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Sample records for cases retrospective review

  1. Silent Sinus Syndrome: A Retrospective Review of 11 Cases

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    Karima DARGHAL

    2014-06-01

    Full Text Available Objective: The purpose of this study is to describe the clinical and radiological features of SSS, and to review therapeutic possibilities and their outcomes.Patients and Methods: Retrospective observational case series in the department of Arthur Vernes Institute between Mars 2007 and  Novembre 2012. Clinical records, including ophthalmology and otolaryngology evaluations as well as computed tomography scans and operative reports, were carefully examined. A literature review for relevant studies was performed to examine similar cases.Results: Eleven cases of  SSS were identified. Nine men and two women (sex ratio 4.5, aged between 23 and 54 years (mean, 30 years. there was 3 to 4 mm enophthalmos in 10 cases (90.9%, and hypoglobus in all cases, with no effect on visual function. In all 11 cases, the maxillary roof (orbital floor was drawn downwards, and the one or more walls of the maxilla were concave. In 4 cases septal deviation was present. 8 patients (72.7% underwent endoscopic sinus surgery, while 3 refused it. Septoplasty was performed in 4 cases (36.3%.Conclusion: The silent sinus syndrome is a rare entity. It mainly presents as unilateral enophthalmos in younger people and has very characteristic clinical and radiologic signs.This case series reports our diagnostic and therapeutic experience with this syndrome.

  2. Deep neck abscess. A 42-case retrospective review

    International Nuclear Information System (INIS)

    We reviewed 42 cases of deep neck abscess drained surgically or treated conservatively between February 2001 and August 2008, based on age, gender, primary focus, main symptom, abscess location, systemic disease, pathogenic bacteria, hospital treatment, hospitalization length, complications and long-term hospitalization. Of the 42, 26 were men and 16 women aged 14 to 80 (central age: 54.5 years). Abscess was caused most by tonsil inflammation (38.1%). Main symptom were sore throat (54.8%) and neck swelling (35.7%). Abscesses were found in the supra- and infrahyoid region in 30 cases and extended to the mediastinum in 2. Of the 42, 14 (33.3%) had hypertension and 11 (26.2%) diabetes mellitus (DM). Inflammation was due to aerobic bacteria (mainly Streptococcus milleri) in 23 cases (54.8%) and to anaerobic bacteria (mainly Peptostreptococcus) in 11 cases (26.2%). Flexible fiberscopic examination was important in evaluating pharyngeal and laryngeal mucosal disorders and enhanced computed tomography was useful in both diagnosis and postoperative observation. Of the 42, 38 required surgical drainage and 4 were cured using needle aspiration and antibiotics. Of the 38 undergoing surgery-tracheostomy was required in 22. Hospitalization for those with tracheostomy and DM was longer than in those without these factors. Complications included 2 cases each of, mediastinal abscess, sepsis, disseminated intravascular coagulation (DIC), acute renal failure, severe pneumonia, upper digestive tract bleeding and swallowing disorder. Early surgical drainage and intravenous antibiotic administration are thus essential for treating deep neck abscesses. (author)

  3. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR Imaging Studies

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    Geraldine H. Chang

    2014-01-01

    Full Text Available Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

  4. Retrospective Study of Castleman's Disease: A Report of Fourteen Cases and Review of the Literature

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    Waiyi Zou; Huixia Lan; Chang Su; Yunxian Chen; Juan Li; Shaokai Luo

    2007-01-01

    OBJECTIVE To enhance the understanding of Castleman's disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed.RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situations in the 14 cases, with a lack of specificity. They were previously misdiagnosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.

  5. Cutaneous adverse events of epidermal growth factor receptor inhibitors: A retrospective review of 99 cases

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    Kumutnart Chanprapaph

    2015-01-01

    Full Text Available Background: Previous reports regarding the cutaneous adverse events of epidermal growth factor receptor inhibitors are mostly limited to small case reports and case series, mainly involving Caucasian patients. Aims: We describe the trends in the clinical presentation of Asian patients who had cutaneous adverse events induced by epidermal growth factor receptor inhibitors and to explore the relationship between skin adverse events and tumor response. Methods: From 2006 to 2010, medical records of Thai patients with non-small cell lung cancer receiving epidermal growth factor receptor inhibitors were retrieved and analyzed. Results: In all, 99 patients were reviewed and analyzed. Erlotinib and gefitinib were commenced in 75 (75.8% and 24 (24.2% patients, respectively. Cutaneous adverse events occurred in 43 (57.3% patients receiving erlotinib and in 15 (62.5% patients receiving gefitinib. The most common adverse event was xerosis (52.5%. Less common adverse events included papulo-pustular eruption (27.3%, erythematous maculopapular rash (11.1%, mucositis (6.7%, paronychia (5.1%, and trichomegaly (2%. Elderly patients had a higher occurrence of xerosis. The presence of cutaneous adverse events was significantly higher in subjects who had a tumor response. Limitations: The limitations of study include its retrospective nature, and the initial screening of cutaneous adverse events was done by non-dermatologists. Conclusions: Cutaneous adverse events due to epidermal growth factor receptor inhibitors are not uncommon in the Asian population. We found a positive correlation between the occurrences of cutaneou adverse events and tumor response supporting the view that they are surrogate markers for therapeutic response.

  6. Physician-Directed Heart Failure Transitional Care Program: A Retrospective Case Review

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    Ota, Ken S.; Beutler, David S; Gerkin, Richard D.; Weiss, Jessica L.; Loli, Akil I.

    2013-01-01

    Background Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. Methods This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist’s...

  7. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

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    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  8. Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study

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    Sam, Sing-Sin; Omar, Sharifah Faridah Syed; Teoh, Boon-Teong; Abd-Jamil, Juraina; Abubakar, Sazaly

    2013-01-01

    Background Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. Methodology/Principal Findings We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if t...

  9. Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study

    OpenAIRE

    Sing-Sin Sam; Sharifah Faridah Syed Omar; Boon-Teong Teoh; Juraina Abd-Jamil; Sazaly AbuBakar

    2013-01-01

    BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if...

  10. Retrospective study of reverse dorsal metacarpal flap and compound flap: a review of 122 cases

    Institute of Scientific and Technical Information of China (English)

    LU Lai-jin; GONG Xu; LIU Zhi-gang; ZHANG Zhi-xin

    2006-01-01

    Objective:To evaluate the clinical application and discuss the operative indication of the reverse dorsal metacarpal flap and its compound flap on the skin defects of hand.Methods: From 1990 to 2003, we applied the reverse dorsal metacarpal flap and its compound flap to repair soft tissue defects of fingers in 122 cases, which included 90cases of the reverse metacarpal flap and 32 cases of its compound flaps with tendon grafts, nerve grafts or bone grafts. Based on the follow-up observations, we analyzed the indications of the reverse metacarpal flap and its compound flaps, the postoperative contours, flap colors and textures in comparison to contralateral fingers retrospectively.Results: In the series of 122 cases, flaps survived and the donor site defects were closed directly. The follow-up period ranged from 1-12 years. The postoperative contours,colors and textures of the flaps and its compound flaps were similar to those of normal fingers, although linear scar remained. According to standards of sense recovery(British Medical Research Council, BMRC ), the sense function of the flaps resumed S3 after operation for 1 year.In 10 cases with the tendon defects treated by the flap with tendon grafts, function of flexion-extension of fingers resumed 50%-75% in comparison to the contralateral fingers using the method of measurement of total active motion. In 7 cases with the phalangeal nonunion or bone defects treated by the flap with bone grafts, union occurred after operation for 3 months.Conclusions: To soft tissue defects on fingers with bone or tendon exposure, the reverse metacarpal flap and its compound flap are a better choice for repairing. The range of repairing is up to the distal interphalangeal joint of fingers. The second dorsal metacarpal artery is more consistent and larger as the choice of vascular pedicle, in comparison with other dorsal metacarpal arteries.Postoperative flap color and texture are similar to normal fingers.

  11. Review of Dengue hemorrhagic fever fatal cases seen among adults: a retrospective study.

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    Sing-Sin Sam

    Full Text Available BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if there have been changes in the presentation of severe to fatal dengue. Nine of ten fatal cases involved adult females with a median age of 32 years. All had secondary dengue infection. The mean duration of illness prior to hospitalization was 4.7 days and deaths occurred at an average of 2.4 days post-admission. Gastrointestinal pain, vomiting, diarrhea, intravascular leakages and bleeding occurred in the majority of cases. DSS complicated with severe bleeding, multi-organ failure and coagulopathy were the primary causes of deaths. Seven patients presented with thrombocytopenia and hypoalbuminemia, five of which had hemoconcentration and increased ALT and AST indicative of liver damage. Co-morbidities particularly diabetes mellitus was common in our cohort. Prominent unusual presentations included acute renal failure, acute respiratory distress syndrome, myocarditis with pericarditis, and hemorrhages over the brain and heart. CONCLUSIONS: In our cohort, dengue fatalities are seen primarily in adult females with secondary dengue infection. The majority of the patients presented with common clinical and laboratory warning signs of severe dengue. Underlying co-morbidities may contribute to the rapid clinical deterioration in severe dengue. The uncommon presentations of dengue are likely a reflection of the changing demographics where adults are now more likely to contract dengue in dengue endemic regions.

  12. Retrospective review on obstetric cases of critically ill and dead patients in Dongguan.

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    Shen, Li-Han; Fang, Yun-Yong; Zheng, Yan-Bing; Xiao, Li-Juan; Huang, Su-Ran; Liu, Xi-Zhen; Cai, Li-Hua

    2015-03-01

    This retrospective analysis was set to understand the epidemiological status of the critically ill obstetric patients in Dongguan city, Guangdong, China. Understanding the risk factors for the death cases can provide scientific evidences for future preventive strategies to decrease the maternal mortality rate. This retrospective included the statistical data and clinical data on the cases of critically ill and dead obstetric patients admitted to Dongguan People's Hospital and Dongguan Maternal & Child Health Hospital from September 1st, 2009 to August 31st, 2013. Data included numbers of the critically ill maternal and obstetric women, common obstetric and maternal comorbidities and complications in the critically ill patients, the basic characteristics of maternal and obstetric deaths, records of regular prenatal examinations, the time intervals between onset of acute symptoms and ICU admission, blood purification, and the acute physiology and chronic health evaluation II (APACHE II) score. During the 5-year period, there were increasing trend of critically ill pregnant and obstetric patients, and the prevalence rate of critically ill obstetric patients was 8.99-9.28 %. The most common obstetric causes of admission were massive postpartum hemorrhage (63.54 %), followed by pregnancy-associated hypertension (15.85 %) and placenta previa (8.92 %). The most common non-obstetric causes of admission were acute heart failure (1.98 %). In the observed period, 20 critically ill obstetric patients died in these two hospitals (mortality rate 0.24 %, 20/8,129). The mean age of dead women was (30.3 ± 6.6) years old and mean gestational age was (30.1 ± 9.3) weeks. 75 % of the patient had more than two pregnancies. Over 90 % of the patients received education below junior high school level. 85 % of the patients were non-Dongguan natives and regular prenatal care rate was only 15 % on dead cases. The most common causes of death were pregnancy-associated hypertension, acute

  13. Gastric cancer at a university teaching hospital in northwestern Tanzania: a retrospective review of 232 cases

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    Mabula Joseph B

    2012-11-01

    Full Text Available Abstract Background Despite marked decreases in its incidence, particularly in developed countries, gastric cancer is still the second most common tumor worldwide. There is a paucity of information regarding gastric cancer in northwestern Tanzania. This study was undertaken to describe our experience, in our local setting, on the management of gastric cancer, outlining the clinicopathological and treatment outcome of these patients and suggesting ways to improve the treatment outcome. Methods This was a retrospective study of histologically confirmed cases of gastric cancer seen at Bugando Medical Centre between January 2007 and December 2011. Data were retrieved from patients’ files and analyzed using SPSS computer software version 17.0. Results A total of 232 gastric cancer patients were enrolled in the study, representing 4.5% of all malignancies. The male to female ratio was 2.9:1. The median age of patients was 52 years. The majority of the patients (92.1% presented late with advanced gastric cancer (Stages III and IV. Lymph node and distant metastasis at the time of diagnosis was recorded in 31.9% and 29.3% of cases, respectively. The antrum was the most frequent anatomical site (56.5% involved and gastric adenocarcinoma (95.1% was the most common histopathological type. Out of 232 patients, 223 (96.1% patients underwent surgical procedures for gastric cancer of which gastro-jejunostomy was the most frequent performed surgical procedure, accounting for 53.8% of cases. The use of chemotherapy and radiotherapy was documented in 56 (24.1% and 12 (5.1% patients, respectively. Postoperative complication and mortality rates were 37.1% and 18.1%, respectively. According to multivariate logistic regression analysis, preoperative co-morbidity, histological grade and stage of the tumor, presence of metastases at the time of diagnosis was the main predictors of death (P P Conclusions Gastric cancer in this region shows a trend towards relative

  14. Mucocele of the appendix. Review of 10 cases; Les mucoceles appendiculaires. Etude retrospective a propos de 10 cas

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    Souei-Mhiri, M.; Tlili-Graies, K.; Ben Cherita, L.; Jeddi, M.; Derbel, F.; Dahmen, Y. [Hopital Sahloul, Sousse (Tunisia); Hmissa, S. [Hopital F Hached, Sousse (Tunisia)

    2001-04-01

    The purpose of our work was to assess the value of abdominal sonography (US) and computed tomography (CT) in the preoperative diagnosis of appendiceal mucocele. We retrospectively reviewed 10 cases of mucocele of the appendix, 7 cases without pseudo myxoma peritonei, and 3 cases with pseudo-myxoma peritonei. All cases were investigated radiologically by plain film and US, barium enema was performed in 3 cases and CT in 5 cases. Mucoceles of the appendix are rare and their clinical presentation is not specific. US confirms the appendicular involvement, but often poses the differential diagnosis with acute inflammation, abscess or localized appendicular peritonitis. CT appears as a mandatory examination since it allows accurate preoperative diagnosis period. In this series, the diagnosis was made preoperatively in the 5 cases where CT had been performed. US is useful to confirm the abnormal pattern of the appendix but does not allow accurate diagnosis of mucocele. CT is more specific and accurate for diagnosis of mucocele of the appendix. (authors)

  15. Obstetric Scar Endometriosis: Retrospective Study on 19 Cases and Review of the Literature.

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    Kaplanoglu, Mustafa; Kaplanoğlu, Dilek Kaya; Dincer Ata, Ceren; Buyukkurt, Selim

    2014-01-01

    Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. This disease is one of the most common gynecologic disorders in reproductive age women. It generally occurs in pelvic cavity. But extrapelvic location has been defined (such as extremities, central nervous system, lungs, pleurae, liver, umbilicus, pericardium, urinary tract, intestines, and surgical scar tissue). Scar endometriosis is a rare disease and defined as presence of endometriotic lesions on the abdominal (such as cesarean section and hysterectomy) or vaginal (episiotomy) excision line. It is difficult to diagnose due to the extreme variability in presentation. The symptoms are nonspecific, typically involving pain, swelling at the incision site at the time of menstruation. Excision and histopathologic examination are necessary for diagnosis. We present a case series of obstetric scar endometriosis and review of the literature. PMID:27379258

  16. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

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    Kawasumi, Yusuke, E-mail: ssu@rad.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Usui, Akihito, E-mail: t7402r0506@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosokai, Yoshiyuki, E-mail: hosokai@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Igari, Yui, E-mail: igari@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosoya, Tadashi [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hayashizaki, Yoshie, E-mail: yoshie@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Saito, Haruo, E-mail: hsaito@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Ishibashi, Tadashi, E-mail: tisibasi@med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Funayama, Masato, E-mail: funayama@forensic.med.tohoku.ac.jp [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan)

    2015-04-15

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  17. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

    International Nuclear Information System (INIS)

    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  18. The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

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    Alexandru V. Georgescu

    2012-10-01

    Full Text Available Background : Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. Patients and methods : This article reviews 25 propeller perforator flaps (PPF which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. Results : A primary healing rate (96% was obtained in 18 (72% cases. Revisional surgery and SG for skin necrosis was performed in six (24% cases with one complete loss of the flap (4% which led to a lower extremity amputation. Conclusions : The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds.

  19. The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

    Science.gov (United States)

    Georgescu, Alexandru V.; Matei, Ileana R.; Capota, Irina M.

    2012-01-01

    Background Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used with varying degrees of success to cover diabetic lower leg or foot ulcerations. Other methods include: local or regional muscle and fasciocutaneous flaps, free muscle and fasciocutaneous, or perforator flaps, which also have varying degrees of success. Patients and methods This article reviews 25 propeller perforator flaps (PPF) which were performed in 24 diabetic patients with acute and chronic wounds involving the foot and/or lower leg. These patients were admitted beween 2008 and 2011. Fifteen PPF were based on perforators from the peroneal artery, nine from the posterior tibial artery, and one from the anterior tibial artery. Results A primary healing rate (96%) was obtained in 18 (72%) cases. Revisional surgery and SG for skin necrosis was performed in six (24%) cases with one complete loss of the flap (4%) which led to a lower extremity amputation. Conclusions The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds. PMID:23050066

  20. Carcinoma involving the gallbladder: a retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma

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    Giang Tran H

    2012-01-01

    Full Text Available Abstract Background Carcinoma of the gallbladder (GBC clinically mimics benign gallbladder diseases and often escapes detection until advanced stage. Despite the frequency of cholecystectomy, diagnosis of GBC remains problematic in many situations. We sought to identify pathologic features that contribute to the difficulty in recognition of GBC. Methods We identified 23 patients (ranged from 45 to 86 years, male to female ratio 1:4.5 with carcinoma involving the gallbladder referred to an academic medical center over a period of 10 years for study. This includes 10 cases of primary GBC, 6 cases of metastatic tumor to gallbladder, 6 cases of directly invasive adenocarcinoma arising elsewhere in the biliary tree, and one case of unidentified origin adenocarcinoma. Primary tumors include adenocarcinoma not otherwise specified (NOS in 6 cases, papillary adenocarcinoma in 2 cases, and single cases of undifferentiated carcinoma and combined adenocarcinoma and neuroendocrine carcinoma (NEC. Metastatic tumors to gallbladder were from a wide range of primary sites, predominantly the gastrointestinal tract. Results These cases illustrate seven potential pitfalls which can be encountered. These include: 1 mistakenly making a diagnosis of adenocarcinoma of gallbladder when only benign lesions such as deeply penetrating Rokitansky-Aschoff sinuses are present (overdiagnosis, 2 misdiagnosing well-differentiated invasive carcinoma with minimal disease as benign disease (underdiagnosis, 3 differentiating between primary NEC of gallbladder and metastasis, 4 confusing primary mucinous adenocarcinoma of gallbladder with pseudomyxoma peritonei from a low grade appendiceal neoplasm disseminated to gallbladder, 5 confusing gangrenous necrosis related to cholecystitis with geographic tumoral necrosis, 6 undersampling early, grossly occult disease, and 7 misinterpreting extracellular mucin pools. Conclusions Clinical history and a high index of suspicion are

  1. Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases

    International Nuclear Information System (INIS)

    We report on embolization in 36 cases of postpartum hemorrhage (PPH). The 36 patients with severe PPH, including one patient who had undergone an emergency hysterectomy, were transferred to the regional interventional vascular radiology unit in a mean time of 6 hours 12 min. Bilateral occlusion of the anterior trunk of the hypogastric arteries was carried out using gelatin sponge. Immediate success was achieved in all cases. In 3 cases, however, a second embolization was necessary before day 2. In 17%, complementary nonvascular surgery was performed. Complications included one puncture site false aneurysm treated by compression, two cases of regressive lower limb paraesthesia, one femoral vein thrombosis, and nonsignificant puncture site hematomas (19.5%). Long-term follow-up was conducted in 23 patients: 91% resumed regular menstrual cycles, 8.7% dysmenorrhea. New pregnancy occurred in 13% (two full-term pregnancies and one voluntary termination). Immediate efficacy, low morbidity and preservation of fertility make embolization the technique of choice for severe PPH

  2. Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature

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    Camila Almeida Silva

    2010-12-01

    Full Text Available Neurological disorders caused by Cytomegalovirus (CMV in patients with Acquired Immunodeficiency Syndrome (AIDS are rarely reported in the Highly Active Antiretroviral Therapy (HAART period. The objective of this study was to describe the main clinical and laboratory features of patients with CMV-related neurological complications in HIV-infected patients admitted to a referral center in São Paulo, Brazil. CMV disease requires the identification of the virus in the cerebrospinal fluid (CSF using Polymerase Chain Reaction (PCR. Thirteen cases were identified between January, 2004 and December, 2008. The median age of patients was 38 years and nine (69% were men. At admission all patients were aware of their HIV status and only four (31% patients were on HAART. Patients who were not on antiretroviral therapy before admission received HAART while inpatients. CMV disease was the first AIDS-defining illness in eight (62% patients. The neurologic syndromes identified were diffuse encephalitis (n = 7; 62%, polyradiculopathy (n = 7; 54%, focal encephalitis (rhombencephalitis (n = 1; 8%, and ventriculo-encephalitis (n = 1; 8%. Seven (54% patients presented extra-neural CMV disease and four (31% had retinitis. The median of CD4+ T-cell count was 13 cells/µL (range: 1-124 cells/µL. Overall in-hospital mortality was 38%. Eight patients used ganciclovir or foscarnet (in-hospital mortality: 50% and five patients used ganciclovir and foscarnet (in-hospital mortality: 20%. None of the patients fulfilled the diagnosis criteria of immune reconstitution inflammatory syndrome. Four patients were lost to follow-up, and three patients presented immune recovery and discontinued secondary prophylaxis. Although infrequent, distinct neurological syndromes caused by CMV continue to cause high mortality among AIDS patients. Survival depends upon the use of effective antiviral therapy against CMV and the early introduction of HAART.

  3. Injuries suffered by dogs from riding in the back of open pickup trucks: a retrospective review of seventy cases.

    Science.gov (United States)

    Houston, D M; Fries, C L; Alcorn, M J; Thomas, S S

    1995-08-01

    Case records of 70 dogs injured while riding in the back of open pickup trucks during the period January 1, 1982, to May 1, 1993, were reviewed. Most dogs were young (mean age 2.4 y) and of medium to large size (average weight 22.6 kg). Sixty-five dogs (93%) were injured during the months of April through October. Forty-nine dogs (70%) had single injuries and 21 dogs (30%) sustained multiple injuries. Fractures were the most frequent injury incurred, with fractures of the femur the most common. Surgical repair was recommended in all but 2 cases. PMID:7585438

  4. Primary pancreatic lymphoma – pancreatic tumours that are potentially curable without resection, a retrospective review of four cases

    International Nuclear Information System (INIS)

    Primary pancreatic lymphomas (PPL) are rare tumours of the pancreas. Symptoms, imaging and tumour markers can mimic pancreatic adenocarcinoma, but they are much more amenable to treatment. Treatment for PPL remains controversial, particularly the role of surgical resection. Four cases of primary pancreatic lymphoma were identified at Prince of Wales Hospital, Sydney, Australia. A literature review of cases of PPL reported between 1985 and 2005 was conducted, and outcomes were contrasted. All four patients presented with upper abdominal symptoms associated with weight loss. One case was diagnosed without surgery. No patients underwent pancreatectomy. All patients were treated with chemotherapy and radiotherapy, and two of four patients received rituximab. One patient died at 32 months. Three patients are disease free at 15, 25 and 64 months, one after successful retreatment. Literature review identified a further 103 patients in 11 case series. Outcomes in our series and other series of chemotherapy and radiotherapy compared favourably to surgical series. Biopsy of all pancreatic masses is essential, to exclude potentially curable conditions such as PPL, and can be performed without laparotomy. Combined multimodality treatment, utilising chemotherapy and radiotherapy, without surgical resection is advocated but a cooperative prospective study would lead to further improvement in treatment outcomes

  5. Primary pancreatic lymphoma – pancreatic tumours that are potentially curable without resection, a retrospective review of four cases

    Directory of Open Access Journals (Sweden)

    Chin Melvin T

    2006-05-01

    Full Text Available Abstract Background Primary pancreatic lymphomas (PPL are rare tumours of the pancreas. Symptoms, imaging and tumour markers can mimic pancreatic adenocarcinoma, but they are much more amenable to treatment. Treatment for PPL remains controversial, particularly the role of surgical resection. Methods Four cases of primary pancreatic lymphoma were identified at Prince of Wales Hospital, Sydney, Australia. A literature review of cases of PPL reported between 1985 and 2005 was conducted, and outcomes were contrasted. Results All four patients presented with upper abdominal symptoms associated with weight loss. One case was diagnosed without surgery. No patients underwent pancreatectomy. All patients were treated with chemotherapy and radiotherapy, and two of four patients received rituximab. One patient died at 32 months. Three patients are disease free at 15, 25 and 64 months, one after successful retreatment. Literature review identified a further 103 patients in 11 case series. Outcomes in our series and other series of chemotherapy and radiotherapy compared favourably to surgical series. Conclusion Biopsy of all pancreatic masses is essential, to exclude potentially curable conditions such as PPL, and can be performed without laparotomy. Combined multimodality treatment, utilising chemotherapy and radiotherapy, without surgical resection is advocated but a cooperative prospective study would lead to further improvement in treatment outcomes.

  6. Ten-year experiences with Tracheostomy at a University teaching hospital in Northwestern Tanzania: A retrospective review of 214 cases

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    Gilyoma Japhet M

    2011-11-01

    Full Text Available Abstract Background Tracheostomy remains a very important life saving surgical procedure worldwide and particularly in our environment where patients present late in upper airway obstruction. Little work has been done on this subject in our environment and therefore it was necessary to conduct this study to describe our own experiences with tracheostomy, outlining the common indications and outcome of tracheostomized patients in our setting and compare our results with those from other centers in the world. Methods This was a 10-year retrospective study which was conducted at Bugando Medical Centre from January 2001 to December 2010. Data were retrieved from patients' files kept in the Medical record department and analyzed using SPSS computer software version 15.0. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study. Results A total of 214 patients were studied. The male to female ratio was 3.1: 1. The majority of patients were in the 3rd decade of life. The most common indication for tracheostomy was upper airway obstruction secondary to traumatic causes in 55.1% of patients, followed by upper airway obstruction due to neoplastic causes in 39.3% of cases. The majority of tracheostomies (80.4% were performed as an emergency. Transverse skin crease incision was employed in all the cases. Post-tracheostomy complication rate was 21.5%. Complication rate was significantly higher in emergency tracheostomy than in electives (P Conclusion Upper airway obstruction secondary to trauma and laryngeal tumors still remains the most common indication for tracheostomy in our centre and tracheostomy is still a life saving procedure in the surgical management of airway despite complications which are seen more commonly in paediatric patients. Most of tracheostomy related complications can be avoided by meticulous attention to the details of the technique and postoperative tracheostomy care by skilled

  7. Skin cancers among Albinos at a University teaching hospital in Northwestern Tanzania: a retrospective review of 64 cases

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    Mabula Joseph B

    2012-06-01

    Full Text Available Abstract Background Skin cancers are a major risk associated with albinism and are thought to be a major cause of death in African albinos. The challenges associated with the care of these patients are numerous and need to be addressed. The aim of this study was to outline the pattern and treatment outcome of skin cancers among albinos treated at our centre and to highlight challenges associated with the care of these patients and proffer solutions for improved outcome. Methods This was a retrospective study of all albinos with a histopathological diagnosis of skin cancer seen at Bugando Medical Centre from March 2001 to February 2010. Data collected were analyzed using descriptive statistics. Results A total of 64 patients were studied. The male to female ratio was 1.5:1. The median age of patients was 30 years. The median duration of illness at presentation was 24 months. The commonest reason for late presentation was financial problem. Head and the neck was the most frequent site afflicted in 46(71.8% patients. Squamous cell carcinoma was the most common histopathological type in 75% of cases. Surgical operation was the commonest modality of treatment in 60 (93.8% patients. Radiotherapy was given in 24(37.5% patients. Twenty-seven (42.2% of the patients did not complete their treatment due to lack of funds. Local recurrence following surgical treatment was recorded in 6 (30.0% patients. Only thirty-seven (61.7% patients were available for follow-up at 6–12 months and the remaining patients were lost to follow-up. Conclusions Skin cancers are the most common cancers among albinos in our environment. Albinism and exposure to ultraviolet light appears to be the most important risk factor in the development of these cancers. Late presentation and failure to complete treatment due to financial difficulties and lack of radiotherapy services at our centre are major challenges in the care of these patients. Early institution of preventive

  8. Facing the airway challenges in maxillofacial trauma: A retrospective review of 288 cases at a level i trauma center

    OpenAIRE

    Gupta, Babita; Prasad, Arunima; Ramchandani, Sarita; Singhal, Maneesh; Mathur, Purva

    2015-01-01

    Background: Maxillofacial trauma is an apt example of a difficult airway. The anesthesiologist faces challenges in their management at every step from airway access to maintenance of anesthesia and extubation and postoperative care. Methods: A retrospective study was done of 288 patients undergoing surgery for maxillofacial trauma over a period of five years. Demographic data, detailed airway assessment and the method of airway access were noted. Trauma scores, mechanism of injury, duration o...

  9. Insulation Failure of the Linox Defibrillator Lead: A Case Report and Retrospective Review of a Single Center Experience.

    Science.gov (United States)

    Howe, Andrew J; McKeag, Nicholas A; Wilson, Carol M; Ashfield, Kyle P; Roberts, Michael J

    2015-06-01

    Implantable cardioverter defibrillator (ICD) lead insulation failure and conductor externalization have been increasingly reported. The 7.8F silicon-insulated Linox SD and Linox S ICD leads (Biotronik, Berlin, Germany) were released in 2006 and 2007, respectively, with an estimated 85,000 implantations worldwide. A 39-year-old female suffered an out-of-hospital ventricular fibrillation (VF) arrest with successful resuscitation. An ICD was implanted utilizing a single coil active fixation Linox(Smart) S lead (Biotronik, Berlin, Germany). A device-triggered alert approximately 3 years after implantation confirmed nonphysiological high rate sensing leading to VF detection. A chest X-ray showed an abnormality of the ICD lead and fluoroscopic screening confirmed conductor externalization proximal to the defibrillator coil. In view of the combined electrical and fluoroscopic abnormalities, urgent lead extraction and replacement were performed. A review of Linox (Biotronik) and Vigila (Sorin Group, Milan, Italy) lead implantations within our center (n = 98) identified 3 additional patients presenting with premature lead failure, 2 associated with nonphysiological sensed events and one associated with a significant decrease in lead impedance. All leads were subsequently removed and replaced. This case provides a striking example of insulation failure affecting the Linox ICD lead and, we believe, is the first to demonstrate conductor externalization manifesting both electrical and fluoroscopic abnormalities. PMID:25711237

  10. Variations in chemoprophylaxis for meningococcal disease: a retrospective case note review, analysis of routine prescribing data and questionnaire of general practitioners

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    Neal Keith R

    2001-12-01

    Full Text Available Abstract Background Invasive meningococcal disease is a significant cause of mortality and morbidity in the UK. Administration of chemoprophylaxis to close contacts reduces the risk of a secondary case. However, unnecessary chemoprophylaxis may be associated with adverse reactions, increased antibiotic resistance and removal of organisms, such as Neisseria lactamica, which help to protect against meningococcal disease. Limited evidence exists to suggest that overuse of chemoprophylaxis may occur. This study aimed to evaluate prescribing of chemoprophylaxis for contacts of meningococcal disease by general practitioners and hospital staff. Methods Retrospective case note review of cases of meningococcal disease was conducted in one health district from 1st September 1997 to 31st August 1999. Routine hospital and general practitioner prescribing data was searched for chemoprophylactic prescriptions of rifampicin and ciprofloxacin. A questionnaire of general practitioners was undertaken to obtain more detailed information. Results Prescribing by hospital doctors was in line with recommendations by the Consultant for Communicable Disease Control. General practitioners prescribed 118% more chemoprophylaxis than was recommended. Size of practice and training status did not affect the level of additional prescribing, but there were significant differences by geographical area. The highest levels of prescribing occurred in areas with high disease rates and associated publicity. However, some true close contacts did not appear to receive prophylaxis. Conclusions Receipt of chemoprophylaxis is affected by a series of patient, doctor and community interactions. High publicity appears to increase demand for prophylaxis. Some true contacts do not receive appropriate chemoprophylaxis and are left at an unnecessarily increased risk.

  11. Retrospective review of the case of cutaneous anthrax-malignant pustule from 1995 in 15-year old girl.

    Science.gov (United States)

    Kajfasz, Piotr; Bartoszcze, Michał; Borkowski, Piotr Karol; Basiak, Wojciech

    2014-01-01

    A 15-year-old girl was admitted to our Department with cutaneous lesion resembling black eschar. Anamnesis revealed that before getting ill she was wearing pullover made of rough sheep's wool and ornaments made of leather like straps. Cutaneous anthrax was confirmed by identification of B. anthracis in specimens from weeping ulceration, culture from black eschar, thermoprecipitation test, and bioassay on guinea pig. The girl was treated with crystalline Penicillin. She responded well to the therapy and recovered after 28 days. What attracts attention in presented case is the fact that the girl didn't belong to high risk group of human anthrax, which might lead to misdiagnosis. In 1990-1999, Poland there were reported 22 cases of anthrax - it was almost exclusively cutaneous form. In the years following 1999 antrax was reported even less often - in the period 1991-2013 it was recorded a total of 26 cutaneous anthrax cases.

  12. Postmortem computed tomography for detecting causes of sudden death in infants and children. Retrospective review of cases

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the usefulness of postmortem computed tomography (PMCT) in detecting causes of sudden death in infants and children. Our subjects were 15 nontraumatically deceased patients (nine boys and six girls, ranging in age from 20 days after birth to 12 years old, mean age 1.6 years), who had been in a state of cardiopulmonary arrest on arrival at our hospital. PMCT was performed within 2 h after certification of death: head (15 cases), chest (11 cases), and abdomen (12 cases). Blood was collected from 11 of the patients at the time of cardiopulmonary resuscitation. An autopsy was conducted on two. PMCT did not show any traumatic changes indicating child abuse. It was difficult to presume the cause of death with PMCT alone, but the cause of death in 14 of 15 cases could be presumed by combining information from their medical history, clinical course before death, PMCT findings, laboratory data, and bacterial culture. The remaining subject was classified as cause unknown. The causes of sudden death in infants and children were detected at a high rate when we comprehensively investigated the PMCT and other examination findings. (author)

  13. Clinicopathologic and radiologic features of extraskeletal myxoid chondrosarcoma: a retrospective study of 40 Chinese cases with literature review.

    Science.gov (United States)

    Shao, Rui; Lao, I Weng; Wang, Lei; Yu, Lin; Wang, Jian; Fan, Qinhe

    2016-08-01

    The aim of this study is to describe the clinicopathologic and radiologic features of 40 cases of extraskeletal myxoid chondrosarcoma (EMC) from China. There were 25 males and 15 females (sex ratio, 1.7:1). Apart from an adolescent, all patients were adults with a median age of 49years. Twenty-four tumors (60%) occurred in the lower limb and limb girdles, especially the thigh, followed by the upper limb and limb girdles (20%) and trunk (10%). Other less commonly involved locations included the head and neck, sacrococcygeal region, and perineum. Tumors ranged in size from 1.5 to 19cm (mean, 7cm). By radiology, they appeared as hypoattenuated or isoattenuated masses on computed tomography with hyperintense signal on T2-weighted magnetic resonance imaging. Intralesional hypointense septa were present in most cases. Of the 40 tumors, 30 belonged to the classic subtype, whereas 9 cases were cellular, and 1 case had a rhabdoid phenotype. Tumor cells showed variable expression of synaptophysin (36%), S-100 protein (29%), epithelial membrane antigen (11%), and neuron-specific enolase (7%). Ki-67 index was remarkably higher in the cellular variant (mean, 30%). EWSR1-related rearrangement was detected in 12 of 14 cases tested by fluorescence in situ hybridization using break-apart probes. The overall 5- and 7-year survival was 71% and 60%, respectively. Awareness of the imaging features may help pathologists in the diagnosis of EMC. Fluorescence in situ hybridization also serves as a useful diagnostic tool for EMC, especially in the distinction from its mimics. PMID:27402218

  14. Retrospective evaluation of childhood alopecia areata cases

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    Munise Daye

    2013-09-01

    Full Text Available Background and design: Approximately 20% of alopecia areata (AA cases are children. There is limited information about childhood AA.We aimed to examine demographic features,treatments and diseases prognosis of child cases of AA that were followed in our clinic. Material and methods: Datas of 110 AA patients who are 16 and under 16 years old were examined retrospectively.The age,gender,disease onset age,duration of disease,types of AA and onset area,nail involvement, accompanying systemic and dermatological diseases,laboratory tests,treatments and the prognosis were evaluated in their follow-up time.Results: Female cases were 46,4%, male cases were 53,6%.The mean age was 10,35 years.The age of disease onset was 8,65 years.Primary onset areas of AA cases were scalp in 83,6%, eyebrows in 5,4%, body hair in 5,4%, eyelashes in 2,7%, eyebrows and eyelashes in 2,7%.Types of disease were AA in 73,4% cases,alopecia totalis in 19% cases, alopecia universalis in 5,4% cases,ophiaisis in 1,8% cases.Nail involvement was established in 36,3% cases. Nevus flammeus was established in 2,7% cases.Mean disease duration was 17,02 months.Accompaying dermatosis were vitiligo in 2,7% cases,atopic dermatitis in 6,3% cases. The accompaying systemic diseases were autoimmune thyroiditis in 1,8% cases and Down's Syndrome in 2,7% cases.Thyroid autoantibodies were high in 0,9% cases.We have treated 24,5% of cases with topical corticosteroid lotion, 30,9% of cases with anthralin, 0,9%of cases with 2% minoxidil lotion, 0,9% of cases with calcipotriol lotion, 1,8% of cases with topical calcineurin inhibitors, 10% of cases with intralesional corticosteroids.We have treated 15,4% of cases with systemic corticosteroids and PUVA therapy who were resistant to topical treatment.We have treated 14,5% of cases with different combinations of topical treatments.Remission was observed in 34,5% of cases.The mean remission duration was 12.2 months.Relapse was observed at a average of two

  15. Odontoma: a retrospective study of 73 cases

    Energy Technology Data Exchange (ETDEWEB)

    An, Seo Young; An, Chang Hyeon; Choi, Karp Shik [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

    2012-06-15

    The purpose of the present study was to retrospectively evaluate the clinical findings and treatment results for impacted permanent teeth associated with odontomas. We retrospectively investigated 73 odontomas in 72 patients who visited Kyungpook National University Dental Hospital from April 2004 through November 2011. The study was performed using medical records, panoramic radiographs, and pathological reports. Data gathered included age, gender, location, chief complaints, effects on dentition, and treatment of odontoma and the impacted tooth associated with odontoma. Most compound odontomas (46.7%) were found in the second decade and complex odontomas were not related to age. Odontomas showed no gender predilection. Fifty-five cases (75.3%) of odontomas were detected on routine dental radiographs. Sixty percent of compound odontomas occurred in the canine area and 57.1% of complex odontomas in the molar areas. Impaction of permanent teeth (61.6%) was the most common complication on the adjacent teeth. Most odontomas (84.9%) were removed surgically and impacted permanent teeth were managed by surgical removal (53.2%), orthodontic treatment (25.5%), or surgical repositioning (6.4%). There was a statistically significant relation between age and preservation of the impacted permanent teeth associated with odontomas (p<0.01). Early detection and treatment of odontomas increase the possibility of preservation of the impacted tooth. Therefore, it would be suggested that periodic panoramic examination during the first and second decade of life might be beneficial for the early detection and better prognosis of odontomas.

  16. Primary and secondary malignant involvement of gynaecological organs at radical cystectomy for bladder cancer: review of literature and retrospective analysis of 360 cases.

    Science.gov (United States)

    Salem, H; El-Mazny, A

    2012-08-01

    The pathological analysis of cystectomy specimens from 360 female patients who underwent radical cystectomy for bladder cancer was retrospectively reported. The uterus was not available in 29 specimens, while one ovary was absent in 18 specimens and the two ovaries were absent in 20 specimens. Uterine involvement was observed in one case of transitional cell carcinoma, and benign uterine pathology was detected in 37 cases. All patients had normal ovaries, while the vagina was involved in 13 cases. A total of 12% of the patients had urethral involvement. None of the 29 patients, in whom the internal genitalia were totally or partially preserved, had late ovarian, vaginal or uterine recurrence at the last follow-up. Thus, the preservation of female internal genitalia in young patients undergoing radical cystectomy should be considered under strict criteria (low-grade, low-stage tumours away from the bladder neck). This will improve the quality-of-life (QoL) and the functional outcome without compromising cancer control. PMID:22779969

  17. Pyoderma Gangrenosum: Retrospective Evaluation of 20 Cases

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    Zehra Aşiran Serdar

    2011-06-01

    Full Text Available Background and Design: The objective of this study is to examine the clinical properties, comorbid systemic diseases and the treatment protocols of the patients diagnosed with pyoderma gangrenosum (PG. Material and Method: Between 2003 and 2009 years, 20 patients diagnosed with pyoderma gangrenosum were evaluated in this study. The clinical properties, comorbid systemic diseases and the treatment protocols were examined retrospectively.Results: In a six-year period, 20 patients with PG (11 female and 9 male, ranging in age from 19 to 75 (mean age 45±16.39 years were evaluated. Lesions had started as papule in 3 (16% patients, as bullous in 1 (5% patient, as erythematous plaque in 1 (5% patient and as pustule in 15 (74% patients. Whereas 14 (70% patients had single lesion, the other patients had multiple lesions. The lesions were located at lower extremities in 14 (70% patients most frequently, The most frequent comorbid disease in patients with pyoderma gangrenosum was inflammatory bowel diseases (colitis ulcerosa n: 4 and Crohn disease n: 2 total n: 6, 30%. The other comorbid diseases included vitiligo (n: 1, 5%, Behcet’s disease (n: 1, 5%, hidradenitis suppurativa (n: 1, 5%, deep venous thrombosis and pulmonary embolism (n: 1, 5%, pangastritis (n: 1, 5%, acute renal failure (n: 1, 5%, systemic lupus erythematosus (n: 2, 10% and iatrogenic immunosuppression (n: 1, 5%. Systemic corticosteroid therapy was the most common treatment (n=16, 80%. The treatment response was 100% in all patients. Conclusion: In our study, inflammatory bowel diseases were the most frequent comorbid diseases with pyoderma gangrenosum. Most of cases were as single lesions located in the lower extremities and the best treatment response was achieved by the administration of systemic corticosteroids.

  18. Farming tractor fatalities in Virginia: an 11-year retrospective review.

    Science.gov (United States)

    Fulcher, James; Noller, Anna; Kay, Deborah

    2012-12-01

    This retrospective case review examines farm tractor-related deaths in the Commonwealth of Virginia for an 11-year period, from 1997 to 2007. This study compares decedent's demographic information, toxicology results, and medical histories.A vast majority of farm tractor-related deaths were male (98%) and white (91%). The average age was 60 years with most deaths occurring between the ages of 40 and 80 years. Ethanol use was observed in 9% of all cases with 7% of cases being more than 0.08% wt/vol ethanol, which is the legal limit in Virginia to operate a motor vehicle.The more mountainous, Western District Office of the Chief Medical Examiner composed 60% of total cases with 43% of these western cases related to tractor use on a natural slope or incline. The deaths in other districts were all less than 13% natural slope or incline related, reflecting the topography of these areas.These findings confirm much of what observation would suggest; accidents with farming tractors typically involve older white men. Operating a tractor on steep inclines is dangerous as many tractors do not have adequate rollover protection. The use of ethanol is dangerous when using any heavy equipment.This study provides an initial look at tractor-related deaths in Virginia, and more research is needed in this area to improve safety mechanisms on this machinery.

  19. 42 CFR 456.709 - Retrospective drug use review.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic... pattern analysis, using predetermined standards, of physician prescribing practices, drug use by... 42 Public Health 4 2010-10-01 2010-10-01 false Retrospective drug use review. 456.709 Section...

  20. Chest trauma experience over eleven-year period at al-mouassat university teaching hospital-Damascus: a retrospective review of 888 cases

    Directory of Open Access Journals (Sweden)

    Al-Koudmani Ibrahim

    2012-04-01

    Full Text Available Abstract Background Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this study, we present our 11-year experience in the management and clinical outcome of 888 chest trauma cases as a result of blunt and penetrating injuries in our university hospital in Damascus, Syria. Methods We reviewed files of 888 consequent cases of chest trauma between January 2000 and January 2011. The mean age of our patients was 31 ± 17 years mostly males with blunt injuries. Patients were evaluated and compared according to age, gender, etiology of trauma, thoracic and extra-thoracic injuries, complications, and mortality. Results The leading cause of the trauma was violence (41% followed by traffic accidents (33%. Pneumothorax (51%, Hemothorax (38%, rib fractures (34%, and lung contusion (15% were the most common types of injury. Associated injuries were documented in 36% of patients (extremities 19%, abdomen 13%, head 8%. A minority of the patients required thoracotomy (5.7%, and tube thoracostomy (56% was sufficient to manage the majority of cases. Mean hospital LOS was 4.5 ± 4.6 days. The overall mortoality rate was 1.8%, and morbidity (n = 78, 8.7%. Conclusions New traffic laws (including seat belt enforcement reduced incidence and severity of chest trauma in Syria. Violence was the most common cause of chest trauma rather than road traffic accidents in this series, this necessitates epidemiologic or multi-institutional studies to know to which degree violence contributes to chest trauma in Syria. The number of fractured ribs can be used as simple indicator of the severity of trauma. And we believe that significant neurotrauma, traffic accidents, hemodynamic status and GCS upon arrival, ICU admission, ventilator use, and complication of therapy are predictors of dismal prognosis.

  1. Keloid Management: A Retrospective Case Review on a New Approach Using Surgical Excision, Platelet-Rich Plasma, and In-office Superficial Photon X-ray Radiation Therapy

    Science.gov (United States)

    Jones, Michael E.; Hardy, Cherrell; Ridgway, Julie

    2016-01-01

    ABSTRACT OBJECTIVE: The objective of this retrospective study was to evaluate the efficacy of the authors’ combination therapy protocol for keloid treatment. DESIGN: Retrospective. SETTING: Plastic surgery office-based outpatient setting in New York City. PATIENTS: Forty patients with 44 keloid scars requiring surgical excision. INTERVENTIONS: Keloid scars were treated using surgical excision, platelet-rich plasma, and postoperative in-office superficial photon X-ray radiation therapy. Intralesional triamcinolone injections were administered once to 4 patients with poor results on scar scale assessment. Patient follow-up visits ranged from 3 to 11 months to assess for evidence of recurrence and adverse effects. MAIN OUTCOME MEASURE(S): For the purpose of this study, recurrence was defined as any sign of extraordinary erythema, induration, and hypertrophy beyond the site of excision. MAIN RESULTS: In the 16 keloids treated with 2 fractions, there was no evidence of recurrence. One of 25 keloids treated with 3 fractions demonstrated evidence of recurrence. One of 3 keloids treated with a single fraction displayed signs of recurrence. Postirradiation hyperpigmentation was noted in all patients. CONCLUSIONS: Surgical excision combined with platelet-rich plasma and postoperative in-office superficial radiation therapy achieved a 95.5% nonrecurrence rate at 1- to 3-month follow-up. This protocol appears to be a safe and viable option in the management of keloids and merits further randomized controlled study of its comparative efficacy. PMID:27300360

  2. P14.03MEDULLOBLASTOMA IN MOROCCO: A RETROSPECTIVE REVIEW

    OpenAIRE

    Hami, H.; Ayoujil, A.; Habib, F.; Soulaymani, A.; Mokhtari, A.; Quyou, A.

    2014-01-01

    INTRODUCTION: Medulloblastoma is the most common malignant brain tumor in children. The aim of this study is to describe the epidemiological characteristics of medulloblastoma in Morocco. METHODS: This is a descriptive retrospective study of cases diagnosed and treated for medulloblastoma between 1994 and 2004 at Al Azhar Oncology Center in Rabat. RESULTS: There were 23 cases diagnosed with medulloblastoma at Al Azhar Oncology Center, accounting for 7.8% of all brain tumors reported during th...

  3. [Retrospective analysis of 39 child cases of paragonimiasis].

    Science.gov (United States)

    Guo, Mei; Wang, Wei; Jiang, Jian-yu

    2011-08-01

    Clinical data of 39 children with paragonimiasis treated in Chongqing Three Gorges Central Hospital during 2008-2010 were retrospectively analyzed. The cases aged from 3 to 10 years old, with 25 cases of polyserositis (64.1%), 14 cases of cerebral paragonimiasis (35.9%). Among the cases of polyserositis, all showed dyspnea,tachypnea and diminished respiration (100%). Other symptoms or signs included purulent pleurisy, orthopnea, restricted activity, distant heart sounds, purulent pericarditis, abdominal distension, and hepatomegaly. In the 14 cases of cerebral paragonimiasis, 10 cases (71.4%) complained headache, 8 cases (57.1%) with vomiting, and other symptoms such as seizures, limb rigidity associated with conscious disturbance. Eight patients were treated with surgery and praziquantel, while others with praziquantel alone. After treatment 25 cases (64.1%) were cured, 13 cases (33.3%) improved, and 1 case (2.6%) showed no change.

  4. Simultaneus bilateral spontaneus pneumothoraces: A Retrospective Analysis of 11 Cases

    Directory of Open Access Journals (Sweden)

    Ufuk Cobanoglu

    2011-09-01

    Full Text Available Spontaneous pneumothorax (SP is relatively common in clinical practice and occurs more frequently in young, tall thin men, and in smokers. However, simultaneous bilateral spontaneous pneumothorax (SBSP is a rare clinical condition that often presents with significant respiratory distress. It is often dangerous; therefore, the chest drain should be inserted immediately. In this study, simultaneus bilateral spontaneus pneumothoraces cases were divided into two groups and retrospectively evaluated according to age, sex, diagnostic methods, treatments, and results. Material and Methods :Between January 2006 and May 2009, 11 patients with SBSP were enrolled into our study. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, duration of chest tube and postoperative hospital stay of the patients were reviewed. Arterial blood gas values (before and after intervention in patiens with primary and secondary spontaneous pneumothorax were evaluated. Results; 7 patients (63.63 % were male and 4 patients (36.37 % were female and their mean age was 34,5±6.81 years. There were 4 (36.37% primary SP and 4 (36.37% secondary SP patients. Chronic obstructive pulmonary disease (COPD was the most common cause in secondary SP patients. In two (18.18% patients recurrency were observed. Eight (72.72% patients had smoking history. The most common symptom in both groups was dyspnea. All patients had immediate bilateral chest tubes on admission. We treated these patients with chest drain insertion, VATS (Video-Assisted Thoracoscopic Surgery, axillary thoracotomy, and chemical pleurodesis. Postoperative morbidity was detected in 3 (27.27% patients (prolonged air leak in 1 case, empyema in 1 case and pneumonia in 1 case. No mortality was observed in alll cases. Recurrence developed in 3 (27.27% patients in this series. Conclusions: An urgent and effective treatment requires in the

  5. Dermatologic manifestation of hyperandrogenism: a retrospective chart review.

    Science.gov (United States)

    Clark, Charlotte M; Rudolph, Jennifer; Gerber, Donald A; Glick, Sharon; Shalita, Alan R; Lowenstein, Eve J

    2014-01-01

    Several studies have described a wide spectrum of hyperandrogenism diseases, many of which are difficult to distinguish from each other. In order to better understand diseases of hyperandrogenism, the authors performed a retrospective study of the cutaneous features and metabolic findings in women with hyperandrogenism. A retrospective chart analysis compiled by three dermatologists in both academic and private settings was performed, including patients presenting with > or = 2 manifestations of hyperandrogenism. Relevant dermatologic and associated manifestations and laboratory and imaging study findings were reviewed. Moderate to severe acne was the most common manifestation. Other common manifestations that patients first presented with include hirsutism, acanthosis nigricans, androgenic alopecia, and skin tags. Oligomenorrhea was the most common systemic presenting sign. Statistical analysis of various clinical markers revealed correlations with hyperandrogenemia. Acanthosis nigricans and hirsutism were found to be useful clinical markers for hyperandrogenism, whereas androgenic alopecia was not. This study provides some insights into the presentation and diverse manifestations seen in hyperandrogenism. PMID:24933845

  6. A retrospective study of nine cases of Acanthamoeba keratitis

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    Tetsuya Mutoh

    2010-10-01

    Full Text Available Tetsuya Mutoh, Isao Ishikawa, Yukihiro Matsumoto, Makoto ChikudaDokkyo Medical University Koshigaya Hospital, Saitama, JapanPurpose: To evaluate the clinical features of Acanthamoeba keratitis in nine patients diagnosed at Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.Methods: In nine eyes of nine patients, Acanthamoeba keratitis was diagnosed by direct light microscopy of corneal scrapings stained by the Parker ink-potassium hydroxide method between September 2006 and September 2009. Their clinical features and course were studied retrospectively. Antifungal eye drops, systemic antifungal therapy, and surgical debridement of the corneal lesions were performed in all patients.Results: At presentation, the clinical stage was initial in six cases, transient in one case, and complete in two cases. The patients were all contact lens wearers who had washed their lens storage cases with tap water. After treatment, final visual acuity was improved in six cases, unchanged in one case, and worse in two cases. The patient with the worst final vision (hand motion had rheumatoid arthritis and was taking oral prednisolone, which led to corneal perforation and prevented adequate debridement from being done.Conclusion: Acanthamoeba keratitis is closely related to wearing contact lenses and washing the lens storage case with tap water. Although final visual acuity improved after treatment in most patients, insufficient surgical debridement resulted in a poor visual prognosis.Keywords: surgical debridement, Acanthamoeba keratitis, contact lens wearers

  7. Characterization of tinnitus in different age groups: A retrospective review

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    Jamil Al-Swiahb

    2016-01-01

    Full Text Available Objectives: The aim of this study was to characterize tinnitus in affected patients. Methods: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed. Results: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores. Conclusions: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.

  8. Odontoid fractures: A retrospective analysis of 53 cases

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    Shetty Arjun

    2009-01-01

    Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

  9. Retrospective Economic and Outcomes Analyses Using Non-US Databases: A Review

    OpenAIRE

    Lizheng Shi; Wu, Eric Q.; Meredith Hodges; Andrew Yu; Howard Birnbaum

    2007-01-01

    Retrospective database analyses pose a series of methodological challenges, some of which are unique to their data sources, particularly in countries outside the US. This study aimed to qualitatively review the methodological challenges of using non-US databases to conduct retrospective economic and outcomes research studies. We conducted a MEDLINE search to obtain a sample of literature published after the year 2000 on retrospective analyses using non-US databases. We reviewed all relevant c...

  10. Retrospective Clinical Analysis of 38 Cases of Pulmonary Embolism

    Institute of Scientific and Technical Information of China (English)

    Ruiyun Liang; Wei Zhang; Wei Wu; Shanping Jiang; Zhiqiang Lü

    2007-01-01

    To investigate the clinical feature of acute pulmonary embolism.Methods Retrospective clinical analysis was performed according to the data of 38 cases of pulmonary embolism.Results There were ground diseases and predisposing factors in 36 cases of pulmonary embolism among 38 cases,the ratio was 94.7 %,among the total predisposing factors,tumor,cardiovascular disease,venous thrombosis of lower extremity,smoking and long-term bed were common.There was no specificity in clinical feature,physical sign and rout chest X ray,electrocardiography,and their appearances were diversified.There were specificity and sensitivity in echocardiogram (UCG) and D-dimer to some extent.But,the final diagnosis must depend on some special examinations,such as selective pulmonary arteriography,CTPA,MRA and so on.Conclusions The special examinations must be done to make a definite diagnosis to confirm pulmonary embolism when the high risk factors and ground diseases are existing.It is necessary to some cases when the clinical feature can not be explained by other diseases.

  11. Coblation cryptolysis to treat tonsil stones: a retrospective case series.

    Science.gov (United States)

    Chang, Christopher Y; Thrasher, Richard

    2012-06-01

    We introduce a novel and potentially effective approach in the treatment of tonsil stones using Coblation technology. A retrospective pilot case series was performed demonstrating the effectiveness of a technique that we call Coblation tonsil cryptolysis. This technique is unique in that it can be performed in adult patients without sedation using only local anesthesia, much like laser tonsil cryptolysis. As with laser cryptolysis, pain is significant for only a few days and most adults can resume normal diet and activity within 1 week. In contrast, tonsillectomy entails significant morbidity for several weeks. However, Coblation avoids the significant disadvantages of laser use, including the potential for airway fire, retinal damage from reflected scatter, dealing with plume from vaporized tissues, oral/facial burns, and the high cost of purchasing and maintaining laser equipment. After a single session of Coblation tonsil cryptolysis, a significant decrease and even elimination of tonsil stones can potentially be achieved.

  12. 'Schizoid' personality and antisocial conduct: a retrospective case not study.

    Science.gov (United States)

    Wolff, S; Cull, A

    1986-08-01

    A retrospective case not analysis for 30 boys diagnosed as having a 'schizoid' personality disorder (Asperger's syndrome) in childhood, and for 30 matched clinic attenders (with systematic follow-up data for 19 matched pairs), showed the incidence of antisocial conduct to be the same in the two groups. However, the 'schizoid' boys stole less often and had fewer alcohol problems. In this group antisocial conduct was less related to family disruption and social disadvantage, and more to an unusual fantasy life. Clinical descriptions of a series of 'schizoid' boys and girls with conspicuous antisocial conduct follow. They suggest that characteristic patterns of antisocial conduct in such children are persistent expressions of hostility and, especially in girls, pathological lying, for which environmental circumstances provide no explanation.

  13. RETROSPECTIVE REVIEW OF MORTALITY IN GIANT PACIFIC OCTOPUS (ENTEROCTOPUS DOFLEINI).

    Science.gov (United States)

    Seeley, Kathryn E; Clayton, Leigh A; Hadfield, Catherine A; Muth, Dillon; Mankowski, Joseph L; Kelly, Kathleen M

    2016-03-01

    The giant Pacific octopus (Enteroctopus dofleini) is a popular exhibit species in public display aquaria, but information on health and disease is limited. This retrospective review evaluates time in collection and describes antemortem clinical signs and pathology of giant Pacific octopuses in an aquarium setting. Between March 2004 and December 2013, there were 19 mortalities: eight males, 10 females, and one individual whose sex was not recorded. Average time spent in collection for all octopuses was 375 ± 173 days (males 351 ± 148 days, females 410 ± 196 days). Ten (52.6%) of the octopuses were sexually mature at the time of death, six (31.6%) were not sexually mature, and reproductive status could not be determined in three octopuses (15.8%). Minimal changes were noted on gross necropsy but branchitis was histologically evident in 14 octopuses, often in conjunction with amoeboid or flagellate parasites. Senescence, parasitism, and husbandry were all important contributors to mortality and should be considered when caring for captive octopuses.

  14. RETROSPECTIVE REVIEW OF MORTALITY IN GIANT PACIFIC OCTOPUS (ENTEROCTOPUS DOFLEINI).

    Science.gov (United States)

    Seeley, Kathryn E; Clayton, Leigh A; Hadfield, Catherine A; Muth, Dillon; Mankowski, Joseph L; Kelly, Kathleen M

    2016-03-01

    The giant Pacific octopus (Enteroctopus dofleini) is a popular exhibit species in public display aquaria, but information on health and disease is limited. This retrospective review evaluates time in collection and describes antemortem clinical signs and pathology of giant Pacific octopuses in an aquarium setting. Between March 2004 and December 2013, there were 19 mortalities: eight males, 10 females, and one individual whose sex was not recorded. Average time spent in collection for all octopuses was 375 ± 173 days (males 351 ± 148 days, females 410 ± 196 days). Ten (52.6%) of the octopuses were sexually mature at the time of death, six (31.6%) were not sexually mature, and reproductive status could not be determined in three octopuses (15.8%). Minimal changes were noted on gross necropsy but branchitis was histologically evident in 14 octopuses, often in conjunction with amoeboid or flagellate parasites. Senescence, parasitism, and husbandry were all important contributors to mortality and should be considered when caring for captive octopuses. PMID:27010286

  15. STAPHYLOCOCCAL SCALDED SKIN SYNDROME:RETROSPECTIVE ANALYSIS OF 82 CASES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To explore distinctive clinical manifestations and appropriate treatment, and assess prognosis of staphylococcal scalded skin syndrome ( SSSS). Methods A retrospective analysis was conducted of the data of 82 cases of SSSS hospitalized at Xinhua Hospital during the period from May 1993 to September 2003.Results The disease in all the 82 patients occurred in their first decade ( mean 2.5 years). Possible predisposing factors were found in 48 (58. 5% ). Fever was present in 78 (95. 1% ). Radial spokes of crusting around mouth were present in 80 (97. 6% ). Erythema began on the face, especially around the mouth and eye in 63 (76. 8% ).The course was acute in all cases and the eruptions quickly spread to the whole body within one day to two days. Of the 82 cases of SSSS, 47 were complete form of SSSS, 27 were abortive form of SSSS, and 8 were between the two forms. Staphylococcus aureus with positive staphylocoagulase was isolated from the possible primary infection sites including pharynx, eyelid, conjunctiva, nose, ear, and skin in 18 of 31 patients. Microbiological cultures of bullae and little pustulae developed after the onset were negative in 16 cases. All the 82 patients completely recovered after receiving antibiotic therapy ( ceftriaxone, oxacillin ) alone or in combination with human immunoglobulin (IVIG) therapy. Additional IVIG therapy was used in those patients who had systemic involvements such as pneumonia, fever higher than 38. 5℃ or leukocytosis. Conclusion SSSS is a spectrum disease. Besides abortive and complete forms, presenting between the two forms a new form might be appeared in 8 cases who developed both scarlatiniform rash and flaccid bullae. The abortive form and complete form are usually misdiagnosed clinically. Radial spokes of crusting around mouth seem to be characteristic manifestation of SSSS. All the patients in this study had favorable prognosis after receiving prompt diagnosis and appropriate treatment.

  16. Seven to twelve year results with Versys ET cementless stem. A retrospective study of 225 cases.

    Science.gov (United States)

    D'Angelo, Fabio; Murena, Luigi; Vulcano, Ettore; Zatti, Giovanni; Cherubino, Paolo

    2010-01-01

    A retrospective review was conducted to evaluate the mid-term results (8.5 years follow-up) of the Versys ET stem (Zimmer, Warsaw, Indiana, USA). From 1995 to 2000, 225 total hip arthroplasties (THA) were performed using this device. All patients were evaluated clinically by the Harris Hip Score, and radiographically. The Hip Score increased from 54 preoperatively to 97 points postoperatively. The stem displayed a varus alignment between 5 degrees and 10 degrees in 17 cases without any clinical consequences (HHS 96.8). We recorded one case of septic loosening and one case of aseptic loosening. The stability of the stem was radiographically evaluated according to Engh's criteria, confirming bone ongrowth in all other cases. PMID:20235069

  17. Retrospective review of serologic rubella activity in University Hospital Kuala Lumpur.

    Science.gov (United States)

    Chua, K B; Lam, S K; Hooi, P S; Chua, B H; Lim, C T

    2000-09-01

    A retrospective review of rubella serological results carried out in the Virus Diagnostic Unit, University Hospital Kuala Lumpur (UHKL) from January 1993 to September 1999 showed the presence of rubella infection annually which appeared to increase periodically every two to three years. There was no statistical significant difference in the rubella positive rate between male and female population aged 14 to 48 years. Congenital rubella infections (CRI) occurred in babies delivered in UHKL yearly from 1993 to 1998 with an average incidence rate of 48 per 100,000 deliveries. Peaks of rubella cases appeared to be followed by an increase in incidence of CRI cases 6 to 9 months later. The study showed that only 50.8% clinically diagnosed rubella was confirmed by laboratory finding. This study also showed an increase of rubella activity for the months of July, August and September 1999 and this may herald an increase of CRI cases in the coming millennium.

  18. Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Jalaludin, M A

    1993-10-01

    Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

  19. Bisphosphonates in Langerhans Cell Histiocytosis: An International Retrospective Case Series

    Science.gov (United States)

    Chellapandian, Deepak; Makras, Polyzois; Kaltsas, Gregory; van den Bos, Cor; Naccache, Lamia; Rampal, Raajit; Carret, Anne-Sophie; Weitzman, Sheila; Egeler, R. Maarten; Abla, Oussama

    2016-01-01

    Background Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH), which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results Ten patients (77%) had a single system bone disease, and 3 (23%) had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years). Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve (92%) achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years). One patient did not respond. No major adverse effects were reported in this series. Conclusion Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted. PMID:27413525

  20. Meningitis admitted to a military hospital: a retrospective case series.

    Science.gov (United States)

    Harrell, Travis; Hammes, John S

    2012-10-01

    Meningitis is a common admission diagnosis. No case series or descriptive studies on meningitis have recently been published. Additionally, no recent data exist on meningitis in the U.S. Military Health System. We reviewed charts of adult patients admitted to Naval Medical Center San Diego between January 2004 and December 2008 with an admission diagnosis of meningitis. Charts were excluded if they did not meet our case definition of meningitis, if missing data, or if meningitis was nosocomial or iatrogenic. We reviewed results of cerebrospinal fluid cultures during this period. We compared rates and characteristics, and outcomes of bacterial and aseptic meningitis. Two hundred twenty-one cases met our criteria. Of these, 208 were aseptic. Cerebrospinal fluid polymerase chain reaction testing was positive for enteroviruses and herpes simplex viruses in 42 (20.2%) and 17 (8.2%) cases, respectively. Of culture/polymerase chain reaction/serologically positive cases, the pathogens were Neisseria meningitidis (3), Streptococcus pneumoniae (3), viridans streptococci (2), Cryptococcus neoformans (2), Coccidioides immitis (2), and Mycobacterium tuberculosis (1). Three patients had poor outcomes: one died from S. pneumoniae and two had long-term neurologic deficits. Meningitis is a common admission diagnosis, but serious virulent pathogens are uncommon and adverse outcomes are rare.

  1. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    Directory of Open Access Journals (Sweden)

    Angalakuditi M

    2011-06-01

    Full Text Available Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR, pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group.Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505 were involved in a repeated intervention vs 18.2% (428 in controls (P < 0.001, which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%, and for controls it was drug–drug interactions (1796, 25.4%. The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls (P = 0.01.Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.Keywords: pharmacy management, spillover effect, RDUR, DUR

  2. STROKE IN YOUNG ADULTS: A RETROSPECTIVE STUDY OF 68 CASES

    Directory of Open Access Journals (Sweden)

    M. H. Harirchian

    2006-06-01

    Full Text Available Numerous etiologies are responsible for cases of stroke in young adults. This study reviews the causes of two types of stroke (ischemic and intracerebral hemorrhage in young adults aged 15 to 40years, admitted to our center (a tertiary care center from 1997 to 2002. The purpose of this study is to determine the relative frequency of causes of stroke in young adults and compare this with published data in the literature. Using the codes 46.0 to 46.8 of the International Classification of Diseases- 10th Edition (ICD-10, cases were identified from the records of the stroke patients admitted in Imam Khomeini Hospital and the data were collected from their files using a comprehensive questionnaire. Forty-two cases of ischemic stroke (62% and 26 cases of intracerebral hemorrhage (38% were identified. The leading cause of ischemic stroke was cardioembolism (38.1%, followed by atherosclerosis in 5 cases (11.9%. Among cardiac causes infarction was attributable to consequences of rheumatic heart disease in 8 cases. In 3 cases a cessation or decrease in dose of warfarin was followed directly by an ischemic stroke. The most leading cause of intracerebral hemorrhage was hypertension (30.8%. Other causes were anticoagulant therapy, intratumoral hemorrhage, aplastic anemia, leukemia, arteriovenous malformations, and chronic active hepatitis. In conclusion, cardioembolism and hypertension were the most leading causes of ischemic and hemorrhagic stroke in young adults admitted in our hospital.

