scholarly journals Pituitary stalk thickening: the role of an innovative MRI imaging analysis which may assist in determining clinical management

2016 ◽  
Vol 175 (4) ◽  
pp. 255-263 ◽  
Author(s):  
Emilia Sbardella ◽  
Robin N Joseph ◽  
Bahram Jafar-Mohammadi ◽  
Andrea M Isidori ◽  
Simon Cudlip ◽  
...  
Keyword(s):  
University Hospital ◽  
Pituitary Stalk ◽  
Imaging Analysis ◽  
Mri Imaging ◽  
Mri Features ◽  
Neoplastic Lesions ◽  
Long Term Follow Up ◽  
Pituitary Stalk Thickening

Context Disease processes that affect the pituitary stalk are broad; the diagnosis and management of these lesions remains unclear. Objective The aim was to assess the clinical, biochemical and histopathological characteristics of pituitary stalk lesions and their association with specific MRI features in order to provide diagnostic and prognostic guidance. Design and methods Retrospective observational study of 36 patients (mean age 37years, range: 4–83) with pituitary stalk thickening evaluated at a university hospital in Oxford, UK, 2007–2015. We reviewed morphology, signal intensity, enhancement and texture appearance at MRI (evaluated with the ImageJ programme), along with clinical, biochemical, histopathological and long-term follow-up data. Results Diagnosis was considered certain for 22 patients: 46% neoplastic, 32% inflammatory and 22% congenital lesions. In the remaining 14 patients, a diagnosis of a non-neoplastic disorder was assumed on the basis of long-term follow-up (mean 41.3months, range: 12–84). Diabetes insipidus and headache were common features in 47 and 42% at presentation, with secondary hypogonadism the most frequent anterior pituitary defect. Neoplasia was suggested on size criteria or progression with 30% sensitivity. However, textural analysis of MRI scans revealed a significant correlation between the tumour pathology and pituitary stalk heterogeneity in pre- and post-gadolinium T1-weighted images (sensitivity: 88.9%, specificity: 91.7%). Conclusions New techniques of MRI imaging analysis may identify clinically significant neoplastic lesions, thus directing future therapy. We propose possible textural heterogeneity criteria of the pituitary stalk on pre- and post-gadolinium T1 images with the aim of differentiating between neoplastic and non-neoplastic lesions with a high degree of accuracy.

scholarly journals Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Revision Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Control Group ◽  
University Hospitals ◽  
Balloon Sinuplasty ◽  
Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

Oxford University Hospital Long Term Follow Up Data of Vaginal Vault Brachytherapy Following a Serious Radiation Incident

Brachytherapy ◽  
2019 ◽  
Vol 18 (3) ◽  
pp. S90
Author(s):  
Loryn Caulfield ◽  
Mary Costelloe ◽  
Sally Trent ◽  
Amanda Horne ◽  
Amanda Horne
Keyword(s):  
University Hospital ◽  
Vaginal Vault ◽  
Oxford University ◽  
Radiation Incident ◽  
Long Term Follow Up

Clinical Relevance of Neovascularisation on Duplex Ultrasound in the Long-Term Follow-up after Varicose Vein Operation

1999 ◽  
Vol 14 (3) ◽  
pp. 118-122 ◽  
Author(s):  
M. G. De Maeseneer ◽  
I. F. Tielliu ◽  
P. E. Van Schil ◽  
S. G. De Hert ◽  
E. J. Eyskens
Keyword(s):  
Varicose Vein ◽  
Clinical Relevance ◽  
Varicose Veins ◽  
University Hospital ◽  
Duplex Scanning ◽  
Recurrent Varicose Veins ◽  
Varicose Vein Operation ◽  
Long Term Follow Up

