3001
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Huscher C, Marchegiani F, Cobellis F, Tejedor P, Pastor C, Lazzarin G, Wheeler J, Di Saverio S. Robotic oncologic colorectal surgery with a new robotic platform (CMR Versius): hope or hype? A preliminary experience from a full-robotic case-series. Tech Coloproctol 2022; 26:745-753. [PMID: 35637355 PMCID: PMC9360145 DOI: 10.1007/s10151-022-02626-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 04/22/2022] [Indexed: 12/16/2022]
Abstract
Background The present case-series describes the first full-robotic colorectal resections performed with the new CMR Versius platform (Cambridge Medical Robotics Surgical, 1 Evolution Business Park, Cambridge, United Kingdom) by an experienced robotic surgeon. Methods In a period between July 2020 and December 2020, patients aged 18 years or older, who were diagnosed with colorectal cancer and were fit for minimally invasive surgery, underwent robotic colorectal resection with CMR Versius robotic platform at “Casa di Cura Cobellis” in Vallo della Lucania,Salerno, Italy. Three right colectomies, 2 sigmoid colectomies and 1 anterior rectal resection were performed. All the procedures were planned as fully robotic. Surgical data were retrospectively reviewed from a prospectively collected database. Results Four patients were male and 2 patients were female with a median (range) age of 66 (47–72) years. One covering ileostomy was created. Full robotic splenic flexure mobilization was performed. No additional laparoscopic gestures or procedures were performed in this series except for clipping and stapling which were performed by the assistant surgeon due to the absence of robotic dedicated instruments. Two ileocolic anastomoses, planned as robotic-sewn, were performed extracorporeally. One Clavien–Dindo II complication occurred due to a postoperative blood transfusion. Median total operative time was 160 (145–294) min for right colectomies, 246 (191–300) min for sigmoid colectomies and 250 min for the anterior rectal resection. Conclusions The present series confirms the feasibility of full-robotic colorectal resections while highlighting the strengths and the limitations of the CMR Versius platform in colorectal surgery. New devices will need more clinical development to be comparable to the current standard. Supplementary Information The online version contains supplementary material available at 10.1007/s10151-022-02626-9.
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Affiliation(s)
- Cristiano Huscher
- Casa di Cura Cobellis, Vallo della Lucania, Salerno, Italy
- Department of Surgical Oncology, Robotics and New Technologies, Policlinico Abano, Padua, Italy
| | - Francesco Marchegiani
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Francesco Cobellis
- Casa di Cura Cobellis, Vallo della Lucania, Salerno, Italy
- University of Padua, Padua, Italy
| | - Patricia Tejedor
- Department of Colorectal Surgery, University Hospital Gregorio Marañon, Madrid, Spain
| | - Carlos Pastor
- Department of Colorectal Surgery, University Clinic of Navarre, Madrid-Pamplona, Spain
| | - Gianni Lazzarin
- Department of Surgical Oncology, Robotics and New Technologies, Policlinico Abano, Padua, Italy
| | - James Wheeler
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Salomone Di Saverio
- General Surgery Department "Paride Stefanini", La Sapienza University of Rome, Rome, Italy.
- Department of General Surgery, Madonna del Soccorso Hospital, Asur Marche Area Vasta 5, San Benedetto del Tronto, Ascoli Piceno, Italy.
- Brighton and Sussex University Medical School , Brighton, UK.
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3002
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Glosser LD, Zakeri BS, Lombardi CV, Ekwenna OO, Grenda R. Conservative Management of Muscle Invasive Bladder Cancer in Kidney-Pancreas Transplant Patient. Case Rep Transplant 2022; 2022:1-4. [PMID: 35677063 PMCID: PMC9168198 DOI: 10.1155/2022/5373414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction. Solid organ transplant increases the risk for muscle-invasive bladder cancer (MIBC). Although a common tumor, urothelial cell carcinoma (UCC) of the bladder in patients with kidney-pancreas transplants is scarcely reported. Case Presentation. A 65-year-old male with history of type 1 diabetes and a 14-year status post deceased donor pancreas-kidney transplant presented with 3 weeks of gross hematuria. CT scan showed multiple bladder masses. Transurethral resection of bladder tumor (TURBT) showed papillary UCC. 5 months later, the patient reported new-onset gross hematuria. TURBT showed MIBC. The patient elected for bladder-preserving TMT. On cystoscopy there was no gross evidence of carcinoma at 3.5 years of follow up. Discussion. Currently, no specific management guidelines target this population with MIBC. The first-line treatment for MIBC is radical cystectomy (RC) with neoadjuvant chemotherapy. For patients that are medically unfit or unwilling to undergo RC, trimodal therapy (TMT) is an alternative. TMT for bladder cancer consists of complete tumor resection with chemotherapy and radiation. This report demonstrates a unique case of a patient with kidney-pancreas transplant diagnosed with MIBC treated with TMT that has no evidence of gross tumorigenesis at 3.5 years after diagnosis. Our findings suggest that trimodal therapy should be considered for treatment of MIBC in patients with kidney-pancreatic transplants to preserve the donated allografts.
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3003
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Carnesten H, Wiklund Gustin L, Skoglund K, Von Heideken Wågert P. Battling extraordinary situations and conflicting emotions-A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic. Nurs Open 2022; 9:2370-2380. [PMID: 35633153 PMCID: PMC9348284 DOI: 10.1002/nop2.1250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/23/2022] [Accepted: 05/10/2022] [Indexed: 02/06/2023] Open
Abstract
Aim To describe newly graduated registered nurses’ (NGRNs’) experiences of encountering stress in emergency departments (EDs) during the COVID‐19 pandemic. Design A qualitative descriptive study. Methods Data from 14 in‐depth interviews with NGRNs working in an ED for 3‐36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic. Results Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.
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Affiliation(s)
- Hillewi Carnesten
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
| | - Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden.,Department of Health and Care Sciences, UiT/The Arctic University of Norway, Narvik, Norway
| | - Karin Skoglund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Västerås, Sweden
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3004
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Garrido-Fernández A, García-Padilla FM, Ramos-Pichardo JD, Romero-Martín M, Sosa-Cordobés E, Sánchez-Alcón M. Attitude towards the Promotion of Healthy Eating among Secondary School Teachers—Construction and Validation of a Questionnaire. Nutrients 2022; 14:nu14112271. [PMID: 35684071 PMCID: PMC9183166 DOI: 10.3390/nu14112271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
Health promotion activities in secondary schools are scarce and have little involvement of the teaching staff. Most often, activities are developed from the curriculum that appears in school materials, with little capacity for adaptation and innovation. The aim of this study was to construct and validate a tool to find out teachers’ attitudes towards activities to promote healthy eating in secondary schools. For this purpose, a descriptive study was conducted. The total sample of the study consisted of 200 teachers from secondary schools. Internal consistency was determined by Cronbach’s alpha coefficient globally and by dimension, and with the corrected item–test correlation. The construct validity of the questionnaire was assessed by means of an exploratory factor analysis, for which the principal components method with Varimax rotation was used. A Likert-type scale with nine items and four response options about attitude was designed. The exploratory factor analysis showed a nine-factor solution, of which two had eigenvalues greater than 1. These two factors explained 63.4% of the variance. The Cronbach’s alpha internal consistency index obtained for the global scale was 0.81, and 0.75 and 0.85 for each component. The results obtained with this structure confirmed an adequate reliability and validity of the questionnaire.
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3005
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Hajjar D, Sultan D, Khalaf A, Hesso H, Kayyali A. A case of total ophthalmoplegia associated with a COVID-19 infection: case report. Oxf Med Case Reports 2022; 2022:omac050. [PMID: 35619686 PMCID: PMC9127945 DOI: 10.1093/omcr/omac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/19/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
We are presenting a rare case of an acute complete external ophthalmoplegia with positive polymerase chain reaction (PCR) for SARS-CoV-2. Our case is the first case that depicts development of Tolosa-Hunt Syndrome (THS) following infection with COVID-19, with a challenging diagnosis and spontaneous improvement. A 65-year-old diabetic female presented with a complete external ophthalmopegia in the left eye and a severe left-sided headache. The PCR result for SARS-CoV-2 was positive. Brain and orbital computed tomography scan and magnetic resonance imaging were both unremarkable. We diagnosed the case as THS after ruling out other differential diagnoses. The patient refused to receive prednisone, so we had to observe her closely for 6 months during which period we recorded a spontaneous recovery. Acute ophthalmoplegia is a very challenging presentation. It needs full workup to exclude the wide range of differential diagnoses.
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Affiliation(s)
- Doaa Hajjar
- Department of Ophthalmology, Aleppo University Hospital, Aleppo, Syria
| | - Dana Sultan
- Department of Ophthalmology, Aleppo University Hospital, Aleppo, Syria
| | - Abdullah Khalaf
- Department of Ophthalmology, Aleppo University Hospital, Aleppo, Syria
| | - Hussein Hesso
- Department of Ophthalmology, Aleppo University Hospital, Aleppo, Syria
| | - Ammar Kayyali
- Department of Ophthalmology, Aleppo University Hospital, Aleppo, Syria
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3006
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Wolff DT, Ross C, Lee P, Badlani G, Matthews CA, Evans RJ, Walker SJ. Pulsed Electromagnetic Field Therapy for Pain Management in Interstitial Cystitis/Bladder Pain Syndrome: A Proof-of-Concept Case Series. Urology 2022; 167:96-101. [PMID: 35636637 DOI: 10.1016/j.urology.2022.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the efficacy of pulsed electromagnetic field (PEMF) therapy for symptom and pain management in women with non-bladder centric interstitial cystitis/bladder pain syndrome (IC/BPS). METHODS Women with non-bladder centric IC/BPS and a numeric rating scale score for pelvic pain ≥6 underwent twice-daily 8-minute full body PEMF therapy sessions for 4 weeks. The primary outcome metric was a reduction in pelvic pain score ≥2 points. A 7-day voiding diary (collected at baseline and conclusion), 3 validated symptom scores, and the Short Form-36 Quality of Life questionnaire (completed at baseline, conclusion of treatment, and 8-week follow-up), were used to assess secondary outcomes. Treatment effects were analyzed via Wilcoxon-signed rank test; P < .05 was considered significant. RESULTS The 4-week treatment protocol was completed by 8 of 10 enrolled patients, and 7:8 (87.5%) had a significant reduction in pelvic pain (-3.0 points, P = .011) after 4 weeks. There was also a significant decrease in scores on all validated IC/BPS questionnaires, daily number of voids, and nocturia symptom score (P < .05). Significant increases in several quality-of-life questionnaire sub-scores were also identified at 4 weeks (P < .05). At 8-week post-therapy, the positive effects were somewhat attenuated, yet 4:8 patients (50%) continued to have significant pain reduction (P = .047). No adverse events or side effects were reported. CONCLUSION Whole body pulsed electromagnetic field therapy is an alternative treatment option for women with chronic bladder pain syndrome that warrants investigation through comparative trials.
