Acute lobar nephronia: Pitfalls and insights of an underdiagnosed urologic condition

Background: Acute lobar nephronia (ALN) is an underdiagnosed urological condition which has scarce publications available. It is described as an acute inflammatory and bacterial infection of the kidney without liquefaction, and in fact likely represents a mid-point between acute pyelonephritis and renal abscess. Patients usually present with fevers, septic shock, and occasionally abdominal and flank pain. To date there is no consensus on its optimal management. Objective: The aim of this study was to describe the presentation, evaluation, multidisciplinary involvement and management, and follow-up of ALN. Method: An observational study was performed utilising four patients from our single centre urology department. Data collected included basic demographics and diagnosis and management. All four patients are presented below. Observations and comparisons were made between all patients to aid in understanding the commonality between their presentations and managements. Conclusion: ALN is an underdiagnosed condition. Its diagnosis and management is difficult and requires a multidisciplinary approach. Many patients require prolonged inpatient management and close follow-up. An underlying renal mass is always an important differential diagnosis to be considered. Level of evidence: Not applicable for this multicentre audit.

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The ‘shark mouth’ flap approach for digital glomus tumours in 24 patients: technique and clinical outcomes

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193419867049 ◽

2019 ◽

Vol 45 (2) ◽

pp. 153-159

Author(s):

Ghada Asmar ◽

Tahar Mati ◽

Ioana Anastasia Pop ◽

Marc-Olivier Falcone

Keyword(s):

Clinical Outcomes ◽

Nail Plate ◽

Easy Access ◽

Postoperative Phase ◽

Single Centre ◽

Level Of Evidence ◽

Germinal Matrix ◽

Single Centre Study ◽

Subperiosteal Approach

This retrospective, single-centre study was carried out on patients with digital subungual glomus tumours. We describe a subperiosteal approach with a ‘shark mouth’ flap containing the nail plate and nail bed as a single unit, providing ideal exposure and easy access to the tumour. It combines the advantages of the transungual and lateral approaches, whether the subungual tumours are located centrally, peripherally or under the germinal matrix. The ‘shark mouth’ flap approach was used by the same surgeon in 24 patients with solitary glomus tumours of the fingers. Clinical outcomes at the early postoperative phase and at the last follow-up were satisfactory. Pain relief and wound healing were quickly achieved. No complications, such as fingertip numbness or nail deformities, were observed, and there was only one recurrence. This approach is reliable, nail-sparing and less time-consuming than other techniques. Level of evidence: IV

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Carpal tunnel syndrome and finger deformities in children with mucopolysaccharidoses and mucolipidoses: a retrospective review of 52 patients

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211061980 ◽

2021 ◽

pp. 175319342110619

Author(s):

Clément Thirache ◽

Mathilde Gaume ◽

Cyril Gitiaux ◽

Arielle Salon ◽

Caroline Dana ◽

...

Keyword(s):

Retrospective Study ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Clinical Signs ◽

Single Centre ◽

Level Of Evidence ◽

Age At Surgery ◽

Tunnel Syndrome ◽

The Mean

This single-centre retrospective study reports our management of carpal tunnel syndrome in 52 children (103 hands) with mucopolysaccharidoses and mucolipidoses. All except one were bilateral. The median age at surgery was 4 years (range 1.5 to 12). The diagnosis of carpal tunnel syndrome was confirmed by an electromyogram (EMG) in all patients; 38% of these presented without any clinical signs. Surgical neurolysis was performed in all hands, combined with epineurotomy in 52 hands (50%) and flexor tenosynovectomy in 75 hands (73%). Surgery was bilateral in 98% of children (102 hands). The mean follow-up was 12 years (range 1 to 19) and the EMG was normalized in 78% of hands. Ten patients suffered recurrence, eight of whom required further surgery. Screening for carpal tunnel syndrome is essential for the management of children mucopolysaccharidoses and mucolipidoses. Surgical treatment should be carried out early with follow-up by EMG to detect recurrence. Level of evidence: IV

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Four-corner arthrodesis using the 4Fusion® quadripodal shape memory staple: a long-term review

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211063614 ◽

2021 ◽

pp. 175319342110636

Author(s):

Gwenaël Mevel ◽

Aymeric De Geyer ◽

Warren Kim ◽

Maud Ebalard ◽

Mickaël Ropars ◽

...

