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Zien NHR, Bakar NAA, Saad R. Unveiling insights: A dataset analysis of Islamic quality management systems in educational institutions toward SDG-aligned education. Data Brief 2024; 54:110343. [PMID: 38586132 PMCID: PMC10998043 DOI: 10.1016/j.dib.2024.110343] [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: 02/19/2024] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
This article presents data derived from a survey conducted to assess the validity and reliability of a newly developed instrument for Quality Management System items in the context of educational institutions. By analyzing the descriptive statistics, a concise overview of the main characteristics of the data set is provided, which facilitates the implementation and interpretation of the newly developed Quality Management System. Considering the need for quality education highlighted in the United Nations Sustainable Development Goals, organizations need to prioritize quality management, which can be achieved through the implementation of Quality Management Systems. The present data set focuses on Islamic Quality Management Systems in Malaysian educational institutions and includes responses from 35 Islamic private elementary school in different states in Malaysia. This dataset covers a wide range of variables relevant to the education sector and provides valuable insights for education stakeholders and curriculum developers. By aligning with the principles of quality education advocated by the SDGs, these findings offer significant opportunities to support educators and improve the quality of education.
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Affiliation(s)
| | - Nurul Azma Abu Bakar
- Islamic Business School, College of Business, Universiti Utara Malaysia, Kedah, Malaysia
| | - Rohaizah Saad
- School of Technology Management and Logistics, College of Business, Universiti Utara Malaysia, Kedah, Malaysia
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Duan Z, Ye Y, Li Z, Zhang B, Liu Q, Zhao Z, Wang W, Yu Z, Zhang H, Zhao Q, Wang B, Lv J, Guo S, Ren H, Gao R, Xu H, Wu Y. Contemporary spectrum, characteristics, and outcomes of adult patients with rheumatic valvular disease in China: Insights from the China-VHD study. Int J Cardiol Cardiovasc Risk Prev 2024; 21:200259. [PMID: 38525097 PMCID: PMC10957411 DOI: 10.1016/j.ijcrp.2024.200259] [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] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/28/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
Background Rheumatic valvular disease (RVD) represents a significant health concern in developing countries, yet a scarcity of detailed data exists. This study conducts a comprehensive examination of RVD patients in China, exploring aspects of the disease's spectrum, characteristics, investigation, management, and outcomes. Methods The China Valvular Heart Disease (China-VHD) study, a nationwide, multicenter, prospective observational study, enrolled 13,917 adults with moderate-to-severe valvular heart disease from April to June 2018. Among these, 2402 patients with native RVD (19.7% of native VHD patients) were analyzed. Results Among the RVD patients, the median age was 57 years (interquartile range 50-65), with 82.5% falling within the 40-70 age range; females were notably predominant (63.9%). Rheumatic etiology prevailed, particularly in southern regions (48.8%). Multivalvular involvement was observed in 47.4% of RVD cases, and atrial fibrillation emerged as the most common comorbidity (43.2%). Severe RVD affected 64.2% of patients. Valvular interventions were undertaken by 66.9% of RVD patients, predominantly involving surgical valve replacement (90.8%). Adverse events, encompassing all-cause mortality and heart failure hospitalization, occurred in 7.3% of patients during the 2-year follow-up. Multivariable analysis identified factors such as age, geographical region, low body mass index, renal insufficiency, left atrial diameter, and left ventricular ejection fraction <50% (all P < 0.05) associated with adverse events, with valvular intervention emerging as a protective factor (HR: 0.201; 95%CI: 0.139 to 0.291; p < 0.001). Conclusions This study delivers a comprehensive evaluation of RVD patients in China, shedding light on the spectrum, characteristics, investigation, management, and outcomes of this prevalent condition.
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Affiliation(s)
- Zhenya Duan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Yunqing Ye
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Zhe Li
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Bin Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Qingrong Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Zhenyan Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Weiwei Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Zikai Yu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Haitong Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Qinghao Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Bincheng Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Junxing Lv
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Shuai Guo
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Haocheng Ren
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Haiyan Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
| | - Yongjian Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing 100037, China
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Igai H, Sawabata N, Obuchi T, Matsutani N, Tsuboshima K, Okamoto S, Hayashi A. Current situation of management of spontaneous pneumothorax in Japan: A cross-sectional cohort study. Respir Investig 2024; 62:328-333. [PMID: 38401246 DOI: 10.1016/j.resinv.2024.02.006] [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: 09/27/2023] [Revised: 01/03/2024] [Accepted: 02/11/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Limited epidemiological information is available on spontaneous pneumothorax. To address this gap, the Japan Society for Pneumothorax and Cystic Lung Disease (JSPCLD) conducted a nationwide retrospective survey to investigate the current epidemiology of spontaneous pneumothorax in Japan. METHODS In this study, we conducted a retrospective cross-sectional cohort study to demonstrate the clinical features of spontaneous pneumothorax in one year from April 2019 to March 2020, compare patient characteristics and treatment outcomes between primary (PSP) and secondary spontaneous pneumothorax (SSP), and investigate the risk factors associated with in-hospital mortality among patients with SSP. RESULTS A total of 1784 patients from 28 institutions were enrolled in the study, with PSP observed in 956 cases (53.6%) and SSP in 817 cases (45.8%). The age distribution showed a biphasic peak caused by the different peaks between PSP and SSP. In-hospital mortality occurred in 42 cases (2.4%) among all patients, with 0 cases (0%) in PSP and 42 cases (5.1%) in SSP. Multivariable analyses revealed that interstitial pneumonia as an underlying disease (odds ratio: 2.4700, 95% confidence interval: 1.1100 to 5.4800, p = 0.0269), performance status≧3 (odds ratio: 7.3900, 95% confidence interval: 3.1900 to 17.2000, p < 0.0001), and lower value of serum albumin on admission (odds ratio: 0.4060, 95% confidence interval: 0.2140 to 0.7690, p = 0.0057) were significantly associated with in-hospital mortality among patients with SSP. CONCLUSIONS SSP patients with poor baseline conditions are at a higher risk for in-hospital mortality. It is crucial to provide close and meticulous management for SSP patients with compromised conditions.
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Affiliation(s)
- Hitoshi Igai
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, 389-1 Asakura, Maebashi, Gunma, 371-0811, Japan.
| | - Noriyoshi Sawabata
- Department of Thoracic and Cardio-Vascular Surgery, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8511, Japan
| | - Toshiro Obuchi
- Department of Thoracic Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka, 830-8543, Japan
| | - Noriyuki Matsutani
- Department of Surgery, Teikyo University Hospital, Mizonokuchi, 5-1-1 Futago, Takatsu, Kawasaki, Kanagawa, 213-8507, Japan
| | - Kenji Tsuboshima
- Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya, Tokyo, 158-0095, Japan
| | - Shouichi Okamoto
- Department of Respiratory Medicine, Saiseikai Ibaraki Hospital, 2-1-45 Mitsukeyama, Ibaraki, Osaka, 567-0035, Japan
| | - Akihiro Hayashi
- Department of General Thoracic Surgery, Shin Koga Hospital, 120 Tenjin, Kurume, Fukuoka, Japan
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Almothahbi A, Bukhari M, Almohizea M, Alsubaie N, Alharbi TF, Alhazzani HM, Zagzoog F. Recent updates in laryngeal hemangioma management: a scoping review. Eur Arch Otorhinolaryngol 2024; 281:2211-2222. [PMID: 38158419 DOI: 10.1007/s00405-023-08378-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To provide a comprehensive review of the current strategies in the management of laryngeal hemangiomas, with an aim to introduce a management algorithm that aligns with the variable clinical presentations and anatomical complexities of these lesions. METHODS We conducted an extensive literature search across major databases using specific and general terms, combined with Boolean operators, to ensure comprehensiveness. Articles from January 2004 to August 2023 were included, with findings categorized by management approach. RESULTS Laryngeal hemangiomas exhibit a spectrum of manifestations, ranging from asymptomatic lesions to those causing severe airway obstruction. Optimal management demands an individualized approach tailored to the patient's unique presentation and anatomical considerations. Diverse treatment modalities, each with distinct indications, advantages, and limitations, are explored. Notable highlights encompass the prominent role of Beta-blockers, notably Propranolol, in addressing problematic infantile hemangiomas, the nuanced efficacy of laser therapies contingent upon hemangioma type and depth, and the critical relevance of tracheotomy in emergencies. Novel approaches like transoral robotic surgery and transoral ultrasonic surgery, demonstrate promise in specific scenarios. We propose a management algorithm based on the complexity and presentation of laryngeal hemangiomas, emphasizing individualized treatment strategies, thereby addressing the unique challenges and nuances of each case. CONCLUSION Laryngeal hemangioma management requires personalized approaches informed by diverse therapies, clinical expertise, and collaboration. The review introduces an algorithm spanning observation to advanced interventions, adapting to each case's complexity. Ongoing research promises innovative treatments.
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Affiliation(s)
- Ali Almothahbi
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia.
| | - Manal Bukhari
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Nawaf Alsubaie
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Talal F Alharbi
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Faisal Zagzoog
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
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Guo L, Kang X, Su Y, Liu X, Xie W, Meng S, Liu Y, Wang W, Wang C. Oncologic and reproductive outcomes after fertility-sparing surgery for bilateral borderline ovarian tumors: A retrospective study. Eur J Obstet Gynecol Reprod Biol 2024; 296:107-113. [PMID: 38422803 DOI: 10.1016/j.ejogrb.2024.02.027] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES To investigate the oncological safety and fertility outcomes of different fertility-sparing surgery procedures for bilateral borderline ovarian tumors (BOTs) and to identify the safest and most effective approach to help patients conceive with minimal risk. STUDY DESIGN A retrospective study of 144 patients (≤40 years) with pathologically confirmed bilateral BOTs were included in the study.The effects of surgery type on fertility outcome and recurrence were compared. Cox regression analysis was employed to determine potential prognostic factors. Survival analysis utilized the Kaplan-Meier method. RESULTS Three therapeutic modalities were applied in our study, including bilateral ovarian cystectomy (BOC; n = 29), unilateral adnexectomy + contralateral cystectomy (UAC; n = 4) and radical surgery (n = 61). Totally 33 cases (22.9 %) relapsed during the follow-up period. In 37 % of cases administered conservative surgery, relapses were diagnosed in the first 2 years. Only conservative surgery and adjuvant chemotherapy were risk factors for recurrence. Meanwhile, a pregnancy rate of 55.4 % was obtained in patients with bilateral BOTs. The pregnancy rate was slightly higher but no significant (P = 0.539) difference in patients treated with BOC (n = 17, 63 %) compared with UAC (n = 29, 55.8 %) group. GnRHa treatment significantly improved the clinical pregnancy rate in this study(P = 0.029). CONCLUSIONS Satisfactory pregnancy rate can be achieved after conservative surgery in patients with bilateral BOTs. BOC is worth recommending for bilateral borderline ovarian tumors and a critical factor in fertility is the preservation of maximum healthy ovarian tissue. Patients should make a pregnancy plan in 2 years after the first surgery. GnRHa increase the rate of successful clinical pregnancies.
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Affiliation(s)
- Lili Guo
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyan Kang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Su
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wan Xie
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Silu Meng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhuan Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weijiao Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changyu Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Kuhar HN, Nesemeier R, Kim LR. Prevention and Management of Complications in Nasal Reconstruction. Facial Plast Surg Clin North Am 2024; 32:303-313. [PMID: 38575288 DOI: 10.1016/j.fsc.2024.01.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Nasal reconstruction is a challenging practice with the potential for complications. Surgeons can prevent complications through preoperative optimization of patient factors, refinement of intraoperative surgical techniques, and postoperative surgical and nonsurgical wound care. Preoperatively, optimization of modifiable and recognition of nonmodifiable risk factors is paramount. Intraoperatively, meticulous flap design and surgical technique promote healing. In the postoperative setting, attentive wound care, adjuvant therapies, and close follow-up for consideration of additional procedures enhance outcomes. By anticipating potential complications across perioperative settings, surgeons can prevent common complications in nasal reconstruction and more effectively manage those complications that arise.
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Affiliation(s)
- Hannah N Kuhar
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University Wexner Medical Center, Ohio State Eye and Ear Institute, 915 Olentangy River Road, Suite 4000, Columbus, OH 43212, USA
| | - Ryan Nesemeier
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University Wexner Medical Center, Ohio State Eye and Ear Institute, 915 Olentangy River Road, Suite 4000, Columbus, OH 43212, USA
| | - Leslie R Kim
- Department of Otolaryngology-Head and Neck Surgery, Ohio State University Wexner Medical Center, Ohio State Eye and Ear Institute, 915 Olentangy River Road, Suite 4000, Columbus, OH 43212, USA.
