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Concept: Robert C. Merton


Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic options in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

Concepts: Medicine, Pain, Pancreatic cancer, Term, Suffering, Pancreatic pseudocyst, Robert C. Merton, Celiac plexus


Sulcus vocalis and vocal fold scar involve derangement of the superficial lamina propria of the vocal fold, which results in significant dysphonia. Many options exist for treatment, most of which have unsatisfactory and unpredictable outcomes. Autologous transplantation of temporalis fascia into the vocal fold (ATFV) has the potential to be a better treatment option, but long-term outcomes have not been well studied.

Concepts: Human voice, Derivative, Myron Scholes, Histology of the Vocal Folds, Robert C. Merton


Despite that the availability of new therapeutic options has expanded the multiple sclerosis (MS) disease-modifying therapy arsenal, interferon β (IFN-β) remains an important therapy option in the current decision-making process. This review will summarize the present knowledge of IFN-β mechanism of action, the overall safety, and the short- and long-term efficacy of its use in relapsing remitting MS and clinically isolated syndromes. Data on secondary progressive MS is also provided, although no clear benefit was identified.

Concepts: Time, Therapy, Multiple sclerosis, Cognition, Derivative, Futures contract, Myron Scholes, Robert C. Merton


Aortic valve replacement using a pulmonary autograft is an accepted option in children and young patients. The use of a pulmonary valve with congenital anomaly as autograft is controversial. We describe a case in which a quadricuspid pulmonary valve was used as autograft in childhood. The patient presented with severe regurgitation 13 years later. Repair was performed with stabilization of the root and cusp prolapse correction, leading to normalized valve function. Despite concerns over the long term durability of an anomalous pulmonary valve as autograft good mid- to long-term results can be achieved.

Concepts: Time, Patient, Tricuspid valve, Term, Aortic valve, Aortic valve replacement, Myron Scholes, Robert C. Merton


Maxillary defects with buconasal/businusal communications are situations difficult to manage and solve. Several treatment options are available on the literature, each one with its indication. Temporal muscle flap is one of these options, being a technique that requires more experience of the surgeon to be properly performed and that is mainly indicated for difficult cases, large defects and those nonresponsive to simpler techniques. The main purpose of this paper is to report 3 clinical patients of the application of the temporal muscle flap for the closure of extensive oral defects. None of the patients had necrosis, nervous deficits, or any long-term changes. The authors conclude that the use of this flap was shown to be a viable, safe technique with low complication and high success rates, which may contribute to the rehabilitation of well-indicated patients.

Concepts: Medical terms, Physician, Creativity techniques, Derivative, Myron Scholes, Robert C. Merton, Real options analysis


The Amatsu tracheoesophageal shunt (ATES) represents a nonprosthesis surgical option for voice restoration in laryngectomized patients. However, data regarding the long-term efficacy of ATES are lacking.

Concepts: Derivative, Myron Scholes, Robert C. Merton


Long-term prophylaxis is needed in many patients with hereditary angioedema and poses many challenges. Attenuated androgens are effective in many but are limited by side effect profiles. There is less evidence for efficacy of tranexamic acid and progestagens; however, the small side effect profile makes tranexamic acid an option for prophylaxis in children and progestagens an option for women. C1 inhibitor is beneficial, but at present requires intravenous delivery and may need dose titration for maximum efficacy. Short-term prophylaxis should be considered for all procedures. New therapies are promising in overcoming many problems encountered with current options for long-term prophylaxis.

Concepts: Time, Effectiveness, Efficacy, Derivative, Term, Hereditary angioedema, Myron Scholes, Robert C. Merton


Ureterocalicostomy (UC) is a well-established treatment option for patients with recurrent ureteropelvic junction obstruction (UPJO) with postoperative fibrosis and a relatively inaccessible renal pelvis. This study aimed to evaluate the long-term outcome of UC and factors predicting its failure.

Concepts: Time, Kidney, Derivative, Term, Long-term memory, Long-Term Capital Management, Myron Scholes, Robert C. Merton


Severe post-traumatic ankle arthritis poses a reconstructive challenge in young and active patients. Although technically demanding and despite unsolved immunological issues, bipolar fresh total osteochondral allograft (BFTOA) represent an intriguing option to arthrodesis and prosthetic replacement. The purpose of this paper is to evaluate the outcomes of a series of 48 ankle BFTOA at 10 years follow up and to investigate the rate of survival long term.

Concepts: Time, Immunology, Derivative, Term, Long-term memory, Long-Term Capital Management, Myron Scholes, Robert C. Merton


The orally available BRAF kinase inhibitor vemurafenib is an effective and tolerable treatment option for patients with metastatic melanoma harbouring BRAF(V600) mutations. We assessed the safety of vemurafenib in a large population of patients with few alternative treatment options; we report updated 2-year safety.

Concepts: Metastasis, Melanoma, Derivative, Alternative medicine, Myron Scholes, Robert C. Merton