scholarly journals Idopathic tigeminal neuralgia: Radiophrequency rhizotomy of ganglion Gasseri

2004 ◽  
Vol 51 (4) ◽  
pp. 31-38
Author(s):  
Eugen Slavik ◽  
S. Ivanovic ◽  
M. Spaic ◽  
B. Djurovic
Keyword(s):  
Radio Frequency ◽  
Sensory Loss ◽  
Duration Of Illness ◽  
Idiopathic Trigeminal Neuralgia ◽  
Risk Patients ◽  
Lancinating Pain ◽  
Single Radio ◽  
One Year ◽  
Almost All ◽  
Ganglion Gasseri

Idiopathic trigeminal neuralgia (ITN), ( tic douloureux), may be defined as a chronic painfull disorder of the sensory divisions of the trigeminal nerve, with unexplained cause and pathogenesis. The clinical features are characterized by recurrent paroxysmal lancinating pain confined to distribution of one or more branches of the nerve. Radio frequency rhizotomy (RFR) of ganglion Gasseri is a method of choice in treatment of ITN. We present the series of 1600 patients suffering from ITN who underwent RFR between 1984 and 2001. Ages ranged from 29 to 88 years, with a mean age of 62 years. Total pain relief immediately after a single radio frequency lesion was achieved in 1469 (92%) of patients. After one year a recurrence of pain was present in 145 (10%). Age, sex and duration of illness were unrelated to outcome. Patients previously treated by open surgery appeared to receive less benefit from subsequent RFR. Clinical outcome correlated with the degree of sensory deficit created by RFR. Patients acquiring dense deficit demonstrated a reduced risk of recurrence: 203/1129 (18%) of patients with dense sensory loss and 75/258 (29%) of those with a partial deficit developed a recurrence by three years, whereas almost all patients (78/82) without initial sensory loss suffered a recurrence by three years. Serious complications resulting from RFR were infrequent and the most common was the permanent dysesthesia in 9 (0,6%) of patients. Our results suggest that the RFR is an well bearable and effective long term surgical treatment for ITN, especially for older and poor-risk patients.

scholarly journals Recruitment, Dispersal, and Demographic Rescue in Spatially-Structured White-Tailed Ptarmigan Populations

The Condor ◽  
2000 ◽  
Vol 102 (3) ◽  
pp. 503-516 ◽  
Author(s):  
Kathy Martin ◽  
Peter B. Stacey ◽  
Clait E. Braun
Keyword(s):  
General Pattern ◽  
Population Connectivity ◽  
Site Location ◽  
Breeding Sites ◽  
Stochastic Conditions ◽  
Local Survival ◽  
Regular Event ◽  
Study Sites ◽  
One Year ◽  
Almost All

Abstract We studied recruitment and dispersal of White-tailed Ptarmigan (Lagopus leucurus) breeding in naturally fragmented alpine habitats at four study sites in Colorado from 1987–1998. Almost all recruitment for both sexes, particularly females, was of birds produced outside local populations and also external to nearby studied populations. Populations were more dependent on female recruitment than on male recruitment to sustain them, and patterns of recruitment were not correlated with local survival of adults or production of young the previous year, except at one site for females. Over 95% of recruits were yearlings. Breeding dispersal of adults, an infrequent but regular event, was also important to inter-population connectivity. Our data for multiple populations allowed us to describe movement patterns among populations to assess consistency with conditions required for a rescue system. After widespread reproductive failure in one year, we expected all populations the next year would have low recruitment due to a reduced supply of recruits produced in the region. Recruitment was low, but impact varied among populations. We conducted an over-winter study of radio-marked offspring to determine possible influences of winter site location and relatives on recruitment patterns. Contrary to expectation, offspring remained on or near breeding sites in winter, but were not located near their mothers or siblings. Recruitment location was related to winter site location. White-tailed Ptarmigan exhibit a well developed capacity for external recruitment that allows them to persist in small populations with stochastic conditions for breeding and survival. Extensive external recruitment may be a general pattern for birds.

