scholarly journals Rate of Incidental Parathyroidectomy in a Pediatric Population

OTO Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 2473974X2110590
Author(s):  
Grace Sahyouni ◽  
Beth Osterbauer ◽  
Soyun Park ◽  
Connie Paik ◽  
Juliana Austin ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Practical Method ◽  
Related Factors ◽  
Patient Demographics ◽  
Final Multivariable Model ◽  
Included Patient ◽  
Potential Risk Factors ◽  
Pathology Reports

Objective Incidental parathyroidectomy is a relatively common occurrence in thyroid surgery, which may lead to hypoparathyroidism and postoperative hypocalcemia, but it is not well studied in children. The objectives of this study were to determine the rate of incidental parathyroidectomy, identify potential risk factors, and investigate postoperative complications in children undergoing thyroidectomy. Study Design Retrospective cohort study. Setting Patients who underwent thyroidectomy over a 10-year period at a tertiary children’s hospital. Methods Pathology reports were reviewed to determine incidental parathyroid gland tissue. Additional data collected included patient demographics, type of procedure, underlying thyroid pathology, as well as immediate and long-term postoperative clinical outcomes. Results Of 209 patients, 65 (31%) had incidental parathyroidectomy. Several variables were associated with incidental parathyroidectomy on univariable analysis. However, in the final multivariable model, only thyroidectomy with lymph node dissection was associated with increased odds of having incidental parathyroidectomy (odds ratio, 3.3; P = .04; 95% CI, 1.1-9.8). After a median follow up of 1 year, a significantly higher percentage of patients with incidental parathyroidectomy had evidence of long-term hypoparathyroidism (9/62 [15%] vs 3/144 [2%], P = .001). Conclusion Incidental parathyroidectomy was relatively common in our pediatric thyroidectomy population, which may be a result of several anatomic, clinical, and surgeon-related factors. Close attention to parathyroid preservation with meticulous surgical technique is the most practical method of preventing long-term hypoparathyroidism and hypocalcemia.

scholarly journals Value of Three-Dimensional Digital Subtraction Angiography for Detection and Classification of Intracranial Aneurysm Remnants After Clipping

2021 ◽  
Author(s):  
Serge Marbacher ◽  
Matthias Halter ◽  
Deborah R Vogt ◽  
Jenny C Kienzler ◽  
Christian T J Magyar ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Digital Subtraction Angiography ◽  
Diagnostic Yield ◽  
Three Dimensional ◽  
P Value ◽  
Digital Subtraction ◽  
Patient Demographics ◽  
Included Patient ◽  
2D And 3D

Abstract BACKGROUND The current gold standard for evaluation of the surgical result after intracranial aneurysm (IA) clipping is two-dimensional (2D) digital subtraction angiography (DSA). While there is growing evidence that postoperative 3D-DSA is superior to 2D-DSA, there is a lack of data on intraoperative comparison. OBJECTIVE To compare the diagnostic yield of detection of IA remnants in intra- and postoperative 3D-DSA, categorize the remnants based on 3D-DSA findings, and examine associations between missed 2D-DSA remnants and IA characteristics. METHODS We evaluated 232 clipped IAs that were examined with intraoperative or postoperative 3D-DSA. Variables analyzed included patient demographics, IA and remnant distinguishing characteristics, and 2D- and 3D-DSA findings. Maximal IA remnant size detected by 3D-DSA was measured using a 3-point scale of 2-mm increments. RESULTS Although 3D-DSA detected all clipped IA remnants, 2D-DSA missed 30.4% (7 of 23) and 38.9% (14 of 36) clipped IA remnants in intraoperative and postoperative imaging, respectively (95% CI: 30 [ 12, 49] %; P-value .023 and 39 [23, 55] %; P-value = <.001), and more often missed grade 1 (< 2 mm) clipped remnants (odds ratio [95% CI]: 4.3 [1.6, 12.7], P-value .005). CONCLUSION Compared with 2D-DSA, 3D-DSA achieves a better diagnostic yield in the evaluation of clipped IA. Our proposed method to grade 3D-DSA remnants proved to be simple and practical. Especially small IA remnants have a high risk to be missed in 2D-DSA. We advocate routine use of either intraoperative or postoperative 3D-DSA as a baseline for lifelong follow-up of clipped IA.

scholarly journals Factors affecting the course of body and kidney growth in infants with urolithiasis: A critical long-term evaluation

