Surgical creation of multiple drainage holes versus local injection of corticosteroids for treatment of aural hematomas in dogs: 51 dogs with 71 aural hematomas (2000–2017)

2021 ◽  
Vol 260 (S1) ◽  
pp. S15-S23
Author(s):  
Teruo Itoh ◽  
Atsuko Kojimoto ◽  
Kentaro Kojima ◽  
Kazuhiro Mikawa ◽  
Hiroki Shii
Keyword(s):  
Corticosteroid Injection ◽  
Clinical Findings ◽  
Long Term Outcomes ◽  
Treatment Development ◽  
Allergic Dermatitis ◽  
Risk Factors For Recurrence ◽  
A Site ◽  
Labrador Retrievers ◽  
Treated Site

Abstract OBJECTIVE To investigate the outcome of surgical creation of multiple drainage holes (MDHs) versus local corticosteroid injection (LCI) for treatment of aural hematomas (AHs) in dogs and identify risk factors for recurrence and development of new AHs. ANIMALS 51 dogs with 71 AHs. PROCEDURES Medical records were reviewed, and information on signalment, clinical findings, and outcome was recorded. Recurrence was defined as development of an AH at the primary site after the first month of treatment. Development of a new AH was defined as an AH occurring at a site different from the treated site. RESULTS The recurrence rate after the first month of treatment was significantly higher following the LCI procedure (17/48 AHs [33%]) than after the MDH procedure (1/24 AHs [4%]). The odds of recurrence increased as the numbers of LCI in the first month increased (OR, 2.414). Recurrent AHs after LCI resolved with additional LCIs; only 1 AH (2%) required a change to MDHs. No recurrence was observed after the eighth month, and the cosmetic results were good. Sixteen of 51 (31%) dogs had multiple or new AHs. The risk of new AHs was higher in Golden Retrievers and Labrador Retrievers and in dogs with allergic dermatitis. CONCLUSIONS AND CLINICAL RELEVANCE Long-term outcomes suggested that both creation of MDHs and LCI can be therapeutic options for dogs with AHs. However, the risk of new AH development should be considered, especially in retriever breeds and dogs with allergic dermatitis.

Strictureplasty for Crohn’s disease of the small bowel in the biologic era: long-term outcomes and risk factors for recurrence

2020 ◽  
Vol 24 (7) ◽  
pp. 711-720 ◽  
Author(s):  
M. Rottoli ◽  
M. Tanzanu ◽  
C. A. Manzo ◽  
M. L. Bacchi Reggiani ◽  
P. Gionchetti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Long Term Outcomes ◽  
Risk Factors For Recurrence

PS02.098: LONG-TERM OUTCOMES OF ADDITIONAL THERAPY FOLLOWING ENDOSCOPIC RESECTION FOR T1B-SM ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 148-149
Author(s):  
Tsuyoshi Tanaka ◽  
Masaki Ueno ◽  
Toshiro Iizuka ◽  
Shu Hoteya ◽  
Shusuke Haruta ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Lymphatic Invasion ◽  
Additional Treatment ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Risk Factors For Recurrence ◽  
Recurrent Patterns

Abstract Background Esophagectomy is the standard treatment strategy for superficial esophageal cancer diagnosed as pT1b(sm) following endoscopic resection (EMR/ESD). However, chemoradiotherapy (CRT) is expected to be an alternative treatment option. This study retrospectively compared the long-term outcomes of surgery and CRT as additional treatments for EMR/ESD pT1b esophageal cancer. Methods In a retrospective single-center study, the data of 83 consecutive patients who underwent EMR/ESD and were diagnosed with pT1b(sm) from January 2002 to December 2013 were collected, and additional treatment was administered to 59 of these patients (26 surgery and 33 CRT). Long-term outcomes, recurrent patterns, and risk factors for recurrence were analyzed. Results Median patient age was 63 (range, 43–79) years, and male/female ratio was 54:5. Tumor characteristics were as follows: location, Ce/Ut/Mt/Lt/Ae/EG = 1/6/32/13/3/4; median size, 25 (range, 5–88) mm; depth, sm1/sm2 = 18/41; vascular invasion (ly, v), + / − = 37/22; and cut end (HM, VM), + or × / − = 17/42. Sex, Charlson comorbidity index, tumor size, macroscopic type, cut end, and resection state were not different between the two groups. Meanwhile, age, tumor location, histological type, tumor depth, and vascular invasion were different between the two groups. The 5-year survival rates (relapse-free survival rate; RFS) were 92.3% (92.3%; RFS) and 80.3% (70.4%; RFS) in the surgery and CRT groups, respectively. The surgery group was significantly superior to the CRT group in terms of RFS (P = 0.042). All tumor recurrence was observed in the CRT group (P = 0.030). Recurrent patterns were as follows: hematogenous metastases (lung, bone, and adrenal gland) in three patients and lymph node metastases (four regional and an extra-regional) in four patients. In multivariate analysis, tumor size (P = 0.048) and lymphatic invasion (P = 0.032) were revealed as significant risk factors for recurrence in the CRT group. Conclusion Surgery is recommended as the additional treatment for ESD/EMR-pT1b esophageal cancer for better recurrent-free survival. Although CRT could be an acceptable treatment choice, the indication should be carefully decided, particularly in cases with large tumor size or lymphatic invasion. Disclosure All authors have declared no conflicts of interest.

