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Sy E, Sorensen MD. Medial Double Arthrodesis Through Single Approach. Clin Podiatr Med Surg 2023; 40:623-632. [PMID: 37716741 DOI: 10.1016/j.cpm.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Triple arthrodesis is a time-tested procedure toward primary salvage in the context of posterior tibial tendon dysfunction, symptomatic rigid and severe hindfoot malalignment, end-stage degenerative and posttraumatic arthritis, and sequelae of paralytic diseases. Today, the indication for hindfoot arthrodesis is applied to correct painful deformities and arthritic joints, such as advanced cases of adult-acquired flatfoot secondary to ligament collapse and insufficiency of the posterior tibial tendon. Although the triple arthrodesis is an effective and reliable outcome procedure, the popularity of a medial double arthrodesis has increased.
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Affiliation(s)
- Edgar Sy
- Weil Foot & Ankle Institute, Chicago, IL, USA.
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2
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Davulcu EA, Pekerbas M, Karaca E, Durmaz B, Özsan N, Akın H, Saydam G. Complex karyotype with double Philadelphia chromosome and T315I mutation results in blastic phase and extensive extramedullary infiltration in a chronic myeloid leukemia patient. Cancer Genet 2022; 266-267:74-80. [PMID: 35843036 DOI: 10.1016/j.cancergen.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/15/2022] [Accepted: 07/01/2022] [Indexed: 12/12/2022]
Abstract
Chronic myeloid leukemia (CML) is a common hematological malignancy originating from bone marrow stem cells. Chromosomal abnormalities can be seen in almost all cases, the most known anomaly being Philadelphia (Ph) chromosome, a derivative chromosome resulting from a translocation between 9. and 22. chromosome. Other chromosomal abnormalities may be present in 10% of patients at diagnosis, although they emerge frequently during the acute transformation and can be associated with unfavorable significance. Also, point mutations like T315I in BCR-ABL fusion gene may arise during the course of the disease and thereby cause tyrosine kinase inhibitors (TKI) resistance. Here, we report a BCR-ABL positive CML patient who was followed for 6 years in major molecular response (MMR), complete cytogenetic response (CCR), and complete hematological response (CHR). He had a sudden loss of hematological, cytogenetic, and molecular response with a very aggressive blastic course and extensive extramedullary infiltration, with T315I mutation, complex translocations, an extra Ph chromosome, and additional chromosomes. The patient who received intensive cytotoxic chemotherapy together with ponatinib treatment, which is effective for the T315I mutation, never went into remission, and there was no chance of transplantation because a suitable donor for HLA could not be found. Although these findings are not very rare individually, coexistence of complex karyotype and T315I mutation is not frequent and complicates clinical management. Our patient is the first case in literature with all disclosed findings together and indicates the importance of early detection of these chromosomal and molecular abnormalities.
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3
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Jaswal V, Rana P, Bansal V, Gourav KP, Sharma A, Thingnam SKS. A six-chambered heart: cor triatriatum sinister with double-chambered right ventricle in association with ventricular septal defect. Egypt Heart J 2022; 74:10. [PMID: 35171367 DOI: 10.1186/s43044-022-00246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/06/2022] [Indexed: 11/26/2022] Open
Abstract
Background Cor triatriatum has been described as a heart with three atria in which the left atrium (cor triatriatum sinistrum) or right atrium (cor triatriatum dextrum) is divided into two compartments by a fold of tissue, a membrane, or a fibromuscular band. Double-chambered right ventricle, on the other hand, is identified by the presence of an anomalous muscle bundle dividing the right ventricle into two chambers.
Case presentation Here, we describe the case of a child who had a combination of both of these rare entities, effectively creating a heart with six chambers. The child underwent a successful intracardiac repair. Conclusions The association of CTS with DCRV forming a “6-chambered heart” is extremely rare. Awareness of its existence and accurate preoperative diagnosis has important implications in its surgical repair with all the components of this disease spectrum, further increasing the complexity of a successful surgical repair.