2016 ◽  
Vol 88 (4) ◽  
pp. 249 ◽  
Author(s):  
Kemal Sarica ◽  
Fatma Narter ◽  
Kubilay Sabuncu ◽  
Ahmet Akca ◽  
Utku Can ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Clinical Course ◽  
Stone Disease ◽  
The Body ◽  
Renal Growth ◽  
Related Factors ◽  
Growth Status ◽  
Long Term Follow Up

Objective: To investigate the possible effects of dietary, patient and stone related factors on the clinical course of the stone disease as well as the body and renal growth status of the infants. Patients and Methods: A total of 50 children with an history of stone disease during infancy period were studied. Patient (anatomical abnormalities, urinary tract infection - UTI, associated morbidities), stone (obstruction, UTI and required interventions) and lastly dietary (duration of sole breast feeding, formula feeding) related factors which may affect the clinical course of the disease were all evaluated for their effects on the body and renal growth during long-term follow-up. Results: Mean age of the children was 2.40 ± 2.65 years. Our findings demonstrated that infants receiving longer period of breast feeding without formula addition seemed to have a higher rate of normal growth percentile values when compared with the other children. Again, higher frequency of UTI and stone attacks affected the growth status of the infants in a remarkable manner than the other cases. Our findings also demonstrated that thorough a close follow-up and appropriately taken measures; the possible growth retardation as well as renal growth problems could be avoided in children beginning to suffer from stone disease during infancy period. Conclusions: Duration of breast feeding, frequency of UTI, number of stone attacks and stone removal procedures are crucial factors for the clinical course of stone disease in infants that may affect the body as well as kidney growth during long-term follow-up.

scholarly journals 763. 30 Day Readmission Outcomes in Patients Over 80 Years of Age Enrolled in an Outpatient Parenteral Antibiotic Therapy (OPAT) Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S339-S340
Author(s):  
Kathleen R Sheridan ◽  
Joshua Wingfield ◽  
Lauren McKibben ◽  
Natalie Clouse
Keyword(s):  
Readmission Rate ◽  
Chart Review ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Model Of Care ◽  
Readmission Rates ◽  
Parenteral Antibiotic ◽  
Patient Demographics

Abstract Background OPAT is a well-established model of care for the monitoring of patients requiring long-term IV antibiotics1. We have previously reported a reduction in the 30-day readmission rate to our facility for patients managed in our OPAT program. However, little has been published to date regarding outcomes in OPAT patients over 80 years of age 2–3. Our OPAT program was established in 2013. Patients can be discharged to a facility or home to complete their course of antibiotics. Methods We conducted a retrospective chart review of all OPAT patients discharged from our facility from 2015 to 2018. Patients were divided into two groups based on age, <80 (n = 4618) and >80 (n = 562). Results Patient demographics are listed in Table 1. The overall 30-day readmission rate for patients older than 80 was 27.8%. For patients over 80 that had a follow-up ID clinic appointment, the 30-day readmission rate decreased to 15.7%. For patients younger than 80, the 30-day readmission rate was 36.0% with a decrease to 16.2% if patients were evaluated in the outpatient clinic. Figure 1. Staphylococcus Aureus was the predominant organism in both age categories. Vancomycin was the most common antibiotic used in both age groups followed by β lactams. Conclusion In general, patients aged over 80 years were more likely to be discharged to a facility to complete their antibiotic course than younger patients. These patients also were more likely to have other comorbidities. The 30-day readmission rate in each age group was relatively similar. OPAT in patients over age 80 can have similar 30-day readmission rates as for patients less than 80 years of age Disclosures All authors: No reported disclosures.

scholarly journals Corneal Cross-linking in Patients Younger than 18 Years: Long-term Follow-up in Three Israeli Medical Centers

2014 ◽  
Vol 3 (2) ◽  
pp. 84-87
Author(s):  
David Zadok ◽  
Isaac Avni ◽  
Erez Bakshi ◽  
Irina S Barequet ◽  
Isaac Aizenman ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Population ◽  
Cross Linking ◽  
Safe Procedure ◽  
Medical Centers ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
Long Term Follow Up

