Surgical repair of thoraco-lumbar vertebral fracture-luxations in eight cats using screws and polymethylmethacrylate fixation

2014 ◽  
Vol 27 (04) ◽  
pp. 306-312 ◽  
Author(s):  
M. Manassero ◽  
D. Leperlier ◽  
S. Scotti ◽  
V. Viateau ◽  
P. Moissonnier ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Clinical Outcome ◽  
Short Term ◽  
Lumbar Vertebral Fracture ◽  
Retrospective Clinical Study ◽  
Spinal Segments

SummaryObjective: To report our clinical experience in the surgical treatment of feline thora-columbar vertebral fracture-luxations using optimal safe implantation corridors as previously described in vitro.Study design: Retrospective clinical study.Materials and Methods: Medical records and radiographs of cats with vertebral fracture- luxations stabilized by screws and polymethylmethacrylate (PMMA) using optimal safe implantation corridors between 2009 and 2011 were reviewed. For each patient the data included: signalment, cause of vertebral fracture-luxations, presence of concurrent injuries, pre- and postoperative neurological grade, surgical treatment, imaging findings, and clinical outcome with short-term (2 weeks) and long-term (12 months) follow-up.Results: Eight cats with vertebral fracture-luxations involving the lumbar (L)(n = 5), the thoracic (T) spinal segments (n = 2), or the thoraco-lumbar junction (n = 1) were included in the study. Screws and PMMA were used bilaterally in five cats and unilaterally in three cats. No surgical intra-operative complications using the defined corridors were recorded. Implant failure followed by spontaneous recovery was recorded in one case. Two cats died in the postoperative period (≤4 days). The short-term and long-term clinical outcome was excellent in four out of eight cats and satisfactory in two out of eight cats.Conclusion and Clinical relevance: This pilot study demonstrates the clinical applicability of optimal safe implantation corridors for stabilization of feline thoraco-lumbar vertebral fracture-luxations with screws and PMMA. This technique can be used with limited risks of iatrogenic injuries for stabilization of vertebral fracture-luxation localized between T11-L4.

Predictors of Mid- to Long-Term Outcomes in Patients Experiencing a Knee Dislocation: A Systematic Review of Clinical Studies

2021 ◽  
Author(s):  
John-Rudolph H. Smith ◽  
John W. Belk ◽  
Jamie L. Friedman ◽  
Jason L. Dragoo ◽  
Rachel M. Frank ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Clinical Studies ◽  
Small Sample ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
Short Term ◽  
Female Sex

AbstractKnee dislocations (KDs) are devastating injuries for patients and present complex challenges for orthopaedic surgeons. Although short-term outcomes have been studied, there are few long-term outcomes of these injuries available in the literature. The purpose of this study is to determine factors that influence mid- to long-term clinical outcomes following surgical treatment of KD. A review of the current literature was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies published from 2010 to 2019 with a minimum 2-year follow-up that reported outcomes following surgical treatment of KDs. Ten studies (6 level III, 4 level IV) were included. At mid- (2–10 y) to long-term (>10 y) follow-up, concomitant arterial, cartilage, and combined meniscus damage were predictive factors for inferior Lysholm and International Knee Documentation Committee (IKDC) scores when compared with patients without these associated injuries. Although concomitant neurological damage may influence short-term outcomes due to decreased mobility, at longer follow-up periods it does not appear to predict worse clinical outcomes when compared with patients without concomitant neurological injury. Frank and polytrauma KDs have been associated with worse mid- to long-term outcomes when compared with transient and isolated KDs. Patients who underwent surgery within 6 weeks of trauma experienced better long-term outcomes than those who underwent surgery longer than 6 weeks after the initial injury. However, the small sample size of this study makes it difficult to make valid recommendations. Lastly, female sex, patients older than 30 years at the time of injury and a body mass index (BMI) greater than 35 kg/m2 are factors that have been associated with worse mid- to long-term Lysholm and IKDC scores. The results of this review suggest that female sex, age >30 years, BMI >35 kg/m2, concomitant cartilage damage, combined medial and lateral meniscal damage, KDs that do not spontaneously relocate, and KDs associated with polytrauma may predict worse results at mid- to long-term follow-up.

