scholarly journals Prosthodontic Rehabilitation of Bilateral Maxillary Lateral Incisors Agenesis: A Case Report with One-Year Follow-Up

2021 ◽  
Vol 16 (2) ◽  
pp. 241-251
Author(s):  
Beh Yew Hin ◽  
Zaihan Ariffin
Keyword(s):  
Treatment Options ◽  
Social Background ◽  
Prolonged Treatment ◽  
Tooth Agenesis ◽  
Team Approach ◽  
Craniofacial Growth ◽  
Optimal Outcome ◽  
Care Approach ◽  
One Year

Globally, non-syndromic tooth agenesis is commonly seen in clinical practice. However, its management is often complex and requires a multidisciplinary team approach for the maximal outcome. While various treatment options are possible, considerations for the treatment are not only based on the dentofacial conditions but also cultural and social background and personal preference of the patient. Thus, patientcentred care approach should always be practised for an optimal outcome. In the present case, a patient with established craniofacial growth presenting with bilateral agenesis of maxillary lateral incisors and over-retained deciduous maxillary left canine sought for aesthetic improvements. The patient did not prefer any orthodontic treatment citing a prolonged treatment duration and sub-optimal motivation as a hindrance. Thus, a prosthodontic only approach was taken by providing a conventional cantilever bridge and ceramic veneers to achieve the aims of treatment. This article discusses the possible limitation of such prosthodontic only solution in managing tooth agenesis.

Symptomatic Treatment of Agoraphobia and Social Phobias: A Follow-up Study

1975 ◽  
Vol 127 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Peter Tyrer ◽  
Derek Steinberg
Keyword(s):  
Personality Disorder ◽  
Social Adjustment ◽  
Prolonged Treatment ◽  
Comparable Efficacy ◽  
List Type ◽  
Behaviour Therapy ◽  
Double Blind ◽  
Social Phobias ◽  
One Year

Summary1.Twenty-six out of 28 out-patients with agoraphobia and social phobias who had originally been treated with phenelzine or placebo in a double-blind clinical trial were followed up for a mean period of one year. During the follow-up period patients received further pharmacotherapy or behaviour therapy, except that those patients originally receiving placebo were not allowed therapy with monoamine oxidase inhibitors.2.Ratings of phobic and additional symptoms, social adjustment and degree of personality disorder were made after one year by one of the authors (D.S.) who had no prior knowledge of the treatment each patient had received.3.There were no significant differences in any of the ratings between the patients of the two groups, but those originally receiving placebo had more additional treatment in the follow-up period. Patients continuing to receive phenelzine frequently experienced a return of symptoms if the drug was withdrawn before six months treatment had elapsed.4.Degree of personality disorder showed a significant negative correlation (p = –0.6) with improvement in the phenelzine group but not in those receiving placebo originally.5.Improvement in social adjustment items was less than improvement in symptoms at follow-up. The implications of this are discussed.6.The results suggest that phenelzine is of comparable efficacy to other symptomatic treatments for agoraphobia and social phobias, but that it acts mainly by symptom suppression. Prolonged treatment in patients with personality disorders is not indicated, for improvement is less likely and the dangers of dependence are greater.

scholarly journals Sertoli-Leydig Cell Tumor with Concurrent Rhabdomyosarcoma: Three Case Reports and a Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Trisha Plastini ◽  
Arthur Staddon
Keyword(s):  
Leydig Cell ◽  
Malignant Tumors ◽  
Case Reports ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Salvage Chemotherapy ◽  
Response To Chemotherapy ◽  
One Year ◽  
Lost To Follow Up

Sertoli-Leydig Cell Tumors (SLCTs) make up <1% of all ovarian tumors and are benign or malignant, androgen-secreting tumors. Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble developing skeletal muscle. There have been case reports of patients with concurrent SLCT and RMS with limited treatment options. We aim to demonstrate treatment strategies used in our patients, which seemed to have prolonged survival when compared to prior case reports of patients not cured by surgical resection. Herein we describe 22 cases of SLCT with RMS elements as discussed in prior case reports and three cases from the authors’ institution. Of the 19 cases from prior case reports, five were lost to follow-up and two had NED after surgical intervention. Eleven patients had recurrence and were deceased within one year. Of those patients not surgically cured, only three patients were documented as living beyond two years, all of whom received chemotherapy. The three patients presented from our institution had clinical evidence of response to chemotherapy that is traditionally used for RMS. In conclusion, chemotherapy with doxorubicin and ifosfamide has activity in patients with SLCT and RMS as does salvage chemotherapy with vincristine, irinotecan, and temozolomide.

