Isolated frontosphenoidal synostosis: a rare cause of synostotic frontal plagiocephaly

2014 ◽  
Vol 13 (5) ◽  
pp. 553-558 ◽  
Author(s):  
Tina M. Sauerhammer ◽  
Albert K. Oh ◽  
Michael Boyajian ◽  
Suresh N. Magge ◽  
John S. Myseros ◽  
...  
Keyword(s):  
Demographic Data ◽  
Correct Diagnosis ◽  
Retrospective Chart Review ◽  
Ct Scanning ◽  
Ct Imaging ◽  
Radiographic Findings ◽  
Anterior Cranial Base ◽  
The Mean ◽  
Orbital Correction ◽  
The Right

Object Unilateral fusion of the frontoparietal suture is the most common cause of synostotic frontal plagiocephaly. Localized fusion of the frontosphenoidal suture is rare but can lead to a similar, but subtly distinct, phenotype. Methods A retrospective chart review of the authors' craniofacial database was performed. Patients with isolated frontosphenoidal synostosis on CT imaging were included. Demographic data, as well as the clinical and radiographic findings, were recorded. Results Three patients were identified. All patients were female and none had an identifiable syndrome. Head circumference was normal in each patient. The mean age at presentation was 4.8 months (range 2.0–9.8 months); 2 fusions were on the right side. Frontal flattening and recession of the supraorbital rim on the fused side were consistent physical findings. No patient had appreciable facial angulation or orbital dystopia, and 2 patients had anterior displacement of the ipsilateral ear. All 3 patients were initially misdiagnosed with unilateral coronal synostosis, and CT imaging at a mean age of 5.4 months (range 2.1–10.8 months) was required to secure the correct diagnosis. Computed tomography findings included patency of the frontoparietal suture, minor to no anterior cranial base angulation, and vertical flattening of the orbit without sphenoid wing elevation on the fused side. One patient underwent CT scanning at 2.1 months of age, which demonstrated a narrow, but patent, frontosphenoidal suture. The patient's condition was assumed to be a deformational process, and she underwent 6 months of unsuccessful helmet therapy. A repeat CT scan obtained at 10.7 months of age demonstrated the synostosis. All 3 patients underwent fronto-orbital correction at mean age of 12.1 months (range 7.8–16.1 months). The mean duration of postoperative follow-up was 11.7 months (range 1.9–23.9 months). Conclusions Isolated frontosphenoidal synostosis should be considered in the differential diagnosis of atypical frontal plagiocephaly.

scholarly journals Influenza With an Infiltrate: Investigating the New Community-Acquired Pneumonia Guidelines

2020 ◽  
Vol 41 (S1) ◽  
pp. s302-s302
Author(s):  
Amanda Barner ◽  
Lou Ann Bruno-Murtha
Keyword(s):  
Demographic Data ◽  
Retrospective Chart Review ◽  
Vaccination Rate ◽  
Community Acquired Pneumonia ◽  
Teaching Hospitals ◽  
Antibiotic Prescribing ◽  
Supporting Evidence ◽  
Radiographic Findings ◽  
Significant Difference ◽  
The Impact