Clinical outcome after surgical clipping or endovascular coiling for cerebral aneurysms: a pragmatic meta-analysis of randomized and non-randomized trials with short- and long-term follow-up

2016 ◽  
Vol 9 (3) ◽  
pp. 264-277 ◽  
Author(s):  
Alberto Falk Delgado ◽  
Tommy Andersson ◽  
Anna Falk Delgado
Keyword(s):  
Clinical Outcome ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Lower Mortality ◽  
Controlled Trials ◽  
Short Term ◽  
Unruptured Aneurysms ◽  
Long Term Follow Up

BackgroundTwo randomized trials have evaluated clipping and coiling in patients with ruptured aneurysms. Aggregated evidence for management of ruptured and unruptured aneurysms is missing.ObjectiveTo conduct a meta-analysis evaluating clinical outcome after aneurysm treatment.MethodsPubMed, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov were searched for studies evaluating aneurysm treatment. The primary outcome measure was an independent clinical outcome (modified Rankin scale 0–2, Glasgow Outcome Scale 4–5, or equivalent). Secondary outcomes were poor outcome and mortality. ORs were calculated on an intention-to-treat basis with 95% CIs. Outcome heterogeneity was evaluated with Cochrane's Q test (significance level cut-off value at <0.10) and I2(significance cut-off value >50%) with the Mantel–Haenszel method for dichotomous outcomes. A p value <0.05 was regarded as statistically significant.ResultsSearches yielded 18 802 articles. All titles were assessed, 403 abstracts were evaluated, and 183 full-text articles were read. One-hundred and fifty articles were qualitatively assessed and 85 articles were included in the meta-analysis. Patients treated with coiling (randomized controlled trials (RCTs)) had higher independent outcome at short-term follow-up (OR=0.67, 95% CI 0.57 to 0.79). Independent outcome was favored for coiling at intermediate and long-term follow-up (RCTs and observational studies combined—OR=0.80, 0.68 to 0.94 and OR=0.81, 0.71 to 0.93, respectively). Independent outcome and lower mortality was favored after coiling in unruptured aneurysms (database registry studies) at short-term follow-up (OR=0.34, 0.29 to 0.41 and OR=1.74, 1.52 to 1.98, respectively).ConclusionsThis meta-analysis evaluating clinical outcome after coiling or clipping for intracranial aneurysms, indicates a higher independent outcome and lower mortality after coiling.

scholarly journals Tendon Repair Leads to better Long-Term Clinical Outcome than Debridement in Massive Rotator Cuff Tears

2017 ◽  
Vol 11 (1) ◽  
pp. 546-553 ◽  
Author(s):  
Matthias Alexander König ◽  
Volker Alexander Braunstein
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcome ◽  
Tendon Repair ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Short Term ◽  
Massive Rotator Cuff Tears ◽  
Massive Tears

Introduction: Massive tears in the rotator cuff are debilitating pathologies normally associated with loss of function and pain. Tendon reconstruction is seen as the standard treatment in order to preserve shoulder function and to inhibit cuff associated osteoarthritis. However, the effect on longer-term shoulder function and patient satisfaction is unknown. Material and Methods: 165 consecutive patients with massive tears were included. 57 debridement (mean age 61.9±8.7 years (range 43-77)) and 108 reconstruction (mean age 57.5±8.9 years (range 45-74)) cases could be followed up 2-4 (short-term), 5-6 (mid-term) and 8-10 (long-term) years after surgery. Evaluation was performed with the Constant, a modified ASES and the DASH score. Statistical analysis was done using Sigma-Stat Version 3.5 with a p-value<0.05 indicating statistical significant differences. Results: All three scoring systems showed no significant differences in the short-term follow-up for the two groups (mean values: Constant debridement/repair: 70±11.9/66±13.6; ASES debridement/repair: 22.3±3.3/ 23.3±3.3; DASH debridement/repair: 22.3±11.0/ 24.3±10.1). In the mid-term (Constant debridement/repair: 51±2.9/68.3±5.2; ASES debridement/repair: 20.3±1.3/24.3±1.7; DASH debridement/repair: 31.0±6.5/20.3±5.4) and long-term follow-up (Constant debridement/repair: 42.3±3.8 /60.7±2.6, ASES debridement/repair: 17.3±0.5/21.7±0.5, DASH debridement/repair: 41.3±6.2/25.0±1.4), rotator cuff reconstruction revealed better objective results and better patients’ satisfaction. Conclusion: Rotator cuff tendon repair leads to better long-term clinical outcome and subjective satisfaction compared to debridement. Tendon reconstruction should be considered as a treatment for patients suffering from massive rotator cuff tears, thus preserving shoulder function and by that means delay indication for reverse arthroplasty.

scholarly journals Short-, medium- and long-term results of the sling operations effectiveness and safety for urinary incontinence in women