scholarly journals Therapeutic Challenges for Elderly Patients with Primary Hyperparathyroidism

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Kenneth Sluis ◽  
Hyon Kim ◽  
Yuling He ◽  
Beatrice Wong ◽  
Xiangbing Wang
Keyword(s):  
Primary Hyperparathyroidism ◽  
Chart Review ◽  
Treatment Options ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Long Term Stability ◽  
Feasible Option ◽  
One Year

Primary hyperparathyroidism (PHPT) predominantly affects older adults, and parathyroidectomy can achieve definitive cure in symptomatic PHPT and asymptomatic meeting surgical criteria. As the population continues to age, the treatment of PHPT in octogenarians and nonagenarians presents a clinical conundrum. This case series presents the management of eight patients 85 years of age and older diagnosed with PHPT. A retrospective chart review of patients diagnosed with primary hyperparathyroidism were identified in a single institution. Those patients 85 years of age and older who were followed up for over one year were included in this case series. The literature on treatment options for this age group was also reviewed. Eight cases of PHPT patients aged 88 ± 2.5 years old with a follow-up average of 5.6 ± 4.4 years were reported in our case series. Six PHPT patients were medically managed and two PHPT patients underwent parathyroid resection. Most of the medically managed PHPT patients except for one had long-term stability of disease for over five years. The treatment of PHPT diagnosed in patients over 85 years of age presents a clinical challenge for which there is no clear consensus guideline. Our case series supports that medical therapy is a feasible option for PHPT patients over 85 years old.

scholarly journals Hyaluronic acid injections for chronic tennis elbow

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Gershon Zinger ◽  
Alexander Bregman ◽  
Ori Safran ◽  
Shaul Beyth ◽  
Amos Peyser
Keyword(s):  
Hyaluronic Acid ◽  
Tennis Elbow ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Saline Group ◽  
Primary Outcome Measure ◽  
Saline Control ◽  
Vas Score ◽  
One Year

Abstract Background For most patients, tennis elbow (TE) resolves within 6 months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatments for TE but have usually failed. In this study, we tested the hypothesis that injections with hyaluronic acid (HA) would be effective at reducing pain from chronic TE. Methods Patients with a minimum of six months of pain from TE and with a pain level of 50 or greater (out of 100) were included in the study. They were randomized equally into one of two treatment groups: injection with HA or injection with saline control. Follow-up was conducted at 3, 6 and 12 months from the initial injection. Both the patient and the examiner at the follow-up visits were blinded to the treatment arm. The primary outcome measure was the visual analog scale (VAS pain) score at one year. Additional outcome measures included the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and Patient Rated Tennis Elbow Evaluation (PRTEE) scores. Results Eighteen patients were randomized into the HA injection treatment arm, and 17 (94%) completed the study. The average age was 51.9 years, and 10 of the subjects were male. Patients had an average of 28.1 months of pain before entering the study. The VAS score in the HA group decreased from a baseline of 76.4–14.3 at 12 months. All 17 patients in the HA group showed VAS score reductions above the minimal clinically important difference (MCID) of at least 18. The PRTEE score improved from 67 to 28.1. The QuickDASH score improved from 53.7 to 22.5. Follow-up in the saline group was less than 50% and was therefore not used as a comparator. Conclusions HA injections yielded significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from receiving injections of hyaluronic acid rather than having to undergo surgery.

scholarly journals Playing jeopardy by not treating the whole person with arthritis

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Patricia Lynn Dobkin ◽  
Gilles Boire
Keyword(s):  
Clinical Outcomes ◽  
Joint Damage ◽  
First Year ◽  
Biomedical Model ◽  
Potent Predictor ◽  
Whole Person ◽  
Care Approach ◽  
Using Data ◽  
One Year

