6% of the patients with CD and median time to hormonal remission was 15 months. Tumor size control was obtained in all of the patients. There was no significant relationship between remission rate and laboratory, radiological and pathological variables except for preoperative UFC. Remission rate was higher in patients with lower preoperative UFC. Time to remission increased in parallel to postoperative cortisol and 1mg DST level. Although medical therapy before RT did not affect the rate of- and time to remission, medical therapy after RT prolonged the time to hormonal remission. Conclusion In this current single center experience, postoperative cortisol and 1mg DST levels were found as the determinants of time to remission. Although medical therapy before RT did not affect the rate of- and time to remission, medical therapy after RT prolonged the time to biochemical control . This latter finding might suggest a radioprotective effect of cortisol lowering medication use on peri-RT period.

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