scholarly journals Surgical Treatment of Cystic Adventitial Disease of the Popliteal Artery: Five Case Reports

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Kimihiro Igari ◽  
Toshifumi Kudo ◽  
Takahiro Toyofuku ◽  
Yoshinori Inoue

Cystic adventitial disease (CAD) is a rare cause of intermittent claudication and nonatherosclerotic conditions in middle-aged men without cardiovascular risk factors. The etiology of CAD is unclear; however, the direct communication between a cyst and a joint is presumed to be a cause. We herein report a case series of CAD of the popliteal artery (CADPA), in which patients were treated with surgical resection and vascular reconstruction. Although less invasive treatment modalities, including percutaneous cyst aspiration and percutaneous transluminal angioplasty, have been the subject of recent reports, these treatments have had a higher recurrence rate. Therefore, all of the CAPDA cases in the present series were treated surgically, which lead to good outcomes.

2003 ◽  
Vol 10 (4) ◽  
pp. 253-257 ◽  
Author(s):  
Ch Chung

Objective To review the treatment modalities available for paraphimosis, with special emphasis on those applicable to the emergency department. Data source Relevant medical literature was searched through MEDLINE, EMBASE, CINAHL, and Cochrane Database. Manual search was performed in books on Urology, General Surgery and Emergency Medicine available in the Hospital Library. Further information was obtained through the Internet at < www.infoseek.com >. References cited in articles were also retrieved. Study selection Key words for the literature, Internet and textbook search were ‘paraphimosis’ and ‘treatment’. All available years of study were reviewed. Data extraction Relevant full text articles were obtained through the hospital library network. Original articles, review papers, medical practice, case reports, and relevant book chapters were reviewed. Data synthesis There were no prospective, randomised, controlled studies available. The majority were case series and expert experience or opinions only. Currently, a multitude of non-invasive and invasive treatment options are available, including manual reduction, help of non-crushing tissue forceps, puncture technique and dorsal slit. Conclusion All treatment methods are within the capability of the emergency physician. Hospitalization should rarely be required, unless there are serious complications.


2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 57-62 ◽  
Author(s):  
O. Masuo ◽  
T. Terada ◽  
T. Tsumoto ◽  
H. Yamaga ◽  
K. Nakai ◽  
...  

The number of successful case reports with percutaneous transluminal angioplasty (PTA) / stenting for intracranial atherosclerotic stenoses is recently increasing with the advent of flexible coronary stents. However, it is not well known whether the perforating artery is occluded or not after stent placement in the atherosclerotic stenotic vessels. We investigated this issue using five New Zealand white rabbits. We deployed stainless steel stents in the atherosclerosis-induced abdominal aorta across the lumbar artery in which the diameters of the abdominal arteries were similar to those of human intracranial arteries. We evaluated the patency of lumbar artery by angiography and scanning electron microscopy three months after stent placement. The lumbar arteries were patent in four out of five rabbits. However, SEM findings demonstrated stent struts were covered with thick neointima and the ostia between stent struts were partially occluded. It is possible that stent placement in the atherosclerotic arteries can cause the obliteration of the perforating arteries.


2020 ◽  
Vol 12 (3) ◽  
pp. 103-107
Author(s):  
Antonio Gatto ◽  
Serenella Angelici ◽  
Claudia Di Pangrazio ◽  
Lorenzo Nanni ◽  
Danilo Buonsenso ◽  
...  

Accidental swallowing of foreign bodies is a common problem among the pediatric population (6 months to 3 years), especially if the foreign body (FB) presents a sharp end that could potentially lead to perforation of the gastrointestinal (GI) tract, resulting in infection and complications. We report the case of a 2-year-old, admitted to the Emergency Department of our hospital after ingesting two FBs classifiable as sharp objects, specifically two metal nails, both approximately 4-cm long, which had been swallowed in one go, as reported by the parents. The patient had been previously admitted to another hospital in the same region, where the Emergency Department (ED) doctors took an X-ray to confirm the ingestion. The foreign bodies ingestion was thus confirmed, and they were, according to their report, located in the GI tract over the stomach. The patient has been monitored through all of his stay in the hospital and the progression of the foreign bodies has been documented with serial X-rays. Since neither clinical nor radiological signs of perforation were present, putting the FBs in the small bowel, a non-operative expectant management was followed. After 4 days of admission, the patient had passed one of the two FBS and later on the second one, without any complication. Thereafter the patient was discharged. The management of sharp gastrointestinal foreign objects ingestion is still debated, and the data of the current literature are poor. A number of case reports and small case series describe successful conservative management for the majority of ingested sharp objects. According to the literature data, our report confirms that the ingestion of sharp objects and relatively big objects in a baby can be successfully non-operatively managed, even despite the age of the patient and though the FBs are multiple.