  3. Ovarian endometriomas and IVF: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Guidetti Daniela

    2011-06-01

    Full Text Available Abstract We performed this retrospective case-control study analyzing 428 first-attempt in vitro fertilization (IVF cycles, among which 254 involved women with a previous or present diagnosis of ovarian endometriosis. First, the results of these 254 cycles were compared with 174 cycles involving patients with proven non-endometriotic tubal infertility having similar age and body mass index. Women with ovarian endometriosis had a significantly higher cancellation rate, but similar pregnancy, implantation and delivery rates as patients with tubal infertility. Second, among the women with ovarian endometriosis, the women with a history of laparoscopic surgery for ovarian endometriomas prior to IVF and no visual endometriosis at ovum pick-up (n = 112 were compared with the non-operated women and visual endometriomas at ovum pick-up (n = 142. Patients who underwent ovarian surgery before IVF had significantly shorter period, lower antral follicle count and required higher gonadotropin doses than patients with non-operated endometriomas. The two groups of women with a previous or present ovarian endometriosis did, however, have similar pregnancy, implantation and live birth rates. In conclusion, ovarian endometriosis does not reduce IVF outcome compared with tubal factor. Furthermore, laparoscopic removal of endometriomas does not improve IVF results, but may cause a decrease of ovarian responsiveness to gonadotropins.

  4. Duodenal fistula after gastrectomy: retrospective study of 13 new cases

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    María de los Ángeles Cornejo

    2016-01-01

    Full Text Available Introduction: Duodenal stump fistula (DSF after gastrectomy has a low incidence but a high morbidity and mortality, and is therefore one of the most aggressive and feared complications of this procedure. Material and methods: We retrospectively evaluated all DSF occurred at our hospital after carrying out a gastrectomy for gastric cancer, between January 1997 and December 2014. We analyzed demographic, oncologic, and surgical variables, and the evolution in terms of morbidity, mortality and hospital stay. Results: In the period covered in this study, we performed 666 gastrectomies and observed DSF in 13 patients (1.95%. In 8 of the 13 patients (61.5% surgery was the treatment of choice and in 5 cases (38.5% conservative treatment was carried out. Postoperative mortality associated with DSF was 46.2% (6 cases. In the surgical group, 3 patients developed severe sepsis with multiple organ failure, 2 patients presented a major hematemesis which required endoscopic haemostasis, 1 patient had an evisceration and another presented a subphrenic abscess requiring percutaneous drainage. Six patients (75% died despite surgery, with 3 deaths in the first 24 hours of postoperative care. The 2 patients who survived after the second surgical procedure had a hospital stay of 45 and 84 days respectively. In the conservative treatment group the cure rate was 100% with no significant complications and an average postoperative hospital stay of 39.5 days (range, 26-65 days. Conclusion: FMD is an unusual complication but it is associated with a high morbidity and mortality. In our experience, conservative management has shown better results compared with surgical treatment.

  5. BISPHOSPHONATES IN LANGERHANS CELL HISTIOCYTOSIS: AN INTERNATIONAL RETROSPECTIVE CASE SERIES

    Directory of Open Access Journals (Sweden)

    Deepak Chellapandian

    2016-07-01

    Full Text Available Background: Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH, which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method: We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results: Ten patients (77% had a single system bone disease, and 3 (23% had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years. Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve  (92% achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years. One patient did not respond. No major adverse effects were reported in this series.  Conclusion: Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted.

  6. Congenital Zika syndrome with arthrogryposis: retrospective case series study

    Science.gov (United States)

    Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli

    2016-01-01

    Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital

  7. Metastatic Brain Tumors: A Retrospective Review in East Azarbyjan (Tabriz

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    Zinat Miabi

    2011-02-01

    Full Text Available A set of one hundred and twenty nine patients with known primary malignancy and suspected brain metastasis was reviewed in present study. The patients were selected among patients presented to the MRI section of Imam Khomeini Hospital or a private MRI center in Tabriz (Iran. Primary tumor site, clinical manifestations, number and site of lesions were identified in this patient population. The primary tumor site was breast in 55 patients (42.6%, followed by lung (40.3%, kidney (7.7%, colorectal (4.6%, lymphoma (3.1% and melanoma (1.5%. Most patients were presented with features of increased intracranial pressure (headaches and vomiting, seizures and focal neurologic signs. Single brain metastasis occurred in 16.3% of patients, while multiple lesions accounted for 83.7% of patients. Ninety seven patients had supratentorial metastases (75.2%. Twenty cases (15.5% had metastases in both compartments. Infratentorial lesions were observed only in twelve patients (9.3%.

  8. Oral cancer: a retrospective study of 100 Danish cases

    DEFF Research Database (Denmark)

    Pinholt, E M; Rindum, J; Pindborg, J J

    1997-01-01

    One hundred Danes with oral cancer who were collected consecutively from 1986 to 1991 were evaluated retrospectively. The study included subjective and objective observations in 56% men and in 44% women. M:F ratio was 1.2:1. Fifty percent of the patients were non-smokers. Nine percent were women...

  9. Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review

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    Das Dilip Kumar

    2012-12-01

    Full Text Available Abstract Background The incidence and mortality from necrotizing fasciitis (NF are increasing in New Zealand (NZ. Triggered by a media report that traditional Samoan tattooing was causing NF, we conducted a chart review to investigate the role of this and other predisposing and precipitating factors and to document NF microbiology, complications and interventions in NZ. Methods We conducted a retrospective review of 299 hospital charts of patients discharged with NF diagnosis codes in eight hospitals in NZ between 2000 and 2006. We documented and compared by ethnicity the prevalence of predisposing and precipitating conditions, bacteria isolated, complications and interventions used. Results Out of 299 charts, 247 fulfilled the case definition. NF was most common in elderly males. Diabetes was the most frequent co-morbid condition, followed by obesity. Nearly a quarter of patients were taking non-steroidal anti-inflammatory drugs (NSAID. Traditional Samoan tattooing was an uncommon cause. Streptococcus pyogenes and Staphylococcus aureus were the two commonly isolated bacteria. Methicillin-resistant Staphylococcus aureus was implicated in a relatively small number of cases. Shock, renal failure, coagulation abnormality and multi-organ dysfunction were common complications. More than 90% of patients underwent surgical debridement, 56% were admitted to an intensive care unit (ICU and slightly less than half of all patients had blood product transfusion. One in six NF cases had amputations and 23.5% died. Conclusion This chart review found that the highest proportion of NF cases was elderly males with co-morbidities, particularly diabetes and obesity. Tattooing was an uncommon precipitating event. The role of NSAID needs further exploration. NF is a serious disease with severe complications, high case fatality and considerable use of health care resources.

  10. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

    Directory of Open Access Journals (Sweden)

    Fadzillah Mohd-Tahir

    2012-01-01

    Full Text Available Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27% were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41% cases of positive isolates. Of these, in eleven cases (23.40% patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34% cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future.

  11. A 5-year retrospective review of fungal keratitis at hospital universiti sains malaysia.

    Science.gov (United States)

    Mohd-Tahir, Fadzillah; Norhayati, A; Siti-Raihan, Ishak; Ibrahim, M

    2012-01-01

    Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27%) were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41%) cases of positive isolates. Of these, in eleven cases (23.40%) patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34%) cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future. PMID:23304138

  12. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review

    Institute of Scientific and Technical Information of China (English)

    Sami Akbulut; Mahmut Tas; Nilgun Sogutcu; Zulfu Arikanoglu; Murat Basbug; Abdullah Ulku; Heybet Semur; Yusuf Yagmur

    2011-01-01

    AIM: To document unusual findings in appendectomy specimens.METHODS: The clinicopathological data of 5262 pa-tients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies per-formed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English lan-guage studies published between 2000 and 2010 on unusual findings in appendectomy specimens.RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltra-tions, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two pa-tients who were diagnosed with tuberculous appendi-citis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed.CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appen-dectomy specimens should be sent for routine histo-pathological examination.

  13. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    OpenAIRE

    Angalakuditi M; Gomes J.

    2011-01-01

    Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR), pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription dat...

  14. Fatal cases of gestational trophoblastic neoplasia over four decades in the Netherlands: a retrospective cohort study

    NARCIS (Netherlands)

    Lybol, C.; Centen, D.W.; Thomas, C.M.G.; ten Kate-Booij, M.J.; Verheijen, R.H.; Sweep, F.C.; Ottevanger, P.B.; Massuger, L.F.A.G.

    2012-01-01

    OBJECTIVE: To describe fatal cases of gestational trophoblastic neoplasia (GTN) over four decades and evaluate whether treatment was given according to the protocol and reveal possible implications for future management. DESIGN: Retrospective cohort study. SETTING: The Netherlands. POPULATION: Women

  15. Transforaminal versus posterior lumbar interbody fusion as operative treatment of lumbar spondylolisthesis, a retrospective case series

    Directory of Open Access Journals (Sweden)

    S.L. de Kunder, MD

    2016-09-01

    Conclusion: In this case series, TLIF was associated with shorter surgical time. Other assumed advantages of TLIF could not be verified in this retrospective patient series. Further prospective research is needed to confirm these results.

  16. Adolescent idiopathic scoliosis: Retrospective analysis of 235 surgically treated cases

    Directory of Open Access Journals (Sweden)

    Unnikrishnan Ranjith

    2010-01-01

    Full Text Available Background : The surgical treatment of adolescent idiopathic scoliosis (AIS has taken great strides in the last two decades. There have been no long term reported studies on AIS from India with documented long term followup. In this study we review a single surgical team′s series of 235 surgically treated cases of AIS with a follow-up from two to six years. Materials and Methods : Pre operative charts, radiographs and MRI scans for 235 patients were collected for this study. The patients were grouped into three groups where anterior correction and fusion (n=47, posterior correction and fusion (n=123 and combined anterior release and posterior instrumentation (n=65 was performed. Each group was divided into two subgroups based on the surgical approach and instrumentation strategy (all screw construct or hybrid construct used. Patients were followed up for coronal and saggital plane corrections, apical vertebral translation (AVT, trunk balance and back pain. The percentage of correction was calculated in each group as well as sub groups. Results : The incidence of MRI detected intraspinal anomaly in this series is 5.9% with 3.4% of them requiring neurosurgical procedure along with scoliosis correction. Average coronal major curve correction was 66% in the all screw group and 58.5% in the hybrid group. The coronal plane correction was better when the all screw constructs were employed. Also, the AVT and trunk balance was better with the all screw constructs. The anterior corrections resulted in better correction of the AVT and trunk balance as compared to the posterior correction. There were eight (3.4% complications in this series. The coronal and saggital plane correction paralleled the published international standards. Conclusion : The coronal plane correction was better when all screw constructs were employed. Use of all pedicle screw systems obviated the need for costoplasty in most cases. The increased incidence of intraspinal anomaly may

  17. Accuracy of frozen section diagnosis: a retrospective analysis of 4785 cases

    DEFF Research Database (Denmark)

    Winther, Charlotte; Graem, Niels

    2011-01-01

    During a 1-year period 4785 intraoperative consultations were performed. The pathology reports were retrospectively reviewed to determine the accuracy of frozen section diagnosis in various tissue types. Skin for evaluation of section margins and axillary sentinel lymph nodes for evaluation...... of deferred specimens was 57. The accuracy of frozen section diagnosis varied between tissue types, and axillary sentinel lymph nodes accounted for the greatest number of discordances. In conclusion, the frozen section diagnosis is a reliable method with varying concordance and deferral rates between tissue...... of metastatic disease were most frequently sent for frozen section diagnosis. The number of discordant cases were 182, 178 were false negative and four were false positive. When frozen section diagnoses were compared with permanent section diagnoses, the overall diagnostic concordance was 95.1%. The number...

  18. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients

    Directory of Open Access Journals (Sweden)

    Nielsen SA

    2013-04-01

    Full Text Available CorrigendumNielsen SA, McDonald MB, Majmudar PA. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients. Clinical Ophthalmology. 2013;7:149–156. The paper titled "Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients," contains an inaccurate description of the intraoperative use of medications.In the Results section it is reported that 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had drops applied directly to the flap interface. We have determined that ambiguity in the design of the electronic case report form resulted in all day-of-surgery drops provided to patients in the LASER suite being reported in the flap interface field. The authors have since clarified with each surgeon who reported intraoperative drug use that the drops were delivered either prior to the flap creation, or following replacement of the flap.The sentence at the top of page 152 stating: "Of note, 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had drops applied directly to the flap interface" should say: "Of note, 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had intraoperative drops applied."Read the original article

  19. A Retrospective Study of 15 Cases of Premature Pubarche

    OpenAIRE

    Çaksen, Hüseyin; Kurtoğlu, Selim; Yüksel, Şaban

    2000-01-01

    In this study the findings of 15 patients with premature pubarche PP [one of them aged 7 5 months the others between 4 years 1 month and 9 years the mean age 6 50±3 50 years ] were evaluated retrospectively Our purpose was to determine the factors that are operative in the pathophysiology of PP Of 15 patients 13 83 1 were girls two 16 9 were boys Appearence of pubic hair began between ages 4 and 8 5 6 25±3 18 years in all patients except for the patient aged 7 5 months It began at 7 months of...

  20. Five-Year Retrospective Review of Acute Generalized Exanthematous Pustulosis

    Science.gov (United States)

    Thienvibul, Chitprapassorn; Vachiramon, Vasanop; Chanprapaph, Kumutnart

    2015-01-01

    Background. Acute generalized exanthematous pustulosis (AGEP) is an acute pustular eruption characterized by widespread nonfollicular sterile pustules. The aim of this study is to characterize the etiology, clinical features, laboratory findings, management, and outcome of patients with AGEP in Asians. Patient/Methods. A retrospective analysis was performed on patient who presented with AGEP between August 2008 and November 2012 in a tertiary center in Thailand. Results. Nineteen patients with AGEP were included. AGEP was generally distributed in seventeen patients (89.5%) and localized in two (10.5%). Fever and neutrophilia occurred in 52.6% and 68.4%, respectively. Hepatitis was found up to 26.3%. The most common etiology was drugs (94.7%), comprising of antibiotics (73.6%), proton pump inhibitors (10.5%), nonsteroidal anti-inflammatory drugs (5.3%), and herbal medicine (5.3%). Beta-lactams were the most common causal drug, particularly carbapenems and cephalosporins. This is the first report of Andrographis paniculata as an offending agent for AGEP. We found no differences between various treatment regimens (topical corticosteroid, systemic corticosteroid, and supportive treatment) regarding the time from drug cessation to pustules resolution (P = 0.171). Conclusions. We have highlighted the presentation of AGEP among Asians. We found high association with systemic drugs. Carbapenems were one of the leading culprit drugs. Finally, a localized variant was observed. PMID:26783390

  1. Five-Year Retrospective Review of Acute Generalized Exanthematous Pustulosis

    Directory of Open Access Journals (Sweden)

    Chitprapassorn Thienvibul

    2015-01-01

    Full Text Available Background. Acute generalized exanthematous pustulosis (AGEP is an acute pustular eruption characterized by widespread nonfollicular sterile pustules. The aim of this study is to characterize the etiology, clinical features, laboratory findings, management, and outcome of patients with AGEP in Asians. Patient/Methods. A retrospective analysis was performed on patient who presented with AGEP between August 2008 and November 2012 in a tertiary center in Thailand. Results. Nineteen patients with AGEP were included. AGEP was generally distributed in seventeen patients (89.5% and localized in two (10.5%. Fever and neutrophilia occurred in 52.6% and 68.4%, respectively. Hepatitis was found up to 26.3%. The most common etiology was drugs (94.7%, comprising of antibiotics (73.6%, proton pump inhibitors (10.5%, nonsteroidal anti-inflammatory drugs (5.3%, and herbal medicine (5.3%. Beta-lactams were the most common causal drug, particularly carbapenems and cephalosporins. This is the first report of Andrographis paniculata as an offending agent for AGEP. We found no differences between various treatment regimens (topical corticosteroid, systemic corticosteroid, and supportive treatment regarding the time from drug cessation to pustules resolution (P=0.171. Conclusions. We have highlighted the presentation of AGEP among Asians. We found high association with systemic drugs. Carbapenems were one of the leading culprit drugs. Finally, a localized variant was observed.

  2. Cerebrospinal fluid cytomorphologic findings in 41 intracranial tumors: a retrospective review

    Directory of Open Access Journals (Sweden)

    Maria José Sá

    1995-06-01

    Full Text Available The main objective of this retrospective review of clinical and cerebrospinal fluid (CSF data from 41 patients with intracranial tumors diagnosed between 1975 and 1989, is to report the role that the finding of neoplastic cells in CSF plays, specially when cerebral CT-scanning and MRI were not currently done. Another objective is to study the CSF proteic abnormalities in cerebral tumors. CSF cell count, cytomorphologic pictures obtained after sedimentation and protein findings are described. Tumor cells were seen in 12 cases (29%: medulloblastomas - 6, meningeal carcinomatosis - 3, multiforme glioblastoma - 1, ependymoma -1, cerebral metastasis -1; in two cases it was an unexpected finding. We noticed that tumoral localization next to the ventricles favoured cell exfoliation. Although pleocytosis was rare and uncorrelated with the presence of neoplastic cells, pathological cytomorphologic pictures appeared in most of the cases including all "positive" ones. Our results stress that the appearance of neoplastic cells in CSF remains helpful specially when it is an unexpected finding.

  3. Mucormycosis caused byMucor irregularis, a retrospective review of 20 cases%不规则毛霉感染引起的皮肤毛霉病20例回顾性分析

    Institute of Scientific and Technical Information of China (English)

    夏志宽; 刘畅; 丛林; 陈卫; 张德全; 田艳丽; 王文岭; 杨蓉娅

    2014-01-01

    目的:通过对不规则毛霉感染病例的回顾性分析,探讨不规则毛霉感染引起皮肤毛霉病的流行病学、易感因素、临床表现、诊断方法及治疗策略,提高临床医生的警惕性及诊治经验。方法对检索到的20例不规则毛霉感染病例资料进行总结、分析。结果20例不规则毛霉感染患者均表现为皮肤毛霉病,仅1例同时伴有肺部感染。15例来自中国,1例有糖尿病史,1例有白血病史,10例有外伤、手术或叮咬史。皮损几乎均出现在暴露部位,其中鼻面部13例,四肢7例,病程多呈慢性。早期表现为红斑、丘疹、结节,后期可发展成溃疡、坏死、黑痂及骨质破坏。经真菌镜检、培养、组织病理、ITS区测序等检查证实为不规则毛霉。两性霉素B及其脂质体单独或联合伊曲康唑治疗预后好。结论不规则毛霉感染多发生于免疫正常者,外伤、烧伤、手术及叮咬是最主要诱发因素。感染主要累及鼻面部及四肢皮肤暴露部位,以红斑、坏死为主要表现,极少累及内脏。真菌培养及组织病理检查可以诊断该病, ITS区测序可明确鉴定到种。及早诊断并给予清创及两性霉素B是治疗成功的关键。%ObjectiveTo investigate and discuss the epidemiology, risk factors, clinical manifestations, diagnostic methods and treatment strategies forMucor irregularis infection. To improve the experience of diagnosis and treatment of mucormycosis. MethodsTwenty cases of mucormycosis caused byMucor irregularis from our case and reported literature were retrospectively summarized and analyzed.ResultsOf the 20 cases, 15 cases were found in China and all were cutaneous mucormycosis, except for one case, which was accompanied with pulmonary infection. Two patients had history of diabetes and acute myeloblastic leukemia (AML) respectively, while other ten patients had injuries, surgery or bite history. The lesions were

  4. CUTANEOUS HYPERPIGMENTATION IN MEGALOBLASTIC ANEMIA: A FIVE YEAR RETROSPECTIVE REVIEW.

    Directory of Open Access Journals (Sweden)

    Somanath Padhi

    2016-04-01

    Full Text Available Background: Cutaneous hyperpigmentation is an often overlooked clinical sign in megaloblastic anemia (MA which has been sporadically reported in the literature. Methods: We describe the bone marrow (BM changes and clinicolaboaratory characteristics of 25 of 198 adult cases (>16 years with cutaneous hyperpigmentation who underwent BM evaluation for cytopenia (s. Results:  Twenty-one of 25 cases (84% had MA, while MA without hyperpigmentation occurred only in 12 of remainder 173 cases (P0.05. In six cases where follow-up data were available, there was significant reversal of hyperpigmentation at 12 weeks following parenteral cobalamine therapy. In all five cases with pyrexia, fever subsided after 24 to 72 hours following administration of parenteral cobalamine therapy. Conclusion: Cutaneous hyperpigmentation, pyrexia, and cytopenia (s are strongly associated with megaloblastic anemia. Knuckle pad hyperpigmentation is much more common than diffuse pigmentation of the palms and/or soles in such patents. A nonsignificant trend towards a greater degree of MA was found in cases with pigmentation of the knuckles.

  5. Optimization of machining techniques – A retrospective and literature review

    Indian Academy of Sciences (India)

    Aman Aggarwal; Hari Singh

    2005-12-01

    In this paper an attempt is made to review the literature on optimizing machining parameters in turning processes. Various conventional techniques employed for machining optimization include geometric programming, geometric plus linear programming, goal programming, sequential unconstrained minimizationtechnique, dynamic programming etc. The latest techniques for optimization include fuzzy logic, scatter search technique, genetic algorithm, Taguchi technique and response surface methodology.

  6. 75 Years of the International Labour Review: A Retrospective.

    Science.gov (United States)

    Thomas, Albert; And Others

    1996-01-01

    Contains 18 articles published in International Labour Review from 1921-1975 that discuss the International Labour Organisation, international labor movement and law, economics and the labor market, family security, full employment, population growth, industrial welfare, trade policy and employment growth, and income expectations and rural-urban…

  7. Sedation for pediatric neuroradiological examinations. Retrospective study of 160 cases

    International Nuclear Information System (INIS)

    A retrospective study of 160 pediatric neuroradiological examinations was conducted to determine the efficacy and safety of two sedation regimens (figs. 1, 2). For CT purposes, 150 patients (fig. 3) were orally given monosodium trichlorethyl phosphate syrup (100 mg/kg, with repeat 50 mg/kg if necessary), and for cerebral angiography, 15 patients (fig. 4) were intramuscularly administered a modified D.P.T. cocktail (pentazocine, chlorpromadine, promethazine). Failure rate in the oral syrup group was 6%, and in the D.P.T. group 6.7%. Diagnostic-quality images were obtained in 99.3% and 100%, respectively, of the two groups. There were neither mortality nor significant complications (table 3). It was concluded that each method had proved acceptably safe and effective, and that measures can be taken to further decrease complications and sedation failures. (author)

  8. Histological review of skin cancers in African Albinos: a 10-year retrospective review

    International Nuclear Information System (INIS)

    Skin cancer is rare among Africans and albinism is an established risk for skin cancer in this population. Ultraviolet radiation is highest at the equator and African albinos living close to the equator have the highest risk of developing skin cancers. This was a retrospective study that involved histological review of all specimens with skin cancers from African albinos submitted to The Regional Dermatology Training Center in Moshi, Tanzania from 2002 to 2011. A total of 134 biopsies from 86 patients with a male to female ratio of 1:1 were reviewed. Head and neck was the commonest (n = 75, 56.0%) site affected by skin cancers. Squamous cell carcinoma (SCC) was more common than basal cell carcinoma (BCC) with a ratio of 1.2:1. Only one Acral lentiginous melanoma was reported. Majority (55.6%) of SCC were well differentiated while nodular BCC (75%) was the most common type of BCC. Squamous cell carcinoma is more common than basal cell carcinoma in African albinos

  9. [Retrospective evaluation of brucellosis cases inhabiting in Mus province].

    Science.gov (United States)

    Sit, Dede; Kadiroğlu, Ali Kemal; Kayabaşi, Hasan; Hoşoğlu, Salih

    2006-07-01

    The aim of this study was to evaluate the brucellosis patients inhabiting in Mus province, in Eastern Anatolia of Turkey, retrospectively. The mean age of the patients (n: 87) was 38.1 +/- 12.4 years, and 45% of them were female. The transmission route was the consumption of unpasteurized fresh cheese (in 85%), and unboiled milk (in 45%). The most common symptoms were recorded as chills (89%), fever (87%), and arthralgia (81%). Splenomegaly (71%) and hepatomegaly (63%) were the predominant physical examination signs. Diagnosis was made based on the clinical features and positive Rose-Bengal test result (93%), however, blood cultures could not be performed due to insufficient laboratory equipment. In 92% of the patients at least one complication has been detected indicating delayed admission to the hospital, while the most common complications were sacroileitis (79%) and spondylitis (44%). Streptomycin+doxycyclin, streptomycin+doxycyclin+ ciprofloxacin, and streptomycin+doxycyclin+ rifampicin combination therapies were used in 62%, 24% and 14% of the patients, respectively, for six weeks, resulting with complete cure. PMID:17001861

  10. Molecular and Functional Characterization of Bacopa monniera: A Retrospective Review.

    Science.gov (United States)

    Rajan, Koilmani Emmanuvel; Preethi, Jayakumar; Singh, Hemant K

    2015-01-01

    Over the last 50 years, laboratories around the world analyzed the pharmacological effect of Bacopa monniera extract in different dimensions, especially as a nerve tonic and memory enhancer. Studies in animal model evidenced that Bacopa treatment can attenuate dementia and enhances memory. Further, they demonstrate that Bacopa primarily either acts via antioxidant mechanism (i.e., neuroprotection) or alters different neurotransmitters (serotonin (5-hydroxytryptamine, 5-HT), dopamine (DA), acetylcholine (ACh), γ-aminobutyric acid (GABA)) to execute the pharmacological effect. Among them, 5-HT has been shown to fine tune the neural plasticity, which is a substrate for memory formation. This review focuses on the studies which trace the effect of Bacopa treatment on serotonergic system and 5-HT mediated key molecular changes that are associated with memory formation. PMID:26413131

  11. Molecular and Functional Characterization of Bacopa monniera: A Retrospective Review

    Science.gov (United States)

    Rajan, Koilmani Emmanuvel; Preethi, Jayakumar; Singh, Hemant K.

    2015-01-01

    Over the last 50 years, laboratories around the world analyzed the pharmacological effect of Bacopa monniera extract in different dimensions, especially as a nerve tonic and memory enhancer. Studies in animal model evidenced that Bacopa treatment can attenuate dementia and enhances memory. Further, they demonstrate that Bacopa primarily either acts via antioxidant mechanism (i.e., neuroprotection) or alters different neurotransmitters (serotonin (5-hydroxytryptamine, 5-HT), dopamine (DA), acetylcholine (ACh), γ-aminobutyric acid (GABA)) to execute the pharmacological effect. Among them, 5-HT has been shown to fine tune the neural plasticity, which is a substrate for memory formation. This review focuses on the studies which trace the effect of Bacopa treatment on serotonergic system and 5-HT mediated key molecular changes that are associated with memory formation. PMID:26413131

  12. Dorgan's lateral cross-wiring of supracondylar fractures of the humerus in children: A retrospective review.

    LENUS (Irish Health Repository)

    Queally, Joseph M

    2010-06-01

    The currently accepted treatment for displaced supracondylar humeral fractures in children is closed reduction and fixation with percutaneous Kirschner wires. The purpose of this study was to retrospectively review a novel cross-wiring technique where the cross-wire configuration is achieved solely from the lateral side, thereby reducing the risk of ulnar nerve injury.

  13. Insertion of balloon retained gastrostomy buttons: a 5-year retrospective review of 260 patients.

    LENUS (Irish Health Repository)

    Power, Sarah

    2013-04-01

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review.

  14. 77 FR 55833 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    Science.gov (United States)

    2012-09-11

    ... community water system is required by Federal regulations (63 FR 44512, August 19, 1998) to provide to its... AGENCY Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review..., 2012, to listen to stakeholder comments on potential approaches for providing Consumer...

  15. 76 FR 78183 - Preliminary Plan for Retrospective Review Under E.O. 13579

    Science.gov (United States)

    2011-12-16

    ... regulations fulfill the Commission's mission and are effective, cost-efficient and understandable. Comment..., 2012. Please note that the electronic Federal Docket Management System will not accept comments after... 2003. 68 FR 41696-41714 (July 15, 2003). The retrospective review will include an analysis of...

  16. 76 FR 38328 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    Science.gov (United States)

    2011-06-30

    ... focuses on the importance of maintaining a consistent culture of retrospective review and analysis by..., resources, organizational structure and rulemaking history and volume.'' II. The Commission's Plan As part... FR 12888, Mar. 9, 2011; to conform the requirements under 17 CFR part 4 governing the operations...

  17. Eccrine Angiomatous Hamartoma: A Retrospective Study of 15 Cases

    OpenAIRE

    Yi-Ting Lin; Chien-Ming Chen; Chih-Hsun Yang; Yea-Huey Chuang

    2012-01-01

    Background: Eccrine angiomatous hamartoma (EAH) comprises a rare nevoid proliferation of normal eccrine glands and small blood vessels and occasionally otherelements in the middle and deep dermis with variable clinical manifestations.Case series have rarely been published except for case reports and literaturereviews. The aims of this article were to investigate the clinical and pathologic features of patients with EAH in Taiwan and to compare our resultswith the results of previous studies.M...

  18. Retrospective Evaluation of Cases Diagnosed with Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Gülseren Şahin

    2012-04-01

    Full Text Available In­tro­duc­ti­on: Inflammatory bowel disease (IBD is a chronic inflammatory disease of the gastrointestinal canal characterised by remissions and exacerbations. This study aimed to make a retrospective evaluation of clinical and laboratory findings of patients being monitored with a diagnosis of IBD.Materials and Methods: Medical records of 18 patients with a diagnosis of IBD and 7 years of follow-up at our pediatric gastroenterology departments were investigated with respect to demographic data, complaints on presentation and accompanying diseases. Unusual findings from physical examination, endoscopic findings, histopathological findings and the applied treatments were examined.Results: The 18 patients (10 female, 8 male included in this study had a mean age of 13.6±2.9 years and the mean time from onset of symptoms to diagnosis was 6.9±4.5 months. Seventeen patients were diagnosed with ulcerative colitis and 1 patient with intermediate colitis. There was a positive family history of the disease in 2 patients (11%. At the time of diagnosis, the most common complaints on presentation were found to be abdominal pain (100%, bloody diarrhea (94.5% and tenesmus (44.4%. The most frequent laboratory findings were CRP positivity (89%, increased sedimentation rate (83.3% and iron-deficient anaemia (77.7%. On colonoscopy, pancolitis involvement (66.6% was most frequently encountered. Accompanying diseases to IBD were found to be familial Mediterranean fever (FMF (11%, celiac disease (5.5% and Heliobacter pylori gastritis (5.5%. One patient (5.5% who did not respond to medical treatment for pancolitis involvement underwent a colectomy. Discussion: The number of diagnoses of IBD in childhood is gradually increasing. Nonetheless, it can be difficult to define diseases with non-specific symptoms and this may cause a delay in diagnosis. Because of the association of autoimmune diseases with IBD, despite appropriate therapy, diseases with no remission

  19. Prognostic factors and outcomes of adult-onset hemophagocytic lymphohistiocytosis: a retrospective analysis of 34 cases

    Directory of Open Access Journals (Sweden)

    Masafumi Oto

    2015-06-01

    Full Text Available Adult-onset hemophagocytic lymphohistiocytosis (HLH has features that are distinct from that of HLH in pediatric patients. The clinical records at the Japanese Red Cross Kumamoto Hospital were reviewed. We retrospectively analyzed 34 patients who fulfilled the diagnostic criteria of HLH-2004. The median age of patients was 60.0 (range 15-86. Underlying diseases were diagnosed in 17 patients. They consisted of malignant lymphoma (n=3, other neoplastic disease (n=3, viral infection (n=4, collagen vascular disease (n=3, Kikuchi’s disease (n=3 and drug (n=1. Underlying diseases were not diagnosed in 17 patients despite examination. The treatments were steroids (n=18, dexamethasone + cyclosporine A (CSA + etoposide (n=4, multidrug chemotherapy (n=2, steroids and CSA (n=3. Eleven patients died during observation. In a multivariate analysis, the significant predictor for death was age at onset (hazard ratio, 1.22; 95%CI, 1.02-1.44; P=0.027. Autopsy was performed in 4 cases, but the underlying disease remained unknown in 3 of those cases. Adult-onset HLH has high diversity and various outcomes. The mechanism of adult-onset HLH is not fully understood and further research is required.

  20. Avian mycobacteriosis in psittacines: a retrospective study of 123 cases.

    Science.gov (United States)

    Palmieri, C; Roy, P; Dhillon, A S; Shivaprasad, H L

    2013-02-01

    One hundred and twenty-three cases of mycobacterioses were diagnosed in psittacine birds from a total of 9,241 submissions for necropsy examination or histopathology made to the California Animal Health and Food Safety Laboratory System between 1990 and 2007. The species affected most commonly were Amazon parrots (Amazona spp.)(n = 32; 26%) and grey-cheeked parakeets Brotogeris pyrrophterus (n = 23; 18.7%). The main gross findings on necropsy examination were enlarged and mottled pale livers and spleens and thickening of the small intestinal wall with numerous pale miliary nodules on the mucosa. Microscopical examination revealed infiltration of foamy macrophages and giant cells containing acid-fast bacteria in various organs. The gene encoding mycobacterial 65 kDa heat shock protein (hsp65) was amplified by nested polymerase chain reaction (PCR) from DNA extracted from 22 cases. The species of Mycobacterium involved was determined by analysis of restriction endonuclease patterns of the PCR products. Mycobacterium genavense was detected in 19 cases and Mycobacterium avium in two cases. One parrotlet (Touit spp.) had a mixed infection of both species of mycobacteria. It is concluded that M. genavense is the primary cause of mycobacteriosis in psittacine birds and the potential for zoonotic disease should be considered, especially for immunocompromised owners. PMID:22884283

  1. Total joint arthroplasty in nonagenarians--a retrospective review of complications and resource use.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-12-01

    Increased age brings with it the potential for increased surgical risk. Assessment of specific age cohorts is necessary to plan future service provision and this is the case in hip and knee arthroplasty as the demand for these procedures is anticipated to increase. We retrospectively reviewed the outcomes, including complications, length of stay and blood transfusion rate, in a cohort of 35 nonagenarians undergoing primary or revision total hip and knee arthroplasty. All patients were pre-assessed by anaesthetists before being deemed suitable to undergo surgery in the unit. The mean length of hospital stay was 13.7 +\\/- 10 days (range 2-56). Thirty-one percent of patients required a blood transfusion. Patients who underwent primary total hip arthroplasty reported improved joint specific functional scores. In this appropriately selected group of nonagenarians, we found no evidence to suggest surgery be withheld on the basis of age alone. However, patients with multiple medical comorbidities warrant appropriate assessment and surgical intervention in an institution with appropriate support. Future planning needs to take into account the predicted increase in demand for arthroplasty surgery in this age group.

  2. Employment for adults with autism spectrum disorders: A retrospective review of a customized employment approach.

    Science.gov (United States)

    Wehman, Paul; Brooke, Valerie; Brooke, Alissa Molinelli; Ham, Whitney; Schall, Carol; McDonough, Jennifer; Lau, Stephanie; Seward, Hannah; Avellone, Lauren

    2016-01-01

    Over the past few decades, there has been an increase in prevalence of children with autism spectrum disorders (ASD), and those children are now becoming young adults in need of competitive integrated employment (CIE). Customized employment (CE) is one pathway to employment that has been successful for other individuals with developmental disabilities (DD), though research has been very limited on the effectiveness with individuals with ASD. This paper provides a retrospective review of 64 individuals with ASD who came to our program from 2009 to 2014 for supported employment services as referred by the state vocational rehabilitation services agency. Employment specialists engaged in situational assessment, discovery, job development, customized job descriptions, on-site training and support, positive behavioral supports, and job retention techniques. The employment specialists were responsible for tracking their actual time spent working directly with or for the jobseeker with autism spectrum disorders (ASD). All vocational rehabilitation clients with ASD served during this time successfully secured CIE, and maintained their employment with ongoing supports, with intensity of support time decreasing over time. The majority (63/64, 98.4%) of individuals successfully secured CIE through the use of supported employment, in 72 unique employment positions. Of the majority of the individuals who secured employment, 77% (50) individuals indicated that they had never worked before and additional 18% (12) reported having short intermittent histories of employment. Despite this lack of employment experience, in all cases the jobseeker directed the job search and ultimately the job selection. PMID:26855048

  3. MULTIPLE SCLEROSIS ASSOCIATED WITH ANAEMIC SYNDROME: A RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Nadezhda S. Deleva

    2012-02-01

    Full Text Available An association of MS with different anaemic syndromes, most often pernicious and Vit. B12 deficiency anaemia has been reported in the literature. Accordingly, the coincidence of anaemia with MS has been considered to impact seriously on clinical presentation, therapeutic strategy and patient´s quality of life. Objective: To perform a retrospective analysis of 18 cases with anaemic syndrome as a factor of comorbidity in patients with MS. Material and methods: 18 MS patients (15 women and 3 men with RRMS (13, PPMS (2, and SPMS (3 diagnosed according to McDonald criteria were included in the present study. Average age was 36.4±8.5 (22-42 years, average disease duration 10.6±6.8 (4-18 years and means EDSS - 3.5±2.5 points (2-6. All individuals underwent clinical, MRI and hematological examinations. Results: The study group included patients with pernicious (n=8, Vitamin B12 (n=6, and iron (n=3 deficiency anaemia, as well as with β-thalassemia (n=1. In 12 patients anaemic syndrome proceeded MS and in 6 evolved during the course of the desease.Conclusion: Our own notices and literature review suggests a possible causative relation between MS and anaemic syndrome. The role of this coincidence on clinical presentation, necessity of additional treatment, and patient´s quality of life is discussed.

  4. Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series

    OpenAIRE

    Friedman Jonathan A; Briner Rudy P; Liu Jeffrey T

    2009-01-01

    Abstract Background Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P). Methods All patients undergoing single-level anterior cervical discectomy and fusion with plating between August 2005 and May 2007 by two surgeons (RPB or JAF) were retrospectively reviewed. All patients underwent anterior cervical microdiscectomy, arthrodesis using structur...

  5. Tympanoplasty Outcomes: A Review of 789 Cases

    Directory of Open Access Journals (Sweden)

    Shabbir Indorewala

    2015-03-01

    Full Text Available Introduction: Tympanoplasty is indicated to restore hearing disability and prevent recurrent otorrhea.  Materials and Methods: This study was a retrospective review of patients who underwent tympanoplasty with or without mastoidectomy over a 1-year period.  Results: A total of 789 tympanoplasties were reviewed, with a male-to-female ratio of 1:1.1. In total, 91% and 9% of tympanoplasties were performed without and with mastoidectomy, respectively. Complete graft take was observed in 98.6% of cases. Approximately 25% of patients had an air-bone gap (ABG gap ≤20dB pre-operatively, increasing to 75.6% post-operatively. ABG closure improved from 0.8% to 46.7%. Mean ABG improved from 26.30 ±8.1dB pre-operatively to 14 ± 10.41dB post- operatively (t=28.7, P

  6. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications.

    Science.gov (United States)

    Slade, J F; Gillon, T

    2008-01-01

    The purpose of this paper is to retrospectively review 234 consecutive cases of scaphoid fractures and nonunions treated using arthroscopy with the dorsal percutaneous implantation of a headless compression screw for healing and complications. Solid union of fracture is determined by CT scan. We identified 126 acute injuries, including 65 proximal pole fractures; 67 grossly displaced fractures; 12 trans-scaphoid perilunate dislocations including four trans-scaphoid trans-capitate fractures; and ten combined scaphoid and distal radius fractures. 108 scaphoid nonunions were identified. 98 were correctly aligned and ten had a humpback deformity which was correctable using arthroscopic assisted reduction techniques at the time of surgery. 82 presented with a fracture gap 2mm or greater requiring percutaneous bone grafting. 12 cases of avascular necrosis (AVN) were identified by MRI. 20 nonunions had surgery performed at other institutions. The mean time to surgery for the nonunions was 20 months. 99% union rate of acute scaphoid fractures was obtained by 12 weeks, as determined by CT scan. Two complications were identified (3%). One case of delayed healing was identified. this delayed union was treated with percutaneous bone grafting and continued on to heal uneventfully. The other complication was a case of volar trans-scaphoid peri-lunate dislocation. While the fracture healed, the patient developed a traumatic dislocation requiring a capitate-lunate arthrodesis. Treatment of scaphoid nonunions resulted in ten cases of delayed healing, which were treated with repeat percutaneous bone grafting. This represented a 9% complication rate. of the ten cases of delayed unions that were re-bone grafted, four failed to heal by nine months. This resulted in a 96% union rate of our nonunion group by nine months. when acute fracture healing was compared to nonunions the average healing of acute fractures as determined by CT scanning measuring trabecular bridging was 12 weeks

  7. Pigmented villonodular synovitis: a retrospective multicenter study of 237 cases.

    Directory of Open Access Journals (Sweden)

    Guo-ping Xie

    Full Text Available To review clinical characteristics of pigmented villonodular synovitis (PVNS in China.Electronic medical records (EMR of four Chinese institutes were queried for patients with histologically proven PVNS between January 2005 and February 2014. Their data were collected including gender, age at diagnosis, clinical presentation, affected site, symptom duration, comorbidities, treatment strategy, recurrence and routine laboratories.A total of 237 patients with biopsy-proven PVNS were investigated. The gender ratio was 1.35 for a female predominance (101 males and 136 females. The average age was 36 years (range, 2 to 83 years. The median delay from initial clinical symptom to diagnosis was 18 months. Main affected areas were the knee (73.84% and the hip (18.14%. Forty patients had a clear history of joint trauma. Six patients were concurrently diagnosed with PVNS and avascular necrosis (AVN. Five patients suffered from PVNS following implantation of orthopaedic devices including artificial prosthesis, plate and wire. One hundred and twenty-nine patients underwent arthroscopic synovectomy and 108 open synovectomy. Altogether 48 patients (26 males and 22 females had recurrence of disease. The relapse rate was 24% (knee and 6.98% (hip, 20.93% (open surgery and 19.44% (arthroscopy, respectively. Erythrocyte sedimentation rate (ESR and C-reactive protein (CRP rate were elevated in 45.83% and 38.41% of the patients respectively.To our knowledge, this study is the largest sample size of PVNS patients reported as well as the largest sample of PVNS with concurrent AVN reported to date. Our outcomes suggest that PVNS shows a female predominance, occurs mostly between 20-40 years and favors the knee and hip. Recurrence is frequent, particularly in the knee. Serum ESR and CRP may be elevated in some patients. Additionally, the present study supports the theory of an association between PVNS and orthopedic surgery, which is not limited to joint replacement.

  8. A retrospective review of visual outcome and complications in the treatment of retinoblastoma.

    LENUS (Irish Health Repository)

    O'Doherty, M

    2005-01-01

    The aim of this study was to look at the visual outcome and treatment complications of children diagnosed with Retinoblastoma during the years 1985-2003 inclusive. A retrospective review of all patients records was performed. Patient characteristics, treatment methods and complications were recorded. Twenty eight children presented to Temple street Hospital between 1985-2003. Six of these infants had bilateral tumours. The mean age at presentation was 23.7 months. Sixty-nine percent presented with Leucocoria, of these 33% also had a squint. The mean duration of symptoms was only known in 58% and this figure was approximately 19.8 months. Enucleation was performed in 24 eyes of 24 patients. Three patients required adjuvant chemotherapy post enucleation. Two eyes was treated with external beam radiation and one eye with plaque radiotherapy. One eye (second eye) was treated with systemic chemotherapy and radiation. Five eyes of three patients were treated with systemic chemotherapy followed by adjuvant Argon laser, cryotherapy and diode laser to each eye.The complications of each treatment group was recorded. The visual outcome in the salvaged eyes was favourable. There were no deaths recorded. Though chemotherapy with adjuvant local treatments provide adequate treatment for early tumours, enucleation still plays a major role in the treatment of Retinoblastoma. The total eye salvage rate in this study was 29% with an enucleation rate of 90% in unilateral cases and 33% in bilateral cases. Sixty-six percent of bilateral eyes affected were salvaged. Seventy-one percent of tumours were diagnosed after a parent noticed a gross abnormality of the eye. This highlights the possible need for screening for retinoblastoma in the infant population.

  9. Retrospective Evaluation of Intoxication Cases Presented to Sivas Numune Hospital

    Directory of Open Access Journals (Sweden)

    Yadigar Yılmaz

    2013-12-01

    Full Text Available Aim: In this study, we aimed to evaluate the epidemiological and demographic features and prognosis of all patients admitted to the emergency department and followed in intensive care unit due to poisoning. Methods: We resrospectively evaluated the patients over 14 years of age, who attended to the emergency department and was followed in our intensive care unit due to poisoning, were evaluated according to their demographic characteristics, anamnesis and prognosis. Results: Of 1894 patients, who were admitted to the emergency department, 1034 were female (54.8%. The mean age was 32.76±14.88 years. 36.4% of these patients were suicide attempters. Three hundred twenty-eight patients (17.3% were admitted to the intensive care unit. Two hundred thirty-four (17.3% were females and the mean age was 27.98±13.87 years. Of those patients, 263 (80.2% were treated for drug intoxications, 33 (10.1% for carbonmonoxide (CO intoxications, 18 (5.5% for food intoxications, 4 (1.2% for insecticide poisoning, 4 (1.2% for bee sting, 3 (0.9% for rat poison intoxications, 1 (0,3% for alcohol intoxication, and 1 (0.3% was treated for snakebite. 80.5% of them were suicide attempters. The most frequently taken drugs were antidepressants (25.8%. Conclusion: Intoxication cases admitted to the emergency department and intensive care unit were mostly young women, and drug overdose was the most common attempted method of suicide. The most frequent used drugs were antidepressants. In this study, we determined the patient profile of intoxication in Sivas province. (The Medical Bulletin of Haseki 2013; 51: 178-82

  10. Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series

    Directory of Open Access Journals (Sweden)

    Marcello H. Nogueira-Barbosa

    2015-12-01

    Full Text Available Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5% patients (mean age, 50.9 years; age range, 42-58 years; 42% female. Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

  11. A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

    Science.gov (United States)

    Lee, So-Yeon; Ahn, Kangmo; Kim, Jihyun; Jang, Gwang Cheon; Min, Taek Ki; Yang, Hyeon-Jong; Pyun, Bok Yang; Kwon, Ji-Won; Sohn, Myung Hyun; Kim, Kyung Won; Kim, Kyu-Earn; Yu, Jinho; Hong, Soo-Jong; Kwon, Jung Hyun; Kim, Sung-Won; Song, Tae Won; Kim, Woo Kyung; Kim, Hyung Young; Jeon, You Hoon; Lee, Yong Ju; Lee, Hae Ran; Kim, Hye-Young; Ahn, Youngmin; Yum, Hye Yung; Suh, Dong In; Kim, Hyun Hee; Kim, Jin-Tack; Kim, Jeong Hee; Park, Yong Mean

    2016-01-01

    Purpose Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. Methods We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. Results A total of 991 cases (mean age=5.89±5.24) were reported, with 63.9% involving patients younger than 6 years of age and 66% involving male children. Food was the most common anaphylaxis trigger (74.7%), followed by drugs and radiocontrast media (10.7%), idiopathic factors (9.2%), and exercise (3.6%). The most common food allergen was milk (28.4%), followed by egg white (13.6%), walnut (8.0%), wheat (7.2%), buckwheat (6.5%), and peanut (6.2%). Milk and seafood were the most common anaphylaxis triggers in young and older children, respectively. Drug-triggered anaphylaxis was observed more frequently with increasing age, with antibiotics (34.9%) and nonsteroidal anti-inflammatory drugs (17.9%) being the most common causes. Conclusions The most common anaphylaxis trigger in Korean children was food. Data on these triggers show that their relative frequency may vary by age. PMID:27582405

  12. A retrospective review of telehealth services for children referred to a paediatric nephrologist

    OpenAIRE

    Trnka, Peter; White, Megan M.; Renton, William D.; McTaggart, Steven J.; Burke, John R.; Smith, Anthony C.

    2015-01-01

    Background Telemedicine has emerged as an alternative mode of health care delivery over the last decade. To date, there is very limited published information in the field of telehealth and paediatric nephrology. The aim of this study was to review our experience with paediatric telenephrology in Queensland, Australia. Methods A retrospective audit of paediatric nephrology telehealth consultations to determine the nature of the telehealth activity, reasons for referral to telehealth, and to co...

  13. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    OpenAIRE

    Slothower Molly P; Anbar Ran D

    2006-01-01

    Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if...

  14. Substandard and falsified medicines in the UK: a retrospective review of drug alerts (2001–2011)

    OpenAIRE

    Almuzaini, Tariq; Sammons, Helen; Choonara, Imti

    2013-01-01

    Objective: To determine the extent of substandard and falsified medicines in the UK. Design: A retrospective review of drug alerts and company-led recalls. Setting: The Medicines and Healthcare Products Regulatory Agency (MHRA) website search for drug alerts issued between 2001 and 2011. Eligibility criteria: Drug alerts related to quality defect in medicinal products. Main outcome measure: Relevant data about defective medicines reported in drug alerts and co...

  15. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

    OpenAIRE

    Fadzillah Mohd-Tahir; Norhayati, A.; Ishak Siti-Raihan; Ibrahim, M.

    2012-01-01

    Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospit...

  16. RETROSPECTIVE STUDY OF 861 CASES OF ENDOSCOPIC ENDONASAL DCR: OUR EXPERIENCE

    OpenAIRE

    Mahajan,, S.; Priya; James,, Alan L; Girija; Mayur; Paresh; Anshuman; Kapil

    2014-01-01

    AIM: To focus on difficulties in endoscopic endonasal DCR, to improve the final outcome of endoscopic endonasal DCR. To elaborate the steps this will avoid recurrence. MATERIAL AND METHODS: This article presents retrospective study of 861 cases that underwent Endoscopic endonasal DCR between Oct 2004 and Nov 2011. The patients operated were in the age group from 5 years to 94 years. The cases of lacrimal abscesses were tackled by endo DCR which gave a substantial advantage over the convention...

  17. COMPUTED TOMOGRAPHY IMAGING OF GASTRO INTESTINAL STROMAL TUMOUR: RETROSPECTIVE STUDY OF 40 CASES

    OpenAIRE

    Ishwar; Akhil; Namrata,; Narender,; Mukesh Kumar; Anamika; Satya; Harvindra Singh

    2014-01-01

    : BACKGROUND: GIST is a visceral sarcoma that arises from the gastrointestinal tract. Computed tomography (CT) is an imaging modality of choice for diagnosing GIST. The clinical features and radiologic differential diagnosis of gastrointestinal stromal tumours are discussed by evaluating CT features of GIST in 40 cases. METHODS & MATERIALS: In this study, 40 biopsy proven cases of GIST attending our department from November 2010 to July 2012 are evaluated retrospectively. ...

  18. Tick-borne encephalitis: a retrospective study of clinical cases in Bornholm, Denmark

    DEFF Research Database (Denmark)

    Laursen, Kirsten; Knudsen, Jenny Dahl

    2003-01-01

    Tick-borne encephalitis (TBE) is caused by a flavivirus, tick-borne encephalitis virus (TBEV). For decades TBE has been known to cause disease in Bornholm, a Danish island. A retrospective study was performed to identify undiagnosed cases of TBE among patients hospitalized with signs and symptoms...... of meningitis or encephalitis in the 5 y period 1994-1999. This investigation revealed 5 new, and initially undiagnosed cases of TBE. In total, 14 cases of TBE were found in the 7 y period 1994-2000; 2 patients were tourists and 12 cases were inhabitants in Bornholm, giving an incidence of 3.81 per 100...

  19. One-Year Retrospective Analysis of Forensic Cases Referred to Child and Adolescent Psychiatry Outpatient Clinic in the Province of Adiyaman

    OpenAIRE

    Funda Gumustas; Yasemin Yulaf; Sebla Gokce; Sema Saglam; Emel Koyuncu Kutuk

    2014-01-01

    Purpose: This study’s aim is to investigate child and adolescent cases referred for forensic examination to our child and adolescent psychiatry outpatient clinic. Material and Methods: File informations of 121 cases who referred to Adiyaman University Training and Research Hospital, child psychiatry clinic between 01 June 2012 and 31 May 2013 were reviewed retrospectively. Socio-demographic characteristics of the children and reasons for referral determined. The study was focused on ...

  20. The clinical diagnosis and treatment about 22 cases of limbic encephalitis were retrospectively analyzed.

    Science.gov (United States)

    Zang, Weiping; Zhang, Zhijun; Feng, Laihui; Zhang, Ailing

    2016-03-01

    To summarize and analyze the clinical characteristics and treatment of limbic encephalitis, in order to provide the basis for clinical work. We retrospectively analyzed the clinical characteristics, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) and self immune antibody results of 22 patients with limbic encephalitis in Zheng zhou people's Hospital from March 2013 to May 2014. 22 cases of patients with psychiatric disturbance, such as hallucinations being typical clinical manifestations: Memory decline in 18 cases: Seizures in 13 patients: Altered level of consciousness in 10 cases; Movement disorders in 7 cases and 9 cases with febrile.14 cases have relieved after treating with antiviral and immunosuppressive therapy, 5 cases left memory decline, 2 patients left overwhelmingly excited, 1 cases of seizures. The clinical symptoms of patients with limbic encephalitis are complicated changeable and unspecific. so earlier diagnosis and treatment are very important for the prognosis of patients.

  1. Gamma-knife for treating pituitary adenomas in 501 cases: Retrospective case analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Gamma-knife is characterized by low risk and low death rate, without trauma, bleeding or infection. MRI has replaced CT as a method of location, and provides a good choice for treating pituitary tumors.OBJECTIVE: To analyze the effectiveness and complications of 501 cases with pituitary adenoma by using gamma-knife retrospectively.DESIGN: Case-analysis.SETTING: Gamma-knife Center, the 363 Hospital of Chinese PLA.PARTICIPANTS: A total of 501 cases were selected from Gamma-knife Center, the 363 Hospital of Chinese PLA from January 1997 to December 2002. All patients were certainly diagnosed with CT and MRI scanning. There were 186 males and 315 females. Their ages ranged from 15 to 84 years with the mean age of 39 years. All patients provided confirmed consent.METHODS: All 501 cases with pituitary adenomas were treated by gamma-knife or combined with operations: The average iso-dose curve was 50% (30% - 65%), peri-dose was 14 Gy and the average target number was 5.17. ① At 35 months after treatment, patients received follow-up including clinical symptoms,imaging symptoms and endocrine symptoms. ② Patients who received second gamma-knife treatment were analyzed and their complications were observed after operation.MAIN OUTCOME MEASURES: ① Follow-up results of clinical symptoms, image and endocrine indexes; ② second gamma-knife treatment; ③ postoperative complications.RESULTS: Among 501 accepted patients, 275 cases were involved in the follow up of clinical symptoms,154 in image symptoms and 98 in endocrine symptoms. ① Follow-up results of clinical symptoms, image and endocrine indexes: Follow up of clinical symptoms demonstrated that clinical symptoms of 169 cases were relieved, of 68 disappeared, and of 38 deteriorated. Follow-up of image symptoms indicated that pituitary tumor of 25 cases disappeared, of 84 shortened, of 42 not changed, and of 3 enlarged. Follow-up of endocrine symptoms suggested that endocrine of 50 cases was abnormal, of 29

  2. Mortality and morbidity in children caused by falling televisions: a retrospective analysis of 71 cases

    OpenAIRE

    Gokhan, Servan; Kose, Ozkan; Ozhasenekler, Ayhan; Orak, Murat; USTUNDAG, Mehmet; Guloglu, Cahfer

    2011-01-01

    Objectives To quantify injuries in children that result from toppled televisions. Methods Children presenting directly to emergency department due to injuries caused by falling televisions were identified from our digital patient database, and a retrospective chart review of 71 children was performed. Descriptive statistics were applied. Results 71(1.8%) out of 3856 admissions due to injuries sustained at home were TV-related injuries. There were 50 (70.4%) boys and 21(29.6%) girls. Mean age ...

  3. Maternal and paternal filicides: a retrospective review of filicides in Finland.

    Science.gov (United States)

    Kauppi, Anne; Kumpulainen, Kirsti; Karkola, Kari; Vanamo, Tuija; Merikanto, Juhani

    2010-01-01

    The purpose of this retrospective study was to illustrate the differences in maternal and paternal filicides in Finland during a 25-year period. In the sample of 200 filicides [neonaticides (n = 56), filicide-suicides (n = 75), other filicides (n = 69)], the incidence was 5.09 deaths per 100,000 live births: 59 percent of filicides were committed by mothers, 39 percent by fathers, and 2 percent by stepfathers. The mean age of the maternal victims (1.6 y) was significantly lower than that of the paternal victims (5.6 y), but no correlation between the sex of the victim and the sex of the perpetrator was found, and the number of female and male victims was equal. The sample of other filicides (n = 65) was studied more closely by forensic psychiatric examination and review of collateral files. Filicidal mothers showed mental distress and often had psychosocial stressors of marital discord and lack of support. They often killed for altruistic reasons and in association with suicide. Maternal perpetrators also dominated in filicide cases in which death was caused by a single episode or recurrent episodes of battering. Psychosis and psychotic depression were diagnosed in 51 percent of the maternal perpetrators, and 76 percent of the mothers were deemed not responsible for their actions by reason of insanity. Paternal perpetrators, on the other hand, were jealous of their mates, had a personality disorder (67%), abused alcohol (45%), or were violent toward their mates. In 18 percent of the cases, they were not held responsible for their actions by reason of insanity. During childhood, most of the perpetrators had endured emotional abuse from their parents or guardians, some of whom also engaged in alcohol abuse and domestic violence. The purpose of this study was to examine the differences between maternal and paternal filicides in a sample of 200 cases in Finland. This report also provides a psychosocial profile of the perpetrator and victim in 65 filicides and a

  4. The surgical management of giant intracranial vestibular schwannoma via retrosigmoid approach: a retrospective review of 657 cases%手术治疗颅内巨大型听神经瘤:657例经验总结

    Institute of Scientific and Technical Information of China (English)

    黄翔; 纪开元; 徐健; 邵春红; 王炜; 徐铭; 陈旦麒; 陈明宇; 钟平

    2016-01-01

    Objective To discuss the surgical technique and common complications from the microsurgical treatment of giant intracranial vestibular schwannoma via suboccipital retrosigmoid approach and to propose strategies for minimizing such complications.Methods Surgical outcomes and complications were evaluated in a consecutive series of 657 unilateral giant vestibular schwannomas treated in Shanghai Huashan Hospital via suboccipital retrosigmoid approach from 1999 to 2014.According to the international classification of vestibular schwannoma,giant tumor means tumor' s size over 4 cm in diameter.Clinical status and complications were assessed postoperatively within 14 days and at follow-ups (range,6-191 months;mean,59.6 months).Results Follow-up data were available for 566 of the 657 patients (86.1%).The most frequent clinical symptoms were hearing loss in different levels (100%),deafness (36.4%),facial numbness (68.8%).Total tumor resection was achieved in 556 patients (84.6%),subtotal resection in 99 patients (15.1%),and partial resection in 2 patients (0.3%).The common postoperative complications included new deafness (49.6%),intracranial infection (7.6%),low cranial nerve defect (7.5%) and pneumonia (6.2%).The facial nerve was preserved anatomically in 589 cases (89.6%) after operation,and the functional valuation of facial nerve according to postoperative House-Brackmann showed 216 patients (32.9%) in grade Ⅰ-Ⅱ,308 cases (46.9%) in grade Ⅲ,133 patients (20.2%) in grade Ⅳ-Ⅵ.Long-term followed-up results showed 428 patients (75.6%) in grade Ⅰ-Ⅲ one year after surgical treatment.Conclusions Many of these complications are avoidable.Surgical experiences and the clinical anatomy of the approach,accompany with using intraoperative nerve monitoring,preoperatively study the individual imaging and clinical data and multidisciplinary cooperation are the key points to avoid the complications of giant intracranial vestibular schwannoma

  5. Odontogenic tumors in Nigerian children and adolescents- a retrospective study of 92 cases

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    Adeyemo Wasiu L

    2004-11-01

    Full Text Available Abstract Background Tumours arising from odontogenic tissues are rare and constitute a heterogenous group of interesting lesions. The aim of this study was to determine the relative frequency of odontogenic tumors (OT among Nigerian children and adolescents 19 years or younger. Patients and methods The histopathology records were retrospectively reviewed for all the tumors and tumor-like lesions of the oral cavity and the jaws seen in children and adolescents ≤ 19 years seen between January 1980 and December 2003. Hematoxylin and eosin-stained sections were re-evaluated and the diagnosis in each case was confirmed or modified according to World Health Organization (WHO classification, 1992; and were subjected to analysis of age, sex, site of tumor and histopathologic type. Results A total of 477 tumors and tumor-like lesions were seen in patients ≤ 19 years during the period of the study. Of these, 92 (19.3% were odontogenic tumors. Benign odontogenic tumors constituted 98.9% of the cases seen, while only 1 case (1.1% of malignant variety was seen during the period. The mean (SD age of patients was 14.9 (± 3.1 years (range, 4–19 years. Male-to-female ratio was 1:1; and mandible-to-maxilla ratio was 2.7:1. OT's were most frequently seen in patients aged 16–19 years (46.7% and the least number (2.2% were found in patients aged 0–5 years. Among nine histologic types of OT seen, ameloblastoma (48.9%, adenomatoid odontogenic tumor (19.6% and odontogenic myxoma (8.7% were predominant. Multicystic/solid and unicystic variants of ameloblastoma were diagnosed in 40 (89% and 5 (11% cases respectively. Conclusions Odontogenic tumors are relatively common in children and adolescents in Nigeria. One out of every 5 children and adolescents with tumors and tumor-like lesions of oral cavity and the jaws seen in this study had a diagnosis of odontogenic tumor.

  6. Surgery or radiotherapy for the treatment of bone hydatid disease: a retrospective case series

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    Zengru Xie

    2015-04-01

    Conclusion: This retrospective case series describes, for the first time, the clinical outcomes in a series of patients treated with radiotherapy for bone hydatid disease. Although no direct comparison between the treatment groups could be made due to methodological limitations of the study design, this study indicates that well-designed prospective randomized controlled clinical trials assessing radiotherapy may be warranted in patients with inoperable hydatid disease of the bones.

  7. [On the value of tattoos for identifying unknown bodies - a retrospective study of forensic autopsy cases from Giessen, Germany].

    Science.gov (United States)

    Birngruber, Christoph G; Görner, Nicole; Ramsthaler, H Frank

    2016-01-01

    The number of tattooed people in Germany has constantly grown over the past few years. The present study deals with the question if this social trend can be seen in foren- sic autopsy cases as well. In a retrospective study, forensic autopsy cases of two periods (1990-1994 and 2010-2014) have been reviewed and statistically analyzed. Comparison of the two periods revealed a significant increase in tattooed individuals, especially in the female subgroup. Between 2010 and 2014, 14.2 % of the deceased showed tattoos. There are significant differences in the frequency and localization of tattoos dependent on age and sex. About 50 % of the tattooed deceased showed tattoos on body sites that are visible for other persons in everyday life. The resulting value of tattoos for the purpose of identifying unknown bodies is discussed and illustrated. PMID:26934763

  8. [On the value of tattoos for identifying unknown bodies - a retrospective study of forensic autopsy cases from Giessen, Germany].

    Science.gov (United States)

    Birngruber, Christoph G; Görner, Nicole; Ramsthaler, H Frank

    2016-01-01

    The number of tattooed people in Germany has constantly grown over the past few years. The present study deals with the question if this social trend can be seen in foren- sic autopsy cases as well. In a retrospective study, forensic autopsy cases of two periods (1990-1994 and 2010-2014) have been reviewed and statistically analyzed. Comparison of the two periods revealed a significant increase in tattooed individuals, especially in the female subgroup. Between 2010 and 2014, 14.2 % of the deceased showed tattoos. There are significant differences in the frequency and localization of tattoos dependent on age and sex. About 50 % of the tattooed deceased showed tattoos on body sites that are visible for other persons in everyday life. The resulting value of tattoos for the purpose of identifying unknown bodies is discussed and illustrated.

  9. Pregnancy-associated deaths: a 15-year retrospective study and overall review of maternal pathophysiology.

    Science.gov (United States)

    Christiansen, Lydia R; Collins, Kim A

    2006-03-01

    Pregnancy-related death is defined by the International Classification of Diseases, Tenth Revision (ICD-10) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. In the year 2000, a collaborative effort involving World Health Organization (WHO), UNICEF, and UNFPA estimated 660 maternal deaths in the United States. This averages 11 maternal deaths per 100,000 live births reported. Many pregnancy-associated deaths are not easily identified as such since the presence of a recent or current pregnancy may not be listed on the death certificate. Thus, the WHO estimates that in the United States, the maternal mortality is approximately 17/100,000 pregnancies. This is significantly higher than the goal set by the US Department of Health and Human Services in Healthy People 2010, which sets the target for maternal mortality at less than 3.3/100,000 live births. The most common causes of maternal death vary somewhat from region to region in the United States. They include pulmonary thromboembolism, amniotic fluid embolism, primary postpartum uterine hemorrhage, infection, and complications of hypertension including preeclampsia and eclampsia. Pulmonary disease, complications of anesthesia, and cardiomyopathy also are significant contributors to maternal mortality in some populations. The death of a pregnant or recently pregnant individual poses a wide scope of challenges to the forensic pathologist and investigator. The pathologist must have a broad knowledge of the physiologic and biochemical changes that occur during pregnancy, as well as the clinical and pathological manifestation of these changes. Conditions that may be "benign" in the nonpregnant individual may be lethal in the puerperal period. In addition, it should be kept in mind that deaths during pregnancy may be due to unnatural causes. Accident, homicide, and suicide must be ruled out in each case. The authors reviewed all forensic cases

  10. The Effect of Rapid Response Teams on End-of-Life Care: A Retrospective Chart Review

    OpenAIRE

    Benjamin Tam; Mary Salib; Alison Fox-Robichaud

    2014-01-01

    BACKGROUND: A subset of critically ill patients have end-of-life (EOL) goals that are unclear. Rapid response teams (RRTs) may aid in the identification of these patients and the delivery of their EOL care.OBJECTIVES: To characterize the impact of RRT discussion on EOL care, and to examine how a preprinted order (PPO) set for EOL care influenced EOL discussions and outcomes.METHODS: A single-centre retrospective chart review of all RRT calls (January 2009 to December 2010) was performed. The ...

