Simple limbal epithelial transplantation (SLET) in failed cultivated limbal epithelial transplantation (CLET) for unilateral chronic ocular burns

2018 ◽  
Vol 102 (12) ◽  
pp. 1640-1645 ◽  
Author(s):  
Sayan Basu ◽  
Sashwanthi Mohan ◽  
Swapnil Bhalekar ◽  
Vivek Singh ◽  
Virender Sangwan
Keyword(s):  
Case Series ◽  
Primary Outcome Measure ◽  
Successful Outcome ◽  
Kaplan Meier ◽  
Limbal Stem Cell ◽  
Prospective Case Series ◽  
Ocular Burns ◽  
Cultivated Limbal Epithelial Transplantation ◽  
Better Than

AimsCultivated limbal epithelial transplantation (CLET) fails in around 20%–30% of cases. This study aimed to report the clinical outcomes of autologous simple limbal epithelial transplantation (SLET) in eyes with recurrent unilateral limbal stem cell deficiency (LSCD) due to failure of CLET.MethodsThis was a prospective case series which included 30 eyes of 30 patients who underwent SLET between 2010 and 2016 after failure of one (n=24) or two (n=6) previous CLET procedures for chronic unilateral ocular burns. The primary outcome measure was success of SLET defined on the basis of relative improvement in five objective criteria: best corrected visual acuity (BCVA), and grades of symblepharon, corneal conjunctivalisation, vascularisation and opacification.ResultsAt a mean follow-up of 2.3 years, 24 (80%) of the 30 eyes maintained a successful outcome. Kaplan-Meier analysis showed a 5-year survival probability of 77%±8%. At 1 year postoperatively statistically significant improvement was noted in BCVA (logarithm of the minimum angle of resolution of 3 to 1) and in the median grades of corneal conjunctivalisation (2 to 0), vascularisation (2 to 0) and opacification (2 to 1) (P≤0.0026). In 62.5% of successful cases, BCVA improved to 20/200 or better. The success rate of SLET in failed CLET was better than that of repeat CLET (53.5%, P=0.011). None of the donor eyes developed any complications.ConclusionSLET is an effective alternative to CLET in eyes with recurrence of LSCD after previously failed CLET procedures. Since SLET is single-staged and less expensive, it is probably preferable to repeating CLET.

scholarly journals Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Loris Perticarini ◽  
Stefano Marco Paolo Rossi ◽  
Marta Medetti ◽  
Francesco Benazzo
Keyword(s):  
Revision Surgery ◽  
Case Series ◽  
Bone Defects ◽  
Harris Hip Score ◽  
Type Ii ◽  
Level Of Evidence ◽  
Kaplan Meier ◽  
Prospective Case Series ◽  
Acetabular Components

Abstract Background This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. Methods Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29–90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. Results Average follow-up was 91 (range 24–146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25–70; SD 9) preoperatively to 84.4 (range 46–99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan–Meier survivorship was assessed to be 88.54% (95% CI 80.18–93.52%) at 71 months, with failure of the cup for any reason as the endpoint. Conclusion Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. Level of evidence Level IV prospective case series

Transoral Laser Microsurgery for Untreated Glottic Carcinoma

2007 ◽  
Vol 137 (3) ◽  
pp. 482-486 ◽  
Author(s):  
David G. Grant ◽  
John R. Salassa ◽  
Michael L. Hinni ◽  
Bruce W. Pearson ◽  
Richard E. Hayden ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Case Series ◽  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Average Hospital ◽  
Kaplan Meier ◽  
Prospective Case Series ◽  
Preservation Rate

OBJECTIVES: To report the oncology and functional outcomes of transoral laser microsurgery (TLM) for untreated glottic carcinoma. STUDY DESIGN: A 2 center prospective case series analysis. SETTING: Academic, tertiary referral centers. RESULTS: Seventy-six patients underwent TLM. Pathologic T stages were: T1, 45 (59%); T2, 21 (28%); T3, 5 (7%); and T4, 5 (7%). Five (7%) patients had neck dissections. Five (7%) patients received adjuvant radiotherapy. Mean follow-up was 42 months. Respective T1 and T2 5-year Kaplan-Meier estimates were: local control, 90% and 93%; loco-regional control, 90% and 93%; disease specific survival, 90% and 93%; and overall survival, 94% and 93%. The average hospital stay was 2 days. Two (3%) patients experienced major complications. The overall laryngeal preservation rate was 95% (72 of 76). CONCLUSIONS: TLM is a safe and effective treatment in select carcinoma of the glottic larynx. Low morbidity and mortality and short periods of hospitalization make TLM an attractive therapeutic option. SIGNIFICANCE: TLM is an emerging strategy in the treatment of laryngeal cancer.

