Bleomycin sclerotherapy following doxycycline lavage in the treatment of ranulas: A retrospective analysis and review of the literature

2021 ◽  
pp. 197140092110087
Author(s):  
Sayan Manna ◽  
Devin V Bageac ◽  
Alejandro Berenstein ◽  
Catherine F Sinclair ◽  
Diana Kirke ◽  
...  
Keyword(s):  
Complete Response ◽  
Treatment Result ◽  
Complete Excision ◽  
Percutaneous Sclerotherapy ◽  
Submandibular Salivary Glands ◽  
First Choice ◽  
History Of ◽  
Secondary Endpoints ◽  
Cyst Content

Objective A ranula is a mucus-filled salivary pseudocyst that forms in the floor of the mouth, commonly arising from the sublingual or submandibular salivary glands following obstruction or trauma. Complete excision of the injured gland and removal of the cyst content is the first-choice therapy, but has the potential for complications related to injury to nearby structures. As such, minimally invasive approaches such as percutaneous sclerotherapy have been investigated. We aim to contribute to the literature by assessing the efficacy and safety of our technique through our experience with 18 patients over the last decade. Methods This retrospective study evaluated 18 patients with intraoral and plunging ranulas treated by percutaneous bleomycin ablation. The primary endpoint was the treatment result. Secondary endpoints included bleomycin dosage and complications. Results The study evaluated 12 males and six females with a median age of 23.5 years (range 13–39 years). At a final follow-up of at least 2 months (6.5±5.5 months), four patients demonstrated complete response (22%) and 14 patients demonstrated residual presence, recurrence, or regrowth of the lesion (78%). There were no statistically significant associations between outcomes and history of prior treatment, number of treatments, and size or type of ranula. No complications were noted. Conclusions Our findings indicate that bleomycin, while safe for use in various head and neck malformations, is of limited utility in ranula therapy when the offending gland is not addressed primarily.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

scholarly journals Is the Recurrence of Fibroma of the Tendon Sheath Underestimated? An Instructive Case Report and a Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
E. Lüdke ◽  
G. Kohut ◽  
H. C. Bäcker ◽  
M. Maniglio
Keyword(s):  
Scientific Literature ◽  
Healthy Woman ◽  
Tendon Sheath ◽  
Gadolinium Enhancement ◽  
Complete Excision ◽  
History Of ◽  
Initial Outcome ◽  
The Right ◽  
Instructive Case

We report a case of a 21-year-old healthy woman with a history of a painful growing mass in the palm of the right hand, with a trigger finger phenomenon. The mass was surgically entirely excised, and the histological findings of the tumor were those of a fibroma of the tendon sheath (FTS) starting from the flexor tendons. Although the initial outcome was good, the patient experienced the same symptoms at the same location 4.5 years later. The MRI demonstrated a 50×10×5 mm mass of low intensity on T1-weighted images and high intensity on T2-weighted images and gadolinium enhancement. A second complete excision of the tumor was performed by the same senior surgeon, and the histology confirmed the recurrence of the FTS. We also reviewed the scientific literature about FTS in the hand. Most recent studies show a low rate or no recurrence at all. We hypothesize that a lot of recurrences are missed because of a short follow-up and that the recurrence rate may be higher than thought.

scholarly journals Primary orbital extraskeletal osteosarcoma and review of literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jingwen Hui ◽  
Yun Zhao ◽  
Lei Zhang ◽  
Jinyong Lin ◽  
Hong Zhao
Keyword(s):  
Soft Tissues ◽  
Malignant Tumour ◽  
Extraskeletal Osteosarcoma ◽  
Complete Excision ◽  
Case Presentation ◽  
Left Orbit ◽  
Orbital Wall ◽  
Previous Trauma ◽  
History Of

Abstract Background Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. Case presentation The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. Conclusions ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.

