scholarly journals Diagnosis of Spinal Tuberculosis in Retrovirus Negative Cases: A Case Series

2021 ◽  
Author(s):  
DR Gayathri Devi ◽  
B Rama Soujanya ◽  
Ashok Kumar Padmanabhan ◽  
SR Mangala Gouri ◽  
M Mahesh
Keyword(s):  
Clinical Diagnosis ◽  
Imaging Techniques ◽  
Spinal Tuberculosis ◽  
Case Series ◽  
Daily Regimen ◽  
Combined Approach ◽  
Acid Fast Bacilli ◽  
Tb Treatment

Spinal Tuberculosis (TB) is the most common destructive form of extrapulmonary TB. The diagnosis of spinal TB is challenging involving combined approach of clinical diagnosis, imaging techniques, detection of acid-fast bacilli in microscopy, histopathology, and culture. This case series reports four patients of spinal TB diagnosed clinically, radiologically and microbiologically that were treated appropriately with standard anti-TB treatment according to Category I daily regimen.

scholarly journals Impact of DaTscan Imaging on Clinical Decision Making in Clinically Uncertain Parkinson’s Disease

2021 ◽  
pp. 1-5
Author(s):  
Jonathan R. Isaacson ◽  
Salima Brillman ◽  
Nisha Chhabria ◽  
Stuart H. Isaacson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Diagnosis ◽  
Clinical Decision Making ◽  
Photon Emission ◽  
Case Series ◽  
Emission Computed Tomography ◽  
Medication Therapy ◽  
Clinical Scenarios ◽  
The Impact

Background: The diagnosis of Parkinson’s disease (PD) is primarily clinical, but in cases of diagnostic uncertainty, evaluation of nigrostriatal dopaminergic degeneration (NSDD) by imaging of the dopamine transporter using DaTscan with single-photon emission computed tomography (SPECT) brain imaging may be helpful. Objective/Methods: In the current paper, we describe clinical scenarios for which DaTscan imaging was used in a prospective case series of 201 consecutive patients in whom a movement disorder specialist ordered DaTscan imaging to clarify NSDD. We describe the impact of DaTscan results on changing or confirming pre-DaTscan clinical diagnosis and on post-DaTscan treatment changes. Results/Conclusion: DaTscan imaging can be useful in several clinical scenarios to determine if NSDD is present. These include in patients with early subtle symptoms, suboptimal response to levodopa, prominent action tremor, drug-induced parkinsonism, and in patients with lower extremity or other less common parkinsonism clinical presentations. We also found DaTscan imaging to be useful to determine underlying NSDD in patients with PD diagnosis for 3-5 years but without apparent clinical progression or development of motor fluctuations. Overall, in 201 consecutive patients with clinically questionable NSDD, DaTscan was abnormal in 58.7% of patients, normal in 37.8%, and inconclusive in 3.5%. DaTscan imaging changed clinical diagnosis in 39.8% of patients and led to medication therapy changes in 70.1% of patients.

scholarly journals Penile Prosthesis Placement with Immediate Buried Penis Correction: A Retrospective Chart Review

2021 ◽  
pp. 1-3
Author(s):  
Christopher J. Salgado ◽  
Christopher J. Salgado ◽  
Genesis Navas ◽  
Lalama Maria ◽  
Lindsay M. Tanner ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Chart Review ◽  
Functional Performance ◽  
Case Series ◽  
Penile Prosthesis ◽  
Retrospective Chart Review ◽  
Combined Approach ◽  
Suspensory Ligament ◽  
Cosmetic Appearance ◽  
Buried Penis

Introduction: We present a case report on six patients who underwent a combined approach to improve the cosmetic appearance and functional performance of their buried penis. Aim: To report our combined approach to improve both buried penis and erectile dysfunction. Methods: In one surgery, we performed: a malleable penile prosthesis, ventral phalloplasty, and penile suspensory ligament release followed by a suprapubic lipectomy. Results: Postoperatively, all patients had an increase in penile length and were able to achieve successful penetrative intercourse. The average difference between the pre-operational and post-operational flaccid length of our six patients was 3.5 cm ± 1.38 (range, 1.9 to 5.08 cm). Conclusion: This case series serves as successful examples of using a combined approach in one stage to not only improve the cosmetic appearance of a buried penis but also address erectile dysfunction.

