Medium- and Long-term Outcomes of Surgical Reconstruction in Acute Charcot Neuroarthropathy

OrthoMedia ◽  
2021 ◽  
Keyword(s):  
Surgical Reconstruction ◽  
Long Term Outcomes ◽  
Charcot Neuroarthropathy

scholarly journals Long-term foot outcomes following differential abatement of inflammation and osteoclastogenesis for active Charcot neuroarthropathy in diabetes mellitus

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259224
Author(s):  
Liza Das ◽  
Ashu Rastogi ◽  
Edward B. Jude ◽  
Mahesh Prakash ◽  
Pinaki Dutta ◽  
...  
Keyword(s):  
Bone Mineral ◽  
Mineral Content ◽  
Foot Deformities ◽  
Long Term Outcomes ◽  
Charcot Neuroarthropathy ◽  
Total Contact Cast ◽  
Group A ◽  
Group B ◽  
New Onset

Aims Inflammatory osteolysis is sine-qua-non of active Charcot neuroarthropathy (CN) causing decreased foot bone mineral density (BMD) and fractures. We aimed to explore the effect of anti-inflammatory or anti-resorptive agents for effect on foot bone mineral content (BMC) and consequent long-term outcomes of foot deformities, fractures and amputation. Methods Forty-three patients with active CN (temperature difference >2°C from normal foot) were evaluated. Patients were off-loaded with total contact cast and randomized to receive either methylprednisolone (1gm) (group A), zoledronate (5mg) (group B) or placebo (100ml normal saline) (group C) once monthly infusion for three consecutive months. Change in foot BMC was assessed at 6 months or at remission and followed subsequently up to 4 years for the incidence of new-onset fracture, deformities, or CN recurrence. Results Thirty-six participants (24 male, 12 female) were randomized (11 in group A, 12 group B, 13 group C). The mean age was 57.7± 9.9 years, duration of diabetes 12.3± 5.8 years and symptom duration 6.5± 2.8 weeks. BMC increased by 36% with zoledronate (p = 0.02) but reduced by 13% with methylprednisolone (p = 0.03) and 9% (p = 0.09) with placebo at remission. There were no incident foot fractures, however, two patients sustained ulcers, and 3 had new-onset or worsening deformities and none required amputation during 3.36 ± 0.89 years of follow-up. Conclusion Bisphosphonate for active CN is associated with an increase in foot bone mineral content as compared to decrease with steroids or total contact cast but long-term outcomes of foot deformities, ulceration and amputation are similar. Trial registration ClinicalTrials.gov: NCT03289338.

Recurrent Ventral Curvature with Long-Term Follow-up after Transverse Preputial Island Urethroplasty

2019 ◽  
Vol 30 (05) ◽  
pp. 429-433
Author(s):  
Chaoxu Wang ◽  
Hongcheng Song ◽  
Weiping Zhang
Keyword(s):  
Island Flap ◽  
Surgical Reconstruction ◽  
Long Term Outcomes ◽  
Urethral Plate ◽  
Urethral Strictures ◽  
Primary Surgery ◽  
Age At Surgery ◽  
Long Term Follow Up

Abstract Objective This study was aimed to assess the long-term outcomes of recurrent ventral curvature (VC) repaired in early childhood after transverse preputial island flap urethroplasty. Materials and Methods A total of 378 patients underwent transverse preputial island flap urethroplasty between January 2000 and January 2005 at our hospital. Of these patients, 43 were invited for assessment of VC after puberty. The age at surgery, types of hypospadias, degrees of recurrent VC, and surgical procedures were analyzed. Results The study included 43 patients with a mean age of 15.9 years (range, 12.3–17.9). The average age at the time of primary surgery was 1.9 years (range, 1.2–3.6). Of 43 patients, recurrent VC was identified in 14 (32.5%). In total, 8 out of 16 patients (50.0%) were successfully treated by urethral plate transection with skin release during the primary surgery, and 6 out of 27 patients (28.6%) underwent additional dorsal plication (DP; p = 0.093). Severe recurrent VC was observed in four, moderate curvature was observed in four, and mild curvature was observed in six cases. Recurrent VC was present more often in patients with complications (34.6 vs. 24.1%, p = 0.331), especially in severe urethral strictures that required open surgical reconstruction (p = 0.039). Conclusion Although the patients in our study represent only a small portion of the overall hypospadias population, it is notable that 32.5% of these patients showed recurrent VC, including 28.6% of patients with transection plus DP. We suggest long-term follow-up of hypospadias at least during adolescence or even into adulthood.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

1337: Long Term Outcomes of Detrusor Myectomy

2007 ◽  
Vol 177 (4S) ◽  
pp. 441-441
Author(s):  
Muhammad Z. Aslam ◽  
Meena Agarwal ◽  
Timothy P. Stephenson
Keyword(s):  
Long Term Outcomes

1002: Long Term Outcomes for Patients with High Volume Retroperitoneal Teratoma Undergoing Post Chemotherapy Surgery

2007 ◽  
Vol 177 (4S) ◽  
pp. 331-331 ◽  
Author(s):  
Stephen D.W. Beck ◽  
Richard S. Foster ◽  
Richard Bihrle ◽  
John P. Donohue
Keyword(s):  
High Volume ◽  
Long Term Outcomes ◽  
Retroperitoneal Teratoma

23: High Volume Hospitals do not have Better Long Term Outcomes Following Cystectomy for Bladder Cancer

2006 ◽  
Vol 175 (4S) ◽  
pp. 8-9 ◽  
Author(s):  
Brent K. Hollenbeck ◽  
Yongliang Wei ◽  
John D. Birkmeyer
Keyword(s):  
Bladder Cancer ◽  
High Volume ◽  
Long Term Outcomes

Abstract #238: Improved Short Term and Long Term Outcomes of Early Insulin Initiation in Type 2 Diabetes Over 10 Years

2017 ◽  
Vol 23 ◽  
pp. 50
Author(s):  
Jothydev Kesavadev ◽  
Shashank Joshi ◽  
Banshi Saboo ◽  
Hemant Thacker ◽  
Arun Shankar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Initiation ◽  
Long Term Outcomes ◽  
Short Term
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