scholarly journals Functional Neurorehabilitation in Dogs with an Incomplete Recovery 3 Months following Intervertebral Disc Surgery: A Case Series

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2442
Author(s):  
Ângela Martins ◽  
Débora Gouveia ◽  
Ana Cardoso ◽  
Carla Carvalho ◽  
Cátia Silva ◽  
...  
Keyword(s):  
Pain Perception ◽  
Therapeutic Option ◽  
Case Series ◽  
Spinal Reflex ◽  
Type I ◽  
Locomotor Training ◽  
Pharmacological Management ◽  
Case Series Study ◽  
Flexion Extension

This case series study aimed to evaluate the safety, feasibility, and positive outcome of the neurorehabilitation multimodal protocol (NRMP) in 16 chronic post-surgical IVDD Hansen type I dogs, with OFS 0/DPP− (n = 9) and OFS 1/DPP+ (n = 7). All were enrolled in the NRMP for a maximum of 90 days and were clinically discharged after achieving ambulation. The NRMP was based on locomotor training, functional electrical stimulation, transcutaneous electrical spinal cord stimulation, and 4-aminopyridine (4-AP) pharmacological management. In the Deep Pain Perception (DPP)+ dogs, 100% recovered ambulation within a mean period of 47 days, reaching OFS ≥11, which suggests that a longer period of time is needed for recovery. At follow-up, all dogs presented a positive evolution with voluntary micturition. Of the DPP− dogs admitted, all achieved a flexion/extension locomotor pattern within 30 days, and after starting the 4-AP, two dogs were discharged at outcome day 45, with 78% obtaining Spinal Reflex Locomotion (SRL) and automatic micturition within a mean period of 62 days. At follow-up, all dogs maintained their neurological status. After the NRMP, ambulatory status was achieved in 88% (14/16) of dogs, without concurrent events. Thus, an NRMP may be an important therapeutic option to reduce the need for euthanasia in the clinical setting.

scholarly journals Chemical cauterization of peristomal granulomas with 50% trichloroacetic acid

2019 ◽  
Author(s):  
Rosaura Paczek ◽  
Luisa Passberg
Keyword(s):  
Trichloroacetic Acid ◽  
Therapeutic Option ◽  
Case Series ◽  
Clinical Results ◽  
Focal Lesions ◽  
Regular Treatment ◽  
Case Series Study ◽  
Chemical Cauterization ◽  
The Individual

Objetive: This study deals with the treatment of granulomas, one of the possible complications of the stomies, which are characterized as focal lesions, whose formation occurs due to the presence of aggressive agents to the tissues from the increase of the degree of cellularity and other tissue elements, generating annoyance and anxiety to patients. This study aims to describe the clinical results of the treatment of peristomal granulomas with the use of 50% trichloroacetic acid (TCA). Methods: This is a case series study, carried out by professionals in a referral center for the treatment of individuals with an ostomy in the city of Porto Alegre, state of Rio Grande do Sul. Results: The study sample consisted of 13 patients who underwent follow-up for treatment of peristomal granulomas with TCA. Data collection was performed during nursing consultations, based on the observation and photographic record of the granulomas, with subsequent evolution in the individual charts. Conclusion: It was concluded from this study that the regular treatment with TCA resulted in regression of the granulomas until their total disappearance, being this acid able to be considered, therefore, a potential therapeutic option; however, it is recommended to carry out further studies on its use in stomatherapy, seeking the use of more robust clinical research methodologies and with bias control.

scholarly journals Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sergio Haimovich ◽  
Maite López-Yarto ◽  
Julio Urresta Ávila ◽  
Alejandro Saavedra Tascón ◽  
José L. Hernández ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Case Series ◽  
Uterine Cavity ◽  
Hysteroscopic Myomectomy ◽  
Submucous Myoma ◽  
Case Series Study ◽  
Laser Enucleation ◽  
A Prospective Study ◽  
Series Study

Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary.Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility) assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used.Results. Sixty-one women (mean age: 47.3 years) were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD) diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5) mm. In 29 cases (47.5%), the diameter of the resected myoma was >20 mm and in 10 cases (16.4%) >30 mm. After a mean follow-up of 68.2 (16.5) days, none of the patients showed a residual myoma inside the uterine cavity.Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option.

scholarly journals Bone Marrow Concentrate in the Treatment of Aneurysmal Bone Cysts: A Case Series Study