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Hewitt L, Dadich A, Hartz DL, Dahlen HG. The sustainability of midwifery group practice: A cross-sectional study of midwives and managers. Women Birth 2024; 37:101602. [PMID: 38518577 DOI: 10.1016/j.wombi.2024.101602] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/05/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
PROBLEM Although there is robust evidence for the benefits of midwifery group practice (MGP) caseload care, there are limited opportunities for women to access this model in Australia. There is also limited knowledge on how to sustain these services. BACKGROUND MGP can benefit childbearing women and babies and improve satisfaction for women and midwives. However, sustainability of the model is challenging. While MGPs are often supported and celebrated, in Australia some services have closed, while others struggle to adequately staff MGPs. AIM To investigate midwives and managers opinions on the management, culture, and sustainability of MGP. METHODS A national survey of MGP midwives and managers was distributed (2021 and 2022). Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using content analysis. RESULTS A total of 579 midwives and 90 managers completed the survey. The findings suggest that many MGPs do not support new graduates and students to work in MGP. Over half (59.8%) the participants (midwives and managers) reported that the women and families were the best aspect about working in MGP, while 44.3% said the effects on midwives' lifestyle and families were the worst aspect. DISCUSSION The relationship with women remains the major motivator for providing MGP care. However, work-life imbalance is a deterrent, exacerbated by staffing shortages. Staffing might be improved by adequate renumeration, strengthening orientation, and attracting new graduates and students through experience in MGP. CONCLUSIONS There is a need to attract midwives to MGP and improve work-life balance and sustainability.
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Affiliation(s)
- Leonie Hewitt
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Ann Dadich
- School of Business, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Donna L Hartz
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
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Tang WL, Rodriguez F. Racial and Ethnic Disparities in the Management of Chronic Coronary Disease. Med Clin North Am 2024; 108:595-607. [PMID: 38548466 PMCID: PMC10979033 DOI: 10.1016/j.mcna.2023.11.008] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Chronic coronary disease (CCD) comprises a continuum of conditions that include obstructive and non-obstructive coronary artery disease with or without prior acute coronary syndrome. Racial and ethnic representation disparities are pervasive in CCD guideline-informing clinical trials and evidence-based management. These disparities manifest across the entire spectrum of CCD management, spanning from non-pharmacological lifestyle changes to guideline-directed medical therapy, and cardiac rehabilitation to invasive procedures. Recognizing and addressing the historical factors underlying these disparities is crucial for enhancing the quality and equity of CCD management within an increasingly diverse population.
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Affiliation(s)
- Wilson Lay Tang
- Department of Medicine, Stanford University, 300 Pasteur Drive, L154, Stanford, CA 94305-5133, USA
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine and Cardiovascular Institute, Department of Medicine, Center for Academic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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Abstract
Inflammatory bowel disease is an important cause of chronic diarrhea in children, with a rising incidence, globally. The two main subtypes include Crohn's disease and ulcerative colitis. The clinical features are variable, and diagnosis requires initial first-line investigations followed by the involvement of specialist input for targeted imaging and endoscopy with biopsy, to confirm the diagnosis. Despite detailed investigation, inflammatory bowel disease may be clinically indistinguishable from chronic infections such as intestinal tuberculosis, and anti-tuberculosis treatment may be considered prior to further management considerations. The medical management of inflammatory bowel disease depends on subtype classification and severity, and may involve a step-wise approach to immunosuppressive therapies. In children, the consequences of poorly controlled disease are wide ranging, from psychosocial impacts and school non-attendance, to growth impairment and pubertal delay with subsequent impacts on bone health. In addition, an increased need for hospitalization and surgical intervention, and ultimately risk of cancer long-term. A multi-disciplinary team with expertise in inflammatory bowel disease is recommended to mitigate these risks and help to achieve the goal of sustained remission with endoscopic healing. This review focuses on updates on best clinical practice on the diagnosis and management of inflammatory bowel disease in children.
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Affiliation(s)
- Asha Jois
- Department of Gastroenterology and Nutrition, Royal Children's Hospital, Melbourne, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - George Alex
- Department of Gastroenterology and Nutrition, Royal Children's Hospital, Melbourne, 50 Flemington Road, Parkville, VIC, 3052, Australia.
- Department of Pediatrics, The University of Melbourne, Parkville, VIC, Australia.
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Kewan T, Stahl M, Bewersdorf JP, Zeidan AM. Treatment of Myelodysplastic Syndromes for Older Patients: Current State of Science, Challenges, and Opportunities. Curr Hematol Malig Rep 2024:10.1007/s11899-024-00733-y. [PMID: 38632155 DOI: 10.1007/s11899-024-00733-y] [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] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE OF REVIEW Myelodysplastic syndromes/neoplasms (MDS) represent a diverse group of pathologically distinct diseases with varying prognoses and risks of leukemia progression. This review aims to discuss current treatment options for elderly patients with MDS, focusing on patients ineligible for intensive chemotherapy or allogenic hematopoietic stem cell transplantation (HSCT). The challenges associated with treatment in this population and emerging therapeutic prospects are also explored. RECENT FINDINGS Recent advancements in molecular diagnostics have enhanced risk stratification by incorporating genetic mutations, notably through the molecular International Prognostic Scoring System (IPSS-M). Lower-risk MDS (LR-MDS) treatment ranges from observation to supportive measures and erythropoiesis-stimulating agents (ESAs), with emerging therapies like luspatercept showing promise. High-risk MDS (HR-MDS) is treated with hypomethylating agents (HMAs) or allogenic HSCT, but outcomes remain poor. Elderly MDS patients, often diagnosed after 70, pose challenges in treatment decision-making. The IPSS-M aids risk stratification, guiding therapeutic choices. For LR-MDS, supportive care, ESAs, and novel agents like luspatercept are considered. Treatment of HR-MDS involves HMAs or allogenic HSCT. Emerging treatments, including oral HMAs and novel agents targeting FLT3, and IDH 1/2 mutations, show promise. Future research should refine treatment strategies for this elderly population focusing on quality-of-life improvement.
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Affiliation(s)
- Tariq Kewan
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, and Yale Comprehensive Cancer Center, Yale University, New Haven, CT, USA
| | - Maximillian Stahl
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Jan Philipp Bewersdorf
- Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, and Yale Comprehensive Cancer Center, Yale University, New Haven, CT, USA.
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Campus G, Niu JY, Sezer B, Yu OY. Prevention and management of dental erosion and decay. BMC Oral Health 2024; 24:468. [PMID: 38632545 DOI: 10.1186/s12903-024-04257-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/19/2024] Open
Abstract
The 2017 Global Disease Study revealed 2.3 billion untreated cavities and 139 million other oral conditions like dental erosion. Modern treatments prioritise controlling etiological factors and preventing related diseases. This Editorial invites researchers to contribute to the collection, 'Prevention and management of dental erosion and decay'.
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Affiliation(s)
- Guglielmo Campus
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin Zahnmedizinische Kliniken, University of Bern, Bern, Switzerland
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Oskarsson IML, Vik E. Suggesting a holistic framework for understanding healthcare services leadership competence - a critical interpretive synthesis. Leadersh Health Serv (Bradf Engl) 2024; 37:99-129. [PMID: 38619933 DOI: 10.1108/lhs-08-2023-0059] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
PURPOSE Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners. DESIGN/METHODOLOGY/APPROACH In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence. FINDINGS Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal - and technical, and organisational internal and - external competencies. RESEARCH LIMITATIONS/IMPLICATIONS This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books. PRACTICAL IMPLICATIONS The holistic framework for healthcare leadership competences offers a common understanding of a "fuzzy" concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders. ORIGINALITY/VALUE This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.
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Affiliation(s)
| | - Erlend Vik
- Department of Business Administration and Social Sciences, Molde University College, Molde, Norway
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Nielsen MB, Evensen MC, Parveen S, Finne LB. Leaders as the targets of workplace bullying - prevalence and outcomes. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02066-y. [PMID: 38616187 DOI: 10.1007/s00420-024-02066-y] [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: 01/07/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Bullying of leaders is an underexplored topic in organizational research. To fill this knowledge gap, the aims of this study were to determine the prevalence of bullying of leaders and to examine whether holding a formal leadership position influences the relationships between exposure to bullying and the outcomes job satisfaction and depression. METHODS Data from two separate surveys were employed: (1) A cross-sectional occupation specific sample comprising 678 Norwegian child welfare social workers; (2) A nationally representative probability sample of 1,608 Norwegian employees with two time-points (6 months' time-lag). RESULTS Analyzing multiple indicators of workplace bullying, holding a formal leadership position had no impact on the initial risk of being bullied. Analyses of prospective data showed that leaders report a somewhat stronger increase in levels of bullying over time compared to non-leaders, although the effect size was small. With exception of a small buffering effect on the cross-sectional association between exposure to bullying behaviors and job satisfaction in the second sample, holding a leadership position had no effect on the strength of the association between bullying and outcomes. CONCLUSION The findings show that leaders have the same risk of being bullied and are influenced by bullying in roughly the same manner as non-leaders. Organizational measures and interventions against bullying should therefore consider leaders as a risk group in line with other employees.
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Affiliation(s)
- Morten Birkeland Nielsen
- National Institute of Occupational Health, PB 8149 Dep, Oslo, N-0033, Norway.
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.
| | | | - Sana Parveen
- National Institute of Occupational Health, PB 8149 Dep, Oslo, N-0033, Norway
| | - Live Bakke Finne
- National Institute of Occupational Health, PB 8149 Dep, Oslo, N-0033, Norway
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Mingels S, Granitzer M, Luedtke K, Dankaerts W. Therapeutic Patient Education as Part of the Physiotherapy Management of Adults with Headache: A Scoping Review. Curr Pain Headache Rep 2024:10.1007/s11916-024-01253-3. [PMID: 38613735 DOI: 10.1007/s11916-024-01253-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE OF REVIEW Physiotherapy interventions for headache mostly include exercise and manual therapy. Yet, the complex nature of headache, sometimes characterized by symptoms of facilitated central pain mechanisms, demands an individualized approach in which therapeutic patient education could be supportive. This scoping review aimed to summarize the position of therapeutic patient education within the physiotherapy management of adults with headache. PubMed, EMBASE, Web of Science, and Scopus were searched. The search-query comprised terminology relating to "headache", "education", and "physiotherapy". Eligibility criteria were: adults with headache, interventions including education within the domain of physiotherapy, reviews, clinical trials, cohort, case report, case-control studies. RECENT FINDINGS Eleven publications were included from the 281 retrieved publications. These publications were clinical trials (n = 4), reviews (n = 4), case-reports (n = 2), and a guideline (n = 1). Type of headaches studied were migraine (n = 3), post-traumatic headache (n = 2), tension-type headache (n = 2), cervicogenic headache (n = 1), primary headaches (n = 1), chronic daily headache (n = 1), and mixed migraine-cervicogenic headache (n = 1). Education seems an umbrella-term for postural education, lifestyle advice, and pain education. Three themes emerged across the publications: handling headache triggers (migraine, post-traumatic headache), promoting active lifestyle (post-traumatic headache, chronic daily headache, migraine), evaluating posture (post-traumatic headache, chronic daily headache, tension-type headache, cervicogenic headache). All publications recommended education in the management of headache. Only one (of the 11 included) publication described the educational program and determined its efficacy. Based on this scoping review, therapeutic patient education seems supported within physiotherapy management of headache. However, it is unclear how such education is tailored to the specific needs of the individual, the headache subtype, or when it should be added to physiotherapy management of headache.
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Affiliation(s)
- Sarah Mingels
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven University, Tervuursevest, 101, 3001, Leuven, Belgium.
- Faculty of Rehabilitation Sciences and Physiotherapy, REVAL Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium.
| | - Marita Granitzer
- Faculty of Rehabilitation Sciences and Physiotherapy, REVAL Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Kerstin Luedtke
- Department of Physiotherapy, Pain and Exercise Research, Universität Zu Lübeck, Lübeck, Germany
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven University, Tervuursevest, 101, 3001, Leuven, Belgium
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He Q, He Y, Duan L, Fan R. Application of nurse-led hierarchical management model on the patients of hepatobiliary surgery department. Asian J Surg 2024:S1015-9584(24)00597-9. [PMID: 38609826 DOI: 10.1016/j.asjsur.2024.03.170] [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: 02/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Affiliation(s)
- Qun He
- Department of Nursing, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, 641000, China.
| | - Yongzhi He
- Department of Rehabilitation, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, 641000, China
| | - Li Duan
- Department of Nursing, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, 641000, China
| | - Rui Fan
- Department of Nursing, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, 641000, China
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Fernandez de Casadevante T, Camino X, Arteche A, Alonso A, Martinage P. [Infective endocarditis due to Listeria monocytogenes: Case treated without surgical intervention with adequate clinical evolution]. Rev Esp Quimioter 2024:fernandez10apr2024. [PMID: 38594903 DOI: 10.37201/req/141.2023] [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] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Affiliation(s)
- T Fernandez de Casadevante
- Telmo Fernandez de Casadevante, H. U. Donosti, Begiristain Doktorea Pasealekua, s/n, 20014 Donostia, Gipuzkoa, Spain.
