scholarly journals In Dogs With Pyothorax Does Medical Management Alone, Invasive Medical Management, or Surgical Management Result in Better Long-term Outcome?

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Barnaby Luke Dean ◽  
Sophie Adamantos
Keyword(s):  
Surgical Management ◽  
Antimicrobial Therapy ◽  
Medical Management ◽  
Survival Rates ◽  
Bottom Line ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Thoracic Drainage

<p><strong>Clinical bottom line:</strong></p><p>Currently available literature on canine pyothorax management is low quality, so it is difficult to draw meaningful conclusions from it. With this in mind, however, the literature does suggest that invasive medical management (thoracic drainage and lavage via in-dwelling thoracostomy tubes, and antimicrobial therapy) and surgical management (in conjunction with antimicrobial therapy) of canine pyothorax provide better long-term survival rates compared to non-invasive medical management (antimicrobial therapy, with or without thoracocentesis) alone. More definitive conclusions cannot be made until higher quality evidence (prospective, randomised, blinded) is available on the topic.</p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

Surgical resection of pulmonary inflammatory pseudotumors: long-term outcome

2017 ◽  
Vol 25 (6) ◽  
pp. 440-445 ◽  
Author(s):  
Marine Peretti ◽  
Dana M Radu ◽  
Karel Pfeuty ◽  
Antoine Dujon ◽  
Marc Riquet ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Survival Rates ◽  
R0 Resection ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Inflammatory Pseudotumors

Background Pulmonary inflammatory pseudotumors are rare lesions that remain problematic in several aspects, especially regarding the therapeutic strategy. The goal of this study was to evaluate long-term survival in a multicenter series of patients who required surgery for pulmonary inflammatory pseudotumors. Methods Thirty-six cases of pulmonary inflammatory pseudotumors, operated on in 3 French thoracic surgery departments between 1989 and 2015, were studied retrospectively. We recorded pre-, peri- and postoperative data for each patient, and long-term survival was analyzed. Results There were 22 men and 14 women. Mean age was 53.5 years (range 14–81 years). Three pneumonectomies, 1 bilobectomy, 19 lobectomies, 2 segmentectomies, 10 wedge resections, and 1 biopsy were performed. Complete resection was carried out in 32 (88.8%) patients. Median follow-up was 76 months. Five-year and 10-year survival rates were respectively 86.8% and 81.7% (96% and 90% for patients with R0 resection). Conclusions Long-term survival was excellent for patients with pulmonary inflammatory pseudotumors who benefited from surgery, especially when surgical resection was complete. These results confirm that surgical resection must be proposed as the first-line treatment for patients with pulmonary inflammatory pseudotumors.

scholarly journals Aetiology and 30-Year Long-Term Outcome of Children with Cardiomyopathy Necessitating Heart Transplantation

2020 ◽  
Vol 10 (4) ◽  
pp. 251
Author(s):  
Martin Zschirnt ◽  
Josef Thul ◽  
Hakan Akintürk ◽  
Klaus Valeske ◽  
Dietmar Schranz ◽  
...  
Keyword(s):  
Survival Rate ◽  
Heart Transplantation ◽  
Survival Rates ◽  
Diagnostic Workup ◽  
Morbidity And Mortality ◽  
Neurocognitive Deficits ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome

Studies assessing the long-term outcome after heart transplantation HTX in patients with cardiomyopathy (CM) in the paediatric age range are rare. The aim of this study was to determine the survival rate of children with CM undergoing HTX and to analyse how aetiology of cardiomyopathy influenced morbidity and mortality. We retrospectively analysed the medical records of children; who were transplanted in our centre between June 1988 and October 2019. 236 heart transplantations were performed since 1988 (9 re-transplants). 98 of 227 patients (43.2%) were transplanted because of CM. Survival rates were 93% after 1; 84% after 10 and 75% after 30 years. Overall; the aetiology of CM could be clearly identified in 37 subjects (37.7%). This rate increased up to 66.6% (12/19) by applying a comprehensive diagnostic workup since 2016. The survival rate was lower (p < 0.05) and neurocognitive deficits were more frequent (p = 0.001) in subjects with systemic diseases than in individuals with cardiac-specific conditions. These data indicate that the long-term survival rate of children with CM after HTX in experienced centers is high. A comprehensive diagnostic workup allows unraveling the basic defect in the majority of patients with CM undergoing HTX. Aetiology of CM affects morbidity and mortality in subjects necessitating HTX.

scholarly journals LONG-TERM FOLLOW UP AND TREATMENT OUTCOMES OF A 2 YEAR-OLD-BOY WITH METASTATIC TESTOSTERONE-SECRETING ADRENOCORTICAL CARCINOMA

