Complications of Paget bone disease: a study of 69 patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Saoussen Miladi ◽  
Leila Rouached ◽  
Kaouther Maatallah ◽  
Safa Rahmouni ◽  
Alia Fazaa ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Disease ◽  
Lower Limb ◽  
Neurological Disease ◽  
Elderly Women ◽  
Bone Architecture ◽  
Primary Reason ◽  
Local Bone ◽  
Over Time ◽  
Main Complication

Introduction: Paget bone disease (PBD) is characterized by a disorder in the bone remodeling activity at sites of involvement. This can produce dramatic alterations of local bone architecture and causes most of the complications. We aimed to focus on the characteristics of complications of PDB among hospitalized patients. Material and Methods: A retrospective study was conducted, on PBD patients hospitalized in two rheumatology centers from 1994 to 2019. Characteristics of the PBD complications were studied. Results: Sixty-nine patients were collected with a sex ratio of 0.76 and a mean age of 75.4±6.4 years [43-101]. The diagnosis of PBD was established in the average age of 64.2±11.5 years. The primary reason for consultation was pain (78.3%). The PBD was localized in the pelvis (58%), lower limb (42%), spine (36.2%), skull (23.2%) and upper limb (5.8%). It was polyostotic in 44.9% of cases. Dosage of ALP was 324 [68-8390]. The PDB complication rate was 52.2% and it decreased over time. The main complication was osteoarthritis (23.2%), followed by deafness (17.4%), fracture (15.9%), hydrocephalus (7.2%), neurological disease (7.2%) and osteosarcoma (1.4%). The presence of complications was significantly associated with the polyostotic form (p=0.01), the skull localization (p=0.04), an increased ALP (p=0.02). Conclusion: According to our study, the incidence rate of PBD among hospitalized cases is higher among elderly women and decreases over time. Complications related to PDB are frequent (52%). It concerns patients with a polyostotic form, skull localization and high ALP.

Seizures following surgery for supratentorial extratemporal low-grade tumors in children: a multicenter retrospective study

2020 ◽  
Vol 26 (1) ◽  
pp. 27-33
Author(s):  
Jonathan Roth ◽  
Or Bercovich ◽  
Ashton Roach ◽  
Francesco T. Mangano ◽  
Arvind C. Mohan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Brain Tumors ◽  
Seizure Control ◽  
Seizure Activity ◽  
Refractory Epilepsy ◽  
Low Grade ◽  
Refractory Seizures ◽  
Low Rate ◽  
Over Time ◽  
New Onset

OBJECTIVEResection of brain tumors may lead to new-onset seizures but may also reduce seizure rates in patients presenting with seizures. Seizures are seen at presentation in about 24% of patients with brain tumors. For lesional epilepsy in general, early resection is associated with improved seizure control. However, the literature is limited regarding the occurrence of new-onset postoperative seizures, or rates of seizure control in those presenting with seizures, following resections of extratemporal low-grade gliomas (LGGs) in children.METHODSData were collected retrospectively from 4 large tertiary centers for children (< 18 years of age) who underwent resection of a supratentorial extratemporal (STET) LGG. The patients were divided into 4 groups based on preoperative seizure history: no seizures, up to 2 seizures, more than 2 seizures, and uncontrolled or refractory epilepsy. The authors analyzed the postoperative occurrence of seizures and the need for antiepileptic drugs (AEDs) over time for the various subgroups.RESULTSThe study included 98 children. Thirty patients had no preoperative seizures, 18 had up to 2, 16 had more than 2, and 34 had refractory or uncontrolled epilepsy. The risk for future seizures was higher if the patient had seizures within 1 month of surgery. The risk for new-onset seizures among patients with no seizures prior to surgery was low. The rate of seizures decreased over time for children with uncontrolled or refractory seizures. The need for AEDs was higher in the more active preoperative seizure groups; however, it decreased with time.CONCLUSIONSThe resection of STET LGGs in children is associated with a low rate of postoperative new-onset epilepsy. For children with preoperative seizures, even with uncontrolled epilepsy, most have a significant improvement in the seizure activity, and many may be weaned off their AEDs.

Cirurgia Paliativa em Pacientes com Tumor Periampular Irressecável: Estudo Retrospectivo de 5 Anos em um Hospital em São José dos Campos – SP/Surgical Palliation in Patients with Unresectable Periampullary Tumor: a Retrospective Study of 5 Years in a Hosp

1970 ◽  
Vol 3 (4) ◽  
pp. 9-20
Author(s):  
José Henrique Gomes Torres ◽  
Rosyane Rena De Freitas
Keyword(s):  
Pancreatic Cancer ◽  
Retrospective Study ◽  
Survival Rates ◽  
Periampullary Tumor ◽  
The Past ◽  
Palliative Procedure ◽  
Surgical Palliation ◽  
Head Of The Pancreas ◽  
Keywords Pancreatic Cancer ◽  
Main Complication

