Headache in progressive facial hemiatrophy (Parry-Romberg syndrome): A paradigmatic case and systematic review of the literature

Cephalalgia ◽  
2021 ◽  
pp. 033310242110434
Author(s):  
Thomas Foiadelli ◽  
Alessandra Rossi ◽  
Chiara Trabatti ◽  
Eugenia Spreafico ◽  
Viola Santi ◽  
...  

Background Parry-Romberg syndrome is a neuro-cutaneous disease characterized by progressive hemifacial atrophy. Although common, headache in this population is scarcely reported in the literature. Objective To evaluate the clinical features of headache in pediatric and adult patients with Parry-Romberg syndrome, and to discuss diagnostic and treatment approaches of headache in Parry-Romberg syndrome. Methods We conducted a systematic review in accordance with PRISMA guidelines. We searched the MEDLINE database to identify eligible studies and identified patients with Parry-Romberg syndrome and headache. We further reported a paradigmatic case with a complex headache disorder and described its management and outcome. Results We identified 74 articles, 41 of which were included in the analysis. A total of 52 patients (55.8% female) were included for data analysis. The main age at onset of headache was 20 years (SD 15.2; range 3–56). A diagnosis of migraine was made in 53.9%. Abnormal brain imaging was found in 82.2% of patients. Conclusion Long-term follow-up of patients is required, because headache may develop (and evolve) at any time over the course of the disease. Primary and secondary headaches often co-occur in patients with Parry-Romberg syndrome. Further research into the underlying etiopathogenesis and therapeutic targets would be recommended.

2020 ◽  
pp. bjsports-2020-102525
Author(s):  
Stefanos Karanasios ◽  
Vasileios Korakakis ◽  
Rod Whiteley ◽  
Ioannis Vasilogeorgis ◽  
Sarah Woodbridge ◽  
...  

ObjectiveTo evaluate the effectiveness of exercise compared with other conservative interventions in the management of lateral elbow tendinopathy (LET) on pain and function.DesignSystematic review and meta-analysis.MethodsWe used the Cochrane risk-of-bias tool 2 for randomised controlled trials (RCTs) to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation methodology to grade the certainty of evidence. Self-perceived improvement, pain intensity, pain-free grip strength (PFGS) and elbow disability were used as primary outcome measures.Eligibility criteriaRCTs assessing the effectiveness of exercise alone or as an additive intervention compared with passive interventions, wait-and-see or injections in patients with LET.Results30 RCTs (2123 participants, 5 comparator interventions) were identified. Exercise outperformed (low certainty) corticosteroid injections in all outcomes at all time points except short-term pain reduction. Clinically significant differences were found in PFGS at short-term (mean difference (MD): 12.15, (95% CI) 1.69 to 22.6), mid-term (MD: 22.45, 95% CI 3.63 to 41.3) and long-term follow-up (MD: 18, 95% CI 11.17 to 24.84). Statistically significant differences (very low certainty) for exercise compared with wait-and-see were found only in self-perceived improvement at short-term, pain reduction and elbow disability at short-term and long-term follow-up. Substantial heterogeneity in descriptions of equipment, load, duration and frequency of exercise programmes were evident.ConclusionsLow and very low certainty evidence suggests exercise is effective compared with passive interventions with or without invasive treatment in LET, but the effect is small.PROSPERO registration numberCRD42018082703.


Author(s):  
Charlotte J Hagerman ◽  
Rebecca K Hoffman ◽  
Sruthi Vaylay ◽  
Tonya Dodge

Abstract Implementation intentions are a goal-setting technique in which an individual commits to perform a particular behavior when a specific context arises. Recently, researchers have begun studying how implementation intention (II) interventions can facilitate antismoking efforts. The current systematic review synthesized results of experimental studies that tested the effect of an II intervention on smoking cognitions and behavior. Of 29 reviewed articles, 11 studies met inclusion criteria. Nine studies (81.8%) tested an II intervention as a cessation tool for current smokers, whereas two tested II interventions as a tool to prevent smoking among predominantly nonsmoking adolescents. A majority of the studies (66.7%) testing II interventions as a cessation tool reported a positive effect on cessation at long-term follow-up. Of the two studies testing II interventions as a tool for prevention, one study found a positive effect on long-term follow-up. Methodology varied between the studies, highlighting the discrepancies between what researchers consider “implementation intentions” to be. II interventions are a promising tool for antismoking efforts, but more research is necessary to determine the best methodology and the populations for whom this intervention will be most effective. Implications Brief, free, and easily scalable, II interventions to prevent smoking are highly attractive for antismoking efforts. This review outlines the circumstances under which II interventions have demonstrated effectiveness in helping people resist smoking cigarettes. We illuminate gaps in the existing literature, limitations, methodological discrepancies between studies, and areas for future study.


The Lancet ◽  
2019 ◽  
Vol 394 ◽  
pp. S96
Author(s):  
Charlotte Wahlich ◽  
Umar A R Chaudhry ◽  
Rebecca Fortescue ◽  
Derek G Cook ◽  
Shashi Hirani ◽  
...  

