scholarly journals Long-term Effectiveness of Microwave Thermoablation in Persons With Residual Limb Hyperhidrosis: A Case Series

2021 ◽  
Author(s):  
Shena A Kravitz ◽  
Ford M Lannan ◽  
Meagan M Simpson

ABSTRACT Excessive sweating or focal hyperhidrosis (HH) of the residual limb in persons with amputations is thought to be a significant contributor to residual limb dermatoses, prosthesis dysfunction, and decreased quality of life. Treatment algorithms used for HH in persons without amputation do not effectively translate to residual limb HH, and research in this area is sparse. We discuss the long-term outcomes of three patients treated with microwave thermoablation (MT) on their residual limbs who had previously been unsuccessfully managed with topical antiperspirants and botulinum toxin injections. On average, there was a decrease of two points in the Hyperhidrosis Severity Scale score among the three patients 4-6 years after treatment. Although the reported side effects of post-procedure edema and prolonged time out of a prosthesis are challenging, MT of the residual limb appears to be a promising treatment modality for persons with amputation. Further investigations for standardized treatment guidelines are required to improve management of residual limb HH with MT.

2016 ◽  
Vol 98 (2) ◽  
pp. 116-120
Author(s):  
J Cartwright ◽  
E Forbat ◽  
A Botha

Oesophagectomies and gastrectomies are performed predominantly for the treatment of malignant disease. However, in this case series, we describe three patients with benign disease who had a laparoscopic oesophagogastrectomy with gastroduodenal detachment and Roux-en-Y biliary diversion, and discuss the operative feasibility and consequent patient outcomes. Our aim was to modify the procedure using an established reconstruction already practised in gastric and bariatric surgery, thereby preventing operative sequelae that lead to a poor quality of life (eg reflux oesophagitis and vomiting). During the first postoperative year, our first two patients experienced weight loss, indigestion and lower bowel symptoms with no apparent improvement in gastric function compared with a standard gastric tube pull-up reconstruction. In the longer term, in both patients, the gastric tube interpositions appeared to function well and there was no evidence of gastro-oesophageal reflux disease, delayed gastric emptying or troublesome indigestion. Our third patient, who had lifelong severe reflux symptoms, was eating normally three months after the operation with no need for antacid medication. We therefore conclude that laparoscopic Ivor–Lewis oesophagogastrectomy with Roux-en-Y bypass is a more complex reconstruction with added risks but may in the long term result in better overall outcomes and satisfaction for patients, particularly those with benign disease.


2021 ◽  
Vol 6 (3) ◽  
pp. 166-170
Author(s):  
Pradeep Nivas Varatharajan ◽  
Manoj kumar thirunavukkarasu ◽  
Athul Babu Kurian ◽  
K. Madhuram

Successful endodontic treatment depends upon the clinician’s precise knowledge and ability to manage complex internal anatomy in order to avoid failure during endodontic treatment. Mandibular canines normally have single root with centrally placed single canal and internal anatomy as simple as could be expected, but there are such canines with a single root with two canals, two roots or fused roots. The occurrence of two canal joining to one for a men may be a rare entity with 4-15% prevalence. Canine is the cornerstone of mouth due to its position and very important as abutment for any type of restoration, so long term success of the restorative depend directly on the quality of endodontic treatment. This article presents a case series of successful endodontic management of mandibular canine with two canals which merge into one canal with one foramina and mandibular canine with two roots and two canals.


2002 ◽  
Vol 16 (5) ◽  
pp. 269-273 ◽  
Author(s):  
Stacey L. Schulze ◽  
Todd A. Loehrl ◽  
Timothy L. Smith

Background The aim of this study was to examine the long-term outcomes of the modified endoscopic Lothrop procedure for the management of the most severe forms of recalcitrant chronic frontal sinusitis. Methods This case series evaluated 13 consecutive cases of the modified endoscopic Lothrop procedure for chronic frontal sinusitis from April 1996 to December 1999. Patent communication to the frontal sinus was evaluated by postoperative endoscopic exam. Postoperative patient symptomatology and medication requirements were assessed during clinic evaluation and by standardized telephone questionnaire. Results At a mean follow-up period of 34.5 months, a 77% patency rate was obtained, with 2 of the 13 patients requiring an osteoplastic flap with obliteration. Telephone questionnaire results indicate improved symptoms and decreased medication requirements in the majority of patients who maintained patency. Conclusions These results show that the modified endoscopic Lothrop procedure provides a good alternative to the osteoplastic flap with obliteration for patients with the most severe forms of chronic frontal sinusitis. Initially, high patency rates decline with longer-term follow-up, and severe forms of chronic rhinosinusitis continue to significantly impact patient-perceived quality of life in some patients. The modified endoscopic Lothrop procedure should be reserved for patients who have failed more conservative endoscopic approaches to the frontal recess.


