scholarly journals Spinal biopsies: a clinicopathologic review of 53 cases diagnosed between 2011 and 2018 at a tertiary hospital in Kampala, Uganda

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
James J. Yahaya

Abstract Background Early diagnosis of spinal cord neoplasia serves patients from developing a number of complications and even death. Methods After obtaining ethical approval, retrospectively, a total of 53 tissue blocks of patients attended at the spinal ward were reviewed. Statistical analysis was done using SPSS version 20.0, and p value of less than 0.05 was applied to establish the existence of statistical significance between the compared categorical variables. Results The mean age of the patients was 30.7 ± 15.96 years. Most of the patients 32.1% (n = 17) were aged ≤ 19 years, and majority of the neoplasia 77.3% (n = 41) were extramedullary. Also, majority of the neoplasia 60.4% (n = 32) were benign and the malignant ones were 35.8% (n = 19). The mean duration of onset of symptoms for benign and malignant neoplasia in this study was 13.1 ± 16.4 and 3.4 ± 2.8 years, respectively, with statistical difference (95% CI 2.09–17.35, p = 0.014). Conclusion The patients with spinal cord neoplasia in the present study were of young age, and majority of them had benign neoplasia that were extramedullary located. The mean duration of onset of symptoms for patients with malignant neoplasia was significantly shorter than that of benign neoplasia.

2018 ◽  
Vol 6 (2) ◽  
pp. 66
Author(s):  
Dr Harpreet Kaur Gandhoke ◽  
Dr Vasanti Lagali Jirge ◽  
Dr Anjana Bagewadi

Background: Studies estimating the Tobacco- specific nitrosamines, (TSNA’s) which are the strongest carcinogens in the saliva oftobacco users and tobacco quitters, are limited.Objectives: To assess and compare the levels of N- nitrosamines (NNN, NNK) in the saliva of tobacco chewers and non -chewers including those who have quit the habit of tobacco use.Methods: The study included 120 patients who were divided into three groups of 40 each: Group I- Smokeless tobacco chewersGroup II- Tobacco chewers who have completely stopped the habit at least 2 weeks prior to sample collection andGroup III- non-chewers. The salivary levels of two tobacco specific nitrosamines; NNN & NNK levels were estimated in the three study groups. Statistical analysis was done by Kruskal– Wallis, one-way analysis of variance (ANOVA) test, Mann-Whitney U test. (p-value < 0.05 was considered to be statistically significant)Results: In Group I, the mean level of NNN was 651.84 ± 359.78 and mean level of NNK was 168.32 ± 131.83. In Group II, the mean level of NNN was 119.52 ± 95.05 and mean level of NNK was 42.78 ± 43.19. In Group III, the mean level of NNN was 3.44 ±6.55 and mean level of NNK was 1.98 ± 3.68. There was a statistical difference in the 3 groups with respect to mean levels of NNN and NNK.Conclusion: The study indicated that salivary tobacco-specific nitrosamines are elevated in tobacco chewers. Saliva can be used to detect TSNA’s and screen for TSNA’s during each patient’s de-addiction process.  


Author(s):  
Lukas Widhiyanto ◽  
Aliefio Japamadisaw ◽  
Kukuh Dwiputra Hernugrahanto

Abstract Background Spinal cord injury (SCI) can cause considerable morbidity and mortality. Until now there is no spinal cord injury profile in Indonesia. Therefore, this study aims to provide an overview of the spinal cord injury profile as well as to analyze the functional outcome at the sixth month and the first year. Results Most spinal cord injury cases were traumatic SCI (67.5%). Meanwhile, non-traumatic SCI was 32.5%. The mean age of patients who had traumatic SCI was 41.9 ± 17.4 years while non-traumatic SCI patients was 48.4 ± 13.7 with a significant difference (p < 0.05). Most cases occurred in men rather than women with significant differences based on the type of injury (p < 0.05). Traffic accidents were the most common cause of cervical injuries (47.1%). Surgery was the most common treatment modality in cervical injury cases (60.4%) with the posterior approach being the preferred approach in most operative measures (72.4%). Respiratory failure was the leading cause of death (48.9%). The mean LOS of patients with traumatic SCI was 28.8 ± 14.3 days while the mean LOS of non-traumatic SCI patients was 44.7 ± 28.7 with a significant difference (p < 0.05). There was significance difference between the initial outcome and after the sixth month to first year follow-up (p < 0.05). Conclusions This study demonstrated the epidemiology and characteristics of spinal cord injury which mostly had a good neurological outcome.


Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Pedro Lavigne de Castello Branco Moreira ◽  
César Cabello dos Santos ◽  
Renato Zocchio Torresan ◽  
Fabrício Palermo Brenelli ◽  
Susana Oliveira Botelho Ramalho

Introduction: Breast cancer is the most common malignant neoplasm affecting the female gender (besides non-melanoma skin cancer). It is a heterogenous disease with different phenotypic subtypes; the most common subtype is the luminal-like, which presents poor response to neoadjuvant chemotherapy. If patients with positive axilla at diagnosis are submitted to surgery, axillary dissection must be carried out, which is a surgery with major morbidities; however, if the patients are treated with neoadjuvant chemotherapy and develop negative axillary disease, they can avoid axillary dissection. Objective: to assess axillary response to neoadjuvant therapy in patients with cT1-3 cN1-2 luminal-like breast cancer. The secondary objectives were to assess the association between the axillary response to neoadjuvant chemotherapy according to: tumor replication marker (Ki67), estrogen and progesterone receptors (ER and PR), tumor histological grade, according to the Nottingham classification, tumor size (cT), level of axillary compromise (cN1, cN2 or cN3), chemotherapy scheme, luminal subtype and epidemiological variables (age, BMI, menopause status). Method: reconstituted cohort including female patients diagnosed with invasive breast cancer stage cT1-3 cN1-2 M0 at physical or ultrasound examination, who received neoadjuvant chemotherapy. Axillary compromise can be assumed. The patients were followed-up at the ambulatory of Clinical Oncology and Mastology at CAISM UNICAMP. A convenience sample was used. Statistical analysis: Statistical analysis will be carried out using the Statistical Package for the Social Sciences, version 22.0 (SPSS). Correlations between categorical variables will be analyzed with the chi-square test. Differences between means will be verified using Student’s t-test. Nonparametric tests will be used according to necessity. All tests will be bicaudal, with 5% as the threshold of statistical significance. Results: One hundred and forty three cases were included, respecting the inclusion criteria. Of these, 2.8% evolved with pathological complete response per se (pCR); 5.6%, with pCR in the breast; and 23.1%, with axillary pCR. The lower the axillary compromise at diagnosis, the higher the frequency of axillary pCR (cN1 26.7%, cN2-3 11.1% - p=0.049). The smaller the residual lesion in the breast after chemotherapy (ycT), the higher the chances of axillary pCR (ycT0 28.8%, ycT1 38.5%, ycT2 9.7%, ycT3-4 0 cases – p=0.042). The anthropometric, immunohistochemical and anatomopathological parameters did not present statistical relevance. Conclusion: Patients with luminal-like breast cancer and axillary compromise at diagnosis may benefit from avoiding dissection in about 20% of the time if treated with neoadjuvant chemotherapy, so this therapeutic strategy should be considered in these cases.


2022 ◽  
Vol 11 (1) ◽  
pp. 01-10
Author(s):  
Orlando Villarreal-Barrera ◽  
Gustavo Melo-Guzman ◽  
Juan Isidro Ramirez-Rodriguez ◽  
Jonathan Ortiz-Rafael ◽  
Emma Del Carmen Macias-Cortes ◽  
...  

