scholarly journals Heavy Silicone Oil as a Long-Term Endotamponade Agent for Complicated Retinal Detachments

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Juliana Prazeres ◽  
Octaviano Magalhães ◽  
Luiz F. A. Lucatto ◽  
Rodrigo Milan Navarro ◽  
Nilva S. Moraes ◽  
...  
Keyword(s):  
Silicone Oil ◽  
Common Adverse Effect ◽  
Wilcoxon Test ◽  
Heavy Silicone Oil ◽  
Oxane Hd ◽  
High Chance ◽  
Anatomic Success ◽  
Made In

We retrospectively evaluated a heavy silicone oil (HSO) as a long-term intraocular endotamponade agent to treat complicated RD by inferior PVR in 25 eyes of 25 patients. Patients underwent PPV and injection of Oxane HD as an internal tamponade agent. A comparison of preoperative and postoperative BCVA at month 1, month 6, and last visit was made in the group in which HSO was removed and in the group in which HSO was not removed. Statistical calculations were performed using the Wilcoxon test. The HSO was removed from 11 patients after a mean of 26.55 ± 21.38 months. The HSO remained inside the vitreous cavity in 14 eyes due to a high chance of PVR recurrence (mean follow-up period, 11.07 ± 7.44 months). Anatomic success was achieved in 92%. The BCVA in the group, in which HSO was not removed, improved significantly during the first 6 months. Among the patients who had the oil removed, there was improvement in BCVA after 1 month. Oil emulsification was the most common adverse effect in 52% of eyes. HSO is an effective tamponade in complex rhegmatogenous and tractional RD complicated by PVR. HSO can remain in the eye for long periods with relative tolerability and safety.

scholarly journals Long-term follow-up of thoracoscopic ablation for long-standing persistent atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Harlaar ◽  
M.A.P Oudeman ◽  
S.A Trines ◽  
G.S De Ruiter ◽  
M Khan ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Pulmonary Vein ◽  
Atrial Arrhythmia ◽  
Wilcoxon Test ◽  
Continuous Group ◽  
Loop Recorder ◽  
Long Term Follow Up ◽  
Rhythm Monitoring

Abstract Background Catheter ablation in patients with long-standing persistent AF (LSPAF) remains challenging and often requires repeated procedures with variable results. We report long-term outcomes of a bipolar thoracoscopic pulmonary vein and left atrial posterior wall ablation for LSPAF, and compare continuous and interval rhythm monitoring. Methods Seventy-seven LSPAF patients who underwent thoracoscopic pulmonary vein and box isolation between 2009–2017 in two Dutch centers were included. Follow-up consisted of continuous rhythm monitoring using an implanted loop recorder or 24-h Holter at 3/6/12/24/60 months. Results Mean age was 59±8 years with a median AF duration of 3.8 [1.2–6.3] years. In the total cohort, at 2-year follow-up, 86.0% of patients were in sinus rhythm, 12.3% were in paroxysmal AF and 1.6% in persistent AF. At 5 years, 62.9% of patients were in sinus rhythm, 20.0% in paroxysmal AF, 14.3% in persistent AF and 2.9% was experiencing atrial flutter. Continuous rhythm monitoring was performed in 46% of patients. Comparing continuous and interval rhythm monitoring, freedom from any atrial arrhythmia episode at 2- and 5 years was 60.0% and 49.9% in the continuous group and 93.8% and 51.9% in the interval monitoring group, respectively (p=0.02, Breslow-Wilcoxon test). In patients with continuous rhythm monitoring the mean atrial arrhythmia burden was reduced from 99.1% preoperatively to 0.1% at the end of the blanking period and 7.3% at 2-year follow-up. Conclusions Thoracoscopic box ablation is highly effective in restoring sinus rhythm at medium term follow-up. However, it is not a curative treatment as demonstrated by the 50% arrhythmia-free survival at long-term follow-up. Whether this is due to the progressive nature of AF needs further investigation. Continuous rhythm monitoring shows earlier recurrence detection with a potential early treatment adaptation. Funding Acknowledgement Type of funding source: None

scholarly journals Refractive outcome of cataract surgery in eyes filled with silicone oil

2019 ◽  
Author(s):  
Piotr Kanclerz ◽  
Christoph Leisser ◽  
Andrzej Grzybowski ◽  
Paweł Lipowski
Keyword(s):  
Cataract Surgery ◽  
Silicone Oil ◽  
Spherical Equivalent ◽  
Refractive Outcome ◽  
Spherical Equivalent Refraction ◽  
Cataract Development ◽  
Oil Injection ◽  
Phacoemulsification Cataract Surgery