Neurosurgery ◽  
2012 ◽  
Vol 72 (2) ◽  
pp. 221-231 ◽  
Author(s):  
Sandra G.J. Boccard ◽  
Erlick A.C. Pereira ◽  
Liz Moir ◽  
Tipu Z. Aziz ◽  
Alexander L. Green

Abstract BACKGROUND: Deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy has reported variable outcomes and has gained United Kingdom but not USA regulatory approval. OBJECTIVE: To prospectively assess long-term efficacy of DBS for chronic neuropathic pain in a single-center case series. METHODS: Patient reported outcome measures were collated before and after surgery, using a visual analog score, short-form 36-question quality-of-life survey, McGill pain questionnaire, and EuroQol-5D questionnaires (EQ-5D and health state). RESULTS: One hundred ninety-seven patients were referred over 12 years, of whom 85 received DBS for various etiologies: 9 amputees, 7 brachial plexus injuries, 31 after stroke, 13 with spinal pathology, 15 with head and face pain, and 10 miscellaneous. Mean age at surgery was 52 years, and mean follow-up was 19.6 months. Contralateral DBS targeted the periventricular gray area (n = 33), the ventral posterior nuclei of the thalamus (n = 15), or both targets (n = 37). Almost 70% (69.4%) of patients retained implants 6 months after surgery. Thirty-nine of 59 (66%) of those implanted gained benefit and efficacy varied by etiology, improving outcomes in 89% after amputation and 70% after stroke. In this cohort, >30% improvements sustained in visual analog score, McGill pain questionnaire, short-form 36-question quality-of-life survey, and EuroQol-5D questionnaire were observed in 15 patients with >42 months of follow-up, with several outcome measures improving from those assessed at 1 year. CONCLUSION: DBS for pain has long-term efficacy for select etiologies. Clinical trials retaining patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Sylwia Wagner ◽  
Grzegorz Wagner ◽  
Ewa Mrukwa-Kominek

Purpose. Long-term evaluation of the visual refractive outcomes and the quality of life after implantation of the WIOL-CF (Medicem, Czech Republic) in both eyes. Design. retrospective, nonrandomized noncomparative case series. Methods. 50 eyes of 25 patients, including 11 women (44%) and 14 men (56%). The age range of the patients was 38 to 77 years (mean age 55.48 ± 10.97 years). All patients underwent bilateral implantation of the WIOL-CF. Exclusion criteria were previous ocular surgeries except for cataract surgery and refractive lens exchange, irregular corneal astigmatism of >1.0 diopter, and ocular pathologies or corneal abnormalities. Postoperative examinations were performed at 14 days and 3, 6, 12 months of surgery; the last follow-up was between 24 and 36 months after the procedure. All exams included manifest refraction, monocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 5 m (Snellen), monocular uncorrected visual acuity in 70 cm and 40 cm (Jeager) and binocular UCVA, DCVA in 5 m, 70 cm, and 40 cm, binocular contrast sensitivity (CS) under photopic conditions, binocular defocus curves, high-order aberrations, quality-of-vision VF-14 questionnaire, and spectacle independence. Results. Significant improvement in monocular visual acuity at all distances was demonstrated; the mean postoperative spherical equivalent was 0.32 ± 0.45D. The postoperative means of binocular distance UCVA and BCVA were also improved ( p  < .001) and so were the mean uncorrected intermediate VA (2.053 ± 1.268) and near uncorrected VA (2.737 ± 1.447). There was a significant improvement in contrast sensitivity at all spatial frequencies and higher-order aberration, compared to preoperative results. Conclusions. The evaluation of a WIOL-CF showed good distance, intermediate, and near visual acuity. Contrast sensitivity increased after surgery in all spatial frequencies. Patient satisfaction was high despite some optical phenomena. The rate of postoperative spectacle independence also turned out high. Financial Disclosure. No author has a financial or proprietary interest in any material or method mentioned.


