scholarly journals Increased Incidence of Benign Pancreatic Pathology following Pancreaticoduodenectomy for Presumed Malignancy over 10 Years despite Increased Use of Endoscopic Ultrasound

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Shadi S. Yarandi ◽  
Thomas Runge ◽  
Lei Wang ◽  
Zhijian Liu ◽  
Yueping Jiang ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Demographic Data ◽  
Whipple Procedure ◽  
University Hospital ◽  
Imaging Data ◽  
Imaging Studies ◽  
Benign Diseases ◽  
Logistic Regression Models ◽  
Drinking History ◽  
History Of

Despite using imaging studies, tissue sampling, and serologic tests about 5–10% of surgeries done for presumed pancreatic malignancies will have benign findings on final pathology. Endoscopic ultrasound (EUS) is used with increasing frequency to study pancreatic masses. The aim of this study is to examine the effect of EUS on prevalence of benign diseases undergoing Whipple over the last decade. Patients who underwent Whipple procedure for presumed malignancy at Emory University Hospital from 1998 to 2011 were selected. Demographic data, history of smoking and drinking, history of diabetes and pancreatitis, imaging data, pathology reports, and tumor markers were extracted. 878 patients were found. 95 (10.82%) patients had benign disease. Prevalence of benign finding had increased over the recent years despite using more EUS. Logistic regression models showed that abdominal pain (OR: 5.829, 95% CI 2.681–12.674, P ≤ 0.001) and alcohol abuse (OR: 3.221, CI 95%: 1.362–7.261, P: 0.002) were predictors of benign diseases. Jaundice (OR: 0.221, 95% CI: 0.084–0.58, P: 0.002), mass (OR: 0.145, 95% CI: 0.043–0.485, P: 0.008), and ductal dilation (OR: 0.297, 95% CI 0.134–0.657, P: 0.003) were associated with malignancy. Use of imaging studies, ERCP, and EUS has not decreased the percentage of benign findings after surgery for presumed pancreatic malignancy.

Rate of Prophylaxis Oophorectomy and Associated Factors at the Time of Hysterectomy in Premenopausal Women with Benign Diseases

2021 ◽  
Vol 104 (5) ◽  
pp. 709-714
Keyword(s):  
Associated Factors ◽  
Premenopausal Women ◽  
Abdominal Hysterectomy ◽  
University Hospital ◽  
Benign Diseases ◽  
Prophylactic Oophorectomy ◽  
Gynecologic Oncologist ◽  
Menstrual History ◽  
History Of ◽  
Operative Notes

Objective: To determine the rate of oophorectomy and associated factors at the time of hysterectomy in premenopausal women with benign diseases. Materials and Methods: The medical records of the premenopausal women that underwent hysterectomy with or without oophorectomy due to benign gynecologic conditions between January 1, 2012 and December 31, 2017 at Khon Kaen University Hospital (Thailand) were retrospectively reviewed. The data collected included age, BMI, parity, indication for surgery, family history of carcinoma, route of hysterectomy, procedure, specialization of the surgeon, operative notes, and histopathological reports of the ovaries. Results: Six hundred thirty-eight subjects underwent hysterectomy due to benign gynecologic conditions. Bilateral salpingo-oophorectomy (BSO) was performed in 57.37% (366) of the cases. In 81.97% (300) of these cases, either one or both patient’s ovaries were grossly normal. The rate of prophylactic oophorectomy among all cases was 47.02% (300 in 638). The strongest associated factor with BSO was age (odds ratio 8.421, 95% CI 5.488 to 12.921). Other associated factors were irregular menstrual history, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. No cases of ovarian cancer were found. Conclusion: Nearly half of premenopausal women that underwent hysterectomy due to benign conditions underwent prophylactic oophorectomy. Associated factors were age, irregular menstruation, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. Keywords: Hysterectomy, Premenopausal women, Prophylactic oophorectomy

P195 THE STRUCTURE OF A CONSULTATION HOUR FOR BENIGN DISEASES OF THE UPPER GASTROINTESTINAL TRACT AT A CENTRE OF EXCELLENCE FOR ESOPHAGEAL AND GASTRIC SURGERY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
L Knepper ◽  
D T Müller ◽  
H Fuchs ◽  
C Fuchs ◽  
S Brinkmann ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Demographic Data ◽  
Gastric Surgery ◽  
University Hospital ◽  
Upper Gastrointestinal Tract ◽  
Benign Diseases ◽  
High Resolution Manometry ◽  
Surgical Department ◽  
Centre Of Excellence ◽  
Upper Gastrointestinal