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4
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Angelini A, Mavrogenis AF, Crimì A, Georgoulis J, Sioutis S, Bekos A, Igoumenou VG, Cerchiaro MC, Berizzi A, Ruggieri P. Double fractures of the femur: a review of 16 patients. Eur J Orthop Surg Traumatol 2021; 31:1345-1354. [PMID: 33496867 DOI: 10.1007/s00590-021-02873-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Double ipsilateral femoral fractures account for 1-9% of femoral fractures. There is no clear advantage between single or double implant osteosynthesis. We present a series of patients with double ipsilateral femoral fractures, to address the challenges in treatment, namely the implants for osteosynthesis and complications of treatment. MATERIALS AND METHODS We retrospectively studied 16 patients (7 men, 9 women; mean age, 51 years) treated from January 2015 to December 2018. Motor vehicle accidents were the leading cause of injury. Types of fractures were pertrochanteric and shaft (6), pertrochanteric and distal (2), double shaft (3), neck and shaft (2), neck and distal (1), shaft and distal (1), and triple fracture including a pertrochanteric, shaft and distal (1). In five patients, two different implants were used (plate and screws, cannulated hip screws, femoral nail), whereas in 11 patients a long femoral nail was used. RESULTS Fourteen patients experienced union at a mean of 3 months (2-6 months). Two patients experienced nonunion: both had plate and screws osteosynthesis. One patient died 15 days after admission from polytrauma and another patient experienced central venous catheter thrombosis and pneumonia. Surgical complications (2 patients) included a thigh skin necrosis, and external fixator pin tract infection/infected non-union. Weight-bearing was delayed in all patients; full weight-bearing was allowed in 11 patients at 4 months postoperatively, and in four patients at 5 months. CONCLUSION Due to the rarity and the difficulty of standardization of double ipsilateral femoral fractures, there is variable information on the optimal osteosynthesis of the fractures and the outcome of the patients. It seems that closed reduction and long hip nailing is the treatment of choice, with few complications.
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Affiliation(s)
- Andrea Angelini
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| | - Alberto Crimì
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy
| | - Jim Georgoulis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Spyros Sioutis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Achilles Bekos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vasilios G Igoumenou
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Maria Chiara Cerchiaro
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy
| | - Antonio Berizzi
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy
| | - Pietro Ruggieri
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy
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Sale D. Single versus Double Burr Hole for Drainage of Chronic Subdural Hematoma: Randomized Controlled Study. World Neurosurg 2021; 146:e565-7. [PMID: 33130139 DOI: 10.1016/j.wneu.2020.10.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic subdural hematoma (CSDH) is one of the most common neurosurgical emergencies. Most neurosurgeons currently drained CSDH through single or double burr holes; however, few studies have compared the 2 approaches to drainage. The aim of this study is to compare the recurrent rate following double and single burr hole for CSDH in our practice. METHODS This is a randomized controlled study from January 2015 to December 2019 in a neurosurgical unit in Kaduna, Nigeria. All patients with imaging diagnosis of subacute or chronic subdural hematoma who enrolled in the study had either a single or double burr hole. Patients were followed up for 6 months after surgery to assess for recurrence. Data were analyzed using SPSS version 25 for Windows. The Fisher exact test was performed to compare the 2 treatment groups. A 2-sided P value < 0.05 was considered statistically significant. RESULTS A total of 192 patients were enrolled in the study with 99 in the single-burr hole group and 93 in the double burr-hole group. The overall recurrence rate in this study was 2.6%. The recurrence rate in the single arm was 3%, and in the double arm it was 2.2%. There was no statistically significant difference in recurrence between the 2 groups (P = 1.000). CONCLUSIONS A single burr hole is as efficacious as a double burr hole in terms of relief of symptoms and recurrence, and it has a shorter duration of surgery.
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Al-Muharraqi MA. Dental and medical dual qualification in Oral and Maxillofacial Surgery: a global identity. Br J Oral Maxillofac Surg 2020; 58:1235-1239. [PMID: 33248803 DOI: 10.1016/j.bjoms.2020.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022]
Abstract
The argument of whether or not Oral and Maxillofacial Surgery (OMFS) should have both dental and medical core education in the training pathway remains an issue of debate and contention to date. The mid-90s witnessed a gradual trend internationally towards a dual qualification which has slowed down or come to a standstill the last 10 years. This has been more evident in rapidly growing nations in the Middle East/North Africa and Asian subcontinent regions. The maxillofacial identity of a dual degree is being questioned in OMFS-pioneering countries, such as the United Kingdom (UK), which has played a role in the domination of the single degree pathway globally. In this mini review, we will attempt to shed light on the aforementioned regions and put forward a more global role the UK can play in standardising education and training while addressing the cost burden of the dual qualification pathway.
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Affiliation(s)
- M A Al-Muharraqi
- Royal Medical Services of the Bahrain Defence Force (RMS-BDF), Bahrain.
