A Colombian experience involving SpineJack®, a consecutive series of patients experiencing spinal fractures, percutaneous approach and anatomical restoration 2016–2017

Background: To evaluate the value of time-of-flight MR angiography (TOF MRA) for the assessment of extracranial-intracranial (EC-IC) bypass in Moyamoya disease in comparison with computed tomography angiography (CTA). Patients and methods: A consecutive series of 23 patients with Moyamoya disease were analyzed retrospectively. Twenty three patients underwent 25 procedures of extracranial-intracranial bypass. Cranial CTA was performed within one week after the surgery to assess bypass patency. Then TOF MRA was scanned within 24 h after CTA on a 3T MRI system. Using 5-point scales (0 = poor to 4 = excellent), two radiologists rated the image quality and vessel integrity of bypass for three segments (extracranial, trepanation, intracranial). Results: Image quality was high in both CTA and TOF MRA (mean quality score 3.84 ± 0.37 and 3.8 ± 0.41), without statistical difference (p = 0.66). Mean scores of TOF MRA with respect to bypass visualization were higher than CTA in the intracranial segment (p = 0.026). No significant difference of bypass visualization regarding the extracranial and trepanation segments was found between TOF MRA and CTA (p = 0.66 and p = 0.34, respectively). For the trepanation segment, TOF MRA showed pseudo lesions in 2 of all 25 cases. Conclusions: 3T TOF MRA, a non-contrast technique not exposing the patients to radiation, proved to be at least equal to CTA for the assessment of EC-IC bypass, and even superior to CTA with respect to the intracranial segment. In addition, readers should be aware of a potential overestimation showing focal pseudo lesions of the bypass at the trepanation segment in TOF MRA.

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Long-term Outcome after Reimplantation of Autologous Bone Flaps in a Consecutive Series of 100 Patients

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0034-1383768 ◽

2014 ◽

Vol 75 (S 02) ◽

Author(s):

L. Stieglitz ◽

C. Fung ◽

M. Murek ◽

J. Fichtner ◽

P. Schucht ◽

...

Keyword(s):

Consecutive Series ◽

Term Outcome ◽

Long Term Outcome ◽

Autologous Bone

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Evaluation of a New Rapid Quantitative D-dimer Assay in Patients with Clinically Suspected Deep Vein Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650288 ◽

1996 ◽

Vol 75 (03) ◽

pp. 412-416 ◽

Cited By ~ 70

Author(s):

Armando D’Angelo ◽

Gabriella D’Alessandro ◽

Loredana Tomassini ◽

Jean Louis Pittet ◽

G Dupuy ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Predictive Value ◽

Cost Savings ◽

Pretest Probability ◽

First Episode ◽

Consecutive Series ◽

Vein Thrombosis ◽

Baseline Testing ◽

Deep Vein ◽

D Dimer

SummaryThe sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Merieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test (≥1.0 Μg/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 Μg/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence.The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.

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AB0 Blood Groups and Coronary Heart Disease (CHD)

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650035 ◽

1980 ◽

Vol 43 (02) ◽

pp. 137-140 ◽

Cited By ~ 22

Author(s):

Jan Erikssen ◽

Erik Thaulow ◽

Helge Stormorken ◽

Ole Brendemoen ◽

Arvid Hellem

Keyword(s):

Coronary Artery ◽

Blood Group ◽

Artery Bypass ◽

Laboratory Data ◽

Epidemiological Data ◽

Consecutive Series ◽

Related Factors ◽

Ab0 Blood Groups ◽

Clinically Significant ◽

Artery Disease

SummaryThe view based on epidemiological and laboratory data that blood group A subjects (=A) have clinically significant higher thrombotic potential than blood group 0 subjects (= O), is supported by the present finding of a significantly higher platelet retention in A than 0.The completely normal ABO distribution found among 71 cases of proven latent CHD, and the disproportionate excess of 0 vs. A in a consecutive series of 191 coronary artery bypass candidates apparently conflict with epidemiological data indicating a higher risk of achieving CHD in A than 0. The conflict may be solved by suggestinga) that the »thrombotic proneness« in A compared with 0 causes a poorer prognosis in CHD among the former, leaving a disproportionate excess of 0 among longterm CHD survivors, and b) that AB0-related factors have had an insignificant, independent impact on the evolution of preclinical coronary artery disease in our 71 men with latent CHD.

