scholarly journals MR Imaging Biomarkers for Clinical Impairment and Disease Progression in Patients with Shoulder Adhesive Capsulitis: A Prospective Study

2021 ◽  
Vol 10 (17) ◽  
pp. 3882
Author(s):  
Romain Gillet ◽  
François Zhu ◽  
Pierre Padoin ◽  
Aymeric Rauch ◽  
Gabriella Hossu ◽  
...  
Keyword(s):  
Prospective Study ◽  
Signal Intensity ◽  
Adhesive Capsulitis ◽  
Imaging Biomarkers ◽  
Mri Findings ◽  
Significant Difference ◽  
Clinical Impairment ◽  
Pain Duration ◽  
One Year

Background: MRI diagnostic criteria of shoulder adhesive capsulitis (AC) are nowadays widely used, but there is little information available on the association between MRI findings and clinical impairment. Purpose: To determine the correlation of MRI findings with the Constant–Murley Score (CMS), pain duration and symptoms at the one-year follow-up in AC patients. Materials and methods: This monocentric prospective study included 132 patients with a clinical diagnosis of shoulder AC who underwent shoulder MRI. Mean patient age was 54.1 ± 9.3 years, and there were 55 men and 77 women. A radiologist examined all patients and completed the CMS just prior to MRI. Pain duration was assessed along with the signal intensity and measured the maximal thickness of the inferior glenohumeral ligament (IGHL) by two radiologists. Medical record analysis was performed in a sub-group of 49 patients to assess prognosis approximately one year after the MRI examination. Linear regression analysis with the Pearson test and the Fisher exact test were used to determine the association between MRI findings and clinical impairment. Results: There was a significant difference in mean pain duration score (3.8 ± 1.2 versus 3.2 ± 0.9 and 3.8 ± 1.2 versus 3.2 ± 0.9, respectively, for readers 1 and 2) and in mean mobility scores (15.7 ± 8 points versus 19.6 ± 10.1 points and 15.8 ± 8.2 points versus 19.4 ± 10 points, respectively, for readers 1 and 2) in patients with a high IGHL signal compared to those with a low IGHL signal (p < 0.05). IGHL was thicker in patients with clinical improvement at one-year follow-up compared to those presenting clinical stability or worsening (p < 0.05). Conclusions: In patients with shoulder AC, the degree of signal intensity at the IGHL was inversely related to shoulder pain duration and range of motion, and a thickened IGHL indicated a favorable outcome at one-year follow-up.

Correlation Between MRI Findings and Clinical Impairment In Patients With Shoulder Adhesive Capsulitis: A Prospective Study

2020 ◽  
Author(s):  
Romain GILLET ◽  
Francois ZHU ◽  
Pierre PADOIN ◽  
Gabriella HOSSU ◽  
Aymeric RAUCH ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Adhesive Capsulitis ◽  
Mri Findings ◽  
Significant Difference ◽  
Clinical Impairment ◽  
Pain Duration ◽  
One Year ◽  
The One ◽  
A Prospective Study

Abstract Objectives: MRI diagnostic criteria of shoulder adhesive capsulitis (AC) are widely used, but there is little information available on the association between MRI findings and clinical impairment. The aim of our study was to determine the correlation of MRI findings with the Constant-Murlay Score (CMS), pain duration, and symptoms at the one-year follow-up in AC patients. Methods: MRI of 132 patients with a clinical diagnosis of shoulder AC were prospectively studied. A radiologist examined all patients and completed the CMS just prior to MRI. Pain duration was assessed. The signal intensity and the maximal thickness of the inferior glenohumeral (IGHL) and coracohumeral (CHL) ligaments were measured by two radiologists. Medical record analysis was performed in a sub-group of 49 patients to assess correlation approximately one year after the MRI examination. Results: There was a significant difference in mean pain duration score (3.8 ± 1.2 versus 3.2 ± 0.9 and 3.8 ± 1.2 versus 3.2 ± 0.9 respectively for readers 1 and 2) and in mean mobility scores (15.7 ± 8 points versus 19.6 ± 10.1 points and 15.8 ± 8.2 points versus 19.4 ± 10 points respectively for readers 1 and 2) in patients with a high IGHL signal compared to those with a low signal (P < .05). IGHL was thicker in patients with clinical improvement at one-year follow-up compared to those presenting clinical stability or worsening (P < .05). Conclusion: In shoulder AC patients, the degree of signal intensity at the IGHL was inversely related to shoulder pain duration and range of motion, and a thickened IGHL indicated a favorable outcome at one-year follow-up.

