scholarly journals Prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats

2020 ◽  
pp. 1098612X2092492
Author(s):  
Oliver Marsh ◽  
Giulia Corsini ◽  
Jan Van Dijk ◽  
Rodrigo Gutierrez-Quintana ◽  
Luisa De Risio
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Idiopathic Epilepsy ◽  
Severe Neutropenia ◽  
Inclusion Criteria ◽  
Study Objective ◽  
Structural Epilepsy

Objectives The study objective was to investigate the prevalence and clinical characteristics of phenobarbitone-associated adverse effects in epileptic cats. Methods The medical records of two veterinary referral clinics from 2007 to 2017 were searched for cats fulfilling the inclusion criteria of a diagnosis of epilepsy, treatment with phenobarbitone and available follow-up information on the occurrence of adverse effects. Follow-up information was obtained from the medical records of the primary veterinarian and referral institutions and a questionnaire completed by the cats’ owners. Results Seventy-seven cats met the inclusion criteria. Fifty-eight were affected by idiopathic epilepsy and 19 by structural epilepsy. One or more of the following adverse effects were reported in 47% of the cats: sedation (89%); ataxia (53%); polyphagia (22%); polydipsia (6%); polyuria (6%); and anorexia (6%). Logistic regression analyses revealed significant associations between adverse effect occurrence and both phenobarbitone starting dosage and administration of a second antiepileptic drug (AED). For each 1 mg/kg q12h increment of phenobarbitone, the likelihood of adverse effects increased 3.1 times. When a second AED was used, the likelihood of adverse effects increased 3.2 times. No association was identified between epilepsy aetiology and adverse effect occurrence. An idiosyncratic adverse effect, characterised by severe neutropenia and granulocytic hypoplasia, was diagnosed in one cat. This resolved following phenobarbitone discontinuation. Conclusions and relevance The prevalence of phenobarbitone-associated adverse effects was 47%. Sedation and ataxia were most common. These are type A adverse effects and are predictable from phenobarbitone’s known pharmacological properties. In the majority of cases, adverse effects occurred within the first month of treatment and were transient. Idiosyncratic (type B) adverse effects, which were not anticipated given the known properties of the drug, occurred in one cat. Increased phenobarbitone starting dosage and the addition of a second AED were significantly associated with the occurrence of adverse effects.

scholarly journals Clinical characteristics of patients with subacute thyroidits and factors affecting development hypothyroidism after subacute thyroiditis

2022 ◽  
Author(s):  
İNAN ANAFOROĞLU ◽  
Murat Topbas
Keyword(s):  
Neck Pain ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Subacute Thyroiditis ◽  
Upper Respiratory Tract ◽  
Inclusion Criteria ◽  
Imaging Studies ◽  
Factors Affecting ◽  
Upper Respiratory

IntroductionSubacute thyroiditis (SAT) is typically a self-limiting, inflammatory disease. Patients can experience hypothyroidism during or after an episode. We examined the clinical characteristics based on laboratory and imaging studies in patients with SAT and possible factors contributing to the development of permanent hypothyroidism after SAT.Material and methodsWe retrospectively examined medical records of patients diagnosed with SAT at one medical facility in Turkey. Patients known to have previous thyroid disease, those with <6 months of follow-up after resolution of SAT, and those who lacked sufficient data for analysis were excluded. Of the 283 patients identified 119 met all inclusion criteria. We extracted data on demographics, laboratory tests, neck pain and other symptoms, ultrasonography findings, medication use, and SAT recurrence. We examined the relationships between these variables and development of permanent hypothyroidism.ResultsThe patients were 42 years old on average, and 78% were women. Most patients (70%) described flu-like symptoms before neck pain started; accordingly, 57% had initially visited a specialty other than endocrinology before SAT was diagnosed, and 28% had received antibiotics for misdiagnosed upper respiratory tract infection. In all, 10 patients (8.4%) developed permanent hypothyroidism after SAT. These patients had received steroids significantly longer than did those without permanent hypothyroidism (mean 17.7 vs. 8.9 weeks; P = .021). Development of hypothyroidism was significantly lower among patients with thyrotoxicosis.ConclusionsThe diagnosis of SAT can be challenging. Patients who require longer-term steroids after SAT and who have recurrent SAT should be closely monitored for development of hypothyroidism.

