scholarly journals Reconstructive surgery in recurrent deformity (clubfoot relapse)

2021 ◽  
Vol 27 (4) ◽  
pp. 435-440
Author(s):  
P. Lascombes ◽  
◽  
D.A. Popkov ◽  
S.S. Leonchuk ◽  
◽  
...  
Keyword(s):  
Reconstructive Surgery ◽  
Severe Disease ◽  
Functional Results ◽  
Surgical Approaches ◽  
Idiopathic Clubfoot ◽  
Achilles Tenotomy ◽  
Anterior Tibial ◽  
History Of ◽  
Initial Correction ◽  
Recurrent Deformity

Introduction Recurrent clubfoot deformity may be due to either an imperfect initial correction, or a natural history of a severe disease. In the later, idiopathic clubfoot is uncommon. In the review we describe reconstructive surgery in recurrent deformity of idiopathic clubfoot. Material and methods Surgery may be justified at different age and according to the type of deformity. Different surgical approaches and their indications are exposed in the article. Results After Ponseti’s method application additional surgeries may be considered in recurrent clubfoot deformity which may represent 10 to 20 % of cases: second Achilles tenotomy, postero-lateral relapse, complete antero-medial and postero-lateral relapse, transfer of the anterior tibial tendon, correction of sequelae: metatarsus varus, residual equinus, residual rotation of the calcaneopedal unit. Conclusion Idiopathic equine varus clubfoot is a frequent condition. Well-codified management should lead to extremely favorable functional results. Unfortunately, some cases lead to a recurrence of the deformity. Surgical procedures are sometimes required. The goal is to avoid as much as possible arthrodesis and secondary degenerative arthritis.

scholarly journals Ponseti treated idiopathic clubfoot - outcome predictive factors in the test of time: analysis of 500 feet followed for five to 20 years

2021 ◽  
pp. 1-7
Author(s):  
Yoram Hemo ◽  
Ariella Yavor ◽  
Meirav Kalish ◽  
Eitan Segev ◽  
Shlomo Wientroub
Keyword(s):  
Cost Effective ◽  
Functional Score ◽  
Idiopathic Clubfoot ◽  
Level Of Evidence ◽  
Achilles Tenotomy ◽  
Pirani Score ◽  
Institutional Review ◽  
Level Ii ◽  
Chi Squared ◽  
Initial Correction

Purpose To investigate a set of risk factors on the outcome of Ponseti treated idiopathic clubfeet (ICF). Methods This study was approved by the institutional review board. A retrospective analysis of prospectively gathered data over a 20-year period, at a single dedicated clubfoot clinic. Records of 333 consecutive infants with 500 ICF were analyzed. Initial Pirani score, number of casts, need for tenotomy, foot abduction brace compliance and functional score had been documented. The need for surgery after initial correction was the outcome measure. All children were followed by the same team throughout the study period. Descriptive statistics, chi-squared and multivariate analysis were performed. Results In total, 82 children (24%) with 119 feet (23.8%) were operated on, with 95.1% of feet being operated up to the age of nine years. There was a significant correlation between the Pirani score at presentation and the number of surgical procedures (chi-squared = 79.32; p < 0.001). Achilles tenotomy was done in 94.8% of patients. Pirani score of > 4.5 before casting was strongly associated with increased surgical risk (odds ratio = 1.95). When six to eight cast changes were needed, surgical prospect was 2.9 more, increasing to 11.9 when nine or more casts were needed. Conclusion Foot severity and number of cast changes were the strongest predictors for future surgery. Estimation of the risk of deformity recurrence after initial correction may help in tailoring a cost-effective personal treatment and follow-up protocol. Personalized focused protocol will help patients and caregivers and will reduce expenses. Level of Evidence Level II - prognostic study.

Corticosteroids in Inflammatory Bowel Disease patients: a practical guide for physicians.

