scholarly journals Bilobed testicle in children: diagnosis and management

2013 ◽  
Vol 3 (6) ◽  
pp. 87 ◽  
Author(s):  
Claudio De Carli ◽  
Luis Guerra ◽  
Michael Leonard
Keyword(s):  
Surgical Treatment ◽  
Testicular Tumour ◽  
Insufficient Data ◽  
Testicular Mass ◽  
Diagnosis And Management

Bilobed testicle is an extremely rare testicular malformation inchildren. It may be presumed that this condition could be an incompleteexpression of polyorchidism; however, the etiology of bothentities remains unknown. In this report, a 3-year-old boy presentedwith a right bilobed testicle mimicking a testicular tumour. Sincethere are insufficient data in the pediatric literature presenting theideal management of bilobed testicles, we believe it is importantto report this case to provide more information about this condition.Although rare, bilobed testis should be considered in the differentialdiagnosis of a testicular mass. Surgical treatment is notmandatory, and conservative follow-up may play a role.

scholarly journals Primary synovial osteochondromatosis of the shoulder: a rare cause of shoulder pain

2018 ◽  
Vol 11 (1) ◽  
pp. e227281
Author(s):  
Emma Poyser ◽  
Rhys Morris ◽  
Hemang Mehta
Keyword(s):  
Surgical Treatment ◽  
Shoulder Pain ◽  
Synovial Membrane ◽  
Tendon Sheath ◽  
Diagnostic Uncertainty ◽  
Diagnosis And Management ◽  
Synovial Osteochondromatosis ◽  
Specialist Referral ◽  
History Of

Synovial osteochondromatosis is a benign neoplastic condition which manifests as multiple cartilaginous or osteocartilaginous nodules within a joint, bursa and tendon sheath. It typically results in pain and stiffness of the affected joint, and is thought to arise as a result of synovial membrane proliferation and metaplasia. 1 We report the diagnosis and management of a 36-year-old man who presented with a long history of shoulder pain, which had been managed conservatively prior to referral to orthopaedics. Following investigation and subsequent diagnosis, he underwent successful surgical treatment of primary synovial osteochondromatosis, in the form of open synovial debridement and excision of nodules, with no recurrence demonstrated at 1-year follow-up. This case illustrates the diagnosis and management of primary synovial osteochondromatosis, and emphasises the importance of serial imaging and specialist referral for cases of diagnostic uncertainty or failure to respond to treatment as expected.

Epicardial cryoablation as surgical treatment for atrial fibrillation: One year follow up in 84 patients

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
R Uhl ◽  
I Marcolino ◽  
E Zimmer ◽  
F Beyersdorf ◽  
E Eschenbruch
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
One Year

Case of follow-up and successful surgical treatment rare form of subaortic membrane in infant

2017 ◽  
Vol 14 (3) ◽  
pp. 161-165
Author(s):  
A.I. Kim ◽  
Т.V. Rogova ◽  
R.М. Кurganov ◽  
Е.V. Kholmanskaya
Keyword(s):  
Surgical Treatment ◽  
Rare Form ◽  
Subaortic Membrane

Delayed Pancreatic Metastasis of Renal Clear Cell Carcinoma

2013 ◽  
Vol 13 (2) ◽  
pp. 79-80
Author(s):  
Zane Simtniece ◽  
Gatis Kirsakmens ◽  
Ilze Strumfa ◽  
Andrejs Vanags ◽  
Maris Pavars ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Primary Tumour ◽  
Renal Clear Cell Carcinoma ◽  
Pancreatic Metastasis ◽  
Distal Pancreatic Resection

Abstract Here, we report surgical treatment of a patient presenting with pancreatic metastasis (MTS) of renal clear cell carcinoma (RCC) 11 years after nephrectomy. RCC is one of few cancers that metastasise in pancreas. Jaundice, abdominal pain or gastrointestinal bleeding can develop; however, asymptomatic MTS can be discovered by follow-up after removal of the primary tumour. The patient, 67-year-old female was radiologically diagnosed with a clinically silent mass in the pancreatic body and underwent distal pancreatic resection. The postoperative period was smooth. Four months after the surgery, there were no signs of disease progression.

Patients with “benign” Chiari I malformations require surgical decompression at a low rate

2019 ◽  
Vol 23 (4) ◽  
pp. 498-506 ◽  
Author(s):  
Tofey J. Leon ◽  
Elizabeth N. Kuhn ◽  
Anastasia A. Arynchyna ◽  
Burkely P. Smith ◽  
R. Shane Tubbs ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Multivariate Logistic Regression Analysis ◽  
Large Cohort ◽  
Initial Evaluation ◽  
Published Data ◽  
Posterior Fossa Decompression ◽  
Signal Abnormality ◽  
Chiari I