Bulimia nervosa: treatment and short-term outcome

1986 ◽  
Vol 16 (1) ◽  
pp. 65-70 ◽  
Author(s):  
L. K. George Hsu ◽  
Diane Holder
Keyword(s):  
Treatment Outcome ◽  
Bulimia Nervosa ◽  
Response To Treatment ◽  
Dropping Out ◽  
Methodological Issues ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Duration Of Illness ◽  
One Year

SynopsisFifty-six bulimia nervosa patients were treated by means of a behavioural approach and followed for at least one year after completion or dropping out of treatment. Outcome was encouraging in about half of the patients and several psychiatric indicators, such as duration of illness and response to treatment, were identified. The significance of the findings and unresolved methodological issues are discussed.

MANAGEMENT OF ACUTE APPENDICITIS DURING THE EARLY PHASE OF THE COVID-19 PANDEMIC: A SINGLE NHS CENTRE STUDYONE YEAR FOLLOW UP STUDY.

2021 ◽  
pp. 87-89
Author(s):  
Yamen Jabri ◽  
Md Mahfooz Buksh ◽  
Alicia Skrervin
Keyword(s):  
Operative Treatment ◽  
Open Surgery ◽  
Ct Scanning ◽  
Disease Recurrence ◽  
Diagnostic Value ◽  
Complicated Appendicitis ◽  
Risk Patients ◽  
Risk Of Disease ◽  
One Year

Introduction: Early during the COVID-19 pandemic, the royal college of surgeons advised to use Non-Operative Treatment of appendicitis NOTA or otherwise open surgery for appendicitis. This study has explored the resulted management differences, and the outcome after one year follow up. Methods: Retrospective study covering Pre-pandemic data over March-May,2019 & COVID-19 pandemic data over March-May,2020. We compared the outcome of non-operative treatment approach (NOTA), open and laparoscopic surgical outcome between the 2 groups. Results: The number of admissions was lower in the COVID compared to the Pre-COVID Group (35 vs 43). In the COVID group had more CT scanning of the abdomen and pelvis (65.7% vs 42.2%; p=0.036). There was no difference in the diagnostic value for these imaging methods between the 2 groups (87.5% vs 86.6%) During COVID period Signicantly fewer patients underwent surgery (77.1 vs 92.8; p<0.04), There were signicantly more complicated appendicitis cases in the COVID group compared to Pre-COVID group (59.2 vs 28.2; p:0.021). There was in reduction LOS when comparing Laparoscopic to NOTA (1.7 vs 2.6 days; p:0.03). There has been higher complication rate in the open and NOTA treatments compared to Laparoscopic, but this was not statistically signicant (24.3 % vs 14.8%; p: 0.29). In the NOTA group 41 % of the patients had emergency or interval appendectomy in after one year follow up period. Conclusions: There was a tendency towards conservative approach/open surgery during the pandemic. Our study suggests that Laparoscopic surgery should remain the preferred method of management of appendicitis during COVID-19 pandemic considering the more complicated appendicitis. NOTA should be limited to selected high risk patients. accepting the risk of disease recurrence and need for further interval or emergency surgery

scholarly journals Treatment of children and adolescents with hemangioma using propranolol: preliminary results from a retrospective study

2014 ◽  
Vol 132 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Juliana Costa Albuquerque ◽  
Rosane Aline Magalhaes ◽  
Jamille Araujo Felix ◽  
Maria Vilani Rodrigues Bastos ◽  
Juvenia Bezerra Fontenele ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Children And Adolescents ◽  
Previous Treatment ◽  
Capillary Hemangioma ◽  
Response To Treatment ◽  
Vascular Tumors ◽  
Lesion Volume ◽  
Chi Square ◽  
One Year ◽  
Almost All

CONTEXT AND OBJECTIVE: Hemangiomas are the commonest vascular tumors during childhood. In 2008, the effect of propranolol for treating capillary hemangiomas was demonstrated. Other similar results followed, showing that it rapidly reduces lesion volume. The objective here was to evaluate children and adolescents with hemangiomas that were treated with propranolol. DESIGN AND SETTING: Retrospective study, conducted in a children's hospital. METHODS : Patients aged 0-19 years with or without previous treatment, who were treated between January 2009 and December 2010, were included. The response was assessed by comparing the lesion appearance between the start of treatment and the last consultation. We considered partial or complete responses as the response to treatment. RESULTS : Sixty-nine patients with a median follow-up of 11 months (mean age: 31 months) were included. Of these, 58 patients were recently diagnosed and 11 had had previous treatment. A response (partial or complete) was seen in 60 patients (87%). Among the capillary hemangioma cases, responses were seen in 50 out of 53 (94%), while in other lesion types, it was 10 out of 16 (63%) (P = 0.3; chi-square). Responses in patients less than one year of age were seen in 37 out of 38 (97%), whereas in those over one year of age, in 23 out of 31 (74%) (P = 0.4; chi-square). Side effects were uncommon and mild. CONCLUSIONS: Propranolol seemed to be effective for treatment of hemangiomas in children and adolescents, and not just in the proliferative stage, with responses in almost all the patients.