2020 ◽  
pp. 81-82
Author(s):  
Khushali Jain ◽  
Mariya Jiandani ◽  
Pramila Lohakare

SARS-CoV-2 2 also known COVID 19, has been observed to cause long term functional impairments. There have been reports of post covid discharge symptoms such as dyspnoea, fatigue, and reduced overall capacity. Physiotherapy is an integral component of pulmonary rehabilitation. It plays a key role in improving functional status and quality of life in patients with chronic respiratory diseases. COVID 19 being a multisystem disease with primary affection of the lung can be benefitted with physiotherapy intervention. We present a case series of four patients with complaints of dyspnoea and fatigue post covid, enrolled for face to face pulmonary rehabilitation at our tertiary care centre.


2019 ◽  
Vol 22 (6) ◽  
pp. 582-588 ◽  
Author(s):  
Margaret R Slater ◽  
Sharon Pailler ◽  
J’mai M Gayle ◽  
Illoneete Cohen ◽  
Erin L Galloway ◽  
...  

Objectives The objective of this study was to evaluate the long-term quality of life in cats following perineal urethrostomy. Methods This study comprised a retrospective case series of 74 cats with urinary obstructions that received perineal urethrostomies at the American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Hospital between September 2015 and July 2017. Medical records were reviewed for information on the number of obstructions prior to surgery, urinary tract problems at the time of surgery and other potential factors influencing long-term welfare. Owners were surveyed by telephone and text 5–29 months after their cat’s surgery. Responses were compiled and analyzed to determine owner perception of welfare postsurgery, and to identify patterns in medical history and welfare outcomes. Results In total, 105 cat owners were eligible for the survey; 74 responded. Altogether, 100% of responding individuals reported at least the same quality of life postsurgery compared with the cat’s quality of life before demonstrating urinary problems (48% reported better). On a quality-of-life scale of 1–10 (10 = excellent), 100% of responding cat owners reported at least 7; 75% reported 10. Conclusions and relevance Quality-of-life outcomes for cats 5–29 months after receiving perineal urethrostomy surgery were reported to be very good. Given this finding, and that perineal urethrostomy surgery should mitigate future blockages, we suggest considering perineal urethrostomy surgery as a standard tool to manage urinary obstructions in cats. The needs of the specific client and patient, including risks, costs and welfare of the cats, should drive the options for management of urinary obstructions in male cats.


Dental Update ◽  
2021 ◽  
Vol 48 (7) ◽  
pp. 571-578
Author(s):  
Nahal Razaghi ◽  
Mike Hughes ◽  
Mital Patel

This clinical case series highlights an under-reported and often unidentified complication of implant-retained overdentures that may leave patients with a risk of long-term discomfort and preventable damage to the opposing dentition. A variety of cases is discussed to demonstrate potential problems and symptoms that can flag up signs of parafunctional habits in implant patients, and how these can be managed successfully. CPD/Clinical Relevance: Implant-retained overdentures provide a significant improvement in quality of life; however, careful patient assessment and management is essential to ensure the components do not cause damage to the opposing dentition.


2021 ◽  
pp. 194589242110496
Author(s):  
Jae Woong Hwang ◽  
Mun Soo Han ◽  
Sung Hoon Kang ◽  
Ji Won Kwak ◽  
Hyun Keun Kim ◽  
...  

Background Various graft materials have been used to repair nasoseptal perforation, but there is no standardized treatment method. The anterior maxillary sinus wall is flattened in appearance and can be easily obtained in a sufficient amount for a large-sized nasoseptal perforation. Objectives The aim of this study is to determine whether the anterior maxillary sinus wall is suitable as an interpositional graft in the surgical repair of septal or nasoseptal perforation. Methods This is a retrospective review of 21 patients who underwent repair of nasoseptal perforation using anterior maxillary sinus wall as an interpositional graft. The etiology, pre- and post-operative NOSE and GBI score, and perforation size were reviewed. The surgical outcome was considered successful if total closure was achieved after postoperative follow-up. Results 19 of the 21 perforations were successfully repaired with anterior maxillary sinus wall. Failure of the repair was found in 2 patients. Causal etiology of perforation was previous septoplasty in 10 patients, and electrocautery in 1 case, but not identified in 10 cases. The largest size was 2.7 × 2.2 cm. The most common symptoms were epistaxis, crusting, and nasal obstruction. Closure of septal perforation resulted in improved subjective symptoms and quality of life which were evaluated with NOSE and GBI score. Conclusion Anterior maxillary sinus wall as interpositional graft between mucoperichondrial flaps can be used to reliably repair nasoseptal perforations.


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