Abstract Background Cataract development is common in phakic eyes filled with silicone oil (SO), necessitating subsequent cataract removal. This study evaluated the refractive outcome in eyes filled with SO undergoing phacoemulsification cataract surgery (PCS). Methods This retrospective study evaluated patients with SO tamponade who were scheduled for PCS. Results Subjects (n=26) were followed-up for 29.5 ± 13.9 months after cataract surgery. The median spherical equivalent refraction (SER) was +5.3 D (interquartile range [IQR] +2.9 to +6.7) before PCS, and +3.4 D (IQR +2.0 to +4.4) after PCS. Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes (57.7%). In 13 eyes assessment of refraction after SO-removal was possible, and showed a myopic shift of -4.6 D (IQR -2.9 to -7.3) in the SER. After SO removal, 5 of 13 eyes (38.5%) were within ±1.0 D of the target refraction, while 9 out of 13 eyes (69.2%) were within ±2.0 D. Conclusions The refractive outcome after PCS for eyes filled with SO is less predictable than that for normal eyes. Some of the eyes undergoing silicone oil injection may require long-term tamponade.

scholarly journals Post-COVID-19 Pulmonary Fibrosis: Report of Two Cases

2021 ◽  
Author(s):  
Saurabh Karmakar ◽  
Priya Sharma ◽  
Ameet Harishkumar ◽  
Deependra Kumar Rai
Keyword(s):  
Respiratory Failure ◽  
Severe Acute Respiratory Syndrome ◽  
Pulmonary Fibrosis ◽  
Restrictive Lung Disease ◽  
Hospitalised Patients ◽  
Short And Long Term ◽  
Remarkable Progress ◽  
Made In

COVID-19 caused by severe acute respiratory syndrome coronavirus 2 has led to a pandemic situation worldwide. However, remarkable progress has been made in evolving policies, strengthening healthcare efforts, and pharmacotherapy. As more patients are recovering from COVID-19, clearer concepts about possible short- and long-term complications are emerging. Respiratory failure is the most common morbidity in hospitalised patients, and post-COVID-19 pulmonary fibrosis is the most common respiratory complication after recovery. The authors report two cases of COVID-19 pneumonia with respiratory failure who were cured but developed pulmonary fibrosis with restrictive lung disease in the follow-up period.

Lens-sparing vitrectomy for stage 4A retinopathy of prematurity in infants with aggressive-posterior ROP: Anatomic and functional results

2020 ◽  
pp. 112067212094693
Author(s):  
Sara Macor ◽  
Silvia Pignatto ◽  
Antonio Capone Jr ◽  
Stefano Piermarocchi ◽  
Paolo Lanzetta
Keyword(s):  
Retinal Detachment ◽  
Retinopathy Of Prematurity ◽  
Functional Outcomes ◽  
Vitreous Hemorrhage ◽  
Functional Results ◽  
Postmenstrual Age ◽  
Refractive Correction ◽  
Anatomic Success

Aim: To assess long-term anatomic and functional outcomes of early lens-sparing vitrectomy (LSV) for stage 4A retinopathy of prematurity (ROP) in infants with aggressive-posterior ROP (AP-ROP) which progressed to retinal detachment despite laser treatment. Methods: Chart review of infants who underwent early 25-gage LSV for stage 4A ROP. Outcomes were anatomic success, mean visual acuity (VA), development of postoperative complications, and refractive changes. Follow-up examinations were performed at 1, 3, 6, 12, and then every 6 months. Results: Ten eyes of seven preterm infants who underwent LSV were included. Mean follow-up was 36 ± 13.4 months and mean postmenstrual age (PMA) at last follow-up was 37 ± 13.7 months. Mean gestational age (GA) and weight at birth was 26 ± 1.4 weeks and 639 ± 180 g. Two eyes had vitreous hemorrhage 4 and 14 days after surgery, respectively. At last follow-up anatomic success was 100%, mean VA was 20/80 and eight eyes (80%) had high myopic refractive correction (mean spherical equivalent –11.25 D). Conclusion: Early LSV for stage 4A ROP with AP-ROP and progression to retinal detachment is efficacious in terms of anatomic and functional outcomes. Anatomic success is associated with visual improvement despite possible myopic refraction changes during follow-up.

Is MRI suitable for conclusive work-up of suspicious findings in mammography and ultrasound?

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 3-3
Author(s):  
Kevin Strobel ◽  
Simone Schrading ◽  
Christiane K. Kuhl
Keyword(s):  
False Positive ◽  
Breast Mri ◽  
Short Term ◽  
Long Term Follow Up ◽  
Mass Lesions ◽  
Work Up ◽  
Suspicious Lesions ◽  
Made In

