scholarly journals Therapy of Pyothorax in Cats via Small-Bore Thoracostomy Tube in Terms of Efficacy, Complications and Outcomes

Animals ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 107
Author(s):  
Evelyn Heier ◽  
Gabriel Wurtinger ◽  
Esther Hassdenteufel ◽  
Matthias Schneider
Keyword(s):  
Case Series ◽  
Comparable Efficacy ◽  
Closed Chest ◽  
Treatment Groups ◽  
First Line Therapy ◽  
Intravenous Antibiotics ◽  
A New Technique ◽  
Long Term Prognosis ◽  
One Year

First-line therapy for cats with pyothorax consists of intravenous antibiotics, drainage of the septic pleural effusion and closed-chest lavage. Large-bore thoracostomy tubes are traditionally used for drainage, but case series indicate a comparable efficacy using small-bore tubes. In this retrospective study, we describe a new technique of sheath-guided small-bore (6 F) thoracostomy tubes in cats with pyothorax and evaluate their efficacy and complications. Additionally, we compare outcomes between two treatment groups. Placement and use of the small-bore thoracostomy tubes described here has a low complication rate of 4% (3/67 tubes), and 53% (24/45) of the cats could be treated with thoracostomy tubes and closed-chest lavage according to the protocol. The success rate is reduced by 18% (8/45) due to deaths caused mainly by sepsis, 16% (7/45) due to structural diseases requiring surgery and a further 14% (6/43) due to lavage failures that could only be cured after additive therapy (thoracotomy or fibrinolysis). The long-term prognosis was very good, with a survival rate one year after discharge of 94% (30/32). We detected no effect on survival by early placement of bilateral thoracostomy tubes or closed-chest lavage with a heparinised solution. In conclusion, therapy of pyothorax with small-bore thoracostomy tubes is as successful as therapy with large- or medium-bore tubes.

scholarly journals Treatment and Prognosis of Myocardial Infarction Outside Cardiology Departments

2020 ◽  
Vol 10 (1) ◽  
pp. 106
Author(s):  
Anton Gard ◽  
Bertil Lindahl ◽  
Nermin Hadziosmanovic ◽  
Tomasz Baron
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Cardiology Department ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Short And Long Term ◽  
Long Term Prognosis ◽  
One Year

Aim: Our aim was to investigate the characteristics, treatment and prognosis of patients with myocardial infarction (MI) treated outside a cardiology department (CD), compared with MI patients treated at a CD. Methods: A cohort of 1310 patients diagnosed with MI at eight Swedish hospitals in 2011 were included in this observational study. Patients were followed regarding all-cause mortality until 2018. Results: A total of 235 patients, exclusively treated outside CDs, were identified. These patients had more non-cardiac comorbidities, were older (mean age 83.7 vs. 73.1 years) and had less often type 1 MIs (33.2% vs. 74.2%), in comparison with the CD patients. Advanced age and an absence of chest pain were the strongest predictors of non-CD care. Only 3.8% of non-CD patients were investigated with coronary angiography and they were also prescribed secondary preventive pharmacological treatments to a lesser degree, with only 32.3% having statin therapy at discharge. The all-cause mortality was higher in non-CD patients, also after adjustment for baseline parameters, both at 30 days (hazard ratio (HR) 2.28; 95% confidence interval (CI) 1.62–3.22), one year (HR 1.82; 95% CI 1.39–2.36) and five years (HR 1.62; 95% CI 1.32–1.98). Conclusions: MI treatment outside CDs is associated with an adverse short- and long-term prognosis. An improved use of percutaneous coronary intervention (PCI) and secondary preventive pharmacological treatment might improve the long-term prognosis in these patients.

scholarly journals Characteristics and resolution of hypertension in obese African American bariatric cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charu Gandotra ◽  
Motahar Basam ◽  
Ankit Mahajan ◽  
Julius Ngwa ◽  
Gezzer Ortega ◽  
...  
Keyword(s):  
Weight Loss Surgery ◽  
Surgical Techniques ◽  
Antihypertensive Medications ◽  
University Center ◽  
First Line Therapy ◽  
Howard University ◽  
Long Term Effect ◽  
Bariatric Patients ◽  
One Year