scholarly journals Analyzing the short term and long-term complication of hysterectomy: a prospective study

2021 ◽  
Vol 10 (4) ◽  
pp. 1478
Author(s):  
Sindhu N. R. ◽  
Bharathi Rao ◽  
Sabah Mohd. Zubair
Keyword(s):  
Sexual Dysfunction ◽  
Prospective Study ◽  
Vaginal Hysterectomy ◽  
Urinary Dysfunction ◽  
Short Term ◽  
Significant Difference ◽  
One Year ◽  
A Prospective Study

Background: Hysterectomy is the most common surgical procedure done worldwide in women. Although many studies were done regarding short term complications, long term complications are not very well followed up. The objective of the study is to analyze short term and also long-term complications for the different mode of hysterectomy.Methods: It was a time-bound hospital-based prospective study which includes all the women who underwent hysterectomy for benign conditions in the hospital except women with prior psychiatric, bowel, bladder and sexual dysfunctions. All the patients were followed up for one year using a set of questionnaires to study short term and long-term complications.Results: No significant difference in short term post-operative complications concerning the mode of hysterectomy except for UTI was more common in vaginal hysterectomy group and haemorrhage in TAH route. Sexual dysfunction was noted even after 1 year of surgery in all modes of hysterectomy. Mild urinary dysfunction found statistically significant even at 1 year follow up in vaginal hysterectomy mode however there was no bothersome urinary dysfunction persistent after one year.Conclusions: Sexual dysfunction is the most common persistent long-term morbidity following hysterectomy found in the present study.

scholarly journals A206 EVOLUTION OF PEDIATRIC AUTOIMMUNE CHOLANGITIS AND PRIMARY SCLEROSING CHOLANGITIS INTO ADULTHOOD

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 234-236
Author(s):  
P Willems ◽  
J Hercun ◽  
C Vincent ◽  
F Alvarez
Keyword(s):  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Response To Treatment ◽  
Similar Proportion ◽  
Autoimmune Cholangitis ◽  
Significant Difference ◽  
One Year ◽  
Liver Tests

Abstract Background The natural history of primary sclerosing cholangitis (PSC) in children seems to differ from PSC in adults. However, studies on this matter have been limited by short follow-up periods and inconsistent classification of patients with autoimmune cholangitis (AIC) (or overlap syndrome). Consequently, it remains unclear if long-term outcomes are affected by the clinical phenotype. Aims The aims of this is study are to describe the long-term evolution of PSC and AIC in a pediatric cohort with extension of follow-up into adulthood and to evaluate the influence of phenotype on clinical outcomes. Methods This is a retrospective study of patients with AIC or PSC followed at CHU-Sainte-Justine, a pediatric referral center in Montreal. All charts between January 1998 and December 2019 were reviewed. Patients were classified as either AIC (duct disease on cholangiography with histological features of autoimmune hepatitis) or PSC (large or small duct disease on cholangiography and/or histology). Extension of follow-up after the age of 18 was done for patients followed at the Centre hospitalier de l’Université de Montréal. Clinical features at diagnosis, response to treatment at one year and liver-related outcomes were compared. Results 40 patients (27 PSC and 13 AIC) were followed for a median time of 71 months (range 2 to 347), with 52.5% followed into adulthood. 70% (28/40) had associated inflammatory bowel disease (IBD) (78% PSC vs 54% AIC; p=0.15). A similar proportion of patients had biopsy-proven significant fibrosis at diagnosis (45% PSC vs 67% AIC; p=0.23). Baseline liver tests were similar in both groups. At diagnosis, all patients were treated with ursodeoxycholic acid. Significantly more patients with AIC (77% AIC vs 30 % PSC; p=0.005) were initially treated with immunosuppressive drugs, without a significant difference in the use of Anti-TNF agents (0% AIC vs 15% PSC; p= 0.12). At one year, 55% (15/27) of patients in the PSC group had normal liver tests versus only 15% (2/13) in the AIC group (p=0.02). During follow-up, more liver-related events (cholangitis, liver transplant and cirrhosis) were reported in the AIC group (HR=3.7 (95% CI: 1.4–10), p=0.01). Abnormal liver tests at one year were a strong predictor of liver-related events during follow-up (HR=8.9(95% CI: 1.2–67.4), p=0.03), while having IBD was not (HR=0.48 (95% CI: 0.15–1.5), p=0.22). 5 patients required liver transplantation with no difference between both groups (8% CAI vs 15% CSP; p=0.53). Conclusions Pediatric patients with AIC and PSC show, at onset, similar stage of liver disease with comparable clinical and biochemical characteristics. However, patients with AIC receive more often immunosuppressive therapy and treatment response is less frequent. AIC is associated with more liver-related events and abnormal liver tests at one year are predictor of bad outcomes. Funding Agencies None

scholarly journals Effect of coronavirus disease 2019 on recurrences and follow up of head and neck squamous cell carcinoma

