scholarly journals December 2021 Medical Image of the Month: Aspirated Dental Implant

2021 ◽  
Vol 23 (6) ◽  
pp. 149-150
Author(s):  
Prasad Panse ◽  
◽  
Sreeja Biswas Roy ◽  
Robert Viggiano
Keyword(s):  
Medical Image ◽  
Uneventful Recovery ◽  
Low Grade ◽  
Dental Procedure ◽  
Pleuritic Chest Pain ◽  
Thoracostomy Tube ◽  
Foreign Objects ◽  
Dental Procedures ◽  
Falling Asleep ◽  
Patient Reported

No abstract available. Article truncated after first 150 words. A 76-year-old woman with a past medical history significant for left-sided breast cancer status post lumpectomy recently underwent an extensive dental procedure about 1 month prior to presentation. The dental procedure was prolonged, and the patient reported falling asleep during the procedure several times. She presented with fatigue, right pleuritic chest pain, low-grade fevers, and drenching sweats. She underwent chest radiography at an outside institution which disclosed pneumonia, for which she was treated with cefdinir and doxycycline without improvement. Thoracostomy tube drainage of the pleural effusion was performed and showed empyema. Imaging showed an airway foreign body which was retrieved bronchoscopically. The patient made an uneventful recovery. Aspiration during dental procedures is rare but reported (1). Dental items have been reported as the second most commonly ingested/aspirated foreign objects in adults. If the airway is not compromised, assessment for any lost or missing instrument and its component should be done …

Automated Early Detection of Astrocytomas Tumor Based on Optimized Adaptive Cluster with Super Pixel Model

2021 ◽  
Vol 30 (06n08) ◽  
Author(s):  
V. K. Deepak ◽  
R. Sarath
Keyword(s):  
Brain Tumor ◽  
Medical Image ◽  
Automatic Segmentation ◽  
Tumor Segmentation ◽  
Low Grade ◽  
Grey Wolf ◽  
Dice Coefficient ◽  
Grey Wolf Optimization ◽  
Brain Tumor Segmentation ◽  
Better Than

In the medical image-processing field brain tumor segmentation is aquintessential task. Thereby early diagnosis gives us a chance of increasing survival rate. It will be way much complex and time consuming when comes to processing large amount of MRI images manually, so for that we need an automatic way of brain tumor image segmentation process. This paper aims to gives a comparative study of brain tumor segmentation, which are MRI-based. So recent methods of automatic segmentation along with advanced techniques gives us an improved result and can solve issue better than any other methods. Therefore, this paper brings comparative analysis of three models such as Deformable model of Fuzzy C-Mean clustering (DMFCM), Adaptive Cluster with Super Pixel Segmentation (ACSP) and Grey Wolf Optimization based ACSP (GWO_ACSP) and these are tested on CANCER IMAGE ACHRCHIEVE which is a preparation information base containing High Grade and Low-Grade astrocytoma tumors. Here boundaries including Accuracy, Dice coefficient, Jaccard score and MCC are assessed and along these lines produce the outcomes. From this examination the test consequences of Grey Wolf Optimization based ACSP (GWO_ACSP) gives better answer for mind tumor division issue.

NCOG-42. SYMPTOM ONSET TO TIME OF DIAGNOSIS IN PRIMARY CENTRAL NERVOUS SYSTEM TUMOR PATIENTS: A REVIEW OF FINDINGS FROM THE NOB-NHS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi161-vi161
Author(s):  
Matthew Lindsley ◽  
Elizabeth Vera ◽  
Alvina Acquaye ◽  
Nicole Briceno ◽  
Anna Choi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Tumor Location ◽  
Low Grade ◽  
Central Nervous System Tumor ◽  
Tumor Patients ◽  
Patient Reported ◽  
Reported Data

