Background In about 20–40% of patients, damage to the soft tissues surrounding the ankle leads to recurrent and chronic pain with signs of instability of the talus in the tibiofibular fork. Purpose The aim of the study was to assess the usefulness of stress X-ray images in the diagnosis of long-term outcomes of conservative versus surgical treatment of anterolateral ankle instability. Material and Methods Thirty patients with chronic ankle instability (CAI) were recruited for the study. The participants were divided into two groups. The first group consisted of 15 non-operatively treated individuals diagnosed with anterior talofibular ligament (ATFL) damage. The second group consisted of 15 patients who had undergone surgical reconstruction of the ATFL. In both groups of patients, the contralateral normal limb was used as a control. In all patients, anteroposterior and lateral view stress radiographs of both ankles were taken using the TELOS Stress Device (GA – III/E, Hungen, Germany). Results Statistical tests showed that the surgically treated patients had a significantly greater ankle stability compared to the non-surgically treated patients ( P = 0.001 for talar tilt angle and P = 0.009 for anterior drawer distance). The results obtained in this study indicate that this method can also be used in postoperative assessment of the function of the reconstructed lateral ankle ligaments. Conclusions Stress radiography is a reliable and safe tool for diagnosing CAI. This imaging method is an objective instrument that can be successfully used in postoperative assessment of the function of the reconstructed ATFL.
Introduction This retrospective study analyzes radiological findings, therapeutic management and outcomes of patients with intracranial extension of juvenile nasopharyngeal angiofibroma (JNA). The routes of intracranial spread, incidence of intracranial disease and influence on therapeutic approach are discussed. Material and methods An evaluation on the records of 62 patients with JNA was performed and 10 patients with intracranial tumors were included in the study. All patients were males aged 10 to 19 years. Results According to Andrews' classification 8 patients presented with stage IIIb, 1 patient stage IVa and another patient stage IVb tumor. Intracranial invasion was extradural in 8 cases and intradural in 2 patient. Surgery was performed in 9 cases and the most common was combined approach: infratemporal fossa and sublabial transantral. One patient was referred for radiotherapy. Follow-up ranged from 8 to 26 years. There was extracranial recurrence in 2 (22%) of 9 operated patients. Conclusions The superior orbital fissure is the most frequent route of intracranial spread in patients with extensive involvement of the infratemporal fossa. Due to high risk of recurrence and potential serious complications advanced cases of JNA should be managed by experienced multidisciplinary team, preferably in tertiary referral centers, with an access to modern diagnostic and therapeutic modalities.
Introduction. Thiram, a fungicides, is widely used on seeds and as foliar agent on turf, vegetables and fruit. It is also used in the rubber industry as a vulcanization accelerator. When absorbed through the respiratory system, it is rapidly metabolised to dimethylthiocarbamate and carbon disulphide, causing noxious effects. A brief review is presented of the literature, centering on the interesting case of a 45-year-old woman admitted to the hospital suffering from acute respiratory failure. Results. Computer tomography in angiographic option (angio-CT) showed an extensive, irregular area of ground glass in both upper lobes and apical segments of the lower lobes of the lungs. A significant enlargement of both atria was also described. There was no improvement after cardiac treatment and patient was transferred to the pulmonary department where she was succesfully treated with systemic glucocortycosteroids. The patient remains under the supervision of the pulmonary out-patient department.
1measuring 70 × 65 mm (FIGURE 1A). The mobile fragment of the tumor had a size of 22 × 14 mm, visible in the inflow tract of the right ventricle, increasing the risk of pulmonary embolism (FIGURE 1B). Ultrasonography showed a metastasis to the sixth rib and to the liver (FIGURE 1C and 1D). Magnetic resonance imaging (MRI) revealed a tumor measuring 82 × 71 × 114 mm, infiltrating the right atrium, tricuspid valve, narrowing A 33 -year -old pregnant woman in the 23rd week of her third pregnancy (G3P1A1: gravidity, 3; parity, 1; abortion/miscarriage, 1) was admitted to an intensive cardiac care unit due to new -onset atrial fibrillation. Laboratory results showed mild anemia, D -dimer levels of 2111 ng/ml, and β -chorionic gonadotropin levels of 6850 mIU/ ml. Transthoracic echocardiography (TTE) revealed a pathological mass in the right atrium,
total cholesterol levels, cardiovascular comorbidities, senility, severe chronic obstructive pulmonary disease, and familial tendency. 1,2 A recent study has indicated that aortic dilation may be also attributed to immunosuppressive treatment (mammalian target of rapamycin inhibitors) in renal graft recipients. 3 AAAs can be treated either conservatively or surgically. Pharmacological blood pressure control remains the main focus of conservative treatment, while the surgical approach encompasses INTRODUCTION In recent years, the increasing prevalence of abdominal aortic aneurysms (AAAs) has become a challenge for health care providers in rapidly developing countries. The rationale behind this phenomenon is a prolonged life expectancy and a widespread use of ultrasound, which is considered the fundamental diagnostic method for such evaluations. AAA affects 1.9% to 8.6% of the population above the age of 45 years, and is associated with tobacco smoking, hypertension, elevated low-density lipoprotein cholesterol and
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