scholarly journals A 15-year pheochromocytoma and paraganglioma experience in a single centre: a Singapore perspective

2021 ◽  
Author(s):  
Y Lee ◽  
LYR Tan ◽  
SAKK Abdul Shakoor
Keyword(s):  
Positive Family History ◽  
Distant Metastases ◽  
Disease Recurrence ◽  
Haemodynamic Instability ◽  
Preoperative Preparation ◽  
Presenting Symptoms ◽  
Clinical Presentations ◽  
Wide Range

Introduction: Pheochromocytomas (PCC) and paragangliomas (PGL) are rare endocrine tumours. The objective of this study was to describe our experience with these two entities in a Singapore population. Methods: We identified patients with positive histopathological confirmations of PCC and PGL who were treated at a tertiary Singapore hospital between January 2000 and December 2015. The results were analysed for clinical presentations, treatment and long-term outcomes. Results: A total of 27 cases (20 PCC, 7 PGL) were identified over a 15-year period. One case of PGL developed bilateral disease on follow-up. There were 17 male and 10 female patients with a median age of 57 (range 24–77) years. A positive family history was uncommon and present in only 3.7% of patients. Uniquely, the top three presenting symptoms were abdominal discomfort, palpitations and diaphoresis. Despite adequate preoperative preparation, intraoperative haemodynamic instability occurred in 70.4% and early postoperative hypotension occurred in 11.1% of patients. After surgery, hypertension was resolved in 41.2% (7/17) and diabetes mellitus in 60% (3/5). Disease recurrence was reported in 22.2% and distant metastases in 14.8%. At the end of the follow-up period (median 35 [range 3–148] months), 70.4% were still alive. Conclusion: PCC and PGL can present with a wide range of symptoms. Intraoperative haemodynamic instability was frequent despite good preoperative preparation. Disease recurrences and metastasis occurred in up to one-fifth of the patients. Genetic screening should be offered to patients with PCC and PGL.

scholarly journals MRI-Negative Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Antibody Spectrum Demyelinating Disease

2019 ◽  
Vol 6 ◽  
pp. 2329048X1983047 ◽  
Author(s):  
Carlos A. Pérez ◽  
Stephanie Garcia-Tarodo ◽  
Regina Troxell
Keyword(s):  
Demyelinating Disease ◽  
Disease Recurrence ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Spectrum Disorder ◽  
Antibody Testing ◽  
Immune Mediated ◽  
Clinical Presentations ◽  
The Central Nervous System

Myelin oligodendrocyte glycoprotein is expressed in the central nervous system on the surface of oligodendrocytes and is associated with a broad range of adult and pediatric demyelinating phenotypes. The entire spectrum of clinical and radiologic features of myelin oligodendrocyte glycoprotein antibody spectrum disorder remains to be fully elucidated. We describe the case of a 9-year-old boy with immune-mediated myelitis undetectable by conventional magnetic resonance imaging in the context of relapsing anti-myelin oligodendrocyte glycoprotein spectrum disorder. Despite the severe clinical presentation, his symptoms improved significantly following treatment with corticosteroids. Because timely diagnosis and treatment is imperative to prevent disease recurrence and reduce long-term morbidity, serum anti-myelin oligodendrocyte glycoprotein antibody testing should be considered in all children with acute demyelinating syndromes and unusual clinical presentations—including seizures—both at presentation and at follow-up.

scholarly journals Clinical presentations and long term prognosis of childhood onset polyarteritis nodosa in single centre of Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee
Keyword(s):  
Polyarteritis Nodosa ◽  
Clinical Manifestations ◽  
Long Term Outcomes ◽  
Childhood Onset ◽  
Laboratory Findings ◽  
Clinical Presentations ◽  
Long Term Prognosis ◽  
Digital Amputation

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.

scholarly journals Establishing a nurse-led thyroid cancer follow-up clinic

2021 ◽  
Vol 30 (4) ◽  
pp. S28-S35
Author(s):  
Andrew Fishburn ◽  
Nicola Fishburn
Keyword(s):  
Thyroid Cancer ◽  
Complex Disease ◽  
Disease Recurrence ◽  
Patient Survey ◽  
Safe Patient Care ◽  
Face To Face ◽  
Number Of Patients ◽  
Risk Of Disease