Abstract Prior reports suggest the low prevalence of primary central nervous system (PCNS) tumors and the healthcare setting where patients seek care can contribute to diagnostic delays, potentially affecting prognosis. This descriptive report highlights findings from patient-reported data at presentation collected from a sample of 623 PCNS tumor patients. Participants were White (88%), males (56%), median age at diagnosis 41 (2-79) with high grade (HG) (66%) brain tumors (BT) (89%). Among BT patients, 30% reported ≥ 3 concurrent symptoms at presentation including headaches (40%), seizures (30%), and memory problems or difficulty with balance/walking (20% each). Over half (57%) had symptoms for < 6 months before diagnosis and 60% presented to the Emergency Room. Sixty-five percent of HG BT patients had symptoms for < 6 months prior to diagnosis compared to low grade (LG) tumors (40%) and had surgery in < 1 month from presentation (68% vs 51%, p < 0.01). More HG BT patients presented with weakness in the arms/legs than LG BT (14% vs 8%). Among spine tumor (ST) patients, 45% reported ≥ 3 concurrent symptoms at presentation including back pain (65%), sensory changes (45%), and weakness (40%). Almost half (46%) were symptomatic for > 1 year before diagnosis, presented in an outpatient clinic (64%) with 41% having surgery < 1 month from presentation. Younger (40% vs 16%) and HG ST patients (56% vs 21%) more often reported symptoms for < 6 months before diagnosis. HG ST patients more often presented to Emergency Rooms (67% vs 25%) and had surgery < 1 month from presentation (60% vs 36%). Further analysis of symptom presentation and clinical course is ongoing. Tumor location, grade, patient age and healthcare setting were associated with the time from clinical presentation to diagnosis. Development of aids providing guidance on diagnostic evaluation/treatment to front-line healthcare providers is warranted.

scholarly journals Colon Interposition for Esophageal Reconstruction in Cancer Patients

2018 ◽  
Vol 103 (5-6) ◽  
pp. 238-247
Author(s):  
Martin H. Hangaard ◽  
Michael B. Mortensen
Keyword(s):  
Cancer Patients ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Colon Interposition ◽  
Esophageal Reconstruction ◽  
Low Grade ◽  
Extensive Review ◽  
First Choice ◽  
Patient Reported ◽  
Esophagectomy For Cancer

Objective: The aim of this study was to report our experience with colon interposition (COI) and to compare the results with an extensive review of the COI literature. Summary of Background Data: The stomach is the first choice as an esophageal substitute following esophagectomy in cancer patients, while COI is reserved for patients where the stomach is not available or must be included in the resection due to cancer. Methods: We retrospectively reviewed the records of cancer patients undergoing colon interposition from 2006 to 2017. Outcomes were compared with an extensive review of the literature published between 2000 and 2017. Results: A total of 13 patients underwent planned COI. Mortality was zero and overall morbidity was 53%; 4 patients suffered from leakage and 2 patients from strictures. None of the patients suffered from necrosis of the interponat and there was no need for subsequent redundancy operations. The extensive review identified 23 publications. Overall study grading was low (grade C). Only 3 studies were prospective, no randomized studies were found, and many outcomes were poorly defined. The rates for 30-day and in-hospital mortality were 1% and 2%, respectively. Overall morbidity was 43%. The reported number of leakages, strictures, necrosis of the interponat, and redundancy operations varied between 0% and 50%, 0% and 21%, 0% and 9%, and 0% and 2%, respectively. Conclusions: COI is a complex technique that is necessary in a relatively small group of selected patients after esophagectomy for cancer. Prospective and comparative studies with strict outcome definitions, long-term follow up, and patient reported outcome measures are lacking.

scholarly journals Neuroendocrine tumours: what gastroenterologists need to know

2020 ◽  
pp. flgastro-2020-101431
Author(s):  
Mohid S Khan ◽  
D Mark Pritchard
Keyword(s):  
Quality Of Life ◽  
Neuroendocrine Tumours ◽  
Comprehensive Evaluation ◽  
Treatment Options ◽  
Somatostatin Analogue ◽  
Low Grade ◽  
Multiple Treatment ◽  
Gastrointestinal Problems ◽  
Patient Reported

Gastroenterologists are intermittently involved in diagnosing and managing patients who have neuroendocrine tumours (NETs). However, few UK gastroenterologists have received extensive training about this topic. This article aims to provide a brief introduction to NETs; it is aimed at a general gastroenterologist audience.NETs present in diverse ways and many symptomatic patients unfortunately experience significant delays in diagnosis. Comprehensive evaluation of a patient with a possible NET involves assessing their symptoms, the tumour’s primary organ of origin, its differentiation status, grade and stage, whether the NET is secreting hormones and whether there is any underlying hereditary predisposition. Such assessment often needs specialist investigations such as nuclear medicine scans. All these factors influence patient management and prognosis, so a patient’s case and investigations should always be discussed by a fully constituted NET multidisciplinary team. Most localised tumours are considered for resection, but there are multiple treatment options for metastatic disease and many patients receive several different therapies during the course of their illness. The most common first line treatment in patients who have metastatic low grade NETs is monthly long acting somatostatin analogue injections. Prognosis is highly variable, but some patients who have inoperable metastases survive for many years on treatment with good quality of life. Gastroenterologists may also be involved in managing the non-tumour associated chronic gastrointestinal problems that some patients experience. Their involvement has been shown to improve patient-reported outcomes and quality of life.