  11. Sternal Insufficiency Fractures of Post-menopausal Women:Retrospective Analysis of 17 Cases

    Institute of Scientific and Technical Information of China (English)

    Zhe-yuan Huang; Bi-long Yi; Hao-yuan Liu

    2012-01-01

    Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures (SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.Results Twelve patients complained of severe pain in their anterior chest.Other symptoms included cough (5 cases),dyspnoea (3 cases),breathlessness (3 cases),and wheeze (2 cases).Four patients had no discomfort.The sternums of 11 cases were tender to palpation.Seventeen patients had osteoporosis.Other associated diseases were chronic obstructive pulmonary disease (7 cases),rheumatoid arthritis (3 cases),systemic lupus erythematosus (1 case),asthma (1 case),and thoracic vertebral fracture (13 cases).Nine patients had received glucocorticoid treatment.The fractures were located in the body of the sternum in 15 patients,in the manubrium in 1 patient,and in the manubriosternal junction in 1 patient.Displaced fracture was present in 13 cases.Lateral radiography of the sternum showed a fracture line in 14 patients.In the remaining 3 cases,other imaging examinations such as bone scan,computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.Conclusions Osteoporosis,glucocorticoid therapy,chronic obstructive pulmonary disease,and rheumatoid arthritis might be risk factors for SIFs.SIFs should be considered in the differential diagnosis of chest pain.

  12. Complications of microvascular decompression in hemifacial spasm treatment Retrospective analysis of 156 cases

    Institute of Scientific and Technical Information of China (English)

    Yongfeng Sun; Guanghui Dai; Jun Yuan; Weidong Zhai; Jianwei Zhong; Tao Wang

    2008-01-01

    BACKGROUND: Microvascular decompression has become a well-accepted, safe method in the treatment of hemifacial spasms. However, postoperative complications exist and influence the prognosis of the disease.OBJECTIVE: This study aimed to analyze, by case review, the characteristics and regularity of microvascular decompression complications in the treatment of hemifacial spasm. DESIGN: Retrospective analysis.SETTING: Beijing General Group Hospital of the Chinese People's Armed Police Forces.PARTICIPANTS: A total of 156 patients with hemifacial spasm were admitted to the Department of Neurosurgery, Beijing General Group Hospital of the Chinese People's Armed Police Forces from June 2004 to June 2006 and recruited for this study. The patients, 57 males and 99 females, averaged 46 years of age (range 17-68-years old). All suffered from facial innervated muscular paroxysmal and recurrent contraction, which could not be controlled by consciousness. Electromyogram demonstrated waves of fibrillation and fasciculation. Prior to admission, all patients had received other treatments. Written informed consents for treatment were obtained from all patients. This protocol was approved by the Hospital’s Ethics Committee. METHODS: After anesthesia, a cranial bone pore was drilled below the connection of the lateral sinus and sigmoid sinus. Dura mater was dissected at the "⊥" shape and held in the air. Under microscopy, the flocculus cerebelli was lifted slightly up for convenient observation of the cerebellopontine angle. The mucous membrane was sharply separated. Corresponding vessels were identified at the root of the facial nerves and subsequently liberated and disassociated from the root exit zone. Suitably sized Teflon cotton was placed between the corresponding vessels and brain stem.MAIN OUTCOME MEASURES: Complications of microvascular decompression.RESULTS: All 156 patients participated in the final analysis. ① Postoperatively, 66 (42%) patients presented with obvious

  13. Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature

    Directory of Open Access Journals (Sweden)

    SEVERO Luiz Carlos

    2000-01-01

    Full Text Available Eleven cases of involvement of the genital tract in paracoccidioidomycosis were collected in a retrospective study of the clinical records of 683 patients seen in Porto Alegre, Rio Grande do Sul, Brazil. These cases are herein summarily reported. Eighteen similar cases were gathered in review of the Brazilian literature. Obtained data are discussed.

  14. 76 FR 23520 - Periodic Review of Existing Regulations; Retrospective Review Under E.O. 13563

    Science.gov (United States)

    2011-04-27

    ... 2008 (73 FR 75625, December 12, 2008). We currently conduct this review of pending proposed rules about... needs and to take advantage of and support advances in innovation. The goal of this review of existing... possible in your comments. To support its efforts to support innovation, FDA is particularly interested...

  15. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases.

    Science.gov (United States)

    Uzün, Ibrahim; Büyük, Yalçin; Gürpinar, Kağan

    2007-10-01

    We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine during the five-year period between 1998 and 2002 to document the characteristics of fatalities resulting from hanging which is the commonest mode of suicide in Istanbul. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. Seven hundred sixty one hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, cause of death, internal findings in neck organs, other traumatic findings suggesting the use of another method for suicide, toxicological findings and microscopic findings in delayed death cases. In 364 of these cases suspension was complete and in 397 incomplete. Five hundred thirty seven of those (70.56%) were male and 224 (29.44%) were female. The preponderance of male cases in our autopsy population was also detected in suicidal hanging cases. There was no case aged lower 10 and the number of the cases in the age group of cases aged over 80 was the lowest (n=3, 0.4%). In 634 of cases, the place of hanging was the subject's own house, most victims selected rope (652 cases) for the ligature with the rest using sheet, belt, cable and necktie. There were traumatic findings showing attempts of suicide other than hanging in 24 cases (tentative marks in 22 cases and non-fatal burning in 2). In 23 of cases, there were bruises of different ages. In these cases females constituted the majority suggesting violence against women that is a social problem in various cultural subgroups of our country. This violence may have played a role in the decision of suicide. Superficial bruises were detected in 56 cases and were attributed to the trauma. Fractures in neck organs were detected in 446 of cases. In fracture-determined cases, fracture in hyoid bone was seen in 177, in

  16. [Fat embolism still exists. A retrospective study of 17 cases in a surgical intensive care unit].

    Science.gov (United States)

    Gaertner, E; Simon, P; Pottecher, T

    1995-01-01

    Fat embolism is a severe complication in patients with femoral fractures. This retrospective study records 17 cases of post traumatic fat embolism diagnosed between 1979 and 1993 among 430 patients admitted for femoral fractures (incidence: 2.7%). These cases underline the high frequency of early hypovolaemia (10/17), of respiratory and cerebral disorders (15/17), all occurring during the first post trauma week. Three cases were observed in the postoperative period. Severity of fat embolism is proved by three deaths and a mean mechanical ventilation period of 13 days. With early osteosynthesis, incidence of fat embolism could be lowered to 0.2%. Prevention is based on osteosynthesis, avoidance of hypovolemia and of hypoalbuminemia. PMID:7671054

  17. A retrospective chart review to identify perinatal factors associated with food allergies

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    Karpa Kelly

    2012-10-01

    Full Text Available Abstract Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02 were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005. Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  18. Retrospective chart review of duloxetine and pregabalin in the treatment of painful neuropathy.

    Science.gov (United States)

    Mittal, Manoj; Pasnoor, Mamatha; Mummaneni, Reddiah B; Khan, Saud; McVey, April; Saperstein, David; Herbelin, Laura; Ridings, Larry; Wang, Yunxia; Dimachkie, Mazen M; Barohn, Richard J

    2011-09-01

    The primary aims of our study were to compare pregabalin and duloxetine in a neuromuscular clinic for diabetic neuropathic pain (DPN) and to study the effect of these medications in cryptogenic sensory polyneuropathy. We performed a retrospective chart review of 143 patients who were started on pregabalin or duloxetine during a 10-month period in a tertiary neuromuscular outpatient center for neuropathic pain. Duloxetine and pregabalin were started in 103 and 91 patients, respectively. Ninety-two patients tried only one of the two medications while both medications were used at different time periods in 51 patients. Follow-up was available for 87 patients on pregabalin and 89 patients on duloxetine. More patients with neuropathic pain reported an improvement with pregabalin (33%) than duloxetine (21%). Duloxetine (38%) had a higher frequency of side effects compared to pregabalin (30%). However, these differences between pregabalin and duloxetine were not statistically significant. Despite the study's limitations of retrospective design, these findings suggest that both pregabalin and duloxetine are probably effective for neuropathic pain, secondary to diabetes or cryptogenic sensory peripheral neuropathy in a tertiary care academic neuromuscular center. Prospective randomized controlled comparative effectiveness studies are required for both drugs in the treatment of neuropathic pain.

  19. Neurobrucellosis: three case reports and literature review

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    WANG Jia-wei

    2013-01-01

    Full Text Available Background Brucellosis is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of this infection. This article aims to present clinical manifestations and to discuss the clinical features and management of 3 neurobrucellosis cases. Methods The diagnosis, treatment, laboratory results and accessory examination findings of 3 patients with neurobrucellosis between August 2010 and March 2012 were retrospectively analyzed, and relevant literature was reviewed. Results All the 3 cases had definite history of exposure to epidemic areas or infectious diseases, and history of being infected with Brucella by drinking raw milk. During the screening because of fever for reasons unknown, they were proved to be infected with Brucella by etiological or serological tests. Initial clinical manifestations consisted of fever and headache, with meningitis symptoms and signs, spondylitis, uroschesis and constipation (which might be caused by lumbosacral nerve root lesion, or neurological manifestations in auditory nerve and abducent nerve, such as hearing loss and diplopia. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Conclusion Neurobrucellosis presents with various clinical signs and symptoms, and is often accompanied by systemic infection. Brucellosis should be kept in mind during the screening of fever for reasons unknown, and be differentiated from Mycobacterium tuberculosis infection. The combined treatment by antibotics of different pharmacological mechanisms with full dose and long range is effective, and the prognosis is favorable.

  20. Clinical features and surgical management of spinal osteoblastoma: a retrospective study in 18 cases.

    Directory of Open Access Journals (Sweden)

    Zhonghai Li

    Full Text Available OBJECTIVES: To investigate the clinical manifestation and surgical outcome of spinal osteoblastoma. METHODS: From June 2006 to July 2011, 18 patients with spinal osteoblastoma treated surgically were analyzed retrospectively. There were 11 males and 7 females with an average age of 27.5 years(range, 16-38 years. The tumors were located at C5 in 7, C6 in 6, C7 in 3, C6-T1 1 in 1 and T11 in 1. Based on WBB classification, 16 were 1-3 or 10-12 and 2 were 4-9 and 1-3. 18 operations had been performed with en bloc resection. A posterior approach was used for 16 patients, and a combined posterior and anterior approach was used for 2 patients. Reconstruction using instrumentation and fusion was performed using spinal instrumentation in 13 patients. We used visual analogue scales (VAS to evaluate the change of pain before and after the operation, and the McCormick System to assess functional status of the spine. Imaging test was used to review the stability and recurrence rate of spine cord, and the confluence of graft bones. RESULTS: All cases were followed up for 24-80 months (average, 38.4 months. The average surgical time was 120.8 minutes (range, 80-220 minutes, with the average intraoperative blood loss of 520 ml (range, 300-1200 ml. During the follow-up period, the VAS grade reduced from 6.46±1.32 to 2.26±1.05 (P <0.05. 15 patients had neurological function improved and 3 remained no change which was evaluated by McCormick scale for spinal function status at final follow-up. CONCLUSIONS: Spinal osteoblastoma has its own specific radiographic features. There is some recurrence in simple curettage of tumor lesion. The thoroughly en bloc resection of tumor or spondylectomy, bone fusion and strong in Ter fixation are the key points for successful surgical treatment.

  1. RETROSPECTIVE ANALYSIS OF PULMONARY SARCOMA AND BLASTOMA WITH REVIEW OF LITERATURES

    Institute of Scientific and Technical Information of China (English)

    陈晋峰; 张力建; 刘静贤

    2003-01-01

    Objective: To explore the clinical characteristics, diagnosis and treatment of pulmonary sarcoma and blastoma. Methods: Seven cases of pulmonary sarcoma (including 1 case of pulmonary carcinosarcoma, 1 case of pulmonary malignant fibroneuroma, 1 case of pulmonary malignant fibrous tissue tumor and 1 case of pulmonary blastoma from August 1995 to June 2002 in our hospital) were retrospectively summarized the histological characteristics, clinical features, diagnosis and treatment. Results: Pulmonary sarcoma and blastoma both are rare malignant tumors and can be easily misdiagnosed or mistreated. The main symptoms of both diseases are cough and expectoration. X ray or CT shows node or focus in lung. They both are diagnosed by histological pathology. Because the symptoms of these diseases are not typical, it is difficult for patients to be diagnosed without pathology. Conclusion: These two kinds of diseases are often easy to be misdiagnosed. Early diagnosis and treatment are important to improve the efficiency of treatment. Surgical resection is the best method of treatment, and it is important to combine with chemotherapy and radiation treatment.

  2. A retrospective review of the adnexal outcome after detorsion in premenarchal girls

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    Abdullah Yildiz

    2014-01-01

    Full Text Available Background: The aim of this study was to report our results on premenarchal girls with adnexal torsion who were treated with different approaches. Materials and Methods: Twenty-six adnexal torsions in children were analysed retrospectively. Group 1 included cases of oophorectomy for the twisted adnexa. Group 2 contained the patients with adnexal torsion who untwisted either with a laparoscopic or open approach. Postoperative restoration of ovarian function was evaluated by Doppler ultrasound at the 6 th month. All oophorectomy and biopsy specimens were also evaluated. Results: Group 1 consisted of eleven cases that underwent oophorectomy due to gangrenous change and haemorrhagic infarction. Histology was of a mature teratoma in two cases and haemorrhagic necrosis due to torsion in seven. Group 2 consisted of 15 patients. In 10 out of 15 patients, preoperative biopsy is performed in which their histology revealed haemorrhagic necrosis in eight cases, and simple cyst with a benign nature in two cases. In all of the 10 untwisted adnexas, postoperative radiological imaging showed complete recovery with normal follicular development. No malignancy or increased tumour markers were noted in both groups. Conclusion: Adnexas can be left in place regardless of the preoperative degree of necrosis. Biopsy can be added to the procedure to rule out malignancy.

  3. Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Yiotakis Ioannis E

    2009-08-01

    Full Text Available Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23% and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.

  4. Review of translocations detected by fish for retrospective biological dosimetry applications

    International Nuclear Information System (INIS)

    Several European laboratories have combined their research efforts to arrive at a consensus view on using fluorescence in situ hybridisation (FISH) for retrospective dosimetry. The aim of this review is to report these views and to highlight some areas where further work is needed. Translocations in the stable cells should be measured only in the cells that contain the full complement of the painted material. Two-way and one-way translocations should be combined with equal weight. The control level of translocations has a strong dependence on age, which has now been measured and the system has been calibrated. In conclusion, the technique works and a lifetime dose to the bone marrow from low-linear energy transfer radiation of 0.5 Gy above normal background levels can be measured for any individual. The main application is considered to provide an independent verification of lifetime doses to individuals who might form a part of an epidemiological study. (authors)

  5. Morphological heterogeneity of the simultaneous ipsilateral invasive tumor foci in breast carcinoma: a retrospective study of 418 cases of carcinomas.

    Science.gov (United States)

    Boros, Monica; Marian, Cristina; Moldovan, Cosmin; Stolnicu, Simona

    2012-10-15

    The aim of this paper was to assess whether the morphological appearance (i.e. histological tumor type and histological grade) of simultaneous invasive breast carcinoma foci is heterogeneous, since it is known that adjuvant therapy is established according to these parameters. Patients with simultaneous breast tumors in which only the features of the largest neoplastic focus are reported could thus be undertreated. A retrospective study of 418 cases of breast carcinomas was conducted over a 3-year period. The histological tumor types and histological grades of multifocal/multicentric carcinomas in each tumor focus were compared, and mismatches among foci were recorded. Ninety-one of the 418 cases reviewed had multiple carcinomas (21.77%). A comparison between multiple synchronous tumor foci revealed that their histological type was different in 12.08% of the cases. Mismatches among foci were also observed in 9.89% of the cases when evaluating the histological grade, and 5 out of 9 additional tumor foci with a different grade from the largest (index) tumor (55.55%) displayed a higher grade compared to the index tumor. Since the histological tumor type and histological grade of the individual foci may vary considerably within the same tumor and the additional foci may be of higher grade than the index tumor, we believe that reporting morphologic parameters with more unfavorable characteristics in addition to the parameters of the index tumor is imperative.

  6. Paracoccidioidomycosis in southern Rio Grande do Sul: a retrospective study of histopathologically diagnosed cases

    Directory of Open Access Journals (Sweden)

    Silvana Pereira de Souza

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and is endemic to Brazil. The aim of this study was to perform a retrospective analysis of the PCM cases in the countryside south of Rio Grande do Sul, Brazil. The files from four histopathology laboratories located in the city of Pelotas were obtained, and all of the epidemiological and clinical data from the PCM diagnosed cases were collected for analysis. A total of 123 PCM cases diagnosed between 1966 and 2009 were selected. Of these patients, 104 (84.5% were male, and 17 were female. The patients ranged from 02 to 92 years of age. Fifty-two cases (41.9% were obtained from the oral pathology laboratory, and the remaining 71 cases (58.1% were obtained from the three general pathology laboratories. Of all of the patients studied, 65.2% lived in rural zones and worked in agriculture or other related fields. Data on the evolution of this disease was available for 43 cases, and the time frame ranged from 20 to 2920 days (mean = 572.3 days. An accurate diagnosis performed in less than 30 days only occurred in 21% of the cases. PCM is endemic to the countryside of Rio Grande do Sul. Therefore, it is recommended that PCM be included as a differential diagnosis, mainly for individuals between 30 and 60 years of age, living in rural zones and who have respiratory signs and associated-oropharyngeal lesions.

  7. Mesenchymal Chondrosarcoma in Children and Young Adults: A Single Institution Retrospective Review

    Directory of Open Access Journals (Sweden)

    Michael W. Bishop

    2015-01-01

    Full Text Available Background. Mesenchymal chondrosarcoma is an aggressive, uncommon histologic entity arising in bone and soft tissues. We reviewed our institutional experience with this rare diagnosis. Methods. We conducted a retrospective chart review on patients with mesenchymal chondrosarcoma over a 24-year period. Clinicopathologic and radiographic features were reviewed. Results. Twelve patients were identified. Nine were females; median age was 14.5 years (1.2–19.7 years. The most common site was the head/neck (7/12. Disease was localized in 11/12 patients (one with lung nodules. Six with available tissue demonstrated NCOA2 rearrangement by FISH. Six underwent upfront surgical resection, and six received neoadjuvant therapy (2 chemotherapy alone and 4 chemotherapy and radiation. All patients received adjuvant chemotherapy (most commonly ifosfamide/doxorubicin and/or radiation (median dose 59.4 Gy. At a median follow-up of 4.8 years, 5-year disease-free survival and overall survival were 68.2% (95% CI 39.8%, 96.6% and 88.9% (95% CI 66.9%, 100%. Two patients had distant recurrences at 15 and 42 months, respectively. Conclusion. Aggressive surgical resection of mesenchymal chondrosarcoma with chemoradiotherapy yields excellent local control and may reduce likelihood of late recurrence. Characterization of downstream targets of the HEY1-NCOA2 fusion protein, xenograft models, and drug screening are needed to identify novel therapeutic strategies.

  8. Retrospective Review on the Final Assessment Categorization of the Suspicious Microcalcifications

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Hun; Park, Mi Jung; Yim, Hyeon Woo [Catholic University, Seoul (Korea, Republic of); Lee, Jae Hee [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Choi, Bo Bae [Chungnam University Hospital, Daejeon (Korea, Republic of)

    2009-02-15

    The ACR BI-RADS 4th edition provides little guidance on how to classify microcalcifications depicted on mammogram into final assessment categories. We retrospectively evaluated whether our categorization could predict the probability of malignancy, based on histopathology and imaging follow-up. From 2004 to 2005, 83 women who underwent image-guided biopsy for suspicious microcalcifications were subjected. Each lesion was classified by the final assessment categories as category 3 (probably benign finding), category 4A (low suspicion of malignancy), category 4BC (intermediate to moderate suspicion of malignancy), and category 5 (highly suggestive of malignancy) according to our criteria. The positive predictive value (PPV) of each category was assessed. The final assessment categories were category 3 in 4 cases (4.8%), category 4A in 40 cases (48.1%), category 4BC in 31 cases (37.3%), and category 5 in 8 cases (9.6%). The PPVs for malignancy were 0% in C3, 7.5% in C4A, 64.5% in C4BC and 87.5% in C5. Our categorization correlated well with the suggested probability of malignancy in the BI-RADS. It is thought that the application of the subcategories, 4A and 4BC, is of help to stratify the probability of malignancy of lesions requiring biopsy

  9. An 11-year retrospective review of venlafaxine ingestion in children from the California Poison Control System.

    Science.gov (United States)

    Doroudgar, S; Perry, P J; Lackey, G D; Veselova, N G; Chuang, H M; Albertson, T E

    2016-07-01

    Venlafaxine is commonly used in the United States for approved and non-Food and Drug Administration-approved indications in adults. It is used off-label to treat children for psychiatric diagnoses. The aim of the study was to describe venlafaxine toxicities in children and to identify the venlafaxine dose per weight that correlates with toxicities. An 11-year retrospective study of venlafaxine ingestion in children was performed using the California Poison Control System (CPCS) database. Data was extracted from phone calls received by CPCS clinicians and follow-up phone calls made to assess the patient's progress in a health-care setting. Inclusion criteria were venlafaxine ingestion cases reported to CPCS between January 2001 and December 2011, children aged 20 years and under, venlafaxine as the only ingested substance, managed in a health-care facility, and followed to a known outcome. Two hundred sixty-two cases met the study criteria. Common presentations included gastrointestinal (14.9%), altered mental status (13.7%), and tachycardia (13.4%). The majority of the cases resulted in no effect (51.5%) or minor effect (19.9%). The average estimated dose per weight was 18.3 mg/kg in all patients and 64.5 mg/kg in those experiencing moderate-to-severe adverse effects. Seizures occurred in only 4 of the 262 cases at doses ranging from 1500 to 7500 mg. Although the estimated dose per weight exceeded 10 mg/kg for the majority of the cases, only 12 cases resulted in moderate or severe outcomes. The majority of venlafaxine ingestion cases in children resulted in either no clinical effects or minor clinical effects. PMID:26351291

  10. The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review.

    Science.gov (United States)

    Fishco, W D; Goecker, R M; Schwartz, R I

    2000-02-01

    A retrospective study was conducted on the use of the instep plantar fasciotomy for the treatment of recalcitrant plantar fasciitis. A total of 83 patients (94 feet) were analyzed. The average postoperative follow-up time was 20.9 months. Surgery was deemed successful 93.6% of the time, and in 95.7% of cases, the patient would recommend the procedure to someone with the same condition. The main complications were scarring (9.6%), medial arch or heel pain (7.5%), cramping in the arch (6.4%), lateral column pain (5.3%), aching or pain across the dorsal midfoot (5.3%), and burning or tingling of the ball of the foot (5.3%). PMID:10697969

  11. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips

    Energy Technology Data Exchange (ETDEWEB)

    Toms, A.P. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)], E-mail: andoni.toms@nnuh.nhs.uk; Marshall, T.J.; Cahir, J. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Darrah, C.; Nolan, J. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Donell, S.T. [Institute of Health, University of East Anglia, Norwich, Norfolk (United Kingdom); Barker, T. [Department of Pathology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Tucker, J.K. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)

    2008-01-15

    Aim: To perform a retrospective review of all the conventional radiographic and magnetic resonance imaging (MRI) studies performed in patients with early postoperative pain following cobalt-chrome metal-on-metal total hip arthroplasty. Methods: A retrospective review of the radiology, surgical findings and histology in nineteen patients who had undergone a total of 20 hip arthroplasties using a cobalt-chromium on cobalt-chromium alloy prosthesis was undertaken. Results: Measures of implant placement on the immediate postoperative radiographs were all within the normal ranges (n = 20). Where more than one postoperative radiograph was available statistical analysis revealed no evidence of progressive change before the MRI examination (14). The median postoperative time to MRI was 35 months (range 11-63 months). Abnormalities were demonstrated using MRI in all symptomatic hips (n = 20). These comprised: periprosthetic fluid collections (20), which were isointense to muscle on T1-weighted images in 19 cases and hyperintense on T2-weighted images in 18 cases, periprosthetic bone marrow oedema (n = 6), muscle oedema (n = 4), avulsion of the gluteus minimus and medius tendons (n = 5), atrophy of piriformis (n = 15) and obturator internus (n = 17), and fracture of the medial calcar (n = 1). Operative findings in patients who had undergone revision surgery (n = 15) included: fluid-filled cavities (n = 11), soft tissue necrosis (n = 8), gluteal tendon avulsion (n = 5), proximal femoral diaphyseal necrosis (n = 4), and pitting and corrosion of the femoral stems (n = 8), which were, in all cases, firmly fixed to the cement mantle. Histology revealed viable tissue in six hips with necrosis (n = 12) and fibrin deposition (n = 15) being the predominate findings. Other findings included a perivascular lymphocytic infiltrate (n = 5), features of active inflammation (n = 4), and metallosis (n = 1). Conclusion: A significant number of patients with metal-on-metal hip replacements

  12. Management of Esophageal Carcinoma Associated with Cirrhosis: A Retrospective Case-Control Analysis

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    Florence Trivin

    2009-01-01

    Full Text Available Objectives. Esophageal carcinoma and cirrhosis have the overlapping etiologic factors. Methods. In a retrospective analysis conducted in 2 Breton institutions we wanted to asses the frequency of this association and the outcome of these patients in a case-control study where each case (cirrhosis and esophageal cancer was paired with two controls (esophageal cancer. Results. In a 10-year period, we have treated 958 esophageal cancer patients; 26 (2.7% had a cirrhosis. The same treatments were proposed to the 2 groups; cases received nonsignificantly different radiation and chemotherapy dose than controls. Severe toxicities and deaths were more frequent among the cases. At the end of the treatment 58% of the cases and 67% of the controls were in complete remission; median and 2-year survival were not different between the 2 groups. All 4 Child-Pugh B class patients experienced severe side effects and 2 died during the treatment. Conclusions. This association is surprisingly infrequent in our population! Child-Pugh B patients had a dismal prognosis and a bad tolerance to radiochemotherapy; Child-Pugh A patients have the same tolerance and the same prognosis as controls and the evidence of a well-compensated cirrhosis has not modified our medical options.

  13. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Sarah L.; Lawrence, Sarah [University of Ottawa, Division of Endocrinology, Children' s Hospital of Eastern Ontario, Ottawa (Canada); Laffan, Eoghan [Children' s University Hospital, Pediatric Radiology, Dublin 1 (Ireland)

    2012-07-15

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  14. Distal posterior cerebral artery aneurysms: Retrospective review of characteristics and endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jin Wook [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jeong, Bae Woong [Dept. of Diagnostic Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of); Seung, Won Bae [Dept. of Neurosurgery, Kosin University College of Medicine, Gospel Hospital, Busan (Korea, Republic of)

    2016-04-15

    The objective of this study was to review the clinical outcome after treatment of distal posterior cerebral artery (PCA) aneurysms via endovascular approach. Eleven patients with 11 distal PCA aneurysms who were treated via endovascular approach in Inje University Busan Paik Hospital and Kosin University Gospel Hospital from December 2002 to December 2013 were retrospectively reviewed. Among the 11 patients, there were 3 males (27.3%) and 8 females (72.7%). The mean age was 56.6 years (range 44 -72 years) and the mean aneurysm size was 8.45 mm (3 - 30 mm). Four (36.4%) aneurysms were located in the P2 segment, 6 (54.5%) in the P3 segment and 1 (9.1%) in the P1/2 junction. Seven (63.6%) aneurysms were treated with preservation of the parent artery; and the remaining 4 (36.4%) aneurysms were treated with parent artery occlusion. After treatment, the overall complication rate was 27% with the morbidity rate of 9.1% and the mortality rate of 18%. Endovascular treatment of distal PCA aneurysm might be used to minimize neurologic deficit, considering the diverse and rich collaterals of posterior cerebral artery.

  15. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    International Nuclear Information System (INIS)

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  16. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

    International Nuclear Information System (INIS)

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.)

  17. COMPUTED TOMOGRAPHY IMAGING OF GASTRO INTESTINAL STROMAL TUMOUR: RETROSPECTIVE STUDY OF 40 CASES

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    Ishwar

    2014-08-01

    Full Text Available : BACKGROUND: GIST is a visceral sarcoma that arises from the gastrointestinal tract. Computed tomography (CT is an imaging modality of choice for diagnosing GIST. The clinical features and radiologic differential diagnosis of gastrointestinal stromal tumours are discussed by evaluating CT features of GIST in 40 cases. METHODS & MATERIALS: In this study, 40 biopsy proven cases of GIST attending our department from November 2010 to July 2012 are evaluated retrospectively. The CT scan was performed prior to the treatment in all these patients. CT imaging features that were taken into account include tumour location, size/diameter, degree & pattern of enhancement, intraluminal/exophytic, internal necrosis & haemorrhage, perilesional fat stranding, local spread, nodal & distant metastasis. RESULTS: In 26 out of 40 cases (65%, tumour was found in stomach, 8/40 (20% in small bowel (jejunum & ileum, 4/40 (10% in omentum and mesentery; and 2 (5% tumour was found in transverse colon. 28/40 (70% had exophytic tumour with communication to lumen of gastrointestinal tract or in omentum and mesentery; rest 12/40 (30% had polypoidal mass. Size of tumour ranged from 4 to 15 cm, with mean of 7.9 cm. 30/40 (75% cases showed heterogeneous enhancement with necrosis and/or calcification, rest 10/40 (25% had homogenous enhancement. The CT HU ranged from 35 to 55, with mean of 40. 28/40 (75 % cases had well defined margins of tumour, and rest 12 (30% cases showed perilesional fat stranding and loss of fat plane with adjacent organ. 4/40 (10% cases showed regional nodal involvement and 6/40 (15% cases shows distant metastasis to liver & lungs. CONCLUSIONS: The stomach was the commonest site of GIST occurrence among our patients. The CT features of GIST were exophytic, ulcerated mass with well-defined tumour margins, and heterogeneous enhancement on post-contrast CT images

  18. Retrospective Study of Postmortem Cases of ‘Hanging – A Method Of Suicide

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    Mohammed Ziyauddin G Saiyed

    2013-07-01

    Full Text Available Introduction and Objective: Hanging is a form of violent asphyxial death. It produces painless death for the victims so that it is a widely accepted method of suicide. The rate of suicidal hanging cases is increasing day by day. The Objective of study is to find out demography of hanging, its distribution according to age group, sex, most common ligature material used by victim and observed post-mortem findings and in this way try to identify the causative factors and developing the preventive measures that are essential to reduce death due to hanging.Material and Methods: A retrospective study of hanging cases reported to mortuary of Vadilal Sarabhai General Hospital, Ahmedabad during a period of 2 years, (from November 2009 to October 2011 is carried out.Results: Out of total 2244 cases of post-mortem during 2 years, 74 (3.29% were hanging cases. Maximum cases 34 (45.94% of death due to hanging seen in age group 21-30 years. Majority of cases 46 (62.16% were observed in Males. Majority of victims have used Dupatta, 40 (54.05% as a ligature material. Manner of death is suicide in all cases. Cyanosis, salivary marks and petechial hemorrhage in brain observed in variable number of cases. Conclusion: Suicide by Hanging has become very common now a days. A well designed and comprehensive programme is needed to identify the causative factor and prevention of suicidal hanging. Appropriate education, reducing unemployment, improving the quality of self esteem and involvement of young generation in encouraging activities may reduce rate of death due to hanging

  19. Clinical characteristics and prognosis of traumatic basal ganglia hematomas: A retrospective analysis of 40 cases

    Institute of Scientific and Technical Information of China (English)

    Jialiang Li; Chunjiang Yu

    2006-01-01

    AIM: To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas (TBGH).METHODS: A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People's Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale (GOS) at 6 months after injury, and GOS scoring standard was 1-5 points (1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study).RESULTS: The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ② At admission, the Glasgow coma scale (GCS) scores were as follow: 13-15 scores (mild) in 10 cases,9-12 scores (moderate)in 20 cases, and 3-8 scores (severe) in 10 cases. Hemiplegia presented in 37 cases,aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within

  20. POSTOPERATIVE INTUSSUSCEPTION IN CHILDREN: A REVIEW OF 14 CASES

    Institute of Scientific and Technical Information of China (English)

    Zhi-bin Niu; Ying Hou; Chang-lin Wang

    2005-01-01

    Objective To search the etiologic factor, clinical diagnosis points and treatment of postoperative intussusception (PI).Methods To retrospectively review the clinical materials of 14 cases with PI including the cause of disease and treatment.Results PI occurred within 10 days (average 4 days) after the primary operation. Bowel obstructive symptoms gradually emerged. One case was diagnosed with intussusception by sonography and received enema reduction of intussusception by hydrostatic pressure. Thirteen cases were performed secondary operation. Small intestine was main site of intussusception. Manual reduction of the lesion was performed in 12 cases and bowel resection and anastomosis was done in 1 case with bowel necrosis.Conclusion PI should be suspected if child presents with the symptoms of ileus in early postoperative period.Abdominal sonography may have some value on diagnosis of PI. Operation is the first choice for the treatment of PI.

  1. Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study.

    Science.gov (United States)

    Recipon, Guillaume; Piver, Éric; Caille, Agnès; Le Pape, Patrice; Pihet, Marc; Pagès, Jean-Christophe; Chandenier, Jacques; Desoubeaux, Guillaume

    2015-12-01

    Procalcitonin (PCT) levels are commonly used for diagnostic guidance in routine bacterial infections. By contrast, little data are currently available regarding PCT in parasitic diseases, and its role in cases of invasive amoebiasis has not yet been described. For this purpose, 35 adult patients with a proven diagnosis of invasive or digestive amoebiasis were included in a 4-year study period. Serum PCT was retrospectively assessed. Results were analysed with regard to the usual inflammatory biomarkers, like C-reactive protein (CRP). PCT was significantly higher in patients with proven invasive amoebiasis than in digestive amoebiasis (mean value: 4.03 μg/L versus 0.07 μg/L, respectively; P < 0.001), but the SD was greater than with CRP, and the effect was less than that demonstrated in bacterial infections. By contrast, PCT was not shown to be elevated during digestive amoebiasis. PMID:26388549

  2. Ascites due to pre-sinusoidal portal hypertension in dogs: a retrospective analysis of 17 cases.

    Science.gov (United States)

    James, F E; Knowles, G W; Mansfield, C S; Robertson, I D

    2008-05-01

    Accumulation of a pure transudate abdominal effusion in the absence of significant hypoalbuminaemia is uncommon in dogs and is due to pre-sinusoidal portal hypertension. Reported causes of pre-sinusoidal portal hypertension vary, but suggest a reasonable prognosis. A retrospective analysis of 17 dogs that presented to our institution with ascites due to pre-sinusoidal portal hypertension identified idiopathic hepatic fibrosis or canine chronic hepatitis as the underlying cause in the majority of cases. Twelve (70.5%) dogs were 4 years of age or younger at time of presentation. Total serum protein was higher in dogs with chronic hepatitis than it was in dogs without inflammatory disease. The prognosis was generally poor and no histological, imaging or biochemical parameters were useful as prognostic indicators. Dogs died or were euthanased due to severe clinical signs associated with the portal hypertension and/or perceived poor prognosis.

  3. Clinical Outcome of Patients with Breast Phyllodes Tumors: A Retrospective Analysis of 129 Cases in Shiraz, Southern Iran

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    Majid Akrami

    2015-10-01

    Full Text Available Background: Phyllodes tumors are uncommon neoplasms of the breast. Data about their outcome is limited. This study aims to evaluate patients diagnosed with phyllodes tumors in terms of local recurrence, distant metastasis and overall survival. Methods: We retrospectively reviewed the medical records of 129 women with phyllodes tumors who referred to our center from 1999 to 2013. Clinical and pathological features, local and regional recurrence, distant metastasis and overall survival were determined. SPSS 15.0 statistical software was used for analysis. Results:Mean patient age was 39 years (17-67 years. Mean size of the tumor was 5.38 cm. There were 105 (81.4% benign, 8 (6.2% borderline and 16 (12.4% malignant tumors. The mean follow-up period of patients was 28 months (6 to 128 months. The rate of local recurrence among benign tumors was 3.8% (4 cases; in borderline cases the rate was 12.5% (1 case and for malignant cases, it was 18.7% (3 cases. Three patients each recurred twice and one patient had local recurrence for a third time. Two patients died of malignant tumor-related disease - one due to advanced regional recurrence and lung metastasis, and the other to wide-spread metastasis. Another patient died from an unrelated cause (myocardial infarction one year after surgery. For those with malignant phyllodes tumors, the five-year overall survival was 77.8% and disease-free survival rate was 85.7%. Conclusion: Although, the prognosis for phyllodes tumors is good, the malignancy rate is higher in older patients and those with larger tumors. A higher local recurrence rate in malignant phyllodes tumors suggests the importance for adequate resection of margins in surgical management of these tumors.

  4. Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study.

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    Mohammod Jobayer Chisti

    Full Text Available In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.In this retrospective case-control study SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50 with those without severe sepsis (controls = 354. Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p<0.001. In logistic regression analysis after adjusting for potential confounders, lack of BCG vaccination, drowsiness, abdominal distension, acute kidney injury, and metabolic acidosis at admission remained as independent predicting factors for severe sepsis in pneumonic SAM children (p<0.05 for all comparisons.We noted a much higher case fatality among under-five SAM children with pneumonia and severe sepsis who required fluid resuscitation in addition to standard antibiotic and other supportive therapy compared to those without severe sepsis. Independent risk factors and outcome of the management of severe sepsis in our study children highlight the importance for defining optimal fluid resuscitation therapy aiming at reducing the case fatality in such children.

  5. A retrospective study of 18 cases of adenoid cystic cancer at a tertiary care centre in Delhi

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    K Sharma

    2010-01-01

    Full Text Available Context: Adenoid cystic carcinoma (ACC is a rare neoplasm that usually arises from the salivary, lacrimal, or other exocrine glands. It is characteristically locally infiltrative in nature and has a tendency toward local recurrence, high propensity for perineural invasion, and prolonged clinical course. Aim: To analyze the presentation and natural history of cases of adenoid cystic tumors of salivary glands in our institution; and to compare with the existing literature. Design and Setting: Retrospective study at the Department of Radiotherapy. Materials and Methods: Data on 18 patients of ACC of the salivary glands treated between 2004 and 2008 were reviewed with respect to clinical presentation, stage, and histology. Results: There were 8 cases of major salivary gland tumors (47%, of which 2 were in the submandibular and 6 were involving the parotid. Ten patients (53% had minor salivary gland involvement. Two patients had metastasis at the time of presentation. All patients underwent surgery. Radiotherapy was delivered to 16 patients and chemotherapy to 6 patients (concurrent, n = 3 and adjuvant, n = 3 and no adjuvant therapy was given to 2 patients. All patients were alive at a median follow-up of 3 years. No patient developed local or distant failure during the study duration. Conclusion: ACC has locally aggressive behavior. Radiotherapy adjuvant to surgery improves local control in locally advanced disease. Longer follow-up is mandatory in view of incidence of late metastasis.

  6. When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

    International Nuclear Information System (INIS)

    Objective: to evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis). Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others). Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant) out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14%) cases presented changes after the second analysis, as follows: nephrolithiasis (10%), steatosis (3%), adrenal nodule (0.7%) and cholelithiasis (0.3%). Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis. (author)

  7. When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Danilo Manuel Cerqueira; Salvadori, Priscila Silveira; Monjardim, Rodrigo da Fonseca; Bretas, Elisa Almeida Sathler; Torres, Lucas Rios; Caldana, Rogerio Pedreschi; Shigueoka, David Carlos; Medeiros, Regina Bitelli; D' ippolito, Giuseppe, E-mail: giuseppe_dr@uol.com.br [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Departamento de Diagnostico por Imagem

    2013-06-15

    Objective: to evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis). Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others). Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant) out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14%) cases presented changes after the second analysis, as follows: nephrolithiasis (10%), steatosis (3%), adrenal nodule (0.7%) and cholelithiasis (0.3%). Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis. (author)

  8. When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

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    Danilo Manuel Cerqueira Costa

    2013-07-01

    Full Text Available Objective: To evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis. Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others. Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14% cases presented changes after the second analysis, as follows: nephrolithiasis (10%, steatosis (3%, adrenal nodule (0.7% and cholelithiasis (0.3%. Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis.

  9. Surgical Treatment of Aortic Aneurysm and Aortic Dissection:A Retrospective Analysis of 122 Cases

    Institute of Scientific and Technical Information of China (English)

    Tucheng SUN; Xionggang JIANG; Kailun ZHANG; Jie CAI; Shu CHEN; NYANGASSA B J; Zongquan SUN

    2009-01-01

    The study summarizes the clinical experience of surgical treatments of various types of thoracic aneurysm and aortic dissection.Clinical data of 122 patients with thoracic aneurysm and aortic dissection during July 2005 to July 2008 were retrospectively analyzed.The elective operations were performed in 107 patients while emergency surgery was done in 15 cases.Different surgical strategies were employed on the basis of diseased region,including simple ascending aortic replacement (n=3),aortic root replacement (n=43),hemi-arch replacement/total arch replacement + elephant trunk technique (n=32),thoracic/thoracoabdominal aortic replacement (n=8) and endovascular repair (n=36).In this series,there is 4 cases of perioperative death due to massive cerebral hemorrhage (n=1),respiratory failure (n=1) and multiple organ dysfunction syndrome (MODS) (n=2).Three cases developed post-operative massive cerebral infarction and the relatives of the patients abandoned treatment.Instant success rate of endovascular repair was 100%.The intimal rupture was sealed.Blood flow was unobstructed in true lumen and no false lumen was visualized.It was concluded that aggressive surgery should be considered in the patients with thoracic aneurysm and aortic dissection.Surgical procedures should vary with the location and the nature of the lesions.

  10. A retrospective evaluation of the quality of malaria case management at twelve health facilities in four districts in Zambia

    Institute of Scientific and Technical Information of China (English)

    Pascalina Chanda-Kapata; Emmanuel Chanda; Freddie Masaninga; Annette Habluetzel; Felix Masiye; Ibrahima Soce Fall

    2014-01-01

    Objective: To establish the appropriateness of malaria case management at health facility level in four districts in Zambia. Methods: This study was a retrospective evaluation of the quality of malaria case management at health facilities in four districts conveniently sampled to represent both urban and rural settings in different epidemiological zones and health facility coverage. The review period was from January to December 2008. The sample included twelve lower level health facilities from four districts. The Pearson Chi-square test was used to identify characteristics which affected the quality of case management.Results:Out of 4891 suspected malaria cases recorded at the 12 health facilities, more than 80% of the patients had a temperature taken to establish their fever status. About 67% (CI95 66.1-68.7) were tested for parasitemia by either rapid diagnostic test or microscopy, whereas the remaining 22.5% (CI95 21.3.1-23.7) were not subjected to any malaria test. Of the 2247 malaria cases reported (complicated and uncomplicated), 71% were parasitologically confirmed while 29% were clinically diagnosed (unconfirmed). About 56% (CI95 53.9-58.1) of the malaria cases reported were treated with artemether-lumefantrine (AL), 35% (CI95 33.1-37.0) with sulphadoxine-pyrimethamine, 8% (CI95 6.9-9.2) with quinine and 1% did not receive any anti-malarial. Approximately 30% of patients WHO were found negative for malaria parasites were still prescribed an anti-malarial, contrary to the guidelines. There were marked inter-district variations in the proportion of patients in WHOm a diagnostic tool was used, and in the choice of anti-malarials for the treatment of malaria confirmed cases. Association between health worker characteristics and quality of case malaria management showed that nurses performed better than environmental health technicians and clinical officers on the decision whether to use the rapid diagnostic test or not. Gender, in service training on malaria

  11. The clinical outcomes of surgical treatment of noncontiguous spinal tuberculosis: a retrospective study in 23 cases.

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    Jia Huang

    Full Text Available STUDY DESIGN: A retrospective clinical study. OBJECTIVE: To evaluate the clinical efficacy of the surgical treatment of noncontiguous spinal tuberculosis (NSTB, and to discuss its therapeutic strategies. METHODS: We performed a retrospective review of clinical and radiographic data that were prospectively collected on 550 consecutive spinal tubercular patients including 27 patients who were diagnosed and treated as NSTB in our institution from June 2005 to June 2011. Apart from 4 patients being treated conservatively, the remainder received surgery by posterior transforaminal debridement, interbody fusion with instrumentation, posterior instrumentation and anterior debridement with fusion in a single or two-stage operation. The clinical outcomes were evaluated before and after treatment in terms of hematologic and radiographic examinations, bone fusion and neurologic status. The Oswestry Disability Index score was determined before treatment and at the last follow-up visit. RESULTS: 23 patients (15 M/8F, averaged 44.6 ± 14.2 years old (range, 19 to 70 yd, who received surgical treatment, were followed up after surgery for a mean of 52.5 ± 19.5 months (range, 24 to 72 months. The kyphotic angle was changed significantly between pre- and postoperation (P<0.05. The mean amount of correction was 12.6 ± 7.2 degrees, with a small loss of correction at last follow-up. All patients achieved solid bone fusion. No patients with neurological deficit deteriorated postoperatively. Neither mortalities nor any major complications were found. There was a significant difference of Oswestry Disability Index scores between preoperation and the final follow-up. CONCLUSION: The outcomes of follow-up showed that posterior and posterior-anterior surgical treatment methods were both viable surgical options for NSTB. Posterior transforaminal debridement, interbody fusion and posterior instrumentation, as a less invasive technique, was feasible and effective to treat

  12. Patterns of skin disease in a sample of the federal prison population: a retrospective chart review

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    Gavigan, Geneviève; McEvoy, Alana; Walker, James

    2016-01-01

    Background: Dermatology in vulnerable populations is under-researched. Our objective was to analyze the most commonly referred skin diseases affecting the Correctional Service Canada inmates in Ontario. Methods: An observational, cross-sectional, retrospective chart review of inmate patients seen from 2008 until 2013 was performed. Two groups of patients were included in the analysis: those assessed in-person, and those evaluated by e-consult. Results: In the in-person patient group, the 3 most common diagnoses were acne, psoriasis and other superficial mycoses. For the e-consult group, the 3 most frequent diagnoses were acne, psoriasis and rosacea. There was a clear bias toward more inmates being seen in-person where the service was provided (Collins Bay Institution) than from other correctional institutions in Eastern Ontario. Interpretation: Most of the skin diseases that affected the incarcerated population studied were common afflictions, similar to those affecting the general population, which is in agreement with other studies. Future studies investigating skin diseases in male and female inmates across Canada would bestow more generalizable data. PMID:27398381

  13. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

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    Cindy L. Lamerson

    2012-01-01

    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  14. A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

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    Kristie L. DeBlasio

    2012-12-01

    Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

  15. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

    Science.gov (United States)

    Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

    2013-04-01

    Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs. PMID:22772159

  16. Potential brain death organ donors - challenges and prospects: A single center retrospective review

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    Yousef Al-Maslamani

    2014-01-01

    Full Text Available Organ donation after brain death (BD is a major source for obtaining transplantable organs for patients with end-stage organ disease (ESOD. This retrospective, descriptive study was carried out on all potential BD patients admitted in different intensive care units (ICUs of the Hamad medical Corporation (HMC, Doha, Qatar during a period from January 2011 to April 2012. Our aim was to evaluate various demographic criteria and challenges of organ donation among potential BD organ donors and plan a strategy to improve the rate of organ donation in Qatar. Various aspects of BD patients in the ICUs and their possible effects on organ donation were studied. The time intervals analyzed to determine the possible causes of delay of organ retrieval were: time of diagnosing fixed dilated pupils in the ICU, to performing the first BD test, then to the second BD test, to family approach, to organ retrieval and/or circulatory death (CD without organ retrieval. There were a total of 116 potential BD organ donors of whom 96 (82.75% were males and 20 (17.25% were females. Brain hemorrhage and head injury contributed to 37 (31.9% and 32 (27.6% BD cases, respectively. Time interval between diagnosing fixed dilated pupil and performing the first test of BD was delayed >24 h in 79% of the cases and between the first and second BD tests was >6 h in 70.8% of the cases. This delay is not compatible with the Hamad Medical Corporation (HMC policy for BD diagnosis and resulted in a low number of organs retrieved. BD organ donation, a potential source for organs to save patients with ESOD has several pitfalls and every effort should be made to increase the awareness of the public as well as medical personnel to optimize donation efficacy.

  17. Factors associated with car seat test failure in late preterm infants: A retrospective chart review

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    Smith, Ryan W; Mohamed, Adel; Young, Jennifer; Jefferies, Ann; Shah, Vibhuti

    2016-01-01

    BACKGROUND: Professional organizations recommend car seat testing of preterm infants before discharge from hospital. Late preterm infants (LPIs, 340/7 to 366/7 weeks’ gestational age) are at the greatest risk for failure, despite often being well. OBJECTIVE: To determine the incidence of car seat testing failure in LPIs and associative factors. METHODS: A retrospective chart review was performed of inborn LPIs admitted to all levels of newborn care between July 1, 2012 and June 30, 2013. Data collected included maternal demographics, labour and delivery history, and neonatal course. Data were analyzed using backward logistic regression. RESULTS: A total of 511 charts were reviewed and 367 LPIs were eligible for inclusion. Of the 313 LPIs tested (mean [± SD] gestational age 36 weeks ±6 days and birth weight 2614±405 g), 80 (26%) failed (95% CI 21% to 31%). Most failed due to desaturations (≥2) of <88% for ≥10 s (n=33 [41%]). Multiple gestation was associated with failure (adjusted OR 2.45 [95% CI 1.44 to 4.18]; P=0.001), and there was a trend toward statistical significance for the variable postnatal age (0.996 [95% CI 0.99 to 1.00]; P=0.05). Infants who passed their car seat test had higher postnatal ages than those who failed (mean difference 39.4 h [95% CI 12.7 h to 66.0 h]; P=0.004). CONCLUSION: Twenty-six percent of LPIs failed car seat testing. Ideally, infants should be tested after an appropriate transitional period. The authors identified factors that may be important in designing future, prospective studies in this area. Future research should evaluate the clinical significance of car seat testing and resource utilization. PMID:26941555

  18. Osteosarcoma in Pediatric Patients and Young Adults: A Single Institution Retrospective Review of Presentation, Therapy, and Outcome

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    Candace L. Haddox

    2014-01-01

    Full Text Available Background. Little is known about how cumulative chemotherapy delivery influences the poorer outcome observed in young adult (YA, 18–40 years versus pediatric (<18 years osteosarcoma patients. Here, we retrospectively examined differences in presentation, therapy, including cumulative chemotherapy dose, and outcome in YA and pediatric patients. Methods. We reviewed 111 cases of high-grade osteosarcoma at Moffitt Cancer Center between 1988 and 2012. Presentation factors, therapies, and survival were compared between YA and pediatric cohorts. Results. The cohorts were equivalent with respect to metastatic status, gender, tumor size, tumor site, and histological subtype. We found that the YA patients tended to have poorer histologic response to neoadjuvant chemotherapy measured by necrosis with 55% and 35% of pediatric versus YA patients responding favorably (P=0.06. Only 39% of YA patients achieved the typical pediatric dose of methotrexate, doxorubicin, and cisplatin. These patients had a 3-year EFS of 76% (CI 53–100% versus 47% (CI 26–69%; P=0.09 in those who received less chemotherapy. Conclusion. Age continues to be a prognostic factor in osteosarcoma. Our study suggests that presentation factors are not associated with prognosis, while poorer response to chemotherapy and lower cumulative dose of chemotherapy delivered to YA patients may contribute to poorer outcomes.

  19. Approach to cases with postpartum haemorrhage: Retrospective analysis of 41 cases

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    Adnan İncebıyık

    2014-03-01

    Full Text Available Objective: To assess treatment approaches and outcomes in 41 cases with postpartum haemorrhage (PPH. Methods: Screening the electronic database of the hospital identified 41 cases admitted to the obstetrics clinic with a diagnosis of PPH (ICD codes: O72, O72, O72.2 between January 1, 2010, and June 30, 2013. The clinical findings and the results of the surgical and medical treatments used were noted in all the patients. Results: Forty-one cases with PPH were detected who had been managed at the clinic during a 3-year period. Normal spontaneous vaginal delivery (26 patients; 63.4% was the most common type of delivery. Uterine atony was the most common cause of PPH in 30 patients (73.2%. Medical therapy was the most common therapeutic approach in PPH caused by uterine atony (16 patients; 53.3%, followed by total abdominal hysterectomy (TAH plus bilateral hypogastric artery ligation (9 patients; 30.0%, uterine packing sutures plus bilateral hypogastric artery ligation (BHAL (4 patients; 13.3% and intrauterine balloon tamponade (IUBT (one patient; 2.4%. Only one of 3 patients with uterine rupture underwent a hysterectomy. Three patients in whom placental adhesion anomalies were detected were treated by a combination of manual removal of the placenta, uterine curettage and IUBT. Conclusion: The results suggest that care should be taken regarding PPH in pregnant women, even in those without any risk factors. In particular, the third phase of labour should be carefully monitored. Medical treatment and organ-sparing surgery are generally associated with positive outcomes in patients with stable haemodynamic status. J Clin Exp Invest 2014; 5 (1: 18-23

  20. Neurogenic pruritus: an unrecognised problem? A retrospective case series of treatment by acupuncture.

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    Stellon, Anthony

    2002-12-01

    Intractable localised segmental pruritus without a rash has been reported over the years under various titles depending on the area of the body affected. Notalgia paresthetica and brachioradial pruritus are the two terms used for what is believed to be a form of neuropathy. The clinical observations reported here suggest that other localised cases of pruritus exist that share common clinical features, and the term neurogenic pruritus is suggested to encompass these under one clinical condition. Acupuncture has been used to treat skin conditions, of which pruritus is one symptom. This retrospective study looked at the symptomatic relief of neurogenic pruritus in 16 patients using acupuncture. In 12 cases the affected dermatomes of the body were innervated by cervical spinal nerves, seven innervated by dorsal spinal nerves and four innervated by the lumbar spinal nerves. Seven patients had areas affected by two different regions of the spine. Restricted neck or back movements were noted in patients as were areas of paravertebral spasm or tenderness of the muscles. Total resolution of symptoms as judged by VAS occurred in 75% of patients. Relapse occurred in 37% of patients within 1-12 months following treatment. Acupuncture appeared to be effective in alleviating the distressing symptom of itching in patients presenting with neurogenic pruritus. PMID:12512793

  1. RETROSPECTIVE STUDY OF 861 CASES OF ENDOSCOPIC ENDONASAL DCR: OUR EXPERIENCE

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    Mahajan

    2014-02-01

    Full Text Available AIM: To focus on difficulties in endoscopic endonasal DCR, to improve the final outcome of endoscopic endonasal DCR. To elaborate the steps this will avoid recurrence. MATERIAL AND METHODS: This article presents retrospective study of 861 cases that underwent Endoscopic endonasal DCR between Oct 2004 and Nov 2011. The patients operated were in the age group from 5 years to 94 years. The cases of lacrimal abscesses were tackled by endo DCR which gave a substantial advantage over the conventional external approach by avoiding a scar. The stenting of the canalicular system was restricted to the situations where the patency of the lacrimal canaliculi was absent and the sac syringing done on operation table showed no fluid coming from the new stoma due to the blocked canaliculi or fibrosis of lacrimal sac. The stent used was silicon bicanalicular lacrimal intubation set. CONCLUSIONS: Local anaesthesia preferred over general anaesthesia as it has less bleeding and less morbidity. Endoscopic DCR avoids scar of external approach. Coexistent sinonasal disease can be tackled at same sitting. Adequate marsupialization of sac mucosa is key for avoiding recurrence.

  2. A rarity that can lead to a casualty - A retrospective study of 12 cases of Dermatomyositis

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    Matilda Naesström

    2015-09-01

    Full Text Available Aims: Lesions of the skin are omnipresent in Internal Medicine practice. The varying etiopathology when facing multiple system involvement may pose a challenge when it comes to diagnostics and management, especially when faced with less common skin diseases. Dermatomyositis is a rare skin disorder that manifests on the skin and in muscle; it also comes with a higher risk of comorbid cancers. Therefor we present the cases of dermatomyositis diagnosed at our departmet during the last 17 years, with the specific attention to ocurrance of oncological processes. Method: A retrospective study was performed on 12 cases hospitalized between 1996 to 2011 due to dermatomyositis. The analysis was based on the course of the disease, clinical picture, treatment and frequency of neoplasms. Results: Within those 12 patients (in addition to dermatomyositis five patients had concomitant oncological process. The tumors of these five patients were located in discrete anatomical locations. The oncological process occured before, during, or after the appearance of dermatomyositis. Conclusions: The combination of hallmark signs and symptoms seen in dermatomyositis are specific for the disease. Physicians need to be better informed about this rare, yet important disease, because it can be considered a paraneoplastic process.

  3. Liver resection for benign hepatic lesions: A retrospective analysis of 827 consecutive cases

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions.METHODS: A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 to December 2005 in the Chinese PLA General Hospital were investigated retrospectively according to their medical documentation.RESULTS: The effect of operative and perioperative factors on the outcome of patients were analyzed. Of the 827 cases undergoing hepatectomy for more than 3 liver segments accounted for 22.1%, 316 (38.21%) required transfusion of blood products during operation. The average operating time was 220.59 ± 109.13 min, the average hospital stay after operation was 13.55 ± 9.38 d. Child-Pugh A accounted for 98.13%. The postoperative complication rate was 13.54% and the in-hospital mortality rate was 0.24%. Multivariate analysis showed that operating time (P = 0.004, OR = 1.003) and albumin value (P = 0.040, OR = 0.938) were the independent predictors of morbidity and indicated that operating time, blood transfusion, complication rate, and LOS had a trend to decrease.CONCLUSION: Hepatectomy for benign hepatic lesions can be performed safely with a low morbidity and mortality, provided that it is carried out with optimized perioperative management and an innovative surgical technique.

  4. Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

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    Hassan BOUSSAKRI

    2016-03-01

    Full Text Available This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4 of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP, as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%. 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.

  5. Retrospective study of dog bite cases at Ahmadu Bello University, Zaria, Nigeria and its environment

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    Ajoke Modupeoluwa Ehimiyein

    2014-08-01

    Full Text Available Aim: A 10-year retrospective study was undertaken to determine the prevalence of dog bites reported to the Veterinary Teaching Hospital (VTH, Ahmadu Bello University (ABU, Zaria, and to implement measures to control rabies exposure in the environment. Materials and Methods: Data on dog bite cases, reported to the VTH of ABU, Zaria, Nigeria between January, 2002 and December, 2011, were retrieved and analyzed using Statistical Package for Social Sciences version 17.0, Chicago, IL, USA. Result: A total of 236 dog bite-related cases was presented, of which 1.7% dogs died of rabies. The number of cases (59.7% increased through time with the highest number (32 recorded in 2011. Majority of the cases were recorded between June and October of each year. Of the biting dogs, 22.5% were puppies (1-6 months and 77.5% were adults (above 6 months. The human victims were 92.4%, while the dog victims were 7.6%. Eight of the dogs were stray dogs, while 228 (96.6% were owned dogs. Of the owned dogs, 71.2% were free-roaming. Only 22% of the owned dogs were vaccinated. The most common offending breeds included the Nigerian Indigenous local breeds (73.3%, cross breeds (24.6%, Alsatians (0.8%, Terriers (0.8%, and Bulldogs (0.4%. Conclusion: In conclusion, rabies is endemic in Zaria, Nigeria, and the incidence of dog bites is on the rise. Strict measures including vaccination of the dogs and the leash law should be adopted to prevent dog bites.

  6. [Retrospective analysis for 104 cases of early-stage Hodgkin's Lymphoma treated with different modality therapies].

    Science.gov (United States)

    Du, Ting-Ting; Xiao, Xiu-Bin; Su, Hang; Da, Yong; Chen, Xin-Lin; Zhong, Kai-Li; Zhao, Shi-Hua; Lu, Yun; Wang, Shuang; Zhang, Wei-Jing

    2012-04-01

    This paper explored the curative effect of combined modality therapy and extended field radiotherapy for early-stage Hodgkin's Lymphoma. 104 cases of early-stage Hodgkin's Lymphoma from Jan 1987 to Dec 2010 in PLA Hospital 307 were retrospectively analyzed, including 76 cases in combined modality therapy group and 28 cases in extended field radiotherapy group, and the long-term efficacy and toxicity of two therapy modalities were evaluated. The results showed that the median survival time of 104 cases was 85.42 months, the complete remission rates of combined modality therapy and extended field radiotherapy groups were 72.4 and 71.4 respectively (P = 0.924); the overall response rates of combined modality therapy and extended field radiotherapy groups were 97.4 and 96.4 respectively (P = 0.779); the 5-year overall survival (OS) rates in the 2 groups were 89.5 and 89.1 respectively, and the 8-year OS rates of the 2 groups were 81.3 and 70.6. No statistical difference was found in above-mentioned 2 groups. Moreover, the 5-year progression free survival (PFS) rates of these 2 groups were 84.2 and 69.0 (P = 0.04), and 8-year PFS rates of these 2 groups were 80.0 and 55.5 (P = 0.04) respectively, the 5-year relapse rates of these 2 groups were 28.1 and 45.6 (P = 0.023) respectively. It is concluded that the combined modality therapy can raise the PFS rate and reduce the relapse rate as compared with extended field radiotherapy for early-stage Hodgkin's Lymphoma, but there is no difference in the overall survival rate between the 2 groups.

  7. Diagnostic utility of two case definitions for anaphylaxis: a comparison using a retrospective case notes analysis in the UK.

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    Erlewyn-Lajeunesse, Michel; Dymond, Sandra; Slade, Ingrid; Mansfield, Helen L; Fish, Rosie; Jones, Owen; Benger, Jonathan R

    2010-01-01

    Anaphylaxis is a clinical diagnosis with no gold-standard test. Recent case definitions have attempted to provide objective criteria for diagnosis. The aim of this study was to compare the diagnostic concordance of the Brighton Collaboration case definition (the 'Brighton' case definition) to the consensus case definition from the Second Symposium on the Definition and Management of Anaphylaxis (the 'Symposium' definition). The study setting was a hospital-based emergency department in the UK. We identified cases of anaphylaxis by physicians' discharge diagnoses over a 2-year period from 2005 to 2006, and used randomly selected cases of allergic reaction, asthma and urticaria as a control group. Data was extracted by clinicians (who were unaware of the content of either case definition), and the two case definitions were applied by Boolean operators in a Microsoft Excel spreadsheet. Concordance between the case definitions was measured using Cohen's kappa (kappa) statistic. We reviewed 128 sets of notes, with 47 cases of anaphylaxis. Brighton and Symposium definitions had sensitivities of 0.681 and 0.671, respectively, and specificities of 0.790 and 0.704, respectively. A discordant result was found in 36/128 cases (28.1%; kappa = 0.414 [95% CI 0.253, 0.574]), which represents a moderate level of agreement between case definitions. The Brighton case definition has a similar diagnostic concordance to the Symposium case definition. It does not seem to over- or underestimate cases and is sufficiently unique that the identification of an allergic trigger does not have to form part of the case definition. This will be important in the recognition of anaphylaxis resulting from the administration of drug and vaccines, where causality should be examined separately from case ascertainment. PMID:20000867

  8. A review of Craniopharyngioma and the retrospective study on 100 patients

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    Larijani B

    1995-07-01

    Full Text Available This study was performed in order to improve the knowledge about Craniopharyngioma tumors, and tried to present extensive datas about the signs and symptoms, the clinical process and the treatments and their complications of the patients with Craniopharyngioma, admitted in the hospitals of Tehran university during 15 years (1355-70. Ultimately, these datas have been compared with those in the reputable books and new medical papers; And the results are present at the end of the discussion. Undoubtedly, this study is not free of the limitations of retrospective studies. Our patients-contrary to the textbooks are predominantly males; And also their most common chief complaints are neurological manifestations, and headache (82% is the most common one. There is only a little difference in the prevalence of some of the endocrinologic and ophthalmic manifestations between our datas and what in the texts, while, in some others, we can see a great diversity between the 2. For instance, decreased libido in men and amenorrhea in women, among our patients are prominently less than what we study in the books; And blood pressure disturbances, sensory and motor symptoms and urinary incontinence have not been seen in our patients. In most cases, CT scan leads to diagnosis and its diagnostic accuracy in 2 times higher than that of the simple radiography and it can show the sella enlargement obviously. In a majority of cases (More than 95%, excision a part of the tumor (From just limited to the biopsy area to 90% of tumor mass was the only therapeutic measure. In only a few patients, tumor excision was followed by radiotherapy, that showed the better results. The most common delayed complication was the recurrence of the disease.

  9. A retrospective study on malaria cases admitted to the University Hospital, Kuala Lumpur, 1984-1988.

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    Sidhu, P S; Ng, S C

    1991-06-01

    A review of malaria cases over a five year period from 1984-1988 at the University Hospital, Kuala Lumpur, Malaysia is presented. A total of 64 cases were recorded; 50% of which were due to Plasmodium falciparum, 40.6% were due to Plasmodium vivax, 6.2% due to Plasmodium malariae and 3.1% due to a mixed infection of Plasmodium falciparum and Plasmodium vivax. The breakdown of species type compared similarly with other studies conducted in the region. Of this total, sixteen cases were imported from Pakistan, India, Thailand, Indonesia, Sri Lanka, Vietnam, Madagascar and Mali. The presenting symptoms and the clinical findings were typical of a malaria infection. The main problem in the future will be the increase in imported cases of malaria.

  10. Toxicologic Laboratory Findings in Cases Reported with Hanging Death: a Two-Year Retrospective Study in Northeast Iran

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    Mohammad Ranjbar

    2013-09-01

    How to cite this article: Ranjbar R, Liaghat AR, Ranjbar A, Mohabbati H. Toxicologic Laboratory Findings in Cases Reported with Hanging Death: a Two-Year Retrospective Study in Northeast Iran. Asia Pac J Med Toxicol 2013;2:92-5.

  11. Neuroelectrophysiological indexes and clinical characteristics of patients with peroneal muscular atrophy: Retrospective analysis of 24 cases

    Institute of Scientific and Technical Information of China (English)

    Changchun Su; Qinbao Qin

    2006-01-01

    BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis.Nerve conductive velocity is helpful in the diagnosis of atypical cases.OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG),motor and sensory nerve conduction velocity of patients with PMA.DESIGN: Retrospective case analysis.SETTING: Department of Neurology, Guangzhou First People's Hospital.PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old,admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited.Informed consents were obtained from all the patients.METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed.MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients.RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA.Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ② Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down,especially in 16 patients with type Ⅰ PMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m

  12. Tracheobronchial foreign bodies in children - a retrospective study of 2,000 cases in Northwestern China.

    Science.gov (United States)

    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  13. Surgical Treatment and Recurrence of Cutaneous Nasal Malignancies: A 26-Year Retrospective Review of 1795 Patients.