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7
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Ebigbo A, Tziatzios G, Gölder SK, Probst A, Messmann H. Double-endoscope assisted endoscopic submucosal dissection for treating tumors in rectum and distal colon by expert endoscopists: a feasibility study. Tech Coloproctol 2020; 24:1293-1299. [PMID: 32815048 PMCID: PMC7661416 DOI: 10.1007/s10151-020-02308-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/13/2020] [Indexed: 12/28/2022]
Abstract
Background Colorectal endoscopic submucosal dissection (ESD) is an effective but challenging procedure. To facilitate ESD, several methods that apply traction are available; however, the optimal one remains to be established. The aim of this study was to evaluate the feasibility and safety of the double-endoscope assisted ESD (DEA-ESD) by improving traction to treat complex colorectal lesions. Methods Naïve or previously treated lesions in the rectum and sigmoid colon were included. A grasping forceps advanced through a small-caliber endoscope (GIF-XP190N, Olympus Medical Systems, Tokyo, Japan, 5.4 mm outer diameter) was used to apply traction to the mucosal flap. Lesions were deemed complex when they exceeded a total of nine points on the SMSA scoring system (size, morphology, site, and access) and recurrent when they were previously treated with endoscopic mucosal resection (EMR). Outcome measures included procedural success, total procedure time, complications, and recurrence rate at 3-month follow-up. Results Nine patients (mean age 62.3 ± 14.5 years) were included; five had rectal and four had tumors in the sigmoid colon. The median SMSA score was 14 (SMSA Level IV—complex polyp), while three patients were pre-treated with EMR. DEA-ESD was technically feasible in all cases. En bloc resection and R0 resection rates were 100%, respectively, with a mean procedure time of 128.4 ± 54.1 min. No immediate or delayed complications occurred. Conclusions DEA-ESD is a feasible and safe method for treating complex or recurrent tumors in the rectum and distal colon. Electronic supplementary material The online version of this article (10.1007/s10151-020-02308-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Ebigbo
- Department of Gastroenterology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany.
| | - G Tziatzios
- Department of Gastroenterology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - S K Gölder
- Department of Gastroenterology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - A Probst
- Department of Gastroenterology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - H Messmann
- Department of Gastroenterology, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
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8
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Soman M, Arun S, Gehlot A, Mohan R, Nair U, Mohan A. Indocyanine green angiography and multimodal imaging in a case of torpedo maculopathy. Indian J Ophthalmol 2020; 68:1448-1449. [PMID: 32587189 PMCID: PMC7574111 DOI: 10.4103/ijo.ijo_2277_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manoj Soman
- Department of Vitreo-Retina, Chaithanya Eye Hospital and Research Institute; CITE, Trivandrum, India
| | - Sheera Arun
- Department of Vitreo-Retina, Chaithanya Eye Hospital and Research Institute, Trivandrum, India
| | - Anshuman Gehlot
- Department of Vitreo-Retina, Chaithanya Eye Hospital and Research Institute, Trivandrum, India
| | - Rejina Mohan
- Department of Vitreo-Retina, Chaithanya Eye Hospital and Research Institute, Trivandrum, India
| | - Unnikrishnan Nair
- Department of Vitreo-Retina, Chaithanya Eye Hospital and Research Institute; CITE, Trivandrum, India
| | - Ashwin Mohan
- Department of Vitreo-Retina, Chaithanya Eye Hospital and Research Institute; CITE, Trivandrum, India
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9
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Galli M, Andreotti F, D'Amario D, Vergallo R, Montone RA, Niccoli G, Crea F. Randomised trials and meta-analyses of double vs triple antithrombotic therapy for atrial fibrillation-ACS/PCI: A critical appraisal. Int J Cardiol Heart Vasc 2020; 28:100524. [PMID: 32435688 PMCID: PMC7229495 DOI: 10.1016/j.ijcha.2020.100524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 12/21/2022]
Abstract
The optimal antithrombotic regimen to be used in patients with AF and PCI or ACS is still debated. Each of the six randomised controlled trials comparing double to triple therapy has limitations. None was powered to assess differences between treatment arms in ischaemic event rates. The contrasting results regarding ischaemic events within published meta-analyses can be explained by heterogeneity, incompleteness and varying definitions of stent thrombosis. The overall reduced bleeding rates, but increased early definite and probable stent thrombosis rates with double versus triple antithrombotic therapy encourage consideration of triple therapy during the first weeks from PCI followed by double therapy.
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Affiliation(s)
- Mattia Galli
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Felicita Andreotti
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico D'Amario
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Rocco Vergallo
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Rocco A Montone
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Giampaolo Niccoli
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Crea
- Department of Cardiovascular Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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10
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Leese C, Bresnahan R, Doran C, Simsek D, Fellows AD, Restani L, Caleo M, Schiavo G, Mavlyutov T, Henke T, Binz T, Davletov B. Duplication of clostridial binding domains for enhanced macromolecular delivery into neurons. Toxicon X 2020; 5:100019. [PMID: 32140681 PMCID: PMC7043326 DOI: 10.1016/j.toxcx.2019.100019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/25/2019] [Accepted: 12/19/2019] [Indexed: 12/03/2022] Open
Abstract
Neurological diseases constitute a quarter of global disease burden and are expected to rise worldwide with the ageing of human populations. There is an increasing need to develop new molecular systems which can deliver drugs specifically into neurons, non-dividing cells meant to last a human lifetime. Neuronal drug delivery must rely on agents which can recognise neurons with high specificity and affinity. Here we used a recently introduced ‘stapling’ system to prepare macromolecules carrying duplicated binding domains from the clostridial family of neurotoxins. We engineered individual parts of clostridial neurotoxins separately and combined them using a strong alpha-helical bundle. We show that combining two identical binding domains of tetanus and botulinum type D neurotoxins, in a sterically defined way by protein stapling, allows enhanced intracellular delivery of molecules into neurons. We also engineered a botulinum neurotoxin type C variant with a duplicated binding domain which increased enzymatic delivery compared to the native type C toxin. We conclude that duplication of the binding parts of tetanus or botulinum neurotoxins will allow production of high avidity agents which could deliver imaging reagents and large therapeutic enzymes into neurons with superior efficiency. Macromolecules carrying duplicated clostridial binding domains (Hc) were produced. Double tetanus Hc increased protein delivery into cultured rodent neurones. Double tetanus Hc increased enzyme delivery into rodent spinal cord and brain area. Double BoNT/D Hc increased enzyme delivery into rat and human neurones in culture. Recombinant double-Hc BoNT/C was engineered, increasing delivery in cell cultures.
