Presentation and Management of Atypical Orofacial Cleft Clefts: A Single-Institution Experience for 13 Year Period

2021 ◽  
pp. 105566562110550
Author(s):  
O James ◽  
VY Sabo ◽  
OO Adamson ◽  
B Otoghile ◽  
AA Adekunle ◽  
...  
Keyword(s):  
Health Facility ◽  
Medical Records ◽  
Surgical Care ◽  
Multidisciplinary Care ◽  
Common Type ◽  
Single Institution ◽  
South West ◽  
Present Complex ◽  
Age At Surgery ◽  
History Of

This study reviews the craniofacial clefts that presented at a Nigerian tertiary health facility, highlighting our experience with the pattern of presentation and surgical care of these patients. A retrospective review of the smile train database and medical records of all individuals who had been diagnosed with any of the Tessier craniofacial clefts and managed between 1st January 2007 and 31st December 2020 was done. The data were presented as numbers and percentages of cases. The cleft clinic of a tertiary health facility and a major cleft referral center in South-West Nigeria. Forty-five patients with craniofacial clefts were managed over the study period. 15.6% had associated syndromes, 2.2% had a family history of similar craniofacial cleft and 11% had a history of a possible teratogen. There were 21 (46.7%) middle clefts, 14(31.1%) lateral clefts and 10(22.2%) oblique clefts. The most common type of cleft was Tessier 0 while the Tessier 6 was the least common type. The median age at surgery was 10 months for male and 5months for female subjects, 15.3% complication rate was found in this study. Four patients had revision surgeries to correct residual deformities in this study. The diverse presentations and occurrence of the rare craniofacial clefts present complex aesthetic and functional problems that require individualized often multidisciplinary care. The execution of a properly planned treatment will reduce complications and the need for revision surgeries.

scholarly journals Acne:Clinico-Epidemiological Study In DermatologyVenereology Outpatient Clinic Of Dr. M. Djamil Hospital Padang During January 2016 – December 2018

2020 ◽  
Vol 13 (4) ◽  
pp. 325-328
Author(s):  
Satya Wydya Yenny
Keyword(s):  
Retrospective Study ◽  
Family History ◽  
Epidemiological Study ◽  
Clinical Features ◽  
Outpatient Clinic ◽  
Medical Records ◽  
Skin Disorder ◽  
Epidemiological Data ◽  
Common Type ◽  
History Of

Although acne is usually recognized as an adolescent skin disorder, the prevalence of adults with acne is increasing. The clinical and epidemiological data of acne were evaluated with a view to establishing possible contributing etiological factors and observing whether clinical features differ from adolescent acne. Division of Dermatology and Venereology Outpatient Clinic Dr. M. Djamil hospital padang during January 2016 until December 2018.Retrospective study performed in Medical Cosmetic Division of Dermatology and Venereology Outpatient Clinic Dr. M. Djamil hospital padang during January 2016 until December 2018. Data was taken from medical records. Out of 224 patients included in the study 54.01% were women and 45.98 % were men. Majority of the patients had comedonal acne (45.53 %), whereas nodulocystic was the least common (13.39%). Most common predominant site of involvement was cheek (44.20 %), followed by chin (25.45 %), and mandibular area (14.58 %). Family history of acne was present in 57.70 %. Scarring was observed in a 39.2 %. Acne is predominant in women, with the most commonly involved of the cheeks, with the most common type was comedones type.

scholarly journals KARAKTERISTIK PERSALINAN LETAK SUNGSANG DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE 1 JANUARI 2014 – 31 DESEMBER 2014

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Matricia Delaros G. Silinaung ◽  
Juneke J. Kaeng ◽  
Erna Suparman
Keyword(s):  
Medical Records ◽  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Previous History ◽  
Breech Presentation ◽  
Common Type ◽  
Structural Abnormality ◽  
Fetal Anomalies ◽  
Breech Delivery ◽  
History Of

