scholarly journals Long – term effect of nephrocalcinosis on renal function and body growth index in children

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Thu Hương Nguyễn
Keyword(s):  
Renal Tubular Acidosis ◽  
Clinical Signs ◽  
Case Series ◽  
Growth Index ◽  
Bartter Syndrome ◽  
Long Term Effect ◽  
Sterile Pyuria ◽  
Renal Tubular

Aims:  To evaluate effect of NC on growth index, kidney function and its etiology  of children at National Children’s Hospital. Methods: A case series prospective study,34 patients from 1/07/2013 to 30/06/2019. Results: 58,8% cases were males. The most common symptoms were failure to develop heightand weight for 64,7% and 73,5%, respectively. Ultrasound examinations reveal a higher degree, stage 2b and 3 were the most frequent according to Hoyer’s grading. Mean GFR was 101,2 ± 27,5 ml/min/1,73 m2 in presentation.There were 35,3% patients with hypercalciuria and 38,2% cases had sterile pyuria. During a median follow – up of 30 months in 24 patients, growth index improved more than -2SD in 60%,mean GFR 105,2 ± 22 ml/min/1,73 m2 in follow - up.  The most common leading cause to NC was renal tubular acidosis in 50% followed by primary hypercalciuria and the cause of  NC remained unknown (14,7%). Other causes included vitamin D excess, bartter syndrome, nephrocalcinosis - hypercalciuria -hypomagiemia, hypophosphomia ricket. Conclusions:nephrocalcinosis is a rare disease, and clinical signs are atypical.Growth retardation was the most common clinical manifestation andthe most popular cause of this condition in our study is renal tubular acidosis. There was significant increase in height and weight from the first to last observation. GFR remained stable within a long - term.  

Long-Term Evaluation of the Roux-Elmslie-Trillat Procedure for Patellar Instability

2005 ◽  
Vol 33 (8) ◽  
pp. 1220-1223 ◽  
Author(s):  
Joseph R. Carney ◽  
Timothy S. Mologne ◽  
Michael Muldoon ◽  
Jay S. Cox
Keyword(s):  
Confidence Interval ◽  
Case Series ◽  
Level Of Evidence ◽  
Long Term Effect ◽  
Functional Scores ◽  
Study Population ◽  
Term Evaluation ◽  
Subluxation Of The Patella

Background Few published articles exist reporting the long-term evaluation of the Roux-Elmslie-Trillat procedure. Purpose To assess the long-term effect of the Roux-Elmslie-Trillat procedure in preventing recurrent subluxation and dislocation of the patella. Study Design Case series; Level of evidence, 4. Methods Eighteen patients who underwent the Roux-Elmslie-Trillat procedure for dislocation or subluxation of the patella were identified from a group previously evaluated at a mean follow-up of 3 years. The prevalence of recurrent subluxation or dislocation at a mean follow-up of 26 years was compared with the prevalence reported at the mean follow-up of 3 years. Although not the focus of this study, Cox functional scores were obtained from the smaller group and compared with the results at the 3-year follow-up. Results Seven percent (95% confidence interval, 0.00-0.32) of the patients had recurrent subluxation at 26 years compared with 7% (95% confidence interval, 0.03-0.13) of the study population reported at 3 years (P = 1.00). Fifty-four percent (95% confidence interval, 0.27-0.79) rated their affected knee as good or excellent at 26 years compared with 73% (95% confidence interval, 0.64-0.81) of the larger study population reported at 3 years (P = .14). Conclusion The prevalence of recurrent subluxation and dislocation in patients with patellofemoral malalignment who underwent the Roux-Elmslie-Trillat procedure for dislocation or subluxation of the patella is similar at 3 and 26 years after the procedure. The long-term functional status of the affected knee in patients who underwent the Roux-Elmslie-Trillat procedure declined.

scholarly journals Feline and Canine Cutaneous Lymphocytosis: Reactive Process or Indolent Neoplastic Disease?

