Intraductal Fragmentation in Sialolithiasis Using Pneumatic Lithotripsy: Initial Experience and Results

2021 ◽  
pp. 019459982110512
Author(s):  
Michael Koch ◽  
Mirco Schapher ◽  
Matti Sievert ◽  
Konstantinos Mantsopoulos ◽  
Heinrich Iro
Keyword(s):  
Multimodal Therapy ◽  
University Hospital ◽  
Single Frequency ◽  
Operating Pressure ◽  
Initial Experience ◽  
Clinical Factors ◽  
Tertiary Referral ◽  
Stone Size ◽  
Tertiary Referral Center ◽  
Increased Risk

Objective To report initial experience in using a pneumatic lithotripter to treat salivary stones. Study Design Level IV retrospective study. Setting University hospital and tertiary referral center. Methods A pneumatic lithotripter was used to treat salivary stones after these were diagnosed. Probes with diameters of 0.7 mm were used. Total fragmentation was intended in all stones. Stone fragments were removed using several instruments in serial sialendoscopies to achieve complete stone clearance. Results A total of 62 patients with 77 stones were treated. Forty-three submandibular stones were treated in 34 patients, and 34 parotid stones were treated in 28 patients. An operating pressure of 2.5 bar and a single frequency mode were used. Complete fragmentation was achieved in all but one of the treated stones in both glands (98.7%). Among the patients, 90.32% became stone free and 100% symptom free. Multiple stones were treated in 24.19% of the patients, and multimodal therapy was also carried out in 24.19%. All of the glands were preserved. Conclusions The pneumatic lithotripter proved to be effective in the treatment of sialolithiasis. Stone size, location, and the gland involved were important clinical factors. The device was sufficient to achieve success without any increased risk for complications in the patients or damage to the sialendoscopes.

scholarly journals Short and Intermediate Term Outcomes of the Convergent Procedure: Initial Experience in a Tertiary Referral Center

2020 ◽  
Vol 26 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Robert Tonks ◽  
Gurion Lantz ◽  
Jeremy Mahlow ◽  
Jeffrey Hirsh ◽  
Lawrence S. Lee
Keyword(s):  
Initial Experience ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

scholarly journals Long COVID in Inflammatory Bowel Diseases

2021 ◽  
Vol 10 (23) ◽  
pp. 5575
Author(s):  
Silvia Salvatori ◽  
Francesco Baldassarre ◽  
Michelangela Mossa ◽  
Giovanni Monteleone
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Negative Impact ◽  
Acute Infection ◽  
Demographic Characteristics ◽  
University Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Background and aims. SARS-CoV-2-infected patients can experience long-lasting symptoms even after the resolution of the acute infection. This condition, defined as Long COVID, is now recognized as a public health priority and its negative impact on the quality of life of the patients could be more relevant in individuals with debilitating pathologies. We here evaluated the frequency of Long COVID in patients with inflammatory bowel diseases (IBD). Methods. IBD patients afferent for scheduled visits to our tertiary referral center at the Tor Vergata University Hospital, Rome, were recruited from 7 September to 22 October 2021. During the visits, patients were investigated about previous COVID-19 infection and the possible development of Long COVID. Results. Fifty-three out of 528 IBD patients (10%) have had a SARS-CoV-2 infection. Of these, 21 patients (40%) developed Long COVID, and asthenia was the more frequent symptom as it occurred in nearly two-thirds of patients. Patients with Long COVID were more frequently females, while other clinical and demographic characteristics did not differ between patients with Long COVID and those without Long COVID. In particular, the IBD relapses occurred with the same frequency in the two groups. Conclusions. Long COVID appears to be common in IBD patients even though it does not influence the IBD course.