2020 ◽  
Vol 6 (6) ◽  
pp. e300-e304
Author(s):  
Danielle LoGiurato ◽  
Zoltan Antal ◽  
Ping Zhou
Keyword(s):  
Adrenocortical Carcinoma ◽  
Survival Rates ◽  
Disease Status ◽  
Central Precocious Puberty ◽  
Outcome Data ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival

Objective: Treatment of metastatic adrenocortical carcinoma (ACC) is challenging and long-term survival rates are exceedingly low. Long-term outcome data for pediatric patients who received mitotane is very limited. Methods: We describe the case of a 2-year-old boy with ACC with a lung metastasis. He was treated with surgery, chemotherapy, and mitotane, and remains disease-free 13 years after diagnosis. Results: The key endocrine issues learned from this case include: adrenal-derived sex-steroid and insulin-like growth factor-2 levels are correlated with disease status; very high doses of glucocorticoid and mineralocorticoid are required while on treatment of mitotane; and central precocious puberty needs to be detected and treated in a timely manner to preserve final adult height. Conclusion: We report a case of pediatric ACC with metastasis that was successfully treated with surgery, chemotherapy, and adjuvant therapy with mitotane. Appropriate endocrine testing and management are important for long-term survival and quality of life.

scholarly journals Comparison of medical and/or surgical management of 23 cats with intracranial empyema or abscessation

2018 ◽  
Vol 21 (6) ◽  
pp. 566-574 ◽  
Author(s):  
Sophie Martin ◽  
Randi Drees ◽  
Balazs Szladovits ◽  
Elsa Beltran
Keyword(s):  
Surgical Management ◽  
Medical Management ◽  
Statistical Significance ◽  
Imaging Findings ◽  
Short Term ◽  
Term Outcome ◽  
Term Survival ◽  
Treatment Protocols ◽  
Long Term Survival

Objectives Feline intracranial abscessation or empyema is infrequently reported in the veterinary literature. To date, the largest study is based on a population of 19 cats with otogenic infection. The aim of this study was to review a larger population of cats with intracranial empyema from multiple aetiologies and document their signalment, imaging findings, treatment protocols (including medical and/or surgical management) and to compare outcomes. Methods Cases presenting to a single referral centre over a 10 year period with compatible history, neurological signs and imaging findings consistent with intracranial abscessation and empyema were reviewed retrospectively. Results Twenty-three cats met the inclusion criteria. Advanced imaging (CT and/or MRI) was performed in 22/23 cats; one case was diagnosed via ultrasound. Ten cases underwent medical and surgical management combined, 10 underwent solely medical management and three were euthanased at the time of diagnosis. Short-term outcome showed that 90% of surgically managed and 80% of medically managed cats were alive at 48 h post-diagnosis. Long-term survival showed that surgically managed cases and medically managed cases had a median survival time of 730 days (range 1–3802 days) and 183 days (range 1–1216 days), respectively. No statistical significance in short- or long-term survival ( P >0.05) was found between medically and surgically managed groups. Conclusions and relevance Feline intracranial abscessation and empyema are uncommon conditions that have historically been treated with combined surgical and medical management. This study documents that, in some cases, intracranial abscessation and empyema can also be successfully treated with medical management alone.

Malignant Ovarian Germ Cell Tumors: Identification of Novel Prognostic Markers and Long-Term Outcome After Multimodality Treatment

2006 ◽  
Vol 24 (30) ◽  
pp. 4862-4866 ◽  
Author(s):  
Nirupa Murugaesu ◽  
Peter Schmid ◽  
Gairin Dancey ◽  
Roshan Agarwal ◽  
Lydia Holden ◽  
...  
Keyword(s):  
Overall Survival ◽  
Germ Cell ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Multimodality Treatment ◽  
Prognostic Parameters ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome

Purpose Malignant ovarian germ cell tumors are rare and knowledge about prognostic parameters currently is limited. This study was undertaken to evaluate long-term outcome of patients with malignant ovarian germ cell tumors (MOGCTs) after chemotherapy and to assess prognostic parameters. Patients and Methods A total of 113 patients with stage IC to IV MOGCTs were included into this retrospective study. Patients were treated at two large regional cancer centers between 1977 and 2003. Results Ten-year recurrence-free and overall survival rates were 82% and 81%, respectively. A total of 20 patients experienced relapse, all within the first 8 years. Outcome after relapse was poor, with only 10% of patients achieving long-term survival. Univariate and multivariate analyses demonstrated that initial stage of disease (relative risk [RR], 5.96; 95% CI, 3.47 to 10.22; P = .03) and elevation of serum markers β-human chorionic gonadotropin and alpha-fetoprotein (RR, 3.90; 95% CI, 1.40 to 10.9; P = .009) were significant predictors of overall survival, whereas age at diagnosis was of no prognostic value. Conclusion This is the first study to identify stage and tumor markers as prognostic parameters for patients with MOGCTs. This might help to select patients for risk-adapted treatment. There is need for improvement of therapeutic strategies after relapse.

