Clinical and radiological characteristics of tumefactive demyelinating lesions: follow-up study

2012 ◽  
Vol 18 (10) ◽  
pp. 1448-1453 ◽  
Author(s):  
A Altintas ◽  
B Petek ◽  
N Isik ◽  
M Terzi ◽  
F Bolukbasi ◽  
...  
Keyword(s):  
Clinical Course ◽  
Demographic Data ◽  
Laboratory Data ◽  
Study Groups ◽  
Oligoclonal Band ◽  
Medical Centers ◽  
Closed Ring ◽  
Demyelinating Lesions ◽  
The Difference

Background: Demyelinating lesions over 20 mm in size, referred to as tumefactive demyelinating lesions, can be misdiagnosed as being either a tumor or an abscess. Although some radiological characteristics can help make a differential diagnosis easier, a cerebral biopsy may still be necessary. Objective: Our objective was to assess the clinical characteristics of tumefactive lesions, with or without a diagnosis of multiple sclerosis (MS), and present follow-up data for 54 patients with tumefactive lesions. Methods: Demographic, clinical, radiological and laboratory data were gathered and treatment responses were evaluated in a total of 54 patients from five medical centers. Result: Twenty-nine patients were diagnosed with tumefactive lesions at the onset, whereas 25 patients were diagnosed with tumefactive lesions after a diagnosis of MS. Median follow-up was 38.12 months. At final examination, 19 of the patients with a tumefactive lesion diagnosis at the onset eventually developed relapsing–remitting MS, while 10 remained with the condition as a clinically isolated syndrome. The tumefactive lesions studied were mostly focal, with closed-ring enhancement. We found that oligoclonal band positivity was less frequent in the patients with tumefactive onset. Conclusion: Although our demographic data were similar to formerly collected Turkish MS data, we found that the distribution of the patients’ clinical course differed if there was an absence of primary progressive MS and that there was a lower frequency of secondary progressive MS cases in our group of patients. We believe that less frequent oligoclonal band positivity and the difference we witnessed in the clinical course of disease in our study groups suggest that there is a need for further studies to compare all the biological and immunological differences between MS and tumefactive lesion cases, in order to reveal whether there are different pathogenetic mechanisms involved.

scholarly journals Osteochondral Defects in Hallux Rigidus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0019
Author(s):  
David Ciufo ◽  
Michelle Lawson ◽  
Benjamin Strong ◽  
Benedict DiGiovanni
Keyword(s):  
Outcome Measures ◽  
Demographic Data ◽  
Age Groups ◽  
Operative Management ◽  
Hallux Rigidus ◽  
Entire Cohort ◽  
Sf 36 ◽  
The Difference ◽  
Component Scores