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Affiliation(s)
- Charlotte Leese
- Department of Biomedical Science, University of Sheffield, Sheffield, S10 2TN, UK
| | - Rebecca Bresnahan
- Department of Biomedical Science, University of Sheffield, Sheffield, S10 2TN, UK
| | - Ciara Doran
- Department of Biomedical Science, University of Sheffield, Sheffield, S10 2TN, UK
| | - Deniz Simsek
- Department of Biomedical Science, University of Sheffield, Sheffield, S10 2TN, UK
| | - Alexander D Fellows
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Laura Restani
- CNR Neuroscience Institute, Pisa, 1-56124 Pisa, Italy
| | - Matteo Caleo
- CNR Neuroscience Institute, Pisa, 1-56124 Pisa, Italy
| | - Giampietro Schiavo
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.,UK Dementia Research Institute, University College London, London, WC1E 6BT, UK
| | - Timur Mavlyutov
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Tina Henke
- Institute of Cellular Biochemistry, Hannover Medical School, Hannover, 30625, Germany
| | - Thomas Binz
- Institute of Cellular Biochemistry, Hannover Medical School, Hannover, 30625, Germany
| | - Bazbek Davletov
- Department of Biomedical Science, University of Sheffield, Sheffield, S10 2TN, UK
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Collazo-Gutiérrez N, de Jesús O, Villamil-Jarauta M, Alvarado M, González L, Ramírez M, Carlo-Chevere VJ. Double Pituitary Adenomas with Synchronous Somatotroph and Corticotroph Clinical Presentation of Acromegaly and Cushing's Disease. World Neurosurg 2019; 132:161-164. [PMID: 31505284 DOI: 10.1016/j.wneu.2019.08.224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Double pituitary adenomas are a rare occurrence. Synchronous clinical manifestation is extremely rare. CASE DESCRIPTION We report a case of a 51-year-old female with symptoms of both hypercortisolism and acromegaly during the past 2 years. Endocrine evaluation confirmed active acromegaly and revealed adrenocorticotropin hormone-dependent hypercortisolemia. Preoperative magnetic resonance imaging of the pituitary demonstrated separated double microadenomas with different intensity. Immunohistochemical analysis of each separate adenoma confirmed an exact diagnosis. The diagnosis of acromegaly and adrenocorticotropin hormone-dependent Cushing's disease was confirmed. CONCLUSIONS This is the third reported case in the literature of synchronous clinical manifestation of acromegaly and Cushing's disease. Extensive surgical exploration of the sella must be performed to avoid surgical failures from residual tumor. Immunohistochemical analysis is required to confirm an exact diagnosis for each of the double pituitary adenomas.
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Affiliation(s)
| | - Orlando de Jesús
- Section of Neurosurgery, University of Puerto Rico, San Juan, Puerto Rico.
| | | | - Milliette Alvarado
- Section of Endocrinology, University of Puerto Rico, San Juan, Puerto Rico
| | - Loida González
- Section of Endocrinology, University of Puerto Rico, San Juan, Puerto Rico
| | - Margarita Ramírez
- Section of Endocrinology, University of Puerto Rico, San Juan, Puerto Rico
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SahraNavard B, Hudson PW, de Cesar Netto C, Wills BW, Araoye IB, Bergstresser S, Cone BM, Shah A. A comparison of union rates and complications between single screw and double screw fixation of sliding calcaneal osteotomy. Foot Ankle Surg 2019; 25:84-89. [PMID: 29409301 DOI: 10.1016/j.fas.2017.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/03/2017] [Accepted: 08/28/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND The number of screws used for sliding calcaneal osteotomy fixation has not been examined in the literature. The purpose of this paper is to examine this topic. METHODS Retrospective chart review was performed on 190 patients who met selection criteria. We compared complication risk for single versus double screw, headed versus headless screw, and short versus longitudinal incision cases. RESULTS The mean age was 48.4 (18-83) years and average follow up was 28 (12-150) weeks. All cases achieved radiographic union. Overall complication rate was 19.5% (37/190). Risk of complication did not differ significantly between single and double screw (RR: 1.170; 95% CI: 0.66-2.09; p=0.594) or short and extended incision groups (RR: 0.868; 95% CI: 0.42-1.80; p=0.704). Risk of complication differed significantly between headed and headless screw fixation (RR: 5.558; 95% CI: 2.69-11.50; p<0.0001). CONCLUSIONS Single screw fixation of sliding calcaneal osteotomy achieves similar outcomes as double screw fixation. Headless screws are advantageous for minimizing hardware pain and subsequent hardware removal.