    Science.gov (United States)

    Christopoulos, George; Sergentanis, Theodoros N; Karantonis, Fotis; Karypidis, Dimitrios; Hampsas, Grigoris; Kostopoulos, Epaminondas; Kostaki, Maria; Papadopoulos, Othon

    2016-08-01

    Frequent localization of facial malignancies in the nasal area and their required complete surgical extirpation pose a significant challenge to the plastic surgeon, who is called to perform a suitable delicate reconstruction of produced nasal skin defects. The present study was aimed to examine the role of tumor characteristics in the prognosis of patients with nasal skin cancer undergoing surgical management.A retrospective review of 1795 patients operated on for nasal cutaneous neoplasms during a 26-year period is presented in our study. Descriptive statistics were appropriately calculated; multivariate Cox regression analysis was performed regarding the possible risk factors for recurrence. Only those with a complete follow-up were included in the study. The mean age of our study population was 66.7 years with a male majority (52.4%). Basal cell carcinoma appeared as the most common histological type (87.7%), followed by squamous cell carcinoma (7.9%); the latter correlated with poor prognosis.The nasal sidewalls were the most frequent lesion location (29.8%), followed by the alae (27.8%), dorsum (21.7%), and tip (19.3%). The columella was very rarely affected (0.5%) but was associated with increased recurrence [hazard ratio, 4.74; 95% confidence interval (CI), 1.12-20.00; P = 0.034]. Most patients were treated with elliptical excision and direct closure (58.7%). Local flaps (31.0%) and skin grafting (9.0%) proved very reliable surgical options, especially for larger, high-risk lesions. Recurrence transpired in 46 patients (2.6%) and 4 skin cancer-related deaths occurred.Surgical modality of choice should be individualized and carefully adjusted to patients' needs. Moreover, more elective techniques, such as Mohs micrographic surgery or cumulative therapeutic approaches, like irradiation, should be examined as a beneficial aid to confront high-risk malignancies. PMID:26207539

  14. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

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    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  15. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

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    Slothower Molly P

    2006-08-01

    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  16. Primary Nasopharyngeal non-Hodgkin lymphomas: a retrospective review of 26 Moroccan patients

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    Ismaili Mohammed

    2009-11-01

    Full Text Available Abstract Background Nasopharyngeal non-Hodgkin lymphomas (NNHL are extremely rare. In this study, we will report the progress achieved in the management of this disease in our institute. Methods We retrospectively reviewed the records of 26 patients having primary NNHL who were managed between January 1997 and December 2008, to evaluate and compare their clinical characteristics and treatment outcome. Clinical variables, including age, sex, stage, and treatment modality, were assessed. Disease free survival and overall survival were measured. Survival curves were constructed using the KaplanMeier method. The log-rank test was used to compare them. Results Median age of our patients was 52.7 years. Nasal obstruction, nasal discharge and epistaxis were the frequent symptoms in NNHL patients. Histology of NNHL were mainly large B-cell and follicular lymphoma. Four patients (15.4% were at stage I, 15 (57.6% at stage II, and 7 (27% were at stage III/IV. The patients were treated with chemotherapy alone (27% or chemotherapy plus radiotherapy (73%. At early stage (stage I/II, the patients were managed with chemo-radiotherapy. When the whole treatment was completed, 18 patients (69.2% achieved complete response and remained disease free. After 25.9 months median follow-up, overall survival at 1 year was 87% and disease free survival at 1 year was 71%. The difference in term of overall and disease free survival between stage I, II, III and IV was significant (Log rank test: p = 0.02 for overall survival and p = 0.01 for disease free survival. Conclusion From our study, we conclude that histological characteristics, principle of treatment and outcome of primary NNHL patients are particular and more studies have to be directed.

  17. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Power, Sarah, E-mail: sarahpower28@yahoo.co.uk; Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2013-04-15

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  18. Retrospective analysis of suspected rabies cases reported at Bugando Referral Hospital, Mwanza, Tanzania

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    Humphrey D Mazigo

    2010-01-01

    Full Text Available Aims: The aim of this study was to determine the incidence of humans being bitten by rabies-suspected animals, and the victims′ adherence to post-exposure prophylaxis (PEP regimen. Materials and Methods: A retrospective analysis of data of victims treated at Bugando Medical Centre during the period 2002-2006 (n=5 years was done. Results: A total of 767 bite injuries inflicted by rabies-suspected animals were reported, giving a mean annual incidence of ~58 cases per 100,000 (52.5% males, 47.5% females. The proportion of children bitten was relatively higher than that of adults. All victims were treated by using inactivated diploid-cell rabies vaccine and were recommended to appear for the second and third doses. However, only 28% of the victims completed the vaccination regime. Domestic dogs were involved in 95.44% of the human bite cases, whereas cats (3.9%, spotted hyena (Crocuta crocuta (0.03%, vervet monkey (Cercopithecur aethiops (0.01% and black-backed jackal (0.01% played a minor role. The majority of rabies-suspected case reports were from Nyamagana district and occurred most frequently from June to October each year. Conclusions: In conclusion, this study revealed that incidences of humans being bitten by dogs suspected of rabies are common in Tanzania, involve mostly children, and victims do not comply with the prophylactic regimen. Rigorous surveillance to determine the status of rabies and the risk factors for human rabies, as well as formulation and institution of appropriate rabies-control policies, is required.

  19. Aetiology of canine otitis externa: a retrospective study of 100 cases.

    Science.gov (United States)

    Saridomichelakis, Manolis N; Farmaki, Rania; Leontides, Leonidas S; Koutinas, Alexander F

    2007-10-01

    The objective of this retrospective study was to investigate in 100 dogs with otitis externa (OE) the possible associations between signalment, history, clinical and laboratory findings and the various primary, secondary and perpetuating causative factors of ear canal inflammation. The age of the dogs ranged from 3 months to 14 years (median: 4.75 years) and they included 45 males and 55 females. Cocker spaniels, Jura des Alpes and Brittany spaniels were significantly overrepresented among dogs with OE when compared to the hospital canine population. In the majority of the cases, OE was chronic-recurrent (63%) or bilateral (93%). Allergic dermatitis (43/100 dogs), grass awns (12/100) and otoacariasis (7/100) were the most common primary causative factors; no primary factor could be incriminated in 32 cases and more than one was found in three dogs. Malassezia spp. (66/100 dogs), cocci (38/100) and rods (22/100) were the secondary causative factors, while ear canal stenosis (38/100) and tympanic membrane perforation-otitis media (25/100) were the most important perpetuating factors. Atopic dermatitis and adverse food reactions-associated OE was more common in females and dogs with a history of pruritic skin disease, while grass awn-induced OE occurred in cocker spaniels and acute cases. Tympanic membrane perforation was less frequent in atopic dermatitis and adverse food reactions-associated OE, but more common when otoscopic and ear canal cytological examination revealed the presence of grass awns and rods, respectively. Finally, cocci overgrowth was positively associated with ear canal stenosis. PMID:17845622

  20. A Retrospective Observational Case Series of Low-Flow Venovenous Extracorporeal Carbon Dioxide Removal Use in Patients with Respiratory Failure.

    Science.gov (United States)

    Moss, Caroline E; Galtrey, Eleanor J; Camporota, Luigi; Meadows, Chris; Gillon, Stuart; Ioannou, Nicholas; Barrett, Nicholas A

    2016-01-01

    We aimed to describe the use of venovenous extracorporeal carbon dioxide removal (ECCO2R) in patients with hypercapnic respiratory failure. We performed a retrospective case note review of patients admitted to our tertiary regional intensive care unit and commenced on ECCO2R from August 2013 to February 2015. Fourteen patients received ECCO2R. Demographic data, physiologic data (including pH and partial pressure of carbon dioxide in arterial blood [PaCO2]) when starting ECCO2R (t = 0), at 4 hourly intervals for the first 24 hours, then at 24 hour intervals until cessation of ECCO2R, and overall outcome were recorded. Patients are reported separately depending on whether the indication for ECCO2R was an exacerbation of chronic obstructive pulmonary disease (COPD; n = 5), or acute respiratory distress syndrome (ARDS) and persisting hypercapnoea (n = 9). Patients were managed with ECCO2R (Hemolung, ALung Inc, Pittsburgh, PA). Median duration of ECCO2R was 5 days. Four complications related to ECCO2R were reported, none resulting in serious adverse outcomes. Ten patients were discharged from intensive care unit (ICU) alive. A statistically significant improvement in pH (p = 0.012) was demonstrated. Our observational series of ECCO2R shows that this technique can be safely used to achieve therapeutic goals in patients requiring lung protection, and in COPD, in line with current publications in this area. PMID:27195746

  1. Use of a Dehydrated Amniotic Membrane Allograft on Lower Extremity Ulcers in Patients with Challenging Wounds: A Retrospective Case Series.

    Science.gov (United States)

    Lintzeris, Dimitrios; Yarrow, Kari; Johnson, Laura; White, Amber; Hampton, Amanda; Strickland, Andy; Albert, Kristy; Cook, Arlene

    2015-10-01

    Lower extremity ulcers in patients with diabetes mellitus may take a long time to heal despite the use of advanced topical therapies. A retrospective review of cases was conducted to assess the use of a dehydrated amniotic membrane allograft (DAMA) in a convenience sample of 9 wounds in 8 patients (5 men, 3 women, average age 62 years [range 31-81 years]) with diabetes mellitus and/or vascular disease. Wound data and patient characteristics were abstracted from medical records. Descriptive statistics were used to summarize the data. In 5 of 9 wounds, DAMA was applied after a failure to demonstrate a 50% reduction in area after 4 weeks of treatment with advanced wound care, offloading, and compression as indicated. In 4 wounds, DAMA was applied 2-4 weeks after presentation because of concerns about existing patient risk factors for nonhealing. Wounds were present for an average of 11 weeks (range 1-35 weeks) before application of DAMA. Mean baseline wound area and volume were 3.11 cm2 (± 3.73) and 0.55 cm3 (± 0.58), respectively. All wounds healed in an average of 5.7 (± 2.9) weeks (range: 1-9 weeks) after a mean of 2.7 applications (± 1.7) (range 1-5 applications). No adverse events occurred. These observations suggest prospective, randomized, controlled clinical studies to compare the use of DAMA to other topical treatment modalities are warranted. PMID:26479124

  2. Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series

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    Friedman Jonathan A

    2009-03-01

    Full Text Available Abstract Background Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P. Methods All patients undergoing single-level anterior cervical discectomy and fusion with plating between August 2005 and May 2007 by two surgeons (RPB or JAF were retrospectively reviewed. All patients underwent anterior cervical microdiscectomy, arthrodesis using structural allograft, and titanium plating. A planned change from doing ACDF+P on an inpatient basis to doing ACDF+P on an outpatient basis was instituted at the midpoint of the study. There were no other changes in technique, patient selection, instrumentation, facility, or other factors. All procedures were done in full-service hospitals accommodating outpatient and inpatient care. Results 64 patients underwent ACDF+P as inpatients, while 45 underwent ACDF+P as outpatients. When outpatient surgery was planned, 17 patients were treated as inpatients due to medical comorbidities (14, older age (1, and patient preference (2. At a mean follow-up of 62.4 days, 90 patients had an excellent outcome, 19 patients had a good outcome, and no patients had a fair or poor outcome. There was no significant difference in outcome between inpatients and outpatients. There were 4 complications, all occurring in inpatients: a hematoma one week post-operatively requiring drainage, a cerebrospinal fluid leak treated with lumbar drainage, syncope of unknown etiology, and moderate dysphagia. Conclusion In this series, outpatient ACDF+P was safe and was not associated with a significant difference in outcome compared with inpatient ACDF+P.

  3. Clinicopathologic analysis of 21 cases of nevus sebaceus: A retrospective study

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    Simi C

    2008-01-01

    Full Text Available Background: Nevus sebaceus (NS, otherwise designated as ′organoid nevus′, involves proliferative changes of the sebaceous glands, sweat glands, and the hair follicles. It displays a range of appearances, depending on the lesion′s age. Aims: To study the histopathological features of NS and correlate these with clinical findings. Methods: All skin biopsy specimens over a 12-year period from 1995 to 2007 which had a diagnosis of NS were included. Clinical data with follow-up notes and histopathology were reviewed. Results: Half of the cases had a verrucous clinical appearance, while the rest presented as papules, plaques, or patches. All the cases showed immature hair follicles, and 24% of cases showed immature sebaceous glands. Normal terminal hair follicles were characteristically absent in the lesion. Nineteen percent of the cases showed dilated apocrine glands, and 14% showed hyperplasia of eccrine glands. Epidermal changes in the form of acanthosis, papillomatosis, and hyperkeratosis were seen in 86% of cases. Dilated keratin-filled infundibula were observed in 24% of cases. One case was associated with a squamous cell carcinoma. Conclusions: Nevus sebaceus is a cutaneous hamartoma, consisting of various elements indigenous to the organ. Normal terminal hair follicles are characteristically absent in the lesion although the same may be seen in rest of the epidermis, a feature of diagnostic importance, not usually highlighted in literature. The divergent differentiation observed in NS is consistent with the common embryologic origin of the folliculosebaceous-apocrine unit and should not mislead the pathologist.

  4. A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

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    Carl Magnus Sköld

    2016-07-01

    Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

  5. Does the South African Physiotherapy Journal fulfill the needs of its constituency? A retrospective article review

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    J.M. Frantz

    2011-02-01

    Full Text Available Professional  journals  are  used  to  disseminate  the  knowledge of scholars in the profession and to provide clinicians with guidance for best practice.  This  article  aimed  to  retrospectively  review  the  role  of the  South African  Journal  of  Physiotherapy  and  its  contribution  to  the profession.  An archival  research  design  was  used  to  collect  information from  the  archives of  the  South  African  Society  of  Physiotherapy website.  The  information  was retrieved  using  a  data  capture  sheet and descriptive  statistics  were  used throughout  to  establish  frequencies  for the  relevant  information.  During  the identified period, 170 articles were published. The greatest number of papers originated in South Africa (81%, 8% from the rest of Africa and 11% written by international authors. Authors with a Masters degree contributed almost 50% of the papers and those with doctorates were responsible for at least 25% of the papers. Most of the papers presented original research (81% with secondary research such as reviews and scholarly papers accounting for 19% of the total. The most common speciality area addressed through research  was  linked  to musculoskeletal  conditions.  The  journal  appears  to  have  provided  an important  platform  for  South African academics and emerging researchers to publish their findings. It is suggested that the journal should give preference to papers that deal with issues that are unique to South Africa and sub-Saharan Africa, as these are the least likely to be published elsewhere. In addition, the journal should emphasise papers that will advance the profession.

  6. Primary breast lymphoma - review and case reports

    International Nuclear Information System (INIS)

    Primary breast lymphoma (PBL) is a rare lymphoproliferative disease. More than 80 % cases show B-cell origin. Diffuse large B-cell lymphoma is most common type. The treatment depends on the histologic type of the non-Hodgkin lymphoma. Mastectomy and axillary dissection are poor factor for overall survival and lymphoma specific survival according to the retrospective analyses and therefore surgery should be limited to the biopsy. Cases demonstrate different histologic types of the PBL with different surgery and chemotherapy approach. (author)

  7. Evaluation of Maternal Mortality Cases in the Province of Elazig, Turkey, 2007-2013: A Retrospective Study

    OpenAIRE

    2014-01-01

    The aim of this study was to determine the causes and factors influencing maternal mortality. All maternal deaths occurring between January 2007 and November 2013 in the Elazıg Province of Turkey were retrospectively investigated. The maternal age, obstetric history, cause of death, encountered delay model of each case, as well as the overall number of annual live births in the Province were determined. The information of cases was obtained from Directorate of Public Health and hospital recor...

  8. Tuberculosis Case Finding in Benin, 2000-2014 and Beyond: A Retrospective Cohort and Time Series Study.

    OpenAIRE

    Serge Ade; Wilfried Békou; Mênonli Adjobimey; Omer Adjibode; Gabriel Ade; Harries, Anthony D; Séverin Anagonou

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The "R" software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 ...

  9. Spontaneous acromegaly: a retrospective case control study in German shepherd dogs.

    Science.gov (United States)

    Fracassi, F; Zagnoli, L; Rosenberg, D; Furlanello, T; Caldin, M

    2014-10-01

    Acromegaly results from the overproduction of growth hormone in adulthood and is characterised by overgrowth of soft tissue and/or bone as well as insulin resistance. There are few data indicating the risk factors associated with this disease in dogs or its clinicopathological features and sequelae. The objective of this retrospective study was to catalogue and assess these aspects of the disease in German shepherd dogs (GSDs) which were found to be over-represented among acromegalic dogs attending two veterinary referral clinics over a period of 7 years. Each acromegalic dog (AD) was compared with two breed/age/sex matched controls. Clinical signs of acromegaly included panting, polyuria/polydipsia, widened interdental spaces, weakness, inspiratory stridor, macroglossia, weight gain, redundant skin folds, thick coat, exophthalmos and mammary masses. Serum alkaline phosphatase, creatine-kinase, glucose, triglyceride, phosphate ion, and 'calcium per phosphate product' concentrations were significantly higher in acromegalic animals while haemoglobin concentration, blood urea nitrogen, sodium and chloride ion concentrations, and urinary specific gravity, osmolality and fractional excretion of phosphate were significantly lower. Although, in the majority of cases clinicopathological abnormalities resolved following ovariohysterectomy, in one dog, acromegalic signs abated and insulin-like growth factor-1 concentrations normalised only following the surgical excision of mammary tumours carried out 2 months after ovariohysterectomy. The findings of this study indicate that GSDs are predisposed to the development of acromegaly with a suspected inherited susceptibility.

  10. Diagnosis and treatment of small intestinal bleeding: Retrospective analysis of 76 cases

    Institute of Scientific and Technical Information of China (English)

    Ming-Chen Ba; San-Hua Qing; Xiang-Cheng Huang; Ying Wen; Guo-Xin Li; Jiang Yu

    2006-01-01

    AIM: To investigate the causes of small intestinal bleeding as well as its diagnosis and therapeutic approaches.METHODS: A retrospective analysis was conducted according to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years.RESULTS: In these patients, tumor was the most frequent cause of small intestinal bleeding (37/76), followed by Meckel's diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients,21 were diagnosed by digital subtraction angiography,13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by exploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and enteroanastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications.CONCLUSION: Tumor is the major cause of small intestinal bleeding followed by Meckel's diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction angiography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examination of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleeding.

  11. Orthopedic Management of Patients with Pompe Disease: A Retrospective Case Series of 8 Patients

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    Gerrit Haaker

    2014-01-01

    Full Text Available Introduction. Pompe disease (PD, a lysosomal storage disease as well as a neuromuscular disorder, is a rare disease marked by progressive muscle weakness. Enzyme replacement therapy (ERT in recent years allowed longer survival but brought new problems to the treatment of PD with increasing affection of the musculoskeletal system, particularly with a significantly higher prevalence of scoliosis. The present paper deals with the orthopedic problems in patients with PD and is the first to describe surgical treatment of scoliosis in PD patients. Patients and Methods. The orthopedic problems and treatment of eight patients with PD from orthopedic consultation for neuromuscular disorders are retrospectively presented. We analyzed the problems of scoliosis, hip dysplasia, feet deformities, and contractures and presented the orthopedic treatment options. Results. Six of our eight PD patients had scoliosis and two young patients were treated by operative spine stabilization with benefits for posture and sitting ability. Hip joint surgery, operative contracture release, and feet deformity correction were performed with benefits for independent activity. Conclusion. Orthopedic management gains importance due to extended survival and musculoskeletal involvement under ERT. Surgical treatment is indicated in distinct cases. Further investigation is required to evidence the effect of surgical spine stabilization in PD.

  12. Various Techniques to Increase Keratinized Tissue for Implant Supported Overdentures: Retrospective Case Series

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    Ahmed Elkhaweldi

    2015-01-01

    Full Text Available Purpose. The purpose of this retrospective case series is to describe and compare different surgical techniques that can be utilized to augment the keratinized soft tissue around implant-supported overdentures. Materials and Methods. The data set was extracted as deidentified information from the routine treatment of patients at the Ashman Department of Periodontology and Implant Dentistry at New York University College of Dentistry. Eight edentulous patients were selected to be included in this study. Patients were treated for lack of keratinized tissue prior to implant placement, during the second stage surgery, and after delivery of the final prosthesis. Results. All 8 patients in this study were wearing a complete maxillary and/or mandibular denture for at least a year before the time of the surgery. One of the following surgical techniques was utilized to increase the amount of keratinized tissue: apically positioned flap (APF, pedicle graft (PG, connective tissue graft (CTG, or free gingival graft (FGG. Conclusions. The amount of keratinized tissue should be taken into consideration when planning for implant-supported overdentures. The apical repositioning flap is an effective approach to increase the width of keratinized tissue prior to the implant placement.

  13. Surgical Treatment of the Accessory Navicular (Os Tibiale Externum) in Dancers: A Retrospective Case Series.

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    Rietveld, A B M Boni; Diemer, Willemijn M

    2016-01-01

    This study is to draw attention to a relatively common anatomical anomaly and its possible operative treatment in dancers. The accessory navicular, or os tibiale externum, is an accessory bone on the medial side of the navicular of the foot at the insertion of the posterior tibial tendon (PTT). It can cause obvious hyperpronation, medial foot pain, and a limited and painful relevé in dancers. To the best of our knowledge, this is the first report on the operative treatment of the accessory navicular exclusively in dancers. Six dancers (10 feet) were treated in our clinic for a symptomatic accessory navicular Type II. Five of them (eight feet) underwent surgery, two unilaterally and three bilaterally (at the same time). All five had an excellent result at mean follow-up of 4.7 years, given that they fully resumed their professional dance activities without restriction, discomfort, or residual symptoms. One patient stopped dancing for unrelated reasons and became symptom free without further (surgical) treatment. Although no conclusions can be drawn from a retrospective case series and other treatment modalities were not considered, simple excision of a symptomatic accessory navicular Type II seems to be a good choice in dancers. PMID:27661622

  14. Unplanned decannulation of tracheotomy tube in massive burn patients: a retrospective case series study

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    BEN Dao-feng; MA bing; XIA Zhao-fan; L(U) Kai-yang; CHEN Xu-lin; YU Xi-ya; XI Hui-Jun; CHANG Fei; ZHU Shi-hui; TANG Hong-tai; LU Wei

    2011-01-01

    Background Unplanned extubation is associated with adverse outcomes in intensive care unit.The massive burn patient differs from other critically ill patients in many ways.However,little is known about the unplanned decannulation (UD) in Burn Intensive Care Unit.This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients.Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively.A total of 21 patients with 29 UD events were identified.Demographic data,diagnosis,intervention,UD events and outcome of UD patients were collected.Differences in proportions were compared using the chi-square (X2) or Fisher's exact test.Results Patients with UD were often burned with head and neck (67%) and combined with inhalation injury (62%).The majority of them (76%) were transferred patients,occurred early (55%) and were accidental UD (79%).UD events tended to happen in day shift (90%) and to be associated with the medical procedure that was performing by caregivers at besides (79%).Loose of the stabilizing rope,medical procedure and tracheotomy malposition were the main causes of UD.Early UD and reintubation failure were associated with patients' death.Conclusions UD happened to massive burn patients can lead to patient death.Careful management of respiratory tract was essential for massive burn patients.

  15. Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review.

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    Díaz Del Arco, Cristina; Álvarez Sánchez, Ángel; Fernández Aceñero, M Jesús

    2016-09-01

    Gastrointestinal xanthomas are infrequent non-neoplastic lesions characterized by the accumulation of foam cells in the lamina propria. They are commonly seen in association with dyslipidemia, chemotherapy or radiotherapy, and infections in immunosuppressed patients. However, no clear connection to hyperlipidemia has been found. They occur more frequently in the stomach, and are very rare in the small bowel and esophagus. We identified all cases of non-gastric xanthoma or xanthomatosis reported in the English literature by searching the PubMed database and retrospectively reviewed the clinical, endoscopic, and histopathologic features of the 11 cases of non-gastric gastrointestinal xanthomas diagnosed in our hospital. Nine lesions were located in the large bowel, one in the duodenum and one in the esophagus. All xanthomas were small (<5 mm) sessile polyps except the esophageal xanthoma, which measured 13 mm. Two cases in the large bowel and the case in the small bowel were multiple. Most patients with large bowel xanthomas had hypercholesterolemia, unlike esophageal and small bowel cases. The esophageal lesion occurred in a patient with a history of partial fundoplication due to gastroesophageal reflux disease and the small bowel case was associated to chronic atrophic gastritis with intense activity. In our search of the English literature, we found 19 cases of xanthoma or xanthomatosis in the esophagus, 13 cases in the small bowel and 61 cases in the large bowel. In conclusion, gastrointestinal xanthomas, other than the gastric ones, are rare, and are usually incidental findings. PMID:27689205

  16. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

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    Schlampp, Ingmar; Rieken, Stefan; Habermehl, Daniel; Foerster, Robert; Debus, Juergen; Rief, Harald [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-09-15

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.) [German] Die retrospektive Analyse untersuchte osteolytische Knochenmetastasen von Patienten mit Mammakarzinom der thorakalen und lumbalen Wirbelsaeule nach Radiotherapie (RT) hinsichtlich Stabilitaet anhand eines validierten Scores. Die Stabilitaet von 157 osteolytischen Metastasen bei 115 Patienten mit Brustkrebs, behandelt von Januar 2000 bis Januar 2012, wurde retrospektiv anhand des Taneichi-Scores evaluiert. Prognostische Faktoren bezueglich Stabilitaet und Ueberlebensraten wurden analysiert. Vor RT wurden 85 Laesionen (54 %) als instabil gewertet. Nach 3 und 6 Monaten wurden 109 (70 %) und 124 (79 %) Laesionen als stabil klassifiziert. Vor RT wurden 30 Frakturen gefunden, nach RT zeigten sich 7 weitere (4,5 %) pathologische Frakturen. Kein prognostischer

  17. A retrospective study of 296 cases of intra uterine fetal deaths at a tertiary care centre

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    Neetu Singh

    2013-04-01

    Full Text Available Background: To identify the risk factors and to streamline preventive and management protocols for IUD. Methods: This was a retrospective study from January 2011 to December 2012 which was conducted at G.S.V.M. Medical College, Kanpur. IUD was defined as fetal death beyond 20 weeks of gestation and/or birth weight > 500g. Maternal and fetal records were analysed. Mode of delivery and associated complications were studied. Results: Total number of deliveries were 7310.Incidence of IUD at our centre was 40 per 1000. 55.73% were antepartum and 11.06% were intra partum. In 33.44% cases, no causes were identified. Among the identifiable causes, very severe anemia (16.55% and hypertensive disorders (10.81% were most common followed by placental causes (12.16%.Congenital malformations were responsible for 9.45% cases .Induction was done in 151 patients,111 patients had spontaneous onset of labour and caesarean section was done in 34 patients. The most devastating complication of IUD was DIC found in 14 patients (3.71%. Conclusions: The present study is an effort to compile a profile of maternal, fetal and placental causes culminating to IUD at our centre. This emphasizes the importance of proper antenatal care and identification of risk factors and its treatment. Institutional deliveries should be promoted to prevent intrapartum fetal deaths .A substantial number of IUD are still labeled as unexplained, hence cannot be prevented. Decrease in the incidence of IUD would significantly reduce the perinatal mortality. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 141-146

  18. A retrospective clinical and epidemiological analysis of cases of hepatitis E in St. Petersburg

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    H. D. Peradze

    2012-01-01

    Full Text Available Hepatitis E – zoonotic disease that has received a nosological independence twenty years ago, when Russian scientist, Professor M.S. Balayan, identified the pathogen (hepatitis E. It was believed that the disease can manifest itself only in the acute form, and occur only in regions with subtropical and tropical climate conditions. The development and introduction of practicing of modern scientific research methods for detecting antibodies to activator change, to view the global prevalence of infection and present doubts on inabilities of transformation into a chronic f a retrospective analysis of hospital cases of acute jaundice hepatitis E in Saint-Petersburg.Etiologic accessory to hepatitis E implemented by discovery in serum of patients a specific marker of infection hepatitis E – an anti-HEV.In the analysis of archive documentation for 2000–2011 from the patients which were hospitalized in the Clinical Infectious Diseases Hospital by S.P. Botkin only 11patients were diagnosed with «acute hepatitis E». Which indicates the presence of patients with acute hepatitis E infection among hospitalized in hospitals of the city of St. Petersburg are not endemic for this disease. The presence of cases of disease of the indigenous inhabitants of the city during the past years, which isn’t going beyond its limits, indicates the existence of «autochthonous» hepatitis E.

  19. ANAESTHETIC CHALLENGES IN THE MANAGEMENT OF PEDIATRIC ENCEPHALOCOELE REPAIR: RETROSPECTIVE CASE SERIES

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    Ravindra Giri

    2015-02-01

    Full Text Available INTRODUCTION: Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium and is far less common than spinal dysraphism. 1 Anaesthetic challenges in management of occipital meningoencephalocele include securing the airway with intubation in lateral position, intraoperative prone position and its associated complications, careful securing of the endotracheal tube and accurate assessment of blood loss. These babies also have associated congenital anomalie s, gastrointestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula, making anaesthetic management even more difficult. Meticulous anaesthetic management is crucial for early repair of encephalocoele to prevent any sequel. 2 METHODS: To identify the anaesthetic challenges, perioperative and postoperative complications during encephalocele repair, 20 cases were studied retrospectively from 2012 to 2014 at Department of Anaesthesia , Department of Neurosurgery, MR Medical College, Gulbarga. RESULTS: 20 cases of encephalocoele repair were undertaken during the study period. Out of these 12 (60% were male and 8(40% female. Age range was 1 day to 6 years. Most common type of encephalocele was occipital 12(60%, which posed a difficulty during positioning & intubation, followed by occipito - cervical 4(20%, Parietal 2(10%, Fronto - nasal 1(5% & Fronto - naso - ethmoidal 1(5%. Most of the patients were extubated successfully on table, only one patient required post - operative ventilator support for a day. Peri - operative complications included bronchospasm (15%, followed by hypotension, tachycardia, laryngospasm, hypoxia, accidental extubation (10% each & bradycardia, endobronchial intubation (5%. CONCLUSION: Children with Encephalocoele are prone to have peri - operative complications which can be managed by meticulous anaesthetic managenement. 3 Early surgical management of encephalocoele is not

  20. Cutaneous reactive histiocytosis in dogs: a retrospective evaluation of 32 cases.

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    Palmeiro, Brian S; Morris, Daniel O; Goldschmidt, Michael H; Mauldin, Elizabeth A

    2007-10-01

    Thirty-two cases of canine cutaneous histiocytosis were retrospectively evaluated. Median age at onset was 4 years. Lesions included nodules and plaques affecting the head/face, trunk and limbs, and erythema, swelling and depigmentation of the nasal planum/nares. Systemic involvement was not ruled out in all cases. All dogs had complete resolution of dermatological lesions after initial treatment (median 45 days). Initial treatment included prednisone +/- antibiotics (12 of 32 dogs), prednisone and tetracycline/niacinamide (four of 32), prednisone and azathioprine (three of 32), tetracycline/niacinamide +/- vitamin E/essential fatty acids (six of 32), antibiotics +/- antihistamines (three of 32), cyclosporine and ketoconazole (one of 32), topical therapy (two of 32), and no treatment (one of 32). Seventeen dogs received maintenance therapy which consisted of tetracycline/niacinamide +/- vitamin E/essential fatty acids (12 of 17), cyclosporine/ketoconazole (two to three times a week) (two of 17), azathioprine daily (one of 17), prednisone/azathioprine (two times a week) (one of 17), and prednisone daily (one of 17). Median follow up was 25 months. Nine dogs had a recurrence of cutaneous histiocytosis (median days to recurrence 130 days), with seven of nine having more than one recurrence. At study completion, six dogs were deceased (no lesions at the time of death) and 26 of 32 were alive with no lesions. Ten of 26 dogs were on maintenance treatment (eight tetracycline/niacinamide, one azathioprine, one vitamin E). Previous dermatological disease and season had no detectable influence on recurrence. Recurrence was significantly more likely in dogs with nasal planum/nares lesions than dogs without these lesions. Tetracycline/niacinamide was an effective treatment option for dogs in this study population.

  1. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature

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    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.

    2016-01-01

    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  2. Retrospective analysis of 140 cases of medullary thyroid carcinoma followed-up in a single institution

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    SIMÕES-PEREIRA, JOANA; BUGALHO, MARIA JOÃO; LIMBERT, EDWARD; LEITE, VALERIANO

    2016-01-01

    Familial cases of medullary thyroid carcinoma (MTC) may be diagnosed by genetic screening, while in sporadic tumors the diagnosis relies mainly on fine-needle aspiration cytology. The aim of the present study was to determine the demographic, clinical and pathological characteristics of MTC patients followed-up at the Portuguese Institute of Oncology Francisco Gentil (Lisbon, Portugal). For that purpose, a retrospective analysis of 140 MTC patients diagnosed between 1990 and 2010 was performed. The results indicated that patients with hereditary MTC (11.4%) were significantly younger than patients with sporadic MTC. Of the latter, 34.3% had no clinical suspicion of MTC prior to surgery. The sensitivity of cytology and calcitonin (CT) assay in diagnosing MTC were 51.3 and 98.7%, respectively. All familial index cases and 69.0% of sporadic cases presented with advanced stage disease at the time of diagnosis, while 73.0% of familial MTC detected by genetic/pentagastrin screening were diagnosed at the early stage of the disease. Biochemical cure (BC) was achieved in 39.7% of patients and, of these, only 6.5% relapsed. The 5 and 10-year survival rates were 79.3 and 73.6%, respectively. Age >45 years (P=0.026), advanced stage at diagnosis (P<0.001) and absence of BC (P<0.001) were predictors of a worse prognosis on univariate analysis. However, when the patients detected by genetic/pentagastrin screening were excluded from the analysis, age was no longer a prognostic factor, although disease stage remained a significant prognostic factor. On multivariate analysis, BC was the only factor with a significant impact on prognosis (P=0.031). In addition, the present study confirmed that the majority of patients were diagnosed at advanced stages, and CT determination was observed to be more sensitive than cytology to diagnose MTC. Patients at early stages were more prone to achieve BC, which was a favorable prognostic factor. To the best of our knowledge, the present study

  3. Faciomaxillary fractures in a Semi-urban South Indian Teaching Hospital: A retrospective analysis of 638 cases

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    Rajasekhar Gali

    2015-01-01

    Full Text Available Background and Objective: The incidence of maxillofacial trauma is increasing at a very fast pace in developing countries like India and poses a major health burden. Hence, the epidemiological data of maxillofacial trauma during a 6 year period, was analyzed to study the characteristics, factors predisposing, and aid in advocating strict guidelines to prevent the same. Materials and Methods: Data related to 638 cases with maxillofacial trauma, from January 2008 to December 2014 were reviewed retrospectively and the data regarding gender, age, etiology, anatomic location of fracture, alcohol consumption, associated head and other injuries, modality of treatment rendered and associated complications were analyzed with descriptive statistics. Results: A total of 638 patients presenting with 869 maxillofacial fractures were analyzed. Most of them [344 (53.9%] were young adults aged 18-40, whereas, 123 (19.2% were 11 to 17 years, and 97(15.2% adults. Men (79.4% were more affected than women. Road traffic accidents remain the main etiology causing fractures in 470 (73.6%, whereas 397 (62.2% had history of consumption of alcohol. Those with alcohol intoxication had multiple injuries. Mandible was more frequently involved with 360 (41.4% fractures, and condyle being the most common site. A total of 374 (58.6% underwent open reduction with internal fixation under general anesthesia. Prevalence of other injuries was noted in 207 (32.4% and complications of fracture treatment in 41(6.4% cases. Conclusion: Road traffic accidents under alcohol influence were most commonly associated with comminuted facial fractures with head injuries, frequently leading to death. Mandible was the most commonly fractured facial bone followed by zygoma

  4. Parvovirus B19 infection and severe anaemia in Kenyan children: a retrospective case control study

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    Tuju James

    2010-04-01

    Full Text Available Abstract Background During acute Human parvovirus B19 (B19 infection a transient reduction in blood haemoglobin concentration is induced, due to a 5-7 day cessation of red cell production. This can precipitate severe anaemia in subjects with a range of pre-existing conditions. Of the disease markers that occur during B19 infection, high IgM levels occur closest in time to the maximum reduction in haemoglobin concentration. Previous studies of the contribution of B19 to severe anaemia among young children in Africa have yielded varied results. This retrospective case/control study seeks to ascertain the proportion of severe anaemia cases precipitated by B19 among young children admitted to a Kenyan district hospital. Methods Archival blood samples from 264 children under 6 years with severe anaemia admitted to a Kenyan District Hospital, between 1999 and 2004, and 264 matched controls, were tested for B19 IgM by Enzyme Immunosorbent Assay and 198 of these pairs were tested for B19 DNA by PCR. 536 samples were also tested for the presence of B19 IgG. Results 7 (2.7% cases and 0 (0% controls had high B19 IgM levels (Optical Density > 5 × cut-off value (McNemar's exact test p = 0.01563, indicating a significant association with severe anaemia. The majority of strongly IgM positive cases occurred in 2003. 10/264 (3.7% cases compared to 5/264 (1.9% controls tested positive for B19 IgM. This difference was not statistically significant, odds ratio (OR = 2.00 (CI95 [0.62, 6.06], McNemar's exact test p = 0.3018. There was no significant difference between cases and controls in the B19 IgG (35 (14.8% vs 32 (13.6%, OR = 1.103 (CI95 [0.66, 1.89], McNemar's exact test, p = 0.7982, or the detection of the B19 DNA (6 (3.0% vs 5 (2.5%, OR = 1.2 (CI95 [0.33, 4.01], McNemar's exact test p = 1. Conclusions High B19 IgM levels were significantly associated with severe anaemia, being found only among the cases. This suggests that 7/264 (2.7% of cases of severe

  5. A retrospective study of low-vision cases in an Indian tertiary eye-care hospital

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    Khan Sarfaraz

    2000-01-01

    Full Text Available Purpose:To obtain data on the characteristics of low-vision patients seen at a tertiary eye care hospital in India. Methods:Records of 410 patients were retrospectively reviewed at the Centre for Sight Enhancement, L.V.Prasad Eye Institute, Hyderabad, India. Patients underwent a comprehensive clinical low-vision examination. Data obtained included age, gender, consangunity, visual acuity, visual fields, ocular conditions causing low vision and types of low-vision devices and methods prescribed. Results:Two hundred and ninety seven (72% of 450 patients were male. One-fifth were in the 11-20 years age group (21%. Visual acuity in the better eye was <6/18 - 6/60 in almost half these patients (49.3%. One hundred and twenty two patients (29.9% referred with a visual acuity of ≥ 6/18, either had difficulty in reading normal print or had restricted visual fields. The main causes for low vision were: retinitis pigmentosa (19%, diabetic retinopathy (13%, Macular diseases (17.7%, and degenerative myopia (9%. Visual rehabilitation was achieved using accurate correction of ametropia (174 patients, approach magnification (74 patients and telescopes (45 patients for recognising faces, watching television and board work. Spectacle magnifiers (187 patients, hand/stand magnifiers (9 patients, closed-circuit television (3 patients, overhead illumination lamp (143 patients and reading stand (24 patients were prescribed for reading tasks. Light control devices (146 patients were used for glare control, and cane (128 patients and flashlight (50 patients for mobility. Patients were trained in activities to improve their daily living skills, (54 patients; counselled in environmental modification (144 patients and ancillary care (63 patients for educational and vocational needs. Conclusion:Data obtained from this study elucidates the characteristics of low-vision patients. This information is likely to help in the development of appropriate low vision services.

  6. A Retrospective Case-Series of Children With Bone and Joint Infection From Northern Australia.

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    Brischetto, Anna; Leung, Grace; Marshall, Catherine S; Bowen, Asha C

    2016-02-01

    Our clinical workload as infectious diseases pediatricians in northern Australia is dominated by complicated bone and joint infections in indigenous children. We reviewed the clinical presentation, microbiology, management, and outcomes of children presenting to Royal Darwin Hospital with bone and joint infections between 2010 and 2013, and aimed to compare severity and incidence with other populations worldwide.A retrospective audit was performed on children aged 0 to 18 years who were admitted to Royal Darwin Hospital between 1 January 2010 and 31 December 2013 with a bone and joint infection.Seventy-nine patients were identified, of whom 57 (72%) had osteomyelitis ± associated septic arthritis and 22 (28%) had septic arthritis alone. Sixty (76%) were indigenous Australians. The incidence rate of osteomyelitis for indigenous children was 82 per 100,000 children. Staphylococcus aureus was the confirmed pathogen in 43/79 (54%), of which 17/43 (40%) were methicillin resistant. Median length of stay was 17 days (interquartile range: 10-31 days) and median length of IV antibiotics was 15 days (interquartile range: 6-24 days). Fifty-six (71%) required at least 1 surgical procedure. Relapse within 12 months was documented in 12 (15%) patients.We report 3 key findings: osteomyelitis incidence in indigenous children of northern Australia is amongst the highest reported in the world; methicillin-resistant S aureus accounts for 36% of osteomyelitis with a positive microbiological diagnosis; and the severity of disease requires extended antibiotic therapy. Despite this, 15% of the cohort relapsed within 12 months and required readmission. PMID:26937926

  7. Comparison of external dacryocystorhinostomy and 5-fluorouracil augmented endonasal laser dacryocystorhinostomy. A Retrospective review

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    Watts Patrick

    2001-01-01

    Full Text Available Purpose: To compare the success rates of external dacryocystorhinostomy (EXT-DCR with 5-fluorouracil (5-FU augmented endonasal laser dacryocystorhinostomy (ENL-DCR and to record the complications associated with 5-FU augmented ENL-DCR Materials and Methods: This was a retrospective non-randomised study. Forty-one patients with primary acquired nasolacrimal duct obstruction underwent an EXT-DCR (19 patients or an ENL-DCR (22 patients over a 3-year period. A Holmium YAG laser (Ho:YAG was used in the latter group of patients. Silicone tubes intubated in all patients were removed at three months. 5-FU was applied intraoperatively at the site of the ostium in the ENL-DCR patients. The median follow-up was 12 months (range 3-24 months for the ENL-DCR group and 22 months (range 6-28 months for the EXT-DCR group. The patency of the lacrimal system and the severity of epiphora were assessed at a final-review. Results: The median age of the EXT-DCR group was 77 years (range 53-87 and that of the ENL-DCR group was 71 years (range 23 to 84. There were 12 female patients in the former group and 19 in the latter. The percentage of success in the EXT-DCR group was 94.7% (95% confidence interval (CI = 75.4-99.1 = , and 63.6% in the ENL-DCR group (95% CI= 43.0-80.3. The confidence interval for the difference of 31.1% was 5.6-52.2. There was a statistically significant difference between the two groups, p=0.024 (Fisher exact test. Conclusions: These data suggest that EXT-DCR provides better results than 5-FU augmented ENL-DCR. However, ENL-DCR is the procedure of choice in certain circumstances such as in elderly, frail or medically unfit patients. Our results of 5-FU augmented ENL-DCR compare favourably with other published series.

  8. Radiotherapy in stage 1 testicular seminoma: retrospective study and review of literature; Radiotherapie des seminomes testiculaires de stade 1: etude retrospective et revue de la litterature

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    Bauduceau, O.; Le-Moulec, S.; Bernard, O. [Hopital des Armees du Val-de-Grace, Service de Radiotherapie et Oncologie, 75 - Paris (France); Souleau, B. [Hopital des Armees Percy, Service d' Hematologie, 92 - Clamart (France); Houlgatte, A. [Hopital des Armees du Val-de-Grace, Service d' Urologie, 75 - Paris (France)

    2003-12-01

    Introduction. - Seminoma accounts for about 40% of germ cell tumours of the testicle. In this retrospective analysis, we review literature concerning management of stage I seminoma. Materials and methods. - Between March 1987 and April 2001, 65 patients with stage I pure testicular seminoma received adjuvant radiotherapy with a 25 MV linear accelerator. Results. - Median age was 33 years. Testicular tumour has been found on the right testis in 39 patients and on the left one in 24 patients. Patients have been treated using an anterior-posterior parallel pair and have received 20-25 Gy in 10-14 fractions. The target volume consisted of paraaortic, and paraaortic + homolateral iliac lymph nodes in 17 and 46 patients, respectively. Acute toxicity was mainly digestive, 38% of patients presenting nausea and vomiting. Median follow-up time was 37 months. All patients are alive in complete remission. Discussion. - Because of good radio-sensitivity of seminoma, radiotherapy is regarded as standard adjuvant treatment (5 years relapse rate: 3-5%). Acute toxicity is dominated by moderate gastro-intestinal side effects. Secondary neoplasia represents one of the worst possible long-term complications of therapy. Waiting for ongoing randomized trials, the modern literature for seminoma reflects a trend toward lower radiation doses (20-25 Gy) and smaller treatment volumes (paraaortic field). Adjuvant chemotherapy with two courses of carbo-platin, might be equivalent to radiotherapy but must be investigated in randomized trials. A surveillance policy is one of the other management options less recommended. (author)

  9. A retrospective study of 72 cases diagnosed with idiopathic trigeminal neuralgia in indian populace

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    Yadav, Sunil; Mittal, Hitesh-Chander; Sachdeva, Akash; Verma, Ajay; Dhupar, Vikas; Dhupar, Anita

    2015-01-01

    Context: Trigeminal neuralgia is as a chronic, debilitating condition, which can have a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental populations. Objectives: To evaluate the retrospective data of the patients diagnosed with idiopathic trigeminal neuralgia and to understanding the disorder in the Indian populace. Methods: The retrospective data of 72 patients with typical idiopathic trigeminal neuralgia regarding age of onset, gender, site of invol...

  10. Stereotactic surgery for refractory epilepsy complicated by mental disorders A retrospective case analysis

    Institute of Scientific and Technical Information of China (English)

    Yifang Wang; Aigang Xu; Qifu Tan; Zhengwei Wang; Dongsheng Jiao; Hao Zhu; Kaidong Liu

    2008-01-01

    BACKGROUND: Anti-epilepsy and anti-psychosis drugs have traditionally been used in the clinic to treat epilepsy complicated by mental disorders. However, there is still no effective therapy for refractory epilepsy patients suffering from persistent mental disorders. OBJECTIVE: To explore the therapeutic effects of stereotactie multi-element localization and multi-target radiofrequency ablation on patients with refractory primary epilepsy and mental disorders. DESIGN: A retrospective case analysis. SETTING: Department of Neurosurgery, the 454 Hospital of Chinese PLA. PARTICIPANTS: Between June and November 2004, 13 patients with refractory primary epilepsy complicated by persistent mental disorders were admitted to the Department of Neurosurgery, the 454 Hospital of Chinese PLA. The patient group consisted of nine males and four females, with an average age of 25 years (range 18-39 years), and a course of disease ranging 3-11 years. Diagnosis of mental disorders was in accordance with Chinese Classification of Mental Disorders. Written informed consent was obtained from all patients and their families, and the treatment protocol was approved by the Ethics Committee of the Hospital. METHODS: Under venous inhalation anesthesia, the disease targets, including bilateral corpus callosum, bilateral amygdala, and bilateral medial septal area, as well as unilateral Forel-H area, were coagulated by RFG-3CF radiofrequency thermocoagulation at 75-80 ℃ for 60-70 seconds. During thermocoagulation, the targets were identified using deep-brain microelectrodes and localized according to electrophysiology and electric resistance values. MAIN OUTCOME MEASURES: One year post-surgery, epileptic seizures were assessed on the basis of the Tan classification, and psychogenic (non-epileptic) seizures were evaluated using a 5-grade system. RESULTS: All enrolled 13 epileptic patients were included in the final analysis. The results of follow-up evaluations demonstrated that epilepsy was

  11. Our Clinic Experience with Infliximab in Cases with Moderate-Severe Psoriasis: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Emel Bülbül Başkan

    2009-09-01

    Full Text Available Background and Design: In this study, we aimed to evaluate the efficacy, safety and side effects of infliximab therapy in patients followed up in our clinic with moderate-severe psoriatic patients unresponsive to conventional therapies.Material and Method: Twenty-six psoriasis patients who were given infliximab therapy in our clinic between years 2006-2008, were retrospectively analyzed for their demographical clinical features, changes in PASI score, duration, efficacy and adverse effects of the therapy. Results: There were 15 female and 11 male psoriasis patients; ages ranging from 18 to 70 years (45.2±12.9. 17 of them were diagnosed as generalize plaque type psoriasis, 2 as eritrodermic psoriasis, 5 as generalize pustular, two of them as palmoplantar pustular psoriasis. Thirteen have associated psoriatic arthritis. All patients received 5 mg/kg intravenous infliximab infusion at weeks 0, 2, and 6, followed by every 8 weeks. Number of infliximab therapy sections was ranging from 2 to 16 and duration of treatment from 1 month to 28 months. Improvement in PASI between pretreatment and after induction therapy was statistically significant (p<0.05. Additional systemic treatment for disease activation was applied to patients receiving infliximab monotherapy at 14.-38. weeks. We observed allergic infusion reactions in 15.4% of the patients. Conclusion: In compatible with data in literature, we found that infliximab therapy provides a rapid clinical response in patients (generalized, eritrodermic and/or pustular psoriasis who are unresponsive to immunosupressive agents or in cases which these treatment modalities cannot be used because of side effects.

  12. Pregnancy associated nasopharyngeal carcinoma: A retrospective case-control analysis of maternal survival outcomes

    International Nuclear Information System (INIS)

    Background: Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC. Methods: After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPC patients (control group) who were treated at our institution between 2000 and 2010. Results: The median age of both groups was 30 years (range, 23–35 years); median follow-up for all patients was 70 months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p = 0.72), distant metastasis-free survival (79% vs. 76%, p = 0.77), loco-regional relapse-free survival (97% vs. 91%, p = 0.69) and disease-free survival (69% vs. 74%, p = 0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS. Conclusion: This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC

  13. 77 FR 57566 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review...

    Science.gov (United States)

    2012-09-18

    ...) 250-8793. Correction In the Federal Register of September 11, 2012, in FR Doc. FRL-9726- 8; on page... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective...

  14. 76 FR 39343 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    Science.gov (United States)

    2011-07-06

    ... changes in net benefits, cost- effectiveness ratios, or other financial metrics? With respect specifically... this section. To view Executive Order 13563 go to: http://www.gpo.gov/fdsys/pkg/FR-2011-01-21/pdf/2011... on January 21, 2011 (76 FR 3821)), which directs agencies to conduct a retrospective analysis...

  15. Fatal firearm injuries in autopsy cases at central Bangkok, Thailand: a 10-year retrospective study.

    Science.gov (United States)

    Myint, Sithu; Rerkamnuaychoke, Budsaba; Peonim, Vichan; Riengrojpitak, Suda; Worasuwannarak, Wisarn

    2014-11-01

    Even though there have been previously published reports on firearm injuries in various countries, the incidence and pattern of death from firearm injuries in Thailand have not been studied before. In present study, 149 fatal firearm injuries from 2002 to 2011 were reviewed. At total of 7126 autopsies, fatal firearm injuries comprised of 2.09% (n = 149) of total autopsies cases. Among those victims, 136 were male (91.3%), 13 (8.7%) were female. The youngest age of victim was 10 years and the oldest was 79 years. Mean age of the victims was 33.79 years and median age was 30 years. Outdoor incident was the most common scene of crime. Night time incident (18:00 PM-05:59 AM) was higher than day time one. Most of the cases occurred in week ends (n = 52). Homicide (77.2%) was the most frequent manner of death. Head/face and chest were the most common sites of entrance. The autopsy report also study on entrance wound, range and types of projectiles. Blood alcohol concentration was examined in 122 cases and 38 victims showed positive results, 11 cases revealed using of illegal substances in blood and urine analysis. This study also included the association between manner of death and other factors. Age group, time of incidence, place of incidence, number of entrance wound and range showed statistically significant association with manner of death.

  16. Chinese specific characteristics of sporadic Creutzfeldt-Jakob disease: a retrospective analysis of 57 cases.

    Directory of Open Access Journals (Sweden)

    Wei Zhao

    Full Text Available OBJECTIVE: Sporadic Creutzfeldt-Jakob disease (sCJD is a fatal and transmissible neurodegenerative disorder. However, no studies have reported Chinese specific characteristics of sCJD. We aimed to identify differences in sCJD between Chinese patients and patients from other countries. METHODS: The data from 57 Chinese sCJD patients were retrospectively analyzed, including demographic data, clinical manifestations, laboratory examinations, electroencephalograms (EEGs, diffusion-weighted imaging (DWI scans, positron emission tomography (PET scans, and pathological results. RESULT: The disease was pathologically confirmed in 11 patients. 39 cases were diagnosed as probable sCJD, and 7 were possible. Of the total cases, 33 were male, and 24 were female. The onset age ranged from 36 to 75 years (mean: 55.5, median: 57. Disease onset before the age of 60 occurred in 57.9% of patients. The disease duration from onset to death ranged 5-22 months (mean: 11.6, median: 11, and 51.9% of patients died 7 to 12 months after disease onset. The majority of patients presented with sub-acute onset with progressive dementia. 3 of the 9 patients who took 14-3-3 protein analysis had positive results (33.3%. The sensitivity of EEG was 79.6% (43/54. For DWI and PET examinations, the sensitivities were 94% (47/50 and 94.1% (16/17, respectively. In seven patients who did not show typical hyper-intensities on the first DWI examination, abnormalities of hypo-metabolism in the cerebral cortex were clearly detected by PET. In 13 out of the 17 patients, PET detected extra abnormal regions in addition to the hyper-intense areas observed in DWI. CONCLUSION: This is the first study to indicate that Chinese sCJD patients have a much earlier onset age and a longer disease duration than other populations, which is most likely related to racial differences. The longer disease duration may also be a probable characteristic of Asian populations. PET had high sensitivity for the

  17. Are reviewers suggested by authors as good as those chosen by editors? Results of a rater-blinded, retrospective study

    Directory of Open Access Journals (Sweden)

    Parkin Emma C

    2006-05-01

    Full Text Available Abstract Background BioMed Central (BMC requires authors to suggest four reviewers when making a submission. Editors searching for reviewers use these suggestions as a source. The review process of the medical journals in the BMC series is open – authors and reviewers know each other's identity – although reviewers can make confidential comments to the editor. Reviews are published alongside accepted articles so readers may see the reviewers' names and recommendations. Our objective was to compare the performance of author-nominated reviewers (ANR with that of editor-chosen reviewers (ECR in terms of review quality and recommendations about submissions in an online-only medical journal. Methods Pairs of reviews from 100 consecutive submissions to medical journals in the BMC series (with one author-nominated and one editor-chosen reviewer and a final decision were assessed by two raters, blinded to reviewer type, using a validated review quality instrument (RQI which rates 7 items on 5-point Likert scales. The raters discussed their ratings after the first 20 pairs (keeping reviewer type masked and resolved major discrepancies in scoring and interpretation to improve inter-rater reliability. Reviewers' recommendations were also compared. Results Reviewer source had no impact on review quality (mean RQI score (± SD 2.24 ± 0.55 for ANR, 2.34 ± 0.54 for ECR or tone (mean scores on additional question 2.72 ANR vs 2.82 ECR (maximum score = 5 in both cases. However author-nominated reviewers were significantly more likely to recommend acceptance (47 vs 35 and less likely to recommend rejection (10 vs 23 than editor-chosen reviewers after initial review (p Conclusion Author-nominated reviewers produced reviews of similar quality to editor-chosen reviewers but were more likely to recommend acceptance during the initial stages of peer review.

  18. Septic Arthritis in Infants Younger Than 3 Months: A Retrospective Review.

    Science.gov (United States)

    Bono, Kenneth T; Samora, Julie Balch; Klingele, Kevin E

    2015-09-01

    Septic arthritis in infants is rare and can be difficult to diagnose. This study reviewed a series of patients younger than 3 months to identify factors that may assist in early diagnosis and treatment. A query of records at a large Midwestern pediatric hospital (1994-2010) was performed to identify all patients younger than 3 months at the time of diagnosis. Analysis included birth history, joint involvement, physical examination findings, laboratory results, imaging results, method of treatment, and outcome. In 14 cases (11 boys, 3 girls; mean age at diagnosis, 42.2 days), complete records were available for review. Involved joints included the knee, hip, and shoulder. The most common findings on physical examination were decreased range of motion (100%), tenderness (100%), and swelling (71.4%). Mean temperature was 38.5°C. Mean white blood cell count was 18.5 K/µL, mean erythrocyte sedimentation rate was 48.9 mm/h, and mean C-reactive protein level was 6.1 mg/dL. More than half (57.1%) of joint aspirates grew positive cultures, and 41.7% of blood cultures had positive results. Causative organisms were group B streptococcus, methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Salmonella enterica, and Candida albicans. The most common physical examination findings in infants younger than 3 months with septic arthritis include tenderness, decreased range of motion, and swelling. White blood cell count, C-reactive protein level, and erythrocyte sedimentation rate are likely to be elevated, but these findings should be used in combination with findings on physical examination and radiographic studies to aid in diagnosis.

  19. Economic burden of chronic bronchitis in the United States: a retrospective case-control study

    Directory of Open Access Journals (Sweden)

    Christopher M Blanchette

    2011-01-01

    Full Text Available Christopher M Blanchette1, Melissa H Roberts1, Hans Petersen1, Anand A Dalal2, Douglas W Mapel31Division of Clinical and Outcomes Research, Lovelace Respiratory Research Institute, Kannapolis, NC, USA; 2US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA; 3Lovelace Clinic Foundation, Albuquerque, NM, USABackground: Chronic bronchitis (CB is often misdiagnosed or diagnosed at a later stage of chronic obstructive pulmonary disease (COPD. We examined how this later diagnosis may impact health care costs and utilization during the 12 months prior to and 24 months post initial CB diagnosis.Methods: This retrospective case-control analysis used claims data from a large US database from July 1, 2003 through June 30, 2007. Patients with CB aged 40 years and older were propensity matched (N = 11,674 to patients without evidence of COPD or asthma by demographics, CB diagnosis quarter/year, and comorbidities. Group differences were assessed using Student's t-test and Pearson chi-square test statistics.Results: Six months prediagnosis, CB patients had higher frequencies of any hospitalization (9.6%, 6.7%; P < 0.05, emergency department/urgent care visits (13.3%, 6.7%; P < 0.05, and prescriptions (97.3%, 94.1%; P < 0.05. Six months postdiagnosis, CB patients had 5.6 times more hospitalizations (P < 0.05 and 3.1 times more emergency department/urgent care visits (P < 0.05 compared with controls. Mean total costs (US$ for CB patients 12 months prediagnosis were significantly higher than controls (months 12–7: $4212, $3826; P < 0.05; months 6–1: $5289, $4285; P < 0.05. CB patients had higher mean total costs ($8919; P < 0.05 6 months postdiagnosis. Costs remained $2429 higher for CB patients 19–24 months postdiagnosis (P < 0.05.Conclusion: Health care costs and utilization among CB patients are increased both prior to diagnosis and during the 2 years postdiagnosis. This study suggests that not accurately diagnosing CB early has a

  20. Outcomes of Coaxial Micro-incision Phacoemulsification in Nanophthalmic Eyes:Report of Retrospective Case Series

    Institute of Scientific and Technical Information of China (English)

    Zi Ye; Zhaohui Li; Shouzhi He; Bing Chen; Xiaojuan Xing; Chunyan Ren

    2015-01-01

    Purpose:The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsi-fication and evaluate postoperative complications. Methods:.Fifty nine patients (89 eyes) with axial length (AL)< 21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-inci-sion phacoemulsification and IOL implantation..The main outcome measures included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (A CA), intraocular pressure(IOP) and best corrected visual acu-ity (BCVA). Wilcoxon signed rank test or Mann-Whitney test, and Chi-square test and logistic regression analysis were per-formed for statistical tests as appropriate. Results:.The median AL was 19.63 mm...Sixty-six eyes (74.16%) had a history of surgical intervention. Postoperative ACD, ACV and ACA were increased significantly (all P<0.001), whereas postoperative IOP was decreased significantly. (P<0.001) after surgery. Previous surgical intervention was related to a reduction in the postoperative ACD and ACA (P<0.01), and both preoperative and postoperative IOP. (P<0.001). Postoperative BCVA was improved in 94.38% of the cases. Intraoperative complications mainly included iridoschisis (6 eyes, 6.74%). Early postoperative complications included tem-porary corneal edema (TCE) (23 eyes, 25.84%), anterior in-flammatory response (AIR)(19 eyes, 21.35%), cystoid mac-ular edema (CME) (14 eyes, 15.73%), and uveal effusion (4 eyes, 4.49%). Late postoperative complications included CME (8 eyes, 8.99%), uveal effusion (8 eyes, 8.99%), malignant glaucoma (2 eyes, 2.25%) and posterior capsular opacification (PCO) (10 eyes, 11.24%). The majority of complications (80%) were successfully resolved by pharma-cotherapy or operation. The risk of surgical complications was greater in patients

  1. Case report and literature review

    Science.gov (United States)

    Flahault, Adrien; Vignon, Marguerite; Rabant, Marion; Hummel, Aurélie; Noël, Laure-Hélène; Canioni, Danielle; Knebelmann, Bertrand; Suarez, Felipe; El Karoui, Khalil

    2016-01-01

    Abstract Introduction: We report the case of a multicentric Castleman disease (MCD) with initial renal involvement. Although the renal involvement in this case was typical of MCD, it constitutes a rare presentation of the disease, and in our case the renal manifestations led to the haematological diagnosis. Clinical Findings/Patient Concerns: The patient was admitted for fever, diarrhea, anasarca, lymphadenopathies and acute renal failure. Despite intravenous rehydration using saline and albumin, renal function worsened and the patient required dialysis. While diagnostic investigations were performed, right hemiplegia occurred. There was no anemia or thrombocytopenia. Diagnoses: Kidney biopsy was consistent with glomerular thrombotic microangiopathy (TMA). Lymph node histology was consistent with hyalin-vascular variant of Castleman disease. Outcomes: Given the renal and neurological manifestations of this MCD-associated TMA, the patient was treated with plasma exchange during one month, and six courses of rituximab, cyclophosphamide and dexamethasone. The evolution was favorable. Conclusion: Although rare, this diagnosis is worth knowing, as specific treatment has to be started as soon as possible and proved to be efficient in our case as well as in other reports in the literature. PMID:27741115

  2. The American Board of Radiology Holman Research Pathway: 10-Year Retrospective Review of the Program and Participant Performance

    International Nuclear Information System (INIS)

    Introduction: In 1999, the American Board of Radiology (ABR) implemented an innovative training program track in diagnostic radiology (DR) and radiation oncology (RO) designed to stimulate development of a cadre of future academic researchers and educators in the 2 disciplines. The program was designated the Holman Research Pathway (HRP). An in-depth retrospective review of initial certification examination performance, post-training career choices, and academic productivity has not been written. This report represents a 10-year retrospective review of post-training performance of a cohort of trainees who have had sufficient time to complete their training and initial certification process and to enter practice. Methods and Materials: All pertinent proceedings of the ABR and Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committees for DR and RO between 1997 and May 2011 were reviewed. Thirty-four HRP candidates who fulfilled the established evaluation criteria were identified, and their ABR data files were analyzed regarding performance on the qualifying and certifying examinations. All candidates were contacted directly to obtain a current curriculum vitae. Results: Twenty candidates in RO and 14 candidates in DR were identifiable for review. All candidates attained initial certification. At the time of analysis, 23 of 33 (66.6%) candidates were employed in full-time academic practice (1 DR candidate remained in a fellowship and was not evaluated regarding employment status). Fifteen of 20 (75%) RO candidates were in faculty positions compared with 7 of 13 (53.8%) DR trainees. Additional academic productivity metrics are reported. Conclusions: A high percentage of HRP trainees remained in academic practice and demonstrated significant academic productivity as measured by manuscript authorship and research support. Additional time and observation will be needed to determine whether these findings will be sustained by past, current

  3. The American Board of Radiology Holman Research Pathway: 10-Year Retrospective Review of the Program and Participant Performance

    Energy Technology Data Exchange (ETDEWEB)

    Wallner, Paul E., E-mail: pwallner@theabr.org [21st Century Oncology, LLC, Fort Myers, Florida, and American Board of Radiology, Tucson, Arizona (United States); Ang, K. Kian [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zietman, Anthony L. [Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (United States); Harris, Jay R. [Harvard Medical School and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Ibbott, Geoffrey S. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mahoney, Mary C. [University of Cincinnati Medical Center, Cincinnati, Ohio (United States); Mezwa, Duane G. [Oakland University William Beaumont School of Medicine, Royal Oaks, Michigan (United States); Wilson, Lynn D. [Yale University School of Medicine, New Haven, Connecticut (United States); Becker, Gary J. [American Board of Radiology, Tucson, Arizona (United States)

    2013-01-01

    Introduction: In 1999, the American Board of Radiology (ABR) implemented an innovative training program track in diagnostic radiology (DR) and radiation oncology (RO) designed to stimulate development of a cadre of future academic researchers and educators in the 2 disciplines. The program was designated the Holman Research Pathway (HRP). An in-depth retrospective review of initial certification examination performance, post-training career choices, and academic productivity has not been written. This report represents a 10-year retrospective review of post-training performance of a cohort of trainees who have had sufficient time to complete their training and initial certification process and to enter practice. Methods and Materials: All pertinent proceedings of the ABR and Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committees for DR and RO between 1997 and May 2011 were reviewed. Thirty-four HRP candidates who fulfilled the established evaluation criteria were identified, and their ABR data files were analyzed regarding performance on the qualifying and certifying examinations. All candidates were contacted directly to obtain a current curriculum vitae. Results: Twenty candidates in RO and 14 candidates in DR were identifiable for review. All candidates attained initial certification. At the time of analysis, 23 of 33 (66.6%) candidates were employed in full-time academic practice (1 DR candidate remained in a fellowship and was not evaluated regarding employment status). Fifteen of 20 (75%) RO candidates were in faculty positions compared with 7 of 13 (53.8%) DR trainees. Additional academic productivity metrics are reported. Conclusions: A high percentage of HRP trainees remained in academic practice and demonstrated significant academic productivity as measured by manuscript authorship and research support. Additional time and observation will be needed to determine whether these findings will be sustained by past, current

  4. A Retrospective Review of Imaging and Operative Modalities Performed in Patients with Primary Hyperparathyroidism at a Mid-Volume Surgical Centre in Southeast Asia

    DEFF Research Database (Denmark)

    Tan, Matthew Zw; Ng, Jeremy Cf; Eisman, John A;

    2016-01-01

    in the 1990s. This study aimed to explore what the change has been in preoperative localisation tools compared to the previous study and if the ability of these tools to correctly localise pathologic parathyroid glands has improved. MATERIALS AND METHODS: A retrospective review of patients who had surgery......%, respectively. Eighty percent of patients who had positive localisation had limited exploration. LOHS was 2.8 days (1.6, 4.8) and 4.3 days (2.1, 9.0) for limited and bilateral exploration respectively, P = 0.011. CONCLUSION: Our study highlights the marked change in the surgical landscape for primary...... hyperparathyroidism in the last 2 decades in Singapore. Improved preoperative localisation has resulted in a swing from predominantly bilateral, to limited exploration in almost all cases of primary hyperparathyroidism due to solitary adenoma. LOHS was significantly shorter in patients who had limited as compared...