Thyroid cancer is a complex disease requiring management by a large multidisciplinary team. The number of patients with a diagnosis of thyroid cancer is significantly increasing year-on-year, and traditional models of consultant-led follow up are no longer sustainable. Although nurse-led cancer follow-up clinics are becomining increasingly common, thyroid cancer nurse-led follow-up clinics are rare. An excellent understanding of the disease, treatment and management of risk of disease recurrence is essential for safe patient care, and is discussed in this article. The clinic discussed uses the skill set of head and neck nurse specialists, including psychological support, coping strategies for long-term side effects of treatment and non-medical prescribing. A patient survey of the service revealed high levels of patient satisfaction and a desire to continue face-to-face consultations rather than telephone clinics.

scholarly journals Periodontitis subject with failing dentition and management with cross arch bridge and implants

2016 ◽  
Vol 2 (3) ◽  
pp. 58
Author(s):  
Farhan Durrani
Keyword(s):  
Periodontal Disease ◽  
Tooth Loss ◽  
Disease Recurrence ◽  
Prosthetic Rehabilitation ◽  
Long Term Follow Up ◽  
Full Mouth Rehabilitation ◽  
Severe Periodontal Disease ◽  
Arch Bridges

<p class="abstract"><span lang="EN-US">Severe periodontal disease often leads to tooth loss, necessitating prosthetic rehabilitation to restore function and aesthetics. The concept of perio-prosthetic treatment using extensive bridges of cross-arch design was introduced approximately 30 years ago. Long term follow-up studies have shown that teeth with reduced periodontal support can be used as abutments for extensive fixed prostheses, provided periodontal disease had been treated successfully and an effective recall program had been instituted to prevent periodontal disease recurrence. Implants along with cross arch bridges in controlled periodontitis subject have never been used together for complete full mouth rehabilitation.</span></p>

scholarly journals Neonatal Outcomes in Pregnant Women Infected with COVID-19 in Babol, North of Iran: A Retrospective Study with Short-Term Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Neonatal Outcomes ◽  
Long Term Outcomes ◽  
Short Term ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
North Of Iran

During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6-40) and 3077.50 ± 697.64 gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

scholarly journals Neonatal outcomes in pregnant women infected with COVID-19 in Babol, North of Iran: retrospective study with short-term follow-up

2021 ◽  
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Neonatal Outcomes ◽  
Short Term ◽  
Post Discharge ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
North Of Iran

Abstract During the Coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks post-discharge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 who were admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6 − 40) and 3077.50 ± 697.64 gr (1720–3900) respectively. Apgar score of the first and fifth minutes in all neonates was ≥ 8 and ≥ 9 out of 10 respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP), in three infants, are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results almost similar to those described for non-pregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

Serving Students With Acquired Brain Injury: Understanding Long-Term Need and Outcomes After the BrainSTEPS Program

2021 ◽  
pp. 1-14
Author(s):  
Jessica Salley Riccardi ◽  
Libby Crook ◽  
Brenda Eagan-Johnson ◽  
Monica Vaccaro ◽  
Angela H. Ciccia
Keyword(s):  
Brain Injury ◽  
Regular Education ◽  
Acquired Brain Injury ◽  
Transition Services ◽  
Student Outcome ◽  
Severe Injuries ◽  
School Based ◽  
Wide Range

Purpose: The purpose of this study was to inform school-based services for children with acquired brain injury (ABI) by describing and analyzing functional student-outcome data from a state-wide, school-based, school re-entry consultation program, BrainSTEPS (Strategies Teaching Educators, Parents, and Students), in Pennsylvania. Method: A nonexperimental, retrospective analysis was conducted with data collected during a pilot follow-up survey for BrainSTEPS. Caregivers reported on 337 students with ABI participating in BrainSTEPS. Results: Most students post-ABI who were participating in BrainSTEPS were enrolled in regular education and reported no ongoing symptoms, as well as no parent perception of need for additional BrainSTEPS consultation during the time period of the follow-up survey. Current receipt of therapy was significantly associated with injury type, χ 2 (1, n = 329) = 16.72, p < .001. A multiple logistic regression was significant ( p < .001) in predicting the need for additional BrainSTEPS consultation. More severe injuries, educational placement postinjury of regular education with a 504 plan (compared to regular education), and current receipt of therapy significantly increased the odds of need for consultation. Conclusions: Due to the wide range of experiences of students in this sample, hospital-to-school transition services, educational supports and services, and long-term follow-up must be individualized for children with ABI. Speech-language pathologists are critical members of the school-based academic team for students with ABI to decrease long-term unmet needs.