scholarly journals Private Practice Pricing in the Birmingham Region

2019 ◽  
Vol 8 (1) ◽  
pp. 34-37
Author(s):  
Anant Bakshi ◽  
Raeesa Khan ◽  
Bilal Ahmed
Keyword(s):  
Dental Implants ◽  
Average Cost ◽  
Dental Treatment ◽  
Dental Procedure ◽  
Dental Procedures ◽  
Dental Intervention ◽  
The Mean ◽  
The Difference ◽  
Mean Cost ◽  
Insight Into

This study was carried out to evaluate the difference in prices for dental treatments carried out privately in general dental practice within the Birmingham area. Ten different practices were chosen at random, which were spread across Birmingham, in order to get a better insight into the differences across the districts. Their prices for pre-determined dental procedures were procured off the practices’ respective websites or through telephoning. The findings of this study have shown a wide variation in prices for each dental procedure, with the greatest variation in prices between practices being £850 for dental implants. The procedures with the lowest average cost were fissure sealants at £23.14. The procedure with the highest average cost was dental implants at £2,261.11. This study also showed that as more dental treatment was required, the mean cost for the dental intervention increased, regardless of the tooth being treated.

scholarly journals Retubularization of the ileocystoplasty patch for conversion into an ileal conduit

2013 ◽  
Vol 7 (7-8) ◽  
pp. 462
Author(s):  
Peter A. Massaro ◽  
Jerzy B. Gajewski ◽  
Greg Bailly
Keyword(s):  
Urinary Tract ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Low Grade ◽  
Complication Rates ◽  
Bladder Pain ◽  
Persistent Symptoms ◽  
Additional Surgery ◽  
Patient Reported ◽  
Tract Infections

Introduction: We present the outcomes and long-term follow-up of patients who underwent conversion to an ileal conduit urinary diversion using the retubularized patch from the initial augmentation ileocystoplasty.Methods: We reviewed the charts of all patients who underwent this surgery at our centre. The indications for surgery, workup, clinical outcomes and complication rates were assessed. Patient reported symptom response based on global response assessment (GRA) was determined and used as a subjective measure of overal ltreatment effectiveness.Results: Thirteen patients with either bladder pain syndrome/interstitialcystitis (BPS/IC) (n = 11) or neurogenic bladder (n = 2) were followed for a mean of 80 months. The most common indication for surgical conversion was persistent lower urinary tract symptoms (LUTS) or bladder pain. Late complications were frequent, typically low-grade, and usually manageable with conservative therapy; the most common were urinary tract infections (n = 6) and parastomal hernias (n = 5). Two patients developed ureteric strictures. Nine of 13 patients required additional surgery to manage complications or persistent symptoms. Only 5 of 11 GRA respondents reported a successful therapeutic outcome and BPS/IC patients who underwent concurrent cystourethrectomy tended to be most satisfied (2/3). Nevertheless, several patients still achieved symptom control when no other treatment options were available to them.Conclusion: Conversion to an ileal conduit using the retubularized ileocystoplasty patch offers several technical and therapeutic advantages over creating a urinary diversion from a new bowel segment. It should therefore be considered a viable treatment option in patients who have exhausted more conservative management of their LUTS.

scholarly journals The Onset of Enhanced Intestinal Permeability and Food Sensitivity Triggered by Medication Used in Dental Procedures: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Aristo Vojdani ◽  
Jama Lambert
Keyword(s):  
Intestinal Permeability ◽  
Present Report ◽  
Wheat Gluten ◽  
Secretory Iga ◽  
Dental Procedure ◽  
Food Sensitivity ◽  
Gut Dysfunction ◽  
Dental Procedures ◽  
Bacterial Endotoxins ◽  
The Many