2020 ◽  
Vol 8 (4) ◽  
pp. 80-92
Author(s):  
O. B. Loran ◽  
A. V. Seregin ◽  
Z. A. Dovlatov
Keyword(s):  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Stress Urinary Incontinence ◽  
Long Term Results ◽  
Surgical Experience ◽  
Medium Term ◽  
Short Term ◽  
Mini Sling

Introduction. Sling urethropexy is considered the «gold standard» surgical treatment for stress urinary incontinence in women. However, the long-term results of such operations have not yet been fully studied.Purpose of the study. To evaluate the results of using various options for sling operations at different periods of postoperative follow-up.Materials and methods. In 698 women aged 42 - 68 years (median — 54 years) suffering stress incontinence were used 4 variants of sling operations according to the database of the S.P. Botkin City Clinical Hospital: TVT retropubic technique; transobturator technique TVT-O («inside-out»); transobturator technique TOT («outside-in»); mini sling system. The period of postoperative follow-up was 6 - 139 months (median 79 months). Evaluation of treatment results was carried out according to the following periods of postoperative follow-up: short-term (up to 1 year inclusive); mediumterm (a period from 1 to 5 years inclusive); long-term (over 5 years). The success of the treatment was determined by the criterion of the absence of urine involuntary loss during the cough test and the 1-hour pad test.Results. Treatment success in the entire sample of patients was 96.1% (671 / 698) for the short-term criterion, 93.1% (591 / 635) for the medium-term criterion and 86.2% for the long-term criterion (467 / 642). The effectiveness of short-term treatment after TVT was 97%, TVT-O — 95.8%, TOT — 96.2%, mini-sling system — 95.5%, in medium-term — 92.2%, 93.1%, 90.9% and 92.3%, respectively, for long-term — 87.1%, 86.2%, 85.2% and 85%, respectively. There were no significant differences between the indicated variants of sling operations in terms of treatment efficacy for all observation periods (p > 0.05). Intra and early postoperative complications were noted in 51 (7.3%) cases, late — in 79 (11.3%). There were no significant differences in the incidence of both categories of complications between the surgical techniques used (p > 0.05). Only surgical experience significantly affects the risk of recurrent urinary incontinence after surgery, early and late postoperative complications.Conclusions. The success of surgical treatment for stress urinary incontinence in women does not significantly depend on the type of sling surgery but depends mainly on the surgical experience. Therefore, it is advisable to use sling operations in hospitals with extensive experience in this area.

Prednisolone Resistance in Childhood Acute Lymphoblastic Leukemia: Vitro-Vivo Correlations and Cross-Resistance to Other Drugs

Blood ◽  
1998 ◽  
Vol 92 (1) ◽  
pp. 259-266 ◽  
Author(s):  
G.J.L. Kaspers ◽  
R. Pieters ◽  
C.H. Van Zantwijk ◽  
E.R. VanWering ◽  
A. Van Der Does-Van Den Berg ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Clinical Outcome ◽  
Clinical Response ◽  
Lymphoblastic Leukemia ◽  
Cross Resistance ◽  
Short Term ◽  
Childhood All ◽  
Response To Chemotherapy

As an important determinant of response to chemotherapy, accurate measurement of cellular drug resistance may provide clinically relevant information. Our objectives in this study were to determine the relationship between in vitro resistance to prednisolone (PRD) measured with the colorimetric methyl-thiazol-tetrazolium (MTT) assay, and (1) short-term clinical response to systemic PRD monotherapy, (2) long-term clinical outcome after combination chemotherapy within all patients and within the subgroups of clinical good and poor responders to PRD, and (3) in vitro resistance to 12 other drugs in 166 children with newly diagnosed acute lymphoblastic leukemia (ALL). The 12 clinical poor PRD responders had ALL cells that were median 88-fold more in vitro resistant to PRD than 131 good responders (P = .013). Within all patients, increased in vitro resistance to PRD predicted a significantly worse long-term clinical outcome, at analyses with and without stratification for clinical PRD response, and at multivariate analysis (P ≤ .001). Within both the clinical good and poor responder subgroups, increased in vitro resistance to PRD was associated with a worse outcome, which was significant within the group of clinical good responders (P &lt; .001). LC50 values, ie, lethal concentrations to 50% of ALL cells, for PRD and each other drug correlated significantly with those of all other 12 drugs, with an average correlation coefficient of 0.44 (standard deviation 0.05). The highest correlations were found between structurally related drugs. In conclusion, in vitro resistance to PRD was significantly related to the short-term and long-term clinical response to chemotherapy, the latter also within the subgroup of clinical good responders to PRD. There was a more general in vitro cross-resistance between anticancer drugs in childhood ALL, although drug-specific activities were recognized.