Glomus tumors of the upper extremity

2021 ◽  
Vol 53 (01) ◽  
pp. 72-75
Author(s):  
Hüseyin Bilgehan Çevik ◽  
Çagla Amutkan Çiçek ◽  
Sibel Kayahan ◽  
Seyit Ali Gümüstas ◽  
Gaye Taylan Filinte
Keyword(s):  
Upper Extremity ◽  
Glomus Tumor ◽  
Middle Finger ◽  
Clinical Findings ◽  
Long Term Outcomes ◽  
Glomus Tumors ◽  
Clinical Triad ◽  
Paroxysmal Pain

Abstract Background Glomus tumors are uncommon and painful benign perivascular neoplasms. They usually occur in the subungual region of phalanx, and present with a classic clinical triad of localized tenderness, cold hypersensitivity, and excruciating paroxysmal pain. The aim of this study was to review 45 cases of glomus tumor according to the clinical, radiological and therapeutic characteristics, and the clinical and functional outcomes of surgical treatment. Materials and methods A retrospective review was made of 45 glomus tumors of the upper extremity operated on between June 2005 and January 2019. Data were collected of demographic characteristics and the diagnostic, immunohistochemical, therapeutic and postoperative clinical findings. Results The patients comprised 69 % females and 31 % males with a median age of 41 years at the time of surgery. The most commonly affected anatomic location was the digits (87 %). Of the 39 cases with an affected digit, there was a predominance of the middle finger in 28 % and the peri-subungual area in 51 %. There was no recurrence or need for secondary surgical intervention in any patient in this study. The mean QuickDASH score was 1.47 at mean 66 months follow-up. Conclusions Glomus tumor, which is usually seen in the middle finger of middle-aged women, presents with excruciating paroxysmal pain out of proportion to the tumor size. The long-term outcomes after surgical loupe-assisted surgery with a transungual approach were seen to be good, without local recurrence and an acceptable rate of postoperative nail dystrophy.

scholarly journals Long-Term Outcomes Following a Single Corticosteroid Injection for Trigger Finger

2014 ◽  
Vol 96 (22) ◽  
pp. 1849-1854 ◽  
Author(s):  
Robert D Wojahn ◽  
Nicholas C Foeger ◽  
Richard H Gelberman ◽  
Ryan P Calfee
Keyword(s):  
Corticosteroid Injection ◽  
Trigger Finger ◽  
Long Term Outcomes

scholarly journals Blood Viral Load (VL) Not Clinically Meaningful in Symptomatic Congenital Cytomegalovirus (cCMV) Infection

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S22-S23
Author(s):  
Concetta Marsico ◽  
Inmaculada Aban ◽  
Huichien Kuo ◽  
Pablo J Sanchez ◽  
Amina Ahmed ◽  
...  
Keyword(s):  
Treatment Duration ◽  
Clinical Findings ◽  
Long Term Outcomes ◽  
Research Support ◽  
Congenital Cytomegalovirus ◽  
Hearing Outcomes ◽  
Post Hoc ◽  
Congenital Cmv

Abstract Background Sensorineural hearing loss (SNHL) and neurodevelopmental (ND) outcomes are favorably impacted by antiviral therapy in infants with symptomatic cCMV disease. We correlated blood VL before and during therapy with clinical findings at presentation and follow-up in this population. Methods Post-hoc analysis of two clinical trials conducted by the CASG from 2002 to 2013 evaluating valganciclovir therapy. 120 subjects (73 treated × 6 weeks, 47 treated × 6 months) were included. Whole blood VL was determined by real-time PCR at a central laboratory before therapy (baseline, BL) and periodically for 6 months. Results In subjects treated for 6 months, increases in BL VL correlated with decreased probability of better hearing outcomes at 12 months (Figure 1), but clinically meaningful VL thresholds that predict SNHL were not identified (Table 1). Subjects treated for 6 weeks had no correlation between BL VL and SNHL. No correlation was found between BL VL and Bayley ND testing at 12 and 24 months for subjects receiving either treatment duration. Subjects treated for 6 months who achieved and sustained VL suppression (<2.5 log) between treatment day 14 and month 4 had better hearing outcomes at 6, 12, and 24 months (89% vs. 56%, P = 0.01; 100% vs. 63%, P = 0.0007; 94% vs. 68%, P = 0.04), but 56%–68% of subjects not achieving suppression still had improved hearing. Higher BL VL correlated with BL CNS involvement, thrombocytopenia, and transaminase elevation for subjects receiving either treatment duration, but with substantial overlap in quantity of virus detected (Figure 2). Subjects with >3 symptoms of congenital CMV at presentation had higher BL VL than subjects with ≤3 symptoms (3.75 log, range 1.00–5.65, vs. 3.38 log, range 1.00–5.36; P = 0.005). Conclusion Blood VL at BL and during therapy has little clinically meaningful predictive value for long-term outcomes in symptomatic congenital CMV. Disclosures J. Englund, Gilead: Consultant and Investigator, Research support; Chimerix: Investigator, Research support; Alios: Investigator, Research support; Novavax: Investigator, Research support; MedImmune: Investigator, Research support; GlaxoSmithKline: Investigator, Research support

scholarly journals Extent of collateralization predicting symptomatic cerebral vasospasm among pediatric patients: correlations among angiography, transcranial Doppler ultrasonography, and clinical findings

