Extensive Dynamics of Aneurysms and Long-term Prognosis in IRVAN Syndrome: A Case Series

2020 ◽  
pp. 1-5
Author(s):  
Yun Zhang ◽  
Tiancong Chang ◽  
Ge Ge ◽  
Meixia Zhang
Keyword(s):  
Case Series ◽  
Long Term Prognosis

scholarly journals Salvage endoscopic resection in patients with esophageal adenocarcinoma after chemoradiotherapy

2018 ◽  
Vol 06 (09) ◽  
pp. E1126-E1129 ◽  
Author(s):  
Irma C. Noordzij ◽  
Wouter L. Curvers ◽  
Clément J. Huysentruyt ◽  
Grard A.P. Nieuwenhuijzen ◽  
Geert-Jan Creemers ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Endoscopic Resection ◽  
Argon Plasma Coagulation ◽  
Case Series ◽  
Argon Plasma ◽  
Residual Tumor ◽  
Esophageal Resection ◽  
Sustained Remission ◽  
Long Term Prognosis

Abstract Background and study aims For early esophageal adenocarcinoma, endoscopic resection is an accepted curative treatment with an excellent long-term prognosis. Case series from Japan have reported endoscopic resection of residual esophageal squamous cell carcinoma after chemoradiotherapy. This is the first report describing endoscopic resection of residual esophageal adenocarcinoma after chemoradiotherapy. Two patients with advanced esophageal adenocarcinoma had been treated with chemoradiotherapy because comorbidity precluded esophageal resection. When residual tumor was observed endoscopically, complete remission was achieved by salvage endoscopic therapy alone or in combination with argon plasma coagulation (APC). Both patients achieved long-term sustained remission and died of non-tumor-related causes.

scholarly journals RESECTION AND REGENERATION- A HOPE FOR THE HOPELESS

2020 ◽  
pp. 1-5
Author(s):  
Apeksha Annigeri B. ◽  
Rajiv Nidasale Puttaswamaiah ◽  
Avinash Janaki Lingaraju
Keyword(s):  
Alveolar Bone ◽  
Treatment Plan ◽  
Treatment Options ◽  
Case Series ◽  
Cost Effective ◽  
Ridge Preservation ◽  
Tooth Structure ◽  
Implant Placement ◽  
Long Term Prognosis

Preservation of tooth structure has always been the prime aim of dental practice. Teeth with advanced periodontal disease in multirooted teeth often pose a significant challenge to the clinician, complicating the treatment plan and compromising long term prognosis. The outcome of the treatment is determined by proper case selection and surgical, endodontic and prosthetic parameters. Resective and regenerative osseous procedures are often employed to help preserve the tooth structure, alveolar bone involving the retained root of multirooted teeth and are cost effective over the other treatment options like ridge preservation/augmentation followed by implant placement. This case series describes application of resective and regenerative techniques for molars with extensive combined periodontal-endodontic disease.

scholarly journals Chronic headache treatment: can we always follow international guidelines?

2019 ◽  
Vol 3 (24) ◽  
pp. 5-9
Author(s):  
N. V. Latysheva
Keyword(s):  
Chronic Headache ◽  
Beta Blockers ◽  
Botulinum Toxin Type A ◽  
Case Series ◽  
Botulinum Toxin Type ◽  
Tension Type Headache ◽  
International Guidelines ◽  
Long Term Prognosis ◽  
Type Headache

International guidelines on the prevention of migraine recommend the use of five main classes of medications: beta-blockers, antiepileptics, antidepressants (amitriptyline and venlafaxine), angiotensin receptor antagonists and botulinum toxin type A. Chronic tension-type headache (CTTH) guidelines are even more limiting and contain only amitriptyline, venlafaxine and mirtazapine. However, long-term intake of these medications is substantially limited by their tolerability issues. Moreover, most recommended medications cannot control the most frequently observed comorbidities, where depression plays the most important role in treatment selection, efficacy and long-term prognosis. This paper reviews the current migraine and CTTH prevention guidelines and complexities that physicians encounter with their use. The paper also includes a case series of treating chronic headache with a new multimodal antidepressant vortioxetine.

scholarly journals Therapy of Pyothorax in Cats via Small-Bore Thoracostomy Tube in Terms of Efficacy, Complications and Outcomes

Animals ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 107
Author(s):  
Evelyn Heier ◽  
Gabriel Wurtinger ◽  
Esther Hassdenteufel ◽  
Matthias Schneider
Keyword(s):  
Case Series ◽  
Comparable Efficacy ◽  
Closed Chest ◽  
Treatment Groups ◽  
First Line Therapy ◽  
Intravenous Antibiotics ◽  
A New Technique ◽  
Long Term Prognosis ◽  
One Year