Objetivo: Avaliar diferentes métodos paliativos quanto a sua resolução, complicações e sobrevida em pacientes com tumor periampular irressecável. Materiais e métodos: Estudo retrospectivo com análise dos prontuários de pacientes com tumor periampular irressecável e que foram submetidos a procedimento paliativo no Hospital Municipal Dr José de Carvalho Florence nos últimos cinco anos. Resultados: O principal tumor periampular foi o de cabeça de pâncreas, com incidência de 94%, acometendo pacientes com média de 66 anos, sem preferência por sexo. Os procedimentos mais realizados foram derivação biliar e colocação de endoprótese através de colangiopancreatografia endoscópica retrógrada, apresentando sobrevidas de 586 e 56 dias, respectivamente. Conclusão: A coledocojejunostomia foi o procedimento mais realizado e apresentou menor tempo de internação e maiores sobrevida e tempo de permanência anictérico. Pneumonia foi a complicação mais frequente.  Palavras chave: Câncer pancreático, Colangiocarcinoma, Cuidados paliativos.  Objective: To evaluate different palliative methods concerning its resolution, complications and survival in patients with unresectable periampular tumor. Materials and methods: Retrospective study analysing records of patients with unresectable periampullary tumor and who underwent palliative procedure in the Hospital Municipal Dr José de Carvalho Florence in the past five years. Results: The main periampullary tumor was the head of the pancreas, with an incidence of 94%, affecting patients with an average of 66 years old, regardless of gender. The most common procedures were bypass and biliary stent, with survival rates of 586 and 56 days, respectively. Conclusion: Coledocojejunostomy was the procedure which was the most often performed and showed a shorter hospital stay and longer survival time and time without jaundice. Pneumonia was the main complication.  Keywords: Pancreatic cancer, Cholangiocarcinoma, Palliative care  

scholarly journals A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kátia Cristina Dantas ◽  
Thais Mauad ◽  
Carmen D. Saldiva de André ◽  
Ana Luiza Bierrenbach ◽  
Paulo Hilário Nascimento Saldiva
Keyword(s):  
Retrospective Study ◽  
Essential Role ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Single Centre ◽  
Historical Trends ◽  
Aids Pandemic ◽  
History Of ◽  
Frequent Infection ◽  
Over Time

AbstractAutopsy continues to play an essential role in monitoring opportunistic fungal infections. However, few studies have analysed the historical trends of fungal infections in autopsies. Here, we analyse available data on fungal infections obtained from autopsy reports during 85 years of autopsies performed by the largest autopsy service in Brazil. All invasive fungal infections presented in autopsy reports between 1930 and 2015 were included. Of the 158,404 autopsy reports analysed, 1096 involved invasive fungal infections. In general, paracoccidioidomycosis (24%) was the most frequent infection, followed by candidiasis (18%), pneumocystosis (11.7%), cryptococcosis (11%), aspergillosis (11%) and histoplasmosis (3.8%). Paracoccidioidomycosis decreased after the 1950s, whereas opportunistic fungal infections increased steadily after the 1980s during the peak of the AIDS pandemic. The lung was the most frequently affected organ (73%). Disseminated infection was present in 64.5% of cases. In 26% of the 513 cases for which clinical charts were available for review, the diagnosis of opportunistic fungal infections was performed only at autopsy. Our unique 85-year history of autopsies showed a transition from endemic to opportunistic fungal infections in São Paulo, Brazil, reflecting increased urbanization, the appearance of novel diseases, such as AIDS in the 1980s, and advances in medical care over time.

Guideline-recommended incorporation of biomarker testing results in metastatic colorectal cancer therapy

2020 ◽  
Vol 17 (3) ◽  
pp. 185-194
Author(s):  
Jared Freml ◽  
Thomas Delate ◽  
Jesus Hermosillo-Rodriguez
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Study ◽  
Cancer Therapy ◽  
Metastatic Colorectal Cancer ◽  
Small Proportion ◽  
Biomarker Testing ◽  
Over Time

Aim: To describe pharmacogenomic tumor testing among patients with metastatic colorectal cancer. Methods: This was a retrospective study of patients with metastatic colorectal cancer diagnosed between 1 January 2014 and 30 June 2018. Patients were assessed for pharmacogenomic testing and appropriateness of chemotherapy use. Results: Overall, 112/167 (67.1%) patients had at least one of the three recommended pharmacogenomic tests and 41/167 (24.6%) had all tests. Twenty-four patients were treated with cetuximab with 8/167 (4.7%) identified as being treated with a RAS variant (n = 3) or incomplete testing (n = 5); thus, not in accordance with guidelines. Conclusion: Uptake of testing was variable but increased over time; however, a small proportion of patients received cetuximab with a variant or not all recommended tests being performed.

A variant of the gene HARS detected in the clinical exome: etiology of a peripheral neuropathy undiagnosed for 20 years

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Raquel Lahoz Alonso ◽  
Paula Sienes Bailo ◽  
Jose Luis Capablo Liesa ◽  
Sara Álvarez de Andrés ◽  
Jose Luis Bancalero Flores ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Neurological Disease ◽  
Motor Impairment ◽  
Lower Limbs ◽  
Case Presentation ◽  
Genetic Sequencing ◽  
Charcot Marie Tooth ◽  
Sensory Motor ◽  
Exacerbation Of Symptoms ◽  
Over Time

AbstractObjectivesDescribe a case with axonal Charcot-Marie-Tooth (CMT) type 2W, a neurological disease characterized by peripheral neuropathy typically involving the lower limbs and causing gait alterations and distal sensory-motor impairment.Case presentationWe report this case, where the application of massive genetic sequencing (NGS) with clinical exome in a molecular genetics laboratory enabled to detect the presence of candidate variants of the clinic of the patient.ConclusionsThe variant detected in HARS gene suggests that this variant could be causative of the symptoms of the patient, who went undiagnosed for 20 years and experienced an exacerbation of symptoms over time.

scholarly journals Has the quality of physiotherapy care in patients with Whiplash-associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators

2018 ◽  
Vol Volume 12 ◽  
pp. 2291-2308 ◽  
Author(s):  
Rob A.B. Oostendorp ◽  
Hans Elvers ◽  
Emiel van Trijffel ◽  
Geert M. Rutten ◽  
Gwendolyne GM Scholten-Peeters ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Quality Indicators ◽  
Routinely Collected Data ◽  
Whiplash Associated Disorders ◽  
Over Time
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