Abstract Aim The aim of the study is to analyze the structure and the patient population of a consultation hour for benign diseases of the upper gastrointestinal tract at a centre of excellence for esophageal and gastric surgery. Background and Methods The increasing specialization in visceral surgery leads to a higher number of special consultation hours, e.g. for benign diseases of the esophagus and stomach. In this study we examine both the reasons for an introduction at a specialized clinic and the therapy suggestions. The clinical and demographic data of all patients who visited an appointment for functional diseases of the upper gastrointestinal tract of the University Hospital Cologne during the entire year 2018 were collected prospectively for this study and evaluated at the end of the year. Results In 2018, a total of 412 patients attended the benign OGI consultation hour (54% male). 107 patients (26%) attended more than once. 293 patients attended the consultation hour for the first time. The following diagnoses most frequently led to the presentation in the special consultation hour: GERD (n=262, 63%), achalasia (n=52, 13%), upside-down-stomach (n=24, 6%), dysphagia of unknown genesis (n=15, 4%), and other motility disorders of the esophagus (n=14, 3%). 190 patients received an EGD because they had not received an endoscopic examination in the last year. Functional diagnostics were performed in almost all new presentations: High- resolution-manometry (n=243), 24h-pH-metry (n=199). Even though the surgical department led the consultation hour, a conservative approach was recommended to 231 patients (56%). Surgery was recommended to 156 patients (38%) and an endoscopic approach was recommended in 25 cases (6%). Overall, 101 patients (43%) received an operation during the observation period. Most common indication for surgery was GERD (n=63, 62%). Of those 63 patients, 42 received a laparoscopic Nissen fundoplication. Conclusion The demand for a specialized clinic for reflux treatment is significant and includes a high degree of diagnostics. A differentiation of the symptoms is decisive in order to select the right patients for surgical therapy. Only about every third patient is recommended for surgery.

scholarly journals The Outcome of Agitation in Poisoned Patients in an Iranian Tertiary Care University Hospital

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Ali Mohammad Sabzghabaee ◽  
Ahmad Yaraghi ◽  
Elham Khalilidehkordi ◽  
Seyyed Mohammad Mahdy Mirhosseini ◽  
Elham Beheshtian ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Demographic Data ◽  
Tertiary Care ◽  
Previous History ◽  
University Hospital ◽  
Richmond Agitation Sedation Scale ◽  
Alcohol Abusers ◽  
History Of ◽  
Acute Agitation ◽  
Time Of Admission

Introduction. This study was conducted to evaluate and document the frequency and causes of agitation, the symptoms accompanying this condition in intoxications, relationship between agitation score on admission and different variables, and the outcome of therapy in a tertiary care referral poisoning center in Iran.Methods. In this prospective observational study which was done in 2012, 3010 patients were screened for agitation at the time of admission using the Richmond Agitation Sedation Scale. Demographic data including age, gender, and the drug ingested were also recorded. The patients’ outcome was categorized as recovery without complications, recovery with complications (hyperthermia, renal failure, and other causes), and death.Results. Agitation was observed in 56 patients (males,n=41), mostly aged 19–40 years (n=38) and more frequently in illegal substance (stimulants, opioids and also alcohol) abusers. Agitation score was not significantly related to the age, gender, and previous history of psychiatric disorders. Forty nine patients had recovery without any complication. The need for mechanical ventilation was the most frequent complication. None of the patients died.Conclusion. Drug abuse seems to be a must-to-consider etiology for patients presenting with acute agitation and its morbidity and mortality could be low in agitated poisoning cases if prompt supportive care is performed.

scholarly journals Development and Validation of a Risk Prediction Model for Acute Kidney Injury After the First Course of Cisplatin

2018 ◽  
Vol 36 (7) ◽  
pp. 682-688 ◽  
Author(s):  
Shveta S. Motwani ◽  
Gearoid M. McMahon ◽  
Benjamin D. Humphreys ◽  
Ann H. Partridge ◽  
Sushrut S. Waikar ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Albumin ◽  
Regression Models ◽  
Primary Outcome ◽  
Estimated Glomerular Filtration Rate ◽  
Demographic Data ◽  
Kidney Injury ◽  
Logistic Regression Models ◽  
History Of ◽  
Development And Validation