ABSTRACT Purpose To report refractive, topographic and safety outcomes of corneal cross-linking (CXL) in patients younger than 18 years of age with progressive keratoconus. Materials and methods In this retrospective study, we enrolled 31 eyes of 21 children aged 11 to 17 years that underwent corneal riboflavin-ultraviolet A induced CXL due to progressive keratoconus at three different ophthalmology departments in Israel. They were followed for 3 to 48 months (average 23 ± 13.6 months). Evaluated parameters were uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction, pachymetry, slit- lamp examination and corneal topography at baseline and at 1,3,6,12,24 and 48 months. Results We found a nonsignificant improvement in UCVA and BSCVA with a small reduction of manifest cylinder and no significant change in spherical equivalent or K-values. Following CXL, stability of UCVA and BSCVA at the last follow-up examination was found in 71 and 77% of treated eyes, respectively. No permanent adverse events have been recorded throughout the study period. Conclusion In our series, CXL was a safe procedure in the pediatric population. Stabilization of progressive keratoconus was achieved in visual acuity, refractive and topography parameters with no improvement in corneal indices in contrary to adult CXL treatment. How to cite this article Bakshi E, Barequet IS, Aizenman I, Levinger S, Avni I, Zadok D. Corneal Corss-linking in Patients Younger than 18 Years: Long-term Follow-up in Three Israeli Medical Centers. Int J Kerat Ect Cor Dis 2014;3(2):84-87.

scholarly journals Familial oral lichen planus in a 3-year-old boy: a case report with eight years of follow-up

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang Wang ◽  
Ya-Qin Tan ◽  
Jing Zhang ◽  
Gang Zhou
Keyword(s):  
Lichen Planus ◽  
Oral Mucosa ◽  
Buccal Mucosa ◽  
Oral Lichen Planus ◽  
Familial Aggregation ◽  
Pediatric Population ◽  
Case Presentation ◽  
Oral Lichen

Abstract Background Oral lichen planus (OLP) is a chronic mucocutaneous disease characterized by adult predominance and a prolonged course. However, it is rare in the pediatric population with familial aggregation. Case presentation A 3-year-old boy presented with pain and irritation on the oral mucosa while contacting spicy food for 2 months. Oral examination showed widespread whitish reticular and papular lesions on the lips, the dorsum of the tongue, and bilateral buccal mucosa, with diffuse erosions covered with pseudomembrane on the buccal mucosa. The boy’s parents were examined to exhibit white reticular and plaque-like lesions on their oral mucosa. The three patients were clinically diagnosed as affected by OLP and histopathologically confirmed. The boy underwent topical treatment with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel, and oral lesions gradually resolved and healed. Neither of his parents received treatment. During the subsequent follow-ups, none of three patients underwent any medical treatment. Fortunately, their lesions had almost faded over 8 years. Conclusions Our case emphasizes that pediatric OLP should be recorded with family history. Besides, long-term periodic follow-up is recommended in pediatric patients with OLP for monitoring any changes in lesions.

Surgical treatment for intramedullary spinal cord melanocytomas

2008 ◽  
Vol 9 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Eric M. Horn ◽  
Peter Nakaji ◽  
Stephen W. Coons ◽  
Curtis A. Dickman
Keyword(s):  
Spinal Cord ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Complete Resection ◽  
Intramedullary Spinal Cord ◽  
Local Infiltration ◽  
Patients Âgés ◽  
Patient Demographics

Spinal meningeal melanocytomas are rare lesions that are histologically benign and can behave aggressively, with local infiltration. The authors present their experience with intramedullary spinal cord melanocytomas consisting of 3 cases, which represents the second largest series in the literature. A retrospective chart review was performed following identification of all spinal melanocytomas treated at the author's institution, based on information obtained from a neuropathology database. The charts were reviewed for patient demographics, surgical procedure, clinical outcome, and long-term tumor progression. Three patients were identified in whom spinal melanocytoma had been diagnosed between 1989 and 2006. The patients' ages were 37, 37, and 48 years, and the location of their tumor was C1–3, T9–10, and T-12, respectively. All 3 had complete resection with no adjuvant radiotherapy during follow-up periods of 16, 38, and 185 months, respectively. One patient demonstrated a recurrence 29 months after resection and the other 2 patients have demonstrated asymptomatic recurrences on imaging studies obtained at 16 and 38 months following resection. With these cases added to the available literature, the evidence strongly suggests that complete resection is the treatment of choice for spinal melanocytomas. Even with complete resection, recurrences are common and close follow-up is needed for the long term in these patients. Radiation therapy should be reserved for those cases in which complete resection is not possible or in which there is recurrence.

scholarly journals Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0017
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph T. O’Neil ◽  
Steven M. Raikin
Keyword(s):  
Bone Marrow ◽  
Osteochondral Lesions ◽  
Treatment Technique ◽  
Foot And Ankle ◽  
Bone Marrow Stimulation ◽  
Time Of Surgery ◽  
Patient Demographics ◽  
Marrow Stimulation

