Mandibular osteoma as a cause of ankylosis and progressive trismus

2021 ◽  
Vol 14 (9) ◽  
pp. e244014
Author(s):  
Noelia Ortega Beltrá ◽  
Silvia Matarredona Quiles ◽  
Miguel Martín Arroyo ◽  
Francisco Pons Rocher
Keyword(s):  
Primary Care ◽  
Treatment Options ◽  
Clinical Aspects ◽  
Rare Entity ◽  
Craniofacial Skeleton ◽  
Peripheral Osteoma ◽  
Local Problems ◽  
Benign Tumours ◽  
Clinical Stability

Osteomas are benign tumours of bone tissue restricted to the craniofacial skeleton. The aim of this article is to present and discuss the demographic and clinical aspects and the management of craniomaxillofacial osteomas. When the patient was submitted from primary care to our hospital, he was 68 years old, and he had ankylosis of the temporomandibular joint for the previos 4 years. A CT scan was performed, finding a giant mandibular osteoma. Conservative treatment and radiological follow-up were carried out with clinical stability. Osteomas more often are seen in the paranasal sinuses and in young adults, with no differences in gender. Most are asymptomatic, but they can cause local problems. For its diagnosis, CT is usually performed. Treatment options are conservative management and follow-up or surgery. Although rarely, they can recur. Mandibular peripheral osteoma is a rare entity. Depending on the symptoms, a conservative or surgical treatment can be chosen. A clinical and radiological follow-up is necessary to detect possible recurrences or enlargement.

Evaluation of a tertiary and district general hospital menopause service

2020 ◽  
pp. 205336912094762
Author(s):  
Kristyn M Manley ◽  
T Hillard ◽  
D Holloway ◽  
D Bruce ◽  
J Rymer
Keyword(s):  
Primary Care ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Treatment Resistance ◽  
District General Hospital ◽  
Behavioural Therapy ◽  
Alternative Methods ◽  
Require Time ◽  
Co Morbidity

Objective Requests for management of menopausal symptoms and hormone replacement are increasing in the UK. Referrals to specialist clinics have to be balanced with increasing recommendations within the NHS to improve efficiency and patient care. Study design Retrospective evaluation of clinic records over two months at a district general (Poole Hospital) and tertiary (Guy’s Hospital) menopause service. Data on referral origin, reason for referral, interval from referral to review and outcome were collected and compared between trusts. Main outcome measures To evaluate and compare referrals and outcomes in a tertiary and district general menopause service and provide recommendations for improving efficiency. Results Most referrals are from primary care but up to 25% are from other specialties. Half of the appointments are new referrals and 95% of women attend. Of the new referrals, 50% have multiple medical comorbidities, 25% a personal or family history of cancer and 25% treatment resistance; 30% have premature ovarian insufficiency. At Guy’s Hospital, 30% are reviewed more than 18 weeks after referral, at Poole Hospital this is 6%. Treatment resistance is reported in half of the women reviewed at follow-up. Conclusions Menopause services review a complex patient population and the majority of referred women have more than one co-morbidity; they require time, specialist knowledge of current treatment options and a multidisciplinary approach. The main barrier to service efficiency is capacity, particularly in population dense areas; cognitive behavioural therapy and non-hormonal methods appear under-utilised in primary care, as do alternative methods of follow-up within the clinics such as telephone and patient-initiated appointments.

scholarly journals Infrarenal Infected Aortic Aneurysm Caused by Streptococcus pyogenes

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Floryn Cherbanyk ◽  
Markus Menth ◽  
Bernhard Egger ◽  
Véronique Erard
Keyword(s):  
Streptococcus Pyogenes ◽  
Current Knowledge ◽  
Treatment Options ◽  
Diagnostic Methods ◽  
Rare Entity ◽  
Microbiological Characteristics ◽  
Serious Disease ◽  
Infected Aortic Aneurysm ◽  
Infectious Aneurysm

Infectious aneurysm is a rare entity associated with significant morbidity and mortality. Current knowledge on pathogenesis, outcome, diagnosis, management, and follow-up remains debatable. We report the case of a patient with Streptococcus pyogenes aneurysm who was successfully treated with a homograft implant and discuss microbiological characteristics, diagnostic methods, and treatment options currently available for this serious disease.

scholarly journals Treatment Options for Villous Adenoma of the Ampulla of Vater

HPB Surgery ◽  
2000 ◽  
Vol 11 (5) ◽  
pp. 325-331 ◽  
Author(s):  
C. Hoyuela ◽  
E. Cugat ◽  
E. Veloso ◽  
C. Marco
Keyword(s):  
High Risk ◽  
Villous Adenoma ◽  
Recurrent Disease ◽  
Treatment Options ◽  
Ampulla Of Vater ◽  
Severe Dysplasia ◽  
Rare Tumour ◽  
Results Of Treatment ◽  
Benign Tumours

