scholarly journals Imaging of Carpal Instabilities

2020 ◽  
Author(s):  
Jan-Peter Grunz ◽  
Carsten Herbert Gietzen ◽  
Katharina Grunz ◽  
Thorsten Bley ◽  
Rainer Schmitt
Keyword(s):  
Load Transfer ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Mr Arthrography ◽  
Carpal Instability ◽  
Stress Imaging ◽  
Diagnostic Significance ◽  
Interosseous Ligament ◽  
Key Points ◽  
Traumatic Lesions

Background The term “carpal instability” describes different debilitating wrist conditions, in which the carpus is unable to maintain its physiological range of motion and load transfer. Depending on the cause and location of the dysfunction, four groups can be defined: dissociative, non-dissociative, complex, and adaptive carpal instability. As the most common form by far, dissociative carpal instability can further be categorized as dorsal or palmar intercalated segment instability, contingent on the afflicted interosseous ligament. Method This review article outlines the different entities of carpal instability, their pathophysiology, and their clinical presentation. It further discusses the diagnostic significance of different imaging methods as well as the established treatment options for each form of instability in context with the current literature. Results and Conclusion Early detection and treatment of carpal instability are essential for preventing carpal osteoarthritis. Traumatic lesions of the scapholunate interosseous ligament are the most frequent cause of instability. They can occur in an isolated fashion or in context with other carpal injuries. While stress imaging and fluoroscopy facilitate the differentiation between dynamic and static forms of carpal instability, only MRI and CT/MR arthrography can directly reveal the extent of ligament discontinuity. Key Points: Citation Format

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

Phlegmasia cerulea dolens – an uncommon but alarming manifestation of deep vein thrombosis

VASA ◽  
2020 ◽  
Vol 49 (5) ◽  
pp. 422-426
Author(s):  
Manuela Nickler ◽  
Sebastian Haubitz ◽  
Adriana Méndez ◽  
Martin Gissler ◽  
Peter Stierli ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Bleeding Risk ◽  
Venous Intervention ◽  
Aggressive Treatment ◽  
Vein Thrombosis ◽  
Prompt Treatment ◽  
Surgical Thrombectomy ◽  
Deep Vein ◽  
Phlegmasia Cerulea Dolens

Summary: In phlegmasia cerulea dolens (PCD), immediate diagnosis and prompt treatment is crucial for limb salvage. Aggressive treatment options including venous intervention, thrombolysis and/or surgical thrombectomy should be considered. Due to the lack of data, the most appropriate intervention depends upon etiology of PCD, clinical presentation and patient’s bleeding risk.

scholarly journals Surgical Management of Pediatric Gastroesophageal Reflux Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Hope T. Jackson ◽  
Timothy D. Kane
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Surgical Management ◽  
Reflux Disease ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Treatment Options ◽  
Failure To Thrive ◽  
Solid Diet ◽  
Esophageal Sphincter

Gastroesophageal reflux (GER) is common in the pediatric population. Most cases represent physiologic GER and as the lower esophageal sphincter (LES) matures and a solid diet is introduced, many of these patients (>65%) experience spontaneous resolution of symptoms by two years of age. Those who continue to have symptoms and develop complications such as failure to thrive, secondary respiratory disease, and others are classified as having gastroesophageal reflux disease (GERD). Goals of GERD treatment include the resolution of symptoms and prevention of complications. Treatment options to achieve these goals include dietary or behavioral modifications, pharmacologic intervention, and surgical therapy. This paper will review the clinical presentation of GERD and discuss options for surgical management and outcomes in these patients.

Spinal artery aneurysms: clinical presentation, radiological findings and outcome

2018 ◽  
Vol 10 (7) ◽  
pp. 644-648 ◽  
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.

Treatment of acute limb ischemia with focus on endovascular techniques

VASA ◽  
2009 ◽  
Vol 38 (2) ◽  
pp. 123-134 ◽  
Author(s):  
Zeller ◽  
Tepe
Keyword(s):  
Randomized Trials ◽  
Mechanical Thrombectomy ◽  
Clinical Presentation ◽  
Patient Survival ◽  
Treatment Options ◽  
Limb Ischemia ◽  
Bleeding Complications ◽  
Acute Limb Ischemia ◽  
Endovascular Techniques ◽  
Local Lysis

Acute limb ischemia is still the most frequent cause of major limb loss. Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE). New lytic agents and their modified application such as via a pulse spray catheter or combined with an ultrasound catheter and the combination with glycoprotein IIb/IIIa receptor antagonists have increased the efficacy and speed of thrombolysis. Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis.

scholarly journals Spinal lipomas: clinical spectrum, embryology, and treatment

2007 ◽  
Vol 23 (2) ◽  
pp. 1-12 ◽  
Author(s):  
Michael A. Finn ◽  
Marion L. Walker
Keyword(s):  
Surgical Treatment ◽  
Clinical Presentation ◽  
Wide Spectrum ◽  
Spinal Dysraphism ◽  
Treatment Options ◽  
Conus Medullaris ◽  
Clinical Spectrum ◽  
Pathological Features ◽  
Occult Spinal Dysraphism ◽  
Pathological Mechanism

