scholarly journals Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction

Breast Care ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. 184-188 ◽  
Author(s):  
Lars Schröder ◽  
Christian Rudlowski ◽  
Gisela Walgenbach-Brünagel ◽  
Claudia Leutner ◽  
Walther Kuhn ◽  
...  
Keyword(s):  
Chart Review ◽  
Glandular Tissue ◽  
Benign Condition ◽  
Surgical Strategies ◽  
Pathological Conditions ◽  
Gland Tissue ◽  
Male Patients ◽  
Preoperative Examination ◽  
Low Rate ◽  
Rule Out

Background: Gynecomastia (GM) is a benign condition with glandular tissue enlargement of the male breast. GM is classified into 4 grades of increasing severity. We describe a series of GM grade I-II, diagnosed, treated surgically and analyzed regarding feasibility, complication rate, and satisfaction. Methods: From 2005 to 2012, a chart review was performed for 53 patients. Preoperative examination included endocrine and urological examination and exclusion of other pathological conditions. The surgical technique consisted of liposuction through an inframammarian-fold incision and excision of the glandular tissue by a minimal periareolar approach. Results: A total number of 53 male patients with 104 breasts were available for analysis. By liposuction, a median of 300 ml (range: 10-1000 ml) was aspirated from each breast and 25.1 g (range: 3-233 g) gland tissue was resected. Surgery lasted between 25 and 164 min per patient (median: 72 min). 2 postoperative hemorrhages occurred (n = 2, 3.8%). 2 patients underwent re-operation due to cosmetic reasons (n = 2, 3.8%). Conclusions: This analysis demonstrates that treatment of GM grade I-II can easily be performed by liposuction combined with subcutaneous resection of the glandular tissue as a minimally invasive and low-impact surgical treatment with a low rate of complications and excellent patient satisfaction. Preoperative workup is important to rule out specific diseases or malignancy causing the GM.

scholarly journals Value of 18F-PSMA-PET/MRI for Assessment of Recurring Ranula

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1462
Author(s):  
Felix Tilsen ◽  
Siegmar Reinert ◽  
Jürgen Frank Schäfer ◽  
Christian la Fougère ◽  
Anthony Valentin ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Glandular Tissue ◽  
Imaging Protocol ◽  
Submandibular Region ◽  
Surgical Interventions ◽  
Psma Pet ◽  
Head And Neck Imaging ◽  
Gland Tissue ◽  
Suspected Recurrence ◽  
Rule Out

We report the case of a 6-year-old patient with suspected recurrence of a plunging ranula in clinical and ultrasonographic examination. Surgical resection of the left submandibular and sublingual glands had already been performed. Since persistent glandular tissue could not be excluded with certainty via MRI, we expanded diagnostics by performing a PET/MRI using a head and neck imaging protocol and the radiotracer 18F-PSMA-1007, which is physiologically expressed by salivary gland tissue. The 18F-PSMA-PET/MRI provided evidence of a cystically transformed, diminishing seroma in the left retro-/submandibular region. No 18F-PSMA expressing glandular tissue could be detected in the area of resection, excluding a relapse of a plunging ranula. As a consequence, we opted for a conservative treatment without further surgical intervention. We conclude that a simultaneous 18F-PSMA-PET/MRI is a comprehensive imaging modality, which can help to rule out persistent salivary tissue and recurring plunging ranula. It is a useful tool to facilitate the decision making of surgical interventions.

Bone Marrow Culture Yield for the Diagnosis of Opportunistic Diseases in Patients with AIDS and Disseminated Kaposi Sarcoma

2020 ◽  
Vol 18 (4) ◽  
pp. 277-282
Author(s):  
P. Cornejo-Juárez ◽  
B. Islas-Muñoz ◽  
A.F. Ramírez-Ibargüen ◽  
G. Rosales-Pedraza ◽  
B. Chávez-Mazari ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Kaposi Sarcoma ◽  
Opportunistic Pathogens ◽  
Reactive Protein ◽  
Negative Results ◽  
Recent Diagnosis ◽  
Male Patients ◽  
Liver Tests ◽  
Rule Out