Objective: To evaluate the clinical relevance of neovascularisation at the saphenous ligation site. Design: Long-term follow-up after previous varicose vein surgery in a single patient group. Setting: Vascular clinic of a university hospital. Patients: Eighty-two patients (106 limbs) with a mean follow-up period of 56 months after correct saphenous ligation were submitted to duplex scanning. Intervention: Clinical assessment and colour duplex scanning of all the operated limbs. Reintervention in 15 limbs with perioperative evaluation of recurrent veins. Main outcome measures: Limbs with and without recurrent varicose veins were classified according to the degree of neovascularisation: grade 0 = no new communicating veins, grade 1 = tiny new vein with diameter <4 mm, grade 2 = new communicating vein with diameter >4 mm and pathological reflux. On reintervention the presence of neovascular veins at the site of the previous ligation was checked. Results: In 68 limbs without recurrent varicose veins, grade 0 was observed in 50 limbs (74%), grade 1 in 12 limbs (18%) and grade 2 in six limbs (9%). In 38 limbs with recurrent varicose veins, grade 0 was diagnosed in eight limbs (21%), grade 1 in four limbs (11%) and grade 2 in 26 limbs (68%). In 15 limbs with recurrent varicose veins and grade 2 neovascularisation, reintervention confirmed the duplex findings. Conclusions: The presence of grade 2 neovascularisation was associated with the recurrence of varicose veins, suggesting a causal relationship.

Long-term Outcome Analysis of the Supraclavicular Surgical Release for the Treatment of Thoracic Outlet Syndrome

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. 1085-1092 ◽  
Author(s):  
Esther Vögelin ◽  
Lorenz Haldemann ◽  
Mihai A. Constantinescu ◽  
Ariane Gerber ◽  
Ulrich Büchler
Keyword(s):  
Standard Deviation ◽  
Thoracic Outlet Syndrome ◽  
University Hospital ◽  
Outcome Analysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up ◽  
Surgical Release

Abstract OBJECTIVE This is a long-term outcome analysis of patients who underwent surgical treatment with a supraclavicular release for thoracic outlet syndrome (TOS). METHODS All patients undergoing supraclavicular release between January 1, 1987, and December 31, 2000, at University Hospital, Inselspital, Bern, Switzerland, were included in this study. Of 29 treated patients, 22 patients (24 TOS) underwent both long-term clinical follow-up (median 12.5 years, standard deviation 3.5 years, range 5–18 years) and short-term clinical follow-up (median 6.6 months, standard deviation 4.5 years, range 3–12 months). RESULTS Eleven patients (12 TOS operations) were classified as having a neurogenic cause of TOS, whereas the other 11 (12 TOS operations) were classified as having disputed TOS. Patient data, including various outcome parameters, such as pain and disabilities of arm, shoulder, and hand scores, were evaluated pre- and postoperatively and at long-term follow-up by an independent examiner. The surgical supraclavicular technique is described in detail. In 21 of 24 surgical release procedures, the first rib was resected. There was a marked permanent long-term postoperative reduction of symptoms in both neurogenic and disputed TOS groups. The pain and disabilities of arm, shoulder, and hand scores improved significantly after surgery, regardless of the etiology, in the short- and long-term postoperative observation periods. There were no patients with workers' compensation or litigation issues. CONCLUSION This study demonstrates the successful, constant long-term relief of symptoms in carefully selected patients with neurogenic and disputed TOS using the described surgical supraclavicular release technique.

scholarly journals Central Diabetes Insipidus as the Inaugural Manifestation of Langerhans Cell Histiocytosis: Natural History and Medical Evaluation of 26 Children and Adolescents

2011 ◽  
Vol 96 (9) ◽  
pp. E1352-E1360 ◽  
Author(s):  
Isis Marchand ◽  
Mohamed Aziz Barkaoui ◽  
Catherine Garel ◽  
Michel Polak ◽  
Jean Donadieu ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Langerhans Cell Histiocytosis ◽  
Third Ventricle ◽  
Langerhans Cell ◽  
Central Diabetes Insipidus ◽  
Pituitary Stalk ◽  
The Third ◽  
Mri Features ◽  
Pituitary Stalk Thickening

