scholarly journals Duodenal Duplication Cysts in Children: Clinical Features and Current Treatment Choices

2020 ◽  
Vol 5 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Valeria Dipasquale ◽  
Paolo Barraco ◽  
Simona Faraci ◽  
Valerio Balassone ◽  
Paola De Angelis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Early Recognition ◽  
Treatment Options ◽  
Management Strategies ◽  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Duplication Cyst ◽  
Duodenal Duplication ◽  
Pubmed Search

Background: Duodenal duplication cysts are rare gastrointestinal tract malformations. Most patients experience symptom onset in the first decade of life. This review aims to examine clinical presentation, management strategies and outcomes of duodenal duplication cysts in childhood. Methods: A Pubmed/Medline (http://www.ncbi.nlm.nih.gov/pubmed/) search in October 2019 for articles published since 1999 using the keywords “duodenal duplication cyst,” “child” and “newborn” was carried out. Clinical symptoms, complications, diagnostic examinations, treatment options and outcomes were analyzed and tabulated. Results: There were 41 citations in the literature providing adequate descriptions of 45 cases of duodenal duplication cysts. The age of presentation ranged from newborn to 18 years. The median interval between initial presentation and definitive diagnosis and treatment was 17 months (range: 2 months to 12 years). Overall, 67% of cases presented with abdominal pain, and 43% were complicated with pancreatitis. Different surgical and endoscopic therapeutic strategies were reported. Conclusions: Duodenal duplication cysts may be associated with life-threatening complications and/or recurrent symptoms, impairing quality of life. Early recognition of patients who demonstrate suggestive signs and symptoms is important to ensure success of treatment. This review may be useful to highlight the main diagnostic aspects and limit the risk of a delayed diagnosis.

Meningiomas Of the Internal Auditory Canal

Neurosurgery ◽  
2004 ◽  
Vol 55 (1) ◽  
pp. 119-128 ◽  
Author(s):  
Makoto Nakamura ◽  
Florian Roser ◽  
Sharham Mirzai ◽  
Cordula Matthies ◽  
Peter Vorkapic ◽  
...  
Keyword(s):  
Cerebellopontine Angle ◽  
Clinical Symptoms ◽  
Management Strategies ◽  
Internal Auditory Canal ◽  
Signs And Symptoms ◽  
Vestibular Schwannomas ◽  
Additional Patient ◽  
Surgical Removal ◽  
Neurosurgical Department ◽  
Vestibulocochlear Nerve

Abstract OBJECTIVE: Meningiomas arising primarily within the internal auditory canal (IAC) are notably rare. By far the most common tumors that are encountered in this region are neuromas. We report a series of eight patients with meningiomas of the IAC, analyzing the clinical presentations, surgical management strategies, and clinical outcomes. METHODS: The charts of the patients, including histories and audiograms, imaging studies, surgical records, discharge letters, histological records, and follow-up records, were reviewed. RESULTS: One thousand eight hundred meningiomas were operated on between 1978 and 2002 at the Neurosurgical Department of Nordstadt Hospital. Among them, there were 421 cerebellopontine angle meningiomas; 7 of these (1.7% of cerebellopontine angle meningiomas) were limited to the IAC. One additional patient underwent surgery at the Neurosurgical Department of the International Neuroscience Institute, where a total of 21 cerebellopontine angle meningiomas were treated surgically from 2001 to 2003. As a comparison, the incidence of intrameatal vestibular schwannomas during the same period, 1978 to 2002, was 168 of 2400 (7%). There were five women and three men, and the mean age was 49.3 years (range, 27–59 yr). Most patients had signs and symptoms of vestibulocochlear nerve disturbance at presentation. One patient had sought treatment previously for total hearing loss before surgery. No patient had a facial paresis at presentation. The neuroradiological workup revealed a homogeneously contrast-enhancing tumor on magnetic resonance imaging in all patients with hypointense or isointense signal intensity on T1- and T2-weighted images. Some intrameatal meningiomas showed broad attachment, and some showed a dural tail at the porus. In all patients, the tumor was removed through the lateral suboccipital retrosigmoid approach with drilling of the posterior wall of the IAC. Total removal was achieved in all cases. Severe infiltration of the facial and vestibulocochlear nerve was encountered in two patients. There was no operative mortality. Hearing was preserved in five of seven patients; one patient was deaf before surgery. Postoperative facial weakness was encountered temporarily in one patient. CONCLUSION: Although intrameatal meningiomas are quite rare, they must be considered in the differential diagnosis of intrameatal mass lesions. The clinical symptoms are very similar to those of vestibular schwannomas. A radiological differentiation from vestibular schwannomas is not always possible. Surgical removal of intrameatal meningiomas should aim at wide excision, including involved dura and bone, to prevent recurrences. The variation in the anatomy of the faciocochlear nerve bundle in relation to the tumor has to be kept in mind, and preservation of these structures should be the goal in every case.