Category: Midfoot/Forefoot Introduction/Purpose: Hallux rigidus, or 1st metatarsophalangeal (MTP) joint degeneration, is commonly encountered in foot and ankle practice. Operative management can include a dorsal cheilectomy, a motion sparing procedure to reduce impingement. Hallux rigidus affects patients across all age groups, and etiologies may include trauma, first ray hypermobility, pes planus, or hallux valgus. First MTP joint trauma may result in an osteochondral defect (OCD). Literature is sparse regarding OCD management in the 1st MTPJ, as is follow-up data on cheilectomy using validated outcome measures. We hypothesize that the presence of an OCD is associated with symptomatic hallux rigidus at a lower Coughlin and Shurnas grade. We also hypothesize that OCD treatment concurrent with cheilectomy leads to outcomes equivalent to patients treated with isolated hallux rigidus. Methods: A retrospective review of prospectively collected data was performed. All patients of a single surgeon were reviewed based on the CPT code (28289) for cheilectomy from 1/1/2011 to 12/31/2015. Demographic data, presence/drilling of an OCD on operative reports, and Coughlin grading were recorded. All patients had taken the FAAM and SF-36 preoperatively per the surgeon’s routine preoperative data collection. After approval by the institutional review board, all patients were contacted by telephone for follow-up and answered the FAAM, SF-36 and Patient Acceptable Symptom State (PASS) questionnaires. Visual analog scores (VAS), patient satisfaction, complications, and whether they would opt for surgery again were recorded.Paired T-tests were performed to evaluate improvement in FAAM activity of daily living (ADL), FAAM sport, SF-36 physical component scores (PCS), and SF-36 mental component scores (MCS). Two-tailed T-tests were performed to evaluate the difference in groups with and without OCDs. Results: Seventy-one patients met inclusion criteria. Follow-up was obtained from 28 patients (29 feet) for analysis, 10 with OCDs. Mean responder age was 53.1 years (32.6-70.9), with average 4 year follow-up (minimum 2 years). Patients with OCDs had lower Coughlin grade (p<0.01) and trended towards lower age (p=0.07), but similar improvement in FAAM sport (p=0.43), SF-36 PCS (p=0.33), and MCS (p=0.46). Patients with OCDs trended towards greater improvement in FAAM ADL (p=0.07). The entire cohort demonstrated significant improvements (p<0.01) in ADL, Sport, PCS, and MCS after cheilectomy. ADL and Sport scores met the MCID of 8 and 9 points, respectively. MCID is not well-defined for SF-36. One patient required subsequent fusion. Conclusion: Cheilectomy is an effective surgical option for improving function and pain in the setting of hallux rigidus, as measured at intermediate-term follow-up with validated patient outcome measures. Patients with a 1st MTP joint OCD become symptomatic at a younger age and with a lower radiographic grade of hallux rigidus. These patients demonstrate equivalent improvements in the FAAM sport, SF-36 PCS and MCS while trending towards greater improvement in the FAAM ADL score as those without OCDs. The presence and treatment of a 1st MTP joint OCD should be considered in younger patients with symptomatic hallux rigidus and lower radiographic severity.

PERFIL EPIDEMIOLÓGICO Y FACTORES DE RIESGO DE MORTALIDAD EN ADULTOS CON COVID-19: ESTUDIO RETROSPECTIVO.

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
Dayami Martínez Sosa ◽  
Oswaldo Vásconez Hatt ◽  
Katherine Rosero Arboleda ◽  
Fabian Zurita Alvarado ◽  
Mónica Hernández Lojano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Course ◽  
Demographic Data ◽  
Severity Of Illness ◽  
Factors Associated ◽  
Related Risk ◽  
Factores De Riesgo ◽  
New Type ◽  
Epidemiological Characteristics

By the ending of 2019 a new type of coronavirus was identified named SARS-CoV 2, and now known to be the etiological agent of the acute respiratory syndrome coronavirus (SARS-CoV-2). Known as coronavirus 2019 disease or (COVID-19) constitutes a challenge for the world in many unknown aspects and problems in public health. In Ecuador the first reported of a confirmed appeared on February 29 2020, and in March 12 an emergency health status is declared. Objective: To determine the epidemiological characteristics and factors related to death and survival in patients with COVID-19. Design: The study is of transversal retrospective design, the patients chosen were those seen in the respiratory or suspicious of COVID-19 area of Hospital Vozandes Quito between March 2 and April 30. Demographic data and related risk factors for mortality were obtained using the EPI-1 individual form, epidemiological research files, the VI Epi system and electronic promptuary of patients. Results: 250 patients were obtained for this study, 87 of those were confirmed COVID-19, out those eight died and 79 were alive at the ending of the follow up. Regarding the severity of illness, 61% of the patients were classified as mild and 6 % critical (p =<0.001). Elevated values of CRP (OR 1 IC 95% 1.000 – 1.024), age about 55 years old to diagnosis (OR 42,040 IC 95% 36,320 – 47,760) and the presence of hiporexia (OR 24 IC 95% 1.183 – 504.413) were associated with higher mortality levels amongst COVID-19 positive patients. Conclusions The majority of COVID-19 cases showed no serious manifestations, were treated symptomatically and home isolation. Elevated values of CRP and the presence of hiporexia at the diagnosis are factors consistently with death. Future investigations are required to determine the risk factors associated with worst clinical course and prognosis.