Abstract: The cause of breech presentation is unknown, but there are some risk factors besides prematurity such as structural abnormality of the uterus, polyhydramnion, placenta previa, multiparity, uterine myoma, multiple pregnancy, fetal anomalies (anencephaly, hydrocephalus), and previous history of breech presentation. Before the age of 28 weeks, the incidence of breech presentation ranges from 25-30%, and most fetus will turn into a cephalic presentation after 34 weeks of gestation. This study aimed to determine the characteristics of breech delivery.This was a descriptive retrospective study using medical records of Prof. Dr. R. D. Kandou Hospital Manado period 1 January 2014 – 31 December 2014. This study obtained 214 cases of breech delivery out of the total of 3,347 deliveries. Breech delivery was most common in multigravida, at the age of 37-41 weeks The most common type of presentation was incomplete breech presentation and the management of labour was mostly per vaginam (spontaneous Bracht). Birthweights were more common in the range of 2500 - 3999 grams and the newborn babies were not asphyxiated. Complications were rarely found, however, there were 15 cases of infant death. Keywords: breech delivery, breech presentation Abstrak: Penyebab terjadinya presentasi bokong tidak diketahui, tetapi terdapat beberapa faktor risiko selain prematuritas, yaitu abnormalitas struktural uterus, polihidramnion, plasenta previa, multiparitas, mioma uteri, kehamilan multiple, anomali janin (anensefali, hidrosefalus), dan riwayat presentasi bokong sebelumnya.Sebelum umur kehamilan 28 minggu, kejadian presentasi bokong berkisar antara 25-30%, dan sebagian besar akan berubah menjadi presentasi kepala setelah umur kehamilan 34 minggu.Tujuan penelitian ini untuk mengetahui karakteristik dari persalinan letak sungsang. Penelitian ini menggunakan metode deskriptif retrospektif melalui rekam medik di RSUP Prof. dr. R. D. Kandou Manado periode 1 Januari 2014 – 31 Desember 2014. Dari penelitian ini diperoleh 214 kasus persalinan letak sungsang dari total persalinan 3.347 persalinan. Persalinan letak sungsang paling banyak ditemukan pada multigravida, kelompok usia kehamilan 37 – 41 minggu, jenis presentasi bokong kaki (incomplete breech) dengan penanganan paling banyak ialah persalinan pervaginam (spontaneus Bracht). Berat badan lahir bayi letak sungsang paling sering berkisar 2500 – 3999 gram, umumnya bayi tidak mengalami asfiksia. Walaupun jarang ditemukan komplikasi, mortalitas bayi letak sungsang terdapat sebanyak 15 kasus.Kata kunci: persalinan letak sungsang, presentasi letak sungsang

Prevalence of arytenoid asymmetry in relation to vocal symptoms

2010 ◽  
Vol 125 (3) ◽  
pp. 282-287 ◽  
Author(s):  
A-L Hamdan ◽  
J Nassar ◽  
J Ashkar ◽  
A Sibai
Keyword(s):  
Standard Deviation ◽  
Medical Records ◽  
Common Type ◽  
Common Symptom ◽  
Vocal Fatigue ◽  
Video Recordings ◽  
Aryepiglottic Fold ◽  
History Of ◽  
The Voice

AbstractObjectives:(1) To assess the prevalence of arytenoid asymmetry during adduction, and (2) to correlate arytenoid asymmetry with vocal symptoms.Materials and method:The medical records and video recordings of 116 patients who presented to the voice clinic were reviewed for the presence of arytenoid asymmetry, as regards sharpening of the aryepiglottic fold angle and altered positioning of the cuneiform and corniculate cartilages.Results:There were 61 males and 55 females, with a mean age of 39 years and a standard deviation of 15 years. Almost one-third had a history of reflux, 25 per cent had a history of smoking and 9.6 per cent had a history of allergy. Hoarseness was the most common symptom, occurring in 42.2 per cent of patients, followed by vocal fatigue (25 per cent) and inability to project the voice. The most common type of asymmetry was corniculate asymmetry, present in 27.6 per cent of the cases and accounting for 74.39 per cent of cases. This was followed by cuneiform cartilage asymmetry, present in 15.5 per cent of cases. There was no correlation between arytenoid asymmetry and vocal symptoms, except for vocal fatigue (p = 0.038).Conclusion:The prevalence of arytenoid asymmetry during adduction is common. The presence of vocal symptoms such as hoarseness, breathiness, inability to project the voice and straining does not generally seem to correlate with the prevalence of arytenoid asymmetry. However, subjects with vocal fatigue are more likely to have cuneiform asymmetry.

