scholarly journals Review of Extraosseous Applications of Thermal Ablation in the Treatment of Moderate to Severe Large Joint Osteoarthritis

2021 ◽  
Vol 25 (06) ◽  
pp. 745-755
Author(s):  
Andrew Tran ◽  
David A. Reiter ◽  
J. David Prologo ◽  
Mircea Cristescu ◽  
Felix M. Gonzalez
Keyword(s):  
Treatment Options ◽  
Additional Treatment ◽  
Joint Disease ◽  
Restricted Range ◽  
Pharmacologic Agent ◽  
Stage Disease ◽  
Large Joint ◽  
Short And Long Term ◽  
End Stage

AbstractOsteoarthritis (OA) is the most common joint disease worldwide, leading to significant pain, restricted range of motion, and disability. A gap exists between short- and long-term symptom-relieving therapies. Although arthroplasty is an effective treatment for symptomatic end-stage disease, most patients ultimately do not receive a joint replacement due to suboptimal surgical qualifications, comorbidities, or an aversion to surgery. The lack of additional treatment options in this setting makes opioid agonists a commonly used pharmacologic agent, contributing to the addiction epidemic that greatly afflicts our communities. Cooled radiofrequency ablation (CRFA) has arisen as a treatment modality in the setting of moderate to severe OA among patients refractory to conservative management, generally showing greater efficacy compared with other existing strategies. This review focuses on the benefits of CRFA and its technical feasibility as a management option among patients experiencing debilitating large joint OA with limited clinical options.

Considering a Potential Role of Linalool as a Mood Stabilizer for Bipolar Disorder

2020 ◽  
Vol 26 (40) ◽  
pp. 5128-5133
Author(s):  
Kate Levenberg ◽  
Wade Edris ◽  
Martha Levine ◽  
Daniel R. George
Keyword(s):  
Bipolar Disorder ◽  
Treatment Options ◽  
Mood Stabilizer ◽  
Well Being ◽  
Epidemiologic Studies ◽  
Treatment Regimens ◽  
Bipolar Spectrum Disorders ◽  
Short And Long Term

Epidemiologic studies suggest that the lifetime prevalence of bipolar spectrum disorders ranges from 2.8 to 6.5 percent of the population. To decrease morbidity and mortality associated with disease progression, pharmacologic intervention is indicated for the majority of these patients. While a number of effective treatment regimens exist, many conventional medications have significant side effect profiles that adversely impact patients’ short and long-term well-being. It is thus important to continue advancing and improving therapeutic options available to patients. This paper reviews the limitations of current treatments and examines the chemical compound Linalool, an alcohol found in many plant species, that may serve as an effective mood stabilizer. While relatively little is known about Linalool and bipolar disorder, the compound has been shown to have antiepileptic, anti-inflammatory, anxiolytic, anti-depressive, and neurotrophic effects, with mechanisms that are comparable to current bipolar disorder treatment options.

P1239SHORT- AND LONG-TERM OUTCOME OF END-STAGE RENAL DISEASE PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hirota Kida ◽  
Shungo Hikoso ◽  
Akihiro Sunaga ◽  
Oeun Bolrathanak ◽  
Takayuki Kojima ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
End Stage Renal Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
All Cause Mortality ◽  
Short And Long Term ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background and Aims End-stage renal disease (ESRD) patients frequently have the coronary artery disease. However, the short- and long-term outcome of ESRD patients with acute myocardial infarction (AMI) is little known. The aim of this study was to clarify it. Method Using the database of the Osaka Acute Coronary Insufficiency Study (OACIS), 8702 consecutive AMI patients (male: 75.2%, mean age: 66.9±12.2yrs) from 2002 to 2013 were analyzed. We classified these patients into two groups, those with ESRD [ESRD group (n=271)] and without ESRD [No-ESRD group (n=8431)] and examined in-hospital or long-term all-cause mortality. ESRD was defined as eGFR<15ml/min/1.73m2. Results ESRD group had higher frequency of diabetes (59.3% vs 37.8%, p<0.01), hypertension (90.1% vs 63.3%, p<0.01), Killip class≧2 (40.1% vs 21%, p<0.01), multi-vessel disease (69.3% vs 50.8%, p<0.01), and lower frequency of peak CK>3000 (21.7% vs 32.4%, p<0.01) than No-ESRD group. Mean follow-up period was 1041±721 days. In hospital mortality of ESRD group was 27% and No-ESRD group 7.2%. In patients who discharged alive (8027 patients), 1-year mortality of ESRD group was 12.2% and No-ESRD group 3.3%, 3-year mortality of ESRD group was 29.3% and No-ESRD group 8.7%. Kaplan-Meier analysis revealed that the all-cause mortality (log-rank p<0.01) was significantly higher in ESRD group than No-ESRD group. In ESRD patients who discharged alive (203patients), Cox univariate analysis after multiple imputation revealed that peak CK>3000 was significantly associated with an increased risk of mortality (Hazard ratio 2.67, 95% confidence interval 1.18to 6.07, p=0.031). Conclusion In patients with AMI, ESRD was significantly associated with worse short- and long-term outcome, suggesting that careful treatment might be required in ESRD patients with AMI, especially had peak CK>3000.