  5. Total laparoscopic hysterectomy in cases of very large uteri: a retrospective comparative study.

    Science.gov (United States)

    Fiaccavento, Andrea; Landi, Stefano; Barbieri, Fabrizio; Zaccoletti, Riccardo; Tricolore, Carlo; Ceccaroni, Marcello; Pomini, Paola; Bruni, Francesco; Soriano, David; Stepniewska, Ania; Selvaggi, Luigi; Zanolla, Luisa; Minelli, Luca

    2007-01-01

    In this review, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uteri weighting more than 500 grams. We compared surgical outcomes and short term follow-up in 149 patients with the uterus weighing less than 350 g (group A: 40-350 g) and 100 patients with the uterus weighing more than 500 g (group B: 500-1550 g). We discovered no statistical difference between the 2 groups in terms of intraoperative complications (group A: 0%; group B: 2%) and postoperative stay (group A: 3.05 +/- 1.89 days; group B: 3.2 +/- 1.28 days). There were statistically significant differences between the 2 groups in terms of operative time (group A: 101.3 +/- 34.3 min; group B: 149.1 +/- 57.2 min.; p <.0001) and postoperative hospital stay length (group A: 2.8 +/- 0.7 days; group B: 3.5 +/- 1.7 days; p <.0001). No major complications occurred in either group. Postoperative minor complications were more frequent in group B (group A: 8.7%; group B: 18%; p = .03). Median time to well-being was comparable in both groups. In conclusion, TLH is a feasible surgical technique also in cases of very large uteri. An increase in operative time, intraoperative blood loss, hospital stay length, and postoperative minor complications can be expected as the uterine weight increases. PMID:17848315

  6. Retrospective Cohort Study of 207 Cases of Osteochondritis Dissecans of the Knee

    Science.gov (United States)

    Green, Daniel W.; Arbucci, John; Silberman, Jason; Luderowski, Eva; Uppstrom, Tyler J.; Nguyen, Joseph; Tuca, Maria

    2016-01-01

    Objectives: Describe the clinical characteristics, image findings, and outcomes of patients with juvenile osteochondritis dissecans (JOCD) of the knee. To our knowledge, this is the largest single-surgeon cohort of JOCD patients. Methods: Retrospective cohort study of knee JOCD patients assessed by a single pediatric orthopaedic surgeon at a tertiary care center between 2005-2015. All diagnoses were confirmed by magnetic resonance imaging (MRI). Patients with patellar dislocations or osteochondral fractures were excluded. Demographic data, sports played, comorbidities, surgical procedures, and clinical data were extracted from charts. Images were analyzed to identify the location and size of lesions. Chi-square or Fisher’s exact tests were used to compare discrete variables, and Mann-Whitney U and Kruskal Wallis tests to compare continuous variables between groups. P-values of <0.05 were considered significant. Results: Sample consisted of 180 patients (207 knees), 124 boys and 56 girls. Average age at diagnosis was 12.8 years (7.5-17.5). Majority were active in sports (80.8%), primary soccer (36.7%) and basketball (29.4%). JOCD was present bilaterally in 27 patients (15%), 14 knees had bifocal OCD (6.8%), and only 1 patient had bifocal lesions in both knees. Most common location was medial femoral condyle (56.3%) followed by lateral femoral condyle (23.1%), trochlea (11.4%), patella (9%), and tibia (0.5%). In the sagittal view, most common location was the middle third of the condyles (48.7%). Surgery was performed in 72 knees (34.8%), with an average age at surgery of 14.1 years (9.3-18.1). Bilateral JOCD was present in 13 surgical patients (18.8%), but only 3 patients had bilateral surgery. Two operative patients had bifocal JOCD (2.7%) and surgery on both lesions. Location distribution did not differ between surgical and non-surgical lesions. The average normalized area of non-surgical JOCD lesions was 6.8 (0.1-18), whereas surgical lesions averaged a

  7. Retrospective Cohort Study of 207 Cases of Osteochondritis Dissecans of the Knee

    Science.gov (United States)

    Green, Daniel W.; Arbucci, John; Silberman, Jason; Luderowski, Eva; Uppstrom, Tyler J.; Nguyen, Joseph; Tuca, Maria

    2016-01-01

    Objectives: Describe the clinical characteristics, image findings, and outcomes of patients with juvenile osteochondritis dissecans (JOCD) of the knee. To our knowledge, this is the largest single-surgeon cohort of JOCD patients. Methods: Retrospective cohort study of knee JOCD patients assessed by a single pediatric orthopaedic surgeon at a tertiary care center between 2005-2015. All diagnoses were confirmed by magnetic resonance imaging (MRI). Patients with patellar dislocations or osteochondral fractures were excluded. Demographic data, sports played, comorbidities, surgical procedures, and clinical data were extracted from charts. Images were analyzed to identify the location and size of lesions. Chi-square or Fisher’s exact tests were used to compare discrete variables, and Mann-Whitney U and Kruskal Wallis tests to compare continuous variables between groups. P-values of basketball (29.4%). JOCD was present bilaterally in 27 patients (15%), 14 knees had bifocal OCD (6.8%), and only 1 patient had bifocal lesions in both knees. Most common location was medial femoral condyle (56.3%) followed by lateral femoral condyle (23.1%), trochlea (11.4%), patella (9%), and tibia (0.5%). In the sagittal view, most common location was the middle third of the condyles (48.7%). Surgery was performed in 72 knees (34.8%), with an average age at surgery of 14.1 years (9.3-18.1). Bilateral JOCD was present in 13 surgical patients (18.8%), but only 3 patients had bilateral surgery. Two operative patients had bifocal JOCD (2.7%) and surgery on both lesions. Location distribution did not differ between surgical and non-surgical lesions. The average normalized area of non-surgical JOCD lesions was 6.8 (0.1-18), whereas surgical lesions averaged a significantly higher area of 7.7 (0.5-17) (p=0.023). Average BMI was 21.6 versus 20.2 for surgical and non-surgical patients, respectively, significantly higher for those who underwent surgery (p=0.002). Most common procedure was fixation

  8. Surgical excision of wrist ganglia; literature review and nine-year retrospective study of recurrence and patient satisfaction

    Directory of Open Access Journals (Sweden)

    Surjit Lidder

    2009-06-01

    Full Text Available The main options for the treatment of wrist ganglia are reassurance, aspiration, arthroscopic resection and open excision. Variations within each option have been described and the literature is clouded by widespread variability in the results reported. We present the results of our own long-term retrospective study, review the literature and question the surgical risks and demands placed on healthcare resources. A retrospective review of the surgical results of dorsal and volar wrist ganglia excision between January 1998 and March 2005 was undertaken at a single institution. Of the 152 patients in this consecutive series, 117 (77% patients responded to a telephone questionnaire. The mean length of follow-up in this series of 117 patients was 4.2 years (range 1.5-8.7 years. The overall recurrence rate following excision of all wrist ganglia in this series was 41.8 %. When looking just at volar ganglia, the risk of recurrence is higher at 46.8%. Should the ganglion recur, the risk of developing a moderate to severely tender scar is 34.6% and the risk of developing an unsightly scar is 8.2%. This study questions the effectiveness of surgical excision in the treatment of wrist ganglia when performed by a mixture of surgeons in that the recurrence rates are very similar to the rates seen in studies that merely observe or aspirate wrist ganglia. We propose that for symptomatic ganglia, specialists in hand surgery may be more appropriate at treating such a pathology.

  9. Retrospective review of thoracic neural damage during lung ablation - what the interventional radiologist needs to know about neural thoracic anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Palussiere, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonie, Department of Interventional Radiology (France); Canella, Mathieu [Centre Hospitalier Pau, Department of Radiology (France); Cornelis, Francois; Catena, Vittorio; Descat, Edouard [Institut Bergonie, Department of Interventional Radiology (France); Brouste, Veronique [Institut Bergonie, Clinical and Epidemiological Research Unit (France); Montaudon, Michel [CHU Haut Leveque, Department of Radiology (France)

    2013-12-15

    Background and Purpose: Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution. Materials and Methods: We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years. Results: Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3). Conclusion: Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications.

  10. Effects of Emergency Cervical Cerclage on Pregnancy Outcome: A Retrospective Study of 158 Cases

    OpenAIRE

    Zhu, Li-Qiong; Chen, Hui; Chen, Li-Bin; Liu, Ying-Lin; Tan, Jian-Ping; Wang, Yun-hui; Zhang, Rui; Zhang, Jian-ping

    2015-01-01

    The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed tha...

  11. Clinical features and outcomes of autoimmune hemolytic anemia: a retrospective analysis of 32 cases

    OpenAIRE

    Baek, Seung-Woo; Lee, Myung-Won; Ryu, Hae-Won; Lee, Kyu-Seop; SONG, IK-CHAN; Lee, Hyo-Jin; Yun, Hwan-Jung; Kim, Samyong; Jo, Deog-Yeon

    2011-01-01

    Background There has been no report on the clinical features or natural history of autoimmune hemolytic anemia (AIHA) in the Korean adult population. This study retrospectively analyzed the clinical characteristics and long-term outcomes of AIHA in the Korean adults. Methods Patients newly diagnosed with AIHA between January 1994 and December 2010 at Chungnam National University Hospital were enrolled. Patient characteristics at diagnosis, response to treatment, and the natural course of the ...

  12. Identification and Referral of Patients at Risk for Post-traumatic Stress Disorder: A Literature Review and Retrospective Analysis.

    Science.gov (United States)

    Bolduc, Aaron; Hwang, Brice; Hogan, Christopher; Bhalla, Varun K; Nesmith, Elizabeth; Medeiros, Regina; Alexander, Cassie; Holsten, Steven B

    2015-09-01

    Post-traumatic stress disorder (PTSD) is a well-established psychological disorder after severe traumatic injury but remains poorly recognized. Recent changes in the "Resources for Optimal Care of the Injured Trauma Patient 2014" stress the need for comprehensive screening and referral for PTSD and depression after injury. Our purpose was to review the current PTSD literature and perform a retrospective chart review to evaluate screening at our institution. We hypothesized a lack of documentation and thus referral of these patients to mental health professionals. We performed a literature review of 43 publications of risk factors for PTSD in the civilian adult population followed by a retrospective review. Records were analyzed for basic demographics, risk factors found in the literature, and referrals to mental health providers. Risk factors included amputation, dissociative symptoms, female gender, history of mental health disorder, and peri-traumatic emotionality. Traumatic amputation status and gender were recorded in all patients. History of mental health disorder was present in 11.5 per cent patients, absent in 80.75 per cent, and not recorded in 7.75 per cent with an overall documentation of 91.75 per cent. Dissociative symptoms and peri-traumatic emotionality were recorded in 0.5 per cent and 1.0 per cent of patients, respectively. Only 13 patients of 400 (3.25%) were referred to mental health professionals. Despite extensive evidence and literature supporting risk factors for the development of PTSD, identification and treatment at our level 1 trauma center is lacking. There is a need for consistent screening among trauma centers to identify PTSD risk factors and protocols for risk reduction and referrals for patients at risk.

  13. A retrospective monocenter review of simultaneous pancreas-kidney transplantation with bladder drainage in China

    Institute of Scientific and Technical Information of China (English)

    BI Hai; HOU Xiao-fei; MA Lu-lin; LUO Kang-ping; WANG Guo-liang; ZHAO Lei; LIU Ya-li

    2011-01-01

    Background Simultaneous pancreas-kidney transplantation (SPKT) frees the diabetic patient with end-stage nephropathy from dialysis and daily insulin injections.Herein,we review consecutive cases of SPKT with bladder drainage performed at our institution over an 8-year period.Methods The study population included 21 patients (16 males and 5 females) who underwent SPKT between September 2001 and September 2009.Seven patients had type-1 diabetes and 14 had type-2 diabetes.Nineteen patients were on dialysis at the time of transplantation.Donation after cardiac death donors were selected for SPKT.The mean human leukocyte antigen match was 2 (range 0-4).SPKT was always performed using bladder drainage and vascular anastomoses to the systemic circulation.Immunosuppressive treatment consisted of anti-lymphocyte globulin induction followed by tacrolimus,mycophenolate mofetil,and prednisone.Results The mean hospital stay was 45.43 days.After a mean follow-up of 39.4 months,survival rates for patient,kidney,and pancreas were 76.2%,76.2%,and 66.7% at 1 year;76.2%,59.3%,and 55.6% at 5 years;and 57.1%,39.5%,and 41.7% at 8 years,respectively.Major complications included anastomotic leaks,reflux pancreatitis,and rejection.Six patients died from septic shock (n=3),duodenal stump leak (1),cardiac arrest (1),or renal failure (1).Eight kidney grafts were lost due to acute rejection (n=2),chronic rejection (3),and death with a functioning graft (3).Pancreatic graft failure (9) was caused by thrombosis (n=1),rejection (2),duodenal stump leak (1),and death with a functioning graft (5).Concluslons SPKT is a valid therapeutic option for uremic diabetics although few hospitals in China can undertake SPKT.

  14. RECENT METHODS FOR OPTIMIZATION OF PLASTIC INJECTION MOLDING PROCESS –A RETROSPECTIVE AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    P.K. Bharti

    2010-09-01

    Full Text Available Injection molding has been a challenging process for many manufacturers and researchers to produce products meeting requirements at the lowest cost. Faced with global competition in injection molding industry, using the trialand- error approach to determine the process parameters for injection molding is no longer good enough. Factors that affect the quality of a molded part can be classified into four categories: part design, mold design, machineperformance and processing conditions. The part and mold design are assumed as established and fixed. During production, quality characteristics may deviate due to drifting or shifting of processing conditions caused by machine wear, environmental change or operator fatigue. Determining optimal process parameter settings critically influences productivity, quality, and cost of production in the plastic injection molding (PIM industry. Previously, production engineers used either trial-and-error method or Taguchi’s parameter design method to determine optimal process parameter settings for PIM. However, these methods are unsuitable in present PIM because of the increasing complexity of product design and the requirement of multi-response quality characteristics. This article aims to review the recent research in designing and determining process parameters of injection molding. A number of research works based on various approaches have been performed in the domain of the parameter setting for injection molding. These approaches, including mathematical models, Taguchi method, Artificial Neural Networks (ANN,Fuzzy logic, Case Based Reasoning (CBR, Genetic Algorithms (GA, Finite Element Method(FEM,Non Linear Modeling, Response Surface Methodology, Linear Regression Analysis ,Grey Rational Analysis and Principle Component Analysis (PCA are described in this article. The strength and theweakness of individual approaches are discussed. It is then followed by conclusions and discussions of the potential

  15. Tuberculosis Case Finding in Benin, 2000–2014 and Beyond: A Retrospective Cohort and Time Series Study

    Science.gov (United States)

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D.; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  16. Tuberculosis Case Finding in Benin, 2000–2014 and Beyond: A Retrospective Cohort and Time Series Study

    Directory of Open Access Journals (Sweden)

    Serge Ade

    2016-01-01

    Full Text Available Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22% were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country.

  17. Tuberculosis Case Finding in Benin, 2000-2014 and Beyond: A Retrospective Cohort and Time Series Study.

    Science.gov (United States)

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The "R" software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15-34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  18. Alveolar proteinosis: case report and literature review

    Directory of Open Access Journals (Sweden)

    2013-07-01

    Full Text Available Alveolar proteinosis is a rare disease. Its etiology, pathology, and manifestations are becoming increasingly more apparent. Few cases have been reported, which highlights the importance of reporting this case and reviewing current literature. New therapeutic options are being introduced with adequate outcomes thereby making it possible to manage patients who were previously unresponsive to conventional treatment. 25% of cases resolve spontaneously, while most patients require conventional treatment with total lung lavage that often does not improve prognosis. The case reported in this article was associated to Mycobacterium tuberculosis infection and diabetes. Primary alveolar proteinosis can have a direct relationship to these concomitant conditions.

  19. YEYUNAL DIVERTICULAE: CASE REPORT AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    D. A. Ferreyra

    2014-11-01

    Full Text Available The jejunal diverticula are an uncommon usually asymptomatic small bowel pathology, which should be suspected in cases of malabsorption, anemia, chronic abdominal pain or abdominal discomfort. Complications such as diverticulitis, perforation, bleeding or intestinal obstruction increase morbidity and mortality of the disease. This is a retrospective study based on a case treated at “Hospital Provincial de Rosario”, of a 53 years-old woman that was primarily treated for an intestinal occlusion due to adhesions from previous surgeries. It was primarily interpreted as an ileus from adhesions, but due to its torpid evolution surgical treatment should be performed, where diagnose a complication of this disease. It is concluded that yeyunal diverticulae are generally a benign condition, which affects principally the elder population. Because of its low incidence rate and the inespecificity of its symptoms, it is usually diagnosed during surgery. Incidentally diagnosed asymptomatic diverticula should not be treated due to its low rate of complications. Sometimes, they can lead to complications of surgical treatment. A high level of suspicion because of the high morbidity and mortality in cases of late diagnosis is required. In case of complications, resection of the affected bowel segment is usually the best treatment option. diagnose

  20. 微创腰椎经椎间孔椎体间融合术的并发症分析:131例病例回顾和文献复习%Perioperative complications of minimally invasive transforaminal lumbar interbody fusion: retrospective study for 131 cases and literature review

    Institute of Scientific and Technical Information of China (English)

    吴文坚; 梁裕; 张兴凯; 曹鹏; 陈新用; 郑涛

    2012-01-01

    Background: Though minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been widely used in the surgical treatment of lumbar degenerative disease with satisfactory results, it may have more complications. Objective: The purpose of the present study is to evaluate the incidence of the complications of MIS-TLIF and to investigate its reasons and prevention. Methods: A retrospective analysis was performed on 131 consecutive cases of minimally invasive surgery-transforarainal lumbar interbody fusion (MIS-TLIF) from January 2010 to May 2011. The operation time, intra-operative blood loss, post-operative hospitalization and the peri-operative complications were recorded. The visual analog scale ( VAS) for back pain, Oswestry disability index (ODI) and Japanese Orthopaedic Association (JOA) score for functional evaluation were recorded preoperatively, 3 months postoperatively and at the final follow-up. Results: Mean follow-up duration was 8. 3 months. Average operation time was (146. 4 ± 36. 9) min, average intra-operative blood loss was (176. 7 ± 86. 1) ml and average post-operative hospital stay was (4.4 ± 1.6) d. The VAS for back pain, ODI and JOA score were all significantly improved after surgery and at the final follow-up. Complications happened in 16 patients; 1 case with post-operative hematoma; 6 cases of dura tearing (4. 6% ) without CSF leakage, with a higher risk for cases of bilateral decompression via unilateral approach (P =0.012); 6 cases of screw malposition; 1 case of drop foot for unknown causes; lease of pulmonary infection and 1 case of urinary retention for elderly patient. Conclusions: MIS-TLIF in the treatment of lumbar degenerative disc disease is safe and effective. The incidence of complications is low and correlated more with the feature of the technique, the learning curve and the patient selection. Surgical technique training and patient selection are critical for the prevention of peri-operative complications. If

  1. Surgical Management of Solitary Nerve Sheath Tumors of the Cervical Spine: A Retrospective Case Analysis Based on Tumor Location and Extension

    OpenAIRE

    Abe, Junya; Takami, Toshihiro; NAITO, Kentaro; Yamagata, Toru; Arima, Hironori; Ohata, Kenji

    2014-01-01

    Complete resection of spinal nerve sheath tumors (NSTs) does not always result in significant neurological deficit. The purpose of this retrospective case analysis was to discuss the optimal surgical strategy for spinal NST of the cervical spine. Twenty-four patients who underwent surgery for solitary cervical NST over the past decade were included in this retrospective study. Patients with neurofibromatosis or schwannomatosis were excluded. Seventeen of the 24 cases (70.8%) showed extradural...

  2. Management of acute mastoiditis in children. A retrospective study and literature review

    Directory of Open Access Journals (Sweden)

    Wafa Abid

    2014-11-01

    Conclusion: Initial management of acute mastoiditis starts with intravenous antibiotics and computerized tomographic scan of the petrous temporal bones. Surgical approach is required in case of complications or failure of medical treatment. Watchful clinical monitoring is essential in all cases.

  3. Peer review comments on drug trials submitted to medical journals differ depending on sponsorship, results and acceptance: a retrospective cohort study

    NARCIS (Netherlands)

    Lent, M. van; Hout, J. in't; Out, H.J.

    2015-01-01

    OBJECTIVE: During peer review, submitted manuscripts are scrutinised by independent experts to assist journal editors in their decision-making and to help improve the quality of articles. In this retrospective cohort study, peer review comments for drug trials submitted to medical journals were anal

  4. A retrospective analysis of submissions, acceptance rate, open peer review operations, and prepublication bias of the multidisciplinary open access journal Head & Face Medicine

    Directory of Open Access Journals (Sweden)

    Cehreli Murat

    2007-06-01

    Full Text Available Abstract Background Head & Face Medicine (HFM was launched in August 2005 to provide multidisciplinary science in the field of head and face disorders with an open access and open peer review publication platform. The objective of this study is to evaluate the characteristics of submissions, the effectiveness of open peer reviewing, and factors biasing the acceptance or rejection of submitted manuscripts. Methods A 1-year period of submissions and all concomitant journal operations were retrospectively analyzed. The analysis included submission rate, reviewer rate, acceptance rate, article type, and differences in duration for peer reviewing, final decision, publishing, and PubMed inclusion. Statistical analysis included Mann-Whitney U test, Chi-square test, regression analysis, and binary logistic regression. Results HFM received 126 articles (10.5 articles/month for consideration in the first year. Submissions have been increasing, but not significantly over time. Peer reviewing was completed for 82 articles and resulted in an acceptance rate of 48.8%. In total, 431 peer reviewers were invited (5.3/manuscript, of which 40.4% agreed to review. The mean peer review time was 37.8 days. The mean time between submission and acceptance (including time for revision was 95.9 days. Accepted papers were published on average 99.3 days after submission. The mean time between manuscript submission and PubMed inclusion was 101.3 days. The main article types submitted to HFM were original research, reviews, and case reports. The article type had no influence on rejection or acceptance. The variable 'number of invited reviewers' was the only significant (p Conclusion The positive trend in submissions confirms the need for publication platforms for multidisciplinary science. HFM's peer review time comes in shorter than the 6-weeks turnaround time the Editors set themselves as the maximum. Rejection of manuscripts was associated with the number of invited

  5. 77 FR 5193 - Retrospective Review Under E.O. 13563: Shipping-Removal of Obsolete Regulations

    Science.gov (United States)

    2012-02-02

    ... 12866, ``Regulatory Planning and Review,'' (58 FR 51735, 10/4/1993), by requiring Federal agencies to design cost- effective, evidence-based regulations that are compatible with economic growth, job creation... outlined a plan to improve regulation and regulatory review (76 FR 3821, 1/21/11). Executive Order...

  6. Pulmonary Langerhans Cell Histiocytosis: Case Series and Literature Review

    OpenAIRE

    WEI, PING; Lu, Hai-Wen; Jiang, Sen; Fan, Li-Chao; Li, Hui-Ping; Xu, Jin-Fu

    2014-01-01

    Abstract Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease with insidious onset and nonspecific manifestations. The objective of this article was to characterize the clinical manifestations and features of PLCH by retrospectively analyzing clinical data of patients with PLCH in addition to simultaneous review of literature. A retrospective analysis was conducted on clinical data of patients with PLCH (n = 7), whose conditions were diagnosed by biopsy from pulmonary tissue (n = ...

  7. Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

    OpenAIRE

    Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

    2009-01-01

    Editors' Summary Background Sexual violence has significant short- and long-term mental and physical health consequences for the victim. Estimates of how common rape is vary within and between countries. The World Health Organization (WHO) estimates that between 1% and 12% of women aged 15 or over have experienced sexual violence by a nonpartner. It has also been used as a weapon of war. The WHO recognises that rape may be committed by a spouse, partner, or acquaintance as well as a stranger,...

  8. [Inventory of unsafe abortions: retrospective study of 451 cases treated in Moulay Ismail Military Hospital of instruction, Meknes, Morocco].

    Science.gov (United States)

    Laghzaoui, Omar

    2016-01-01

    Unsafe abortion is a plague spreading around the world but especially in Africa where it is a lucrative market for traditional practitioners which exposes patients to serious complications including death. Our retrospective study of 451 cases represent an exhaustive sample of this practice in Morocco exploring the reasons why women experience an unsafe abortion, what age group is most affected, conditions and complications inherent in this practice. Our study focuses on the need for intervention before pregnancy by developing the concept of contraception among girls from their early years to minimize these non-health practices. PMID:27642422

  9. Radiographic evaluation of INBONE total ankle arthroplasty: a retrospective analysis of 30 cases

    Energy Technology Data Exchange (ETDEWEB)

    Datir, Abhijit [Emory University Hospital, Musculoskeletal Division, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Emory Orthopaedics and Spine Center, Division of Musculoskeletal Radiology, Atlanta, GA (United States); Xing, Minzhi; Kakarala, Aparna; Terk, Michael R. [Emory University Hospital, Musculoskeletal Division, Department of Radiology and Imaging Sciences, Atlanta, GA (United States); Labib, Sameh A. [Emory University Hospital, Department of Orthopaedic Surgery, Atlanta, GA (United States)

    2013-12-15

    The objectives of this work were to retrospectively describe the radiographic assessment of INBONE total ankle arthroplasty in 30 patients using validated linear and angular measurements and to correlate these findings with the final surgical outcome over a 2-year follow-up period. Thirty consecutive patients (21 females, nine males; mean age, 64.8 years) underwent INBONE total ankle arthroplasty during 2007-2011. After IRB approval, a retrospective pre- and post-operative radiographic analysis was performed using validated linear and angular measurements. The pre- and post-operative assessment included the tibial angle, talar angle, tibial slope, and coronal deformity. Post-operative measurements also included the talocalcaneal angle, joint space height, talar height, lateral tibial component angle, lateral talar component angle, and anteroposterior tibial component angle. The post-operative bone loss, subluxation, positioning, and subsidence were also assessed. Statistical analysis was performed using two-sample t test and Fisher's exact test. Out of 30 patients, 23 had a successful clinical outcome with intact prosthesis at a 2-year follow-up. The only variables with significant correlation (p < 0.05) to the post-surgical outcome were the lateral talar component angle (p = 0.002) and the mean difference between pre- and post-operative tibial slope (p = 0.001). The coronal deformity had significant mean difference between pre- and post-operative values (p < 0.001); however, it lacked a significant correlation to the final surgical outcome. None of the categorical variables had a significant correlation with post-surgical outcome. In our retrospective study, only the lateral talar component angle and the mean difference between the pre- and post-operative tibial slope had significant correlation with post-surgical outcome in INBONE ankle arthroplasty. These measurements may be helpful in radiographic assessment of the INBONE ankle arthroplasty. (orig.)

  10. ENDOSCOPIC SEPTOPLASTY: REVIEW OF 72 CASES

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    Gurivi Reddy Siva Prasad

    2016-07-01

    Full Text Available OBJECTIVES To review 72 patients who underwent endoscopic septoplasty over a period of three years. STUDY DESIGN Prospective Study. RESULTS Out of 72 cases, 53 cases were performed alone as a primary procedure, 19 cases were performed in conjunction with endoscopic sinus surgery, 39 cases were presented with spur, 24 cases with broadly-based deviations, 9 were traumatic deviations. There were 46 males and 26 were female. CONCLUSION Endoscopic septoplasty offers an alternative to conventional septoplasty with superior visualisation and minimal trauma. Endoscopic septoplasty helps in better correction of complex deformities and in correcting high deviations. It facilitates realignment by limited and precise resection of the deviated area. It effectively relieves headache caused by contact areas in nasal cavity especially in cases of septal spur.

  11. Malignant minor salivary gland tumors: A retrospective study of 28 cases: Clinical experience of a single institution

    Directory of Open Access Journals (Sweden)

    Abeer Hussien Anter

    2015-03-01

    Full Text Available Purpose: This retrospective study was done to report our experience with the management of patients with primary malignant tumors of minor salivary glands that were treated with various combinations of surgery, radiation, and chemotherapy and to review treatment outcome. Methods: The records of all patients with malignant minor salivary gland tumors presenting for treatment at our department between 2000 and 2010 were retrospectively reviewed. Variables were collected and outcome measures were defined in terms of overall survival, disease-free survival. Descriptive statistics were compiled and statistically evaluated. Survival was described using the Kaplan-Meier method. Results: Twenty eight patients (10 males and 18 females ranging in age from 18 to 80 years (median, 64 years met the criteria for inclusion in the study. The majority of tumors were located in the oral cavity (n = 20, followed by nasal cavity and paranasal sinuses (n = 8. Adenoid cystic carcinoma was the most common neoplasm (n = 18. All patients were treated with surgery as the primary modality. Neck dissection was performed in 18% of patients, and all patients (n = 28 were treated with adjuvant external beam radiation therapy to a dose of 50 to 60 Gy. The disease-free survival rate and overall survival at 5 years were 80% and 85%, respectively. Conclusion: Postoperative radiation therapy is effective in preventing local recurrence in most patients with minor salivary gland tumors after gross total excision.

  12. Retrospective Analysis of Thrombolysis Therapy for 64 Cases of Acute Myocardial Infarction with Elevated ST Segment

    Institute of Scientific and Technical Information of China (English)

    傅晓霞; 肖文剑; 吕健; 吴乐文; 杨帆

    2009-01-01

    Objective:To explore the cardiac protective effect of integrative therapy in acute myocardial infarction(AMI) with elevated ST segment after reperfusion.Methods:Sixty-four AMI patients who having received decimalization by thrombolysis were assigned to two groups by retrospective analysis,36 patients in the treated group and 28 in the control group.Both were treated by intravenous administering of urokinase for thrombolysis,and to the treated group,intravenous dripping of Xueshuantong Injection(血栓通注射液,XS...

  13. Neuropsychiatric complications after liver transplantation: Retrospective analysis of three cases and literature review%肝移植术后神经精神系统并发症:3例回顾性分析及文献复习

    Institute of Scientific and Technical Information of China (English)

    李春友; 李森; 付云强

    2007-01-01

    , and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy, a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one, male aged 54 years of hepatitis B liver cirrhosis and large, with a history of hypertension for 15 years and diabetes for 10 years. On September 25th, 2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia, hyperkalemia, liver and kidney failure clinically. Case two, male aged 47 years of hepatitis B, cirrhosis and huge hepatocellular carcinoma, chronic calculous cholecystitis, with a history of hypertension for 5 years and diabetes for 2 years. On December 26th, 2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm, sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53, drowsiness and depressed spirit appeared; at day 54, the patient was disoriented, and at day 55 hemiparesis occurred at right side, gradually coma, by brain CT scan it confirmed to be intracerebral hemorrhage, and died. Case three, male aged 59 years of hepatitis B, cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th, 2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia, gradually motor dysfunction, swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium, chloral hydrate enema and luminal sodium treatment, focal epilepsy and irritable symptoms were effectively controlled, but aphasia and left hemiparesis still occurred. After five months, the patient died

  14. Prognostic factors in interstitial lung disease associated with primary Sjogren's syndrome: a retrospective analysis of 33 pathologically-proven cases.

    Directory of Open Access Journals (Sweden)

    Yasunori Enomoto

    Full Text Available INTRODUCTION: Interstitial lung disease associated with primary Sjögren's syndrome (pSS-ILD shows several patterns such as nonspecific interstitial pneumonia (NSIP and usual interstitial pneumonia (UIP. Although UIP is a well-recognized prognostic determinant in idiopathic interstitial pneumonias, whether this is also the case in pSS-ILD is unclear. The objectives of this study were to evaluate the prognostic effect of UIP, and to identify the prognostic factors in pSS-ILD. METHODS: A retrospective review of medical records identified 33 consecutive patients with pathologically-proven pSS-ILD. Each patient was classified into each ILD pattern by multidisciplinary analysis. Baseline clinical-radiologic-pathologic characteristics and survival rates were compared between the ILD patterns. Finally, the prognostic factors in pSS-ILD were assessed by univariate and subsequent multivariate analyses using Cox's proportional hazards regression model. RESULTS: pSS-ILD patients were diagnosed with NSIP (n = 22 or UIP (n = 11. The median follow-up period was 110 months, and five-year survival rate was 87.3% in the total patient population. The prognosis of the UIP patients was not significantly different from that of the NSIP patients (NSIP to UIP, hazard ratio [HR]: 0.77, 95% confidence interval [CI]: 0.18-3.36, P = 0.73. Multivariate analysis identified PaCO2 (HR: 1.68 per 1 Torr increase, 95% CI: 1.24-2.28, P < 0.01, extent of reticular abnormality on high-resolution CT (HR: 4.17 per 1-grade increment, 95% CI: 1.18-14.73, P = 0.03, and severity of fibroblastic foci (HR: 9.26 per 1-grade increment, 95% CI: 1.74-49.35, P < 0.01 as prognostic factors in pSS-ILD. CONCLUSIONS: UIP in pSS-ILD was not related to poorer prognosis than NSIP. Assessment of detailed clinical-radiologic-pathologic findings is more important than distinguishing UIP to evaluate prognosis in this disease.

  15. Retrospective Review Article: The Contribution of Neurolinguistics to Second and Foreign Language Theory and Practice.

    Science.gov (United States)

    Danesi, Marcel

    1990-01-01

    A review of some of the major works in neurolinguistics published during the last decade extrapolates many implications for second and foreign language theory and practice, covering such issues as hemispheric dominance, language processing, and bilingualism. (35 references) (CB)

  16. The use of the temporoparietal fascia flap in various clinical scenarios: A review of 71 cases

    OpenAIRE

    Nitin J Mokal; Ghalme, Amol N.; Kothari, Deepak S.; Mahinoor Desai

    2013-01-01

    Objective: This report details our experience with the use of the temporoparietal fascia flap in different scenarios of reconstruction and to discuss our technique of harvest, clinical applications, and review of literature of this versatile flap. Materials and Methods: A retrospective study of 82 cases of temporoparietal fascia flap in 71 patients, operated over a period of 10 years was conducted. Patients were grouped based on various clinical indications. The follow up period ranged from a...

  17. Retrospective case studies of the efficacy of caprylic triglyceride in mild-to-moderate Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Maynard SD

    2013-10-01

    Full Text Available Steven Douglas Maynard,1,2 Jeff Gelblum31Union Associated Physicians Clinic, 2Indiana University School of Medicine, Terre Haute, IN, 3Mt Sinai Medical Center of Miami, Aventura Hospital, Aventura, FL, USAAbstract: Under normal conditions, the adult human brain is fueled primarily by glucose. A prominent feature of Alzheimer's disease (AD is region-specific decreases in cerebral glucose metabolism. Ketone bodies are a group of compounds produced from fat stores during periods of low glucose availability that can provide an alternative to glucose for brain metabolism. Consumption of sufficient quantities of caprylic triglyceride (CT increases plasma concentrations of ketone bodies and may be beneficial in conditions of compromised glucose metabolism, such as AD. The present study describes the use of CT in mild-to-moderate AD in routine clinical practice. Case records from eight patients with extensive monitoring of cognitive function using the Mini-Mental State Examination (MMSE and who had received CT for ≥6 months were reviewed. All were outpatients aged ≥50 years, cared for in standard practice, had a diagnosis of probable AD of mild-to-moderate severity (MMSE 14–24, and had received CT for at least 6 months in addition to other approved pharmacotherapy for AD. Response to CT administration as measured by MMSE scores varied by patient. However, the rate of decline in MMSE scores appeared slower than previously published reports for patients treated with pharmacotherapy alone. Profiling of individual patients may provide insight regarding those most likely to benefit from addition of CT to currently approved AD pharmacotherapy.Keywords: ketosis, cognition, Alzheimer's disease, metabolism, glucose

  18. Nocardia pulmonary infection, Case report and review

    International Nuclear Information System (INIS)

    Nocardia infections are an important cause of pulmonary morbidity, in part associated with the use of immunosuppressant therapy in patients with hematological neoplasia, organ transplants and in patients with HIV infection. In this article we report a case of nocardia infection in a patient with high doses of steroids and diabetes mellitus, and make a review of the literature of nocardia infections

  19. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

    Directory of Open Access Journals (Sweden)

    Hualei Li

    2014-01-01

    Full Text Available Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT alone or with high dose rate (HDR brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS compared to surgery alone (P=0.044 and P=0.028, resp.. Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  20. Never go to sleep on undrained pus: a retrospective review of surgery for intraparenchymal cerebral abscess.

    Science.gov (United States)

    Smith, S J; Ughratdar, I; MacArthur, D C

    2009-08-01

    Cerebral abscess is an emergency requiring urgent drainage via craniotomy or burrhole aspiration. We examine whether initial method of drainage affects outcome and important characteristics in patients with cerebral abscess. This is a retrospective analysis of 62 patients operated on in our unit with a loculated infected cerebral collection in the years 2003-2007 inclusive. Full statistical analysis was performed using data appropriate tests. Burrhole and craniotomy groups were evenly matched with no difference in any demographic factors. Surgical method made no difference to rate of re-operation (p = 0.276), antibiotic duration (p = 0.648), discharge GCS (p = 0.509), length of stay (p = 0.647) or GOS (p = 0.968). There was a trend to worsened outcome with delay to surgery (p = 0.132) with delayed patients requiring longer hospital stays (p < or = 0.005). Patients requiring a longer antibiotic duration had worse outcomes (p < or = 0.005). Surgical method did not have a significant effect on outcome, so burrhole aspiration with its advantages in terms of speed and scale of surgery should be strongly considered. Delay had an adverse affect, so operation should be as expeditious as possible whenever the differential diagnosis includes abscess, diagnosis of which may be aided by advanced magnetic resonance imaging techniques.

  1. Spontaneous Pneumothorax: A retrospective study of twenty-five patients and literature review

    International Nuclear Information System (INIS)

    We present a retrospective study of 25 patients with spontaneous pneumothorax (three recurrent) comprising 16 Saudis (nine males and seven females) and eight non-Saudi's (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient) and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients. Other underlying pulmonary diseases, precipitating spontaneous pneumothorax in the group included pulmonary fibrosis, metastatic mesothelioma and immunosuppression in a medulloblastoma patient undergoing chemotherapy with the development of chickenpox. Closed thoracostomy tube drainage was the only method of treatment in 20 out of 25 patients, with three failures of closed thoracostomy tube drainage needing thoractomy and resection of blebs/bullae. The only complication was empyema in two of the patients. Two patients were successfully treated conservatively with observation alone. (author)

  2. Retrospective review of the clinical BNCT trial at Brookhaven National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Diaz, A.Z.; Chanana, A.D.; Coderre, J.A.; Ma, R. [Brookhaven National Laboratory, Medical Department, Upton, NY (United States)

    2000-10-01

    The primary objective of the phase I/II dose escalation studies was to evaluate the safety of the boronophenylalanine-fructose (BPA-F) mediated boron neutron capture therapy (BNCT) in subjects with glioblastoma multiforme (GBM). A secondary objective was to retrospectively assess the palliation of GBM by BNCT. Fifty-three subjects with GBM were treated under multiple dose escalation protocols at the Brookhaven Medical Research Reactor (BMRR). Twenty-six subjects were treated using one field, 17 subjects were treated using 2 fields and 10 subjects were treated using 3 fields. BPA-F related toxicity was not observed. The maximum radiation dose to a volume of approximately 1 cc of the normal brain varied from 8.9 to 15.9 gray-equivalent (Gy-Eq). The volume-weighted average radiation dose to normal brain varied from 1.9 to 9.5 Gy-Eq. Six RTOG (Radiation Therapy Oncology Group) grade 3 or 4 toxicities were attributed to BNCT. Four of the 53 subjects are still alive with 3 of them free of recurrent disease with over two years follow-up. The median times to progression and median survival time from diagnosis were 28.4 weeks and 12.8 months respectively. (author)

  3. Synchronous and Metachronous Breast Malignancies: A Cross-Sectional Retrospective Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ambrogio P. Londero

    2014-01-01

    Full Text Available Objective. There is increasing interest in patients with metachronous (MBC and synchronous breast cancer (SBC. The objective of this study was to evaluate the occurrence and outcome of MBCs and SBCs. Methods. A retrospective study on women operated in our department for breast cancer between 2002 and 2005 was carried out. Patients were divided into three groups: women with MBC, SBC, and unilateral breast cancer (UBC. Moreover, we performed a meta-analysis of the English literature about multiple breast cancers between 2000 and 2011 taking into consideration their prevalence and overall survival (OS. Results. We identified 584 breast cancer patients: 16 women (3% presented SBC and 40 MBC (7%, second cancer after 72-month follow-up IQR 40–145. Although the meta-analysis showed significant OS differences between MBC or SBC and UBC, we did not observe any significant OS difference among the three groups of our population. Anyway, we found a significant worse disease-free survival in MBC than UBC and a significant higher prevalence of radical surgery in MBC and SBC than UBC. Conclusions. Despite the low prevalence of MBC and SBC, the presence of a long time risk of MBC confirms the crucial role of ipsi- and contralateral mammographies in the postoperative follow-up.

  4. Sexual dysfunction with the use of antidepressants in a tertiary care mental health setting - a retrospective case series

    Directory of Open Access Journals (Sweden)

    Kingshuk Lahon

    2011-01-01

    Full Text Available Sexual dysfunction affects patients′ quality of life. It can occur secondary to physical or mental disorders, substance abuse and treatment with prescription drugs like antidepressants. We wanted to study the prevalence of sexual dysfunction associated with antidepressant use in the psychiatric unit of a tertiary care hospital and assess for causality, severity and preventability. We did a retrospective data collection from case records of patients on antidepressants from the Psychiatry outpatient clinic of a tertiary care teaching hospital during the period 1 st January 2006 to 31 st December 2006, excluding those with complaints of sexual dysfunction prior to treatment. Data are presented as a case series. Documented adverse events were subjected to analysis for causality, severity and preventability using Naranjo′s, modified Hartwig and Siegel and modified Schumock and Thornton′s Preventability scales respectively. Out of 169 patients, four patients developed sexual dysfunction (2.36% associated with duloxetine, mirtazapine, trazodone and sertraline. We observed a possible causal relationship of mild to moderately severe ADR (sexual dysfunction which was not preventable. Prevalence of antidepressant associated sexual dysfunction was lower than quoted in Western literature probably due to the retrospective nature of our study design. Active monitoring and intervention can greatly improve the quality of life and compliance to treatment.

  5. Retrospectives: Trouble in the Inaugural Issue of the American Economic Review: The Cross/Eaves Controversy

    OpenAIRE

    Ann Mari May; Robert W. Dimand

    2009-01-01

    The papers from the first year of the American Economic Review are included in the Archives of the American Economic Association. While researching the early years of the AEA, Ann Mari May came across a folder marked "Controversies, Criticisms, etc."-which stood out in the midst of a review of AEA minutes and reports. This folder included a bulky file on what AER Editor Davis Rich Dewey would come to refer to as the "Cross/Eaves Controversy"-a controversy that, according to a letter he wrote,...

  6. Twenty two cases of canine neural angiostronglyosis in eastern Australia (2002-2005) and a review of the literature

    OpenAIRE

    Lunn Julian A; Lee Rogan; Smaller Joanna; MacKay Bruce M; King Terry; Hunt Geraldine B; Martin Patricia; Krockenberger Mark B; Spielman Derek; Malik Richard

    2012-01-01

    Abstract Cases of canine neural angiostrongylosis (NA) with cerebrospinal fluid (CSF) evaluations in the peer-reviewed literature were tabulated. All cases were from Australia. A retrospective cohort of 59 dogs was contrasted with a series of 22 new cases where NA was diagnosed by the presence of both eosinophilic pleocytosis and anti-Angiostrongylus cantonensis immunloglobulins (IgG) in CSF, determined by ELISA or Western blot. Both cohorts were drawn from south east Queensland and Sydney. T...

  7. Laparoscopic Sacropexy: A Retrospective Analysis of the Subjective Outcome in 310 Cases

    Directory of Open Access Journals (Sweden)

    B. Bojahr

    2012-01-01

    Full Text Available Background and Objective. The aim of this study was to assess the subjective outcome following laparoscopic sacropexy. Methods. We performed a retrospective cohort study among women treated for descensus with laparoscopic sacropexy between January 2000 and December 2007. 310 patients received questionnaires during followup assessing major pre- and postoperative symptoms and overall satisfaction. Results. 214 (69% patients responded to the questionnaire. Mean followup was 24.5 months. The number of patients with back or lower abdominal pain, foreign body sensation in the vagina and prolapse-related symptoms, urinary symptoms, vaginal and bladder infections, and the need for pessary usage decreased significantly postsurgically. Bowel symptoms increased slightly but not significantly. Two years after surgery, nearly 2 thirds of the women were satisfied or very satisfied with the outcome. Conclusion. Laparoscopic sacropexy is an effective treatment of descensus, with favorable or satisfactory subjective outcomes.

  8. Obesity & hypertension are determinants of poor hemodynamic control during total joint arthroplasty: a retrospective review

    Directory of Open Access Journals (Sweden)

    Nwachukwu Benedict U

    2013-01-01

    Full Text Available Abstract Background Proper blood pressure control during surgical procedures such as total joint arthroplasty (TJA is considered critical to good outcome. There is poor understanding of the pre-operative risk factors for poor intra-operative hemodynamic control. The purpose of this study is to identify risk factors for poor hemodynamic control during TJA. Methods We performed a retrospective cohort analysis of 118 patients receiving TJA in the Dominican Republic. We collected patient demographic and comorbidity data. We developed an a priori definition for poor hemodynamic control: 1 Mean arterial pressure (MAP 135% of preoperative MAP. We performed bivariate and multivariate analyses to identify risk factors for poor hemodynamic control during TJA. Results Hypertension was relatively common in our study population (76 of 118 patients. Average preoperative mean arterial pressure was 109.0 (corresponding to an average SBP of 149 and DBP of 89. Forty-nine (41.5% patients had intraoperative blood pressure readings consistent with poor hemodynamic control. Based on multi-variable analysis preoperative hypertension of any type (RR 2.9; 95% CI 1.3-6.3 and an increase in BMI (RR 1.2 per 5 unit increase; 95% CI 1.0-1.5 were significant risk factors for poor hemodynamic control. Conclusions Preoperative hypertension and being overweight/obese increase the likelihood of poor blood pressure control during TJA. Hypertensive and/or obese patients warrant further attention and medical optimization prior to TJA. More work is required to elucidate the relationship between these risk factors and overall outcome.

  9. Canine small clear cell/T-zone lymphoma: clinical presentation and outcome in a retrospective case series.

    Science.gov (United States)

    Martini, V; Marconato, L; Poggi, A; Riondato, F; Aresu, L; Cozzi, M; Comazzi, S

    2016-08-01

    Published studies, taken together, suggest the existence of a single canine lymphoma entity, with a small clear cell appearance by cytological evaluation, a histopathological T-zone pattern and an aberrant CD45-negative T-cell phenotype, mostly characterized by long-term survival. We describe clinical presentation and outcome in a retrospective case series of canine small clear cell/T-zone lymphoma. Despite the reported predisposition of Golden retriever, this breed was not represented in our case series. Most dogs presented with stage V disease, whereas only few had clinical signs or peripheral cytopenias. Blood was almost always more infiltrated than bone marrow. Median survival confirmed the favourable prognosis described in literature, but a few dogs died within a short time. Also, a subgroup of dogs developed second malignancies, eventually leading to death. We did not investigate possible prognostic factors because of the wide variety in treatments, and further studies are needed to identify high-risk animals.

  10. 76 FR 47527 - Retrospective Regulatory Review Under E.O. 13563

    Science.gov (United States)

    2011-08-05

    ... the changing economic and technological landscape. The review determined that the current export..., 2010, BIS issued a proposed rule (75 FR 76653) describing the proposed new License Exception Strategic... Exception STA will authorize, with conditions, the export, reexport and transfer (in-country) of...

  11. Repair and reconstruction of severe leg injuries: retrospective review of eighty-five patients

    Institute of Scientific and Technical Information of China (English)

    XU Yong-qing; SHI Ji-hong; LI Chun-xiao; MA Tao; LIN Yue-qiu; LI Jun; DING Jing; ZHU Yue-liang; RUAN Mo; GUO Yuan-fa; WANG Xin-ming; X(U) Xiao-shan

    2006-01-01

    Objective: To explore a good way of the reconstruction of severe tibial shaft fractures by using different flaps and external fixators.Methods: Eighty-five patients of Type ⅢC tibial shaft fractures with average age of 42.5 years were treated in our hospital from 1990 to 2005. Injuries were caused by motorcycle accidents in 66 patients, by machine accidents in 16 patients, and by stone bruise in 3 patients. The management procedures consisted of administration of antibiotics, serial debridment, bone grafting if needed,application of different flaps, such as free thoracoumbilical flaps, fasciocutaneous flaps, saphenous neurocutaneous vascular flaps, sural neurocutaneous vascular flaps and gastrocnemius muscular flaps, and different external fixations, for instance, half-ring fixators, unilateral axial dynamic fixators, AO fixators, Weifang fixators, and Hybrid fixators. The average follow up was 6.3 years.Results: All flaps survived. Eighty-three cases had bone healed. The average bone healing time of different external fixations was 5.5 months in 47 cases with half-ring fixators, 9.2 months in 4 cases treated with unilateral axial dynamic fixators, 8.5 months in 6 cases with AO fixators,10.7 months in 16 cases with Weifang fixators, and 7.8months in 10 cases with assembly fixators. Except half-ring fixation, other fixations all needed necessary bone graft.Two cases treated with unilateral axial dynamic fixators had nonunion of bone and developed osteomyelitis. The wounds healed after the removal of the fixators and immobilization by plaster. The last follow up examination showed ankle and knee motion was normal and no pain was noted.Conclusions: The combination of half- ring external fixators with various flaps provides good results for Type ⅢC tibial shaft fractures.

  12. Review of optically stimulated luminescence (OSL) instrumental developments for retrospective dosimetry

    DEFF Research Database (Denmark)

    Bøtter-Jensen, Lars; Thomsen, Kristina Jørkov; Jain, Mayank

    2010-01-01

    This review describes 40 years of experience gained at Risø National Laboratory in the development of facilities for irradiation, thermal/optical stimulation and luminescence signal detection. These facilities have mainly been used in luminescence dating and nuclear accident dosimetry. We focus e...... especially on methods for light stimulation and irradiation, and developments of new portable TL/OSL readers for determining doses directly in the field on both Earth and the planet Mars....

  13. Salivary gland enlargement and sialorrhoea in dogs with spirocercosis: A retrospective and prospective study of 298 cases

    Directory of Open Access Journals (Sweden)

    Liesel L. van der Merwe

    2012-04-01

    Full Text Available This longitudinal cross-sectional clinical study investigated the incidence of sialorrhoea in dogs with spirocercosis and determined whether breed, body weight and the extent of the oesophageal involvement was associated with this presentation. A retrospective analysis was performed on the medical records of 233 dogs and information pertaining to 65 dogs was collected as part of a prospective study. All the animals were client-owned. Patients from the retrospective study underwent thoracic radiography or oesophageal endoscopy to diagnose and characterise the infection and were placed on therapy with a macrocyclic lactone, whereas the patients in the prospective study had both radiography and endoscopy routinely performed and biopsies of the oesophageal nodules collected where possible. Tru-cut biopsies of affected salivary glands were taken in 10 of 13 patients demonstrating clinical signs of sialorrhoea and salivary gland enlargement. The entire salivary gland was sectioned in an additional three dogs with spirocercosis and no sialorrhoea that were presented for post mortem examination. Sialorrhoea was present in 33/298 cases (11%. Fox terrier breeds were over-represented in the patients with sialorrhoea, comprising 36% of cases, whereas they only comprised 1.5% of the patients without sialorrhoea (p < 0.001, chi squared test and 5% of the combined group. Dogs weighing 12 kg or less were significantly over-represented in the sialorrhoea group, 69% versus 19.5% (p < 0.001, chi square test. Age was not significantly different between the two groups (p < 0.08, Mann-Whitney test. The number of oesophageal nodules per case was significantly higher in the non-sialorrhoea cases (p = 0.048, Mann-Whitney test. The prevalence of distal oesophageal and lower oesophageal sphincter involvement, and neoplastic transformation of the nodules were not statistically different between the two groups. None of the fox terriers in either group showed neoplastic

  14. Plant maintenance management practices in automobile industries: a retrospective and literature review

    Directory of Open Access Journals (Sweden)

    Mahesh Pophaley

    2010-12-01

    Full Text Available This paper endeavors to present a classification, review and analysis of the literature on Plant Maintenance Management Practices (PMMP employed in Automobile Industries. There is a considerable amount of published research available concerning plant maintenance during the last few decades. Similarly many research articles are available which focuses on various aspects of automobile industries. However, very few studies focus on critical examination of maintenance practices in Automobile Industries in particular. Hence considering the slump in automobile industries in the recent times, a wide-ranging and focused review is attempted here and only those researches have been examined which mainly concentrates on this core aspect. Thus one of the objectives of this literature review is to investigate the present state of Plant Maintenance Management Practices, based on studies conducted in different countries and published in a variety of journals over the past two decades. An examination of 55 pertinent research studies have shown that the publications can be grouped in two categories namely Conceptual and Empirical Research. An analysis of these research articles published between 1990 and 2008, revealed that current maintenance practices ranges from conventional to the latest techniques for optimizing maintenance function like TPM, RCM and Proactive Maintenance. These studies focused more on maintenance problem solving and the main difficulties are reported along with probable solutions. Another goal of the paper is to analyze the articles by year and type of journal they were published in, to determine the trends in maintenance management studies and recommend future direction for research.

  15. Inducible urticaria: Case series and literature review.

    Science.gov (United States)

    Amaya, Daniel; Sánchez, Andrés; Sánchez, Jorge

    2016-01-01

    Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment. PMID:27622434

  16. Compensation trends of the angulation of first molars:retrospective study of 1 403 malocclusion cases

    Institute of Scientific and Technical Information of China (English)

    Hong Su; Bing Han; Sa Li; Bin Na; Wen Ma; Tian-Min Xu

    2014-01-01

    We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1 403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First, angulation of the upper first molar varied significantly with age and tipped most distally in cases aged ,12 years and least distally in cases aged .16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability.

  17. Membranous Nephropathy Associated With Immunological Disorder-Related Liver Disease: A Retrospective Study of 10 Cases.

    Science.gov (United States)

    Dauvergne, Maxime; Moktefi, Anissa; Rabant, Marion; Vigneau, Cécile; Kofman, Tomek; Burtey, Stephane; Corpechot, Christophe; Stehlé, Thomas; Desvaux, Dominique; Rioux-Leclercq, Nathalie; Rouvier, Philippe; Knebelmann, Bertrand; Boffa, Jean-Jacques; Frouget, Thierry; Daugas, Eric; Jablonski, Mathieu; Dahan, Karine; Brocheriou, Isabelle; Remy, Philippe; Grimbert, Philippe; Lang, Philippe; Chazouilleres, Oliver; Sahali, Dil; Audard, Vincent

    2015-07-01

    The association between membranous nephropathy (MN) and immunological disorder-related liver disease has not been extensively investigated, and the specific features of this uncommon association, if any, remain to be determined.We retrospectively identified 10 patients with this association. We aimed to describe the clinical, biological, and pathological characteristics of these patients and their therapeutic management. The possible involvement of the phospholipase A2 receptor (PLA2R) in these apparent secondary forms of MN was assessed by immunohistochemistry with renal and liver biopsy specimens.The mean delay between MN and liver disease diagnoses was 3.9 years and the interval between the diagnosis of the glomerular and liver diseases was PLA2R antibodies were detected in 4 out of 9 patients but the test was performed under specific immunosuppressive treatment in 3 out of 9 patients. Seven of the 9 patients with available renal tissue specimens displayed enhanced expression of PLA2R in glomeruli whereas PLA2R was not expressed in liver parenchyma from these patients or in normal liver tissue. The study of immunoglobulin (Ig) subclasses of deposits in glomeruli revealed that the most frequent pattern was the coexistence of IgG1 and IgG4 immune deposits with IgG4 predominating.Detection of PLA2R antibodies in glomeruli but not in liver parenchyma is a common finding in patients with MN associated with autoimmune liver disease, suggesting that these autoantibodies are not exclusively detected in idiopathic MN.

  18. A DOUBLE-CENTER RETROSPECTIVE 5 YEARS SURVEY OF 385 CABG CASES COMPARING GENDER CHARACTERISTICS

    Directory of Open Access Journals (Sweden)

    A. A. Karimi

    1999-06-01

    Full Text Available Coronary artery disease is one of the leading causes of morbidity and mortality especially in the indusirialzcd societies. This retrospective study was carried out on 385 patients who were referred to Shariati and Jamaran Hospitals from 1992 till 1997 and who underwent coronaty artery bypass grafting. The objective was to obtain a descriptive analysis of the important factors in this population and to draw a comparison betweent the two genders and to draw genders regarding these variables. The data were obtained from patients' files, angiography and operation notes; 82.9% of the study population were of male. The mean age of women was higher than men by 2.2years. The most common risk factors among the male gender were found to be smoking, hyperlipedemia, hypercholesterolemia and hypertension. Except for smoking which was omitted in women, all other risk factors showed a comparative low prevalence in this gender. Most patients (93.37% fell in group II and III of functional class as per NYHA classification and the most frequent signs and symptoms on admission being chest pain (81.5% and dyspnea (11.2%. The affected vessels in order of frequency were the left anterior descending, the right coronary and the circumflex arteries respectively. The average number of grafts utilized were 3 in the entire population. Overall mortality recorded was 2.1%.

  19. Acquired hemophilia a: retrospective analysis of 49 cases from a single Chinese hemophilia center.

    Science.gov (United States)

    Yang, Yanhui; Xue, Feng; Shi, Hao; Wang, Hongmei; Zhang, Lei; Ji, Linxiang; Yang, Renchi

    2015-01-01

    Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the autoantibody directed against factor VIII in patients without previous history of a bleeding disorder. We retrospectively analyzed the characteristics and outcomes of 49 patients with AHA diagnosed in our center from February 1994 to October 2012. Twenty-four patients with acute bleeding episodes were treated with prothrombin complex concentrate (PCC) at a relative low dose of 30 to -50 U/kg/d and achieved good outcomes without any adverse reaction. Corticosteroids alone or in combination with cyclophosphamide were used as the first-line therapy to eradicate the inhibitors. In 39 evaluable patients, 35 (89.7%) achieved complete remission (CR). This study demonstrates that when bypassing agents such as recombinant activated factor VII and activated PCCs are not affordable or available, low dose PCC is effective and safe to control acute bleeding in patients with AHA. First-line therapy achieved good outcomes with a CR rate of 89.7%.

  20. BOOK REVIEW: Case Studies in Knowledge Management

    OpenAIRE

    BOYACI, Reviewed By Dr. Adnan

    2005-01-01

    161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM) as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…...

  1. Both typical and atypical long-acting injectable antipsychotics in bipolar disorder: a retrospective chart review

    OpenAIRE

    Alpak, Gokay; Demir, Bahadir; Aksoy, Ihsan; Kaya, Hilal; Unal, Ahmet; Bulbul, Feridun; Savas, Haluk A.

    2014-01-01

    Objective: Bipolar disorder (BD) is a chronic psychiatric disorder which shows difficulties in the process of diagnosis and treatment. One of the biggest problems in BD maintenance therapy is to ensure medication compliance. Long-acting injectable (LAI) antipsychotic medications have important advantages in such cases. In this study we aimed to include both LAI atypical and typical antipsychotics and to compare the clinical status, number of hospitalization, and side effects of pre and post-t...

  2. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Tri Indah Winarni

    2012-01-01

    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  3. Intracranial hydatid cyst : a report of five cases and review of literature.

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    Gupta S

    1999-07-01

    Full Text Available The authors present five cases of intracranial hydatid cysts managed at the department of Neurosurgery, King Edward Memorial Hospital, Mumbai, between 1984-1997. The mean age of presentation was 13.4 years. Four patients (80% were in the first decade of life. All patients presented with focal neurological deficit and clinical features of raised intracranial pressure. Radiological investigations included computerised tomography (CT scan in three cases, CT and magnetic resonance (MR scan in one case and accidental cystogram in one case. Two patients had multiple intracranial cysts. One patient had a solitary cyst in the lateral ventricle. Commonest location was in the parietal lobe (3 cases. Total excision of the cyst was done in all five cases. Recurrence was seen in two cases, probably as a result of rupture of the cyst during first surgery. The features of this rare disease are retrospectively analyzed in this presentation and the literature is reviewed.

  4. Disability Case Review of Administrative Law Judge Hearing Decisions

    Data.gov (United States)

    Social Security Administration — The Disability Case Review is a post-effectuation quality review of administrative law judge (ALJ) disability hearing decisions. This dataset includes results from...

  5. The inter-rater agreement of retrospective assessment of adverse events does not improve with two reviewers.

    NARCIS (Netherlands)

    Zegers, M.; Bruijne, M.C. de; Wagner, C.; Groenewegen, P.P.; Wal, G. van der; Vet, H.C.W. de

    2008-01-01

    Methods: In the Dutch Adverse Event Study, 4272 records of discharged or deceased patients in 2004 from 21 Dutch hospitals were independently reviewed by two physicians (physician A+B) for the determination of adverse events (AEs) and their degree of preventability. In case of disagreement between t

  6. ROLE OF LAPAROSCOPY IN INVESTIGATION OF FEMALE INFERTILITY: A RETROSPECTIVE STUDY OF 50 CASES

    Directory of Open Access Journals (Sweden)

    Sailatha

    2014-07-01

    Full Text Available : Infertility is not only a medical, but a serious social problem as well, especially in our country. Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and is found to be very effective method in evaluating these cases. Traditional way to assess the uterine cavity, tubal structures and tubal patency was hysterosalpingography, but it has now largely been superseded by hysteroscopy and laparoscopy. It is concluded that laparoscopy is useful in diagnosing cases with endometriosis, tubal factor infertility and exclusion of bilateral anatomical tubal pathology by diagnostic laparoscopy could avoid IVF treatment in these cases.

  7. Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series

    DEFF Research Database (Denmark)

    Givol, Navot; Rosen, Eyal; Bjørndal, Lars;

    2011-01-01

    The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication....

  8. Evaluation of maternal mortality cases in the province of Elazig, Turkey, 2007-2013: a retrospective study.

    Science.gov (United States)

    Burcin Kavak, Salih; Celik Kavak, Ebru; Demirel, Ismail; Turkoglu, Abdurrahim; Halil Akkus, Ibrahim; Ilhan, Rasit; Kaplan, Selcuk

    2014-08-31

    The aim of this study was to determine the causes and factors influencing maternal mortality. All maternal deaths occurring between January 2007 and November 2013 in the Elazig Province of Turkey were retrospectively investigated. The maternal age, obstetric history, cause of death, encountered delay model of each case, as well as the overall number of annual live births in the Province were determined. The information of cases was obtained from Directorate of Public Health and hospital records.  Families or family doctors were also interviewed to obtain details about the circumstances surrounding each death. There were a total of 64,423 live births in the Province of Elazig between 2007- 2013. The number and ratio of maternal deaths due to direct and indirect causes were 12 and 18.6, respectively. The direct causes of maternal death were hypertensive diseases of pregnancy (n=5, 41.7%), obstetric hemorrhages (n=3, 25%) and pulmonary embolism (n=1, 8.3%). The indirect causes of death were cardiac diseases (n=2, 16.7%) and malignancy (n=1, 8.3%). When classified according to the "Three Delays Model", 2 cases were in the first delay model and 3 cases in the third delay model; the second delay model led to no maternal deaths. Hypertensive diseases of pregnancy are the leading cause of maternal mortality in our province. The preventable causes of maternal mortality and factors contributing to death must be identified to reduce the incidence.

  9. Patterns of intracranial glioblastoma recurrence after aggressive surgical resection and adjuvant management. Retrospective analysis of 43 cases

    International Nuclear Information System (INIS)

    The present retrospective study evaluated the recurrence patterns after aggressive surgical removal of intracranial glioblastomas in 43 consecutive adult patients. The resection rate of the enhanced lesion on magnetic resonance imaging was 100% and 95-99% in 22 and 21 cases, respectively. All patients received postoperative fractionated radiotherapy (60 Gy in 30 fractions) with additional chemotherapy (25 cases) or vaccine therapy (18 cases). During follow-up (median 17 months), tumor recurrence was identified in 33 patients, most frequently regional within the wall of the resection cavity (20 cases). No clinical factor differed significantly between the groups of patients with regional or marginal tumor progression (N=22) and patients with distant or multiple recurrences (N=8). Progression-free survival did not differ significantly between these two groups (p=0.27). However, overall survival was significantly longer (p=0.04) in patients with regional or marginal tumor progression, and constituted 90% and 54% at 1 and 2 years after surgery, respectively, compared to 75% and 0% in patients with distant or multiple recurrences. Aggressive surgical resection and adjuvant management of intracranial glioblastoma may change its recurrence pattern. Tumor progression appears in the wall of the resection cavity or within 2 cm from its margin in approximately half of patients. (author)

  10. Pollution Status of Pakistan: A Retrospective Review on Heavy Metal Contamination of Water, Soil, and Vegetables

    Directory of Open Access Journals (Sweden)

    Amir Waseem

    2014-01-01

    Full Text Available Trace heavy metals, such as arsenic, cadmium, lead, chromium, nickel, and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. In addition to these metals, copper, manganese, iron, and zinc are also important trace micronutrients. The presence of trace heavy metals in the atmosphere, soil, and water can cause serious problems to all organisms, and the ubiquitous bioavailability of these heavy metal can result in bioaccumulation in the food chain which especially can be highly dangerous to human health. This study reviews the heavy metal contamination in several areas of Pakistan over the past few years, particularly to assess the heavy metal contamination in water (ground water, surface water, and waste water, soil, sediments, particulate matter, and vegetables. The listed contaminations affect the drinking water quality, ecological environment, and food chain. Moreover, the toxicity induced by contaminated water, soil, and vegetables poses serious threat to human health.