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 3-3
Author(s):  
Kevin Strobel ◽  
Simone Schrading ◽  
Christiane K. Kuhl

3 Background: The current ACR practice guidelines discourage use of MRI for work-up of suspicious findings in mammography (Mx) and ultrasound (US). We investigated whether additional breast MRI assessment of suspicious Mx and U.S. findings could improve PPV and thus possibly help reduce the number of biopsies for false positive findings in Mx or U.S. Methods: Between 06/2010 and 04/2012, a total 2,754 patients underwent DCE breast MRI. Of these, 277 underwent MRI for further work-up of suspicious findings made in Mx (n=173, 57 patients with mass lesions, 33 with asymmetries, 12 with architectural distortions, and 71 with suspicious calcifications) or U.S. (n=104, 74 with masses, 30 with miscellaneous U.S. findings such as suspected intraductal pathology, focal acoustic shadowing or architectural distortions) . All lesions categorized as MR-BIRADS 4 and 5 underwent biopsy, lesions categorized as MR-BIRADS 1 or 2 did not proceed to biopsy, except for selected women with mammographic calcifications suggestive of DCIS. Lesions categorized as MR-BIRADS 3 underwent additional short term follow-up by MRI, US and/or Mx. All women who did not undergo biopsy (MR-BIRADS 1-3) underwent long term follow-up for so far 12-24 months. Results: For suspicious lesions in mammography, MRI increased PPV from 19.3% (11/57) to 92.3% (12/13) for masses, from 3% (1/33) to 33.3% (1/3) for asymmetries, from 8.3% (1/12) to 25% (1/4) for architectural distortions and from 21.1% (15/71) to 62.5% (15/24) for calcifications. For suspicious lesions in ultrasound, MRI increased PPV from 13.5% (10/74) to 71.4% (10/14) for masses and from 3.3% (1/30) to 50% (1/2) for non-mass U.S. findings. In 4/277 patients, MRI showed additional suspicious findings, requiring MR-guided biopsy, one of which was histologically proven malignant. So far, none of the patients who, because of an MR-BIRADS 1-3, did not undergo biopsy has been diagnosed with invasive cancer or DCIS or with progressive conventional imaging findings necessitating secondary biopsy. Conclusions: MRI improves PPV for both suspicious Mx and U.S. findings, especially mass lesions. In experienced hands, careful use of MRI can help avoid biopsies for false positive diagnoses made in Mx and U.S.


2017 ◽  
Vol 114 ◽  
pp. 131-138 ◽  
Author(s):  
Christina Signorelli ◽  
Claire E. Wakefield ◽  
Joanna E. Fardell ◽  
W. Hamish B. Wallace ◽  
Eden G. Robertson ◽  
...  

2007 ◽  
Vol 4 (4) ◽  
pp. 94-95 ◽  
Author(s):  
Saima Niaz ◽  
Nadia Arshad ◽  
Mariam Haroon ◽  
Fahd A. Cheema ◽  
Khalid A. Mufti ◽  
...  

Heroin addiction is a chronic, relapsing and remitting condition. Each year 2–5% of addicts discontinue drug use permanently and 1–2% die, mostly of overdose (Robins, 1993). A study of 129 opiate-addicted patients on a monthly maintenance regimen found that those with a family history of opium use had an earlier age at onset (Chaudhry et al, 1991). Long-term follow-up studies of people who misuse opiates have revealed that opioid dependence appears to run a chronic, relapsing and remitting course with a significant mortality (10–15%) over 10 years (Robson, 1992). Metrebian et al (1998) reported that long-term heroin abstinence was associated with less criminality, psychological distress and morbidity; Hser et al (2001) reported it was associated with higher employment rates.


2018 ◽  
Vol 4 (3) ◽  
pp. 30-34
Author(s):  
Narendra Wankhade ◽  
Atul Khalkar ◽  
Suhas Ghule Ghule ◽  
Hemant Naik

Background: Impacted PUJ calculi are well known entity.  Nephrolithiasis is a common disorder that accounts for significant cost, morbidity, and loss of work. Over last 3 decades considerable advances have been made in the management of kidney stone disease, still there is no single universally accepted and uniformly effective modality of treatment in medium size of impacted PUJ calculi. Aim: To study the efficacy of lithotripsy and MINIPERC in 11mm to 18mm impacted PUJ calculi. Methodology: The patients with impacted PUJ calculi of size 11 to 18mm of both sexes of all age group varying form 18-60 years, on consecutive sampling method total 84 patients were included. All patients underwent basic lab investigations, USG, IVU and investigations for fitness purpose. Group 1: All procedures were tubeless.  We used 15 Fr Richard Wolf nephroscope for the procedure. 16 to 20 Fr Amplatz sheath was used depending upon situation. Fragmentation was performed using pneumatic lithoclast or holmium Laser depending upon stone size and characteristics. Group 2: Underwent DJ stenting under subarachnoid block or short GA depending upon situation. On the next day they were subjected for lithotripsy on Dorniel alpha machine under USG guidance, 3000 shocks were given in each sitting. One to three such sittings were given. Post operatively ultrasonography and X-ray KUB was done in all the patients and stents were removed after assuring complete clearance. Patients with absence of stone or presence of stone less than 4 mm on USG or x-ray KUB were declared as completely cleared. Results: Average hospital stay was 48 hours in miniperc group and it was 30 hours in DJ with ESWL group. Clearance rate was 100 % in Miniperc group and it was 85.71 % in DJ with ESWL group. Five patients (11.9%) in DJ lithotripsy group required another procedure. (Two needed miniperc and three needed URS). Two(4.76 %) patients in miniperc group had fever in post op period but nobody suffered major sepsis. Conclusion: Miniperc fulfils many criteria if we see results and complications. Although bigger sized multicentric study and long term follow up is needed. 


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