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Starace M, Pampaloni F, Lazaridou E, Kyrmanidou E, Stratigos A, Lallas A, Katoulis A, Sgouros D, Quadrelli F, Rapparini L, Cedirian S, Bruni F, Ala L, Rossi A, Piraccini BM, Apalla Z. Current Diagnostic and Therapeutic Practices in Alopecia Areata in Two Mediterranean Countries: A Survey-Based Study. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01141-z. [PMID: 38598171 DOI: 10.1007/s13555-024-01141-z] [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: 01/29/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Alopecia areata (AA) affects approximately 2% of the general population and is associated with significant psychosocial morbidity and poor health-related quality of life. Despite the high incidence of the disease the available clinical practice guidelines to help clinicians and improve patients' care are very poor and of a low methodological quality, as compared to other high-burden dermatoses. The aim of this survey is to capture the current clinical practice in AA management, as performed by dermatologists, in two Mediterranean countries to identify potential disparities and gaps in diagnosis and treatment. METHODS A 50-item questionnaire was created in the English language and then translated into Greek and Italian language and sent to the Greek and Italian dermatologists via email. RESULTS A total of 490 dermatologists from Italy and 234 from Greece participated in the survey. The diagnosis of AA is usually based on history and clinical examination, supported by trichoscopy. The rate of use of severity scores and scales to evaluate impact on quality of life by dermatologists was low. Treatment of patchy AA, in both adult and pediatric populations, is based on use of topical steroids as first-line treatment. Results on special site involvement (eyebrows, beard, and ophiasis), chronic cases, and the pediatric population highlight extreme heterogeneity in treatment approach. CONCLUSIONS Our results highlight that management of AA, in terms of diagnosis and treatment, is still challenging.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Pampaloni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elisabeth Lazaridou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Kyrmanidou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Aimilios Lallas
- 1st Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attiko" General Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attiko" General Hospital, Athens, Greece
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Ala
- Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Alfredo Rossi
- Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Zoe Apalla
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Eltweri AM, Basamh M, Ting YY, Harris M, Garcea G, Kuan LL. A retrospective multicentre clinical study on management of isolated splenic vein thrombosis: risks and benefits of anticoagulation. Langenbecks Arch Surg 2024; 409:116. [PMID: 38592545 PMCID: PMC11003905 DOI: 10.1007/s00423-024-03295-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Isolated splenic vein thrombosis (iSVT) is a common complication of pancreatic disease. Whilst patients remain asymptomatic, there is a risk of sinistral portal hypertension and subsequent bleeding from gastric varices if recanalisation does not occur. There is wide variation of iSVT treatment, even within single centres. We report outcomes of iSVT from tertiary referral hepatobiliary and pancreatic (HPB) units including the impact of anticoagulation on recanalisation rates and subsequent variceal bleeding risk. METHODS A retrospective cohort study including all patients diagnosed with iSVT on contrast-enhanced CT scan abdomen and pelvis between 2011 and 2019 from two institutions. Patients with both SVT and portal vein thrombosis at diagnosis and isolated splenic vein thrombosis secondary to malignancy were excluded. The outcomes of anticoagulation, recanalisation rates, risk of bleeding and progression to portal vein thrombosis were examined using CT scan abdomen and pelvis with contrast. RESULTS Ninety-eight patients with iSVT were included, of which 39 patients received anticoagulation (40%). The most common cause of iSVT was acute pancreatitis n = 88 (90%). The recanalisation rate in the anticoagulation group was 46% vs 15% in patients receiving no anticoagulation (p = 0.0008, OR = 4.7, 95% CI 1.775 to 11.72). Upper abdominal vascular collaterals (demonstrated on CT scan angiography) were significantly less amongst patients who received anticoagulation treatment (p = 0.03, OR = 0.4, 95% CI 0.1736 to 0.9288). The overall rate of upper GI variceal-related bleeding was 3% (n = 3/98) and it was independent of anticoagulation treatment. Two of the patients received therapeutic anticoagulation. CONCLUSION The current data supports that therapeutic anticoagulation is associated with a statistically significant increase in recanalisation rates of the splenic vein, with a subsequent reduction in radiological left-sided portal hypertension. However, all patients had a very low risk of variceal bleeding regardless of anticoagulation. The findings from this retrospective study should merit further investigation in large-scale randomised clinical trials.
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Affiliation(s)
- A M Eltweri
- Hepatobiliary and Pancreatic Surgery Department, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK.
| | - M Basamh
- Hepatobiliary and Pancreatic Surgery Department, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
| | - Y Y Ting
- Department of Surgery, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
| | - M Harris
- Department of Surgery, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
| | - G Garcea
- Hepatobiliary and Pancreatic Surgery Department, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
| | - L L Kuan
- Department of Surgery, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
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Si PEH, Parker S, Abdelhafiz D, Summerbell A, Muzulu S, Abdelhafiz AH. Cardiovascular risk reduction in older people with type 2 diabetes mellitus-a comprehensive narrative review. Diabetes Res Clin Pract 2024; 211:111662. [PMID: 38599285 DOI: 10.1016/j.diabres.2024.111662] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
Metabolic targets are controversial in older people with type 2 diabetes due to functional heterogeneity and morbidity burden. Tight blood pressure and metabolic control appears beneficial in fit individuals who are newly diagnosed with type 2 diabetes and have fewer comorbidities. The benefits of low blood pressure and tight metabolic control is attenuated with the development of comorbidities, especially frailty. Guidelines consider frail older people as one category and recommend relaxed targets. However, sarcopenic obese frail individuals may benefit from tight targets and intensification of therapy due to their unfavourable metabolic profile, accelerated diabetes trajectory and high cardiovascular risk. In addition, the early use of sodium glucose transporter-2 inhibitors and glucagon like peptide-1 receptor agonists may be beneficial in this frailty phenotype due to their cardio-renal protection, which is independent of glycaemic control, provided they are able to engage in resistance exercise training to avoid loss of muscle mass. In the anorexic malnourished frail individual, early use of insulin, due to its weight gain and anabolic properties, is appropriate. In this phenotype, targets should be relaxed with deintensification of therapy due to significant weight loss, decelerated diabetes trajectory and increased risk of medication side effects.
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Affiliation(s)
- Pann Ei Hnynn Si
- Sheffield Kidney Institute, Sheffield Teaching Hospitals, Herries Road, Sheffield S5 7AU, UK
| | - S Parker
- Translational Health Sciences, Bristol Medical School, Bristol, BS8 1QU
| | - D Abdelhafiz
- Lancaster Medical School, Lancaster, LA1 4YG, UK
| | - A Summerbell
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2 UD, UK
| | - S Muzulu
- Department of Diabetes and Endocrinology Rotherham General Hospital, UK
| | - Ahmed H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2 UD, UK.
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Gu S, Min X, Xu J, Chen S. Correlation of negative emotion, fatigue level and internet addiction in college students: implication for coping strategies. BMC Psychiatry 2024; 24:264. [PMID: 38594712 PMCID: PMC11003112 DOI: 10.1186/s12888-024-05711-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Internet addiction has an important influence on the development of physical and mental health of college students. The purpose of this study is to evaluate the current status and the correlation between college students' negative emotion, fatigue level and Internet addiction disorder, and to provide reference for the care and management of college students. METHODS We conducted a questionnaire survey on a cluster sample of college students from October to November 15, 2022. Internet addiction scale, fatigue assessment scale and positive and negative emotion scale were used for survey. Pearson correlation analysis and mediating effect test were performed to analyze the correlation and effects. RESULTS A total of 1546 valid questionnaires were collected. The incidence of internet addiction in college student was 20.38%. The total score of internet addiction was 52.94 ± 12.47, the total fatigue score was 69.27 ± 3.19, the score of positive emotion of college students was 31. 41 ± 5.09, and the negative emotion score was 18.54 ± 5.68. The total score of internet addiction were positively correlated with score of negative emotion (all P < 0. 05). The total score of internet addiction scale of college students were positively correlated and each factor score of with the score of fatigue severity (all P < 0. 05). Fatigue played an intermediary role in the prediction of negative emotion and internet addiction of college students, with an intermediary role of-0.433, accounting for 76.35% of the total effect. CONCLUSION The college students' positive emotion may be strengthened to reduce their fatigue level and negative emotion so as to reduce internet addiction.
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Affiliation(s)
- Shanshan Gu
- Zhejiang Business College, 310053, Hangzhou, Zhejiang, China
| | - Xue Min
- Zhejiang Business College, 310053, Hangzhou, Zhejiang, China
| | - Jing Xu
- Zhejiang Business College, 310053, Hangzhou, Zhejiang, China
| | - Shu Chen
- Center for Rehabilitation Medicine, Department of Rehabilitation, Comprehensive Rehabilitation Ward, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, No. 158 Shangtang road, Gongshu district, 310024, Hangzhou, Zhejiang Province, China.
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Galgani F, Rangel-Buitrago N. White tides: The plastic nurdles problem. J Hazard Mater 2024; 470:134250. [PMID: 38613955 DOI: 10.1016/j.jhazmat.2024.134250] [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] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
The proliferation of plastic pollution, particularly from nurdles (small plastic pellets used in manufacturing), poses significant environmental and ecological risks. Originating with the invention of Bakelite in 1907 and escalating post-World War II with advanced petrochemical technologies, nurdles are the second largest source of primary microplastic pollution globally. Each year an estimated 445,970 tonnes of nurdles enter the environment worldwide. Nurdle spills, such as those along Spain's Galician coast and other global incidents, underline the need for improved spill response, preventive measures, and international regulatory coordination. The environmental impact of nurdles, compared to more visible oil spills, is insidious and long-lasting due to their persistence and widespread dispersion. Current regulations, like the International Maritime Organization's (IMO) guidelines, reveal gaps in enforcement and fail to fully address the long-term consequences of spills. Recent technological innovations and policy interventions aim to mitigate risks, but there's an urgent need for coordinated global action, stricter controls, and investment in biodegradable alternatives to safeguard marine environments and ensure ecological sustainability.
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Affiliation(s)
- Francois Galgani
- Unité Ressources Marines en Polynésie Francaise, Institut Français de Recherche pour l'Exploitation de la Mer (Ifremer), BP 49, Vairao, Tahiti, French Polynesia
| | - Nelson Rangel-Buitrago
- Programade Física, Facultad de Ciencias Básicas, Universidad del Atlántico, Barranquilla, Atlántico, Colombia.
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Kanaya Y, Kawai N. Anger is eliminated with the disposal of a paper written because of provocation. Sci Rep 2024; 14:7490. [PMID: 38594343 PMCID: PMC11003969 DOI: 10.1038/s41598-024-57916-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Anger suppression is important in our daily life, as its failure can sometimes lead to the breaking down of relationships in families. Thus, effective strategies to suppress or neutralise anger have been examined. This study shows that physical disposal of a piece of paper containing one's written thoughts on the cause of a provocative event neutralises anger, while holding the paper did not. In this study, participants wrote brief opinions about social problems and received a handwritten, insulting comment consisting of low evaluations about their composition from a confederate. Then, the participants wrote the cause and their thoughts about the provocative event. Half of the participants (disposal group) disposed of the paper in the trash can (Experiment 1) or in the shredder (Experiment 2), while the other half (retention group) kept it in a file on the desk. All the participants showed an increased subjective rating of anger after receiving the insulting feedback. However, the subjective anger for the disposal group decreased as low as the baseline period, while that of the retention group was still higher than that in the baseline period in both experiments. We propose this method as a powerful and simple way to eliminate anger.
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Affiliation(s)
- Yuta Kanaya
- Department of Cognitive and Psychological Sciences, Nagoya University, Nagoya, 464-8601, Japan
| | - Nobuyuki Kawai
- Department of Cognitive and Psychological Sciences, Nagoya University, Nagoya, 464-8601, Japan.
- Academy of Emerging Science, Chubu University, Kasugai City, 487-8501, Japan.
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Roganovic J, Saric L, Segulja S, Dordevic A, Radosevic M. Panhypopituitarism caused by a suprasellar germinoma: A case report. World J Clin Cases 2024; 12:1844-1850. [DOI: 10.12998/wjcc.v12.i10.1844] [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: 01/04/2024] [Revised: 01/31/2024] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Suprasellar germinomas are rare intracranial tumors frequently associated with permanent endocrine disorders. We present the clinical picture, treatment, and complications of suprasellar germinoma at pediatric age which, besides being life-threatening, has lifelong endocrinological consequences.