Osteochondritis Dissecans of the Talus: Long-Term Results of Surgical Treatment

Foot & Ankle ◽  
1989 ◽  
Vol 10 (3) ◽  
pp. 161-163 ◽  
Author(s):  
Peter Angermann ◽  
Peter Jensen
Keyword(s):  
Surgical Treatment ◽  
Osteochondritis Dissecans ◽  
Long Term Results ◽  
Short Term ◽  
Time Of Surgery ◽  
Pain At Rest ◽  
Results Of Surgery ◽  
Generalized Osteoarthritis

Twenty patients with osteochondritis dissecans of the ankle were reviewed for a clinical and radiographical follow-up 9 to 15 years after surgery including multiple drilling of the lesion combined with excision of loose fragments. The short-term results of surgery were satisfactory: 85° of the patients were improved or cured. At follow-up, more than half of the patients had some degree of pain during activity, and swelling of the ankle, but only a few had locking or pain at rest. Only one of the 18 patients without osteoarthritis at the time of surgery had developed generalized osteoarthritis at the followup. Although the initial good results of surgery were demonstrated to deteriorate with time, the procedure can still be recommended in patients with longstanding symptoms.

scholarly journals SIX-MONTH FOLLOW-UP OF KINESITHERAPY FOR CEREBRAL MOTOR DISORDERS IN EARLY CHILDHOOD

2021 ◽  
Vol 9 (06) ◽  
pp. 701-708
Author(s):  
V.K. Kostova ◽  
◽  
A. Aleksiev ◽  
Keyword(s):  
Early Childhood ◽  
Statistical Significance ◽  
Control Group ◽  
Motor Disorders ◽  
Cranial Ultrasound ◽  
Short Term ◽  
Primitive Reflexes

Introduction:- There is a consensus about the positive effect of kinesitherapy in cerebral motor disorders, but not about its recommended frequency. There is no consensus on the statistical significance of predictive factors. Aim:- To compare the effect of kinesitherapy versus control, as well as to compare the statistical significance of the following factors: age, corrected age, weight, gender, pregnancy, number of pregnancies, conception, birth, twins, pathological reflexes, primitive reflexes, kinesiology tests, cranial ultrasound, follow-up and frequency of kinesitherapy. Material and methods:- 27 children (age 8.21 ± 5.49 months) with cerebral motor disorders were followed for six months. They were divided into kinesitherapy group and control group. The control group (n = 15) was followed up in the beginning, at the second week, and at the sixth month. The treatment group (n = 12) was followed up in the same way but received kinesitherapy once daily for two weeks at the beginning of every month. Parents were instructed to perform the same techniques with their children as often as possible at home. The following factors were recorded and analyzed: age, corrected age, weight, gender, pregnancy (normal or pathological), number of pregnancies, conception (normal or in vitro), birth (normal or pathological), twins (yes or no), pathological reflexes, primitive reflexes, kinesiology tests, cranial ultrasound, follow-up (short-term and long-term) and frequency of kinesitherapy. Results:- At the beginning of the follow-up, there was no difference between the two groups regarding all factors (P>0.05). Both groups showed better results after two weeks (P<0.05) and after six months (P<0.05) regarding kinesiology tests, pathological and primitive reflexes. The kinesitherapy group showed better results versus the control group at the end of the second week (P<0.05) and at the end of the sixth month (P<0.05) regarding kinesiology tests, pathological and primitive reflexes. The regression coefficients of the factors decreased in the following sequence: frequency of kinesitherapy (0.787), kinesiology tests (0.412), primitive reflexes (0.352), conception (0.298) , birth (0.282), twins (0.221), corrected age (0.220), age (0.197), pregnancy (0.197), pathological reflexes (0.143), cranial ultrasound (0.127), number of pregnancies (0.0501), gender (0.0306), follow-up (0.00547), and weight (0.0000031). Conclusion:- Kinesitherapy has a significant short-term and long-term effect that exceeds the placebo effect. Significance of the factors decreased in the following order: frequency of kinesitherapy, kinesiology tests, primitive reflexes, conception, birth, pregnancy, corrected age, age, pathological reflexes, cranial ultrasound, pregnancy, gender, follow-up, and weight. The frequency of kinesitherapy is the most important factor, which should be recommended at least three times daily in cerebral motor disorders in early childhood.

