scholarly journals The Use of Percutaneous Ultrasound-Guided Radiofrequency Heat Ablation for Treatment of Primary Hyperparathyroidism in Eight Dogs: Outcome and Complications

2018 ◽  
Vol 5 (4) ◽  
pp. 91
Author(s):  
Rodolfo Oliveira Leal ◽  
Laura Frau Pascual ◽  
Juan Hernandez
Keyword(s):  
Primary Hyperparathyroidism ◽  
Medical Records ◽  
Therapeutic Option ◽  
Respiratory Arrest ◽  
Vitamin D Supplementation ◽  
Ultrasound Guided ◽  
Short Term ◽  
Successful Resolution

Percutaneous ultrasound-guided radiofrequency heat-ablation (UG-RHA) is a therapeutic option for dogs with primary hyperparathyroidism (PHPTH) but information about its outcome is still controversial. This retrospective study aimed to evaluate the outcome and complications of UG-RHA in dogs with PHPTH. The medical records of dogs with PHPTH submitted to UG-RHA between June 2012 and September 2015 in a French referral center were retrospectively reviewed. Eight cases were included. No sex predisposition was found. The median age at diagnosis was 12 years. The most common clinical sign was polyuria/polydipsia. All of the dogs were hypercalcaemic prior to UG-RHA, and all showed a parathyroid nodule identified upon cervical ultrasound. UG-RHA was uneventful, allowing a successful resolution of hypercalcemia in all dogs (8/8). Six out of eight dogs did not receive vitamin D supplementation either pre- or post-procedure. From these, three dogs developed biochemical hypocalcemia, but only one required therapy. Other short-term complications included Horner’s syndrome (1/8) and aspiration bronchopneumonia, which led to cardio-respiratory arrest in one large-breed dog (1/8). Long-term complications were scarce, with no recurrence reported in all of the cases that were assessed in follow-up (4/7). This study demonstrates that UG-RHA has few short or long-term complications, and it is a good therapeutic alternative for dogs with PHPTH.

The Safety of Ultrasound Guided Tenotomy for Upper and Lower Extremity Tendinopathies: A Retrospective Study

2020 ◽  
Author(s):  
Benjamin Fick ◽  
Daniel Stover ◽  
Ruth Chimenti ◽  
Mederic Hall
Keyword(s):  
Lower Extremity ◽  
Physical Function ◽  
Complication Rate ◽  
Plantar Fascia ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
Short Term ◽  
Long Term Follow Up

Abstract Background: Ultrasound guided tenotomy (USGT) is a minimally invasive treatment option for patients with chronic tendinopathy who fail to benefit from conservative exercise interventions. The complication rate and effectiveness of USGT remain poorly defined in the literature. Purpose: This study aimed to evaluate the risks associated with USGT and outcomes across upper extremity and lower extremity tendinopathy/fasciopathy sites. Methods Patients who had USGT at the elbow, patellar, or Achilles tendons or along the plantar fascia were identified by retrospective review of charts. Screening for complications (infection, tendon rupture, and hypersensitivity) and satisfaction with the procedure were assessed at routine short-term follow-up visits and at long-term follow-up via phone/email. Outcomes (pain, quality of life) were assessed using the region specific pain scales and the Short Form-12, respectively, at baseline prior to the procedure, short-term follow up, and long term follow up. Results: A total of 262 patients were identified through chart review. There was a low complication rate of 0.7% including one superficial wound infection and one case of wound hypersensitivity. Prior to USGT, the majority of patients reported moderate/daily pain that decreased by short-term and long-term follow-up to mild/occasional pain (p < 0.05). Additionally, most patients reported abnormally low physical function prior to USGT that was within normal range of physical function by long-term follow-up (p < 0.05). The majority of responders (63% at the plantar fascia to 92% at the Achilles midportion) reported being either ‘very satisfied’ or ‘somewhat satisfied’ with the procedure at short-term follow-up. Conclusions: This study found that USGT is a safe procedure with a low complication rate in a heterogeneous sample. Study findings provide preliminary evidence on the utility of USGT to reduce pain and improve function with a high rate of patient satisfaction.