  11. Pollution status of Pakistan: a retrospective review on heavy metal contamination of water, soil, and vegetables.

    Science.gov (United States)

    Waseem, Amir; Arshad, Jahanzaib; Iqbal, Farhat; Sajjad, Ashif; Mehmood, Zahid; Murtaza, Ghulam

    2014-01-01

    Trace heavy metals, such as arsenic, cadmium, lead, chromium, nickel, and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. In addition to these metals, copper, manganese, iron, and zinc are also important trace micronutrients. The presence of trace heavy metals in the atmosphere, soil, and water can cause serious problems to all organisms, and the ubiquitous bioavailability of these heavy metal can result in bioaccumulation in the food chain which especially can be highly dangerous to human health. This study reviews the heavy metal contamination in several areas of Pakistan over the past few years, particularly to assess the heavy metal contamination in water (ground water, surface water, and waste water), soil, sediments, particulate matter, and vegetables. The listed contaminations affect the drinking water quality, ecological environment, and food chain. Moreover, the toxicity induced by contaminated water, soil, and vegetables poses serious threat to human health. PMID:25276818

  12. Adrenal Cortical and Medullar Hyperplasia-A Retrospective Analysis of 6 Cases

    Institute of Scientific and Technical Information of China (English)

    陈敏; 鲁功成; 张齐均

    2002-01-01

    Summary: The features of the symptoms, laboratory tests and pathological characteristics of a-drenal cortical and medullary hyperplasia were studied. In 6 cases of hypercatecholaminenia, plas-ma norepinephrine (NE), epinephrine (E), catecholamine (CA) and 24-h urinary vanillylmandelicacid (VMA), 17-hydroxycorticosteroid (OHCS) and 17-ketosteroid (KS) were determined. A-drenal glands were examined by CT scan and 131I-MIBG imaging. Pathological examination wasperformed after operation. The results showed that in 6 cases of hypercatecholaminenia (3 menand 3 women) aged from 34-50 years, the clinical features were just like "pheochromocytoma",for example, episodic headache, perspiration, palpitation, pallor, apprehension, nausea, tremor,anxiety and so on. Plasma levels of CA, NE and E were elevated in all 6 cases. 24-h urinary sam-ples obtained at the onset revealed elevated VMA in 1 case. 24-h urinary cortisol was obviously el-evated in all 6 cases. 24-h urinary 17-OHCS, 17-KS was normal. B-type ultrasound, CT, MRIand 13I-MIBG revealed 9 lateral adrenal gland diffuse or nodular enlargement in 6 cases. Patholog-ic examination showed adrenal cortical and medullary hyperplasia. Clinically, adrenal cortical andmedullary hyperplasia resembled "pheochromocytoma". The most significant feature of this dis-ease was both elevated plasma CA and 24-h urinary cortisol obviously. Pathologic examinationshowed adrenal cortex nodular hyperplasia and medullar diffuse or limit hyperplasia. Whether it isan independent disease or symptoms of the other disease has not final conclusion up till now

  13. Therapeutic Approaches in Cases with Heterotopic Pregnancy: A Retrospective Analysis of Six Patients

    Directory of Open Access Journals (Sweden)

    Adnan Ižncebiyik

    2014-03-01

    Full Text Available Aim: To assess presenting complaints, diagnostic and therapeutic approaches and outcomes of pregnancy in cases with heterotopic pregnancy managed in our clinic. Material and Method: We screened the electronic database of our hospital for patients admitted to our clinic between January 1, 2010, and June 30, 2013, using diagnostic codes of pregnancy and ectopic pregnancy. Six patients with a heterotopic pregnancy who underwent either surgical or medical therapy were included in the study. Results: Six cases with a heterotopic pregnancy were detected who had been managed at the clinic during a 3-year period. The presenting complaints in 3 cases were abdominal pain and vaginal bleeding and in 2 case an acute abdomen due to a haemoperitoneum. A heterotopic pregnancy was detected by transvaginal sonography in one patient who presented to the clinic for routine control. Salpingectomy via laparotomy was performed in the 2 patients who presented with acute abdomen, and conservative surgery via laparoscopy was performed in 2 patients without haemodynamic instability and tubal rupture. The remaining 2 patients were treated with potassium chloride and methotrexate instillation into the gestational sac via ultrasound guidance. Of the 6 patients treated for heterotopic pregnancy, there were 3 live births and 3 foetal losses. Discussion: A careful pelvic examination for heterotopic pregnancy plays an important role in reducing both maternal and foetal mortality, particularly in cases in which pregnancy is achieved by assisted reproductive techniques, even in cases of detection of intrauterine pregnancy.

  14. Urinary lithiasis and urinary tract malformations in children: A retrospective study of 34 cases

    Directory of Open Access Journals (Sweden)

    Jamila Chahed

    2011-01-01

    Full Text Available Background: Although the association of urinary lithiasis and urinary tract malformation is not rare, their management poses challenges. The aim of this study was to evaluate the relationship between urolithiasis and malformations of the urinary system. There were 34 patients (19 males and 15 females with a mean age of 4.8 years (range, 2 months to 14 years. All patients had urinary lithiasis with a urinary tract malformation. Abdominal pain was the most frequent clinical symptom (38%. Urinary infection was found in 7 patients (21% and macroscopic haematuria was present in 10 patients (29%. The most frequent urinary tract malformations were megaureter (8 cases, uretero-pelvic junction obstruction (7 cases and vesico-ureteric reflux (8 cases, but its malformative origin could not be confirmed. Treatment consisted of lithiasis extraction in 32 cases associated with specific treatment of the uropathy in 27 cases. Postoperative outcome was uneventful in all cases. In fact, urinary lithiasis and urinary tract malformation association is not rare. Indeed, 9-34% of urinary lithiasis are noted to be associated with urinary tract malformation. Positive diagnosis relies specifically on kidney ultrasound, intravenous urography, and urethrocystography. Treatment depends on the type of urinary tract malformation, localisation and size of the urinary lithiasis. Conclusion: In conclusion, urinary lithiasis and urinary tract malformation association is a frequent eventuality. Surgical intervention is the usual mode of treatment.

  15. Retrospective study on radiotherapy efficacy in case of painful heel spur

    International Nuclear Information System (INIS)

    Objective: The effect of radiotherapy in context of a plantar fasciitis in order to reduce pain was evaluated in this retrospective study. Patients and methods: The data of 188 patients who suffered of heel spur pain and who were irradiated in the period from 1994 to 2009 were evaluated in this study. All of them had at least one follow up examination after radiatiotherapy. The mean age amounted to 57 years. 76.5% of the patients were female. All patients described a local pain which was the basis for the indication. 74.4 % of the patients described pain especially under stress. The duration of anamnesis was averaged as follows: 15 % of the patients had pain for some weeks to 3 months, 43 % for 4 to 6 months, 28% even for 7 to 12 months. The period of medical history was longer than 12 months for 12 % of the patients in this study. 122 of 188 patients received orthopedic arch support (shoe inlays) as first therapy method. Most of the patients were irradiated using regular lateral opposing fields with photons of the energy 4 MV and 6 MV of a linear accelerator, applying a total dose of 6Gy in 6 fractions to 1,0Gy twice weekly. Only one patient was irradiated using a Co60 machine. The acquisition of data regarding the effect was performed on the last day of the radiotherapy and in 3 to 6 monthly follow ups. Additionally the doctors who attended the patients beyond the radiotherapy received a special questionnaire about the pain reduction, so that the follow up data could be completed. Results: On the last day of radiotherapy 120/188 patients (63,8%)reported an improvement of pain reduction, 7/188 patients (3,7%) absence of pain. For 52/188 patients (27.6 %) pain remained constant. At the second follow up examination after in the median 100 days the effect of radiotherapy of 165 patients could be evaluated, 43/165 patients (26 %) were pain free, 79/165 patients (47,8 %) reported an obvious pain reduction, and for 33/165 patients there was no pain improvement. At the

  16. Keloidal Scleroderma: Case Report and Review

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    Sama Kassira

    2015-01-01

    Full Text Available Objective. We report a rare case of keloidal scleroderma and provide an analysis of similar cases. Results. A 41 year-old woman presented with dark brown, indurated, exophytic nodules over the chest along with smaller hyperpigmented plaques scattered over the abdomen, with concomitant sclerodactyly. The clinical, laboratory, and pathological findings were consistent with a diagnosis of keloidal scleroderma. The patient was treated with methotrexate, resulting in reduced firmness of her plaques and no new lesions. A literature review of previously reported cases was performed using keywords including keloidal morphea, keloidal scleroderma, nodular morphea, and nodular scleroderma. In our review, the majority of patients were African American and female. 91% of cases had nodular lesions with distribution on the trunk. The majority of patients exhibited sclerodactyly and pulmonary involvement was reported in 28%1. The majority of patients were ANA positive (63% and only 10% demonstrated anti-SCL-70 positivity. Conclusion. Keloidal scleroderma is a rare presentation, which can often be clinically confused with keloid and scar formation. Due to this being a rare variant, our knowledge of treatment options and efficacy is limited. Methotrexate could be considered as an initial treatment option for patients with progressive keloidal scleroderma.

  17. Interstitial brachytherapy of periorificial skin carcinomas of the face: A retrospective study of 97 cases

    International Nuclear Information System (INIS)

    Purpose: To analyze outcomes after interstitial brachytherapy of facial periorificial skin carcinomas. Patients and Methods: We performed a retrospective analysis of 97 skin carcinomas (88 basal cell carcinomas, 9 squamous cell carcinomas) of the nose, periorbital areas, and ears from 40 previously untreated patients (Group 1) and 57 patients who had undergone surgery (Group 2). The average dose was 55 Gy (range, 50-65 Gy) in Group 1 and 52 Gy (range, 50-60 Gy) in Group 2 (mean implantation times: 79 and 74 hours, respectively). We calculated survival rates and assessed functional and cosmetic results de visu. Results: Median age was 71 years (range, 17-97 years). There were 29 T1, 8 T2, 1 T3, and 2 Tx tumors in Group 1. Tumors were <2 cm in Group 2. Local control was 92.5% in Group 1 and 88% in Group 2 (median follow-up, 55 months; range, 6-132 months). Five-year disease-free survival was better in Group 1 (91%; range, 75-97) than in Group 2 (80%; range, 62-90; p = 0.23). Of the 34 patients whose results were reassessed, 8 presented with pruritus or epiphora; 1 Group 2 patient had an impaired eyelid aperture. Cosmetic results were better in Group 1 than in Group 2 with, respectively, 72% (8/11) vs. 52% (12/23) good results and 28 (3/11) vs. 43% (10/23) fair results. Conclusions: Brachytherapy provided a high level of local control and good cosmetic results for facial periorificial skin carcinomas that pose problems of surgical reconstruction. Results were better for untreated tumors than for incompletely excised tumors or tumors recurring after surgery

  18. Thoracic injury: a review of 276 cases

    Institute of Scientific and Technical Information of China (English)

    Moosa Zargar; Ali Khaji; Mojgan Karbakhsh Davari

    2007-01-01

    Objective: Chest injury, one of the most important aspects of trauma, directly accounts for 25% of all traumarelated deaths and plays a major contributing role in another 25% of trauma deaths. This paper aimed to explore the spectrum and outcome of thoracic injuries seen in a multi centric study of trauma patients.Methods: A total of 276 consecutive trauma patients in 6 general hospitals were analyzed. The feature of injury,injury severity score (ISS), clinical treatment and mortality were recorded in a prospective manner and analyzed retrospectively. Multiple logistic regression analysis was used to determine the independent predictors of mortality following the chest trauma.Results: There were 246 males ( 89.1%) and 30 females (10.9% ) ranging from 3 to 80 years with a mean age of (34 ± 17) years. Road traffic accident was the main cause of injury, especially for pedestrians, followed by stab wound (89 cases, 32.1% ) and falling injuries (32 cases,11.6% ), respectively. Haemothorax or pneumothorax (50.4%) and rib fracture (38.6%) were the most common types of chest injury. Extremity fracture was the most common associated injury with the rate of 37% ( 85/230), followed by head injury (25.2% ) and abdominal trauma (19.6%). These injuries contributed significantly to the morbidity and mortality of trauma patients.Conclusions: According to the results, most patients with chest injury can be treated conservatively with close observation and tube thoracostomy. The presence of blunt trauma, head injury and abdominal injury independently adversely affect mortality after chest trauma. It is necessary to investigate the causes and patterns of injuries resulting from stab wound for effective prevention.

  19. Exertional rhabdomyolysis after spinning: case series and review of the literature.

    Science.gov (United States)

    Ramme, Austin J; Vira, Shaleen; Alaia, Michael J; VAN DE Leuv, Jonathan; Rothberg, Robert C

    2016-06-01

    Spinning is a popular indoor stationary cycling program that uses group classes as a motivational tool. Exertional rhabdomyolysis (ER) is frequently reported in athletes and military recruits; however, infrequently it has been reported after spinning class. ER is diagnosed by clinical history, physical exam, and laboratory values. Hydration, electrolyte management, and pain control are key components to treatment of this condition. Severe cases can be complicated by acute renal failure, compartment syndrome, arrhythmia, and disseminated intravascular coagulation. We describe three cases of admission due to rhabdomyolysis after spinning. The diagnosis, admission criteria, and medical treatment of ER are presented in the context of a literature review. A retrospective review of three cases with review of the current literature. The medical and laboratory records of three patient cases were reviewed. A search of the PubMed database was used to perform a comprehensive review of exertional rhabdomyolysis. Our institution's IRB reviewed this study. We report three cases of exertional rhabdomyolysis after spinning and describe the diagnostic workup and medical management of these patients. The diagnosis of ER is made by clinical history, physical exam, and laboratory values. The disease spectrum ranges from mild to severe with the potential of serious complications in some patients. We demonstrate three cases of ER in deconditioned individuals who presented to the emergency department for evaluation. Careful medical management and patient monitoring resulted in improved patient symptomatology and eventual return to physical activity.

  20. [Hyperthyroidism and pregnancy. A retrospective multicenter study Nord-Picardie-Champagne. Report of 48 cases].

    Science.gov (United States)

    Dorangeon, P H; Quereux, C; Wahl, P

    1989-12-01

    In 92,130 pregnancies followed between 1980 and 1987, 48 cases of hyperthyroidism were reported including 38 Grave's diseases, 5 toxic adenomas, 4 multinodules goiters. In comparing the results with those mentioned in the literature, a number of conclusions may be reached. In case of hyperthyroidism treated before the pregnancy or discovered at the beginning, there is, in every other case, an aggravation at the end of the first trimester, then a stabilization in the 2nd or 3rd trimester and finally an aggravation in the post-partum period. There is a high rate of abortions (35 p. cent), a delayed intra-uterine growth in half of the cases. The problem of the treatment is of paramount importance; there is no problem with Beta-blockers but the SAT are not without danger: risk of hypothyroidism and fetal goiter, but also risk of maternal hypothyroidism. From the 15th week, the doses should therefore be decreased, and sometimes the treatment discontinued and replaced with Beta-blockers. The best SAT drug during pregnancy is the propylthioracile which is the least likely to cross the fetal barrier. Surgery is only exceptionally indicated. In a woman who is cured from her Grave's disease, recurrences are always possible, and also fetal hyperthyroidism caused by crossing of thyreostimulins immunoglobins, even in case of maternal euthyroidism. PMID:2696063

  1. A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

    Directory of Open Access Journals (Sweden)

    Joanna Reeves

    2015-06-01

    Full Text Available Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011. The age-bands frequently injured were 10–19 (22%, 40–49 (22%, 30–39 (14% and 50–59 (13% years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39. Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton.

  2. [Extensive excision of fixed cancers of the colon. A retrospective study of 44 cases].

    Science.gov (United States)

    Le Treut, Y P; Bozon-Verduraz, E; Sabiani, P; Maillet, B; Bricot, R

    1986-01-01

    Out of 268 resections for colonic carcinoma, 44 were extended because of an involvement to adjacent tissues or organs. Abdominal wall (14 cases), vesical dome (12 cases) and small bowel (11 cases) were most frequently resected. Post-operative mortality (15.9%) and five years survival rates (57.5%) of this radical procedures do not significantly differ compared to results after conventional procedures (15.3 and 64.3% respectively). Carcinomatous adhesions are difficult to distinguish from inflammatory ones at the time of laparotomy. They were found in 47% of the specimens only. This had a lesser prognostic significance than lymph nodes involvement. This results are in favour of extensive surgery for locally advanced tumours of the colon. PMID:3771668

  3. Primary bone lymphoma: A report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Singh Tejinder

    2010-01-01

    Full Text Available Primary bone lymphoma (PBL is an uncommon tumor accounting for approximately 4-5% of extra nodal lymphoma and less than 1% of all non-Hodgkin′s lymphoma. Disease may be complicated at presentation by pathological fracture or spinal cord compression. Diffuse large-B-cell lymphoma (DLBCL accounts for the majority of cases of PBL. Owing to its rarity, only a few retrospective studies have been published addressing the prognosis and treatment of primary bone lymphoma. In this paper, we report our experience with two cases of PBL treated with chemotherapy and radiotherapy and review literature to elucidate the optimal treatment of primary bone lymphoma.

  4. Acute Fatty Liver of Pregnancy: A Retrospective Analysis of 56 Cases

    Institute of Scientific and Technical Information of China (English)

    Yan-Ping Zhang; Wei-Qi Kong; Sheng-Ping Zhou; Yun-Hoi Gong; Rong Zhou

    2016-01-01

    Background:Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening complication occurring in the third trimester.It is often fatal to both mother and fetus.The complicated clinical manifestations as well as an insufficient understanding of the disease make the precise diagnosis and effective treatment of AFLP challenging.A full understanding of the risk factors,clinical features,and test findings of AFLP is critical for its timely diagnosis and treatment.Methods:We performed a retrospective study of 56 patients with AFLP between June 2008 and July 2013.We analyzed the clinical features,laboratory results,perioperative management,and patient outcomes.Results:The initial symptoms varied considerably,with nausea and vomiting (13/56,23%) being the most common.Liver-function indexes were remarkable,including elevated levels of serum alanine aminotransferase (262.16 ± 281.71 U/L),aspartate aminotransferase (260.98 ± 237.91 U/L),lactic dehydrogenase (1011.76 ± 530.34 U/L),and direct bilirubin (85.59 ± 90.02 μmol/L).Coagulation disorders were indicated by abnormal levels of fibrinogen (245.95 ± 186.11 mg/dL),D-dimer (2.46 ± 4.01 mg/L),and fibrin degradation products (43.62 ± 48.71 mg/L).The main maternal complications were hypoproteinemia (75%),coagulopathy (54%),and acute renal failure (39%).Multivariate logistic regression analysis identified prothrombin time (PT;odds ratio [OR] =1.558,95% confidence interval [CI] =1.248-1.946,P =0.016) and international normalized ratio (INR;OR =40.034,95% CI=2.517-636.693,P =0.009) as risk factors.The perinatal infant death rate was related to gestational age at delivery (OR =1.298,95% CI=1.040-1.618,P =0.021),direct bilirubin (OR =1.05,95% CI=1.008-1.094,P =0.020),and fibrin degradation products (OR =0.973,95% CI =0.950-0.996,P =0.021).Conclusions:Nausea and vomiting may be the most common symptoms of AFLP.Indexes of liver dysfunction and coagulation disorders should also be considered.PT and INR

  5. A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

    Institute of Scientific and Technical Information of China (English)

    Mei Jin; Yong-Mei Liang; Xiao-Fang Wang; Bao-Jing Guo; Ke Zheng; Yan Gu; Zhen-Yu Lyu

    2015-01-01

    Background:Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China.Since then,several devices have been invented for occluding PDA.This study aimed to evaluate the technical feasibility,safety,and efficacy of transcatheter occlusion of PDA with different devices.Methods:One thousand five hundred and twenty-six patients (537 boys,989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure.We retrospectively analyzed data of these patients,including gender,age,weight,size and morphology of PDA,and devices used in transcatheter occlusion,outcomes,and postoperational complications.Results:Median age and median weight were 4.0 years (range:0.3-52.0 years old) and 15.3 kg (range:4.5-91.0 kg),respectively.Mean ductal diameter,aortic ductal diameter,ductal length,and pulmonary artery pressure were 3.50 ± 2.15 mm,l 0.08 ± 2.46 mm,7.49 ± 3.02 mm,and 30.21 ± 17.28 mmHg,respectively.Morphology of PDA assessed by descending aortogram was of type A in 1428 patients,type B in 6 patients,type C in 79 patients,type D in 4 patients,and type E in 9 patients according to the classification of Krichenko.Of all the 1526 patients,1497 patients underwent transcatheter PDA closure,among which 1492 were successful.Devices used were Amplatzer duct occluder Ⅰ (ADO Ⅰ,1280,85.8%),Cook detachable coils (116,7.8%),ADO Ⅱ (ADO Ⅱ,68,4.6%),muscular VSD occluder (12,0.8%),and Amplatzer vascular plug (16,1.0%).Conclusions:Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types.With transcatheter occlusion technique and devices developing,more patients with PDA can be treated with transcatheter closure both safely and efficiently.

  6. Esofagitis necrosante aguda: análisis retrospectivo Acute esophageal necrosis: a retrospective case series

    Directory of Open Access Journals (Sweden)

    R. Ramos

    2008-09-01

    Full Text Available Introducción: la esofagitis necrosante aguda es una entidad rara. Se reconoce por el aspecto negro difuso del esófago a la endoscopia. Su incidencia e patogénesis se desconoce. Pacientes y métodos: se analizaron retrospectivamente 11 pacientes con esofagitis necrosante aguda desde el punto de vista de los datos clínicos, de laboratorio y endoscopicos en 2 años. Resultados: se analizaron las endoscopias realizadas a 3.976 pacientes, observándose esofagitis necrosante aguda en 11 pacientes. El estado nutricional era malo en 6 pacientes. La resolución completa de la esofagitis se observó en cuatro pacientes. Durante el seguimiento se observó una estenosis en un paciente y un nuevo episodio de esofagitis necrosante aguda en otro paciente. Siete pacientes fallecieron, pero esta elevada mortalidad parece deberse a las enfermedades de base y no es atribuible a las lesiones de la esofagitis necrosante. Conclusiones: la incidencia de esofagitis necrosante aguda en nuestra serie fue 0,28%. La esofagitis necrosante aguda tiene una elevada mortalidad.Background: acute esophageal necrosis has been considered a rare event. It is defined as the presence of diffuse dark pigmentation of the esophagus on upper endoscopy. Its incidence has not yet been established. The pathogenesis remains unknown. Patients and methods: a retrospective analysis of clinical, laboratory, endoscopic, and histological data, and of the clinical course of 11 patients with acute necrotizing esophagitis was carried out over a 2-year period. Results: among 3,976 patients who underwent upper endoscopy, 11 (0.28% with acute esophageal necrosis were identified. Nutritional status was poor for 6 patients. Complete resolution of acute esophageal necrosis without further recurrence was observed in 4. One stricture appeared during follow-up and other patient developed new-onset acute esophageal necrosis. Seven patients died, but no death was directly related to acute esophageal necrosis

  7. A 25 year retrospective review of the psychological consequences of the Chernobyl accident.

    Science.gov (United States)

    Bromet, E J; Havenaar, J M; Guey, L T

    2011-05-01

    The Chernobyl Forum Report from the 20th anniversary of the Chernobyl nuclear power plant disaster concluded that mental health effects were the most significant public health consequence of the accident. This paper provides an updated review of research on the psychological impact of the accident during the 25 year period since the catastrophe began. First responders and clean-up workers had the greatest exposure to radiation. Recent studies show that their rates of depression and post-traumatic stress disorder remain elevated two decades later. Very young children and those in utero who lived near the plant when it exploded or in severely contaminated areas have been the subject of considerable research, but the findings are inconsistent. Recent studies of prenatally exposed children conducted in Kiev, Norway and Finland point to specific neuropsychological and psychological impairments associated with radiation exposure, whereas other studies found no significant cognitive or mental health effects in exposed children grown up. General population studies report increased rates of poor self-rated health as well as clinical and subclinical depression, anxiety, and post-traumatic stress disorder. Mothers of young children exposed to the disaster remain a high-risk group for these conditions, primarily due to lingering worries about the adverse health effects on their families. Thus, long-term mental health consequences continue to be a concern. The unmet need for mental health care in affected regions remains an important public health challenge 25 years later. Future research is needed that combines physical and mental health outcome measures to complete the clinical picture.

  8. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    Science.gov (United States)

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis.

  9. Helicobacter pylori infection and gastric cancer: evidence fron a retrospective cohort study and nested case-control study in China

    Institute of Scientific and Technical Information of China (English)

    Run-Tian Wang; Chou-Wen Zhu; Hai Yu; Yu-Jun Cong; Sbu Zheng; Bing-Quan Wu; Tao Wang; Kun Chen; Ji-Yao Wang; Jie-Ping Zhang; San-Ren Lin; Yi-Min Zhu; Wen-Ming Zhang; Yu-Xin Cao

    2002-01-01

    AIM: To explore the association between Helicobacter pylori (Hp) infection and risk of gastric cancer in China. METHODS: Utilizing gastroendoscopic biospsy tissue banks accumulated from1980 to1988 in Shandong, Zhejiang, and Jiangsu, where stomach cancer incidence was high, during stomach cancer screening conducted by Health Science Center of Peking University, School of Medicine of Zhejiang University, and Zhongshan Hospital of Fudan University. Warthin Starry silver staining method was applied to determine H. pyloriinfection status of biopsies collected during gastroendoscopic examination. In the retrospective study, the subjects were divided into two cohorts, the exposure cohort was positive H. pyloriinfection, and the non-exposure cohort was negative. Death from stomach cancer was determined as the outcome of the study. Logistic regression and Cox regression were applied to analyze the association between Helicobacterpyloriinfection and gastric cancer risk. In the nested case-control study, there were 28 deaths from gastric cancer in the fields of Muping, Shandong province, and Zhoushan, Zhejiang provinces. 4 controls were matched to each case on the basis of age (±5 years old), sex, residential place at the same time entered into the study. Conditional logistic regression analysis was used to analyze the data.RESULTS: There were a total of 2 719 subjects (male 1 399,female 1 320) with gastroendoscopic biopsies stored available treated as a cohort. H. pyloripositive cohort included 1 671 subjects (61.5 %) and H. pylorinegative cohort 1 048 subjects(38.5 %). These subjects were followed up for 1-19 years, averaged 10.88 years. The outcome of death from stomach cancer in the exposure cohort was 33, and in the non-exposure cohort 11. After adjustment for age and sex, RR=1.9850 (P=0.0491), 95 % CI was 1.0026, and 3.9301. The results of conditional logistic regression showed an OR of 4.467 and 95 % CI of 1.161, and 17.190 for the nested case control study

  10. Hepatic Angiosarcoma: a Review of Twelve Cases

    Institute of Scientific and Technical Information of China (English)

    Qiang Li; Xishan Hao

    2005-01-01

    OBJECTIVE Hepatic angiosarcoma (HAS), a lethal disease, is the most common sarcoma arising in the liver. Little information about the epidemiology, etiology, diagnosis and management of HAS has been reported. Increased familiarity with this disease will facilitate correct diagnosis and help to improve management of this condition in the future.The objective of this study was to describe cases of hepatic angiosarcoma and to discuss the etiologic, diagnostic, therapeutic features and prognosis of this tumor. This report not only serves to give more evidence of the relationship between hepatic angiosarcoma and carcinogenic exposure, but also demonstrates the key points in different methods of diagnosis and the optimal treatment of hepatic angiosarcoma.METHODS Twelve cases of hepatic angiosareoma were analyzed retrospectively, representing the different character in clinical presentations and laboratory computed tomographical scans; pathological data and treatment are described. Clinical and biologic follow-up was carried out for two years after surgical treatment.RESULTS There were nine men and three women varying in ages from 57 to 71 years with an average of 64.3 years. Ten patientshad a history of exposure to vinyl chloride or thorotrast. Mild or moderate abdominal pain and bloating, abdominal mass and fever were the common clinical presentations. Tumors were visualized by ultrasonography and CT scans in all patients. Biochemical profiles yielded variable results and proved to be of little value in detection or diagnosis. Surgical resection was feasible for each patient who was treated as follows: two wedge resections, six segementectomies and four bisegmentectomies. Five patients received Neoadjuvant chemotherapy postoperatively. The survival rate of those cases was poor. The maximum survival time was fourteen months. The mean survival time for this chemotherapeutic group was 11 months. The difference between the survival time of those treated with an operation

  11. Cardiac amyloidosis in a heart transplant patient - A case report and retrospective analysis of amyloidosis evolution

    OpenAIRE

    Kintsler, Svetlana; Jäkel, Jörg; Brandenburg, Vincent; Kersten, Katrin; Knuechel, Ruth; Röcken, Christoph

    2015-01-01

    Cardiac amyloidosis is a very rare cause of heart failure in heart transplant recipients but an important differential diagnosis in cases of progressive cardiac failure. We report a 72-year-old male patient with the diagnosis of senile systemic amyloidosis (SSA) in a transplanted heart 15 years after transplantation by the initial diagnosis of the dilated cardiomyopathy. Additionally performed immunohistochemical analysis with anti-transthyretin antibody of the cardiac biopsies of the last 15...

  12. The strategy of parallel approaches in projects with unforeseeable uncertainty: the Manhattan case in retrospect

    OpenAIRE

    Lenfle, Sylvain

    2011-01-01

    International audience This paper discusses the literature on the management of projects with unforeseeable uncertainty. Recent work demonstrates that, when confronted with unforeseeable uncertainties, managers can adopt either a learning, trial-and-error-based strategy, or a parallel approach. In the latter, different solutions are developed in parallel and the best one is chosen when enough information becomes available. Studying the case of the Manhattan Project, which historically exem...

  13. Therapeutic Approaches in Cases with Heterotopic Pregnancy: A Retrospective Analysis of Six Patients

    OpenAIRE

    Adnan Incebiyik

    2014-01-01

    Aim: To assess presenting complaints, diagnostic and therapeutic approaches and outcomes of pregnancy in cases with heterotopic pregnancy managed in our clinic. Material and Method: We screened the electronic database of our hospital for patients admitted to our clinic between January 1, 2010, and June 30, 2013, using diagnostic codes of pregnancy and ectopic pregnancy. Six patients with a heterotopic pregnancy who underwent either surgical or medical therapy were included in the study. Resul...

  14. ROLE OF LAPAROSCOPY IN INVESTIGATION OF FEMALE INFERTILITY: A RETROSPECTIVE STUDY OF 50 CASES

    OpenAIRE

    Sailatha; Sathiya; Famida.; Vijayalakshmi; Renuka; Misha Pepsi

    2014-01-01

    : Infertility is not only a medical, but a serious social problem as well, especially in our country. Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and is found to be very effective method in evaluating these cases. Traditional way to assess the uterine cavity, tubal structures and tubal patency was hysterosalpingography, but it has now largely been superseded by hysteroscopy and laparoscopy. It is concluded that lap...

  15. Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

    Science.gov (United States)

    Trestrail, J H; al-Mahasneh, Q M

    1989-04-01

    From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world. PMID:2929130

  16. Histerectomias: estudo retrospectivo de 554 casos Hysterectomies: a retrospective study of 554 cases

    Directory of Open Access Journals (Sweden)

    Eddie Fernando Cândido Murta

    2000-10-01

    Full Text Available OBJETIVO: A histerectomia é uma operação muito realizada, entretanto há poucos trabalhos na literatura nacional sobre suas indicações, técnica e complicações. O objetivo deste trabalho é avaliar estes procedimentos realizados na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. MÉTODO: Estudo retrospectivo de 470 histerectomias abdominais e 84 vaginais foi conduzido analisando as indicações, tempo de cirurgia e internação, tipo de incisão e morbidez. RESULTADOS: As principais indicações foram o mioma uterino e o prolapso uterino para as histerectomias abdominais e vaginais, respectivamente. As complicações intra-operatórias aconteceram em 3,4% e as pós-operatórias em 2,4% do total de casos. Nenhuma diferença estatística foi encontrada no número de complicações em relação ao tipo de incisão (vertical ou transversal. O tempo de cirurgia e o de hospitalização foram estatisticamente maiores nas incisões verticais. A hemorragia foi a mais freqüente complicação intra-operatória e a infecção da incisão operatória foi a mais freqüente no pós-operatório. CONCLUSÕES: A histerectomia é um procedimento de baixo risco, no entanto, a realização de revisões sobre indicações e complicações, e a pesquisa de melhores técnicas cirúrgicas são necessárias para torná-la cada vez mais segura.OBJECTIVE: Hysterectomy is a frequently performed surgery, but national literature gives limited information regarding indications, technique and complications. The aim of this study is to evaluate our results with this operation performed by the Discipline of Gynecology and Obstetrics of the Faculty of Medicine of "Triângulo Mineiro". METHODS: A retrospective study of 470 abdominal and 84 vaginal hysterectomies was conducted in which the indications, operation time, abdominal approach, hospitalization time, and morbidity were analyzed. RESULTS: Uterine myoma and uterine prolapse

  17. Incidence of Soft-Tissue Injuries in Patients with Posterolateral Tibial Plateau Fractures: A Retrospective Review from 2009 to 2014.

    Science.gov (United States)

    Wang, Yanqing; Cao, Fujiang; Liu, Minghui; Wang, Jiantao; Jia, Shikong

    2016-08-01

    Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures. Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data. Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%. Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures. PMID:27183240

  18. A Retrospective Review on Feasibility and Safety of a New Pneumatic Compression Device for Femoral Arteriotomy Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Min Ho [Chungbuk National University Hospital, Cheongju (Korea, Republic of); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-01-15

    To report our initial experience on the technical feasibility and safety for hemostasis of a new pneumatic compression device in patients undergoing femoral arteriotomy. This study included 40 consecutive patients in whom hemostasis after transfemoral catheterization was readered by using a pneumatic compression device consisting of an inflatable bulb-containing main body and four pieces of supplementary tape. Medical records were retrospectively reviewed for outcomes and complications of hemostasis. Technical success was defined as achieving immediate hemostasis 10 minutes after applying the device over the arteriotomy sites, and clinical success was defined as the ability to ambulate after 4 hours of bed rest without any complications. Technical and clinical success was achieved in 38 (95%) and 37 (93%) patients, respectively. In two patients, hemostasis was achieved after conversion to manual compression. One patient required sand bag placement after removal of the device to control minimal oozing of blood. No patients had late complications. The new pneumatic compression device provides effective and safe hemostasis after transfemoral catheterization in selected patient populations.

  19. Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review

    International Nuclear Information System (INIS)

    Myelofibrosis (MF) is a clonal hematopoietic malignancy characterized by constitutional and localized symptoms, progressive splenomegaly, bone marrow fibrosis, and cytopenias. Although MF is well studied, few studies exist regarding its symptomatic burden in routine clinical practice. This study aimed to characterize symptoms and other clinical features of MF among patients in the United States. We conducted a retrospective medical record review of adult patients with an MF diagnosis between 1 January 2005 and 31 March 2010, stratified by the presence of palpable splenomegaly. Eligible patients had 12 months or more of follow-up after diagnosis (or after detection of splenomegaly, if present) unless death occurred. Demographic and clinical characteristics, MF-related symptoms, and treatments were reported by treating physicians. We report on 180 MF patients: 102 with splenomegaly, 78 without. Median age was 66 years, 63% were male, and 82% had intermediate-2 or high-risk MF (International Prognostic Scoring System). Fatigue was reported by ∼85% of patients; weight loss, night sweats, and fever (any grade) were each reported by 50% or more of patients. Generalized abdominal pain, left subcostal pain, and early satiety occurred more frequently among patients with splenomegaly. Multiple symptoms were reported by 95% of patients. Common comorbidities were hypertension, diabetes, and chronic pulmonary disease. Symptoms are common in MF patients, regardless of the presence of palpable splenomegaly. Careful assessment of symptom burden is an important aspect of the clinical evaluation of patients with MF

  20. A retrospective, quality improvement review of maggot debridement therapy outcomes in a foot and leg ulcer clinic.

    Science.gov (United States)

    Campbell, Noreen; Campbell, Donna

    2014-07-01

    Maggot debridement is the deliberate use of larvae known to consume only necrotic tissue. A retrospective quality improvement analysis of maggot debridement therapy (MDT) was conducted among patients with devitalized tissue or gangrene attending a Canadian foot and leg ulcer clinic who received MDT between January 2001 and June 2006. MDT was applied every 48 hours until >90% of necrotic tissue was debrided. The authors identified MDT patients in the clinic database and reviewed their medical records for age, gender, presence of diabetes or peripheral arterial disease (PAD), type of wound, number of maggot applications required, wound outcomes, and nursing visit costs (week before, during, and after MDT) and noted patient experiences. Records of 68 patients (average age 71, range 22 to 95, years) were identified and abstracted. Of those, 44% had leg ulcers and 67% had both diabetes and PAD. The majority (39, 58%) of wounds required three debridement sessions. All but one patient achieved debridement of >90% of necrotic tissue in 2 to 10 days. Most wounds (56) healed with follow-up moist wound care. Only one patient withdrew from MDT. No other patient or safety concerns were documented. Total nursing visits for all patients the week before and then after MDT were 307 and 102, respectively. These findings confirm results of previous reports about the effectiveness of MDT for wound debridement. Randomized, controlled clinical studies are needed to confirm the efficacy and cost-effectiveness of MDT compared to other debridement modalities.

  1. Reproductive outcome after hysteroscopic septoplasty in patients with septate uterus - a retrospective cohort study and systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Stögbauer Lucija

    2010-05-01

    Full Text Available Abstract Background Septate uterus, one of the most common forms of congenital uterine malformations, negatively affects female reproductive health. Methods In a retrospective cohort study, we evaluated the reproductive outcome after hysteroscopic septoplasty in 64 women with septate uterus and primary or secondary infertility. We performed a systematic review of studies evaluating the reproductive outcome after hysteroscopic septoplasty. Results Sixty-four women underwent hysteroscopic septoplasty. In 2/64 (3% women, intraoperative uterine perforation occurred. Complete follow-up was available for 49/64 (76% patients. Mean follow-up time was 68.6 +/- 5.2 months. The overall pregnancy rate after hysteroscopic septoplasty was 69% (34/49. The overall life birth rate (LBR was 49% (24/49. The mean time interval between surgery and the first life birth was 35.8 +/- 22.5 months. Including our own data, we identified 18 studies investigating the effect of septoplasty on reproductive outcome in 1501 women. A pooled analysis demonstrated that hysteroscopic septoplasty resulted in an overall pregnancy rate of 60% (892/1501 and a LBR of 45% (686/1501. The overall rate of intra- and postoperative complications was 1.7% (23/1324 and the overall rate of re-hysteroscopy was 6% (79/1324. Conclusions In women with septate uterus and a history of infertility, hysteroscopic septoplasty is a safe and effective procedure resulting in a pregnancy rate of 60% and a LBR of 45%.

  2. Non-injected illicit drug use and infectious disease risk of donor tissue: a single institution retrospective review.

    Science.gov (United States)

    Barton, Mark D; Qureshi, Amir; Vijapura, Anita; Temple, H Thomas

    2015-12-01

    This study assessed the relationship of non-injected illicit drug use and infectious disease seropositivity for human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), hepatitis C virus (HCV), and Syphilis. In a retrospective review of 986 donor charts recovered from 2009 to 2011 at a single tissue bank, the absence of reported non-injected illicit drug use corresponded with seropositivity in 6.61 %, of recovered donors while reported illicit drug use in the medical and social history corresponded with seropositivity in 11.25 %, representing a 70 % increased risk. There was no significant difference noted for overall seropositivity rates between types on noninjected illicit drugs, although donors that used cocaine had a higher incidence of HIV, while marijuana use was associated with a higher rate of HBV, HCV, and syphilis positivity. Toxicology screening results were not an accurate predictor of seropositivity (PPV = 3.77 %; NPV = 91.56 %). Further, the degree of relationship between the donor and the next of kin had no bearing on the veracity of actual drug use when comparing the response of the medical-social history and the toxicology screen. PMID:26006785

  3. Incidence and Cause of Delirium in Hospitalized Patients between the Ages of 18 and 56: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Michelle T. Weckmann

    2014-01-01

    Full Text Available Background. Delirium is a common and devastating condition which has been well characterized in elderly cancer patients, but little is known about delirium in cancer patients under the age of 65. Aim. A pilot study to explore the incidence and potential causes of delirium in hospitalized advanced cancer patients at the age of 18–56 years. Design. A retrospective chart review using validated instruments was used to examine the charts of hematology-oncology admissions in a large academic institution. Data was collected as to the likelihood of delirium and potential precipitants. Results. Delirium incidence was 29% among advanced cancer patients. The associated precipitants of delirium were multifactorial, the most common being medications and infection. Delirium was more common in patients admitted for either acute symptom management or the presence of a lung malignancy. Patients with delirium demonstrated significantly increased total hospital cost and a borderline significant result for increased mortality compared to those without delirium. Conclusions. Delirium is common in hospitalized advanced cancer patients (age 18–56 years and the cause is typically multifactorial. Delirium results in a more complicated hospital course and likely increased mortality. Further research is needed to define strategies to prevent and treat this common and distressing condition.

  4. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie's disease: a retrospective analysis of 309 cases.

    Science.gov (United States)

    Paulis, Gianni; Romano, Gennaro; Paulis, Andrea

    2016-01-01

    Peyronie's disease (PD) is a chronic inflammatory disease involving the tunica albuginea of the penis. Erectile dysfunction (ED) is a possible invalidating symptom of PD. The aim of this study was to evaluate the prevalence, psychological impact, and risk factors of ED in patients with PD. The study was conducted by carrying out a retrospective analysis of the clinical records of 309 patients with PD who visited our andrology clinic. All patients underwent the following tests: body mass index, common blood tests and hormone assays, questionnaire for erectile function assessment, dynamic penile color Doppler ultrasonography, imaging of the penis at maximum erection with photographic poses according to Kelâmi, psychosexual impact evaluation with PD Questionnaire (symptom bother score), evaluation of depression symptoms with the Patient Health Questionnaire-9, and evaluation of the intensity of penile pain with the pain intensity numeric rating scale. ED was observed in 37.5% of the cases. We divided the cases into two groups: group A (PD + ED), 116 cases, and group B (PD without ED), 193 cases. After multivariate analysis, we concluded that the following comorbidities are independent risk factors for ED: dyslipidemia, obesity, chronic prostatitis, benign prostatic hyperplasia, and autoimmune diseases. A depressive disorder was observed in 62.4%, and it was more frequent in patients with PD + ED (91.37% versus 45.07% group B). Sexual bother was greater in group A compared with group B (9.7 versus 7.6). Intensities of depressive symptoms and sexual bother were significantly higher compared with cases with no curvature when the bend angle was ≥30°. Our study confirms that an integrated psychological support with medical treatment is needed in patients with PD. PMID:27486570

  5. Emphysematous gastritis: case report and literature review

    International Nuclear Information System (INIS)

    Emphysematous gastritis is a rare form of gastritis that results from infection of the stomach wall by gas-forming organisms. Diagnosis of this commonly fatal condition rests on radiological demonstration of gas within the stomach wall. This can be observed on plain radiographs or CT scans of the abdomen. Only by prompt diagnosis and treatment can mortality be avoided. A new case of empysematous gastritis, diagnosed on CT scan by the demonstration of both intramural and portal venous gas, is presented and the literature is reviewed. Copyright (2001) Blackwell Science Pty Ltd

  6. Cerebral cysticercosis: a review of 42 cases

    International Nuclear Information System (INIS)

    Forty-two cases of cysticercosis involving the central nervous system using computed tomography are reviewed. The types of involvement were classified according to an evolutionary phase of the larva and its tomographic appearance. Four main types were identified: Type I - seven patients - cysts of several sizes with discrete or no enhancement which correspond to young cysticerci; Type II - nine patients - cystic lesions with ring enhancement with dense walls representing the initial regressive phase of the parasite associated to an adjacent oedema; Type III - three patients - calcifications, mainly intraparenchymatous, presenting enhancement in the periphery without associated oedema; Type IV - two patients - calcifications with no oedema nor enhancement, signifying a residual lesion produced by the parasite. Multiple lesions were present in 26 cases and about 50% of all patients suffered combined forms of neuro cysticercosis. (author)

  7. 157例妊娠期妇女口腔疾病的回顾性分析%Retrospective analysis on 157 cases of oral disease in pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘华

    2015-01-01

    目的:总结分析妊娠期女性口腔疾病的临床特点和治疗方法,探索治疗方法。方法通过回顾性分析2009年1月至2014年12月口腔科治疗的157名妊娠患者临床资料,对疾病病因、诊断、治疗等进行分析。结果妊娠期牙周炎73例;妊娠期牙龈炎10例;冠周炎32例;牙髓炎和根尖炎患者42例。结论妊娠期口腔疾病以牙周炎比例最高,以冠周炎临床症状较重。孕妇口腔疾病容易引起早产,应重视孕前检查。%To analyze the clinical features and treatment of oral disease in pregnancy and to explore preventive methods. 157 patients from January 2009 to December 2014 were retrospectively reviewed. Etiology, diagnosis, treatment and outcome were analyzed. There were 73 cases of pregnancy periodontitis; 10 cases of pregnancy gingivitis; 32 cases of pericoronitis; 42 cases of pulpitis and papicitis. During pregnancy, there is the highest proportion of periodontitis, and the heaviest symptom of pericoronitis in oral disease. Oral disease may cause pre-mature birth easily, pregnant women should attach importance to pre-pregnancy check.

  8. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Hoffman DA

    2012-06-01

    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  9. The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases

    International Nuclear Information System (INIS)

    The objective of this retrospective analysis is to systematically assess osseous lesions on the basis of a validated scoring system in terms of stability and fractures prior to and following radiotherapy in 338 lung cancer patients with bone metastases in the vertebral column. The stability of 338 patients with 981 osteolytic metastases in the thoracic and lumbar spine was evaluated retrospectively on the basis of the Taneichi-Score between January 2000 and January 2012. 64% (215 patients) were classified stable prior to radiotherapy. Of the stable osseous metastases, none were rated unstable in the further course (p < 0.001, McNemar test). Of the 123 patients in whom the metastases were classified unstable prior to radiotherapy, 21 patients (17%) were classified stable after three months, and 30 patients (24%) stable after six months. A pathological fracture was diagnosed in 62 patients (18%) prior to radiotherapy. Regarding cases of osteolytic metastases of the vertebral bodies in which no fractures could be detected prior to the start of therapy, fractures occurred in 2% of all patients (n = 7) within six months following radiotherapy. Our analysis demonstrated that pathological fractures following radiotherapy occur in the very minority of vertebral lesions for patients with a favorable outcome. The use of a systematic radiological scoring system to classify osteolytic metastases of the vertebral column has shown to be feasible in daily routine. Prospective clinical trials are warranted in order to analyse, to what extent patients with osseous metastases can be mobilized by physiotherapy for strengthening the paravertebral muscles before radiotherapy effects can be measured by means of radiological recalcification

  10. Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

    Directory of Open Access Journals (Sweden)

    Kachelmeyer Andrea

    2011-09-01

    Full Text Available Abstract Objective The AAP recommends that a follow-up skeletal survey be obtained for all children Methods A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were Results Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7; the mean number of days between skeletal surveys was 18.7 (SD 10.1 Four children (8.5% had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75% had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. Conclusion 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.

  11. Aseptic suppurative meningitis in juvenile boxer dogs: retrospective study of 12 cases.

    Science.gov (United States)

    Behr, Sebastien; Cauzinille, Laurent

    2006-01-01

    Immune-mediated central nervous system inflammation is described in a series of 12 juvenile boxer dogs. A diagnosis of steroid-responsive meningitis-arteritis was made based on the clinical presentation and on diagnostic findings. The boxer breed was at a higher risk for this inflammatory condition than other breeds. Long-term follow-up (>2 years) confirmed a better prognosis in this breed than in the beagle and the Bernese mountain dog. Complete resolution of clinical signs without significant deficits or recurrences was obtained in all cases. Early clinical recognition and immunosuppressive treatment resulted in a better response and complete resolution of the disorder. PMID:16822766

  12. PERSIST: Physician's Evaluation of Restasis® Satisfaction in Second Trial of topical cyclosporine ophthalmic emulsion 0.05% for dry eye: a retrospective review

    Directory of Open Access Journals (Sweden)

    Mah F

    2012-11-01

    Full Text Available Francis Mah,1 Mark Milner,2 Samuel Yiu,3 Eric Donnenfeld,4 Taryn M Conway,5 David A Hollander51University of Pittsburgh, Pittsburgh, PA, 2The Eye Center, Hamden, CT, 3University of Southern California, Los Angeles, CA, 4Ophthalmic Consultants of Long Island and Connecticut, Rockville Centre, New York, NY, 5Allergan Inc, Irvine, CA, USABackground: Chronic dry eye disease often requires long-term therapy. Tear film alterations in the setting of dry eye may include reduced tear volume as well as an increase in inflammatory cytokines and osmolarity. Topical cyclosporine ophthalmic emulsion 0.05% (Restasis®; Allergan Inc, Irvine, CA is indicated to increase tear production in patients with dry eye and reduced tear production presumed to be due to ocular inflammation. This study was designed to evaluate the efficacy of a second trial of topical cyclosporine in patients with dry eye who were previously considered treatment failures.Materials and methods: This multicenter (three cornea practices retrospective chart review evaluated clinical outcomes in patients with dry eye who received a second trial of cyclosporine after a prior treatment failure, defined as prior discontinuation of topical cyclosporine after less than 12 weeks.Results: Thirty-five patients, most of whom were female (71.4% and Caucasian (62.9%, were identified. Prior discontinuation was most commonly due to burning/stinging (60%. The median duration of second treatment was 10 months (range 1 week to 45 months. Physician education was provided in the second trial in 97.1% of cases. At initiation of the second trial of cyclosporine, 10 (28.6% patients received courses of topical corticosteroids. Physicians reported on a questionnaire that 80% of patients achieved clinical benefit with a second trial of cyclosporine.Conclusion: A repeat trial with topical cyclosporine can achieve clinical success. Direct patient education via the physician and staff may be key to success. Proper patient

  13. Collagenous gastritis: a case report and review.

    Science.gov (United States)

    Ravikumara, Madhur; Ramani, Pramila; Spray, Christine H

    2007-08-01

    In this article, we report a case of collagenous gastritis in a child and review the paediatric cases reported to date. Collagenous gastritis is a rare entity, with only less than 30 cases reported so far, including 12 children, since the first description of this entity by Colletti and Trainer in 1989. This is a histological diagnosis characterised by a dramatically thickened subepithelial collagen band in the gastric mucosa associated with an inflammatory infiltrate. Children with this condition often present with epigastric pain and severe anaemia, with no evidence of extragastric involvement, in contrast to the adult patients, where chronic watery diarrhoea is the main presentation due to associated collagenous colitis. A macroscopic pattern of gastritis with nodularity of gastric mucosa, erythema and erosions are characteristic endoscopic findings in paediatric patients. Specific therapy has not been established and resolution of the abnormalities, either endoscopic or histological, has not been documented. In conclusion, collagenous gastritis is a rare entity of unknown aetiology, pathogenesis and prognosis. Gastroenterologists and pathologists need to be aware of this condition when evaluating a child with epigastric pain, anaemia and upper gastrointestinal bleeding, particularly when endoscopy reveals the nodularity of gastric mucosa. The identification, reporting and long-term follow-up of cases will shed more light on this puzzling condition. PMID:17453238

  14. Natural course of hematogenous pyogenic osteomyelitis (a retrospective study of 110 cases.

    Directory of Open Access Journals (Sweden)

    Kharbanda Y

    1991-04-01

    Full Text Available Hundred and ten consecutive cases in acute and various stages of chronicity were studied. Incidence regarding age, sex, bone affected and complications was established. The optimum way to manage osteomyelitis in different stages was sought. It was found that in acute stage early decompression of bone leads to resolution of disease. Hip involvement leads to necrosis of capital epiphysis and should be treated on an emergency basis. In the sub-acute stage it is necessary to protect the weakened bone. In chronic stage, we suggest sequestrectomy only after adequate involucrum has formed properly. Antibiotics in acute stage should be instituted as early as possible and should be continued for three weeks after the fever subsides. Antibiotics in sub-acute and chronic stage are given only in cases of reactivation of infection and around the time of surgery. Surgery, when required should be performed without too much soft tissue damage especially the covering periosteum. But repeated surgery should be avoided as they lead to cicatrization of muscles and further sequestration of bone.

  15. The epidemiology of fungemia in an infectious diseases hospital in Mexico city: A 10-year retrospective review.

    Science.gov (United States)

    Gaona-Flores, Verónica Alejandra; Campos-Navarro, Luz Arcelia; Cervantes-Tovar, Rosa María; Alcalá-Martínez, Enrique

    2016-08-01

    The epidemiology of invasive fungal infections has recently changed in immunosuppressed populations as a result of HIV infection, organ transplant, chemotherapy and in elderly patients. The diagnosis of invasive fungal infections by culture is prolonged since fungi grow slowly in vitro. we wanted to estimate the frequency of fungemia diagnoses established through the Clinical Mycology Laboratory over the past 10 years; through a retrospective study; data was obtained from the laboratory patient registry in the Infectious Disease Hospital's laboratory registry of patients with a systemic fungal isolate between 2005 and 2014. One hundred and thirty two (132) systemic fungal infections were identified. They were more prevalent in males, in the age group between 20 and 59 years and in patients with a diagnosis of AIDS. The most frequently isolated agents belonged to the genus Candida and others such as Histoplasma sp., Cryptococcus sp., Aspergillus sp., and Coccidioides sp. Of all blood and bone marrow cultures received 17.9% had fungal development; of these, in 70% of cases it was through blood cultures. In general, fungal agents were not diagnostically suspected. We identified that Sixty percent (60%) of fungemias developed in AIDS patients, followed by patients with sepsis. The most common agents belonged to the genus Candida, predominantly the albicans species. They were more frequently identified by blood culture than by bone marrow culture. Invasive fungal infections have not followed a usual clinical pattern and are not easily recognizable. PMID:27118806

  16. A retrospective study of pyometra at five RSPCA hospitals in the UK: 1728 cases from 2006 to 2011.

    Science.gov (United States)

    Gibson, A; Dean, R; Yates, D; Stavisky, J

    2013-10-26

    A retrospective cross-sectional study was used to analyse pyometra cases at five RSPCA Animal Hospitals across the UK from 2006 to 2011. A total of 1728 cases of pyometra were recovered from a female dog outpatient caseload of 78,469 animals, giving a total prevalence of 2.2 per cent over the study period. There was an annual increase in the incidence of pyometra within the population, while elective ovariohysterectomy caseload has declined. There were variations in breed and age at presentation. Bullmastiffs (Ppyometra population when compared with the female dog outpatient caseload. Mean age at presentation was 7.7 years. Some breeds presented at a significantly lower age, including dogue de Bordeaux (mean age 3.3 years) and bullmastiffs (mean age 5.4 years), while others presented as older dogs, including Yorkshire terriers (mean age 9.4 years) and border collies (mean age 10.3 years). Surgical mortality rate at the Greater Manchester Animal Hospital was 3.2 per cent. Pyometra is of significant welfare concern, and also has cost implications, particularly in charity practice. These results serve to highlight this condition so that future change in charity practice caseload can be anticipated and strategies can be directed to improve animal welfare. PMID:24114733

  17. Cervical foraminal steroid injections under CT guidance: retrospective study of in situ contrast aspects in a serial of 248 cases

    Energy Technology Data Exchange (ETDEWEB)

    Pottecher, Pierre; Krause, Denis; Di Marco, Lucy; Loffroy, Romaric; Estivalet, Louis [CHU Dijon Bocage Central, Departement de Radiologie et Imagerie Diagnostique et Interventionnelle, Dijon (France); Duhal, Romain; Demondion, Xavier [CHRU de Lille, Service de Radiologie Musculosquelettique, CCIAL, Laboratoire d' Anatomie, Faculte de Medecine de Lille, Hopital Roger Salengro, Lille (France)

    2015-01-15

    To describe all the CT findings after in situ contrast injection just before steroid injection and to recognize the abnormal aspects associated with intravascular contamination. We retrospectively evaluated 248 cervical transforaminal steroid injections done at the university hospital in Dijon, France, in 2008-2012, to treat cervicobrachial neuralgia inadequately improved by optimal medical treatment for at least 3 weeks. Features describing the opacification patterns were recorded. Five main nonvascular opacification patterns were identified: clumps of contrast agent outside the foramen (16 %), a crab claw pattern surrounding the ganglion (13 %), a ''French'' circumflex accent pattern (15 %), reflux along the needle (7 %), and facet joint capsule opacification (22 %). Concerning the situations requiring a change in needle position, intravenous injection occurred in 26 % of the patients, with a crab claw pattern in half the cases and a clump pattern in half the cases. Intraarteriolar injection was noted in two patients. CT after in situ contrast injection ensures proper needle positioning outside the blood vessels before steroid injection. Penetration of the needle tip into a vein is very common, whereas arteriolar puncture is extremely rare. (orig.)

  18. Gastric leptomeningeal carcinomatosis: Multi-center retrospective analysis of 54 cases

    Institute of Scientific and Technical Information of China (English)

    Sung Yong Oh; Su-Jin Lee; Jeeyun Lee; Suee Lee; Sung-Hyun Kim; Hyuk-Chan Kwon; Gyeong-Won Lee; Jung Hun Kang; In Gyu Hwang; Joung-Soon Jang; Ho Yeong Lim; Young Suk Park; Won Ki Kang; Hyo-Jin Kim

    2009-01-01

    AIM: To identify the clinical features and outcomes of infrequently reported leptomeningeal carcinomatosis (LMC) of gastric cancer.METHODS: We analyzed 54 cases of cytologically con- firmed gastric LMC at four institutions from 1994 to 2007.RESULTS: The male-to-female ratio was 32:22, and the patients ranged in age from 28 to 78 years (median,48.5 years). The majority of patients had advanced disease at initial diagnosis of gastric cancer. The clinical or pathologic tumor, node and metastasis stage of the primary gastric cancer was Ⅳ in 38 patients (70%).The median interval from diagnosis of the primary malignancy to the diagnosis of LMC was 6.3 mo, ranging between 0 and 73.1 mo. Of the initial endoscopic findings for the 45 available patients, 23 (51%) of the patients were Bormann type Ⅲ and 15 (33%) patients were Bormann type Ⅳ. Pathologically, 94% of cases proved to be poorly differentiated adenocarcinomas.Signet ring cell component was also observed in 40% of patients. Headache (85%) and nausea/vomiting (58%) were the most common presenting symptoms of LMC. A gadolinium-enhanced magnetic resonance imaging was conducted in 51 patients. Leptomeningeal enhancement was noted in 45 cases (82%). Intrathecal (IT) chemotherapy was administered to 36 patientsprimarily methotrexate alone (61%), but also in combination with hydrocortisone/± Ara-C (39%). The median number of IT treatments was 7 (range, 1-18). Concomitant radiotherapy was administered to 18 patients,and concomitant chemotherapy to seven patients. Seventeen patients (46%) achieved cytological negative conversion. Median overall survival duration from the diagnosis of LMC was 6.7 wk (95% CI: 4.3-9.1 wk). In the univariate analysis of survival duration, hemoglobin,IT chemotherapy, and cytological negative conversion showed superior survival duration ( P = 0.038, P = 0.010, and P = 0.002, respectively). However, in our multivariate analysis, only cytological negative conversion was predictive of

  19. Diabetes mellitus is associated with hepatocellular carcinoma: a retrospective case-control study in hepatitis endemic area.

    Directory of Open Access Journals (Sweden)

    Ze Zheng

    Full Text Available BACKGROUND: A number of case-control patient studies have been conducted to investigate the association between diabetes mellitus (DM and hepatocellular carcinoma (HCC. Despite some controversial reports, it has been suggested that DM is associated with HCC. The previous studies on this subject vary in the selection of populations, sample sizes, methodology, and analysis results. Therefore, it is necessary to further delineate the involvement of DM, together with other related risk factors, in HCC with large sample size and strict analysis methodology. METHODS: We conducted a hospital-based retrospective case-control study at Perking Union Medical College Hospital, China. A total of 1,568 patients with liver diseases were enrolled in the statistical study to evaluate the association of DM and other risk factors with HCC. Among these patients, 716 of them were diagnosed with benign liver diseases, and 852 patients were diagnosed as HCC. We utilized binary logistic regression and stepwise logistic regression to investigate the associations among DM, hypertension, fatty liver, cirrhosis, gallstone, HBV infection, HCV infection, and HCC. RESULTS: Statistical analysis through the stepwise regression model indicated that the prevalence of DM, male gender, cirrhosis, HCV infection, or HBV infection is higher in the HCC patient group compared to the control group. However, the prevalence of gallstone is negatively associated with HCC cases. DM co-exists with HBV infection, male gender, and age in the HCC cases. Binary logistic regression analysis suggested that DM may synergize with HBV infection in HCC development. CONCLUSION: DM is strongly associated with the increased risk of HCC regardless of the prevalence of HBV infection, HCV infection, cirrhosis, male gender, and age. However, the synergistic interaction between DM and HBV in HCC occurrence is significant. Therefore, DM patients with HBV infection represent a very high HCC risk population and

  20. Airway management in patients with maxillofacial trauma - A retrospective study of 177 cases

    Directory of Open Access Journals (Sweden)

    Chetan B Raval

    2011-01-01

    Full Text Available Background: Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, falls and gunshot wounds. Any flaw in airway management may lead to grave morbidity and mortality in prehospital or hospital settings and as well as for reconstruction of fractures subsequently. Methods: One hundred and seventy-seven patients of maxillofacial injuries, operated over a period of one and half years during July 2008 to December 2009 in Al-Nahdha hospital were reviewed. All patients were reviewed in depth with age related type of injury, etiology and techniques of difficult airway management. Results: The major etiology of injuries were road traffic accidents (67% followed by sport (15% and fall (15%. Majority of patients were young in the age group of 11-30 years (71 %. Fracture mandible (53% was the most common injury, followed by fracture maxilla (21%, fracture zygoma (19% and pan-facial fractures (6%. Maxillofacial injuries compromise mask ventilation and difficult airway due to facial fractures, tissue edema and deranged anatomy. Shared airway with the surgeon needs special attention due to restrictions imposed during surgery. Several methods available for securing the airway, both decision-making and performance, are important in such circumstances. Airway secured by nasal intubation with direct visualization of vocal cords was the most common (57%, followed by oral intubation (17%. Other methods like tracheostomy and blind nasal intubation was avoided by fiberoptic bronchoscopic nasal intubation in 26% of patients. Conclusion: The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the

  1. Radiographic diagnosis of bile duct cysts. Retrospective analysis of thirteen cases

    Energy Technology Data Exchange (ETDEWEB)

    Paeivaensalo, M.; Merikanto, J.; Laehde, S.; Hietala, S.O.; Leinonen, A.; Jouppila, P.; Lohela, P.; Lanning, P.

    Twelve patients and a foetus with congenital bile duct cysts suggested in the majority of cases at routine upper abdominal sonography were examined by two or more of the following investigations: Ultrasonography (10 patients), computed tomography (5 patients), CT-cholangiography (2 patients), oral cholecystography (7 patients), intravenous cholangiography (4 patients), endoscopic retrograde cholangiopancreatography (ERCP) (6 patients) and cholescintigraphy (2 patients). The sensitivity of each investigation for the diagnosis of bile duct cysts was: Ultrasound 40%, computed tomography 20%, CT-cholangiography 100%, oral cholecystography 17%, intravenous cholangiography 75%, ERCP 83% and cholescintigraphy 50%. When a bile duct cyst has been suggested by ultrasonography or other examinations, without a conclusive diagnosis being made, CT-cholangiography is recommended as the next examination. In patients with impaired biliary excretion of contrast medium, ERCP may be required to achieve the diagnosis.

  2. Retrospective exposure assessment and quality control in an international multi-centre case-control study

    DEFF Research Database (Denmark)

    Tinnerberg, H; Heikkilä, P; Huici-Montagud, A;

    2003-01-01

    to the original CA studies at the time of CA testing, but not for the whole work life. An independent occupational hygienist coordinated harmonization of the assessment criteria and the quality control procedure. The reliability of the exposure assessments was calculated as deviation from the majority......The paper presents the exposure assessment method and quality control procedure used in an international, multi-centre case-control study within a joint Nordic and Italian cohort. This study was conducted to evaluate whether occupational exposure to carcinogens influenced the predictivity of high...... was higher among the original assessors (the assessor from the same country as the subject) than the average prevalence assessed by the other four in the quality control round. The original assessors classified more job situations as exposed than the others. Several reasons for this are plausible: real...

  3. Models for retrospective quantification of indoor radon exposure in case-control studies

    International Nuclear Information System (INIS)

    In epidemiologic studies on lung cancer risk due to indoor radon the quantification of individual radon exposure over a long time period is one of the main issues. Therefore, radon measurements in one or more dwellings, which in total have been inhabited by the participants for a sufficient time-period, are necessary as well as consideration of changes of building characteristics and ventilation habits, which influence radon concentration. Given data on 1-y alpha-track measurements and personal information from 6,000 participants of case-control studies in West and East Germany, and improved method is developed to assess individual radon exposure histories. Times spent in different rooms of the dwelling, which are known from a personal questionnaire, are taken into account. The time spent outside the house varies substantially among the participants. Therefore, assuming a substantially lower radon exposure outside the dwelling, the residence time constitutes an important aspect of total radon exposure. By means of an analysis of variance, important determinants of indoor radon are identified, namely constant conditions such as type of house, type of construction, year of construction, floor and type of basement, and changeable conditions such as heating system, window insulation, and airing habits. A correction of measurements in former dwellings by factors derived from the analysis is applied if current living conditions differ from those of the participants at the time when they were living in the particular dwellings. In rare cases the adjustment for changes leads to a correction of the measurements with a factor of about 1.4, but a reduction of 5% on average only. Exposure assessment can be improved by considering time at home and changes of building and ventilation conditions that affect radon concentration. The major concern that changes in ventilation habits and building conditions lead to substantial errors in exposure assessment cannot be confirmed in the

  4. Risk factors and the clinical and surgical features of fungal prosthetic joint infections: A retrospective analysis of eight cases

    Science.gov (United States)

    Geng, Lei; Xu, Meng; Yu, Ligang; Li, Jie; Zhou, Yonggang; Wang, Yan; Chen, Jiying

    2016-01-01

    Fungal prosthetic joint infections (PJI) and reports of their clinical investigation are rare. In addition, there has been little evidence regarding the outcome of the two-stage exchange protocol for the treatment of fungal PJI. In order to investigate the risk factors and clinical, microbiological and pathological features of fungal PJIs, as well as the effects of the two-stage exchange protocol on their outcome, the present study analyzed eight retrospective fungal PJI cases, involving four cases affecting the hips and four affecting the knees, between May 2000 and March 2012. In all cases, a cemented spacer saturated with antimicrobials was used during the two-stage exchange protocol, and systematic antifungal agents were administrated during the interim period. The average follow-up duration was 4.4 years. Of the eight cases, six had undergone additional surgery on the infected joint prior to infection with the fungus. Following histological analyses, it was determined that the average number of polymorphonuclear cells in the three patients infected with a fungus was only 5/HPF. The average Harris Hip scores or Hospital for Special Surgery knee scores were 43.6 preoperatively and 86 at the last follow-up. The two-stage exchange protocol was performed eight times in seven cases, with a failure rate of 12.5%. The remaining case was successfully treated by resection arthroplasty. The average duration of antifungal agent administration during the interim period in five of the eight cases was 1.5 months. For three of the patients, the duration of antifungal agent administration was prolonged until the c-reactive protein levels were decreased to normal. The average duration of spacer implantation into the joint was 4.3 months. The results of the present study suggested that undergoing surgery on a prosthetic joint may be a potential risk factor for the development of fungal PJI. In addition, infiltration of polymorphonuclear leukocytes into the site of the infection

  5. Epidemiological characteristics of thyroid nodules and risk factors for malignant nodules: a retrospective study from 6 304 surgical cases

    Institute of Scientific and Technical Information of China (English)

    Huan Qin; Wang Kun; Lou Fuchen; Zhang Li; Huang Qingxian; Han Yunfeng; Sun Hancheng

    2014-01-01

    Background The prevalence of thyroid nodules (TN) is increasing rapidly.This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules (MN) to provide more understanding of the differential diagnosis of TN.Methods A total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study.The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN.The nature of TN (benign nodules (BN) or MN),medical records,laboratory data,and imaging data were analyzed.The risk factors for MN were screened using Spearman's rank correlation analysis and nonconditional binary Logistic regression analysis.Results The number of surgically treated TN cases increased yearly.A total of 34.33% of cases were MN and 65.67% were BN.Up to 56.74% of these cases underwent unnecessary surgery.Among the MN cases,papillary thyroid carcinoma accounted for 94%,in which 46.71% coexisted with benign thyroid disease and 32.28% with multiple foci.Single-related factor analysis showed that age,employment,disease duration,history of breast nodules and/or hypertension,the levels of serum thyroid-stimulating hormone (TSH),thyroglobulin antibody (TgAb),and thyroid peroxidase antibody (TPoAb),and ultrasound features of TN were related to MN.Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN,including <40 years old,previous history of breast nodules and/or hypertension,disease duration <1 month,employment,hypoechoic nodule,irregular nodules,nodule calcification,solid echo nodule,fuzzy boundary,rich blood flow within nodules,abnormal lymph nodes around the neck,nodule diameter <1 cm,and abnormally high TgAb.Conclusions Our results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary

  6. Combined Internal and External Fixation for Diabetic Charcot Reconstruction: A Retrospective Case Series.

    Science.gov (United States)

    Hegewald, Kenneth W; Wilder, Megan L; Chappell, Todd M; Hutchinson, Byron L

    2016-01-01

    Diabetic Charcot neuroarthropathy is a complex, limb-threatening disease process with major lifestyle-altering repercussions for patients. When Charcot neuroarthropathy leads to unstable deformity, ulceration, and potential infection despite conservative therapies, foot and ankle surgeons often consider reconstructive limb salvage procedures to restore function. The purpose of the present study was to evaluate the clinical and radiographic outcomes of diabetic Charcot reconstruction using combined internal and external fixation. A total of 22 patients were reviewed; 16 (72.73%) midfoot and 6 (27.27%) tibiotalocalcaneal arthrodesis procedures were consecutively performed from March 2009 to May 2013. All surgical procedures were performed in nonacute phases of the Charcot process in patients with diagnosed diabetes mellitus and documented peripheral neuropathy. Patients were excluded from the study if they were not diabetic despite having undergone Charcot reconstruction, regardless of the fixation method, or if they did not complete radiographic imaging. During a mean follow-up period of 58.60 ± 42.37 (range 16 to 164) weeks, limb salvage was achieved in 20 patients (90.91%), and 2 (9.09%) required below-the-knee amputation at a mean of 42 ± 14.14 weeks. Wound dehiscence occurred in 8 (36.36%), pin tract infection in 10 (45.45%), and superficial wound infection in 9 (40.91%) and peaked in bimodal fashion at 4 and 8 weeks postoperatively. Radiographic analysis of the pre- versus postoperative alignment showed statistically significant changes in the lateral talo-first metatarsal angle (p = .02) and lateral talar declination angle (p = .01). The limb salvage rates with diabetic Charcot reconstruction are improving in part because of the continued development of increasingly superior modalities for both internal and external fixation.