Influence of job assignment on melanoma (MEL) incidence in commercial aircrew.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21058-e21058
Author(s):  
Lee D. Cranmer
Keyword(s):  
Meta Analysis ◽  
Occupational Exposures ◽  
Study Groups ◽  
Job Assignment ◽  
Commercial Aircraft ◽  
Cabin Crew ◽  
Different Types ◽  
Keywords Cancer ◽  
The Difference

e21058 Background: Commercial cabin and cockpit aircrews are at increased cutaneous MEL risk. Occupational and social factors have been invoked to explain this. However, the two groups work in on-board environments with different types/levels of potential exposures. Meta-analysis is conducted to address the hypothesis that differences exist in aircrew MEL risk based on location of in-aircraft job assignment, reflecting differential etiologic occupational exposures. Methods: Medline was searched with the keywords “Cancer,” “Aviation,” and “Melanoma.” Included studies: (1) primarily focused on cutaneous MEL; (2) were in commercial aircrew; (3) measured risk vs a general population; (4) measured risk by Standardized Incidence Ratio (SIR) with 95% confidence intervals (CI); (5) defined the gender distribution; and (7) defined cabin vs cockpit job assignment. Summary SIRs and CIs were calculated using maximum-likelihood, random effects meta-analysis. Values obtained were compared to one another using a z-test, with p < 0.05 pre-specified for null hypothesis rejection. Results: 6 primary studies were identified in the initial search. These were screened for other pertinent references. The secondary search yielded an additional 9 primary studies. For cabin crew, 10 study groups from 6 studies were included. 411,561 person-years of follow-up among 28,093 subjects (86% female) were included (SIR 2.18, 95% CI 1.83-2.60). For cockpit crew, data from 9 studies representing 830,670 person-years of follow-up among 45,986 subjects (1% female) were included (SIR 2.44, 95% CI 1.94-3.08). z-test for the difference indicated that the two SIR values were not statistically different ( z= 0.77, p = 0.441). Conclusions: Though cockpit crew demonstrate an increased SIR vs cabin crew, this is not statistically significant. These results suggest that occupational exposures in different locations within commercial aircraft does not influence MEL risk. Other factors, such as cosmic radiation, non-aircraft occupational exposures and avocational exposures, should be the targets of further assessment.

scholarly journals Favorable Outcomes of Chinese HCV-Related Cirrhotic Patients with Sustained Virological Response after Pegylated Interferon Plus Ribavirin Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Geng-lin Zhang ◽  
You-ming Chen ◽  
Ting Zhang ◽  
Qing-xian Cai ◽  
Xiao-hong Zhang ◽  
...  
Keyword(s):  
Sustained Virological Response ◽  
Virological Response ◽  
Clinical Course ◽  
Laboratory Data ◽  
Pegylated Interferon ◽  
Liver Function Tests ◽  
Hcv Rna ◽  
Pegylated Interferon Plus Ribavirin ◽  
Cirrhotic Patients