First-line therapy for cats with pyothorax consists of intravenous antibiotics, drainage of the septic pleural effusion and closed-chest lavage. Large-bore thoracostomy tubes are traditionally used for drainage, but case series indicate a comparable efficacy using small-bore tubes. In this retrospective study, we describe a new technique of sheath-guided small-bore (6 F) thoracostomy tubes in cats with pyothorax and evaluate their efficacy and complications. Additionally, we compare outcomes between two treatment groups. Placement and use of the small-bore thoracostomy tubes described here has a low complication rate of 4% (3/67 tubes), and 53% (24/45) of the cats could be treated with thoracostomy tubes and closed-chest lavage according to the protocol. The success rate is reduced by 18% (8/45) due to deaths caused mainly by sepsis, 16% (7/45) due to structural diseases requiring surgery and a further 14% (6/43) due to lavage failures that could only be cured after additive therapy (thoracotomy or fibrinolysis). The long-term prognosis was very good, with a survival rate one year after discharge of 94% (30/32). We detected no effect on survival by early placement of bilateral thoracostomy tubes or closed-chest lavage with a heparinised solution. In conclusion, therapy of pyothorax with small-bore thoracostomy tubes is as successful as therapy with large- or medium-bore tubes.

scholarly journals No Differences in the Long-Term Prognosis of Iris and Choroidal Melanomas when Adjusting for Tumor Thickness and Diameter

2021 ◽  
Author(s):  
Shiva Sabazade ◽  
Christina Herrspiegel ◽  
Viktor Torgny Gill ◽  
Gustav Stålhammar
Keyword(s):  
Cumulative Incidence ◽  
Case Series ◽  
Tumor Diameter ◽  
Basal Diameter ◽  
Choroidal Melanomas ◽  
Long Term Prognosis ◽  
Survival Differences ◽  
Related Mortality

Abstract Objective:To assess the long-term prognosis for patients with iris melanomas and compare it with the prognosis for small choroidal melanomas.DesignRetrospective observational case seriesMethodsAll patients treated for iris melanomas at a single referral institution between January 1st 1986 and January 1st 2016 were included. Patients treated for small choroidal melanomas during the same period were included for comparison. The cumulative incidence of melanoma-related mortality was calculated. Patient and tumor characteristics and size-adjusted hazard ratio (HR) for melanoma-related mortality were compared between iris and small choroidal melanomas.ResultsForty-five iris melanomas and 268 small choroidal melanomas were included. Twenty-four iris melanomas (53 %) had been treated with local resection, 12 (27 %) with Ruthenium-106 brachytherapy, 7 (16 %) with enucleation and 2 (4 %) with proton beam irradiation. Twenty-three patients had deceased before the end of follow-up. Median follow-up for the 22 survivors was 13.3 years (SD 9.4, table 1). Patients with iris melanomas were more often asymptomatic at presentation and had a trend towards significantly lower age (59 versus 63 years, Student’s T-tests p=0.057). Further, iris melanomas had significantly smaller basal diameter (5.8 versus 8.0 mm, p< 0.0001) and tumor volume (79 mm3 versus 93 mm mm3, p< 0.0001) but greater thickness (3.0 versus 2.5 mm, p< 0.0001). The cumulative incidence of iris melanoma-related mortality was 5 % at 5 years after diagnosis, and 8 % at 10, 15 and 20 years. The incidence was not significantly different to small choroidal melanomas (Wilcoxon p=0.46). In multivariate Cox regression with tumor diameter and thickness as covariates, patients with choroidal melanomas did not have increased HR for melanoma-related mortality (HR 2.2, 95 % CI 0.5 – 9.6, p=0.29). Similarly, there were no significant survival differences in matched subgroups (Wilcoxon p=0.82).ConclusionsThere are no survival differences between iris and choroidal melanomas when adjusting for tumor size. The reason for the relatively favorable prognosis of iris melanomas compared to melanomas of the choroid and ciliary body is likely that they are diagnosed at a smaller size.

scholarly journals No differences in the long-term prognosis of iris and choroidal melanomas when adjusting for tumor thickness and diameter

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shiva Sabazade ◽  
Christina Herrspiegel ◽  
Viktor Gill ◽  
Gustav Stålhammar
Keyword(s):  
Cumulative Incidence ◽  
Case Series ◽  
Tumor Diameter ◽  
Basal Diameter ◽  
Choroidal Melanomas ◽  
Long Term Prognosis ◽  
Survival Differences ◽  
Related Mortality