OBJECTIVEThere are sparse published data on the natural history of “benign” Chiari I malformation (CM-I)—i.e., Chiari with minimal or no symptoms at presentation and no imaging evidence of syrinx, hydrocephalus, or spinal cord signal abnormality. The purpose of this study was to review a large cohort of children with benign CM-I and to determine whether these children become symptomatic and require surgical treatment.METHODSPatients were identified from institutional outpatient records using International Classification of Diseases, 9th Revision, diagnosis codes for CM-I from 1996 to 2016. After review of the medical records, patients were excluded if they 1) did not have a diagnosis of CM-I, 2) were not evaluated by a neurosurgeon, 3) had previously undergone posterior fossa decompression, or 4) had imaging evidence of syringomyelia at their first appointment. To include only patients with benign Chiari (without syrinx or classic Chiari symptoms that could prompt immediate intervention), any patient who underwent decompression within 9 months of initial evaluation was excluded. After a detailed chart review, patients were excluded if they had classical Chiari malformation symptoms at presentation. The authors then determined what changes in the clinical picture prompted surgical treatment. Patients were excluded from the multivariate logistic regression analysis if they had missing data such as race and insurance; however, these patients were included in the overall survival analysis.RESULTSA total of 427 patients were included for analysis with a median follow-up duration of 25.5 months (range 0.17–179.1 months) after initial evaluation. Fifteen patients had surgery at a median time of 21.0 months (range 11.3–139.3 months) after initial evaluation. The most common indications for surgery were tussive headache in 5 (33.3%), syringomyelia in 5 (33.3%), and nontussive headache in 5 (33.3%). Using the Kaplan-Meier method, rate of freedom from posterior fossa decompression was 95.8%, 94.1%, and 93.1% at 3, 5, and 10 years, respectively.CONCLUSIONSAmong a large cohort of patients with benign CM-I, progression of imaging abnormalities or symptoms that warrant surgical treatment is infrequent. Therefore, these patients should be managed conservatively. However, clinical follow-up of such individuals is justified, as there is a low, but nonzero, rate of new symptom or syringomyelia development. Future analyses will determine whether imaging or clinical features present at initial evaluation are associated with progression and future need for treatment.

Thyroidectomy in a patient with a giant multinodular nontoxic cervical retrosternal goiter

2020 ◽  
pp. 97-99
Author(s):  
U. V. Kukhtenko ◽  
O. A. Kosivtsov ◽  
L. A. Ryaskov ◽  
E. I. Abramian
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Clinical Signs ◽  
Disease Relapse ◽  
Cardiac Pathology ◽  
Nontoxic Goiter ◽  
Retrosternal Goiter

A clinical case of successful surgical treatment of a patient with a giant cervical retrosternal nontoxic goiter with severe cardiac pathology is presented. Thyroidectomy from cervical access without sternotomy was performed. At the follow-up examination 5 months after the operation, instrumental and clinical signs of disease relapse were not detected.

TRATAMENTO CIRÚRGICO DE CANINO INCLUSO EM REGIÃO MENTUAL: RELATO DE CASO

2019 ◽  
Author(s):  
Rodrigo Figueiredo de Brito Resende
Keyword(s):  
Surgical Treatment ◽  
Key Words ◽  
Oral Surgery ◽  
Tooth Eruption ◽  
Points Of View ◽  
The Aesthetic ◽  
Relationship Of ◽  
Transverse Position

RESUMOO dente denominado incluso nada mais é que um dente retido ou impactado dentro do alvéolo dentário de maneira parcial ou completa que não conseguiu erupcionar por motivos patológicos ou simplesmente anatômicos após o período de rizogênese. O canino, em especial, é de suma importância sob os pontos de vista estético e funcional. O deslocamento do canino incluso ultrapassando, ou se aproximando da linha média antes da erupção dentária do mesmo, é mais frequente na mandíbula do que na maxila.  Este trabalho tem por objetivo descrever o caso de um paciente de 21 anos que apresentava um canino incluso na região mentual, em posição transversal, inicialmente visualizado em uma radiografia periapical e posteriormente submetido a radiografia com a técnica de Donavan. Através de uma radiografia oclusal, foi possível observar o posicionamento do dente para a vestibular mentoniana e íntima relação do dente retido com as raízes dos incisivos centrais decíduos do paciente. Foi realizada a extração do dente retido no mento, removendo o mesmo por completo sendo feitas osteotomias e odontossecções. O paciente está em acompanhamento clínico à 1 ano após o tratamento cirúrgico.Palavras – chave: Dente incluso; Cirurgia Oral; Imaginologia. ABSTRACTThe tooth inserted  is nothing more than a tooth retained or impacted within the dental socket partially or completely that failed to erupt for pathological or simply anatomical reasons after the period of rhizogenesis. The canine, in particular, is of the utmost importance from the aesthetic and functional points of view. The displacement of the canine, even surpassing or approaching the midline before tooth eruption, is more frequent in the mandible than in the maxilla. This work aims to describe the case of a 21 - year - old patient who had a canine included in the mental region, in a transverse position, which was initially visualized on a periapical radiograph and later submitted to radiography with the Donavan technique. An occlusal radiograph showed the positioning of the tooth for the mental vestibular and the intima relationship of the retained tooth with the roots of the patient's central deciduous incisors. Removal of the tooth retained in the denture was performed, removing the tooth completely and osteotomies and odontosections were performed. The patient is in clinical follow-up at 1 year after the surgical treatment. key words: Tooth included; Oral surgery; Imaginology.  