The effect of migraine and motion sickness on symptoms evoked by the caloric vestibular test

2021 ◽  
pp. 1-10
Author(s):  
Ozlem Gedik Soyuyuce ◽  
Pinar Yalinay Dikmen ◽  
Nazim Korkut
Keyword(s):  
Data Analysis ◽  
Motion Sickness ◽  
Retrospective Data ◽  
Tertiary Referral ◽  
Sensory Stimuli ◽  
Tertiary Referral Center ◽  
Retrospective Data Analysis ◽  
Increased Risk ◽  
Vestibular Symptoms ◽  
The Mean

BACKGROUND: The caloric vestibular test (CVT) may evoke headache and vestibular symptoms in susceptible people. Patients with migraines have higher susceptibility to motion sickness. In migraines, impaired habituation to repetitive stimuli is a well-known interictal abnormality. OBJECTIVE: This study is aimed at evaluating CVT-evoked headache, nausea, vomiting, and imbalance in patients with and without migraine and/or motion sickness. METHODS: A retrospective data analysis was performed on 554 patients with a complaint of dizziness who underwent bithermal CVT at a tertiary referral center. The occurrences of CVT-evoked headache, nausea, vomiting, and imbalance were observed in four groups: patients with only migraine (MG; n = 94), those with only motion sickness (MSG; n = 89), those with migraine and motion sickness (MMSG; n = 122), and those without migraine and motion sickness (non-MMSG; n = 146). The differences between the groups were assessed. RESULTS: The mean ages of groups were similar (p = 0.534). The proportions of females were higher in the MG, MSG, and MMSG (p = 0.001). The severity of nausea and headache for each gender was higher in the MG, MSG, and MMSG (p <  0.001). Vomiting was more common in MMSG among males (p = 0.003), while there was no difference between groups among females (p = 0.099). Imbalance was more common in MMSG among females (p <  0.001). A relationship was detected between age and imbalance (p <  0.001), where an increased risk for imbalance was evident with greater age. Three patients in the MMSG needed hospitalization after CVT. CONCLUSIONS: Special caution is needed when performing caloric testing for patients with migraines or MS since CVT-evoked symptoms may occur with higher incidence and intensity, which might be related to a lack of habituation in neuronal information processing after robust sensory stimuli like CVT.

Analysis of Congenital Heart Diseases in a Tertiary Referral Center of Brazil: A 7-Months Initial Experience

2013 ◽  
Vol 39 (5) ◽  
pp. S89
Author(s):  
E. Araujo Júnior ◽  
L.A.R. Amorim ◽  
A.T.F. Leslie ◽  
L.C. Rolo ◽  
L.M.M. Nardozza ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Diseases ◽  
Congenital Heart Diseases ◽  
Initial Experience ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

Outcomes of Overlapping Surgery in Otolaryngology

2019 ◽  
Vol 162 (2) ◽  
pp. 181-185
Author(s):  
Pedrom C. Sioshansi ◽  
Robert K. Jackler ◽  
Edward J. Damrose
Keyword(s):  
Patient Outcomes ◽  
Complication Rate ◽  
Odds Ratio ◽  
University Hospital ◽  
Complication Rates ◽  
Readmission Rates ◽  
Tertiary Referral Center ◽  
Increased Risk ◽  
Institutional Experience ◽  
Reoperation Rates

Objective To compare outcomes in otolaryngology between overlapping and nonoverlapping surgeries. Study Design Retrospective cohort study. Setting Tertiary referral center. Subjects and Methods All patients undergoing otolaryngologic procedures at Stanford University Hospital between January 2009 and June 2016 were included (n = 13,479). Cases were divided into 2 cohorts: overlapping (n = 1806, 13.4%) vs nonoverlapping (n = 11,673, 86.6%). Variables reviewed were type of operation performed, multidisciplinary team involvement, complications, reoperations, readmissions, and deaths. Results The total complication rate over 7.5 years studied was 3.3% (n = 450). Complication rates were lower for overlapping cases (0.77%) compared to nonoverlapping cases (3.73%) with an odds ratio of 0.2014, which was statistically significant ( P < .0001). When examined by subspecialty, the complication rate for rhinology and endoscopic skull base procedures was approximately 10 times lower when overlapping (0.30%) was compared to nonoverlapping (3.15%), with an odds ratio of 0.094 ( P = .0001). There was no difference in complication rates for other surgical subspecialties. There were no deaths associated with overlapping surgery. The rate of major complications requiring reoperation was similarly lower for overlapping procedures (0.276%) compared to nonoverlapping procedures (1.35%) with an odds ratio of 0.2023 ( P = .0004). Readmission rates were lower for overlapping cases (0.49%) when compared to nonoverlapping cases (1.09%), with an odds ratio of 0.4553 ( P = .0229). Conclusions Patients undergoing overlapping surgery had lower overall complication rates, lower reoperation rates, lower readmission rates, and no mortalities. The institutional experience presented provides evidence that with appropriate patient and case selection, otolaryngologists may safely perform overlapping surgery without increased risk of adverse patient outcomes.

