scholarly journals Clinical efficacy of single intraoperative 500 mg methylprednisolone management therapy for thoracic myelopathy caused by ossification of the ligamentum flavum

2020 ◽  
Author(s):  
Xiaoyang Huo ◽  
Jiaming Zhou ◽  
Shiwei Liu ◽  
Xing Guo ◽  
Yuan Xue
Keyword(s):  
Posterior Approach ◽  
Ligamentum Flavum ◽  
Thoracic Myelopathy ◽  
Time Points ◽  
Significant Difference ◽  
Before And After ◽  
Long Term Follow Up ◽  
Frankel Grade

Abstract Background: The objective of our study was to compare clinical outcome and postoperative complications between patients with thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) treated with and without intraoperative methylprednisolone (MP).Methods: This retrospective study enrolled 101 patients who underwent posterior approach surgery for OLF and were followed up at least 1 year. Patients were divided into two groups according to MP use in the operation: MP group (n=47) and non-MP group (n=54). Clinical outcomes and complications were evaluated before and after operation and at the last follow-up. Results: Significant differences were found in modified Japanese Orthopedics Association (mJOA) scores and proportion of Frankel grade (A-C) between the two groups immediately after surgery and at 2-week follow-up. No significant differences were found between the two groups in mJOA score before operation and at the final follow-up. Moreover, no significant differences were observed in recovery rate according to mJOA score at any time points, and there was no significant difference in the proportion of Frankel grade (A-C) between the two groups at final follow-up. There were 13 documented infections: 10 in the MP group and 3 in the non-MP group (P=0.034).Conclusion: Management therapy with intraoperative 500 mg MP showed better recovery of nerve function within 2 weeks in patients with thoracic myelopathy caused by OLF compared with those did not receive MP. However, long-term follow-up results showed that there was no significant difference in neurological recovery between patients with intraoperative MP or not. Moreover, intraoperative MP increased the rate of wound infection.

scholarly journals Clinical efficacy of single intraoperative 500 mg methylprednisolone management therapy for thoracic myelopathy caused by ossification of the ligamentum flavum

2020 ◽  
Author(s):  
Xiaoyang Huo ◽  
Jiaming Zhou ◽  
Shiwei Liu ◽  
Xing Guo ◽  
Yuan Xue
Keyword(s):  
Posterior Approach ◽  
Ligamentum Flavum ◽  
Nerve Function ◽  
Thoracic Myelopathy ◽  
Time Points ◽  
Before And After ◽  
Long Term Follow Up ◽  
Frankel Grade

Abstract Background The objective of our study was to compare clinical outcome and postoperative complications between patients with thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) treated with and without intraoperative methylprednisolone (MP).Methods This retrospective study enrolled 101 patients who underwent posterior approach surgery for OLF and were followed up at least 1 year. Patients were divided into two groups according to MP use in the operation: MP group (n=47) and non-MP group (n=54). Clinical outcomes and complications were evaluated before and after operation and at the last follow-up.Results Significant differences were found in modified Japanese Orthopedics Association (mJOA) scores and proportion of Frankel grade (A-C) between the two groups immediately after surgery and at 2-week follow-up. No significant differences were found between the two groups in mJOA score before operation and at the final follow-up. Moreover, no significant differences were observed in recovery rate according to mJOA score at any time points, and there were no significant differences in the proportion of Frankel grade between the two groups. There were 13 documented infections: 10 in the MP group and 3 in the non-MP group ( P =0.034).Conclusion Management therapy with intraoperative 500 mg methylprednisolone promoted the recovery of nerve function within 2 weeks in patients with thoracic myelopathy caused by OLF. However, long-term follow-up results showed that intraoperative methylprednisolone was inefficient. Moreover, intraoperative methylprednisolone increased the rate of wound infection.

scholarly journals Dynamic Analysis of Ocular Fundus Changes after Different Doses of Bevacizumab in the Treatment of Retinopathy of Prematurity in Threshold Period