2022 ◽  
Vol 9 (1) ◽  
pp. 26
Author(s):  
Francesco Albanese ◽  
Francesca Abramo ◽  
Michele Marino ◽  
Maria Massaro ◽  
Laura Marconato ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Clinical Signs ◽  
Case Series ◽  
Response To Treatment ◽  
Neoplastic Disease ◽  
Retrospective Case ◽  
Term Survival ◽  
Dermal Infiltrate

Cutaneous lymphocytosis (CL) is an uncommon and controversial lymphoproliferative disorder described in dogs and cats. CL is generally characterized by a heterogeneous clinical presentation and histological features that may overlap with epitheliotropic lymphoma. Therefore, its neoplastic or reactive nature is still debated. Here, we describe clinicopathological, immunohistochemical, and clonality features of a retrospective case series of 19 cats and 10 dogs with lesions histologically compatible with CL. In both species, alopecia, erythema, and scales were the most frequent clinical signs. Histologically, a dermal infiltrate of small to medium-sized lymphocytes, occasionally extending to the subcutis, was always identified. Conversely, when present, epitheliotropism was generally mild. In cats, the infiltrate was consistently CD3+; in dogs, a mixture of CD3+ and CD20+ lymphocytes was observed only in 4 cases. The infiltrate was polyclonal in all cats, while BCR and TCR clonal rearrangements were identified in dogs. Overall, cats had a long-term survival (median overall survival = 1080 days) regardless of the treatment received, while dogs showed a shorter and variable clinical course, with no evident associations with clinicopathological features. In conclusion, our results support a reactive nature of the disease in cats, associated with prolonged survival; despite a similar histological picture, canine CL is associated with a more heterogeneous lymphocytic infiltrate, clonality results, and response to treatment, implying a more challenging discrimination between CL and CEL in this species. A complete diagnostic workup and detailed follow-up information on a higher number of cases is warrant for dogs.

Evaluation of Unilateral Arytenoid Lateralization for the Treatment of Laryngeal Paralysis in 14 Cats

2010 ◽  
Vol 46 (6) ◽  
pp. 418-424 ◽  
Author(s):  
Brian Thunberg ◽  
Gary C. Lantz
Keyword(s):  
Postoperative Complications ◽  
Airway Obstruction ◽  
Median Duration ◽  
Clinical Signs ◽  
Case Series ◽  
Upper Airway ◽  
Common Cause ◽  
Laryngeal Paralysis

Laryngeal paralysis is a relatively common cause of upper airway obstruction in middle-aged to older, large-breed dogs; however, it is rare in the cat. The purpose of this study is to describe a series of cats diagnosed with laryngeal paralysis treated by unilateral arytenoid lateralization. Fourteen cats met the criteria of the study. Intraoperative and postoperative complications were seen in 21% (three of 14) and 50% (seven of 14) of cases, respectively. Median duration of follow-up was 11 months (range 3 weeks to 8 years). None of these cats had recurrence of clinical signs. Based on this brief case series, unilateral arytenoid lateralization appeared to be a suitable method for treating laryngeal paralysis in cats. Additional studies are warranted to determine the type and frequency of long-term complications.

Arthroscopic treatment of fragmented coronoid process with severe elbow incongruity

2013 ◽  
Vol 26 (01) ◽  
pp. 27-33 ◽  
Author(s):  
E. de Bakker ◽  
D. Van Vynckt ◽  
E. Coppieters ◽  
H. van Bree ◽  
B. Van Ryssen ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Case Series ◽  
Term Treatment ◽  
Coronoid Process ◽  
Heavy Exercise ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Treatment

SummaryThe purpose of this study was to investigate the long-term treatment results of fragmented coronoid process (FCP) in joints with a radio-ulnar step greater than 3 mm. Treatment of these patients only consisted of fragment removal, without correction of the incongruity.The eight Bernese Mountain Dogs (11 joints) included in this study showed obvious clinical signs of elbow disease and were diagnosed with severe elbow incongruity and concomitant FCP in the time period from 1999–2003. At that time, elbow radiography, computed tomography, and arthroscopy were performed. The mean follow-up period was 5.6 years. The follow-up consisted of a telephone questionnaire combined with a clinical and radiographic re-evaluation at our clinic.The questionnaire revealed that all dogs were either free of lameness or only lame following heavy exercise. One dog sporadically required medication after heavy exercise. The owner satisfaction rate was 100%. The clinical re-evaluation did not reveal any signs of pain or lameness in all cases. Range-of- motion was decreased in nine of the 11 elbows. Radiographs revealed an increase in severity of osteoarthritis in every case.In this case series, arthroscopic fragment removal without treatment of incongruity was demonstrated to be a valuable treatment option and may provide a satisfactory long-term outcome.

