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Lonnen E, Paskell R. Gender, sex and complex PTSD clinical presentation: a systematic review. Eur J Psychotraumatol 2024; 15:2320994. [PMID: 38506757 PMCID: PMC10956909 DOI: 10.1080/20008066.2024.2320994] [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: 10/02/2023] [Accepted: 02/11/2024] [Indexed: 03/21/2024] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) prevalence and clinical presentation reportedly vary with gender and/or sex. Equivalent complex PTSD (CPTSD) research is in its relative infancy and to date no systematic review has been conducted on this topic.Objective: To systematically review the literature and provide a narrative addressing the question of whether gender and/or sex differences exist in CPTSD prevalence and clinical presentation.Method: Embase, PsycINFO, PTSDpubs, PubMed, Web of Science, EThOS and Google Scholar were searched. Twelve papers were eligible for inclusion. Data were extracted and synthesised narratively.Results: Four themes were identified: (i) the reporting of gender and/or sex; (ii) index trauma; (iii) CPTSD prevalence rates; and (iv) CPTSD clinical presentation. Findings were mixed. Nine papers reported prevalence rates: eight found no gender and/or sex differences; one found higher diagnostic rates among women and/or females. Four papers reported clinical presentation: one reported higher cluster-level scores among women and/or females; two used single gender and/or sex samples; and one found higher scores in two clusters in men and/or males. Most papers failed to report in gender- and/or sex-sensitive ways.Conclusions: Gender- and sex-sensitive research and clinical practice is needed. Awareness in research and clinical practice is recommended regarding the intersect between identity and the experience and expression of complex trauma.
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Affiliation(s)
- Ella Lonnen
- Department of Psychology, University of Bath, Bath, UK
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2
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Regmi S, Farazi PA, Lyden E, Kotwal A, Ganti AK, Goldner W. Disparities in Thyroid Cancer Diagnosis Based on Residence and Distance From Medical Facility. J Endocr Soc 2024; 8:bvae033. [PMID: 38481601 PMCID: PMC10928505 DOI: 10.1210/jendso/bvae033] [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: 01/02/2024] [Indexed: 04/07/2024] Open
Abstract
Context Rural-urban disparities have been reported in cancer care, but data are sparse on the effect of geography and location of residence on access to care in thyroid cancer. Objective To identify impact of rural or urban residence and distance from treatment center on thyroid cancer stage at diagnosis. Methods We evaluated 800 adults with differentiated thyroid cancer in the iCaRe2 bioinformatics/biospecimen registry at the Fred and Pamela Buffett Cancer Center. Participants were categorized into early and late stage using AJCC staging, and residence/distance from treating facility was categorized as short (≤ 12.5 miles), intermediate (> 12.5 to < 50 miles) or long (≥ 50 miles). Multivariable logistic regression was used to identify factors associated with late-stage diagnosis. Results Overall, 71% lived in an urban area and 29% lived in a rural area. Distance from home to the treating facility was short for 224 (28%), intermediate for 231 (28.8%), and long for 345 (43.1%). All 224 (100%) short, 226 (97.8%) intermediate, and 120 (34.7%) long distances were for urban patients; in contrast, among rural patients, 5 (2.16%) lived intermediate and 225 (65.2%) lived long distances from treatment (P < .0001). Using eighth edition AJCC staging, the odds ratio of late stage at diagnosis for rural participants ≥ 55 years was 2.56 (95% CI, 1.08-6.14) (P = .03), and for those living ≥ 50 miles was 4.65 (95% CI, 1.28-16.93) (P = .0075). Results were similar using seventh edition AJCC staging. Conclusion Older age at diagnosis, living in rural areas, and residing farther from the treatment center are all independently associated with late stage at diagnosis of thyroid cancer.
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Affiliation(s)
- Sunita Regmi
- Kansas Department of Health and Environment, Bureau of Epidemiology and Public Health Informatics, Curtis State Office Building, 1000 SW Jackson ST., Suite 130, Topeka, KS 66612-1365, USA
- Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, Omaha, NE 68198, USA
| | - Paraskevi A Farazi
- Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, Omaha, NE 68198, USA
- School of Medicine, European University Cyprus, 6 Diogenous Street, 2404 Engomi, Nicosia, Cyprus
| | - Elizabeth Lyden
- Department of Biostatistics, University of Nebraska Medical Center, College of Public Health, Omaha, NE 68198, USA
| | - Anupam Kotwal
- Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Apar Kishor Ganti
- Department of Medicine, Division of Hematology and Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- VA Nebraska Western Iowa Health Care System, 4101 Woolworth Avenue, Omaha, NE 68105-1850, USA
| | - Whitney Goldner
- Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Nebraska Medical Center, Omaha, NE 68198, USA
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3
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Kim DY, Dee EC, Cheng I, Hartman RI. Advanced melanoma presentation and disease-specific survival disparities among disaggregated Asian American, Native Hawaiian, and Pacific Islander populations. J Am Acad Dermatol 2024; 90:623-626. [PMID: 37923219 DOI: 10.1016/j.jaad.2023.10.052] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Daniel Y Kim
- Harvard-MIT Health Sciences and Technology Program, Harvard Medical School, Boston, Massachusetts
| | - Edward C Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Rebecca I Hartman
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Dermatology Section, VA Integrated Service Network 1 (VISN-1), Jamaica Plain, Massachusetts.
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Ocampo AA, Xue Z, Chang NC, Thakkar KP, Reddy SB, Greenberg SB, Lee CJ, Ketchem CJ, Redd WD, Eluri S, Reed CC, Dellon ES. Clinical Features and Treatment Response to Topical Steroids in Ethnic and Racial Minority Patients With Eosinophilic Esophagitis. Am J Gastroenterol 2024; 119:262-269. [PMID: 37782465 PMCID: PMC10872844 DOI: 10.14309/ajg.0000000000002532] [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: 01/20/2023] [Accepted: 09/05/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Differences in eosinophilic esophagitis (EoE) presentation and outcomes by ethnicity or race remain understudied. We aimed to determine whether EoE patients of Hispanic/Latinx ethnicity or non-White race have differences in presentation at diagnosis or response to topical corticosteroid (tCS) treatment. METHODS This retrospective cohort study included subjects of any age with a new diagnosis of EoE and documentation of ethnicity or race. For those who had treatment with tCS and follow-up endoscopy/biopsy, we assessed histologic response (<15 eosinophils/hpf), global symptom response, and endoscopic response. Hispanic EoE patients were compared with non-Hispanics at baseline and before and after treatment. The same analyses were repeated for White vs non-Whites. RESULTS Of 1,026 EoE patients with ethnicity data, just 23 (2%) were Hispanic. Most clinical features at presentation were similar to non-Hispanic EoE patients but histologic response to tCS was numerically lower (38% vs 57%). Non-White EoE patients (13%) were younger at diagnosis and had less insurance, lower zip code-level income, shorter symptom duration, more vomiting, less dysphagia and food impaction, fewer typical endoscopic features, and less dilation. Of 475 patients with race data treated with tCS, non-Whites had a significantly lower histologic response rate (41% vs 59%; P = 0.01), and odds of histologic response remained lower after controlling for potential confounders (adjusted odds ratio 0.40, 95% confidence intervals: 0.19-0.87). DISCUSSION Few EoE patients at our center were Hispanic, and they had similar clinical presentations as non-Hispanics. The non-White EoE group was larger, and presentation was less dysphagia-specific. Non-White patients were also less than half as likely to respond to tCS.
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Affiliation(s)
- Adolfo A. Ocampo
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Zeyun Xue
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Nicole C. Chang
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Kisan P. Thakkar
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Sumana B. Reddy
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Sydney B. Greenberg
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Christopher J. Lee
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Corey J. Ketchem
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Walker D. Redd
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Swathi Eluri
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Craig C. Reed
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
| | - Evan S. Dellon
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
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Behmer Hansen RT, Palma SD, Blocher III WA, Behmer Hansen RA, Gold JL, Susman SJ, Batchu S, Silva NA, Richardson AM. A Decade of Global Skull Base Researchers: Authorship Trends from 3,295 Abstracts in the Journal of Neurological Surgery Part B: Skull Base. J Neurol Surg B Skull Base 2024; 85:44-56. [PMID: 38274488 PMCID: PMC10807966 DOI: 10.1055/a-2008-2884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/01/2023] [Indexed: 01/07/2023] Open
Abstract
Objective The North American Skull Base Society (NASBS) multidisciplinary annual conference hosts skull base researchers from across the globe. We hypothesized that the work presented at the NASBS annual conference would reveal diverse authorship teams in terms of specialty and geography. Methods In this retrospective review, abstracts presented at the NASBS annual meeting and subsequently published in the Journal of Neurological Surgery Part B: Skull Base between 01/01/2011 and 12/31/2020 were collected. Variables extracted included year, type of presentation, and author names and affiliations. Statistical analyses were performed with SPSS V23.0 with p -values less than 0.05 considered significant. Geographic heat maps were created to assess author distribution, and a network analysis was performed to display authorship collaboration between geographic regions. Results Of 3,312 published abstracts, 731 (22.1%) had an author with an affiliation outside of the United States. Fifty-seven distinct countries were represented. Three-hundred twenty-four abstracts (9.8%) had authorship teams representing at least 2 different countries. The top five US states by abstract representation were Pennsylvania, California, New York, Ohio, and Minnesota. A majority of authors reported neurosurgery affiliations (56.7% first authors, 53.2% last authors), closely followed by otolaryngology (39.1% first authors, 41.5% last authors). No solo authors and very few (3.3%) of the first authors reported a departmental affiliation outside of otolaryngology or neurosurgery. Conclusions Authors from many countries disseminate their work through poster and oral presentations at the NASBS annual meeting. Ten percent of abstracts were the product of international collaboration. Most authors were affiliated with a neurosurgery or otolaryngology department.
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Affiliation(s)
| | - Samantha D. Palma
- Department of Neurosurgery, Indiana University Indianapolis, Indiana, United States
| | | | | | - Justin L. Gold
- Department of Neurosurgery, Cooper Medical School of Rowan University, Camden, New Jersey, United States
| | - Stephen J. Susman
- Department of Neurosurgery, Indiana University Indianapolis, Indiana, United States
| | | | - Nicole A. Silva
- Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States
| | - Angela M. Richardson
- Department of Neurosurgery, Indiana University Indianapolis, Indiana, United States
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Amdani S, Auerbach SR, Bansal N, Chen S, Conway J, Silva JPDA, Deshpande SR, Hoover J, Lin KY, Miyamoto SD, Puri K, Price J, Spinner J, White R, Rossano JW, Bearl DW, Cousino MK, Catlin P, Hidalgo NC, Godown J, Kantor P, Masarone D, Peng DM, Rea KE, Schumacher K, Shaddy R, Shea E, Tapia HV, Valikodath N, Zafar F, Hsu D. Research Gaps in Pediatric Heart Failure: Defining the Gaps and Then Closing Them Over the Next Decade. J Card Fail 2024; 30:64-77. [PMID: 38065308 DOI: 10.1016/j.cardfail.2023.08.026] [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: 02/07/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 01/13/2024]
Abstract
Given the numerous opportunities and the wide knowledge gaps in pediatric heart failure, an international group of pediatric heart failure experts with diverse backgrounds were invited and tasked with identifying research gaps in each pediatric heart failure domain that scientists and funding agencies need to focus on over the next decade.