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Affiliation(s)
- Dylan T Wolff
- Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC; Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Christina Ross
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Peyton Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Gopal Badlani
- Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Robert J Evans
- Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Stephen J Walker
- Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC; Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
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3007
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Scarano A, Tartaglia G, Rapone B, Inchingolo F, Lorusso F. Maxillary Sinus Osteoma as a Support for Dental Implant Associated to Sinus Augmentation Procedure: A Case Report and Literature Review. Applied Sciences 2022; 12:5435. [DOI: 10.3390/app12115435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Maxillary sinus augmentation is a method extensively used to restore sufficient bone volume in the posterior maxilla to allow for the placement of fixtures. The purpose of the present case report was to describe a rare case of sinus osteoma used for implant support and to review the relevant literature. Materials and Methods: A 58-year-old man with a radiopaque intrasinusal lesion was referred for rehabilitation of the maxilla. The lesion was probably an osteoma and involved the nasal wall of the maxillary sinus. After discussing the options with the patient, he agreed to maintain the lesion and a sinus augmentation with a bone graft. A part of the osteoma was partially removed for histological analysis while avoiding perforation or tearing of the schneiderian membrane. After six months, 6 implants (Bone System Implant, Milano, Italy) were placed in the maxilla, two of which were inserted in the osteoma. Results: The two implants placed in the osteoma were perfectly osseointegrated. The graft material appeared well-integrated with no local signs of inflammation. No postoperative events or symptoms were reported after the surgery stages and at a 6-month follow-up. Regarding the two implants placed in the osteoma: article selection identified 9 case reports, 2 case series, and 1 retrospective study for a total of 58 subjects, 35 males and 25 females. The patients’ ages were heterogeneous and ranged between 12 and 79 years old. Conclusions: In the present case, we decided to leave the osteoma because it was asymptomatic and used as dental implant support. The effectiveness of the present investigation can provide useful guidance for surgeons and dentists in the management of similar clinical situations.
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3008
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Ding X, Tang Q, Xu Z, Xu Y, Zhang H, Zheng D, Wang S, Tan Q, Maitz J, Maitz PK, Yin S, Wang Y, Chen J. Challenges and innovations in treating chronic and acute wound infections: from basic science to clinical practice. Burns Trauma 2022; 10:tkac014. [PMID: 35611318 PMCID: PMC9123597 DOI: 10.1093/burnst/tkac014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/06/2022] [Indexed: 12/30/2022]
Abstract
Acute and chronic wound infection has become a major worldwide healthcare burden leading to significantly high morbidity and mortality. The underlying mechanism of infections has been widely investigated by scientist, while standard wound management is routinely been used in general practice. However, strategies for the diagnosis and treatment of wound infections remain a great challenge due to the occurrence of biofilm colonization, delayed healing and drug resistance. In the present review, we summarize the common microorganisms found in acute and chronic wound infections and discuss the challenges from the aspects of clinical diagnosis, non-surgical methods and surgical methods. Moreover, we highlight emerging innovations in the development of antimicrobial peptides, phages, controlled drug delivery, wound dressing materials and herbal medicine, and find that sensitive diagnostics, combined treatment and skin microbiome regulation could be future directions in the treatment of wound infection.
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Affiliation(s)
- Xiaotong Ding
- School of Pharmacy, Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Qinghan Tang
- School of Pharmacy, Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Zeyu Xu
- School of Pharmacy, Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Ye Xu
- Department of Burns and Plastic Surgery, The affiliated Drum Tow Hospital of Nanjing University of Chinese Medicine, Nanjing 210008, People's Republic of China
| | - Hao Zhang
- Department of Burns and Plastic Surgery, The affiliated Drum Tow Hospital of Nanjing University of Chinese Medicine, Nanjing 210008, People's Republic of China
| | - Dongfeng Zheng
- Department of Burns and Plastic Surgery, The affiliated Drum Tow Hospital of Nanjing University of Chinese Medicine, Nanjing 210008, People's Republic of China
| | - Shuqin Wang
- Department of Burns and Plastic Surgery, The affiliated Drum Tow Hospital of Nanjing University of Chinese Medicine, Nanjing 210008, People's Republic of China
| | - Qian Tan
- Department of Burns and Plastic Surgery, The affiliated Drum Tow Hospital of Nanjing University of Chinese Medicine, Nanjing 210008, People's Republic of China
| | - Joanneke Maitz
- Burns Injury and Reconstructive Surgery Research, ANZAC Research Institute, University of Sydney, Sydney, Australia, 2137
| | - Peter K Maitz
- Burns Injury and Reconstructive Surgery Research, ANZAC Research Institute, University of Sydney, Sydney, Australia, 2137
| | - Shaoping Yin
- School of Pharmacy, Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Yiwei Wang
- School of Pharmacy, Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Jun Chen
- School of Pharmacy, Jiangsu Provincial Engineering Research Center of Traditional Chinese Medicine External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
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3009
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Fourati K, Tlili A, Masmoudi A, Laabidi T, Ben Ameur H, Boujelben S. Primary retroperitoneal hydatid cyst with intraperitoneal rupture: a case report. J Med Case Rep 2022; 16:202. [PMID: 35610709 PMCID: PMC9131640 DOI: 10.1186/s13256-022-03415-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Hydatid disease is endemic in Mediterranean countries and most commonly occurs in the liver followed by the lung. A primary localization in the retroperitoneum is extremely rare. Case presentation We report the case of a 29-year-old Tunisian patient presenting with progressive left flank pain and skin urticaria. On abdominal ultrasonography and computed tomography scan, a ruptured retroperitoneal hydatid cyst was diagnosed, which was confirmed by positive hydatid serology. The treatment consisted of resection of protruding dome. The evolution was favorable. No local recurrence was detected during postoperative follow-up. Conclusions Primary retroperitoneal hydatid cyst is extremely rare and has uncommon presentation, but we should learn the keys to its diagnosis. In endemic regions, high suspicion for this disease is justified regardless of localization.
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Affiliation(s)
- Kais Fourati
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ahmed Tlili
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.,Department of Surgery, Mohamed Ben Sassi Hospital, Gabes, Tunisia
| | - Abderrahmen Masmoudi
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia. .,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
| | - Taher Laabidi
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hazem Ben Ameur
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Salah Boujelben
- Departement of surgery, Habib Bourguiba Hospital, Sfax, Tunisia.,Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
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3010
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Lamrissi A, Madri F, Bouab M, Bensouda M, Jalal M, Bouhya S. Tuberculosis of the breast neoplastic-like about two report cases: A rare often unrecognized diagnosis. Int J Surg Case Rep 2022; 96:107242. [PMID: 35777336 PMCID: PMC9283992 DOI: 10.1016/j.ijscr.2022.107242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/10/2022] [Accepted: 05/21/2022] [Indexed: 02/07/2023] Open
Abstract
Tuberculosis of the breast is a very rare infection; it occurs chiefly in women of childbearing potential, usually as an apparently primary infection and constitutes a diagnosis and therapeutic challenge. Administration of antituberculous agents is the mainstay of therapy. Surgery is required in some cases. We report tow cases of breast tuberculosis. The diagnosis has been established on histology. Outcome was favorable under anti bacillary treatment. Through the literature data we recall the epidemiological, clinical, diagnostic and treatment of this pathology.
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Affiliation(s)
- A. Lamrissi
- Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco,Gynecology Obstetric Department, Faculty of Medicine and Pharmacy of Casablanca, Hassan 2 University of Casablanca, Morocco,Biology and Health Laboratory (LBS), Hassan 2 University of Casablanca, Morocco,Corresponding author at: Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco.
| | - F. Madri
- Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco,Gynecology Obstetric Department, Faculty of Medicine and Pharmacy of Casablanca, Hassan 2 University of Casablanca, Morocco
| | - M. Bouab
- Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco,Gynecology Obstetric Department, Faculty of Medicine and Pharmacy of Casablanca, Hassan 2 University of Casablanca, Morocco
| | - M. Bensouda
- Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco,Gynecology Obstetric Department, Faculty of Medicine and Pharmacy of Casablanca, Hassan 2 University of Casablanca, Morocco
| | - M. Jalal
- Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco,Gynecology Obstetric Department, Faculty of Medicine and Pharmacy of Casablanca, Hassan 2 University of Casablanca, Morocco
| | - S. Bouhya
- Maternity Service, Mother and Child Hospital Abderrahim Harouchi, University Hospital IBN ROCHD of Casablanca, Morocco,Gynecology Obstetric Department, Faculty of Medicine and Pharmacy of Casablanca, Hassan 2 University of Casablanca, Morocco,Biology and Health Laboratory (LBS), Hassan 2 University of Casablanca, Morocco
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3011
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Meng Q, Liu H, Wu H, Shun D, Tang C, Fu X, Fang X, Xu Y, Chen B, Xie Y, Liu Q. A Network Pharmacology Study to Explore the Underlying Mechanism of Safflower ( Carthamus tinctorius L.) in the Treatment of Coronary Heart Disease. Evid Based Complement Alternat Med 2022; 2022:3242015. [PMID: 35607519 DOI: 10.1155/2022/3242015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/10/2022] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
Abstract
Safflower has long been used to treat coronary heart disease (CHD). However, the underlying mechanism remains unclear. The goal of this study was to predict the therapeutic effect of safflower against CHD using a network pharmacology and to explore the underlying pharmacological mechanisms. Firstly, we obtained relative compounds of safflower based on the TCMSP database. The TCMSP and PubChem databases were used to predict targets of these active compounds. Then, we built CHD-related targets by the DisGeNET database. The protein-protein interaction (PPI) network graph of overlapping genes was obtained after supplying the common targets of safflower and CHD into the STRING database. The PPI network was then used to determine the top ten most significant hub genes. Furthermore, the DAVID database was utilized for the enrichment analysis on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). To validate these results, a cell model of CHD was established in EAhy926 cells using oxidized low-density lipoprotein (ox-LDL). Safflower was determined to have 189 active compounds. The TCMSP and PubChem databases were used to predict 573 targets of these active compounds. The DisGeNET database was used to identify 1576 genes involved in the progression of CHD. The top ten hub genes were ALB, IL6, IL1B, VEGFA, STAT3, MMP9, TLR4, CCL2, CXCL8, and IL10. GO functional enrichment analysis yielded 92 entries for biological process (BP), 47 entries for cellular component (CC), 31 entries for molecular function (MF), and 20 signaling pathways, which were obtained from KEGG pathway enrichment screening. Based on these findings, the FoxO signaling pathway is critical in the treatment of CHD by safflower. The in vitro results showed that safflower had an ameliorating effect on ox-LDL-induced apoptosis and mitochondrial membrane potential. The western blot results showed that safflower decreased Bax expression and acetylation of FoxO1 proteins while increasing the expression of Bcl-2 and SIRT1 proteins. Safflower can be used in multiple pathways during CHD treatment and can exert anti-apoptotic effects by regulating the expression of Bax, Bcl-2, and SIRT1/FoxO1 signaling pathway-related proteins.
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3012
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Lu Y, Zheng W, Cao W, Yang X, Zhao L, Chen Y. Acute fibrinous and organizing pneumonia in a patient with Sjögren's syndrome and Legionella pneumonia: a case report and literature review. BMC Pulm Med 2022; 22:205. [PMID: 35610634 PMCID: PMC9128202 DOI: 10.1186/s12890-022-01997-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/13/2022] [Indexed: 01/03/2023] Open
Abstract
Background Acute fibrinous and organizing pneumonia (AFOP) is a rare clinicopathological condition. Studies in the literature have reported that AFOP may be associated with respiratory infections, such as respiratory syncytial virus, influenza virus, Pneumocystis jirovecii, Penicillium citrinum, and Chlamydia infections. However, AFOP associated with Legionella infection has not been reported previously. Here, we report a case of a patient with AFOP secondary to Sjögren’s syndrome and Legionella infection. Case presentation A 47-year-old man was admitted to the hospital because of fever, expectoration, and shortness of breath. Lung imaging showed irregular patchy consolidation. A diagnosis of Legionella pneumonia was initially considered on the basis of the patient’s history of exposure to soil before disease onset, signs of extrapulmonary involvement, and a positive Legionella urine antigen test result. However, the patient’s symptoms and lung imaging did not improve after treatment with levofloxacin, moxifloxacin, and tigecycline for Legionella infection. In addition, Sjögren’s syndrome was diagnosed on the basis of clinical manifestations and immunological indicators. Pathological changes associated with AFOP were confirmed from the results of ultrasound-guided percutaneous lung biopsy. The patient’s clinical symptoms improved rapidly after a short course of low-dose corticosteroid therapy, and lung imaging showed significant improvement. Conclusions The possibility of secondary AFOP should be considered when Legionella pneumonia does not improve after standard antibiotic therapy. Lung biopsy and histopathological examination are important for the adjustment of treatment strategy. Our case also highlights the importance of screening for autoimmune diseases in patients with AFOP.