scholarly journals Non-invasive Cardiac Radiation for Ablation of Ventricular Tachycardia: a New Therapeutic Paradigm in Electrophysiology

2018 ◽  
Vol 7 (1) ◽  
pp. 8 ◽  
Author(s):  
Eun-Jeong Kim ◽  
Giovanni Davogustto ◽  
William G Stevenson ◽  
Roy M John ◽  
◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Tissue ◽  
Imaging Techniques ◽  
Case Series ◽  
Structural Heart Disease ◽  
Multicenter Studies ◽  
Invasive Approach ◽  
Non Invasive ◽  
Surface Ecg ◽  
Early Case

Non-invasive ablation of cardiac tissue to control ventricular tachycardia (VT) is a novel therapeutic consideration in the management of ventricular arrhythmias associated with structural heart disease. The technique involves the use of stereotactic radiotherapy delivered to VT substrates. Although invasive mapping can be used to identify the target, the use of non-invasive ECG and imaging techniques combined with multi-electrode body-surface ECG recordings offers the potential of a completely non-invasive approach. Early case series have demonstrated a consistent decrease in VT burden and sufficient early safety to allow more detailed multicenter studies. Such studies are currently in progress to further evaluate this promising technology.

Coexistent Malignant Melanoma and Renal Cell Carcinoma

2009 ◽  
Vol 95 (4) ◽  
pp. 518-520 ◽  
Author(s):  
Balaji Venugopal ◽  
TR Jeffry Evans
Keyword(s):  
Renal Cell Carcinoma ◽  
Malignant Melanoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Past History ◽  
Imaging Techniques ◽  
Case Series ◽  
Second Primary ◽  
Increased Risk

Patients with malignant melanoma are at an increased risk of developing subsequent primary melanomas and also nonmelanoma cutaneous cancers. Several studies have reported an association between malignant melanoma and breast cancer, bladder cancer, colorectal cancer, neuroectodermal tumours, non-Hodgkin's lymphoma, leukaemia and renal cell carcinoma. We report a case series of patients with a diagnosis of malignant melanoma who also developed a renal mass. In two of these cases, the renal mass became apparent on diagnostic imaging as part of the staging investigations at the time of initial diagnosis of the malignant melanoma. In both of these cases, biopsy of the renal mass confirmed the presence of a separate primary renal cell carcinoma which had presented concurrently with the malignant melanoma. A third case presented with bone metastases ten years after excision of a thin melanoma. Further imaging revealed pulmonary metastases and a renal mass, biopsy of which confirmed renal cell carcinoma. In contrast, a fourth patient underwent a right nephrectomy for a renal mass having presented with abdominal discomfort. The histology of this lesion was in keeping with metastatic melanoma, and the patient's past history included a diagnosis of ocular melanoma eight years prior to the development of metastatic disease in the right kidney. Survival rates for patients with many types of malignant disease are improving, and there have been significant advances in clinical imaging techniques. Consequently the development and detection of a second primary cancer, either presenting concurrently or on subsequent follow-up, is likely to be increasingly observed. The series of patients reported here highlights the importance of a diagnostic biopsy in patients with malignant melanoma who develop a renal mass in order to establish a diagnosis and to plan optimal treatment.

Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management

2011 ◽  
Vol 31 (6) ◽  
pp. E15 ◽  
Author(s):  
Anil K. Roy ◽  
Nicholas P. Slimack ◽  
Aruna Ganju
Keyword(s):  
Conservative Management ◽  
Incidental Finding ◽  
Imaging Techniques ◽  
Case Series ◽  
Neurological Dysfunction ◽  
Type I ◽  
Retrospective Case ◽  
Chiari Malformation Type I ◽  
Comprehensive Review ◽  
Idiopathic Syringomyelia

