Superior ophthalmic vein thrombosis (SOVT) is an extremely rare condition. Few studies have been published about clinical aspects of this condition. In this study, we have studied the symptoms, underlying etiologies, treatment, pathogenesis and complication of the SOVT and we tried to classify it based on the etiology, treatment, and prognosis. Methods: We reviewed the patients' data from a tertiary academic referral center. Each patient with SOVT was then reviewed for symptoms associated with SOVT, underlying etiology, treatment protocol, treatment response, complications, possible pathogens, and final outcome. Results: Twenty-four cases of SOVT were included in this study. Overall, 13 cases were diagnosed as right-sided SOVT, out of which, eight had simultaneous right-sided cavernous sinus thrombosis (CST). Eighteen cases were diagnosed to have left-sided SOVT, out of which, 11 had simultaneous left-sided CST. Conclusions: The SOVT can be secondary to different mechanisms. The SOVT secondary to trauma, recent surgery and coagulopathy are mostly non-aggressive, and can be managed by conservative therapy and anticoagulation. The SOVT in patients with orbital cellulitis, history of active sinusitis or paranasal sinus surgery are aggressive presenting with acute orbital swelling, abscess and visual loss. This type of SOVT can be complicated by extension to the cavernous sinus and intracranial structures. These patients require urgent antibiotics therapy and sinus surgery. The most severe type of SOVT is caused by mucormycosis which may also extend intracranially resulting in stroke and is often life-threatening.

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The aim of this study is to compare the outcomes of the elective-start versus urgent-start use of peritoneal dialysis (PD) catheters using percutaneous radiologic or laparoscopic techniques. Patients having their first peritoneal dialysis catheter placed and used between January 2005 and January 2018 were identified, and their medical records were retrospectively reviewed. Two groups were identified: elective-start (n = 211) and urgent-start (n = 29). Patient’s demographics were similar between the two groups with the exception of age, which was higher in the elective-start group. The catheter complication rates and catheter removal rates at 3 and 12 months, mean days-to-first complication, mean days-to-catheter removal, and overall patient survival at 12 months were analyzed. Catheter complication rates at 3 and 12 months were similar between the two groups (27.8% and 48.9%, respectively, in the elective-start group versus 35.9% and 54.2%, respectively, in the urgent-start group, p=0.415). The catheter removal rates at 3 and 12 months were also similar between the two groups (p=0.088). Catheter leak was higher in the urgent-start group (13.8% versus 3.3%, respectively, p=0.011). There was no difference between the elective-start and the urgent-start groups in the mean days-to-first complication (95 vs 69, p=0.086), mean days-to-catheter removal (145 vs 127, p=0.757), and overall patient survival at 12 months (100% vs 97%, p=0.41). In conclusion, apart from catheter leak, there were similar rates of catheter complication and removal for PD catheter used for the elective-start compared to the urgent-start PD. Furthermore, the technique of placement did not affect the outcomes.

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and progress-free survival. However, it fails to control the duration of disease prior to presenting for liver directed therapy (LDT). Our study aims to identify potential lead time (L-T) bias that may affect therapy choice and subsequent outcomes. Materials: We reviewed 51 NELM who underwent LDT from 2012-2016 at our institution. Therapy paradigms (Tx) included Y90, cTACE, or mixed. Data collection included L-T from diagnosis to first presentation of LDT, survival duration from first LDT, age, gender, prior hepatectomy, prior octreotide or other chemotherapy, tumor burden, dominate lesion size, lobe involvement, and presence of extrahepatic metastasis. A Cox Regression with a backwards-likelihood ratio (threshold p < 0.10 for inclusion) analysis was performed for L-T and the duration of survivability after first LDT, controlling for the above factors. Results: For L-T, factors meeting threshold criteria included Tx (p ¼ 0.06), prior surgery (p ¼ 0.05), prior octreotide (p ¼ 0.007), dominant lesion size (p ¼ 0.03), multiplicity (p ¼ 0.02), and extrahepatic metastasis (p ¼ 0.09). For Tx, cTACE (24.3 months, p ¼ 0.04) and Mixed (32.6 months, p ¼ 0.06) had earlier presentations when compared to Y90 (52 months). For survivability, factors meeting threshold criteria were Tx (p ¼ 0.08), prior octreotide (p ¼ 0.04), any chemotherapy (p ¼ 0.02), and dominant lesion size (p ¼ 0.008). For Tx, cTACE (30.3 months, p ¼ 0.6) and Mixed (28.2 months, p ¼ 0.02) had longer survivability compared to Y90 (20.4 months). An ad hoc survival analysis accounting for L-T did not alter the above survivability outcomes. Conclusions: Our analysis agrees that cTACE-only may be a superior Tx than Y90-only, but also shines light that a mixed Tx may be even more efficacious in term of survivability than either alone. While Tx was an important factor predicting L-T, L-T does not influence the outcomes in our survivability analysis suggesting that a L-T bias is not present.

The annual volume of vertebral augmentation declined in 2009 following two negative trials on vertebroplasty. While these publications had a persistent negative impact on practice of vertebroplasty, the overall frequency of vertebral augmentation in the Medicare population has not changed significantly between 2005 to 2015. Instead, there has been a significant shift in provider practice patterns in favor of kyphoplasty in increasingly outpatient and office-based settings.

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