scholarly journals Head and Neck Sarcomas - Our Experience at a Tertiary Care Center in Rabat, Morocco

2015 ◽  
Vol 2 (1) ◽  
pp. 7-10
Author(s):  
Rajae Borki ◽  
Sophia Nitassi ◽  
Ali El Ayoubi ◽  
Razika Bencheikh ◽  
Abdelilah Oujilal ◽  
...  
Keyword(s):  
Head And Neck ◽  
Lung Metastases ◽  
Care Center ◽  
Tertiary Care ◽  
Maxillofacial Surgery ◽  
University Hospital ◽  
Treatment Protocols ◽  
Study Results ◽  
Surgery Department ◽  
The University

Introduction: Head and neck sarcomas are rare, malignant and very heterogeneous tumors. The difficulty to manage these sarcomas requires the intervention of a multidisciplinary team to improve the prognosis. The aim of our study is to report our series (epidemiological, histological and progressive characteristics) and evaluate our treatment results. Patients and methods: This is a retrospective study on 42 cases of head and neck sarcomas, assembled at ENT and Maxillofacial Surgery department in the University Hospital of Rabat, for a period of 5 years (2010-2015). All sarcomas were confirmed by histological examination with immunohistochemical study. Results: There were 29 men and 13 women. The average age of our patients was 35.5 years (extremes of age: 13 and 70 years). All patients received a CT scan with MRI scan in 21 cases. A remote extension assessment showed lung metastases in 8 cases. The most frequently found histological type was synovial sarcoma, which was noted in 13 patients (30.9%) followed by osteosarcoma (21.2%). The osteosarcoma treatment was curative in 19 cases, based on surgery with radiotherapy. Total remission was noted in twelve patients. Conclusion: Head and neck sarcomas are rare and very aggressive cancers with poor prognosis. The treatment approach combines surgery and chemoradiation. However, in the absence of adequate and effective treatment protocols, it is necessary to establish a surgical indication in time to ensure excision as complete as possible.

scholarly journals The impact of COVID-19 in the attendance of patients to the otolaryngology clinic: a retrospective review

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kanachai Boonpiraks ◽  
Yanin Nawachartkosit ◽  
Dhave Setabutr
Keyword(s):  
Head And Neck ◽  
Retrospective Review ◽  
Care Center ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Patient Specific ◽  
One Year ◽  
Surgery Department ◽  
The Impact

Abstract Background To evaluate the impact of the COVID-19 outbreak on patient management at an Otolaryngology Head and Neck Surgery Department at a tertiary care center in Southeast Asia. This is a retrospective review. Patient load and diagnosis at the Outpatient Division of the Otolaryngology Head and Neck Surgery Department were reviewed at the height of the initial wave of the COVID-19 pandemic. Patient-specific data was then compared during the same timeframe one year prior. Patients were then grouped into an additional subspecialty subgroup based upon their diagnosis. Descriptive statistics were analyzed. Results A total of 819 cases were identified in 2019 during the study period. At the peak of the first wave, cases fell to 483, constituting a 41% decrease between the years (p value = 0.083). The largest decrease was in Otology cases with a drop by 53% (p value = 0.047), with the smallest decrease noted in General cases. Laryngology visits overall showed an increase in cases by 41.7%. Moreover, new visits decreased by 35.5%, with the largest decrease in new Laryngology visits and new Head and Neck Oncology cases. New visits for general issues had the smallest drop in patients, decreasing by only 21% (p value = 0.006) Conclusions The COVID-19 pandemic caused a significant decrease in overall cases in the Otolaryngology Head and Neck Surgery outpatient department. Thus, in anticipation of future outbreaks, interventions may be tailored according to these trends.

scholarly journals Is minor surgery safe during the COVID-19 pandemic? A multi-disciplinary study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251122
Author(s):  
Michael Baboudjian ◽  
Mehdi Mhatli ◽  
Adel Bourouina ◽  
Bastien Gondran-Tellier ◽  
Vassili Anastay ◽  
...  
Keyword(s):  
Ct Scan ◽  
Care Center ◽  
Tertiary Care ◽  
Maxillofacial Surgery ◽  
Chest Ct ◽  
University Hospital ◽  
Surgical Patient ◽  
Rt Pcr ◽  
Minor Surgery ◽  
Chest Ct Scan

