Non-surgical retreatment of teeth with persisting apical periodontitis following apicoectomy: decision making, treatment strategies and problems, and case reports

2016 ◽  
Vol 34 (1) ◽  
pp. 64-89 ◽  
Author(s):  
Michael Hülsmann ◽  
Gabriel Tulus
Keyword(s):  
Decision Making ◽  
Case Reports ◽  
Treatment Strategies ◽  
Apical Periodontitis

Neurobiological Reward-Related Abnormalities Across Mood Disorders

2019 ◽  
pp. 222-238
Author(s):  
Alexis E. Whitton ◽  
Michael T. Treadway ◽  
Manon L. Ironside ◽  
Diego A. Pizzagalli
Keyword(s):  
Decision Making ◽  
Mood Disorders ◽  
Treatment Strategies ◽  
Reward Processing ◽  
Reward Learning ◽  
Symptom Presentation ◽  
Psychiatric Symptomatology ◽  
Symptom Dimensions ◽  
Psychotherapeutic Interventions ◽  
Primary Focus

This chapter provides a critical review of recent behavioral and neuroimaging evidence of reward processing abnormalities in mood disorders. The primary focus is on the neural mechanisms underlying disruption in approach motivation, reward learning, and reward-based decision-making in major depression and bipolar disorder. Efforts focused on understanding how reward-related impairments contribute to psychiatric symptomatology have grown substantially in recent years. This has been driven by significant advances in the understanding of the neurobiology of reward processing and a growing recognition that disturbances in motivation and hedonic capacity are poorly targeted by current pharmacological and psychotherapeutic interventions. As a result, numerous studies have sought to test the presence of reward circuit dysfunction in psychiatric disorders that are marked by anhedonia, amotivation, mania, and impulsivity. Moreover, as the field has increasingly eschewed categorical diagnostic boundaries in favor of symptom dimensions, there has been a parallel rise in studies seeking to identify transdiagnostic neural markers of reward processing dysfunction that may transcend disorders. The thesis of this chapter is twofold: First, evidence indicates that specific subcomponents of reward processing map onto partially distinct neurobiological pathways. Second, specific subcomponents of reward processing, including reward learning and effort-based decision-making, are impaired across different mood disorder diagnoses and may point to dimensions in symptom presentation that possess more reliable behavioral and neural correlates. The potential for these findings to inform the development of prevention and treatment strategies is discussed.

Patellar fractures in cats: Repair techniques and treatment decision-making

2021 ◽  
Vol 23 (7) ◽  
pp. 649-661
Author(s):  
Sorrel J Langley-Hobbs
Keyword(s):  
Decision Making ◽  
Case Reports ◽  
Case Series ◽  
Treatment Decision ◽  
Evidence Base ◽  
Treatment Technique ◽  
Treatment Decision Making ◽  
Fracture Types ◽  
Patellar Fractures ◽  
Repair Techniques

Practical relevance: While feline patellar fractures are not commonly encountered in practice, they tend to be found more often in younger cats; no breed or sex predispositions are recognised. If there is no evidence of a traumatic aetiology, the cat may be suspected of having patellar fracture and dental anomaly syndrome (PADS). Patellar fractures are easy to diagnose on lateral radiographs and there are several different fracture types. The type of fracture, the age of the cat at fracture occurrence and whether there is suspicion of a pathological aetiology are all relevant when considering treatment technique. Clinical challenges: While some cats with patellar fractures will do well with conservative management, surgical treatment is often indicated and decision-making can be challenging. Evidence base: Information and recommendations provided in this review are based on the literature and the author’s own clinical experience. There are several publications on PADS, but there is limited evidence as to what the underlying cause of this condition is, and the best method for managing patellar fractures is still an area where more research is needed. Aim: This review aims to gather the papers, case series and case reports published over the past few decades in order to discuss how best to manage different types of patellar fractures.

Rerupture of a Blister Aneurysm After Treatment With a Single Flow-Diverting Stent

Neurosurgery ◽  
2016 ◽  
Vol 79 (5) ◽  
pp. E634-E638 ◽  
Author(s):  
Marcus D. Mazur ◽  
Philipp Taussky ◽  
Joel D. MacDonald ◽  
Min S. Park
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Successful Treatment ◽  
Internal Carotid ◽  
Case Reports ◽  
Treatment Strategies ◽  
Artery Aneurysm ◽  
Flow Diversion ◽  
Multiple Treatment ◽  
Internal Carotid Artery Aneurysm

Abstract BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS. CLINICAL PRESENTATION: A 29-year-old man presented with subarachnoid hemorrhage and a ruptured dorsal variant internal carotid artery aneurysm. Despite a technically successful treatment with a single FDS, a second catastrophic hemorrhage occurred during the course of his hospitalization. CONCLUSION: This case highlights the risk of hemorrhage during the period after deployment of a single FDS. Ruptured aneurysms, especially of the blister type, are at risk for rehemorrhage while the occlusion remains incomplete after flow diversion.