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Affiliation(s)
- Shahnawaz Amdani
- Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio.
| | - Scott R Auerbach
- Division of Pediatric Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Neha Bansal
- Division of Pediatric Cardiology, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine, New York, New York
| | - Sharon Chen
- Division of Pediatric Cardiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California
| | - Jennifer Conway
- Division of Pediatric Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Julie Pires DA Silva
- Division of Pediatric Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Jessica Hoover
- Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio
| | - Kimberly Y Lin
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Shelley D Miyamoto
- Division of Pediatric Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kriti Puri
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Jack Price
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Joseph Spinner
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Rachel White
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Joseph W Rossano
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - David W Bearl
- Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, Tennessee
| | - Melissa K Cousino
- Department of Pediatrics, University of Michigan, C. S. Mott Children's Hospital, Ann Arbor, Michigan
| | - Perry Catlin
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - Nicolas Corral Hidalgo
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Justin Godown
- Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, Tennessee
| | - Paul Kantor
- Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Daniele Masarone
- Heart Failure Unit, Department of Cardiology, AORN dei Colli-Monaldi Hospital Naples, Naples, Italy
| | - David M Peng
- Department of Pediatrics, University of Michigan, C. S. Mott Children's Hospital, Ann Arbor, Michigan
| | - Kelly E Rea
- Department of Pediatrics, University of Michigan, C. S. Mott Children's Hospital, Ann Arbor, Michigan
| | - Kurt Schumacher
- Department of Pediatrics, University of Michigan, C. S. Mott Children's Hospital, Ann Arbor, Michigan
| | - Robert Shaddy
- Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Erin Shea
- Heart Failure Unit, Department of Cardiology, AORN dei Colli-Monaldi Hospital Naples, Naples, Italy
| | - Henry Valora Tapia
- Division of Pediatric Cardiology, University of Utah. Salt Lake City, Utah
| | - Nishma Valikodath
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas
| | - Farhan Zafar
- The Heart Institute, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Daphne Hsu
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
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7
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Yang SD, Seu M, Qiao JB, Tsiang JTH, Pecoraro N, Germanwala AV. Posters Presented at North American Skull Base Society 2016-2018: What Factors Influence Their Publication? J Neurol Surg B Skull Base 2023; 84:531-537. [PMID: 37854529 PMCID: PMC10581821 DOI: 10.1055/a-1946-5521] [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: 06/18/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022] Open
Abstract
Objective Research productivity impacts an individual's academic credentials and serves to advance the field of neurosurgery at large. Poster presentations allow researchers to share preliminary results with respected colleagues; however, more critical is the ability to publish peer-reviewed articles. Key factors that lead posters to journal publication are not well understood and difficult to quantify. This study investigates the association between bibliometrics of authors who presented posters at the North American Skull Base Society (NASBS) meeting and odds of journal publication. Methods Posters from the 2016 to 2018 NASBS archive were reviewed. Hirsch-index (h-index) of first (FH) and senior (SH) authors, research type, research topic, and number of poster authors (nAuthPost) were collected. For posters published as journal articles, number of days from poster presentation to publication (nDays), number of authors in published articles (nAuthArt), and journal impact factor (JIF) were recorded. Results One-hundred sixty-nine of 481 posters (35.1%) were published as articles. Median FH and SH for published versus unpublished posters were 7 versus 5 ( p = 0.01) and 29 versus 19 ( p < 0.001), respectively. When adjusted with multivariate regression, only SH ( p < 0.001) and nAuthPost ( p = 0.001) were significantly associated with odds of publication. Median (interquartile range [IQR]) nDays was 361 (394). Increased authors from poster to article ( p = 0.017) and lower FH ( p = 0.08) were correlated with increased time to publication. Median (IQR) JIF for all publications was 1.723 (1.068). Conclusions Bibliometrics such as h-index and number of authors from posters can help objectively characterize and predict future success in research productivity.
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Affiliation(s)
- S. Daniel Yang
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, United States
| | - Michelle Seu
- Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States
| | - James B. Qiao
- Department of Medicine, Loyola University Medical Center, Maywood, Illinois, United States
| | - John Ta-Hsiang Tsiang
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, United States
| | - Nathan Pecoraro
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, United States
| | - Anand V. Germanwala
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, United States
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Rezkallah E, Hanna RS, Elsaify WM. Thyroid Lymphoma: Case Series Review. Am Surg 2023; 89:4811-4816. [PMID: 35759750 DOI: 10.1177/00031348221111512] [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: 11/16/2022]
Abstract
BACKGROUND Primary thyroid lymphoma (PTL) is a rare malignancy accounting for about 5% of all thyroid malignancies and less than 2% of extra-nodal lymphomas. Diffuse B-cell lymphoma is the most common pathological subtype of PTL. PATIENTS AND METHODS This is a retrospective review of all patients diagnosed with thyroid lymphoma in our hospital during the period from 2011 to 2021. All patients had clinical, radiological, and pathological evaluation. We have followed up these patients since diagnosis till now. RESULTS Eight patients were included in our review. Four patients were males and four were females. Mean age at diagnosis was 63 ± 32 years of age. Diagnosis was confirmed only with tissue histology. Six patients had stage IIE disease and two had stage IVE disease. Four patients had disease related mortality. Of the other four patients, two had chemotherapy (RCHOP) and one had local radiotherapy; all achieved complete remission, and the last one had hemithyroidectomy to relieve airway compression and still under treatment. CONCLUSION Primary thyroid lymphoma is rare malignancy of the thyroid gland. Advanced stage and age at the time of diagnosis, the presence of compression manifestations, large tumor mass, and presence of distant metastasis, all are poor prognostic criteria. Our knowledge of the disease pathology, diagnosis, and management is still limited and more research studies are required.
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Affiliation(s)
- Emad Rezkallah
- General Surgery Department, James Cook University Hospital, England
| | - Ragai S Hanna
- General Surgery Department, Faculty of Medicine, Assiut University, Egypt
| | - Wael M Elsaify
- General Surgery Department, James Cook University Hospital, England
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Worku DA. Tick-Borne Encephalitis (TBE): From Tick to Pathology. J Clin Med 2023; 12:6859. [PMID: 37959323 PMCID: PMC10650904 DOI: 10.3390/jcm12216859] [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: 09/07/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Tick-borne encephalitis (TBE) is a viral arthropod infection, endemic to large parts of Europe and Asia, and is characterised by neurological involvement, which can range from mild to severe, and in 33-60% of cases, it leads to a post-encephalitis syndrome and long-term morbidity. While TBE virus, now identified as Orthoflavivirus encephalitidis, was originally isolated in 1937, the pathogenesis of TBE is not fully appreciated with the mode of transmission (blood, tick, alimentary), viral strain, host immune response, and age, likely helping to shape the disease phenotype that we explore in this review. Importantly, the incidence of TBE is increasing, and due to global warming, its epidemiology is evolving, with new foci of transmission reported across Europe and in the UK. As such, a better understanding of the symptomatology, diagnostics, treatment, and prevention of TBE is required to inform healthcare professionals going forward, which this review addresses in detail. To this end, the need for robust national surveillance data and randomised control trial data regarding the use of various antivirals (e.g., Galidesivir and 7-deaza-2'-CMA), monoclonal antibodies, and glucocorticoids is required to improve the management and outcomes of TBE.
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Affiliation(s)
- Dominic Adam Worku
- Infectious Diseases, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea SA6 6NL, UK;
- Public Health Wales, 2 Capital Quarter, Cardiff CF10 4BZ, UK
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Al-Mousa A, Al-Dwairy S, Dajani N, Sami R, Shtaya A. Giant cell glioblastoma multiforme presents as acute pathological nontraumatic subdural haematoma. Br J Neurosurg 2023; 37:1160-1162. [PMID: 33369511 DOI: 10.1080/02688697.2020.1866747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/09/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
We describe a case of giant cell glioblastoma multiforme (GBM) that presented with a non-traumatic acute subdural haematoma (NASDH). A 57-year-old male had a sudden onset headache and rapid deterioration in conscious level with Glasgow Coma Scale (GCS) of 5 and dilated unreactive left pupil. CT of the head revealed a left acute subdural haematoma with mass effect and a left parietal lesion. Our literature review revealed that glioblastoma presenting as an acute subdural haematoma is extremely unusual. To our knowledge, we report the second case. We propose an invasion of the arachnoid and cortical veins by the aggressive tumour as a possible underlying mechanism.
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Affiliation(s)
- Alaa Al-Mousa
- Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
- Department of Surgery, Prince Hamza Hospital, Amman, Jordan
| | - Salem Al-Dwairy
- Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
- Department of Surgery, Prince Hamza Hospital, Amman, Jordan
| | - Nina Dajani
- Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Rawan Sami
- Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Anan Shtaya
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Atkinson Morley Neurosurgery Centre, St George's University Hospital NHS Trust, London, UK
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Alotaibi H, Aldossari A, Alnasser S. Impetiginous Cutaneous Leishmaniasis after COVID-19 Infection in a Patient with Poor Cardiac Profile: A Case Report and Literature Review. Trop Med Infect Dis 2023; 8:443. [PMID: 37755904 PMCID: PMC10536164 DOI: 10.3390/tropicalmed8090443] [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: 07/05/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
Cutaneous leishmaniasis incidence has been rising in the past couple of decades. Standard therapy often includes antileishmanial drugs; however, due to their low safety and toxicity threshold, alternative treatments are being investigated. The association between COVID-19 and cutaneous leishmaniasis remains unclear and exploring this connection may offer crucial insights into the pathophysiology of and treatment strategies for infected patients. In this article, we describe a case of a male patient with a history of cardiac and other comorbidities who presented with cutaneous leishmaniasis in the form of impetigo-like skin lesions after being infected with COVID-19. Due to the patient's poor cardiac profile, sodium stibogluconate was not used and an alternative therapeutic approach was employed. The patient was treated with oral terbinafine, cryotherapy on specific lesions, and a course of cephalexin. Following the course of treatment and subsequent follow-up, the patient exhibited complete resolution and healing of the lesions with scarring, and no active lesions or recurrence were observed. This case highlights the potential for alternative treatment strategies for cutaneous leishmaniasis in patients with comorbidities and emphasizes the importance of further research to better understand the link between COVID-19 and cutaneous leishmaniasis.
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Affiliation(s)
- Hend Alotaibi
- Department of Dermatology, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia;
| | | | - Sultan Alnasser
- College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia;
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12
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Lazarides MK, Georgiadis GS, Papanas N. Elevator Speeches (Pitches) and the Pareto Principle. INT J LOW EXTR WOUND 2023:15347346231197499. [PMID: 37635317 DOI: 10.1177/15347346231197499] [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] [Indexed: 08/29/2023]
Affiliation(s)
- Miltos K Lazarides
- Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - George S Georgiadis
- Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Nikolaos Papanas
- Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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13
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Vasques A, Lagarto M, Pinto M, Ferreira F, Martins A. The Successful Treatment of a Case of Prostate Cancer With Brain Metastasis at Diagnosis. Cureus 2023; 15:e42022. [PMID: 37593296 PMCID: PMC10430886 DOI: 10.7759/cureus.42022] [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] [Accepted: 07/14/2023] [Indexed: 08/19/2023] Open
Abstract
Brain metastasis in prostate cancer is quite a rare entity, especially when it manifests at diagnosis. The symptoms are usually non-focal and vary based on the location affected. It is almost always associated with a poor prognosis, with an overall survival of less than a year. The ideal management modality for these patients is not well established but a combination of surgery, radiation, and chemotherapy may be possible options based on the extent and systemic involvement. Brain screening is not done systematically in prostate cancer and more research is needed to understand the outcome this decision would lead to. We report a case of a patient diagnosed with prostate cancer with single metastasis to the brain that manifested as headache and vomiting. The patient was treated with surgery, adjuvant irradiation of the surgical bed, and androgen deprivation therapy. He later underwent intensity-modulated radiation therapy (IMRT) to the prostate and has been remarkably relapse-free for four years.
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Affiliation(s)
- Ana Vasques
- Medical Oncology, Hospital São Francisco Xavier, Lisbon, PRT
| | | | - Marta Pinto
- Medical Oncology, Centro Hospitalar Tondela - Viseu, Viseu, PRT
| | - Filipa Ferreira
- Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT
| | - Ana Martins
- Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT
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14
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Kim DY, Behbahani S, Hartman RI. Impact of COVID-19 pandemic on melanoma presentation by facility type and region in the United States. J Am Acad Dermatol 2023; 89:175-178. [PMID: 36898529 PMCID: PMC9995293 DOI: 10.1016/j.jaad.2023.02.046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Daniel Y Kim
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sara Behbahani
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rebecca I Hartman
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Dermatology Section, VA Integrated Service Network 1 (VISN-1), Jamaica Plain, Massachusetts.
