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1.
Improvement in Tricuspid Annular Plane Systolic Excursion with Pulmonary Hypertension Therapy in Pediatric Patients 下载免费PDF全文
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Background
Despite significant pain relief following total hip arthroplasty (THA) in patients with ankylosing spondylitis, a small subset of patients presenting with extra-articular extension contracture of hips remains unsatisfied.Methods
We retrospectively evaluated the patients with ankylosing spondylitis who underwent simultaneous bilateral THA and had extensor tightness of both hips preoperatively. They were managed with modified Z-plasty of iliotibial band. Patients with windswept deformity, commonly seen in bilateral hip arthritis caused by ankylosing spondylitis, were excluded.Results
Between July 2011 and June 2015, out of 148 patients with bilateral hip involvement, 10 patients (20 hips) had extension contracture of both hips that was addressed during surgery. All patients were followed up for a minimum of 2 years. They could sit comfortably on a chair of height 18 inches with hips and knees flexed to at least 90°. The mean postoperative sum range of motion was 144.6° with an average hip flexion of 95° (range, 90°-105°). None of them had recurrence of extension contracture. There was significant improvement in range of motion and hence ambulation and function. No radiolucent lines exceeding 2 mm were seen in any of the zones around either of the components as evaluated in latest X-rays.Conclusion
Extension contracture of hip although rare is a noticeable problem and needs to be addressed during THA. Modified Z-plasty technique of iliotibial band is a reliable method in managing these patients. 相似文献4.
Uday Yanamandra Prateek Deo Kamal Kant Sahu Ram Vasudevan Nampoothiri Nalini Gupta Anusree Prabhakaran Deb Prasad Dhibhar Alka Khadwal Gaurav Prakash Man Upadesh Singh Sachdeva Deepesh Lad Neelam Varma Subhash Varma Pankaj Malhotra 《Clinical Lymphoma, Myeloma & Leukemia》2019,19(3):183-189.e1
Background
Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.Patients and Methods
In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.Results
Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.Conclusion
MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis. 相似文献5.
Rajesh Verma Puneet Kumar Dixit Rakesh Lalla Babita Singh 《Annals of Indian Academy of Neurology》2015,18(2):246-248
Mirror movements are simultaneous, involuntary, identical movements occurring during contralateral voluntary movements. These movements are considered as soft neurologic signs seen uncommonly in clinical practice. The mirror movements are described in various neurological disorders which include parkinsonism, cranio veretebral junction anamolies, and hemiplegic cerebral palsy. These movements are intriguing and can pose significant disability. However, no such observation regarding mirror movements in progressive hemifacial atrophy have been reported previously. We are reporting a teenage girl suffering from progressive hemifacial atrophy and epilepsy with demonstrable mirror movements in hand. 相似文献
6.
Rajesh Bhat Alison Severn Sam Chakraverty 《Nephrology, dialysis, transplantation》2006,21(9):2642-2643
Placement of tunnelled dialysis lines is effective using ultrasoundand fluoroscopic guidance [1] and has a higher success ratethan blind insertion [2]. After the ultrasound guided access into a neck vein, wires andcatheters are guided in to a suitable position in the 相似文献
7.
Ajay Punpale C S Pramesh Nirmala Jambhekar Rajesh C Mistry 《Annals of thoracic and cardiovascular surgery》2006,12(6):425-427
Liposarcomas are extremely rare in the mediastinum. They may achieve considerable size before causing any symptoms. Mediastinal liposarcomas may invade surrounding structures like the pericardium or the superior vena cava. Complete surgical excision is the optimal treatment in resectable cases. Excision of adjacent structures like the pericardium may be needed if the tumor infiltrates them. We report on a case of a giant liposarcoma of the mediastinum involving both hemithoraces and extending into the neck, which was successfully managed by complete surgical excision. 相似文献
8.
Joe Jacob Shibhu George B. R. Suchit Roy P. U. Rajesh 《Indian journal of otolaryngology and head and neck surgery》2006,58(1):76-77
Malignancy larynx usually presents early, the common symptoms being hoarseness, pain thorat, cough and irritation of throat. An advanced malignancy is likely to be complicated by a pharyngo-cutaneous fistula. However it is an occurrence towards the end stage of the disease. Here we present a case of malignancy larynx primarily presenting as pharyngo-cutaneous fistula without any other symptoms. 相似文献
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Uday Eknathrao Jadhav M.Ch. Raghavendra Chikkatur M.Ch. Rajesh Parida M.Ch. Susheel Kumar M.Ch. Vinod Ahuja M.Ch. Ashish Agrawal MS Anil Tendolkai M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):116-120
Introduction Coronary artery bypass grafting (CABG) associated with Endarterectomy is a high risk procedure. After the first report of
coronary endarterectomy by Bailey et al in 1951, the preference for this surgical procedure was decreased due to increased
morbidity and mortality In patients with total or subtotal large coronary artery obstructions in which there is no possibility
to receive a conduit as graft for myocardial revascularisation, endarterectomy remains the procedure of choice. This study
was designed to study early and midterm results of off pump coronary artery endarterectomy.
Methods Of 172 Consecutive Off Pump CABG done at our institution from Jan 2003 to July 2005, 22 patients underwent supplementary coronary
endarterectomy. 16 patients had chronic stable angina 4 had unstable angina two required emergency CABG with endarterectomy
following perioperative infarction. The mean ejection fraction was 29.2±4.3 and all of the patients were in New York Heart
Association (NYHA) III or IV. All patients were planned for complete total arterial revascularisation using Left Internal
Mammary Artery (LIMA). Right Internal Mammary Artery (RIMA), Radial composite “Y” graft, Two patients operated for periop
infarct received vein graft. In 16 patients closed endarterectomy was done in five patients double endarterectomy in single
vessel was done to chase the plaque distally, in one patient open left anterior descending (LAD) endarterectomy with vein
patch reconstruction was performed.
Results There were no deaths. None of the procedures were converted to on pump operation. All endarterectomies and bypasses were performed
on Beating Heart, all patients were completely revascularised. Peri operative cardiac enzymes studied showed no significant
rise in the Creatinine Phoshpokinase (CPK)-Creatinine Phosphokinase myocardial Band (CPK-MB). The mean postoperative Ejection
Fraction (EF) was 36.7%±7.2% which was significantly higher than the Preoperative one (p<.05). At the end of four months to
one and half year 22 patients were in NYHA class I to II and all were angina free in canadian cardiovascular society class.f
Conclusions Coronary End Arterectomy without cardiopulmonary bypass can be performed in patients who are expected to benefit from complete
revascularisation. It can be performed with closed as well as open method. However to achieve complete endarterectomy by closed
technique in some patients it is essential to chase the plaque. Early and mid term results are encouraging. 相似文献