scholarly journals P451 Short-and long-term effectiveness of ustekinumab in patients with Crohn’s disease: real-world data from a German IBD cohort

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S405-S405
Author(s):  
A Kubesch ◽  
L Rueter ◽  
K Farrag ◽  
T Krause ◽  
K Stienecker ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Treatment Options ◽  
Real World Data ◽  
Free Response ◽  
Faecal Calprotectin ◽  
Short And Long Term

Abstract Background The IL-12/23 inhibitor ustekinumab (UST) opened up new treatment options for patients with Crohn’s disease (CD). Due to the recent approval, Real-World German data on long-term efficacy and safety are lacking. This study aimed to assess the clinical course of CD patients under UST therapy and to identify potential predictive markers. Methods Patients with CD receiving UST treatment in three hospitals and two outpatient centres were included and retrospectively analysed. Rates for short- and long-term remission and response were analysed with the help of clinical (Harvey–Bradshaw Index [HBI]) and biochemical (C-reactive protein [CRP], faecal calprotectin [fCal]) parameters for disease activity. Results Data from 180 patients were evaluated. One hundred six patients had a follow-up of at least 8 weeks and were included. 96.2% of the patients were pre-exposed to anti- TNFα agents and 34.4% to both anti-TNFα and anti-integrin. The median follow-up was 49.1 weeks (95% CI 42.03–56.25). At week 8, 51 patients (54.8%) showed response to UST, and 24 (24.7%) were in remission. At week 48, 39 (41.9%) responded to UST, and 20 patients (21.5%) were in remission. Steroid-free response and remission at week eight were achieved by 30.1%, and 19.3% of patients. At week 48, 26.9% showed steroid-free response to UST, and 15.1% of the initial patient population was in steroid-free remission. Clinical response at week 16 was independently associated with remission at week 48. Conclusion Our study confirms short- and long-term UST effectiveness and tolerability in a cohort of multi-treatment exposed patients.

Cardiac Surgery for Carcinoid Heart Disease: A Weapon Not to Be Misused

Cardiology ◽  
2016 ◽  
Vol 136 (4) ◽  
pp. 243-251 ◽  
Author(s):  
Maria Bonou ◽  
Chris J. Kapelios ◽  
Gregory Kaltsas ◽  
Konstantinos Perreas ◽  
Konstantinos Toutouzas ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Treatment Options ◽  
Optimal Timing ◽  
Special Focus ◽  
Carcinoid Heart Disease ◽  
Term Survival ◽  
Patient Profile ◽  
Short And Long Term

Carcinoid heart disease (CHD) complicates approximately 25% of patients with a carcinoid tumor and carcinoid syndrome and leads to heart valve degeneration with mixed-stenotic and regurgitation pathology and consequent heart failure (HF) leading to significant morbidity and mortality. Cardiac surgery in symptomatic, severe CHD leads to significantly better functional capacity and prolonged survival when compared to medical treatment alone. Recent studies have shown improvement in postoperative outcomes of patients undergoing surgery for CHD over the last decades. The trend for early diagnosis and application of surgery prior to the manifestation of HF symptoms, which tended to develop during the previous years, does not seem justifiable based on the findings of recent studies. Therefore, the optimal timing of intervention in CHD and the type of valve that should preferably be used remain issues of controversy. This review comprehensively examines the existing literature on the treatment options for patients with CHD, with a special focus on short- and long-term survival after cardiac surgery, and discusses the selection of the exact patient profile and intervention timing that are more likely to optimize the benefit-to-risk ratio for surgical intervention.

scholarly journals SHORT AND LONG-TERM OUTCOMES OF DIFFERENT REVASCULARIZATION STRATEGIES IN PATIENTS WITH END STAGE RENAL DISEASE ON HEMODIALYSIS

2012 ◽  
Vol 59 (13) ◽  
pp. E549 ◽  
Author(s):  
Abel E. Moreyra ◽  
Peter Hynes ◽  
Yingzi Deng ◽  
Nora M. Cosgrove ◽  
Christopher Brown ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Stage Renal Disease ◽  
End Stage

New advances in the diagnosis and management of hepatocellular carcinoma

BMJ ◽  
2020 ◽  
pp. m3544 ◽  
Author(s):  
Ju Dong Yang ◽  
Julie K Heimbach
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Treatment ◽  
Early Stage ◽  
Treatment Options ◽  
Intermediate Stage ◽  
Phase Iii ◽  
Advanced Hepatocellular Carcinoma ◽  
Long Term Outcomes ◽  
Stage Disease

