scholarly journals Significance and Impact of the Intersphincteric Plane Sepsis in the Management of the Perianal Sepsis: Ultrasound Study

2021 ◽  
Author(s):  
Ashraf Talaat Youssef
Keyword(s):  
Digital Rectal Examination ◽  
Perianal Fistula ◽  
Final Diagnosis ◽  
Abscess Formation ◽  
Study Group ◽  
Potential Space ◽  
Anal Glands ◽  
Ultrasound Study ◽  
Perianal Sepsis

Abstract Background The intersphincteric plane (ISP) is a potential space between the external and the internal anal sphincters. About 90% of the perianal sepsis is caused by an obstruction of the ducts of anal glands with subsequent secondary bacterial infection. The imaging modalities used to diagnose perianal sepsis are the ultrasound via endoanal and transperineal routes and magnetic resonance imaging. Objective  The study aimed to identify the various patterns of the ISP sepsis and their incidence among our study group and to clarify the significance of ISP in the pathogenesis of anorectal abscesses and various types of perianal fistula tracts, to optimize the surgical management. Methods Retrospective descriptive study in which 57 patients with an ISP sepsis were evaluated with full medical history, clinical exam, and ultrasound; the final diagnosis was based on combining the results of ultrasound, digital rectal examination under anesthesia, and the operative results. Results The current study showed many patterns of the ISP sepsis and estimated the incidence of each pattern among our study group; such patterns could be fistula tracts, sinus tracts, abscesses, intersphincteric abscess with supralevator extension, sinus with abscess formation, fistula with abscess formation, distension of the ISP with free pus, and other complex patterns like horse abscess, abscess with transsphincteric sinus, and ISP fistula/sinus with transsphincteric branches. Conclusion Understanding the role of the ISP in the pathogenesis of anorectal abscesses and perianal fistula tracts can help in reaching the optimum way of management.

A prospective study of the role of coxsackie B and other enterovirus infections in the pathogenesis of IDDM. Childhood Diabetes in Finland (DiMe) Study Group

Diabetes ◽  
1995 ◽  
Vol 44 (6) ◽  
pp. 652-657 ◽  
Author(s):  
H. Hyoty ◽  
M. Hiltunen ◽  
M. Knip ◽  
M. Laakkonen ◽  
P. Vahasalo ◽  
...  
Keyword(s):  
Prospective Study ◽  
Study Group ◽  
Childhood Diabetes ◽  
A Prospective Study ◽  
Coxsackie B

Perianal sepsis in neutropaenic patients with haematological malignancies: the role of magnetic resonance imaging and surgery

2020 ◽  
Vol 90 (9) ◽  
pp. 1642-1646
Author(s):  
Claudia Ashkar ◽  
Maneka Britto ◽  
Peter Carne ◽  
Wa Cheung ◽  
Naseem Mirbagheri
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Haematological Malignancies ◽  
Resonance Imaging ◽  
Perianal Sepsis

scholarly journals The Utility of Rapid On-Site Evaluation during Bronchoscopic Biopsy: A 2-Year Respiratory Endoscopy Central Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Hansheng Wang ◽  
Na Wei ◽  
Yijun Tang ◽  
Yunyun Wang ◽  
Guoshi Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
International Association ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
European Respiratory Society ◽  
Macroscopic Appearance ◽  
Visible Lesion ◽  
Bronchoscopic Biopsy ◽  
Site Evaluation

Background. Rapid on-site evaluation (ROSE) is commonly used to evaluate the adequacy of biopsy materials in fine-needle aspiration; however, the diagnostic performance of ROSE during fiber optic bronchoscopy (FOB) biopsy under direct vision is rarely reported. Here, we evaluated the role of ROSE during FOB biopsy of visible lesion in trachea or bronchi. Methods. The role of ROSE was prospectively evaluated in consecutive bronchoscopy specimens obtained between January 2016 and January 2018. The agreement and accuracy between ROSE and final histopathological interpretation were assessed. The frequency and possible reasons for discrepancy between ROSE and definitive histopathology results were identified. Histological and cytological classification was performed according to the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (IASLC/ATS/ERS) criteria of lung ADCs classification. Results. The study enrolled 651 patients, of which 33 were excluded because of insufficient cells. Final diagnosis of malignancy was achieved in 462 cases (74.8%), whereas 156 cases (25.2%) were nonmalignant. ROSE and pathology were well correlated for the diagnosis of squamous cell carcinoma (SCC) (Kappa = 0.718, p<0.05), adenocarcinoma (AdC) (Kappa = 0.662; p<0.05) and small cell lung cancer (SCLC) (Kappa = 0.955; p<0.05). In 24 cases diagnosed as malignant by ROSE and nonmalignant by pathology, the lesion tissues were surgically excised and re-analyzed, and the 24 cases were finally confirmed as malignant by pathology. Conclusions. ROSE technique allows bronchoscopists to obtain viable and adequate material for the diagnosis of histopathology, and provides them with an onsite preliminary diagnosis especially in cases with inconclusive macroscopic appearance. ROSE and pathology should be used in combination to increase the accuracy of diagnosis.

