scholarly journals Device for intervertebral assisted motion: technique and initial results

2007 ◽  
Vol 22 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Jean Taylor ◽  
Patrick Pupin ◽  
Stephane Delajoux ◽  
Sylvain Palmer
Keyword(s):  
Surgical Management ◽  
Chart Review ◽  
Anterior Column ◽  
Effective Alternative ◽  
Patient Questionnaire ◽  
Retrospective Evaluation ◽  
Functional Integrity ◽  
Wide Range ◽  
Initial Results

Object The DIAM is a polyester-encased silicone interspinous dynamic stabilization device that can unload the anterior column and reestablish the functional integrity of the posterior column. Methods The DIAM was implanted in 104 patients between May 1, 2001 and October 30, 2001. A retrospective evaluation was performed based on chart review and patient questionnaire at a median follow-up interval of 18.1 months. Results Conclusions The DIAM implant appears to be a useful and effective alternative in the surgical management of a wide range of lumbar disorders. Patient complications are few and satisfaction is high.

scholarly journals A retrospective chart review of the guiding symptoms of the successful prescription of Natrum muriaticum at a homoeopathic satellite clinic

2018 ◽  
Author(s):  
◽  
Nompumelelo Marcia Sibeko
Keyword(s):  
Health Care ◽  
Sample Size ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Community Clinic ◽  
Materia Medica ◽  
Wide Range ◽  
Clinical Verification ◽  
Clinical Conditions

Brief background In the practice of Homoeopathy, widely acting remedies or polychrest homoeopathic medicines are prescribed in the treatment of a wide range of clinical conditions. The documenting of the guiding symptoms in successfully treated cases will assist in offering guidelines for the prescription of remedies in the future and thus serves as scientific and clinical verification of the remedies. The operational definition of success for the purposes of clinical verification is the alleviation or improvement of existing symptoms (Van Wassenhoven 2013). This definition was applied in the context of this study. To facilitate high standards of health care as well as teaching and learning, Durban University of Technology (DUT) Department of Homoeopathy in collaboration with Lifeline established its first Homoeopathic Community Clinic in 2004 called Ukuba Nesibindi Homoeopathic Community Clinic (UNHCC) located in Warwick Junction, Durban. UNHCC provides a free Homoeopathic primary health care service on the third floor of the Lifeline building in Acorn Road, Warwick Triangle, less than one kilometre from the main DUT campus The area is classified as being disadvantaged with high crime rates, prostitution, violence, small informal businesses and low cost housing (Smillie 2010, Watson 2015 and Dube 2015). Aim of the study The study aimed to determine and compare the guiding symptoms of the successful prescription of Natrum muriaticum at Ukuba Nesibindi Homoeopathic Community Clinic (UNHCC) between 2013 and 2016. Methodology A retrospective chart review was conducted at the Ukuba Nesibindi Homoeopathic Community Clinic on the patient files between 2013 and 2016. A rubric (Appendix B) was used to document the demographics, clinical conditions, homoeopathic guiding symptoms, posology and follow up presentation of each chart where Natrum muriaticum was successfully prescribed. Furthermore, a comparison of the guiding prescribing symptoms was made against existing materia medica. A sample size of 197 patient files which had appropriate consent forms enclosed allowing for the use of information for research purposes was established. Prior to gathering the relevant information and the commencement of the study, gate keeper permission to conduct the study on patient files and at the mentioned location was requested and granted by all relevant stakeholders. The actual sample size was derived from the successful cases with follow ups until data saturation. Files that were excluded from the 197 patient files were of those patients who did not attend the follow up appointment and cases which were not treated successfully with the remedy. The sample size for the study was 37. Descriptive statistics was derived and illustrated using bar graphs and pie charts. Tabulations and graphical presentation of the comparison were created. Themes and inferences were drawn based on the emerged data from the symptoms and rubrics. Thereafter, a comparison to the existing materia medica was conducted by comparing the arising symptomatology with the existing content in the materia medica. Results The results of the study showed that the symptoms that arise in the study corresponded with the symptoms in the existing materia medica, however there were additional symptoms that emerged in the study and these symptoms were not listed in the materia medica, but were successfully treated with Natrum muriaticum. It was concluded that the guiding symptoms that were considered in formulating the prescriptions of Natrum muriaticum correlate with the characteristic symptoms of Natrum muriaticum in the materia medicas by Vermeulen, Boericke and Phatak

scholarly journals Adrenal adenomas: what to do with them? Review 2

2021 ◽  
Vol 17 (3) ◽  
pp. 241-249
Author(s):  
S. Rybakov
Keyword(s):  
Malignant Tumors ◽  
Optimal Operation ◽  
Gross Error ◽  
Wide Range ◽  
Morphological Diagnosis ◽  
The Subject ◽  
Definition Of ◽  
Significant Size ◽  
Initial Results