2021 ◽  
Author(s):  
Feng Chen ◽  
Ying Yu ◽  
Jianxun Wang ◽  
Tian Liu ◽  
Daoman Xiang
Keyword(s):  
Retinopathy Of Prematurity ◽  
Fundus Examination ◽  
Time Points ◽  
Bevacizumab Treatment ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Consecutive Time ◽  
Different Doses

Abstract Purpose: To analyze the efficacy of three different doses of bevacizumab treatment on Threshold retinopathy of prematurity during different periods . Methods: 36 cases (72 eyes) of infants with threshold ROP were analyzed, whom were treated with intravitreal injection of 1.25mg, 0.75mg or 0.5mg bevacizumab respectively from October 1st, 2016 to September 30th, 2017. After treatment, fundus examination results during five time points were recorded and classified into four grades according to the efficacy. Results: There were significant differences in the changes of fundus among the 3 groups on the 4th day and the 2nd week after treatment （P<0.001）. In the 1.25mg group, there was a significant difference in the changes of fundus on the 4th day after treatment VS. the 2nd week after treatment (P<0.001). In the 0.5mg and 0.75mg group respectively, the changes of fundus were significantly different between each consecutive time points of the 4th day, 2nd week, 4th week and 2nd month after treatment (P<0.001,P<0.001,P=0.01; P<0.001,P=0.01,P=0.032). The proportion of normal retinal vessels of the three groups is 41.67% - 66. 67% in the 3rd month after treatment.Conclusion: Among the three doses of bevacizumab treatment, the efficacy of 1.25mg group is the best on the 4th day and the 2nd week after treatment, and there was no difference after 4 weeks. The efficacy of 0.5mg and 0.75mg group changed significantly from the 4th day to the 2nd month after treatment. Long-term follow-up of fundus changes was still needed to avoid recurrence of ROP whatever the dose of bevacizumab was uesed.

scholarly journals Dynamic Analysis of Ocular Fundus Changes After Different Doses of Bevacizumab in the Treatment of Retinopathy of Prematurity in Threshold Period

2021 ◽  
Author(s):  
Feng Chen ◽  
Daoman Xiang ◽  
Ying Yu ◽  
Jianxun Wang ◽  
Tian Liu
Keyword(s):  
Retinopathy Of Prematurity ◽  
Statistical Significance ◽  
Time Points ◽  
Bevacizumab Treatment ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Consecutive Time ◽  
Different Doses

Abstract Purpose: To analyze the efficacy of three different doses of bevacizumab treatment on Threshold retinopathy of prematurity during different periods . Methods: 36 cases (72 eyes) of infants with threshold ROP were analyzed, whom were treated with intravitreal injection of 1.25 mg, 0.75 mg or 0.5 mg bevacizumab respectively from October 1st, 2016 to September 30th, 2017. After treatment, fundus examination results during five time points were recorded and classified into four grades according to the efficacy. Results: There were significant differences in the changes of fundus among the 3 groups from the 4th day to the 4th week after treatment （P<0.01）. In the 1.25 mg group, there was a significant difference in the changes of fundus on the 4th day after treatment VS. the 2nd week after treatment (P<0.001). In the 0.75 mg and 0.5 mg group respectively, the changes of fundus were significantly different between each consecutive time points of the 4th day, 2nd week, 4th week and 2nd month after treatment (P<0.001,P=0.001,P=0.002; P<0.001,P=0.001,P=0.003). The proportion of normal retinal vessels respectively in 1.25 mg , 0.75 mg and 0.5 mg group is 66.67%、43.48% and 50% in the 3rd month after treatment.Conclusion: Retinal complete vascularization was slightly better in 1.25 mg group, but failed to reach a statistical significance. Based on results, the lowest dose 0.5 mg may be preferred since our final results were similar (p>0.05). Long-term follow-up of fundus changes was still needed to avoid recurrence of ROP whatever the dose of bevacizumab was uesed.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

A randomized trial of levamisole versus placebo as adjuvant therapy in malignant melanoma.