Background: Disseminated Kaposi sarcoma (DKS) is present in patients with advanced HIV infection in whom co-infection with other opportunistic pathogens can occur. Bone marrow (BM) aspirate and biopsy comprises a robust diagnostic tool in patients with fever, cytopenias, and abnormal liver tests. However, the yield in patients with DKS has not been determined. Objective: The aim of this study was to evaluate the utility of BM aspirate and biopsy in patients with DKS. Methods: We included 40 male patients with recent diagnosis of DKS. BM aspirate and biopsy was performed as part of the workup to rule out co-infections. Results: In four patients, Mycobacterium avium complex (MAC) was recovered from culture. In another four patients, intracellular yeasts were observed in the Grocott stain, diagnosed as Histoplasma. The yield of BM was calculated in 20%. Only 12 patients (30%) had fever and 11 (27.5%) had pancytopenia. Alkaline phosphatase (ALP) above normal values and C-reactive protein (CRP) were higher in patients with positive results for BM than in those with negative results (63% vs. 21.9%, and 3.0 vs. 1.2 mg/L; p = 0.03 in both comparisons). No differences were found on comparing complete blood-count abnormalities. Conclusion: We recommend performing a BM aspirate for stains, culture, and biopsy in all HIV patients with DKS, as this will permit the early diagnosis of co-infections and prevent further complications in those who receive chemotherapy.

Defining Asthma in the Preschool-Aged Child

PEDIATRICS ◽  
2002 ◽  
Vol 109 (Supplement_E1) ◽  
pp. 357-361
Author(s):  
Robert C. Strunk
Keyword(s):  
Chart Review ◽  
Skin Testing ◽  
Definitive Diagnosis ◽  
Pulmonary Medicine ◽  
Specific Test ◽  
Sweat Chloride ◽  
Preschool Aged Child ◽  
Aged Child ◽  
Allergy Skin Testing ◽  
Rule Out

A physician faces many challenges in making a definitive diagnosis of asthma in young children. Although there are clinical and historical features consistent with asthma, identical features are present in many other diseases. Furthermore, there is no specific test for asthma. Other diseases must always be ruled out before a definitive diagnosis of asthma is made. Determining whether cough or wheeze is the primary symptom is important because asthma is primarily a wheezing disease. Sweat chloride testing, chest radiography, and allergy skin testing should be performed in children with persistent wheezing to rule out other causes and help support a diagnosis of asthma. Allergy skin testing provides particularly useful information for making a diagnosis of asthma in the preschool-aged child. A chart review of patients presenting consecutively to the Division of Allergy and Pulmonary Medicine provides insight and information on an approach to make an asthma diagnosis for this population.

scholarly journals Post-operative fever in children undergoing mastoidectomy due to complicated acute mastoiditis

2021 ◽  
Author(s):  
Oren Ziv ◽  
Aviad Sapir ◽  
Eugene Leibowitz ◽  
Sofia Kordeluk ◽  
Daniel KAPLAN ◽  
...  
Keyword(s):  
Chart Review ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Acute Mastoiditis ◽  
Benign Condition ◽  
Subperiosteal Abscess ◽  
Cortical Mastoidectomy ◽  
New Findings ◽  
Mastoid Surgery

Abstract Objectives: To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) following surgical treatment. Study Design: A retrospective chart review of children diagnosed with CAM who underwent mastoid surgery during 2012-2019. Setting: Tertiary care university hospital. Participants: the study includes 33 patients, divided into two groups: 17 patients with subperiosteal abscess (SPA) alone - single complication group (SCG) and 16 patients with SPA and additional intracranial or intratemporal complications -multiple complications group (MCG). Main Outcome Measures: post-operative fever course and pattern (POF). Results :33 patients belong to the SCG 17(51%) and 16(49%) belonged to the MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs. 12/16(75%) in the MCG (P=0.012). At post-operative day 2 (POD2), 10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG (P=0.013). POF was recorded until POD6 in both groups. Seven patients, all from MCG with POF, underwent second imaging with no new findings. Conclusion: Following a cortical mastoidectomy for CAM, POF is not unusual in the first 6 days and seem to be benign condition. POF is more common, higher, and persistent for a longer duration in MCG compared with SCG. At POD 6, fever is expected to normalize in both groups, so if fever persists further evaluation should be considered.

Pilot Study: Outcomes of the Full Abdominopelvic Ultrasound Protocol for Diagnosis of Acute Appendicitis in Children: A Retrospective Chart Review

2020 ◽  
Vol 36 (6) ◽  
pp. 530-534
Author(s):  
Robert Dima ◽  
Yongdong Wang ◽  
Sarah Zuccolo ◽  
Michelle Palmer ◽  
Kerry Cheong
Keyword(s):  
Pilot Study ◽  
Acute Appendicitis ◽  
Emergency Room ◽  
Teaching Hospital ◽  
Patient Management ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Sonographic Evaluation ◽  
Suspected Acute Appendicitis ◽  
Rule Out