Eating Disorders. Review Of Current Treatment Options For Anorexia Nervosa, Focused On Psychotherapy And Pharmacological Treatment

2016 ◽  
Vol 33 (S1) ◽  
pp. S432-S432
Author(s):  
B. Sánchez Sánchez ◽  
P. Muñoz-Calero Franco ◽  
N. Rodriguez Criado ◽  
J.F. Cruz Fourcade ◽  
R. Martín Aragón ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Pharmacological Treatment ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Cognitive Behavioral ◽  
Nutritional Rehabilitation ◽  
Clinical Practices ◽  
Major Health Problem ◽  
Competing Interest

IntroductionAnorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.ObjectivesResearch of current pharmacological and psychotherapy treatments options of the disease.Material and methodsLiterature review based on articles and publications on this topic.ResultsIn anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.ConclusionsNowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment

2004 ◽  
Vol 17 (5) ◽  
pp. 1-9 ◽  
Author(s):  
James K. Liu ◽  
Oren N. Gottfried ◽  
Amin Amini ◽  
William T. Couldwell
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Asymptomatic Patients ◽  
Cranial Nerve Palsies ◽  
Close Observation

Aneurysms arising in the petrous segment of the internal carotid artery (ICA) are rare. Although the causes of petrous ICA aneurysms remain unclear, traumatic, infectious, and congenital origins have been implicated in their development. These lesions can be detected incidentally on routine neuroimaging. Patients can also present with a wide spectrum of signs and symptoms, including cranial nerve palsies, Horner syndrome, pulsatile tinnitus, epistaxis, and otorrhagia. The treatment of petrous ICA aneurysms remains challenging. Treatment options include close observation, endovascular therapies, and surgical trapping with or without revascularization. Management dilemmas exist, particularly for incidental lesions found in asymptomatic patients. The authors review the literature and discuss the anatomy of the petrous ICA as well as the pathophysiological features of aneurysms arising in this region, and they propose a management paradigm with current treatment options.

Current Treatment Options for Vulvovaginal Candidiasis

2005 ◽  
Vol 1 (2) ◽  
pp. 253-261 ◽  
Author(s):  
Jack Sobel
Keyword(s):  
Antifungal Agents ◽  
Topical Therapy ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Management Strategies ◽  
Current Treatment ◽  
Vulvovaginal Candidiasis ◽  
Short Term ◽  
Appropriate Therapy ◽  
Antimycotic Agent

For practitioners, selecting successful therapy for vulvovaginal candidiasis is anything but trivial. The dominant problem; however, lies not with selecting the correct antimycotic agent, but with making the correct diagnosis and not treating non-yeast infections and noninfections as yeast-induced. Moreover, not all cases of vulvovaginal candidiasis are equal and practitioners owe patients the obligation of selecting appropriate therapy based upon the specific type and severity of vulvovaginal candidiasis. Uncomplicated candidiasis is readily treated with short-term oral or topical therapy, whereas complicated candidiasis needs additional strategies using the plethora of therapies available. Problematic refractory cases still abound and the pipeline for new, more potent antifungal agents is largely empty. Management strategies for complicated Candida vaginitis are discussed.

Management of bladder, bowel, and sexual dysfunction

2015 ◽  
pp. 281-313 ◽  
Author(s):  
Ulrich Mehnert
Keyword(s):  
Sexual Dysfunction ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Bowel Function ◽  
Current Treatment ◽  
Major Surgery ◽  
Therapeutic Principles ◽  
Treatment Knowledge ◽  
Treatment Concepts

This chapter provides an overview of the pathophysiological basis of bladder, bowel, and sexual dysfunction, relevant therapy principles, and treatment options. These dysfunctions are frequent sequelae of neurotrauma and neurodegenerative diseases that require adequate management and treatment. Knowledge of basic neurophysiological and pathophysiological processes involved is important for understanding and interpretation of clinical symptoms and findings and for understanding current treatment concepts. Treatment is mandatory and therapy options range from simple conservative measures to major surgery. The main therapeutic principles include protection of kidney function, reduction of urinary and/or faecal incontinence, independent management of bladder and bowel function, ability to sustain a satisfactory sexual relationship, fertility support, and improvement of quality of life. To comply with such principles and to select, initiate, maintain, and eventually adapt the ‘optimal’ treatment regimen for each patient requires a specialized multidisciplinary team.