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Affiliation(s)
- Ye Lu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Zheng
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Cao
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xianghong Yang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Zhao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Chen
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
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3013
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Kelleher R, McGurk L, Hannan S, Wilson CE. Retracted: 'We were on our knees long before COVID': How healthcare workers experienced the compassionate care model during COVID-19. Couns Psychother Res 2022; 24:CAPR12545. [PMID: 35941921 PMCID: PMC9348390 DOI: 10.1002/capr.12545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
Aim This qualitative study aimed to explore the impact of a novel compassion‐based intervention on healthcare workers during a pandemic. Sample Participants were N = 10 healthcare workers (HCW) recruited from a healthcare organisation in Northern Ireland, including nurses, allied health professionals, managerial staff and administrative staff. The sample was 80% female with an average age of 45.1 years. Intervention All participants engaged in a compassion‐based staff support psychological intervention. The ‘compassionate care’ intervention was based on the compassion‐focussed staff support model. Modalities included face‐to‐face, remote, individual and group intervention, offered by clinical psychologists and psychotherapists. Method Ethical approval was obtained through the researcher’s academic institution. After obtaining informed consent, participants completed individual interviews, analysed using reflexive thematic analysis. Results Findings highlighted model appropriateness and feasibility, detailing post‐intervention changes. Three themes were generated. The first two, Preparing for war: A threat without boundary and Masking the pain: Externalising resistance to compassion, describe the transition from an initial burnout state to a state of derealisation via avoidance coping. The final theme, Reconnection: Returning to compassion, highlights how participants rehabilitated via the intervention, reconnecting with relationships and personal values. Conclusion Participants reported personal and professional experiential changes relating to compassion and resilience, while noting organisational blocks to compassion. The model appears appropriate across a variety of presentations and levels of chronicity of distress, across age, disciplines and gender groups, and for both managers and non‐managerial staff. Participants reported its usefulness in clinical and administrative settings, as well as application of the skills gained to settings outside work.
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Affiliation(s)
| | - Lorraine McGurk
- Southern Trust, HSCPortadownUK
- Craigavon Area HospitalCraigavonUK
| | - Sinéad Hannan
- Paediatric Psychology Service, Craigavon HospitalSouthern Trust, HSCCraigavonUK
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3014
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Sarhan FMA, Al-Jasim A, Alwahsh RHM, Mansour IIA. Factor V deficiency with a unique genetic mutation presenting as post-circumcision bleeding in a neonate, A-case-report. Ann Med Surg (Lond) 2022; 78:103723. [PMID: 35600191 DOI: 10.1016/j.amsu.2022.103723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Factor V deficiency is a rare bleeding disorder with varying presentations from minor mucosal bleeding to a life-threatening postoperative bleed. Currently, treatment is mainly supportive with Fresh Frozen Plasma. Case presentation A previously healthy 14-day-old male presented with an uncontrollable bleeding following a circumcision. Physical examination was normal. Investigations showed hemoglobin 15.5 g/dl, platelets 409000, Prothrombin Time 57 seconds, Partial-Thromboplastin-Time 120 seconds. Mixing study corrected the coagulation profile, and the factor assay showed factor V activity of 11%. Genetic testing showed a pathogenic frameshift mutation in the F5 gene p.(P927Lfs*7) causing premature termination after 7 codons thus the diagnosis of Factor V deficiency was made. Clinical discussion In this case, factor V deficiency presented as post-circumcision bleeding. For diagnosis, increased PT and PTT with normal thrombin time increases the index of suspicion for a bleeding disorder. Further testing with coagulation factors assays is required to make the final diagnosis. Factor V deficient patients undergoing surgery should be adequately prepared, and factor V activity level should be maintained at least at 25% of the normal activity level. The patient level prior to the circumcision was unknown, which led to the life threatening bleed. Conclusions One of the early presentations of factor V deficiency is a post-circumcision bleeding. Adequate preparation with laboratory tests before circumcision is therefore recommended, especially for high-risk individuals. More than 100 genetic mutations were detected; frameshift mutation involving F5 gene p.(P927Lfs*7) was seen in our case.
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3015
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De Ravin E, Carey RM, Stubbs VC, Jaffe S, Lee JYK, Rajasekaran K, Newman JG. Second Window Indocyanine Green for Oropharyngeal Tumors: A Case Series and Comparison of Near-Infrared Camera Systems. Clin Otolaryngol 2022; 47:589-593. [PMID: 35604054 DOI: 10.1111/coa.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/24/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Emma De Ravin
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Ryan M Carey
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Vanessa C Stubbs
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Samantha Jaffe
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - John Y K Lee
- Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Jason G Newman
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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3016
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Schlanger D, Popa C, Ciocan A, Șofron C, Al Hajjar N. Emergency Pancreatoduodenectomy: A Non-Trauma Center Case Series. J Clin Med 2022; 11:jcm11102891. [PMID: 35629017 PMCID: PMC9143146 DOI: 10.3390/jcm11102891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 11/21/2022] Open
Abstract
(1) Background: Emergency pancreatoduodenectomy (EPD) is a rare procedure, especially in non-trauma centers. Pancreatoduodenectomy is a challenging intervention, that has even higher risks in emergency settings. However, EPD can be a life-saving procedure in selected cases. (2) Methods: Our study is a single-center prospective consecutive case series, on patients that underwent emergency pancreatoduodenectomies in our surgical department between January 2014 to May 2021. (3) Results: In the 7-year period, 4 cases were operated in emergency settings, out of the 615 patients who underwent PD (0.65%). All patients were male, with ages between 44 and 65. Uncontrollable bleeding was the indication for surgery in 3 cases, while a complex postoperative complication was the reason for surgery in one other case. In three cases, a classical Whipple procedure was performed, and only one case had a pylorus-preserving pancreatoduodenectomy. The in-hospital mortality rate was 25% and the morbidity rate was 50%; the two patients that registered complications also needed reinterventions. The patients who were discharged had a good long-term survival. (4) Conclusion: EPD is a challenging procedure, rare encountered in non-traumatic cases, that can be a life-saving intervention in well-selected cases, offering good long-term survival.
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Affiliation(s)
- Diana Schlanger
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania; (D.S.); (A.C.); (C.Ș.); (N.A.H.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19–21, 400162 Cluj-Napoca, Romania
| | - Călin Popa
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania; (D.S.); (A.C.); (C.Ș.); (N.A.H.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19–21, 400162 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-074-357-8432
| | - Andra Ciocan
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania; (D.S.); (A.C.); (C.Ș.); (N.A.H.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19–21, 400162 Cluj-Napoca, Romania
| | - Cornelia Șofron
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania; (D.S.); (A.C.); (C.Ș.); (N.A.H.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19–21, 400162 Cluj-Napoca, Romania
| | - Nadim Al Hajjar
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac no 13, 400023 Cluj-Napoca, Romania; (D.S.); (A.C.); (C.Ș.); (N.A.H.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. O. Fodor, Street Croitorilor no 19–21, 400162 Cluj-Napoca, Romania
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3017
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Demir B, Sahin SK, Atalay UM, Aslan E, Elboga G, Altindag A. How did the psychological impact of COVID-19 change healthcare workers in times of fighting the pandemic? Work 2022; 72:19-26. [DOI: 10.3233/wor-210896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: This study is the second leg of a two-leg project. In the first leg, the effect of the COVID-19 pandemic on healthcare workers (HCWs) was investigated in the period between the first case in Turkey and the arrival of the first case in the hospital. OBJECTIVE: In this second leg, three months after the first evaluation, we aimed to investigate whether psychological effects of COVID-19 such as stress, anxiety, depression, and sleep quality have been changed on HCWs. METHODS: This was a 3-month observational study. 169 hospital staff who participated in the first leg of the study were reached and asked to participate in the second leg evaluation in Gaziantep University Medical Faculty Hospital.110 HCWs accepted to participate. Impact of Event Scale (EIS-R), Depression Anxiety Stress Scale (DASS-21), and Pittsburgh Sleep Quality Index (PSQI) were used to assess in both two legs. Paired Sample T-test was used for comparison of normally distributed variables. Wilcoxon test was used for the comparison of abnormally distributed variables. SPSS 22.0 software was used in the analysis of variables. RESULTS: Of the HCWs with an average age of 33.9±6.6 years, 59% (65) were males. There was no significant difference between the two legs in terms of IES-R, DASS-21, and PSQI scales. CONCLUSION: This study suggests that the psychological effects of the COVID-19 pandemic on HCWs started with the pandemic, before the arrival of the first case in the hospital. Also, these psychological effects continued similarly without significant change after the initiation of direct contact with COVID-19 patients and even after the increase in COVID-19 patients in a hospital which in they work.
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Affiliation(s)
- Bahadir Demir
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sengul Kocamer Sahin
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Unzile Meryem Atalay
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Esra Aslan
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Gülcin Elboga
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Abdurrahman Altindag
- Department of Psychiatry, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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3018
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Fadhel FH, Alqahtani MM, Arnout BA. Working with patients and the mental health of health care workers during the COVID-19 pandemic. Work 2022; 72:27-38. [DOI: 10.3233/wor-211134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Anxiety and concern are among the most common problems facing healthcare workers (HCWs) during epidemic diseases. OBJECTIVE: To identify the predictive factors of anxiety, fears, and psychological distress among healthcare workers during the COVID-19 pandemic. METHODS: An online survey method was used on a sample of 153 of HCWs; (110) frontline and (43) non-frontline HCWs. They answered on the Hamilton anxiety rating scale, the Kessler psychological distress scale (K10), and the COVID-19 Concerns Questionnaire. RESULTS: The results demonstrated that 47.05% of HCWs have a severe level of fear related to COVID-19, 43.13% have very severe anxiety, and 30.71% experience severe psychological distress. The differences between frontline and non-frontline HCWs, female and male HCWs, and HCWs working in medical clinics, on quarantine, or in another place were significant in the three scales. Predictive factors of anxiety, fear, and psychological distress include working on the front lines, being female, and being over 50 years old. Meanwhile, working in a workplace with COVID-19 patients predicted anxiety and psychological distress, but not fears associated with COVID-19. CONCLUSION: HCWs have a high prevalence of symptoms of mental disorders that may interfere with their work. These results may have therapeutic applications during pandemics.
