Evaluation of Treatment Outcomes in Oromandibular Dystonia Using Surface Electromyography: A Case Series

Introduction Lesser tuberosity osteotomy (LTO) during anatomic total shoulder arthroplasty has a 13% nonunion rate. Treatment for LTO nonunion is controversial and poorly described in the literature. The purpose of this study was to compare the surgical and nonsurgical treatment outcomes of LTO nonunion. Methods A retrospective case series of 9 consecutive patients with LTO nonunion after primary anatomic shoulder arthroplasty at 1 institution from 2010 to 2016 were studied. Outcomes measured were radiographic evaluation of LTO on axillary X-ray, clinical range of motion (ROM), subscapularis strength, and pain at the time of LTO nonunion diagnosis and after either conservative care or surgical repair of the LTO nonunion. Results LTO nonunion was treated surgically in 4 and conservatively in 5 patients with average follow-up of 30 and 22 months, respectively. There were no significant differences in age, sex, or smoking status between groups. Treatment decision was a shared model of surgeon and patient. Displaced LTO nonunion was treated surgically in 2 and conservatively in 3 patients. There were no differences in LTO union rate of 50% in the surgical versus 60% in the conservative group. Abdominal compression test was abnormal in 50% of surgical versus 40% of conservative groups. At follow-up, ROM was lower in the surgical group with 128° forward elevation (FE) and 33° external rotation (ER) compared to 148° FE and 62° ER. Only 1 patient with LTO nonunion required conversion to reverse replacement. Conclusion LTO nonunion after shoulder arthroplasty is rare. Surgical repair of LTO nonunion does not significantly improve clinical or radiographic outcomes compared to conservative care.

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Playing With BEARS: Balancing Effort, Accuracy, and Response Speed in a Semantic Feature Verification Anomia Treatment Game

Journal of Speech Language and Hearing Research ◽

10.1044/2021_jslhr-20-00543 ◽

2021 ◽

pp. 1-27

Author(s):

William S. Evans ◽

Robert Cavanaugh ◽

Yina Quique ◽

Emily Boss ◽

Jeffrey J. Starns ◽

...

Keyword(s):

Treatment Outcomes ◽

Retrieval Practice ◽

Single Case ◽

Case Series ◽

Response Speed ◽

Semantic Feature ◽

System Calibration ◽

Trade Offs ◽

Practice Efficiency ◽

Speed Accuracy

Purpose The purpose of this study was to develop and pilot a novel treatment framework called BEARS (Balancing Effort, Accuracy, and Response Speed). People with aphasia (PWA) have been shown to maladaptively balance speed and accuracy during language tasks. BEARS is designed to train PWA to balance speed–accuracy trade-offs and improve system calibration (i.e., to adaptively match system use with its current capability), which was hypothesized to improve treatment outcomes by maximizing retrieval practice and minimizing error learning. In this study, BEARS was applied in the context of a semantically oriented anomia treatment based on semantic feature verification (SFV). Method Nine PWA received 25 hr of treatment in a multiple-baseline single-case series design. BEARS + SFV combined computer-based SFV with clinician-provided BEARS metacognitive training. Naming probe accuracy, efficiency, and proportion of “pass” responses on inaccurate trials were analyzed using Bayesian generalized linear mixed-effects models. Generalization to discourse and correlations between practice efficiency and treatment outcomes were also assessed. Results Participants improved on naming probe accuracy and efficiency of treated and untreated items, although untreated item gains could not be distinguished from the effects of repeated exposure. There were no improvements on discourse performance, but participants demonstrated improved system calibration based on their performance on inaccurate treatment trials, with an increasing proportion of “pass” responses compared to paraphasia or timeout nonresponses. In addition, levels of practice efficiency during treatment were positively correlated with treatment outcomes, suggesting that improved practice efficiency promoted greater treatment generalization and improved naming efficiency. Conclusions BEARS is a promising, theoretically motivated treatment framework for addressing the interplay between effort, accuracy, and processing speed in aphasia. This study establishes the feasibility of BEARS + SFV and provides preliminary evidence for its efficacy. This study highlights the importance of considering processing efficiency in anomia treatment, in addition to performance accuracy. Supplemental Material https://doi.org/10.23641/asha.14935812

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Pancreatic acinar cell carcinoma: A multi-center series on clinical characteristics and treatment outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16253 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16253-e16253

Author(s):

Vishwajith Sridharan ◽

Mari Mino-Kenudson ◽

James M. Cleary ◽

Osama E. Rahma ◽

Kimberly Perez ◽

...