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Lorenzo Andreani ◽  
Sheila Shytaj ◽  
Elisabetta Neri ◽  
Fabio Cosseddu ◽  
Antonio D’Arienzo ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Plain Radiograph ◽  
Case Series ◽  
Autologous Bone Marrow ◽  
Type I ◽  
Bone Cysts ◽  
Bone Marrow Concentrate ◽  
Case Series Study ◽  
Aneurysmal Bone Cysts

Introduction. A recent attractive option regarding mesenchymal stem cells (MSC) application is the treatment of bone cystic lesions and in particular aneurysmal bone cysts (ABC), in order to stimulate intrinsic healing. We performed a retrospective evaluation of the results obtained at our institution. Methods. The study group consisted of 46 cases with an average follow-up of 33 months. Forty-two patients underwent percutaneous treatment as the first approach; four patients had curettage as first treatment. In all cases, autologous bone marrow concentrate (BMC) was associated too. The healing status was followed up through a plain radiograph 45 days and 2 months after the procedure. Results and Conclusions. At the final follow-up, thirty-six patients healed with a Neer type II aspect, nine healed with a type I aspect, and one patient was not classified having total hip arthroplasty. Bone marrow concentrate is easy to obtain and to manipulate and can be immediately available in a clinical setting. We can assert that the use of BMC must be encouraged being harmless and having an unquestionable high osteogenic and healing potential in bone defects.

scholarly journals Efficacy of Traditional Chinese Medicine Regimen Jian Pi Qu Shi Formula for Refractory Patients with Idiopathic Membranous Nephropathy: A Retrospective Case-Series Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Bin Shi ◽  
Rong-rong Zhang ◽  
Ying Liang ◽  
Xin-hui Wang ◽  
Rui Lang ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Adverse Events ◽  
Membranous Nephropathy ◽  
Partial Remission ◽  
Therapeutic Option ◽  
Case Series ◽  
Idiopathic Membranous Nephropathy ◽  
Case Series Study

Background. The treatment of adult refractory idiopathic membranous nephropathy with steroid and other immunosuppressant-resistant nephrotic syndromes can be a significant challenge. We evaluated the efficacy and safety of the traditional Chinese medicine Jian Pi Qu Shi Formula (JPQSF) as a promising regimen. Methods. We analyzed 15 consecutive patients with biopsy-proven idiopathic membranous nephropathy who failed immunosuppressive therapy from October 2013 to January 2017. JPQSF was administered orally two times per day, respectively, in the morning and at night for 6 months. All patients had at least 1 year of follow-up. The primary endpoints included complete or partial remission. Secondary endpoints included change of clinical parameters and adverse events after 12 months of treatment. Results. After 12 months, complete remission was achieved in 13.3% of patients and partial remission in 66.7%, yielding a response rate of 80%. Proteinuria, serum albumin, and cholesterol were improved significantly (P<0.001, P<0.001, and P<0.05, respectively). After 1 year of treatment, proteinuria (mean ± SD) decreased from 5.93 ± 2.54 g per 24 h to 1.99 ± 1.17 g per 24 h (P<0.001). No serious adverse events occurred during the observation. Conclusions. JPQSF may be an alternative therapeutic option for steroid and general immunosuppressant-resistant membranous nephrotic syndrome patients, with a favorable safety profile. Larger and longer follow-up studies evaluating this regimen are warranted.

Intensive Functional Neurorehabilitation and Follow-up of 84 Paraplegic Dogs Affected by Intervertebral Disc Disease

2020 ◽  
Author(s):  
Ângela Rocha Martins ◽  
Débora Gouveia ◽  
Ana Cardoso ◽  
Inês Viegas ◽  
Darryl Millis ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Pain Perception ◽  
Spinal Reflex ◽  
Prospective Clinical Study ◽  
Type I ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Expected Time