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Affiliation(s)
- Fahmi H. Fadhel
- Department of Psychology, King Khalid University, Abha, Kingdom of Saudi Arabia
- Department of Psychology, Faculty of Arts, Hodeidah University, Al Hudaydah, Yemen
| | | | - Boshra A. Arnout
- Department of Psychology, King Khalid University, Abha, Kingdom of Saudi Arabia
- Department of Psychology, Faculty of Arts, Zagazig University, Zagazig, Egypt
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3019
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Albesher MB, Alqahtani S, Alghamdi FR. Castleman disease: Report of a case and review of literature on role of preoperative embolization. Int J Surg Case Rep 2022; 95:107222. [PMID: 35661495 PMCID: PMC9511694 DOI: 10.1016/j.ijscr.2022.107222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Castleman disease, which was first described by Dr. Castleman in 1954, is relatively rare and represents a spectrum of heterogeneous lymphoproliferative disorders with characteristic histological features on biopsy. It is classified based on body location and histology with variable clinical presentations. Its treatment depends on the subtype, and preoperative embolization for Castleman disease has rarely been discussed in the literature. Presentation of case A 22-year old man presented to the ENT clinic with a four-week history of a mass on the left side of the neck, which was associated initially with headache, fever, and fatigue for 2 days. Contrast tomography and magnetic resonance imaging revealed a hypervascular mass located at levels two and three of the left side of the neck with feeding vessels from the external carotid artery. Preoperative embolization was planned; however, the neurointerventionist considered it a lymph node that did not need embolization. Surgical excision was performed with relatively increased operative time and bleeding. A biopsy confirmed a hyaline-vascular type Castleman disease. Discussion We reviewed the evidence-based management of CD. We reviewed the available literature on the role of preoperative embolization in management. Conclusion Based on published articles and the hypervascular nature of the disease, we believe that preoperative embolization helps decrease morbidity. Castleman disease is an angiofollicular lymph node hyperplasia and a form of lymphoproliferative disorder Different disease types have different clinical presentation and management Main treatment of unicentric castleman disease is surgical excision Castleman disease lymph nodes are highly vascular and are prone to intraoperative bleeding and need for blood transfusion Preoperative embolization can help reduce operation time and complications
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Affiliation(s)
- Meshal B Albesher
- Department of Otorhinolaryngology Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, 12233, Saudi Arabia.
| | - Saeed Alqahtani
- Department of Otorhinolaryngology Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, 12233, Saudi Arabia
| | - Fareed R Alghamdi
- Department of Otorhinolaryngology Head and Neck Surgery, Prince Sultan Military Medical City, Riyadh, 12233, Saudi Arabia
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3020
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Salehi M, Nourbakhsh SMK, Ardakani MV, Abdollahi A, Khaki PA, Aliramezani A. Bilateral hip septic arthritis caused by nontyphoidal Salmonella group D in a 16-year-old girl with COVID-19: A case report. Int J Surg Case Rep 2022; 95:107202. [PMID: 35661497 PMCID: PMC9163488 DOI: 10.1016/j.ijscr.2022.107202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction and importance Nontyphoidal Salmonella infection can lead to gastroenteritis, enteric fever, and bacteremia. However, joint infections due to this bacterium are rare, and usually associated with immunosuppressive disorders. Case presentation A 16-year-old girl, with a recent history of acute lymphocytic leukemia (ALL) presented with bacteremia, and bilateral hip pain after COVID-19 symptoms. Clinical presentation, laboratory features and imaging showed bilateral nontyphoidal Salmonella septic arthritis. We administered antibiotics, based on antibiotics susceptibility pattern of the isolated Salmonella. Clinical discussion The case is presented because reports of bilateral hip joint infection due to nontyphoidal Salmonella are rare especially after COVID-19. When the patient presents with joint discomfort, the clinician should think infection especially in immunocompromised hosts. Conclusion It illustrates successful management of septic arthritis requires prompt clinical diagnosis, microorganism identification, administration of appropriate systemic antibiotics and hip joint surgery. Nontyphoidal Salmonella is one of the most important organisms involved in septic shock and arthritis. Acute lymphocytic leukemia (ALL) is a type of cancer that affects white blood cells (WBC). COVID-19 is a contagious disease caused by severe acute respiratory syndrome coronavirus.
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Affiliation(s)
- Mohammadreza Salehi
- Department of Infectious Diseases and Tropical Medicines, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Kazem Nourbakhsh
- Department of Pediatrics, Pediatric Hematology and Oncology Section, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Vahedian Ardakani
- Department of Orthopedics, Joint Reconstruction Research Centre, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Abdollahi
- Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Afarinesh Khaki
- Central Laboratory, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Aliramezani
- Central Laboratory, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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3021
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Eghbali F, Bhahdoust M, Khanafshar E, Pazouki A, Shahabi S, Kermansaravi M. Retroperitoneal duodenal perforation due to COVID-19: An extremely rare case report. Int J Surg Case Rep 2022; 95:107191. [PMID: 35572616 PMCID: PMC9091164 DOI: 10.1016/j.ijscr.2022.107191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/26/2022] [Accepted: 05/08/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction and importance Gastrointestinal (GI) symptoms are the most common extrapulmonary presentation of coronavirus disease 2019 (COVID-19) infection. GI perforation may be an unusual manifestation of COVID-19 infection. Case presentation We report a 45-year-old man who presented with acute abdominal pain without any respiratory symptoms to our emergency department. Investigations revealed retroperitoneal duodenal perforation and fibrotic changes in lung bases. Laboratory findings demonstrated a positive polymerase chain reaction (PCR) test for COVID-19 and mild leukocytosis. Clinical discussion COVID-19 related perforation of the retroperitoneal part of the duodenum is extremely rare, and to the best of our knowledge, this is the first reported case. With increasing COVID-19 infection, we might see more cases of GI perforation. In the era of COVID-19 pandemic, any abdominal signs and symptoms should alert the clinicians to consider COVID-19 diagnosis in the differential. Conclusion Conservative management with close monitoring, antibiotic therapy and serial examinations were completely successful. The patient's general condition improved, and he was discharged on day 7 of hospitalization. Retroperitoneal perforation of duodenum in COVID patients may occur rarely. Conservative management with close observation in these patients is feasible. CT scan and contrast study to roll out the generalized peritonitis are helpful.
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Affiliation(s)
- Foolad Eghbali
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mansour Bhahdoust
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Khanafshar
- Department of Pathology, University of California, San Francisco, California
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahab Shahabi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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3022
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Samarage HM, Kim WJ, Zarrin D, Goel K, Chin-Hsiu Wang A, Johnson J, Kaneko N, Nour M, Szeder V, Tateshima S, Jahan R, Duckwiler G, Colby GP. The "Bright Falx" Sign-Midline Embolic Penetration Is Associated With Faster Resolution of Chronic Subdural Hematoma After Middle Meningeal Artery Embolization: A Case Series. Neurosurgery 2022; 91:389-398. [PMID: 35551167 DOI: 10.1227/neu.0000000000002038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic subdural hematomas (CSDHs) are common in the elderly population and patients taking antiplatelet/anticoagulation medications. Middle meningeal artery (MMA) embolization has become an adjunctive treatment to observation and surgery. Despite many embolization techniques, best practices for optimal CSDH resolution remain unknown. OBJECTIVE To report a retrospective case series of MMA embolization for CSDHs regarding rate of hematoma improvement and the significance of distal embolic penetration into the falx. METHODS Retrospective chart review was performed on all patients who underwent MMA embolization for CSDHs between January 2017 and June 2021. Patient demographics, clinical presentation, anticoagulant use, and radiographic features were collected. Pre-embolization and postembolization computed tomography scans were analyzed for volumetric changes and assessed for midline penetration of embolic material in the falx. RESULTS MMA embolization was performed in 37 patients and 53 hemispheres. Older patients took longer to obtain complete resolution of CSDHs (r = 0.47, P = .03). Patients with larger pre-embolization (r = 0.57, P = .007) and postembolization (r = 0.56, P = .008) CSDH volumes took longer to completely resolve. Patients who had n-butyl cyanoacrylate embolization with midline penetration, as evidenced by the "bright falx" sign, had faster improvement rates than those who did not (5.64 cm3/d vs 1.2 cm3/d, P = .02). CONCLUSION Distal penetration of embolic material, particularly n-butyl cyanoacrylate, into the falx may lead to more rapid improvement of CSDH.
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Affiliation(s)
- Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Anthony Chin-Hsiu Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Naoki Kaneko
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - May Nour
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Satoshi Tateshima
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Reza Jahan
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Gary Duckwiler
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey Philip Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA.,Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
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3023
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Jamieson MJ, Byon W, Dettloff RW, Crawford M, Gargalovic PS, Merali SJ, Onorato J, Quintero AJ, Russ C. Apixaban Use in Obese Patients: A Review of the Pharmacokinetic, Interventional, and Observational Study Data. Am J Cardiovasc Drugs 2022; 22:615-631. [PMID: 35570249 PMCID: PMC9618533 DOI: 10.1007/s40256-022-00524-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
Abstract Relatively little is known about the influence of extreme body weight on the pharmacokinetics (PK), pharmacodynamics (PD), efficacy, and safety of drugs used in many disease states. While direct oral anticoagulants (DOACs) have an advantage over warfarin in that they do not require routine drug monitoring, some may regard this convenience as less compelling in obese patients. Some consensus guidelines discourage using DOACs in patients weighing > 120 kg or with a body mass index > 35–40 kg/m2, given a sparsity of available data in this population and the concern that fixed dosing in obese patients might lead to decreased drug exposure and lower efficacy. Per the prescribing information, apixaban does not require dose adjustment in patients weighing above a certain threshold (e.g., ≥ 120 kg). Data from healthy volunteers and patients with nonvalvular atrial fibrillation (NVAF) or venous thromboembolism (VTE) have shown that increased body weight has a modest effect on apixaban’s PK. However, the paucity of exposure data in individuals > 120 kg and the lack of guideline consensus on DOAC use in obese patients continue to raise concerns about potential decreased drug exposure at extreme weight. This article is the first to comprehensively review the available PK data in obese individuals without NVAF or VTE, and PK, PD, efficacy, effectiveness, and safety data for apixaban in obese patients with either NVAF or VTE, including subgroup analyses across randomized controlled trials and observational (real-world) studies. These data suggest that obesity does not substantially influence the efficacy, effectiveness, or safety of apixaban in these patients. Trial Registration ARISTOTLE: NCT00412984; AVERROES: NCT00496769; AMPLIFY: NCT00643201; AMPLIFY-EXT: NCT00633893; ADVANCE-1: NCT00371683; ADVANCE-2: NCT00452530; ADVANCE-3: NCT00423319 Video abstract Apixaban Use in Obese Patients: A Review of the Pharmacokinetic, Interventional, and Observational Study Data (MP4 161.22 MB)
Supplementary Information The online version contains supplementary material available at 10.1007/s40256-022-00524-x.
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Affiliation(s)
| | - Wonkyung Byon
- Global Product Development, Clinical Pharmacology, Pfizer, Groton, CT, 06340, USA
| | | | - Matthew Crawford
- Worldwide Research and Development, Computational Sciences, Pfizer, New York, NY, 10017, USA
| | - Peter S Gargalovic
- US Medical Cardiovascular, Bristol Myers Squibb, Princeton, NJ, 08648, USA
| | - Samira J Merali
- Clinical Pharmacology and Pharmacometrics, Bristol Myers Squibb, Princeton, NJ, 08648, USA
| | - Joelle Onorato
- US Medical Cardiovascular, Bristol Myers Squibb, Princeton, NJ, 08648, USA
| | - Andres J Quintero
- Internal Medicine, Medical Affairs, Medical Innovation and Effectiveness, Pfizer, New York, NY, 10017, USA
| | - Cristina Russ
- Internal Medicine, Medical affairs, Pfizer, New York, NY, 10017, USA
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3024
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Hammouda SB, Mabrouk S, Bellalah A, Maatouk M, Zakhama A, Njim L. Large splenic epithelial cyst: A rare presentation. Int J Surg Case Rep 2022; 95:107201. [PMID: 35594788 DOI: 10.1016/j.ijscr.2022.107201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Splenic cysts are infrequent and most of them are related to parasitic diseases. Splenic epithelial cyst (SEC) is the most common type of primary non-parasitic splenic cysts. Its pathogenesis is not yet clear. Splenic cysts are usually asymptomatic and are detected incidentally during imaging exams or an exploratory laparotomy. Case presentation Our case is about a primary SEC discovered incidentally. An 18-year-old male patient without any personal and family medical history, presented with symptoms of upper urinary tract infection. Renal ultrasound was performed and found incidentally a solitary cystic lesion in the spleen. A laparoscopic partial splenectomy was made then. The specimen was sent for pathological examination and a diagnosis of primary (epidermoid) epithelial splenic cyst was given. Clinical discussion SEC is a rare pathology that could mimic other splenic cysts like hydatid cyst. The preoperative diagnosis of SEC can be suspected by ultrasonography, computed tomography or magnetic resonance imaging. However, histopathological examination is mandatory to confirm the diagnosis. A wide range of differential diagnoses is considered when we suspect clinically SEC because of its lower incidence. Conclusion Actually, spleen-preserving surgery with minimally invasive methods such as laparoscopy is the gold standard for the treatment of SEC despite the risk of recurrence encountered with these techniques. However, different surgical modalities are discussed depending on the size and the location of the cyst and the patient's age. Splenic cysts are infrequent and most of them are related to parasitic diseases. Splenic epithelial cysts are usually asymptomatic and are detected incidentally during imaging exams. Histopathological examination is mandatory to confirm the diagnosis. Spleen-preserving surgery with minimally invasive methods such as laparoscopy is the gold standard for the treatment of splenic epithelial cyst.
