Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

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.

Download Full-text

Toxoplasma encephalitis presenting as neoplastic disease: A single institution case series

Interdisciplinary Neurosurgery ◽

10.1016/j.inat.2021.101174 ◽

2021 ◽

Vol 25 ◽

pp. 101174

Author(s):

Jennifer L. Perez ◽

Zachary C. Gersey ◽

Daniel F. Marker ◽

Georgios A. Zenonos ◽

Pascal O. Zinn

Keyword(s):

Case Series ◽

Neoplastic Disease ◽

Single Institution ◽

Toxoplasma Encephalitis

Download Full-text

Ultrasound Biomicroscopy Documented Anterior Uveal Melanoma Regression after Ruthenium-106 Plaque Therapy

Ocular Oncology and Pathology ◽

10.1159/000512030 ◽

2021 ◽

pp. 1-9

Author(s):

Biljana Kuzmanović Elabjer ◽

Mladen Bušić ◽

Andrej Pleše ◽

Mirjana Bjeloš ◽

Daliborka Miletić ◽

...

Keyword(s):

Uveal Melanoma ◽

Tumor Regression ◽

Corneal Thickness ◽

Case Series ◽

Ultrasound Biomicroscopy ◽

Close Monitoring ◽

Single Institution ◽

Retrospective Case ◽

Caucasian Patients

Introduction: Ultrasound biomicroscopy (UBM) is the only widely used method for the evaluation of anterior uveal melanoma (AUM). Objective: Documentation of regression of AUM treated with ruthenium-106 (Ru-106) plaque types CCB and CCC using UBM. Methods: This single institution-based retrospective case series involved 10 Caucasian patients with AUM followed after brachytherapy with UBM from January 2014 until February 2019. The largest prominence of the tumor perpendicular to the sclera or the cornea (including scleral/corneal thickness) (D) and the largest basal dimension (B) were measured in millimeters with UBM for all patients prior to the brachytherapy and at 4-month interval follow-up. Tumor regression was calculated as a percentage of decrease in the initial D and B values. Results: The study involved 10 patients with a mean age of 64.4 years (yr) (range 46–80 yr). D ranged from 1.82 to 5.5 mm (median 2.99 mm) and B from 2.32 to 12.38 mm (median 4.18 mm). The apical radiation dose in all patients was 100 Gy. The median follow-up was 42.02 months. Regression for D was 21.11 ± 13.66%, 31.09 ± 14.66%, and 34.92 ± 19.86% at 1st, 2nd, and 3rd year of the follow-up, respectively, while for B it was 21.58 ± 16.05%, 28.98 ± 17.71%, and 32.06 ± 18.96%, respectively. Tumor recurrence was documented in 2/10 patients. Conclusion: The major regression of AUM, treated with Ru-106 plaque types CCB and CCC, was documented in the first 2 years after brachytherapy in our study group. In the following years, only minimal regression was documented that warns of the need for close monitoring and active search for local recurrences.

Download Full-text

The Use of Staples for External Ventricular Drain Catheter Fixation: A Single Institution Case Series

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2021.106761 ◽

2021 ◽

pp. 106761

Author(s):

Mohamed M. Salem ◽

Luis C. Ascanio ◽

Alejandro Enriquez-Marulanda ◽

Santiago Gomez-Paz ◽

Charles E. Mackel ◽

...

Keyword(s):

External Ventricular Drain ◽

Case Series ◽

Single Institution

Download Full-text

Cryobiopsy as a New Tool for Complications Diagnosis During Follow-up After Lung Transplantation: Single Institution Case Series

Transplantation Proceedings ◽

10.1016/j.transproceed.2021.03.041 ◽

2021 ◽

Author(s):

Sławomir Żegleń ◽

Wojtek Karolak ◽

Gabriela Mikołajczyk ◽

Nicole Geryk ◽

Zuzanna Gogulska ◽

...

Keyword(s):

Lung Transplantation ◽

Case Series ◽

Single Institution

Download Full-text

Total Ankle Arthroplasty Survivorship, Complication, and Revision Rates in Patients Younger Than 55 Years

Foot & Ankle Specialist ◽

10.1177/1938640020980925 ◽

2021 ◽

pp. 193864002098092

Author(s):

Devon W. Consul ◽

Anson Chu ◽

Travis M. Langan ◽

Christopher F. Hyer ◽

Gregory Berlet

Keyword(s):