scholarly journals Clinical, Paraclinical Characteristics in Children with Renal Tubular Acidosis

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Nguyen Thanh Tung ◽  
Nguyen Thu Huong ◽  
Pham Van Dem ◽  
Nguyen Thi Quynh Huong
Keyword(s):  
Renal Tubular Acidosis ◽  
Clinical Signs ◽  
Distal Renal Tubular Acidosis ◽  
Renal Tubules ◽  
Nephrol Dial Transplant ◽  
Long Term Outcome ◽  
Female Ratio ◽  
Arterial Blood ◽  
Renal Tubular

This descriptive study describes the clinical, paraclinical characteristics in children with renal tubular acidosis. In this study, 36 children with renal tubular acidosis were hospitalized in the National Hospital of Pediatrics from June, 2012 to July, 2017. Among the patients, 64.0% were male; the male/female ratio was 1.8/1. The average age of the patients was 7.7 ± 4.6 years. There were 29 type 1 renal tubular acidosis patients (80.6%) and 7 type 2 renal tubular acidosis (19.6%). The most common clinical signs were slow weight gain (100%), polyuria and vomiting were 25.7%, excessive water drinking (16.7%), diarrhea (13.9%), weak lower limb (11.1%), and apnea (8.3%). The laboratory values on admission were: blood pH 7.23 ± 0.11; HCO3- 12.5 ± 5.07; serum sodium 136 ± 7mmol/l; potassium 2.9 ± 0.5 mmol/l; chloride 112 ± 9 mmol/l. The study concludes that 53.8% of the clinical, paraclinical characteristics in children with Renal Tubular Acidosis were inconspicuousness, which effected the children’s growth. The study recommends a long-term strategy for diagnosis and follow–up treatment of renal tubular acidosis. Keywords Renal tubular acidosis, Fanconi syndrome. References [1] Edyta Golembiewska and Kazimierz Ciechanowski, Renal tubular acidosis—underrated problem?, Acta biochimica polonica. 59(2) (2012) 213-215.[2] WHO (2011), Haemoglobin concentrations for the diagnosis of annaemia and assessment of severity, VMNIS, 1.[3] A.P. Sharma, R.K. Sharma, R. Kapoor, et al, Incomplete distal renal tubular acidosis affects growth in children, Nephrol Dial Transplant. 22 (10) (2007) 2879-2783.[4] WHO Child Growth Standards: Methods and development, tại trang web http://www.who.int/childgrowth/standards/technical_report/en/, truy cập ngày 30/10/2018.[5] A. Bagga Bajpai, P. Hari, A. Bardia, et al, Long-term outcome in children with primary distal renal tubular acidosis, Indian Pediatr. 42(4) 321 -328.[6] J.C. Chan, F. Santos, Renal tubular acidosis in children, Diagnosiseatment and prognosis., Am J Nephrol. 6(4) (2005) 289-294.[7] Symptoma Renal Tubular Acidosisuy, tại trang web https://www.symptoma.com/en/info/renal-tubular-acidosis, truy cập ngày 30/10/2018.[8] Julian Yaxley, Christine Pirrone, Review of the Diagnostic Evaluation of Renal Tubular Acidosis, Ochsner J. 16(4) (2016) 525-232.[9] Pramod Sood, Gunchan Paul, and Sandeep Puril, Interpretation of arterial blood gas, Indian J Crit Care Med. 14(2) (2010) 57-63.[10] J.L. Wilson, A.M. Butler, S. Farber, Dehydration and acidosis with calcification at renal tubules, The Journal of Pediatrics. 8 (2006) 489-494.  

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

Primary Calvarial Ewing Sarcoma: A Case Series

2021 ◽  
Author(s):  
Sandeep Mohindra ◽  
Manjul Tripathi ◽  
Aman Batish ◽  
Ankur Kapoor ◽  
Ninad Ramesh Patil ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Excision ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intradural Tumor ◽  
Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

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