Purpose Cisplatin-associated acute kidney injury (C-AKI) is common. We sought to develop and validate a predictive model for C-AKI after the first course of cisplatin. Methods Clinical and demographic data were collected on patients who received cisplatin between 2000 and 2016 at two cancer centers. C-AKI was defined as a 0.3 mg/dL rise in serum creatinine within 14 days of receiving cisplatin. Using multivariable logistic regression models with C-AKI as the primary outcome, we created a scoring model from the development cohort (DC) and tested it in the validation cohort (VC). Results C-AKI occurred in 13.6% of 2,118 patients in the DC and in 11.6% of 2,363 patients in the VC. Factors significantly associated with C-AKI included age 61 to 70 years (odds ratio [OR], 1.64 [95% CI, 1.21 to 2.23]; P = .001) and 71 to 90 years (OR, 2.97 [95% CI, 2.06 to 4.28]; P < .001) compared with ≤ 60 years; cisplatin dose 101 to 150 mg (OR, 1.58 [95% CI, 1.14 to 2.19]; P = .007) and > 150 mg (OR, 3.73 [95% CI, 2.68 to 5.20]; P < .001) compared with ≤ 100 mg; a history of hypertension (OR, 2.10 [95% CI, 1.54 to 2.72]; P < .001) compared with no hypertension; and serum albumin 2.0 to 3.5 g/dL (OR, 2.21 [95% CI, 1.62 to 3.03]; P < .001) compared with > 3.5 g/dL. The baseline estimated glomerular filtration rate was not significantly associated with the risk of C-AKI. The c-statistics of the score-based model in the DC and the VC were 0.72 (95% CI, 0.69 to 0.75) and 0.70 (95% CI, 0.67 to 0.73), respectively. Scores of 0, 3.5, and 8.5 were associated with a probability of C-AKI of 0.03 (95% CI, 0.03 to 0.05), 0.12 (95% CI, 0.11 to 0.14), and 0.51 (95% CI, 0.43 to 0.60), respectively. Conclusion A score-based model created by using the patient’s age, cisplatin dose, hypertension, and serum albumin is predictive of C-AKI.

scholarly journals The Relation between Fatigue Level and Nurses’ Caring Behavior in The Orthopedic Department

2020 ◽  
Vol 1 (4) ◽  
pp. 17
Author(s):  
Yasmin F. M. AbdElazeem ◽  
Rasha F. Ahmed ◽  
Eman F. A. M. Aly
Keyword(s):  
Demographic Data ◽  
Structured Interview ◽  
University Hospital ◽  
Direct Patient Care ◽  
Moderate Degree ◽  
Caring Behaviors ◽  
Caring Behavior ◽  
Orthopedic Department ◽  
History Of ◽  
Unpleasant Feeling

Contents: Caring is a concept that is inherently difficult to define. The term caring is expressed in different ways in many cultures. Nurse's caring can impact a person's life processes, wellbeing, and functioning. On the other hand, fatigue is a subjective unpleasant feeling ranging from tiredness to exhaustion that could be physical, mental, or both. It may significantly interfere with functioning and may persist despite periods of rest. Aim: The present study investigates the relation between fatigue level and nurses' caring behavior in the orthopedic department. Methods: Research formulates three questions. What is the nurses' level of fatigue in the orthopedic department? What are the nurses' caring behaviors in the orthopedic department? What is the relation between fatigue level and nurses' caring behavior in the orthopedic department? The study utilized a correlational research design. The study conducted in El Hadra Orthopedic and Traumatology University Hospital, Alexandria, Egypt, on all available nurses (50 nurses) who provide direct patient care and work in the previously mentioned setting. Two tools were used for data collection. Structured interview questionnaire; It consists of two parts. The first part was concerned with socio-demographic data, past medical history of psychological problems, and chronic illness. The second part was Fatigue Visual Analog Scale (VAS), a one-dimensional scale, consisting of an unmarked 10 cm line to rate the nurses' level of fatigue. The second tool was the Orthopedic Nurse Caring Behavior Observation Checklist. This tool was used to assess nurses' caring behavior toward orthopedic patients through concealed observation. Results: It was observed that 60.0% of studied nurses had a severe level of fatigue. The study showed a moderate level of caring behaviors with a mean of 199.92±13.50 for the morning shift nurses and 222.34±14.27 for the nurses in the evening shift. The study evidenced a significant correlation between fatigue level and overall caring behavior.  Conclusion: About two-thirds of the studied nurses had a severe level of fatigue. The overall nurses' caring behaviors dimensions were of a moderate degree. There is a significant positive correlation between fatigue level and the overall nurses' caring behaviors in both morning and evening shifts in the orthopedic department. The study recommended to provide nurses with fatigue countermeasure strategies and to provide the organization with strategies to overcome fatigue. Nurses are recommended to pay more attention to caring behaviors.