Objective: Recurrent cerebral ischemic events are estimated to appear in between 12-15% of symptomatic intracranial atherosclerotic disease (ICAD), regardless of the use of leading pharmacological therapies. Balloon expandable stent (balloon mounted coronary stent) could represent a feasible alternative in this disease’s treatment. This study pretends to report the balloon-expandable placement experience in our center. Materials and Methods: A unicentric retrospective study dated between September 2009 and March 2018 was conducted. Patients previously diagnosed with ICAD and symptomatic stenosis treated with balloon-expandable stent were included. Clinical features, morbidity, mortality, short and long-term evolution, and pre-and post-treatment angiographic features were analyzed, as well as a mean 8 years-period follow-up. Data are presented as means, frequencies, and percentages for categorical variables, and ranks for continuous variables. Statistical analysis was carried by IBM SPSS Statistics Base V22.0 (IBM Corporation, Mexico). A Wilcoxon Signed-rank test statistical analysis was performed. Statistical significance was considered when a p-value lesser than 0.05 was measured for every result. Results: A total of 6 patients with 7 affected vessels were treated, with an average age of 62.7 years. Affected and treated vessels were located in the Internal Carotid Artery (ICA) segment in 42.9%, Vertebral Artery (VA) V4 segment in 14.3%, Middle Cerebral Artery (MCA) M1 segment in 28.5%, and Posterior Cerebral Artery (PCA) P1 segment in 14.3%. The incidence of peri-operatory thrombotic events was 0%. Intracranial hemorrhage presented in 0% of cases. Recurrent ischemic or thrombotic events were not reported in a 97-months mean follow-up. 71.4% of patients scored ≤2 in the modified Rankin Score (mRS) pre-treatment, in a 90 day and 12-month follow-up. 100% presented a favorable evolution with mRS ≤2. Restenosis cases were not reported in radiologic control and retreatment was not needed in a 97-month mean follow-up. Conclusions: This study suggests that balloon-expandable stent therapy with some technical endovascular variants for its navigation and placement could be a safe and effective alternative in the treatment of ICAD as a means of cerebral ischemic event early secondary prevention. We propose to consider not to limit endovascular treatment exclusively to those symptomatic ICAD patients refractory to medical-exclusive treatment, as a means to reduce the risk of presenting a new neurological deficit. Further expanded clinical trials are needed to confirm these findings and the advantage of this kind of stents against other kinds reported in the literature.


2017 ◽  
Vol 27 (4) ◽  
pp. 28181
Author(s):  
Dagoberto França Rocha ◽  
Ana Elizabeth Figueiredo ◽  
Simone Travi Canabarro ◽  
Aline Winter Sudbrack

***Evaluation of adherence to immunosuppressive therapy by self-report of patients submitted to renal transplantation***AIMS: To evaluate the characteristics and risk factors related to the adherence to immunosuppressive treatment of renal transplant patients using the self-report method by means of the Basel Assessment of Adherence Scale for Immunosuppressives (BAASIS).METHODS: A prospective cohort study with a quantitative approach was performed at the Nephrology and Transplantation Service of São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, with patients older than 18 years, transplanted from kidneys from deceased or living donors, with a minimum transplant time of three months and a maximum of 12 months. The BAASIS instrument was applied to evaluate adhesion. For statistical analysis, Fisher exact test (Monte Carlo simulation) was used to verify the association between the categorical variables, Student t test for independent sample means and Mann Whitney test in the variables without normality. A p<0.05 was adopted for the results to be considered significant.RESULTS: The sample consisted of 59 patients, 57.6% of whom were male, 79.7% were white, the mean age was 45.8 years, 57.6% had elementary school and 72.9% were catholic. Hemodialysis was the most used method, in 86.4% of patients before transplantation, and the mean time in the waiting list was 19.5 months. After transplantation, the mean time of hospitalization was 17.2 days. The assessment of adherence by BAASIS characterized 83% of patients as non-adherent. The main fact considered as non-adherence was to take the immunosuppressive drugs with more than two hours difference from the prescribed time, at least once a week, in the last four weeks. There was no significant difference when the statistical analysis was performed to compare the adhesion rate among the various categories of the demographic and clinical variables of the patients.CONCLUSIONS: A high rate of patients not adherent to the immunosuppressive treatment was identified, and the change in the schedule of immunosuppressants was the main fact that characterized this behavior. A shorter waiting time in the transplant queue was associated with non-adherence. The other variables, demographic and clinical, were not associated to the classification of adherent or non-adherent.