Introduction: Duodenal villous adenoma arising from the ampulla of Vater has a high risk of malignant development. Excluding associated malignant disease prior to resection of an adenoma of the ampulla is not always possible. Therefore, the surgical procedure of choice to treat this rare tumour is still controversial.Objective: To evaluate retrospectively results of treatment of villous adenoma arising from ampulla of Vater with dysplasia or associated carcinoma limited to the ampulla.Patients and Methods: From 1985 to 1996, eight patients have been diagnosed with ampullary villous adenoma suitable for resection. We have reviewed treatment, morbidity, mortality, follow-up and final outcome.Results: Pancreatoduodenectomy (PD) was performed in 4 patients. Transduodenal ampullectomy and endoscopic resection was performed in 2 patients each. There was no perioperative mortality. None of the patients had biliary, pancreatic or intestinal leakage but two patients who underwent PD had minor postoperative complications. The mean follow-up was 44 (range: 6–132) months. Villous adenoma was associated with adenocarcinoma in 50% of the cases (4/8 patients). During the followup both patients who underwent transduodenal ampullectomy developed recurrent disease. All patients initially treated by PD are alive without evidence of recurrent disease.Conclusions: Treatment of villous adenoma of the ampulla must be individualized within certain limits. In our series, PD achieve good results and it appears to be the procedure of choice in order to treat villous adenomas with proved presence of carcinoma, carcinoma in situ or severe dysplasia. Endoscopic or local resection may be appropriate for small benign tumours in high risk patients.

Inguinal endometriosis, a rare entity of which surgeons should be aware: clinical aspects and long-term follow-up of nine cases

Hernia ◽  
2018 ◽  
Vol 22 (5) ◽  
pp. 881-886 ◽  
Author(s):  
N. Wolfhagen ◽  
N. E. Simons ◽  
K. H. de Jong ◽  
P. J. M. van Kesteren ◽  
M. P. Simons
Keyword(s):  
Clinical Aspects ◽  
Rare Entity ◽  
Long Term Follow Up

scholarly journals Schwannoma of the extracranial portion of the accessory nerve presenting as spinal adenopathy

2019 ◽  
Vol 12 (5) ◽  
pp. e228647
Author(s):  
Mohamed Mehdi El Fakiri ◽  
Meryem Lahjaouj ◽  
Mohammed Roubal ◽  
Mohammed Mahtar
Keyword(s):  
Sternocleidomastoid Muscle ◽  
Accessory Nerve ◽  
Histopathological Analysis ◽  
Rare Entity ◽  
Transcervical Approach ◽  
Benign Tumours ◽  
The Right ◽  
Slow Growing ◽  
Growing Mass

Schwannomas are benign tumours arising from Schwann cells in the peripheral nerve. The schwannoma of the accessory nerve is a very rare entity. We report a case of Schwannoma of the extracranial accessory nerve. A 22-year-old man presented with a slow-growing mass, located on the right upper neck. The patient did not have any neurological deficit. CT scan showed a hypodense mass behind sternocleidomastoid muscle. The suspected diagnosis was an adenopathy of the accessory spinal chain. Surgery was done via transcervical approach. The histopathological analysis concluded with a diagnosis of schwannoma. No recurrence was noted at the follow-up examination 29 months after surgery.

scholarly journals Bilateral Huge Perirenal Angiomyolipoma: Conservative Management of a Time Bomb

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Alireza Lashay
Keyword(s):  
Rare Disease ◽  
Surgical Resection ◽  
Conservative Management ◽  
Watchful Waiting ◽  
Treatment Options ◽  
Rare Entity ◽  
Case Presentation ◽  
Risks And Benefits

Introduction: Bilateral huge perirenal Angiomyolipoma is a very rare entity and has not been reported in the literature to date. The choice of appropriate management for such a rare disease may be a dilemma because each strategy can harbor its own advantages and hazards. Case Presentation: We present our experience with such a patient over seven years of follow-up. Performing surgery in this patient might have ended up in unilateral or bilateral kidney loss, and he refused the surgery and underwent watchful waiting. Conclusions: Like conservative management that was successful for more than seven years. In this case, other treatment options such as angioembolization and surgical resection are vital options with their own risks and benefits.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

Efficacy and safety of oral dapsone in acne vulgaris – experience of a tertiary care teaching hospital in central Lahore

2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  
Keyword(s):  
Side Effects ◽  
Therapeutic Option ◽  
Acne Vulgaris ◽  
Treatment Options ◽  
Tertiary Care ◽  
Poor Response ◽  
Global Assessment Scale ◽  
Severe Acne ◽  
Hematologic Profile

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.

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