Keyword(s):

Shape Memory ◽

Clinical Assessment ◽

Consecutive Series ◽

Device Removal ◽

Single Centre ◽

Level Of Evidence ◽

Good Strength ◽

Lost To Follow Up

We investigated the reliability of the 4Fusion® quadripodal memory staple in a consecutive series of 59 four-corner arthrodeses in a single centre. Forty-one patients (46 wrists) had a radiological and clinical assessment at a mean follow-up of 7.4 years. Thirteen patients (13 wrists) were lost to follow-up. Bone union was achieved in all but one patient. Seven patients were reoperated, six for device removal and one for nonunion. Most patients were satisfied, had a functional range of wrist mobility, good strength and were free of pain, comparable with the best previously reported series. Level of evidence: IV

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Outcomes of secondary trapeziectomy after revision of trapeziometacarpal implants: a retrospective comparative matched study

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211039184 ◽

2021 ◽

pp. 175319342110391

Author(s):

Alexandre Cerlier ◽

Didier Guinard ◽

André M Gay ◽

Régis Legré

Keyword(s):

Median Time ◽

Prosthesis Failure ◽

Single Centre ◽

Level Of Evidence ◽

Centre Study ◽

Significant Difference ◽

Single Centre Study ◽

Matched Study

We evaluated secondary trapeziectomy for revision of trapeziometacarpal implants and compared this to primary trapeziectomy with a matched retrospective single centre study performed between October 2003 and February 2015. Thirty-one patients with trapeziometacarpal prosthesis failure who had a secondary trapeziectomy were matched with a primary trapeziectomy regarding sex, date of the operation and age. We evaluated function, mobility, autonomy, pain, strength, complications and shortening of the thumb on radiographs. The median time until removal of the implant was 37 months. The median age in both groups was similar. Median follow-up was more than 7 years in both groups. There was no statistically significant difference in terms of function, mobility, autonomy, pain, strength, complications and shortening of the thumb. Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy. Level of evidence: III

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Avascular necrosis of the capitate: report of six cases and review of the literature

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193414524876 ◽

2014 ◽

Vol 40 (5) ◽

pp. 520-525 ◽

Cited By ~ 13

Author(s):

S. J. Peters ◽

I. Degreef ◽

L. De Smet

Keyword(s):

Avascular Necrosis ◽

Clinical Presentation ◽

German Literature ◽

Patient Characteristics ◽

Dash Score ◽

Optimal Management ◽

Review Of The Literature ◽

Level Of Evidence ◽

Quick Dash

Avascular necrosis of the capitate is rare. Little is known about the aetiology, disease progression or optimal management. From 1992 to 2012 we treated six patients; four had a scaphocapitolunate arthrodesis and two had a four corner arthrodesis. The average follow up was 9 years (range 1–20). Three patients had good or excellent results, two fair and one poor, based on a visual analogue scale for pain and satisfaction and a Quick-DASH score. The Mayo wrist score was satisfactory in five cases and poor in one. Better results were seen when the arthrodesis fused. In the English, French and German literature 42 other cases were found. The aetiology, patient characteristics, clinical presentation, treatment and outcome were reviewed. Type of study/level of evidence: therapeutic IV.

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AAC Supports for Individuals With Rett Syndrome Across the Lifespan

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac24.3.74 ◽

2015 ◽

Vol 24 (3) ◽

pp. 74-85

Author(s):

Sandra M. Grether

Keyword(s):

Rett Syndrome ◽

Communication Skills ◽

Preliminary Analysis ◽

Multidisciplinary Approach ◽

Motor Deficits ◽

Complex Profile ◽

Communication Behaviors ◽

The Individual

Individuals with Rett syndrome (RS) present with a complex profile. They benefit from a multidisciplinary approach for diagnosis, treatment, and follow-up. In our clinic, the Communication Matrix © (Rowland, 1990/1996/2004) is used to collect data about the communication skills and modalities used by those with RS across the lifespan. Preliminary analysis of this data supports the expected changes in communication behaviors as the individual with RS ages and motor deficits have a greater impact.

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Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽

10.1024/0301-1526/a000287 ◽

2013 ◽

Vol 42 (4) ◽

pp. 264-274

Author(s):

Dagmar Krajíčková ◽

Antonín Krajina ◽

Miroslav Lojík ◽

Martina Mulačová ◽

Martin Vališ

Keyword(s):

Death Rate ◽

Long Term Outcomes ◽

Single Centre ◽

Intracranial Atherosclerotic Stenosis ◽

Atherosclerotic Stenosis ◽

Angioplasty And Stenting ◽

Aggressive Medical Management ◽

Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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