CASE SUMMARY A 12-year-old female patient was presented having had intensive headaches for three weeks and visual disturbances for six months. An ophthalmological examination revealed bilateral papilledema and a marked loss of vision. Emergency brain magnetic resonance imaging (MRI) showed a suprasellar tumor, involving the infundibulum and the optic chiasm, extending to the third ventricle. Laboratory tests confirmed decreased levels of thyroxine, cortisol, gonadotropins, and insulin-like growth factor 1. Maximal tumor reduction was performed, and immunohistopathology established the diagnosis of suprasellar germinoma. MRI of the spine and cerebrospinal fluid cytology confirmed the localized disease. Adjuvant chemotherapy and radiotherapy were performed according to the SIOP CNS GCT II protocol. A post-treatment MRI showed no residual tumor, but pituitary function had not recovered. Three and a half years after the end of the treatment, the patient is in a complete remission, requiring hormonal replacement therapy, continuous education, and psychological support.
CONCLUSION This complex case highlights the importance of timely diagnosis, a multidisciplinary approach, and close follow-up in children with suprasellar germinomas.
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Affiliation(s)
- Jelena Roganovic
- Department of Pediatrics, Clinical Hospital Centre Rijeka, Rijeka 51000, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
| | - Lea Saric
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
| | - Silvije Segulja
- Faculty of Health Sciences, University of Rijeka, Rijeka 51000, Croatia
| | - Ana Dordevic
- Department of Business Development, Jadran Galenski Laboratorij, Rijeka 51000, Croatia
| | - Mia Radosevic
- Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
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Standing HR, Boag KF, Hamstead EC, Vaughan-Williams SR, Hughes MT, Peckham-Cooper A. Is pelvic ultrasound useful in the clinical assessment and management of women with right iliac fossa pain? A single-centre retrospective study. Ann R Coll Surg Engl 2024. [PMID: 38578035 DOI: 10.1308/rcsann.2023.0098] [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] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Acute right iliac fossa (RIF) pain is a common presenting symptom in surgical patients, with a wide range of differentials, particularly in premenopausal females. This study explores ultrasound usage in the management of women aged 16-55 years presenting with RIF pain. METHODS A total of 1,082 patients who presented to a tertiary hospital over 12 months were included. Data were collected from patients' electronic records, including initial clinical impression, imaging, management, operative findings, histology and subsequent hospital attendances within 6 weeks and within 6 months. RESULTS Following clinical assessment, 607 (56%) of patients underwent an ultrasound. Of these, 280 (25.9%) patients received no radiological imaging on initial presentation, and 252 (42%) had pathology identified on ultrasound. The most common finding was an ovarian cyst, closely followed by unexplained free pelvic fluid. Of the 607 patients scanned, 29 (4.8%) had an ultrasound diagnosis of appendicitis; 254 of 1,082 (23.5%) patients underwent operative management. Of the 254 patients who had surgery, 179 (70.5%) had preoperative imaging. Of the 29 (11.4%) cases where the intraoperative finding was gynaecological, 15 (51.7%) cases had not had any preoperative imaging. The negative appendicectomy rate was 21.3% (45/211). Of the 45 patients who had a histologically normal appendix, 22 (48.9%) had not had any previous imaging. Ultrasound had a specificity of 78% for diagnosing appendicitis. CONCLUSIONS In patients who underwent operative management, a negative finding or finding not requiring surgical management was associated with no preoperative imaging. This supports the use of ultrasound scans as an adjunct in a multimodal approach to the assessment of women presenting with RIF pain.
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Affiliation(s)
| | - K F Boag
- Leeds Teaching Hospitals NHS Trust, UK
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Flinspach AN, Raimann FJ, Kaiser P, Pfaff M, Zacharowski K, Neef V, Adam EH. Volatile versus propofol sedation after cardiac valve surgery: a single-center prospective randomized controlled trial. Crit Care 2024; 28:111. [PMID: 38581030 PMCID: PMC10996161 DOI: 10.1186/s13054-024-04899-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/03/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Optimal intensive care of patients undergoing valve surgery is a complex balancing act between sedation for monitoring and timely postoperative awakening. It remains unclear, if these requirements can be fulfilled by volatile sedations in intensive care medicine in an efficient manner. Therefore, this study aimed to assess the time to extubation and secondary the workload required. METHODS We conducted a prospective randomized single-center trial at a tertiary university hospital to evaluate the postoperative management of open valve surgery patients. The study was randomized with regard to the use of volatile sedation compared to propofol sedation. Sedation was discontinued 60 min after admission for critical postoperative monitoring. RESULTS We observed a significantly earlier extubation (91 ± 39 min vs. 167 ± 77 min; p < 0.001), eye-opening (86 ± 28 min vs. 151 ± 71 min; p < 0.001) and command compliance (93 ± 38 min vs. 164 ± 75 min; p < 0.001) using volatile sedation, which in turn was associated with a significantly increased workload of a median of 9:56 min (± 4:16 min) set-up time. We did not observe any differences in complications. Cardiopulmonary bypass time did not differ between the groups 101 (IQR 81; 113) versus 112 (IQR 79; 136) minutes p = 0.36. CONCLUSIONS Using volatile sedation is associated with few minutes additional workload in assembling and enables a significantly accelerated evaluation of vulnerable patient groups. Volatile sedation has considerable advantages and emerges as a safe sedation technique in our vulnerable study population. TRIAL REGISTRATION Clinical trials registration (NCT04958668) was completed on 1 July 2021.
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Affiliation(s)
- Armin Niklas Flinspach
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.
| | - Florian Jürgen Raimann
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Philipp Kaiser
- Department of Cardiothoracic Surgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Michaela Pfaff
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Kai Zacharowski
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Vanessa Neef
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Elisabeth Hannah Adam
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany
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Pozo-Rosich P, Carmo M, Muñiz A, Armada B, Moya-Alarcón C, Pascual J. Migraine treatment: quo vadis? Real-world data study (2015-2022) in Spain. BMC Neurol 2024; 24:107. [PMID: 38566063 PMCID: PMC10985889 DOI: 10.1186/s12883-024-03600-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Migraine is a leading cause of disability, estimated to affect one-in-ten people in Spain. This study aimed to describe the management of migraine in Spain and identify improvement areas. METHODS Non-interventional, retrospective, cross-sectional cohort study conducted using an electronic medical records database covering visits to public healthcare providers for 3% of the Spanish population. Patients with a migraine diagnosis (ICD-9 346) between 01/2015 and 04/2022 were included, as well as their demographic and clinical characteristics, prescribed migraine treatments and the specialty of the prescribing physicians. RESULTS The database included 61,204 patients diagnosed with migraine. A migraine treatment had been prescribed to 50.6% of patients over the last 24 months (only acute to 69.5%, both acute and preventive to 24.2%, and only preventive to 6.3%). The most frequently prescribed treatments were NSAIDs (56.3%), triptans (44.1%) and analgesics (28.9%). Antidepressants were the most common preventive treatment (prescribed to 17.9% of all treated patients and 58.7% of those treated with a preventive medication), and anti-CGRP monoclonal antibodies the least prescribed (1.7%; 5.7%). In 13.4% of cases, preventive medications were the first treatment: alone in 5.8% of cases and together with an acute medication in 7.6%. A fifth of patients who were initially prescribed with only acute treatment were later prescribed a preventive medication (20.7%). On average, it took 29.4 months for this change to occur. Two-thirds of patients started their preventive treatment in primary care (64.2%). The percentage of patients treated by a neurologist increased with the number of received preventive medications. However, 28.8% of patients who had already been prescribed five or more distinct preventive treatments were not treated by a neurologist. Migraine patients had between 1.2- and 2.2-times higher prevalence of comorbidities than the general population, age-gender adjusted. CONCLUSIONS Our study emphasizes the need for improved management of migraine in Spain to reduce the risk of chronification and improve patient outcomes. More training and coordination across healthcare professionals is necessary to recognize and address risk factors for migraine progression, including multiple associated comorbidities and several lines of treatment, and to provide personalized treatment plans that address the complex nature of the condition.
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Affiliation(s)
- Patricia Pozo-Rosich
- Neurology Department, Headache Unit, Hospital Universitari Vall d'Hebron, 119-129 Passeig de la Vall d'Hebron, Barcelona, 08035, Spain.
- Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | | | | | | | | | - Julio Pascual
- Service of Neurology, University Hospital Marqués de Valdecilla, Universidad de Cantabria and Valdecilla Biomedical Research Institute (IDIVAL), Santander, Cantabria, Spain
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Ntalouka MP, Koutalos A, Angelis F, Bareka M, Hantes M, Karachalios T, Arnaoutoglou E. Appraisal of the clinical practice guidelines on thromboprophylaxis in orthopaedic procedures; Do we AGREE (II)? Injury 2024; 55:111517. [PMID: 38582056 DOI: 10.1016/j.injury.2024.111517] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE Optimal thromboprophylaxis in orthopaedic procedures is crucial in an attempt to lower the risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism. We aim to: 1) identify clinical practice guidelines (CPGs) and recommendations (CPRs) on thromboprophylaxis in adult patients undergoing orthopaedic procedures, and 2) assess the methodological quality and reporting clarity of these guidelines. METHODS The study was conducted following the 2020 PRISMA guidelines for a systematic review and has been registered on the international prospective register of systematic reviews (PROSPERO) under the registration number (CRD42023406988). An electronic search was conducted using Medline, Embase, Cochrane, Web of Science, Google Scholar and medRxiv. The search terms used were ""adults", "orthopedic surgery", "orthopedic surgeries", "orthopedic surgical procedure", "orthopedic surgical procedures" "english language", "venous thromboembolism", in all possible combinations (January 2013 to March 2023). The eligible studies were evaluated by four blind raters, employing the Appraisal of Guidelines for Research & Evaluation II (AGREE-II) analysis tool. RESULTS The literature research resulted in 931 studies. Finally, a total of 16 sets of guidelines were included in the current analysis. There were 8 national and 8 international CPGs. Eight CPGs made specific recommendations for orthopaedic surgery and referred mostly to joints; one guideline focused on pelvi-acetabular trauma, while the rest were more inclusive and non-specific. Four guidelines, one from the American Society of Hematology (ASH), two from the United Kingdom (UK) and one from India were found to have the highest methodological quality and reporting clarity according to the AGREE-II tool. Inter-rater agreement was very good with a mean Cohens Kappa 0.962 (95 % CI, 0.895-0.986) in the current analysis. So, the reliability of the measurements can be interpreted as good to excellent. CONCLUSION Optimal thromboprophylaxis in orthopaedic procedures is crucial. The available guidelines were found to be mostly of high methodological quality and inter-rater agreement was very good, according to our study.
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Affiliation(s)
- Maria P Ntalouka
- Department of Anaesthesiology, Faculty of Medicine, School of Health Sciences University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece.
| | - Antonis Koutalos
- Department of Orthopaedic Surgery and Musculoskelatal Trauma, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece
| | - Fragkiskos Angelis
- Department of Orthopaedic Surgery and Musculoskelatal Trauma, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece
| | - Metaxia Bareka
- Department of Anaesthesiology, Faculty of Medicine, School of Health Sciences University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece
| | - Michael Hantes
- Department of Orthopaedic Surgery and Musculoskelatal Trauma, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece
| | - Theofilos Karachalios
- Department of Orthopaedic Surgery and Musculoskelatal Trauma, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece
| | - Eleni Arnaoutoglou
- Department of Anaesthesiology, Faculty of Medicine, School of Health Sciences University of Thessaly, Larissa University Hospital, 41110, Larissa, Thessaly, Greece.
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Panzuto F, Parodi MC, Esposito G, Massironi S, Fantin A, Cannizzaro R, Milione M, De Angelis CG, Annibale B. Endoscopic management of gastric, duodenal and rectal NETs: Position paper from the Italian Association for Neuroendocrine Tumors (Itanet), Italian Society of Gastroenterology (SIGE), Italian Society of Digestive Endoscopy (SIED). Dig Liver Dis 2024; 56:589-600. [PMID: 38216439 DOI: 10.1016/j.dld.2023.12.015] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/14/2024]
Abstract
The present paper reflects the position of the Italian Association for Neuroendocrine Tumors (Itanet), the Italian Society of Gastroenterology (SIGE), and the Italian Society of Digestive Endoscopy (SIED) regarding the management of patients affected by gastric, duodenal, and rectal neuroendocrine neoplasms (NENs) amenable to endoscopic treatment. The key questions discussed in this paper are summarized in Table 1. Data were extracted from the MEDLINE database through searches; expert opinions and recommendations are provided in accordance with the available scientific evidence and the authors' expertise. Recommendations are presented alongside a level of evidence and grade of recommendation based on the GRADE system. This paper specifically focuses on subgroups of NENs considered suitable for endoscopic management according to current international guidelines: i. well-differentiated gastric neuroendocrine tumors (gNET) type 1 < 2 cm and selected cases of type 3; ii. well-differentiated duodenal, non-functioning, non-ampullary NET with size < 2 cm; and well-differentiated rectal NET with size < 2 cm.