Keyword(s):

Cell Carcinoma ◽

Treatment Outcomes ◽

Acinar Cell ◽

Metastatic Disease ◽

Demographic Data ◽

Case Series ◽

Acinar Cell Carcinoma ◽

Rank Test ◽

Survival Difference ◽

Localized Disease

e16253 Background: Acinar cell carcinoma (ACC) is a very rare tumor of the exocrine pancreas, representing less than 1% of all pancreatic malignancies. The majority of data regarding ACC are limited to small case series. Methods: This is a retrospective study conducted at a large healthcare system from 1996-2019. Patients with pathologically confirmed ACC were included, and demographic data, tumor characteristics, and treatment outcomes were abstracted by chart review. Survival curves were obtained by using the Kaplan-Meier method and compared using the log-rank test. Results: Sixty-six patients with ACC were identified. The median patient age at diagnosis was 64, and 42% presented with metastatic disease. The majority presented with abdominal pain or pancreatitis (69%), and laboratory parameters did not correlate with tumor size, metastatic disease, or survival. Several somatic abnormalities were noted in tumors (BRCA2, TP53, and mismatch-repair genes). In patients with localized disease that underwent resection, the median time to develop metastatic lesions was 13 months. The median overall survival (OS) was 24.7 months from diagnosis, with a survival difference based on metastatic disease at diagnosis (median 15 vs 38 mos). Surgery conferred OS benefit in non-metastatic cases (p = 0.006) but not metastatic cases (p = 0.22), and chemotherapy provided OS benefit in metastatic disease (p < 0.01). Patients with metastatic ACC treated after 2010 utilized more platinum-based agents, and there was a OS benefit to FOLFOX or FOLFIRINOX chemotherapy compared to gemcitabine or capecitabine-based regimens (p = 0.006). Conclusions: Pancreatic ACC patients often present with advanced disease. Surgery confers survival benefit among patients presenting with localized disease. The use of FOLFOX or FOLFIRINOX chemotherapy regimens was associated with improved OS in metastatic patients. These data add to our knowledge in this rare malignancy, and improves understanding about the genomic underpinnings, prognosis and treatment for acinar cancers.

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Treatment Outcomes and Prognostic Factors of Adult Sinonasal Sarcomas: A Single-Institution Case Series

Medical Science Monitor ◽

10.12659/msm.909116 ◽

2018 ◽

Vol 24 ◽

pp. 6113-6118

Author(s):

Jianming Ding ◽

Cuihong Wang ◽

Jun Xiang ◽

Chunying Shen ◽

Chaosu Hu ◽

...

Keyword(s):

Prognostic Factors ◽

Treatment Outcomes ◽

Case Series ◽

Single Institution

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Acute retinal necrosis: a case series with clinical features and treatment outcomes

Clinical and Experimental Ophthalmology ◽

10.1111/j.1442-9071.2009.02083.x ◽

2009 ◽

Vol 37 (5) ◽

pp. 473-477 ◽

Cited By ~ 28

Author(s):

Joanne L Sims ◽

Jonathan Yeoh ◽

Richard J Stawell

Keyword(s):

Treatment Outcomes ◽

Clinical Features ◽

Case Series ◽

Acute Retinal Necrosis

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Venovenous ECMO treatment, outcomes, and complications in adults according to large case series: A systematic review

The International Journal of Artificial Organs ◽

10.1177/0391398820975408 ◽

2020 ◽

pp. 039139882097540

Author(s):

Jun Hyun Kim ◽

Marina Pieri ◽

Giovanni Landoni ◽

Anna Mara Scandroglio ◽

Maria Grazia Calabrò ◽

...