Abstract Context: Isolated central diabetes insipidus (CDI) can be the first manifestation of Langerhans cell histiocytosis (LCH), creating diagnostic dilemmas such as dysgerminoma and other inflammatory lesions. Method: In 2010, the French national LCH registry had enrolled 1236 LCH patients under 18 yr of age. Isolated CDI was the initial presentation of LCH in 26 patients. We reviewed their clinical and magnetic resonance imaging (MRI) features. Results: Median age at the diagnosis of CDI was 9.6 yr (1.8–16.3), and median follow-up after CDI diagnosis was 9.9 yr (3.5–26.6). In addition to CDI, two patients had visual field defects, four had secondary amenorrhea, and 11 had anterior pituitary deficiency. Cerebral imaging (including computed tomography in two cases), performed in 22 patients within 3 months of CDI diagnosis, showed pituitary stalk thickening in 14 patients, which was moderate (3.0–7 mm) in nine cases and marked (&gt;7 mm) in five cases. In eight cases, the lesion extended to the floor of the third ventricle. One child with LCH presented with a mild enlarged sellar content. During follow-up, 22 patients developed extrapituitary involvement, mainly of bone (n = 15), lung (n = 9), and skin (n = 9). Pituitary biopsy was performed in eight cases and was conclusive in six cases. Conclusions: Pituitary stalk thickening can be observed in LCH as well as lesions extending to the floor of the third ventricle. In all cases but one, the intrasellar content was not enlarged. Long-term follow-up with close attention to bone, skin, and lung disorders may lead to the diagnosis of LCH.

scholarly journals Controlled Cyclophotocoagulation with diode laser in refractory glaucoma and long term follow up at King Abdulaziz University Hospital, Riyadh

2010 ◽  
Vol 24 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Essam A. Osman ◽  
Abdulrahman Al-Muammar ◽  
Ahmed Mousa ◽  
Hani Al-Mezaine ◽  
Saleh A. Al-Obeidan
Keyword(s):  
Diode Laser ◽  
University Hospital ◽  
Refractory Glaucoma ◽  
Long Term Follow Up ◽  
King Abdulaziz University

scholarly journals Gastric epithelial dysplasia: Characteristics and long-term follow-up results after endoscopic resection according to morphological categorization.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 190-190
Author(s):  
Bong Eun Lee ◽  
Gwang Ha Kim ◽  
Dong Hoon Baek
Keyword(s):  
Endoscopic Resection ◽  
Epithelial Dysplasia ◽  
University Hospital ◽  
Clinicopathologic Characteristics ◽  
Morphologic Characteristics ◽  
Study Results ◽  
National University ◽  
Long Term Follow Up

190 Background: Gastric epithelial dysplasia (GED) can be morphologically categorized into adenomatous and foveolar types. To date, there have been few studies on the clinical characteristics of GEDs according to the morphologic types. Therefore, we here aimed to elucidate the clinicopathologic characteristics of patients with GED and the long-term follow-up results after endoscopic resection according to the morphologic characteristics of GEDs. Methods: A total of 357 patients who underwent endoscopic resection for GEDs at Pusan National University Hospital between January 2008 and December 2009 were included in the study. Results: Patients with GED were divided into 3 groups: adenomatous (n = 167, 46.8%), foveolar (n = 103, 28.9%), and hybrid (n = 87, 24.3%) types. Compared to the adenomatous type, foveolar type lesions were more frequently located in the antrum/pylorus, flat/depressed lesions, and normal/reddish in color; and showed more frequent high-grade dysplasia. During the follow–up period (median, 37.3 months), the overall incidence of synchronous and metachronous lesions was 20.8% and 20.1%, respectively; of these, the incidence of synchronous and metachronous gastric cancer was 8.7% and 5.4%, respectively. There were no significant differences in the incidence of synchronous and metachronous lesions according to morphologic types. Conclusions: GEDs appear to have different clinicopathologic characteristics according to morphologic types. Irrespective of the morphology, synchronous and metachronous gastric cancers are commonly found after endoscopic resection of GEDs. Therefore, close follow-up surveillance after endoscopic resection of GEDs should be performed for all patients.

scholarly journals POST-HERETIC NEURALGIA

2016 ◽  
Vol 23 (01) ◽  
pp. 056-059
Author(s):  
Sadaf Ahmed Asim ◽  
Humaira Maryum Agha ◽  
Qamar-un -Nisa ◽  
Muhammad Masroor
Keyword(s):  
Pain Score ◽  
University Hospital ◽  
Test Results ◽  
Post Herpetic Neuralgia ◽  
Duration Of Symptoms ◽  
Local Infiltration ◽  
Long Term Follow Up ◽  
The Mean