AbstractWeight reduction continues to be first-line therapy in the treatment of hypertension (HTN). However, the long-term effect of bariatric malabsorptive surgical techniques such as Roux-en-Y Gastric Bypass (RYGB) surgery in the management of hypertension (HTN) is less clear. African Americans (AA) are disproportionately affected by obesity and hypertension and have inconsistent outcomes after bariatric surgery (BS). Despite a plethora of bariatric literature, data about characteristics of a predominantly AA bariatric hypertensive cohort including hypertension in obese (HIO) are scarce and underreported. The aims of this study were, (1) to describe the preoperative clinical characteristics of HIO with respect to HTN status and age, and (2) to identify predictors of HTN resolution one year after RYGB surgery in an AA bariatric cohort enrolled at the Howard University Center for Wellness and Weight Loss Surgery (HUCWWS). In the review of 169 AA bariatric patients, the average BMI was 48.50 kg/m2 and the average age was 43.86 years. Obese hypertensive patients were older (46 years vs. 37.89 years; p < .0001); had higher prevalence of diabetes mellitus (DM, 43.09% vs. 10.87%; p < .0001) and dyslipidemia (38.2% vs. 13.04%; p 0.002). Hypertensive AA who were taking ≥ 2 antihypertensive medications prior to RYGB were 18 times less likely to experience HTN resolution compared to hypertensive AA taking 0–1 medications, who showed full or partial response. Also, HIO was less likely to resolve after RYGB surgery in patients who needed ≥ 2 antihypertensive medications prior to surgical intervention.

scholarly journals Salvage endoscopic resection in patients with esophageal adenocarcinoma after chemoradiotherapy

2018 ◽  
Vol 06 (09) ◽  
pp. E1126-E1129 ◽  
Author(s):  
Irma C. Noordzij ◽  
Wouter L. Curvers ◽  
Clément J. Huysentruyt ◽  
Grard A.P. Nieuwenhuijzen ◽  
Geert-Jan Creemers ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Endoscopic Resection ◽  
Argon Plasma Coagulation ◽  
Case Series ◽  
Argon Plasma ◽  
Residual Tumor ◽  
Esophageal Resection ◽  
Sustained Remission ◽  
Long Term Prognosis

Abstract Background and study aims For early esophageal adenocarcinoma, endoscopic resection is an accepted curative treatment with an excellent long-term prognosis. Case series from Japan have reported endoscopic resection of residual esophageal squamous cell carcinoma after chemoradiotherapy. This is the first report describing endoscopic resection of residual esophageal adenocarcinoma after chemoradiotherapy. Two patients with advanced esophageal adenocarcinoma had been treated with chemoradiotherapy because comorbidity precluded esophageal resection. When residual tumor was observed endoscopically, complete remission was achieved by salvage endoscopic therapy alone or in combination with argon plasma coagulation (APC). Both patients achieved long-term sustained remission and died of non-tumor-related causes.

scholarly journals Consecutive Case Series of Healed Single-Molar Sites Immediately Restored with Wide-Diameter Implants: A 1-Year Evaluation

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Hadi Antoun ◽  
Pierre Cherfane ◽  
Bouchra Sojod
Keyword(s):  
Success Rate ◽  
Case Series ◽  
Marginal Bone Loss ◽  
Wide Diameter ◽  
Bone Level ◽  
One Year ◽  
Lost To Follow Up ◽  
Single Crowns

Introduction. To evaluate outcomes of wide-diameter (6 mm) implants immediately provisionalized with cement-retained single crowns in posterior molar sites.Materials and Methods. Forty-eight consecutive patients received a total of 53 moderately rough-surface, 6 mm diameter implants in healed sites. All implants were immediately provisionalized with a cement-retained provisional crown. Final prosthesis with cement-retained porcelain fused to metal crowns was delivered 3–6 months later. Patients were followed up for 1 year. Outcome measures were implant failures and success rate, complications, marginal bone levels, bone level changes, papilla index, bleeding on probing, and inflammation.Results. One patient was lost to follow-up. At one year, the implant survival and success rate were 98.1%. The mean marginal bone loss after 1 year was −0.17±1.84 mm. Ideal papilla score was recorded at 83.8% of the sites. More than 95.6% of the sites showed no bleeding or inflammation. No procedure-related or device-related adverse events were reported.Conclusion. Wide-diameter (6 mm) implants can safely and successfully replace single posterior molars. Longer follow-up studies are necessary to evaluate the long-term success of these implants.