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

Percutaneous cervical cordotomy for the treatment of cancer pain: A prospective case series of 52 patients with a long‐term follow‐up

Pain Practice ◽  
2020 ◽  
Author(s):  
Paul J. Zomers ◽  
George Groeneweg ◽  
Sara Baart ◽  
Frank J.P. Huygen
Keyword(s):  
Cancer Pain ◽  
Case Series ◽  
Long Term Follow Up ◽  
Prospective Case Series

scholarly journals Good results at 2-year follow-up of a custom-made triflange acetabular component for large acetabular defects and pelvic discontinuity: a prospective case series of 50 hips

2021 ◽  
pp. 1-7
Author(s):  
Marieke Scharff-Baauw ◽  
Miranda L Van Hooff ◽  
Gijs G Van Hellemondt ◽  
Paul C Jutte ◽  
Sjoerd K Bulstra ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Case Series ◽  
Pelvic Discontinuity ◽  
Custom Made ◽  
Prospective Case Series ◽  
Acetabular Defects

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

2019 ◽  
Vol 41 (2) ◽  
pp. 187-192
Author(s):  
Ricardo E. Colberg ◽  
Monte Ketchum ◽  
Avani Javer ◽  
Monika Drogosz ◽  
Melissa Gomez ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Plantar Fasciitis ◽  
Case Series ◽  
Successful Outcome ◽  
Oral Steroid ◽  
Tarsal Tunnel ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

Bioactive glass S53P4 to fill-up large cavitary bone defect after acute and chronic osteomyelitis treated with antibiotic-loaded cement beads: a prospective case series with a minimum 2-year follow-up

Injury ◽  
2021 ◽  
Author(s):  
Kodi Edson Kojima ◽  
Fernando Brandão de Andrade e Silva ◽  
Marcos de Camargo Leonhardt ◽  
Vladimir Cordeiro de Carvalho ◽  
Priscila Rosalba Domingos de Oliveira ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Bone Defect ◽  
Chronic Osteomyelitis ◽  
Case Series ◽  
Prospective Case Series

scholarly journals Definite total radical resection in treatment of patients, suffering low-differentiated cancer of the bladder

2020 ◽  
Vol 87 (11-12) ◽  
pp. 76-79
Author(s):  
P. G. Yakovlev
Keyword(s):  
Radical Resection ◽  
Average Period ◽  
Total Resection ◽  
Primary Radical ◽  
Kaplan Meier ◽  
Salvage Resection ◽  
Cancer Of The Bladder ◽  
The Difference ◽  
Better Than

Objective. To determine the operative volume of surgical treatment in total radical resection of the bladder in autonomous regime and to estimate the survival indices in patients with low-differentiated cancer of the bladder depending on time of conduction of radical total resection of the bladder. Materials and methods. Retrospectively 522 histories of the diseases were analyzed in the patients with diagnosis of low-differentiated cancer of the bladder, including 190, in whom radical total resection of the bladder was performed in 1998 - 2016 yrs period. The survival indices were determined. Using Kaplan-Meier method, comparative analysis of the survival indices in patients was done, to whom radical total resection or salvage resection of the bladder performed. Results. Total radical resection of the bladder in autonomous regime was done in 24.7% patients with low-differentiated cancer of the bladder or in 67.9% patients, to whom total resection of the bladder was performed. The indices of total 3-, 5- and 10-yr survival of the patients have constituted 96, 93 and 45%, accordingly. The survival indices in the patients after organ-preserving treatment and further salvage total resection of the bladder for locally progression of cancer were better, than in the patients, to whom the treatment consisted of primary radical total resection of the bladder, but the difference have appeared statistically nonsignificant (p=0.286). Average period between conduction of organ-preserving treatment and salvage total resection of the bladder have constituted 34 mo. Conclusion. Radical total resection of the bladder in autonomous regime constitutes the extended method of treatment of muscularly-invaded low-differentiated cancer of the bladder (performed in 24.7% of all the patients) and guarantees satisfactory late follow-up results while primary or postponed performance.

scholarly journals Nonmyeloablative Allogeneic Stem-Cell Transplantation for Hematologic Malignancies: A Systematic Review