Abstract Objective To assess the long-term prognosis for patients with iris melanomas and compare it with the prognosis for small choroidal melanomas. Design Retrospective observational case series. Methods All patients treated for iris melanomas at a single referral institution between January 1st 1986 and January 1st 2016 were included. Patients treated for small choroidal melanomas during the same period were included for comparison. The cumulative incidence of melanoma-related mortality was calculated. Patient and tumor characteristics and size-adjusted hazard ratio (HR) for melanoma-related mortality were compared between iris and small choroidal melanomas. Results Forty-five iris melanomas and 268 small choroidal melanomas were included. Twenty-four iris melanomas (53%) had been treated with local resection, 12 (27%) with Ruthenium-106 brachytherapy, 7 (16%) with enucleation and 2 (4%) with proton beam irradiation. Twenty-one (68%), 7 (16%) and 2 (4%) of the iris melanomas were of the spindle, mixed and epithelioid cell types, respectively. Twenty-three patients had deceased before the end of follow-up. Median follow-up for the 22 survivors was 13.3 years (SD 9.4). Patients with iris melanomas were more often asymptomatic at presentation and had a trend towards significantly lower age (59 versus 63 years, Student’s T-tests p = 0.057). Further, iris melanomas had significantly smaller basal diameter (5.8 versus 8.0 mm, p < 0.0001) and tumor volume (79 mm3 versus 93 mm mm3, p < 0.0001) but greater thickness (3.0 versus 2.5 mm, p < 0.0001). The cumulative incidence of iris melanoma-related mortality was 5% at 5 years after diagnosis, and 8% at 10, 15 and 20 years. The incidence was not significantly different to small choroidal melanomas (Wilcoxon p = 0.46). In multivariate Cox regression with tumor diameter and thickness as covariates, patients with choroidal melanomas did not have increased HR for melanoma-related mortality (HR 2.2, 95% CI 0.5–9.6, p = 0.29). Similarly, there were no significant survival differences in matched subgroups (Wilcoxon p = 0.82). Conclusions There are no survival differences between iris and choroidal melanomas when adjusting for tumor size. The reason for the relatively favorable prognosis of iris melanomas compared to melanomas of the choroid and ciliary body is likely that they are diagnosed at a smaller size.

Children With Trisomy 21 and Lennox-Gastaut Syndrome With Predominant Myoclonic Seizures

2021 ◽  
pp. 088307382110260
Author(s):  
Matthew Macdonald ◽  
Jacqueline Crawford ◽  
Anita N. Datta
Keyword(s):  
Trisomy 21 ◽  
Case Series ◽  
Severe Form ◽  
Seizure Type ◽  
Pediatric Epilepsy ◽  
Retrospective Case ◽  
Spike Wave Discharges ◽  
Long Term Prognosis ◽  
Atypical Absence

Introduction: Lennox-Gastaut syndrome is a severe form of pediatric epilepsy that is classically defined by a triad of drug-resistant seizures, including atonic, tonic, and atypical absence seizures; slow spike-and-wave discharges and paroxysmal fast activity on electroencephalography (EEG); and cognitive and behavioral dysfunction. In the vast majority, Lennox-Gastaut syndrome develops in patients with an identified etiology, including genetic or structural brain abnormalities. Long-term prognosis is generally poor with progressive intellectual deterioration and persistent seizures. At present, there are few reported cases of Lennox-Gastaut syndrome and trisomy 21 in the literature. To further delineate the spectrum of epilepsy in trisomy 21, we reviewed children with trisomy 21 and Lennox-Gastaut syndrome at one center over 28 years. Methods: This is a retrospective case series. At our institution, all EEG results are entered into a database, which was queried for patients with trisomy 21 from 1992 to 2019. Pertinent electroclinical data was obtained from medical records. Results: Of 63 patients with trisomy 21 and epilepsy, 6 (10%) had Lennox-Gastaut syndrome and were included in the study. Four of the 6 patients were male and 5 of 6 had neuroimaging, which was normal. Follow-up ranged from 3 to 20 years. Notably, 5 of 6 had predominant myoclonic seizures throughout the course of their epilepsy, associated with generalized spike-wave discharges, <100 milliseconds. Conclusion: We observed myoclonic seizures to be a predominant seizure type in patients with trisomy 21, suggestive that trisomy 21 patients may have a unique pattern of Lennox-Gastaut syndrome.

scholarly journals P.104 Children with Trisomy 21 and Lennox-Gastaut Syndrome with predominant myoclonic seizures

2021 ◽  
Vol 48 (s3) ◽  
pp. S49-S49
Author(s):  
MJ MacDonald ◽  
J Crawford ◽  
A Datta
Keyword(s):  
Trisomy 21 ◽  
Case Series ◽  
Severe Form ◽  
Seizure Type ◽  
Pediatric Epilepsy ◽  
Retrospective Case ◽  
Spike Wave Discharges ◽  
Long Term Prognosis ◽  
Neuro Imaging

Background: Lennox-Gastaut syndrome (LGS) is a severe form of pediatric epilepsy that is classically defined by a triad of drug-resistant seizures, characteristic EEG patterns, and intellectual disability. Long-term prognosis is generally poor with progressive intellectual deterioration and persistent seizures. At present, there are few reported cases of LGS and Trisomy 21 (T21) in the literature. To further delineate the spectrum of epilepsy in T21, we reviewed children with T21 and LGS at one center over 28 years. Methods: This is a retrospective case series. At our institution, all EEG results are entered into a database, which was queried for patients with T21 from 1992-2019. Pertinent electro-clinical data was obtained from medical records. Results: 63 patients with T21 and epilepsy, 6 (10%) had LGS and were included in the study. Four of the six patients were male and 5/6, had neuro-imaging, which was normal. Follow-up ranged from 3-20 years. Notably, 5/6 had predominant myoclonic seizures throughout the course of their epilepsy, associated with generalized spike-wave discharges. Conclusions: Myoclonic seizures appear to be a predominant seizure type in patients with T21, suggestive that T21 patients may have a unique pattern of LGS.

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