Few studies have conducted follow-up investigations of the clinical course in HCV-related cirrhotic patients who achieved a sustained virological response (SVR) with pegylated interferon plus ribavirin treatment (PegIFN + RBV). We investigated the clinical course and laboratory data in a prospective cohort study enrolling HCV-related cirrhotic patients who received PegIFN + RBV between August 2008 and July 2013 in China. Complete blood counts, liver function tests, and HCV-RNA were serially examined. Liver-related complications were recorded. To detect hepatocellular carcinoma (HCC), alpha-fetoprotein assays, and ultrasound scans were repeated at 6-month intervals. Twenty-five patients were enrolled, including 8 patients with decompensation events before treatment. Eighteen patients achieved SVR with a mean follow-up period of 25.78 months. During the follow-up period, only one patient exhibited HCV-RNA positivity and no decompensation events were detected, but 4 patients developed HCC after SVR. APRI decreased more in patients with SVR than in patients with non-SVR (median, −1.33 versus 0.86,P<0.001). The albumin levels and platelet counts significantly increased during the follow-up period after SVR (44.27±4.09versus42.63±4.37,P=0.037and173.89±87.36versus160.11±77.97,P=0.047). These data indicated that HCV-related cirrhotic patients with SVR after PegIFN + RBV may have a favorable clinical course and improvements in laboratory data. Moreover, HCC should be monitored.

scholarly journals Current use and outcomes of hematopoietic stem cell transplantation: The first Brazilian summary slides

JBMTCT ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. p99
Author(s):  
Anderson João Simione ◽  
Heliz Regina Alves das Neves ◽  
Cinthya Corrêa da Silva ◽  
Bruna Letícia Da Silva Santos Geraldo ◽  
Marcelo C. Pasquini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cellular Therapy ◽  
Demographic Data ◽  
Marrow Transplant ◽  
National Registry ◽  
Hematopoietic Stem ◽  
The Us ◽  
Analysis Of Results ◽  
The Difference

Understanding the HSCT scenario in Brazil is challenging due to the lack of a national registry that allows the analysis of results. The partnership between the Brazilian Cellular Therapy and Bone Marrow Transplant Society (SBTMO) and the Center for International Blood and Marrow Research (CIBMTR) allowed the return of Brazilian data registered in the CIBMTR, through the Data Back to Center (DBtC), in a standardized and organized way. With this database it was possible to know the demographic data and the outcomes of transplants performed in Brazil. The spreadsheet was imported into the Power BI desktop, and functions and charts were created. Between 2008 and 2019, 7,264 transplants were reported to the CIBMTR from 24 Brazilian transplant centers. The partnership between SBTMO and CIBMTR, made the Brazilian registry possible and allowed the development of the first Brazilian Summary slides. Despite the difference in the number of cases and of follow-up time, the results in this study were similar to those presented in the US Summary Slides.

Delayed Hemolytic Anemia after Treatment with Artesunate: Case Report and Literature Review

2019 ◽  
Vol 14 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Mohammadreza Salehi ◽  
Hosein Masoumi-Asl ◽  
Mehrdad Assarian ◽  
Niloofar Khoshnam-Rad ◽  
Afsaneh Motevalli Haghi ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Causality Assessment ◽  
Clinical Course ◽  
Laboratory Data ◽  
Vital Signs ◽  
Travel History ◽  
Dark Urine ◽  
Medical Drug ◽  
Severe Falciparum Malaria

Background: In recent years, few cases of post-artemisinin delayed hemolysis have been reported. Objective: All cases of post-artemisinin delayed hemolysis were reported from non-middle east areas. No case of post-artemisinin delayed hemolysis has yet been reported from this region. In this paper, we describe a case of post-artemisinin delayed hemolysis in an Iranian female. Moreover, previous reports have been reviewed. Methods: Patient’s data including demographic characteristics, past medical, drug and travelling history, present illness, vital signs, laboratory data, clinical course of current illness and follow-up findings were considered. Results: A 27-year-old female with a recent travel history to Ghana admitted with severe falciparum malaria. She was successfully treated with parenteral artesunate. However after 12 days of post artesunate treatment, she returned with dark urine, malaise and fatigue. Conclusion: Considering the clinical course and base on a reliable causality assessment scale, post artesunate delay hemolytic anemia was possible.

scholarly journals Post-surgical follow-up (by ELISA and immunoblotting) of cured versus non-cured cystic echinococcosis in young patients

