Does Discontinuing Teriparatide Treatment and Replacing It with Bisphosphonate Maintain the Volume of the Bone Fusion Mass after Lumbar Posterolateral Fusion in Women with Postmenopausal Osteoporosis?

<sec><title>Study Design</title>Retrospective case series.</sec><sec><title>Purpose</title>The purpose of this study was to determine whether discontinuing teriparatide treatment and replacing it with bisphosphonate treatment maintains the volume of the fusion mass after posterolateral fusion (PLF) in women with postmenopausal osteoporosis.</sec><sec><title>Overview of Literature</title>Clinical data support the efficacy of parathyroid hormone (PTH) for lumbar PLF. However, the use of PTH is limited to 2 years.</sec><sec><title>Methods</title>We treated 19 women diagnosed with osteoporosis and degenerative spondylolisthesis with teriparatide (20 µg daily subcutaneously). All patients underwent one-level instrumented PLF. Teriparatide was used during 2 months prior to surgery and more than 8 months after surgery. After discontinuing teriparatide treatment, all patients used bisphosphonate (17.5 mg risedronate weekly, oral administration). Area of the fusion mass across the transverse processes at one segment was determined on an anteroposterior radiograph at 1, 2, and 3 years after surgery.</sec><sec><title>Results</title>We followed 19 patients for 3 years. The average duration of teriparatide treatment was 11.5 months. The bone union rate was 95%. The average area of the bone fusion mass was not significantly different between the right and left sides at 1, 2, or 3 years after surgery (<italic>p</italic>>0.05).</sec><sec><title>Conclusions</title>This study showed that replacing teriparatide treatment with bisphosphonate maintained the bone fusion mass volume after PLF in women with postmenopausal osteoporosis.</sec>

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Absent right superior caval vein in situs solitus

Cardiology in the Young ◽

10.1017/s1047951115000268 ◽

2015 ◽

Vol 26 (2) ◽

pp. 334-339 ◽

Cited By ~ 1

Author(s):

Rebekka Lytzen ◽

Karin Sundberg ◽

Niels Vejlstrup

Keyword(s):

Incidental Finding ◽

Clinical Manifestations ◽

Case Series ◽

Retrospective Case ◽

Caval Vein ◽

Cardinal Vein ◽

Benign Condition ◽

Superior Caval Vein ◽

Case Series Study ◽

The Right

AbstractIntroductionIn up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening.Material and methodsThis is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein at the national referral hospital, Rigshospitalet, Denmark, from 2009 to 2012.ResultsIn total, five cases of absent right superior caval vein were reviewed. No significant associated cardiac, extra-cardiac, or genetic anomalies were found. Postnatal echocardiographies confirmed the diagnosis and there were no postnatal complications. All children were found to have healthy hearts at follow-up.ConclusionsIn all cases, the findings proved to be a benign condition with no clinical manifestations or complications. Although isolated absent right superior caval vein does not seem to affect the outcome, associated anomalies may be serious. Absent right superior caval vein should, therefore, prompt a search for additional malformations. Furthermore, the diagnosis of an isolated absent right superior caval vein is important, because knowledge of the anomaly can prevent future problems when invasive procedures are necessary.

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Tracheal Bronchus: Classification, Endoscopic Analysis, and Airway Management

Otolaryngology ◽

10.1067/mhn.2002.122703 ◽

2002 ◽

Vol 126 (3) ◽

pp. 240-243 ◽

Cited By ~ 72

Author(s):

Andrew M. Doolittle ◽

Eric A. Mair

Keyword(s):