One-year, low-dose neuroleptic study of in-patients with chronic schizophrenia characterised by persistent negative symptoms

1997 ◽  
Vol 171 (6) ◽  
pp. 564-568 ◽  
Author(s):  
Jeremy C. Speller ◽  
Thomas R. E. Barnes ◽  
David A. Curson ◽  
Christos Pantelis ◽  
J. L. Alberts
Keyword(s):  
Negative Symptoms ◽  
Low Dose ◽  
Chronic Schizophrenia ◽  
Anticholinergic Medication ◽  
Treatment Groups ◽  
Substituted Benzamide ◽  
One Year ◽  
To Receive ◽  
Persistent Negative Symptoms

BackgroundAmisulpride is a potent substituted benzamide antipsychotic drug claimed to improve the negative symptoms of schizophrenia, particularly at low dosage.MethodSixty long-term in-patients with schizophrenia and selected for predominant negative symptoms were randomised to receive either haloperidol or amisulpride. Over a year there was systematic dose reduction, as symptoms allowed.ResultsThere were no significant differences between the treatment groups in the proportion receiving low-dose treatment, the control of positive symptoms, or ratings of social behaviour, side-effects or tardive dyskinesia. For negative symptoms, there were consistent but non-significant trends in favour of amisulpride. The amisulpride patients required significantly less anticholinergic medication.ConclusionsIn chronically-hospitalised in-patients with schizophrenia characterised by persistent negative symptoms, amisulpride was a well-tolerated maintenance antipsychotic medication. The drug had only a limited effect in reducing negative symptoms, which were relatively stable, enduring phenomena in this sample, despite dosage reduction.

Aortic Valve Intervention During Aortic Root Surgery in Children: A Systematic Review

2020 ◽  
Vol 11 (5) ◽  
pp. 611-618
Author(s):  
Maria Rodriguez ◽  
Anahita Malvea ◽  
Dayre McNally ◽  
Vid Bijelic ◽  
Ming Guo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Aortic Root Surgery ◽  
Valve Sparing ◽  
One Year

Background: Pediatric aortic root dilatation is a life-threatening condition that lacks guidelines for surgical management. We aimed to analyze the data on aortic valve interventions during root surgery to guide decision-making. Methods: A search was performed of MEDLINE, Embase, CENTRAL, ClinicalTrials.gov , and WHO ICTRP. Citations were screened in duplicate and independently to identify randomized controlled trials, cohorts, and case series involving populations aged 0 to 18 years, who received valve-sparing and valve-replacing aortic root surgeries between 1999 and 2019. Outcomes considered included mortality (perioperative, one year, five year), reintervention rates. Results: After duplicate removal, 689 citations were screened through abstract and full text review, identifying five eligible studies. All five were observational studies evaluating valve-sparing procedures. There were 81 patients with a mean study age range of 9.9 to 13.9 years. Both reimplantation (74%) and remodeling (26%) subtypes were done. Range of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality reported until the one-year follow-up period. The long-term mortality rate was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13). Conclusions: There is limited experience on aortic valve intervention during aortic root surgery in children. Single-arm studies on valve-sparing surgeries show excellent survival up to one year. Mortality and reintervention rates increase in the longer term. The small sample size and lack of controlled studies do not allow for direct comparisons between procedure types.

scholarly journals Anti-NMDAR encephalitis

2019 ◽  
Vol 7 (1) ◽  
pp. e633 ◽  
Author(s):  
Xiaolu Xu ◽  
Qiang Lu ◽  
Yan Huang ◽  
Siyuan Fan ◽  
Lixin Zhou ◽  
...  
Keyword(s):  
Ovarian Teratoma ◽  
Long Term Outcomes ◽  
First Line ◽  
Factors Affecting ◽  
First Line Therapy ◽  
Nmdar Encephalitis ◽  
Clinical Presentations ◽  
Long Term Prognosis

ObjectiveTo describe the detailed clinical characteristics, immunotherapy, and long-term outcomes of patients with anti-NMDA receptor (NMDAR) encephalitis in China.MethodsA single-center, prospective study. Patients who met the diagnostic criteria were enrolled from 2011 to 2017 and followed up. The clinical features, treatment, and long-term outcomes were collected prospectively. Factors affecting the long-term prognosis were analyzed.ResultsThe study included 220 patients. The most common clinical presentations were psychosis (82.7%) and seizures (80.9%). Of the patients, 19.5% had an underlying neoplasm; of which ovarian teratoma was 100% of tumors in females and only one male had lung cancer. Most patients (99.5%) received first-line therapy (glucocorticoids, IV immunoglobulin, or plasmapheresis alone or combined), and only 7.3% received second-line immunotherapy (rituximab, cyclophosphamide alone, or combined). Long-term immunotherapy (mycophenolate mofetil or azathioprine >1 year) was administered to 53.2% of patients. During the first 12 months, 207 (94.1%) patients experienced improvement, and 5 (2.3%) died, whereas 38 (17.3%) experienced relapses. At 12-month follow-up, 92.7% had favorable clinical outcomes (modified Rankin Scale score ≤2).ConclusionsPatients in China present with psychosis and seizure frequently but have a low percentage of underlying neoplasms. Re-enforced first-line immunotherapy is effective in managing anti-NMDAR encephalitis in the acute phase. Although relapse is relatively common, with combined first-line and long-term immunotherapy, most patients reached favorable outcomes.