2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Carrie A. Jones ◽  
Kelly S. Acharya ◽  
Chaitanya R. Acharya ◽  
Douglas Raburn ◽  
Suheil J. Muasher

Abstract Background To evaluate the association of patient and IVF cycle characteristics with blastulation rate and formation of high-quality blastocysts Results We analyzed autologous blastocyst cycles from 2013 to 2017. Cycles were subdivided into low (< 33%), intermediate (33–66%), and high (> 66%) blastulation rates. Embryo quality was assigned by embryologists using Gardner Criteria. R statistical package was used, and the blastulation groups were compared using analysis of variance (ANOVA) for continuous variables and chi-squared tests for categorical variables. The Bonferroni correction was used to adjust for multiple comparisons. One hundred seventeen IVF cycles met our inclusion criteria. Of these, 20 (17.1%) had low, 74 (63.2%) had intermediate, and 23 (19.7%) had high blastulation rates. Low blastulation rate was associated with a lower number of blastocysts, including fewer high-quality blastocysts. The mean number of oocytes retrieved was highest (18.1) in the group with the lowest blastulation rate, and lowest (13.4) in those with the highest blastulation rate, although this did not reach statistical significance. There were no significant differences between blastulation rates and age, gravidity, prior live birth, anti-mullerian hormone, estradiol and progesterone levels on the day of ovulation trigger, follicle-stimulating hormone dose, or fertility diagnosis. Conclusions High blastulation rate is associated with a greater number of blastocysts, including a greater number of high-quality blastocysts. Higher oocyte yield, however, is not associated with improved blastulation rates. Blastulation rates, blastocyst number, and quality remain difficult to predict based on cycle characteristics alone, and oocyte yield may not be an accurate predictor of either outcome.


2020 ◽  
Vol 19 (1) ◽  
pp. 44-47
Author(s):  
FERNANDO BRENO DE OLIVEIRA RIBEIRO ◽  
ALDERICO GIRÃO CAMPOS DE BARROS ◽  
JUAN DANIEL PAZOS AQUINO ◽  
RODRIGO JOSÉ FERNANDES DA COSTA ◽  
LUIS EDUARDO CARELLI TEIXEIRA DA SILVA

ABSTRACT Objective To identify the incidence and possible risk factors associated with rod breakage in patients who underwent vertebral column resection (VCR) or pedicle subtraction osteotomy (PSO) to treat complex deformities of the spine. Methods Retrospective analysis of a series of 32 patients operated from 2014 to 2018 in a single center. The patients were analyzed for demographic (sex, age), biometric (BMI), radiographical (pre- and postoperative angular variations), and surgical (arthrodesed and osteotomized levels) characteristics. Descriptive analyses were performed for the numerical variables (mean, standard deviation, maximum, median, and minimum) and frequency analysis was performed for the categorical variables. Logistic regression analysis was performed for the dependent variable “rod breakage”, using a stepwise technique to select the variables for the best model, assuming statistical significance of 0.05. Results Of the 32 patients selected, rod breakage occurred in 34.4%. Mean age was 36.6 years (± 19.8), ranging from 10 to 74 years, and the mean BMI was 25.1 (±6.0). Most patients were subjected to VCR (75.0%), were males (56.2%) and did not smoke (90.6%). Logistic regression analysis showed that “arthrodesed levels” were was positively associated with rod breakage (OR 1.72; CI95%: 1.13-3.10; p<0.05). The other factors were not associated with breakage. Conclusion Rod breakage is a frequent complication after three-column osteotomy, especially in long constructions. Level of evidence III; Retrospective Study.