Case Series ◽

Ankle Arthrodesis ◽

Total Ankle Replacement ◽

Implant Survival ◽

Ankle Arthritis ◽

Single Institution ◽

Retrospective Case ◽

Ankle Replacement ◽

End Stage

Total ankle replacement has become a viable alternative to ankle arthrodesis in the surgical management of advanced ankle arthritis. Total ankle replacement has generally been reserved for patients who are older and for those who will have a lower demand on the replacement. The purpose of the current study is to review patient outcomes, complications, and implant survival in patients younger than 55 years who underwent total ankle replacement at a single institution. A single-center chart and radiographic review was performed of consecutive patients who underwent total ankle replacement for treatment of end-stage ankle arthritis. All surgeries were performed by 1 of 5 fellowship-trained foot and ankle surgeons at a single institution. A total of 51 patients met inclusion criteria with a mean follow-up of 31.2 months (SD = 16.2). Implant survival was 94%, There were 7 major complications (13%) requiring an unplanned return to the operating room and 8 minor complications (15%) that resolved with conservative care. The results of this study show that total ankle replacement is a viable treatment option for patients younger than 55 years. Levels of Evidence: A retrospective case series

Download Full-text

Tildrakizumab Inadequate Responders Switching to an Alternative IL-23 Inhibitor: A Case Series

Journal of Psoriasis and Psoriatic Arthritis ◽

10.1177/24755303211037308 ◽

2021 ◽

pp. 247553032110373

Author(s):

Eingun James Song ◽

Audrey Jia Shin Wong

Keyword(s):

Adverse Events ◽

Expert Opinion ◽

Case Series ◽

Tnf Alpha ◽

Published Data ◽

Inadequate Response ◽

Limited Time ◽

Case Description ◽

Single Institution ◽

Inadequate Responders

Background: Biologic switching is not uncommon in the treatment of psoriasis and is most often due to inadequate response of adverse events. Staying within or switching out of the class is still based on expert opinion but there are published data on intra-class switching with TNF-alpha and IL-17 inhibitors. Less is known about the IL-23 inhibitors because of their limited time in the market. We would like to present our experience with inadequate responders to tildrakizumab, a selective IL23 inhibitor, who were switched to an alternative IL-23 inhibitor. Case Description: This is a case series of 6 patients at a single institution considered inadequate responders to tildrakizumab, which included primary failures, secondary failures, and intermediate responders, who were subsequently switched to another IL-23 inhibitor. Conclusion: All 6 patients who were inadequate responders to tildrakizumab showed significant improvement after switching to another IL-23 inhibitor, with 5/6 reaching IGA 0/1 after 16 weeks of treatment.

Download Full-text

Case series of COVID-19 in patients with myasthenia gravis: a single institution experience

Acta Neurologica Belgica ◽

10.1007/s13760-021-01662-w ◽

2021 ◽

Author(s):

Sven Županić ◽

Martina Perić Šitum ◽

Maja Majdak ◽

Mirna Karakaš ◽

Silvio Bašić ◽

...

Keyword(s):

Myasthenia Gravis ◽

Case Series ◽

Single Institution

Download Full-text

Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases

Viruses ◽

10.3390/v13030512 ◽

2021 ◽

Vol 13 (3) ◽

pp. 512

Author(s):

Szilárd Váncsa ◽

Fanni Dembrovszky ◽

Nelli Farkas ◽

Lajos Szakó ◽

Brigitta Teutsch ◽

...

Keyword(s):

Individual Patient Data ◽

Case Reports ◽

Severe Disease ◽

Descriptive Analysis ◽

Case Series ◽

Disease Course ◽

Chain Reaction ◽

Baseline Characteristics ◽

Polymerase Chain ◽

Meta Analyses

Repeated positivity and reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a significant concern. Our study aimed to evaluate the clinical significance of repeatedly positive testing after coronavirus disease 2019 (COVID-19) recovery. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. With available individual patient data reporting on repeatedly SARS-CoV-2 positive (RSP) patients, case reports, and case series were included in this analysis. We performed a descriptive analysis of baseline characteristics of repeatedly positive cases. We assessed the cases according to the length of their polymerase chain reaction (PCR) negative interval between the two episodes. Risk factors for the severity of second episodes were evaluated. Overall, we included 123 patients with repeated positivity from 56 publications, with a mean repeated positivity length of 47.8 ± 29.9 days. Younger patients were predominant in the delayed (>90 days) recurrent positive group. Furthermore, comparing patients with RSP intervals of below 60 and above 60 days, we found that a more severe disease course can be expected if the repeated positivity interval is shorter. Severe and critical disease courses might predict future repeatedly positive severe and critical COVID-19 episodes. In conclusion, our results show that the second episode of SARS-CoV-2 positivity is more severe if it happens within 60 days after the first positive PCR. On the other hand, the second episode’s severity correlates with the first.

Download Full-text