scholarly journals 1313. Complementary Effects of Medical Follow-up and Virologic Suppression for Reincarcerated Inmates Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S474-S474
Author(s):  
Melissa E Badowski ◽  
R Kane Stafford ◽  
Brian W Drummond ◽  
Thomas D Chiampas ◽  
Sarah M Michienzi ◽  
...  
Keyword(s):  
Hiv Care ◽  
People Living With Hiv ◽  
Virologic Suppression ◽  
Management Support ◽  
Chi Square ◽  
History Of ◽  
Secondary Endpoints ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background Although prison presents an opportunity to achieve virologic suppression (VS) among people living with HIV, continued success is not guaranteed upon release. Methods A retrospective cohort study was performed in reincarcerated Illinois prisoners from January 1, 2016 to July 31, 2018. Patients were included if they were age ≥18 years, carried a diagnosis of HIV/AIDS, on antiretroviral therapy (ART) at the time of release, and had CD4 and HIV-1 RNA labs drawn within 6 months of release and reincarceration. Potential subjects were excluded if reincarcerated within 30 days due to a technical violation and not receiving ART at the time of prison release. Primary and secondary endpoints were percent of patients achieving VS upon reincarceration and percent of patients following at an HIV clinic while released. Statistical analysis included descriptive statistics, chi-square, and paired t-tests. Results Among 505 patients released during the study period, 95 patients were reincarcerated and 80 were included (Figure 1). Demographic information can be found in Table 1. Fifty-one patients (64%) reported follow-up at an HIV clinic while released, whereas 29 (36%) did not. Patients who had VS at the time of prison release were more likely to make their follow-up appointment (90%) compared with those who did not (69%) (P < 0.001). In addition, patients making their follow-up appointment were also more likely to have VS at the time of reincarceration (86% vs. 10%, P < 0.001). Recidivist patients adherent to ART were less likely to experience decreases in mean CD4 count (P = 0.03) (Table 2). Subjects reporting a history of substance use were more likely not to re-engage in post-release HIV care (P = 0.001), but no difference was noted in patients with a documented psychiatric history (P = 0.2). Conclusion Patients failing to meet VS at the time of prison release should be targeted for more intensive re-entry medical and case management support to ensure adherence to follow-up and maintenance of immunologic function. Disclosures All authors: No reported disclosures.

Rituximab in the Treatment of Adults with Chronic Idiopathic Thrombocytopenic Purpura (ITP) and Autoimmune Hemolytic Anemia (AIHA).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3930-3930 ◽  
Author(s):  
Ghassan Zalzaleh ◽  
Ahmad Jajeh ◽  
Diemante Tamoseviciene
Keyword(s):  
Partial Response ◽  
Hemolytic Anemia ◽  
Complete Response ◽  
Pure Red Cell Aplasia ◽  
Lymphocytic Leukemia ◽  
Overall Response ◽  
Medical Centers ◽  
History Of ◽  
Refractory Itp

Abstract Corticosteroids have been the first line of treatment of ITP since 1950, however some patients do not respond to this treatment (refractory) and some will relapse after its discontinuation. For such patients second line treatments were introduced. Some patients will continue to be refractory to this treatment and need other therapy modality. Rituximab is a chimeric monoclonal antibody directed against the CD20 antigen exposing B Lymphocytes, causing its depletion. This could alter the production of auto-antibodies in some Auto-Immune diseases and thus could be used in their treatment. Few medical centers had reported using Rituximab in the treatment of refractory (ITP) and (AIHA), yet its definite role could not be determined, and here we share our experience. Patients with documented diagnosis of ITP or AIHA who were refractory to at least two lines of therapy including steroids were offered to receive Rituximab (375mg/m2 weekly for 4 weeks). 15 patients were enrolled, 10 with ITP, 4 with AIHA, 1 with Coombs negative Hemolytic anemia, and 1 with pure red cell aplasia. One had both ITP and AIHA. 10 were females and 5 males. 5 were >60 years old and 10 were < 60 years old. 2 out of the 10 patients with ITP had also Chronic Lymphocytic Leukemia (CLL). Duration of follow up ranged from 2 months to 17 months (average 7 mos). Of the 10 patients with refractory ITP treated with Rituximab overall response was 60%. 4 were NR (no response), 2 were MR (minimal response: Platelets increased to <50000), 2 were PR (Partial response: Platelets increased to <100000) and 2 were complete response (Platelets became normal). 3 patients of 6 with Hemolytic anemia or PRC aplasia had NR, 1 had MR (Hct <30), and 2 had partial response (Hct 30–35). No complete response was observed in this group. In 3 patients with hemolytic anemia and CLL 1 had MR, 1 had PR and 1 had NR. 2 patients with hemolytic anemia who had NR died as a complication of their disease (one with septic shock and one with severe autoimmune flare up). Only one patient with refractory ITP had mild allergic side effects and did not complete 4 doses. No Rituximab related mortality was observed. CONCLUSION: Rituximab therapy had a variable but valuable effect in the treatment of patients with chronic refractory ITP and refractory/ relapsed AIHA. Overall response in our group reached 60%. No clinical or laboratory parameters were found to predict response, although there was a suggestion that males, younger age, and no history of splenectomy have a better chance of response. As we lack an effective alternative treatment in chronic refractory ITP and AIHA, Rituximab use could be a valid option in view of its mild toxicity. Further follow up of our patients and input from other institutions in this regard are needed.