2020 ◽  
Vol 15 ◽  
Author(s):  
Maria Carla Di Paolo ◽  
Cristiano Pagnini ◽  
Maria Giovanna Graziani
Keyword(s):  
Severe Disease ◽  
Unknown Etiology ◽  
History Of Disease ◽  
Bowel Diseases ◽  
Literature Evidence ◽  
History Of ◽  
Inflammatory Bowel ◽  
Favorable Safety ◽  
Pass Metabolism

: Inflammatory bowel diseases (IBDs) are chronic conditions characterized by unknown etiology and pathogenesis with deregulation of mucosal immunity. Among possible treatments, corticosteroids, already available from the 50’, are still the mainstay of treatment for moderate-severe disease. Nonetheless, the use of steroids is still largely empirical and solid evidence about therapeutic schemes are lacking. Moreover, due to the important side-effects and for the unsatisfactory impact on long-term natural history of disease, the steroid sparing has become an important therapeutic goal in IBD management. Besides conventional steroids, the so called “low bioavailability” steroids, which are steroids with high affinity for peripheral receptors and elevated hepatic first-pass metabolism, have demonstrated efficacy and more favorable safety profile. In the present review of the literature evidence of efficacy and safety of conventional and low bioavailability steroids in IBD patients are evaluated, and practical suggestions for a correct use in clinical practice are presented according to the current clinical guidelines.

scholarly journals COVID-19 in a Cohort of Patients with Congenital Myasthenic Syndrome

2021 ◽  
pp. 1-3
Author(s):  
Setareh Alabaf ◽  
Karen O'Connell ◽  
Sithara Ramdas ◽  
David Beeson ◽  
Jacqueline Palace
Keyword(s):  
High Risk ◽  
Neuromuscular Transmission ◽  
Genetic Disorders ◽  
Severe Disease ◽  
Congenital Myasthenic Syndrome ◽  
Referral Centre ◽  
History Of ◽  
Myasthenic Syndrome ◽  
The Uk ◽  
Rare Group

Congenital Myasthenic Syndrome (CMS) are a rare group of genetic disorders of neuromuscular transmission. Some subtypes of CMS can be associated with respiratory and bulbar weakness and these patients may therefore be at high risk of developing a severe disease from COVID-19. We screened 73 patients with genetically confirmed CMS who were attending the UK national referral centre for evidence of previous Severe Acute Respiratory Syndrome Corona Virus 2 infection and their clinical outcome. Of 73 patients, seven had history of confirmed COVID-19. None of the infected patients developed a severe disease, and there were no signals that CMS alone carries a high risk of severe disease from COVID-19.

scholarly journals Global Hypertrophic Calcification of Shoulder Joint Capsule

2021 ◽  
Vol 14 ◽  
pp. 117954762110253
Author(s):  
Abdulkarim Yousef Aldehaim ◽  
Abdurhman Saud Alarfaj
Keyword(s):  
Rheumatoid Arthritis ◽  
Shoulder Joint ◽  
Joint Capsule ◽  
Surgical Approaches ◽  
Contributing Factors ◽  
Severe Arthritis ◽  
History Of ◽  
Excellent Control ◽  
Specific Symptoms ◽  
Calcific Deposits

Background: Calcification around the shoulder joint usually occur inside or around the tendons of the rotator cuff. We herein report on a case of global hypertrophic calcification of shoulder joint capsule in a patient with Rheumatoid arthritis. Case Report: An 86 years-old male with a long-standing history of seropositive Rheumatoid arthritis. The treatment for his Rheumatoid arthritis included Methotrexate and Hydroxychloroquine initially, but due lack of control, adalimumab was added with excellent control of his arthritis. He has progressively experienced an increasing pain and stiffness in his shoulders, in addition to an increasing limitation of shoulder movement. Magnetic Resonance Imaging revealed severe arthritis with remoulding deformity with extensive capsular calcification, intra-articular loose-bodies. Discussion: This phenomenon of calcification of shoulder capsule has not been reported before. The pathophysiology of calcific tendinopathy of the shoulder remains controversial. The calcific deposits consist of poorly-crystallized hydroxyapatite. Conclusion: Global hypertrophic calcification of shoulder joint capsule is unique and unreported in the literature. We can postulate that the long-standing inflammation of the synovial lining of the capsules had a major part. Moreover, Diabetes Mellitus, smoking, and repetitive manoeuvres are recognized contributing factors as well for similar conditions. Genetic predisposition seems to play a role as well. We think all those have played part in the development of this unprecedented presentation. Management should be tailored to target specific symptoms for pain, rigidity, and decreasing calcification size. Several options are available, including Kinesiotherapy, electrotherapy modalities, iontophoresis, electroshock wave therapy, and finally surgical approaches for progressive and refractory cases.