Adrenal incidentalomas (AI) are a collective, working category that contains a wide range of different forms of patho­logy of these glands. They differ in the original tissue structures from which they originate, in clinical and hormonal characte­ristics, in diagnostic and tactical approaches. Such a wide range of emergencies, which are hidden under the guise of accidentally detected AI, puts before the clinician the task of identifying them (establishing a clinical and, if possible, morphological diagnosis) with the definition of tactical approaches. Based on the analysis of these data, as well as numerous publications, their working classification is proposed. When deciding on surgical treatment, the surgeon must have a clinical diagnosis — what nosological form of adrenal pathology is to be operated on. Interventions with the diagnosis AI are unacceptable and are a gross error. The optimal operation for most such tumors is laparoscopic adrenalectomy with the tumor. Open operations are indicated for malignant tumors of significant size, especially with signs of invasion into surrounding structures. Given that most AI are benign formations, it is equally important to determine further tactics for them — the mode and duration of observation, the order and scope of control clinical and hormonal and imaging studies, the principles of evaluation of the results. Several guidelines indicate that in the presence of hormonally inactive adenomas, without signs of malignancy, less than 3–4 cm in size, no further observation is indicated. It is noted that in such tumors the tendency to growth, malignancy, emergence of hormonal activity is extremely seldom observed. In other cases, especially with the slightest doubt of the initial results, follow-up examinations are recommended after 3, 6, 12 months and then after 1–2 years, the maxi­mum period is set to five years. These parameters are the subject of discussion in various clinics.

Stereospecific, Palladium-catalyzed C(sp3)–H Alkenylation and Alkynylation of a Proline Derivative Enabled by 8-Aminoquinoline as a Directing Group

2020 ◽  
Author(s):  
Aleksandra Balliu ◽  
Aaltje Roelofje Femmigje Strijker ◽  
Michael Oschmann ◽  
Monireh Pourghasemi Lati ◽  
Oscar Verho
Keyword(s):  
Carboxylic Acid ◽  
Building Blocks ◽  
Wide Range ◽  
Palladium Catalyzed ◽  
Directing Group ◽  
High Yields ◽  
Vinyl Iodides ◽  
Initial Results

<p>In this preprint, we present our initial results concerning a stereospecific Pd-catalyzed protocol for the C3 alkenylation and alkynylation of a proline derivative carrying the well utilized 8‑aminoquinoline directing group. Efficient C–H alkenylation was achieved with a wide range of vinyl iodides bearing different aliphatic, aromatic and heteroaromatic substituents, to furnish the corresponding C3 alkenylated products in good to high yields. In addition, we were able show that this protocol can also be used to install an alkynyl group into the pyrrolidine scaffold, when a TIPS-protected alkynyl bromide was used as the reaction partner. Furthermore, two different methods for the removal of the 8-aminoquinoline auxiliary are reported, which can enable access to both <i>cis</i>- and <i>trans</i>-configured carboxylic acid building blocks from the C–H alkenylation products.</p>

Cerebellotrigeminal Dermal Dysplasia (Gómez-López-Hernández Syndrome)

2018 ◽  
Vol 16 (05) ◽  
pp. 362-368 ◽  
Author(s):  
Federica Sullo ◽  
Agata Polizzi ◽  
Stefano Catanzaro ◽  
Selene Mantegna ◽  
Francesco Lacarrubba ◽  
...  
Keyword(s):  
De Novo ◽  
Chromosomal Rearrangements ◽  
Number Of Patients ◽  
Wide Range ◽  
Visual Problems ◽  
Neurodevelopmental Abnormalities ◽  
Clinical Triad ◽  
High Degree ◽  
Motor Handicap

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

scholarly journals Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001440
Author(s):  
Shameer Khubber ◽  
Rajdeep Chana ◽  
Chandramohan Meenakshisundaram ◽  
Kamal Dhaliwal ◽  
Mohomed Gad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Management ◽  
Medical Management ◽  
Cox Regression ◽  
Artery Bypass ◽  
Management Strategies ◽  
Coronary Artery Aneurysms ◽  
Kaplan Meier

BackgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.MethodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.ResultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.ConclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

scholarly journals Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199455
Author(s):  
Nicola Maffulli ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Filippo Migliorini
Keyword(s):  
Surgical Management ◽  
Revision Surgery ◽  
Case Series ◽  
Sports Participation ◽  
Patellar Tendinopathy ◽  
Symptom Duration ◽  
Level Of Evidence ◽  
Training Time ◽  
The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

scholarly journals A rare triad of morning glory disc anomaly, moyamoya vasculopathy, and transsphenoidal cephalocele: pathophysiological considerations and surgical management