Availability of potent medications, earlier diagnosis and use of drug combinations should have made rheumatoid arthritis yesterday’s disease. Unfortunately the majority of patients never reach remission. The focus of treatment has been based on the biomedical model aiming to reduce inflammation, regulate the immune system, and prevent joint damage – all worthy outcomes. A whole person care approach would add to patient care by including attention to the psychosocial aspects of illness that contribute to clinical outcomes. Two studies using data from a longitudinal cohort followed out to four years with early arthritis patients will be highlighted. The first identified predictors of pain one year after baseline in 211 patients. While overall pain decreased over time, emotion-oriented coping contributed to pain intensity and affective pain. The second study examined the link between depression and clinical outcomes four years later using data from 275 patients. It was found that when depression persisted into the first year it was the most potent predictor of disease activity at each follow-up visit. Moreover, the proportion of patients who ever reached remission decreased from 84.3% to 31.3% for patients with depressive symptoms at 12 months. vailability of potent medications, earlier diagnosis and use of drug combinations should have made rheumatoid arthritis yesterday’s disease.   Unfortunately the majority of patients never reach remission. The focus of treatment has been based on the biomedical model aiming to reduce inflammation, regulate the immune system, and prevent joint damage – all worthy outcomes. A whole person care approach would add to patient care by including attention to the psychosocial aspects of illness that contribute to clinical outcomes.   Two studies using data from a longitudinal cohort followed out to four years with early arthritis patients will be highlighted. The first identified predictors of pain one year after baseline in 211 patients. While overall pain decreased over time, emotion-oriented coping contributed to pain intensity and affective pain. The second study examined the link between depression and clinical outcomes four years later using data from 275 patients. It was found that when depression persisted into the first year it was the most potent predictor of disease activity at each follow-up visit. Moreover, the proportion of patients who ever reached remission decreased from 84.3% to 31.3% for patients with depressive symptoms at 12 months.  It is recommended that both curing and healing be considered when treating arthritis patients given the importance of psychosocial factors to the trajectory of the disease. This could be done by screening for and treating depression in arthritis patients. Antidepressant medications and/or psychological interventions such as Mindfulness-Based Stress Reduction or Cognitive Behavioural Therapy are options to be considered.

scholarly journals P1300 Analysis of clinical and echocardiographic follow-up of patients with heart failure and severe secondary mitral regurgitation 1 year after MitraClip implantation, single centre experience

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Petr ◽  
H Linkova ◽  
E Paskova ◽  
F Bednar ◽  
T Budesinsky ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Systolic Function ◽  
Treatment Options ◽  
Functional Class ◽  
Published Data ◽  
Patients With Heart Failure ◽  
Echocardiographic Examination ◽  
One Year

Abstract Introduction MitraClip implantation is one possible method of treatment of patients with heart failure and severe mitral regurgitation. Goal. Analysis of clinical and echocardiographic data of patients 1 year after MitraClip implantation. Methods The first 63 consequtive patients whom underwent MitraClip implantation at our cardiocentre were analyzed. Implantation was performed after all possible conservative treatment options according to guidelines were exhausted. Each patient underwent careful clinical and echocardiographic examination before and 12 months after implantation. Results Average age of the patient population was 70,5 ± 7,4 years. Baseline average ejection fraction (EF) of left ventricle (LV) was 35,2 ± 12,6%, enddiastolic volume of LV 196 ± 53ml, 63 (100%) had mitral regurgitation (MR) ≥ 3/4, average ERO 27,4 ± 10,2cm2 RV 40,5 ± 12,9ml. During 1 year follow-up 11 (17%) of patients died, 1 (1,6%) from a periprocedural complication. In the patients who survived we observed a decreasing incidence of severe mitral MR , (MR ≥ 3/4 before procedure in 63 (100%) vs. 12 (19%) in patients after procedure). A significant improvement in functional class NYHA (NYHA II-IV before implantation in 63 (100%) patients vs. 17 patients (33%) at one year follow-up). Mortatility was mostly influenced by Euroscore (p 0,08), creatitnine level (p 0,10), from echocardiographic parameters LV EF (36,4% vs. 29,5% p 0,10) and TAPSE (17,8 vs. 15,2mm p 0,04). Conclusion One year mortality in our study population was comparable with previously published data from larger registries. Significant regression of mitral regurgitation and improvement of symptoms was observed in patients after implantation. Moratility was affected by comorbidities, and systolic function of left and right ventricle.

Social Factors and Life Events as Predictors for Children's Health

1982 ◽  
Vol 10 (3) ◽  
pp. 87-93 ◽  
Author(s):  
Jørgen Aagaard
Keyword(s):  
Life Events ◽  
Present State ◽  
Social Factors ◽  
Family Background ◽  
Social Background ◽  
State Of Health ◽  
Index Hospitalization ◽  
Paediatric Department ◽  
One Year

During a period of one year information concerning social background, life events and diseases of children (aged 1—14) admitted to a paediatric department had been obtained. One year after this index hospitalization, information concerning the children's present state of health was obtained. Forty (13%) had been readmitted to hospital during the follow-up year, and the parents of 72 children (23%) reported that their child's present state of health was poor. A multivariate predictor analysis was performed. The associations discovered suggest 1) that the selected social or psycho-social factors do not appear to be of considerable importance for prediction of readmission to hospital, 2) that “poor health” in the children has a very complex prediction pattern, partly due to disease variables, partly due to indices of unfavourable family background.