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Affiliation(s)
- Bahman SahraNavard
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Parke W Hudson
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Cesar de Cesar Netto
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Bradley W Wills
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Ibukunoluwa B Araoye
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Shelby Bergstresser
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Brent M Cone
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
| | - Ashish Shah
- University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA.
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13
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Carroll MK, Carroll K, Rheinstein J, Highsmith MJ. FUNCTIONAL DIFFERENCES OF BILATERAL TRANSFEMORAL AMPUTEES USING FULL-LENGTH AND STUBBY-LENGTH PROSTHESES. Technol Innov 2018; 20:75-83. [PMID: 31788157 DOI: 10.21300/20.1-2.2018.75] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many unilateral amputations are followed by a contralateral amputation within three years, sometimes presenting as bilateral transfemoral amputations. Bilateral transfemoral amputees that successfully use prostheses are an understudied patient population. This study establishes reference values for this population in users of short non-articulating (stubby) or full-length articulating prostheses. Anthropometric and demographic information was collected from participants. Additionally, participants completed a self-reported Prosthesis Evaluation Questionnaire-Mobility Subscale 12/5 (PEQ-MS) and performed multiple physical mobility tests, including walking tests and the multi-directional Four Square Step Test (FSST). Full-length users rated their abilities to complete the PEQ-MS tasks as less difficult than stubby users in eight of the 12 items. Gait analysis revealed a greater amount of time is spent in stance phase with a greater portion in double limb support for both user groups, and a greater percentage in stance phase for the subject-reported dominant limb. Stubby users' gait velocity had a significant reduction from that of their full-length peers; however, cadence was similar between groups. Both user groups completed the FSST at comparable times. These outcomes may be of benefit for identifying tasks bilateral transfemoral prosthetic users may find to be most difficult as well as for identifying normal ambulation patterns within this population. Future studies with a greater number of subjects would enable these results to be further generalized.
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Affiliation(s)
- Michael K Carroll
- Orlando VA Medical Center, U.S. Department of Veterans Affairs, Orlando, FL, USA.,College of Medicine, University of Central Florida, Orlando, FL, USA
| | | | | | - M Jason Highsmith
- Extremity Trauma & Amputation Center of Excellence, U.S. Department of Veterans Affairs, Tampa, FL, USA.,School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA.,319 Minimal Care Detachment, U.S. Army Reserves (SP Corps), Pinellas Park, FL, USA
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Baron F, Ruggeri A, Beohou E, Labopin M, Mohty M, Blaise D, Cornelissen JJ, Chevallier P, Sanz G, Petersen E, Savani BN, Gluckman E, Nagler A. Single- or double-unit UCBT following RIC in adults with AL: a report from Eurocord, the ALWP and the CTIWP of the EBMT. J Hematol Oncol 2017. [PMID: 28637512 PMCID: PMC5479038 DOI: 10.1186/s13045-017-0497-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background The feasibility of cord blood transplantation (CBT) in adults is limited by the relatively low number of hematopoietic stem/progenitor cells contained in one single CB unit. The infusion of two CB units from different partially HLA-matched donors (double CBT) is frequently performed in patients who lack a sufficiently rich single CB unit. Methods We compared CBT outcomes in patients given single or double CBT following reduced-intensity conditioning (RIC) in a retrospective multicenter registry-based study. Inclusion criteria included adult (≥18 years) patients, acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), complete remission (CR) at the time of transplantation, first single (with a cryopreserved TNC ≥ 2.5 × 107/kg) or double CBT between 2004 and 2014, and RIC conditioning. Results Data from 534 patients with AML (n = 408) or ALL (n = 126) receiving a first single (n = 172) or double (n = 362) CBT were included in the analyses. In univariate analysis, in comparison to patients transplanted with a single CB, double CB recipients had a similar incidence of neutrophil engraftment but a suggestion for a higher incidence of grade II–IV acute GVHD (36 versus 28%, P = 0.08). In multivariate analyses, in comparison to single CBT recipients, double CBT patients had a comparable incidence of relapse (HR = 0.9, P = 0.5) and of nonrelapse mortality (HR = 0.8, P = 0.3), as well as comparable overall (HR = 0.8, P = 0.17), leukemia-free (HR = 0.8, P = 0.2) and GVHD-free, relapse-free (HR = 1.0, P = 0.3) survival. Conclusions These data failed to demonstrate better transplantation outcomes in adult patients receiving double CBT in comparison to those receiving single CBT with adequate TNC after RIC. Electronic supplementary material The online version of this article (doi:10.1186/s13045-017-0497-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Frédéric Baron
- Department of Hematology, University of Liege, CHU Sart-Tilman, 4000, Liege, Belgium.
