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Different Management (different + management)

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Medical Sciences100%

Terms modified by Different Management

  • different management option
  • different management practice
    		•
  • different management regime
  • different management scenario
    		•
  • different management strategy

    • Selected Abstracts

    Ruptured symptomatic internal carotid artery dorsal wall aneurysm with rapid configurational change.

    EUROPEAN JOURNAL OF NEUROLOGY, Issue 10 2010
    Clinical experience, management outcome: an original article
    Background:, Aneurysms located at non-branching sites, protruding from the dorsal wall of the supraclinoid internal carotid artery (ICA) with rapid configurational changes, were retrospectively reviewed in effort to identify and characterize these high-risk aneurysms. Methods:, A total of 447 patients with 491 intracranial aneurysms were treated from March 2005 to August 2008, and of these, eight patients had ICA dorsal wall aneurysms. Four of them suffered subarachnoid hemorrhage (SAH), and all had aneurysms undergoing rapid configuration changes during the treatment course. Digital subtraction cerebral angiography (DSA) performed soon after the SAH events. Data analyzed were patient age, sex, Hunt and Kosnik grade, time interval from first DSA to second DSA, aneurysm treatment, and modified Rankin scale score after treatment for 3 months. Success or failure of therapeutic management was examined among the patients. Results:, Digital subtraction cerebral angiography showed only lesions with small bulges in the dorsal walls of the ICAs. However, the patients underwent DSA again for re-bleeding or for post-treatment follow-up, confirming the SAH source. ICA dorsal wall aneurysms with rapid growth and configurational changes were found on subsequent DSA studies. Conclusions:, Among the four patients, ICA dorsal wall aneurysms underwent rapid growth with configurational change from a blister type to a saccular type despite different management. ICA trapping including the lesion segment can be considered as the first treatment option if the balloon occlusion test (BOT) is successful. If a BOT is not tolerated by the patient, extracranial,intracranial bypass revascularization surgery with endovascular ICA occlusion is another treatment option. [source]

    Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach

    HEMATOLOGICAL ONCOLOGY, Issue 4 2009
    Cristiana Bellan
    Abstract Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an "aggressive B-cell non-Hodgkin's lymphoma", characterized by a high degree of proliferation of the malignant cells and deregulation of the c- MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of "B-cell lymphoma, unclassificable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma", now listed in the updated WHO classification. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Community-acquired febrile urinary tract infection in diabetics could deserve a different management: a case,control study

    JOURNAL OF INTERNAL MEDICINE, Issue 3 2003
    J. P. Horcajada
    Abstract., Horcajada JP, Moreno I, Velasco M, Martínez JA, Moreno-Martínez A, Barranco M, Vila J, Mensa J (Hospital Clínic Universitari-IDIBAPS, Barcelona, Spain) Community-acquired febrile urinary tract infection in diabetics could deserve a different management: a case,control study. J Intern Med 2003; 254: 280,286. Objective., To investigate if there are relevant differences in clinical, microbiological and outcome characteristics of community-acquired febrile urinary tract infection (UTI) between diabetic and nondiabetic patients. Design., A prospectively matched case,control study. Setting., An 800-bed tertiary care university-affiliated hospital. Subjects., A total of 108 patients (54 diabetic and 54 nondiabetic patients matched by age and gender) admitted between January 1996 and September 1999 with febrile UTI. Methods., Clinical, analytical, microbiological and outcome variables were analysed by means of McNemar test (categorical) or Wilcoxon matched pairs signed rank test (continuous). Results., Mean age (SD) in both groups was 67.9 (14.4) years. In comparison with controls, diabetic patients were more likely to have fever without localizing symptoms (27% vs. 9%, P , 0.0001), diminished consciousness level at admission (25% vs. 10%, P = 0.03), aetiological microorganism different from Escherichia coli (17% vs. 0, P = 0.0004), and quinolone-resistant bacteria (17% vs. 3.7%, P = 0.07). Duration of fever after the onset of treatment was 1.75 (1) days in diabetics and 1.5 (1.1) days in nondiabetics (P = 0.17). However, diabetic patients had a longer hospitalization [5.2 (3.3) days] than nondiabetics [3.9 (2.6) days, P = 0.006]. Conclusions., In diabetic patients, febrile UTIs have clinical and microbiological peculiarities that may have diagnostic and therapeutic implications. [source]