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15
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Packiyarajah P, Sundaresan KT, Nusair MSM. Rare Sensory Ataxic Variant of Guillain-Barre Syndrome: A Case Report. Cureus 2023; 15:e40920. [PMID: 37496540 PMCID: PMC10367119 DOI: 10.7759/cureus.40920] [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] [Accepted: 06/24/2023] [Indexed: 07/28/2023] Open
Abstract
The sensory ataxic variant of Guillain-Barre syndrome (GBS) is a rare subtype, with limited case reports available. We present the case of a previously healthy 26-year-old female university student who presented with bilateral foot numbness and unsteady gait for five days, without limb weakness. There were no signs of infection or recent history suggestive of infection. Examination revealed reduced pain and light touch sensation, as well as proprioception impairment in the bilateral distal lower limb, accompanied by an ataxic gait. Bilateral upper and lower limb power was normal. Cerebrospinal fluid (CSF) studies showed albuminocytological dissociation, while nerve conduction studies indicated unrecordable sensory responses with normal motor responses. Through a comprehensive evaluation of history, examination, and investigations, other potential differential diagnoses were excluded. Then the patient was diagnosed with a sensory ataxic variant of Guillain-Barre syndrome and treated with intravenous immunoglobulin (IVIG). Over time, the patient demonstrated gradual improvement and was able to resume her university studies four months after discharge.
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Affiliation(s)
| | - K T Sundaresan
- Department of Clinical Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
| | - M S M Nusair
- Internal Medicine, Teaching Hospital Batticaloa, Batticaloa, LKA
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16
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Kailemia PN, Lee EC, Renfrew MJ. Intersection of social determinants of symptomatic breast cancer presentation in a rural setting: A critical ethnographic study. J Adv Nurs 2023; 79:1882-1897. [PMID: 36949633 DOI: 10.1111/jan.15645] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/17/2023] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
AIM The aim of the study was to explore the determinants of time to presentation of women with breast cancer symptoms within a rural setting in Kenya. DESIGN A critical ethnographic study. METHODS Data were collected between July 2019 and April 2020 using semi-structured interviews and focus groups with 12 women and 23 disclosure recipients, respectively. Interviews and focus group discussions were audio recorded, transcribed verbatim, translated into English and thematically analysed. Further analysis using an intersectional lens added new insights into the data. Ethics approval was obtained in both Kenya and United Kingdom. RESULTS Participants narrated their experiences from the time they self-discovered breast cancer symptoms to the time they first came into contact with a healthcare professional. The core themes identified included local cancer knowledge, embodied experience, women's responses, social networks, cultural cancer schemas, gendered social structures and healthcare system experiences. CONCLUSION The findings revealed that symptomatic women predominantly faced multiple intersecting barriers to timely presentation. The key drivers of timeliness to presentation of women with breast cancer symptoms were identified. Several proximal and distal determinants, including economic, social, psychological and cultural determinants intersected to shape women's timeliness to symptomatic presentation. IMPACT This study identified intersectional structural determinants to timely symptomatic presentation of women with breast cancer symptoms. The findings have global health implications for social inequalities in female breast cancer and may inform the development of intersectional interventions to promote timely symptomatic presentation. Furthermore, this study identified an additional interval, precursory interval and revision of the Model of pathway to treatment may be needed should this interval be validated by future studies. PATIENT OR PUBLIC CONTRIBUTION To ensure the interview guides were culturally sensitive, they were co-designed with a female breast cancer survivor, nurses providing reproductive health care to women and a bilingual expert. Both women and disclosure recipients participated in scheduling for the interviews, including the mutually agreeable days and time. Participants were frequently contacted during data analysis and report writing to clarify meaning of certain words or pieces of data.
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Affiliation(s)
- Peter Ntoiti Kailemia
- School of Nursing, University of Embu, Embu, Kenya
- Mother and Infant Research Unit, School Health Sciences, University of Dundee, Dundee, UK
| | - Elaine Carole Lee
- Mother and Infant Research Unit, School Health Sciences, University of Dundee, Dundee, UK
| | - Mary Josephine Renfrew
- Mother and Infant Research Unit, School Health Sciences, University of Dundee, Dundee, UK
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17
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Gartner-Schmidt JL. The New Normal - Virtual and Hybrid Presentations: Developing Content, Designing Slides, and Delivery Guidelines. Ear Nose Throat J 2023; 101:20S-28S. [PMID: 36860095 DOI: 10.1177/01455613231158799] [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: 03/03/2023] Open
Abstract
OBJECTIVE To outline best practices for virtual and hybrid presentation effectiveness. METHODS Retrospective review of recommendations from world experts in how to develop a solid story, design slides that visually communicate, and improve delivery skills that connect with the audience. Virtual and hybrid presenting is not as strongly dependent on all the new technical and software means as supposed. Presentation basics remain critical. RESULT Best practice in presentation effectiveness will statistically decrease the incidence of and risk factors for Nodding-off Episodes per Lecture (NOELs). CONCLUSION The future of presenting is here, and it is mostly online. Mastering the presentation basics and understanding the limitations and opportunities for this new virtual/hybrid presentation space will allow presenters the reach and influence their message deserves.
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18
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Yu LT, Wu HP. EFL university students' perceptions about cross-cultural presentations via videoconferencing. Front Psychol 2023; 14:1101334. [PMID: 36814656 PMCID: PMC9940848 DOI: 10.3389/fpsyg.2023.1101334] [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: 11/17/2022] [Accepted: 01/12/2023] [Indexed: 02/09/2023] Open
Abstract
This study aims to examine EFL university students' perceptions about cross-cultural videoconferencing presentations for professors in the United States. Nineteen Taiwanese English-as-foreign-language university students who studied in a night program for a bachelor's degree attended the study. Each of them was free to choose a topic related to Taiwanese cultures and individually made a 25-min presentation plus a five-minute question-and-answer session. After the presentation, they watched recordings of their presentations, completed a five-point Likert-scale attitude survey, and wrote down their reflections. The results showed that the participants were positive about the activity. Based on the analysis of their reflections, the participants acknowledged various aspects of the cross-cultural presentations, such as the opportunities to use English meaningfully, motivation to prepare for the project, and the authentic nature of the interaction. However, the participants had concerns about their language abilities, anxiety, and limited preparation time. Finally, they mentioned the impact the presentation had on them. Pedagogical implications and suggestions for future research are provided.
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Affiliation(s)
- Li-Tang Yu
- Department of English Instruction, National Tsing Hua University, Hsinchu, Taiwan,*Correspondence: Li-Tang Yu, ✉
| | - Hsiao-Ping Wu
- Department of Educator and Leadership Preparation, Texas A&M University-San Antonio, San Antonio, TX, United States
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19
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Shajahan S, Sun L, Harris K, Wang X, Sandset EC, Yu AY, Woodward M, Peters SA, Carcel C. Sex differences in the symptom presentation of stroke: A systematic review and meta-analysis. Int J Stroke 2023; 18:144-153. [PMID: 35411828 DOI: 10.1177/17474930221090133] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 02/01/2023]
Abstract
BACKGROUND Early diagnosis through symptom recognition is vital in the management of acute stroke. However, women who experience stroke are more likely than men to be initially given a nonstroke diagnosis and it is unclear if potential sex differences in presenting symptoms increase the risk of delayed or missed stroke diagnosis. AIMS To quantify sex differences in the symptom presentation of stroke and assess whether these differences are associated with a delayed or missed diagnosis. METHODS PubMed, EMBASE, and the Cochrane Library were systematically searched up to January 2021. Studies were included if they reported presenting symptoms of adult women and men with diagnosed stroke (ischemic or hemorrhagic) or transient ischemic attack (TIA) and were published in English. Mean percentages with 95% confidence intervals (CIs) of each symptom were calculated for women and men. The crude relative risks (RRs) with 95% CI of symptoms being present in women, relative to men, were also calculated and pooled. Any data on the delayed or missed diagnosis of stroke for women compared to men based on symptom presentation were also extracted. RESULTS Pooled results from 21 eligible articles showed that women and men presented with a similar mean percentage of motor deficit (56% in women vs 56% in men) and speech deficit (41% in women vs 40% in men). Despite this, women more commonly presented with nonfocal symptoms than men: generalized nonspecific weakness (49% vs 36%), mental status change (31% vs 21%), and confusion (37% vs 28%), whereas men more commonly presented with ataxia (44% vs 30%) and dysarthria (32% vs 27%). Women also had a higher risk of presenting with some nonfocal symptoms: generalized weakness (RR 1.49, 95% CI 1.09-2.03), mental status change (RR 1.44, 95% CI 1.22-1.71), fatigue (RR 1.42, 95% CI 1.05-1.92), and loss of consciousness (RR 1.30, 95% CI 1.12-1.51). In contrast, women had a lower risk of presenting with dysarthria (RR 0.89, 95% CI 0.82-0.95), dizziness (RR 0.87, 95% CI 0.80-0.95), gait disturbance (RR 0.79, 95% CI 0.65-0.97), and imbalance (RR 0.68, 95% CI 0.57-0.81). Only one study linking symptoms to definite stroke/TIA diagnosis found that pain and unilateral sensory loss are associated with lower odds of a definite diagnosis in women compared to men. CONCLUSION Although women showed a higher prevalence of some nonfocal symptoms, the prevalence of focal neurological symptoms, such as motor weakness and speech deficit, was similar for both sexes. Awareness of sex differences in symptoms in acute stroke evaluation, careful consideration of the full constellation of presenting symptoms, and further studies linking symptoms to diagnostic outcomes can be helpful in improving early diagnosis and management in both sexes.
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Affiliation(s)
- Sultana Shajahan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Lingli Sun
- The George Institute for Global Health, Beijing, China
| | - Katie Harris
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Xia Wang
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Else Charlotte Sandset
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Department of Research and Development, The Norwegian Air Ambulance Foundation, Oslo, Norway
| | - Amy Yx Yu
- Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Sanne Ae Peters
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,The George Institute for Global Health, School of Public Health, Imperial College London, London, UK.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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20
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Pourriyahi H, Aryanian Z, Afshar ZM, Goodarzi A. A systematic review and clinical atlas on mucocutaneous presentations of the current monkeypox outbreak: With a comprehensive approach to all dermatologic and nondermatologic aspects of the new and previous monkeypox outbreaks. J Med Virol 2023; 95:e28230. [PMID: 36254380 DOI: 10.1002/jmv.28230] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/26/2022] [Revised: 10/03/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022]
Abstract
Monkeypox is a zoonotic disease, endemic in central and west African regions, and has re-emerged, currently causing an outbreak as of May 2022. In this systematic review, we aimed to characterize the current face of the disease, with a detailed categorization of mucocutaneous, as well as systemic symptoms of the disease. We searched four main online databases with the keywords "monkeypox" and "Orthopoxvirus". A total of 46 articles were included, with a cumulative number of 1984 confirmed cases. Patients were predominantly men who have sex with men, who were mostly in their 30s, with a history of unprotected sexual contact or international travel. Among mucocutaneous manifestations, anogenital lesions were the most commonly observed, followed by lesions on the limbs, face, trunk, and palms or soles. Among lesion types, vesiculopustular, pustular or pseudo-pustular, vesicular-umbilicated and papular lesions were the most common, mainly presenting asynchronously, with less than 10 lesions on each patient. Almost all patients also reported systemic manifestations, namely fever, lymphadenopathy, fatigue, myalgia, headaches, pharyngitis, and proctitis. Sexual contact is the main pathway of transmission in the current outbreak, with viral shedding in bodily fluids playing a key role. We've compared these idiosyncratic findings of the new outbreak with previous outbreaks. We've also gathered and categorized images from our included studies to make a "clinical atlas" for this "new" face of monkeypox, which can be of utmost importance for clinicians to be familiarized with, and have a clear picture of monkeypox for their differential diagnoses.
