scholarly journals Challenging treatment of hidradenitis suppurativa with happy ending

2019 ◽  
Vol 6 (5) ◽  
pp. 1467
Author(s):  
Murat Akici ◽  
Murat Cilekar
Keyword(s):  
Hidradenitis Suppurativa ◽  
Skin Grafting ◽  
Complete Recovery ◽  
Fatty Tissue ◽  
Multiple Site ◽  
Happy Ending ◽  
Surgical Methods ◽  
Subcutaneous Fatty Tissue ◽  
Secondary Healing

Background: Hydradenitis supurativa (HS) is a chronic, recurrent and inflammatory disease which involves skin and subcutaneous fatty tissue. The aim of this study was to retrospectively evaluate the treatment results of 12 patients who were diagnosed as hidradenitis suppurativa with local or multiple site involvements in our clinic.Methods: Data of 12 patients with local or multiple site involvement, who had hidradenitis suppurativa surgery between January 2013 and January 2018 were evaluated retrospectively.Results: Twelve patients, who were male, were included in the study. The average age was 39.4 (25-56) years old. A total of 5 patients were with local and 7 patients were with multiple region involvements. 8 patients had axillary, 3 patients had genitalia, 4 patients had perianal and 7 patients had sacral region involvements. Two of 4 patients with perianal region had protective stomas. In total, 16 surgical procedures were performed to the patients. In 6 patients, some parts of wounds were primary closed and followed-up with secondary healing. Skin grafting was performed for the four of these patients in late period. In 4 patients, defects were closed with primary closure and with rotation flaps in 2 patients. No recurrence was observed among the patients. The average duration of follow-up was 32.5 months.Conclusions: The surgical treatment process of hidradenitis suppurativa, which is a chronic disease, is not more difficult and longer than its natural course. In recent years, complete recovery can be achieved with current surgical methods.

scholarly journals Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities

2016 ◽  
pp. 28-32
Author(s):  
S. V. Kolesov ◽  
M. L. Sazhnev ◽  
A. A. Snetkov ◽  
A. I. Kaz’Min
Keyword(s):  
Spinal Deformity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Fatty Tissue ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Spine Deformities ◽  
Subcutaneous Fatty Tissue ◽  
Preservation Technique

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.

scholarly journals Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities

2016 ◽  
Vol 23 (3) ◽  
pp. 28-32
Author(s):  
S. V Kolesov ◽  
M. L Sazhnev ◽  
A. A Snetkov ◽  
A. I Kaz’min
Keyword(s):  
Spinal Deformity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Fatty Tissue ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Spine Deformities ◽  
Subcutaneous Fatty Tissue ◽  
Preservation Technique

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.

Use of tongue flap in submucous palatal fibrosis

1986 ◽  
Vol 100 (4) ◽  
pp. 455-460 ◽  
Author(s):  
M. G. Tepan ◽  
G. S. Saigal ◽  
Sheela B. Tilak
Keyword(s):  
Fibrous Tissue ◽  
Skin Grafting ◽  
Tongue Flap ◽  
Surgical Methods ◽  
Retromolar Region

SummarySubmucous palatal fibrosis invariably leads to trismus due to fibrosis in the retromolar region. Medical lines of treatment are of no use in relieving the trismus once it is established. Various surgical methods, such as excision of fibrous tissue or excision of fibrous tissue with skin grafting, have been suggested, but none of them has been proved to give a lasting cure. We have made use of tongue flaps on either side in cases of trismus due to submucous palatal fibrosis in the retromolar region. Twentyfive cases have been operated upon with this technique and the results are quited encouraging. Regular follow-up for up to three years has shown good results without any complications.

Hybrid Endovascular Repair of Thoracoabdominal Aorta: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 146
Author(s):  
Osman Tansel Darcin ◽  
Mehmet Kalender ◽  
Ayse Gul Kunt ◽  
Okay Guven Karaca ◽  
Ata Niyazi Ecevit ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Therapeutic Option ◽  
Complete Recovery ◽  
Aortic Aneurysms ◽  
Thoracoabdominal Aorta ◽  
Mortality And Morbidity ◽  
Early Results ◽  
The Mean ◽  
Procedural Success