“The Fumes of Polonism and the Stench of Herzenism”: “Vestnik Zapadnoy Rossii” Against Class Revolution and Clas Reaction

2020 ◽  
Vol 58 ◽  
pp. 118-134
Author(s):  
Aleksandr E. Kotov
Keyword(s):  
Short History ◽  
South West ◽  
The People ◽  
History Of ◽  
Stereotypical Image

The journal of Ksenofont A. Govorsky “Vestnik Yugo-Zapadnoy I Zapadnoy Rossii” (“South-West and West Russia Herald”) is known in the history of pubic thought as odious and reactionary. However, this stereotypical image needs some revision: the anti-Polish discourse on the pages of the magazine was not so much nationalistic as anti-aristocratic in nature. Considering the “Poles” primarily as carriers of the aristocratic principles, the editorial board of the magazine claimed to protect the broad masses of the people. Throughout its short history, the magazine consistently opposed both revolutionary and aristocratic propaganda. However, the regional limitations of the problems covered in the magazine did not give it the opportunity to reflect on the essential closeness of the revolutionary and reactionary principles. Yu.F. Samarin and I.S. Aksakov – whose conservative-democratic views, on the whole, were close to “Western Russianism”, promoted by the authors of “Vestnik Yugo-Zapadnoy I Zapadnoy Rossii”, managed to reach that goal.

The use of a Domain Ontology for the Management of Essential Hypertension (Preprint)

2020 ◽  
Author(s):  
Emma Chavez ◽  
Vanessa Perez ◽  
Angélica Urrutia
Keyword(s):  
Decision Making ◽  
Essential Hypertension ◽  
Medical History ◽  
Medical Records ◽  
Medical Training ◽  
Relevant Information ◽  
Domain Ontology ◽  
Free Text ◽  
Snomed Ct ◽  
History Of

BACKGROUND : Currently, hypertension is one of the diseases with greater risk of mortality in the world. Particularly in Chile, 90% of the population with this disease has idiopathic or essential hypertension. Essential hypertension is characterized by high blood pressure rates and it´s cause is unknown, which means that every patient might requires a different treatment, depending on their history and symptoms. Different data, such as history, symptoms, exams, etc., are generated for each patient suffering from the disease. This data is presented in the patient’s medical record, in no order, making it difficult to search for relevant information. Therefore, there is a need for a common, unified vocabulary of the terms that adequately represent the diseased, making searching within the domain more effective. OBJECTIVE The objective of this study is to develop a domain ontology for essential hypertension , therefore arranging the more significant data within the domain as tool for medical training or to support physicians’ decision making will be provided. METHODS The terms used for the ontology were extracted from the medical history of de-identified medical records, of patients with essential hypertension. The Snomed-CT’ collection of medical terms, and clinical guidelines to control the disease were also used. Methontology was used for the design, classes definition and their hierarchy, as well as relationships between concepts and instances. Three criteria were used to validate the ontology, which also helped to measure its quality. Tests were run with a dataset to verify that the tool was created according to the requirements. RESULTS An ontology of 310 instances classified into 37 classes was developed. From these, 4 super classes and 30 relationships were obtained. In the dataset tests, 100% correct and coherent answers were obtained for quality tests (3). CONCLUSIONS The development of this ontology provides a tool for physicians, specialists, and students, among others, that can be incorporated into clinical systems to support decision making regarding essential hypertension. Nevertheless, more instances should be incorporated into the ontology by carrying out further searched in the medical history or free text sections of the medical records of patients with this disease.