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Affiliation(s)
- Homa Pourriyahi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, School of Medicine, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), Iran University of Medical Sciences, Tehran, Iran
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21
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Rezkallah E, Elsaify A, Martin V, Viva L, Nag S, Green B, Cheesman M, Elsaify W. Pheochromocytoma associated with a succinate dehydrogenase subunit B mutation: A minireview and a case report. Endocr Regul 2023; 57:121-127. [PMID: 37285461 DOI: 10.2478/enr-2023-0015] [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] [Indexed: 06/09/2023] Open
Abstract
Objective. Pheochromocytomas and paragangliomas are rare neuroendocrine tumors that arise from the chromaffin cells of the adrenal medulla or extra-adrenal tissues. These tumors are characterized by an excessive secretion of catecholamines, which are responsible for the clinical manifestation of the disease. Although most of these tumors are sporadic, underlying genetic abnormalities may be present in up to 24% of the cases. A succinate dehydrogenase subunit B (SDHB) mutation represents one of the rare presentations of the disease. In this study, we represent a rare case of pheochromocytoma associated with SDHB mutation. Methods. We performed a retrospective review of our case in addition to reviewing the available literature on the same topic. Results. A 17-year-old patient presented with sustained hypertension. Clinical, laboratory, and radiological evaluations confirmed the diagnosis of catecholamine-secreting tumor. Laparoscopic adrenalectomy was performed. Histopathological and genetic testing confirmed a pheochromocytoma associated with SDHB mutation. No recurrence was detected on two-years of follow up. Conclusion. Pheochromocytoma associated with SDHB mutation is a rare presentation. Genetic testing for suspecting cases is essential to help to establish the appropriate follow-up plan.
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Affiliation(s)
- Emad Rezkallah
- 1General Surgery Department, James Cook University Hospital, England
| | - Andrew Elsaify
- 2Medical School, Misr University for Science and Technology, Egypt
| | - Victorino Martin
- 3Consultant Pathologist, James Cook University Hospital, England
| | - Laura Viva
- 4Consultant Radiologist, James Cook University Hospital, England
| | - Sath Nag
- 5Consultant Endocrinologist, James Cook University Hospital, England
| | - Barnabas Green
- 6Consultant Vascular Surgeon, James Cook University Hospital, England
| | - Matthew Cheesman
- 7Consultant Anesthetist, James Cook University Hospital, England
| | - Wael Elsaify
- 8General Surgery Department, James Cook University Hospital, England
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22
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Rezkallah EMN, Elsaify A, Tin SMM, Dey D, Elsaify WM. Breast lymphoma: General review. Breast Dis 2023; 42:197-205. [PMID: 37393489 DOI: 10.3233/bd-220051] [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: 07/03/2023]
Abstract
BACKGROUND Lymphoma of the breast can be classified as either primary breast lymphoma (PBL) or secondary to systemic lymphoma (SBL). PBL is a rare disease with Diffuse Large B cell Lymphomas (DLBCL) being the most common subtype. OBJECTIVES In the current study, we represented eleven cases diagnosed with breast lymphoma in our trust; two of them had PBL and nine had SBL. We focused mainly on the clinical presentation, diagnosis, management and outcomes. METHODS We did this retrospective review for all breast lymphoma patients who were diagnosed in our trust during the periods from 2011-2022. Patients' data were obtained from the hospital recording system. We followed up these patients thus far to identify the outcome of treatment in each patient. RESULTS Eleven patients were included in our review. All patients were females. Average age of diagnosis was 66.1 ± 13 years of age. Eight patients were diagnosed with DLBCL, two patients were diagnosed with follicular lymphomas, and the last one had lymphoplasmacytic lymphoma. Chemotherapy +∕- radiotherapy was the standard treatment regimen in all patients. Four patients passed away within one year of chemotherapy, five patients achieved complete remission, one patient had two relapses and is still under treatment, while the last patient was diagnosed recently and still awaiting treatment. CONCLUSION Primary breast lymphoma is an aggressive disease. The treatment for PBL is mainly systemic with chemoradiotherapy. The role of surgery is now limited to the diagnosis of the disease. Early diagnosis and proper treatment are crucial for the management of such cases.
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Affiliation(s)
- Emad M N Rezkallah
- General Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
| | | | - Su M M Tin
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - Debdeep Dey
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - Wael M Elsaify
- General Surgery Department, James Cook University Hospital, Middlesbrough, United Kingdom
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23
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Muacevic A, Adler JR. A Rare Case of Primary Peritoneal Carcinoma With Large Bowel Metastasis. Cureus 2023; 15:e34167. [PMID: 36843709 PMCID: PMC9957569 DOI: 10.7759/cureus.34167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
Primary serous peritoneal carcinoma (PPC) is a rare malignancy often presenting with a significant disease burden and a poor prognosis. A 65-year-old female was seen in the surgical outpatient clinic with a two-month history of weight loss, altered bowel habits and a CT scan characterizing a heterogenous right paracolic gutter mass and suspicious liver lesions. At colonoscopy, a prominent appendiceal orifice was biopsied to be poorly differentiated carcinoma favouring gynaecological tract origin. The patient was admitted with an acute small bowel obstruction secondary to progression of metastases and underwent neoadjuvant chemotherapy with a near complete response on repeat staging. A debulking hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy and small bowel nodule excision were performed. The diagnosis of PPC was confirmed when no malignancy was found in the pelvic organs. The presence of intraluminal colonic metastasis with PPC is exceedingly rare with this being only the third such case in the literature.
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24
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Alabi AO, Alabi AS, Sowunmi AC, Ololade KO, Adegboyega BC, Habeebu MYM, Fatiregun OA, Akinsola FB. Presentation and Management of Orbito-Ocular Malignancies in a Tertiary Institution in Southwest Nigeria. J West Afr Coll Surg 2023; 13:1-5. [PMID: 36923813 PMCID: PMC10010579 DOI: 10.4103/jwas.jwas_37_21] [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: 08/16/2021] [Accepted: 10/20/2022] [Indexed: 03/18/2023]
Abstract
Purpose The aim of this study was to review the management of orbito-ocular malignancies in the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital, between January 1997 and December 2011 in comparison to previous and recent studies globally. Materials and Methods This was a retrospective study of orbito-ocular malignancies seen at the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital from 1997 to 2011. Case files and treatment cards were retrieved through the Medical Records department and the information required was extracted with the aid of a data extraction form. Results A total of 98 cases with histologically confirmed orbito-ocular malignancies seen during the 15-year study period were analysed. Retinoblastoma (51 [52.0%]) was the most common orbito-ocular malignancies seen in children, whereas squamous cell carcinoma of the conjunctiva (25 [25.5%]) was the most common in adults. Seventeen (17%) patients had a combination of radiotherapy, surgery, and chemotherapy. Thirty (33%) had enucleation, whereas 33 (36%) had exenteration. Thirty-six patients had chemotherapy, whereas 44 patients benefited from radiotherapy, and radical treatment was offered to 24 patients. Total radical treatment dose was 35-65 Gy in 20-35 fractions over 4-7 weeks. Most of the patients (84 [85.7%]) were lost to follow up. Five (5.1%) died from disease progression and four (4.1%) are still alive and on regular follow-up. Conclusion This study showed that the use of multimodality treatment was implemented but did not improve survival because the majority of patients presented late. The need for a collaborative effort in early detection and prompt referral for treatment of cancer cases cannot be overemphasised.
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Affiliation(s)
- Adewumi Olabimpe Alabi
- Department of Radiation Biology, Radio-diagnosis and Radiotherapy, College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria
| | - Adegboyega Sunday Alabi
- Department of Ophthalmology, College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria
| | - Anthonia Chima Sowunmi
- Department of Radiation Biology, Radio-diagnosis and Radiotherapy, College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria
| | - Kehinde O. Ololade
- Department of Radiation Biology, Radio-diagnosis and Radiotherapy, College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria
| | | | - Muhammad Yaqub M. Habeebu
- Department of Radiation Biology, Radio-diagnosis and Radiotherapy, College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria
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Ahmed O, Awan OAR. Introducing Radiology to First Year Medical Students: Tips for Educators. Acad Radiol 2022; 29:1911-2. [PMID: 35027309 DOI: 10.1016/j.acra.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 01/26/2023]
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Cannata A, Bhatti P, Roy R, Al-Agil M, Daniel A, Ferone E, Jordan A, Cassimon B, Bradwell S, Khawaja A, Sadler M, Shamsi A, Huntington J, Birkinshaw A, Rind I, Rosmini S, Piper S, Sado D, Giacca M, Shah AM, McDonagh T, Scott PA, Bromage DI. Prognostic relevance of demographic factors in cardiac magnetic resonance-proven acute myocarditis: A cohort study. Front Cardiovasc Med 2022; 9:1037837. [PMID: 36312271 PMCID: PMC9606774 DOI: 10.3389/fcvm.2022.1037837] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022] Open
Abstract
Aim Acute myocarditis (AM) is a heterogeneous condition with variable estimates of survival. Contemporary criteria for the diagnosis of clinically suspected AM enable non-invasive assessment, resulting in greater sensitivity and more representative cohorts. We aimed to describe the demographic characteristics and long-term outcomes of patients with AM diagnosed using non-invasive criteria. Methods and results A total of 199 patients with cardiac magnetic resonance (CMR)-confirmed AM were included. The majority (n = 130, 65%) were male, and the average age was 39 ± 16 years. Half of the patients were White (n = 99, 52%), with the remainder from Black and Minority Ethnic (BAME) groups. The most common clinical presentation was chest pain (n = 156, 78%), with smaller numbers presenting with breathlessness (n = 25, 13%) and arrhythmias (n = 18, 9%). Patients admitted with breathlessness were sicker and more often required inotropes, steroids, and renal replacement therapy (p < 0.001, p < 0.001, and p = 0.01, respectively). Over a median follow-up of 53 (IQR 34-76) months, 11 patients (6%) experienced an adverse outcome, defined as a composite of all-cause mortality, resuscitated cardiac arrest, and appropriate implantable cardioverter defibrillator (ICD) therapy. Patients in the arrhythmia group had a worse prognosis, with a nearly sevenfold risk of adverse events [hazard ratio (HR) 6.97; 95% confidence interval (CI) 1.87-26.00, p = 0.004]. Sex and ethnicity were not significantly associated with the outcome. Conclusion AM is highly heterogeneous with an overall favourable prognosis. Three-quarters of patients with AM present with chest pain, which is associated with a benign prognosis. AM presenting with life-threatening arrhythmias is associated with a higher risk of adverse events.