Keyword(s):

Systematic Review ◽

Treatment Outcomes ◽

Influenza A ◽

Influenza Pandemic ◽

Case Series ◽

H1n1 Influenza ◽

Novel Coronavirus ◽

Ecmo Treatment ◽

Vv Ecmo ◽

Large Case

Background: Venovenous extracorporeal membrane oxygenation (VV ECMO) has gained popularity for the treatment of refractory respiratory failure during and after the 2009 influenza pandemic, and still represents a precious therapeutic resource for severe novel coronavirus 2019 infection. However, most of the published studies are small case series, and only two randomized trials exist in literature. Aim: Aim of this systematic review is to describe trends in VV ECMO treatment outcomes according to large studies only. Methods: We searched and included studies with more than 100 VV ECMO cases dated up to August 1st, 2019. Results: Thirty-three studies published in the period 2011–2019 met inclusion criteria, for a total of 12,860 patients (age 46.3 ± 17.4 years). ARDS was mainly by pneumonia, in 3126 (37%) cases; further 401(7%) patients had H1N1 Influenza A infection. Cannulation-related complications occurred in 502 (7%) cases. Weighted mean (95% confidence interval) of VV ECMO duration was 8.9 (8.7–9.1) days, and ICU stay was 23.6 (22.4–24.8) days. Mortality at the longest follow up available was 40%. Data collection in 70% of the studies had a duration of >5 years. Conclusion: This study reveals the characteristics of large case VV ECMO studies.

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Clinical Manifestations and Treatment Outcomes of Syphilitic Uveitis in a Chinese Population

Journal of Ophthalmology ◽

10.1155/2016/2797028 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Rui Zhang ◽

Jiang Qian ◽

Jie Guo ◽

Yifei Yuan ◽

Kang Xue ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Treatment Outcomes ◽

Chinese Population ◽

Retinal Vasculitis ◽

Clinical Manifestations ◽

Case Series ◽

Posterior Uveitis ◽

Retrospective Case ◽

Serological Tests ◽

Immunodeficiency Virus

Purpose. To describe the clinical manifestations and treatment outcomes of syphilitic uveitis in a Chinese population.Methods. This is a retrospective case series of 15 consecutive patients with syphilitic uveitis treated at a uveitis referral center between 2012 and 2015.Results. Fifteen patients were diagnosed with syphilitic uveitis based on positive serological tests. Nine patients were male. Coinfection with human immunodeficiency virus was detected in two patients. Twenty eyes presented with panuveitis and all patients had posterior involvement. The most frequent manifestations were retinal vasculitis and papillitis, while syphilitic posterior placoid chorioretinitis was only found in three eyes. All patients received systemic penicillin therapy according to CDC guidelines. Nine patients were misdiagnosed before presenting to our center and the delay in treatment with penicillin was associated with poor final visual outcomes (P<0.05).Conclusions. In our series, both male and female were almost equally affected and coinfection of syphilis with human immunodeficiency virus was uncommon. All patients in this study had posterior involvement and the most common manifestations were retinal vasculitis and papillitis. Syphilis should be considered as an important differential diagnosis especially for posterior uveitis and panuveitis. Early diagnosis and appropriate treatment are important for visual prognosis.

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Treatment outcomes and factors associated with “successful treatment” among tuberculosis patients at peripheral health settings of Northern Ethiopia: a registry-based retrospective case-series analysis.

10.21203/rs.2.11942/v2 ◽

2019 ◽

Author(s):

Mahmud Abdulkader ◽

Ischa van Aken ◽

Selam Sahle Niguse ◽

Haftamu Hailekiros ◽

Mark Spigt

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Successful Treatment ◽

Treatment Success ◽

Case Series ◽

Northern Ethiopia ◽

Multinomial Regression ◽

Retrospective Case ◽

Factors Associated ◽

Objective Evidence

Abstract Objective Evidence on treatment outcomes and identifying factors facilitating treatment success through a register based retrospective study have significant contribution in the improvement of a National Tuberculosis Program. However there is a scarcity of data from peripheral health settings in Ethiopia. Therefore this study was aimed at determining treatment outcomes and factors associated with “successful treatment” outcomes among tuberculosis patients.Results A total of 3445 patient records were included. More than half, (58%) were males and the mean age was 33.88 ± 16.91 (range: 0-90). Majority, 1471 (42.7%) had extra-pulmonary TB. From the total TB patients, 18.8% were HIV co infected. The overall treatment success rate was 89.5%. The treatment outcome of TB patients were 371 (10.8%) cured, 2234 (64.8) treatment completed, died 119 (3.5%) died, 9 (0.3%) failed, 178 (5.1%) defaulted and 534 (15.5%) were transferred out. A successful treatment outcome was achieved in 2605 (89.3%). Multinomial regression analysis revealed that being new treatment case (AOR 1.76; 95% CI: 1.19 to 2.60, p=0.005) and age less than 17 years old (AOR 1.65; 95% CI: 1.01 to 2.68, p=0.045) to be statistically associated with favorable treatment outcome.

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