Safety and Efficacy of Single-Dose Ketorolac for Postoperative Pain Management After Primary Palatoplasty: A Prospective Cohort Study With Historical Controls

2021 ◽  
pp. 105566562110128
Author(s):  
Jason R. Stein ◽  
Esperanza Mantilla-Rivas ◽  
Marudeen Aivaz ◽  
Md Sohel Rana ◽  
Ishwarya Shradha Mamidi ◽  
...  
Keyword(s):  
Single Dose ◽  
Postoperative Pain Management ◽  
Postoperative Hemorrhage ◽  
Bleeding Complications ◽  
Control Group ◽  
Study Group ◽  
Safety And Efficacy ◽  
Opioid Dose ◽  
Historical Controls

Objective: To analyze safety and efficacy of single-dose ketorolac after primary palatoplasty (PP). Design: Consecutive cohort of patients undergoing PP, comparing to historical controls. Setting: A large academic children’s hospital. Patients, Participants: A consecutive cohort of 111 patients undergoing PP (study n = 47) compared to historical controls (n = 64). Interventions: All patients received intraoperative acetaminophen, dexmedetomidine, and opioids while the study group received an additional single dose of ketorolac (0.5 mg/kg) at the conclusion of PP. Main Outcome Measures: Safety of ketorolac was measured by significant bleeding complications and need for supplementary oxygen. Efficacy was assessed through bleeding, Face Legs Activity Cry Consolability (FLACC) scale, and opioid dose. Results: Length of stay was similar for both groups (control group 38.5 hours [95% CI: 3.6-43.3] versus study group 37.6 hours [95% CI: 31.3-44.0], P = .84). There were no significant differences in all postoperative FLACC scales. The mean dose of opioid rescue medication measured as morphine milligram equivalents did not differ between groups ( P = .56). Significant postoperative hemorrhage was not observed. Conclusions: This is the first prospective study to evaluate the safety and efficacy of single-dose ketorolac after PP. Although lack of standardization between study and historical control groups may have precluded observation of an analgesic benefit, analysis demonstrated a single dose of ketorolac after PP is safe. Further investigations with more patients and different postoperative regimens may clarify the role of ketorolac in improving pain after PP.

scholarly journals The Role of CD68 (+) Histiocytic Macrophages in Nasal Polyp Development

2020 ◽  
Author(s):  
Nuray Bayar Muluk ◽  
Osman Kürşat Arikan ◽  
Pınar Atasoy ◽  
Rahmi Kiliç ◽  
Eda Tuna Yalçinozan
Keyword(s):  
Nasal Cavity ◽  
Nasal Polyp ◽  
Nasal Polyps ◽  
Deep Layer ◽  
Ethmoid Sinus ◽  
Adult Patients ◽  
Control Group ◽  
Study Group ◽  
Deep Layers

Abstract Objectives The aim of this study was to investigate the role of CD68 (+) histiocytic macrophages (H-M) in the nasal polyp pathogenesis. Materials and Methods The study group consisted of 24 adult patients with nasal polyposis. The control group consisted of 11 adult patients without nasal polyps. A total of 36 nasal polyp samples (10-nasal cavity, 10-maxillary sinus, and 16-ethmoid sinus) from the study group and 11 inferior turbinate samples from the control group were analyzed by immunohistochemical staining, with monoclonal antibodies against CD68 (+) H-M. Results CD68 positivity was significantly higher than the control group in the subepithelial (SE) layer of the ethmoid sinus, and deep layers of nasal cavity, maxillary, and ethmoid sinuses. In SE and deep layers of ethmoid and maxillary sinuses, CD68 positivity was significantly higher than that of the epithelial layer. In the deep layer, histiocytic macrophages tended to gather around eosinophils. Conclusion The high numbers of CD68 (+) histiocytic macrophages mainly located in deep layer of lamina propria may be responsible for the phagocytosis of eosinophils within the polyp tissue. Therefore, it may be concluded that increased macrophages in nasal polyps do not trigger the growth of nasal polyps. Instead, they may serve to reduce the number of eosinophils in already-developed nasal polyps.