Background To assess the risk of postoperative SARS-CoV-2 infection during the COVID-19 pandemic. Methods The CONCEPTION study was a cohort, multidisciplinary study conducted at Conception University Hospital, in France, from March 17th to May 11th, 2020. Our study included all adult patients who underwent minor surgery in one of the seven surgical departments of our hospital: urology, digestive, plastic, gynecological, otolaryngology, gynecology or maxillofacial surgery. Preoperative self-isolation, clinical assessment using a standardized questionnaire, physical examination, nasopharyngeal RT‐PCR and chest CT scan performed the day before surgery were part of our active prevention strategy. The main outcome was the occurrence of a SARS-CoV-2 infection within 21 days following surgery. The COVID-19 status of patients after discharge was updated during the postoperative consultation and to ensure the accuracy of data, all patients were contacted again by telephone. Results A total of 551 patients from six different specialized surgical Departments in our tertiary care center were enrolled in our study. More than 99% (546/551) of included patients underwent a complete preoperative Covid-19 screening including RT-PCR testing and chest CT scan upon admission to the Hospital. All RT-PCR tests were negative and in 12 cases (2.2%), preoperative chest CT scans detected pulmonary lesions consistent with the diagnosis criteria for COVID-19. No scheduled surgery was postponed. One patient (0.2%) developed a SARS-CoV-2 infection 20 days after a renal transplantation. No readmission or COVID-19 -related death within 30 days from surgery was recorded. Conclusions Minor surgery remained safe in the COVID-19 Era, as long as all appropriate protective measures were implemented. These data could be useful to public Health Authorities in order to improve surgical patient flow during a pandemic.

Anaerobic bacteria in 118 patients with deep-space head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria

2006 ◽  
Vol 55 (9) ◽  
pp. 1285-1289 ◽  
Author(s):  
Lyudmila Boyanova ◽  
Rossen Kolarov ◽  
Galina Gergova ◽  
Elitsa Deliverska ◽  
Jivko Madjarov ◽  
...  
Keyword(s):  
Head And Neck ◽  
Maxillofacial Surgery ◽  
Anaerobic Bacteria ◽  
Bacteroides Fragilis ◽  
Empirical Treatment ◽  
University Hospital ◽  
Detection Rates ◽  
Resistance Rates ◽  
The University ◽  
Head And Neck Infections

The aim of this study was to assess the incidence and susceptibility to antibacterial agents of anaerobic strains in 118 patients with head and neck abscesses (31) and cellulitis (87). Odontogenic infection was the most common identified source, occurring in 73 (77.7 %) of 94 patients. The incidence of anaerobes in abscesses and cellulitis was 71 and 75.9 %, respectively, and that in patients before (31 patients) and after (87) the start of empirical treatment was 80.6 and 72.4 %, respectively. The detection rates of anaerobes in patients with odontogenic and other sources of infection were 82.2 and 71.4 %, respectively. In total, 174 anaerobic strains were found. The predominant bacteria were Prevotella (49 strains), Fusobacterium species (22), Actinomyces spp. (21), anaerobic cocci (20) and Eubacterium spp. (18). Bacteroides fragilis strains were isolated from 7 (5.9 %) specimens. The detection rate of Fusobacterium strains from non-treated patients (32.2 %) was higher than that from treated patients (13.8 %). Resistance rates to clindamycin and metronidazole of Gram-negative anaerobes were 5.4 and 2.5 %, respectively, and those of Gram-positive species were 4.5 and 58.3 %, respectively. One Prevotella strain was intermediately susceptible to ampicillin/sulbactam. In conclusion, the start of empirical treatment could influence the frequency or rate of isolation of Fusobacterium species. The involvement of the Bacteroides fragilis group in some head and neck infections should be considered.

scholarly journals Prevalence, Persistence, and Factors Associated with SARS-CoV-2 IgG Seropositivity in a Large Cohort of Healthcare Workers in a Tertiary Care University Hospital in Northern Italy

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1064
Author(s):  
Gitana Scozzari ◽  
Cristina Costa ◽  
Enrica Migliore ◽  
Maurizio Coggiola ◽  
Giovannino Ciccone ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multivariable Analysis ◽  
Northern Italy ◽  
University Hospital ◽  
Care Workers ◽  
Increased Risk ◽  
Never Smokers ◽  
The University ◽  
Job Profile ◽  
Pandemic Wave