  7. Hip Joint Osteochondroma: Systematic Review of the Literature and Report of Three Further Cases

    Directory of Open Access Journals (Sweden)

    Asim M. Makhdom

    2014-01-01

    Full Text Available The aim of this study is to systematically review the literature with regards to surgical treatment of patients with hip joint osteochondromas, and to report our surgical management of three paediatric patients who had femoral neck or acetabular osteochondromas in association with acetabular dysplasia. We performed a systematic review using PubMed and Embase databases for all studies that reported surgical treatments for patients with peritrochanteric or acetabular osteochondroma with or without acetabular dysplasia. We also retrospectively reviewed three patients who were diagnosed with a hip osteochondroma in association with actetabular dysplasia. These patients were known to have hereditary multiple exostoses (HME. The systematic review revealed 21 studies that met our inclusion criteria. All studies were case reports and retrospective in nature and failed to conclude a uniform treatment plan. The three reported cases illustrate successful excision of hip osteochondromas and treatment of acetabular dysplasia. Early excision of hip osteochondromas might prevent acetabular dysplasia in HME patients. Routine radiographic pelvic survey at the time of diagnosis of HME is recommended for early detection of hip osteochondromas and acetabular dysplasia in these children.

  8. Intracranial germ cell tumors in adults. A retrospective study of 19 cases; Les tumeurs germinales cerebrales de l`adulte. Etude retrospective de 19 cas

    Energy Technology Data Exchange (ETDEWEB)

    Agranat, P.; Jedynak, P.; Epardeau, B.; Mignot, L. [Hopital Foch, 92 - Suresnes (France); Extra, J.M. [Hopital Saint-Louis, 75 - Paris (France)

    1995-12-31

    The authors report on the retrospective analysis of 19 patients with primary cerebral germ cell tumors which were treated between 1965 and 1993. Median age is 18 years (extremes: 16-55 years). There were 16 men and three women. The location of the primary tumor was the pineal area in six patients, suprasellar and hypothalamic area in five patients and other areas in eight patients. The histological pattern was non seminoma in six patients, dysgerminoma in eight; however no histological sample was obtained in five patients who did not have any particular characteristics (either cytological abnormalities or elevated tumor marker level). Three patients were treated by surgery only, eight patients received exclusive radiotherapy and eight patients had first line chemotherapy and further cranial irradiation. One was lost to follow up. Six of eight assessable patients with dysgerminoma are alive with non evolutive disease (NED) after 15 to 176 month of follow-up. One out of five assessable patients with non seminomatous tumor in NED (163 month of follow-up). Finally all five patients who have no histological subtyping are alive with NED at 24 to 138 months. The standard treatment of dysgerminoma is currently first line chemotherapy followed by relatively low-dose and limited irradiation; the standard treatment of non-seminomatous cerebral germ cell tumor is chemotherapy, the study of which is warranted with the aim to decrease the toxicity and to increase the efficacy. (authors). 36 refs., 7 tabs.

  9. Chlorinated pesticides and cancer of the head and neck: a retrospective case series.

    Science.gov (United States)

    Govett, Gregg; Genuis, Stephen John; Govett, Hannah E; Beesoon, Sanjay

    2011-07-01

    Cancer of the head and neck is a pervasive problem with recognized determinants including tobacco use, alcohol consumption, and earlier radiation exposure. Organochlorine pesticides (OCPs) have been shown to have carcinogenic potential in both animals and humans. OCPs have previously been widely used in the agricultural industry of rural Oklahoma. Seven patients from rural Oklahoma with head and neck cancer and without any of the usual risk factors were tested for the presence of OCPs in their adipose tissue. Clinical and toxicological data on each of these patients are presented for consideration. Results were compared with (i) levels from five individuals not experiencing cancer but who lived in the same area, and (ii) adipose tissue OCP levels in other population groups. Each of the seven patients tested had markedly elevated levels of some OCPs in their adipose tissue compared with the cohort of noncancer patients. Further research is required to confirm whether there is a causative link between OCP bioaccumulation and head and neck cancer as suggested by this case series. PMID:21633202

  10. Pituitary metastasis as a presenting manifestation of silent systemic malignancy: A retrospective analysis of four cases

    Directory of Open Access Journals (Sweden)

    P Dutta

    2011-01-01

    Full Text Available Background: Pituitary metastasis as a presenting manifestation of silent systemic malignancy is rare. We describe four such cases. Materials and Methods: Four patients (0.7% of malignancy with pituitary metastasis out of 540 patients of sellar mass within a period of 10 years were analyzed for clinical, hormonal and radiological findings. Result: The age range of these patients was 39-60 years with lag time ranging from 2to 5 months. Pituitary pathology was presenting manifestation in all 4 patients including diabetes insipidus, ophthalmoplegia and variable anterior pituitary hormone deficiency. 2 patients had bronchogenic carcinoma and one each had squamous cell and adenocarcinoma with unknown primary. Diagnosis of pituitary metastasis was confirmed in three on pituitary mass histopathology and in one it was based on rapidly appearing mass in a short time. Conclusion: Rapidly appearing mass in the sellar region, short lag time,sudden onset of ophthalmoplegia, -symptoms and signs disproportionate to the size of mass, presence of diabetes insipidus and destroyed but normal sized sella should invoke the suspicion of pituitary metastasis.

  11. Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis of 17 Cases from a Single Center in Turkey

    Directory of Open Access Journals (Sweden)

    Sibel Arınç

    2016-08-01

    Full Text Available Objective: Idiopathic chronic eosinophilic pneumonia (ICEP is a rare eosinophilic lung disorder with an unknown etiology and is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or peripheral eosinophilia, and the accumulation of eosinophils in the lungs. We aimed to present diagnostic test results and follow-up outcomes of 17 patients who were diagnosed with ICEP in our hospital in light of literature. Methods: Between 2008 and 2013, we examined 17 cases of ICEP. We evaluated clinical and laboratory findings together with the long-term follow-up data. Results: The patients had a mean age of 40.8 years at presentation, and the female/male ratio was 0.8. The most common symptoms were cough (94%, shortness of breath (76%, and high fever (35%. Bronchoalveolar lavage eosinophil percentages of the patients ranged from 3% to 80%. Nine (53% patients experienced recurrence. Six patients were maintained on low dose steroid due to repeating relapses. Among these patients, 7 (77.7% had a total IgE level of above 500/IU/mL. Conclusion: Relapses are common in ICEP after the withdrawal of corticosteroid treatment or during dose reduction. We point out the importance of the close monitoring of patients for identifying relapse. A higher total IgE level during diagnosis may serve as a predictor of recurrence.

  12. Hypofractionated electron-beam radiation therapy for keloids. Retrospective study of 568 cases with 834 lesions

    International Nuclear Information System (INIS)

    We aimed to analyze the outcomes of hypofractionated high-energy electron beam radiotherapy for the treatment of keloids. From February 1998 to January 2012, 568 patients with a total of 834 keloids underwent radiotherapy: 826 lesions with postoperative radiotherapy, and 36 with skin-grafting. Lesion size was >5 cm in 335 keloids. An electron-beam of 6 or 7 MeV was used, with a total dose of 18 Gy (two fractions with a 1-week interval) covering the lesion with a 1-cm margin. The time between surgery and radiotherapy was 24–48 h. Skin-grafted patients underwent radiotherapy 10–15 days after the operation. The median follow-up was 40 months (range: 12–160 months). The local control rate was 88.25% (736/834). The relapse rate was 9.59% (80/834), and the time to relapse was 6–28 months (median: 12 months). Univariate analyses showed that gender, age, keloid size, keloid site, skin grafting, and operation-to-irradiation interval influenced the local control rate. Multivariate analysis showed that the relapse rate was correlated with gender (P = 0.048), age (P < 0.01), operation-to-irradiation interval (P < 0.01), keloid site (P < 0.01), surgical method (P = 0.04) and keloid size (P < 0.02). Adverse effects were observed in 9.83% (82/834). No radiation-induced cancers were observed. Hypofractionated high-energy electron beam radiotherapy for keloids yielded excellent outcomes, especially in cases without skin grafting. Early postoperative radiotherapy with limited hypofractionation could be a good choice for keloid treatment. (author)

  13. Cutaneous and Subcutaneous Soft Tissue Tumours in Snakes: A Retrospective Study of 33 Cases.

    Science.gov (United States)

    Dietz, J; Heckers, K O; Aupperle, H; Pees, M

    2016-07-01

    Cutaneous and subcutaneous soft tissue tumours have been rarely described in detail in snakes. Several malignant entities show strikingly similar histological patterns and therefore the term soft tissue sarcoma (STS) has become a standard histopathological diagnosis. The present study characterizes soft tissue tumours in 33 snakes. Samples included 29 surgically excised masses and four carcasses. Additionally, six animals were humanely destroyed and submitted for necropsy examination following tumour recurrence. Benign neoplasms (n = 8) were described as lipomas of varying differentiation. Recurrence was observed in two of five snakes in which the clinical course was recorded. Malignant neoplasms (n = 25) were diagnosed as STS and graded according to a three-point system previously applied to canine STS. Five (20%) of the primary tumours were classified as grade 1, eleven (44%) as grade 2 and nine (36%) as grade 3 sarcomas. Clinically, recurrence of STS was observed in 11 of 17 cases with available follow-up information. Pathologically, multiple cutaneous metastases were found in one grass snake (Natrix natrix), while visceral metastases were observed in one carpet python (Morelia spilota) and two corn snakes (Pantherophis guttatus). Metastatic risk appears to increase with histological grade. Surgical excision generally represents the current therapy of choice for STS. This study includes the first reports of conventional lipomas in a ribbon snake (Thamnophis radix), angiolipomas in a black-headed python (Aspidites melanocephalus) and a corn snake as well as of STS in a Jamaican boa (Epicrates subflavus), emerald tree boa (Corallus caninus), grass snake (N. natrix), African house snake (Lamprophis fuliginosus), California kingsnake (Lampropeltis getula californiae) and common garter snake (Thamnophis sirtalis). PMID:27324744

  14. Cutaneous and Subcutaneous Soft Tissue Tumours in Snakes: A Retrospective Study of 33 Cases.

    Science.gov (United States)

    Dietz, J; Heckers, K O; Aupperle, H; Pees, M

    2016-07-01

    Cutaneous and subcutaneous soft tissue tumours have been rarely described in detail in snakes. Several malignant entities show strikingly similar histological patterns and therefore the term soft tissue sarcoma (STS) has become a standard histopathological diagnosis. The present study characterizes soft tissue tumours in 33 snakes. Samples included 29 surgically excised masses and four carcasses. Additionally, six animals were humanely destroyed and submitted for necropsy examination following tumour recurrence. Benign neoplasms (n = 8) were described as lipomas of varying differentiation. Recurrence was observed in two of five snakes in which the clinical course was recorded. Malignant neoplasms (n = 25) were diagnosed as STS and graded according to a three-point system previously applied to canine STS. Five (20%) of the primary tumours were classified as grade 1, eleven (44%) as grade 2 and nine (36%) as grade 3 sarcomas. Clinically, recurrence of STS was observed in 11 of 17 cases with available follow-up information. Pathologically, multiple cutaneous metastases were found in one grass snake (Natrix natrix), while visceral metastases were observed in one carpet python (Morelia spilota) and two corn snakes (Pantherophis guttatus). Metastatic risk appears to increase with histological grade. Surgical excision generally represents the current therapy of choice for STS. This study includes the first reports of conventional lipomas in a ribbon snake (Thamnophis radix), angiolipomas in a black-headed python (Aspidites melanocephalus) and a corn snake as well as of STS in a Jamaican boa (Epicrates subflavus), emerald tree boa (Corallus caninus), grass snake (N. natrix), African house snake (Lamprophis fuliginosus), California kingsnake (Lampropeltis getula californiae) and common garter snake (Thamnophis sirtalis).

  15. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

    Science.gov (United States)

    Liang, Jianmin; Hu, Juan; Chang, Huimin; Gao, Ying; Luo, Huanan; Wang, Zhenghui; Zheng, Guoxi; Chen, Fang; Wang, Ting; Yang, Yeye; Kou, Xiaohui; Xu, Min

    2015-01-01

    The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs). We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females) who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs), anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01). Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. PMID:26357477

  16. Usual interstitial pneumonia preceding collagen vascular disease: a retrospective case control study of patients initially diagnosed with idiopathic pulmonary fibrosis.

    Directory of Open Access Journals (Sweden)

    Masato Kono

    Full Text Available BACKGROUND: The aim of this study was to evaluate the cumulative incidence and the predictive factors for collagen vascular disease (CVD in patients initially diagnosed with idiopathic pulmonary fibrosis (IPF, and to examine the features of patients who then developed CVD. METHODS: This was a retrospective review of 111 consecutive patients with IPF diagnosed at our institution. None of the patients fulfilled any of the CVD criteria from the American College of Rheumatology (ACR within 6 months or more after the diagnosis of IPF. RESULTS: Ten patients (9.0% developed CVD during the follow-up period: four had rheumatoid arthritis (RA; four had microscopic polyangiitis (MPA; one had systemic sclerosis (SSc; and one had SSc and Sjogren's syndrome (SjS. The mean time until CVD diagnosis was 3.9 years. The cumulative incidences of CVD at 1, 5, and 10 years were 0.91%, 9.85%, and 15.5%, respectively. Patients who developed CVD were significantly younger, more likely to be women and had a better prognosis than those with IPF. Cox proportional hazards regression analysis showed that female sex and the presence of lymphoid aggregates with germinal centers were significantly associated with the occurrence of CVD in patients initially diagnosed with IPF. CONCLUSIONS: CVD is an important underlying condition in IPF, and shows better prognosis. The possibility of the development of CVD should remain a consideration in the follow-up of IPF.

  17. Practical experience of ustekinumab in the treatment of psoriasis: experience from a multicentre, retrospective case cohort study across the U.K. and Ireland.

    LENUS (Irish Health Repository)

    2012-02-01

    Background There are limited data on the use of ustekinumab outside of clinical trials. Objectives To assess the efficacy and safety of ustekinumab in patients with severe psoriasis attending 10 dermatology centres in the U.K. and Ireland. Methods A retrospective case-note review of 129 patients with psoriasis treated with ustekinumab. Results Baseline Psoriasis Area and Severity Index (PASI) was 22.9 +\\/- 10.1 (mean +\\/- SD). After 16 weeks of treatment with ustekinumab PASI 75 (75% reduction in PASI) was observed in 63.0% (n = 80\\/127) of patients, although four patients required concomitant therapy at the 16-week time point. Previous biologic use did show a small, non-significant trend towards treatment failure. A PASI 75 response was seen in 29.4% (n = 5\\/17) of individuals weighing 90-100 kg and treated with the standard 45 mg ustekinumab dose compared with PASI 75 of 70.3%, 71.4%, 75.0% and 55.6% for weight groups < 80, 80-90, 100-110 and > 110 kg, respectively (P = 0.024). Ustekinumab therapy was well tolerated; serious adverse events were observed in 2.3% (n = 3\\/129) of patients. Conclusions Ustekinumab is a novel biologic agent for psoriasis. When used in everyday clinical practice it demonstrates high levels of short-term therapeutic efficacy with an acceptable short-term safety profile.

  18. Management of hypertrophic pylorus stenosis with ultrasound guided single shot epidural anaesthesia - A retrospective analysis of 20 cases

    OpenAIRE

    Willschke, Harald; Machata, Anette-Marie; Rebhandl, Winfried; Benkoe, Thomas; Kettner, Stephan C; Brenner, Lydia; Marhofer, Peter

    2010-01-01

    Abstract Aim: To retrospectively describe the performance of ultrasound guided thoracic epidural anaesthesia under sedation for anaesthesia management of open pyloromyotomy. Background: Anaesthesia management for hypertrophic pylorus stenosis is usually performed under general anaesthesia with tracheal intubation. Only a few publications describe avoidance of tracheal intubation in infants by using spinal or caudal anaesthesia. The present retrospective analysis describes the pe...

  19. Survival analysis of Y-90 radiosynovectomy in the treatment of haemophilic synovitis of the knee: a 10-year retrospective review.

    Science.gov (United States)

    Turkmen, C; Kilicoglu, O; Dikici, F; Bezgal, F; Kuyumcu, S; Gorgun, O; Taser, O; Zulfikar, B

    2014-01-01

    Despite recent advances including new therapeutic options and availability of primary prophylaxis in haemophiliacs, haemophilic synovitis is still the major clinical problem in significant patient population worldwide. We retrospectively reviewed our 10-year experience with Y-90 radiosynovectomy to determine the outcome in the knee joints of patients with haemophilic synovitis. Between 2002 and 2012, 82 knee joints of 67 patients with haemophilic synovitis were treated with Y-90 radiosynovectomy. The mean age was 16.8 ± 7.8 years (range: 5-39 years). The mean follow-up period was 39.6 ± 25.6 months (range: 12-95 months). Failure of therapy represented re-bleeding after a radiosynovectomy was used as an end point in patient time to progression (TTP) analysis. The median TTP was calculated as 72.0 ± 3.6 months (95% CI 64.8-79.1 months) in Kaplan-Meier analysis. The 1, 3 and 5-year survival rates were 89%, 73% and 63% respectively. Longer TTP (hazard ratio for progression, 2.5; P = 0.00) was evident in patients who have greater reduction in bleeding frequency within 6 months after radiosynovectomy. We did not find a relationship between the TTP and the following variables: age, type and severity of haemophilia, the presence or absence of inhibitor, the radiological score, range of motion status of joints and the pretreatment bleeding frequency. We concluded that Y-90 radiosynovectomy in knee joint represents an important resource for the treatment of haemophilic synovitis, markedly reducing joint bleeding and long-term durability, irrespective of the radiographic stage and inhibitor status. PMID:23937560

  20. Retrospective Review of Watershed Characteristics and a Framework for Future Research in the Sarasota Bay Watershed, Florida

    Science.gov (United States)

    Kish, George R.; Harrison, Arnell S.; Alderson, Mark

    2008-01-01

    The U.S. Geological Survey, in cooperation with the Sarasota Bay Estuary Program conducted a retrospective review of characteristics of the Sarasota Bay watershed in west-central Florida. This report describes watershed characteristics, surface- and ground-water processes, and the environmental setting of the Sarasota Bay watershed. Population growth during the last 50 years is transforming the Sarasota Bay watershed from rural and agriculture to urban and suburban. The transition has resulted in land-use changes that influence surface- and ground-water processes in the watershed. Increased impervious cover decreases recharge to ground water and increases overland runoff and the pollutants carried in the runoff. Soil compaction resulting from agriculture, construction, and recreation activities also decreases recharge to ground water. Conventional approaches to stormwater runoff have involved conveyances and large storage areas. Low-impact development approaches, designed to provide recharge near the precipitation point-of-contact, are being used increasingly in the watershed. Simple pollutant loading models applied to the Sarasota Bay watershed have focused on large-scale processes and pollutant loads determined from empirical values and mean event concentrations. Complex watershed models and more intensive data-collection programs can provide the level of information needed to quantify (1) the effects of lot-scale land practices on runoff, storage, and ground-water recharge, (2) dry and wet season flux of nutrients through atmospheric deposition, (3) changes in partitioning of water and contaminants as urbanization alters predevelopment rainfall-runoff relations, and (4) linkages between watershed models and lot-scale models to evaluate the effect of small-scale changes over the entire Sarasota Bay watershed. As urbanization in the Sarasota Bay watershed continues, focused research on water-resources issues can provide information needed by water

  1. A Review of our Clinical Experience: 107 Spontaneus Pneumothorax Cases

    Directory of Open Access Journals (Sweden)

    Ufuk Cobanoglu

    2011-09-01

    Full Text Available Aim: Pneumothorax is the common and life threatening problem of thoracic surgery, needs urgent intervention. In this study, spontaneous pneumothorax (SP cases were divided into two groups and evaluated retrospectively according to age, sex, diagnostic methods, treatments, and results. Material and Methods: Between June 2003 and May 2006, 107 patients with SP were enrolled into our study. There were 44 (41.13% primary spontaneous pneumothorax (PSP and 74 (58.87% secondary spontaneous pneumothorax (SSP patients. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, and hospital stay of the patients were reviewed. Results: 77 patients (71.96 % were male and 30 patients (28.04 % were female and their mean age was 45.7±19.1 years. Chronic obstructive lung disease (COLD was the most common (39.68% cause detected in the cases with secondary spontaneous pneumothorax. In twenty (18.695% patients recurrence was observed and sixteen (14.95 % of these patients underwent surgery. Whereas 49 (%45.79 patients were managed by tube thoracostomy,21(19.62% patients were managed by tube thoracostomy+surgery and 19 (17.75% patients were managed by tube thoracostomy+ pleurodesis. Operative indications were prolonged air leak and bullae + recurrence. Hospital mortality was 1.86%. The mean postoperative hospitalization time of the patients was 9.1±3.5 days. Conclusions: Spontaneous pneumothorax is a pathology with low mortality and curable disease when diagnosed and treated in time. The primary treatment modality for spontaneus pneumothorax is conservative treatment or the thoracotomy depending on the degree of pneumothorax. Surgical procedures can be applied safely, with low recurrence rate, when the tube thoracostomy remains unsuccessful.

  2. Does asymptomatic septal agenesis exist? A review of 34 cases

    Energy Technology Data Exchange (ETDEWEB)

    Belhocine, Ouardia; Andre, Christine; Kalifa, Gabriel; Adamsbaum, Catherine [St Vincent de Paul Hospital, Radiology Department, Paris (France)

    2005-04-01

    Primary septal agenesis (PSA) is a rare brain malformation that can be isolated or part of developmental brain abnormalities (holoprosencephaly, septo-optic dysplasia or cortical malformation). Such associated malformation can be subtle, leading to difficulties in the prenatal management of PSA. Moreover, the neurological prognosis of isolated PSA remains debatable. The aims of the study were to specify the patterns and frequency of brain malformations associated with septal agenesis (SA), to identify the clinical prognosis, and to discuss the aetiology of PSA with the new insights provided by molecular genetics. The study consisted of a 14-year retrospective review of brain MRI in 34 patients having PSA (mean age, 5 years). Chiasm and optic nerves were not evaluated. Post-hydrocephalus SA or incomplete data were excluded. The clinical data were correlated to the MRI patterns. The study disclosed 82.5% associated lesions with MRI (28/34): 11 neuronal migration disorders, 9 holoprosencephalies (HP), 7 pituitary stalk interruptions, 1 corpus callosum partial agenesis; 17.5% (6/34) of cases were apparently isolated PAS. Clinically, the patients had motor dysfunction in 68% (23/34), mental retardation in 65% (22/34), blindness in 24% (8/34), endocrinological defects in 21% (7/34) and epilepsy in 18% (6/34) of cases. Nine percent of patients (3/34) were neurologically normal (including one with scoliosis and two infants younger than 2 years at the last follow-up). Patients with bilateral cortical anomalies and HP (even if mild) had the worst neurological prognosis. A severe motor impairment was present without evidence of hemispheric anomaly in 12% of patients (4/34). Interestingly, the frontal lobes were involved in 90% of cortical anomalies and HP, supporting the malformative aetiology of PSA. PSA rarely appears isolated and severe psychomotor impairment may occur in apparently isolated forms. These unfavourable results should be highlighted and need to be confirmed

  3. A retrospective study of pyometra at five RSPCA hospitals in the United Kingdom: 1,728 cases from 2006-2011

    OpenAIRE

    Gibson, A.; Dean, Rachel; Yates, D; Stavisky, Jenny

    2013-01-01

    A retrospective cross-sectional study was used to analyse pyometra cases at five RSPCA Animal Hospitals across the UK from 2006 to 2011. A total of 1728 cases of pyometra were recovered from a female dog outpatient caseload of 78,469 animals, giving a total prevalence of 2.2 per cent over the study period. There was an annual increase in the incidence of pyometra within the population, while elective ovariohysterectomy caseload has declined. There were variations in breed ...

  4. a retrospective review of medical records of patients in Park-Klinik Weißensee from April 1997 to September 2003

    OpenAIRE

    Gerhardt, Ulrike

    2010-01-01

    Pancreatic pseudocysts are fluid collections that frequently occur as complications of an acute or chronic pancreatitis. Acute pseudocysts in particular do have an intense tendency to involution, the necessity of a therapy only arises in symptomatic pseudocysts. The percutaneous catheter drainage has become an alternative to a surgical treatment of pancreatic pseudocysts. With the help of a retrospective review of medical records of all patients, that were medicated due to symptomatic pse...

  5. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    OpenAIRE

    Greenblatt JM; Sussman C; Jameson M; Yuan L; Hoffman DA; Iosifescu DV

    2011-01-01

    James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a refer...

  6. Retrospective assessment of the most common mitochondrial DNA mutations in a large Hungarian cohort of suspect mitochondrial cases.

    Science.gov (United States)

    Remenyi, Viktoria; Inczedy-Farkas, Gabriella; Komlosi, Katalin; Horvath, Rita; Maasz, Anita; Janicsek, Ingrid; Pentelenyi, Klara; Gal, Aniko; Karcagi, Veronika; Melegh, Bela; Molnar, Maria Judit

    2015-08-01

    Prevalence estimations for mitochondrial disorders still vary widely and only few epidemiologic studies have been carried out so far. With the present work we aim to give a comprehensive overview about frequencies of the most common mitochondrial mutations in Hungarian patients. A total of 1328 patients were tested between 1999 and 2012. Among them, 882 were screened for the m.3243A > G, m.8344A > G, m.8993T > C/G mutations and deletions, 446 for LHON primary mutations. The mutation frequency in our cohort was 2.61% for the m.3243A > G, 1.47% for the m.8344A > G, 17.94% for Leber's Hereditary Optic Neuropathy (m.3460G > A, m.11778G > A, m.14484T > C) and 0.45% for the m.8993T > C/G substitutions. Single mtDNA deletions were detected in 14.97%, while multiple deletions in 6.01% of the cases. The mutation frequency in Hungarian patients suggestive of mitochondrial disease was similar to other Caucasian populations. Further retrospective studies of different populations are needed in order to accurately assess the importance of mitochondrial diseases and manage these patients.

  7. Basal Cell Carcinoma of the Head and Neck Region: A Retrospective Analysis of Completely Excised 331 Cases

    Directory of Open Access Journals (Sweden)

    Duriye Deniz Demirseren

    2014-01-01

    Full Text Available The aim of the study is to analyze all completely excised BCCs in the head and neck region with regard to age, sex, personal and familial history, skin type, tumor localization and size, histopathological subtype of tumor, reconstruction method, and recurrence rates. Incompletely excised BCCs were not included in this study since incomplete excision is the most important preventable risk factor for recurrence. In 320 patients, 331 lesions were retrospectively evaluated by dividing into the following 8 subunits: scalp, frontotemporal, orbital, nose, cheek, auricula, perioral, and chin-neck area. Most of the patients were in 60–70 age group (34.7%. The nose (32.3% was the most common site of presentation. Clinically, all lesions and, histopathologically, most of the lesions (42.2% presented were of the nodular type. All cases of recurrence after complete excision (n=9, 2.7% were located in the median parts of the head and neck region and were mainly diagnosed histopathologically as sclerotic and micronodular. Even though completely excised, head and neck region BCCs, especially which are more prone to recurrence due to anatomical and histopathological properties, should be more closely monitored in order to decrease morbidity and health care costs.

  8. Nutmeg Poisonings: A Retrospective Review of 10 Years Experience from the Illinois Poison Center, 2001–2011

    OpenAIRE

    Ehrenpreis, Jamie E.; DesLauriers, Carol; Lank, Patrick; Armstrong, P. Keelan; Leikin, Jerrold B.

    2014-01-01

    Nutmeg is a commonly consumed spice. The toxic effects of nutmeg have been purported to be due mainly to myristicin oil. Prior poison center series of nutmeg exposures show very few unintentional exposures of nutmeg to children younger than 13. Case series from these centers did not record drug exposures combined with nutmeg. This study is a review of Illinois Poison Center (IPC) data regarding nutmeg exposures from January of 2001 to December 2011. The goal of this study was to compare the I...

  9. Melorheostosis: a review of 23 cases

    International Nuclear Information System (INIS)

    The aim of this study was to review clinical and radiological signs of melorheostosis in a large series of cases. Family history, patient history, clinical data and radiological features of 23 consecutive cases of melorheostosis were investigated. Criteria for establishing the diagnosis ''melorheostosis'' were defined. Sixteen patients (mean age 34 years, equal ratio between genders) had chronic pain in the affected limb(s) and/or subcutaneous fibrosis and/or various skin lesions. Number of involved bones: one bone (n = 10); two bones (n = 4); three or more bones (n = 9). Anatomic distribution: upper extremity (n = 5); lower extremity (n = 16); upper and lower extremity (n = 1); sacrum (n = 1). Radiologic pattern: osteoma-like (n = 7); classic candle wax appearance (n = 5); myositis ossificans-like (n = 1); osteopathia striata-like (n = 6); mixed pattern (n = 4). Patterns different from the appearance formerly judged to be ''classic'' prevail. The standard concept of disease manifestation has to be adjusted. Pathogenesis remains unclear. The classic theory claims the presence of an early embryonic infection of a sensory nerve inducing changes in the respective sclerotome, but we propose the concept of mosaicism as a better explanation for the sporadic occurrence, the asymmetric ''segmental'' pattern with variable extent of involvement and equal gender ratio of the disease. (orig.)

  10. Penile cancer: about ten cases at the University Hospital of Rabat, review of the literature

    OpenAIRE

    Slaoui, Amine; Jabbour, Youness; El Ghazoui, Anouar; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdelatif; Attaya, Ahmed Ibn

    2015-01-01

    The aim of our study was to report the status of penile cancer sites in the urology department at the University Hospital of Rabat and evaluate long-term results of surgical treatment of this cancer. Patients and Methods: Between 1989 and 2015, 10 patients were treated for penile cancer. 10 cases were retrospectively reviewed and the following data were recorded: mode of revelation, seat, staging, TNM stage, treatment, evolution and survival. The mean age of patients was 58,1 years (48-81 yea...

  11. Gastrointestinal stromal tumor masquerading as a lung neoplasm. A case presentation and literature review

    Directory of Open Access Journals (Sweden)

    Papagiannopoulos K

    2008-05-01

    Full Text Available Abstract Gastrointestinal stromal tumors (GISTs are rare neoplasms of the gastrointestinal tract. Their incidence in the esophagus is 1%–3%. Never has a GIST been documented to directly invade the lung. We report a primary esophageal GIST with direct invasion into the lung parenchyma, presenting predominantly with respiratory symptoms. We include a retrospective literature review. Although the principle 'common things are common' usually guides our everyday clinical practice, this case emphasizes that rare entities can mimic common pathologies and underlines the importance of having a clearly defined differential diagnostic list which should be meticulously scrutinized.

  12. Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix:A retrospective study with review of literature

    Directory of Open Access Journals (Sweden)

    Mamta Singla

    2016-01-01

    Full Text Available Background: Pulmonary lymphangitic carcinomatosis (LC secondary to cervical squamous cell carcinoma (SCC is an uncommon cause of diffuse infiltrative lung disease. Its reported incidence is quiet low. Materials and Methods: Fifty cases of cervical carcinoma were studied from 2005 to 2014. There was only one case of squamous cell carcinoma cervix that developed pulmonary lymphangitic carcinomatosis subsequently. Clinical manifestations of LC such as dyspnea and non-productive cough can mimic with clinical picture of pneumonia, pneumonitis, pulmonary embolism, congestive heart failure, asthma, and sarcoidosis and thus can be a diagnostic dilemma for treating physician. A review of world literature was also done to examine all the reported cases of cervical carcinoma which presented as pulmonary lymphangitic carcinomatosis. A few cases have been reported so far. Concussion: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic Squamous Cell Carcinoma (SCC of the cervix and is associated with a poor prognosis. Increased clinical alertness of such patterns of metastases in cervical cancer along with accurate pathological diagnosis is compulsory to guide proper therapy in these patients.

  13. Tracheobronchial foreign bodies in children – a retrospective study of 2,000 cases in Northwestern China

    Directory of Open Access Journals (Sweden)

    Liang JM

    2015-08-01

    Full Text Available Jianmin Liang,1 Juan Hu,1 Huimin Chang,2 Ying Gao,1 Huanan Luo,1 Zhenghui Wang,1 Guoxi Zheng,1 Fang Chen,1 Ting Wang,1 Yeye Yang,1 Xiaohui Kou,1 Min Xu1 1Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi’an Jiaotong University, 2Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Xi’an Medical University, Xi’an, People’s Republic of China Abstract: The aim of this study is to report our experience in the diagnosis and treatment of tracheobronchial foreign bodies (TFBs. We retrospectively reviewed medical records of 2,000 TFB patients (1,260 males and 740 females who were treated between January 2010 and December 2013. Chest radiography and computed tomography were performed to diagnose TFBs. The location and type of foreign bodies (FBs, anesthesia methods, and treatment outcomes and complications were analyzed. Overall, 72.5% of our patients with TFB were aged between 1 years and 3 years. Plant-based FBs are the most common FB type, accounting for 91.5%. Almost 52.1% of the FBs were encountered in the right bronchus. The coincidence rate for computed tomography-based three-dimensional reconstruction was significantly greater than that for chest X-ray examination (98.7% vs 82.0%, P<0.01. Under general anesthesia, the FBs were removed by rigid bronchoscopy. Neither anesthesia complication nor intraoperative hypoxemia occurred. There were seven deaths from acute obstructive asphyxia and eight from residual FB-induced chronic asphyxia and respiration-circulation failure. In conclusion, early diagnosis and prompt treatment of TFBs with rigid bronchoscopy under general anesthesia is effective in reducing complications and mortality in affected children. Keywords: respiratory tract foreign body, children, diagnosis, treatment

  14. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    Science.gov (United States)

    Arun, G R; Kumar, Pradeep; Patnaik, Sarthak; Selvaraj, Karthik; Rajan, David; Singh, Anant; Kumaraswamy, Vinay

    2016-01-01

    Background: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair. Materials and Methods: The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed. Results: The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery. Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair. PMID:27293291

  15. Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis: a retrospective study of 78 pediatric cases in mainland of China

    Institute of Scientific and Technical Information of China (English)

    JIN Ying-kang; XIE Zheng-de; YANG Shuang; LU Gen; SHEN Kun-ling

    2010-01-01

    Background The clinical characteristics of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) are largely unreported in the pediatric patients in mainland of China. The main aim of this study was to recognize the clinical features of EBV-HLH in children and to explore its prognosis and risk factors.Methods A retrospective study was performed on 78 pediatric patients with EBV-HLH who were admitted to Beijing Children's Hospital between 2003 and 2008. All patients' medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory and outcome information was collected. Statistical analysis was conducted via multivariate and univariate analysis.Results The age of onset peaked between 1-2 years and boys were more likely developed EBV-HLH. EBV-HLH occurred mainly in the serological pattern with EBV nuclear antigen (EBNA) positive (70.5%). The overall fatality of the disease was 56.7%. Twelve of the 39 fatalities (30.8%) died rapidly within 2 months after diagnosis. Multivariate analysis revealed that not receiving chemotherapy (P=0.002), ≥4 weeks of illness prior to diagnosis (P=0.004), and albumin levels <20 g/L (P=0.045) significantly predicted an increased fatality risk.Conclusions EBV-HLH is a severe disease with a high fatality rate that occurs mainly in the serological pattern with EBNA positive. Early initiation of chemotherapy and timely diagnosis significantly improves survival rate. Practical strategies should focus on reducing the likelihood of early death.

  16. Acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus: a retrospective case-control study

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate acute and late toxicities of radiotherapy for patients with discoid lupus erythematosus (DLE). A retrospective review was performed of patients with DLE who received radiotherapy at our institution between 1980 and 2005. Patients with other connective tissue disorders were excluded. Control patients were matched 2:1 with the DLE treatment courses based on age, cancer diagnosis, year of treatment, radiotherapy dose, and sex. Acute (within 30 days from the completion of radiotherapy) and late toxicities were evaluated for each treatment course using the Common Terminology Criteria for Adverse Events Version 3.0. Twelve patients with DLE received a total of 15 radiotherapy courses. The median follow-up time was 2.6 years (range, 0.0-15.2 years). Acute toxicity of any organ was observed in 10 (67%) treatment courses, of which 2 (13%) were Grade 3 or higher. Acute Grade 1 or 2 dermatologic toxicity was observed in 8 courses (53%). Late toxicity of any organ was observed in 7 of 12 (58%) evaluable treatment courses, of which 3 (23%) were grade 3 or higher. Late grade 1 or 2 dermatologic toxicity was observed in 5 (42%) courses. No patient experienced acute or late Grade 3 or higher dermatologic toxicity. The rates of any organ or dermatologic acute and late toxicity were not significantly different between DLE and control treatment courses. Our findings do not suggest an increased risk of toxicity to the skin or other organs in patients with DLE receiving radiotherapy

  17. Rare bilateral C3 cervical spondylolysis:Report of four cases and a literature review

    Institute of Scientific and Technical Information of China (English)

    Huaiyu Tong; Hongzhen Jiang; Xinguang Yu; Yuanzheng Zhang

    2015-01-01

    Objective:To review and discuss the etiology, diagnosis and treatment C3 of bilateral cervical spondylolysis. Methods:This was a retrospective review of the clinical features, imaginge findings, and treatment of 4 cases of bilateral C3 cervical spondylolysis, with a review of the literature. Results:A 21‐year‐old woman, a 26‐year‐old man, a 14‐year‐old boy, and a 46‐year‐old man were diagnosed with bilateral C3 cervical spondylolysis. The patients had characteristic bilateral clefts between the articular pillar and the facets of C3, as well as spina bifida on CT. Although spondylolisthesis was not observed, spinal cord compression was definitive. All patients underwent posterior decompression with satisfactory results. Conclusions:C3 cervical spondylolysis is rare condition. The cause is most likely congenital. Diagnosis is dependent on characteristic radiological features. Surgical treatment is the first choice.

  18. The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases

    OpenAIRE

    Rief, Harald; Bischof, Marc; Bruckner, Thomas; Welzel, Thomas; Askoxylakis, Vasileios; Rieken, Stefan; Lindel, Katja; Combs, Stephanie; Debus, Jürgen

    2013-01-01

    Background The objective of this retrospective analysis is to systematically assess osseous lesions on the basis of a validated scoring system in terms of stability and fractures prior to and following radiotherapy in 338 lung cancer patients with bone metastases in the vertebral column. Methods The stability of 338 patients with 981 osteolytic metastases in the thoracic and lumbar spine was evaluated retrospectively on the basis of the Taneichi-Score between January 2000 and January 2012. Re...

  19. Superior mesenteric venous thrombosis: a retrospective study of thirteen cases Trombosis de vena mesentérica superior: estudio retrospectivo de trece casos

    OpenAIRE

    S Muñoz; P. Cubo; J. González-Castillo; J. A. Nuevo; E.J. García-Lamberechts; Sanz, A

    2004-01-01

    Objective: to analyze the epidemiology, associated risk factors, clinical presentation, diagnostic methods, treatment, and evolution of patients diagnosed with superior mesenteric venous thrombosis (SMVT) at an university hospital in Madrid. Experimental design: retrospective and descriptive study. We review the medical records of patients with this diagnosis in our hospital from January 1998 to December 2002. Data were processed by using the SPSS vs. 11 software. Patients: all thirteen subje...

  20. Congenital Treves' field transmesenteric hernia in children: A case series and literature review

    Directory of Open Access Journals (Sweden)

    Ryuta Saka

    2015-08-01

    Full Text Available Transmesenteric hernia is abdominal visceral herniation through a congenital or acquired mesenteric defect. Treves' field is the area of terminal ileal mesentery circumscribed by the ileocolic artery and its last ileal branch. It is very susceptible to congenital defects. To clarify the clinical course of congenital Treves' field transmesenteric hernia (cTFTH, we retrospectively reviewed pediatric cases and conducted a literature review. Five consecutive pediatric cTFTH cases (one male, four females underwent emergency laparotomy at our institutions from April 2009 and December 2014. We analyzed their demographics, preoperative findings, surgical procedures, and outcomes, along with a literature review. Abdominal plain X-ray showed displaced intestinal gas with gas paucity in the center of the abdomen in two cases and diffusely increased intestinal gas in two others. Abdominal computed tomography (CT in four cases showed intestinal loop clusters, mesenteric vessel changes, small-bowel obstruction, and ascites. All cases underwent emergency laparotomy for ileal resection with ileocecal valve preservation. Simultaneous anastomoses were performed in four cases; the remaining case underwent ileostomy because of prematurity. Although one case needed reoperation for postoperative bowel obstruction, all patients survived. Literature review of pediatric cTFTH showed a high frequency of necrosis (70.5% and mortality (26.5%. Among pediatric cTFTH cases, 67.6% were aged <5 years. Mesenteric defect was <5 cm in 70% cases. We should be aware of the clinical importance and radiological features of pediatric cTFTH. Abdominal CT may provide useful information.

  1. Specific management of post-chikungunya rheumatic disorders: a retrospective study of 159 cases in Reunion Island from 2006-2012.

    Directory of Open Access Journals (Sweden)

    Emilie Javelle

    2015-03-01

    Full Text Available BACKGROUND: Since 2003, the tropical arthritogenic chikungunya (CHIK virus has become an increasingly medical and economic burden in affected areas as it can often result in long-term disabilities. The clinical spectrum of post-CHIK (pCHIK rheumatic disorders is wide. Evidence-based recommendations are needed to help physicians manage the treatment of afflicted patients. PATIENTS AND METHODS: We conducted a 6-year case series retrospective study in Reunion Island of patients referred to a rheumatologist due to continuous rheumatic or musculoskeletal pains that persisted following CHIK infection. These various disorders were documented in terms of their clinical and therapeutic courses. Post-CHIK de novo chronic inflammatory rheumatisms (CIRs were identified according to validated criteria. RESULTS: We reviewed 159 patient medical files. Ninety-four patients (59% who were free of any articular disorder prior to CHIK met the CIR criteria: rheumatoid arthritis (n=40, spondyloarthritis (n=33, undifferentiated polyarthritis (n=21. Bone lesions detectable by radiography occurred in half of the patients (median time: 3.5 years pCHIK. A positive therapeutic response was achieved in 54 out of the 72 patients (75% who were treated with methotrexate (MTX. Twelve out of the 92 patients (13% received immunomodulatory biologic agents due to failure of contra-indication of MTX treatment. Other patients mainly presented with mechanical shoulder or knee disorders, bilateral distal polyarthralgia that was frequently associated with oedema at the extremities and tunnel syndromes. These pCHIK musculoskeletal disorders (MSDs were managed with pain-killers, local and/or general anti-inflammatory drugs, and physiotherapy. CONCLUSION: Rheumatologists in Reunion Island managed CHIK rheumatic disorders in a pragmatic manner following the outbreak in 2006. This retrospective study describes the common mechanical and inflammatory pCHIK disorders. We provide a diagnostic

  2. Impact of compromised pulmonary function on major lung resection for non-small cell lung cancer: retrospective study of 127 cases

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yi; JIANG Ge-ning; GAO Wen; CHEN Chang

    2012-01-01

    Background Radical lung resection is the best chance for cure in patients with anatomically resectable non-small cell lung cancer.A retrospective study was performed in an attempt to investigate general rules of major lung resection for non-small cell lung cancer in patients with compromised pulmonary function.Methods Between June 2002 and December 2008,major lung resection was performed in 127 non-small cell lung cancer patients at our institution,who met the criteria of compromised pulmonary function defined as preoperative forced vital capacity <50% of prediction or preoperative forced expiratory volume in one second <50% of prediction.Clinical data of the patients were retrospectively reviewed.Results The patients consisted of 108 males (85.0%) and 19 females (15.0%) with a mean age of 61.7 years.The morbidity rate was 44.1% (56/127) and the mortality rate was 4.7% (6/127).Multivariate analysis identified PaCO2 (P=0.023,OR=2.959,95% C/ 1.164-7.522),the percent predicted postoperative diffusing capacity of the lung for carbon monoxide (P=0.001,OR=0.176,95% C/ 0.064-0.480) and comprehensive preoperative preparation (P=0.048,OR=0.417,95% C/ 0.176-0.993) as the independent predictors of postoperative cardiopuimonary complications that were found in 45 cases.Overall 1-,3- and 5-year survival rates were 90%,55% and 37% respectively.For overall survival,multivariate analysis revealed that TNM staging (P=0.004,OR=1.585,95% C/ 1.154-2.178) was the only independent prognostic factor.Conclusions On the premise of integrated preoperative evaluation and comprehensive preoperative preparation,major lung resection provides an optimal therapeutic for selected non-small cell lung cancer patients with compromised pulmonary function.Hypercapnea and the percent predicted postoperative diffusing capacity of the lung for carbon monoxide <40% could be considered as the independent predictive factors for operative risk in those patients.Chin Med J

  3. BOOK REVIEW: Case Studies in Knowledge Management

    Directory of Open Access Journals (Sweden)

    Reviewed by Dr. Adnan BOYACI

    2005-10-01

    Full Text Available 161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…etc. Because of the growingimportance and the popularity of the KM either as a research topic or specialized coursesubject, a crucial need for understanding, conceptualization and implementation of KM asa system has emerged since the mid 1990’s. In this sense, the book contributes criticallyto fill the gap between theory and implementation as a teaching material.This edited book is published by Idea Group Publishing. The book has twenty chaptersdivided into seven sections. In addition to a section of authors’ biography contributing thebook and an index, there is a preface that the basic terms and key concepts underliningthe cases discussed following chapters, which is explained in a schematized way.Besides the editor, total of 47 authors have contributed to the book. These authors arefrom different countries, academic backgrounds, and institutions. Although approximatelyone third of the authors are from USA, the rest of the authors are from Canada, England,Austria, Germany, Australia, New Zealand, Egypt, Bahrain and China. The authorsrepresent a variety of universities, private companies, and military institutions. Most ofthem have strong professional backgrounds, which help them address the issues bothfrom theoretical and practical perspectives. Contributions of authors having differentbackgrounds and institutions enable the book to have very comprehensive spectrum andthis makes the book attractive practically for those working different sectors

  4. Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series

    Science.gov (United States)

    Gay-Escoda, Cosme; Pérez-Álvarez, Débora; Camps-Font, Octavi

    2016-01-01

    Background The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. Material and Methods A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Results Nine participants (57 implants) were included. The patients’ median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Conclusions Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented. Key words:HIV infection, dental implants, oral implantology, complications, peri-implantitis, peri-implant diseases. PMID:26946205

  5. Phidippides cardiomyopathy: a review and case illustration.

    Science.gov (United States)

    Trivax, Justin E; McCullough, Peter A

    2012-02-01

    Phidippides was a Greek messenger who experienced sudden death after running more than 175 miles in two days. In today's world, marathon running and other endurance sports are becoming more popular and raising concern about sudden deaths at these events. Once etiologies such has hypertrophic cardiomyopathy, anomalous coronary arteries, and coronary atherosclerosis have been excluded, there is now an additional consideration termed Phidippides cardiomyopathy. Because endurance sports call for a sustained increase in cardiac output for several hours, the heart is put into a state of volume overload. It has been shown that approximately one-third of marathon runners experience dilation of the right atrium and ventricle, have elevations of cardiac troponin and natriuretic peptides, and in a smaller fraction later develop small patches of cardiac fibrosis that are the likely substrate for ventricular tachyarrhythmias and sudden death. Cardiac magnetic resonance imaging is emerging as the diagnostic test of choice for this condition. This review and case report summarizes the key features of this newly appreciated disorder.

  6. Orofacial pain of cardiac origin: Review literature and clinical cases

    OpenAIRE

    López-López, José; Garcia-Vicente, Laia; Jané-Salas, Enric; Estrugo-Devesa, Albert; Chimenos-Küstner, Eduardo; Roca-Elias, Josep

    2012-01-01

    The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Resu...

  7. Surgical management of solitary nerve sheath tumors of the cervical spine: a retrospective case analysis based on tumor location and extension.

    Science.gov (United States)

    Abe, Junya; Takami, Toshihiro; Naito, Kentaro; Yamagata, Toru; Arima, Hironori; Ohata, Kenji

    2014-01-01

    Complete resection of spinal nerve sheath tumors (NSTs) does not always result in significant neurological deficit. The purpose of this retrospective case analysis was to discuss the optimal surgical strategy for spinal NST of the cervical spine. Twenty-four patients who underwent surgery for solitary cervical NST over the past decade were included in this retrospective study. Patients with neurofibromatosis or schwannomatosis were excluded. Seventeen of the 24 cases (70.8%) showed extradural dumbbell extension, most frequently at the C1 or C2 vertebral level. Neurological condition was assessed using the modified McCormick functional schema and sensory pain scale. Total removal of the tumor was achieved in 20 of 24 cases (83.3%). Staged surgery using combined anterior and posterior approaches was applied for 2 of 17 cases with extradural dumbbell extension. Tumor involvement with nerve root fibers critical for upper extremity function (C5-C8) was recognized in 6 of 24 cases (25.0%), with complete resection in all 6 cases. Final assessment of neurological function revealed satisfactory or acceptable recovery in all 6 patients. Spinal NSTs with extradural dumbbell extension are a common condition in the cervical spine. Complete removal of spinal NST of the cervical spine may carry a risk of permanent neurological deficit, but such sequelae appeared to be the exception in the present case analysis. A radical and safe surgical strategy, including staged surgery combining anterior and posterior approaches, should be tailored to the individual case. PMID:25367583

  8. Scott Shuler's "Music and Education in the Twenty-First Century: A Retrospective"--Review and Response

    Science.gov (United States)

    McLain, Barbara Payne

    2014-01-01

    Predicting the future is a challenging task for music education, requiring both retrospection, analysis of current events, and foresight. This article examines several predictions from 2001 and challenges music educators to consider factors that may influence the future of teaching music in society.

  9. Giant cardiac hydatid cyst in children: case report and review of the literature.

    Science.gov (United States)

    Fiengo, Leslie; Bucci, Federico; Giannotti, Domenico; Patrizi, Gregorio; Redler, Adriano; Kucukaksu, Denis Suha

    2014-01-01

    Cardiac echinococcus is a rare affliction of the heart caused by the tapeworm Echinococcus granulosus. Primary echinococcosis of the heart represents 0.5-2% of all hydatid disease cases in endemic regions. It evolves slowly, explaining its rarity in children. We report the case of a 11-year-old child affected by a giant cardiac cyst of the left ventricle (LV). The patient underwent cardiac surgery and medical treatment. A retrospective review of the current literature was realized. We found 18 cases: the mean age was 11-years old. Nine cysts were localized in the LV, four in the interventricular septum, three in the right ventricle, and two in the right atrium. All underwent surgery except six patients. Routine echocardiographic screening may be useful in endemic regions where infestation is common. Cardiac echinococcus should be diagnosed in the early and uncomplicated stages and be removed surgically even in asymptomatic patients. PMID:25249763

  10. Transmigration of mandibular cuspids: review of published reports and description of nine new cases.

    Science.gov (United States)

    Díaz-Sánchez, Rosa-María; Castillo-de-Oyagüe, Raquel; Serrera-Figallo, María-Ángeles; Hita-Iglesias, Pilar; Gutiérrez-Pérez, José-Luis; Torres-Lagares, Daniel

    2016-04-01

    We have reviewed all documented cases of mandibular canine transmigration from 1951 (when to our knowledge the first case was published) to 2015, and retrospectively evaluated nine further sequential cases of transmigrating mandibular canines in one hospital by analysing relevant data, including patients' age and sex, presence of retained deciduous canines, radiographic changes, coexisting systemic diseases, and treatment. Transmigration of a mandibular canine is a rare anomaly of eruption, and extraction is the usual treatment. The nine new patients were aged from 16 -48 years, eight of the transmigrated canines were unilateral, and one patient had them bilaterally. They were all completely impacted. Four were retained primary teeth, and five exfoliated primary canines. Eight had no associated radiographic or clinical abnormalities, while one patient had an associated odontoma. Six mandibular canines were removed and three kept under observation. Early detection of transmigrated canines gives the opportunity to monitor their development, which may improve prognosis and treatment.

  11. Transgender Voice and Communication Treatment: A Retrospective Chart Review of 25 Cases

    Science.gov (United States)

    Hancock, Adrienne B.; Garabedian, Laura M.

    2013-01-01

    Background: People transitioning from male to female (MTF) gender seek speech-language pathology services when they feel their voice is betraying their genuine self or perhaps is the last obstacle to representing their authentic gender. Speaking fundamental frequency (pitch) and resonance are most often targets in treatment because the combination…

  12. The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases

    OpenAIRE

    Georgescu, Alexandru V.; Ileana R. Matei; Irina M. Capota

    2012-01-01

    Background: Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin grafting (SG) with or without negative pressure wound therapy and local random flaps have been used wit...

  13. Thyroid carcinoma in children and young adults: retrospective review of 19 cases.

    Science.gov (United States)

    Saraiva, Joana; Ribeiro, Cristina; Melo, Miguel; Gomes, Leonor; Costa, Gracinda; Carrilho, Francisco

    2013-01-01

    Introdução: O carcinoma da tiróide é raro em crianças e em adultos jovens. A maior parte das orientações clínicas baseia-se em dados obtidos na população adulta. Persistem diversas controvérsias no que se refere à agressividade da apresentação clínica e da abordagem terapêutica.Objectivo: Avaliar todos os doentes com carcinoma da tiróide com menos de 20 anos no momento da apresentação, reflectindo a experiência da nossa unidade relativamente ao diagnóstico, tratamento e seguimento desta entidade.Material e Métodos: Trata-se de um estudo de revisão retrospectiva dos registos clínicos de todas as crianças e adultos jovens seguidos na Consulta de Oncologia do Serviço de Endocrinologia do Centro Hospitalar e Universitário de Coimbra entre 1996 e 2012 .Resultados: Foram estudados 19 doentes, com uma média etária de 16 anos, sendo 13 do sexo feminino. Nenhum dos doentes fora previamente submetido a irradiação da região do pescoço. A queixa de apresentação era a presença de uma massa cervical palpável em 84,6% dos casos. Foi realizada citologia aspirativa em 15 doentes, que foi diagnóstica ou suspeita de neoplasia em 71,4% dos casos. A tiroidectomia total foi levada a cabo em 18 casos (94,7%). Em todos estes foi identificada a presença de um carcinoma papilar. A invasão vascular e multicêntrica ocorreu em 21,1% dos casos. A dimensão tumoral média foi de 2,5 cm. O envolvimento ganglionar cervical foi diagnosticado em 31,6% dos casos e a presença de metástases à distância foi identificada em 5,2% dos casos. Na maior parte dos doentes (18 em 19), o quadro foi classificado como doença em estadio I. Todos os doentes fizeram terapêutica supressora com tiroxina e 84,2% dos doentes foram submetidos a ablação pós-operatória com iodo radioactivo (dose média de 85,7mCi). Durante um seguimento médio de cerca de 6 anos, 16 doentes permaneceram em remissão.Conclusão: Na nossa série, as taxas de metastização ganglionar cervical e à distância foram semelhantes às encontradas na população adulta. O prognóstico foi globalmente muito satisfatório.

  14. Myelofibrosis-Associated Lymphoproliferative Disease: Retrospective Study of 16 Cases and Literature Review

    Directory of Open Access Journals (Sweden)

    A. Etienne

    2009-01-01

    Conclusions. MF-associated NHL is a rare manifestation which may be associated with all types of NHL and its presence does not seem to confer a poor prognosis. A search for lymphoproliferation should be considered when the cause of MF is not apparent.

  15. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    OpenAIRE

    Roggeri, Alessandro; Roggeri,Daniela Paola; Rossi, Elisa; Cataudella,Salvatore; Martini, Nello

    2016-01-01

    Daniela Paola Roggeri,1 Alessandro Roggeri,1 Elisa Rossi,2 Salvatore Cataudella,2 Nello Martini,3 1ProCure Solutions, Nembro, Bergamo, 2CINECA Interuniversity Consortium, Bologna, 3Accademia Nazionale di Medicina, Rome, Italy Purpose: Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy...

  16. 40 CFR 155.42 - Registration review cases.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Registration review cases. 155.42 Section 155.42 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS... review cases, including baseline dates, on its website....

  17. Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records.

    Science.gov (United States)

    Kim, Me-Riong; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Ahn, Yong-Jun; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Kim, Sung Geun; Ha, In-Hyuk

    2016-05-01

    We investigated the range and frequency of significant adverse events (AEs) in use of pharmacopuncture and acupuncture using large-scale, single-center safety data as evidence supporting safety of acupuncture with pharmacopuncture, used extensively in Asia, is scarce. Status reports (nurse records in ambulatory and inpatient care units, and administrative event records) as a part of an internal audit at a Korean Medicine hospital specializing in the treatment of musculoskeletal disorders, patient complaints filed through the hospital website, and medical records of patients visiting from December, 2010 (inception of internal audit) to October, 2014 were retrospectively reviewed. A total 80,523 patients (5966 inpatients and 74,557 outpatients) visited during this period. Inpatients received an average 31.9 ± 20.7 acupuncture, 23.0 ± 15.6 pharmacopuncture, and 15.4 ± 11.3 bee venom pharmacopuncture sessions, and outpatients were administered 8.2 ± 12.2 acupuncture, 7.8 ± 11.5 pharmacopuncture, and 10.0 ± 12.3 bee venom sessions, respectively. AEs associated with acupuncture/pharmacopuncture were forgotten needle (n = 47), hypersensitivity to bee venom (n = 37), presyncopic episode (n = 4), pneumothorax (n = 4), and infection (n = 2). Most cases were mild requiring little or no additional intervention and leaving no sequelae. Although serious AEs including infection (n = 2) and anaphylaxis associated with bee venom treatment (n = 3) were also reported, incidence was rare at 0.002% in infection and 0.019% in anaphylaxis. Incidence of AEs associated with acupuncture/pharmacopuncture treatment was low, and most cases were not serious. Still, however rare, avoidable AEs can and should be prevented through education and corrective action. Further prospective studies on the effect of error reduction strategies on incidence of adverse effects are warranted. PMID:27149503

  18. Restrictions in Quality of Life after Intramedullary Nailing of Tibial Shaft Fracture. A retrospective follow-up study of 223 cases

    DEFF Research Database (Denmark)

    Larsen, Peter; Lund, Hans; Læssøe, Uffe;

    2014-01-01

    -2008. The participants completed Knee Injury and Osteoarthritis Outcome Score (KOOS) and these data were compared with published reference population. INTERVENTION: Intramedullary nailing of tibial shaft fracture. MAIN OUTCOME MEASURES: KOOS RESULTS:A total of 223 patients agreed to participate (76%). Mean......OBJECTIVE: To evaluate the long term outcome after intramedullary nailing of tibial shaft fracture. DESIGN: Retrospective, Cross sectional study. SETTING: Level I, Trauma Center. METHODS: Retrospective review of 294 patients treated with intramedullary nailing after tibial shaft fracture from 1998...... time of follow-up was 7.9 years. Compared to reference population, the study group reported 44% higher incidence of knee pain, 39% higher incidence of ADL limitations, 58% higher incidence of limitations in QOL and 60% higher incidence of limitations during sports activities. Comparison of age related...

  19. Disability Case Adjudication and Review System

    Data.gov (United States)

    Social Security Administration — DICARS is the legacy system supporting business processes in the Disability Quality Branches (DQBs). It supports quality reviews of DDS disability determinations....

  20. Retrospective case-analysis of the magnetic resonance imaging characteristics in the brain of patients with Wilson disease

    Institute of Scientific and Technical Information of China (English)

    Hong Li; Kun You; Baoming He; Jiagui Su; Jian Hong; Changbin quan; Hin Zhao

    2006-01-01

    BACKGROUND:Wilson disease (WD)damages liver,brain,kidney,cornea and nervous system severely.It is manifested in four ways:brain,liver,kidney and bone muscle.Whether or not magnetic resonance imagling (MRI)can clearly display the diseased region and range in brain of patient with WD,which provides imageological evidence for clinical practice,is unclear.OBJECTIVE:To observe the charactedstics of MRI of brain in patient with SD,and analyze the correlation of diseased region with clinical symptoms.DESIGN:Retrospective case-analysis.SETTING:Department of Radiology,Second Hospital Affiliated to the General Hospital of Chinese PLA.PARTICIPANTS:Thirty-one patients,including 18 males and 13 females,with WD admitted to the Department of Neurology,Second Hospital Affiliated to the General Hospital of Chinese PLA between January 1999and December 2005 were retrieved.The involved patients presented serum copper oxidase (sCP) activity decreasling and/or caruloplasmin Ievel decreasling and/or urinary copper content increasling;typical extrapyramidal symptoms and/or physical sign;abnormality showed by slit-lamp examination,Kayser-Fleischer rling positive.METHODS:①All the involved patients underwent MRI examination.A GE 1.5T imagling equipment was used.Spin-echo sequence was adopted to perform T2 and T1-weighed image at transverse axis level.Partial cases subjected to head scannling at coronal and/or sagittal level.Gd-DTPA With dosage of 0.1 mmol/kg was the strongest in 4 cases.②MRI characteristics of patients with dliferent clinical symptoms were observed.MAIN OUTCOME MEASURES:MRI detection results of patients with WD and MRI characteristics of patients with different clinical symptoms.RESULTS:Thirty-one patients with WD participated in the result analysis.①Imageological examination results:WD lnvolved many regions in the brain:dorsal caudate putamen(n=28),thalamencephalon(n=25),mesencaphalon(n=25),globus pallidus(n=23),pons(n=21),posterlor limb of intemal capsule(n=16

  1. Split thickness skin grafts for the treatment of non-healing foot and leg ulcers in patients with diabetes: a retrospective review

    OpenAIRE

    John J. Anderson; Wallin, Kelly J.; Spencer, Loren

    2012-01-01

    We retrospectively reviewed 107 diabetic patients who received a split thickness skin graft (STSG) for treatment of a non-healing diabetic foot or leg ulcer to describe healing times based on patient characteristics, comorbidities or complications. The minimum follow-up was 6 months from the time of STSG application. The mean time to healing among all patients was 5.1 weeks (3 to 16 weeks). The mean healing time for patients with complications was 12.0 weeks (10 to 16 weeks) while the mean he...

  2. Psychiatric symptoms and service utilization among refugee children referred to a child psychiatry department: a retrospective comparative case note study.

    Science.gov (United States)

    Vaage, Aina Basilier; Garløv, Ida; Hauff, Edvard; Thomsen, Per Hove

    2007-09-01

    Refugee children may encounter barriers to accessing mental health services. We conducted a case-control study based on a systematic review of clinic records to compare psychopathology and service utilization in refugee and Norwegian children referred to a child psychiatry department in a county in southern Norway. Sixty-one refugee children were compared with 61 Norwegian-born children matched for gender, age and time of referral to the clinic. There was no significant difference in rates of referral or level of service utilization, which were proportional to the population. Compared with Norwegian children, refugee children were diagnosed more frequently with post-traumatic stress disorder and other affective and emotional disorders, and less often with pervasive developmental disorders and attention deficit hyperactivity disorder. The results are discussed in terms of referral pathways and the need for culturally competent care for refugee children. PMID:17938155

  3. Nutmeg poisonings: a retrospective review of 10 years experience from the Illinois Poison Center, 2001-2011.

    Science.gov (United States)

    Ehrenpreis, Jamie E; DesLauriers, Carol; Lank, Patrick; Armstrong, P Keelan; Leikin, Jerrold B

    2014-06-01

    Nutmeg is a commonly consumed spice. The toxic effects of nutmeg have been purported to be due mainly to myristicin oil. Prior poison center series of nutmeg exposures show very few unintentional exposures of nutmeg to children younger than 13. Case series from these centers did not record drug exposures combined with nutmeg. This study is a review of Illinois Poison Center (IPC) data regarding nutmeg exposures from January of 2001 to December 2011. The goal of this study was to compare the Illinois data to the literature as well as look for current trends in nutmeg poisonings. The data were extracted using the code for hallucinogenic plants in the IPC database, and poisonings unrelated to nutmeg exposure were eliminated. Medical outcomes were noted as recorded. Thirty-two cases of nutmeg ingestion were reported. Of the 17 (53.1 %) unintentional exposures, 10 subjects (58.8 %) were under the age of 13. Four of the exposures in children under the age of 13 were ocular exposures. Fifteen exposures (46.9 %) were intentional exposures. Of these intentional exposures, five (33.3 %) were recorded to have combined drug intoxication. All of these were between the ages of 15 and 20. One patient with polypharmaceutical exposure required ventilatory support in the hospital. Our study shows an unexpected percentage of unintentional exposures in juveniles under the age of 13, out of the total exposures to nutmeg. Mixing of nutmeg with other drugs was seen and required more intervention in adolescents. More education about these two factors, i.e., nutmeg exposures as intentional polypharmacy in adolescents and unintentional exposures in young children, is advised. PMID:24452991

  4. Adverse Events Associated with Yoga: A Systematic Review of Published Case Reports and Case Series

    OpenAIRE

    Cramer, Holger; Krucoff, Carol; Dobos, Gustav

    2013-01-01

    While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopeni...

  5. [Glaucoma in dogs and cats. Review and retrospective evaluation of 421 patients. I. Pathobiological background, classification and breed predisposition].

