University of Illinois Medical Center
University of Illinois Medical Center
Hensley C.P.,University of Illinois Medical Center |
Hensley C.P.,University of Illinois at Chicago |
Emerson Kavchak A.J.,University of Illinois Medical Center |
Emerson Kavchak A.J.,University of Illinois at Chicago |
Emerson Kavchak A.J.,American Academy of Orthopaedic Manual Therapists
Manual Therapy | Year: 2012
Peroneal tendinopathy is an uncommon but underappreciated source of lateral hindfoot pain and dysfunction. There is a paucity of literature describing optimal intervention for those suffering with pain secondary to peroneal tendinopathy. The purpose of this case report is to describe the evaluation and treatment incorporating manual therapy and therapeutic exercise for a patient diagnosed with peroneal tendinopathy. The patient was a 50 year-old female with a history of chronic lateral ankle pain and whose presentation was consistent with peroneal tendinopathy. Despite attempts to improve pain and function with over-the-counter orthotics, manual therapy to a hypomobile talocrural joint, and strengthening of the peroneal tendons, successful response was not reported until a lateral calcaneal glide was added. Improvement in impairments (pain, talocrural dorsiflexion, unilateral heel raises, and Star Excursion Balance Test) and function (Lower Extremity Functional Scale and Global Rating of Change), were observed over a course of eight visits. The patient was able to return to work and her recreational work out routine without limitations. In conclusion a successful physical therapy intervention for a patient with peroneal tendinopathy included a unique manual therapy technique, the lateral calcaneal glide, in conjunction with other manual therapy techniques and a structured home exercise program. © 2011 Elsevier Ltd.
Holterman A.-X.,Rush University Medical Center |
Holterman A.-X.,University of Illinois Medical Center |
Browne A.,Rush University Medical Center |
Browne A.,University of Illinois Medical Center |
And 7 more authors.
Journal of Pediatric Surgery | Year: 2010
Background and Materials and Methods: The outcome of patients completing 12 months of follow-up in a prospective longitudinal trial of the safety/efficacy of laparoscopic adjustable gastric banding (LAGB) for morbidly obese adolescents aged 14 to 17 years using a Food and Drug Administration Institutional Device Exemption for the use of the LAPBAND was analyzed. Baseline and outcome data were abstracted from a prospective database. Results: Baseline (mean ± SD) body mass index was 50 ± 10 kg/m 2, and excess weight was 178 ± 53 lb in 20 patients. Comorbidities included hypertension (45%), dyslipidemia (80%), insulin resistance (90%), metabolic syndrome (95%), and biopsy-proven nonalcoholic steatohepatitis (88%). At mean (SD) follow-up of 26 (9) months, % excess weight loss was 34% ± 22% (n = 20) and 41% ± 27% (n = 12), and the metabolic syndrome was resolved in 63% and 82% of the patients at 12 and 18 months, respectively. Hypertension normalized in all patients, along with improvement in lipid abnormalities and quality of life scores (P < .05). At 12 months, of the 5 patients with less than 20% excess weight loss, dyslipidemia and metabolic syndrome were resolved in 2 patients. Conclusion: At intermediate follow-up of a LAGB-based obesity treatment program, weight loss led to resolution or improvement of major obesity-related comorbidities in most patients, supporting the efficacy of LAGB as a surgical adjunct to a comprehensive obesity treatment program and its long-term evaluation. © 2010 Elsevier Inc. All rights reserved.
Popa A.M.,University of Illinois at Chicago |
Valla K.,University of Illinois Medical Center |
Valla K.,Emory University |
Radhakrishnan L.,University of Illinois at Chicago |
And 3 more authors.
Annals of Pharmacotherapy | Year: 2012
OBJECTIVE: To report the serial development of oral mucositis following infusion of bevacizumab in a young woman with a malignant brain tumor and history of cutaneous psoriasis. CASE SUMMARY: A 29-year-old woman with a history of active cutaneous psoriasis and a malignant glioneuronal tumor was treated with bevacizumab for 2.5 years. With each infusion of bevacizumab, she developed oral mucositis within 36 hours. She received temozolomide as part of concurrent therapy with radiation and as maintenance therapy; it was discontinued after continuous therapy for 1.5 years. Bevacizumab 10 mg/kg was added after 7 cycles of maintenance temozolomide, as the tumor had minimal response and evidence of increased perfusion with angiogenesis on imaging studies. All medication, including temozolomide, was evaluated and eventually discontinued, with the exception of bevacizumab, which remained the drug suspected of causing the mucositis. DISCUSSION: Oral mucositis is a frequent adverse effect of cytotoxic chemotherapy, but has not been reported with bevacizumab. The Naranjo probability scale indicated a probable adverse drug reaction. This likely indicates that bevacizumab is one of many drugs known to induce exacerbation of psoriatic disease. We speculate that oral mucositis developed as bevacizumab-induced generation of proinflammatory cytokines within the vascular endothelium, leading to mucosal damage and ulceration. In addition, interruption of reparative angiogenic pathways with bevacizumab likely contributed to the severity of mucositis. CONCLUSIONS: Clinicians should be aware that bevacizumab can potentially exacerbate psoriatic disease.
Hoff S.R.,Stanford University |
Apushkin M.,University of Illinois Medical Center |
Pytynia K.B.,Stanford University
Laryngoscope | Year: 2011
Objectives: To discuss the presentation, diagnosis, histopathology, and characteristics of clear cell carcinoma of the larnyx, including squamous and mucoepidermoid variants. Study Design: Case report and review of the literature. Methods: We report the sixth known case of clear cell carcinoma of the larynx, of squamous orgin, in a patient who presented with massive thyroid cartilage destruction and expansion in a short amount of time. We also present a review of the published literature on these lesions. Results: A 68 year old male presented with a rapidly expanding exophytic supraglottic mass with adjacent cartilage destruction. Biopsy was consistent with a stage IV clear cell carcinoma of the larynx, derived from squamous cells. He underwent total laryngectomy with bilateral neck dissections, followed by radiation and chemotherapy. He remains disease free after 12 months. Conclusions: Clear cell carcinoma (CCC) of the larynx is a rare neoplasm, with only nine cases previously reported in the literature. Of these, four were clear cell variants of mucoepidermoid or adenocarcinoma and five were of squamous cell origin. We report a sixth case of CCC of the larynx derived from squamous cells. These tumors are considered highly aggressive, with high rates of recurrence (> 85%) and short overall survival times (mean = 12 months). There is a predilection for the supraglottis, and they tend to present in elderly men, which corresponds to the findings in our patient. Surgery is the treatment of choice, and postoperative radiation/chemotherapy should be considered for this aggressive neoplasm.