2015 ◽  
Vol 15 (3) ◽  
pp. 282-290 ◽  
Author(s):  
Parham Moftakhar ◽  
Daniel L. Cooke ◽  
Heather J. Fullerton ◽  
Nerissa U. Ko ◽  
Matthew R. Amans ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Vasospasm ◽  
Transcranial Doppler ◽  
Clinical Findings ◽  
Collateral Blood Flow ◽  
Long Term Outcomes ◽  
Asymptomatic Children ◽  
High Incidence ◽  
Traumatic Subarachnoid Hemorrhage

OBJECT Although the development and prevalence of cerebral vasospasm (CV) has been extensively investigated in adults, little data exist on the development of CV in children. The authors hypothesized that even though children have highly vasoreactive arteries, because of a robust cerebral collateral blood flow, they rarely develop symptomatic CV. METHODS The authors retrospectively reviewed their university hospital's neurointerventional database for children (that is, patients ≤ 18 years) who were examined or treated for aneurysmal or traumatic subarachnoid hemorrhage (SAH) during the period 1990–2013. Images from digital subtraction angiography (DSA) were analyzed for the extent of CV and collateralization of the cerebral circulation. Results from transcranial Doppler (TCD) ultrasonography were correlated with those from DSA. Cerebral vasospasm on TCD ultrasonography was defined according to criteria developed for adults. Clinical outcomes of CV were assessed with the pediatric modified Rankin Scale (mRS). RESULTS Among 37 children (21 boys and 16 girls ranging in age from 8 months to 18 years) showing symptoms of an aneurysmal SAH (comprising 32 aneurysms and 5 traumatic pseudoaneurysms), 17 (46%) had CV confirmed by DSA; CV was mild in 21% of these children, moderate in 50%, and severe in 29%. Only 3 children exhibited symptomatic CV, all of whom had poor collateralization of cerebral vessels. Among the 14 asymptomatic children, 10 (71%) showed some degree of vessel collateralization. Among 16 children for whom TCD data were available that could be correlated with the DSA findings, 13 (81%) had CV according to TCD criteria. The sensitivity and specificity of TCD ultrasonography for diagnosing CV were 95% and 59%, respectively. The time to CV onset detected by TCD ultrasonography was 5 ± 3 days (range 2–10 days). Twenty-five (68%) of the children had good long-term outcomes (that is, had mRS scores of 0–2). CONCLUSIONS Children have a relatively high incidence of angiographically detectable, moderate-to-severe CV. Children rarely develop symptomatic CV and have good long-term outcomes, perhaps due to robust cerebral collateral blood flow. Criteria developed for detecting CV with TCD ultrasonography in adults overestimate the prevalence of CV in children. Larger studies are needed to define TCD ultrasonography–based CV criteria for children.

scholarly journals Surgical results of the resection of spinal meningioma with the inner layer of dura more than 10 years after surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroyuki Tominaga ◽  
Ichiro Kawamura ◽  
Kosei Ijiri ◽  
Kazunori Yone ◽  
Noboru Taniguchi
Keyword(s):  
Elderly Women ◽  
Clinical Findings ◽  
Long Term Outcomes ◽  
Spinal Meningioma ◽  
Neurological Improvement ◽  
Simpson Grade ◽  
Pathological Type ◽  
Spinal Meningiomas

AbstractMost spinal meningiomas arise from the thoracic dura in middle-aged and elderly women. Simpson grade 1 resection is recommended to avoid recurrence. For ventral and ventrolateral tumors, reconstruction after total dural resection is difficult, and spinal fluid leakage is likely. To overcome this concern, Saito et al. developed the technique of resecting the tumor with the inner dural layer, preserving the outer dural layer. Although meningioma rarely recurs, the recurrence period is approximately 8 years postoperatively. No studies have evaluated long-term (> 10-year) outcomes of the Saito method. Here, we report 10 cases of the Saito method with > 10-year follow-up and compare outcomes with those of other standard approaches. Twenty-nine pathology-confirmed meningioma patients underwent surgery in our department, ten with the Saito method. We investigated resection method (dura mater treatment), pathological type, and recurrence and compared pre- and postoperative clinical findings. The median follow-up was 132 months. Recurrence occurred after Simpson grades 3 and 4 resection. Simpson grades 1, 2, and the Saito method resulted in no recurrence. Neurological symptoms improved in all patients at final follow-up. This is the first report of long-term outcomes of the Saito method. The method achieved good neurological improvement with no recurrence in > 10-year follow-up.

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