Enhanced intestinal permeability and food sensitivity are two of the many proven causes of gastrointestinal disorders. This present report describes a woman with no previous gastrointestinal (GI) complaints, who underwent dental root canal, bone graft, and implant procedures. Postsurgery she experienced an allergic reaction to the combined medications. In the weeks that followed, she presented with multiple food intolerances. Four weeks after the final dental procedure, she was assessed serologically for mucosal immune function, salivary, and blood-gluten reactivity, intestinal permeability, and other food sensitivities. Compared to her test reports from two months prior to her first dental procedure, the patient’s results showed high total secretory IgA (SIgA) and elevated salivary antibodies to alpha-gliadin, indicating abnormal mucosal immunity and loss of tolerance to gluten. Her serologic assessments revealed immunoglobulin G (IgG) and IgA antibodies to a range of wheat/gluten proteins and peptides, gut bacterial endotoxins and tight junction proteins. These test results indicate gut dysbiosis, enhanced intestinal permeability, systemic gluten-reactivity, and immune response to other dietary macromolecules. The present case suggests that patients who experience severe allergic or pseudoallergic reactions to medication should be assessed and monitored for gut dysfunction. If left untreated this could lead to autoimmune reactions to self tissues.

scholarly journals MIS-TLIF versus O-TLIF for single-level degenerative stenosis: study protocol for randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041134
Author(s):  
Olga N Leonova ◽  
Evgeny A Cherepanov ◽  
Aleksandr V Krutko
Keyword(s):  
Minimally Invasive ◽  
Study Protocol ◽  
Controlled Trial ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Neurogenic Claudication ◽  
Low Grade ◽  
Clinical Safety ◽  
Single Level ◽  
Patient Reported

IntroductionPatients with symptomatic single-level combination of degenerative stenosis and low-grade spondylolisthesis are often treated by nerve root decompression and spinal fusion. The gold standard is traditional open decompression and fusion, but minimally invasive method is more and more prevailing. However, there is lack of high-quality studies comparing these two techniques in order to obtain the advantages and certain indications to use one of these methods. The current study includes clinical, safety and radiological endpoints to determine the effectiveness of minimally invasive decompression and fusion (MIS-TLIF) over the traditional open one (O-TLIF).Methods and analysisAll patients aged 40–75 years with neurogenic claudication or bilateral radiculopathy caused by single-level combination of degenerative stenosis and low-grade spondylolisthesis, confirmed by MRI with these symptoms persisting for at least 3 months prior to surgery, are eligible. Patients will be randomised into MIS-TLIF or traditional O-TLIF. The primary outcome measure is Oswestry Disability Index at 3-month follow-up term. The secondary outcomes are patient-reported outcome measures by the number of clinical scales, radiological parameters including sagittal balance parameters, safety endpoints and cost-effectiveness of each method. All patients will be analysed preoperatively, as well as on the 14th day of hospital stay (or on the day of hospital discharge), 3 months, 6 months, 12 months and 24 months postoperatively. The study has the design of a parallel group to demonstrate the non-inferior clinical results of MIS-TLIF compared with the traditional O-TLIF.Ethics and disseminationThe study will be performed according to Helsinki Declaration. The study protocol was approved by the Local Ethical Committee of Priorov National Medical Research Center of Traumatology and Orthopedics in August 2020. Preliminary and final results will be presented in peer-reviewed journals, especially orthopaedic and spine surgery journals, at national and international congresses.Trial registration numberNCT04594980.

Phase II study of the effect of the topical corticosteroid fluocinonide in patients on endocrine therapy for breast cancer or breast cancer prevention with symptoms of vaginal dryness and dyspareunia.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10105-10105
Author(s):  
Evthokia A. Hobbs ◽  
Kristine Lethert ◽  
Deirdre J. Nauman ◽  
Jenna Bucher ◽  
Emile Latour ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Topical Corticosteroid ◽  
Endocrine Therapy ◽  
Phase Ii ◽  
Index Score ◽  
Low Grade ◽  
Vaginal Symptoms ◽  
Vaginal Dryness ◽  
Number Of Patients ◽  
Patient Reported

