Treating Facial Cuts to a Near Scar Less Outcome in Children

Background: Facial Lacerations constitute an important reason for children (< 18 years) to visit emergency room. While bleeding and pain are the associated acute problems, the long term outcome in terms of a cosmetically acceptable scar is a matter of significant parental concern. The aim of the research is to study the profile of facial lacerations in children and to assess the outcome of repair. Materials and Methods: A retrospective review of children who underwent facial laceration repair between January 2018 and December 2020 was done. The deep ones underwent sutured repair in layers reinforced withtissue adhesive in operation room under intra-venous anesthesia and superficial ones in emergency room with only tissue adhesive following usual wound treatment protocol. Demographics, surgical details and outcomes were studied. All the repaired cuts were followed up at 1 year retrospectively and the cosmetic outcome was evaluated using modified stony brooke scoring system. Results: A total of 40 patients (24 males, 16 females) underwent facial laceration repair at a mean age of 4.7 years (range 1-13 years). Seventeen were deep and 23 were superficial cuts. Only1child in the superficial group with gross wound contamination at presentation developed wound infection. No dissatisfaction was reported in the deep group while parents of 4 children in the superficial group reported dissatisfaction with the final scar. Conclusion: While surface cuts can be treated with irrigations and tissue adhesive in the emergency room, the deeper cuts require layered repair aided by tissue adhesive for optimum scar outcome.

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Muenke syndrome: long-term outcome of a syndrome-specific treatment protocol

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.5.peds1969 ◽

2019 ◽

Vol 24 (4) ◽

pp. 415-422 ◽

Cited By ~ 2

Author(s):

Bianca K. den Ottelander ◽

Robbin de Goederen ◽

Marie-Lise C. van Veelen ◽

Stephanie D. C. van de Beeten ◽

Maarten H. Lequin ◽

...

Keyword(s):

Treatment Protocol ◽

First Year ◽

Ventricular Size ◽

Term Outcome ◽

Long Term Outcome ◽

Skull Growth ◽

Muenke Syndrome ◽

First Year Of Life

OBJECTIVEThe authors evaluated the long-term outcome of their treatment protocol for Muenke syndrome, which includes a single craniofacial procedure.METHODSThis was a prospective observational cohort study of Muenke syndrome patients who underwent surgery for craniosynostosis within the first year of life. Symptoms and determinants of intracranial hypertension were evaluated by longitudinal monitoring of the presence of papilledema (fundoscopy), obstructive sleep apnea (OSA; with polysomnography), cerebellar tonsillar herniation (MRI studies), ventricular size (MRI and CT studies), and skull growth (occipital frontal head circumference [OFC]). Other evaluated factors included hearing, speech, and ophthalmological outcomes.RESULTSThe study included 38 patients; 36 patients underwent fronto-supraorbital advancement. The median age at last follow-up was 13.2 years (range 1.3–24.4 years). Three patients had papilledema, which was related to ophthalmological disorders in 2 patients. Three patients had mild OSA. Three patients had a Chiari I malformation, and tonsillar descent < 5 mm was present in 6 patients. Tonsillar position was unrelated to papilledema, ventricular size, or restricted skull growth. Ten patients had ventriculomegaly, and the OFC growth curve deflected in 3 patients. Twenty-two patients had hearing loss. Refraction anomalies were diagnosed in 14/15 patients measured at ≥ 8 years of age.CONCLUSIONSPatients with Muenke syndrome treated with a single fronto-supraorbital advancement in their first year of life rarely develop signs of intracranial hypertension, in accordance with the very low prevalence of its causative factors (OSA, hydrocephalus, and restricted skull growth). This illustrates that there is no need for a routine second craniofacial procedure. Patient follow-up should focus on visual assessment and speech and hearing outcomes.