Background: The Infectious Diseases Society of America released updated community-acquired pneumonia (CAP) guidelines in October 2019. One of the recommendations, with a low quality of supporting evidence, is the standard administration of antibiotics in adult patients with influenza and radiographic evidence of pneumonia. Procalcitonin (PCT) is not endorsed as a strategy to withhold antibiotic therapy, but it could be used to de-escalate appropriate patients after 48–72 hours. Radiographic findings are not indicative of the etiology of pneumonia. Prescribing antibiotics for all influenza-positive patients with an infiltrate has significant implications for stewardship. Therefore, we reviewed hospitalized, influenza-positive patients at our institution during the 2018–2019 season, and we sought to assess the impact of an abnormal chest x-ray (CXR) and PCT on antibiotic prescribing and outcomes. Methods: We conducted a retrospective chart review of all influenza-positive admissions at 2 urban, community-based, teaching hospitals. Demographic data, vaccination status, PCT levels, CXR findings, and treatment regimens were reviewed. The primary outcome was the difference in receipt of antibiotics between patients with a negative (<0.25 ng/mL) and positive PCT. Secondary outcomes included the impact of CXR result on antibiotic prescribing, duration, 30-day readmission, and 90-day mortality. Results: We reviewed the medical records of 117 patients; 43 (36.7%) received antibiotics. The vaccination rate was 36.7%. Also, 11% of patients required intensive care unit (ICU) admission and 84% received antibiotics. Moreover, 109 patients had a CXR: 61 (55.9%) were negative, 29 (26.6%) indeterminate, and 19 (17.4%) positive per radiologist interpretation. Patients with a positive PCT (OR, 12.7; 95% CI, 3.43–60.98; P < .0007) and an abnormal CXR (OR, 7.4; 95% CI, 2.9–20.1; P = .000003) were more likely to receive antibiotics. There was no significant difference in 30-day readmission (11.6% vs 13.5%; OR, 0.89; 95% CI, 0.21–3.08; P = 1) and 90-day mortality (11.6% vs 5.4%; OR, 2.37; 95% CI, 0.48–12.75; P = .28) between those that received antibiotics and those that did not, respectively. Furthermore, 30 patients (62.5%) with an abnormal CXR received antibiotics and 21 (43.7%) had negative PCT. There was no difference in 30-day readmission or 90-day mortality between those that did and did not receive antibiotics. Conclusions: Utilization of PCT allowed selective prescribing of antibiotics without impacting readmission or mortality. Antibiotics should be initiated for critically ill patients and based on clinical judgement, rather than for all influenza-positive patients with CXR abnormalities.Funding: NoneDisclosures: None

Role of laparoscopic in diagnosis and treatment of undescended testis in children at Viet Duc Hospital

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Hoa Nguyen
Keyword(s):  
Laparoscopic Surgery ◽  
Undescended Testis ◽  
Correct Diagnosis ◽  
Diagnosis And Treatment ◽  
Highly Sensitive ◽  
The Mean ◽  
The Right ◽  
Time Of Operation

Abstract Introduction: Evaluating the role of laparoscopic for diagnosis and treatment of undescended testis in children. Material and Methods: Restrospective study, between 6/ 2014 and 6/2017. All the patients are aged from 1 to 16 years with undescended testis underwent laparoscopic surgery for diagnosis and treatment in Deparment of pediatric surgery – Viet Duc hospital enrolled. Results: Of 95 patiens in total had 106 undescended testis diagnosed and treated by laparoscopy. The mean age of patients was 7,5 ± 3,8 years. 44,2% undescended were on the left side, 44,2% were on the right and 11,6% were undescended bilateral. The correct diagnosis by ultrasound accounted in 79,4%. The locations of testis diagnosed by laparoscopic are : intra abdomen in 45,3%, deep inguinal orifice in 16,9%, extra inguinal orifice in 26,4%, no testicle found in 11,4%. The mean time of operation were 67,33± 28,01 pht. Scrotal positions were achieved 74,5%, remove atrophic testis accounted in 7,6%. Stephen- Flowler technique including step I were in 4,7%, step II in 1,9%. The outcome evaluated by testicular positions following 3 months after operation are : good in 79,2%, moderate 13,2%, poor in 7,6%; By classification of Aubert are : good in 81,1%, moderate in 11,3% and poor in 7,6 %. Conclusion: Laparoscopic surgery is not only a highly sensitive diagnostic method to find accurately the location and size of the testes, but also the most effective method to treat impalpable undescended testes.