| | - Annalisa Ruggeri
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.,AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - Eric Beohou
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - Myriam Labopin
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - Mohamad Mohty
- AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - Didier Blaise
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - Jan J Cornelissen
- Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | - Guillermo Sanz
- Servicio de Hematologia, Hospital Universitario La Fe, Valencia, Spain
| | - Eefke Petersen
- Department of Hematology, University Medical Centre, Utrecht, The Netherlands
| | - Bipin N Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eliane Gluckman
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco, Monaco
| | - Arnon Nagler
- EBMT Paris Office, Hospital Saint Antoine, Paris, France.,Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel and the EBMT Paris Office, Hospital Saint Antoine, Paris, France
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15
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Menekse G, Celik H, Bayar MA. Giant Parietal Encephalocele with Massive Brain Herniation and Suboccipital Encephalocele in a Neonate: An Unusual Form of Double Encephalocele. World Neurosurg 2016; 98:867.e9-867.e11. [PMID: 27867118 DOI: 10.1016/j.wneu.2016.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 11/16/2022]
Abstract
Double encephalocele is extremely rare. We present an unusual form of double encephalocele including giant supratentorial and small infratentorial encephalocele in a neonate.
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Affiliation(s)
- Guner Menekse
- Department of Neurosurgery, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Haydar Celik
- Department of Neurosurgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mehmet Akif Bayar
- Department of Neurosurgery, Ankara Training and Research Hospital, Ankara, Turkey
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16
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Inchauspe AA. Can PC-9 Zhong chong replace K-1 Yong quan for the acupunctural resuscitation of a bilateral double-amputee? Stating the “random criterion problem” in its statistical analysis. World J Crit Care Med 2016; 5:143-149. [PMID: 27152257 PMCID: PMC4848157 DOI: 10.5492/wjccm.v5.i2.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/13/2015] [Accepted: 01/19/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To present an inclusion criterion for patients who have suffered bilateral amputation in order to be treated with the supplementary resuscitation treatment which is hereby proposed by the author.
METHODS: This work is based on a Retrospective Cohort model so that a certainly lethal risk to the control group is avoided.
RESULTS: This paper presents a hypothesis on acupunctural PC-9 Zhong chong point, further supported by previous statistical work recorded for the K-1 Yong quan resuscitation point.
CONCLUSION: Thanks to the application of the resuscitation maneuver herein proposed on the previously mentioned point, patients with bilateral amputation would have another alternative treatment available in case basic and advanced CPR should fail.
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17
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Sharma S, Ojha BK, Chandra A, Singh SK, Srivastava C. Parietal and occipital encephalocele in same child: A rarest variety of double encephalocele. Eur J Paediatr Neurol 2016; 20:493-6. [PMID: 26876766 DOI: 10.1016/j.ejpn.2015.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 11/14/2015] [Accepted: 12/06/2015] [Indexed: 10/22/2022]
Abstract
An encephalocele is a protrusion of the brain and/or meninges through a defect in the skull. Based on the location of the skull defect they are classified into sincipital, basal, occipital or parietal varieties. Occurrence of more than one Encephalocele in a patient is very rare and very few cases of double encephalocele are reported. We report an interesting case where a parietal and an occipital encephalocele were present together. The patient was a 2 months boy who was brought to us with complaints of two swelling on the scalp since birth. Neuroimaging studies confirmed it to be a case of double encephalocele. The rarity of the findings prompted us to report this case. The presentation and management of the case along with and review of the relevant literature is presented.
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Affiliation(s)
- Somnath Sharma
- Department of Neurosurgery, King George's Medical University, Chowk, Lucknow, U.P. 226003, India.
| | - Bal Krishan Ojha
- Department of Neurosurgery, King George's Medical University, Chowk, Lucknow, U.P. 226003, India.
| | - Anil Chandra
- Department of Neurosurgery, King George's Medical University, Chowk, Lucknow, U.P. 226003, India.
| | - Sunil Kumar Singh
- Department of Neurosurgery, King George's Medical University, Chowk, Lucknow, U.P. 226003, India.
| | - Chhitij Srivastava
- Department of Neurosurgery, King George's Medical University, Chowk, Lucknow, U.P. 226003, India.