Cranial Nerve and Hearing Function after Combined-Approach Surgery for Glomus Jugulare Tumors

1996 ◽  
Vol 105 (12) ◽  
pp. 949-954 ◽  
Author(s):  
Mislav Gjuric ◽  
Stephan Rüdiger Wolf ◽  
Malte Erik Wigand ◽  
Manfred Weidenbecher
Keyword(s):  
Tumor Growth ◽  
Cranial Nerve ◽  
Functional Results ◽  
Surgical Approaches ◽  
Tumor Removal ◽  
Transcervical Approach ◽  
Glomus Jugulare ◽  
Cranial Nerve Palsies ◽  
Ablative Surgery ◽  
The Individual

In this retrospective study, oncologic and functional results of 46 patients treated for glomus jugulare tumor are reported. The standard surgical approach was the combined transmastoid-transcervical approach, modified according to the individual tumor growth, and eventually combined with a transtemporal or a suboccipital approach. Complete tumor removal resulted in a cure rate of 90%. New-onset cranial nerve palsies developed in less than 22% of patients. In 54% of cases it was possible to retain middle ear function. From a total of 12 patients with incomplete tumor removal and postoperative irradiation, progressive tumor growth was noted in 4 patients, and was controlled by salvage irradiation or surgery. Radical tumor removal by ablative surgery can be modified by efforts to reduce mutilating resections. In their place, individually tailored and combined multidirectional surgical approaches may allow total tumor removal with lower morbidity.

Irresectable tumours of the temporal bone

1987 ◽  
Vol 101 (5) ◽  
pp. 432-442 ◽  
Author(s):  
R. E. Quiney ◽  
L. M. Flood
Keyword(s):  
Temporal Bone ◽  
Case Reports ◽  
Sporadic Case ◽  
Petrous Apex ◽  
Surgical Approaches ◽  
Total Removal ◽  
Inaccessible Area ◽  
History Of ◽  
Petrous Temporal Bone

AbstractSporadic case reports and the few published series of expanding lesions of the deep petrous temporal bone propose a variety of surgical approaches to ensure excision. All such surgery represents a compromise between exposure adequate for total removal and avoidance of further neurological deficit. Unfortunately pathology in the petrous apex evolves relatively silently and diagnosis is delayed. In many cases total excision is impossible. We present a series of patients presenting with advanced tumours of the deep petrous temporal bone in order to illustrate the spectrum of disease encountered, the limited role of surgery and the natural history of irresectable pathology in this remote and inaccessible area.

Advantages and disadvantages of main surgical approaches for robot-assisted radical prostatectomy

2020 ◽  
Vol 10 (4) ◽  
pp. 347-354
Author(s):  
Dmitriy M. Il’in ◽  
Vladimir A. Makeev
Keyword(s):  
Radical Prostatectomy ◽  
Abdominal Cavity ◽  
Prostate Gland ◽  
Clinical Situation ◽  
Surgical Approaches ◽  
Robot Assisted ◽  
Scientific Databases ◽  
Advantages And Disadvantages ◽  
Robotic Assisted Surgery ◽  
History Of

The introduction of robotic-assisted surgery into clinical practice has opened up new possibilities for the surgical treatment of urological patients. Robot-assisted radical prostatectomy (RARP) is one of the most commonly performed robot-assisted surgery. The review is devoted to the main surgical approaches for RARP. An analysis of publications on this topic was carried out using the search engines of the scientific databases PubMed, Medscape, Google Scholar, eLibrary when writing the article The article presents an overview of the advantages and disadvantages of the existing four access options for RARP: anterior, perineal, lateral and posterior, as well as oncological and functional outcomes of operations. It has been shown that a surgeon with different approaches can choose the most suitable one for a given clinical situation, focusing on the stage of the disease, the patients age, anatomical features of the prostate gland, the state of the patients erectile function, and the history of operations on the abdominal cavity and pelvic organs.