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Affiliation(s)
- Francesco Panzuto
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy.
| | - Maria Caterina Parodi
- Department of Gastroenterology and Digestive Endoscopy, IRCCS Teaching Hospital San Martino, Genova, Italy
| | - Gianluca Esposito
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
| | - Sara Massironi
- Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Alberto Fantin
- Gastroenterology Unit; Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Renato Cannizzaro
- Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - Massimo Milione
- Pathology First Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudio Giovanni De Angelis
- Gastroenterology Department, Endoscopy Unit, Azienda Ospedaliero Universitaria, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Bruno Annibale
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Digestive Disease Unit, ENETS Center of Excellence, Sant'Andrea University Hospital, Rome, Italy
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Ward SA, Habibi AA, Ashkenazi I, Arshi A, Meftah M, Schwarzkopf R. Innovations in the Isolation and Treatment of Biofilms in Periprosthetic Joint Infection: A Comprehensive Review of Current and Emerging Therapies in Bone and Joint Infection Management. Orthop Clin North Am 2024; 55:171-180. [PMID: 38403364 DOI: 10.1016/j.ocl.2023.10.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Periprosthetic joint infections (PJIs) are a devastating complication of joint arthroplasty surgeries that are often complicated by biofilm formation. The development of biofilms makes PJI treatment challenging as they create a barrier against antibiotics and host immune responses. This review article provides an overview of the current understanding of biofilm formation, factors that contribute to their production, and the most common organisms involved in this process. This article focuses on the identification of biofilms, as well as current methodologies and emerging therapies in the management of biofilms in PJI.
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Affiliation(s)
- Spencer A Ward
- NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, Room 1402, New York, NY 10003, USA
| | - Akram A Habibi
- NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, Room 1402, New York, NY 10003, USA
| | - Itay Ashkenazi
- NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, Room 1402, New York, NY 10003, USA
| | - Armin Arshi
- NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, Room 1402, New York, NY 10003, USA
| | - Morteza Meftah
- NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, Room 1402, New York, NY 10003, USA
| | - Ran Schwarzkopf
- NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, Room 1402, New York, NY 10003, USA.
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Román S, Olabarria C, Román M, Vázquez E. Recovery of fishery-stressed seagrass meadows is driven by improvements in wastewater management. Mar Pollut Bull 2024; 201:116282. [PMID: 38522336 DOI: 10.1016/j.marpolbul.2024.116282] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Salvador Román
- CIM - Centro de Investigación Mariña and Departamento de Ecoloxía e Bioloxía Animal, Facultade de Ciencias do Mar, Universidade de Vigo, 36310 Vigo, Spain.
| | - Celia Olabarria
- CIM - Centro de Investigación Mariña and Departamento de Ecoloxía e Bioloxía Animal, Facultade de Ciencias do Mar, Universidade de Vigo, 36310 Vigo, Spain
| | - Marta Román
- CIM - Centro de Investigación Mariña and Departamento de Ecoloxía e Bioloxía Animal, Facultade de Ciencias do Mar, Universidade de Vigo, 36310 Vigo, Spain
| | - Elsa Vázquez
- CIM - Centro de Investigación Mariña and Departamento de Ecoloxía e Bioloxía Animal, Facultade de Ciencias do Mar, Universidade de Vigo, 36310 Vigo, Spain
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Fernández-Ávila DG, Patiño-Hernández D, Moreno-Luna S, Brance L, Arbeláez Á, Vilar AC, Lozada C, Ríos C, Toro C, Ramírez C, Pons-Estel G, Ugarte-Gil M, Narváez M, Albanese M, Roa O, Ruiz O, Burgos P, Xavier R, Fuentes Y, Soriano E. Development of a novel clinimetric tool: PAtient Reported Disease Activity Index in Rheumatoid Arthritis (PARDAI-RA) by PANLAR, for the assessment of patients living with rheumatoid arthritis. Clin Rheumatol 2024; 43:1277-1285. [PMID: 38355831 PMCID: PMC10944809 DOI: 10.1007/s10067-024-06868-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Clinical experience has shown that a single measure is not sufficient to assess disease activity in rheumatoid arthritis (RA). Various clinimetric tools are necessary to address the many clinical situations that can arise. METHODS In order to develop a comprehensive measurement tool, the Pan American League of Associations for Rheumatology searched for the most frequent measures of disease activity applied in RA by means of a semi-systematic review of the available literature. RESULTS We found that the most frequently reported measures of disease activity were the 28-joint Disease Activity Score, C-reactive protein, and the erythrocyte sedimentation rate, followed by patient-reported measures of pain and stiffness and many other composite indices and patient-reported outcome measures. The most frequent physician-reported sign of disease was the swollen joint count, and the most frequently self-reported feature was the increase in disease activity or flares. CONCLUSION In this article, we present a new clinimetric tool developed based on expert consensus and on data retrieved from our search. Disease activity can be better assessed by combining various data sources, such as clinical, laboratory, and self-reported outcomes. These variables were included in our novel clinimetric tool. Key Points • The goal of treatment of RA is to achieve the best possible control of inflammation, or even remission; therefore, disease management should include systematic and regular evaluation of inflammation and health status. • Clinimetric tools evaluate a series of variables (e.g., symptoms, functional capacity, disease severity, quality of life, disease progression) and can reveal substantial prognostic and therapeutic differences between patients. • Our clinimetric tool, which is based on a combination of data (e.g., clinical variables, laboratory results, PROMs), can play a relevant role in patient assessment and care.
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Affiliation(s)
- Daniel G Fernández-Ávila
- Rheumatology Division, Pontificia Universidad Javeriana - Hospital Universitario San Ignacio, Bogotá, Colombia.
| | | | | | - Lorena Brance
- Rheumatology Division, Universidad Nacional de Rosario, Santa Fe, Argentina
| | | | | | - Carlos Lozada
- Rheumatology Division, University of Miami, Coral Gables, USA
| | - Carlos Ríos
- Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador
| | - Carlos Toro
- Centro de Referencia en Osteoporosis y Reumatología, Cali, Colombia
| | | | - Guillermo Pons-Estel
- Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | | | | | | | - Orlando Roa
- Rheumatology Division Keralty, Bogotá, Colombia
| | - Oscar Ruiz
- Rheumatology Division Keralty, Bogotá, Colombia
| | - Paula Burgos
- Clinic Immunology and Rheumatology Department, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Ricardo Xavier
- Rheumatology Service Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Enrique Soriano
- Rheumatology Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Minta KJ, Kannan S, Kaliaperumal C. Outcomes of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of paediatric hydrocephalus: Systematic review and meta-analysis. Childs Nerv Syst 2024; 40:1045-1052. [PMID: 38010433 PMCID: PMC10972931 DOI: 10.1007/s00381-023-06225-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE To evaluate the outcomes of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of paediatric hydrocephalus. METHODS We searched PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials databases for articles published from 2000 to May 2023 (last search date May 6, 2023). Keywords searched included "endoscopic third ventriculostomy", "ventriculoperitoneal shunting", "paediatric population", and "outcomes". Using random-effects models, we compared success rates and complications of ETV and VPS. The primary outcome was ETV vs.VPS success rates, and the secondary outcome was post-treatment complications. Included studies reported on treatment success and complication rates. RESULTS Out of 126 articles, 8 RCTs and 1 prospective study were included. Six studies reported primary outcome data (806 patients identified: 464 in ETV group, 342 in VPS group). Combined success rates were 81.8% (n = 283/346) for ETV and 86.7% (n = 182/210) for VPS (median follow-up 41 months). There was no difference in success rates between ETV and VPS groups (risk ratio 0.84, 95% confidence interval 0.80-0.90, I2 = 0%, p = 0.93). Combined complication rates were 4.6% (n = 16/346) in the ETV group and 27.1% (n = 57/210) in the VPS group. ETV had a lower rate of postoperative complications (risk ratio 0.76, 95% confidence interval 0.42-1.38, I2 = 53%, p = 0.04). CONCLUSIONS Both ETV and VPS are viable surgical options for the management of paediatric hydrocephalus with similar success rates when used as first-line treatment. However, our study concluded that VPS results in a higher complication rate. REGISTRATION This systematic review and meta-analysis was formally registered in the PROSPERO International database under the registration number CRD42023452907 on the 29th of August 2023.
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Affiliation(s)
- Katarzyna Julia Minta
- University of Aberdeen School of Medicine Medical Sciences and Nutrition, Polwarth Building, Foresterhill Rd, Aberdeen, AB25 2ZD, UK.
| | - Siddarth Kannan
- School of Medicine, University of Central Lancashire, Preston, UK
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Mao Y, Ma S, Liu C, Liu X, Su M, Li D, Li Y, Chen G, Chen J, Chen J, Zhao J, Guo X, Tang J, Zhuge Y, Xie Q, Xie W, Lai R, Cai D, Cai Q, Zhi Y, Li X. Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update. Hepatol Int 2024; 18:384-419. [PMID: 38402364 DOI: 10.1007/s12072-023-10633-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/18/2023] [Indexed: 02/26/2024]
Abstract
Drug-induced liver injury (DILI) is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases. Currently, the diagnosis of DILI still follows the strategy of exclusion. Therefore, a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis. This guideline was developed based on evidence-based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice. Based on the clinical settings in China, the guideline also specifically focused on DILI in chronic liver disease, drug-induced viral hepatitis reactivation, common causing agents of DILI (herbal and dietary supplements, anti-tuberculosis drugs, and antineoplastic drugs), and signal of DILI in clinical trials and its assessment.
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Affiliation(s)
- Yimin Mao
- Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China.
| | - Shiwu Ma
- Department of Infectious Diseases, The 920th Hospital of Chinese PLA Joint Logistics Support Force, Kunming, 650032, Yunnan, China
| | - Chenghai Liu
- Institute of Liver Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xiaoyan Liu
- Department of Pharmacy, Huangpu Branch of the 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Minghua Su
- Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Dongliang Li
- Department of Hepatobiliary Medicine, The 900th Hospital of Chinese PLA Joint Logistics Support Force, Fuzhou, 350025, Fujian, China
| | - Yiling Li
- Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China
| | - Gongying Chen
- Department of Liver Diseases, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, Zhejiang, China
| | - Jun Chen
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, 518112, Guangdong, China
| | - Jinjun Chen
- Hepatology Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Jingmin Zhao
- Department of Pathology and Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Xiaoyan Guo
- Department of Gastroenterology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Jieting Tang
- Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China
| | - Yuzheng Zhuge
- Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China
| | - Qing Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Wen Xie
- Center of Liver Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, 100088, China
| | - Rongtao Lai
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Dachuan Cai
- Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China
| | - Qingxian Cai
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, 518112, Guangdong, China
| | - Yang Zhi
- Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China
| | - Xiaoyun Li
- Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China
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Maharani K, Dian S, Ganiem AR, Imran D, Estiasari R, Ardiansyah E, Andini PW, Kristina F, Pangeran D, Chaidir L, Alisjahbana B, Rukmana A, Kusumaningrum A, Adawiyah R, Subekti D, Yunihastuti E, Yunus RE, Waslia L, van Ingen J, van Laarhoven A, Hamers RL, van Crevel R. Clinical presentation, management, and outcome of suspected central nervous system infections in Indonesia: a prospective cohort study. Infection 2024; 52:583-595. [PMID: 38315377 PMCID: PMC10954958 DOI: 10.1007/s15010-023-02170-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Little is known about the etiology, clinical presentation, management, and outcome of central nervous system (CNS) infections in Indonesia, a country with a high burden of infectious diseases and a rising prevalence of HIV. METHODS We included adult patients with suspected CNS infections at two referral hospitals in a prospective cohort between April 2019 and December 2021. Clinical, laboratory, and radiological assessments were standardized. We recorded initial and final diagnoses, treatments, and outcomes during 6 months of follow-up. RESULTS Of 1051 patients screened, 793 were diagnosed with a CNS infection. Patients (median age 33 years, 62% male, 38% HIV-infected) presented a median of 14 days (IQR 7-30) after symptom onset, often with altered consciousness (63%), motor deficits (73%), and seizures (21%). Among HIV-uninfected patients, CNS tuberculosis (TB) was most common (60%), while viral (8%) and bacterial (4%) disease were uncommon. Among HIV-infected patients, cerebral toxoplasmosis (41%) was most common, followed by CNS TB (19%), neurosyphilis (15%), and cryptococcal meningitis (10%). A microbiologically confirmed diagnosis was achieved in 25% of cases, and initial diagnoses were revised in 46% of cases. In-hospital mortality was 30%, and at six months, 45% of patients had died, and 12% suffered from severe disability. Six-month mortality was associated with older age, HIV, and severe clinical, radiological and CSF markers at presentation. CONCLUSION CNS infections in Indonesia are characterized by late presentation, severe disease, frequent HIV coinfection, low microbiological confirmation and high mortality. These findings highlight the need for earlier disease recognition, faster and more accurate diagnosis, and optimized treatment, coupled with wider efforts to improve the uptake of HIV services.