<p><b>Background:</b> Thoracoabdominal aortic aneurysms (TAAA) present a significant clinical challenge, as they are complex and require invasive surgery. In an attempt to prevent considerably high mortality and morbidity in open repair, hybrid endovascular repair has been developed by many authors. In this study, we evaluated the early-term results obtained from this procedure.</p><p><b>Methods:</b> From November 2010 to February 2013, we performed thoracoabdominal hybrid aortic repair in 18 patients. The mean age was 68 years (12 men, 6 women). All of the patients had significant comorbidities. Follow-up computed tomography (CT) scans were performed at 1 week, 3 months, 6 months, and annually thereafter.</p><p><b>Results:</b> All patients were operated on in a staged procedure and stent graft deployment was achieved. Procedural success was achieved in all cases. All patients were discharged with complete recovery. No endoleaks weres detected in further CT examination.</p><p><b>Conclusion:</b> Our results suggests that hybrid debranching and endovascular repair of extensive thoracoabdominal aneurysms represents a suitable therapeutic option to reduce the morbidity and mortality of TAAA repair, particularly in those typically considered at high risk for standard repair.</p>

scholarly journals Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oriel Spierer ◽  
Abraham Spierer
Keyword(s):  
Young Children ◽  
Success Rate ◽  
Lateral Rectus ◽  
Intermittent Exotropia ◽  
Age At Surgery ◽  
Surgical Methods ◽  
Before And After ◽  
The Mean ◽  
Consecutive Esotropia

Abstract Background Different surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Methods The charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented. Results Mean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years. Conclusions In children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.

scholarly journals Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhongcheng An ◽  
Chen Chen ◽  
Junjie Wang ◽  
Yuchen Zhu ◽  
Liqiang Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Bone Cement ◽  
Vertebral Compression Fracture ◽  
Univariate Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation ◽  
Surgical Methods

Abstract Objective To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA. Methods A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337). Conclusions The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

Staphylococcus aureus Carriage in Hidradenitis Suppurativa: Impact on Response to Adalimumab

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Dimitra Stergianou ◽  
Vassiliki Tzanetakou ◽  
Maria Argyropoulou ◽  
Theodora Kanni ◽  
Pantelis G. Bagos ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Response ◽  
Odds Ratio ◽  
Hidradenitis Suppurativa ◽  
Positive Culture ◽  
Nasal Carriage ◽  
Loss Of Response ◽  
Response Score ◽  
Stimulation Of

<b><i>Background:</i></b> Several patients with hidradenitis suppurativa (HS) present flare-ups during treatment with adalimumab (ADA), the cause of which is not clear. ADA is the only FDA-approved biologic for the therapy of moderate-to-severe HS. A previous study of our group has shown that <i>Staphylococcus aureus</i> stimulation of whole blood affects the production of human β-defensin 2 and modulates HS severity. It is, therefore, hypothesized, that carriage of <i>S. aureus</i> may drive HS flare-ups. <b><i>Objective:</i></b> To explore the association between carriage of <i>S. aureus</i> and loss of response to ADA. <b><i>Patients and Methods:</i></b> Among patients with moderate-to-severe HS without carriage of <i>S. aureus</i> at start of treatment with ADA, we investigated for carriage of <i>S. aureus</i> from the nares when flare-ups occurred. Flare-ups were pre-defined as at least 25% increase of inflammatory lesions (sum of inflammatory nodules and abscesses) from baseline. Samplings were also done after completion of 12 weeks of ADA treatment from all patients who did not present flare-ups. Clinical response to ADA was assessed by the HS Clinical Response score (HiSCR). <b><i>Results:</i></b> Thirty-nine patients were studied; 24 with Hurley II stage HS and 15 with Hurley III stage HS. Twenty-nine patients achieved HiSCR after 12 weeks of treatment without any flare-ups; 10 patients had flare-ups and failed HiSCR. Three (10.3%) and 5 (50%) patients, respectively, had nasal carriage of <i>S. aureus</i> (odds ratio 8.67; 95% CI 1.54–48.49; <i>p</i> = 0.014). Among 32 patients reaching follow-up week 48, 20 patients achieved HiSCR and 12 had flare-ups leading to ADA failure; 2 (10%) and 5 (41.7%) patients, respectively, had positive culture for <i>S. aureus</i> (odds ratio 6.42; 95% CI 1.00–41.20; <i>p</i> = 0.05). <b><i>Conclusion:</i></b> Nasal carriage of <i>S. aureus</i> may be associated with loss of response to ADA. Findings need confirmation in larger series of patients.