Electrochemotherapy with intra-tumoral cisplatin for the treatment of fibrosarcoma in a horse

2018 ◽  
Author(s):  
M. Bharathidasan ◽  
B. Justin William ◽  
Ravi Sundar George Sundar George ◽  
A. Arunprasad ◽  
R. Sivasankar
Keyword(s):  
Complete Response ◽  
Tumour Volume ◽  
Needle Aspiration ◽  
Medial Aspect ◽  
History Of ◽  
Subcutaneous Tissues ◽  
Needle Aspiration Cytology ◽  
One Year ◽  
The Right

A two years old Kathiawar stallion was reported with the history of two, pedunculated hard mass medially on the thigh and hock of the right hind limb, progressively increasing for the past two months. Fine needle aspiration cytology revealed fibrosarcoma.The tumour on the medial aspect of the thigh was injected with cisplatin intra-tumorally at a dose rate of 0.3 mg/cm3 of tumour volume and was exposed to ECT. The tumour on the medial aspect of the hock was excised incompletely to preserve skin and subcutaneous tissues around the tumour for wound opposition and treated with intra-tumoral injection of cisplatin followed by ECT. Following electrochemotherapy complete response was noticed onthe 3rd and 4th week for the tumours on the thigh and hock respectively. No recurrence was noticed during the follow-up period of one year revealing ETC with cisplatin as a single treatment and also in combination with surgery is effective for the treatment of fibrosarcoma in equines.

Does Acupuncture Contribute to the Treatment of Chronic Shoulder Pain (Csp)

2002 ◽  
Vol 20 (2-3) ◽  
pp. 122-138
Author(s):  
AF Molsberger
Keyword(s):  
Pain Treatment ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Sham Acupuncture ◽  
Orthopaedic Treatment ◽  
History Of ◽  
Secondary Endpoints ◽  
Group 2 ◽  
Random Groups

Objective Response of Chinese acupuncture compared to conservative orthopaedic treatment and unspecific needling in pain treatment on CSP. Design Prospective, randomized controlled trial with three blinded parallel groups; follow up three months. Setting Outpatients of 26 orthopaedists, who have attended a 140 hours training course on acupuncture. Patients Four hundred and twenty seven out-patients with a history of CSP ≥ six weeks, VAS ≥ 50 mm were selected; three random groups, six weeks treatment. 308 patients reported after three months follow up. Two strata: age 25–45 and age 46–65. Interventions Group 1: VAP: 15 treatments of verum acupuncture (VAP). Group 2: SHM: 15 treatments of non-specific needling, sham acupuncture (SHM). Group 3: COT: conventional conservative orthopaedic treatment (COT). Patients were blinded to allocation between verum and sham acupuncture. Main Outcome Measures Primary endpoint: pain reduction ≥ 50% on VAS three months after the end of the treatment protocol. Secondary endpoints: global assessments on a 4-score scale directly after the end of the treatment protocol. Results The results after three months follow up are: Highly significant effect of CAP over SHM and COT in the whole sample (P<0.0001) and in Stratum1 (P<0.001) and Stratum2 (P<0.001). Conclusions Acupuncture is an important supplement in the management of CSP. BMBF grant: 01KT9411/9

