Role of Routine Imaging in Lymphoma

2011 ◽  
Vol 9 (5) ◽  
pp. 575-584 ◽  
Author(s):  
Nina D. Wagner-Johnston ◽  
Nancy L. Bartlett
Keyword(s):  
Practice Patterns ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Imaging Studies ◽  
Surveillance Imaging ◽  
Single Approach ◽  
Routine Imaging

Patients with lymphoma commonly undergo routine imaging studies after treatment completion, yet the appropriate interval, duration, and modality of follow-up, and the overall efficacy of various approaches is unclear. Existing guidelines are vague and not evidence-based, and consequently, practice patterns are varied. Most surveillance approaches in lymphoma have focused on early detection of recurrence, with the hope of prolonged survival and potential cure. Concerns regarding the prognostic value of frequent scanning, cost-effectiveness, and long-term risks associated with prolonged radiation exposure have led many to question the role of routine imaging in this setting. Given the multiple lymphoma subtypes and the clinical heterogeneity of these entities, a single approach to follow-up may not be reasonable. Much of the available literature focuses on Hodgkin lymphoma, and may not be generalizable. Retrospective series show that most relapses are detected by signs and symptoms regardless of the imaging schedule. In summary, clinicians are still left with “expert opinion” to guide them. This article examines the available data outlining the role of surveillance imaging in lymphoma.

The role of conservative management in congenital tracheal stenosis: an evidence-based long-term follow-up study

2006 ◽  
Vol 41 (7) ◽  
pp. 1203-1207 ◽  
Author(s):  
Wei Cheng ◽  
David E. Manson ◽  
Victor Forte ◽  
Sigmund H. Ein ◽  
Ian MacLusky ◽  
...  
Keyword(s):  
Tracheal Stenosis ◽  
Conservative Management ◽  
Evidence Based ◽  
Congenital Tracheal Stenosis ◽  
Follow Up Study ◽  
Long Term Follow Up

Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

2013 ◽  
Author(s):  
Francesca Menegazzo ◽  
Melissa Rosa Rizzotto ◽  
Martina Bua ◽  
Luisa Pinello ◽  
Elisabetta Tono ◽  
...  
Keyword(s):  
Head Trauma ◽  
Abusive Head Trauma ◽  
Long Term Follow Up

scholarly journals Prognostic role of neoplastic markers in Takotsubo syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francesco Santoro ◽  
Tecla Zimotti ◽  
Adriana Mallardi ◽  
Alessandra Leopizzi ◽  
Enrica Vitale ◽  
...  
Keyword(s):  
Serum Levels ◽  
Takotsubo Syndrome ◽  
Ca 15.3 ◽  
Risk Of Death ◽  
Increased Risk ◽  
Ca 19.9 ◽  
Long Term Follow Up

AbstractTakotsubo syndrome (TTS) is an acute heart failure syndrome with significant rates of in and out-of-hospital mayor cardiac adverse events (MACE). To evaluate the possible role of neoplastic biomarkers [CA-15.3, CA-19.9 and Carcinoembryonic Antigen (CEA)] as prognostic marker at short- and long-term follow-up in subjects with TTS. Ninety consecutive subjects with TTS were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9 and CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Forty-three (46%) patients experienced MACE during hospitalization. These patients had increased admission levels of CEA (4.3 ± 6.2 vs. 2.2 ± 1.5 ng/mL, p = 0.03). CEA levels were higher in subjects with in-hospital MACE. At long term follow-up, CEA and CA-19.9 levels were associated with increased risk of death (log rank p < 0.01, HR = 5.3, 95% CI 1.9–14.8, HR = 7.8 95% CI 2.4–25.1, respectively, p < 0.01). At multivariable analysis levels higher than median of CEA, CA-19.9 or both were independent predictors of death at long term (Log-Rank p < 0.01). Having both CEA and CA-19.9 levels above median (> 2 ng/mL, > 8 UI/mL respectively) was associated with an increased risk of mortality of 11.8 (95% CI 2.6–52.5, p = 0.001) at follow up. Increased CEA and CA-19.9 serum levels are associated with higher risk of death at long-term follow up in patients with TTS. CEA serum levels are correlated with in-hospital MACE.

scholarly journals Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management

2021 ◽  
Vol 18 (8) ◽  
pp. 4350
Author(s):  
Antoni Sisó-Almirall ◽  
Pilar Brito-Zerón ◽  
Laura Conangla Ferrín ◽  
Belchin Kostov ◽  
Anna Moragas Moreno ◽  
...  
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Signs And Symptoms ◽  
Diagnostic Process ◽  
Press Releases ◽  
Expert Opinions ◽  
Number Of Patients ◽  
Patient Groups

Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. The growing number of patients worldwide will have an impact on health systems. Therefore, the main objective of these clinical practice guidelines is to identify patients with signs and symptoms of long COVID-19 in primary care through a protocolized diagnostic process that studies possible etiologies and establishes an accurate differential diagnosis. The guidelines have been developed pragmatically by compiling the few studies published so far on long COVID-19, editorials and expert opinions, press releases, and the authors’ clinical experience. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups.