scholarly journals Onychomycosis in Northwestern Greece over a 7-Year Period

Pathogens ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 851
Author(s):  
Hercules Sakkas ◽  
Christos Kittas ◽  
Georgia Kapnisi ◽  
Efthalia Priavali ◽  
Amalia Kallinteri ◽  
...  
Keyword(s):  
Demographic Data ◽  
Risk Groups ◽  
University Hospital ◽  
History Of ◽  
Study Population ◽  
Etiological Agents ◽  
And Shifts ◽  
The University ◽  
Northwestern Greece ◽  
The Impact

Onychomycosis is considered as one of the major public health problems with a global distribution associated with geographic, demographic and environmental factors, underlying comorbidities and immunodeficiency disorders. This study was conducted to investigate the etiological agents of onychomycosis, in Northwestern Greece during a 7-year period. The study population included 1095 outpatients with clinically suspected onychomycosis that presented to the University Hospital of Ioannina, NW Greece (2011–2017). Samples were examined for causative fungi, and mycological identification was established using standard mycological methods. Demographic data of each patient, comorbidities, localization of infection and history of previous fungal infection were collected. Onychomycosis was diagnosed in 317 of the 1095 suspected cases (28.9%) and the most frequently isolated pathogens were yeasts (50.8%) followed by dermatophytes (36.9%) and non-dermatophyte molds (NDMs) (12.3%). Dermatophytes were mostly involved in toenail onychomycosis (90.6%) and more commonly affected males than females (57.3% vs. 42.7%), while the predominantly isolated pathogen was Τrichophyton rubrum (74.4%) followed by Τrichophyton interdigitale (21.4%). Candida albicans was the most prevalent isolated yeast (82%), whereas among the cases with onychomycosis due to NDMs, Aspergillus spp. were isolated as the principal species (59%). Continuous monitoring should be performed in order to identify possible trends and shifts in species isolation rates and to evaluate the impact of onychomycosis among the general population and high-risk groups.

scholarly journals Asymptomatic SARS-CoV-2 infection among healthcare workers in a non-COVID-19 Teaching University Hospital

2021 ◽  
Author(s):  
Ahmed Mukhtar ◽  
Mostafa Afishawy ◽  
Engy Alkhatib ◽  
Moushira Hosny ◽  
Mohamed Yousef ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Demographic Data ◽  
Rapid Test ◽  
High Risk Group ◽  
Low Risk ◽  
University Hospital ◽  
Vulnerable Groups ◽  
Suspected Case ◽  
History Of

Background: During the COVID-19 pandemic, most of the published reports on COVID-19 emphasized that health care workers (HCWs) get infected more than the general population representing one of the most vulnerable groups. However, that the real percentage of HCWs infected by SARS-CoV-2 in Egypt remains unknown. The researchers conducted the current study to assess seroprevalence of SARS-CoV-2 IgG among HCWs working in a hospital with no SARS-CoV-2 patients, and to identify the potential factors associated with SARS-CoV-2 IgG seropositivity.Design and Methods: The current study is a cross-sectional study carried out among 455 HCWs at Cairo University Hospital. The researchers administered a questionnaire shortly before the SARS-CoV-2 rapid test is performed using closed-ended question format to obtain information on demographic data of the study participants including age, sex, specialty, clinical information including questions about medical conditions, and. history of previous exposure with a confirmed or suspected case of COVID-19, and history of COVID-19- compatible symptoms during the previous 14 days (cough, sore throat, runny nose, fatigue, shortness of breath, fever, headache, vomiting, diarrhea, anosmia, ageusia, and chills). Results: We screened 455 HCWs for SARS-CoV-2 antibodies, 31.4% were in the high-risk group, and 68.6% in the low-risk group. The overall IgG seroprevalence was 36 (7.9%) (95% CI 5.8 to 10.8). The IgG seroprevalence was significantly higher in low-risk group 11% (35/312) versus high-risk group 0.7% (1/143), p<0.001. Conclusions: Low seropositivity rates for SARS-CoV-2 among HCWs is suggestive of lack of immunity and we are still far from herd immunity.