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3025
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Prasetia R, Handoko HK, Rosa WY, Ismiarto AF, Petrasama, Utoyo GA. Primary traumatic shoulder dislocation associated with rotator cuff tear in the elderly. Int J Surg Case Rep 2022; 95:107200. [PMID: 35594787 DOI: 10.1016/j.ijscr.2022.107200] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction and importance The shoulder is one of the most unstable joints of the body. Shoulder dislocation accounts for up to 60% of all major joint dislocations. This study reports two cases of primary traumatic shoulder dislocation and shows that in the elderly, primary traumatic shoulder dislocation is associated with a rotator cuff tear (RCT). Case presentation A case report and narrative review included two female patients, aged 63 and 100 years. Presenting symptoms were instability, pain, and restricted shoulder movement. Both were successfully treated by surgery. Arthroscopy was performed in the first patient and open reduction in the second patient. Clinical discussion In the first case, we found synovitis around the rotator interval, long head of the biceps tendinitis, and tears of the subscapularis tendon, supraspinatus tendon, and subacromial bursitis. The anterior labrum was normal. In the second case, complete detachment of the infraspinatus tendon was found. In both cases, rotator cuff repair was performed. Primary traumatic shoulder dislocation in the elderly is often associated with rotator cuff injury. Therefore, a detailed evaluation and management of the rotator cuff injury is essential. Rotator cuff injuries cause loss of dynamic stabilization of the shoulder, leading to recurrent shoulder dislocation and chronic shoulder instability. Conclusion The associated pathology of the primary traumatic shoulder dislocation in elderly are rotator cuff tear. The management of the rotator cuff tear in primary traumatic shoulder dislocation can prevent further shoulder instability events. Primary traumatic shoulder dislocation in the elderly is highly associated with rotator cuff tear. The rotator cuff acted as a dynamic shoulder stabilizer. Early identification and treatment of the associated rotator cuff tear can prevent further shoulder instability.
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3026
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Bendaoud I, Etindele Sosso FA. Socioeconomic Position and Excessive Daytime Sleepiness: A Systematic Review of Social Epidemiological Studies. Clocks Sleep 2022; 4:240-259. [PMID: 35645243 PMCID: PMC9149899 DOI: 10.3390/clockssleep4020022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/01/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
The objectives of this empirical study are to describe and discuss the current literature available on the relationship between excessive daytime sleepiness (EDS) and the socioeconomic position (SEP) as well as to provide recommendations for consideration of SEP in sleep medicine and biomedical research. Databases Medline/PubMed, Web of Science, Google scholar and Scopus were screened from January 1990 to December 2020 using PRISMA guidelines and 20 articles were included in the final synthesis. Nineteen studies were cross-sectional and one study was longitudinal. Among these studies, 25.00% (n = 5) are focused on children and adolescent and the remaining 75.00% (n = 15) focused on adults and seniors. Ages ranged from 8 to 18 years old for children/adolescent and ranged from 18 to 102 years old for adults. Main SEP measures presented in these studies were education, income, perceived socioeconomic status and employment. The sample size in these studies varied from N = 90 participants to N = 33,865 participants. Overall, a lower educational level, a lower income and full-time employment were associated with EDS. Symptoms of EDS are prevalent in women, especially those with a low income or no job; and children and adolescents with difficult living conditions or working part time reported more sleep disturbances. SEP is already considered as an important determinant for many health outcomes, but if SEP is embedded in the experimental design in psychosomatic research, biomedical research and clinical practice as a constant variable regardless of outcome; it will move forward future investigations.
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Affiliation(s)
- Imene Bendaoud
- Clinical Pharmacology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Global Health and Ecoepidemiology, Redavis Institute, Montreal, QC H3S 1X5, Canada;
- Correspondence:
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3027
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Mavriqi L, Lorusso F, Tartaglia G, Inchingolo F, Scarano A. Transinusal Pathway Removal of an Impacted Third Molar with an Unusual Approach: A Case Report and a Systematic Review of the Literature. Antibiotics (Basel) 2022; 11:antibiotics11050658. [PMID: 35625302 PMCID: PMC9137649 DOI: 10.3390/antibiotics11050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 01/25/2023] Open
Abstract
Background: The purpose of the present case report was to investigate a very rare ectopic third molar removal by a trans-sinusal approach and report the study findings through a systematic review of the literature on this topic. Case presentation: A 38-year-old female patient was visited for pain at the level of the right maxillary region. No relevant medical history was reported. The CBCT tomography assessment revealed an impacted third tooth at the level of the postero-lateral maxilla. Review Methods: An electronic search was performed through Boolean indicators query on Pubmed/Medline, EMBASE, Cochrane Library databases. The clinical reports were identified and selected in order to perform a descriptive analysis. The surgical approach concerned a trans-sinusal access to the site for the ectopic tooth removal with a lateral antrostomy. No evident inflammatory alteration was associated to the ectopic tooth and a non-relevant post-operative sequelae was reported at the follow up. Results: A total of 34 scientific papers were retrieved from the database search. Only two cases reported a wait-and-see radiographical follow-up approach, while the most common treatment was surgical removal, also for asymptomatic cases. Conclusion: The third-molar ectopic tooth into the maxillary sinus is an uncommon occurrence that is beast treated by an in-chair intraoral tran-sinusal approach, with a consistent reduction of the invasivity, a mild morbidity and a successful functional outcome.
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Affiliation(s)
- Luan Mavriqi
- Faculty of Dental Medicine, Albanian University, 1023 Tirane, Albania;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Gianluca Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20122 Milano, Italy;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim 29312, Espirito Santo, Brazil
- Correspondence: ; Tel.: +39-087-1355-4084; Fax: +39-087-1355-4099
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3028
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Ahmead M, Hamamadeh N, Iram IA. The effects of internet and social media use on the work performance of physicians and nurses at workplaces in Palestine. BMC Health Serv Res 2022; 22:633. [PMID: 35550072 PMCID: PMC9097130 DOI: 10.1186/s12913-022-07934-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
Background The use of internet and social media applications in the workplace has increased dramatically with both beneficial and harmful effects. Their use also appears to affect job performance in the workplace. Aim To assess the beneficial and harmful effects of internet and social media application use in the workplace, and on the work performance of health professional in the major 4 referral hospitals in the cities of Hebron and Bethlehem. Method A cross-sectional study was conducted using self-reported questionnaires: a work-related social media questionnaire (WSMQ), and the William Anderson Work Performance Scale. The sample of the study included 409 participants (169 physicians and 240 nurses). Results The Pearson correlation test showed a weak positive statistically significant relationship between the WSMQ and William Anderson Work Performance Scale. The findings revealed that the overall mean score for the WSMQ was high (mean score 3.57), and the higher mean was for the beneficial WSMQ compared with the harmful WSMQ. The mean for the William Anderson Work Performance Scale was moderate performance (3.35). The higher mean was for Organizational Citizenship Behavior-Individual (OCBI), followed by In Role Behavior (IRB). Conclusion Palestinian healthcare professionals should be encouraged to use internet and social media applications to improve health outcomes, and provide health information to the community rather than simply using these tools for communication. Administrative staff and policy makers in Palestinian hospitals should regulate the use of internet and social media applications in hospitals by developing a clear policy on this topic for the workplace.
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Affiliation(s)
- Muna Ahmead
- Faculty of Public Health, Al Quds University, Jerusalem, Palestine.
| | - Nida Hamamadeh
- Faculty of Public Health, Al Quds University, Jerusalem, Palestine
| | - Issa Abu Iram
- Faculty of Public Health, Al Quds University, Jerusalem, Palestine
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3029
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Tortora F, Dei Giudici L, Simeoli R, Chiusolo F, Cairoli S, Bernaschi P, Bianchi R, Picardo SG, Dionisi Vici C, Goffredo BM. Therapeutic Drug Monitoring of Amphotericin-B in Plasma and Peritoneal Fluid of Pediatric Patients after Liver Transplantation: A Case Series. Antibiotics (Basel) 2022; 11:antibiotics11050640. [PMID: 35625284 PMCID: PMC9137682 DOI: 10.3390/antibiotics11050640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
Fungal infections represent a serious complication during the post-liver transplantation period. Abdominal infections can occur following pre-existing colonization, surgical procedures, and permanence of abdominal tubes. In our center, liposomal amphotericin-B is used as antifungal prophylaxis in pediatric patients undergoing liver transplantation. The aim of this study is to evaluate peritoneal levels of amphotericin-B following intravenous administration. Six liver recipients received liposomal amphotericin-B. Three of them were treated as prophylaxis; meanwhile, three patients received liposomal amphotericin-B to treat Candida albicans infection. Plasma and peritoneal amphotericin-B levels were measured by LC-MS/MS in two consecutive samplings. Cmin (pre-dose) and Cmax (2 h after the end of infusion) were evaluated as drug exposure parameters for both plasma and peritoneum. Our results showed that peritoneal amphotericin-B levels were significantly lower than plasma and that the correlation coefficient was 0.72 (p = 0.03) between plasma and peritoneal Cmin. Moreover, although peritoneal levels were within the therapeutic range, they never reached the PK/PD target (Cmax/MIC > 4.5). In conclusion, PK exposure parameters could be differently used to analyze amphotericin-B concentrations in plasma and peritoneum. However, liposomal amphotericin-B should be preferred in these patients as prophylactic rather than therapeutic treatment for fungal infections.
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Affiliation(s)
- Francesca Tortora
- Anesthesia and Critical Care Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.T.); (L.D.G.); (F.C.); (R.B.); (S.G.P.)
| | - Luigi Dei Giudici
- Anesthesia and Critical Care Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.T.); (L.D.G.); (F.C.); (R.B.); (S.G.P.)
| | - Raffaele Simeoli
- Department of Pediatric Specialties and Liver-kidney Transplantation, Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.C.); (C.D.V.); (B.M.G.)
- Correspondence: ; Tel.: +39-0668592174; Fax: +39-0668593009
| | - Fabrizio Chiusolo
- Anesthesia and Critical Care Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.T.); (L.D.G.); (F.C.); (R.B.); (S.G.P.)
| | - Sara Cairoli
- Department of Pediatric Specialties and Liver-kidney Transplantation, Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.C.); (C.D.V.); (B.M.G.)
| | - Paola Bernaschi
- Unit of Microbiology and Diagnostic Immunology, Department of Diagnostic and Laboratory Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Roberto Bianchi
- Anesthesia and Critical Care Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.T.); (L.D.G.); (F.C.); (R.B.); (S.G.P.)
| | - Sergio Giuseppe Picardo
- Anesthesia and Critical Care Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.T.); (L.D.G.); (F.C.); (R.B.); (S.G.P.)
| | - Carlo Dionisi Vici
- Department of Pediatric Specialties and Liver-kidney Transplantation, Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.C.); (C.D.V.); (B.M.G.)
| | - Bianca Maria Goffredo
- Department of Pediatric Specialties and Liver-kidney Transplantation, Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.C.); (C.D.V.); (B.M.G.)