scholarly journals Evolving Experience in The Management of Empyema Thoracis

2012 ◽  
Vol 9 (1) ◽  
pp. 5-7
Author(s):  
K Shrestha ◽  
S Shah ◽  
S Shrestha ◽  
S Thulung ◽  
B Karki ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Bronchopleural Fistula ◽  
Functional Results ◽  
Lung Abscess ◽  
Empyema Thoracis ◽  
High Patient Satisfaction ◽  
Restrictive Lung Disease ◽  
Treatment Groups ◽  
Duration Of Illness ◽  
One Year

Background Empyema thoracis a disease of significant morbidity and mortality, especially in the developing world. However, the optimal management of empyema thoracis remains controversial. Objective To analyse evolving experience in clinical presentation, management, outcome and factors contributing to adverse morbidity in empyema thoracis. Methods This is hospital based retrospective study of patients who were diagnosed with empyema thoracis in cardiothoracic and vascular surgery (CTVS) unit, Bir Hospital, Kathmandu, Nepal over a period of one year (July 2009 to June 2010). A total of forty-six adult cases were categorized into two treatment groups: (i) thoracotomy for decortication (ii) segmentectomy, lobectomy and redo-thoracotomy for pneumonectomy. The median duration of illness prior to hospital admission was compared. The presence of loculated pleural fluid determined the need for thoracotomy. Results Out of forty-six cases, twenty- nine (63.04%) who had early thoracotomy (<22 days) had prompt symptomatic recovery. Forteen out of seventeen (82.35%) of the patients who were initially treated with thoracocentesis or tube thoracostomy eventually needed thoracotomy. There was a positive shift in management towards early thoracotomy resulting in prompt symptomatic recovery. Significant complications were noted in eight patients who had delayed thoracotomy. Complications included recurrent empyema with lung abscess (n = 3), restrictive lung disease (n = 3), bronchopleural fistula (n = 1) and scoliosis (n=1). Conclusion Early thoracotomy and decortication was found to be an excellent surgical procedure with good functional results and high patient satisfaction rate.http://dx.doi.org/10.3126/kumj.v9i1.6253 Kathmandu Univ Med J 2011;9(1):5-7 

Cerebrospinal fluid shunt insertion: techniques of peritoneal catheter placement separate from abdominal fascial and peritoneal incisions

2010 ◽  
Vol 113 (1) ◽  
pp. 79-81 ◽  
Author(s):  
Abdurrahim A. Elashaal ◽  
Michael Corrin ◽  
Michael D. Cusimano
Keyword(s):  
Abdominal Wall ◽  
Csf Shunt ◽  
Abdominal Wall Closure ◽  
Peritoneal Catheter ◽  
Effective Technique ◽  
Shunt Insertion ◽  
Risk Patients ◽  
Abdominal Operations ◽  
Insertion Techniques ◽  
Almost All

Good abdominal wall closure is one of the basic surgical skills and is a common feature of almost all modernday CSF shunt operations. The fact that some patients require multiple abdominal operations highlights the need for a simple and effective technique for peritoneal catheter insertion through the abdominal wall and abdominal wall closure. Although technically simple, abdominal wall closure becomes more complex when combined with the requirement to maintain CSF shunt function in cases in which the shunt catheter passes through the abdominal wall into the peritoneal cavity. In this report, the authors describe a simple technique for passing the peritoneal catheter of a ventriculoperitoneal shunt through the abdominal wall on a pathway separate from the fascial opening. This technique minimizes the risk of abdominal wall–related complications and is especially important in high-risk patients such as those with obesity and/or diabetes and in children.

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