Object A syrinx is a fluid-filled cavity within the spinal cord that can be an incidental finding or it can be accompanied by symptoms of pain and temperature insensitivity. Although it is most commonly associated with Chiari malformation Type I, the advancement of imaging techniques has resulted in more incidental idiopathic syringes that are not associated with Chiari, tumor, trauma, or postinfectious causes. The authors present a comprehensive review and management strategies for the idiopathic variant of syringomyelia. Methods The authors retrospectively identified 8 idiopathic cases of syringomyelia at their institution during the last 6 years. A PubMed/Medline literature review yielded an additional 38 articles. Results Two of the authors' patients underwent surgical treatment that included a combination of laminectomy, lysis of adhesions, duraplasty, and syrinx fenestration. The remaining 6 patients were treated conservatively and had neurologically stable outcomes. Review of the literature suggests that an etiology-driven approach is essential in the diagnosis and management of syringomyelia, although conservative management suffices for most cases. In particular, it is important to look at disturbances in CSF flow, as well as structural abnormalities including arachnoid webs, cysts, scars, and a diminutive posterior fossa. Conclusions The precise etiology for idiopathic syringomyelia (IS) is still unclear, although conceptual advances have been made toward the overall understanding of the pathophysiology of IS. Various theories include the cerebellar piston theory, intramedullary pulse pressure theory, and increased spinal subarachnoid pressure. For most patients with IS, conservative management works well. Continued progression of symptoms, however, could be approached using decompressive strategies such as laminectomy, lysis of adhesions, and craniocervical decompression, depending on the level of pathology. Management for patients with progressive neurological dysfunction and the lack of flow disturbance is unclear, although syringosubarachnoid shunting can be considered.

scholarly journals Clinicopathological study of thyroid swellings in HSK hospital in Karnataka, India

2018 ◽  
Vol 5 (2) ◽  
pp. 420
Author(s):  
Subhash N. Halbhavi ◽  
Mahantayya Ganjigatti ◽  
Shrikant B. Kuntoji ◽  
Mohammedgouse A. Karikazi
Keyword(s):  
Clinical Diagnosis ◽  
Pressure Effect ◽  
Malignant Lesion ◽  
Case Series ◽  
Nodular Goiter ◽  
First Line ◽  
Case Series Study ◽  
One Year ◽  
Series Study ◽  
Rule Out

Background: A thyroid enlargement whether diffuses or in the form of nodules have to be investigated to rule out neoplasm. FNAC is the first line of investigation. USG and TFT are also used. The cases which are at high risk are considered for surgery. Aims and objectives of the study was the clinical presentation of thyroid swellings, incidence of various thyroid swelling, benign versus malignant lesion and to correlate the clinical diagnosis with that of pathological diagnosis.Methods: A case series study of 60 patients attending surgical OPD IPD with symptoms of thyroid in SNMRC and HSK hospital Bagalkot between 1-1-2015 to 30-6-2016. After detailed history thorough, clinical examination was carried out all the patients underwent routine investigations TFT FNAC USG neck. Few patients underwent surgery and all the thyroid specimens were sent for HPE and the clinical diagnosis is correlated with that of pathological diagnosis.Results: Of 60 cases female to male ratio was 9:1. The age group involved is between 31-40 years (31.67%). Duration of goiter is less than one year in 60% of cases. The chief complaint was swelling in front of the neck 100%. Duration of swelling ranged from 15 days to 15 years. Toxic features were present in 18.33% of cases, but after TFT the toxic cases were only 6.67%. Most of the patient showed colloid goiter (43.33%) on FNAC. Out of 60 cases only 22 cases did undergo surgery histopathological specimen were colloid versus nodular goiter in 81.88% out of 22 cases only.Conclusions: Thyroid swellings are common in females they occur in 3rd and 4th decade most commonly. FNAC is very useful in the diagnosis. The main indications of surgery are cosmetic problems, pressure effect symptoms are suspicion of malignancy.

scholarly journals Provisional Stenting for Left Main Bifurcation Disease under IVUS guidance: A Case Series

2021 ◽  
Vol 02 (01) ◽  
pp. 015-018
Author(s):  
Rohit Mody
Keyword(s):  
Imaging Techniques ◽  
Case Series ◽  
Side Branch ◽  
Heart Team ◽  
Left Main ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Procedural Complications ◽  
Bifurcation Lesions ◽  
Provisional Stenting

Around 15-20% of coronary lesions include bifurcation, and among which left main (LM) bifurcation lesions are critical and complex to manage. Though the two-stent strategy is the preferred option for complex LM bifurcation lesions, the provisional strategy should be considered if the side branch is disease-free to avoid peri- and post-procedural complications. Thus, precise anatomical and physiological assessment of LM lesion should be made using intravascular imaging techniques for appropriate decision making. Here, we report three cases of successfully managed LM bifurcation lesions using the provisional stenting technique with the guidance of intravascular ultrasound, fractional flow reserve, and heart team. All three patients were doing well and were ischemia-free on stress echocardiography at three months follow-up.

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