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18
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Manoğlu B, Yılmaz EM, Erdoğan A, Özkan MB, Özçiftci VM. Report of a rare case: Double recurrent laryngeal nerve. Ulus Cerrahi Derg 2015; 32:298-299. [PMID: 28149132 DOI: 10.5152/ucd.2015.2910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/24/2014] [Indexed: 11/22/2022]
Abstract
One of the most important and feared complications of thyroid and parathyroid surgery is injury to the recurrent laryngeal nerve. The main reason for this type of injury is anatomical variations. Currently, nerve monitoring is being widely used to reduce complications due to the high variation rate. However, it is not being used extensively in our country, due to cost related issues. In this case, we present a left sided double recurrent laryngeal nerve.
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Affiliation(s)
- Berke Manoğlu
- Department of General Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Eyüp Murat Yılmaz
- Department of General Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ahmet Erdoğan
- Clinic of General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Murat Bulut Özkan
- Clinic of General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey
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19
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Jagodzinski NA, Parsons AMJ, Parsons SW. Arthroscopic triple and modified double hindfoot arthrodesis. Foot Ankle Surg 2015; 21:97-102. [PMID: 25937408 DOI: 10.1016/j.fas.2014.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 10/11/2014] [Accepted: 10/17/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Arthroscopic arthrodesis is an accepted technique for the ankle but less commonly reported for multiple hindfoot joints. We present a case series review to establish the feasibility of this surgery. METHODS In a consecutive series of 112 arthroscopic hindfoot arthrodeses, 18 involved decortication and fusion of 2 or 3 hindfoot joints. These were reviewed to identify complications, union rates and improvement over preoperative state. RESULTS Mean age was 62 (45-78). Mean follow-up was 4.4 (1.75-7.5) years. There were no perioperative complications. The four patients with triple fusions united with good or excellent outcomes. Of 14 patients with subtalar and talonavicular arthrodeses there were three talonavicular non-unions. CONCLUSIONS Arthroscopic double and triple arthrodeses appear feasible salvage options for pain and deformity. Decortication of all three joints and rotatory correction of deformity is possible whilst preserving the soft tissue envelope. Late adjacent joint pain and arthrosis can occur.
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Affiliation(s)
| | | | - S W Parsons
- The Royal Cornwall Hospital, Truro, United Kingdom
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20
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Rajeev A, Noureldin S, Graham D. Floating thumb with double dislocation of carpometacarpal and metacarpo-phalangeal joints. Int J Surg Case Rep 2014; 5:1102-5. [PMID: 25437649 PMCID: PMC4276275 DOI: 10.1016/j.ijscr.2014.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 11/10/2014] [Accepted: 11/10/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Double dislocations of carpometacarpal and metacarpo-phanlageal joints are rare. We report an unusual case of simultaneous dislocation of both CMC and MCP joints in the thumb. PRESENTATION OF CASE A 31 year old male was admitted following a road traffic accident. He was complaining of pain and deformity of right thumb. The X-ray examination revealed simultaneous dislocation of both CMC and MCP joints. He underwent closed manipulative reduction and percutaneous K wire fixation. The wires were removed after six weeks. After a course of physiotherapy he regained full range of pain free movements. DISCUSSION The incidence of simultaneous dislocation of both CMC and MCP joints in thumb are associated with high energy injuries. The options of treatment are conservative with cast immobilisation and serial X-rays or operative including closed manipulative reduction and K wire fixation or open reduction and internal fixation. CONCLUSION The option of treating this rare injury with closed manipulative reduction and percutaneous K wiring gives excellent and predictable results.
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Affiliation(s)
- Aysha Rajeev
- Department of Trauma and Orthopaedics, Queen Elizabeth Hopsital, Gateshead NE9 6SX, UK.
| | - Soliman Noureldin
- Department of Trauma and Orthopaedics, Queen Elizabeth Hopsital, Gateshead NE9 6SX, UK
| | - David Graham
- Department of Trauma and Orthopaedics, Queen Elizabeth Hopsital, Gateshead NE9 6SX, UK
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21
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Hashem H, Lazarus HM. Double umbilical cord blood transplantation: relevance of persistent mixed-unit chimerism. Biol Blood Marrow Transplant 2014; 21:612-9. [PMID: 25230381 DOI: 10.1016/j.bbmt.2014.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 09/06/2014] [Indexed: 01/12/2023]
Abstract
Double umbilical cord blood transplantation (UCBT) was developed as a strategy to circumvent the cell dose limitation of single UCBT with a concomitant potential benefit of lowering the rate of leukemia relapse. Sustained hematopoiesis after double UCBT usually is derived from a single donor unit, as only a few patients have been reported to display stable mixed-unit chimerism for varying periods of time. Explanations for the 1 unit dominance, predictors for identifying unit superiority, and persistence of long-term mixed-unit chimerism remain elusive. Review of published literature revealed only 11 of 280 patients (4%) with mixed-unit chimerism for at least 1 year after transplantation, with 3 patients receiving reduced-intensity conditioning regimens. Mixed-unit chimerism was more likely if both units were closely HLA matched to each other. Outcome data for patients with stable mixed-unit chimerism, for the most part, were scarcely reported. Analysis of the small sample size revealed a potential advantage of stable mixed-unit chimerism on enhancing the graft-versus-leukemia effect; however, definitive conclusions cannot be made on the effect of mixed-unit chimerism on the rates of graft-versus-host disease. Therefore, gathering outcome data prospectively in larger clinical series will help answer the question of whether stable mixed-unit chimerism is either beneficial and, therefore, should be strived for, detrimental and, thus, needs to be eliminated, or if it is of no clinical consequence.
