scholarly journals Functional outcome of tendoachilles following Ponseti’s tenotomy for treatment of congenital talipes equino varus in children older than two years

2017 ◽  
Vol 3 (5) ◽  
pp. 1057
Author(s):  
Sunny Agarwal ◽  
Suresh B. ◽  
Mathew Varghese ◽  
Vishesh Khanna ◽  
Mandeep Singh Bajaj
Keyword(s):  
Functional Outcome ◽  
Previous Treatment ◽  
Long Term Results ◽  
Walking Ability ◽  
Functional Evaluation ◽  
Age Group ◽  
History Of ◽  
Previously Treated ◽  
Congenital Talipes

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Long term results of tenotomy and Ponseti technique are established worldwide. However, functions of Tendoachilles following Ponseti’s tenotomy in these cases i.e. idiopathic/neglected/operated/relapsed clubfeet (after casting or surgical correction) are not established. Tendoachilles regeneration after tenotomy has been confirmed on USG and MRI but only a few studies have done functional evaluation of tendoachilles<strong>.</strong> This study was done to evaluate the functional outcome of tendoachilles after tenotomy in patients older than two years presenting with CTEV. This study also assessed the influence of age and any previous treatment on tenotomy.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">In this study, 42 children (68 clubfeet) were seen in the two year study period. Children between 2-13 years coming to the outpatient department for treatment using the Ponseti’s method were followed during and after completion of treatment for 2 years. Patients were divided into two groups-first according to age and second according to previous treatment. Clinical evaluation of tendoachilles regeneration was done by evaluating the child’s ability to stand on tip of toes on single leg and walking ability</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The ability to stand on tip of toes after removal of the final cast was delayed maximum in the previously operated patients (9.5 weeks), lesser in patients who were previously treated by casting (7.3 weeks) and least in neglected patients (7 weeks). It also increased as the age increased (2-5 years age group required 7.4 weeks whereas 11-13 years age group required 16 weeks). Neglected patients started walking earlier (4.6 weeks) as compared to patients treated conservatively (4.8 weeks) or operatively (7.2 weeks). Younger children started walking earlier (age 2-5 years required 4.7 weeks whereas 11-13 years age group required 12 weeks). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Functional evaluation of tendoachilles showed that all children who had tenotomy could walk and stand on tip of toes irrespective of age and previous treatment. However, older child and children having history of previous treatment, required longer time for recovery.</span></p>

scholarly journals Confounding variables affecting long term results of standard two screw cephalomedullary nail in intertrochanteric fractures of femur

2020 ◽  
Vol 7 (1) ◽  
pp. 103
Author(s):  
Rajeev Shukla ◽  
Adhir Jain ◽  
Pranav Mahajan ◽  
Ravikant Jain
Keyword(s):  
Functional Outcome ◽  
Final Outcome ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Walking Ability ◽  
Treatment Technique ◽  
Trochanteric Fractures ◽  
Excellent Outcome ◽  
Femur Fractures

<p><strong>Background: </strong>Inter trochanteric fractures of femur are common fractures in the elderly. The aim of the study was to assess the long-term functional outcome of patients treated with trochanteric fixation nail (TFN) for inter trochanteric femur fractures and to determine variables which affect the final outcome of surgery at the end of five years.</p><p><strong>Methods: </strong>The study was done at tertiary centre in central India with 152 patients who sustained intertrochanteric femur fracture. The patients were followed up at 6 weeks, 6 months, 1 year, 2 years and 5 years after the surgery. The assessment of pain, functional activity, walking ability and range of motion were assessed by Harris hip score at 6 months, 1 year, 2 years and 5 years.</p><p><strong>Results: </strong>The good/excellent outcome at the end of 5 years was found in 84% of cases. Patients with age less than 65 years and male patients had better outcome at the end of five years. Some of the complications encountered with this type of implant were z effect, delayed union, screw back-out/breakage, varus collapse which affected the final outcome.</p><p><strong>Conclusions: </strong>TFN is effective treatment technique for inter trochanteric fractures of femur worldwide. There are some complications which can occur with this type of implant in early post-operative period but still long-term follow-up of patients suggested that the fracture pattern, preoperative mobility status, timing of surgery, post op mobilization also plays a key role in determining functional outcome of patients.</p>

scholarly journals A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1474
Author(s):  
Stefan Grasl ◽  
Elisabeth Schmid ◽  
Gregor Heiduschka ◽  
Markus Brunner ◽  
Blažen Marijić ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Classification System ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Previous Treatment ◽  
Extent Of Resection ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Oral Nutrition