Abstract BackgroundThe objectives of this study were to verify whether the functionality obtained with functional neurorehabilitation intensive protocols (FNRIP) improve ambulation, promoting a new therapeutic approach, and understand the expected time for functional recovery. Furthermore, to know whether “spinal reflex” locomotion could be a functional locomotory pattern, which may improve the quality of life.A controlled prospective clinical study using a large cohort of 84 dogs comprising mostly chondrodystrophic-breeds. The dogs were diagnosed with T10-L3 Hansen Type I, using computed tomography or magnetic resonance imaging, and treated with hemilaminectomy. All had postsurgical neurological stage 0 or 1, according to the Open Field Score (OFS), and showed either an absent or decreased flexor peripheral reflex. All patients were subjected to FNRIP within a maximum of 3 months, data were recorded on days 1,3,7,15,30,45,60,75, 90 and patients were followed-up after 8-10 days, at 1 and 6 months, and in some cases, after 1 and 2 years. ResultsFifty-one dogs were admitted with an OFS of 1 and were discharged with an OFS of 13 (100% functionality). Of the 29 dogs that were admitted with an OFS 0, 16 were discharged (55%) in an ambulatory state, of which six dogs recovered deep pain perception (DPP) after 4 weeks, and 10 showed functional “spinal reflex” locomotion. 79.3% of these dogs achieved autonomous miction. The results were time-limited, as they were recorded within 2 to 3 months, with follow-up until 6 months. A pattern of sustained functional “spinal reflex” locomotion was observed in 30% of the dogs observed over 2 years.ConclusionsThe FNRIP are viable to regain independence and quality of life in paraplegic dogs with/without DPP, secondary to acute Intervertebral disc disease (IVDD).

scholarly journals Long-Term Outcomes for Arthroscopic Thermal Treatment for Scapholunate Ligament Injuries

2019 ◽  
Vol 09 (01) ◽  
pp. 022-028 ◽  
Author(s):  
Matthew B. Burn ◽  
Eric J. Sarkissian ◽  
Jeffrey Yao
Keyword(s):  
Grip Strength ◽  
Case Series ◽  
Therapeutic Modality ◽  
Low Grade ◽  
Interosseous Ligament ◽  
Case Series Study ◽  
Flexion Extension ◽  
Electrothermal Treatment

Background Arthroscopic electrothermal treatment of low-grade Geissler's scapholunate interosseous ligament (SLIL) tears has shown clinical benefit at short-term follow-up. Questions/Purpose This study aims to evaluate the long-term functional outcomes in patients undergoing this treatment. Patients and Methods A retrospective review of all patients treated between 2005 and 2013 was performed. Patients were excluded with less than 5 years of follow-up, the presence of static SLIL injuries, prior wrist surgery, and concomitant denervation. Symptom resolution, return to activity, postoperative complications, range of motion, grip strength, and subsequent treatment were recorded. Each patient completed Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Modified Mayo Wrist (MMW), and Patient-Rated Wrist Evaluation (PRWE) questionnaires. Results Nine patients underwent treatment for Geissler's grade I, II, and III SLIL injuries with a mean 7 years (range: 5–11 years) of follow-up. Mean grip strength was 99% of the nonsurgical extremity. Wrist motion was near symmetric with a mean of 76 (±14), 74 (±8), 21 (±13), and 40 degrees (±13) for wrist flexion, extension, radial deviation, and ulnar deviation. QuickDASH improved significantly by a mean 39 points (50 (preoperative)–11 [postoperative], p = 0.009). Postoperative MMW and PRWE scores were 83 and 14, respectively. Visual analog scale (VAS) score was 1.4. A total of 90% was returned to their preinjury level of function or higher. Conclusions Arthroscopic electrothermal treatment of low-grade Geissler's SLIL tears demonstrates excellent objective and subjective outcomes at a minimum 5-year follow-up, providing evidence that this is an effective, safe, and, most importantly, durable-therapeutic modality. Level of Evidence This is a Level IV, case series study.

Effect of Isolated Medial Patellofemoral Ligament Reconstruction in Patellofemoral Instability Regardless of Predisposing Factors

2020 ◽  
Author(s):  
Jae Ik Lee ◽  
Mohd Shahrul Azuan Jaffar ◽  
Han Gyeol Choi ◽  
Tae Woo Kim ◽  
Yong Seuk Lee
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Trochlear Dysplasia ◽  
Case Series ◽  
Patellofemoral Instability ◽  
International Knee Documentation Committee ◽  
Predisposing Factors ◽  
Mpfl Reconstruction ◽  
Patellar Tilt ◽  
Case Series Study

AbstractThe purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to −0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18–74) preoperatively to 94.71 (range: 86–100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10–81) preoperatively to 94.14 (range: 86–100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT–TG distance, or valgus alignment. This is a Level 4, case series study.