scholarly journals Subacromial Decompression in Patients with Impingement Syndrome Results in Better Clinical Outcome Compared to Physiotherapy in the Long Term. A Prospective Randomised Study

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0011 ◽  
Author(s):  
Stefanos Farfaras ◽  
Ninni Sernert ◽  
Lars Rostgard-Christensen ◽  
Erling Hallstrom ◽  
Juri T. Kartus
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Clinical Outcome ◽  
Constant Score ◽  
Impingement Syndrome ◽  
Ultra Sound ◽  
X Rays ◽  
Full Thickness

Objectives: The long-term outcome after treatment of subacromial impingement syndrome (SAIS) with either non-surgical or surgical methods is not thoroughly investigated. The purpose of this study was to evaluate the long-term clinical outcome, the presence of rotator-cuff injuries and osteoarthritis after both surgical and non-surgical treatment. Methods: Eighty-seven patients with SAIS were randomised to three groups: open acromioplasty (OSG), arthroscopic acromioplasty (ASG) or physiotherapy (PTG). The Constant score and the Watson & Sonnabend score were used as outcome measures. Furthermore, bilateral ultrasound examinations to detect rotator-cuff ruptures and bilateral x-rays to detect osteoarthritis were performed. Sixty-six patients (76%) attended the clinical follow-up, 14 (SD 1.5) years after the initial treatment. Results: The groups were demographically comparable at baseline. The Constant score had improved significantly at follow-up in both the OSG and the ASG (p=0.003 and 0.011 respectively). No improvement was detected in the PTG. The OSG revealed a significant improvement compared to the PTG at follow-up (p=0.011), otherwise no significant differences were found. For the Watson & Sonnabend score the OSG revealed significant improvement in 13/14 questions. The corresponding was found in the ASG and the PTG in 9/14 questions (p=0.14). Using ultra-sound 1/20 patients in the OSG revealed a full-thickness rotator cuff rupture on the index side. The corresponding was found for 1/18 in the ASG and 4/28 in the PTG (p=0.29). On the contralateral side 2/20 patients in the OSG revealed a full-thickness rotator cuff tear. The corresponding was found for 1/18 in the ASG and 4/28 in the PTG (p=0.36). On the x-rays 3/20 patients in the OSG revealed moderate or severe osteoarthritis in the index shoulder. The corresponding was found for 1/18 in the ASG and 0/28 in the PTG (p=0.12). 1/20 patients in the OSG revealed osteoarthritis in the contra-lateral shoulder. The corresponding was found for 1/18 in the ASG and 0/28 in the PTG (p=0.11). Conclusion: In the long term surgical treatment of SAIS appears to render better clinical results than physiotherapy. No significant differences were found between the groups in terms of the presence of full thickness rotator cuff ruptures and osteoarthritis.

Ultrastructural investigations of MDL 19,660-induced effects on the canine platelet and megakaryocyte

1990 ◽  
Vol 48 (3) ◽  
pp. 374-375
Author(s):  
D.E. Loudy ◽  
J. Sprinkle-Cavallo ◽  
J.T. Yarrington ◽  
F.Y. Thompson ◽  
J.P. Gibson
Keyword(s):  
Antidepressant Drug ◽  
Beagle Dogs ◽  
Long Term Effects ◽  
Short Term ◽  
Platelet Counts ◽  
Toxicological Studies ◽  
Induced Aggregation ◽  
Internal Architecture

Previous short term toxicological studies of one to two weeks duration have demonstrated that MDL 19,660 (5-(4-chlorophenyl)-2,4-dihydro-2,4-dimethyl-3Hl, 2,4-triazole-3-thione), an antidepressant drug, causes a dose-related thrombocytopenia in dogs. Platelet counts started to decline after two days of dosing with 30 mg/kg/day and continued to decrease to their lowest levels by 5-7 days. The loss in platelets was primarily of the small discoid subpopulation. In vitro studies have also indicated that MDL 19,660: does not spontaneously aggregate canine platelets and has moderate antiaggregating properties by inhibiting ADP-induced aggregation. The objectives of the present investigation of MDL 19,660 were to evaluate ultrastructurally long term effects on platelet internal architecture and changes in subpopulations of platelets and megakaryocytes.Nine male and nine female beagle dogs were divided equally into three groups and were administered orally 0, 15, or 30 mg/kg/day of MDL 19,660 for three months. Compared to a control platelet range of 353,000- 452,000/μl, a doserelated thrombocytopenia reached a maximum severity of an average of 135,000/μl for the 15 mg/kg/day dogs after two weeks and 81,000/μl for the 30 mg/kg/day dogs after one week.

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