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3030
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Mohammed HS, Fattah FH, Rahim HM, Kakamad FH, Mohammed SH, Salih RQ, Salih AM, Naqar S. Accelerated heparin-induced thrombocytopenia in a COVID-19 patient; a case report with literature review. Ann Med Surg (Lond) 2022;:103749. [PMID: 35573471 DOI: 10.1016/j.amsu.2022.103749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/07/2022] [Accepted: 05/08/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Heparin-induced thrombocytopenia (HIT) is a rare and serious immune-mediated complication of heparin therapy which is seldom reported in association with COVID-19. This report aims to present a case of accelerated HIT in a severe COVID-19 patient. Case report A 63-year-old man presents with symptoms of COVID-19 for one week. He was conscious, ordinated, feverish, and had diffused chest crackles. Initial laboratory tests revealed elevated C-reactive protein of 87.66 mg/dL, elevated D-dimmer of 1258.9 ng/ml, elevated ferritin of 1020 ng/ml, and his platelet count was within the normal range. Polymerase chain reaction (PCR) confirmed the diagnosis of COVID-19. On the 9th day of admission, he developed a progressive worsening of dyspnea. His D-dimmer level significantly increased to 7020 ng/ml, and his interleukin-6 was 27.3 pg/ml. Hence, we started him on unfractionated heparin (UFH) for thromboprophylaxis. On the 12th day of hospitalization, the platelet count dropped from 258000 to 111000 cells/μL. He had a high probability of HIT (4Ts score = 6). As a result, we discontinued UFH and switched him to apixaban. His platelet count normalized (174000 cells/μL) within two weeks of ceasing UHF. Discussion HIT results from the production of antibodies against platelet factor 4/heparin complexes. It is associated with a diminished platelet count within 5-10 days post heparin initiation. Because thrombocytopenia can occur in COVID-19 patients, HIT is seldom suspected. Conclusion HIT should be considered a differential diagnosis in COVID-19 patients with thrombocytopenia.
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3031
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Arief A, Budu, Usman MA, Sakti M, Lubis AMT, Bukhari A. Treatment of grade III knee osteoarthritis with bone marrow stimulation and intraarticular injection of triamcinolone and hyaluronic acid combination; three case report and literature review. Int J Surg Case Rep 2022; 95:107177. [PMID: 35623121 PMCID: PMC9136340 DOI: 10.1016/j.ijscr.2022.107177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Osteoarthritis is a severe joint disease that affects more than 60% of the elderly and more common an idiopathic disease or unknown cause although there is also a secondary cause such as trauma, infection, neurological or metabolic disorders. The usual complaints that perceived by osteoarthritis patients is pain in the affected joint. Many patients and providers think of arthroplasty as the only surgical option for the treatment of osteoarthritis of the knee. However, there are several other surgical options for osteoarthritis which can be therapeutic alternatives. The role of bone marrow stimulation and intraarticular injection with triamcinolone and Hyaluronic acid combination on grade III knee osteoarthritis patient has not been reported. CASE PRESENTATION Three patients who presented to orthopedic department with complaints of bilateral knee pain were identified with grade III osteoarthritis (Kellgren and Lawrence) receiving some kind of analgetic treatment for more than 1 year which provided pain relief for some time but not permanent. They underwent arthroscopic procedure (bone marrow stimulation) and then injected with triamcinolone and hyaluronic acid combination. Pre and post operation outcome scores (WOMAC score, Interleukin 15 and MRI) were assessed. At six-month follow-up, all patients reported improvement in pain and stiffness. WOMAC score and Interleukin 15 serum level decreases, MRI with Amadeus score showed improvement of cartilage defect. CLINICAL DISCUSSION This case report showed that our three patients were successfully treated with bone marrow stimulation and intraarticular injection with triamcinolone and hyaluronic acid combination. All three patients have improved in their functional outcome, IL 15 and cartilage defect. CONCLUSION Bone marrow stimulation and intraarticular injection with triamcinolone and hyaluronic acid combination can be a valuable treatment option for moderate active patients with grade III knee osteoarthritis.
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Affiliation(s)
- Ariyanto Arief
- Medical and Health Science Faculty of State Islamic Alauddin University Makassar, Indonesia; Department of Orthopedic and Traumatology, Hasri Ainun Habibie Hospital Parepare, Indonesia.
| | - Budu
- Medical Faculty of Hasanuddin University Makassar, Indonesia
| | - Muhammad Andry Usman
- Medical Faculty of Hasanuddin University Makassar, Indonesia; Department of Orthopedic and Traumatology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Muhammad Sakti
- Medical Faculty of Hasanuddin University Makassar, Indonesia; Department of Orthopedic and Traumatology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Andri Maruli Tua Lubis
- Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusomo Hospital Jakarta, Indonesia
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3032
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Juneja D. Ideal scoring system for acute pancreatitis: Quest for the Holy Grail. World J Crit Care Med 2022; 11:198-200. [PMID: 36331986 PMCID: PMC9136720 DOI: 10.5492/wjccm.v11.i3.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Clinical scoring systems are required to predict complications, severity, need for intensive care unit admission, and mortality in patients with acute pancreatitis. Over the years, many scores have been developed, tested, and compared for their efficacy and accuracy. An ideal score should be rapid, reliable, and validated in different patient populations and geographical areas and should not lose relevance over time. A combination of scores or serial monitoring of a single score may increase their efficacy.
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Affiliation(s)
- Deven Juneja
- Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi 110017, India
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3033
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Kerkeni Y, Thamri F, Zouaoui A, Houidi S, Jouini R. Is pneumoperitoneum specific of post-traumatic appendicitis? Case report and literature review. Ann Pediatr Surg 2022. [DOI: 10.1186/s43159-022-00168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Acute appendicitis and blunt abdominal trauma may co-exist, imposing a dilemma of whether there is only coincidence or there is a cause to effect relationship. The etiopathogenesis of this rare association remains obscure. Pneumoperitoneum has rarely been described in patients with acute perforative appendicitis following abdominal trauma.
Case presentation
We report a rare case of acute perforated appendicitis after blunt abdominal trauma in an 8-year-old boy revealed by a pneumoperitoneum. We also reviewed the literature on this rare condition to assess the specificity of pneumoperitoneum in the diagnosis and to understand its etiopathogenesis.
Conclusion
Abdominal pain and fever several days after an abdominal trauma may be a sign of post-traumatic appendicitis in the pediatric population. Pneumoperitoneum is not specific of post-traumatic appendicitis but it can be a protective sign, since it will lead to immediate laparotomy in patients with an unrecognized surgical abdomen.
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3034
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Pavone G, Tartaglia N, Pacilli M, Maddalena F, Petruzzelli F, Ambrosi A. Leak after sleeve gastrectomy with positive intraoperative indocyanine green test: Avoidable scenario? Int J Surg Case Rep 2022; 95:107168. [PMID: 35567877 PMCID: PMC9111972 DOI: 10.1016/j.ijscr.2022.107168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background The staple line gastric leak (GL) is estimated to be the most serious complication of the sleeve gastrectomy. The use of indocyanine green (ICG) has been introduced in minimally invasive surgery to show the vascularization of the stomach in real time and its application to the gastroesophageal junction (GE) during Laparoscopic Sleeve Gastrectomy (LSG) seems very promising. Case presentation We present the case of a 40-year-old female underwent laparoscopic sleeve gastrectomy. Intraoperative indocyanine green test showed a small dark area in the proximal third of the staple line reinforced with fibrin glue. Two weeks later the patient presented to the emergency room (ED) with abdominal pain, fever, vomiting, intolerance to oral intake and the evidence of a leak on the abdomen Computer Tomography (CT). The UIN for ClinicalTrial.gov Protocol Registration and Results System is: NCT05337644 for the Organization UFoggia. Conclusions This case report shows that intraoperative ICG test can be helpful in determining which patients are at greater risk of the leak and, more importantly, the cause of the leak but further tests are needed to determine if the ICG predicts leak due to ischemia. Fistulas after sleeve gastrectomy are complex and have multifactorial origins. Indocyanine Green (ICG) is a liquid that can be injected into the human bloodstream without adverse effects. This is a case report of a 40-year-old female with a positive intraoperative indocyanine green test as a prediction of the leak after sleeve gastrectomy.
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Affiliation(s)
- Giovanna Pavone
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 71122 Foggia, Italy.
| | - Nicola Tartaglia
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 71122 Foggia, Italy.
| | - Mario Pacilli
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 71122 Foggia, Italy.
| | - Francesca Maddalena
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 71122 Foggia, Italy
| | - Fabio Petruzzelli
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 71122 Foggia, Italy
| | - Antonio Ambrosi
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 71122 Foggia, Italy.
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3035
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Adhiguna MA, Pramod SV, Noegroho BS, Safriadi F, Hernowo BS. Case of metachronous clear cell bladder metastasis on low risk localized renal cell carcinoma patient. Int J Surg Case Rep 2022; 96:107158. [PMID: 35709632 DOI: 10.1016/j.ijscr.2022.107158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/30/2022] [Accepted: 04/30/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Renal cell carcinoma (RCC) is well known for its ability to metastasize into different organs. However, the management of metachronous RCC is still not yet standardized. CASE PRESENTATION A 62 years old man was presented with haematuria for the last 2 months. CT scan revealed bladder mass with a size of 2,5 cm and underwent en-bloc resection of bladder mass. The histopathological result showed non-muscle-invasive bladder clear cell renal carcinoma. The patient had a history of left nephrectomy in 2017 and meningioma mass metastasectomy in 2020 with the same histopathological origin. CONCLUSION Bladder metastasis of RCC can be treated by endoscopic surgical intervention.
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3036
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Émond M, Lachance-Perreault D, Boucher V, Carmichael PH, Turgeon J, Brousseau AA, Akoum A, Tourigny JN, Le Sage N. The impact of post-intubation hypotension on length of stay and mortality in adult and geriatric patients: a cohort study. CAN J EMERG MED 2022. [PMID: 35511403 DOI: 10.1007/s43678-022-00305-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/24/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To evaluate the association between standard post-intubation hypotension (< 90 mmHg) and in-hospital mortality. Secondary objectives were to evaluate the association of post-intubation hypotension and length of stay and to assess the impact of increasing post-intubation hypotension threshold to 110 mmHg on hospital length of stay and 48 h-mortality in patients aged ≥ 65 years. METHODS Design and setting: A cohort of patients admitted in a level-1 trauma centre emergency department (ED) between November 2011 and July 2016. INCLUSION CRITERIA aged ≥ 16 with available pre-intubation vital signs, intubation performed in ≤ 3 attempts with no surgical access needed. MEASURES Prospective electronic data collection was used for clinical data. MAIN OUTCOME 48-h in-hospital mortality. SECONDARY OUTCOME hospital length of stay. ANALYSES Univariate and multivariate analyses. RESULTS A total of 586 patients were included. The mean age was 56.3 ± 18.8 years and 37% were aged ≥ 65 years. Within 60 min of intubation, 224 (38%) patients had at least one systolic blood pressure measure < 90 mmHg and 164(28%) had at least two measures. The < 110 mmHg threshold showed a total of 377 patients (64%) had at least one systolic blood pressure measure < 110 mmHg and 286 (49%) had at least two measures. We found no significant difference in the risk of mortality overall and in stratified-age groups and no association with increased hospital length of stay using both post-intubation hypotension thresholds. CONCLUSION Post-intubation hypotension was recorded in one out of three patients in the ED but we found no association between post-intubation hypotension and 48-h in-hospital mortality overall in adults or geriatric patients.