scholarly journals Outcomes of Multidisciplinary Care for Pediatric Post-Concussive Symptoms

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S18.1-S18
Author(s):  
Jillian O’Neil ◽  
Sean Rose ◽  
Ashley Davidson ◽  
Kathleen Shiplett ◽  
Anthony Castillo ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Psychological Intervention ◽  
Multidisciplinary Treatment ◽  
Symptom Burden ◽  
Multidisciplinary Care ◽  
Exercise Session ◽  
Symptom Improvement ◽  
Final Visit ◽  
Post Injury ◽  
History Of

ObjectiveTo evaluate the effectiveness of a multidisciplinary treatment approach for adolescents experiencing prolonged recovery from concussion.BackgroundAlthough most youth recover from a concussion within 2–4 weeks, an estimated 14% of those injured remain symptomatic at 3 months post-injury. For those experiencing protracted recovery, the 2017 Berlin Concussion in Sport Group Consensus Statement recommends multidisciplinary collaborative care. While recent research utilizing progressive aerobic exercise among adolescents with concussion has shown promise for reduction in symptom burden, limited evidence exists for multidisciplinary care.Design/MethodsParticipants included 39 adolescents (77% female, 87% Caucasian) referred to the Nationwide Children’s Hospital Complex Concussion Clinic. All patients included had persistent (≥30 days post-injury) post-concussion symptoms (SCAT-5 symptom score ≥10). The sample ranged in age from 11-20 years (mean = 15.0, SD = 2.0) and median days since injury was 60 (range = 30–161). 31% of participants had a history of one or more previous concussions, 54% had a history of anxiety or depression, and 26% had a history of ADHD or a learning disorder. The multidisciplinary treatment included sessions with Neurology (mean number of sessions = 2.5), Neuropsychology (mean = 2.1), Physical Therapy (mean = 3.6), and Athletic Training sessions involving graded physical exercise (mean = 4.0), with an average treatment duration of 57.4 days. SCAT-5 symptom rating scales were completed at each visit.ResultsSymptom burden among participants significantly decreased between their initial visit (mean = 49.6, SD = 19.2) and final exercise session (mean = 12.8, SD = 14.1); p < 0.001. Gender did not predict symptom ratings at treatment onset, though males (mean = 5.6) had significantly lower symptom scores than females (mean = 15.0) at their final visit (p < 0.05). Demographic factors and premorbid psychological history did not predict rate of symptom improvement.ConclusionsHigh rates of premorbid psychological problems are evident in children referred for treatment of PCS. Multidisciplinary care involving graded aerobic exercise and psychological intervention shows promise, though specific factors associated with treatment response remain to be elucidated.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

scholarly journals Association between severity of prenatally diagnosed hydronephrosis and receipt of surgical intervention postnatally among patients seen at a fetal-maternal center

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zoë G. Baker ◽  
Arthi Hannallah ◽  
Melissa Trabold ◽  
Danielle Estell ◽  
Cherry Deng ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Renal Scarring ◽  
Tertiary Care ◽  
Rank Test ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Age At Surgery ◽  
History Of ◽  
Pediatric Urologist ◽  
Tract Infections