The case for skin camouflage in the management of upper limb scarring – A case series

Hand Therapy ◽  
2021 ◽  
pp. 175899832110078
Author(s):  
Laura Adamson ◽  
Anna Selby
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Primary Objective ◽  
Self Confidence ◽  
Published Evidence ◽  
Case Series Study ◽  
Visual Impact ◽  
Series Study ◽  
Increasing Function

Introduction For some people the appearance of their hands is as important as function. Upper limb scarring can cause some patients distress. Skin camouflage is an intervention that can be used to reduce the visual impact of a scar but there is limited published evidence for its use for hand scarring. Methods This is a case series study with a primary objective to determine whether skin camouflage reduces distress in patients with an upper limb scar and to evaluate this new service. Patients experiencing distress from an upper limb scar were recruited from a hand therapy outpatient clinic. The intervention delivered was a one hour skin camouflage session. Photographs of the upper limb pre and post skin camouflage intervention were taken. The patient-rated Michigan Hand Questionnaire (MHQ) and Derriford Appearance Scale (DAS24) were completed before treatment, at 1 week and 1 month after treatment. Results Six participants reporting distress from an upper limb scar received skin camouflage intervention. Only three out of six participants completed all follow-up. All three showed improvement in at least two domains of the MHQ (function and aesthetics) at one month post treatment. Increased confidence during functional and work-based activities was also reported on the DAS24. Participants reported increased engagement in daily activities as a result of being able to camouflage their scars. Conclusions This small case series shows that skin camouflage intervention may be beneficial for some patients who are experiencing distress related to an upper limb scar by increasing function and self-confidence.

scholarly journals The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

2020 ◽  
pp. 219256822098044
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Hitoshi Shitara ◽  
Tokue Mieda ◽  
Eiji Takasawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biceps Brachii ◽  
Case Series ◽  
Manual Muscle Test ◽  
Cuff Tear ◽  
Cervical Spondylotic Amyotrophy ◽  
Case Series Study ◽  
Shoulder Abductor ◽  
Series Study

Study Design: Case series study. Objective: We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). Methods: We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. Results: Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. Conclusion: RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.

Long-term Outcomes of Microfracture for Treatment of Osteochondral Lesions of the Talus

2021 ◽  
pp. 107110072199542
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph O’Neil ◽  
Steven Raikin
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Return To Sport ◽  
Osteochondral Lesions ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Additional Surgery ◽  
Case Series Study

Background: Microfracture is the most common reparative surgery for osteochondral lesions of the talus (OLTs). While shown to be effective in short- to midterm outcomes, the fibrocartilage that microfracture produces is both biomechanically and biologically inferior to that of native hyaline cartilage and is susceptible to possible deterioration over time following repair. With orthobiologics being proposed to augment repair, there exists a clear gap in the study of long-term clinical outcomes of microfracture to determine if this added expense is necessary. Methods: A retrospective review of patients undergoing microfracture of an OLT with a single fellowship-trained orthopedic surgeon from 2007 to 2009 was performed. Patients meeting the inclusion criteria were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales and visual analog scale (VAS) for pain, as well as surveyed regarding their satisfaction with the outcome of the procedure and their likelihood to recommend the procedure to a friend with the same problem using 5-point Likert scales. Patient demographics were reviewed and included for statistical analysis. Results: Of 45 respondents, 3 patients required additional surgery on their ankle for the osteochondral defect, yielding a 10-year survival rate of 93.3%. Of surviving cases, 90.4% (38/42) reported being “extremely satisfied” or “satisfied” with the outcome of the procedure. The VAS score at follow-up averaged 14 out of 100 (range, 0-75), while the FAAM-ADL and FAAM-Sports scores averaged 90.29 out of 100 and 82 out of 100, respectively. Thirty-six patients (85.7%) stated that their ankle did not prevent them from participating in the sports of their choice. Conclusion: The current study represents a minimum 10-year follow-up of patients undergoing isolated arthroscopic microfracture for talar osteochondral defects, with a 93.3% survival rate and 85.7% return to sport. While biological adjuvants may play a role in improving the long-term outcomes of microfracture procedures, larger and longer-term follow-up studies are required for procedures using orthobiologics before their cost can be justified for routine use. Level of Evidence: Level IV, retrospective cohort case series study.

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