scholarly journals Evaluation of optic canal anatomy and symmetry using CT

2019 ◽  
Vol 4 (1) ◽  
pp. e000302 ◽  
Author(s):  
Xinxin Zhang ◽  
Yueh Lee ◽  
Daniel Olson ◽  
David Fleischman
Keyword(s):  
North Carolina ◽  
Retrospective Chart Review ◽  
Bilateral Symmetry ◽  
Optic Canal ◽  
Difference Threshold ◽  
Racial Groups ◽  
Cross Sectional ◽  
Minimum Diameter ◽  
The Mean ◽  
The Right

ObjectiveWe aim to describe the anatomy and symmetry patterns of the optic canal in patients having undergone maxillofacial CT imaging.MethodsIn this retrospective chart review, we included all patients who received sinus and maxillofacial CT at the University of North Carolina hospitals between 2008 and 2016, without facial or cranial fractures or other medical conditions that would affect optic canal size. We measured the length of ≥75% enclosed canal, minimum cross-sectional area and minimum diameter bilaterally using iNtuition TeraRecon (Durham, North Carolina) and compared bilateral symmetry using a 20 % difference threshold. Each parameter above was compared among white, black, non-white and non-black patients.ResultsOf 335 patients, the mean canal length was 5.61±2.22 mm. The mean minimum area was 11.84±3.11 mm2. The mean minimum diameter was 3.28±0.55 mm. A total of 39.4% (132/335) of patients had asymmetric canal lengths, 18.8% (63/335) had asymmetric minimum areas, and 12.5% (42/335) had asymmetric minimum diameters. No differences were found between racial groups. The right optic canal was larger than the left (right: 12.12 mm vs left: 11.55 mm, p<0.0001).ConclusionOptic canal asymmetry is not uncommon. It may affect risk of papilloedema severity, explain cases of unilateral or asymmetric papilloedema and possibly asymmetric glaucoma.

scholarly journals The Role of Antioxidants in the Treatment of Congenital CMV-Related Hearing: A Case-Control Study

OTO Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 2473974X1984185 ◽  
Author(s):  
Hilary McCrary ◽  
Veronica del Calvo ◽  
Jeremy Purser ◽  
Geoff Casazza ◽  
Albert Park
Keyword(s):  
Hearing Loss ◽  
Case Control Study ◽  
Retrospective Chart Review ◽  
Case Control ◽  
Antioxidant Therapy ◽  
Hearing Thresholds ◽  
The Mean ◽  
The Right ◽  
Control Study

Objective Antioxidants have been used as a therapeutic measure for several causes of hearing loss, and this study aims to examine the use of antioxidants in children with congenital cytomegalovirus (cCMV)–related hearing loss. Study Design Case-control study. Setting Academic pediatric hospital. Subjects and Methods A retrospective chart review of pediatric patients with cCMV-related hearing loss treated with and without antioxidants (vitamins A, C, and E and magnesium, known as ACE-Mg) was completed. The primary end point was the mean change in hearing thresholds for the right and left ears after therapy. An evaluation of the mean change in thresholds was evaluated at the following frequencies: 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. A 2-sample t test and multiple linear regression were used to evaluate the data. Results A total of 78 children with cCMV-related hearing loss were included in the study, of whom 10 were treated with antioxidants. The average amount of time in which antioxidants were taken was 387 days. When comparing cases and controls, there was no differences in the mean change of hearing thresholds at each frequency for both the right and left ears ( P > .05). Length of antioxidant therapy and age at which therapy was initiated had no effect on hearing scores ( P > .05). Conclusions Oxidative stress plays a role in the pathogenesis of cCMV-related hearing loss. ACE-Mg is a safe adjuvant therapy for the treatment of hearing loss in children; however, this study demonstrates no hearing-related benefit from ACE-Mg antioxidant therapy.

scholarly journals Anterior Segment Surgeries Performed During the Lockdown Period of the COVID-19 Pandemic