2003 ◽  
Vol 10 (1) ◽  
pp. 17-41 ◽  
Author(s):  
Benjamin Djulbegovic ◽  
Jerome Seidenfeld ◽  
Claudia Bonnell ◽  
Ambuj Kumar
Keyword(s):  
Stem Cell ◽  
Case Series ◽  
Disease Status ◽  
Hematologic Malignancies ◽  
Cell Transplants ◽  
Unrelated Donors ◽  
Conditioning Regimens ◽  
Prospective Case Series ◽  
Patient Selection Criteria

Background Increasingly, clinicians advocate the use of nonmyeloablative allogeneic stem-cell transplants (NM-allo-SCTs, “mini-transplants”) to manage hematologic malignancies. They hypothesize that NM-allo-SCT is equally efficacious to standard allo-SCT but produces less regimen-related toxicity. Methods To analyze available evidence on the benefits and harms of “mini-transplants,” we identified 23 manuscripts, 1 abstract, and 1 letter that reported the outcome of mini-transplants in hematologic malignancies. Results Data were compiled on 603 treated patients, with 118 transplants using stem cells from matched unrelated donors. All studies were small prospective case series, and most lacked concurrent or historical controls. Outcomes of interest were not uniformly reported. The studies were heterogeneous and used different patient selection criteria, conditioning regimens, and timing of transplant with respect to disease status. The transplant-related mortality rate was 32%, the relapse rate was 15%, and toxicities included acute and chronic graft-vs-host disease and veno-occlusive disease. The aggregate rate of complete remission was 45%. Survival at 1 year or longer ranged from 30% to 60% at 1 to 5 years of follow-up. All studies reported successful chimerism. Conclusions Disease-specific studies with longer follow-up are needed to evaluate this potentially promising therapy.

Complications Are Rare From Middle Turbinate Resection: A Prospective Case Series

2019 ◽  
Vol 33 (6) ◽  
pp. 657-664 ◽  
Author(s):  
Steven Pinther ◽  
Robert Deeb ◽  
Edward L. Peterson ◽  
Robert T. Standring ◽  
John R. Craig
Keyword(s):  
Middle Turbinate ◽  
Case Series ◽  
Operative Intervention ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Complication Rates ◽  
Prospective Case Series ◽  
Polyp Recurrence ◽  
Snot 22

Background When chronic rhinosinusitis with nasal polyps (CRSwNP) fails to respond to medical therapy, endoscopic sinus surgery (ESS) plays an integral role in management. Some studies have shown that middle turbinate resection (MTR) during ESS leads to decreased polyp recurrence and revision ESS rates. Other studies suggest MTR can lead to complications. Objective The purpose of this study was to assess the safety of MTR during ESS for CRSwNP by determining the incidences of intraoperative cerebrospinal fluid (CSF) leak, postoperative epistaxis requiring operative intervention, and postoperative complete frontal stenosis. Methods A multiinstitutional, prospective case series of 91 adult CRSwNP patients was conducted. Patients with medically refractory CRSwNP underwent primary or revision ESS plus MTR by 3 surgeons. Two of the surgeons performed partial MTRs, and one of the surgeons performed complete MTRs. Patients were evaluated for the following complications: intraoperative CSF leak during MTR, postoperative epistaxis requiring operative intervention, and postoperative complete frontal ostial stenosis. Secondary outcomes included changes from preoperative to postoperative 22-item Sinonasal Outcome Test (SNOT-22) scores and revision ESS rates. Results Unilateral or bilateral complete ESSs with MTRs were performed on 91 CRSwNP patients. In total, 173 MTRs were performed. Two surgeons performed 97 partial MTRs on 49 patients, and the third surgeon performed 76 complete MTRs on 42 patients. One CSF leak occurred during partial MTR (1/173, 0.57%). No patients suffered postoperative epistaxis requiring operative intervention, and no patients developed complete frontal stenosis. From preoperatively to postoperatively, mean SNOT-22 scores decreased from 53.7 to 13.1 ( P = .001). No revision ESS was needed during the follow-up period. Mean follow-up time was 7.5 ± 5.4 months. Conclusions Partial and complete MTR during ESS for CRSwNP in this cohort resulted in very low, acceptable intraoperative and short-term postoperative complication rates and no detriment to SNOT-22 scores.

Sign in / Sign up

Export Citation Format

Share Document