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Affiliation(s)
- Antonio Cannata
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Prashan Bhatti
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Roman Roy
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Mohammad Al-Agil
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Allen Daniel
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Emma Ferone
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | - Antonio Jordan
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Barbara Cassimon
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Susie Bradwell
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Abdullah Khawaja
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Matthew Sadler
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Aamir Shamsi
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Josef Huntington
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | | | - Irfan Rind
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Stefania Rosmini
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Susan Piper
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Daniel Sado
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Mauro Giacca
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | - Ajay M. Shah
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
| | - Theresa McDonagh
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Paul A. Scott
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Daniel I. Bromage
- British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King’s College London, London, United Kingdom
- King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Popkin ME, Goese M, Wilkinson D, Finnie S, Flanagan T, Campa C, Clinch A, Teasdale A, Lennard A, Cook G, Mohan G, Osborne MD. Chemistry Manufacturing and Controls Development, Industry Reflections on Manufacture, and Supply of Pandemic Therapies and Vaccines. AAPS J 2022; 24:101. [PMID: 36168002 PMCID: PMC9514697 DOI: 10.1208/s12248-022-00751-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/02/2022] [Indexed: 01/18/2023] Open
Abstract
This publication provides some industry reflections on experiences from the Chemistry, Manufacturing, and Controls (CMC) development and manufacture and supply of vaccines and therapies in response to the COVID-19 pandemic. It integrates these experiences with the outcomes from the collaborative work between industry and regulators in recent years on innovative science- and risk-based CMC strategies to the development of new, high-quality products for unmet medical needs. The challenges for rapid development are discussed and various approaches to facilitate accelerated development and global supply are collated for consideration. Relevant regulatory aspects are reviewed, including the role of Emergency Use/Conditional Marketing Authorizations, the dialogue between sponsors and agencies to facilitate early decision-making and alignment, and the value of improving reliance/collaborative assessment and increased collaboration between regulatory authorities to reduce differences in global regulatory requirements. Five areas are highlighted for particular consideration in the implementation of strategies for the quality-related aspects of accelerated development and supply: (1) the substantial need to advance reliance or collaborative assessment; (2) the need for early decision making and streamlined engagement between industry and regulatory authorities on CMC matters; (3) the need to further facilitate 'post-approval' changes; (4) fully exploiting prior and platform knowledge; and (5) review and potential revision of legal frameworks. The recommendations in this publication are intended to contribute to the discussion on approaches that can result in earlier and greater access to high-quality pandemic vaccines and therapies for patients worldwide but could also be useful in general for innovative medicines addressing unmet medical needs.
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Affiliation(s)
- Matthew E. Popkin
- grid.418236.a0000 0001 2162 0389GSK, David Jack Centre for R&D, Park Road, Ware, SG12 0DP UK
| | - Markus Goese
- grid.417570.00000 0004 0374 1269F. Hoffmann-La Roche Ltd, CH-4070 Basel, Switzerland
| | - Diane Wilkinson
- grid.417815.e0000 0004 5929 4381AstraZeneca, Derwent Building, Silk Road Business Park, Charter Way, Macclesfield, SK10 2NA UK
| | - Stuart Finnie
- grid.417815.e0000 0004 5929 4381AstraZeneca, Charter Way, Macclesfield, SK10 2NA UK
| | - Talia Flanagan
- grid.421932.f0000 0004 0605 7243UCB Pharma SA, 1420 Braine l’Alleud, Belgium
| | | | - Alexandra Clinch
- grid.418727.f0000 0004 5903 3819UCB Pharma, 208 Bath Road, Slough, SL1 3WE Berkshire UK
| | - Andrew Teasdale
- grid.417815.e0000 0004 5929 4381AstraZeneca, Chemical Development, Pharmaceutical Technology and Development, Operations, Charter Way, Macclesfield, Macclesfield, SK10 2NA UK
| | - Andrew Lennard
- grid.476413.3Amgen, 4, Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DH UK
| | - Graham Cook
- grid.418566.80000 0000 9348 0090Pfizer Ltd., Walton Oaks, Dorking Road, Tadworth, KT20 7NS Surrey UK
| | - Ganapathy Mohan
- grid.417993.10000 0001 2260 0793Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486 USA
| | - Matthew D. Osborne
- grid.473059.cEli Lilly Kinsale Ltd, Dunderrow, Kinsale, P17 NY71 Co. Cork Ireland
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Patel R, Ghadge P, Nair PA, Kumar M, Adhikary L. A review of bridging clinical studies between different presentations of biological products approved by the United States Food and Drug Administration (US FDA). Expert Opin Biol Ther 2022; 22:1293-1310. [PMID: 35968654 DOI: 10.1080/14712598.2022.2113053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There is growing interest in the development of multiple presentations for biological products for subcutaneous (SC) injection for life cycle management and product differentiation. Bridging clinical studies are required to extrapolate the existing data package to new presentations. AREAS COVERED This review compiles information of bridging clinical studies conducted for biological products administered by the SC route and approved in more than one presentation by the United States Food and Drug Administration's Center for Drug Evaluation and Research up until 31 December 2021. Information regarding indication(s), presentation(s), approval pathways, approval timelines, and various aspects of bridging clinical studies was collected from published documents. EXPERT OPINION The type of bridging clinical study can depend on the extent of differences between presentations, existing data packages, and the stage of the product development. Design of a bridging clinical study should be based on the characteristics of a biological product and should be aimed at detecting the relevant differences between presentations. Single-dose comparative pharmacokinetics in normal healthy volunteers is the most common bridging clinical study design. Covariates like body weight and injection site should be considered during the design of these studies. The impact of the different user interfaces of presentations should also be considered.
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Affiliation(s)
- Ronak Patel
- Research and Development, Intas Pharmaceuticals Limited (Biopharma Division), Ahmedabad, India
| | - Pravin Ghadge
- Commercial Development, Intas Pharmaceuticals Limited, Corporate House, Ahmedabad, India
| | - Pravin A Nair
- Research and Development, Intas Pharmaceuticals Limited (Biopharma Division), Ahmedabad, India
| | - Manish Kumar
- Research and Development, Intas Pharmaceuticals Limited (Biopharma Division), Ahmedabad, India
| | - Laxmi Adhikary
- Research and Development, Intas Pharmaceuticals Limited (Biopharma Division), Ahmedabad, India
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Mane SS, Janardhanan J, Pustake M, Wanvat A, Khan GI, Chopade R. Outcome of COVID-19 in Children With Tuberculosis: Single-Center Experience. Indian Pediatr 2022; 59:617-619. [PMID: 35962655 PMCID: PMC9419137] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To evaluate the outcome of Coronavirus disease 2019 (COVID-19) infection in children and adolescents with tuberculosis. METHODS We analyzed hospital records for the period May, 2020 to September, 2021 for children who were severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) positive or SARS-CoV-2 antibody positive. They were divided into two groups viz., those with tuberculosis (tuberculosis group) and those without tuberculosis (non-TB group). Demographic information, symptoms, and outcomes of COVID-19 were compared between the two groups. RESULTS Median (IQR) age of participants was 11 (8,14) and 4.5 (2,9) year for the tuberculosis and non-TB groups, respectively. 93.5% and 36.1% of children were asymptomatic in the tuberculosis and non-TB group, respectively. No variable in the study was significantly associated with COVID-19 positivity in children with tuberculosis. No difference was found in the outcomes of COVID-19 infection in children having tuberculosis. CONCLUSIONS No differences were noted in the outcomes of COVID-19 infection in children having tuberculosis.
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Affiliation(s)
- Sushant S Mane
- Centre of Excellence for Pediatric TB and Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra
| | - Jyothi Janardhanan
- Centre of Excellence for Pediatric TB and Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra
| | - Manas Pustake
- Centre of Excellence for Pediatric TB and Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra. Correspondence to: Dr Manas Pustake, Centre of Excellence for Pediatric TB, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra.
| | - Akshay Wanvat
- Centre of Excellence for Pediatric TB and Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra
| | - Gazi Israil Khan
- Centre of Excellence for Pediatric TB and Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra
| | - Rajratna Chopade
- Centre of Excellence for Pediatric TB and Department of Pediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, Maharashtra
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Chakraborty P, Roy S, Mandal KC, Halder PK, Jana G, Paul K. Esophageal Atresia and Tracheoesophageal Fistula: A Retrospective Review from a Tertiary Care Institute. J West Afr Coll Surg 2022; 12:30-36. [PMID: 36388731 PMCID: PMC9641742 DOI: 10.4103/jwas.jwas_100_22] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND A survey of neonates with esophageal atresia and tracheoesophageal fistula (EA ± TEF) to determine additional factors responsible for poor surgical outcomes in our institution where employing an improved standard of care can ameliorate the outcome. MATERIALS AND METHODS We carried out a retrospective review of 54 neonates, who underwent surgical repair of EA± TEF over a 5-year period. We collected data regarding the patients' demographics, perioperative findings, records of neonatal intensive care, and ascertained the effects of gender, gestational age, birth weight, age at operation, type of anomaly, coexisting major anomalies, preoperative inotrope therapy, and duration of postoperative ventilation on the surgical outcome. RESULTS The mortality rate was 51.9%, out of which, 42.8% of neonates succumbed to ventilator-associated conditions. Age at the time of surgery, gestational age, preoperative inotrope support, presence of coexisting anomalies, and duration of postoperative ventilation were determined as the significant variables predicting mortality(P < 0.05). The area under the Receiver Operating Curve showed the duration of postoperative ventilation as the best indicator of mortality. The Logistic regression model (χ2 = 11.204, P = 0.019) with the above-mentioned variables showed that neonates who were operated before 2.5 days and who required <74.5 hours of postoperative ventilation were 3.91 and 48.30 times more likely to survive respectively, than their counterparts. CONCLUSION A delay in surgery due to delayed diagnosis and or delayed transportation to tertiary centres and prolonged ventilatory support have an additional detrimental effect on the surgical outcomes of EA ± TEF.
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Affiliation(s)
- Partha Chakraborty
- Department of Pediatric Surgery, R. G. Kar Medical College, Kolkata, West Bengal, India
| | - Sourav Roy
- Department of Pediatric Surgery, R. G. Kar Medical College, Kolkata, West Bengal, India
| | - Kartik Chandra Mandal
- Department of Pediatric Surgery, Dr. B. C. Roy, Post Graduate Institute of Pediatric Sciences (PGIPS), Kolkata, West Bengal, India
| | - Pankaj Kumar Halder
- Department of Pediatric Surgery, R. G. Kar Medical College, Kolkata, West Bengal, India
| | - Gunadhar Jana
- Department of Anesthesiology, K. P. C. Medical College, Jadavpur, Kolkata, West Bengal, India
| | - Kallol Paul
- Department of Pediatric Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
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Guerrero Camacho R, Álvarez Román MT, Butta Coll N, Zagrean D, Rivas Pollmar I, Martín Salces M, Gasior Kabat M, Jiménez-Yuste V. Acquired Haemophilia A: A 15-Year Single-Centre Experience of Demography, Clinical Features and Outcome. J Clin Med 2022; 11:2721. [PMID: 35628847 DOI: 10.3390/jcm11102721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023] Open
Abstract
Acquired haemophilia A (AHA) is a rare severe bleeding disorder resulting from the production of autoantibodies directed against coagulation factor VIII. At presentation, bleeding events can be severe, and an early diagnosis and treatment are of major importance. The current study aims to analyse the treated patients who have been diagnosed with AHA for a better understanding of our population and treatment outcome. We conducted a retrospective study with 26 patients who had been diagnosed with AHA and who were treated in our hospital between January 2006 and January 2021. The patients ranged in age from 30 to 85 years old: 46.10% were men, 46.10% had no known underlying condition, 27% had an underlying malignancy, 7.60% presented with other diseases: psoriatic arthritis and Paget's disease, and 19.30% presented with AHA during puerperium. All of the patients had bleeding events and were treated with bypass agents for this as well as with immunosuppressive therapy to eradicate the inhibitor. A total of 53.80% of the patients had major bleeding. Sixty-nine percent of the patients achieved complete remission, but 26.90% died during the follow-up, although bleeding was not the cause of death in any of these cases. Our observations underline the importance of clinical suspicion and early referral to centres with experience and laboratory facilities for managing AHA.