scholarly journals LGG-06. LONG-TERM OUTCOME OF NEWLY DIAGNOSED LOW GRADE GLIOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii367-iii367
Author(s):  
Nongnuch Sirachainan ◽  
Attaporn Boongerd ◽  
Samart Pakakasama ◽  
Usanarat Anurathapan ◽  
Ake Hansasuta ◽  
...  
Keyword(s):  
Surgical Management ◽  
Progression Free Survival ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Newly Diagnosed ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Common Location ◽  
Suprasellar Region

Abstract INTRODUCTION Low grade glioma (LGG) is the most common central nervous system (CNS) tumor in children accounted for 30–50%. Regarding benign characteristic of disease, surgical management remains the mainstay of treatment. However, surgical approach is limited in some conditions such as location at brainstem or infiltrative tumor. Chemotherapy and radiation treatments have been included in order to control tumor progression. The 5-years survival rate is approach 90% especially in patients who receive complete resection. However, the outcome of children with LGG in low to middle income is limited. Therefore, the aim of the study was to determine long-term outcome of children with newly diagnosed LGG. METHODS A retrospective study enrolled children aged &lt;18 years who were newly diagnosed LGG during January 2006- December 2019. Diagnosis of LGG was confirmed by histological findings of grade I and II according to WHO criteria. RESULTS A total of 40 patients, female to male ratio was 1:1.35 and mean (SD) for age was 6.7 (4.0) years. The most common location was optic chiasmatic pathway (42.5%), followed by suprasellar region (25.0%). Sixty percent of patients received at least partial tumor removal. Chemotherapy and radiation had been used in 70% and 10.0% respectively. The 10-year progression free survival was 74.1±11.4% and overall survival was 96.2±3.8%. SUMMARY: Treatment of Pediatric LGG mainly required surgical management, however, chemotherapy and radiation had been used in progressive disease. The outcome was excellent.

Problems in the diagnosis of discordant atrioventricular with concordant ventriculo-arterial connections: anatomical considerations, surgical management, and long-term outcome

2015 ◽  
Vol 26 (1) ◽  
pp. 127-138 ◽  
Author(s):  
Daniela Laux ◽  
Lucile Houyel ◽  
Fanny Bajolle ◽  
Francesca Raimondi ◽  
Younes Boudjemline ◽  
...  
Keyword(s):  
Surgical Management ◽  
Heart Defects ◽  
Pacemaker Implantation ◽  
Heterotaxy Syndrome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Atrial Switch ◽  
Great Vessels

AbstractBackgroundDiscordant atrioventricular with concordant ventriculo-arterial connections is a rare cardiac defect. When isolated, the haemodynamics resemble transposition of the great arteries. In complex heart defects such as heterotaxy, haemodynamics guide the surgical approach.ObjectiveTo report a series of eight patients with discordant atrioventricular and concordant ventriculo-arterial connections focussing on anatomical and diagnostic difficulties, surgical management, and follow-up.MethodsA retrospective review was carried out from 1983 to 2013. Anatomical description was based on segmental analysis. Emphasis was placed on the venoatrial connections.ResultsSegmental arrangement was {I, D, S} in six patients, all with spiralling great vessels. There were two patients with parallel great vessels of whom one had {S, L, D} and the other had {S, L, A} arrangement. Of eight patients, five had heterotaxy syndrome. Median age at repair surgery was 1.4 years (with a range from 1.1 months to 8.1 years). The repair surgery finally performed was the atrial switch procedure in seven out of eight patients. The main post-operative complications were two cases of baffle obstruction and one sick sinus syndrome needing pacemaker implantation. There were two early post-operative deaths and six late survivors. Median follow-up was 4.2 years (with a range from 3.9 to 26.7 years) with good functional status in all survivors.DiscussionDiagnosing discordant atrioventricular with concordant ventriculo-arterial connections remains challenging. There are ongoing controversies about the definition of atrial morphology and heterotaxy syndrome animating the anatomic discussion of these complex heart defects. Haemodynamically, the atrial switch procedure is the surgical method of choice with an encouraging long-term follow-up despite rhythm disturbances and baffle obstruction.

Perinatal Care at the Threshold of Viability

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 974-976
Author(s):  
◽  
◽  
◽  
Keyword(s):  
Perinatal Care ◽  
Survival Rates ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Obstetric Management ◽  
The Cost ◽  
The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

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