Long-Term Survival in a Patient With Abdominal Sarcomatosis From Uterine Leiomyosarcoma: Role of Repeated Laparoscopic Surgery in Treatment and Follow-Up

2016 ◽  
Vol 23 (6) ◽  
pp. 1003-1008 ◽  
Author(s):  
Antonio Macciò ◽  
Paraskevas Kotsonis ◽  
Giacomo Chiappe ◽  
Luca Melis ◽  
Fausto Zamboni ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Uterine Leiomyosarcoma ◽  
Term Survival ◽  
Long Term Survival

The role of the Lich–Gregoir procedure in refluxing duplicated collecting systems: Experience from long-term follow up of 45 children

2008 ◽  
Vol 4 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Christoph Berger ◽  
Mark Koen ◽  
Tanja Becker ◽  
Katharina Mitter ◽  
Marcus Riccabona
Keyword(s):  
Long Term Follow Up

The role of synovectomy in the rehabilitation of patients with rheumatoid arthritis

1982 ◽  
Vol 63 (2) ◽  
pp. 58-59
Author(s):  
K. V. Zvereva ◽  
L. N. Sokolov ◽  
V. Ya. Ermolina
Keyword(s):  
Rheumatoid Arthritis

In order to determine the role of synovectomy in the rehabilitation of patients with rheumatoid arthritis (RA), the results of observations of 60 patients (75% of operated patients) aged 16 to 58 years (43 women and 17 men) were summarized. We determined the efficacy of synovectomy based on two follow-up periods: the nearest one - from 6 months to 1 year, and the long-term one - from 2 to 6 years.

Recurrence and disease-specific survival after 10-year disease-free interval in patients with primary retroperitoneal liposarcoma: Implications for long-term surveillance.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11546-11546
Author(s):  
Mark Archer Eckardt ◽  
Danielle S. Graham ◽  
Brian E. Kadera ◽  
Kyle D. Klingbeil ◽  
Scott D. Nelson ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Surgical Margin ◽  
Disease Specific Survival ◽  
Risk Of Recurrence ◽  
Retroperitoneal Liposarcoma ◽  
Initial Surgery ◽  
Surveillance Imaging ◽  
Disease Specific

11546 Background: Surveillance imaging of patients with retroperitoneal liposarcoma (RP-LPS) following surgical resection is based on a projected risk of locoregional and distant recurrence. The duration of surveillance is not well defined as the long-term natural history of RP-LPS after treatment is poorly understood. We evaluate a cohort of RP-LPS patients—without evidence of disease 10 years following initial resection—to assess the long-term risk of recurrence and disease-specific survival (DSS). Methods: The prospectively maintained UCLA Sarcoma Database was used to identify RP-LPS patients who demonstrated 10-year progression-free survival (10yr-PFS) after initial diagnosis and treatment. Patients in the 10yr-PFS cohort were subsequently evaluated for recurrence and DSS. Time intervals start at date of initial surgical resection. Cox proportional hazards models were used to determine factors associated with recurrence and DSS. Results: From 1972-2010, 76 patients with RP-LPS had at least 10 years of follow-up. Of these, 37 (49%) demonstrated 10yr-PFS. Median follow-up was 15 years (range 10-35 years). Among the 10yr-PFS patients, 43% (16/37) developed a recurrence >10 years after the initial surgery, and 19% (7/37) died of disease. Neither long-term recurrence nor DSS were significantly associated with age, sex, tumor size, LPS subtype, surgical margin, or peri-operative treatment with radiation or chemotherapy (Table). Conclusions: Patients with primary RP-LPS treated with surgical resection +/- multimodality therapy have a long-term risk of recurrence and disease-specific death that is unacknowledged by current surveillance imaging guidelines. Among the patients with a 10yr-PFS, 43% developed a recurrence and 19% died of disease. These findings suggest a need for lifelong surveillance imaging in patients with RP-LPS.[Table: see text]

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