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Affiliation(s)
- Kartika Maharani
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Sofiati Dian
- Department of Neurology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia.
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
| | - Ahmad Rizal Ganiem
- Department of Neurology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Darma Imran
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Riwanti Estiasari
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Edwin Ardiansyah
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Putri Widya Andini
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fransisca Kristina
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - David Pangeran
- Department of Neurology, Faculty of Medicine, Dr. Cipto Mangunkusumo, General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Lidya Chaidir
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Bachti Alisjahbana
- Research Center for Care and Control of Infectious Disease (RC3ID), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Andriansjah Rukmana
- Department of Microbiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Ardiana Kusumaningrum
- Department of Microbiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Robiatul Adawiyah
- Department of Parasitology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Decy Subekti
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Evy Yunihastuti
- Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Reyhan Eddy Yunus
- Department of Radiology, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Lia Waslia
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Jakko van Ingen
- Department of Microbiology, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Arjan van Laarhoven
- Department of Internal Medicine, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Raph L Hamers
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Center for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Reinout van Crevel
- Department of Internal Medicine, Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, Nijmegen, The Netherlands
- Center for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Shan HD, Vilarello BJ, Jacobson PT, Tervo JP, DiMango E, Gudis DA, Overdevest JB. Surgical and medical management of chronic rhinosinusitis in pediatric cystic fibrosis patients: Impact on olfactory symptoms. Int J Pediatr Otorhinolaryngol 2024; 179:111898. [PMID: 38452513 DOI: 10.1016/j.ijporl.2024.111898] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/13/2024] [Accepted: 02/16/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND PURPOSE Olfactory dysfunction (OD) commonly occurs in patients with sinonasal dysfunction, but the prevalence and severity of olfactory issues in adolescents with cystic fibrosis (AwCF) is unclear. OD may contribute to dietary deficiencies and exacerbate nutritional challenges. We sought to review literature on the effectiveness of medical and surgical management of sinonasal symptoms in AwCF and the associated impact on olfactory function. METHODS We performed a systematic literature search of PubMed, Embase, Web of Science, and Ebsco CINAHL from 1980 to 2022 per PRISMA-ScR protocols to conduct a scoping review in an effort to compile data on study design, patient demographics, clinical characteristics and outcomes, along with risk of bias. RESULTS Of 368 abstracts, 3 articles exclusively evaluated AwCF for a total of 34 patients. Two studies evaluated endoscopic sinus surgery (ESS) and dornase alfa. An additional 6 articles were included for mixed pediatric and adult CF populations totaling 313 patients. Interventions included ESS, elexacaftor-tezacaftor-ivacaftor (ETI), ivacaftor, saline, dornase alfa, hyaluronic acid, and hyaluronic acid-tobramycin combination. Outcome measures included subjective assessment of OD using non-validated (4/9) and validated (4/9) surveys, and psychophysical (1/9) smell testing. Studies evaluating ESS, FESS, dornase alfa, ivacaftor, and both hypertonic and isotonic saline reported statistically significant improvement in OD, whereas ETI failed to improve OD despite improvement in other quality of life measures. CONCLUSIONS There is limited data regarding the impact of medical and surgical interventions on olfaction for AwCF. Assessment of olfaction was often limited to subjective and qualitative self-report. We suggest that tracking of olfactory outcomes with psychophysical testing is critical in this population with dietary challenges and weight management issues.
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Affiliation(s)
- Holly D Shan
- Georgetown University School of Medicine, Washington, DC, USA
| | - Brandon J Vilarello
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Patricia T Jacobson
- Department of Pulmonary, Allergy and Critical Care Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Jeremy P Tervo
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Emily DiMango
- Department of Pulmonary, Allergy and Critical Care Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Jonathan B Overdevest
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
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Valimungighe MM, Agossou BY, Wundiyohangi PK, Sikakulya FK, Djalali S, Dansou GG. Breast cancer in adult man treated in a rural hospital: A case report. Int J Surg Case Rep 2024; 117:109534. [PMID: 38537370 PMCID: PMC10987883 DOI: 10.1016/j.ijscr.2024.109534] [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: 01/10/2024] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 04/07/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Breast cancer in a male patient is an uncommon condition known by the general public yet of the same concern as in a female patient. CASE PRESENTATION A 64-year-old male with a 25 years history of a progressive swelling in the right breast, underwent an ultrasound guided biopsy which revealed a mucinous carcinoma of grade SBR I, right mastectomy with lymph-node dissection were done. His postoperative period was uneventful and patient was a live on 7th post-operative day. Chemotherapy and radiotherapy are being considered. CLINICAL DISCUSSION Being rare, breast cancer in males should be fully evaluated and investigated to avoid the associated morbidity and mortality. CONCLUSION Male breast cancer though rare exists and its management follows the same principles as in women. There is a need to do genetic tests to identify patients at risk and guide preventive measures in case of any breast swelling despite the gender.
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Affiliation(s)
- Moïse Muhindo Valimungighe
- Department of Surgery, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo; Department of Surgery, Hopital de zone de Klouekanmé, Benin
| | | | | | - Franck Katembo Sikakulya
- Department of Surgery, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo; Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda.
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Duffy SDX, Khan H, Gelfer Y, Monsell F. Paediatric femoral shaft fractures: an instructional review for the FRCS examination. Eur J Orthop Surg Traumatol 2024; 34:1253-1258. [PMID: 38085371 DOI: 10.1007/s00590-023-03791-9] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 04/02/2024]
Abstract
This review presents the principal features of paediatric femoral shaft fractures including the contemporary management strategies and relevant supporting evidence. The article is an overview of information relevant to clinical practice, in addition to preparation for the FRCS (Orth) examination.
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Affiliation(s)
| | - Hiba Khan
- Trauma and Orthopaedic Department, Kingston Hospital, London, UK
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Talaway AA, Hidayati HB. Diagnosis and management of bilateral vestibular schwannoma in the cerebellopontine angle: A rare case report. Radiol Case Rep 2024; 19:1271-1275. [PMID: 38292801 PMCID: PMC10825540 DOI: 10.1016/j.radcr.2023.12.042] [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: 10/05/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024] Open
Abstract
Vestibular Schwannoma (VS) is a benign nerve sheath tumors comprised of Schwann cells. This tumor is encapsulated, slow-growing, and originates from the internal auditory canal, extending into the cerebellopontine angle (CPA). The incidence in individuals aged 20-44 is 0.75 per 100,000 cases, with bilateral VS incidence of 0.8 per 50,000 cases. Tumors in CPA are the most common type in the posterior fossa and cause serious neurological symptoms or become life-threatening when tumors enlarge and compress the brainstem. The majority of tumors are VS (acoustic neuromas), accounting for 80%-90% of cases. Common clinical symptoms include hearing loss, tinnitus, and vertigo. Additionally, these tumors cause compression of the trigeminal and facial nerves. Advances in rapidly evolving imaging technology and surgical methods have improved diagnosis and management. A 24-year-old male complained of hearing impairment for the past 3 years alongside headaches, and dizziness leading to a feeling of imbalance, double, and blurry vision, as well as a sensation of facial thickness on the left side. Neurological examination showed cranial nerve abnormalities, including bilateral paresis of cranial nerves III, IV, VI, left cranial nerves V and VII, bilateral cranial nerve VIII, right cranial nerve XII, and cerebellar abnormalities such as intention tremor, dysmetria, dysdiadokokinesia, wide-based gait, and falling to the right during Romberg testing with both eyes open and closed. The patient underwent a contrast-enhanced MRI of the head, followed by a right CPA tumors excision through craniotomy. A detailed understanding of the medical history, physical examination, and radiological proved to be crucial in establishing an accurate diagnosis and appropriate management. This was considered essential to minimize a worse prognosis.
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Affiliation(s)
- Athalia Anastasia Talaway
- Department of Neurology, Neurology, Airlangga University Faculty of Medicine, Dr. Soetomo General Hospital, Mayjend Prof. Dr., Moestopo No. 6 - 8, Surabaya-60264, Surabaya-Indonesia
| | - Hanik Badriyah Hidayati
- Department of Neurology, Neurology, Airlangga University Faculty of Medicine, Dr. Soetomo General Hospital, Mayjend Prof. Dr., Moestopo No. 6 - 8, Surabaya-60264, Surabaya-Indonesia
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Ramadan RA. Internet of things dataset for home renewable energy management. Data Brief 2024; 53:110166. [PMID: 38406246 PMCID: PMC10884744 DOI: 10.1016/j.dib.2024.110166] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/14/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024] Open
Abstract
Smart cities, as well as smart homes research, are becoming of concern, especially in the field of energy consumption and production. However, there is a lack in the dataset that can be used to simulate smart city energy consumption and prediction or even smart homes. Therefore, this paper provides a carefully generated dataset for smart home energy management simulation. Five datasets are generated and analysed to ensure suitability, including 20, 50, 100, and 200 homes across 365 days. For more accurate data, energy consumption and production for 50 homes are generated based on real input taken from a dataset for homes in Saudi Arabia. Due to the unavailability of a comprehensive dataset related to the complex scenario of smart home sensors, energy consumption, and peer-to-peer data exchange, synthetic data was generated to support the simulation of smart home energy generation and consumption. This synthetic data plays a crucial role in situations where simulating uncommon events, ensuring data availability, facilitating extensive experimentation and model validation, and enabling scalability are paramount. It offers a valuable opportunity to incorporate these rare yet significant occurrences into the simulation, particularly in the context of infrequent events, such as abnormal energy consumption patterns observed in smart homes. The generated data is analysed and validated in this article, ready to be used for many smart home and city research.
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Affiliation(s)
- Rabie A. Ramadan
- Department of Information Systems, College of Economics, Management & Information Systems, Nizwa University, Nizwa, Sultanate of Oman
- Computer Engineering Department, Faculty of Engineering, Cairo University, Giza, Egypt
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Asokumar D, Gill AS. Asthma Management Considerations for the Otolaryngologist: Current Therapies. Otolaryngol Clin North Am 2024; 57:215-224. [PMID: 37923591 DOI: 10.1016/j.otc.2023.10.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Asthma is frequently comorbid with chronic rhinosinusitis. First-line pharmacologic intervention for asthma includes combination-inhaled corticosteroids with a long-acting-β-agonist, preferably formoterol. Although short-acting-β-agonists have historically been used as sole rescue option, studies show that this approach can lead to more asthma-related exacerbations and greater mortality. Similarly, oral corticosteroids should be used sparingly due to their significant adverse effect profile. Nonpharmacological interventions for asthma include counseling on modifiable risk factors, such as smoking, physical activity, occupational exposures, and healthy diets. Management of patients with unified airway disease should incorporate a multidisciplinary team consisting of otolaryngologists and asthma specialists.