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Garrett C, Steffens D, Solomon M, Koh C. Early-onset colorectal cancer: why it should be high on our list of differentials. ANZ J Surg 2022; 92:1638-1643. [PMID: 35451218 PMCID: PMC9546202 DOI: 10.1111/ans.17698] [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: 01/03/2022] [Revised: 03/09/2022] [Accepted: 03/30/2022] [Indexed: 11/30/2022]
Abstract
Background Early‐onset colorectal cancer (EOCRC) (<50 years) incidence has increased in Australia and worldwide. However, the diagnosis of EOCRC is often delayed. Recent research has discovered some differences from later‐onset colorectal cancer (LOCRC) (>50 years). An awareness of the unique features of EOCRC is crucial to reduce time from symptom onset to diagnosis. Methods A literature search was conducted on electronic databases (MEDLINE, EMBASE and Cochrane Library) using the search terms “early onset colorectal cancer” or “young onset colorectal cancer.” Results The American Cancer Society has reduced the colorectal cancer screening initiation age to 45 for average‐risk adults whilst screening programmes in the United Kingdom and Australia remain unchanged with initiation at 60 and 50, respectively. Exposures resulting in dysbiosis (obesity, westernised diet, alcohol, antibiotic and sugar‐sweetened beverage consumption) have been linked with increased EOCRC risk. EOCRC is often left‐sided presenting with rectal bleeding, altered bowel habit and constitutional symptoms. EOCRC is more commonly sporadic than hereditary, harbouring different genetic mutations than LOCRC. Comparative survival outcomes of EOCRC and LOCRC are conflicting with studies suggesting either better or poorer survival. Young patients better tolerate treatment‐related toxicities, which may account for their improved survival despite comparatively advanced stages and poorer histopathological features at diagnosis. Conclusion Current EOCRC literature is limited by American‐focused datasets and heterogenous EOCRC definitions and study designs (the greatest strength of evidence exists for EOCRC risk factor studies comprised of large retrospective cohorts). There is minimal research into the quality of life and surgical outcomes of EOCRC patients, and this area warrants further investigation.
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Affiliation(s)
- Celine Garrett
- Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, St George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Cherry Koh
- Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
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Townsend DC, Purohit N, Giannoulis K, Shtaya A. Presentation, management and outcome of primary leiomyosarcoma of the spine: A systematic review. World Neurosurg 2022; 163:25-35. [PMID: 35390494 DOI: 10.1016/j.wneu.2022.03.138] [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: 02/06/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Primary spinal leiomyosarcoma (PSL) is extremely rare. A case is presented, followed by a systematic review establishing the consensus on presentation, diagnosis, management and outcomes. Comparison being made with metastatic spinal leiomyosarcoma (MSL). METHODS A systematic review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria was decided upon before the literature search was conducted. Data were extracted and analysed. RESULTS 397 articles were identified, 25 articles conformed to the eligibility criteria. 34 cases were included in the analysis. PSL had a female preponderance (69.2%) with back pain being the most common presenting symptom (60.9%). Neurological signs were present in the majority (69.6%) with tumours typically being in the thoracic spine (46.9%). Diagnosis was primarily made using MRI (64.7%) and CT (55.9%), with a histological sample being obtained in all cases. Most patients underwent operative management (91.2%) with variable use of neoadjuvant and adjuvant therapies. Operative approach differed greatly and outcome following surgical management was stated in 48.4% of cases, all noting an improvement from presentation. Patient follow up was limited (median 7 months), with the majority of patients being free of disease (43.8%). CONCLUSIONS PSL diagnosis is challenging with PET-CT and histopathological sampling playing an important role. There is a limited evidence base for the treatment strategies employed but surgical management is key with generally good outcomes. Prognosis for PSL would appear to be better than MSL. There is scope for more dedicated research in PSL and MSL.
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Affiliation(s)
- Dominic Charles Townsend
- Wessex Spinal Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Wessex Neurological Centre, Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
| | - Neeraj Purohit
- Department of Clinical Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Kyriakos Giannoulis
- Wessex Spinal Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Anan Shtaya
- Wessex Spinal Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Wessex Neurological Centre, Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
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Fomin AA. [The research activity of students in "The public health and health care, health care economics" discipline]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:307-311. [PMID: 35439395 DOI: 10.32687/0869-866x-2022-30-2-307-311] [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: 07/08/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
The article considers research work of students in "The Public health and health care, health economics" discipline in 2001-2020, organized in course of public health and health care of the Medical Institute of Petrozavodsk State University. The article reveals such concepts as student scientific activity, knowledge requirements for discipline to prepare student research work, classification of student research works by degree of collection and analysis of material, levels of student work performance, stages and classes of social hygienic research, requirements for content of presentation, criteria of evaluating report and presentation. During 2001-2021, 250 students of medical institute in the section "Public health and health care" made more than 200 reports, published more than 20 thesis and articles. The annual plan of 30 topics for student research works was developed, including requirements for content of presentation, 3 indices to evaluate quality of work. The text of presentation-report in 90% included information on one discipline "Public health and health care, health economics". At that, topic was disclosed in format of describing research objectives with construction of diagrams and graphs, comparison of indices and only 10% of reports contained statistical analysis of the results.
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Affiliation(s)
- A A Fomin
- The Medical Institute of the Federal State Budget Educational Institution of Higher Education "The Petrozavodsk State University" of Minobrnauka of Russia, 185910, Petrozavodsk, Russia,
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Abstract
In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
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Affiliation(s)
- Andrea L Gray
- Department of Pharmacy Services, UW Health, Madison, WI, USA
| | - Celia W Curtis
- Department of Pharmacy, Emory Healthcare, Atlanta, GA, USA
| | - Mc Kenzie R Young
- Department of Pharmacy, Rush University Medical Center, Chicago, IL, USA
| | - Kaitlyn K Bryson
- Department of Pharmacy Services, UK Healthcare, Lexington, KY, USA
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Mallett KE, Almubarak S, Claxton RM, Ferguson PC, Griffin AM, Rose PS, Wunder JS, Tsoi K, Houdek MT. Preoperative Risk Factors for Fibrosarcomatous Transformation in Dermatofibrosarcoma Protuberans. Anticancer Res 2022; 42:105-108. [PMID: 34969715 DOI: 10.21873/anticanres.15463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/13/2021] [Accepted: 11/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Dermat of ibrosarcoma protuberans (DFSP) is a soft-tissue sarcoma with a high risk of local recurrence, though typically never metastasizes. DFSP can transform into high-grade fibrosarcoma (DFSP-FS), which has a risk of metastasis. Currently, treatment for DFSP includes Moh's micrographic surgery (MMS); however, this is not recommended for DFSP-FS. Often, the transformation to DFSP-FS is not recognized until the final histological diagnosis. At that point, wide local excision (WLE) of a previous MMS site can be morbid. As such, we analyzed patient risk factors to allow identification of DFSP-FS transformation at presentation. PATIENTS AND METHODS We reviewed 368 (174 female, 194 male) patients with a mean age of 42 years from two sarcoma centers. A total of 319 (87%) patients had a history of DFSP and 49 (13%) had DFSP-FS. RESULTS When comparing patients with a DFSP to those with a DFSP-FS, patients with a DFSP-FS were more likely (p<0.05) to be older, female and with larger tumors. A painful mass and rapidly enlarging mass were associated with DFSP-FS. CONCLUSION Patients who presented with DFSP-FS were found to typically have a larger, painful, and growing mass. Patients with these features should be referred for WLE over MMS at presentation.
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Affiliation(s)
| | - Sarah Almubarak
- School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ryan M Claxton
- Alix School of Medicine, Mayo Clinic, Rochester, MN, U.S.A
| | - Peter C Ferguson
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - Anthony M Griffin
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - Peter S Rose
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, U.S.A
| | - Jay S Wunder
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - Kim Tsoi
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, U.S.A.
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Rajani AM, Shah UA, Mittal ARS, Punamiya M. Management of a Rare Case of Cavernous Medullary Intraosseous Hemangioma in Proximal Tibia of a 38-year-old Female. J Orthop Case Rep 2022; 12:96-100. [PMID: 36660152 PMCID: PMC9826562 DOI: 10.13107/jocr.2022.v12.i05.2834] [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: 11/22/2021] [Revised: 02/10/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Intraosseous hemangiomas (IH) are one of the rarest bone tumors that an orthopedic surgeon comes across, more so in the long bones. It most often affects adult females, severely blunting their activities of daily living, coupled with potential debilitating complications such as pathological fracture. Case Presentation We present a case of a 38-year-old female who presented with long standing pain and swelling in the left knee. Radiology, in the form of plain radiographs and magnetic resonance imaging, narrowed the diagnosis down to a benign form of osteoblastoma or hemangioma. With this in mind, the patient underwent radical excision of the lytic lesion, along with a margin of the surrounding normal bone. The defect was filled with impaction bone grafting and supplemented by a hydroxyapatite block and a poly ethyl ether ketone plate. The patient had excellent clinical, functional, and radiological outcomes at 6 months follow-up. Conclusion With the inherent rarity of IH, especially when it affects the long bones, it has barely been reported in orthopedic literature. Subsequently, management protocols for such lesions are ill-defined, which can be deleterious to the patient as well as the surgeon. Through this case report, we show how to approach a patient presenting with associated complaints, and show a detailed outline of an efficacious management regime that gave excellent outcomes in our patient.
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Affiliation(s)
- Amyn M Rajani
- Department of Orthopaedics, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, Maharashtra, India,Address of Correspondence: Dr. Amyn M Rajani, Department of Orthopaedics, OAKS Clinic, 707 Panchshil Plaza, N S Patkar Marg, Opp. Ghanasingh Fine Jewels, Next to Dharam Palace, Gamdevi, Mumbai, Maharashtra, India. E-mail:
| | - Urvil A Shah
- Department of Orthopaedics, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, Maharashtra, India
| | - Anmol R S Mittal
- Department of Orthopaedics, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, Maharashtra, India
| | - Meenakshi Punamiya
- Department of Physiotherapist, Orthopaedic Arthroscopy Knee and Shoulder Clinic, Mumbai, Maharashtra, India
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Alanazy S, Alenezi M, Al-Quniabut I, Al-Juraifani I, Alburayh M, Altuaysi A, Alyahya Y, Al-Homaidan H, Al-Wutayd O. Patterns of allergic rhinitis among adults in Qassim region, Saudi Arabia: a cross sectional study. Pan Afr Med J 2021; 40:70. [PMID: 34804338 PMCID: PMC8590280 DOI: 10.11604/pamj.2021.40.70.30719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/12/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction developing and developed countries have a high prevalence of allergic rhinitis (AR). Severe AR has negative impacts on sleep, quality of life, and work performance. The study aimed to identify the patterns of AR among patients attending the ears nose and throat Unit (ENT) clinic at King Saud Hospital, Qassim, Saudi Arabia. Methods this study was a cross-sectional study conducted at the ENT clinic of King Saudi Hospital, Unaizah City, Qassim region, Saudi Arabia. We examined outpatients diagnosed with AR using an interview questionnaire and clinical examination. Results the sample included 455 patients. Of these, 23.7% were 21-30 years old, 65.7% had a family history of AR, 57.8% had no general symptoms, 75.6% reported runny nose as the most common nasal symptom, and 35.4% reported no complications. Dust was the most common trigger of AR (82.4%), 49.2% reported allergic symptoms in all seasons, 96% of patients have inferior turbinate hypertrophy, and oral histamine was the most commonly used treatment (33.2%). Conclusion perineal AR and inferior turbinate hypertrophy were very common findings comparing to previous studies, further studies to assess the risk factors are highly recommended.
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Affiliation(s)
- Sultan Alanazy
- Department of Surgery, Ears Nose and Throat Unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim Saudi Arabia
| | - Mazyad Alenezi
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, Qassim University, Al Qassim, Saudi Arabia
| | - Ibrahim Al-Quniabut
- Department of Surgery, Ears Nose and Throat Unit, Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim Saudi Arabia
| | - Ibrahim Al-Juraifani
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Malek Alburayh
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Abdullah Altuaysi
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Yahya Alyahya
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Hajaj Al-Homaidan
- Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
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Canals Sans J, Morales Hidalgo P, Roigé Castellví J, Voltas Moreso N, Hernández Martínez C. Prevalence and Epidemiological Characteristics of ADHD in Pre-School and School Age Children in the Province of Tarragona, Spain. J Atten Disord 2021; 25:1818-1833. [PMID: 32649267 DOI: 10.1177/1087054720938866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To report the ADHD estimated prevalence in Spain, considering differences in sex, age, presentation, and severity. Method: This study has a two-phase design and forms part of the Neurodevelopmental Disorders Epidemiological Research Project (EPINED). The ADHD screening was conducted through parent (N = 3,727) and teacher (N = 6,894). To perform ADHD diagnosis (DSM-5), screen positive and a subsample of the screen negative children and their parents were assessed using neuropsychological tests and a semi-structured psychiatric interview. Results: The ADHD overall estimate prevalence was 5.5% (7.7% in school-age children; 3.0% in pre-schoolers) and 3.5% for subclinical conditions. The combined presentation and mild severity were the most common, while 18.2% were highly impaired. Previous diagnoses were found in 12% of pre-schoolers and 41% school-aged. Conclusion: The prevalence found in Spain is higher than other European reports. The low ratio of prior-diagnoses indicates a need to provide resources for assessment in school and clinical settings.