(1) Objective: To evaluate long-term functional outcome in patients who underwent primary or salvage total laryngectomy (TL), TL with partial (TLPP), or total pharyngectomy (TLTP), and to establish a new scoring system to predict complication rate and long-term functional outcome; (2) Material and Methods: Between 1993 and 2019, 258 patients underwent TL (n = 85), TLPP (n = 101), or TLTP (n = 72). Based on the extent of tumor resection, all patients were stratified to (i) localization I: TL; II: TLPP; III: TLTP and (ii) surgical treatment (A: primary resection; B: salvage surgery). Type and rate of complication and functional outcome, including oral nutrition, G-tube dependence, pharyngeal stenosis, and voice rehabilitation were evaluated in 163 patients with a follow-up ≥ 12 months and absence of recurrent disease; (3) Results: We found 61 IA, 24 IB, 63 IIA, 38 IIB, 37 IIIA, and 35 IIIA patients. Complications and subsequently revision surgeries occurred most frequently in IIIB cases but rarely in IA patients (57.1% vs. 18%; p = 0.001 and 51.4% vs. 14.8%; p = 0.002), respectively. Pharyngocutaneous fistula (PCF) was the most common complication (33%), although it did not significantly differ among cohorts (p = 0.345). Pharyngeal stenosis was found in 27% of cases, with the highest incidence in IIIA (45.5%) and IIIB (72.7%) patients (p < 0.001). Most (91.1%) IA patients achieved complete oral nutrition compared to only 41.7% in class IIIB patients (p < 0.001). Absence of PCF (odds ratio (OR) 3.29; p = 0.003), presence of complications (OR 3.47; p = 0.004), and no need for pharyngeal reconstruction (OR 4.44; p = 0.042) represented independent favorable factors for oral nutrition. Verbal communication was achieved in 69.3% of patients and was accomplished by the insertion of voice prosthesis in 37.4%. Acquisition of esophageal speech was reached in 31.9% of cases. Based on these data, we stratified patients regarding the extent of surgery and previous treatment into subgroups reflecting risk profiles and expectable functional outcome; (4) Conclusions: The extent of resection accompanied by the need for reconstruction and salvage surgery both carry a higher risk of complications and subsequently worse functional outcome. Both factors are reflected in our classification system that can be helpful to better predict patients’ functional outcome.

scholarly journals Single-Stage Orbital Socket Reconstruction Using the Oversized Dermis Fat Graft and the 22 mm Silicone Orbital Implant after an Extended Enucleation

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Biljana Kuzmanović Elabjer ◽  
Mladen Bušić ◽  
Daliborka Miletić ◽  
Mirjana Bjeloš ◽  
Borna Šarić ◽  
...  
Keyword(s):  
Choroidal Melanoma ◽  
Single Stage ◽  
Long Term Results ◽  
Fat Graft ◽  
En Bloc ◽  
Orbital Implant ◽  
Absorbable Sutures ◽  
Previously Treated ◽  
Socket Reconstruction

We would like to present a surgical technique of orbital socket reconstruction using oversized dermis fat graft and 22 mm silicone orbital implant in a single-stage after extended enucleation in two patients with massive local recurrence of anteriorly located choroidal melanoma previously treated with endoresection. Orbital tissues en bloc were removed leaving conjunctival lining only at the fornices. Simultaneously, the 22 mm silicone sphere was implanted deeply into the orbit and covered with the oversized dermis fat graft of 30 mm in height and 35 mm in length with 20 mm of the fat thickness. The graft was sutured to the residual forniceal conjunctiva with interrupted 6/0 absorbable sutures overlapping conjunctiva with the graft edge for 2 mm to facilitate the epithelization. Epithelization was completed in two months, leaving well-formed fornices with good fitting of the prosthesis. The key point of orbital socket reconstruction after extended enucleation is to restore conjunctival lining prior to volume. Thus, whenever facing a massive volume and conjunctival lining loss, simultaneous insertion of the 22 mm silicone sphere deep into the orbit combined with oversized dermis fat graft is, in our opinion, the method of choice. It proved to be safe and effective with favourable long-term results.

History of lobotomy in Poland

2017 ◽  
Vol 29 (1) ◽  
pp. 3-21 ◽  
Author(s):  
Kinga Jęczmińska
Keyword(s):  
Clinical Research ◽  
Clinical Evaluation ◽  
Long Term Results ◽  
Short Term ◽  
History Of

In Poland, there were 176 cases of prefrontal leucotomy performed by Moniz’s method between 1947 and 1951. There were also several cases in which alternative psychosurgical techniques were used: prefrontal topectomy by Bilikiewicz and colleagues, and prefrontal topischemia by Ziemnowicz. This article analyses the following: publications by Choróbski, who performed lobotomy in Poland, and by Korzeniowski, who assessed its short-term results; a report by Bornsztajn, who reviewed general results of the method; and clinical research by Broszkiewicz and by Konieczyńska, who assessed Polish patients in terms of long-term results of lobotomy. Negative clinical evaluation of lobotomy led to its abandonment in Poland, a decision strengthened by a regulation that forbade lobotomy in the USSR and impacted Polish psychiatry.