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Affiliation(s)
- Hasan Hashem
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Hillard M Lazarus
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
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Abstract
Double gallbladder is a rare embryological anomaly of clinical significance. Despite availability of modern imaging, only 50% of recently reported cases had preoperative diagnosis, which is desirable in every case to avoid serious operative complications. Double pathology in double gallbladder is extremely rare with only 3 reporting's available till date to the best of author's knowledge. With a preoperative diagnosis of double gallbladder, laparoscopic cholecystectomy can be safely and successfully performed with meticulous dissection, aided by operative cholangiogram. However in all such attempts a lower threshold should be kept for conversion to open surgery. Awareness about this anomaly amongst radiologists and surgeons is of crucial importance. Double gallbladder does not present with any specific symptom, neither it increases disease possibility in either lobe. Prophylactic cholecystectomy has no role in asymptomatic cases diagnosed accidentally. Author reports a case of a symptomatic young male with double gallbladder who presented with short history of dyspepsia, abdominal pain and fever. Definite preoperative diagnosis was reached with ultrasound scan and magnetic resonance cholangio pancreatography and subsequently dealt with laparoscopically. Calculous cholecystitis affected one lobe and acalculous empyema the other. While the 1st lobe drained though a cystic duct into common bile duct (CBD), the 2nd was without any communication with either CBD or its counterpart, thus remained as a blind vesicle.
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Affiliation(s)
- Sumanta Kumar Ghosh
- Department of Surgery ESIC Medical College, Joka, Kolkata, West Bengal, India
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Botchu R, Retnasingam G, Raj V, Husainy MA, Jakanani G, Rao B, Entwisle J. Is There a Role of Double Reporting and CT Pelvis for Lung Cancer Staging? World J Oncol 2012; 3:54-58. [PMID: 29147280 PMCID: PMC5649889 DOI: 10.4021/wjon492w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2012] [Indexed: 11/20/2022] Open
Abstract
Background Lung cancer is the most common cancer in the world. Staging of lung cancer involves CT of chest and abdomen. Subsequently these are discussed in MDT and if required PET imaging is arranged. We have performed a study to assess double reporting of the initial staging CT would identify in field metastasis and hence decrease the use of PET. Methods A refined search from the lung cancer database over 2 years of 980 patients was performed. Metastasis identified on PET (SUV > 2.5) was nominated as the gold standard, 219 patients had both PET and staging CT (chest and abdomen) with 38 patients having metastasis on both PET and CT. CT images were reviewed by two independent radiologist who were blinded to the report. Identified metastases were graded if identified. These were grade as 1- definite, 2- equivocal, 3- normal. Subsequently through a process of arbitration a combined decision about the in field metastasis was achieved. Results There were 21 metastasis which were within the field of chest and abdomen (in field metastasis). Only a half of these were identified by blinded observers. Following an arbitration there was no significant improvement in the pick up rate. There were 19 out of field metastasis in 15 patients out of this cohort. Majority of these (72%) were in the bony pelvis which would have been reported if a CT pelvis was performed as a part of staging. We estimate that one would have to perform 10 CT pelvises to save one PET-CT. Conclusion Double reading of staging scan would not identify all infield metastasis. The increased contrast in PET images makes it easy to spot metastases. Hence there is no role for double reporting of staging CT in lung cancer management. Inclusion of pelvis in staging of lung cancer may be effective and would improve the detection of out of field metastases hence decreasing the use of PET.
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Affiliation(s)
- Rajesh Botchu
- Department of Radiology, GlenfIeId Hospitals, Glenfield, Leicester, UK
| | | | - Vimal Raj
- Department of Radiology, GlenfIeId Hospitals, Glenfield, Leicester, UK
| | | | - George Jakanani
- Department of Radiology, GlenfIeId Hospitals, Glenfield, Leicester, UK
| | - Balaji Rao
- Department of Radiology, GlenfIeId Hospitals, Glenfield, Leicester, UK
| | - James Entwisle
- Department of Radiology, GlenfIeId Hospitals, Glenfield, Leicester, UK
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