ASSESSMENT OF THE TREATMENT RESULT WITH CERVICAL LESIONS AT CAN THO BY CRYOTHERAPY

2016 ◽  
pp. 69-75
Author(s):  
Duc Tam Lam ◽  
Vu Quoc Huy Nguyen
Keyword(s):  
Married Women ◽  
Treatment Result ◽  
Hpv Testing ◽  
Cervical Lesions ◽  
Statistical Software ◽  
Realtime Pcr ◽  
Results Of Treatment ◽  
Gynecological Examination ◽  
History Of

Objective: To evaluate the results of treatment of cervical lesions with cryotherapy in Can Tho. Research methodology: Clinical trials and longitudinal follow-up to 44 married women from 18 to 69, with cervical lesions in Can Tho. Participants collected population sociology, history of illness and maternity wife, husband's medical history, gynecological examination, VIA, Pap's, HPV testing by technical realtime PCR, biopsy, treated lesions cervical abnormalities by cryotherapy and follow-up treatment on clinical, Pap's, the discharge and complication. The data collected is processed by statistical software Stata 10.0. Results: average age of 42.58± 10.24, in which 39- 50 was 34,26%, 27.46% at age 30 to 39. Over 50 years (26.98%). Occupation: Housewife (28.29%), trade (21.12%), farming (16.71%). 91.61% of cases living with her husband. Married age: Age 20 to 25 years old (46.91%). 73.65% of the women with normal cervical. The treatment result with cervical lesions by cryotherapy: increased from 43.18% in 2 weeks to 100% by six months follow-up. Side effect was 54.55% and signs of pain. There are two cases to treat 2nd-cryotherapy (4.55%). No cases of 3rd-cryotherapy. Satisfied were increase from 75% in the immediate post-treatment to 100% after six months. Discharge was 7.68 days, with 1 case discharge 15 days, in which, 50% of women have discharge from 8 to 14 days, 47.73% less than 7 days of discharge. Conclusion: Applying cryotherapy is effective for cervical lesions in Can Tho.

Survival outcomes of the NeoALTTO study: Updated results of a randomized multicenter phase III neoadjuvant trial.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 512-512 ◽  
Author(s):  
Jens Bodo Huober ◽  
Eileen McCormick Holmes ◽  
Jose Baselga ◽  
Evandro De Azambuja ◽  
Michael Untch ◽  
...  
Keyword(s):  
Hormone Receptor ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Phase Iii ◽  
Negative Group ◽  
Her2 Positive ◽  
Secondary Endpoints ◽  
Landmark Analyses ◽  
Pathologic Complete Response Rate

512 Background: In the neoadjuvant NeoALTTO trial dual HER2 blockade with lapatinib (L) plus trastuzumab (T) combined with weekly paclitaxel significantly increased the pathologic complete response rate (pCR) compared with either anti-HER2 agent alone plus paclitaxel. At first analysis pts with pCR had a better event free survival (EFS) and overall survival (OS) after median follow-up of 3.84 yrs. Methods: 455 pts with operable HER2-positive breast cancer were randomized to receive either L (n=154) 1500mg/day, T 4mg/kg loading dose followed by 2mg/kg/wk (n=149) or L 1000mg/day plus T (n=152) for 6 weeks followed by the assigned anti-HER2 treatment combined with paclitaxel weekly x 12. Following surgery pts received 3 cycles fluorouracil, epirubicin and cyclophosphamide q 3 weeks. The assigned anti-HER2 treatment was continued for 34 weeks thereafter. Primary endpoint was pCR (ypT0/is), secondary endpoints were EFS and OS and the association between pCR and OS analyzed by landmark analysis 30 weeks after randomization. Median follow-up was 6.7 years. Results: 6-yrs EFS rate was 67%/ 67%/74% with L/T/TL, respectively (L vs T HR 0.98 [95% CI 0.64–1.51] p=0.93; TL vs T HR 0.81 [95% CI 0.52–1.26] p=0.35). In the hormone receptor negative group 6- yrs EFS rate was 61%/ 63%/74% for the 3 groups, respectively (L vs T HR 1.09 [95% CI 0.61–1.95] p=0.76; TL vs T HR 0.81 [95% CI 0.44–1.51] p=0.52). OS at 6 yrs was 82%/79%/85% for L, T and TL, respectively (L vs T: HR 0.85 [95% CI 0.49-1.46] p=0.56; TL vs T HR 0.72 [95% CI 0.41-1.27] p=0.26). In landmark analyses, pts with a pCR had significantly higher 6-yrs EFS (77% /65%) and OS (89% /77%) compared to those without pCR, both overall and for the hormone receptor negative cohort. Conclusions: The updated results of the NeoALTTO study confirm the sustained survival benefits for pts who achieve a pCR. EFS and OS after 6 yrs did not differ significantly between the 3 treatment groups. The combination of T and L showed numerically higher EFS compared to T, especially in the hormone-receptor negative group. Clinical trial information: NCT00553358. [Table: see text]