scholarly journals P34 Characteristics, diagnosis and management of Cushing’s disease - A systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Danyal Z Khan ◽  
Ronneil Digpal ◽  
Hugo Layard Horsfall ◽  
Hani J Marcus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
A Priori ◽  
Pituitary Surgery ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Diagnosis And Management ◽  
Over Time

Abstract Introduction The clinical practice and research in the diagnosis and management of Cushing’s disease remains heterogeneous and challenging to this day. We sought to establish the characteristics of Cushing’s disease, and the trends in diagnosis, management and reporting in this field. Methods Searches of PubMed and Embase were conducted. Study protocol was registered a-priori. Random-effects analyses were conducted to establish numerical estimates. Results Our screening returned 159 papers. The average age of adult patients with Cushing’s disease was 39.3, and 13.6 for children. The male:female ratio was 1:3. 8% of patients had undergone previous transsphenoidal resection. The ratio of macroadenomas: microadenomas:imaging-undetectable adenomas was 18:53:29. The most commonly reported preoperative biochemical investigations were serum cortisol (average 26.4µg/dL) and ACTH (77.5pg/dL). Postoperative cortisol was most frequently used to define remission (74.8%), most commonly with threshold of 5µg/dL (44.8%). Average remission rates were 77.8% with recurrence rate of 13.9%. Median follow-up was 38 months. Majority of papers reported age (81.9%) and sex (79.4%). Only 56.6% reported whether their patients had previous pituitary surgery. 45.3% reported whether their adenomas were macroadenoma, microadenoma or undetectable. Only 24.1% reported preoperative cortisol, and this did not improve over time. 60.4% reported numerical thresholds for cortisol in defining remission, and this improved significantly over time (p = 0.004). Visual inspection of bubbleplots showed increasing preference for threshold of 5µg/dL. 70.4% reported the length of follow up. Conclusion We quantified the characteristics of Cushing’s disease, and analysed the trends in investigation and reporting. This review may help to inform future efforts in forming guidelines for research and clinical practice.

scholarly journals Surgical treatment of infective endocarditis in intravenous drug abusers

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alina Zubarevich ◽  
Marcin Szczechowicz ◽  
Anja Osswald ◽  
Jerry Easo ◽  
Arian Arjomandi Rad ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Drug Abuse ◽  
Infective Endocarditis ◽  
Mortality Rates ◽  
Blood Cultures ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse ◽  
Enterococcus Species ◽  
Function Impairment

Abstract Background Despite current progress in antibiotic therapy and medical management, infective endocarditis remains a serious condition presenting with high mortality rates. It also is a life-threatening complication in patients with a history of chronic intravenous drug abuse. In this study, we analyzed our institutional experience on the surgical therapy of infective endocarditis in patients with active intravenous drug abuse. The aim of the study is to identify the predictive factors of mortality and morbidity in this subgroup of patients. Methods Between 2007 and 2020, a total of 24 patients (7 female, mean age 38.5 ± 8.7) presenting with active intravenous drug abuse underwent a surgical treatment for the infective endocarditis at out center. The primary endpoint was survival at 30th day after the surgery. The secondary composite endpoint included freedom from death, recurrent endocarditis, re-do surgery, and postoperative stroke during the follow-up period. Mean follow-up was 4.2 ± 4.3 years. Results Staphylococcus species was the most common pathogen detected in the preoperative blood cultures. Infection caused by Enterococcus species as well as liver function impairment were identified as mortality predictor factors. Logistic EuroSCORE and EusoSCORE-II were also predictive factors for mortality in univariate analysis. Survival at 1 and 3 years was 78 and 72% respectively. Thirty-day survival was 88%. 30-day freedom from combined endpoint was 83% and after 1 and 3 years, 69 and 58% of the patients respectively were free from combined endpoint. Five patients (20.8%) were readmitted with recurrent infective endocarditis. Conclusion In patients presenting with active intravenous drug abuse, treatment of infective endocarditis should be performed as aggressively as possible and should be followed by antibiotic therapy to avoid high mortality rates and recurrent endocarditis. Early intervention is advisable in patients with an infective endocarditis and enterococcus species in the preoperative blood cultures, liver function deterioration as well as cardiac function impairment. Attention should be also payed to addiction treatment, due to the elevated relapse rate in patients who actively inject drugs. However, larger prospective studies are necessary to support our results. As septic shock is the most frequent cause of death, new treatment options, e.g. blood purification should be evaluated.

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