Objectives: To assess the efficacy of intra-lesional triamcinolone in for thetreatment of Post Herpetic Neuralgia. Study Design: Prospective interventional study. Setting:Dermatology Department of Dow University Hospital. Period: July 2014 to June 2015. Patientsand Methods: Twenty nine patients with diagnosis of Post Herpetic Neuralgia were includedafter taking written and informed consent. An insulin syringe was used for the injections andthe medicines were injected intralesionally. The mixture contained 30/70% of triamcinolone toxylocaine ratio for local infiltration in post herpetic scars. Pain relief assessment was done withthe help of visual analogue scale (VAS) after two months. Mean pain score before therapy andafter therapy was compared with one sample student t test. Results: Out of total 29 patients 14were male and 15 were females. The mean age ±SD was found to be 45.9± 15.4 years. Themost common region involved was Chest. The mean ±SD duration of Symptoms was 5.58 ±1.80 weeks. The mean pain score before therapy was 6.86 ± 1.66 which after one month oftherapy reduced to 3.72 ± 1.86. The reduction in pain was statistically significant (p<0.001).Conclusion: Post Herpetic Neuralgia can be effectively treated by the local infiltration of amixture of triamcinolone and lignocaine. It is recommended that long-term follow-up studiesshould be done with corticosteroids only or in combination with local anesthetics to additionallyevaluate the effectiveness of such treatment in postherpetic neuralgia.

Abstract #498 Long-Term Follow-Up in a Series of Pituitary Stalk Lesions

2019 ◽  
Vol 25 ◽  
pp. 246
Author(s):  
Monica Livia Gheorghiu ◽  
Sofia Maria Lider Burciulescu ◽  
Anda Dumitrascu ◽  
Dan Hortopan ◽  
Virgil Ionescu ◽  
...  
Keyword(s):  
Pituitary Stalk ◽  
Long Term Follow Up

scholarly journals Experiences using the poststroke checklist in Sweden with a focus on feasibility and relevance: a mixed-method design

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028218 ◽  
Author(s):  
Emma K Kjörk ◽  
Gunnel Carlsson ◽  
Katharina S Sunnerhagen ◽  
Åsa Lundgren-Nilsson
Keyword(s):  
Health Professionals ◽  
Quantitative Methods ◽  
Healthcare Services ◽  
University Hospital ◽  
Group Discussions ◽  
Qualitative And Quantitative Methods ◽  
Wide Range ◽  
Long Term Follow Up

ObjectiveThe wide range of outcomes after stroke emphasises the need for comprehensive long-term follow-up. The aim was to evaluate how people with stroke and health professionals (HPs) perceive the use of the poststroke checklist (PSC), with a focus on feasibility and relevance.DesignAn exploratory design with a mix of qualitative and quantitative methods.SettingOutpatient care at a university hospital and primary care centres in western Sweden.ParticipantsForty-six consecutive patients (median age, 70; range, 41–85; 13 women) and 10 health professionals (median age 46; range, 35–63; 7 women).ResultsMost patients (87%) had one or more problems identified by the PSC. The most common problem areas were life after stroke (61%), cognition (56%), mood (41%) and activities of daily living (39%). Three organisational themes emerged from the focus group discussions. The perception ofthe content and relevance ofthe PSC was that common poststroke problems were covered but that unmet needs still could be missed. Identifying needs was facilitated when using thePSC as a tool for dialogue.The dialogue between the patient and HP as well as HPs stroke expertise was perceived as important. The PSC was seen asa systematic routine and a base for egalitarian follow-up, but participants stressed consideration given to each individual. Addressing identified needs and meeting patient expectations were described as challenging given available healthcare services.ConclusionsThe PSC is a feasible and relevant tool to support egalitarian follow-up and identify patients who could benefit from targeted poststroke interventions. Stroke expertise, room for dialogue and caring for identified needs emerged as important issues to consider when using the PSC. Nutrition, sexuality and fatigue were areas mentioned that might need to be addressed within the discussions. The PSC can facilitate patients in expressing their needs, enhancing their ability to participate in decision-making.

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