This observational study evaluated SARS-CoV-2 IgG seroprevalence and related clinical, demographic, and occupational factors among workers at the largest tertiary care University-Hospital of Northwestern Italy and the University of Turin after the first pandemic wave of March–April 2020. Overall, about 10,000 individuals were tested; seropositive subjects were retested after 5 months to evaluate antibodies waning. Among 8769 hospital workers, seroprevalence was 7.6%, without significant differences related to job profile; among 1185 University workers, 3.3%. Self-reporting of COVID-19 suspected symptoms was significantly associated with positivity (Odds Ratio (OR) 2.07, 95%CI: 1.76–2.44), although 27% of seropositive subjects reported no previous symptom. At multivariable analysis, contacts at work resulted in an increased risk of 69%, or 24% for working in a COVID ward; contacts in the household evidenced the highest risk, up to more than five-fold (OR 5.31, 95%CI: 4.12–6.85). Compared to never smokers, being active smokers was inversely associated with seroprevalence (OR 0.60, 95%CI: 0.48–0.76). After 5 months, 85% of previously positive subjects still tested positive. The frequency of SARS-COV-2 infection among Health Care Workers was comparable with that observed in surveys performed in Northern Italy and Europe after the first pandemic wave. This study confirms that infection frequently occurred as asymptomatic and underlines the importance of household exposure, seroprevalence (OR 0.60, 95%CI: 0.48–0.76).

scholarly journals Clinical and laboratory follow-up after hospitalization for COVID-19 at an Italian tertiary care center

2021 ◽  
Author(s):  
Michele Spinicci ◽  
Iacopo Vellere ◽  
Lucia Graziani ◽  
Marta Tilli ◽  
Beatrice Borchi ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
Tertiary Care Center ◽  
Persistent Symptom ◽  
Post Discharge

Abstract We evaluated 100 post-acute COVID-19 patients, a median of 60 days (IQR 48-67) after discharge from the Careggi University Hospital, Italy. Eighty-four (84%) had at least one persistent symptom, irrespective of COVID-19 severity. A considerable number of hospital re-admission (10%) and/or infectious diseases (14%) during the post-discharge period was reported.

Histopathological Study of Cystoscopic Bladder Biopsies in a Tertiary Care Center

2021 ◽  
Vol 6 (1) ◽  
pp. 1310-1314
Author(s):  
Rachana Dhakal ◽  
Hem Nath Joshi ◽  
Ramesh Makaju ◽  
Shailendra Sigdel
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Pathological Condition ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
World Health ◽  
Histopathological Study ◽  
Neoplastic Lesion ◽  
Neoplastic Lesions

Introduction: Non-neoplastic urinary bladder lesions are not life threatening, but are an important source to cause clinical symptoms and signs. However, neoplasms of the bladder are a source of morbidity, mortality, and exhibit more clinical challenges. Cystoscopy provides overall information about an anatomical/pathological condition of the urinary bladder which will be helpful for patients' management. A cystoscopic biopsy is a primary diagnostic tool for diagnosing urinary bladder cancer. Objectives: The objective of the study was to find the frequency and histomorphological characteristics of urinary bladder lesions in Dhulikhel Hospital, to find the clinical presentation of urinary bladder lesions and to grade the urothelial tumors based on the World Health Organization (WHO)/ International Society of Urological Pathology (ISUP) classification 2004. Methodology: This was a retrospective, cross-sectional, observational study carried out in the Department of Pathology, Dhulikhel Hospital-Kathmandu University Hospital. Convenient sampling was done. All cystoscopy biopsies received from January 2014 to December 2018 were studied. All tissue blocks were retrieved, cut, and stained with Hematoxylin and Eosin. The stained slides were examined under a light microscope by the primary investigator. Result: A total of 70 cystoscopic biopsies were analyzed. The majority of patients 20 (28.6%) were in the age group between 60 and 69 years and males were predominant 43 (61.4%). The neoplastic lesions constituted 40 (57.1%) of all bladder lesions, among them urothelial carcinoma accounted for 38 (54.2%). Similarly, chronic cystitis 27(38.6%) was the most common non-neoplastic lesion. Conclusion: The study found that the neoplastic lesions were commonly encountered in urinary bladder lesions. Among them, lowgrade urothelial carcinoma was the most common bladder tumor. However, most of the non-neoplastic lesions were inflammatory in origin. Cystoscopy combined with histomorphological examination helps in the early detection of bladder lesions. 

scholarly journals Vocational Training and Dental Care in the Unique Health System: Experience Report

2021 ◽  
pp. 15
Author(s):  
Keyword(s):  
Quality Of Care ◽  
Dental Care ◽  
Professional Training ◽  
Tertiary Care ◽  
Oral Care ◽  
Family Health ◽  
Experience Report ◽  
University Hospital ◽  
The University