scholarly journals Endometriosis in a Patient with Mayer-Rokitansky-Küster-Hauser Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Júlia Kefalás Troncon ◽  
Ana Carolina Tagliatti Zani ◽  
Andrea Duarte Damasceno Vieira ◽  
Omero Benedicto Poli-Neto ◽  
Antônio Alberto Nogueira ◽  
...  
Keyword(s):  
Case Report ◽  
Laparoscopic Approach ◽  
University Hospital ◽  
Pelvic Endometriosis ◽  
Tertiary Referral ◽  
Mrkh Syndrome ◽  
Tertiary Referral Center ◽  
Ovarian Endometrioma ◽  
Müllerian Agenesis ◽  
Alternative Theories

Objective. To report a case of Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) in which there were two nonfunctional rudimentary uteruses with the presence of ovarian endometrioma, corroborating that there are valid alternative theories to the existence of endometriosis, rather than Sampson’s theory alone, such as the coelomic metaplasia theory.Design. A case report.Setting. A tertiary referral center, which is also a university hospital.Patient. A fifteen-year-old patient with MRKH syndrome and endometriosis.Intervention. Laparoscopic approach for diagnostic confirmation and treatment of the endometrioma.Results. Evidence of endometriosis in a patient with no functional uterus.Conclusions. This case report and a few others that are available in the literature reinforce the possibility that coelomic metaplasia could be the origin of endometriosis. Patients with müllerian agenesis and pelvic pain should be carefully evaluated, and the presence of pelvic endometriosis should not be excluded.

scholarly journals The management of hepatocellular carcinoma in the era of multimodal therapy: The experience of a Greek tertiary referral center

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S284-S285
Author(s):  
A. Tooulias ◽  
C. Christou ◽  
A. Tsolakidis ◽  
V. Papayiannis ◽  
B. Pianetcki-Tsaintzi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multimodal Therapy ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center

scholarly journals Incidence and outcome of cancer in 16- to 17-year-old adolescents in a tertiary referral hospital

2021 ◽  
Author(s):  
Julia Ventela ◽  
Atte Nikkila ◽  
Arja Jukkola ◽  
Olli Lohi
Keyword(s):  
Cancer Diagnosis ◽  
Cox Regression ◽  
Lymphoblastic Leukemia ◽  
University Hospital ◽  
Published Data ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Adult Type ◽  
Tertiary Referral Center ◽  
Referral Center

BACKGROUND: Adolescents have a unique cancer profile that includes typical childhood cancers such as acute lymphoblastic leukemia (ALL) and adult-type cancers like melanoma and thyroid cancer. In Finland, adolescents above 16 years have been largely treated in adult oncology centers in contrast to many Western countries in which the minimum admittance age is 18 years. The aim of this study was to investigate characteristics, therapy and outcome of cancer in adolescents aged 16 to 17 years. MATERIALS AND METHODS: This retrospective cohort study included adolescents aged 16 to under 18 years at the time of cancer diagnosis between 2000 and 2019 in Tampere University Hospital, a regional tertiary referral center. Clinical data were retrieved from hospital medical records and included diagnosis, clinical and laboratory parameters, therapy and outcome. In addition to standard descriptive statistical analyses, the Kaplan-Meier method and Cox regression modelling were applied to study the outcome and associated factors. RESULTS: A total of 93 patients were diagnosed with a malignant tumour at the age of 16 or 17 years. Males were more often diagnosed with a cancer (62%), while non-CNS (non- central nervous system) solid cancers were the most common entities (76%) and Hodgkin lymphoma was the most common cancer diagnosis (31%). Seventy patients completed their therapy in the referral center and were followed up for a median of 5.4 years. The majority of patients were treated in the adult department (69%). Complete remission was achieved for 89% of patients, while 21% experienced tumor recurrence. The 5-year event-free survival was 65% (95% CI, 54% to 79%) and overall survival 82% (95% CI, 73% to 93%). CONCLUSIONS: The majority of cancers in adolescents of 16 to 17 years of age are solid cancers. Patient outcome in our cohort was favorable and is in line with previously published data.

Sign in / Sign up

Export Citation Format

Share Document