3 Background: The current ACR practice guidelines discourage use of MRI for work-up of suspicious findings in mammography (Mx) and ultrasound (US). We investigated whether additional breast MRI assessment of suspicious Mx and U.S. findings could improve PPV and thus possibly help reduce the number of biopsies for false positive findings in Mx or U.S. Methods: Between 06/2010 and 04/2012, a total 2,754 patients underwent DCE breast MRI. Of these, 277 underwent MRI for further work-up of suspicious findings made in Mx (n=173, 57 patients with mass lesions, 33 with asymmetries, 12 with architectural distortions, and 71 with suspicious calcifications) or U.S. (n=104, 74 with masses, 30 with miscellaneous U.S. findings such as suspected intraductal pathology, focal acoustic shadowing or architectural distortions) . All lesions categorized as MR-BIRADS 4 and 5 underwent biopsy, lesions categorized as MR-BIRADS 1 or 2 did not proceed to biopsy, except for selected women with mammographic calcifications suggestive of DCIS. Lesions categorized as MR-BIRADS 3 underwent additional short term follow-up by MRI, US and/or Mx. All women who did not undergo biopsy (MR-BIRADS 1-3) underwent long term follow-up for so far 12-24 months. Results: For suspicious lesions in mammography, MRI increased PPV from 19.3% (11/57) to 92.3% (12/13) for masses, from 3% (1/33) to 33.3% (1/3) for asymmetries, from 8.3% (1/12) to 25% (1/4) for architectural distortions and from 21.1% (15/71) to 62.5% (15/24) for calcifications. For suspicious lesions in ultrasound, MRI increased PPV from 13.5% (10/74) to 71.4% (10/14) for masses and from 3.3% (1/30) to 50% (1/2) for non-mass U.S. findings. In 4/277 patients, MRI showed additional suspicious findings, requiring MR-guided biopsy, one of which was histologically proven malignant. So far, none of the patients who, because of an MR-BIRADS 1-3, did not undergo biopsy has been diagnosed with invasive cancer or DCIS or with progressive conventional imaging findings necessitating secondary biopsy. Conclusions: MRI improves PPV for both suspicious Mx and U.S. findings, especially mass lesions. In experienced hands, careful use of MRI can help avoid biopsies for false positive diagnoses made in Mx and U.S.

scholarly journals Follow-Up Study of Youth Who Received EIBI as Young Children

2017 ◽  
Vol 43 (2) ◽  
pp. 181-201 ◽  
Author(s):  
Adrienne Perry ◽  
Julie Koudys ◽  
Alice Prichard ◽  
Hilda Ho
Keyword(s):  
Young Children ◽  
General Pattern ◽  
Autism Severity ◽  
Long Term Outcomes ◽  
Follow Up Study ◽  
Intensive Behavioral Intervention ◽  
Effectiveness Studies ◽  
Made In

Although early intensive behavioral intervention (EIBI) has been clearly shown to be evidence-based, there is very little information available regarding long-term outcomes, especially from community effectiveness studies. We present data on cognitive, adaptive, and autism severity measures from four time points (pre- and post-EIBI and two follow-up points) for a sample of 21 youth, currently aged 16 years on average (range = 13-20) who received EIBI as young children and who have been out of EIBI for a mean of 10 years (range = 8.5-14). Results show heterogeneous outcomes and a general pattern of stability since the end of EIBI, suggesting gains made in EIBI are maintained.

scholarly journals PC3 - 142 Gamma Knife Radiosurgery in Patients with Persistent Acromegaly or Cushing’s Disease: Long-Term Risk of Hypopituitarism

2016 ◽  
Vol 43 (S4) ◽  
pp. S22-S22
Author(s):  
O. Cohen-Inbar
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Cushing’S Disease ◽  
Hormone Replacement ◽  
Gamma Knife Radiosurgery ◽  
Common Adverse Effect ◽  
Cushing's Disease ◽  
Pituitary Hormone

For patient with a recurrent or residual acromegaly or Cushing’s disease (CD) after resection, Gamma knife radiosurgery (GKRS) is often used. Hypopituitarism is the most common adverse effect after GKRS treatment. The paucity of studies with long-term follow up has hampered understanding of the latent risks of hypopituitarism in patients with a Acromegaly or CD. We report the long-term risks of hypopituitarism for patients treated with GKRS for Acromegaly or CD. Methods: From a prospectively created, IRB approved database, we identified all patients with a Acromegaly or CD treated with GKRS at the University of Virginia from 1989 to 2008. Only patients with a minimum endocrine follow up of 60 months were included. The median follow-up is 159.5 months (60.1-278). Thorough radiological and endocrine assessments were performed immediately before GKRS and at regular follow-up intervals. New onset of hypopituitarism was defined as pituitary hormone deficits after GKRS requiring corresponding hormone replacement. Results: 60 patients with either Acromegaly or CD were included. Median tumor volume at time of GKRS was 1.3 cm3 (0.3-13.4), median margin dose was 25 Gy (6-30). GKRS induced new pituitary deficiency occurred in 58.3% (n=35) of patients. Growth Hormone deficiency was most common (28.3%, n=17). The actuarial overall rates of hypopituitarism at 3, 5, and 10 years were 10%, 21.7%, and 53.3%, respectively. The median time to hypopituitarism was 61 months after GKRS (range, 12-160). Cavernous sinus invasion of the tumor was found to correlate with the occurrence of a new or progressive hypopituitarism after GKRS (p=0.018). Conclusions: Delayed hypopituitarism increases as a function of time after radiosurgery. Hormone axes appear to vary in terms of radiosensitivity. Patients with adenoma in the cavernous sinus are more prone to develop loss of pituitary function after GKRS.

scholarly journals Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries

2022 ◽  
Vol 8 ◽  
Author(s):  
Huijin Chen ◽  
Jiarui Yang ◽  
Changguan Wang ◽  
Xuefeng Feng ◽  
Kang Feng ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Open Globe Injury ◽  
Oil Migration ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
Baseline Information ◽  
Suturing Methods

PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.

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