scholarly journals Inevitable future: space colonization beyond Earth with microbes first

2019 ◽  
Vol 95 (10) ◽  
Author(s):  
Jose V Lopez ◽  
Raquel S Peixoto ◽  
Alexandre S Rosado
Keyword(s):  
Potential Space ◽  
Public And Private ◽  
Planetary Protection ◽  
Overwhelming Evidence ◽  
Future Space ◽  
Private Research ◽  
Life On Earth ◽  
Space Colonization ◽  
Future Plans

ABSTRACT Based on modern microbiology, we propose a major revision in current space exploration philosophy and planetary protection policy, especially regarding microorganisms in space. Mainly, microbial introduction should not be considered accidental but inevitable. We hypothesize the near impossibility of exploring new planets without carrying and/or delivering any microbial travelers. In addition, although we highlight the importance of controlling and tracking such contaminations—to explore the existence of extraterrestrial microorganisms—we also believe that we must discuss the role of microbes as primary colonists and assets, rather than serendipitous accidents, for future plans of extraterrestrial colonization. This paradigm shift stems partly from the overwhelming evidence of microorganisms’ diverse roles in sustaining life on Earth, such as symbioses and ecosystem services (decomposition, atmosphere effects, nitrogen fixation, etc.). Therefore, we propose a framework for new discussion based on the scientific implications of future colonization and terraforming: (i) focus on methods to track and avoid accidental delivery of Earth's harmful microorganisms and genes to extraterrestrial areas; (ii) begin a rigorous program to develop and explore ‘Proactive Inoculation Protocols’. We outline a rationale and solicit feedback to drive a public and private research agenda that optimizes diverse organisms for potential space colonization.

Questioning Role of Hypochloremia in Bronchopulmonary Dysplasia

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1173-1173
Author(s):  
JEFFREY M. PERLMAN ◽  
JEFF DAWSON
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Metabolic Alkalosis ◽  
Complex Disease ◽  
Disease Process ◽  
Control Group ◽  
Study Group

In Reply.— We appreciate the interest in our report published in Pediatrics (1986;77:212-216). The three letters raise similar questions, and in response we would like to make three points. First, including the two infants in the control group who died with the infants in the study group still resulted in significant differences between the two groups regarding duration of furosemide (Lasix) therapy, hypochloremia, or metabolic alkalosis (P &gt; .001). Second (as noted in our discussion), bronchopulmonary dysplasia is a complex disease process.

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

scholarly journals Occurrence of urogenital mycoplasmas in men with the common genitourinary diseases

2021 ◽  
Author(s):  
Dominika Smolec ◽  
Alicja Ekiel ◽  
Piotr Kłuciński ◽  
Jan Kawecki
Keyword(s):  
Infectious Complications ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Study Group ◽  
Immunocompromised Patients ◽  
Healthy Men ◽  
The Common ◽  
Estimate Prevalence ◽  
Positive Results

Abstract Many serious and fatal infections with urogenital mycoplasmas in immunocompromised patients have been reported. M. genitalium is recognized as a cause of male urethritis and other common genitourinary diseases. The aim of the study was to estimate prevalence of urogenital mycoplasmas which can cause complications in men with common genitourinary diseases. Study included 85 men with genitourinary tract carcinoma (n = 35), urolithiasis (n = 36), and BPH (benign prostatic hyperplasia) (n = 14). The control group consisted of 50 healthy men. FVU (first void urine) samples were examined by PCR for the presence of urogenital mycoplasmas DNA. Occurrence of urogenital mycoplasmas was significantly more common in study group compared with control 24/85 (28.2%) and 7/50 (14%), respectively (p = 0.05). In men with urolithiasis, positive results for mycoplasmas DNA were significantly more frequent than in control: 33.3% vs. 14% (p < 0.05). In patients with urolithiasis DNA of U. urealyticum was most often found, while in the genitourinary carcinoma and BPH groups, U. parvum was more frequent. Incidence of M. fermentans was also significantly higher in the urolithiasis group vs. control (p = 0.03). A higher percentage of positive results for urogenital mycoplasma DNA in study group has been found. Further studies are required to confirm the role of urogenital mycoplasmas in the development of infectious complications among patients with urolithiasis, genitourinary carcinoma, and BPH.

Sign in / Sign up

Export Citation Format

Share Document