Parasitology ◽  
2007 ◽  
Vol 135 (1) ◽  
pp. 105-114 ◽  
Author(s):  
N. BEN NOUIR ◽  
S. NUÑEZ ◽  
E. FREI ◽  
M. GORCII ◽  
N. MÜLLER ◽  
...  
Keyword(s):  
Cystic Echinococcosis ◽  
Prognostic Value ◽  
Clinical Course ◽  
Young Patients ◽  
High Rate ◽  
Imaging Findings ◽  
Course Of Disease ◽  
Post Surgery ◽  
The Difference

SUMMARYThe study was designed to determine comparatively the prognostic value of immunoblotting and ELISA in the serological follow-up of young cystic echinococcosis (CE) patients exhibiting either a cured or a progredient (non-cured) course of disease after treatment. A total of 54 patients (mean age 9 years, range from 3 to 15 years) with surgically, radiologically and/or histologically proven CE were studied for a period up to 60 months after surgery. Additionally, some of the patients underwent chemotherapy. Based on the clinical course and outcome, as well as on imaging findings, patients were clustered into 2 groups of either cured (CCE), or non-cured (NCCE) CE patients. ELISA showed a high rate of seropositivity 4 to 5 years post-surgery for both CCE (57·1%) and NCCE (100%) patients, the difference found between the two groups was statistically not significant. Immunoblotting based upon recognition of AgB subcomponents (8 and 16 kDa bands) showed a decrease of respective antibody reactivities after 4 years post-surgery. Only sera from 14·3% of CCE patients recognized the subcomponents of AgB after 4 years, while none (0%) of these sera was still reactive at 5 years post-surgery. At variance, immunoblotting remained positive for AgB subcomponents in 100% of the NCCE cases as tested between 4 and 5 years after surgical treatment. Immunoblotting therefore proved to be a useful approach for monitoring post-surgical follow-ups of human CCE and NCCE in young patients when based upon the recognition of AgB subcomponents.

Outcome of trabeculectomy versus Ahmed glaucoma valve implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome

2020 ◽  
pp. bjophthalmol-2020-317098
Author(s):  
Bipul Kumer De Sarker ◽  
Mohammad Ibn Abdul Malek ◽  
Sheikh M A Mannaf ◽  
Quazi Sazzad Iftekhar ◽  
Mallika Mahatma ◽  
...  
Keyword(s):  
Surgical Management ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Ahmed Glaucoma Valve ◽  
Kaplan Meier ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
The Difference ◽  
Valve Implantation

AimsTo compare the surgical outcomes of trabeculectomy versus Ahmed glaucoma valve (AGV) implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome (SWS).MethodsA retrospective chart review was performed on 40 eyes of secondary glaucoma in patients with SWS separated into two groups: AGV (N=20) and trabeculectomy with mitomycin C (N=20). Demographic data, intraocular pressure (IOP), visual acuity and the number anti-glaucoma medications (AGM) needed were evaluated prior to and following surgery. Surgical success was defined as an IOP of ≤21 mm Hg, with or without the use of topical AGM. Complete success was achieved when IOP values were obtained without AGM.ResultsMean follow-up duration was 23.15±2.36 months and 22.95±2.87 months in the AGV and trabeculectomy groups, respectively (p=0.811). Both the AGV (34.50±4.65 mm Hg at baseline to 15.20±3.31 mm Hg at last visit) and trabeculectomy (32.10±5.86 mm Hg to 16.10±3.02 mm Hg) groups achieved a statistically significant fall in IOP following surgery (p=0.000). Kaplan–Meier survival of complete success after 24 months was 80% and 70% after AGV implant and trabeculectomy, respectively, but the difference between two groups was not statistically significant (p=0.442).ConclusionsBoth AGV implant and trabeculectomy appear to be safe and efficacious in controlling glaucoma secondary to SWS, although the potential for serious complications such as choroidal detachment must be anticipated when planning surgeries in patient with SWS, and the authors recommend the maintenance of a stable IOP during and following the surgery to avoid such complications.