✓Spinal lipomas, particularly lipomas of the conus medullaris and terminal filum, are the most common form of occult spinal dysraphism and represent a wide spectrum of disease with regard to anatomy, clinical presentation, and treatment options. These lesions, however, are united by a similar embryology and pathological mechanism by which symptoms arise. Recently, the treatment of these lesions has generated much controversy, with some physicians advocating surgical treatment for all patients regardless of symptoms and others proposing that surgery be withheld until symptoms develop. The authors discuss lumbosacral spinal lipomas, with particular attention to the theories of their origin, anatomical and pathological features, and treatment options, including a review of current controversies.

Maturity-Onset Diabetes of the Young (MODY): Genetic Causes, Clinical Characteristics, Considerations for Testing, and Treatment Options

Endocrines ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 485-501
Author(s):  
Zoltan Antal
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Maturity Onset Diabetes ◽  
Onset Diabetes ◽  
Inappropriate Treatment ◽  
Monogenic Forms Of Diabetes ◽  
Initial Description

Maturity Onset Diabetes of the Young (MODY) encompasses a group of rare monogenic forms of diabetes distinct in etiology and clinical presentation from the more common forms of Type 1 (autoimmune) and Type 2 diabetes. Since its initial description as a clinical entity nearly 50 years ago, the underlying genetic basis for the various forms of MODY has been increasingly better elucidated. Clinically, the diagnosis may be made in childhood or young adulthood and can present as overt hyperglycemia requiring insulin therapy or as a subtle form of slowly progressive glucose impairment. Due to the heterogeneity of clinical symptoms, patients with MODY may be misdiagnosed as possessing another form of diabetes, resulting in potentially inappropriate treatment and delays in screening of affected family members and associated comorbidities. In this review, we highlight the various known genetic mutations associated with MODY, clinical presentation, indications for testing, and the treatment options available.

Vascular Neurosurgery

2016 ◽  
pp. 25-46
Author(s):  
Thomas Leipzig
Keyword(s):  
Aneurysmal Subarachnoid Hemorrhage ◽  
Treatment Options ◽  
Physical Symptoms ◽  
Spinal Dural Arteriovenous Fistula ◽  
Symptomatic Carotid ◽  
Symptomatic Carotid Stenosis ◽  
Key Points ◽  
Treatment Plans ◽  
Vascular Neurosurgery ◽  
Treatment Risks

Vascular neurosurgery has long been one of the focal points of neurosurgical practice, and the topic is routinely included in the Oral Board Examination process. Each case involves clinical and diagnostic acumen, a solid grasp of the natural history and treatment risks, consideration of operative approaches, alternative treatment options, and the management of potentially catastrophic complications, as a result of what we have done or what we failed to do. Five cases are discussed in this chapter, and for each case the history and physical symptoms, imaging studies, analyses of the cases and treatment plans, and complications are provided. Key points are also presented after each case. The cases discussed include an aneurysmal subarachnoid hemorrhage (aSAH), an unruptured brain arteriovenous malformation (AVM), an intracerebral hemorrhage (ICH), a spinal dural arteriovenous fistula (dAVF), and symptomatic carotid stenosis.

scholarly journals Treatment of inoperable hepatocellular carcinoma with immunotherapy

2019 ◽  
Vol 12 (7) ◽  
pp. e229744 ◽  
Author(s):  
Sean P Tighe ◽  
Umair Iqbal ◽  
Christopher T Fernandes ◽  
Aijaz Ahmed
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Linkage To Care ◽  
Experimental Treatment ◽  
Hepatitis C Virus Infection ◽  
Chronic Liver Diseases ◽  
The Third ◽  
The Usa ◽  
High Risk Populations

In the USA, mortality associated with hepatocellular carcinoma (HCC) continues to rise. Globally, HCC is the third most common cause of cancer-related death. In early stages of HCC, hepatic resection or liver transplantation are the preferred treatment options with a high probability of recurrence-free postoperative course. However, ineffective screening of chronic liver diseases in high-risk populations, poor linkage to care and suboptimal HCC surveillance has led to increasing rates of late-stage HCC at clinical presentation or diagnosis amenable only to palliative and experimental treatment options. Our case is a 66-year-old man with chronic hepatitis C virus infection complicated by cirrhosis and inoperable HCC which was non-responsive to selective intrahepatic trans-arterial chemoembolisation by interventional radiology. Therefore, he was treated with nivolumab immunotherapy and demonstrated normalisation of previously elevated alpha-fetoprotein levels suggestive of at least a partial response to immunotherapy. No adverse events related to nivolumab immunotherapy were encountered.

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