ABSTRACT Hepatocellular carcinoma is one of the leading causes of cancer related death in the world. Biannual surveillance for the disease in patients with cirrhosis and in high risk carriers of hepatitis B virus allows early stage cancer detection and treatment with good long term outcomes. Liver ultrasonography and serum α fetoprotein are the most commonly used surveillance tests. If suspicious results are found on the surveillance test, multiphasic computed tomography or magnetic resonance imaging should be undertaken to confirm the diagnosis of hepatocellular carcinoma. If radiologic tests show inconclusive results, liver biopsy or repeat imaging could be considered for confirmation of hepatocellular carcinoma. Management of the disease is complex. Patients should be evaluated by a multidisciplinary team, and the selection of treatment should consider factors such as tumor burden, severity of liver dysfunction, medical comorbidities, local expertise, and preference of patients. Early stage hepatocellular carcinoma is best managed by curative treatment, which includes resection, ablation, or transplantation. Patients with intermediate stage disease often receive locoregional treatment. Systemic treatment is reserved for patients with advanced disease. Several positive, phase III, randomized controlled trials have expanded the systemic treatment options for advanced hepatocellular carcinoma with promising long term outcomes, especially trials using combination treatments, which could also have eventual implications for the treatment of earlier stage disease.

Medical Management Considerations for Patients With Lung Transplantation

2001 ◽  
Vol 14 (4) ◽  
pp. 258-276 ◽  
Author(s):  
Robert E. Dupuis ◽  
David J. Taber ◽  
Amy L. Fann ◽  
Kevin P. Lumbert
Keyword(s):  
Lung Transplantation ◽  
Immunosuppressive Agents ◽  
Chronic Obstructive ◽  
Drug Induced ◽  
Obstructive Pulmonary Disease ◽  
Drug Regimens ◽  
Short And Long Term ◽  
End Stage

Lung transplantation has become an accepted modality for the treatment of end-stage lung disease. Adult and pediatric patients with a variety of lung diseases, including cystic fibrosis, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis are candidates for lung transplantation. Lung transplantation can extend survival and improve quality of life for these patients. With the introduction of new immunosuppressive agents and enhanced surgical and medical care, both short- and long-term morbidity and mortality in these populations, although not as good as other transplant types, are improving. After lung transplantation, recipients continue to face a number of obstacles including post-operative complications, complex drug regimens, drug-induced toxicities, infection, and rejection. An understanding of the management and monitoring issues after lung transplantation is the focus of this review.

scholarly journals Genital tuberculosis and infertility

2017 ◽  
Vol 6 (8) ◽  
pp. 3514 ◽  
Author(s):  
Prajakta Shende ◽  
Shalini Mahana Valecha ◽  
Manisha Gandhewar ◽  
Diwija Dhingra
Keyword(s):  
Treatment Options ◽  
Long Term Effects ◽  
Genital Tuberculosis ◽  
Clinical Criteria ◽  
High Incidence ◽  
Short And Long Term ◽  
Tb Pcr ◽  
A Prospective Study ◽  
Strong Suspicion

Background: An analytical study to diagnose genital tuberculosis, using various modalities, it`s treatment options and fertility outcomes in infertile labour class women.Methods: A prospective study, where 120 women, presented to hospital due to infertility were subjected to hystero-laparoscopy over 36 months. Endometrium sent for TB-PCR and HPR. Those diagnosed with GTB were given Anti-Tubercular Drugs as per standard regimes and their fertility outcome was studied.Results: Out of 120 women, 32(27%) were diagnosed with GTB using accepted clinical criteria, TB-PCR and endometrial HPR. 30 of these 32 were diagnosed by HLscopic picture (94%) alone, 18 by positive endometrial TB-PCR (58%) and another 3 by HPR (10%). Among 32 women treated, 9(28%) conceived after treatment.Conclusions: High incidence of GTB amongst the labour class warrants strong suspicion and early diagnosis using hystero-laparoscopy and prompt treatment to minimize the short and long-term effects of GTB on fertility.

Heart failure surgery and transplantation

2021 ◽  
pp. 664-679
Author(s):  
Felix Schoenrath ◽  
Jan Klages ◽  
Volkmar Falk
Keyword(s):  
Heart Failure ◽  
Outpatient Care ◽  
Treatment Options ◽  
Term Treatment ◽  
Complication Management ◽  
Surgical Interventions ◽  
Long Term Treatment ◽  
Potential Benefits ◽  
End Stage

Cardiac surgery in heart failure (HF) patients is gaining more and more importance as HF prevalence is increasing in the general population. Therefore, surgery offers potential benefits at any stage of HF prognosis and for various HF aetiologies. Since both decision making and treatment options are becoming increasingly complex in our aging population, decisions should be made based on a specialized HF team, to achieve optimal and sustained results for the patient. Currently, most intermediate and long-term treatment options for end stage HF patients result in surgical interventions (LVAD therapy, transplantation). However, both pre- and post-operative as well as outpatient care is often managed by the cardiologist. Therefore, gaining expertise in the field through indications and complication management, as well as the know-how surrounding surgical principles is highly valuable for every cardiologist.

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