1991 ◽  
Vol 9 (5) ◽  
pp. 736-740 ◽  
Author(s):  
L E Spitler
Keyword(s):  
Malignant Melanoma ◽  
Adjuvant Therapy ◽  
Randomized Trial ◽  
Control Groups ◽  
Disease Free Interval ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
And Control

We conducted a long-term follow-up (median, 10.5 years) of patients included in a randomized trial of levamisole versus placebo as surgical adjuvant therapy in 203 patients with malignant melanoma. Of the patients randomized, 104 received levamisole, and 99 received placebo. The results show that there is no difference between the treatment and control groups with regard to any of the three end points analyzed. These included disease-free interval, time to appearance of visceral metastasis, and survival. Moreover, there was no significant difference between the treatment and control groups after adjusting for age, sex, or stage of disease.

scholarly journals Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Joanna Wojtasik-Bakalarz ◽  
Zoltan Ruzsa ◽  
Tomasz Rakowski ◽  
Andreas Nyerges ◽  
Krzysztof Bartuś ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Of Death ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Artery Disease ◽  
The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

scholarly journals Long-term follow-up of therapeutic efficacy of everolimus-eluting bioresorbable vascular scaffold in comparison to everolimus-eluting stent in treatment of chronic total occlusion guided by intracoronary imaging

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohammad Abdallah Eltahlawi ◽  
Abdel-Aziz Fouad Abdel-Aziz ◽  
Abdel-Salam Sherif ◽  
Khalid Abdel-Azeem Shokry ◽  
Islam Elsayed Shehata
Keyword(s):  
Chronic Total Occlusion ◽  
Bioresorbable Vascular Scaffold ◽  
Total Occlusion ◽  
Intracoronary Imaging ◽  
Group I ◽  
Significant Difference ◽  
Vascular Scaffold ◽  
Long Term Follow Up

Abstract Background We hypothesized that 1st generation everolimus-eluting bioresorbable vascular scaffold (BVS) stent associated with less complication and less restenosis rate than everolimus-eluting stent (EES) in chronic total occlusion (CTO) recanalization guided by intracoronary imaging. Therefore, we aimed to assess the safety and performance of BVS stent in CTO revascularization in comparison to EES guided by intracoronary imaging. Our prospective comparative cross-sectional study was conducted on 60 CTO patients divided into two groups according to type of stent revascularization: group I (EES group): 40 (66.7%) patients and group II (BVS group): 20 (33.3%) patients. All patients were subjected to history taking, electrocardiogram (ECG), echocardiography, laboratory investigation, stress thallium study to assess viability before revascularization. Revascularization of viable CTO lesion guided by intracoronary imaging using optical coherence tomography (OCT). Then, long-term follow-up over 1 year clinically and by multi-slice CT coronary angiography (MSCT). Our clinical and angiographic endpoints were to detect any clinical or angiographic complications during the follow-up period. Results At 6 months angiographic follow-up, BVS group had not inferior angiographic parameters but without statistically significant difference (p = 0.566). At 12 months follow-up, there was no difference at end points between the two groups (p = 0.476). No differences were found at angiographic or clinical follow-up between BVS and EES. Conclusion This study shows that 1st generation everolimus-eluting BVS is non-inferior to EES for CTO revascularization. Further studies are needed to clearly state which new smaller footprint BVS, faster reabsorption, magnesium-based less thrombogenicity, and advanced mechanical properties is under development. We cannot dismiss the efficacy and safety of new BVS technology. Trial registration ZU-IRB#2498/3-12-2016 Registered 3 December 2016, email: [email protected]

scholarly journals Outcome and Complications of MR Guided Focused Ultrasound for Essential Tremor: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Mohit Agrawal ◽  
Kanwaljeet Garg ◽  
Raghu Samala ◽  
Roopa Rajan ◽  
Vikas Naik ◽  
...  
Keyword(s):  
Essential Tremor ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Meta Analysis ◽  
Post Procedure ◽  
Standard Mean Difference ◽  
Significant Difference ◽  
Long Term Follow Up