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Affiliation(s)
- Dhanya Asokumar
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Amarbir S Gill
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
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Finger G, Zimelewicz Oberman D, Loyola Godoy B, de Miranda Chaves Christiani M, Aversa A. Microsurgical Resection of Giant Radio-Induced Cavernous Malformation: 2- Dimensional Video. World Neurosurg 2024; 184:42-43. [PMID: 38218441 DOI: 10.1016/j.wneu.2024.01.026] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Radioinduced cavernous malformations (RICMs) are low-flow, angiographically occult vascular lesions. Giant radioinduced cavernous malformations (GRICMs) are a subtype of RICMs that are characterized by their large size. GRICMs are defined as RICMs that are larger than 3 cm in diameter.1 They are uncommon conditions accounting for 0.1% to 0.5% among patients who have received radiation therapy for head and neck cancer or brain tumors.2,3 The risk of developing GRICMs increases with the dose of radiation received and the length of time since radiation exposure.4 Other factors that may increase the risk of developing GRICMs include age, genetic predisposition, and underlying medical conditions.5 Due to the relatively low incidence of GRICMs and the limited number of studies on this condition, there are limited data about the management of this condition. This case report describes a 12-year-old female who was previously treated for a pilocytic astrocytoma in 2012. After undergoing stereotactic biopsy and whole-brain radiotherapy (50 gray in 28 sections), she was diagnosed with a radioinduced cavernous malformation in 2016 during follow-up imaging. The RICM was managed conservatively with imaging follow-up, which showed no increase in size between 2016 and 2019. However, in 2020, the patient experienced a seizure episode associated with left-sided hemiplegia. Further investigation with cranial magnetic resonance imaging and digital subtraction angiography showed a mixed-intensity image and surrounded by a low signal intensity rim on T2-weighted images, representing hemosiderin in the right central lobe, with intense perilesional edema, with no enhancement. Given the size and location of the mass, the patient underwent microsurgical resection of the RICM (Video 1). The surgery was successful, and the lesion was successfully resected. This case highlights the importance of careful monitoring for RICMs in patients who have received radiation therapy, as well as the potential for these lesions to cause significant symptoms and disability. The case also demonstrates that surgical intervention may be necessary in some cases to manage RICMs and that microsurgical resection can be an effective treatment option. The patient gave informed consent for surgery and video recording.
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Affiliation(s)
- Guilherme Finger
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - Bruno Loyola Godoy
- Department of Neurosurgery, Instituto Nacional do Câncer, Rio de Janeiro, Brazil
| | | | - Antonio Aversa
- Department of Neurosurgery, Instituto Nacional do Câncer, Rio de Janeiro, Brazil
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Rangel-Buitrago N, Galgani F, Neal WJ. Addressing the global challenge of coastal sewage pollution. Mar Pollut Bull 2024; 201:116232. [PMID: 38457879 DOI: 10.1016/j.marpolbul.2024.116232] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
Coastal environments, essential for about half of the world's population living near coastlines, face severe threats from human-induced activities such as intensified urbanization, aggressive development, and particularly, coastal sewage pollution. This type of pollution, comprising untreated sewage discharging nutrients, pathogens, heavy metals, microplastics, and organic compounds, significantly endangers these ecosystems. The issue of sewage in coastal areas is complex, influenced by factors like inadequate sewage systems, septic tanks, industrial and agricultural runoff, and natural processes like coastal erosion, further complicated by oceanic dynamics like tides and currents. A global statistic reveals that over 80 % of sewage enters the environment without treatment, contributing significantly to nitrogen pollution in coastal ecosystems. This pollution not only harms marine life and ecosystems through chemical contaminants and eutrophication, leading to hypoxic zones and biodiversity loss, but also affects human health through waterborne diseases and seafood contamination. Additionally, it has substantial economic repercussions, impacting tourism, recreation, and fisheries, and causing revenue and employment losses. Addressing this issue globally involves international agreements and national legislations, but their effectiveness is hindered by infrastructural disparities, particularly in developing countries. Thus, effective management requires a comprehensive approach including advanced treatment technologies, stringent regulations, regular monitoring, and international cooperation. The international scientific community plays a crucial role in fostering a collaborative and equitable response to this pressing environmental challenge.
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Affiliation(s)
- Nelson Rangel-Buitrago
- Programade Física, Facultad de Ciencias Básicas, Universidad del Atlántico, Barranquilla, Atlántico, Colombia.
| | - Francois Galgani
- Unité Ressources marines en Polynésie Francaise, Institut français de recherche pour l'exploitation de la mer (Ifremer), BP 49, Vairao, Tahiti, French Polynesia
| | - William J Neal
- Department of Geology, Grand Valley State University, The Seymour K. & Esther R. Padnos Hall of Science 213A, Allendale, MI, USA
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Lagina M, Valley TS. Diagnosis and Management of Acute Respiratory Failure. Crit Care Clin 2024; 40:235-253. [PMID: 38432694 PMCID: PMC10910131 DOI: 10.1016/j.ccc.2024.01.002] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Acute hypoxemic respiratory failure is defined by Pao2 less than 60 mm Hg or SaO2 less than 88% and may result from V/Q mismatch, shunt, hypoventilation, diffusion limitation, or low inspired oxygen tension. Acute hypercapnic respiratory failure is defined by Paco2 ≥ 45 mm Hg and pH less than 7.35 and may result from alveolar hypoventilation, increased fraction of dead space, or increased production of carbon dioxide. Early diagnostic maneuvers, such as measurement of SpO2 and arterial blood gas, can differentiate the type of respiratory failure and guide next steps in evaluation and management.
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Affiliation(s)
- Madeline Lagina
- Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan, Ann Arbor, MI, USA. https://twitter.com/maddielagina
| | - Thomas S Valley
- Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan, Ann Arbor, MI, USA; Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Department of Veterans Affairs, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
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Bonsignore-Opp L, Galivanche A, El Naga AN, Gendelberg D. Return to Play Criteria After Adult Lumbar Spinal Fractures: A Review of Current Literature and Expert Recommendations. Curr Rev Musculoskelet Med 2024; 17:83-92. [PMID: 38300472 PMCID: PMC10917715 DOI: 10.1007/s12178-024-09884-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Understanding the management of lumbar spinal fractures and return to play (RTP) criteria is an essential component of care for adult athletes. Appropriate management of lumbar spinal fractures must balance minimizing time away from physical activity while also minimizing risk of reinjury. The purpose of this review is to summarize current recommendations on lumbar spinal fracture management and RTP guidelines and to provide expert opinion on areas of discrepancy in the field. RECENT FINDINGS There is a paucity of high-level evidence on the management and return to play criteria for adult lumbar spine fractures in athletes. Much of the data and recommendations are based on expert opinion and studies in pediatric or osteoporotic patients, which may not be applicable to adult athletes. These data presented here may be used to aid patient-physician conversations and provide guidance on expectations for patients, coaches, and athletic trainers. In general, we recommend that patients be free of lumbar pain, neurologically intact, and have full strength and motion of the lumbar spine and lower extremities before returning to play. Adequate protective equipment is recommended to be worn at all times during practice and play.
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Affiliation(s)
- Lisa Bonsignore-Opp
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Anoop Galivanche
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ashraf N El Naga
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - David Gendelberg
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.
- Orthopaedic Trauma Institute at Zuckerberg San Francisco General, 2550 23rd Street Building 9, 2nd Floor, San Francisco, CA, 94110, USA.
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Correa R, Vidal N, Quesada-García A, Marcos R, Muñoz Del Toro J, Muñoz-Rodríguez J. Management of patients with localized prostate cancer and biochemical recurrence in Spain: A medical survey. Actas Urol Esp 2024; 48:218-227. [PMID: 37574011 DOI: 10.1016/j.acuroe.2023.08.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION The management of patients with prostate cancer (PCa) is established in clinical practice guidelines, which are based on randomized studies according to the level of evidence. In Spain, the degree of compliance with these guidelines in clinical practice is unknown. OBJECTIVES To describe the profiles of PCa patients at the time of diagnosis and the management of patients with localized PCa and those with BCR in Spain. MATERIALS & METHODS A medical survey was conducted in specialized care (85 urologists [UROs], 64 radiation oncologists [ROs], and 21 medical oncologists [MOs]). Three questionnaires were developed for this study with 22 (UROs and ROs) or 21 questions (MOs). RESULTS The annual incidence of PCa was 24,057 in participating hospitals (N = 131). The extrapolated annual incidence in Spain is 40,531 cases. The estimated prevalence of PCa in Spain is 221,689. Of note, 79% and 80% of patients seen by UROs and ROs, respectively had localized PCa at diagnosis. Biopsy was the most used diagnostic test among the three specialties, followed by abdominopelvic computer tomography. More than 90% of patients with BCR underwent standard tests. Next generation imaging tests and PET-choline/PSMA are still used residually. Most patients with localized PCa are currently treated with either surgery or radiotherapy, while for BCR patients, UROs and ROs prefer radiotherapy and MOs androgen deprivation therapy alone or in combination. CONCLUSION This study describes patient profiles at the time of diagnosis and provides an overview of the current therapeutic management of localized PCa and BCR in clinical practice in Spain.
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Affiliation(s)
- R Correa
- Servicio de Oncología Radioterápica, Hospital Clínico Universitario Virgen de la Victoria Campus Universitario de Teatinos, Málaga, Spain
| | - N Vidal
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Madrid, Spain
| | - A Quesada-García
- Medical Affairs Department, Janssen; Paseo de las Doce Estrellas 5-7, 28042, Madrid, Spain.
| | - R Marcos
- Business Intelligence Department, Janssen; Paseo de las Doce Estrellas 5-7, 28042, Madrid, Spain.
| | - J Muñoz Del Toro
- Medical & Regulatory Affairs Department, Janssen; Lagoas Park, Edificio 9, 2740-262 Porto Salvo, Portugal.
| | - J Muñoz-Rodríguez
- Servicio de Urología, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
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De Simone B, Agnoletti V, Abu-Zidan FM, Biffl WL, Moore EE, Chouillard E, Coccolini F, Sartelli M, Podda M, Di Saverio S, Kaafarani H, Balogh ZJ, Bala M, Leppäniemi AK, Kirkpatrick AW, Pikoulis E, Rasa K, Rosato C, Sawyer R, Ansaloni L, de'Angelis N, Damaskos D, Stahel PF, Kluger Y, Coimbra R, Catena F. The Operating Room management for emergency Surgical Activity (ORSA) study: a WSES international survey. Updates Surg 2024; 76:687-698. [PMID: 38190080 DOI: 10.1007/s13304-023-01668-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/29/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergency surgery. The Operating Room management for emergency Surgical Activity (ORSA) study was conceived to assess the management of operating theatres and resources from a global perspective among expert international acute care surgeons. METHOD The ORSA study was conceived as an international web survey. The questionnaire was composed of 23 multiple-choice and open questions. Data were collected over 3 months. Participation in the survey was voluntary and anonymous. RESULTS One hundred forty-seven emergency and acute care surgeons answered the questionnaire; the response rate was 58.8%. The majority of the participants come from Europe. One hundred nineteen surgeons (81%; 119/147) declared to have at least one emergency OR in their hospital; for the other 20/147 surgeons (13.6%), there is not a dedicated emergency operating room. Forty-six (68/147)% of the surgeons use the elective OR to perform emergency procedures during the day. The planning of an emergency surgical procedure is done by phone by 70% (104/147) of the surgeons. CONCLUSIONS There is no dedicated emergency OR in the majority of hospitals internationally. Elective surgical procedures are usually postponed or even cancelled to perform emergency surgery. It is a priority to validate an effective universal triaging and scheduling system to allocate emergency surgical procedures. The new Timing in Acute Care Surgery (TACS) was recently proposed and validated by a Delphi consensus as a clear and reproducible triage tool to timely perform an emergency surgical procedure according to the clinical severity of the surgical disease. The new TACS needs to be prospectively validated in clinical practice. Logistics have to be assessed using a multi-disciplinary approach to improve patients' safety, optimise the use of resources, and decrease costs.