scholarly journals Current Treatment Options for Intervertebral Disc Pathologies

Cartilage ◽  
2020 ◽  
Vol 11 (2) ◽  
pp. 143-151 ◽  
Author(s):  
Stephen M. Eisenstein ◽  
Birender Balain ◽  
Sally Roberts
Keyword(s):  
Intervertebral Disc ◽  
Annulus Fibrosus ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Complex Structure ◽  
Current Treatment ◽  
Central Nucleus ◽  
Cartilage Endplate ◽  
The Past ◽  
Research World

The complex structure of the intervertebral disc within the spine is well suited to its mechanical function. However, it is also prone to degeneration, which is associated with various clinical symptoms and conditions, ranging from disc herniation to back pain to spinal stenosis. Most patients’ conditions are managed conservatively but a small proportion progress to having surgery. This may be decompression (to remove tissue such as the disc, bone, or hypertrophic ligaments impinging on nerves) or fusion of the normally mobile intervertebral joint to immobilize it and so reduce pain. These used to involve fairly major surgical procedures, but in the past decade there has been much progress to make the surgery more refined and less invasive, for example using endoscopic approaches. Simultaneously, the research world has been studying and developing tissue engineering and cellular techniques for attempting to regenerate the intervertebral disc, whether simply the central nucleus pulposus or a complete intricate assembly to replicate the native structure of this and the surrounding annulus fibrosus, cartilage endplate, and bone. To date, none of the complex entities have been trialed, while cellular approaches are easier to utilize, have progressed to clinical trials, and may offer a better solution.

Management, clinical outcomes, and complications of acute cannula-related peripheral vein phlebitis of the upper extremity: A retrospective study

2014 ◽  
Vol 30 (6) ◽  
pp. 381-388 ◽  
Author(s):  
SE Dunda ◽  
E Demir ◽  
OJ Mefful ◽  
G Grieb ◽  
A Bozkurt ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Treatment Group ◽  
Upper Extremity ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Current Treatment ◽  
Peripheral Vein ◽  
Cubital Fossa ◽  
Hand Region

Objective Acute phlebitis due to peripheral vein catheter use is frequently observed in clinical practice, and requires surgical therapy in severe cases. In this retrospective study, we aimed to increase awareness, evaluate current treatment options, and develop recommendations to optimize treatment outcomes. Methods A total of 240 hospitalized patients with a diagnosis of upper extremity phlebitis from 2006 to 2011 were evaluated in terms of initial clinical features, parameters, co-morbidities and treatment regimes. Severity of phlebitis was graded according to the Baxter scale by assessing clinical symptoms such as pain, erythema, induration, swelling, or palpable venous cord (grade 0–5). Patients were divided in two subgroups: conservative ( n = 132) and operative ( n = 108) treatment. Results Surgical intervention rates and severity were higher for cannula insertion in the cubital fossa region than for cannula insertion in the forearm and hand region ( p < 0.05). Baxter scale grades were higher in the surgical treatment group than in the conservative treatment group (4.47 vs. 2.67, respectively). Conclusions The cubital fossa region is vulnerable to severe phlebitis and is not recommended as the first site of choice for cannulation. Phlebitis of Baxter scale grade 4 or 5 should be considered for early surgical intervention.

Prevention, identification, and treatment options for the management of bed bug infestations

2012 ◽  
Vol 55 (04) ◽  
pp. 89-102 ◽  
Author(s):  
Daniel Fong ◽  
Constance Bos ◽  
Taz Stuart ◽  
Stèphane Perron ◽  
Tom Kosatsky ◽  
...  
Keyword(s):  
Mental Health ◽  
Pest Management ◽  
Clinical Symptoms ◽  
Early Recognition ◽  
Case Reports ◽  
Treatment Options ◽  
Management Approach ◽  
Bed Bugs ◽  
Bed Bug ◽  
Entry Points