Objective: To report the experience lived during the Integrated Multiprofessional Residency in Family Health at the Faculty of Medical Sciences of the University of Pernambuco – FCM/UPE – at the interface with the Residency in Hospital Dentistry with a focus on Oncology at the University of Pernambuco developed at the Oncology Center at the Oswaldo Cruz University Hospital of the University of Pernambuco – CEON/HUOC/UPE. Methods: This is an experience report of dental practice in the context of professional training, in SUS, both in primary, secondary and tertiary care. Results: It is noticeable the need for greater professional qualification of the graduate, their integration in the Services of the institutionalized network and their performance with efficiency in multiprofissional teams, emphasizing the importance of professional training through Residencies, allowing the dental surgeon to improve in the diferente fields of Dentistry activities and, in particular, rescuing the inter-trans-multidisciplinary performance in both primary and hospital care and in the area of oncology. It was noticed that the integrated performance of the dental surgeon in a multidisciplinar team in low and medium complexity with resolvability in oral care is essential for the quality of care in the hospital context. Conclusion: Dental care directly impacts the quality of care and patient’s lives. The training of the dental surgeon throug the Residencies can provide skills and contribute with the other professions to the patient’s quality of life. In addition to its assistance character, the Dentistry Service – CEON/HUOC/UPE assumes an important education function, serving as a teaching research and extension field.

scholarly journals COVID-19 Conversion after Exposure in a Semiprivate Room at a Tertiary Care Center in Iowa, July–December 2020

2021 ◽  
Vol 1 (S1) ◽  
pp. s20-s21
Author(s):  
Alexandra Trannel ◽  
Takaaki Kobayashi ◽  
Oluchi Abosi ◽  
Kyle Jenn ◽  
Holly Meacham ◽  
...  
Keyword(s):  
Exposure Time ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
University Of Iowa ◽  
Subsequent Conversion ◽  
Risk Of Exposure ◽  
Polymerase Chain ◽  
The University

Background: Hospital semiprivate rooms may lead to coronavirus disease 2019 (COVID-19) patient exposures. We investigated the risk of COVID-19 patient-to-patient exposure in semiprivate rooms and the subsequent risk of acquiring COVID-19. Methods: The University of Iowa Hospitals & Clinics is an 811-bed tertiary care center. Overall, 16% of patient days are spent in semiprivate rooms. Most patients do not wear masks while in semiprivate rooms. Active COVID-19 surveillance included admission and every 5 days nasopharyngeal SARS-CoV-2 polymerase chain reaction (PCR) testing. We identified inpatients with COVID-19 who were in semiprivate rooms during their infectious periods during July–December 2020. Testing was repeated 24 hours after the first positive test. Cycle threshold (Ct) values of the two tests (average Ct <30), SARS-CoV-2 serology results, clinical assessment, and COVID-19 history were used to determine patient infectiousness. Roommates were considered exposed if in the same semiprivate room with an infectious patient. Exposed patients were notified, quarantined (private room), and follow-up testing was arranged (median seven days). Conversion was defined as having a negative test followed by a subsequent positive within 14 days after exposure. We calculated the risk of exposure: number of infectious patients in semiprivate rooms/number of semiprivate patient-days (hospitalization days in semiprivate rooms). Results: There were 16,427 semiprivate patient days during July–December 2020. We identified 43 COVID-19 inpatients who roommates during their infectious periods. Most infectious patients (77%) were male; the median age was 67 years; and 22 (51%) were symptomatic. Most were detected during active surveillance: admission testing (51%) and serial testing (28%). There were 57 exposed roommates. The risk of exposure was 3 of 1,000 semiprivate patient days. In total, 16 roommates (28%) did not complete follow-up testing. Of 41 exposed patients with follow-up data, 8 (20%) converted following their exposure. Median time to conversion was 5 days. The risk of exposure and subsequent conversion was 0.7 of 1,000 semiprivate patient days. Median Ct value of the source patient was 20 for those who converted and 23 for those who did not convert. Median exposure time was 45 hours (range, 3–73) for those who converted and 12 hours (range, 1–75) for those who did not convert. Conclusions: The overall risk of exposure in semiprivate rooms was low. The conversion rate was comparable to that reported for household exposures. Lower Ct values and lengthier exposures may be associated with conversion. Active COVID-19 surveillance helps early detection and decreases exposure time.Funding: NoDisclosures: None

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