scholarly journals MON-103 Pattern and Predictors of Thyroid Dysfunction Among Paediatric Endocrine Referrals at Tertiary Care Centre: A Longitudinal Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Shariq Rashid Masoodi ◽  
Mona Sood ◽  
Ovais Ahmed Peerzada ◽  
Moomin Bhat ◽  
Vishnu Vasudevan
Keyword(s):  
Tertiary Care ◽  
Prolonged Treatment ◽  
Antithyroid Drugs ◽  
Thyroid Disorders ◽  
Gradual Change ◽  
Thyroid Disorder ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
One Year

Abstract Background Post iodisation era has experienced gradual change in pattern of thyroid disorders among paediatric population with autoimmunity taking precedence over iodine deficiency disorders and subclinical hypothyroidism (SCH) now more frequently diagnosed but inappropriately managed. Aims This study was conducted to evaluate pattern of abnormal thyroid function among children referred to our tertiary care centre, to ascertain characteristics that influence treatment decisions and to follow them for various outcome measures. Design It was an observational longitudinal follow up study where all children less than 18 years, referred to our outpatient clinic for suspected thyroid disorder were recruited. Demographic data, personal and family history, clinical features were noted and laboratory tests including TT4, TT3, TSH, anti-thyroid peroxidase(antiTPO) and anti-thyroglobulin(antiTG) antibody were conducted in study subjects. Management was based on the clinical judgment of the attending endocrinologist. Patients were followed at 6 week, 3 months, 6 months and one year with clinical and laboratory work up at each visit. Results A total of 241 subjects aged 18 days to 17 years were included out of which 62.25% were females. Initial evaluation revealed SCH in 40% of refereed subjects, overt hypothyroidism (OH) in 33%, congenital hypothyroidism (CH) in 18% and overt thyrotoxicosis in 5%. Autoimmune thyroiditis constituted the major cause of hypothyroidism in the OH group with significantly higher prevalence of anti-TPO and antiTG antibody in comparison of SCH group (61% vs 31%; 45% vs 21.9%, p&lt;0.05) respectively. All subjects in OH group were treated whereas 76% subjects in SCH group were treated and the mean dose of L thyroxine required to treat OH was significantly higher (2.31+1.1ug/kg/day vs 1.76+1.07ug/kg/day; p&lt;0.001) in comparison of SCH group. A major independent predictor of treatment in SCH was initial TSH which was significantly higher in the treated group (11.65 + 3.80 uIU/ml vs 9.24 + 1.31 uIU/ml; p&lt;0.001). Subjects with congenital hypothyroid presented at a mean age of 6 months (18 days to 2 years) with most common aetiology being thyroid hypoplasia and dyshormonogenesis (20% each). Graves’ disease was diagnosed in 11 out of 12 subjects with thyrotoxicosis and were treated with antithyroid drugs. Overall 85.5% of refereed subjects were treated and after one-year follow up management was found to be adequate in 81% subjects. Conclusions The evolving trend of diagnosing children having nonspecific symptoms with SCH is a matter of concern as many are subjected to the burden of unwanted prolonged treatment and frequent testing as highlighted in our study. Delayed presentation of CH in our study warrants active surveillance of children at birth for thyroid disorders to avoid long term adverse effects on mental development.

scholarly journals Melanotic Neuroectodermal Tumor of Infancy in the Maxilla

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Daniel Falbo Martins de Souza ◽  
Daniel Isaac Sendyk ◽  
Juliana Seo ◽  
Eduardo Vasques da Fonseca ◽  
Maria da Graça Naclério-Homem ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Surgical Excision ◽  
Optimal Outcome ◽  
Recurrence Rates ◽  
Anterior Maxilla ◽  
Tumor Excision ◽  
Complete Surgical Excision ◽  
Neuroectodermal Tumors ◽  
One Year

Melanotic neuroectodermal tumors of infancy (MNTIs) are rare fast-growing tumors with high recurrence rates. These tumors, which originate in the neural crest, commonly occur in the anterior maxilla of children under the age of one. Here, we describe an MNTI case in a two-month-old girl with increasing swelling in the left cheek. MNTI was diagnosed in this case following tomography and biopsy. The patient's histological and immunohistochemical profile indicated a remarkable combination of neural, melanocytic, and epithelial cell differentiation. One year following tumor excision, a follow-up examination revealed that the child exhibited no tumor recurrence. Approximately 260 cases of MNTI have been reported since this type of tumor was first described. In the present case, early diagnosis minimized the difficulties and risks associated with treatment and facilitated an optimal outcome. Despite complete surgical excision, careful followup is recommended. In addition, maxillary functional orthopedics and reconstruction may be necessary in cases of MNTI.

Sign in / Sign up

Export Citation Format

Share Document