Single Transsacral Screw and Nut Stabilization of Bilateral Sacroiliac Luxation in 20 Cats

2018 ◽  
Vol 31 (01) ◽  
pp. 044-052 ◽  
Author(s):  
James Grierson ◽  
Andrew Moores ◽  
Andrea Pratesi
Keyword(s):  
Medical Records ◽  
Normal Activity ◽  
Width Ratio ◽  
Slight Reduction ◽  
Short Term ◽  
Canal Width ◽  
Long Term Follow Up ◽  
Safe Technique

Objective This article aims to describe the use of a single transsacral screw and nut in a cohort of cats with bilateral sacroiliac (SI) luxation and document its radiographic and clinical outcome. Methods Medical records and radiographic studies of cats with bilateral SI luxation managed with a transsacral screw and nut stabilization were reviewed. Short-term follow-up included clinical examination and radiographs. Long-term follow-up was via owner questionnaire. Results Twenty consecutive cats with bilateral SI luxation were included. Six cats (35%) had additional musculoskeletal injuries that required stabilization. Luxations were stabilized with a single 2.7 cortical self-tapping transsacral screw and nylon nut (a metallic nut was used in one case). Postoperative radiographs confirmed SI reduction in all cats and a mean pelvic canal width ratio of 1.21 (a ratio of ≥1.1 was considered optimal). All cats available at follow-up examination were able to walk without signs of discomfort. Evaluation of follow-up radiographs showed maintenance of SI reduction and slight reduction of mean pelvic canal width ratio (1.18). Fourteen owner questionnaires were returned (median follow-up time of 40 months): nine cats were deemed to have normal activity and five cats were reported to have slight to mild reduced ability to jump or run. Clinical Significance The use of transsacral screw and nut stabilization of bilateral SI luxation in cats is a successful, repeatable and safe technique.

Treatment of refractory Aspergillus otomycosis with voriconazole: case series and review

2014 ◽  
Vol 128 (6) ◽  
pp. 547-551 ◽  
Author(s):  
Hsu-Chueh Ho ◽  
Shih-Hsuan Hsiao ◽  
Cheng-Yung Lee ◽  
Chen-Chi Tsai
Keyword(s):  
Medical Records ◽  
Therapeutic Option ◽  
Demographic Data ◽  
Local Treatment ◽  
Case Series ◽  
Surgical Debridement ◽  
Underlying Diseases ◽  
Lost To Follow Up

AbstractBackground:Voriconazole is a broad-spectrum azole exhibiting strong anti-Aspergillus activity and good long-term tolerance. However, the evidence for voriconazole efficacy against refractory Aspergillus otomycosis is weak.Method:We reviewed the medical records of patients with Aspergillus otomycosis treated with voriconazole from January 2008 to June 2012 in a Taiwanese regional hospital. Demographic data and information regarding underlying diseases, clinical features, treatment and outcome were assessed.Results:In total, 14 cases of Aspergillus otomycosis were treated with voriconazole, including 5 patients with Aspergillus invasive otitis externa. All patients had failed to respond to local treatment, antibiotics or topical agents. One case was lost to follow up. The symptoms of two patients recurred after voriconazole treatment: one patient received a second 12-week course of voriconazole and was cured; and symptoms of the other patient recurred after a second 12-week course of voriconazole, leading to surgical debridement. The remaining 11 patients were cured by voriconazole treatment without extensive surgical debridement.Conclusion:This study demonstrates that voriconazole can be a very effective and convenient therapeutic option for the management of refractory Aspergillus otomycosis.

Long-term Effects of Skin Tearing on Outcomes After Collagenase Treatment of Dupuytren Contractures

Hand ◽  
2020 ◽  
pp. 155894471989883
Author(s):  
Dafang Zhang ◽  
Philip Blazar ◽  
Kyra A. Benavent ◽  
Brandon E. Earp
Keyword(s):  
Patient Satisfaction ◽  
Medical Records ◽  
Additional Treatment ◽  
Long Term Effects ◽  
Short Term ◽  
Collagenase Treatment ◽  
The Mean ◽  
Dupuytren Disease

Background: The objective of this study was to compare the rates of recurrence, additional treatment, patient satisfaction, and willingness to undergo Clostridium histolyticum (CCH) treatment again for Dupuytren disease in patients with and without skin tearing at minimum 5-year follow-up. Methods: We identified 199 digits in 142 patients who underwent CCH treatments for Dupuytren disease from April 2010 to December 2013 with minimum 5-year follow-up. Patients were contacted by telephone to collect our response variables: perceived recurrence of contracture, additional treatment, satisfaction, and willingness to undergo CCH treatment again. Medical records were reviewed for skin tearing at manipulation and patient-related and disease-specific variables. Results: At the time of manipulation, 16 out of 142 patients (11%) and 22 out of 199 digits (11%) had skin tearing. Older age was associated with skin tearing. At an average 7.2-year follow-up, the mean satisfaction was 7.1 ± 2.6 on a 1 to 10 Likert scale for patients with skin tearing and 6.5 ± 3.4 for patients without skin tearing. Eighty-one percent of patients with skin tearing expressed willingness to undergo CCH treatment again, compared with 68% of patients without skin tearing. Perceived recurrence of contracture occurred in 82% of digits with skin tearing and 80% of digits without skin tearing. Additional treatment was performed in 45% of digits with skin tearing and 54% of digits without skin tearing. No difference was statistically significant. Conclusions: Although skin tearing at CCH manipulation complicates the short-term course following CCH treatment, it does not affect long-term perceived contracture recurrence or patient satisfaction.