scholarly journals A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia

Blood ◽  
1992 ◽  
Vol 80 (9) ◽  
pp. 2203-2209 ◽  
Author(s):  
MS Tallman ◽  
D Hakimian ◽  
D Variakojis ◽  
D Koslow ◽  
GA Sisney ◽  
...  
Keyword(s):  
Complete Remission ◽  
Interferon Alpha ◽  
Hairy Cell Leukemia ◽  
Complete Recovery ◽  
Community Acquired Pneumonia ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Single Cycle ◽  
Severe Pancytopenia

Abstract Twenty-six patients with hairy cell leukemia (HCL) were treated with 2- chlorodeoxyadenosine (2-CdA), a purine analogue resistant to adenosine deaminase, at 0.1 mg/kg/d for 7 days by continuous intravenous infusion. Fifteen patients were previously untreated, while 11 patients had received prior treatment with splenectomy alone (three patients), interferon alpha alone (four), splenectomy, then interferon alpha (two), or splenectomy, interferon alpha, then 2-deoxycoformycin (2-DCF) (two). Sixteen (80%) of 20 patients evaluable at 3 months achieved complete remission (CR), and four (20%) achieved partial remission (PR) following a single cycle of therapy. All four patients in PR had complete recovery of their peripheral blood counts (except one patient whose platelet count remained 84,000/microL), but had residual HCL in the bone marrow (three patients) or residual splenomegaly (one). Patients with bulky adenopathy, massive splenomegaly, and severe pancytopenia responded as well as those with only modest marrow involvement. The three patients with residual marrow disease received a second cycle of 2-CdA, and two have attained CR. Therefore, 18 of 20 (90%) achieved CR with either one or two cycles of therapy. No patient achieving CR has relapsed at a median follow-up of 12 (+/- 2.1) months. Toxicities included myelosuppression and culture-negative fever. A community-acquired pneumonia was the only infectious complication. Since a single cycle of 2-CdA induces sustained CR in the vast majority of patients with minimal toxicity, this agent is emerging as the treatment of choice for all patients with HCL.

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Jurr Boer
Keyword(s):  
Total Dose ◽  
Hidradenitis Suppurativa ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Postal Survey ◽  
Long Term Follow Up ◽  
Late Treatment

<b><i>Background:</i></b> Patients with hidradenitis suppurativa (HS) are still often disappointed with the current treatments offered and there is a clear demand for more effective options. Since the late 1990s there has been a revival in the use of radiotherapy (RT) for different benign diseases, including HS. During the past 20 years one case series and some scattered case reports have described promising results of RT. <b><i>Objectives:</i></b> To evaluate the long-term efficacy of RT in early-stage HS. <b><i>Methods:</i></b> A postal survey-based long-term follow-up with simple factual questions of partly retrospective and partly contemporary characteristics was performed. Sixty-four patients (96 axillae), diagnosed with mild to moderate HS were irradiated with a orthovoltage unit with 100 kV, 3 mm Al or 200 kV, 0.5 Cu filtering, respectively. Four to six biweekly fractional doses ranging from 0.75 to 1 Gy up to a total dose of 6 Gy in one series, and in chronic cases followed by four daily fractions of 2 Gy up to a total dose of 14 Gy, were given. Late treatment toxicity and the rate of remission of the disease were evaluated. <b><i>Results:</i></b> The overall response rate of the survey was 64.1% with 40.6% (26/64) valid, complete questionnaires. In total, 40 axillae were irradiated in these 26 patients. After a median follow-up of 40 years (range 32–52) complete remission of the lesions occurred in 34 of the 40 sites (85%). None of the 26 patients with 40 irradiated sites reported adverse effects at the time of the survey. <b><i>Conclusions:</i></b> RT appears to be an effective treatment for early and mild HS in the majority of patients. In this case series, no side effects were reported after a median follow-up period of 40 years.

Coronary artery patch augmentation for congenital left coronary ostial stenosis in Williams syndrome

2021 ◽  
Keyword(s):  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Sudden Death ◽  
Williams Syndrome ◽  
Coronary Ostium ◽  
Coronary Ostial Stenosis ◽  
Surgical Methods ◽  
Infants And Young Children

Left coronary ostial stenosis, which is associated with sudden death, occasionally occurs in individuals with Williams syndrome. However, surgical methods that provide reliable long-term revascularization remain unknown among infants and young children with coronary ostial stenosis. We describe the case of an 18-month-old boy with Williams syndrome who presented with cardiogenic shock due to left coronary ostial stenosis. We performed patch augmentation of the left coronary ostium using glutaraldehyde-treated autologous pericardium. At the last follow-up, the patient was well without any adverse events or myocardial ischemia.

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