2021 ◽  
Author(s):  
damla bektaşoğlu ◽  
Semih Çakmak ◽  
Ahmet Kırgız ◽  
Nilay Kandemir Beşek ◽  
Burçin Kepez Yıldız ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Demographic Data ◽  
Anterior Segment ◽  
Demographic Characteristics ◽  
Corneal Perforation ◽  
Intervention Process ◽  
The Mean ◽  
Amnion Membrane ◽  
The Right ◽  
First Time

Abstract Purpose: This study aimed to evaluate the anterior segment surgeries performed in the coronavirus (COVID-19) lockdown period when prevention is at the forefront, in terms of etiology, referral region, demographic characteristics, and surgeries performed.Methods: A total of 144 cases who underwent anterior segment surgeries between 19 March 2020 and1 June 2020 were retrospectively reviewed from archive files. The demographic data and ophthalmological examinations of the patients, the region they were referred from, and the surgeries performed were noted.Results: A total of 144 patients, 49 women (34%) and 95 men (66%), were included in this study. The mean age of the patients was 31.30±25.88 (1-86) years. The presenting complaint was in the right eye in 43.7% of the cases, in the left eye in 52.8%, and in both eyes in 3.5% of the cases. While 94.4% of all cases applied from Istanbul, the remaining 5.6% applied from outside the province. Whereas 43.7% of the cases consisted of patients we had followed up previously, 56.3% presented to our hospital for the first time. Our hospital was the first referenced center in only 39.6% of the cases. When evaluated in terms of etiology, corneal perforation (18.1%) was the most common, followed by keratitis (13.2%). The most common surgical intervention was amnion membrane transplantation (19.4%), followed by perforation repair (16.7%).Conclusion: Ophthalmologic surgeries are continuing during the ongoing COVID-19 intervention process. Special algorithms are required to reduce the risk of transmission in terms of COVID-19 and to ensure continuity of health care for ophthalmology patients.

scholarly journals Groin Abscess: Assessing The Diagnostic Accuracy Of Emergency Department Clinicians And Imaging Modalities

2020 ◽  
Vol 7 (2) ◽  
pp. 1-4
Author(s):  
Victor Ameh ◽  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Correct Diagnosis ◽  
Retrospective Chart Review ◽  
District General Hospital ◽  
Adult Patients ◽  
Provisional Diagnosis ◽  
Rare Presentation ◽  
The Right ◽  
Groin Abscess

Objective: To determine the clinical and imaging diagnostic accuracy in adult patients presenting to the Emergency Department with groin abscess. Method: Retrospective chart review of all adult patients presenting to a district general hospital with a provisional diagnosis of groin abscess was undertaken from January 2019 to December 2019. A proforma was used to capture data such as the age, sex, co-morbidities, grade of assessing clinician and imaging profile. Results: 39 patients with a provisional diagnosis of groin abscess were identified; representing approximately 1% of all ED attendances. There were 21 males and 18 females. The age range was from 23 to 73 years (mean age 42). The abscess was located on the left side in 19 patients (49%), 18 (46%) on the right and 2 (5%) were bilateral. The overall rate of correct diagnosis of the ED clinicians compared to CT diagnosis is indicated by a sensitivity of 82%, positive predictive value of 90% and an accuracy of 75%. 22 patients had CT scan which confirmed an abscess in 18 (83%). Conclusion: Groin abscess is a rare presentation to the Emergency department. Most patients were seen by clinicians below the consultant grade. Diagnostic accuracy was highest amongst physicians.

Correlation between the extent of pneumatization of Agger agger Nasi nasi cells and the anterior-to-posterior length of the frontal recess: A a computer-assisted anatomical study.

