Teaguehopper6319
Avulsion fracture of the coracoclavicular ligament accompanied by upward displacement of the medial fragment of the clavicle represents a unique fracture pattern, first described by Latarjet and colleagues in 1975. Due to the function of the underlying articulations and the ligaments found in the area, this fracture pattern results in a combination of horizontal and vertical instability that must be taken into consideration when treating. Several surgical techniques have been proposed but none has been proven superior.
Herein, we present a Latarjet fracture of the distal clavicle treated with a single endobutton. A 45-year-old male underwent open surgical stabilization of distal clavicular fracture 15days after trauma. After stabilization of the fracture, we applied a single endobutton, passing through the medial fragment, inferior fragment and coracoid process. The patient was observed for 14 mo postoperative, during which time he achieved union in all three fragments of the fracture and an excellent functional clinical score.
In Latarjet fracture treatment, augmentation of the coracoclavicular ligament is the most important parameter for a favorable result.
In Latarjet fracture treatment, augmentation of the coracoclavicular ligament is the most important parameter for a favorable result.
The establishment and success of new treatments are significantly influenced by patient satisfaction. Post-operative scarring is an important outcome for patients, and subsequently influences overall satisfaction with treatment. The objective was to measure post-treatment scarring satisfaction using a novel scale, the FACE-Q Skin Cancer Module, to compare electrochemotherapy (ECT) to traditional surgical excision (SE) to demonstrate equivalence of ECT and SE regarding outcome and survivorship.
This was a multicentre first-time appraisal study of the efficacy of ECT. All patients with facial BCCs treated with either ECT or SE were deemed eligible and subsequently recruited from either a previous clinical trial or outpatient clinics, respectively. Of the 40 participants invited, 25 responses were received. Patient information recorded included age, gender, location and size of BCCs, and time since treatment. Patient outcomes were measured using the FACE-Q Skin Cancer Module.
The ECT and SE groups consisted of 14 and 11 patients, respectively. Mean age was 68 years (M
=169), while mean time since treatment was 4.98 years (range 0.3-9.58 years). Appraisal of scars was significantly higher in the ECT cohort versus SE (
=0.034). Cancer worry was equivalent across both cohorts (
=0.804). Linsitinib nmr According to treatment type, no correlation was detected between time since treatment and both appraisal of scars (ECT
=0.466 and SE
=0.214) and adverse effects (ECT
=0.924 and SE
=0.139).
Based on this study, ECT has superior scar outcomes and overall equivalence to SE. This demonstrates high patient satisfaction for those treated with ECT without any additional cancer worry.
Based on this study, ECT has superior scar outcomes and overall equivalence to SE. This demonstrates high patient satisfaction for those treated with ECT without any additional cancer worry.Paraneoplastic neurologic syndromes (PNS) are a rare heterogeneous group of disorders associated with malignancy that can result in significant functional impairment. One syndrome in particular, paraneoplastic cerebellar degeneration (PCD), may be severely disabling. PCD is a rare neurological syndrome, associated with active or subclinical cancer, characterized by acute or subacute onset cerebellar ataxia due to tumor-induced autoimmunity against cerebellar antigens. Treatment of paraneoplastic syndromes is generally unsatisfactory, but early diagnosis and treatment of PCD, which includes neurological treatment, immunotherapy and oncological treatment of associated malignancy, may improve the neurological prognosis. We reported the case of a 59-year-old woman who presented PCD as the first sign of ovarian cancer. Laboratory investigations showed the presence of anti-Yo antibodies in the serum. The brain MRI revealed specific modifications for PCD. After oncological treatment, intravenous immunoglobulin therapy and corticosteroid therapy, the oncological response was satisfactory, but no improvement of the neurologic symptoms was achieved.It is unclear if surveillance for postmenopausal women with medically inoperable stage 1 endometrial cancer (EC) should differ depending on their management strategy. Thus, we investigated the utility of surveillance endometrial sampling among 53 postmenopausal women with medically inoperable, clinical stage I, grade 1 endometrioid EC who received either progestin therapy or radiation between 2009 and 2018, at a single academic institution. Frequency and results of endometrial sampling, as well as recurrence and survival rates were studied. Of 53 patients, 18 (34.0%) received progestin therapy and 35 (66.0%) radiation. Medically managed patients were treated with megestrol acetate (27.7%), a levonorgestrel intrauterine device (27.7%), or both (44.4%). Radiated patients were mostly treated with high-dose rate brachytherapy only (77.1%). Surveillance endometrial sampling (median procedures = 4, range 1-10) was strictly adhered to among all patients who received progestin therapy, but infrequently (6/35, 17.1%) performed among radiated patients, yielding no positive results. Three recurrences occurred over the median follow-up of 38 months. Two (11%) women in the progestin therapy group recurred locally and were diagnosed by endometrial sampling. One (3%) patient in the radiation group recurred distally in the lung 25.3 months after completing brachytherapy. We conclude that appropriate surveillance for women with medically inoperable, clinical stage I, grade 1 EC depends on the management strategy. For those treated with progestins, surveillance with endometrial sampling every 3-6 months can reveal local recurrence. However, given the excellent local control after radiation, endometrial sampling may not be warranted for women treated with definitive radiation.