scholarly journals Therapeutic Apheresis in Acute Relapsing Multiple Sclerosis: Current Evidence and Unmet Needs—A Systematic Review

2019 ◽  
Vol 8 (10) ◽  
pp. 1623 ◽  
Author(s):  
Rolfes ◽  
Pfeuffer ◽  
Ruck ◽  
Melzer ◽  
Pawlitzki ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Series ◽  
Current Evidence ◽  
Comparable Efficacy ◽  
Demyelinating Disorder ◽  
Published Evidence ◽  
The Central Nervous System ◽  
Technical Details ◽  
Relapsing Multiple Sclerosis

Multiple sclerosis (MS) is the most abundant inflammatory demyelinating disorder of the central nervous system. Despite recent advances in its long-term immunomodulatory treatment, MS patients still suffer from relapses, significantly contributing to disability accrual. In recent years, apheresis procedures such as therapeutic plasma exchange (TPE) and immunoadsorption (IA) have been recognized as two options for treating MS relapses, that do not respond to standard treatment with corticosteroids. TPE is already incorporated in most international guidelines, although evidence for its use resulted mostly from either case series or small unblinded and/or non-randomized trials. Data on IA are still sparse, but several studies indicate comparable efficacy between both apheresis procedures. This article gives an overview of the published evidence on TPE and IA in the treatment of acute relapses in MS. Further, we outline current evidence regarding individual outcome predictors, describe technical details of apheresis procedures, and discuss apheresis treatment in children and during pregnancy.

Residual syndrome in convalescents of hemorrhagic fever with renal syndrome

10.12737/6012 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Анисимова ◽  
T. Anisimova ◽  
Ефимова ◽  
E. Efimova
Keyword(s):  
Clinical Course ◽  
Far East ◽  
Hemorrhagic Fever ◽  
Hantaan Virus ◽  
Lumbar Pain ◽  
The Far East ◽  
Eyelid Swelling ◽  
Long Term Prognosis ◽  
One Year

The outcomes of hemorrhagic fever with renal syndrome (HFRS) were analyzed in 55 patients who were under the supervision of a physician – infectious within one year after the disease. This issue has been studied in more detail by the example of Hantaan virus infection in the Far East, the effects of Puumala infection aren’t well understood, vigilance among physicians concerning the formation of chronic kidney disease in patients is lacking. However, it is proved that the peculiarities of the clinical course of HFRS are caused by a specific serotype of the virus. It is revealed that the leading clinical manifestation in patients in early reconvalescence period of HFRS was astheno vegetative syndrome. Long-term prognosis of patients with HFRS, isn’t always favorable, it may be associated with prolonged disorders of the kidneys. Renal pathology includes lumbar – pain, eyelid swelling, dysuric phenomena, polyuria, nycturia, proteinuria, hematuria, cylindruria, reposotory. It is established that the disease is accompanied by a prolonged dysfunction of the nervous system, cardiovascular system, hepato-biliary system, this suggests the possibility of development of chronic pathology of different organs and the need for surveillance of HFRS patients, not only the infectious, but the nephrologist, cardiologist, neurologist.

scholarly journals RESECTION AND REGENERATION- A HOPE FOR THE HOPELESS

2020 ◽  
pp. 1-5
Author(s):  
Apeksha Annigeri B. ◽  
Rajiv Nidasale Puttaswamaiah ◽  
Avinash Janaki Lingaraju
Keyword(s):  
Alveolar Bone ◽  
Treatment Plan ◽  
Treatment Options ◽  
Case Series ◽  
Cost Effective ◽  
Ridge Preservation ◽  
Tooth Structure ◽  
Implant Placement ◽  
Long Term Prognosis

Preservation of tooth structure has always been the prime aim of dental practice. Teeth with advanced periodontal disease in multirooted teeth often pose a significant challenge to the clinician, complicating the treatment plan and compromising long term prognosis. The outcome of the treatment is determined by proper case selection and surgical, endodontic and prosthetic parameters. Resective and regenerative osseous procedures are often employed to help preserve the tooth structure, alveolar bone involving the retained root of multirooted teeth and are cost effective over the other treatment options like ridge preservation/augmentation followed by implant placement. This case series describes application of resective and regenerative techniques for molars with extensive combined periodontal-endodontic disease.

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