scholarly journals Clinico-Pathological Findings of Bangladeshi Covid 19 Patients with their Clinical Outcome: Study of A Cohort of 201 Cases

2020 ◽  
pp. 37-42
Author(s):  
Nasir Uddin Ahmed ◽  
Md Azizul Islam ◽  
Md Anwarul Kabir ◽  
Md Habibur Rahman ◽  
SM Anwar Sadat
Keyword(s):  
Clinical Outcome ◽  
Respiratory Distress ◽  
Sore Throat ◽  
Respiratory System ◽  
Clinical Presentation ◽  
Severe Disease ◽  
Age Groups ◽  
Military Hospital ◽  
Human Beings ◽  
History Of

Introduction: COVID-19 is a major threat to human beings. Clinical characterization, rapid identification of cases and isolation are vital for containments of rapidly spreading disease. The objectives of the study were to evaluate the clinico pathologic profile of Covid 19 positive Bangladeshi patients and also to see their clinical outcome within defined period. Methods: This cohort study on 201 Bangladeshi cases was done in Combined Military Hospital, a tertiary level hospital in Dhaka, Bangladesh from April 2020 to May 2020. Total 201 COVID-19 cases were enrolled after getting the result positive for RT-PCR. After collection, data were analysed to show the characteristics of Covid 19 and their outcome after treatment. Results: Among 201 cases, 180 (90%) were male and 21 (10%) were female. The most prevalent affected age groups were 71 (35.5%) patients in 26-35 years age, 54 (27%) in 16- 25 years, 49 (24.5%) in 35-45 years. Mean age is 32.2±2. Among the total cases, 146 (73%) have positive history of contact, 37 (18.5%) have no history of any contact, 8 (4%) denied any contact with COVID-19 patients. Regarding clinical presentations, 67 (33.5%) patients presented with only one symptoms, 125 (62.5%) had multiple symptoms and 9 (4.5%) cases were asymptomatic. 154 (77%) patients presented with fever. Other presentations were cough 71 (35.5%), headache 27 (13.5%), myalgia 25 (12.5%), sore throat 25 (12.5%), malaise 15 (7.5%), respiratory distress 11 (5.5%). Respiratory system was the dominant domain of clinical presentation. Leukopenia was presented by 12 patients and 12 had lymphopenia. 18 patients had mild thrombocytopenia. Pulse oxymetry showed oxygen saturation below 88% in 12 cases. After oxygen therapy 7 cases were improved and 5 cases were shifted to Corona ICU as their saturation fell below 70. These 5 patients are categorised as severe disease, rest 196 patients were mild in nature. Conclusion: COVID 19 affects male more than female. Common symptoms are fever, cough, headache, myalgia, sore throat, malaise, respiratory distress. Respiratory system is the dominant domain of clinical presentation. ICU support was needed in 2.5 % cases and death rate was 1% which was associated with comorbidity of CKD. J Bangladesh Coll Phys Surg 2020; 38(0): 37-42

scholarly journals Laparoscopic resection of bilateral perinephric pseudocyst in a pediatric feline patient

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691985064
Author(s):  
Margaret Amparo Placer ◽  
Cindy McManis
Keyword(s):  
Laparoscopic Resection ◽  
Kidney Injury ◽  
Abdominal Distension ◽  
Surgical Approaches ◽  
Subtotal Resection ◽  
Invasive Approach ◽  
Less Invasive Approach ◽  
History Of ◽  
Grade 3

Case summary A 6-month-old male domestic shorthair cat presenting with abdominal distension and an acute history of renal azotemia was diagnosed with bilateral perinephric pseudocysts and International Renal Interest Society (IRIS) grade 3 acute kidney injury. Ultrasound-guided drainage of the cysts was performed initially; bilateral subtotal resection of the perinephric pseudocysts was later performed using laparoscopy as a more long-term solution. There was no regrowth or reformation of the perinephric pseudocysts 1 year after the procedure, and the cat remained in IRIS stage 2 chronic kidney disease 1 year postoperatively. Relevance and novel information Compared with traditional surgical approaches, laparoscopic resection of perinephric pseudocysts provides a less invasive approach. Bilateral perinephric pseudocyst in a pediatric feline patient (and associated treatment) has not previously been documented in the literature.

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