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Affiliation(s)
- Josefa Canals Sans
- Department of Psychology, Research Group on Nutrition and Mental Health (NUTRISAM), Research Center for Behavioral Assessment (CRAMC), University Rovira i Virgili, Tarragona, Spain
| | - Paula Morales Hidalgo
- Department of Psychology, Research Group on Nutrition and Mental Health (NUTRISAM), Research Center for Behavioral Assessment (CRAMC), University Rovira i Virgili, Tarragona, Spain
| | - Joana Roigé Castellví
- Department of Psychology, Research Group on Nutrition and Mental Health (NUTRISAM), Research Center for Behavioral Assessment (CRAMC), University Rovira i Virgili, Tarragona, Spain
| | - Núria Voltas Moreso
- Department of Psychology, Research Group on Nutrition and Mental Health (NUTRISAM), Research Center for Behavioral Assessment (CRAMC), University Rovira i Virgili, Tarragona, Spain
| | - Carmen Hernández Martínez
- Department of Psychology, Research Group on Nutrition and Mental Health (NUTRISAM), Research Center for Behavioral Assessment (CRAMC), University Rovira i Virgili, Tarragona, Spain
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Dushnicky MJ, Campbell C, Beattie KA, Berard R, Cellucci T, Chan M, Gerschman T, Johnson N, Lim L, Luca N, Miettunen P, Morishita KA, Proulx-Gauthier JP, Rumsey DG, Schmeling H, Scuccimarri R, Tam H, Guzman J, Batthish M. Impact of the COVID-19 Pandemic on Juvenile Idiopathic Arthritis Presentation and Research Recruitment: Results from the CAPRI Registry. Rheumatology (Oxford) 2021; 61:SI157-SI162. [PMID: 34726738 PMCID: PMC8689883 DOI: 10.1093/rheumatology/keab812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/19/2021] [Revised: 10/25/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has disrupted healthcare delivery and clinical research worldwide, with data from areas most affected demonstrating an impact on rheumatology care. This study aimed to characterize the impact of the pandemic on the initial presentation of JIA and JIA-related research in Canada. METHODS Data collected from the Canadian Alliance of Pediatric Rheumatology Investigators JIA Registry from the year pre-pandemic (March 11, 2019-March 10, 2020) was compared with data collected during the first year of the pandemic (March 11, 2020-March 10, 2021). Outcomes included time from symptom onset to first assessment, disease severity at presentation and registry recruitment. Proportions and medians were used to describe categorical and continuous variables, respectively. RESULTS The median time from symptom onset to first assessment was 138 days (IQR 64-365) pre-pandemic vs 146 days (IQR 83-359) during the pandemic. The JIA category frequencies remained overall stable, (44% oligoarticular JIA pre-pandemic, 46.8% pandemic), except for systemic JIA (12 cases pre-pandemic, 1 pandemic). Clinical features, disease activity (cJADAS10), disability (CHAQ) and quality of life (JAQQ) scores were similar between the two cohorts. Pre-pandemic, 225 patients were enrolled, compared with 111 in the pandemic year, with the greatest decrease from March to June 2020. CONCLUSIONS We did not observe the anticipated delay in time to presentation or increased severity at presentation, suggesting that, within Canada, care adapted well to provide support to new patient consults without negative impacts. The COVID-19 pandemic was associated with an initial 50% decrease in registry enrolment but has since improved.
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Affiliation(s)
- Molly J Dushnicky
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Catherine Campbell
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Karen A Beattie
- Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Roberta Berard
- Division of Rheumatology, Department of Pediatrics, Western University, London, Ontario, Canada
| | - Tania Cellucci
- Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mercedes Chan
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tommy Gerschman
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Johnson
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lillian Lim
- Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Luca
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paivi Miettunen
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kimberly A Morishita
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Dax G Rumsey
- Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Heinrike Schmeling
- Section of Rheumatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rosie Scuccimarri
- Division of Rheumatology, Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Herman Tam
- Division of Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jaime Guzman
- Division of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle Batthish
- Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Akerele IO, Oreh AC, Kawu MB, Ahmadu A, Okechukwu JN, Mbo DN, John DJ, Habib F, Ashikeni MA. Clinical presentation and hospitalisation duration of 201 coronavirus disease 2019 patients in Abuja, Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34797115 PMCID: PMC8603147 DOI: 10.4102/phcfm.v13i1.2940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unfolding. Insights from patient features in different environments are therefore vital to understanding the disease and improving outcomes. AIM This study aimed to describe patient characteristics associated with symptomatic presentation and duration of hospitalisation in coronavirus disease 2019 (COVID-19) patients managed in Abuja. SETTING The study was conducted in Abuja, the Federal Capital Territory, Nigeria. METHODS This was a retrospective study of 201 COVID-19 patients hospitalised in the Asokoro District Hospital COVID-19 Isolation and Treatment Centre between April 2020 and July 2020. Demographic and clinical data were obtained and outcomes assessed were symptom presentation and duration of hospitalisation. RESULTS Patients' median age was 39.3 years (interquartile range [IQR]: 26-52); 65.7% were male and 33.8% were health workers. Up to 49.2% of the patients were overweight or obese, 68.2% had mild COVID-19 at presentation and the most common symptoms were cough (38.3%) and fever (33.8%). Hypertension (22.9%) and diabetes mellitus (7.5%) were the most common comorbidities. The median duration of hospitalisation was 14.4 days (IQR: 9.5-19). Individuals with secondary and tertiary education had higher percentage symptoms presentation (8.5% and 34%, respectively), whilst a history of daily alcohol intake increased the length of hospital stay by 129.0%. CONCLUSION Higher educational levels were linked with symptom presentation in COVID-19 patients and that daily alcohol intake was significantly associated with longer hospital stay. These findings highlight the importance of public education on COVID-19 for symptom recognition, early presentation and improved outcomes.
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Affiliation(s)
- Isaac O Akerele
- Department of Family Medicine, Asokoro District Hospital COVID-19 Isolation and Treatment Centre, Federal Capital Territory Administration, Abuja.
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Ilyas S, Rehman Y, Hussain I, Khan A, Ahmed T, Akbar A. Emergency Department Presentation and Outcome of Children With Cyanotic Congenital Heart Diseases. Cureus 2021; 13:e17960. [PMID: 34660148 PMCID: PMC8515876 DOI: 10.7759/cureus.17960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to assess the outcome and see the spectrum of presenting symptoms of children with cyanotic congenital heart diseases (CHDs) admitted through the emergency department in Lady Reading Hospital (LRH) in Peshawar, Pakistan. Materials and methods This cross-sectional study included 104 children with cyanotic CHD admitted through the emergency department in the pediatric cardiology unit of LRH from February 2019 to January 2020. Diagnosis of cyanotic CHD was confirmed through two-dimensional echocardiography. Patients were treated according to standard protocols for their presenting symptoms. The data were analyzed using Statistical Package for the Social Sciences (SPSS), version 20.0 (IBM Corp., Armonk, NY) and frequencies were expressed as percentages. Results The study included 65 male cases (62.5%) and 39 female cases (37.5%), and participant ages ranged from 10 days to 15 years (mean, 2.7 ± 3.4 years). Of 104 patients, 70 presented with cyanotic spells (84.5%), 53 with fever (10.7%), 28 with respiratory distress (26.5%), 11 with loose stools (10.5%), 10 with hemiplegia (9.6%), and eight with seizures (7.6%). Pneumonia was a precipitating factor in 13 patients (12.5%), infective endocarditis in 12 patients (11%), gastroenteritis in 11 (11%), brain abscess and cerebrovascular accidents in seven patients each (6% each), meningitis in six patients (6%), and tuberculous pericardial effusion in one patient (<1%). The primary CHD was tetralogy of Fallot (TOF) in 52 patients, tricuspid atresia in 14 patients, pulmonary atresia in 13 patients, double outlet right ventricle in 10 patients, transposition of great arteries (TGA) in seven patients, and total anomalous pulmonary venous return (TAPVR), truncus arteriosus, congenitally corrected TGA, and critical pulmonary stenosis in two patients each. Twenty-six patients received treatment of the acute problem and instructions for follow-up monitoring. Twelve patients died during their hospital stay, and three left against medical advice. Fifteen patients received patent ductus arteriosus stenting, and six received right ventricular outflow tract stenting. One patient received a Blalock-Taussig (BT) shunt stent, and one received a left pulmonary artery stent. Two patients received a balloon pulmonary valvotomy, and one received pericardial effusion drainage. Eleven patients received surgical correction of TOF, 11 received surgical correction for BT shunt, four received surgical correction for brain abscess drainage, and two received TAPVR repair. Conclusion TOF was the most common cyanotic heart disease in our study. Cyanotic spells or increased cyanosis was the most common presenting concern. Cyanotic CHDs present with variable extracardiac signs and symptoms in emergencies. Appropriate assessment, immediate management of the acute problem, and timely intervention or surgical management result in good outcomes.
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Affiliation(s)
- Saadia Ilyas
- Paediatric Cardiology, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK
| | - Yasir Rehman
- Paediatric Cardiology, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK
| | - Ijaz Hussain
- Paediatric Cardiology, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK
| | - Assadullah Khan
- Paediatric Cardiology, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK
| | - Tausif Ahmed
- Paediatric Cardiology, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK
| | - Ali Akbar
- Paediatric Cardiology, Lady Reading Hospital, Medical Teaching Institute, Peshawar, PAK
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Aviram A, Barrett JFR, Melamed N, Mei-Dan E. Mode of delivery in multiple pregnancies. Am J Obstet Gynecol MFM 2021; 4:100470. [PMID: 34454159 DOI: 10.1016/j.ajogmf.2021.100470] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/01/2021] [Revised: 07/25/2021] [Accepted: 08/18/2021] [Indexed: 11/25/2022]
Abstract
The mode of delivery in multiple pregnancies has been subject to vigorous debates during the last few decades. Although observational and retrospective data were accumulated, it was not until the publication of the Twin Birth Study that evidence-based recommendations could emerge. However, although some of the most pressing questions were answered by the Twin Birth Study, other questions were left outside the scope of the study. The questions were of great interest and included the following topics: the impact of gestational age, the influence of chorionicity, and the generalizability of the results for women with a previous uterine scar. The current evidence supported a trial of labor in dichorionic-diamniotic or monochorionic-diamniotic twin pregnancies in which the first twin is in cephalic presentation at ≥32 weeks' gestation. Dichorionic-diamniotic, monochorionic-diamniotic, and monochorionic-monoamniotic twins should be delivered at 37 0/7 to 38 0/7, 36 0/7 to 37 0/7, and 32 0/7 to 34 0/7 weeks' gestation, respectively. Breech extraction done by a competent healthcare provider seemed to offer a higher chance of successful vaginal delivery of the second twin than the external cephalic version. The current data did not allow for a clear recommendation regarding the mode of delivery in very preterm birth of low birthweight twins, but most studies did not demonstrate a clear benefit of cesarean delivery vs trial of labor. Furthermore, a trial of labor seemed safe in women with a previous cesarean delivery. Cesarean delivery is likely beneficial for twin pregnancies with the first twin in breech presentation, monochorionic-monoamniotic twins, and higher-order multiple pregnancies. In all multiple pregnancies, delivery should be performed by an experienced practitioner competent in multiple pregnancy deliveries.