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Percutaneous Approach to the Foramen Ovale: An Anatomical Study of the Extracranial Trajectory

Skull Base ◽

10.1055/s-2009-1242423 ◽

2009 ◽

Vol 19 (03) ◽

Author(s):

Jorge Alvernia ◽

Nguyen Dang ◽

Patrick Mertens ◽

Marc Sindou ◽

Miguel Melgar

Keyword(s):

Anatomical Study ◽

Foramen Ovale ◽

Percutaneous Approach

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Comparison of Endoscopic Versus Percutaneous Approach (Blind) to Control the Obturator Jerk in Patients Undergoing Transurethral Resection of Bladder Tumors Under Spinal Anesthesia

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49885 ◽

2020 ◽

Vol 21 (2) ◽

pp. 120-126

Author(s):

Alamgir Md ◽

Karim Km Monwarul ◽

Nandy SP ◽

Md Monwar Ul Haque ◽

Sakhawat Mahmud Khan

Keyword(s):

Statistical Analysis ◽

Spinal Anesthesia ◽

Transurethral Resection ◽

Bladder Tumor ◽

Complete Resection ◽

Satisfaction Level ◽

Bladder Tumors ◽

Percutaneous Approach ◽

Group A ◽

Group B

Objective: The aim of the study was to compare the endoscopic versus percutaneous approach (blind) to control the obturator jerk in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. Materials and methods: A prospective observational study was performed in Department of Urology, Chittagong Medical College, Chittagong and some Private Hospitals (Ltd.) in Chittagong city during the period from January 2016 to June 2016. Total 100 patients were grouped into two, on alternate basis. Fifty(50) patients in group- A conducted with endoscopic infiltration with 20ml of injection 2% lignocaine at the bladder tumor base and another 50 patients in group-B, conducted with blind percutaneous technique with same drug and volume ( 20ml inj.2% lignocaine) to control obturator jerk. Severity of obturator jerk in both procedure, percentage of complete resection, ONB procedure related time, ONB procedure related complications and surgeon’s satisfaction level were recorded and compared between two approaches. Chi-square analysis was performed to compare the ease of approach and outcome of the two techniques. A value of P<0.05 was considered statistically significant. Results: The mean age of the patients were 59.44+7.681. In group-A, 50 patients were given inj. 2% lignocaine endoscopically at the bladder tumor base to control obturator jerk. Twenty five patients (50%) had no jerk, 20 patients(40%) developed mild jerk and 5 patients (10%) developed moderate jerk and no patients developed severe jerk. Second attempt was taken in moderate jerk patients (5 patients) and succeeded in 3(6%) patients. So, in this group, complete resection of bladder tumor was possible in 96%. In group B, complete resection of bladder tumor was possible in 84%. Statistical analysis was done and result is significant in case of endoscopic procedure to control obturator jerk(p<0.05). ONB Procedure related time was <20 mins. in 32(64%) patients in group-A and 45 (90%) patients in group- B. 20 mins. or more time was required for 18 (36%) patients in group-A and 5 (10%) patients in group-B. Statistical analysis was done and result is significant in percutaneous (blind) technique (p<0.05). ONB procedure related complications in group-A and Group –B were noted. Statistical analysis was done and result is insignificant (p>0.05). Surgeons satisfaction level were recorded on the basis of obturator jerk block and complete resection and which was statistically significant in favour of endoscopy group (p<0.05). Conclusion: It is concluded that endoscopic injection of 2% lignocaine into the bladder tumor base is better in case of jerk elimination and complete resection than blind percutaneous approach. Though, ONB procedure related time was significantly less in percutaneous group. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.120-126

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Dedicated Bifurcation Stents Strategy

Interventional Cardiology Review ◽

10.15420/icr.2009.4.1.70 ◽

2009 ◽

Vol 4 (1) ◽

pp. 70

Author(s):

Chen Shao-Liang ◽

Imad Sheiban ◽

◽

Keyword(s):

Interventional Cardiology ◽

Daily Practice ◽

Side Branch ◽

Control Groups ◽

Coronary Bifurcation ◽

Percutaneous Approach ◽

Coronary Bifurcation Lesions ◽

Drug Eluting ◽

Bifurcation Lesions ◽

Provisional Stenting

Coronary bifurcation lesions represent an area of ongoing challenges in interventional cardiology, mainly due to the higher rate of residual stenosis and restenosis at the side branch ostium. Multiple two-stent bifurcation strategies, including T-stenting, V-stenting, simultaneuos kissing stenting, culotte stenting and classic crush techniques, have no advantages over one-stent techniques. This led to provisional stenting being considered as a mainstream approach, based on the results of numerous randomised trials. Dedicated bifurcation stents have been designed specifically to treat coronary bifurcations with the aim of addressing some of the shortcomings of the conventional percutaneous approach and facilitating the provisional approach. The development of more drug-eluting platforms and larger studies with control groups demonstrating their clinical applicability, efficacy and safety are required before these stents are widely incorporated into daily practice.

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The Feasibility of Optimal Surgical Result Prediction according to the Centre of Rotation Shift after Multilevel Cervical Total Disc Replacement

Neurologico Spinale Medico Chirurgico ◽

10.15562/nsmc.v1i2.84 ◽

2018 ◽

Vol 1 (2) ◽

pp. 6

Author(s):

Jun Ho Lee

Keyword(s):