In the past decade, bed bug infestations have been increasing worldwide. Historically, studies have failed to provide evidence for the transmission of human diseases through bed bugs, but recent evidence is lacking. Although physical reactions to bed bug bites continue to be documented, evidence regarding the mental health effects arising from bed bug infestations is limited to anecdotes and case reports. This report provides an update and summary of the bed bug management strategies discussed during a workshop at the 2010 Canadian Public Health Association Conference. “Best practices” regarding prevention, identification, and treatment options are presented, using evidence from existing evaluative studies. Awareness of bed bug behaviour and proper building maintenance can prevent transfer of bed bugs from belongings, including second-hand items, and reduce entry points and harbourage sites. In addition to inspection by trained professionals, early recognition of clinical symptoms and environmental signs of an infestation are important to avoid further spread of bed bugs and to allow implementation of safe and effective treatment options. Early findings may indicate a need for special support for vulnerable individuals with mental health issues potentially exacerbated by bed bug infestations. Preparing units for treatment, including the removal of clutter, is essential. However, physical and financial limitations are challenges for managing bed bug infestations, especially for vulnerable populations. Current treatment options such as application of heat or pesticides can be effective when properly implemented, but there are concerns with pesticide resistance. An Integrated Pest Management approach is recommended and should include ongoing monitoring and prevention that are essential for positive treatment outcomes. Regulatory officials, building management, and pest management professionals are encouraged to collaborate using a systematic approach to address bed bug infestations.

scholarly journals BIOMEDICAL ENGINEERING METHODS AS POTENTIAL TREATMENT OPTIONS FOR INTERVERTEBRAL DISC DEGENERATION

2005 ◽  
Vol 17 (02) ◽  
pp. 97-100
Author(s):  
SHU-HUA YANG ◽  
FENG-HUEI LIN
Keyword(s):  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Biomedical Engineering ◽  
Intervertebral Disc Degeneration ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Current Treatment ◽  
Potential Treatment ◽  
Spinal Disorders ◽  
Health Cost

Degeneration of the intervertebral disc (IVD) and associated spinal disorders are a leading cause of morbidity resulting in substantial pain and increased health cost. Current treatment options may relieve some clinical symptoms but will never stop further degeneration in the IVD. In recent years, several investigations have been carried out trying to regenerate IVD tissue. These biomedical engineering methods aim to retard or even reverse the degenerative process and possibly regain a healthy IVD. In this review, recent progresses on each category of biomedical engineering approaches will be briefly introduced.

scholarly journals Encapsulating Peritoneal Sclerosis: Pathophysiology and Current Treatment Options

2019 ◽  
Vol 20 (22) ◽  
pp. 5765 ◽  
Author(s):  
Rajesh M. Jagirdar ◽  
Andreas Bozikas ◽  
Sotirios G. Zarogiannis ◽  
Maria Bartosova ◽  
Claus Peter Schmitt ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Animal Studies ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Renin Angiotensin System ◽  
Mtor Inhibitors ◽  
Current Treatment ◽  
Therapeutic Interventions ◽  
Ultrafiltration Failure

Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of long-term peritoneal dialysis (PD), which may even occur after patients have switched to hemodialysis (HD) or undergone kidney transplantation. The incidence of EPS varies across the globe and increases with PD vintage. Causative factors are the chronic exposure to bioincompatible PD solutions, which cause long-term modifications of the peritoneum, a high peritoneal transporter status involving high glucose concentrations, peritonitis episodes, and smoldering peritoneal inflammation. Additional potential causes are predisposing genetic factors and some medications. Clinical symptoms comprise signs of intestinal obstruction and a high peritoneal transporter status with incipient ultrafiltration failure. In radiological, macro-, and microscopic studies, a massively fibrotic and calcified peritoneum enclosed the intestine and parietal wall in such cases. Empirical treatments commonly used are corticosteroids and tamoxifen, which has fibrinolytic properties. Immunosuppressants like azathioprine, mycophenolate mofetil, or mTOR inhibitors may also help with reducing inflammation, fibrin deposition, and collagen synthesis and maturation. In animal studies, N-acetylcysteine, colchicine, rosiglitazone, thalidomide, and renin-angiotensin system (RAS) inhibitors yielded promising results. Surgical treatment has mainly been performed in severe cases of intestinal obstruction, with varying results. Mortality rates are still 25–55% in adults and about 14% in children. To reduce the incidence of EPS and improve the outcome of this devastating complication of chronic PD, vigorous consideration of the risk factors, early diagnosis, and timely discontinuation of PD and therapeutic interventions are mandatory, even though these are merely based on empirical evidence.

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