Background: Magnetic resonance guided focused ultrasound (MRgFUS) is a relatively novel technique to treat essential tremor (ET). The objective of this review was to analyze the efficacy and the safety profile of MRgFUS for ET.Methods: A systematic literature review was done. The post procedure changes in the Clinical Rating Scale for Tremor (CRST) score, hand score, disability and quality of life scores were analyzed.Results: We found 29 studies evaluating 617 patients. DTI based targeting was utilized in six cohorts. A significant difference was observed in the pooled standard mean difference between the pre and postoperative total CRST score (p-value &lt; 0.001 and 0.0002), hand score (p-value 0.03 and 0.02); and the disability at 12 months (p-value 0.01). Head pain and dizziness were the most in procedure complications. The immediate pooled proportion of ataxia was 50%, while it was 20% for sensory complications, which, respectively, declined to 31 and 13% on long term follow up. A significant reduction (p = 0.03) in immediate ataxia related complications was seen with DTI targeting.Conclusion: MRgFUS for ET seems to be an effective procedure for relieving unilateral tremor. Use of DTI based targeting revealed a significant reduction in post procedure ataxia related complications as compared to traditional targeting techniques. Analysis of other complications further revealed a decreasing trend on follow up.

Maximum Bite Force of Edentulous Patients before and after Dental Implant Rehabilitation: Long-Term Follow-Up and Facial Type Influence

2016 ◽  
Vol 27 (6) ◽  
pp. 523-527 ◽  
Author(s):  
Ana Cláudia M. Melo ◽  
Ingrid M. Ledra ◽  
Rogéria A. Vieira ◽  
Edivaldo R. Coró ◽  
Ivete Aparecida de M. Sartori
Keyword(s):  
Dental Implant ◽  
Bite Force ◽  
Before And After ◽  
Long Term Follow Up ◽  
Edentulous Patients ◽  
Facial Type

scholarly journals Does immunological remission, defined as disappearance of autoantibodies, occur with current treatment strategies? A long-term follow-up study in rheumatoid arthritis patients who achieved sustained DMARD-free status

2019 ◽  
Vol 78 (11) ◽  
pp. 1497-1504 ◽  
Author(s):  
Debbie M Boeters ◽  
Leonie E Burgers ◽  
René EM Toes ◽  
Annette van der Helm-van Mil
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Dmard Therapy ◽  
Before And After ◽  
Long Term Follow Up ◽  
Free Status

ObjectivesSustained disease-modifying antirheumatic drug (DMARD)-free status, the sustained absence of synovitis after cessation of DMARD therapy, is infrequent in autoantibody-positive rheumatoid arthritis (RA), but approximates cure (ie, disappearance of signs and symptoms). It was recently suggested that immunological remission, defined as disappearance of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF), underlies this outcome. Therefore, this long-term observational study determined if autoantibodies disappear in RA patients who achieved sustained DMARD-free remission.MethodsWe studied 95 ACPA-positive and/or RF-positive RA patients who achieved DMARD-free remission after median 4.8 years and kept this status for the remaining follow-up (median 4.2 years). Additionally, 21 autoantibody-positive RA patients with a late flare, defined as recurrence of clinical synovitis after a DMARD-free status of ≥1 year, and 45 autoantibody-positive RA patients who were unable to stop DMARD therapy (during median 10 years) were studied. Anti-cyclic citrullinated peptide 2 (anti-CCP2) IgG, IgM and RF IgM levels were measured in 587 samples obtained at diagnosis, before and after achieving DMARD-free remission.Results13% of anti-CCP2 IgG-positive RA patients had seroreverted when achieving remission. In RA patients with a flare and persistent disease this was 8% and 6%, respectively (p=0.63). For anti-CCP2 IgM and RF IgM, similar results were observed. Evaluating the estimated slope of serially measured levels revealed that RF levels decreased more in patients with than without remission (p<0.001); the course of anti-CCP2 levels was not different (p=0.66).ConclusionsSustained DMARD-free status in autoantibody-positive RA was not paralleled by an increased frequency of reversion to autoantibody negativity. This form of immunological remission may therefore not be a treatment target in patients with classified RA.

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