Ongoing effects of eConsultation in nephrology on hospital referral rates: An observational study

2020 ◽  
pp. 1357633X2094203
Author(s):  
Victor EA Boom ◽  
Laura T van der Kamp ◽  
Arjan D van Zuilen ◽  
Wendela L De Ranitz ◽  
Willem Jan Bos ◽  
...  
Keyword(s):  
Medical Records ◽  
Chronic Care ◽  
Medical Specialist ◽  
Short Term ◽  
Exclusion Criteria ◽  
Hospital Referral ◽  
Close Proximity ◽  
One Year

Introduction eConsultation in nephrology is an innovative way for general practitioners (GPs) to consult a nephrologist. Studies have shown that questions from GPs can be answered and intended referrals can be avoided by eConsultation. However, follow-up data are lacking. The primary aim of this study was therefore to assess whether patients for whom a referral to the outpatient clinic of a medical specialist was avoided in the short term were not then referred for the same problem within one year after the eConsultation. Methods All eConsultations sent between June 2017 and April 2018 to seven nephrologists in three different hospitals in The Netherlands were included. Exclusion criteria were duplications and missing data on follow-up. Data were obtained from the eConsultation application forms and from GP medical records. Results A total of 173 eConsultations were included. Of the 32 patients for whom a referral was initially prevented, 91% (95% confidence interval 75–98) had not been referred to a specialist for the same problem within one year after the eConsultation. Discussion eConsultation in the field of nephrology can prevent referrals in the long term. It can therefore contribute to a more modern and efficient health-care system in which chronic care is provided by GPs in close proximity to patients, while specialist support is easily available and accessible through eConsultation when necessary.

scholarly journals Recurrence of hyperparathyroidism; a long-term follow-up after surgery for primary hyperparathyroidism

2003 ◽  
pp. 413-421 ◽  
Author(s):  
G Hedback ◽  
A Oden
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Creatinine ◽  
Recurrence Rate ◽  
Medical Records ◽  
Elevated Serum ◽  
Large Patient Series ◽  
Large Patient ◽  
Patient Series

OBJECTIVE: In general it is thought that recurrence of primary hyperparathyroidism is a rare event. To our knowledge, however, only one large patient series has been reported with a mean of more than 7 years of follow-up. The aim of the present study was to determine the long-term recurrence rate in 785 out of 886 patients operated on for primary hyperparathyroidism and followed-up for a mean of 10.03 years after surgery. DESIGN: Medical records were scrutinised. The patients who were still alive answered a questionnaire and had laboratory tests. METHODS: Follow-up data concerning the state of health, medical treatment, other diagnoses, renal function, and serum calcium and creatinine levels were found in the medical records of 203 patients, and were registered at the start of investigation of 582 patients. Intact parathyroid hormone values were determined in 252 patients. Recurrence rate and 95% confidence interval (C.I.) were calculated. RESULTS: Recurrence rate of hyperparathyroidism with constant or intermittent hypercalcaemia (n=39) was 4.97% (95% C.I.=3.45-6.74%) during a mean of 10 years of follow-up. Nine out of 39 had elevated serum creatinine levels. Recurrence rate of hyperparathyroidism with normal serum creatinine levels, including patients with normocalcaemia, intermittent hypercalcaemia, and constant hypercalcaemia was estimated to be 7-8% during a mean of 10 years of follow-up. CONCLUSIONS: Recurrence rate was determined with reasonable precision in this large patient series, and recurrence of hyperparathyroidism cannot be considered to be extremely rare, but it may occur more than 20 years after treatment in both single and multiple gland disease.

Anticoagulation in addition to dual antiplatelet therapy has no impact on long-term follow-up after endovascular treatment of (sub)acute lower limb ischemia

VASA ◽  
2019 ◽  
Vol 48 (4) ◽  
pp. 321-329
Author(s):  
Mariya Kronlage ◽  
Erwin Blessing ◽  
Oliver J. Müller ◽  
Britta Heilmeier ◽  
Hugo A. Katus ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Limb Ischemia ◽  
Bleeding Complications ◽  
Severe Bleeding ◽  
Short Term ◽  
Long Term Follow Up