2021 ◽  
Author(s):  
Marco Pavanello ◽  
Pietro Fiaschi ◽  
Andrea Accogli ◽  
Mariasavina Severino ◽  
Domenico Tortora ◽  
...  
Keyword(s):  
Surgical Management ◽  
Missense Variant ◽  
Morning Glory ◽  
Morning Glory Disc Anomaly ◽  
Long Term Follow Up ◽  
Indirect Revascularization ◽  
Peripapillary Retina

AbstractMorning glory disc anomaly is a congenital abnormality of the optic disc and peripapillary retina reported as an isolated condition or associated with various anomalies, including basal encephaloceles and moyamoya vasculopathy. However, the co-occurrence of these three entities is extremely rare and the pathogenesis is still poorly understood. Moreover, data on the surgical management and long-term follow-up of the intracranial anomalies are scarce. Here, we describe the case of a 11-year-old boy with morning glory disc anomaly, transsphenoidal cephalocele, and moyamoya vasculopathy, who underwent bilateral indirect revascularization with encephalo-duro-myo-arterio-pericranio-synangiosis at the age of 2 years, and endoscopic repair of the transsphenoidal cephalocele at the age of 6 years. A rare missense variant (c.1081T>C,p.Tyr361His) was found in OFD1, a gene responsible for a X-linked ciliopathy, the oral-facial-digital syndrome type 1 (OFD1; OMIM 311200). This case expands the complex phenotype of OFD1 syndrome and suggests a possible involvement of OFD1 gene and Shh pathway in the pathogenesis of these anomalies.

scholarly journals Zebrafish Models to Study New Pathways in Tauopathies

2021 ◽  
Vol 22 (9) ◽  
pp. 4626
Author(s):  
Clément Barbereau ◽  
Nicolas Cubedo ◽  
Tangui Maurice ◽  
Mireille Rossel
Keyword(s):  
Cognitive Deficits ◽  
Tau Protein ◽  
Common Point ◽  
Transgenic Models ◽  
Synaptic Loss ◽  
Wide Range ◽  
Transgenic Lines ◽  
Functional Consequences ◽  
The Common

Tauopathies represent a vast family of neurodegenerative diseases, the most well-known of which is Alzheimer’s disease. The symptoms observed in patients include cognitive deficits and locomotor problems and can lead ultimately to dementia. The common point found in all these pathologies is the accumulation in neural and/or glial cells of abnormal forms of Tau protein, leading to its aggregation and neurofibrillary tangles. Zebrafish transgenic models have been generated with different overexpression strategies of human Tau protein. These transgenic lines have made it possible to highlight Tau interacting factors or factors which may limit the neurotoxicity induced by mutations and hyperphosphorylation of the Tau protein in neurons. Several studies have tested neuroprotective pharmacological approaches. On few-days-old larvae, modulation of various signaling or degradation pathways reversed the deleterious effects of Tau mutations, mainly hTauP301L and hTauA152T. Live imaging and live tracking techniques as well as behavioral follow-up enable the analysis of the wide range of Tau-related phenotypes from synaptic loss to cognitive functional consequences.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

Contemporary Surgical Management of Juvenile Nasopharyngeal Angiofibroma

2021 ◽  
Author(s):  
Salomon Cohen-Cohen ◽  
Kristen M. Scheitler ◽  
Garret Choby ◽  
Jeffrey Janus ◽  
Eric J. Moore ◽  
...  
Keyword(s):  
Surgical Management ◽  
Intracranial Extension ◽  
Preoperative Embolization ◽  
Tumor Diameter ◽  
Historical Cohort ◽  
Nasopharyngeal Angiofibroma ◽  
Estimated Blood Loss ◽  
The Impact ◽  
Previous Series

Abstract Objectives Juvenile nasopharyngeal angiofibromas (JNAs) are uncommon tumors with an evolving treatment paradigm. The objective of this study was to compare our prior experience reported in 2005 with our most contemporary series to compare practice improvements and the impact of expanded endonasal procedures. Design Retrospective review comparing a contemporary 22 patients with JNA who underwent surgical management between 2005 and 2019, compared with a historical cohort of 65 patients from the same center. Results The most common presenting symptom was epistaxis (68%). The median maximum tumor diameter was 4.4 cm. All patients underwent preoperative embolization. An endoscopic endonasal approach (EEA) was used in 18 patients (82%), compared with 9% in the series prior to 2005. Gross total resection was achieved in all patients. The median estimated blood loss was 175 and 350 mL for EEA and open (transfacial) cases, respectively. Only two patients (9%) required a blood transfusion compared with 52% on the previous series. The median follow-up was 19 months. The overall recurrence rate was 9% in this series and 24% in the previous series. No patient required radiation therapy in follow-up compared with 3% in our historical cohort. Conclusion There have been significant changes regarding the management of patients with JNA compared with the previous Mayo Clinic experience. The EEA has become the preferred route over the transfacial approaches to treat JNA in selected patients who do not have intracranial extension. Preoperative embolization has aided in reducing the postoperative transfusion rates.

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