Congenital Anomaly ◽

Airway Management ◽

Main Bronchus ◽

Case Series ◽

Tracheal Bronchus ◽

Lobe Bronchus ◽

Retrospective Case ◽

Tracheal Diverticulum ◽

Pediatric Bronchoscopy ◽

The Right

OBJECTIVE: Tracheal bronchus ( bronchus suis) is an unusual congenital anomaly in which the right upper lobe has its origin in the trachea rather than distal to the carina. We sought to analyze the anatomy, presentation, and airway management principles of tracheal bronchi, and we present the first endoscopically documented tracheal diverticulum. STUDY DESIGN/METHODS: Retrospective case series. RESULTS: The tracheal bronchus is located at the junction of the mid and distal thirds of the right lateral trachea, is more common in males and children with other congenital anomalies, and may be associated with right main bronchus stenosis. Bronchoscopy provides a clear definitive view of the anomaly, which we found in 5 children during a 12-year period (0.5% of pediatric bronchoscopy procedures). We illustrate 3 types of tracheal bronchi: (1) vestigial tracheal diverticulum (newly described), (2) high apical lobe, and (3) fully developed supranumerary aerated tracheal bronchus. Endoscopic documentation of each type is presented. Children with tracheal bronchi may present with stridor, cough, and/or recurrent right-sided pneumonia and/or to have foreign body aspiration ruled out. Treatment is based on the severity of symptoms and ranges from observation to right upper lobectomy. CONCLUSIONS: Otolaryngologists should be aware of the tracheal bronchus, to include classification, endoscopic analysis, and airway management of this uncommon anomaly. Bronchoscopy with selected radiographic imaging allows the otolaryngologist to fully evaluate the child with a tracheal bronchus and to present timely therapeutic options. Tracheal bronchus is a congenital anomaly in which a right upper lobe bronchus has its origin in the trachea rather than at the carina. Bronchus suis, or “pig bronchus,” is an alternate name that is used because a tracheal bronchus is normal in swine and other ruminant animals. In approximately 1000 pediatric bronchoscopy procedures performed by the senior author during a 12-year period, only 5 children (approximately 0.5%) were identified with a tracheal bronchus. We present 3 representative cases to highlight salient features of each variant of the tracheal bronchus. A newly described “tracheal diverticulum” variant is presented. Tracheal bronchus classification based on endoscopic analysis assists with airway management for this uncommon anomaly.

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Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series

10.21203/rs.3.rs-26493/v3 ◽

2020 ◽

Author(s):

Kazuya Shinmura ◽

Satoshi Kato ◽

Satoru Demura ◽

Noriaki Yokogawa ◽

Noritaka Yonezawa ◽

...

Keyword(s):

Revision Surgery ◽

Case Series ◽

Operation Time ◽

Spinal Tumours ◽

Retrospective Case ◽

En Bloc ◽

Total En Bloc Spondylectomy ◽

Bone Fusion ◽

Bloc Spondylectomy ◽

Instrumentation Failure

Abstract Background: There have been several reports of instrumentation failure after 3-column resections such as total en bloc spondylectomy (TES) for spinal tumours; nevertheless, clinical outcomes of revision surgery for instrumentation failure after TES are seldom reported. Therefore, this study assessed the clinical outcomes of revision surgery for instrumentation failure after TES. Methods: This study employed a retrospective case series in a single centre and included 61 patients with spinal tumours who underwent TES between 2010 and 2015 and followed for >2 years. Instrumentation failure rate, back pain, neurological deterioration, ambulatory status, operation time, blood loss, complications, bone fusion after revision surgery, and re-instrumentation failure were assessed. Data were collected on back pain, neurological deterioration, ambulatory status, and management for patients with instrumentation failure, and we documented radiological bone fusion and re-instrumentation failure in cases followed for >2 years after revision surgery. Results: Of the 61 patients, 26 (42.6%) experienced instrumentation failure at an average of 32 (range, 11−92) months after TES. Of these, 23 underwent revision surgery. The average operation time and intraoperative blood loss were 204 min and 97 ml, respectively. Including the six patients who were unable to walk after instrumentation failure, all patients were able to walk after revision surgery. Perioperative complications of reoperation were surgical site infection (n = 2) and delayed wound healing (n = 1). At the final follow-up, bone fusion was observed in all patients. No re-instrumentation failure was recorded. Conclusion: Bone fusion was achieved by revision surgery using the posterior approach alone.

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A word of caution: diabolic behaviour of AndraStents®: inflation of supporting balloon leads to “diabolo”-misconfiguration of the stent

Cardiology in the Young ◽

10.1017/s1047951119001264 ◽

2019 ◽

Vol 29 (7) ◽

pp. 972-976

Author(s):

Christoph M. Happel ◽

Jose L. Zunzunegui Martínez ◽

María Jesús del Cerro ◽

Dietmar Schranz ◽

Markus Khalil ◽

...

Keyword(s):

High Pressure ◽

Right Ventricular ◽

Case Series ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Middle Part ◽

Outflow Tract ◽

Retrospective Case ◽

The Right ◽

Fatal Complications

AbstractAims:Transcatheter implantation of pulmonary balloon-expandable stent-valves requires pre-stenting of the right ventricular outflow tract with large calibre stents. To increase awareness of the associated risks of this part of transcatheter pulmonary valve replacement therapy, we report potential fatal complications during the implantation of AndraStents® in the right ventricular outflow tract in six cases from five different European institutions and their management.Method and result:We present a retrospective case series analysis looking at the time period from 2013 to 2018. Of 127 AndraStents® implanted in the right ventricular outflow tract, in six patients, age from 13 to 71 years, a misconfiguration of the AndraStent® occurred forming a “diabolo”-configuration. During inflation of the balloon, the stent showed extreme “dog-boning”, an expansion of the stent at both ends with the middle part remaining unexpanded. This led to rupture of the balloon and loss of manoeuvrability in four patients. Out of the total six cases, in four patients the stent was eventually expanded with high-pressure balloons, and in one case the stent was surgically retrieved. In one patient, in whom a percutaneous retrieval of the embolised stent was attempted, a fatal bleeding occurred.Conclusions:Pre-stenting of the right ventricular outflow tract by AndraStents® can lead to misconfiguration of the stent with potentially fatal complications. Rescue strategies of misconfigured stents include stent inflation and placement with high pressure non-compliant balloons or surgical backup. Interventional retrieval measures of AndraStents® cannot be advised.