Objective: Sonographic evaluation for acute appendicitis in children often involves an exhaustive protocol, for which the therapeutic yield has not been formally evaluated. The purpose of the study was to pilot a retrospective chart review of children receiving an abdominopelvic sonogram upon presenting with suspected acute appendicitis. Methods: An annual retrospective chart review was designed to review abdominopelvic sonograms to rule out appendicitis and specifically performed at a Canadian children’s teaching hospital. Studies were excluded if the requisition stated multiple clinical concerns or if the patient was >18 years at the time of the sonogram. Results: Based on 230 patient cases reviewed, alternative diagnostic sonographic findings were found in 141 (61%) charts. Only 18 patient cases (8%) demonstrated both alternative sonographic findings as well as a change in management by the emergency room physician. Conclusion: Alternative diagnostic findings, based on a complete abdominopelvic sonogram, were common (61%) in this chart review but rarely changed patient management.

scholarly journals Compliance to service standards for congenital upper limb deficiency: the Northern Ireland experience

2011 ◽  
Vol 36 (1) ◽  
pp. 39-44
Author(s):  
Josephine Hillan ◽  
Lorraine E Graham
Keyword(s):  
Northern Ireland ◽  
Upper Limb ◽  
Multidisciplinary Team ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Rehabilitation Medicine ◽  
British Society ◽  
Current Guidance ◽  
Limb Deficiency ◽  
Low Rate

Background: In 2003, the British Society of Rehabilitation Medicine (BSRM) published guidelines on amputee and prosthetic rehabilitation, including those with congenital limb deficiency.Objectives: The aim of the study was to evaluate the service provided by the Regional Disablement Service (RDS) to children with congenital upper limb deficiency, against BSRM guidelines.Study Design: Retrospective chart review.Methods: Chart review.Results: Analysis of the group ( n = 44) showed 52% were male, with 61% of children affected on the left side, and 73% having a transverse deficiency. Compliance to individual aspects of the guidelines varied considerably. Only 14 (32%) of children had met with the multidisciplinary team by the recommended age of six months. Analysis of referral sources and timings suggested that children were initially seen elsewhere and later referred to RDS after consultation with a surgeon.Conclusions: RDS compliance with the BSRM guidelines was variable. Particularly disappointing was the low rate of children and families meeting the multidisciplinary team at an early age (< 6 months). The low rate of early referral prompted us to contact all paediatricians in Northern Ireland highlighting the guidelines, the benefits of early contact with RDS and encouraging referral on diagnosis.Clinical relevanceThis work will be of interest particularly to those involved in treating paediatric amputees. The challenges we face in treating upper limb deficient children in accordance with current guidance may not be unique and our study may prompt other units to consider how best to improve service to this group.

scholarly journals Stafne’s bone cyst revisited and renamed: the benign mandibular concavity

2020 ◽  
Vol 49 (4) ◽  
pp. 20190475
Author(s):  
Johan K.M. Aps ◽  
Natasha Koelmeyer ◽  
Cina Yaqub
Keyword(s):  
Bone Cyst ◽  
Muscular Tissue ◽  
Fat Tissue ◽  
Patients Âgés ◽  
Left Hand ◽  
Salivary Gland Tissue ◽  
Gland Tissue ◽  
Radiolucent Lesion ◽  
Male Patients ◽  
The Right

Objective: Stafne’s bone cyst (SBC) is an asymptomatic, round or oval-shaped, well-defined, uniform radiolucent lesion, usually incidentally observed in the posterior aspects of the mandible. Radiographical appearance may be confusing though. This study aimed to review the literature on SBCs and to map the SBC as shown in their respective papers. Methods: A Pubmed® search (1/9/2018 till 31/5/2019), mentioning SBC, was carried out. Included papers had to contain: patient’s age, gender and radiographs. Results: In total, 114 papers were found, but only 64 papers were retained, which contained 109 cases (95 males, 14 females). The patients’ ages ranged between 14 and 89 years old (mean age being 52 years). Male patients’ ages (N = 95) ranged from 14 to 89 years (mean age 52.3 years), whereas the females (N = 14) ages ranged between 22 and 68 (mean age 50.2 years). 28 combinations of locations of SBC were recorded. Only three lesions were located at the symphysis, six were bilateral, 55 appeared on the left hand side and 45 on the right hand side of the mandible.The literature mentioned that these cavities could contain salivary gland tissue, muscular tissue, lymphoid tissue, blood vessels, fat tissue or connective tissue. Discussion/Conclusion: This study illustrates the wide variation of SBC locations across the mandible and leads us to conclude that the differential diagnosis of every asymptomatic, oval or round, well-defined, uniform radiolucent lesion on two-dimensional radiographs of the mandible should include “a benign mandibular concavity”, formerly known as SBC.