Differences in Adverse Effect Profiles of Corticosteroids in Palliative Care Patients

2018 ◽  
Vol 36 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Leanna R. Jaward ◽  
Thomas A. O’Neil ◽  
Adam Marks ◽  
Michael A. Smith
Keyword(s):  
Adverse Effect ◽  
Palliative Care ◽  
Adverse Effects ◽  
Symptom Management ◽  
Care Setting ◽  
Management Strategies ◽  
Common Factors ◽  
Inclusion Criteria ◽  
Pubmed Database ◽  
Palliative Care Setting

Background: Corticosteroids are frequently utilized in the palliative care setting to combat symptoms such as fatigue, dyspnea, pain, weakness, anorexia, cachexia, nausea, and vomiting. Often times, adverse effects arise with corticosteroid use, and it is unclear whether switching to another corticosteroid would reduce the risk of specific adverse effects or what measures can be taken to alleviate the adverse effects. Objective: This article aims to review the differentiating pharmacokinetics, potency, and adverse effect profiles of corticosteroids and summarize their clinical applicability. Methods: A literature review of “corticosteroids” and “palliative care” was performed using the PubMed database through July 2018. Original studies relevant to the purpose of this study were identified and those that met inclusion criteria were included. Results: Although corticosteroids share many common factors, including similar pharmacokinetic, pharmacodymanic, and adverse effect profiles, they have significant differences when the details of these variables are reviewed. Providers that prescribe corticosteroids for symptom management should be aware of these differences and the recommended management strategies. Conclusions: Recognition of corticosteroid induced adverse effect profiles and possible management strategies is crucial to optimal symptom management in palliative care patients.

Stifle arthrodesis using a locking plate system in six dogs

2015 ◽  
Vol 28 (04) ◽  
pp. 288-293 ◽  
Author(s):  
T. Nicetto ◽  
M. Petazzoni
Keyword(s):  
Body Weight ◽  
Medical Records ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Sagittal Plane ◽  
Inclusion Criteria ◽  
Radiographic Outcomes ◽  
Locking Plate System ◽  
Plate System

SummaryObjectives: To describe the use of the Fixin locking plate system for stifle arthrodesis in dogs and to retrospectively report the clinical and radiographic outcomes in six cases.[uni2028]Materials and methods: Medical records of dogs that had arthrodesis with the Fixin locking plate system were reviewed. For each patient, data pertaining to signalment and implant used were recorded. Plate series and thickness, number of screws placed, number of cortices engaged, and screw diameters were also recorded. The outcome was determined from clinical and radiographic followups. Radiographic outcomes assessed included the measurement of the postoperative femoral-tibial angle in the sagittal plane.Results: Six dogs met the inclusion criteria for the study. Mean body weight was 13 kg (range: 3 - 34 kg). Radiographic follow-up (mean: 32 weeks, range: 3 - 52 weeks) was available for all dogs. In one case, an intra-operative complication occurred. In another case, a tibial fracture occurred 20 days after surgery. All arthrodeses healed and no implant complication was detected although all cases had mechanical lameness.Clinical significance: Stifle arthrodesis can be performed successfully using a Fixin locking plate system.

scholarly journals Clinical Characteristics of Intermittent Esotropia

2021 ◽  
Vol 62 (12) ◽  
pp. 1650-1656
Author(s):  
Young Chae Yoon ◽  
Nam Yeo Kang
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Age At Onset ◽  
Clinical Findings ◽  
Main Symptom ◽  
Angle Of Deviation ◽  
The Mean ◽  
Onset Angle ◽  
Dissociated Vertical Deviation

Purpose: To evaluate clinical findings and surgical outcomes of intermittent esotropia.Methods: We retrospectively reviewed the medical records of 23 patients (aged 9-42 years) who presented with intermittent esotropia between January 2007 and December 2020. We analyzed the age at onset, angle of deviation, presence of symptomatic diplopia, fusional state, near stereoacuity, and surgical results.Results: The mean age at onset was 19.9 ± 8.0 years and mean duration of esodeviation was 23.4 ± 27.1 months. Mean follow-up time was 13.0 ± 15.6 months. All patients except three had symptomatic diplopia, and 78.3% showed intermittent diplopia. Mean angles of deviation were 21.6 ± 10.3 prism diopters (PD) at distance and 20.2 ± 10.4 PD at near. Twenty-one patients (91.3%) were myopia. No patients had amblyopia and one had dissociated vertical deviation. On Worth’s four-dot test, five patients (21.7%) showed diplopia and four showed suppression at both distance and near. The other patients showed fusion at near or distance. Eleven patients underwent surgical correction. At the final examination, all patients achieved successful motor alignment and fusion with resolution of diplopia. Only two patients (18.2%) achieved normal 60 arcsec stereopsis, and six attained subnormal stereopsis.Conclusions: The main symptom of intermittent esotropia was diplopia. Surgical treatment was effective in achieving good postoperative motor alignment and fusion. However, successful motor alignment did not guarantee recovery of fine stereopsis.