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Affiliation(s)
- Belinda De Simone
- Department of Emergency and Trauma Surgery, Villeneuve St Georges Academic Hospital, Villeneuve St Georges, France.
| | - Vanni Agnoletti
- Department of General and Emergency surgery, Level I Trauma Center, Bufalini Hospital, Cesena, Italy
| | - Fikri M Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Walter L Biffl
- Department of Emergency and Trauma Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA
| | - Ernest E Moore
- Ernest E. Moore Shock Trauma Center, University of Colorado, Denver, USA
| | - Elie Chouillard
- Unit of Metabolic and General Surgery, Clinique St Louis, Poissy, France
| | - Federico Coccolini
- Department of General and Trauma Surgery, University Hospital of Pisa, Pisa, Italy
| | - Massimo Sartelli
- Department of General Surgery, Macerata Hospital, Macerata, Italy
| | - Mauro Podda
- Department of General Surgery, University Hospital of Cagliari, Cagliari, Italy
| | - Salomone Di Saverio
- Department of General Surgery, Santa Maria del Soccorso Hospital, San Benedetto del Tronto, Ascoli Piceno, Italy
| | - Haytham Kaafarani
- Department of Emergency and Trauma Surgery, Harvard Medical School & Massachusetts General Hospital, Boston, USA
| | - Zsolt J Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia
| | - Miklosh Bala
- Acute Care Surgery and Trauma Unit, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem Kiriat Hadassah, Jerusalem, Israel
| | - Ari K Leppäniemi
- Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Andrew W Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada
| | - Emmanouil Pikoulis
- Medical School, National and Kapodistrian University of Athens, (NKUA), Athens, Greece
| | - Kemal Rasa
- Department of Surgery, Anadolu Medical Center, Kocaali, Turkey
| | - Chiara Rosato
- Department of Emergency and General Surgery, Level I Trauma Center, Bufalini Hospital, Cesena, Italy
| | - Robert Sawyer
- General Surgery Department, Western Michigan University, Kalamazoo, MI, USA
| | - Luca Ansaloni
- Department of General Surgery, University Hospital of Pavia, Pavia, Italy
| | - Nicola de'Angelis
- Colorectal and Digestive Surgery Unit, DIGEST Department Beaujon University Hospital (AP-HP), University Paris Cité, Paris, France
| | - Dimitris Damaskos
- Department of General Surgery, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Philip F Stahel
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Raul Coimbra
- Riverside University Health System Medical Center and Loma Linda University School of Medicine, Loma Linda, USA
| | - Fausto Catena
- Department of General and Emergency surgery, Level I Trauma Center, Bufalini Hospital, Cesena, Italy
- eCampus University, CREAS, Ser.In.Ar. Bologna University, Bologna, Italy
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Niu Q, Zhao L, Wang R, Du L, Shi Q, Jia C, Li G, Jin L, Li F. Predictive value of contrast-enhanced ultrasonography and ultrasound elastography for management of BI-RADS category 4 nonpalpable breast masses. Eur J Radiol 2024; 173:111391. [PMID: 38422608 DOI: 10.1016/j.ejrad.2024.111391] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE The objective of this study was to investigate the independent risk factors and associated predictive values of contrast-enhanced ultrasound (CEUS), shear wave elastography (SWE), and strain elastography (SE) for high-risk lesions (HRL) and malignant tumors (MT) among nonpalpable breast masses classified as BI-RADS category 4 on conventional ultrasound. METHODS This prospective study involved consecutively admitted patients with breast tumors from January 2018, aiming to explore the management of BI-RADS category 4 breast tumors using CEUS and elastography. We conducted a retrospective review of patient data, focusing on those with a history of a nonpalpable mass as the primary complaint. Pathologic findings after surgical resection served as the gold standard. The CEUS arterial-phase indices were analyzed using contrast agent arrival-time parametric imaging processing mode, while quantitative and qualitative indices were examined on ES images. Independent risk factors were identified through binary logistic regression multifactorial analysis. The predictive efficacy of different modalities was compared using a receiver operating characteristics curve. Subsequently, a nomogram for predicting the risk of HRL/MT was established based on a multifactorial logistic regression model. RESULTS A total of 146 breast masses from 146 patients were included, comprising 80 benign tumors, 12 HRLs, and 54 MTs based on the final pathology. There was no significant difference in pathologic size between the benign and HRL/MT groups [8.00(6.25,10.00) vs. 9.00(6.00,10.00), P = 0.506]. The diagnostic efficacy of US plus CEUS exceeded that of US plus SWE/SE for BI-RADS 4 nonpalpable masses, with an AUC of 0.954 compared to 0.798/0.741 (P < 0.001). Further stratified analysis revealed a more pronounced improvement for reclassification of BI-RADS 4a masses (AUC: 0.943 vs. 0.762/0.675, P < 0.001) than BI-RADS 4b (AUC:0.950 vs. 0.885/0.796, P>0.05) with the assistance of CEUS than SWE/SE. Employing downgrade CEUS strategies resulted in negative predictive values ranging from 95.2 % to 100.0 % for BI-RADS 4a and 4b masses. Conversely, using upgrade nomogram strategies, which included the independent predictive risk factors of irregular enhanced shape, poor defined enhanced margin, earlier enhanced time, increased surrounding vessels, and presence of contrast agent retention, the diagnostic performance achieved an AUC of 0.947 with good calibration. CONCLUSION After investigating the potential of CEUS and ES in improving risk assessment and diagnostic accuracy for nonpalpable BI-RADS category 4 breast masses, it is evident that CEUS has a more significant impact on enhancing classification compared to ES, particularly for BI-RADS 4a subgroup masses. This finding suggests that CEUS may offer greater benefits in improving risk assessment and diagnostic accuracy for this specific subgroup of breast masses.
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Affiliation(s)
- Qinghua Niu
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Zhao
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruitao Wang
- Department of Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiusheng Shi
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lifang Jin
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fan Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Ullah A, Ullah M, Lim SI. Recent advancements in nanotechnology based drug delivery for the management of cardiovascular disease. Curr Probl Cardiol 2024; 49:102396. [PMID: 38266693 DOI: 10.1016/j.cpcardiol.2024.102396] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
Cardiovascular diseases (CVDs) constitute a predominant cause of both global mortality and morbidity. To address the challenges in the early diagnosis and management of CVDs, there is growing interest in the field of nanotechnology and nanomaterials to develop innovative diagnostic and therapeutic approaches. This review focuses on the recent advancements in nanotechnology-based diagnostic techniques, including cardiac immunoassays (CIA), cardiac circulating biomarkers, cardiac exosomal biomarkers, and molecular Imaging (MOI). Moreover, the article delves into the exciting developments in nanoparticles (NPs), biomimetic NPs, nanofibers, nanogels, and nanopatchs for cardiovascular applications. And discuss how these nanoscale technologies can improve the precision, sensitivity, and speed of CVD diagnosis and management. While highlighting their vast potential, we also address the limitations and challenges that must be overcome to harness these innovations successfully. Furthermore, this review focuses on the emerging opportunities for personalized and effective cardiovascular care through the integration of nanotechnology, ultimately aiming to reduce the global burden of CVDs.
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Affiliation(s)
- Aziz Ullah
- Department of Chemical Engineering, Pukyong National University, Yongso-ro 45, Nam-gu, Engineering Bldg#1, Rm1108, Busan 48513, Republic of Korea
| | - Muneeb Ullah
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Sung In Lim
- Department of Chemical Engineering, Pukyong National University, Yongso-ro 45, Nam-gu, Engineering Bldg#1, Rm1108, Busan 48513, Republic of Korea.
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de Vries P, Deneux-Tharaux C, Caram-Deelder C, Goffinet F, Henriquez D, Seco A, van der Bom J, van den Akker T. Severe postpartum hemorrhage and the risk of adverse maternal outcome: A comparative analysis of two population-based studies in France and the Netherlands. Prev Med Rep 2024; 40:102665. [PMID: 38435415 PMCID: PMC10907197 DOI: 10.1016/j.pmedr.2024.102665] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Objectives Among women with severe PPH (sPPH) in France and the Netherlands, we compared incidence of adverse maternal outcome (major obstetric hemorrhage (≥2.5L blood loss) and/or hysterectomy and/or mortality) by mode of delivery. Second, we compared use and timing of resuscitation and transfusion management, second-line uterotonics and uterine-sparing interventions (intra-uterine tamponade, compression sutures, vascular ligation, arterial embolization) by mode of delivery. Methods Secondary analysis of two population-based studies of women with sPPH in France and the Netherlands. Women were selected by a harmonized definition for sPPH: (total blood loss ≥ 1500 ml) AND (blood transfusion of ≥ 4 units packed red blood cells and/or multicomponent blood transfusion). Findings Incidence of adverse maternal outcome after vaginal birth was 793/1002, 9.1 % in the Netherlands versus 88/214, 41.1 % in France and 259/342, 76.2% versus 160/270, 59.3% after cesarean. Hemostatic agents such as fibrinogen were administered less frequently (p < 0.001) in the Netherlands (vaginal birth: 83/1002, 8.3% versus 105/2014, 49.5% in France; cesarean: 47/342, 13.7% and 152/270, 55.6%). Second-line uterotonics were started significantly later after PPH-onset in the Netherlands than France (vaginal birth: 46 versus 25 min; cesarean: 45 versus 18 min). Uterine-sparing interventions were less frequently (p < 0.001) applied in the Netherlands after vaginal birth (394/1002,39.3 %, 134/214, 62.6%) and cesarean (133/342, 38.9 % and 155/270, 57.4%), all initiated later after onset of refractory PPH in the Netherlands. Interpretation Incidence of adverse maternal outcome was higher among women with sPPH in the Netherlands than France regardless mode of birth. Possible explanatory mechanisms are earlier and more frequent use of second-line uterotonics and uterine-sparing interventions in France compared to the Netherlands.
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Affiliation(s)
- P.L.M. de Vries
- Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands
- Port-Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C. Deneux-Tharaux
- Université Paris Cité, Inserm, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), CRESS UMR 1153, Paris, France
| | - C. Caram-Deelder
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - F. Goffinet
- Port-Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), CRESS UMR 1153, Paris, France
| | - D.D.C.A. Henriquez
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - A. Seco
- Clinical Research Unit Necker Cochin, APHP, Paris, France
| | - J.G. van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - T. van den Akker
- Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands
- Athena Institute, VU University, Amsterdam, The Netherlands
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50
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Umay E, Eyigor S, Demirag K, Kaymak Karatas G, Gundogdu I, Giray E, Panpalli Ates M, Gonenli Kocer B, Gurcay E, Unlu Z, Bengisu S, Karaahmet F, Bagcier F, Vural M, Aydeniz B, Kullukcu H, Oztekin F, Alicura S, Uz C, Barmak E, Uzunkulaoglu A, Adiguzel E. Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (ICU): A Delphi Study from Multidisciplinary Experts in Turkey. Dysphagia 2024; 39:241-254. [PMID: 37542552 DOI: 10.1007/s00455-023-10606-w] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/16/2023] [Indexed: 08/07/2023]
Abstract
There is no study about all aspects of oropharyngoesophageal (OPE) dysphagia from diagnosis to follow-up in a multidisciplinary manner in the world. In order to close this gap, we aimed to create a recommendation study that can be used in clinical practice, addressing all aspects of dysphagia in the ICU in detail with the opinion of experienced multidisciplinary experts. This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-modified Delphi round via e-mail. Firstly, 15 open-ended questions were created, and then detailed recommendations including general principles, management, diagnosis, rehabilitation, and follow-up were created with the answers from these questions, Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation), and divergent consensus (not recommended).In the first Delphi round, a questionnaire consisting of 413 items evaluated with a scale of 0-10 was prepared from the opinions and suggestions given to 15 open-ended questions. In the second Delphi round, 55.4% were accepted and revised suggestions were created. At the end of the third Delphi round, the revised suggestion form was approved again and the final proposals containing 133 items were created. This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU.
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Affiliation(s)
- Ebru Umay
- Ankara Etlik City Physical Medicine and Rehabilitation Hospital, University of Health Sciences Turkey, Halil Sezai Erkut Street, No. 5, 06170, Yenimahalle, Ankara, Turkey.
| | - Sibel Eyigor
- Department of Physical Medicine and Rehabilitation, Ege University, Izmir, Turkey
| | - Kubilay Demirag
- Department of Anesthesiology and Reanimation, Ege University, Izmir, Turkey
| | | | - Ibrahim Gundogdu
- Ankara Etlik City Physical Medicine and Rehabilitation Hospital, University of Health Sciences Turkey, Halil Sezai Erkut Street, No. 5, 06170, Yenimahalle, Ankara, Turkey
| | - Esra Giray
- Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Mehlika Panpalli Ates
- Department of Neurology, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Bilge Gonenli Kocer
- Department of Neurology, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Eda Gurcay
- Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Zeliha Unlu
- Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey
| | - Serkan Bengisu
- Department of Speech and Language Therapy, Fenerbahce University, Istanbul, Turkey
| | - Fatih Karaahmet
- Department of Gastroenterology, Medicana International Ankara Hospital, Ankara, Turkey
| | - Fatih Bagcier
- Department of Physical Medicine and Rehabilitation, Basaksehir Cam Sakura Hospital, Istanbul, Turkey
| | - Meltem Vural
- Department of Physical Medicine and Rehabilitation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Banu Aydeniz
- Department of Physical Medicine and Rehabilitation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Humeyra Kullukcu
- Department of Neurosurgery, Ankara Medical Park Hospital, Ankara, Turkey
| | - Fevzi Oztekin
- Department of Neurology, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Sibel Alicura
- Department of Otolaryngology, Head and Neck Surgery, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Cuma Uz
- Ankara Etlik City Physical Medicine and Rehabilitation Hospital, University of Health Sciences Turkey, Halil Sezai Erkut Street, No. 5, 06170, Yenimahalle, Ankara, Turkey
| | - Elife Barmak
- Department of Speech and Language Therapy, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Aslihan Uzunkulaoglu
- Ankara Etlik City Physical Medicine and Rehabilitation Hospital, University of Health Sciences Turkey, Halil Sezai Erkut Street, No. 5, 06170, Yenimahalle, Ankara, Turkey
| | - Emre Adiguzel
- Ankara Etlik City Physical Medicine and Rehabilitation Hospital, University of Health Sciences Turkey, Halil Sezai Erkut Street, No. 5, 06170, Yenimahalle, Ankara, Turkey
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