scholarly journals The clinical features and outcomes of Tolosa-Hunt syndrome

2021 ◽  
Author(s):  
Shin Yeop Oh
Keyword(s):  
Optic Nerve ◽  
Clinical Features ◽  
Medical Records ◽  
Facial Nerve Palsy ◽  
Ocular Motor ◽  
Hunt Syndrome ◽  
Study Results ◽  
History Of ◽  
The Mean

Abstract Background The objective of this study was to investigate the clinical features and outcomes of Tolosa-Hunt syndrome (THS). Methods A retrospective review of the medical records was performed on patients with THS between March 2016 and January 2020. A total of eleven patients fulfilling the ICHD-3 beta diagnostic criteria for THS were included in this study. Results The average age of the patients with THS was 57.18 ± 13.56 years and the mean duration of recovery was 26.91 ± 24.35 days. All nine patients had orbital or periorbital pain as the first symptom followed by diplopia. Ptosis was found in five patients (45.45%) in the involved eye. Sixth cranial nerve (CN) palsy was most common (eight cases, 72.73%), followed by third and fourth CN palsy (five cases, 45.45%, respectively), optic nerve (two cases, 18.18%), and trigeminal nerve and facial nerve palsy (one case, 9.09%, respectively). One patient with optic nerve (ON) involvement failed to recover visual acuity and the other ten patients completely recovered their ocular motor limitation. All patients were initially treated with steroids. One patient relapsed after five weeks and one patient had a history of THS five years earlier. Conclusions THS responded well to steroid treatment, but if it was accompanied by ON involvement, follow-up with active treatment was important.

scholarly journals The clinical features and outcomes of Tolosa-Hunt syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyuna Kim ◽  
Shin Yeop Oh
Keyword(s):  
Optic Neuritis ◽  
Clinical Features ◽  
Steroid Treatment ◽  
High Dose ◽  
Ocular Motor ◽  
Hunt Syndrome ◽  
History Of ◽  
The Mean

Abstract Background The objective of this study was to investigate the clinical features and outcomes of Tolosa-Hunt syndrome (THS). Methods A retrospective review of the medical records was performed on patients with THS between March 2016 and January 2020. A total of eleven patients fulfilling the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for THS were included in this study. Results The average age of the patients with THS was 57.18 ± 15.32 years and the mean duration of recovery was 26.91 ± 24.35 days. All eleven patients had orbital or periorbital pain as the first symptom followed by diplopia. Ptosis was found in five patients (45.45 %) in the involved eye. Sixth cranial nerve (CN) palsy was most common (eight cases, 72.73 %), followed by third and fourth CN palsy (five cases, 45.45 %, respectively), optic neuritis (two cases, 18.18 %), and trigeminal nerve and facial nerve palsy (one case, 9.09 %, respectively). One patient with optic neuritis failed to recover visual acuity and the other ten patients completely recovered their ocular motor limitation. All patients were initially treated with steroids. One patient relapsed after five weeks and one patient had a history of THS five years earlier. Conclusions THS responded well to steroid treatment, but if it was accompanied by optic neuritis as optic nerve involvement, we suggest follow-up with high dose steroid treatment especially was important.

scholarly journals The clinical profile of childhood optic neuritis

2001 ◽  
Vol 59 (2B) ◽  
pp. 311-317 ◽  
Author(s):  
Marco Aurélio Lana-Peixoto ◽  
Gustavo Cardoso de Andrade
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Medical Records ◽  
Visual Loss ◽  
Visual Outcome ◽  
The Mean ◽  
Group 2 ◽  
Group 1

PURPOSE: To report the clinical features and outcome of a series of children with optic neuritis. METHODS: We reviewed the medical records of patients up to 16 years old with optic neuritis. Group 1 comprised children seen up to two weeks after the onset of visual loss; Group 2 comprised patients already harboring optic atrophy. RESULTS: There were 15 boys and 12 girls. The mean age was 10.9 years. Bilateral optic neuritis occurred in 10. Optic disc pallor was found in 35%, edema in 46%, and 19% had normal fundus. During follow-up visual acuity improved in all but one eye in Group 1, and in six of seven eyes in children in Group 2. Just one child converted to multiple sclerosis. CONCLUSIONS: This study shows that the clinical features of childhood optic neuritis differ from those observed in adults. In children it has a better visual outcome and a lower conversion rate to multiple sclerosis than in adults.