    Science.gov (United States)

    Boevé, M H; Stades, F C

    1985-03-15

    Glaucoma is diagnosed frequently in dogs and cats. A review of case records at the University of Utrecht Small Animal Clinic revealed that during a 4-year period glaucoma accounted for 8.6% of all ophthalmological diagnoses. Glaucoma is defined as an increased intraocular pressure, which sooner or later leads to loss of function of the eye. Primary and secondary types can be distinguished. In primary glaucoma an increased intraocular pressure exists in the absence of other primary eye disorders. By gonioscopy a discrimination can be made between open and narrow or closed anterior chamber angle forms of primary glaucoma. This requires a clear distinction between the definitions of chamber angle and filtration angle. In the Netherlands primary glaucoma is seen especially in the American Cocker Spaniel, Bouvier and Basset breeds. In secondary glaucoma an increased intraocular pressure occurs as a consequence of another primary eye disorder. Dislocation of the lens is the main cause for secondary glaucoma. Several-mainly small-terrier breeds are predisposed to this entity. PMID:3873120

  6. Toxoplasmose em primatas neotropicais: estudo retrospectivo de sete casos Toxoplasmosis in New World primates: Retrospective study of seven cases

    Directory of Open Access Journals (Sweden)

    Renata A. Casagrande

    2013-01-01

    Full Text Available A toxoplasmose é considerada uma doença parasitária fatal em primatas neotropicais. O objetivo deste trabalho foi descrever, através de um estudo retrospectivo, os casos de toxoplasmose em primatas neotropicais. No período de 1999-2009 foram realizados 86 exames anatomopatológicos em primatas e a toxoplasmose foi a enfermidade mais comum (7/86, relatando-se um caso em sagui-do-tufo-preto (Callithrix penicillata e seis em bugio-ruivo (Alouatta guariba. Dois animais foram encontrados mortos e cinco morreram em poucos dias. Os sinais clínicos mais frequentes foram apatia e anorexia (5/7, distensão abdominal (4/7 e febre (3/7. Na necropsia observou-se esplenomegalia (4/7, hemorragia do trato digestório, linfonodos e bexiga (4/7, pulmões avermelhados (3/7 e hepatomegalia (2/7. No exame histopatológico evidenciou-se hepatite (7/7, esplenite (3/7, miocardite (2/7, enterite (2/7, linfadenite (1/7 e sialite (1/7 necróticas e, pneumonia intersticial (4/7. Em fígado, pulmões, baço, coração, linfonodos e glândula salivar havia taquizoítos de Toxoplasma gondii que foram também detectados pelo exame de imuno-histoquímica anti-T. gondii em fígado, baço e pulmões (5/7. A toxoplasmose pode causar alta mortalidade em colônias de primatas neotropicais e representar mais uma ameaça à conversação dessas espécies em cativeiro. Sendo assim, medidas preventivas devem ser tomadas para evitar a contaminação desses animais.Toxoplasmosis is considered to be a fatal parasitic disease in New World primates. The objective of this report was to describe, through a retrospective study, the toxoplasmosis cases in New World primates. From 1999 to 2009 eighty-six anatomopathological exams was performed in primates and toxoplasmosis was the most common disease (7/86. One case occurred in Black-Tufted-Marmoset (Callithrix penicillata and six in Brown-Howler monkeys (Alouatta guariba. Two monkeys were found death and five died within few days. The most

  7. [Pulmonary hyalinizing granuloma: review of two cases].

    Science.gov (United States)

    Hantous-Zannad, S; Zidi, A; Boussema, F; Mestiri, I; Ben Hassine, R; Cherif, O; Kammoun, N; Ben Miled-M'rad, K

    2004-01-01

    Pulmonary hyalinizing granuloma is a rare fibrosing nodular disease of the lung characterized by solitary or multiples pulmonary nodules. This report describes two cases of this rare disorder. MRI was available in one case. For the first case, the stability of the lesions and past history of retroperitoneal fibrosis suggested the diagnosis. For the second case, open lung biopsy was required for diagnosis. When multiple nodules are present, metastatic disease cannot be excluded and biopsy may be required. Evolution is usually benign but follow up is necessary. PMID:15332013

  8. Larva migrans: a case report and review

    Directory of Open Access Journals (Sweden)

    Velho Paulo Eduardo Neves Ferreira

    2003-01-01

    Full Text Available A case of massive Ancylostoma sp. larval infestation is presented in a patient who had received systemic corticosteroid therapy. What attracts attention in this case is the exuberance and rarity of clinical manifestation. Based on the pertinent literature, we discuss the mechanisms of parasital infection, the natural history of the disease and its treatment.

  9. Larva migrans: a case report and review

    OpenAIRE

    Velho Paulo Eduardo Neves Ferreira; Faria Andreia Vasconcellos; Cintra Maria Letícia; Souza Elemir Macedo de; Moraes Aparecida Machado de

    2003-01-01

    A case of massive Ancylostoma sp. larval infestation is presented in a patient who had received systemic corticosteroid therapy. What attracts attention in this case is the exuberance and rarity of clinical manifestation. Based on the pertinent literature, we discuss the mechanisms of parasital infection, the natural history of the disease and its treatment.

  10. Retrospective review of thoracic neural damage during lung ablation – what the interventional radiologist needs to know about neural thoracic anatomy

    International Nuclear Information System (INIS)

    Background and Purpose: Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution. Materials and Methods: We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years. Results: Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3). Conclusion: Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications

  11. Regulatory review of safety cases and safety assessments - associated challenges

    International Nuclear Information System (INIS)

    Regulatory reviews of safety cases and safety assessments are essential for credible decision-making on the licensing or authorization of radioactive waste disposal facilities. Regulatory review also plays an important role in developing the safety case and in establishing stakeholders' confidence in the safety of the facility. Reviews of safety cases for radioactive waste disposal facilities need to be conducted by suitably qualified and experienced staff, following systematic and well-planned review processes. Regulatory reviews should be sufficiently comprehensive in their coverage of issues potentially affecting the safety of the disposal system, and should assess the safety case against clearly established criteria. The conclusions drawn from a regulatory review, and the rationale for them should be reproducible and documented in a transparent and traceable way. Many challenges are faced when conducting regulatory reviews of safety cases. Some of these relate to issues of project and programme management, and resources, while others derive from the inherent difficulties of assessing the potential long-term future behaviour of engineered and environmental systems. This paper describes approaches to the conduct of regulatory reviews and discusses some of the challenges faced. (author)

  12. Echomorphology of cardiomyopathy: review of 217 cases from 1999 to 2010

    International Nuclear Information System (INIS)

    Objective: To study echocardiogram features of different types of cardiomyopathy presenting over a 12 year period at a single centre in Peshawar. Methods: The series comprised a retrospective review of 13,788 consecutive echocardiograms carried out at the Muhammadi Hospital International Medical Research Centre, Hayatabad, Peshawar, from January 1999 to December 2010. Patients were split into two: Group I with paediatric and adolescent cases (0-18 years) and Group II with adults (>18 years). In the adult group, women with peripartum cardiomyopathy were subdivided into two groups of 18-30 years and 30 to 44 years. Standard Echo B and M modes and Doppler parameters were recorded to ascertain the diagnoses of common primary and secondary cardiomyopathies. Patients with myocarditis with chambers dilatation and global dysfunction, and cardiopathy associated with major cardiovascular diseases were excluded. SPSS 14 was used for statistical analysis. Results: Cardiomyopathy was diagnosed in 217 (1.57%) cases. There were 144 (66%) cases of dilated cardiomyopathy with a mean age of 13+-14.8 years; 17 (8%) cases of hypertrophic cardiomyopathy with a mean age of 12+-11.5 years; and 7 (3%) cases of restrictive cardiomyopathy with a mean age of 31+-7.8 years. Primary cardiac amyloidosis was confirmed in 9 (4%) cases, and peripartum cardiomyopathy in 25 (11%) females. Rare subtypes were found in 15 (7%) cases. Conclusion: DCM was the most frequently diagnosed subtype of cardiomyopathy followed by HCM in both the adult and paediatric age groups. (author)

  13. Musical obsessions: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jitender Aneja

    2015-01-01

    Full Text Available The phenomenon of musical obsessions is scantly researched and poorly established. Here we present a case with musical obsessions in addition to body dysmorphophia and severe depression and review the available literature for musical obsessions.

  14. BERTIELLOSIS IN MAN: A REVIEW OF CASES

    Directory of Open Access Journals (Sweden)

    DENEGRI Guillermo M.

    1997-01-01

    Full Text Available The presence of Bertiella mucronata and Bertiella studeri (Cestoda: Anoplocephalidae in humans is reviewed, and international infection rates and a bibliography included. Taxonomic, biological, epidemiological, pathological, diagnostic, control, prevention and therapeutic aspects of the zoonosis are analyzed, and the increase in zoonotic potentiality of the parasitosis is discussed

  15. Intracorneal vacuoles in skin diseases with parakeratotic hyperkeratosis in the dog: a retrospective light-microscopy study of 111 cases (1973-2000).

    Science.gov (United States)

    Senter, David A; Scott, Danny W; Miller, William H; Erb, Hollis N

    2002-02-01

    Two recent case reports described a congenital keratinization defect (congenital follicular parakeratosis; CFP) in Rottweiler and Siberian Husky dogs. Skin biopsy specimens revealed marked parakeratosis targeting the hair follicle and numerous intracorneal vacuoles. A retrospective histopathological study was conducted on skin biopsy specimens from 111 dogs with diseases associated with parakeratotic hyperkeratosis to determine whether intracorneal vacuoles were present. Additional criteria evaluated were the size and location of the vacuoles and the degree of parakeratosis. Cases examined included dogs with primary idiopathic seborrhoea, necrolytic migratory erythema (NME), Malassezia dermatitis, zinc-responsive dermatosis, hereditary nasal hyperkeratosis of Labrador Retriever dogs, thallotoxicosis and CFP. Thirty-seven cases (37/111, 33%) had intracorneal vacuoles, including nine cases of primary idiopathic seborrhoea (9/29, 31%), 10 cases of NME (10/18, 56%), five cases of Malassezia dermatitis (5/19, 26%), five cases of zinc-responsive dermatosis (5/36, 14%), five cases of hereditary nasal hyperkeratosis (5/5, 100%) and three cases of CFP (3/3, 100%). If present, intracorneal vacuoles were found throughout all layers of the parakeratin. The sizes of intracorneal vacuoles varied among diseases, but large (> 5 microm) vacuoles only were present in CFP. Biopsies with a larger degree of parakeratosis were significantly more likely to have intracorneal vacuoles (P = dog, but large (> 5 microm) vacuoles are found only in CFP. PMID:11896970

  16. Congenital intracranial meningioma. A case report and literature review

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1993-01-01

    A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed.......A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed....

  17. Retrospective case studies of the efficacy of caprylic triglyceride in mild-to-moderate Alzheimer’s disease

    Science.gov (United States)

    Maynard, Steven Douglas; Gelblum, Jeff

    2013-01-01

    Under normal conditions, the adult human brain is fueled primarily by glucose. A prominent feature of Alzheimer’s disease (AD) is region-specific decreases in cerebral glucose metabolism. Ketone bodies are a group of compounds produced from fat stores during periods of low glucose availability that can provide an alternative to glucose for brain metabolism. Consumption of sufficient quantities of caprylic triglyceride (CT) increases plasma concentrations of ketone bodies and may be beneficial in conditions of compromised glucose metabolism, such as AD. The present study describes the use of CT in mild-to-moderate AD in routine clinical practice. Case records from eight patients with extensive monitoring of cognitive function using the Mini-Mental State Examination (MMSE) and who had received CT for ≥6 months were reviewed. All were outpatients aged ≥50 years, cared for in standard practice, had a diagnosis of probable AD of mild-to-moderate severity (MMSE 14–24), and had received CT for at least 6 months in addition to other approved pharmacotherapy for AD. Response to CT administration as measured by MMSE scores varied by patient. However, the rate of decline in MMSE scores appeared slower than previously published reports for patients treated with pharmacotherapy alone. Profiling of individual patients may provide insight regarding those most likely to benefit from addition of CT to currently approved AD pharmacotherapy. PMID:24187498

  18. Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey

    Directory of Open Access Journals (Sweden)

    Schötzau Andreas

    2011-02-01

    Full Text Available Abstract Background In Switzerland there are about 150,000 equestrians. Horse related injuries, including head and spinal injuries, are frequently treated at our level I trauma centre. Objectives To analyse injury patterns, protective factors, and risk factors related to horse riding, and to define groups of safer riders and those at greater risk Methods We present a retrospective and a case-control survey at conducted a tertiary trauma centre in Bern, Switzerland. Injured equestrians from July 2000 - June 2006 were retrospectively classified by injury pattern and neurological symptoms. Injured equestrians from July-December 2008 were prospectively collected using a questionnaire with 17 variables. The same questionnaire was applied in non-injured controls. Multiple logistic regression was performed, and combined risk factors were calculated using inference trees. Results Retrospective survey A total of 528 injuries occured in 365 patients. The injury pattern revealed as follows: extremities (32%: upper 17%, lower 15%, head (24%, spine (14%, thorax (9%, face (9%, pelvis (7% and abdomen (2%. Two injuries were fatal. One case resulted in quadriplegia, one in paraplegia. Case-control survey 61 patients and 102 controls (patients: 72% female, 28% male; controls: 63% female, 37% male were included. Falls were most frequent (65%, followed by horse kicks (19% and horse bites (2%. Variables statistically significant for the controls were: Older age (p = 0.015, male gender (p = 0.04 and holding a diploma in horse riding (p = 0.004. Inference trees revealed typical groups less and more likely to suffer injury. Conclusions Experience with riding and having passed a diploma in horse riding seem to be protective factors. Educational levels and injury risk should be graded within an educational level-injury risk index.

  19. Ileo-sigmoid knotting: a review of 61 cases in Kenya

    Science.gov (United States)

    Ooko, Philip Blasto; Saruni, Seno; Oloo, Mark; Topazian, Hillary Mariko; White, Russell

    2016-01-01

    Introduction Ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective was to determine the presentation, management, and outcome of patients with ISK. Methods A seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya. Results A total of 61 cases were identified, with a mean age of 35.8 years (range 2-68), and mean symptom duration of 1.6 days (range 3 hours-7 days). Gangrene was noted to involve both the ileum and colon in 45 patients, the ileum only in 9 patients, and the sigmoid colon only in one. Resection and primary anastomosis was carried out in most cases of gangrenous ileum (48/54, 89%) and gangrenous sigmoid colon (34/46, 74%), while resection and stoma was performed in 8 patients with gangrenous colon. Death occurred in 7 (11.5%) patients due to severe sepsis and multisystem organ failure. Morbidities were noted in 15 (24.6%) patients, including surgical site infection (8, 13.1%), respiratory insufficiency (4, 6.6%), fascial dehiscence (3, 4.9%) and anastomotic leak (2, 3.2%). The mean duration of hospitalization was 8.3 days (range 1-26). Conclusion In this review, though retrospective in nature, ISK was noted to have high rates of bowel gangrene. In the appropriate setting, resection and primary anastomosis can be safely carried out in most cases of gangrenous colon. PMID:27347287

  20. Pompe disease: literature review and case series.

    Science.gov (United States)

    Dasouki, Majed; Jawdat, Omar; Almadhoun, Osama; Pasnoor, Mamatha; McVey, April L; Abuzinadah, Ahmad; Herbelin, Laura; Barohn, Richard J; Dimachkie, Mazen M

    2014-08-01

    Pompe disease is a rare multi-systemic metabolic myopathy caused by autosomal recessive mutations in the acidic alpha glucosidase (GAA) gene. Significant progress had been made in the diagnosis and management of patients with Pompe disease. Here, we describe our experience with 12 patients with various forms of Pompe disease including 4 potentially pathogenic, novel GAA variants. We also review the recent the recent advances in the pathogenesis, diagnosis, and treatment of individuals with Pompe disease.

  1. Efficacy of tranexamic acid in reducing blood loss in posterior lumbar spine surgery for degenerative spinal stenosis with instability: a retrospective case control study

    Directory of Open Access Journals (Sweden)

    Endres Stefan

    2011-11-01

    Full Text Available Abstract Background Degenerative spinal stenosis and instability requiring multilevel spine surgery has been associated with large blood losses. Factors that affect perioperative blood loss include time of surgery, surgical procedure, patient height, combined anterior/posterior approaches, number of levels fused, blood salvage techniques, and the use of anti-fibrinolytic medications. This study was done to evaluate the efficacy of tranexamic acid in reducing blood loss in spine surgery. Methods This retrospective case control study includes 97 patients who had to undergo surgery because of degenerative lumbar spinal stenosis and instability. All operations included spinal decompression, interbody fusion and posterior instrumentation (4-5 segments. Forty-six patients received 1 g tranexamic acid intravenous, preoperative and six hours and twelve hours postoperative; 51 patients without tranexamic acid administration were evaluated as a control group. Based on the records, the intra- and postoperative blood losses were measured by evaluating the drainage and cell saver systems 6, 12 and 24 hours post operation. Additionally, hemoglobin concentration and platelet concentration were reviewed. Furthermore, the number of red cell transfusions given and complications associated with tranexamic acid were assessed. Results The postoperative hemoglobin concentration demonstrated a statistically significant difference with a p value of 0.0130 showing superiority for tranexamic acid use (tranexamic acid group: 11.08 g/dl, SD: 1.68; control group: 10.29 g/dl, SD: 1.39. The intraoperative cell saver volume and drainage volume after 24 h demonstrated a significant difference as well, which indicates a less blood loss in the tranexamic acid group than the control group. The postoperative drainage volume at12 hours showed no significant differences; nor did the platelet concentration Allogenic blood transfusion (two red cell units was needed for eight patients

  2. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Directory of Open Access Journals (Sweden)

    Kumpf, Oliver

    2014-12-01

    Full Text Available [english] Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports.Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interestingConclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

  3. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Science.gov (United States)

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

    2014-01-01

    Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

  4. Radiation Retinopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Young Lorna

    2007-04-01

    Full Text Available Abstract Background Ocular damage from radiation treatment is a well established phenomenon. Many factors are now known to influence the incidence of radiation retinopathy, including total dosage and daily fraction size. Patients who are diabetic, hypertensive or received previous chemotherapy are more susceptible to radiation retinopathy. Case Presentation A 55 year old male was referred from the oncology department with epiphora. His medical history included Type 2 Insulin treated Diabetes Mellitus and hypertension. One year prior to presentation he had undergone a total rhinectomy with a 4 week course of post-operative radiotherapy for an aggressive sqaumous cell carcinoma of the nose. On examination the visual acuity was noted to be 6/36 left eye and 6/9 right eye. Posterior segment examination revealed marked retinal ischaemia present in the posterior pole and macular region of both eyes. The appearance was not thought to be typical of diabetic changes, radiation retinopathy being the more likely diagnosis especially in view of his history. Over the next four months the vision in both eyes rapidly deteriorated to 3/60 left eye and 1/60 right eye. Bilateral pan retinal photocoagulation was thought to be appropriate treatment at this point. Conclusion This case highlights the importance for ophthalmologists and oncologists to be aware of the close relationship between diabetes and radiation treatment and the profound rapid impact this combination of factors may have on visual function. Radiation is being used with increasing frequency for ocular and orbital disease, because of this more cases of radiation retinopathy may become prevalent. Factors which may potentiate radiation retinopathy should be well known including, increased radiation dosage, increased fraction size, concomitant systemic vascular disease and use of chemotherapy. Counselling should be offered in all cases at risk of visual loss. As no effective treatment currently exists

  5. Acute toxicity of second generation HIV protease-inhibitors in combination with radiotherapy: a retrospective case series

    International Nuclear Information System (INIS)

    There is little data on the safety of combining radiation therapy and human immunodeficiency virus (HIV) protease inhibitors to treat cancers in HIV-positive patients. We describe acute toxicities observed in a series of HIV-positive patients receiving modern radiation treatments, and compare patients receiving HIV protease inhibitors (PI) with patients not receiving HIV PIs. By reviewing the clinical records beginning January 1, 2009 from the radiation oncology department, we identified 29 HIV-positive patients who received radiation therapy to 34 body sites. Baseline information, treatment regimen, and toxicities were documented by review of medical records: patient age, histology and source of the primary tumor, HIV medication regimen, pre-radiation CD4 count, systemic chemotherapy, radiation therapy dose and fractionation, irradiated body region, toxicities, and duration of follow-up. Patients were grouped according to whether they received concurrent HIV PIs and compared using Pearson's chi-square test. At baseline, the patients in the two groups were similar with the exception of HIV medication regimens, CD4 count and presence of AIDS-defining malignancy. Patients taking concurrent PIs were more likely to be taking other HIV medications (p = 0.001) and have CD4 count >500 (p = 0.006). Patients taking PIs were borderline less likely to have an AIDS-defining malignancy (p = 0.06). After radiation treatment, 100 acute toxicities were observed and were equally common in both groups (64 [median 3 per patient, IQR 1-7] with PIs; 36 [median 3 per patient, IQR 2-3] without PIs). The observed toxicities were also equally severe in the two groups (Grades I, II, III respectively: 30, 30, 4 with PIs; 23, 13, 0 without PIs: p = 0.38). There were two cases that were stopped early, one in each group; these were not attributable to toxicity. In this study of recent radiotherapy in HIV-positive patients taking second generation PIs, no difference in toxicities was

  6. Acute toxicity of second generation HIV protease-inhibitors in combination with radiotherapy: a retrospective case series

    Directory of Open Access Journals (Sweden)

    Tran Phuoc T

    2011-03-01

    Full Text Available Abstract Background There is little data on the safety of combining radiation therapy and human immunodeficiency virus (HIV protease inhibitors to treat cancers in HIV-positive patients. We describe acute toxicities observed in a series of HIV-positive patients receiving modern radiation treatments, and compare patients receiving HIV protease inhibitors (PI with patients not receiving HIV PIs. Methods By reviewing the clinical records beginning January 1, 2009 from the radiation oncology department, we identified 29 HIV-positive patients who received radiation therapy to 34 body sites. Baseline information, treatment regimen, and toxicities were documented by review of medical records: patient age, histology and source of the primary tumor, HIV medication regimen, pre-radiation CD4 count, systemic chemotherapy, radiation therapy dose and fractionation, irradiated body region, toxicities, and duration of follow-up. Patients were grouped according to whether they received concurrent HIV PIs and compared using Pearson's chi-square test. Results At baseline, the patients in the two groups were similar with the exception of HIV medication regimens, CD4 count and presence of AIDS-defining malignancy. Patients taking concurrent PIs were more likely to be taking other HIV medications (p = 0.001 and have CD4 count >500 (p = 0.006. Patients taking PIs were borderline less likely to have an AIDS-defining malignancy (p = 0.06. After radiation treatment, 100 acute toxicities were observed and were equally common in both groups (64 [median 3 per patient, IQR 1-7] with PIs; 36 [median 3 per patient, IQR 2-3] without PIs. The observed toxicities were also equally severe in the two groups (Grades I, II, III respectively: 30, 30, 4 with PIs; 23, 13, 0 without PIs: p = 0.38. There were two cases that were stopped early, one in each group; these were not attributable to toxicity. Conclusions In this study of recent radiotherapy in HIV-positive patients taking

  7. Alcohol consumption and interpersonal injury in a pediatric oral and maxillofacial trauma population: a retrospective review of 1,192 trauma patients.

    Science.gov (United States)

    McAllister, Peter; Laverick, Sean; Makubate, Boikanyo; Jones, David Carl

    2015-06-01

    The social, financial, and health implications of adult alcohol-related oral and maxillofacial trauma have been recognized for several years. Affordability and widespread accessibility of alcohol and issues of misuse in the pediatric trauma population have fostered concerns alcohol may be similarly implicated in young patients with orofacial trauma. The aim of this study was to review data of pediatric facial injuries at a regional maxillofacial unit, assess the prevalence of alcohol use, and review data of patients sustaining injury secondary to interpersonal violence. This study is a retrospective, 3-year review of a Regional Maxillofacial Unit (RMU) trauma database. Inclusion criterion was consecutive facial trauma patients under 16 years of age, referred to RMU for further assessment and/or management. Alcohol use and injuries sustained were reviewed. Of 1,192 pediatric facial trauma patients, 35 (2.9%) were associated with alcohol intake. A total of 145 (12.2%) alleged assault as the mechanism of injury, with older (12-15 years) (n = 129; 88.9%), male (n = 124; 85.5%) (p role of alcohol in the pediatric trauma population is essential.

  8. Lipomas of the oral cavity: clinicopathological and immunohistochemical study of 24 cases and review of the literature.

    Science.gov (United States)

    Naruse, Tomofumi; Yanamoto, Souichi; Yamada, Shin-Ichi; Rokutanda, Satoshi; Kawakita, Akiko; Takahashi, Hidenori; Matsushita, Yuki; Hayashida, Saki; Imayama, Naomi; Morishita, Kota; Yamashita, Kentaro; Kawasaki, Goro; Umeda, Masahiro

    2015-03-01

    Although lipomas are common soft tissue tumors, few cases of lipoma or its variants have been reported in the oral cavity. We here described the clinical, histological, and immunohistochemical features of 24 cases of oral lipoma obtained from medical records at Nagasaki University Hospital between 1977 and 2010, and also retrospectively reviewed 603 cases of oral lipoma reported in the English literatures. The patients examined comprised 11 men and 13 women with a mean age of 59 years, ranging from 31 to 90 years. The main sites involved were the buccal mucosa (n = 9), followed by the tongue (n = 4), lip and retromolar area (n = 3), floor of the mouth (n = 2), and gingiva (n = 1). The mean tumor size was 2.0 cm, ranging from 0.2 to 5 cm. Histological analysis revealed 20 cases of lipoma, 2 cases of fibrolipoma, and one case each of intramuscular lipoma and spindle cell lipoma. Twenty-three cases were treated surgically while one case underwent biopsy and follow-up. Recurrence was not observed in any case. We reviewed the English literatures, and similar results were obtained. In immunohistochemical analysis, PCNA and ki-67 expression indices were higher in intramuscular lipoma cases than in its variants. Especially, it showed that a long time follow-up may be necessary in ki-67 positive cases.

  9. Cerebral tuberculoma:critical review of two cases

    Institute of Scientific and Technical Information of China (English)

    Amit Agrawal; Sameer Singhal; SRJoharapurkar; SJVagha; Bhushan Wani

    2008-01-01

    Central nervous system tuberculosis can have protean manifestations.We review the clinical and radiological findings in two cases of cerebral tuberculoma in immuoncompetent patients.These two cases represent the spectrum of variations of clinical and radiological features of cerebral tuberculoma and highlight the controver-sies in the approach to diagnosis and management.

  10. Erupted complex odontoma: a case report and literature review.

    Science.gov (United States)

    Litonjua, Luis A; Suresh, Lakshmanan; Valderrama, Lucia S; Neiders, Mirdza E

    2004-01-01

    A case involving a 17-year-old girl with a large erupted odontoma associated with a deeply impacted mandibular molar is reported. The molar, which previously had been displaced to the border of the mandible, erupted successfully three years after surgical removal of the odontoma. A review of the literature presents guidelines for treating similar cases.

  11. Sarcoidosis: Case Presentation and Literature Review

    Directory of Open Access Journals (Sweden)

    Dayana Alomá Fortún

    2016-09-01

    Full Text Available Sarcoidosis is a systemic disease of unknown etiology in which infectious agents have been implicated, inorganic powders or organic substances, characterized by the presence of necrotizing granulomatous inflammation with no accumulation of CD4 + lymphocytes and monocytes in the affected tissues. It is presented the case of a patient who went to the General University Hospital Dr. Gustavo Aldereguía Lima of Cienfuegos reporting dry cough, fever, chest tightness and slight weight loss three of three months evolution which did not improve despite receiving treatment in his health area. After several studies it was diagnosed a proliferative pulmonary sarcoidosis, systemic granulomatous disease whose etiology remains anonymous. Biopsy remains the basis for definitive diagnosis. As this is a difficult entity to explain and understand, besides being scarcely diagnosed in our area, it is decided to present that clinical case.

  12. Inferior Gluteal Artery Perforator Flap for Sacral Pressure Ulcer Reconstruction: A Retrospective Case Study of 11 Patients.

    Science.gov (United States)

    Lin, Chin-Ta; Ou, Kuang-Wen; Chiao, Hao-Yu; Wang, Chi-Yu; Chou, Chang-Yi; Chen, Shyi-Gen; Lee, Tzu-Peng

    2016-01-01

    Despite advances in reconstruction techniques, sacral pressure ulcers continue to present a challenge to the plastic surgeon. The flap from the gluteal crease derives blood supply from the inferior gluteal artery perforator (IGAP) and reliably preserves the entire contralateral side as a donor site. To incorporate the IGAP in the reconstruction of sacral pressure ulcers, a skin paddle over the gluteal crease was created and implemented by the authors. Data from 11 patients (8 men, 3 women; mean age 67 [range 44-85] years old) whose sacral ulcers were closed with an IGAP flap between June 2006 and May 2012 were retrieved and reviewed. All patients were bedridden; 1 patient in a vegetative state with a diagnosis of carbon monoxide intoxication was referred from a local clinic, 2 patients had Parkinson's disease, and 8 patients had a history of stroke. The average defect size was 120 cm(2) (range 88-144 cm(2)). The average flap size was 85.8 cm(2) (range 56-121 cm(2)). Only 1 flap failure occurred during surgery and was converted into V-Y advancement flap; 10 of the 11 flaps survived. After surgery, the patients' position was changed every 2 hours; patients remained prone or on their side for approximately 2 weeks until the flap was healed. After healing was confirmed, patients were discharged. Complications were relatively minor and included 1 donor site wound dehiscence that required wound reapproximation. No surgery-related mortality was noted; the longest follow-up period was 24 months. In this case series, flaps from the gluteal crease were successfully used for surgical closure of sacral pressure ulcers. This flap design should be used with caution in patients with hip contractures. Studies with larger sample sizes are needed to ascertain which type of flap is best suited to surgically manage extensive pressure ulcers in a variety of patient populations. PMID:26779702

  13. Case report and review of literatures:

    Directory of Open Access Journals (Sweden)

    Megahed Mohamed Abdl Fatah

    2016-07-01

    Full Text Available Thoracic epidural anaesthesia for elective laparoscopic myomectomy is good alternative to general anaesthesia and seems to be effective technique, with minimal hemodynamic consequences and excellent patient satisfaction and no post-operative complications provided patient cooperation, minimal inflation pressure and mild table tilt. We present here one case of laparoscopic myomectomy under thoracic epidural anaesthesia in patient with relative contraindication to general anaesthesia.

  14. [Duodenal varices. Review of the literature apropos of a case].

    Science.gov (United States)

    Boutboul, R; Le Treut, Y P; Maurin, B; Ezraty, A; Castro, R; Bricot, R

    1984-01-01

    The authors report a case of digestive hemorrhage secondary to isolated duodenal varicosities, in a patient with ethylic cirrhosis. The diagnosis done through optical fibroscope was confirmed by arteriography. The evolution was unfavorable. Lesions were corroborated by autopsy. A review of the literature is done, about the 22 cases already published. With the help of these cases to authors stress the points that can lead to the good diagnosis and what therapeutical management should be done. PMID:6335644

  15. Periocular granuloma annulare: a case report and review of literature.

    Science.gov (United States)

    Chiang, Katherine; Bhalla, Rohan; Mesinkovska, Natasha A; Piliang, Melissa P; Tamburro, Joan E

    2014-01-01

    Granuloma annulare (GA) is a granulomatous dermatosis that rarely presents on the face and is extremely uncommon in the periocular region. We report our experience with the presentation and management of GA lesions on the eyelids of a 17-year-old girl. We performed a review of published literature and identified 13 cases of pediatric periocular GA. One additional case was identified upon review of all pediatric GA cases at the Cleveland Clinic Foundation. Review of these cases suggests that periocular GA is a benign condition that spontaneously regresses within a few months. GA nodules have a predilection for the upper eyelids. A greater incidence is noted in African American children. Awareness of the self-resolving nature of this condition can prevent unnecessary surgical excisions in affected children. PMID:23551387

  16. Learning based on patient case reviews: an interview study

    Directory of Open Access Journals (Sweden)

    Søndergaard Jens

    2008-09-01

    Full Text Available Abstract Background Recent theories on adult learning recommend that learning is situated in real-life contexts. Learning is considered a continuous process in which every new experience builds on, and integrates with, previously accumulated experiences. Reviewing and reflecting on patient cases is in line with this learning approach. There has, however, been remarkably little research into how patient cases might be applied in professional education. The purpose of this article is to present family physicians' perceptions of the learning process initiated by reviewing patient cases. Methods Thirteen family physicians, who had all participated in a large project on cancer diagnosis in family practice (the CAP-project, currently carried out at the Research Unit for General Practice, University of Aarhus were interviewed on their experiences of reviewing patient cases. In the CAP-project family physicians (n = 467, 81% in the County of Aarhus (640 000 inhabitants completed 2,212 (83% detailed questionnaires on all newly diagnosed patients with cancer encountered in their practices during a one year period (2004–2005. In order to complete the questionnaire the family physicians were required to perform a systematic case review of each patient: they had to consult their records to provide dates of symptom-presentation, investigations and treatments initiated, and reflect on previous encounters with the patients to give detailed information on his/hers knowledge of the patients' care seeking behaviour, mental health and risk factors. The purpose of this article is to present indebt interview-data on family physicians' perceptions of the learning process initiated by reviewing patient cases, and their evaluations of using patient case reviews as a learning method in family practice. Results The process of reflection initiated by reviewing patient cases enabled family physicians to reconsider their clinical work procedures which potentially supported

  17. Mortality and Disease in Wild Turkeys ( Meleagris gallopavo silvestris) in Ontario, Canada, from 1992 to 2014: A Retrospective Review.

    Science.gov (United States)

    MacDonald, Amanda M; Jardine, Claire M; Campbell, G Douglas; Nemeth, Nicole M

    2016-09-01

    Wild turkeys ( Meleagris gallopavo silvestris) were extirpated from Ontario, Canada, in the early 1900s due to unregulated over-hunting and habitat loss. Despite a successful reintroduction program and strong population numbers, information regarding the health of wild turkeys in Ontario is scarce. A 22-yr (1992-2014) retrospective study was performed to evaluate diagnostic data, including the cause(s) and contributors to death, in wild turkeys submitted to the Ontario-Nunavut node of the Canadian Wildlife Health Cooperative (n = 56). Noninfectious diagnostic findings (39/56; 69.6%) were more common than infectious, with emaciation recognized most frequently (n = 19; 33.9%) followed by trauma (n = 11, 19.6%). The majority of deaths due to emaciation occurred in winter and spring (17/18; 94.4%), which is consistent with lack of access to or availability of food resources. Morbidity and mortality due to infectious diseases was diagnosed in 16 (28.6%) wild turkeys. Avian poxvirus was the most common infectious cause of disease (n = 7; 12.5%), followed by bacterial infections (n = 5; 8.9%), the most common of which was Pasteurella multocida . Zinc phosphide toxicosis (n = 7; 12.5%) occurred in two incidents involving multiple birds. This study aims to provide baseline data that can be used for reference and comparison in future wild turkey disease surveillance and population monitoring studies.

  18. Pronuclear morphology evaluation in in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI cycles: a retrospective clinical review

    Directory of Open Access Journals (Sweden)

    Nicoli Alessia

    2013-01-01

    Full Text Available Abstract Background The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the current study was to assess the role of pronuclear morphology evaluation in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI cycles. Methods Retrospective clinical analysis on 755 non-elective transfers of only one embryo (ET. Embryo assessment was performed in days 1 and 2. Clinical and biological data were recorded and analyzed according to embryo and/or pronuclear morphology. Results Both pronuclear and embryo morphology were significantly related to clinical pregnancy and live-birth rates. No significant difference in clinical pregnancy and live-birth rates was detected when the pronuclear and embryo morphology assessments were combined. Embryo morphology and maternal age were the only independent predictors of favorable outcome by logistic regression analysis. Conclusions Pronuclear evaluation is effective to select the best zygotes if ET is performed at day 1, whereas it did not improve the clinical outcomes when combined with embryo morphology evaluation in day 2.

  19. A retrospective outcomes review of patients with idiopathic normal pressure hydrocephalus treated with a low flow valve system

    Directory of Open Access Journals (Sweden)

    Phillip G. St. Louis, MD, FACS

    2015-03-01

    Full Text Available Accepted treatment of patients with Idiopathic Normal Pressure Hydrocephalus (INPH dictates the placement of a Ventriculoperitoneal (VP shunt. Selection of a valve regulated system for implantation is usually determined by the treating surgeon. Data regarding the efficacy of a Low Flow Valve (LFV are sparse. The use of this type of system may be of benefit in patients with INPH. Data from fourteen patients in the Florida Hospital NPH Program Registry with placement of a Low Flow Valve were retrospectively examined. All patients completed baselines studies to quantify gait disturbance, cognitive dysfunction, and ventriculomegaly (Evan's Ratio. Studies were repeated post three day external lumbar drain, as well as 6, 12, and 24 months post shunt placement. Significant improvement was noted in gait (Berg Balance Score at six months and one year post shunt placement. Patients improved from a "medium" fall risk to a "low" fall risk. Significant improvement in NAB was noted at 2 years of follow up, improving from "mildly impaired" to "average". Evan's ratio was stable throughout the study. There were no instances of over drainage or shunt infection. One shunt obstruction which necessitated surgical intervention was observed. Objective improvement in BERG and NAB appears to provide conclusive evidence of efficacy in this small group of patients with INPH treated with placement of an LFV and followed for two years. The absence of over-drainage as a related complication in this small group is encouraging.

  20. Supernumerary teeth: case report and literature review

    International Nuclear Information System (INIS)

    Supernumerary teeth (ST) have been an anomaly of tooth development, this is refered to the increase in the number of pieces in the normal dentition. It can be unique, multiple, unilateral or bilateral, normal or altered form; appear erupted, impacted or retained. Both dentitions are affected, but is most common in the permanent. The literature review has covered and mentioned spanned supernumerary teeth, the definition, etiology, characteristics and classification according to number, position and shape; as diagnose, alterations or clinical sequelae - eruptive associated with them and possible treatments to be done when it occurs. The presence of mechanical accidents have been a frequent complication, within this, displacement of adjacent teeth has been the most common; is associated with different syndromes such as lip and palate cleft; however, they can not be related with pathologies; being mesiodens the most frequent. (author)

  1. Epidemiology of Ornithodoros brasiliensis (mouro tick) in the southern Brazilian highlands and the description of human and animal retrospective cases of tick parasitism.

    Science.gov (United States)

    Reck, José; Marks, Fernanda S; Guimarães, Jorge A; Termignoni, Carlos; Martins, João Ricardo

    2013-02-01

    Ornithodoros brasiliensis, also known as the "mouro" tick, is an argasid tick found exclusively in the southern Brazilian highlands. O. brasiliensis parasitism is frequently associated with severe symptoms directly induced by the tick bite, a condition compatible with the definition of tick toxicosis. The objectives of this work include (i) the determination of the distribution of O. brasiliensis in farms located in the tick-endemic region, (ii) the description of the characteristics of O. brasiliensis habitats, (iii) the analysis of risk factors associated with O. brasiliensis, and (iv) the retrospective description of cases of human and animal parasitism by O. brasiliensis. Of the 30 farms included in this study, O. brasiliensis was identified on 5 farms (frequency 16.7%), in which several ticks found in high density buried in soil were collected. Information regarding the tick habitats and the local population was recorded. The data indicated that O. brasiliensis feeds on humans, dogs, armadillos (Dasypus hybridus), and possibly skunks (Conepatus chinga). The analysis of risk factors indicated that the presence of house basements with an unpaved (natural soil) floor on farms and insufficient sanitary conditions significantly enhanced the probability of identifying O. brasiliensis. Additionally, we describe retrospectively cases of tick parasitism in 28 humans and 11 dogs including the most common symptoms associated with tick toxicosis. This is the first study concerning O. brasiliensis epidemiology, distribution, and habitat, and the report represents the most comprehensive characterization of Ornithodoros bite-associated toxicosis syndrome. PMID:23238249

  2. 78 FR 52580 - Submission for Review: Request for Case Review for Enhanced Disability Annuity Benefit, RI 20-123

    Science.gov (United States)

    2013-08-23

    ... MANAGEMENT Submission for Review: Request for Case Review for Enhanced Disability Annuity Benefit, RI 20-123... collection request (ICR) 3206-0254, Request for Case Review for Enhanced Disability Annuity Benefit, RI 20..., Office of Personnel Management. Title: Request for Case Review for Enhanced Disability Annuity...

  3. Metastatic lesions involving the sella: Report of three cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Weilbaecher Christina

    2004-07-01

    Full Text Available Metastatic cancer must be considered as a possibility for intrasellar masses. Newer treatment modalities, such as gamma knife radiosurgery needs to be explored for these lesions. Three cases of intrasellar metastatic lesions were retrospectively reviewed. Presenting complaints, radiographic studies, operative procedure, and histopathological confirmation were recorded for each patient. All had an unknown primary malignancy prior to the presentation with the intrasellar lesion detected by magnetic resonance imaging (MRI. Presenting symptoms were diplopia with extraocular movement deficits in all patients. Transsphenoidal resection or biopsy was performed. Histopathological analysis revealed small cell carcinoma in two patients and plasmacytoma in one. All patients received postoperative radiation and/or chemotherapy. Survival following initial presentation was 2 months and 6 months for two of the patients; the third patient is alive at 2-month follow-up.

  4. Acral lentiginous melanoma of the foot and ankle: A case series and review of the literature

    Directory of Open Access Journals (Sweden)

    Acland Katharine

    2008-09-01

    Full Text Available Abstract Background Acral lentiginous melanoma (ALM is an uncommon, cutaneous malignant tumour which may arise on the foot. Its relative rarity, atypical appearance and late presentation frequently serve as poor prognostic indicators. Methods At a tertiary skin tumour centre, a retrospective review was undertaken of all patients diagnosed with the tumour at the level of ankle or below. Results Over a six year period, 27 cases (20 female, 7 male were identified with positive histology confirming the disease. The age ranged from 35–96 years of age (mean 62.7 years. The majority of the cohort were white (59% with plantar lesions (62%. 33% of patients were initially were diagnosed incorrectly. The average time taken from the point of recognition, by the patient, to the lesion being correctly diagnosed was around 13.5 months. Conclusion Earlier diagnosis of ALM requires education at both a patient and practitioner level.

  5. AB133. Xanthogranulomatous prostatitis with benign prostatic hyperplasia: a case report and review of the literature

    Science.gov (United States)

    Wang, Anxi

    2016-01-01

    Objective To improve the level of diagnosis and treatment of xanthogranulomatous prostatitis. Methods The clinical data of a case of xanthogranulomatous prostatitis were analyzed retrospectively and discussed with relative literature review. Results A 56-year-old man presented with a 1 month history of difficult urination, which was exacerbated for 10 days. The patient was confirmed with xanthogranulomatous prostatitis with chronic suppurative inflammation and abscess by pathologic diagnosis after plasmakinetic resection of the prostate (PKRP). The patient achieved smooth voiding and was discharged after operation for one week. Urination was normal during two months follow up. Conclusions Xanthogranulomatous prostatitis is rare clinical disease, which should be excluded from prostate cancer and can be confirmed by pathobiology. According to the degree of lower urinary tract obstruction, it is treated by medicine or surgical operation. Examination of PSA regularly and long-term follow-up must be performed.

  6. PRIMARY MALIGNANT MELANOMA OF ESOPHAGUS: REPORT OF FOUR CASES AND REVIEW OF THE LITERATURES

    Institute of Scientific and Technical Information of China (English)

    张辉; 汪良骏; 赵峻

    2002-01-01

    Objective: To investigate the clinical features and prognosis of the primary malignant melanoma of esophagus, to try to find out a rational therapy and to evaluate the value of surgical resection. Methods: Retrospective study was conducted for four cases with Primary malignant melanoma of esophagus hospitalized from May 1975 to April 1999. The relevant literatures of primary malignant melanoma of esophagus in recent years were also reviewed. Results: Four patients received multimodality therapy including surgical resection. The survival time is 16 years, 53 months, 5 months and 6 months, respectively. Conclusion: Primary malignant melanoma of the esophagus has a poor prognosis. Surgical resection plays an important role and is indispensable. The patterns of combination treatment modality need further investigation. Preoperative therapy combined with surgical resection and post-operative therapy may be a better management.

  7. Primary neuroendocrine tumor of the sacrum: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Dujardin, Fanny; Muret, Anne de [Hopital Trousseau, CHRU de Tours, Department of Pathology, Tours (France); Beaussart, Pauline; Waynberger, Eric [Hopital Trousseau, CHRU de Tours, Department of Radiology, Tours (France); Rosset, Philippe [Hopital Trousseau, CHRU de Tours, Department of Orthopaedic Surgery, Tours (France); Mulleman, Denis [Hopital Trousseau, CHRU de Tours, Department of Rheumatology, Tours (France); Pinieux, Gonzague de [Hopital Trousseau, CHRU de Tours, Department of Pathology, Tours (France); Hopital Trousseau, CHRU de Tours, Service d' Anatomie et Cytologie Pathologiques, Tours Cedex 09 (France)

    2009-08-15

    Primary carcinoid tumor (well-differentiated neuroendocrine tumor) of the bone involving the sacrum is extremely rare. We report the case of a 72-year-old man who presented with a 20-year history of intermittent low back pain and was found to have an intraosseous sacral mass on imaging. A needle biopsy revealed that this lesion was a well-differentiated neuroendocrine tumor. Workup did not show any primary tumor or other metastatic disease. There was no associated tailgut cyst or sacrococcygeal teratoma. The lesion was treated with radiation therapy because a surgical approach was rejected. The patient is free of metastatic disease after 28 years evolution of the lesion, retrospectively seen to be present on a conventional radiography performed in 1980. A review of the literature revealed 20 case reports of neuroendocrine tumors arising from the presacral region (with or without associated tailgut cyst or sacrococcygeal teratoma) and sometimes extending to the sacrum. One additional case was located within the neural canal and involved the sacrum, the presacral region, and the rectal wall. Our case is the only tumor arising primarily from the sacrum. The long evolution of this lesion without any other location makes metastatic disease very improbable and this case appears to be a unique example of primary intraosseous sacral carcinoid tumor. (orig.)

  8. Primary neuroendocrine tumor of the sacrum: case report and review of the literature.

    Science.gov (United States)

    Dujardin, Fanny; Beaussart, Pauline; de Muret, Anne; Rosset, Philippe; Waynberger, Eric; Mulleman, Denis; de Pinieux, Gonzague

    2009-08-01

    Primary carcinoid tumor (well-differentiated neuroendocrine tumor) of the bone involving the sacrum is extremely rare. We report the case of a 72-year-old man who presented with a 20-year history of intermittent low back pain and was found to have an intraosseous sacral mass on imaging. A needle biopsy revealed that this lesion was a well-differentiated neuroendocrine tumor. Workup did not show any primary tumor or other metastatic disease. There was no associated tailgut cyst or sacrococcygeal teratoma. The lesion was treated with radiation therapy because a surgical approach was rejected. The patient is free of metastatic disease after 28 years evolution of the lesion, retrospectively seen to be present on a conventional radiography performed in 1980. A review of the literature revealed 20 case reports of neuroendocrine tumors arising from the presacral region (with or without associated tailgut cyst or sacrococcygeal teratoma) and sometimes extending to the sacrum. One additional case was located within the neural canal and involved the sacrum, the presacral region, and the rectal wall. Our case is the only tumor arising primarily from the sacrum. The long evolution of this lesion without any other location makes metastatic disease very improbable and this case appears to be a unique example of primary intraosseous sacral carcinoid tumor. PMID:19360403

  9. Evaluation of Streptococcus pneumoniae in bile samples: A case series review.

    Science.gov (United States)

    Itoh, Naoya; Kawamura, Ichiro; Tsukahara, Mika; Mori, Keita; Kurai, Hanako

    2016-06-01

    Although Streptococcus pneumoniae is an important pathogen of humans, pneumococcal cholangitis is rare because of the rapid autolysis of S. pneumoniae. The aim of this case series was to review patients with bile cultures positive for S. pneumoniae. This study was a single center retrospective case series review of patients with S. pneumoniae in their bile at a tertiary-care cancer center between September 2002 and August 2015. Subjects consisted of all patients in whom S. pneumoniae was isolated in their bile during the study period. Bile specimens for culture were obtained from biliary drainage procedures such as endoscopic retrograde biliary drainage, endoscopic nasobiliary drainage, and percutaneous transhepatic biliary drainage. There were 20 patients with bile cultures positive for S. pneumoniae during the study period. All patients presented with extrahepatic obstructive jaundice due to hepatopancreatobiliary tumors. Nineteen of 20 patients underwent the placement of plastic intrabiliary tubes. The mean time between the first-time drainage and the positive culture was 26 days (range 0-313 days). Although 12 of 20 patients met our definition of cholangitis, 5 were clinically treated with antibiotics based on a physician's assessment of whether there was a true infection. The present study is the largest case series of patients with S. pneumoniae in their bile. Based on our findings, the isolation of S. pneumoniae from bile may be attributed to the placement of biliary drainage devices. PMID:27025902

  10. Grynfelt hernia: case report and literature review.

    Science.gov (United States)

    Cesar, D; Valadão, M; Murrahe, R J

    2012-02-01

    Back lumbar hernia is a rare abdominal wall defect that usually presents spontaneously after trauma or lumbar surgery or, less frequently, during infancy (congenital). Few reports have been published in the literature describing primary lumbar hernia. A general surgeon will have the opportunity to repair only one or a few lumbar hernia cases in his/her lifetime. We report a case of a healthy 50-year-old man, with no previous surgeries or history of trauma, who presented to the outpatient department with abdominal discomfort, pain, and a sensation of a growing mass on his lower left back for 4 years. CT scan of the abdomen showed a mass in the left posterolateral abdominal wall. Specifically, a herniation of retroperitoneal fat between the erector spinae muscle group and internal oblique muscles through aponeurosis of the transversalis muscle (Grynfeltt hernia). The patient underwent a small lumbotomy, polypropylene mesh was placed and he recovered well. Although many techniques have been described for the surgical management of such hernias, none of them can be recommended as the preferred method. Our impression, however, is that the open approach, with a small lumbotomy, seems to be easy, safe and presents good postoperative recovery.

  11. Chronic idiopathic thrombocytopenic purpura in adult Chinese patients: a retrospective single-centered analysis of 1791 cases

    Institute of Scientific and Technical Information of China (English)

    LI Hong-qiang; ZHANG Lei; ZHAO Hui; JI Lin-xiang; YANG Ren-chi

    2005-01-01

    Background Adult chronic idiopathic thrombocytopenic purpura (ITP) is a common hematologic disease characterized by persistent thrombocytopenia. So far, there were only a few reports on adult Chinese patients with chronic ITP. This study aimed at defining the treatment outcome and prognostic factors for chronic ITP based on a large cohort of Chinese patients followed up for over 25 years at a single center.Methods The medical records of 1791 patients aged 14 years or older who were diagnosed as having chronic ITP at our hospital from 1974 to 1999 were retrospectively analyzed.Conclusions Adult Chinese chronic ITP patients can have long-term remission after steroid therapy and splenectomies. Primary steroid refractoriness is a prognostic factor predicting poor subsequent response to a splenectomy.

  12. Nucleoplasty as a therapeutic option for lumbar disc degeneration related pain: a retrospective study of 396 cases

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    José Lourenço Kallás

    2013-01-01

    Full Text Available OBJECTIVES: To make a retrospective analysis and evaluate a clinical response to the control of disc degeneration related pain of 396 patients submitted to percutaneous lumbar nucleoplasty; and to make a record of visual analogical scale (VAS up to a three-year follow-up after the surgical procedure. METHODS: Analysis of VAS score in 396 patients with lumbar disc degeneration related pain, according to anamnesis, clinical examination and magnetic resonance imaging (MRI, without improvement of previous clinical treatment, submitted to percutaneous nucleoplasty. RESULTS: A total of 26% of the patients presented 100% remission of pain or paresthesia, of whom 75% showed at least 50% of pain improvement. The median VAS pain improvement was about 67%. CONCLUSIONS: The median VAS improvement in inferior disc levels was higher than four points. The VAS showed improvement of the pain and paresthesia up to a three-year follow up after the surgical procedure.

  13. [Infant botulism: case report and review].

    Science.gov (United States)

    Arriagada S, Daniela; Wilhelm B, Jan; Donoso F, Alejandro

    2009-04-01

    Botulism is a rare disease in Chile and of the known clinical presentation, infant botulism is the most common. We report the case of a previously healthy seven month old male infant with a two weeks history of rinorrea, cough, fatigue, constipation and progressive weakness after the consumption of honey. Stool cultures were positive for Clostridium botulinum group 1 type A and electromyography was compatible with the diagnosis. The patient evolved with arterial hypertension, interpreted as secondary to autonomic dysfunction, which responded to calcium channel blockers. Muscle tone improved progressively during the following four weeks. Infant botulism is a potentially fatal disease; diagnosis can be difficult given the broad clinical manifestations. Prevention should focus on education of parents of infants as well as medical personnel. PMID:19621149

  14. Treacher Collins syndrome: a case review.

    Science.gov (United States)

    Jensen-Steed, Ginger

    2011-12-01

    Treacher Collins syndrome is named after the English surgeon Edward Treacher Collins, who initially described the syndrome's traits in 1900. This rare autosomal dominant disorder affects approximately 1:50 000 live births. It primarily affects the development of facial structures through a mutation in the TCOF1 gene found at the 5q32-33.1 loci. While common facies and phenotype can be described with this syndrome, the gene has a wide variation of expressivity, thus making the diagnosis of mild cases challenging. This study involves a term female diagnosed with Treacher Collins syndrome, who was also diagnosed with Tracheal Esophageal Fistula. She is expected to be of normal intelligence but, as is typical for Treacher Collins syndrome, has conductive hearing loss and therefore is at risk for developmental delay. This article describes her hospital course and outcomes thus far and is intended to guide the bedside practitioner in recognition and guidance of families in the future.

  15. Oligomeganephronia: Case report and literature review

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    Yang Xiang-Dong

    2014-01-01

    Full Text Available Introduction. Oligomeganephronia (OMN is one of rare congenital kidney disease. The number of nephrons reduces and the volume of glomerulus increases. The incidence of OMN is uncertain because it is difficult to diagnose. There are no any special clinical manifestations of OMN. Renal pathology is the only way to diagnose OMN, so missed diagnosis always happens without renal pathology. Case Outline. A 26-year-old male was diagnosed OMN associated with proteinuria and increased serum creatinine. The size of both kidneys on ultrasound was smaller than normal. Pathological features involved a reduced number of greatly enlarged glomeruli indicating OMN. Conclusion. OMN is a rare disease and it has been rarely reported. The exact mechanism is not clear. The diagnosis mainly depends on pathological findings. For patients with OMN, proteinuria and renal dysfunction are often the main cause to visit a doctor. Early diagnosis is important.

  16. Cervical cerclage. A review of 74 cases.

    Science.gov (United States)

    Schwartz, R P; Chatwani, A; Sullivan, P

    1984-02-01

    The records of seventy-four patients who had had cervical cerclage procedures were surveyed. Without suture placement, these patients would have had a fetal salvage rate of 23%. The Shirodkar method was performed in 67 cases and the McDonald in 7. Spontaneous abortions occurred in ten women (13.5%). Four pregnancies terminated between the 20th and 26th week of gestation; two of these losses were due to chorioamnionitis and two to immature labor. No congenital anomalies were noted. In the remaining 60 patients, 6 pregnancies terminated between the 28th and the 36th week of gestation, and 54 pregnancies were carried beyond the 36th week; all of these infants survived. The salvage rate after the cerclage procedure was 81.8%. The average length of labor in the patients who delivered vaginally was 9 hours, 18 minutes. The incidence of cervical lacerations was 3%. Eight cesarean sections were performed (13.3%) for various reasons.

  17. Cases of Trademark Examination Review and Adjudication

    Institute of Scientific and Technical Information of China (English)

    Cao Xinwei

    2005-01-01

    @@ Case of Reexamination of Rejection of Trademark "GE" On 20 December 2001, the US General Electric Company (GE) filed with the Trademark Office an application for regG Eistration of the trademark "GE"(see Fig.l) on goods in class 8 of the International Classification: hand tools, table cutlery (knives, forks and spoons), side arms other than firearms, fish forks. Upon examination, the Trademark Office, pursuant to Article 11, paragraph one (3) and Article 28 of the Trademark Law of the People's Republic of China, rejected, on 9 October 2002, the application for registration of said mark, and made no publication thereof on the grounds that "the trademark applied for registration was the combination of two letters of ordinary typeface, which was not distinctive, so should not be registered as a trademark".

  18. Traumatic chylothorax: A case report and review

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    Wezi Sendama

    2015-01-01

    Full Text Available Chylothorax is a rare entity characterised by leakage of lymphatic fluid into the pleural cavity from the thoracic duct. We present a case of traumatic chylothorax following a traumatic fracture of the L1 vertebra. An 84-year-old lady presented to the emergency department after being found collapsed at home. She gave a preceding history of one day of diarrhoea. Chest X-ray showed a rightsided effusion. Drainage of the effusion yielded a cloudy, off-white fluid that settled in layers in the drainage container. Pleural fluid examination revealed a lymphocyte-rich transudate with high levels of cholesterol and triglycerides. CT imaging of the chest, abdomen and pelvis revealed an acute left sided pulmonary embolus, and a multisegment burst fracture of the L1 vertebra. The patient was anticoagulated for the pulmonary embolus. Conservative fracture management was advised. Chylous drainage of 1l/24hr was observed. Due to ongoing chylous leak the patient was commenced on a medium-chain fatty acid diet and octreotide. Whilst chylous drainage ceased the patient died from infected pressure sores, malnutrition and acute kidney injury. Spinal trauma can rarely cause disruption of the thoracic duct and chylothorax. Diagnosis of chylothorax hinges on the typically high triglyceride content of chylous fluid and the detection of chylomicrons where the triglyceride concentration is equivocal. Management options for persistently draining chylothorax are varied and range from non-invasive medical measures to radiological and surgical interventions (although the patient in the case we present was an unsuitable candidate for surgery. We discuss pertinent diagnostic testing and put forward possible medical management strategies for chylothorax.

  19. High utility of contact investigation for latent and active tuberculosis case detection among the contacts: a retrospective cohort study in Tbilisi, Georgia, 2010-2011.

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    Tsira Chakhaia

    Full Text Available The study was conducted at the National Center for Tuberculosis and Lung Diseases (NCTBLD in Tbilisi, Georgia.To assess the utility of contact investigation for tuberculosis (TB case detection. We also assessed the prevalence and risk factors for active TB disease and latent TB infection (LTBI among contacts of active pulmonary TB cases.A retrospective cohort study was conducted among the contacts of active pulmonary TB cases registered in 2010-2011 at the NCTBLD in Tbilisi, Georgia. Contacts of active TB patients were investigated according to an "invitation model": they were referred to the NCTBLD by the index case; were queried about clinical symptoms suggestive of active TB disease; tuberculin skin testing and chest radiographs were performed. Demographic, laboratory, and clinical data of TB patients and their contacts were abstracted from existing records up to February 2013.869 contacts of 396 index cases were enrolled in the study; a median of 2 contacts were referred per index case. Among the 869 contacts, 47 (5.4% were found to have or developed active TB disease: 30 (63.8% were diagnosed with TB during the baseline period (co-prevalent cases and 17 (36.2% developed active TB disease during the follow-up period (mean follow up of 21 months (incident TB cases. The incidence rate of active TB disease among contacts was 1126.0 per 100,000 person years (95% CI 655.7-1802.0 per 100,000 person-years. Among the 402 contacts who had a tuberculin skin test (TST performed, 52.7% (95% CI 47.7-57.7% had LTBI.A high prevalence of LTBI and active TB disease was found among the contacts of TB cases in Tbilisi, Georgia. Our findings demonstrated that an "invitation" model of contact investigation was an effective method of case detection. Therefore, contact investigation should be scaled up in Georgia.

  20. Pulmonary Langerhans Cell Histiocytosis: Case Series and Literature Review

    Science.gov (United States)

    Wei, Ping; Lu, Hai-Wen; Jiang, Sen; Fan, Li-Chao; Li, Hui-Ping; Xu, Jin-Fu

    2014-01-01

    Abstract Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease with insidious onset and nonspecific manifestations. The objective of this article was to characterize the clinical manifestations and features of PLCH by retrospectively analyzing clinical data of patients with PLCH in addition to simultaneous review of literature. A retrospective analysis was conducted on clinical data of patients with PLCH (n = 7), whose conditions were diagnosed by biopsy from pulmonary tissue (n = 6) or enlarged lymph nodes in the neck (n = 1) and confirmed by PLCH typical radiological features on computed tomography (CT) scan, between January 2001 and September 2012 at the Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. The review of published reports was made to further emphasize the clinical manifestation and radiological features of PLCH. Long history of cigarette smoking was found in 6 patients. Two patients had recurrent pneumothorax and the other 2 had pulmonary arterial hypertension (World Health Organization group 5 pulmonary hypertension), diagnosed through ultrasonic cardiogram. The nodular shadows were revealed by chest CT scan in 5 patients, cystic shadows in 5 patients, and reticular shadows in 2 patients, as major manifestations, respectively; most of the lesions were located in the middle or upper segments of the lung. The obvious shrank of lesion was found in 1 patient after completely quitting smoking. The pathogenesis of PLCH might be closely associated with smoking. The cystic or nodular lesion was the typical radiological features. Further prospective studies with large sample size are required to further validate the study results and understand the clinical characteristics of PLCH to avoid misdiagnosis. PMID:25415669

  1. Pulmonary langerhans cell histiocytosis: case series and literature review.

    Science.gov (United States)

    Wei, Ping; Lu, Hai-Wen; Jiang, Sen; Fan, Li-Chao; Li, Hui-Ping; Xu, Jin-Fu

    2014-11-01

    Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease with insidious onset and nonspecific manifestations. The objective of this article was to characterize the clinical manifestations and features of PLCH by retrospectively analyzing clinical data of patients with PLCH in addition to simultaneous review of literature.A retrospective analysis was conducted on clinical data of patients with PLCH (n = 7), whose conditions were diagnosed by biopsy from pulmonary tissue (n = 6) or enlarged lymph nodes in the neck (n = 1) and confirmed by PLCH typical radiological features on computed tomography (CT) scan, between January 2001 and September 2012 at the Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. The review of published reports was made to further emphasize the clinical manifestation and radiological features of PLCH.Long history of cigarette smoking was found in 6 patients. Two patients had recurrent pneumothorax and the other 2 had pulmonary arterial hypertension (World Health Organization group 5 pulmonary hypertension), diagnosed through ultrasonic cardiogram. The nodular shadows were revealed by chest CT scan in 5 patients, cystic shadows in 5 patients, and reticular shadows in 2 patients, as major manifestations, respectively; most of the lesions were located in the middle or upper segments of the lung. The obvious shrank of lesion was found in 1 patient after completely quitting smoking.The pathogenesis of PLCH might be closely associated with smoking. The cystic or nodular lesion was the typical radiological features. Further prospective studies with large sample size are required to further validate the study results and understand the clinical characteristics of PLCH to avoid misdiagnosis. PMID:25415669

  2. Gastric sarcoidosis: case report and literature review.

    Science.gov (United States)

    Liang, David B; Price, Jennifer Cohen; Ahmed, Haitham; Farmer, Nicole; Montgomery, Elizabeth A; Giday, Samuel A

    2010-04-01

    Sarcoidosis involving the gastrointestinal tract is extremely rare. Clinically recognizable gastrointestinal system involvement occurs in 0.1% to 0.9% of patients with sarcoidosis. We encountered a 22-year-old African American female admitted to Johns Hopkins Hospital (Baltimore, Maryland) for a 2-week history of fever, chills, eye pain, and abdominal pain. Her abdominal CT scan showed multiple subcentimeter retroperitoneal lymph nodes. An upper endoscopy was performed and discovered an antral nodule that measured about 7 mm and antral gastritis in which biopsies showed active chronic necrotizing granulomatous gastritis. Biopsies of the antral polyp showed focal intestinal metaplasia and active chronic necrotizing granulomatous pattern. Stains for Helicobacter pylori, acid fast, and fungi were negative. A small-bowel series showed no abnormality. Ophthalmologic evaluation revealed panuveitis with bilateral optic disc edema. The patient was later prescribed 60 mg of prednisone by mouth once a day and subsequently her abdominal pain and fever resolved during follow-up 2 months later. This literature review demonstrates the importance in the diagnosis, pathophysiology, clinical manifestations, types of gastric sarcoidosis, major endoscopic findings, and management of gastric sarcoidosis. PMID:20437743

  3. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: A retrospective review

    International Nuclear Information System (INIS)

    Background and purpose: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy. Patients and methods: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT). The significant parameters identified were then selected into categorical variables and compared between those who needed reactive enteral nutrition and the remainder of the group who did not. These results were used to generate predictive factors that could be used to identify those at high risk of malnutrition during RT for whom early or prophylactic enteral nutrition should be considered. Results: Fifty patients required enteral feeding of which 60% required this prior to radiotherapy. Multivariate analysis identified the following factors to be significant-body mass index, performance status (PS), advanced stage, pre-treatment weight loss, low serum albumin and protein, age, and smoking. The most significant categorical predictive parameters for reactive enteral feeding were stage 3-4 disease, PS 2-3, and smoking >20/day. The combination of these factors predicted a 75% chance of needing enteral nutrition. Conclusion: Nutritional assessment is important prior to radiotherapy and is multifactorial. Using a combination of relatively simple and objective parameters (performance status, smoking and disease stage) it is possible to identify those at high risk of needing enteral nutrition prior to starting RT

  4. GENDER-RELATED DIFFERENCES IN CLINICAL COURSE OF CROHN?S DISEASE IN AN ASIAN POPULATION: a retrospective cohort review

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    Siu-tong LAW

    2014-04-01

    Full Text Available Context Data from Asian populations about gender-related differences in Crohn’s disease are few. Objectives This study was to analyze the clinical characteristics between women and men affected by Crohn’s disease. Methods This was a retrospective cohort study to analyze consecutive Crohn’s disease patients from Jan 2000 to Dec 2012. Clinical and phenotypic characteristics and treatment outcomes were evaluated. Results 79 patients (55 male and two of them with positive family history were diagnosed with Crohn’s disease. Ileocolonic disease and inflammatory lesion was the most dominant site of involvement and disease behavior respectively in both men and women. Apart from higher frequency of nausea (45.83 vs 23.64%, P 0.024 and lower body mass index (19.44 vs 22.03 kg/m2, P 0.003 reported in women, no significant gender-related differences in clinical characteristics were observed. Women were more associated with delay use of immunosuppressive therapy (12 vs 36 months, P = 0.028, particularly for those aged less than 40 years old (85 vs 62.6%, P = 0.023. Cox proportional hazard regression analysis revealed that active smoking (HR, 4.679; 95% CI, 1.03-21.18 and delayed use of immunosuppressive therapy (HR, 4.13; 95% CI, 1.01-16.88 were only independent risk factors associated with increased risk of complications. Conclusions There were no significant gender-specific differences in clinical and phenotypic characteristics between male and female Crohn’s disease patients. Smoking history and delay use of immunosuppressive therapy were associated with higher risk of complications.

  5. Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review

    International Nuclear Information System (INIS)

    Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. The delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. The dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity. Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis. After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). In multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m2 (p < 0.01). IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m2

  6. Pachydermodactyly: a Case Report and Literature Review

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    Paravina Mirjana

    2014-12-01