scholarly journals The Difference Incidence of Maternal Uterine Inertia Between Labor With and Without Anemia in Hospital of dr. Soebandi Jember

2019 ◽  
Vol 5 (3) ◽  
pp. 172
Author(s):  
Dina Ayu Savitri ◽  
Yonas Hadisybroto ◽  
Pipiet Wulandari
Keyword(s):  
Pregnant Women ◽  
Demographic Data ◽  
Laboratory Data ◽  
Secondary Data ◽  
Hemoglobin Level ◽  
Chi Square ◽  
Cross Sectional ◽  
Uterine Inertia ◽  
Chi Square Test ◽  
The Difference

One of the indirect causes of maternal death is anemia. Anemia in pregnancy is a woman with a hemoglobin level below 11 g / dl caused by iron deficiency in pregnant women so that the hemoglobin level becomes low and cannot meet the need for oxygen to perfusion to the tissues. This consumes energy in the affected muscles and buildup of lactic acid which causes fatigue and reduced muscle contraction during labor. Inadequate uterine contractions are called uterine inertia and are characterized by a prolonged phase of labor, which is weak, rarely and short duration. The purpose of this study was to determine the differences in the incidence of uterine inertia between labor and anemia released in RSD dr. Soebandi Jember. This study was analytic observational with a cross sectional research design. The study population was all pregnant women who had improved labor and were included in the medical record at RSD Dr. Soebandi Jember period January 1, 2017 - December 31, 2017. Samples from this study were mothers who had approved the delivery and fulfilled the inclusion and exclusion criteria that had been determined until the number of samples could be fulfilled. The number of samples in this study were 76 samples. The type of data used in this study is secondary data obtained by researchers from the medical records of pregnant women who have received labor. The data included in this study contain demographic data consisting of the age of pregnant women and parity, clinical data in the form of uterine inertia and laboratory data consisting of anemia status. In analyzing the data with Chi Square test (X²), a significance value of 0.011 was obtained so that it can be concluded that Ho is rejected and Ha is accepted which means that the incidence of uterine inertia between free labor and anemia is not important in RSD Dr. Soebandi Jember. Keywords: anemia, uterine inertia, pregnancy, age, parity.  

Cardiac Imaging Phenotype in Patients with Coronavirus Disease 2019: Rationale, design and protocol of the COCARDE study (Preprint)

2020 ◽  
Author(s):  
Olivier Lairez ◽  
Virginie Blanchard ◽  
Laurent Balardy ◽  
Fanny Vardon-Bounes ◽  
Stéphanie Cazalbou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Myocardial Injury ◽  
Myocardial Function ◽  
Clinical Course ◽  
Demographic Data ◽  
Cardiac Injury ◽  
University Hospital ◽  
Geriatric Ward ◽  
Improve Patient

UNSTRUCTURED Background – The effects of SARS-Cov-2 (COVID-19) on the myocardium and their role in the clinical course of infected patients are still unknown. The severity of SARS-Cov-2 is driven by hyperinflammation and the effects of SARS-Cov-2 on the myocardium may be significant. The present study proposes to use bedside observations and biomarkers to characterize the association COVID-19 with myocardial injury. Objectives – The aim of the study is to describe the myocardial function and its evolution over the time in patients infected with SARS-COV-2; and to investigate the link between inflammation and cardiac injury. Design – This prospective, monocentric observational study will enroll 150 patients with suspected or confirmed SARS-COV-2 infection at Toulouse University Hospital, Toulouse, France. Patients admitted in intensive care unit, regular cardiologic ward as well as geriatric ward of our tertiary university hospital will be included during the pandemic period. Blood sampling, electrocardiography, echocardiography, as well as morphometric and demographic data will be prospectively collected. Implications – A better understanding of the effects of COVID-19 on myocardia function and the links with inflammation would improve patient follow-up and care. Trial registration – Clinicaltrials.gov NCT04358952

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