Summary. Background: To assess the impact of short- vs. long-term anticoagulation in addition to standard dual antiplatelet therapy (DAPT) upon endovascular treatment of (sub)acute thrombembolic occlusions of the lower extremity. Patient and methods: Retrospective analysis was conducted on 202 patients with a thrombembolic occlusion of lower extremities, followed by crirical limb ischemia that received endovascular treatment including thrombolysis, mechanical thrombectomy, or a combination of both between 2006 and 2015 at a single center. Following antithrombotic regimes were compared: 1) dual antiplatelet therapy, DAPT for 4 weeks (aspirin 100 mg/d and clopidogrel 75 mg/d) upon intervention, followed by a lifelong single antiplatelet therapy; 2) DAPT plus short term anticoagulation for 4 weeks, followed by a lifelong single antiplatelet therapy; 3) DAPT plus long term anticoagulation for > 4 weeks, followed by a lifelong anticoagulation. Results: Endovascular treatment was associated with high immediate revascularization (> 98 %), as well as overall and amputation-free survival rates (> 85 %), independent from the chosen anticoagulation regime in a two-year follow up, p > 0.05. Anticoagulation in addition to standard antiplatelet therapy had no significant effect on patency or freedom from target lesion revascularization (TLR) 24 months upon index procedure for both thrombotic and embolic occlusions. Severe bleeding complications occurred more often in the long-term anticoagulation group (9.3 % vs. 5.6 % (short-term group) and 6.5 % (DAPT group), p > 0.05). Conclusions: Our observational study demonstrates that the choice of an antithrombotic regime had no impact on the long-term follow-up after endovascular treatment of acute thrombembolic limb ischemia whereas prolonged anticoagulation was associated with a nominal increase in severe bleeding complications.

Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small: a systematic review and meta-analysis of 2123 subjects in 30 trials

2020 ◽  
pp. bjsports-2020-102525
Author(s):  
Stefanos Karanasios ◽  
Vasileios Korakakis ◽  
Rod Whiteley ◽  
Ioannis Vasilogeorgis ◽  
Sarah Woodbridge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Short Term ◽  
Lateral Elbow ◽  
Long Term Follow Up ◽  
Wait And See ◽  
Lateral Elbow Tendinopathy

ObjectiveTo evaluate the effectiveness of exercise compared with other conservative interventions in the management of lateral elbow tendinopathy (LET) on pain and function.DesignSystematic review and meta-analysis.MethodsWe used the Cochrane risk-of-bias tool 2 for randomised controlled trials (RCTs) to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation methodology to grade the certainty of evidence. Self-perceived improvement, pain intensity, pain-free grip strength (PFGS) and elbow disability were used as primary outcome measures.Eligibility criteriaRCTs assessing the effectiveness of exercise alone or as an additive intervention compared with passive interventions, wait-and-see or injections in patients with LET.Results30 RCTs (2123 participants, 5 comparator interventions) were identified. Exercise outperformed (low certainty) corticosteroid injections in all outcomes at all time points except short-term pain reduction. Clinically significant differences were found in PFGS at short-term (mean difference (MD): 12.15, (95% CI) 1.69 to 22.6), mid-term (MD: 22.45, 95% CI 3.63 to 41.3) and long-term follow-up (MD: 18, 95% CI 11.17 to 24.84). Statistically significant differences (very low certainty) for exercise compared with wait-and-see were found only in self-perceived improvement at short-term, pain reduction and elbow disability at short-term and long-term follow-up. Substantial heterogeneity in descriptions of equipment, load, duration and frequency of exercise programmes were evident.ConclusionsLow and very low certainty evidence suggests exercise is effective compared with passive interventions with or without invasive treatment in LET, but the effect is small.PROSPERO registration numberCRD42018082703.

scholarly journals The importance of maternal pregnancy vitamin D for offspring bone health: learnings from the MAVIDOS trial

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110069
Author(s):  
Rebecca J. Moon ◽  
Elizabeth M. Curtis ◽  
Stephen J. Woolford ◽  
Shanze Ashai ◽  
Cyrus Cooper ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Development ◽  
Controlled Trial ◽  
Clinical Care ◽  
Later Life ◽  
Vitamin D Supplementation ◽  
Public Health Policies ◽  
Positive Effects

Optimisation of skeletal mineralisation in childhood is important to reduce childhood fracture and the long-term risk of osteoporosis and fracture in later life. One approach to achieving this is antenatal vitamin D supplementation. The Maternal Vitamin D Osteoporosis Study is a randomised placebo-controlled trial, the aim of which was to assess the effect of antenatal vitamin D supplementation (1000 IU/day cholecalciferol) on offspring bone mass at birth. The study has since extended the follow up into childhood and diversified to assess demographic, lifestyle and genetic factors that determine the biochemical response to antenatal vitamin D supplementation, and to understand the mechanisms underpinning the effects of vitamin D supplementation on offspring bone development, including epigenetics. The demonstration of positive effects of maternal pregnancy vitamin D supplementation on offspring bone development and the delineation of underlying biological mechanisms inform clinical care and future public-health policies.

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

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