scholarly journals Characteristics and Incidence of Inpatient Ophthalmology Consultations to Screen for Papilledema

2019 ◽  
Vol 11 (02) ◽  
pp. e40-e43
Author(s):  
Peter J. Belin ◽  
Giovanni H. Greaves ◽  
Jules Winokur ◽  
Matthew Gorski
Keyword(s):  
Optic Nerve ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Inpatient Setting ◽  
Hospital System ◽  
Positive Diagnosis ◽  
Pediatric Inpatient ◽  
Frequent Reason ◽  
Rule Out

Abstract Objective A frequent reason for ophthalmology consultation is to rule out papilledema. The purpose of this study is to evaluate the incidence of consultations to screen for papilledema in an acute inpatient setting and determine the frequency and factors associated with a positive diagnosis of bilateral optic nerve swelling. Methods A retrospective chart review was performed of consecutive adult and pediatric inpatient ophthalmology consultations at a tertiary hospital system to “rule out papilledema” from September through November 2016. All patients had a detailed neuro-ophthalmology examination including a dilated fundus exam. Results A total of 36 consults—13 males and 23 females—with a mean age of 19.8 (range: 3–71) years were called to screen for papilledema. The most common service to request the consult was pediatrics (44%), followed by neurosurgery (42%), medicine (8%), and neurology (6%). The most frequent reason for consultation was headache (61%), followed by visual changes (30.5%) and nausea/vomiting (25%). A positive diagnosis of bilateral optic nerve swelling occurred in 14% (5/36) of consults. Of these five consults, four of them were sent into the hospital by an ophthalmologist who noted the bilateral optic nerve swelling and one was noted by an emergency room pediatrician. Conclusion No new cases of bilateral optic nerve swelling were found in screening consults to “rule out papilledema.” All of the positive diagnoses in our study had been previously identified by another physician and known to the primary team prior to ophthalmology consultation. Screening consultations for optic nerve swelling may not be an effective way to rule out papilledema.

scholarly journals Continuous Positive Airway Pressure Adherence for Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Melissa L. Somers ◽  
Ed Peterson ◽  
Saurabh Sharma ◽  
Kathleen Yaremchuk
Keyword(s):  
Chart Review ◽  
High School Graduates ◽  
Patient Adherence ◽  
Retrospective Chart Review ◽  
Initial Visit ◽  
Obstructive Sleep ◽  
Improve Compliance ◽  
Male Patients ◽  
One Year ◽  
To Receive

Objective. To determine predictors of patient adherence to CPAP. Design. A retrospective chart review identified patients with AHI values greater than 15 who were recommended to receive CPAP. Compliance was measured at a 1-to 4-month interval and at 1 year. Results. There were 106 of 368 (29%) patients who received CPAP therapy that were compliant with CPAP use at 1 to 4 months. Forty-six patients (12%) were using CPAP at one year. For the male group at one year, the model demonstrated the AHI value (P  value=.026) as a predictor of compliance if greater than 27.3 and a significant two-way interaction between age and AHI (P=.023). Increased length of time from the initial visit and receiving the CPAP machine was associated with poorer compliance (P=.002). Those living in areas with higher incomes and with a higher percentage of non-high-school graduates were more likely to be compliant (P=.01 and P=.044). Conclusion. Older male patients with higher AHI values were noted to be more adherent to CPAP. Efforts should be made to try to minimize the length of time between the initial visit and the time to receive CPAP to improve compliance.

“Floating” MMPI Profiles and DSM-III Diagnoses

1983 ◽  
Vol 53 (3_suppl) ◽  
pp. 1119-1122
Author(s):  
Charles S. Newmark ◽  
Pamela Chassin ◽  
Lee Gentry ◽  
Dwight L. Evans
Keyword(s):  
Major Depressive Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Chart Review ◽  
Psychiatric Patients ◽  
Retrospective Chart Review ◽  
Borderline Personality ◽  
Major Depressive ◽  
Male Patients ◽  
A Prospective Study

DSM-III diagnoses of 55 hospitalized psychiatric male patients who produced “floating” MMPI profiles were obtained via retrospective chart review. A prospective study of 16 then was conducted to cross-validate the initial diagnostic findings The results from both investigations suggested that at least half of these hospitalized psychiatric patients received a DSM-III diagnosis of either borderline personality disorder or major depressive disorder. A paucity of schizophrenic diagnoses was noted.

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