1980 ◽  
Vol 135 (5) ◽  
pp. 945-950 ◽  
Author(s):  
S Sprayregen ◽  
KW Sniderman ◽  
TA Sos ◽  
U Vieux ◽  
A Singer ◽  
...  

Author(s):  
Sumod Khedekar ◽  
Renu Rathi ◽  
Bharat Rathi ◽  
Heramb Hattikar ◽  
Suraj Patlekar ◽  
...  

Background: In India, Protein Energy Malnutrition (PEM)remains a significant and challenging public health issue despite implementing different nutritional policies over the period. It is also accompanying with aggravated risk of all-cause morbidity, as well as fatality Ayurveda mentions about various nutritional disorders such as karshya, balashosha, phakka, yakshma which are having similar symptomatology and treatment approach as that of the PEM. Several clinical studies have been conducted and some are under trial but systematic review is still pending to explore an effective treatment modality to combat PEM in Children. Aim: A systematic review to evaluate the efficacy of Ayurveda Interventions specifically on weight gain in the Management of Protein Energy Malnutrition in Children. Materials and Methods: A systematic review which will evaluate published clinical work of Ayurveda treatment modalities specifically for weight gain in the management of PEM in children that will involve “The randomized controlled trials (RCTs), multiple-arms clinical trials, quasi-experimental trials, observational studies (case series and case reports) through databases like PubMed, COCHRANE, AYUSH Research Portal, DHARA; Google Scholar; etc. and Ayurveda compendia to fetch complete available literature.” Observations and Discussion: The work of selection of the studies, data extraction, and synthesis will be taken up. Established guidelines for study selection, quality assessment, and narrative synthesis will be followed. Risk of bias assessment will be performed. A protocol will be designed that will ensure transparency for the completed review. Results of the study will be elaborately synthesized. The data will be presented in percentage, count and frequency; and if we find the data to be sufficiently homogeneous then meta-analysis will be carried out. Conclusion: The results obtained from this systematic review will be useful in identifying the evidence-based efficacy of Ayurveda interventions on weight gain in the Management of PEM. It will also provide substratum for future research studies for generating good-quality evidence that can be helpful to design new health policy to combat PEM effectively.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e14565-e14565 ◽  
Author(s):  
Meghan Mooradian ◽  
Justine Vanessa Cohen ◽  
Anita Giobbie-Hurder ◽  
Riley Fadden ◽  
Krista M. Rubin ◽  
...  

e14565 Background: Checkpoint inhibition (CPI) has significant and durable effectiveness against a broadening range of cancers and currently is FDA approved for more than 10 different malignancies. With increasing use of CPI, there is a need to understand the range and extent of immune-related adverse effects (irAE). Though certain irAEs, such as colitis and pneumonitis have been well studied, CPI- induced arthritis (CA) has not been widely recognized nor well characterized with data on the subject largely comprised of case reports and small case series. Methods: We retrospectively reviewed 125 patients (pts) with advanced melanoma treated with CPI to define the incidence and clinical features of CA. We identified 20 pts who developed CA during the course of CPI treatment. Cases were included only if active rheumatic signs or symptoms developed after receiving therapy. Demographic data (gender, age), type of CPI, number of CPI cycles, treatment of CA and other irAE manifestations were extracted from the medical chart. Results: 16% of patients treated with CPI developed CA. Among the 20 pts, the average age at CA onset was 70.3 (43, 84) with 75% of pts male. 80% had received anti-PD-1 monotherapy, 15% combination anti-PD-1 + anti-CTLA-4 and 5% monotherapy with CTLA-4 inhibition. The average number of infusions prior to symptom onset was 13.5 (1-48) after a median time point of 6.6mths on therapy. Basic rheumatologic testing (RF, CCP, ANA) was only positive in 10% of cases. 20% of pts were treated with non-steroidal anti-inflammatory drugs alone, whereas 40% required corticosteroids (systemic or injection). The remaining 40% necessitated treatment with disease modifying anti-rheumatic drugs. Conclusions: CA is a debilitating irAE with a higher incidence (16%) than most other irAEs and a negative impact on the quality of life of pts affected. Based on our retrospective review, this irAE tends to delayed in onset and often requires systemic immune suppressants for effective treatment. We posit that this is an under recognized and undertreated irAE. Further work is needed to better define the clinical factors that may affect or predict its development.


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