Extramedullary Nasal Plasmacytoma — An Unusual Clinical Entity

1996 ◽  
Vol 75 (3) ◽  
pp. 171-173 ◽  
Author(s):  
Gordon Soo ◽  
Anthony Chan ◽  
Dennis Lam ◽  
Victor Abdullah ◽  
C. Andrew van Hasselt
Keyword(s):  
World Literature ◽  
Residual Disease ◽  
Disease Recurrence ◽  
Extramedullary Plasmacytoma ◽  
Intracranial Extension ◽  
Long Term Follow Up ◽  
Unusual Appearance

A case of extramedullary plasmacytoma with its unusual appearance is reported. This is the second reported case in world literature affecting the paranasal sinuses with intracranial extension. The role of surgery is to obtain tissue for diagnosis and to excise residual disease. Radiotherapy is the treatment of choice and long-term follow-up is necessary for monitoring disease recurrence. The overall 10-year survival is about 50%. The case is discussed with a general review of the management of this pathology.

Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience

2020 ◽  
Vol 30 (3) ◽  
pp. 409-412
Author(s):  
Murat Surucu ◽  
İlkay Erdoğan ◽  
Birgül Varan ◽  
Murat Özkan ◽  
N. Kürşad Tokel ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Systolic Pressure ◽  
Presenting Symptoms ◽  
Long Term Follow Up ◽  
The Right

AbstractObjective:Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery.Methods:We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated.Results:Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1).Conclusion:The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.

scholarly journals Comparison of robot-assisted retroperitoneal laparoscopic adrenalectomy versus retroperitoneal laparoscopic adrenalectomy for large pheochromocytoma: a single-centre retrospective study

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sheng-Qiang Fu ◽  
Chang-Shui Zhuang ◽  
Xiao-Rong Yang ◽  
Wen-Jie Xie ◽  
Bin-Bin Gong ◽  
...  
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Haemodynamic Instability ◽  
Robot Assisted ◽  
Improvement Rate ◽  
Long Term Follow Up ◽  
Tumour Characteristics ◽  
Group 1

Abstract Background To evaluate the feasibility and safety of robot-assisted retroperitoneal laparoscopic adrenalectomy (RARLA) for large pheochromocytomas (PHEOs; size≥6 cm) compared with retroperitoneal laparoscopic adrenalectomy (RLA). Methods Fifty-one patients who underwent adrenalectomy for large PHEOs between March 2016 and January 2019 were enrolled and divided into two groups, including 32 RLA cases and 19 RARLA cases. We compared the perioperative efficacy and long-term follow-up results between the two groups. Results Preoperative data, including demographics, comorbidities and tumour characteristics, were similar between the groups. Intraoperatively, the RARLA group had a lower incidence of haemodynamic instability (26.3% vs. 56.2%, P = 0.038) and less intraoperative blood loss (100 ml vs. Two hundred milliliter, P = 0.042) than the RLA group. The groups showed no significant differences in operative time or transfusion rates. Postoperatively, the time to diet resumption, time to ambulation, time to drainage removal and postoperative hospital stay were shorter in the RARLA group than in the RLA group (1 d vs. 2 d, P = 0.027; 1 d vs. 2 d, P = 0.034; 3 d vs. 5 d, P = 0.002; 5 d vs. 6 d, P = 0.02, respectively). The groups exhibited no significant differences in the duration of anaesthetic use, complications, or long-term follow-up results for the blood pressure (BP) improvement rate. Conclusions Compared with RLA, RARLA is a safe, feasible and even optimized procedure for large PHEOs.

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