2021 ◽  
Author(s):  
Jing jing liu ◽  
Jia Yin Tong ◽  
Hai Ping Yang

Abstract Objective The aim of this study was to analyze the level of CD33 expression in patients with newly diagnosed AML and determine its correlation with clinical characteristics. Methods: Samples were collected for analysis from AML patients at diagnosis. We evaluated the level of CD33 expression by flow cytometry analysis of bone marrow. Chi-square or t- tests were used to assess the association of categorical variables between the high and low CD33 expression groups. Spearman’s rho was applied when appropriate. Survival curves were generated by the Kaplan–Meier method. Results ① In this study we evaluated the level of CD33 expression in de novo patients diagnosed from November 2013 until January 2019. The mean value of 73.4% was used as the cutoff for the two groups. Statistical analysis revealed that 53 of the 86 (61.2%) AML patients were above the mean.② Although there was no statistical significance between CD33 expression level and gene mutation, FLT3 mutation (P=0.002) and NPM1 mutation (P༝0.001)were more likely to be seen in the high CD33 group. ③ The overall survival (OS) was worse in the high CD33 group (39.0 m vs. 16.7 m, x2 = 7.385, P = 0.007). Multivariate analysis showed that the high expression of CD33 was an unfavorable prognostic factor. ④ Of the 86 patients, CD33-high was closely related to the patients with normal karyotype (x2 = 4.891,P = 0.027), high white blood cell count (WBC, t = 2.804, P = 0.007), and a high ratio of primitive cells (t = 2.851, P = 0.005). Conclusions These findings provide a strong rationale for targeting CD33 in combination with chemotherapy, which can be considered a promising therapeutic strategy for AML.


Author(s):  
Hüseyin Avni Eroğlu ◽  
Yasemen Adalı

Background: Hydatidiform mole (HM) is the most frequently encountered disease among gestational trophoblastic diseases. HM can invade myometrium and result in hysterectomy and because of the absence of any predictive method, the disease  can  be lately diagnosed in the periphery. Author aimed to evaluate predictive value of  the inflammatory cell counts in molar pregnancies in this study.Methods: Nineteen (19) cases with histopathologic HM diagnosis and 19 cases of control group with pregnancy termination or abortion material reached to a university hospital's pathology department on the same day were included in the study. The data on the same day or the day before the operation was used as the hemogram data.Results: The mean age of the cases were 33.84±8.477. The mean of neutrophil, lymphocyte, monocyte, basophil and eosinophil numbers of the HM group and control group were compared in the 95% confidence interval with the independent t test. No statistical significance was observed in any of the inflammatory cell means  (p>0.05). The ratio of lymphocyte means was statistically significant (p=0.006).Conclusions: In this study, author assessed whether the inflammatory cell counts were a predictive in detecting HM. The statistically significant results that author founded in the means of lymphocyte, suggests that this finding may be predictive of early diagnosis. They concluded that this result can be routinely used after the confirmation of the results in larger series of cases.


2017 ◽  
Vol 41 (S1) ◽  
pp. S391-S391
Author(s):  
N. Zivkovic ◽  
G. Djokic ◽  
D. Curcic

IntroductionEnhancement of overall functioning is one of most important goals in treatment of schizophrenia (SCH) patients.ObjectiveTo assess efficacy of aripiprazole in treatment of disability and impairment in social, professional and family life in SCH patients.MethodsThis study included 50 patients with SCH diagnosed by ICD-10 criteria, divided into H (Haloperidol, 5–20 mg/24 h) group (25 patients), and A (Aripiprazole, 10–30 mg/24 h) group (25 patients). Antipsychotics were tested for 12 months with Positive and Negative Symptom Schedule Scale (PANSS), Sheehan Disability Scale (SDS) and the number of withdrawals attributed to adverse event (AE).ResultsThe mean pretrial PANSS score was 103.6 in A and 105.3 in H group. The mean PANSS score after 12 months was 53.5 in A and 54.4 in H group. There were no significant statistical difference in PANSS pretrial scores and scores after 12 months between groups, P = 0.619; P = 0.364. There were significant statistical difference in PANSS score reduction after 12 months in both groups (P < 0.001). Aripiprazole improved all SDS scores in comparison to Haloperidol with high statistical significance. Work: A vs. H, P < 0.001; social life: A vs. H, P < 0.001; family life: A vs. H, P < 0.001; days lost: A vs. H, P = 0.012; days unproductive: A vs. H, P = 0.007; 8.0% AEs occurred in A, and 36.0% in H group.ConclusionsAripiprazole showed same efficacy as haloperidol in treatment of SCH. Aripiprazole showed significantly better efficacy in treatment of disability and impairment. Number of withdrawals was significantly higher in haloperidol group.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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