Category: Ankle; Arthroscopy Introduction/Purpose: Bone marrow stimulation procedures, specifically microfracture, have become a common treatment technique for osteochondral lesions of the talus (OLT). Such procedures have been shown to be effective among a variety of patient populations at postoperative time points up to about 5 years (references?). While microfracture has been shown to be effective in short- to medium-term follow-up, there is a paucity of literature demonstrating the long-term efficacy of this procedure. Recently, the development of additional treatment techniques has been explored, with deterioration of the resultant fibrocartilage being a particular concern with microfracture. The purpose of this study is to determine the long-term effectiveness of microfracture bone marrow stimulation for treatment of OLTs in patients at least 10 years removed from surgery. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopaedic foot and ankle surgeon at least 10 years prior was performed. Patients meeting the inclusion criteria were contacted to complete the Foot & Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales, visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure using a 5-point Likert scale. In addition to medical chart review, patients were asked directly over the phone about any subsequent foot and ankle procedures needed, any injections necessary, and whether they wore an ankle brace/orthotic in the time following the procedure. Patient demographics including sex, age at time of surgery, laterality of surgery, and surgical history following their index procedure were reviewed. Descriptive statistics were calculated for patient demographics and survey responses to assess functional outcomes. Results: Forty-two patients were contacted and completed postoperative surveys. Average patient age at the time of the procedure was 38.6 years, and 24 patients (57%) were male. On average, FAAM-ADL score was 86.57 (+-20.85), Sports score was 72.31 (+-30.48), and VAS pain score was 19.52 (scale of 0-100). Patients reported being satisfied with the outcome of the procedure in 35 of 42 cases (83.3%). Five patients (11.9%) had other foot/ankle procedures since their microfracture, with 3 directly addressing the talus in some fashion. Three patients (7.1%) received injection(s) in their ankle in the follow-up period, and 9 patients (21.4%) reported wearing a brace since the time of surgery with 6 patients (14.3%) reporting it as a direct relation to their OLT and surgery. Conclusion: This study demonstrates that microfracture is an effective functional treatment for OLT in the long term, and addresses the valid questions posed about the ability for the procedure to produce durable fibrocartilage. Patients report average functional and pain assessment scores at the 10-year postoperative mark consistent with a generally successful and effective treatment.

Disability pensions in severely disturbed in-patient adolescents

1998 ◽  
Vol 172 (2) ◽  
pp. 159-163 ◽  
Author(s):  
M. Pelkonen ◽  
M. Marttunen ◽  
E. Pulkkinen ◽  
P. Laippala ◽  
J. Lönnqvist ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Disability Pension ◽  
Psychiatric Care ◽  
Critical Time ◽  
Working Capacity ◽  
Short Term ◽  
Related Factors ◽  
Long Term Prognosis

BackgroundKnowledge of working capacity from adolescence until adulthood among severely disturbed in-patients is scarce.MethodIn a follow-up study of 61 adolescent in-patients, we studied associations between being on a disability pension 20 years after hospitalisation, and the patients' psychopathology and treatment-related factors during the hospitalisation and seven-year follow-up.ResultsOf the former in-patients. 27% had not been on a disability pension, 20% had short-term pension periods, and 53% were pensioned. Subjects whose overall psychosocial functioning had improved and who had not utilised in-patient services until the seven-year follow-up, had a better prognosis in terms of working capacity Half of the subjects who had not been on pension during the follow-up had received a diagnosis of conduct disorder at discharge, and half of those pensioned had a psychotic disorder.ConclusionsThe patients' level of psychosocial functioning and capability to work in young adulthood were associated with long-term prognosis in terms of working capacity Adolescence seems to be the critical time for intensive psychiatric care combined with vocational rehabilitation programmes.

Long-Term Follow-Up of Submandibular Duct Rerouting for the Treatment of Sialorrhea in the Pediatric Population

1999 ◽  
Vol 120 (3) ◽  
pp. 303-307 ◽  
Author(s):  
L A. Mankarious ◽  
Ian D. Bottrill ◽  
Phillipa M. Huchzermeyer ◽  
C. Martin Bailey
Keyword(s):  
Pediatric Population ◽  
Submandibular Duct ◽  
Long Term Follow Up
Sign in / Sign up

Export Citation Format

Share Document