2021 ◽  
pp. 1-4
Author(s):  
E Kytö ◽  
E Haapio ◽  
I Kinnunen ◽  
H Irjala
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prospective Study ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
One Year ◽  
Diagnostic Delays

Abstract Objective This prospective study aimed to evaluate possible diagnostic delays in head and neck squamous cell carcinoma recurrences due to the changed follow-up protocol during the coronavirus disease 2019 pandemic. Methods The follow-up appointments of head and neck squamous cell carcinoma patients treated more than one year prior to the pandemic were changed to telephone appointments in order to reduce physical visits to the hospital. All contacts, reasons for contact and recurrent cancers were recorded. Results There were 17 recurrences during a seven-month study period among 178 patients treated in the previous year (10 per cent); 14 of these recurrences occurred in patients whose treatment had ended less than one year previously and 3 occurred more than one year after treatment had ended. There was no delay in diagnoses of recurrent tumours or treatment despite reduced visits because of the coronavirus disease 2019 pandemic. Conclusion According to our analyses, no delay was caused in the diagnoses of recurrent diseases. Follow up by telephone or telemedicine can be considered as part of the follow-up protocol one year after the treatment of head and neck squamous cell carcinoma when necessary.

scholarly journals Incidence, Characteristics, and Prognosis of Incidentally Discovered Hepatocellular Carcinoma after Liver Transplantation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Walid El Moghazy ◽  
Samy Kashkoush ◽  
Glenda Meeberg ◽  
Norman Kneteman
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Tumor Recurrence ◽  
Patient Survival ◽  
Steady Increase ◽  
Liver Transplants ◽  
Significant Difference ◽  
One Year ◽  
Over Time

Background. We aimed to assess incidentally discovered hepatocellular carcinoma (iHCC) over time and to compare outcome to preoperatively diagnosed hepatocellular carcinoma (pdHCC) and nontumor liver transplants.Methods.We studied adults transplanted with a follow-up of at least one year. Patients were divided into 3 groups according to diagnosis of hepatocellular carcinoma.Results.Between 1990 and 2010, 887 adults were transplanted. Among them, 121 patients (13.6%) had pdHCC and 32 patients (3.6%) had iHCC; frequency of iHCC decreased markedly over years, in parallel with significant increase in pdHCC. Between 1990 and 1995, 120 patients had liver transplants, 4 (3.3%) of them had iHCC, and only 3 (2.5%) had pdHCC, while in the last 5 years, 263 patients were transplanted, 7 (0.03%) of them had iHCC, and 66 (25.1%) had pdHCC (P<0.001). There was no significant difference between groups regarding patient survival; 5-year survival was 74%, 75.5%, and 77.3% in iHCC, pdHCC, and non-HCC groups, respectively (P=0.702). Patients with iHCC had no recurrences after transplant, while pdHCC patients experienced 17 recurrences (15.3%) (P=0.016).Conclusions.iHCC has significantly decreased despite steady increase in number of transplants for hepatocellular carcinoma. Patients with iHCC had excellent outcomes with no tumor recurrence and survival comparable to pdHCC.

scholarly journals Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Alastair Faulkner ◽  
Alistair Mayne ◽  
Fraser Harrold
Keyword(s):  
Outcome Measures ◽  
Surgical Management ◽  
Conservative Management ◽  
Morton’S Neuroma ◽  
Significant Difference ◽  
Morton's Neuroma ◽  
One Year ◽  
Patient Related Outcome ◽  
Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

Customised gold weight eyelid implantation in paralytic lagophthalmos

2008 ◽  
Vol 122 (10) ◽  
pp. 1088-1091 ◽  
Author(s):  
N Jayashankar ◽  
K P Morwani ◽  
M J Shaan ◽  
S R Bhatia ◽  
K T Patil
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Study Design ◽  
Study Group ◽  
Upper Eyelid ◽  
Eyelid Closure ◽  
Gold Weight ◽  
One Year ◽  
A Prospective Study

AbstractGold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.Objective:We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.Study design and setting:A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.Results:Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.Conclusion and significance:Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.