scholarly journals Outcome of Inferonasal Conjunctival Autograft in Pterygium Surgery

2021 ◽  
Vol 23 (4) ◽  
pp. 319-323
Author(s):  
Pragati Gautam Adhikari ◽  
Sagun Narayan Joshi
Keyword(s):  
Medical Records ◽  
Demographic Variables ◽  
Inclusion Criteria ◽  
Conjunctival Autograft ◽  
Donor Area ◽  
Mean Size ◽  
Pterygium Surgery ◽  
The Mean ◽  
Pterygium Excision

This study was done to evaluate the outcome of pterygium excision with inferonasal conjunctival autograft at a tertiary eye care centre. Retrospective analysis of medical records of primary pterygia patients operated by a single surgeon between 2017 to 2020 were analyzed. A total of 43 patients who met the inclusion criteria were included in the study. The demographic variables, along with size of pterygium and recurrence over a period of six month follow up was noted. The mean age of patients was 46.97 years (29-74 years). The mean size of pterygium was 3.17 mm. Recurrence was seen in 3 eyes over a period of 6 months. Graft edema was observed in 11 patients and graft hemorrhage along with congestion was seen in 8 cases which resolved over a 3 weeks follow up period. Mild conjunctival scarring was seen over donor area in 5 of the eyes. Pterygium excision with inferior conjunctival autograft is an effective alternative technique to superotemporal autograft technique.

Locking compression plate stabilization of 20 distal radial and ulnar fractures in toy and miniature breed dogs

2015 ◽  
Vol 28 (06) ◽  
pp. 441-447 ◽  
Author(s):  
G. R. Ragetly ◽  
R. J. Boudrieau ◽  
S. Gibert
Keyword(s):  
Distal Radius ◽  
Medical Records ◽  
Clinical Results ◽  
Locking Compression Plate ◽  
Inclusion Criteria ◽  
Compression Plate ◽  
Hybrid Construct ◽  
Mean Time ◽  
Radiographic Union

SummaryObjective: To evaluate retrospectively the effectiveness of the Locking Compression Plate® (LCP), in the form of either a straight or notched head T-plate, for the treatment of fractures of the distal radius and ulna in a series of 20 toy and miniature breed dogs.Methods: The medical records of toy and miniature breed dogs (<6 kg), greater than six months of age, with fractures of the distal radius and ulna from two veterinary hospitals were reviewed. The inclusion criteria included: fractures of the distal 1/3 of the radius and ulna and repair with open reduction and internal fixation utilizing an LCP (straight or notched head T-plate).Results: Twenty fractures (20 dogs) satisfied the inclusion criteria; eight straight and 12 notched head T-plates were used, either 2.0 mm (n = 13) or 2.4 mm (n = 7). Hybrid fixation was performed in all dogs in one or both fragments. Mean time to radiographic union was 6.9 ± 2.5 weeks (range: 4–12 weeks) in 18/20 dogs with radiographic follow-up. One complication was observed: infection that resolved with antibiotic medication and implant removal. No other major complications occurred by the time of last follow-up. In all cases (mean follow-up: 15 ± 7 months), the reported limb function as evaluated by the referring veterinarian or owner was excellent.Clinical significance: The LCP, used as a hybrid construct for the treatment of distal radial and ulnar fractures was shown to yield excellent clinical results with both uncomplicated healing and excellent functional outcomes in this series of toy and miniature breed dogs.

scholarly journals Adverse effects associated to the application of ultrasound-guided percutaneous needle electrolysis

2019 ◽  
Vol 02 (02) ◽  
pp. 115-116
Author(s):  
Valera Garrido F. ◽  
Minaya Muñoz F. ◽  
Ramírez Martínez P. ◽  
Medina i Mirapeix F.
Keyword(s):  
Adverse Effect ◽  
Physical Therapy ◽  
Adverse Effects ◽  
Case Series ◽  
Lower Limbs ◽  
Ultrasound Guided ◽  
Post Intervention ◽  
Case Series Study ◽  
Degenerative Processes