Rating Scale ◽

Clinical Success ◽

Total Disc Replacement ◽

Numeric Rating Scale ◽

Disc Replacement ◽

Cervical Disc ◽

Consecutive Series ◽

Cervical Total Disc Replacement ◽

Successful Group ◽

Centre Of Rotation

Objective: This study investigates the relation between shifted locations of centre of rotation (COR) at each cervical level and subsequent surgical outcomes after multilevel cervical total disc replacement (MCTDR) and identifies radiological parameter that corresponded to change of COR after MCTDR. Methods: The study included a consecutive series of 24 patients who were treated with MCTDR following diagnosis of multilevel cervical disc herniation or stenosis. Numeric rating scale (NRS), range of motion (ROM) at both C2-7 segment and TDR implanted levels, and the location of COR at TDR implanted level were evaluated at pre- and post-MCTDR. These parameters were compared between patients who experienced successful and unsuccessful pain relief.Results: The inherent CORs relatively at ventro-cranial coordinates have demonstrated significant migrations to dorso-caudal locations at each cervical levels, more prominent shifts for the successful group, after MCTDR switch. The unsuccessful group showed markedly reduced C2-7 ROM and reduced angular improvement at C2-7 as well as MCTDR level after surgery in comparison with the successful group. Postoperative C2-7 ROM was related to postoperative COR along the X-axis.Conclusions: The crucial determinants for clinical success after MCTDR, other than mere preservation of the ROM both at C2-7 and TDR implanted levels, was the restoration of COR from ventro-cranial location at degenerated cervical motion segment close to normal coordinates by posterior and inferior shifts after MCTDR. The position of COR along the X-axis after MCTDR was an important factor to determine maintenance of C2-7 RO.

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Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

Acta Marisiensis - Seria Medica ◽

10.2478/amma-2020-0002 ◽

2020 ◽

Vol 66 (1) ◽

pp. 19-22

Author(s):

Melania Macarie ◽

Simona Maria Bataga ◽

Monica Pantea ◽

Razvan Opaschi ◽

Simona Mocan ◽

...

Keyword(s):

Risk Factors ◽

Sex Ratio ◽

Hiatal Hernia ◽

Statistical Significance ◽

Erosive Esophagitis ◽

Male Gender ◽

Consecutive Series ◽

Study Group ◽

Entire Study ◽

Significant Difference

AbstractObjective: This study aims to determine the correlation between risk factors and erosive esophagitis development.Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification.Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%).Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

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Gamma knife radiosurgery as a single treatment modality for large cerebral arteriovenous malformations

Journal of Neurosurgery ◽

10.3171/jns.2000.93.supplement_3.0113 ◽

2000 ◽

Vol 93 (supplement_3) ◽

pp. 113-119 ◽

Cited By ~ 82

Author(s):

D. Hung-Chi Pan ◽

Wan-Yuo Guo ◽

Wen-Yuh Chung ◽

Cheng-Ying Shiau ◽

Yue-Cune Chang ◽

...

Keyword(s):

Gamma Knife ◽

Arteriovenous Malformations ◽

Radiation Treatment ◽

Gamma Knife Radiosurgery ◽

Consecutive Series ◽

Content Type ◽

Obliteration Rate ◽

Complete Obliteration ◽

Fine Print

Object. A consecutive series of 240 patients with arteriovenous malformations (AVMs) treated by gamma knife radiosurgery (GKS) between March 1993 and March 1999 was evaluated to assess the efficacy and safety of radiosurgery for cerebral AVMs larger than 10 cm3 in volume. Methods. Seventy-six patients (32%) had AVM nidus volumes of more than 10 cm3. During radiosurgery, targeting and delineation of AVM nidi were based on integrated stereotactic magnetic resonance (MR) imaging and x-ray angiography. The radiation treatment was performed using multiple small isocenters to improve conformity of the treatment volume. The mean dose inside the nidus was kept between 20 Gy and 24 Gy. The margin dose ranged between 15 to 18 Gy placed at the 55 to 60% isodose centers. Follow up ranged from 12 to 73 months. There was complete obliteration in 24 patients with an AVM volume of more than 10 cm3 and in 91 patients with an AVM volume of less than 10 cm3. The latency for complete obliteration in larger-volume AVMs was significantly longer. In Kaplan—Meier analysis, the complete obliteration rate in 40 months was 77% in AVMs with volumes between 10 to 15 cm3, as compared with 25% for AVMs with a volume of more than 15 cm3. In the latter, the obliteration rate had increased to 58% at 50 months. The follow-up MR images revealed that large-volume AVMs had higher incidences of postradiosurgical edema, petechiae, and hemorrhage. The bleeding rate before cure was 9.2% (seven of 76) for AVMs with a volume exceeding 10 cm3, and 1.8% (three of 164) for AVMs with a volume less than 10 cm3. Although focal edema was more frequently found in large AVMs, most of the cases were reversible. Permanent neurological complications were found in 3.9% (three of 76) of the patients with an AVM volume of more than 10 cm3, 3.8% (three of 80) of those with AVM volume of 3 to 10 cm3, and 2.4% (two of 84) of those with an AVM volume less than 3 cm3. These differences in complications rate were not significant. Conclusions. Recent improvement of radiosurgery in conjunction with stereotactic MR targeting and multiplanar dose planning has permitted the treatment of larger AVMs. It is suggested that gamma knife radiosurgery is effective for treating AVMs as large as 30 cm3 in volume with an acceptable risk.

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