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3037
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Pranasakti ME, Talirasa N, Rasena HA, Purwanto RY, Anwar SL. Thyrotoxicosis occurrence in SARS-CoV-2 infection: A case report. Ann Med Surg (Lond) 2022; 78:103700. [PMID: 35505686 DOI: 10.1016/j.amsu.2022.103700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Coronavirus Disease 2019 (COVID-19) is predominantly manifested as respiratory distress. There are growing reports of extrapulmonary clinical manifestations of COVID-19 in addition to the respiratory symptoms. COVID-19 has been associated with the thyroid function through Angiotensin-converting enzyme 2 (ACE2), the central mechanism through Thyroid Stimulating Hormone (TSH), and direct replication of the virus. Case presentation A 26-year-old woman presented with complaints of palpitation and abdominal pain for three days. Because the symptoms were worsening, she was brought to the emergency room. Her temperature was 37.9 °C without any symptoms of cough, coryza, sneezing, nor headache. Physical examination revealed tremor, tachycardia with 162 beats per minute (bpm), excessive sweating, hyperreflexia of patellar reflex, and no prominent lump in the neck. Electrocardiography (ECG) showed supraventricular tachycardic rhythm (SVT) and 150 J cardioversions were performed. The ECG converted to sinus rhythm, regular, with 120 bpm. Thyroid function tests showed an elevated fT4 level (>7.77 ng/dL) and low TSH level (<0.005 μIU/mL). Chest X-ray showed slight cardiomegaly without prominent abnormality in the lungs that was confirmed with thoracic computerized tomography. The result of the rapid antigen test for COVID-19 was positive and confirmed with polymerase chain reaction testing. She was then treated in the intensive isolation room with remdesivir, anti-hyperthyroid, and supportive therapy. As her condition improved, she was shifted to a non-intensive isolation room and was discharged from the hospital at day 7. Discussion COVID-19 could present as a thyroid crisis as the initial clinical manifestation. Clinicians should be aware that presentation of thyroid dysfunction in a patient without previous endocrine disease could be due to COVID-19 infection. Early recognition, anti-hyperthyroid therapy, and following isolation procedures for COVID-19 are required in the emergency condition. Thyroid crisis could be associated with COVID-19 infection. Extra-respiratory manifestations of COVID-19 infection vary among patients. Clinicians should be aware of thyroid crisis as a COVID-19 infection manifestation.
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3038
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Abdellatif W, Ding J, Spieler BM, Khosa F, Hussien AR, Kamel S, Elsayes KM, El-Diasty TA, Brewington C, Patlas MN. Influences of the Social Media Continuum Model in Radiology: Theory and Reality. Can Assoc Radiol J 2022; 73:618-625. [PMID: 35510769 DOI: 10.1177/08465371221096619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Social media utilization has been growing exponentially worldwide and has created a thriving venue for radiologists and the profession of radiology to engage in on both the academic and social levels. The aim of this article is to conduct updated literature review and address a gap in the literature by introducing a simple classification for social media utilization and a new theoretical model to outline the role and potential value of social media in the realm of radiology. We propose classifying social media through usage-driven and access-driven indices. Furthermore, we discuss the interdependency of radiologists, other physicians and non-physician stakeholders, scientific journals, conferences/meetings and the general public in an integrated social media continuum model. With the ongoing sub-specialization of radiology, social media helps mitigate the physical barriers of making connections with peers and audiences which would have otherwise been unfeasible. The constant evolution and diversification of social media platforms necessitates a novel approach to better understand its role through a radiological lens. With the looming fear of 'ancillary service' labelling, social media could be the golden plate to halt the path towards commoditization of radiology.
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Affiliation(s)
- Waleed Abdellatif
- Department of Radiology, 12334UT Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey Ding
- Faculty of Medicine, 12358University of British Columbia, Vancouver, BC, Canada
| | - Bradley M Spieler
- Department of Radiology, University Medical Center, 440927Louisiana State University, New Orleans, LA, USA
| | - Faisal Khosa
- Department of Emergency and Trauma Radiology, Vancouver General Hospital, Vancouver, BC, Canada
| | | | - Serageldin Kamel
- Department of Lymphoma/Myeloma, 4002University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Khaled M Elsayes
- Department of Abdominal Imaging, 4002The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tarek A El-Diasty
- Radiology Department, Urology and Nephrology Center, 68875Mansoura University, Mansoura, Egypt
| | - Cecelia Brewington
- Department of Radiology, 12334UT Southwestern Medical Center, Dallas, TX, USA
| | - Michael N Patlas
- Division of Emergency/Trauma Radiology, Department of Radiology, 3710McMaster University, Hamilton, ON, Canada
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3039
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Panigrahi M, Patel C, Chandrasekhar YBVK, Vooturi S. Endoscopic Management of Lateral Ventricle Arachnoid Cysts - Case Series with Proposed Classification. World Neurosurg 2022; 164:106-113. [PMID: 35525436 DOI: 10.1016/j.wneu.2022.04.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We present a case series of seven patients with intraventricular arachnoid cysts of lateral ventricle managed with endoscopic treatment with proposed classification of the cyst based on anatomical extent. METHODS In all patients, lateral ventricle arachnoid cyst was primarily located in trigone and body of the lateral ventricle. Proposed classification is based on extension of arachnoid cyst. Type 1-Arachnoid cyst located in lateral ventricle only, Type 2- Lateral ventricle arachnoid cyst extending to quadrigeminal cistern and Type 3- Lateral ventricle arachnoid cyst extending to velum interpositum cistern. RESULTS Two patients were managed with multiple fenestration and septostomy and in one patient where the cyst was not adherent to the ventricular wall and was excised completely. Two patients who had lateral ventricle cyst located in the atrium but extending to quadrigeminal cyst were managed with three fenestration. Two patients with lateral ventricle arachnoid cyst located into the atrium of lateral ventricle and extending to velum interpositum cistern through choroid fissure were managed with endoscopic three fenestrations. Post-operatively patients were followed clinically and by radiological imaging. None of the patients reported recurrence till latest follow up. CONCLUSION Multiple Endoscopic fenestration for lateral ventricle arachnoid cyst according to its location and anatomical extension helps in reduced recurrence and good outcome. Cyst excision is recommended only when the cyst wall is easily separable from the lateral ventricle wall. Intra operative use of thulium LASER helps in achieving early hemostasis and easy perforation of the thick wall of the cyst.
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Affiliation(s)
- Manas Panigrahi
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Telangana.
| | - Chirag Patel
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Telangana
| | - Y B V K Chandrasekhar
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Telangana
| | - Sudhindra Vooturi
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Telangana
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3040
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Arabadzhieva E, Bulanov D, Shavalov Z, Yonkov A, Bonev S. Spontaneous transvaginal intestinal evisceration in case of long-standing uterine prolapse. BMC Surg 2022; 22:157. [PMID: 35509095 DOI: 10.1186/s12893-022-01615-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Transvaginal intestinal evisceration is an extremely rare surgical emergency with potentially fatal consequences. Only a few more than 100 cases with this pathology have been described in the literature. Aetiology is also unclear and multifactoral. Case presentation We report the case of an 80-year-old female who presented with sudden severe abdominal pain and spontaneous small bowel evisceration through the vagina along with associated high-grade uterine prolapse. The loops and their mesentery appeared edematous, thickened and dusky, but without apparent necrosis. An urgent laparotomy was performed with subsequent reduction of the prolapsed small bowel into the abdomen, hysterectomy, partial resection of the vagina and vaginal closure. Additional cholecystectomy was necessary because of the visible pathologic changes of the gallbladder. The postoperative period was uneventful. The unique feature of our case is that there was no trigger factor (trauma, constipation or a coughing episode that would increase the intra-abdominal pressure), provoking the vaginal rupture and intestinal evisceration through it in the context of pelvic floor weakness. Conclusions Early detection and surgical management are crucial for preventing bowel ischemia and abdominal sepsis. If the eviscerated intestine is ischaemic and non-viable, this requires resection and anastomosis. The approach should be individualized and performed by a multidisciplinary team.
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3041
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AlShammari A, Burhamah W, Alnaqi A. A rare presentation of OEIS variant with a recto-bladder neck fistula: A case report and literature review. Int J Surg Case Rep 2022; 95:107144. [PMID: 35594790 PMCID: PMC9121239 DOI: 10.1016/j.ijscr.2022.107144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/26/2022] [Accepted: 04/30/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Omphalocele, bladder extrophy, imperforate anus and spinal defect (known as OEIS) is a very rare congenital anomaly with an unknown etiology. In this report we describe a case of an OEIS variant associated with a wide pubic diastasis, bladder extrophy with a recto-bladder neck fistula and a high ano-rectal malformation. This work has been reported in line with the SCARE 2020 criteria. Presentation of the case A 30-year-old mother delivered a male baby at 39 weeks through a normal vaginal delivery. Examination revealed multiple congenital anomalies in the form of an Omphalocele, extrophied bladder, imperforate anus, ambiguous genitalia and a large pelvic diastasis. Fecal matter was noted at the most inferior point of the extrophied bladder, raising the suspicion of a recto- vesical fistula. An exploratory laparotomy showed a fistula between the rectum and the neck of the extrophied bladder. A sigmoid colostomy was carried out in addition to a mucous fistula. The fascial defect of the Omphalocele was approximated to the upper border of the extrophied bladder. At the age of 2 years, the baby underwent a bladder extrophy repair, a posterior sagittal anorectoplasty and bilateral osteotomies. Discussion OEIS complex has been reported to occur with a wide variety of associated anomalies, and this necessitates a thorough investigation in order to formulate an appropriate treatment plan. A prenatal diagnosis of OEIS complex can be made by ultrasound stressing the importance of antenatal follow up and a multidisciplinary approach in management. Conclusion We described a rare variant of an OEIS complex and management of such anomalies requires a multidisciplinary input. OEIS complex is a very rare congenital anomaly. Our case is an OEIS variant associated with a high ano-rectal malformation. Management in a multidisciplinary team is essential.
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Affiliation(s)
| | | | - Amar Alnaqi
- Faculty of Medicine, Department of Surgery, Kuwait University, Kuwait; Department of Pediatric Surgery, Ibn Sina Hospital, Sabah Medical Center, Kuwait.
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3042
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Sumida K, Han Z, Chiu CY, Mims TS, Bajwa A, Demmer RT, Datta S, Kovesdy CP, Pierre JF. Circulating Microbiota in Cardiometabolic Disease. Front Cell Infect Microbiol 2022; 12:892232. [PMID: 35592652 PMCID: PMC9110890 DOI: 10.3389/fcimb.2022.892232] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 12/14/2022] Open
Abstract
The rapid expansion of microbiota research has significantly advanced our understanding of the complex interactions between gut microbiota and cardiovascular, metabolic, and renal system regulation. Low-grade chronic inflammation has long been implicated as one of the key mechanisms underlying cardiometabolic disease risk and progression, even before the insights provided by gut microbiota research in the past decade. Microbial translocation into the bloodstream can occur via different routes, including through the oral and/or intestinal mucosa, and may contribute to chronic inflammation in cardiometabolic disease. Among several gut-derived products identifiable in the systemic circulation, bacterial endotoxins and metabolites have been extensively studied, however recent advances in microbial DNA sequencing have further allowed us to identify highly diverse communities of microorganisms in the bloodstream from an -omics standpoint, which is termed "circulating microbiota." While detecting microorganisms in the bloodstream was historically considered as an indication of infection, evidence on the circulating microbiota is continually accumulating in various patient populations without clinical signs of infection and even in otherwise healthy individuals. Moreover, both quantitative and compositional alterations of the circulating microbiota have recently been implicated in the pathogenesis of chronic inflammatory conditions, potentially through their immunostimulatory, atherogenic, and cardiotoxic properties. In this mini review, we aim to provide recent evidence on the characteristics and roles of circulating microbiota in several cardiometabolic diseases, such as type 2 diabetes, cardiovascular disease, and chronic kidney disease, with highlights of our emerging findings on circulating microbiota in patients with end-stage kidney disease undergoing hemodialysis.