Efficacy of Thiol disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy

2020 ◽  
Vol 23 ◽  
Author(s):  
Gökhan Akkurt ◽  
Burcu Akkurt ◽  
Emel Alptekın ◽  
Birkan Birben ◽  
Mehmet Keşkek ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Demographic Data ◽  
Previous History ◽  
Significant Negative Correlation ◽  
White Blood Count ◽  
Ischemia Modified Albumin ◽  
Total Thiol ◽  
Duration Of Surgery ◽  
History Of

Aim: The aim of this study is to investigate the efficacy of thiol disulfide homeostasis and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be encountered during laparoscopic cholecystectomy. Materials and Methods: The study included 65 patients who underwent laparoscopic cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT), amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gallbladder, duration on hospital stay, duration of operation, thiol disulfide and IMA values were evaluated. Results: Native thiol and total thiol averages were higher in patients without a history of cholecystitis, on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate, native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis. While there was a statistically significant negative correlation between native and total thiol values and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of intraoperative pericholecystic adhesion increased. Conclusion: We believe that the evaluation of thiol disulfide homeostasis and IMA parameters prior to laparoscopic cholecystectomy can be used as an effective method for predicting intraoperative difficulties.

scholarly journals Gas-filled urachal abscess with a pinging sound in a heifer calf

2019 ◽  
Vol 64 (No. 8) ◽  
pp. 362-366 ◽  
Author(s):  
R Sato ◽  
K Yamada ◽  
Y Shinozuka ◽  
H Ochiai ◽  
K Onda
Keyword(s):  
Fistulous Tract ◽  
Failure To Thrive ◽  
Abdominal Distension ◽  
Intravenous Urography ◽  
University Hospital ◽  
Growth Depression ◽  
Poor Growth ◽  
History Of ◽  
Heifer Calf ◽  
Urachal Abscess

A 6-month-old crossbred of a Holstein and Japanese Black heifer calf weighing 95 kg presented with a history of intermittent abdominal distension and failure to thrive. The physical examination identified a pinging sound over the dorsal left flank. The abdominal radiography showed a huge gas-filled mass. The intravenous urography revealed no communication between the mass and the urinary bladder. Although the visual examination and palpation of the umbilicus did not reveal visible abnormalities, an umbilical disease was suspected because the animal exhibited poor growth, depression, and a hunched back posture. When the eschar adhering to the centre of the umbilicus was removed, the presence of a fistulous tract was revealed. The umbilical ultrasound examination revealed an intra-abdominal abscess and the fistulography demonstrated that the abscess communicated with the umbilicus. The abscess, compressing into the rumen, was observed by computed tomography. From these images, it was diagnosed as an umbilical cord remnant abscess and a definitive diagnosis of a urachal abscess was obtained by open abdominal surgery and the subsequent removal of the mass. The calf was discharged from the university hospital on day 14 after the operation. This case shows that a urachal abscess should be considered when a pinging sound is present, even if the animal exhibits no swelling or pain of the umbilicus.

The Relevance of Old World Archaeology to the First Entry of Man into New Worlds: Colonization Seen from the Antipodes

1977 ◽  
Vol 8 (1) ◽  
pp. 128-148 ◽  
Author(s):  
Sylvia J. Hallam
Keyword(s):  
Demographic Data ◽  
Ecological Zones ◽  
The North ◽  
Technological Potential ◽  
The Pacific ◽  
Peopling Of The Americas ◽  
Rapid Spread ◽  
History Of ◽  
Economic Innovation ◽  
Considerable Complexity

Following several discussions in recent numbers of Quaternary Research on the peopling of the Americas, this paper suggests that movements into the New World should be viewed in the wider context of subsistence, technology, and movement around the western littorals of the Pacific, resulting in the colonization not of one but of two new continents by men out of Asia. Specific points which have been raised by these recent papers are reviewed in the light of Australian, Wallacian, and East Asian data.(1) The earliness of watercraft is evidenced by chronology of the human diaspora through Wallacia and Greater Australia.(2) The simplistic nomenclature of chopper-flake traditions masks considerable complexity and technological potential, revealed in detailed Antipodean studies.(3) These traditions also have great potential for adapting to differing ecological zones, evidenced within Greater Australia; and for technological and economic innovation there, through Southeast Asia, and to Japan and the north Asian littoral.(4) The history of discovery and the nature of the evidence from Australia cannot validly be used to controvert early dates in the Americas.(5) Demographic data from Australia suggest that total commitment to a rapid-spread “bowwave” model for the peopling of new continents may be unwise.

Sign in / Sign up

Export Citation Format

Share Document