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Affiliation(s)
- Amir Aviram
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Drs Aviram and Melamed); Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Drs Aviram, Melamed, and Mei-Dan); Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada (Dr Barrett); Department of Obstetrics and Gynaecology, North York General Hospital, Toronto, Ontario, Canada (Dr Mei-Dan).
| | - Jon F R Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Drs Aviram and Melamed); Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Drs Aviram, Melamed, and Mei-Dan); Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada (Dr Barrett); Department of Obstetrics and Gynaecology, North York General Hospital, Toronto, Ontario, Canada (Dr Mei-Dan)
| | - Nir Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Drs Aviram and Melamed); Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Drs Aviram, Melamed, and Mei-Dan); Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada (Dr Barrett); Department of Obstetrics and Gynaecology, North York General Hospital, Toronto, Ontario, Canada (Dr Mei-Dan)
| | - Elad Mei-Dan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Drs Aviram and Melamed); Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Drs Aviram, Melamed, and Mei-Dan); Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada (Dr Barrett); Department of Obstetrics and Gynaecology, North York General Hospital, Toronto, Ontario, Canada (Dr Mei-Dan)
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Uba-Obiano CU, N Nwosu SN, Okpala NE. Pterygium in Onitsha, Nigeria. Niger J Clin Pract 2021; 24:1206-1210. [PMID: 34397032 DOI: 10.4103/njcp.njcp_89_21] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective To determine the pattern and risk factors of pterygium in adults at the Guinness Eye Centre Onitsha, Nigeria. Materials and Methods Consecutive adults aged ≥30 years with pterygium were studied. Each patient had comprehensive ocular examination including visual acuity, anterior segment, and adnexal assessment and fundoscopy. The pterygium was graded in terms of severity and type. Results A total of 156 patients with pterygium participated; 92 (59%) females versus 64 (41%) males (F:M =3:2). The age range was 30-65 years; mean: 43.9 ± 8.4 years. The majority of the study population (36.5%) was of the age group 40-49 years. The subjects were predominately traders 78 (50%) and 93 (59.6%) of the pterygium patients were outdoor workers. Bivariate analysis indicated that those involved in outdoor work were six times at greater risk of developing pterygium than indoor workers (P = 0.001; OR = 6.2). Out of the 156 pterygium patients seen, 107 (68.6%) of them complained of associated symptoms. Redness of the eye was the commonest symptom reported by 79 (50.9%) cases while 8 (5.1%) cases complained of burning sensation. There was a preponderance of nasal pterygia with temporal pterygia being the least. Blinding pterygium was seen in three eyes (1.3%). Conclusion Pterygium is a common disorder presenting at eye clinics. Outdoor workers are at a greater risk of developing pterygium. Thus, health education is of great importance.
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Affiliation(s)
- C U Uba-Obiano
- Department of Ophthalmology, Nnamdi Azikiwe University, Awka; Guinness Eye Centre, Onitsha, Nigeria
| | - S N N Nwosu
- Department of Ophthalmology, Nnamdi Azikiwe University, Awka; Guinness Eye Centre, Onitsha, Nigeria
| | - N E Okpala
- Department of Ophthalmology, Nnamdi Azikiwe University, Awka; Guinness Eye Centre, Onitsha, Nigeria
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Huang DQ, Hoang JK, Leong J, Riveiro-Barciela M, Maeda M, Yang JD, Accarino EV, Thin K, Trinh L, Cheung RC, Roberts LR, Buti M, Schwartz M, Nguyen MH. Differential characteristics and outcomes of Asian and non-Asian patients with HBV-related hepatocellular carcinoma. Liver Int 2021; 41:1922-1932. [PMID: 33713386 DOI: 10.1111/liv.14877] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/12/2021] [Revised: 02/16/2021] [Accepted: 03/07/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS The epidemiology of hepatitis B virus (HBV) infection differs between Asians and non-Asians, but little is known regarding the effect of ethnicity on outcomes of HBV-related hepatocellular carcinoma (HCC). We aim to characterize the presentation and survival outcomes in Asian and non-Asian patients with HBV-related HCC. METHODS We analyzed the baseline characteristics and long-term survival of 613 Asian and 410 non-Asian patients with HBV-related HCC from three US and one Spanish centre. RESULTS Overall, non-Asian patients were more likely to have HIV or hepatitis C co-infection, cirrhosis, decompensated liver disease and advanced BCLC stage (all P ≤ .04). Compared with Asians, non-Asians were more likely to be listed for transplantation (P < .0001) and undergo HCC treatment with curative intent (P = .003). Propensity-score matching on HCC diagnosis year, gender and age was performed to balance the two groups for survival analysis and yielded 370 pairs of patients. There was no significant difference in survival overall (P = .43) and among patients with cirrhosis (P = .57). Among patients without cirrhosis, non-Asians had poorer 5-year survival compared with Asians (37.6% vs 53.7%, P = .01), and was associated with poorer survival after adjusting for age, gender, diabetes, alcohol, co-infections, diagnosis date, antiviral therapy, BCLC stage and HCC treatment (adjusted HR 2.01 [95% CI 1.07-3.74], P = .03). CONCLUSION Among HBV-related HCC patients, non-Asians presented with more advanced BCLC stage compared to Asians. Non-Asian ethnicity was independently associated with twice the risk of mortality among patients without cirrhosis, but not among those with cirrhosis. Additional studies are needed to clarify this disparity.
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Affiliation(s)
- Daniel Q Huang
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Joseph K Hoang
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Jennifer Leong
- Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mar Riveiro-Barciela
- Liver Unit, Internal Medicine Department, Hospital Universitari Valle d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto Carlos III, Madrid, Spain
| | - Mayumi Maeda
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Ju Dong Yang
- Division of Digestive and Liver Diseases, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, USA
| | - Elena Vargas Accarino
- Liver Unit, Internal Medicine Department, Hospital Universitari Valle d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto Carlos III, Madrid, Spain
| | - Khin Thin
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Lindsey Trinh
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Ramsey C Cheung
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Maria Buti
- Liver Unit, Internal Medicine Department, Hospital Universitari Valle d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto Carlos III, Madrid, Spain
| | - Myron Schwartz
- Recanati-Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
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Abstract
Background Inguinal hernia is a common pathology seen by the general surgeon in the outpatient clinic. Its spectrum of clinical features on presentation significantly varies from the asymptomatic to the complicated. Objective To identify and audit the common clinical presentation and presence of known risk factors for inguinal hernia among adult patients with inguinal hernias presenting to an outpatient clinic. Methods The study involved adults presenting over 1 year at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, family history, abdominal pain, constipation, chronic cough, previous hernia surgery as well as features of bladder outlet obstruction and intra-abdominal mass were recorded into a format. Analysis into a simple percentage, mean, and standard deviation was done with SPSS version 17 (SPSS Inc. Chicago, IL, USA). Results Sixty-five patients were enrolled in the study, comprising 49 males (75.4%) and 16 females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD ± 16.9). The 16-40-year age group had the highest incidence of 29 cases (44.6%) of inguinal hernia. A family history of inguinal hernia (31 cases [47.7%]) and history of previous inguinal hernia surgery (15 cases [23.1%])) was observed. Ten patients with previous surgery presented with a contralateral hernia and 5 with a recurrence. Other factors were chronic constipation 10 cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases, and urethral stricture 1 case. Conclusion Inguinal hernia is common among young and middle-aged adults in our series. Many patients have features suggestive of complications at presentation. Family history and past inguinal hernia surgery were important risk factors.
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Affiliation(s)
- I A Udo
- Department of Surgery, University of Uyo/University of Uyo Teaching Hospital, Uyo, Nigeria
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Kumar Upadhyay A, Prakash A, Rana F, Jain N. A Rare Case of Chondrosarcoma With Metastasis to the Oral Cavity. Cureus 2021; 13:e16283. [PMID: 34373826 PMCID: PMC8346260 DOI: 10.7759/cureus.16283] [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] [Accepted: 07/09/2021] [Indexed: 11/05/2022] Open
Abstract
Chondrosarcomas with metastases to oral cavities are extremely rare. To the best of our knowledge, only six cases of chondrosarcoma with metastases to the oral cavity, maxilla, and/or mandible have been reported in the English-language literature. The last such case was reported three decades earlier; none of the reported cases were from India. We present the case of an Indian patient with chondrosarcoma in the knee region, who was treated with surgical excision in 2013. However, he experienced a recurrence in 2019, developed upper gingival metastasis in 2020, and succumbed within two months of this unique presentation. Oral metastatic lesions have a wide differential diagnosis, and awareness of this rare presentation can help clinicians maintain an index of suspicion for an underlying metastatic malignancy. Our experience emphasizes the importance of detailed history-taking, clinical examination, and consideration of metastases as a differential diagnosis, even if there is no reported history of malignancy. Such lesions may also be the first sign of an occult primary tumor, which will require prompt investigation for early diagnosis and treatment.
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Affiliation(s)
| | | | - Farah Rana
- Pathology, Tata Main Hospital, Jamshedpur, IND
| | - Neeraj Jain
- Medical Oncology, Tata Main Hospital, Jamshedpur, IND
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Abstract
Current immune-based therapies signify a major advancement in cancer therapy; yet, they are not effective in the majority of patients. Physically based local destruction techniques have been shown to induce immunologic effects and are increasingly used in order to improve the outcome of immunotherapies. The various local destruction methods have different modes of action and there is considerable variation between the different techniques with respect to the ability and frequency to create a systemic anti-tumor immunologic effect. Since the abscopal effect is considered to be the best indicator of a relevant immunologic effect, the present review focused on the tissue changes associated with this effect in order to find determinants for a strong immunologic response, both when local destruction is used alone and combined with immunotherapy. In addition to the T cell-inflammation that was induced by all methods, the analysis indicated that it was important for an optimal outcome that the released antigens were not destroyed, tumor cell death was necrotic and tumor tissue perfusion was at least partially preserved allowing for antigen presentation, immune cell trafficking and reduction of hypoxia. Local treatment with controlled low level hyperthermia met these requisites and was especially prone to result in abscopal immune activity on its own.
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Affiliation(s)
- Fahad Aziz
- Division of Nephrology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Arjang Djamali
- Division of Nephrology, Department of Medicine, University of Wisconsin–Madison School of Medicine and Public Health, University of Wisconsin Hospital and Clinics, Madison, Wisconsin,Division of Transplantation, Department of Surgery, University of Wisconsin–Madison School of Medicine and Public Health, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
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Sveticic J, Stapelberg NJ, Turner K. Suicide prevention during COVID-19: identification of groups with reduced presentations to emergency departments. Australas Psychiatry 2021; 29:333-336. [PMID: 33626306 DOI: 10.1177/1039856221992632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Reductions in suicidal and self-harm presentations to emergency departments (EDs) since COVID-19 indicate changes in help-seeking behaviours, but it is unknown if hospital avoidance equally affects all population groups. METHOD Socio-demographic and clinical information relating to suicidal and self-harm presentations to EDs in Queensland, Australia, were compared for the period before (March-August 2019) and since the COVID-19 outbreak (March-August 2020). RESULTS Since COVID, Indigenous Australians and persons with less severe suicidal and self-harm presentations had significantly reduced presentations, while persons younger than 18 years had more presentations. Less suicidal presentations resulted in an admission to inpatient care. CONCLUSIONS Patterns of reduced attendance to ED in some groups suggest the need for innovative and community-based models of care to help prevent suicides during the pandemic.
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Affiliation(s)
- Jerneja Sveticic
- Gold Coast Hospital and Health Service, Mental Health and Specialist Services, QLD, Australia
| | - Nicolas Jc Stapelberg
- Gold Coast Hospital and Health Service, Mental Health and Specialist Services, QLD, Australia.,Faculty of Health Sciences and Medicine, Bond University, QLD, Australia
| | - Kathryn Turner
- Gold Coast Hospital and Health Service, Mental Health and Specialist Services, QLD, Australia
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