Abstract Background Percutaneous needle electrolysis is a technique of invasive physical therapy which is increasingly used by physical therapists in their clinical practice. However, to date, no studies have analyzed the presence of adverse effects.The aim of the present study was to evaluate the incidence of adverse effects and the associated impact of the application of ultrasound-guided percutaneous needle electrolysis in disorders of the neuro-musculoskeletal system. Material and Method A prospective case series study was performed over a period of six months at the Sannus Clinic center (Madrid). A sample of patients was identified and recruited, and follow-up was performed up to six months after discharge. Initial information was collected regarding demographic data (age and sex) and clinical data (affected structure, area, type of pain and process associated to the pathology). During each of the sessions performed, percutaneous needle electrolysis was applied in an isolated manner and data were gathered on the treatment received, as well as the presence of any adverse effects. An adverse effect was considered as being any incident related with the application of percutaneous needle electrolysis which caused any damage, as perceived by both the patient and the physical therapist who applied the treatment. The type of adverse effect was recorded (pain, bleeding, hematoma, post-intervention vegetative reactions [sweating, pallor, abdominal discomfort], syncope, skin lesions, damage to organs, nerve lesions, pneumothorax, metal allergy), the moment these appeared (during application, after application, days after the application), its severity (transitory (<48h), reversible (resolved at discharge), irreversible), its impact (did not require any specific intervention, required an additional specific physical therapy intervention, required intervention from medical staff (without hospitalization), and cause (insufficient skill with the technique, malpractice, inappropriate protocol). The adverse effects were classified as mild or severe depending on whether or not an intervention was required. Results 214 patients (60.7% men; 39.3% women) received a total of 772 sessions, the mean number (and standard deviation) of sessions was 3.6 (1.1). The totality of patients treated with ultrasound-guided percutaneous electrolysis received more than one session, according to the methodology described by Valera & Minaya. The main reasons for consultation were tendinous pathologies (70.5%), muscle pathologies (11.7%), ligaments (6.5%), joint capsule-synovia (5.6%), nerve entrapments (4.2%) and others (1.4%). Degenerative processes were more common than acute inflammatory processes. The greatest incidence was in the lower limbs. Degenerative processes were significantly more frequent than tendinous problems. During the 772 sessions of ultrasound-guided percutaneous needle electrolysis, the most common adverse effects were pain during the intervention (96.1%) and in the days following treatment (71.1%), as well as mild vasovagal responses post-intervention (80.1%). One syncope was recorded (0.13%). All the effects were transitory and without impact. No hematomas were detected in the days after a mild bleeding, when this occurred (9.3%). Interventions were performed on the thorax in 1.5% of the procedures, close to organs (0.5%) or close to peripheral nerves (4.2%) without any adverse effect. In the 6-week follow-up after discharge no adverse effects were detected. Conclusions Percutaneous needle electrolysis is a safe technique. The adverse effects provoked by the application of percutaneous needle electrolysis are mild, transitory, without impact on the person's health and following a homogenous pattern. The pain and the mild vasovagal response associated with the intervention are frequent and inherent to the stimulus generated by the needling and the electric current employed.

Adverse Effects of Implants in Children and Adolescents: A Systematic Review

2019 ◽  
Vol 43 (2) ◽  
pp. 69-77 ◽  
Author(s):  
Rekhalakshmi Kamatham ◽  
Priyanka Avisa ◽  
Dileep Nag Vinnakota ◽  
Sivakumar Nuvvula
Keyword(s):  
Adverse Effects ◽  
Dental Implants ◽  
Case Reports ◽  
Inclusion Criteria ◽  
Mini Implants ◽  
Implant Placement ◽  
Probing Depth ◽  
Crestal Bone Loss ◽  
Ebsco Host

Objective: To determine the evidence on the adverse effects of placing dental implants in healthy growing children. Study design: A systematic search was conducted in five electronic databases: PubMed, Ovid, Cochrane, EBSCO host, ProQuest. Studies on implants placed in children below the age of 19 years, with loss of tooth either due to trauma or caries were included, whereas, studies on mini implants and implants placed due to congenital absence of teeth were excluded. The articles that fulfilled the inclusion criteria were analyzed based on the predetermined criteria of success. Results: A total of 8 publications fulfilled the inclusion criteria. All the included articles were case reports/series, involving a total of 16 implants (15 maxillary, one mandibular) in 11 adolescents (7 boys and 4 girls). The age of implant placement ranged between ten to 17 years with a mean age of 13.4 years and the follow up period, 4.5 months to 13 years. Pain, paresthesia, mobility or peri-implant radiolucency was not reported in any case report, indicating good integration. Radiographic crestal bone loss, probing depth and implant esthetics were not mentioned. The infraocclusion was not reported in 5 cases (age: 11–17 years, follow up: 4.5 months-two years), however, it was an adverse effect in 6 cases (age: ten-17 years, follow up: three-13 years). Conclusion: There is insufficient evidence to contradict the placement of dental implants in healthy growing children; the only reported adverse event is infraocclusion, the management of which too is discussed. However, as all the data is from case reports, the result should be interpreted with caution. Therefore, well-designed randomized controlled trials are needed to address this gap in the literature.