Atezolizumab (atezo) in patients with metastatic urothelial carcinoma (mUC): A 2-year clinical update from a phase Ia study.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 290-290 ◽  
Author(s):  
Daniel Peter Petrylak ◽  
Thomas Powles ◽  
Joaquim Bellmunt ◽  
Fadi S. Braiteh ◽  
Yohann Loriot ◽  
...  
Keyword(s):  
Objective Response ◽  
The United States ◽  
Term Treatment ◽  
Long Term Results ◽  
Platinum Based Chemotherapy ◽  
Long Term Treatment ◽  
Previously Treated ◽  
Ecog Ps

290 Background: Atezo (anti–PD-L1) has demonstrated safety and efficacy in a broad range of cancers and is approved in the United States for mUC previously treated with platinum-based chemotherapy. Here we report long-term results in mUC from Phase Ia study NCT01375842 (PCD4989g). Methods: Previously treated mUC patients received atezo 15 mg/kg or 1200 mg IV q3w. Enrollment in this Phase Ia expansion cohort initially required PD-L1–selected status and later opened to patients regardless of PD-L1 expression on tumor-infiltrating immune cells. The primary endpoint was safety/tolerability. Secondary endpoints included investigator-assessed RECIST v1.1 ORR (confirmed), DOR and OS. Results: 95 patients were safety evaluable (Table). Median age was 66 years, 76% were male and 80% had primary bladder tumors. 61% had ECOG PS 1. 52% received ≥ 3 prior systemic therapies for mUC (70% platinum). Median treatment duration was 3 months (range: 0-32 months); 24% were treated for ≥ 1 year. Treatment-related AEs occurred in 66% (all Grade) and 8% (Grade 3-4) of patients. No treatment-related deaths were reported. In 94 objective response–evaluable patients (follow-up ≥ 12 weeks), the ORR was 27% (95% CI: 18, 37%), and the CR rate was 10%; the SD rate was 19%. mDOR was 22.1 months (95% CI: 12.1, NE months) in all patients; 56% of responses (7/9 CRs and 7/16 PRs) were ongoing at the December 15, 2015 data cutoff. With a 24-month median follow-up duration (range: 1+ to 32 months), the 1-year OS rate was 47% (95% CI: 36, 58%), and the 2-year rate was 29% (19, 40%); mOS is in the Table. Updated clinical data with further follow-up and analyses by PD-L1 status will be presented. Conclusions: Long-term treatment with atezo was well tolerated, without new safety signals in heavily pre-treated mUC patients. The durability of responses, including CRs, along with extended OS, confirm atezo as a new standard for previously treated mUC patients. Clinical trial information: NCT01375842. [Table: see text]

scholarly journals The Application of Hemospray in Gastrointestinal Bleeding during Emergency Endoscopy

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Alexander F. Hagel ◽  
Heinz Albrecht ◽  
Andreas Nägel ◽  
Francesco Vitali ◽  
Marcel Vetter ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Salvage Therapy ◽  
Previous Treatment ◽  
Long Term Results ◽  
Emergency Endoscopy ◽  
Short Term ◽  
Long Term Effect ◽  
Short And Long Term ◽  
Lower Endoscopy

Introduction. Gastrointestinal bleeding represents the main indication for emergency endoscopy (EE). Lately, several hemostatic powders have been released to facilitate EE.Methods. We evaluated all EE in which Hemospray was used as primary or salvage therapy, with regard to short- and long-term hemostasis and complications.Results. We conducted 677 EE in 474 patients (488 examinations in 344 patients were upper GI endoscopies). Hemospray was applied during 35 examinations in 27 patients (19 males), 33 during upper and 2 during lower endoscopy. It was used after previous treatment in 21 examinations (60%) and in 14 (40%) as salvage therapy. Short-term success was reached in 34 of 35 applications (97.1%), while long-term success occurred in 23 applications (65.7%). Similar long-term results were found after primary application (64,3%) or salvage therapy (66,7%). Rebleeding was found in malignant and extended ulcers. One major adverse event (2.8%) occurred with gastric perforation after Hemospray application.Discussion. Hemospray achieved short-term hemostasis in virtually all cases. The long-term effect is mainly determined by the type of bleeding source, but not whether it was applied as first line or salvage therapy. But, even in the failures, patients had benefit from hemodynamic stabilization and consecutive interventions in optimized conditions.

Long-term results of prolapse recurrence and functional outcome after vaginal hysterectomy

2012 ◽  
Vol 120 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Lisa T. Prodigalidad ◽  
Yoav Peled ◽  
Stuart L. Stanton ◽  
Haim Krissi
Keyword(s):  
Functional Outcome ◽  
Vaginal Hysterectomy ◽  
Long Term Results ◽  
Prolapse Recurrence

scholarly journals History of meniscal repair techniques development (foreign literature review)

2018 ◽  
Vol 25 (1) ◽  
pp. 72-79
Author(s):  
Mikhail S. Ryazantsev ◽  
N. E Magnitskaya ◽  
D. O Il’in ◽  
A. P Afanas’ev ◽  
A. V Frolov ◽  
...  
Keyword(s):  
Literature Review ◽  
Surgical Techniques ◽  
Meniscal Repair ◽  
Long Term Results ◽  
Foreign Literature ◽  
History Of ◽  
Repair Techniques

The analysis of the evolution of meniscal repair techniques starting of the arthrotomic interventions to procedures under arthroscopic control is presented. Long-term results as well as the surgical techniques are discussed.

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