Safety and efficacy of atezolizumab (atezo) in patients (pts) with autoimmune disease (AID): Subgroup analysis of the TAIL study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21628-e21628
Author(s):  
Thomas Newsom-Davis ◽  
Belen Rubio Viqueira ◽  
Delvys Rodriguez-Abreu ◽  
Jorge Alatorre-Alexander ◽  
Hans J.M. Smit ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Phase Iii ◽  
Safety Measures ◽  
Safety And Efficacy ◽  
History Of ◽  
Secondary Endpoints ◽  
Previously Treated ◽  
Pleural Infection ◽  
Ecog Ps

e21628 Background: Atezo showed improved survival and a manageable safety profile in advanced NSCLC. The Phase III/IV TAIL study (NCT03285763) evaluated atezo in pts with previously treated advanced NSCLC, including pts often excluded from pivotal trials. We analyzed outcomes in pts with a history of AID in TAIL. Methods: Pts had stage IIIb/IV NSCLC that progressed after 1-2 lines of chemo and ECOG PS ≤ 2. Eligible pts included those with preexisting AID. Pts received atezo 1200 mg IV q3w. The primary endpoint was safety as measured by the incidence of treatment-related (TR) serious AEs (SAEs) and TR immune-related AEs (irAEs). Secondary endpoints included OS, PFS, ORR and other safety measures. Results: Of the 619 pts enrolled, 615 received atezo, including 30 pts with AID. In AID pts, the median age was 67 y, 43.3% were male and 86.7% had ECOG PS 0-1; common preexisting conditions included psoriasis (n = 7) and rheumatoid arthritis (n = 5). 23 pts had active AID at baseline. At data cutoff (Jun 4 2019), median follow-up was 12.7 mo. TR SAEs occurred in 6.7% and 7.9% of AID vs non-AID pts, respectively; TR irAEs occurred in 10.0% and 8.2% (table). AEs occurring in AID pts at a ≥ 10% difference vs non-AID pts were decreased appetite (26.7%), nausea (26.7%), dyspnea (23.3%) and pneumonitis (13.3%). G3-4 AE incidences were similar between groups (30.0% vs 29.9%). AEs leading to treatment discontinuation occurred in 16.7% and 4.3% of AID vs non-AID pts and included G1-2 pneumonitis (6.7%), G3-4 pleural infection (3.3%) and G3-4 pneumonia (3.3%). AEs of special interest (AESI) occurred more frequently in AID (40.0%) vs non-AID (34.2%) pts, with pneumonitis (13.3% vs 3.1%), rash (13.3% vs 10.6%) and hypothyroidism (6.7% vs 9.6%) as the most common AESIs in either group. Exploratory efficacy analyses in AID vs non-AID pts showed an mOS of 10.1 vs 11.1 mo, an mPFS of 2.9 vs 2.7 mo and ORRs of 10.0% vs 11.1%. Conclusions: Despite the small number of AID pts, safety and efficacy outcomes of atezo in TAIL pts with a history of AID were similar to those of pts with no history of AID. Moderate AE increases seen in AID pts tended to be respiratory in nature or GI disorders. These data may inform treatment decisions in pts with advanced NSCLC and AID. Clinical trial information: NCT03285763. [Table: see text]

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