Experiences using the Fixin locking plate system for the stabilization of appendicular fractures in dogs

2013 ◽  
Vol 26 (01) ◽  
pp. 61-68 ◽  
Author(s):  
T. Nicetto ◽  
A. Urizzi ◽  
M. Isola ◽  
M. Petazzoni
Keyword(s):  
Complication Rate ◽  
Medical Records ◽  
Locking Plate ◽  
Inclusion Criteria ◽  
Limb Function ◽  
Long Term Follow Up ◽  
Locking Plate System ◽  
Plate System

SummaryObjectives: To retrospectively evaluate the stabilization of appendicular fractures in dogs using the Fixin locking plate system.Materials and methods: Medical records and radiographs of dogs with fractures stabilized with the Fixin system in the period from May 2005 to September 2010 were reviewed. For each patient, data pertaining to signalment, the nature of the fracture, implants used, and evidence of fracture healing were recorded. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between 40 days and 90 days postoperatively. Owners of pets with complications were contacted by phone for long-term follow-up.Results: Eighty-two fractures in seventy-five dogs met the inclusion criteria for the study. Radiographic re-examinations were carried out between eight days to two years (median 60 days) following surgery. Seventy-three out of 82 fractures (89%) reached union without complications. Major complications were seen in six dogs (7%). Limb function was graded as ‘normal’ in 73/75 (97%) dogs and ‘mild lameness’ in 2/75 (3%) cases.Clinical significance: Despite a modest complication rate, the Fixin locking bone plating system appears to be an acceptable choice of implant for the stabilization of appendicular fractures in dogs.

The Role of Tumor Size in the Radiosurgical Management of Patients with Ambiguous Brain Metastases

Neurosurgery ◽  
2003 ◽  
Vol 53 (2) ◽  
pp. 272-281 ◽  
Author(s):  
Eric L. Chang ◽  
Samuel J. Hassenbusch ◽  
Almon S. Shiu ◽  
Frederick F. Lang ◽  
Pamela K. Allen ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Local Control ◽  
Medical Records ◽  
Tumor Volume ◽  
Unknown Primary ◽  
Inclusion Criteria ◽  
Peripheral Dose

Abstract OBJECTIVE To identify a size cutoff below which it is safe to observe obscure brain lesions suspected of being metastases so that treatment of nonmetastases can be avoided. METHODS Medical records from patients who underwent linear accelerator-based radiosurgery from August 1991 to October 2001 were reviewed. Inclusion criteria were defined as brain metastasis tumor volume less than 5 cm3 (diameter, ∼2.1 cm) treated with a dose of 20 Gy or more. One hundred thirty-five patients had 153 evaluable brain metastases with follow-up imaging that met inclusion criteria. Median age was 54 years (range, 18–79 yr). Lesion primaries were non-small-cell lung (n = 39), melanoma (n = 44), renal (n = 37), breast (n = 18), colon (n = 3), sarcoma (n = 5), other (n = 5), and unknown primary (n = 2). Median tumor volume was 0.67 cm3 (range, 0.06–4.58 cm3). The minimum peripheral dose was 20 Gy (n = 132) or 21 to 24 Gy (n = 21). At the time of analysis, the median follow-up for all patients was 10 months (range, 0.2–99 mo). RESULTS The 1- and 2-year actuarial local control rates for all of the lesions were 69 and 46%, respectively. For lesions of 1 cm (0.5 cm3) or less, the corresponding local control rates were 86 and 78%, respectively, which was significantly higher than the corresponding rates of 56 and 24%, respectively, for lesions larger than 1 cm (0.5 cm3) (P = 0.0016). CONCLUSION A convincing brain metastasis measuring less than 1 cm should be pursued aggressively. If the suspected brain metastasis is ambiguous, observation is proposed up to a diameter of 1 cm. This is the first study in the literature to identify a 1-cm cutoff for radiosurgical control of small brain metastases, and validation by additional studies is required.

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