CLINICAL FEATURES, INDICATIONS AND RESULT OF TRACHEOTOMY

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le
Keyword(s):  
Clinical Features ◽  
University Hospital ◽  
Female Ratio ◽  
Tube Obstruction ◽  
Level Ii ◽  
Study Results ◽  
Male Female Ratio ◽  
Hospital Patients ◽  
Level I

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy

Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation

2021 ◽  
pp. 112067212110206
Author(s):  
Pablo Felipe Rodrigues ◽  
Bernardo Kaplan Moscovici ◽  
Guilherme Ferrara ◽  
Luciano Lamazales ◽  
Marcela Mara Silva Freitas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Spherical Equivalent ◽  
Interventional Study ◽  
Data Comparison ◽  
Corneal Densitometry ◽  
Corrected Visual Acuity ◽  
Ring Segment ◽  
The Mean

Objective: Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Methods: Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. Results: The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from −4.63 (SD ± 3.94) preoperatively to −2.16 (SD ± 2.63) postoperatively. Asphericity varied from −0.69 (SD ± 0.32) preoperatively to −0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Conclusion: Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea’s anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

scholarly journals Comparison of Intravitreal Aflibercept and Ranibizumab following Initial Treatment with Ranibizumab in Persistent Diabetic Macular Edema

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Demircan ◽  
Zeynep Alkin ◽  
Ceren Yesilkaya ◽  
Gokhan Demir ◽  
Burcu Kemer
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Medical Records ◽  
Poor Response ◽  
Intravitreal Aflibercept ◽  
The Mean ◽  
Retrospective Comparative Study ◽  
Switch Group ◽  
Persistent Diabetic Macular Edema

Purpose. To compare the visual and anatomic outcomes in patients with persistent diabetic macular edema (DME) who switched from ranibizumab to aflibercept with those who continued with previous ranibizumab therapy. Methods. In this retrospective comparative study, medical records of consecutive patients with center-involved DME ≥ 350 μm who had at least three recent consecutive monthly ranibizumab injections followed by as-needed therapy with either aflibercept or ranibizumab were reviewed. Data were collected at presentation (preinjection), at the intermediary visit, and at the last visit (at the end of the follow-up period). Results. Forty-three eyes of 43 patients were divided into two groups: the switch group (n=20) and the ranibizumab group (n=23). Though no significant improvement was found in the mean BCVA from the intermediary visit to the last visit, there was a difference in the mean CMT in the switch group and the ranibizumab group (p<0.001 and p=0.03, resp.). The mean CMT decreased after the intermediary visit by 188.6 ± 120.5 μm in the switch group and by 60.3 ± 117.1 μm in the ranibizumab group (p=0.003). Conclusions. Both aflibercept and ranibizumab decreased CMT in patients with persistent DME who showed a poor response to ranibizumab injections. However, switching to aflibercept provided only morphologic improvement.

Association between Patients with Metabolic Syndrome and Other Various Factors Defining Metabolic Syndrome: A Cross-Sectional Study

2021 ◽  
Vol 8 (4) ◽  
pp. 12-17
Author(s):  
Basavaraj PG ◽  
Ashok P Yenkanchi ◽  
Chidanand Galagali
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Diseases ◽  
Abdominal Obesity ◽  
Positive History ◽  
The Metabolic Syndrome ◽  
Study Results ◽  
History Of ◽  
The Mean

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.

Status Epilepticus in Children With Epilepsy: The Role of Antiepileptic Drug Levels in Prevention

PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1119-1121
Author(s):  
Joseph Maytal ◽  
Gerald Novak ◽  
Catherine Ascher ◽  
Robert Bienkowski
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drug ◽  
Medical Records ◽  
Clinic Visit ◽  
Drug Levels ◽  
Progressive Encephalopathy ◽  
History Of ◽  
The Mean ◽  
Subtherapeutic Level