Abstract Background Hydronephrosis (HN) is the most common abnormality detected on prenatal ultrasound. This study sought to stratify outcomes of patients by severity of prenatal HN with postnatal outcomes. Methods This was a retrospective review of patients referred to a tertiary care fetal-maternal clinic with diagnosis of prenatal HN from 2004 to 2019. HN severity was categorized as mild, moderate, or severe. Data were analyzed to determine the association between HN severity and surgical intervention. Decision for surgery was based on factors including history of multiple urinary tract infections, evidence of renal scarring, and/or reduced renal function. Surgery-free survival time was represented by the Kaplan–Meier method, and hazard ratios were calculated using the log-rank test. Results 131 kidneys among 101 infants were prenatally diagnosed with hydronephrosis; 35.9% had mild HN, 29.0% had moderate HN, and 35.1% had severe HN. 8.5% of patients with mild HN, 26.3% of patients with moderate HN, and 65.2% of patients with severe HN required surgery. Patients with severe HN were 12.2 (95% CI 6.1–24.4; p < 0.001) times more likely to undergo surgery for HN than patients with mild HN and 2.9 (95% CI 1.5–5.3; p = 0.003) times more likely to undergo surgery than patients with moderate HN. Patients with moderate HN were 4.3 times more likely to require surgery than patients with mild HN (95% CI 1.5–12.9; p = 0.01). Median age at surgery was 11.8 months among patients with mild HN (IQR 11.7–14.1 months), 6.6 months among patients with moderate HN (IQR 4.2–16.4 months), and 5.4 months among patients with severe HN (3.7–12.4 months). Conclusion Among this cohort of referrals from a fetal-maternal clinic, severity of HN correlated with increased likelihood of surgical intervention. Continued assessment of patients with prenatal HN should be evaluated to best determine the role of the pediatric urologist in cases of prenatal HN.

A Study in the History of Clare, Suffolk; with Special Reference to its Development as a Borough (Alexander Prize Essay, 1928)

1928 ◽  
Vol 11 ◽  
pp. 83-115
Author(s):  
Gladys A. Thornton
Keyword(s):  
Special Reference ◽  
Middle Ages ◽  
Subsequent Development ◽  
Considerable Importance ◽  
Medieval Period ◽  
South West ◽  
Full Development ◽  
History Of ◽  
The Town ◽  
Prize Essay

Clare is situated in the south-west corner of Suffolk, in the valley of the Stour River. At the present day it is only a village, for its market is no longer held; yet its history shows that in earlier times it was of considerable importance, especially during the medieval period, when it was a favourite residence of the Clare lords. The town then had a busy market and a flourishing cloth-making industry; and at one time it seemed possible that Clare might attain full development as a borough, possessing as it did some burghal characteristics. In the following pages it is proposed to study in detail the history of Clare as a seignorial borough during the Middle Ages, and its subsequent development.

Comparison of outcomes of infants with giant omphaloceles over two decades

2020 ◽  
pp. 1-5
Author(s):  
R.E. Witt ◽  
M. Singhal ◽  
A.J. Vachharajani
Keyword(s):  
Mechanical Ventilation ◽  
Medical Records ◽  
Invasive Mechanical Ventilation ◽  
Informed Decision Making ◽  
Membrane Oxygenator ◽  
Associated Anomalies ◽  
Single Institution ◽  
Extracorporeal Membrane Oxygenator ◽  
Pulmonary Vasodilators ◽  
Improved Outcomes

BACKGROUND: The purpose of this study was to compare the outcomes of infants with giant omphalocele (GO) born in two different epochs over two decades at a single institution. Specifically, it examined whether the utilization of selective pulmonary vasodilators and extracorporeal membrane oxygenator (ECMO) in the management of pulmonary hypertension in the second epoch were associated with improved outcomes. METHODS: The medical records of all patients diagnosed with GO at a large children’s hospital from January 1, 1996 to December 31, 2016 were reviewed and divided into two epochs. Patients were classified as having an isolated GO or GO with minor or major associated anomalies. GO was defined as a defect more than or equal to 5 cm in size and/or liver in the sac. RESULTS: During the study period, 59 infants with GO were identified. The duration of invasive mechanical ventilation was significantly shorter among the survivors from the second epoch (p = 0.03), with none greater than seven days. There were no significant differences in the outcomes of survival to NICU discharge and length of stay (LOS) between infants in the two epochs. CONCLUSIONS: Infants with GO who required invasive mechanical ventilation for more than seven days did not survive in the second epoch. Survival did not improve with uses of selective pulmonary vasodilators and ECMO. This information could be shared with families during prenatal and postnatal counselling to facilitate informed decision making regarding goals of care.

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