2017 ◽  
Vol 71 (3) ◽  
pp. 43-55
Author(s):  
Ahmet Altıntaş ◽  
Mustafa Çelik ◽  
Yakup Yegin ◽  
Sinan Canpolat ◽  
Burak Olgun ◽  
...  
Keyword(s):  
Cell Volume ◽  
Anatomical Study ◽  
Ct Imaging ◽  
Sinus Surgery ◽  
Computer Assisted ◽  
Frontal Recess ◽  
Preoperative Ct ◽  
The Mean ◽  
Ct Data ◽  
The Right

Objectives: To explore the correlation between the volume of the aAgger nNasi (AN) cell bulge and the A-P length of the frontal recess (FR). Subjects and methods: In total, 120 patients, who underwent septoplasty, were included. All patients underwent preoperative paranasal sinus computed tomography of the paranasal sinuses (PNS CT) imaging. In total, CT data on of all 120 PNSs patients were analyzed in terms of thewith respect to the extent of pneumatization of the AN cell bulge and the A-P dimensions of the FR. Each side was analyzed separately. Results: We included 120 patients,: 78 (65.0%) females and 42 (35.0 %) males. Their average age was 33.7 ± 11.6 years (range: 18–65 years). The mean volume of the AN cell bulge was 0.26 ± 0.4 mm3 on both the right and left sides. The A-P length of the FR was 7.7 ± 2.2 mm. No significant between-side difference in the mean volume of the AN cell bulge was apparent observed (p=0.906). This volume did not differ significantly by age or sex (p=0.844 and p=0.971, respectively). We found no correlation between the volume of the AN cell bulge and the A-P length of the FR (r = 0.098, p=0.192). Conclusion: In the present study, no correlation between AN cell volume and the A-P length of the FR was found. When studying the anatomical complexity of the FR, it is essential to consider the AN cell volume. We suggest that preoperative CT imaging is critical when endoscopic sinus surgery is planned. However, further studies with larger numbers of patients are needed to explore the relationship between AN cell pneumatization and the anatomy of the FR.

scholarly journals Ocular findings among patients surviving COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ílen Ferreira Costa ◽  
Livia Pimenta Bonifácio ◽  
Fernando Bellissimo-Rodrigues ◽  
Eduardo Melani Rocha ◽  
Rodrigo Jorge ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pigment Epithelium ◽  
Demographic Data ◽  
Retinal Pigment ◽  
Anterior Segment ◽  
Posterior Pole ◽  
Architecture Evaluation ◽  
Severe Group ◽  
The Mean ◽  
The Right

AbstractTo describe the medium-term ophthalmological findings in patients recovering from COVID-19. Patients recovered from the acute phase of COVID-19 underwent a complete ophthalmological evaluation, including presenting and best-corrected visual acuity (BCVA), refractometry, biomicroscopy, tonometry, break-up time and Schirmer tests, indirect ophthalmoscopy, color fundus picture, and retinal architecture evaluation using optical coherence tomography. Socio-demographic data and personal medical history were also collected. According to the severity of systemic manifestations, patients were classified into mild-to-moderate, severe, and critical. Sixty-four patients (128 eyes) were evaluated 82 ± 36.4 days after the onset of COVID’s symptoms. The mean ± SD duration of hospitalization was 15.0 ± 10.7 days. Seven patients (10.9%) had mild-to-moderate, 33 (51.5%) severe, and 24 (37.5%) critical disease. Median [interquartile ranges (IQR)] presenting visual acuity was 0.1 (0–0.2) and BCVA 0 (0–0.1). Anterior segment biomicroscopy was unremarkable, except for dry eye disease, verified in 10.9% of them. The mean ± SD intraocular pressure (IOP) in critical group (14.16 ± 1.88 mmHg) was significantly higher than in severe group (12.51 ± 2.40 mmHg), both in the right (p 0.02) and left eyes (p 0.038). Among all, 15.6% had diabetic retinopathy, and two patients presented with discrete white-yellowish dots in the posterior pole, leading to hyporreflective changes at retinal pigment epithelium level, outer segment, and ellipsoid layers. The present study identified higher IOP among critical cases, when compared to severe cases, and discrete outer retina changes 80 days after COVID-19 infection. No sign of uveitis was found.

scholarly journals Does the Expensive IOFix implant Improve Union Rates?