10105 Background: Gynecologic symptoms and sexual dysfunction from endocrine therapy are troublesome side effects for a significant number of patients. This study explored amelioration of vaginal dryness and dyspareunia with fluocinonide cream, a strong topical corticosteroid. Methods: A single-arm, open-label phase II trial of topical fluocinonide 0.05% cream to improve vaginal symptoms in women on endocrine therapy in the adjuvant setting for early stage breast cancer was performed. Patients with vaginal symptoms applied topical vaginal fluocinonide 0.05% cream twice a day for two weeks then once daily for two weeks. Patients were assessed for symptoms by weekly completion of the Mayo/North Central Cancer Treatment Group Patient Pretreatment Questionnaire. The primary outcome was a change from baseline in patient-reported effects of vaginal dryness and dyspareunia on a scale from 0 (no symptoms) to 4 (very severe symptoms) from time of enrollment and at 4 weeks. Secondary outcomes were decrease in vaginal itching and total vaginal index score. Comparisons were made with Wilcoxon sign rank test with 2.5% significance level. Results: Thirty-four women were accrued. At 4 weeks compared with baseline, vaginal dryness improved from a median score of 2 (moderate symptoms) to 0 (no symptoms) ( P < .001) and dyspareunia from 3 (severe symptoms) compared with 1 (mild symptoms) ( P = .002). Percentage of patients who had > 2 point improvement in vaginal dryness and dyspareunia was 69.0% and 75% respectively. Secondary analysis showed decrease in vaginal itching score from 1 to 0 ( P = .001) and vaginal index score of 6 to 1 ( P = .002). Twenty-one patients experienced low-grade toxicities which were mostly limited to skin irritation. Conclusions: Fluocinonide 0.05% cream improves vaginal dryness and dyspareunia experienced by women receiving endocrine therapy and has the potential to improve quality of life of cancer survivors and compliance of endocrine therapy. Clinical trial information: NCT00297011.

Patient and diagnostic intervals of sarcoma patients: Results from a survivorship study in the Netherlands.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23553-e23553
Author(s):  
Vicky L.M.N. Soomers ◽  
Olga Husson ◽  
Ingrid M.E. Desar ◽  
Michiel van de Sande ◽  
Jacco De Haan ◽  
...  
Keyword(s):  
The Netherlands ◽  
Risk Groups ◽  
Interval Length ◽  
Low Grade ◽  
Middle Aged ◽  
Interval Time ◽  
Patient Reported ◽  
Bone Sarcomas ◽  
Diagnostic Interval ◽  
Diagnostic Intervals

e23553 Background: Sarcoma patients are hypothesised to experience long intervals to cancer diagnosis, due to the rarity of the disease, heterogeneous presentation, and complexity of histological diagnosis. Comprehensive assessment of patient interval (time between first symptom and presentation to a doctor), diagnostic interval (time between presentation to a doctor and diagnosis ), and their associated factors is needed to improve referral pathways and outcomes for sarcoma patients. We investigated patient and diagnostic intervals and identified factors associated with prolonged intervals in order to identify risk groups. Methods: We conducted a cross-sectional cohort study among adult sarcoma survivors, diagnosed between 2008-2016. After informed consent, patient-reported interval length was collected via (online) questionnaires. This data was linked to the Netherlands Cancer Registry, which collects clinical data from patients at diagnosis. Descriptive statistics were used to describe interval lengths. Logistic regression analyses were conducted to investigate associations of patient and tumour characteristics (gender, age at diagnosis, time since diagnosis, histology, presence of metastases, grade, and localisation), with patient and diagnostic interval length. Results: 1099 survivors completed questionnaires (response rate 58%); 53% had a patient interval ≥1 month. Risk factors for a patient interval ≥1 month were bone or breast sarcoma, and being young(18-39 years). An interval ≥3 months (33%) was associated with dermatofibrosarcoma protuberans, bone sarcoma, low grade, and location in skin or pelvis. Diagnostic interval length was ≥1 month in 53%; risk groups were bone sarcomas, females, and young (18-39) or middle-aged (40-69) patients. In 27% the diagnostic interval lasted ≥3 months; risk groups were synovial sarcoma, chordoma, bone sarcomas in general, females, and being young (18-39) or middle aged (40-69). Conclusions: Over half of sarcoma survivors had a patient interval ≥1 month; a third ≥3 months. More than half of them reported a diagnostic interval ≥1 month; a quarter ≥3 months. Females and young patients were more at risk for a long diagnostic interval. Although limited by its retrospective nature, this study is the largest that studied the interval in a sarcoma survivorship group. Our current QUEST study (NTR-7253) will study the diagnostic trajectory prospectively to confirm these findings and find reasons for these results.

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