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Mycobacterium tuberculosisInfection following Kidney Transplantation

BioMed Research International ◽

10.1155/2013/347103 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Karima Boubaker ◽

Tahar Gargah ◽

Ezzedine Abderrahim ◽

Taieb Ben Abdallah ◽

Adel Kheder

Keyword(s):

Demographic Data ◽

Clinical Manifestations ◽

Treatment Protocol ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Graft Dysfunction ◽

Term Outcome ◽

Long Term Outcome ◽

Post Transplant

Introduction and Aims. Post-transplant tuberculosis (TB) is a problem in successful long-term outcome of renal transplantation recipients. Our objective was to describe the pattern and risk factors of TB infection and the prognosis in our transplant recipients.Patients and Methods. This study was a retrospective review of the records of 491 renal transplant recipients in our hospital during the period from January 1986 to December 2009. The demographic data, transplant characteristics, clinical manifestations, diagnostic criteria, treatment protocol, and long-term outcome of this cohort of patients were analyzed.Results. 16 patients (3,2%) developed post-transplant TB with a mean age of 32,5 ± 12,7 (range: 13–60) years and a mean post-transplant period of 36,6months (range: 12,3 months–15,9 years). The forms of the diseases were pulmonary in 10/16 (62,6%), disseminated in 3/16 (18,7%), and extrapulmonary in 3/16 (18,7%). Graft dysfunction was observed in 7 cases (43,7%) with tissue-proof acute rejection in 3 cases and loss of the graft in 4 cases. Hepatotoxicity developed in 3 patients (18,7%) during treatment. Recurrences were observed in 4 cases after early stop of treatment. Two patients (12.5%) died.Conclusion. Extra pulmonary and disseminated tuberculosis were observed in third of our patients. More than 9months of treatment may be necessary to prevent recurrence.

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Dacron Reconstruction of Aortic Aneurysm and Long Term Patients Evolution

Materiale Plastice ◽

10.37358/mp.19.2.5195 ◽

2019 ◽

Vol 56 (2) ◽

pp. 405-408

Author(s):

Cristina Tudoran ◽

Mariana Tudoran ◽

Tudor Ciocarlie ◽

Catalina Giurgi-Oncu ◽

Dana Velimirovici ◽

...

Keyword(s):

Aortic Aneurysm ◽

Emergency Room ◽

Vascular Reconstruction ◽

Dacron Graft ◽

Aortic Reconstruction ◽

Term Outcome ◽

Long Term Outcome ◽

Reconstruction Surgery ◽

Life Threatening

Aortic aneurysm (AA) and especially dissecting aneurism (DAA) represent life threatening medical conditions and vascular reconstruction surgery with the insertion of a vascular prosthetic grafts is often required to save patients life. In this paper we debate over the long term outcome of 23 patients who underwent five to eight years ago an aortic reconstruction surgery with insertion of Dacron grafts. They attended, during 2018, the emergency room of the County Emergency Hospital Pius Brinzeu of Timisoara in terms of patency complications of the prosthesis. Despite slight dilatation of the Dacron graft and of the native aorta, presence of mural thrombi and/or progress of aortic regurgitation, their evolution was satisfactory, without severe complications.

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Cognitive dysfunction and mortality in multiple sclerosis: Long-term retrospective review

Multiple Sclerosis Journal ◽

10.1177/13524585211066598 ◽

2021 ◽

pp. 135245852110665

Author(s):

Sara Cavaco ◽

Inês Ferreira ◽

Inês Moreira ◽

Ernestina Santos ◽

Raquel Samões ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Dysfunction ◽

Retrospective Review ◽

Progressive Disease ◽

Disease Course ◽

Term Outcome ◽

Long Term Outcome ◽

Study Results ◽

Clinical Records

Background: Cognitive dysfunction as a predictor of clinical progression and mortality in multiple sclerosis (MS) is still a matter of debate. Objective: The aim of this study was to explore the long-term outcome associated with neuropsychological performance in a cohort of patients with MS. Methods: A series of 408 MS patients had previously undergone a comprehensive neuropsychological assessment and a contemporaneous neurological evaluation (T1). A retrospective review of the clinical records was conducted 102–192 months after T1. Demographic and clinical data regarding the last clinical appointment with EDSS measurement (T2) were collected and the date of the last clinical contact or death (TS) was recorded. Results: This review revealed that cognitive dysfunction (T1) was associated with higher odds of transitioning from relapsing–remitting course to a progressive disease course (adjusted odds ratio (OR) = 2.29, p = 0.043) and higher hazard of death in the total sample (adjusted hazard ratio (HR) = 3.07, p = 0.006) and the progressive disease course subgroup (adjusted HR = 3.68, p = 0.007), even when adjusting for other covariates. Discussion: The study results demonstrate that cognitive dysfunction in MS is predictive of poorer prognosis and mortality.

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