2020 ◽  
Author(s):  
David Segal ◽  
Nissim Ohana ◽  
Meir Nyska ◽  
Ezequiel Palmanovich
Keyword(s):  
Demographic Data ◽  
Retrospective Chart Review ◽  
Fusion Rate ◽  
Hallux Rigidus ◽  
Hardware Removal ◽  
Functional Score ◽  
Fixation Devices ◽  
Operation Rate ◽  
The Mean

Abstract BACKGROUND First metatarso-phalangeal joint fusion is the current gold standard for severe hallux rigidus. Data regarding the union rate and the re-operation rate when IOFix (an Intra-osseous fixation device, Extremity medical, New Jersey, USA) is used for hallux rigidus fusion is limited but promising. The aim of this study was to review our outcomes with the IOFix implant. METHODS We have conducted a retrospective chart review, following the approval of the hospital IRB committee. Exclusion criteria included bilateral operations on the same patient, multiple surgeries, charcot foot or other structural foot abnormalities (except hallux valgus), rheumatoid arthritis and a recent foot trauma. We collected demographic data, physical examination documentation, functional score evaluations (AOFAS), and X-ray radiographic studies. RESULTS Thirty patients were included in the study. The mean age was 60.36 ± 9.12 (range 36 to 77) years, 18 (60%) female patients and 12 (40%) male. Fourteen (53.33%) were left side pathologies. The average follow up period was 36.2 ± 12.31 (range 12 to 54) months. Union was obtained in 28 (93.33%) patients, of whom none had requested a hardware removal due to a prominent hardware during a minimum of 2 year follow up period. The mean postoperative AOFAS score was 80.5 ± 10.87 (range 35 to 90). A more stringent inclusion criteria and fusion definitions would have led to an exclusion of two more patients and a dropout of two patients from the “fused” group, which would have led to a fusion rate of 85.71%. CONCLUSIONS This is the largest series of hallux rigidus patients that were operated with an IOFix device. The rates of fusion and hardware removal in MTPJ1 arthrodesis performed with an IOFix implant were found to be similar at most when compared to previously described rates that were obtained with other cheaper and more simple fixation devices.

scholarly journals Variation of blood pressure between two arms among the young people of Guwahati, Assam, India

2018 ◽  
Vol 6 (3) ◽  
pp. 859
Author(s):  
Indrani Das ◽  
Bonti Bora ◽  
Raj Sarkar ◽  
Kaustuv Jyoti Bhuyan
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Correct Diagnosis ◽  
Age Group ◽  
Normal Range ◽  
Treatment Of Hypertension ◽  
The Subject ◽  
The Mean ◽  
The Right ◽  
Mercury Sphygmomanometer

Background: Aim and objective of the study was to determine whether a difference in systolic and diastolic blood pressure reading exists in between arms. To establish the mean and normal range of difference in simultaneous systolic and diastolic blood pressure measurements between the right and left arm. It is unclear to what extent inter-arm blood pressure (BP) differences may be present in younger people so that they can take precaution in relation with age.Methods: 51 male and 51 female subjects were selected randomly in age group of 18 -20 yrs. A normal mercury sphygmomanometer was used employing Korotkoff I and V. 3 readings were taken sequentially for each arm using a standard mercury sphygmomanometer with the subject sitting after resting for 10 min.Results: Mean ± SD inter-arm differences in Systolic blood pressure were 4.784 ± 6.338 mmHg in males and 2.314 ± 5.159 mmHg in females while Diastolic blood pressure were 3.451 ± 5.471 mmHg in males and 1.059 ± 5.112 mmHg in females.Conclusions: The frequency of significant inter-arm systolic and diastolic blood pressure differences suggests that the blood pressure should be taken in both arms at the initial consultation. At subsequent visits, the arm in which measurements are taken should be recorded in the case notes. The higher of the two readings should be used to guide further management decisions. The accurate assessment of blood pressure (BP) is vital for the correct diagnosis and treatment of hypertension.

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