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Affiliation(s)
- Keiichi Sumida
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States,*Correspondence: Keiichi Sumida,
| | - Zhongji Han
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Chi-Yang Chiu
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Tahliyah S. Mims
- Department of Nutritional Sciences, College of Agriculture and Life Science, University of Wisconsin-Madison, Madison, WI, United States
| | - Amandeep Bajwa
- Transplant Research Institute, James D. Eason Transplant Institute, Department of Surgery, School of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Susmita Datta
- Department of Biostatistics, University of Florida, Gainesville, FL, United States
| | - Csaba P. Kovesdy
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States,Nephrology Section, Memphis Veterans Affairs (VA) Medical Center, Memphis, TN, United States
| | - Joseph F. Pierre
- Department of Nutritional Sciences, College of Agriculture and Life Science, University of Wisconsin-Madison, Madison, WI, United States
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3043
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Weaver P, Ng TH, Breeden T, Edwin SB, Haan B, Giuliano C. Management of Venous Thromboembolism in Morbid Obesity With Rivaroxaban or Warfarin. Ann Pharmacother 2022; 56:1315-1324. [PMID: 35505606 DOI: 10.1177/10600280221089008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Rivaroxaban is a first-line option for the management of venous thromboembolism (VTE). However, limited data are available regarding its effectiveness in morbidly obese patients. OBJECTIVE To evaluate rates of thrombosis and bleeding in morbidly obese patients receiving rivaroxaban or warfarin for VTE. METHODS A multicenter, retrospective cohort study was conducted to compare rates of bleeding and thrombosis in patients receiving rivaroxaban versus warfarin for acute VTE. Patients were included if they were older than 18 years and had a body mass index (BMI) greater than 40 kg/m2 or weight greater than 120 kg. The primary effectiveness outcome was hazard of VTE recurrence; the primary safety outcome was hazard of major bleeding. Patients were followed for up to 12 months. RESULTS A total of 1281 patients were identified for acute VTE and were included in this study with 487 patients receiving rivaroxaban and 785 receiving warfarin. The average cohort age was 57.6 ± 14.6 years, and the average weight was 136.4 ± 27.2 kg. After controlling for confounding factors, the use of rivaroxaban was not associated with an increased hazard of VTE events when compared with warfarin (hazard ratio [HR] = 0.69, 95% confidence interval [CI]: 0.42-1.08, P = 0.12) or major bleeding (HR = 1.29, 95% CI: 0.66-2.30, P = 0.52). CONCLUSION AND RELEVANCE No difference was observed in obese patients with weight >120 kg or BMI >40 kg/m2 receiving rivaroxaban or warfarin for VTE treatment in hazard of VTE or major bleeding. Either agent may be considered an appropriate treatment option in this population.
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Affiliation(s)
- Paige Weaver
- Department of Pharmacy, Ascension Genesys Hospital, Grand Blanc, MI, USA.,Department of Pharmacy, Maine Medical Center, Portland, ME, USA
| | - Tsz Hin Ng
- Department of Pharmacy, Detroit Receiving Hospital, Detroit, MI, USA.,Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA
| | - Thomas Breeden
- Department of Pharmacy, Ascension Genesys Hospital, Grand Blanc, MI, USA
| | - Stephanie B Edwin
- Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA
| | - Bradley Haan
- Department of Pharmacy, Ascension Genesys Hospital, Grand Blanc, MI, USA
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- Department of Pharmacy, Ascension Genesys Hospital, Grand Blanc, MI, USA.,Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA.,Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Christopher Giuliano
- Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA.,Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
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3044
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Soltany A, Hraib M, Alkhayer M, Ibraheem B, Alshehabi Z. Clinicopathological features of idiopathic granulomatous mastitis: A retrospective study & educational lessons from Syria. Ann Med Surg (Lond) 2022; 77:103587. [PMID: 35444802 PMCID: PMC9014359 DOI: 10.1016/j.amsu.2022.103587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Amjad Soltany
- Department of Plastic and Reconstructive Surgery, Al Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria
- Faculty of Medicine, Cancer Research Centre, Tishreen University, Latakia, Syria
- Corresponding author. Department of Plastic and Reconstructive Surgery, Al Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria.
| | - Munawar Hraib
- Faculty of Medicine, Cancer Research Centre, Tishreen University, Latakia, Syria
| | - Mawya Alkhayer
- Faculty of Medicine, Cancer Research Centre, Tishreen University, Latakia, Syria
| | - Batoul Ibraheem
- Faculty of Medicine, Cancer Research Centre, Tishreen University, Latakia, Syria
| | - Zuheir Alshehabi
- Faculty of Medicine, Cancer Research Centre, Tishreen University, Latakia, Syria
- Department of Pathology, Faculty of Medicine, Tishreen University Hospital, Latakia, Syria
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3045
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A/L Chandrasekaran T, Sahid NA, Maiyauen TK. Synchronous Gastrointestinal Stromal Tumor (GIST) with pancreatic adenocarcinoma: A case report. Ann Med Surg (Lond) 2022; 77:103588. [PMID: 35638052 PMCID: PMC9142392 DOI: 10.1016/j.amsu.2022.103588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Gastrointestinal Stromal Tumors (GIST) are rare mesenchymal neoplasm of gastrointestinal tract. Stomach is the most common site affected by GIST compared to other places in gastrointestinal track. The coexistence of GIST with another malignancy represents a rare phenomenon with few literature reported. Case presentation We present here 65 years old patient with stomach GIST and synchronous pancreatic adenocarcionoma discovered during surgery for suspected pancreatic mucinious cystadenoma. Distal pancreaticosplenectomy with excision of GIST Tumor & wedge resection of stomach was done. Histopathological examination of resected specimens reported the margins are clear. Discussion In this article we discuss on the option of systemic therapy versus upfront surgery and their outcome benefit based on literature review. Conclusion The coexistence of GIST with pancreatic adenocarcinoma is a rare condition. High clinical analysis needed during laparotomy for GIST to detect a synchronous tumor. In a case of GIST the surgeon should recognize the possibility of another tumor with different histological origin. Surgical excision is the mainstay of therapy and it has proven to be curative for our patient. . Due to its rare occurrence and limited literature further studies has to be done on GIST with other synchronous tumor to help the surgeon to manage the patient optimally. A rare presentation of Gastrointestinal Stromal Tumor (GIST) with Pancreatic Adenocarcinoma in a 65 years old gentleman. It is a challenging diagnostic dilemma in patients with dual pathology. There is a need of Intraoperative assessment in patients with GIST tumor to rule out synchronous tumors. It highlight the role of neoadjuvant imatinib versus surgery upfront benefits the prognosis.
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Affiliation(s)
| | - Nik Amin Sahid
- Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Corresponding author.
| | - Thanesh Kumar Maiyauen
- Surgical Department, Hospital Queen Elizabeth, 13a, Jalan Penampang, 88200, Kota Kinabalu, Sabah, Malaysia
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Beji H, Najib F, Zaiem A, Guelbi M, Rebai W, Kacem M. Idiopathic megabowel causing acute bowel obstruction: A case report. Ann Med Surg (Lond) 2022; 77:103665. [PMID: 35638050 PMCID: PMC9142543 DOI: 10.1016/j.amsu.2022.103665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hazem Beji
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
- University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
- Corresponding author. 52 - Street of roses - 8050 Hammamet – Tunisia, University of Tunis El Manar, Faculty of Medicine of Tunis, Department of general surgery A Hospital La Rabta, Tunis, Tunisia.
| | - Fatma Najib
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
- University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Asma Zaiem
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
- University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Mohamed Guelbi
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
- University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Wael Rebai
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
- University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Montassar Kacem
- Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia
- University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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Xiong S, Tang K. A diagnostic dilemma of a pulmonary nodule of a patient who suffered advanced ovarian cancer: A case report and a hypothesis. Int J Surg Case Rep 2022; 94:107111. [PMID: 35658287 PMCID: PMC9062447 DOI: 10.1016/j.ijscr.2022.107111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION This report presents a case of lung cancer which can be easily misdiagnosed as distant metastasis. Along with a literature review on the morphological, pathological and prognostic characteristics of lung cancer associated with cystic airspaces (LCCA), it would help to improve our understanding of the dynamic evolution of LCCA, to avoid its delayed diagnosis and treatment. We also propose here a hypothesis on the etiology of LCCA. CASE PRESENTATION A patient with advanced ovarian cancer who presented with elevated serum CA125 at time of admission and had undergone TAHBSO at first, and second operation of sigmoid colon resection was performed due to her locoregional recurrence of ovarian cancer. After her second operation, patient showed further increment of serum CA125 and CECT scan indicated an airspace-related pulmonary nodule in the right middle lobe of her lungs. It was suspected that distant metastases of ovarian cancer had reoccurred postoperatively. CLINICAL DISCUSSION After comparing the characteristic of metastatic ovarian cancer with LCCA, we diagnosed the pulmonary nodule as primary lung cancer. Surgery eventually confirmed the pulmonary nodule as second primary lung cancer associated with cystic airspaces. CONCLUSION The rare occurrence of LCCA should merit special attention from clinicians and radiologists so as to avoid missed or delayed diagnosis. We propose here a hypothesis that LCCA is related to spreading of tumour cells during surgical procedures in lung cancer surgery. Should our hypothesis be substantiated in further studies, this would affect the operation procedures for surgeons in the future.
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Affiliation(s)
- Shengchun Xiong
- Division of Thoracic, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, PR China.
| | - Keiyui Tang
- Division of Thoracic, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, PR China
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Ben Ismail I, Sghaier M, Boujmil K, Rebii S, Zoghlami A. Hydatid cyst of the liver fistulized into the inferior vena cava. Int J Surg Case Rep 2022; 94:107060. [PMID: 35413675 PMCID: PMC9018139 DOI: 10.1016/j.ijscr.2022.107060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022] Open
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Hennessy MM, Ryan D. Hyponatraemia secondary to terlipressin for gastric variceal bleeding – A case report. International Journal of Surgery Open 2022. [DOI: 10.1016/j.ijso.2022.100494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Yahya O, Obaisy MM, Al Laham O, Ghannam M, Mohammad A. Arteriomegaly with synchronous true aneurysms; Management of Common Femoral Artery and Profunda Femoris Artery aneurysms in a 70-year-old male – A case report. Int J Surg Case Rep 2022; 94:107161. [PMID: 35658314 PMCID: PMC9092966 DOI: 10.1016/j.ijscr.2022.107161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/01/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction and importance Arteriomegaly is characterized by an abnormal elastic defect of arterial vessels, which causes them to become elongated and tortuous. This raises the risk of limb loss due to thromboembolism, bleeding, infection, aneurysmal degeneration, dissection, or rupture. Despite asymptomatic presentations, surgical intervention could be warranted to plummet the morbidity and mortality associated with this pathology. Case presentation We report the case of a 70-year-old male who presented with intermittent claudication in the left lower limb at a 100 m. Clinical examination revealed a pulsatile mass in the left groin with absent pulses in the left Popliteal and Pedal arteries. Radiology demonstrated a diffuse enlargement of the Abdominal Aorta with an infrarenal AAA, a L-CFA aneurysm, and a L-PFA aneurysm accompanied by occlusion of the L-SFA. Open surgical repair was achieved. Clinical discussion Our patient was managed by arterial ligation and surgical excision of both concomitant aneurysms where we placed a Dacron graft from the L-CIA to the branch of the L-PFA whilst placing a supported ePTFE graft from the previously mentioned Dacron graft of the deep femoral branch to the left below-knee Popliteal Artery. Conclusion Arteriomegaly is considered an exceptionally rare and progressive disease. Patients affected by this pathology have higher incidence rates of aneurysmal degeneration and even loss of the affected limb, especially if it's a peripheral aneurysm. Bypass surgical repair is feasible with positive outcomes, and it is prophylactic against the wide spectrum of dire consequences for patients. Arteriomegaly is the vascular ectasia of arteries which may or may not be accompanied by aneurysms. Aneurysms are an abnormal expansion in the lumen diameter of arteries of 1.5 times the original diameter. The incidence of Arteriomegaly ranges from 1.6%–11% as an incidental finding in patients getting lower extremity imaging. FAAs are rare and constitute merely 3.1% out of the total number of arterial aneurysmal repair surgeries. Elective surgical repair of asymptomatic FAAs of a diameter larger than 25 mm is the gold standard.
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