scholarly journals Pharmacology and Adverse Events of Emergency-Use Authorized Medication in Moderate to Severe COVID-19

2021 ◽  
Vol 14 (10) ◽  
pp. 955
Author(s):  
Jen-Yu Hsu ◽  
Yan-Chiao Mao ◽  
Po-Yu Liu ◽  
Kuo-Lung Lai
Keyword(s):  
Adverse Events ◽  
Metabolic Pathways ◽  
Case Reports ◽  
Secondary Infection ◽  
Treatment Strategies ◽  
Serious Adverse Events ◽  
Small Molecule Drugs ◽  
Post Market ◽  
Inflammatory Processes ◽  
Effective Drugs

Some effective drugs have been approved or issued an Emergency Use Authorization for the treatment of COVID-19 in hospitalized patients, but post-market surveillance is warranted to monitor adverse events. We reviewed clinical trials and case reports in patients with moderate-to-severe COVID-19 infection who received remdesivir, baricitinib, tocilizumab, or sarilumab. The drug-specific pharmacokinetics, toxicity, and drug interactions are summarized in this study. Remdesivir and baricitinib are small-molecule drugs that are mainly metabolized by the kidneys, while tocilizumab and sarilumab are monoclonal antibody drugs with metabolic pathways that are currently not fully understood. The most common adverse events of these drugs are alterations in liver function, but serious adverse events have rarely been attributed to them. Only a few studies have reported that remdesivir might be cardiotoxic and that baricitinib might cause thromboembolism. Biological agents such as baricitinib, tocilizumab, and sarilumab could inhibit the pathway of inflammatory processes, leading to immune dysregulation, so the risk of secondary infection should be assessed before prescribing. Further recognition of the pathogenic mechanism and risk factors of adverse events is essential for optimizing treatment strategies.

scholarly journals Management of Pulp Canal Obliteration—Systematic Review of Case Reports

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1237
Author(s):  
Alexandra Vinagre ◽  
Catarina Castanheira ◽  
Ana Messias ◽  
Paulo J. Palma ◽  
João C. Ramos
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Watchful Waiting ◽  
Case Reports ◽  
Intervention Strategy ◽  
Permanent Teeth ◽  
Clinical Approach ◽  
Treatment Pathways ◽  
Patient Reported

Background and Objectives: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). Materials and Methods: An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. Only anterior permanent teeth with PCO due to dental trauma were included. Regarding clinical approaches, only teeth managed with a “watchful waiting” approach, tooth bleaching or root canal treatment (RCT) were included. Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. Results: Twenty case reports were selected, resulting in a total of 27 patients. The number of traumatized teeth diagnosed with PCO was 33. The “watchful waiting” approach was the most implemented clinical strategy. Discolored non-symptomatic PCO teeth were mostly managed with external bleaching. The prevalence of pulp necrosis (PN) was 36.4%. For teeth diagnosed with PN, non-surgical RCT was performed in 10 teeth and surgical RCT in one tooth. Guided endodontic technique was performed in six of those teeth. Conclusions: For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.

scholarly journals Prognostic Genomic Tissue-Based Biomarkers in the Treatment of Localized Prostate Cancer

2022 ◽  
Vol 12 (1) ◽  
pp. 65
Author(s):  
Gianluca Ingrosso ◽  
Emanuele Alì ◽  
Simona Marani ◽  
Simonetta Saldi ◽  
Rita Bellavita ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Positive Impact ◽  
Wide Spectrum ◽  
Locally Advanced ◽  
Treatment Strategies ◽  
Quality Criteria ◽  
Localized Prostate Cancer ◽  
Decision Making Process

In localized prostate cancer clinicopathologic variables have been used to develop prognostic nomograms quantifying the probability of locally advanced disease, of pelvic lymph node and distant metastasis at diagnosis or the probability of recurrence after radical treatment of the primary tumor. These tools although essential in daily clinical practice for the management of such a heterogeneous disease, which can be cured with a wide spectrum of treatment strategies (i.e., active surveillance, RP and radiation therapy), do not allow the precise distinction of an indolent instead of an aggressive disease. In recent years, several prognostic biomarkers have been tested, combined with the currently available clinicopathologic prognostic tools, in order to improve the decision-making process. In the following article, we reviewed the literature of the last 10 years and gave an overview report on commercially available tissue-based biomarkers and more specifically on mRNA-based gene expression classifiers. To date, these genomic tests have been widely investigated, demonstrating rigorous quality criteria including reproducibility, linearity, analytical accuracy, precision, and a positive impact in the clinical decision-making process. Albeit data published in literature, the systematic use of these tests in prostate cancer is currently not recommended due to insufficient evidence.

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