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Teriparatide Accelerates Lumbar Posterolateral Fusion in Women With Postmenopausal Osteoporosis

Spine ◽

10.1097/brs.0b013e31826ca2a8 ◽

2012 ◽

Vol 37 (23) ◽

pp. E1464-E1468 ◽

Cited By ~ 105

Author(s):

Seiji Ohtori ◽

Gen Inoue ◽

Sumihisa Orita ◽

Kazuyo Yamauchi ◽

Yawara Eguchi ◽

...

Keyword(s):

Postmenopausal Osteoporosis ◽

Posterolateral Fusion ◽

Lumbar Posterolateral Fusion

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Review of Othello Syndrome and its Relationship with Neurological Disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2222 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S225-S225 ◽

Cited By ~ 1

Author(s):

P. Michielsen ◽

L. De Jonge ◽

S. Petrykiv ◽

M. Arts

Keyword(s):

Neurological Disorders ◽

Neurological Diseases ◽

Case Reports ◽

Case Series ◽

Lewy Body Disease ◽

Original Research ◽

Elderly Persons ◽

Retrospective Case ◽

Competing Interest ◽

The Right

IntroductionOthello syndrome is a psychotic disorder characterized by delusion of infidelity or jealousy. It predominantly occurs in the context of specific psychiatric or neurological disorders. Othello syndrome is associated with mental changes including excessive aggression, hostility, and irritability. Patients with Othello syndrome misinterpret the behaviour of the spouse or sexual partner to provide evidence for their false perception.Objectives and aimsThe purpose of this paper is to examine the phenomenon of Othello syndrome as a result of specific neurological diseases.MethodsThe study design was a retrospective case series of patients with Othello syndrome. We searched the electronic databases PubMed and Embase for review articles and original research using the search terms ‘Othello syndrome, Morbid Jealousy, Pathological Jealousy, Delusional Jealousy, Delusions and Infidelity, Delusions of Jealousy or Infidelity’.ResultsIn the present study of 95 case reports, the relationship between Othello syndrome and a neurological pathology was described. This syndrome was most commonly associated with neurodegenerative diseases (59%), followed by medication induced Othello syndrome (13.7%) and vascular dementia (8.4%). Lesions particularly in the right (dorsolateral) frontal lobes were associated with this syndrome.ConclusionThis study demonstrates that Othello syndrome occurs most frequently in patients with right frontal lobe dysfunction. It is predominantly related with Lewy Body Disease and Alzheimer's disease. Clinicians should keep an “index of suspicion” regarding dementia when Othello syndrome presents in elderly persons.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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510 Case Series: Four cases of Orbital Extension of Cutaneous Squamous Cell Carcinoma and Their Management

British Journal of Surgery ◽

10.1093/bjs/znab134.295 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Gaston-Grubb ◽

C Boylan

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Case Series ◽

Cutaneous Squamous Cell Carcinoma ◽

Infraorbital Nerve ◽

Temporal Region ◽

Soft Tissue Reconstruction ◽

Retrospective Case ◽

The Right

Abstract Introduction Cutaneous squamous cell carcinoma (cSCC) invading the orbit is exceedingly rare. Understanding its presentation and management is of great value to the plastic surgeon. Method Retrospective case series of four patients aged 54 to 88 years. All patients presented with cSCC of the face or scalp which infiltrated the orbit. All underwent tumour excision and appropriate reconstruction. Results Case 1 and 2 involved cSCC originating from the right temporal and medial maxilla region, respectively. Case 1 posed the further challenge of irreversible blindness in the other eye, making exenteration very undesirable. In Case 2 the tumour extended along the infraorbital nerve and required several reconstructions of the eyelid to improve functionality and aesthetics. Cases 3 and 4 involved cSCC originating from the forehead and temporal region, respectively. Both required burring of the bony outer table and soft tissue reconstruction. Case 4 presented with the additional challenge of perineural spread to the cavernous sinus. Conclusions This case series provides an insight into a rare, advanced presentation of cSCC. Eyeball exenteration has significant physical, aesthetic, and psychological impacts and therefore should be avoided if possible, particularly if the tumour has not breached the orbital septum.

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