Pressure pain thresholds in children before and after surgery: a prospective study

2020 ◽  
Vol 20 (2) ◽  
pp. 339-344
Author(s):  
Line Kjeldgaard Pedersen ◽  
Polina Martinkevich ◽  
Ole Rahbek ◽  
Lone Nikolajsen ◽  
Bjarne Møller-Madsen
Keyword(s):  
Prospective Study ◽  
Orthopaedic Surgery ◽  
Rating Scale ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Bonferroni Adjustment ◽  
Pressure Pain Thresholds ◽  
Significant Difference ◽  
Baseline Values

AbstractBackground and aimsThis prospective study aimed to assess pressure pain thresholds (PPTs) by pressure algometry and the correlation to postoperative pain in children undergoing orthopaedic surgery. We hypothesized, that the PPTs would decline immediately after elective orthopaedic surgery and return to baseline values at follow-up.MethodsThirty children aged 6–16 years were included. PPTs and intensity of pain (Numerical Rating Scale, NRS) were assessed 3–6 weeks before surgery (baseline), 1–2 h before surgery (Day 0), the first postoperative day (Day 1) and 6–12 weeks after surgery (Follow-up).ResultsA significant difference of PPTs between the four assessments was seen using the Friedman test for detecting differences across multiple tests and Wilcoxon signed-rank test with a Bonferroni adjustment. The changes in PPTs between baseline (PPTcrus = 248 kPa, PPTthenar = 195 kPa) and day 1 (PPTcrus = 146 kPa, PPTthenar = 161 kPa) showed a decline of PPTs as hypothesized (Zcrus = 2.373, p = 0.018; Zthenar = 0.55, p = 0.581). More surprisingly, a significant decrease in PPTs between baseline and day 0, just before surgery (PPTcrus = 171 kPa, PPTthenar = 179 kPa), was also measured (Zcrus = 2.475, p = 0.013; Zthenar = 2.414, p = 0.016). PPTs were positively correlated to higher age, weight and height; but not to NRS or opioid equivalent use.ConclusionsChildren undergoing orthopaedic surgery demonstrate significant changes in PPTs over time. The PPTs decrease significantly between baseline and day 0, further decreases the first day postoperatively and returns to baseline values at follow-up. This suggests that other factors than surgery modulate the threshold for pain.ImplicationsAwareness of pressure pain thresholds may help identify children with affected pain perception and hence improve future pain management in children undergoing orthopaedic surgery. Factors as for example anticipatory anxiety, psychological habitus, expected pain, catastrophizing, distraction, physical activity, patient education and preoperative pain medication might play a role in the perception of pain and need further investigation.

scholarly journals MECHANICAL COMPLICATIONS AND LOSS OF CORRECTION IN OSTEOTOMIES OF THE THREE COLUMNS

2017 ◽  
Vol 16 (4) ◽  
pp. 318-322
Author(s):  
Marcelo Simoni Simões ◽  
Ernani Vianna de Abreu ◽  
Samuel Bamberg Pydd
Keyword(s):  
Infectious Complications ◽  
Significant Loss ◽  
Categorical Variables ◽  
Sagittal Imbalance ◽  
Exact Test ◽  
Loss Of Correction ◽  
Mechanical Complications ◽  
Significant Difference ◽  
One Year

ABSTRACT Objectives: To observe the degree of correction and postoperative evolution of the spinopelvic parameters in patients with sagittal imbalance submitted to 3-column osteotomies. Methods: Retrospective analysis of 20 cases of 3-column osteotomies in patients with evident sagittal imbalance and minimum follow-up of one year, computing evolution of radiological data as a function of time, complications and reinterventions, and classification into subgroups by preoperative spinopelvic measures and complications. The variation of measures, quantitative and categorical variables, and differences between groups were evaluated using the Wilcoxon, Spearman, Fischer’s exact test, Kruskal-Wallis and Mann-Whitney tests. Results: There was improvement of all the sagittal parameters, ideal correction in 55% of the cases and maintained until the end of the follow-up in 40% of the cases. No correlation was found between obtaining optimal correction and data or preoperative measurements. Clinical and infectious complications did not affect the maintenance of the correction. The most common mechanical complications were pseudoarthrosis-related rod fracture at osteotomy (30%) and failures at the lower fixation level (15%). There was no significant difference in the maintenance of the correction between the groups with and without mechanical complications treated. In the untreated mechanical complications there was a significantly higher radiological worsening (p<0.05) in the maintenance parameters of the curve correction (loss of 27.5 ± 14.39o vs. 3.69 ± 3.68o) and increased pelvic tilt (PT) (increase of 12.25 ± 7.27o vs. 1.13 ± 1.93o). Conclusion: The perfect correction was obtained in 55% of cases and the significant loss of correction occurred only in cases of untreated mechanical complications.

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