Objectives. To determine the association between subtherapeutic antiepileptic drug (AED) levels or AED withdrawal and status epilepticus (SE) in children with epilepsy. Methods. We studied the AED levels at the time of SE in 51 consecutive children with epilepsy. Information about prior AED levels, possible etiology of seizures, and acute precipitants was extracted from medical records. Results. The mean age at the time of SE was 5.7 years (range, 3 months through 18 years). Forty-three patients had history of remote insult, five had history of progressive encephalopathy, and three patients were classified as idiopathic. At the time of SE all AED levels were therapeutic in 34 (66%) patients and at least one level was therapeutic in 42 (82%) patients. All levels were subtherapeutic in 9 (18%) patients. Four patients had their AED reduced or discontinued less than 1 week before SE. Twelve patients with therapeutic AED levels on their most recent clinic visit had at least one subtherapeutic level at the time of SE. Eight (16%) patients were febrile and one was hyponatremic. Of the 51 patients, 31 (61%) had no obvious explanation for the development of SE, as all known AEDs were therapeutic and there were no known acute insults. Conclusions. Neurologically abnormal children with preexisting epilepsy are at high risk for development of SE despite having therapeutic AED levels at that time. Acute precipitants of SE, such as fever or AED withdrawal, may play a role in inducing SE only in a minority of patients.

Frequency, Predictors, and Outcome of Seizures in Patients With Myelomeningocele: Single-Center Retrospective Cohort Study

2021 ◽  
pp. 088307382110531
Author(s):  
Cemal Karakas ◽  
Emin Fidan ◽  
Kapil Arya ◽  
Troy Webber ◽  
Joan B. Cracco
Keyword(s):  
Good Prognosis ◽  
Cortical Atrophy ◽  
Seizure Freedom ◽  
Single Center ◽  
Seizure Onset ◽  
Shunt Procedure ◽  
History Of ◽  
The Mean

To determine the frequency, predictors, and outcomes of seizures in patients with myelomeningocele, we retrospectively analyzed the data from patients with myelomeningocele followed longitudinally at a single center from 1975 to 2013. We identified a total of 122 patients (61% female). The mean follow-up duration was 11.1 years (minimum-maximum = 0-34.5 years, SD = 8.8, median = 9.1 years). A total of 108 (88.5%) patients had hydrocephalus, and 98 (90.7%) of those patients required a ventriculoperitoneal shunt procedure. Twenty-four (19.7%) patients manifested with seizures, 23 of whom had hydrocephalus. The average age of seizure onset was 4.8 years (median 2 years of age). Falx dysgenesis ( P = .004), lumbar myelomeningocele ( P = .007), and cortical atrophy ( P = .028) were significantly associated with epileptic seizure development. The average seizure-free period at the last follow-up in patients with a history of myelomeningocele and seizures was 8.1 years. We conclude that myelomeningocele patients with seizures have an overall good prognosis with considerable long-term seizure freedom.

Palliative Treatment of Hepatocellular Carcinoma with Transcatheter Arterial Embolization

1993 ◽  
Vol 34 (1) ◽  
pp. 26-29 ◽  
Author(s):  
S. Savastano ◽  
G. P. Feltrin ◽  
D. Neri ◽  
P. da Pian ◽  
M. Chiesura-Corona ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcatheter Arterial Embolization ◽  
Palliative Treatment ◽  
Arterial Embolization ◽  
Percutaneous Ethanol Injection ◽  
Ethanol Injection ◽  
History Of ◽  
The Mean ◽  
Hcc Recurrence

Thirty-three consecutive patients with previously untreated hepatocellular carcinoma (HCC) and 6 patients with recurrent HCC were treated with transcatheter arterial embolization (TAE). The patients were not eligible for surgical resection or percutaneous ethanol injection. TAE was performed with Lipiodol Ultra-Fluid, epidoxorubicin and Gelfoam, with a mean of 1.7 treatments per patient. CT was performed 15 days after TAE. The mean cumulative survival was 14.2 months in patients with previously untreated HCC. The survival of patients stages Okuda I and II did not differ significantly (p > 0.05); tumor size did not affect survival (p > 0.05). Two patients with recurrent HCC died 7.0 and 9.3 months after the diagnosis of tumor recurrence; the remaining 4 patients are still alive with a maximum follow-up of 22.5 months from the diagnosis of HCC recurrence. Ten complications occurred in 8 patients, and were controlled by medical therapy. Eleven patients died during the study; no death was related to TAE. The series was not randomized, but comparison with the natural history of HCC suggests that TAE is effective as palliative treatment of advanced or recurrent HCC.

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