scholarly journals Language aspects of children infected with HIV

Revista CEFAC ◽  
2013 ◽  
Vol 15 (6) ◽  
pp. 1621-1626 ◽  
Author(s):  
Raphaela Barroso Guedes Granzotti ◽  
Silvia Fabiana Biason de Moura Negrini ◽  
Marisa Tomoe Hebihara Fukuda ◽  
Osvaldo Massaiti Takayanagui
Keyword(s):  
Early Stage ◽  
Clinical Classification ◽  
Significant Relation ◽  
Immunological Parameters ◽  
Clinical Criteria ◽  
Immunological Profile ◽  
Viral Burden ◽  
Study Population

PURPOSE: to assess the lexical proficiency and the incidence of phonologic disorders in the language of children infected with HIV. METHOD: the study population consisted of 31 children between three and seven year-old. For evaluation purposes the Test of Infantile Language - ABFW was applied in the areas of phonology and vocabulary. RESULTS: the results obtained were analyzed according to the clinical criteria for the classification of the disease proposed by the CDC and regarding the immunological profile and the viral burden using the Mann-Whitney test for statistical analysis. In the vocabulary evaluation, 100% of the children presented an inappropriate response for their age in at least two distinct conceptual fields. In the phonologic evaluation, 67.7% of the assessed children were considered to be affected by some phonologic disorder. When we compared adequate and inadequate results of phonologic evaluation to the clinical and immunological parameters of AIDS such as clinical classification (p=0,16), CD4 count (p=0,37) and viral burden (p=0,82), we did not detect a statistically significant relation between language alterations and disease severity. CONCLUSION: this research has shown that the studied group presents a high risk for language disorders and that constant phonoaudiological follow-up is essential to identify the alterations in early stage.

scholarly journals Giant Cell Urothelial Carcinoma of Bladder

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Harshima Disvini Wijesinghe ◽  
Ajith Malalasekera
Keyword(s):  
Urothelial Carcinoma ◽  
Giant Cell ◽  
Early Stage ◽  
Giant Cells ◽  
World Health ◽  
World Health Organization Classification ◽  
Health Organization

Giant cell urothelial carcinoma is a rare variant of bladder cancer recognized by the current World Health Organization classification of urologic tumours. It is an aggressive tumour with a poor prognosis that usually presents at an advanced stage. It is characterized histologically by pleomorphic giant cells. We discuss a case of giant cell urothelial carcinoma presenting at an early stage in a previously well 62-year-old woman. Histology showed a tumour comprising pancytokeratin positive bizarre mononuclear and multi-nuclear giant cells admixed with areas of conventional urothelial carcinoma and carcinoma in situ. Three-month follow-up cystoscopy and magnetic resonance imaging showed no evidence of recurrence or pelvic lymphadenopathy.

scholarly journals Prevalence and follow-up of subclinical rheumatic heart disease amongst asymptomatic school children in a north-western district of India based on the World Heart Federation echocardiographic criteria

2020 ◽  
Author(s):  
Dinesh Choudhary ◽  
Sadik Panwar ◽  
Balkishan Gupta ◽  
Raja Panwar ◽  
Rajeev Gupta ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Active Surveillance ◽  
School Children ◽  
Early Stage ◽  
Significant Proportion ◽  
Screening Methods ◽  
High Prevalence ◽  
Study Population ◽  
Rheumatic Heart

Background Past active surveillance have reported prevalence of subclinical RHD amongst school children which are not comparable because of major differences in screening methods. The present study is based on the WHF criteria to assess the prevalence of subclinical carditis due to RHD and elucidate evolution of the disease when these children were placed on appropriate antibiotic prophylaxis and regular follow-up. This is the first large active surveillance study which has been conducted in a single district of India after the publication of WHF criteria and is reporting short-medium term follow-up data. Methods For active surveillance of RHD among urban and rural school children of Bikaner, a random inclusion strategy was adopted. The diagnostic labelling based on the echocardiographic criteria proposed by World Heart Federation was done by a group of experienced cardiologists. The follow up of the patients recruited in to the study was done to ascertain the early evolution of the disease in the presence of appropriate antibiotic prophylaxis. Results A high prevalence of subclinical RHD was noted in the study population. Pathological mitral and/or aortic valves regurgitation was the commonest lesion and significant proportion of cases improved on regular antibiotic prophylaxis. There was no case of fixity of leaflets/ stenosis. Conclusion The prevalence of subclinical RHD and these cases are reversible if appropriate antibiotic prophylaxis is instituted at an early stage.

scholarly journals Prognostic Value of Invasion, Markers of Proliferation, and Classification of Giant Pituitary Tumors, in a Georeferred Cohort in Brazil of 50 Patients, with a Long-Term Postoperative Follow-Up

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Juliano Coelho de Oliveira Zakir ◽  
Luiz Augusto Casulari ◽  
José Wilson Corrêa Rosa ◽  
João Willy Corrêa Rosa ◽  
Paulo Andrade de Mello ◽  
...  
Keyword(s):  
Pituitary Tumors ◽  
Biological Behavior ◽  
Significant Relation ◽  
Ki 67 ◽  
Radiological Features ◽  
Current Classification ◽  
Geographical Cluster

Although some pituitary adenomas may have an aggressive behavior, the vast majority are benign. There are still controversies about predictive factors regarding the biological behavior of these particular tumors. This study evaluated potential markers of invasion and proliferation compared to current classification patterns and epidemiogeographical parameters. The study included 50 patients, operated on for tumors greater than 30 mm, with a mean postoperative follow-up of 15.2 ± 4.8 years. Pituitary magnetic resonance was used to evaluate regrowth, invasion, and extension to adjacent tissue. Three tissue biomarkers were analyzed: p53, Ki-67, and c-erbB2. Tumors were classified according to a combination of histological and radiological features, ranging from noninvasive and nonproliferative (grade 1A) to invasive-proliferative (grade 2B). Tumors grades 2A and 2B represented 42% and 52%, respectively. Ki-67 (p=0.23) and c-erbB2 (p=0.71) had no significant relation to tumor progression status. P53 (p=0.003), parasellar invasion (p=0.03), and classification, grade 2B (p=0.01), were associated with worse clinical outcome. Parasellar invasion prevails as strong predictive factor of tumor recurrence. Severe suprasellar extension should be considered as invasion parameter and could impact prognosis. No environmental factors or geographical cluster were associated with tumor behavior.

scholarly journals Governance Standards and their Requirements in Private Palestinian Universities in the Southern Governorates and their Relationship to the Level of Performance

2021 ◽  
Vol 14 (47) ◽  
pp. 73-101
Author(s):  
Ziad Jalal Khalil Aldammagh
Keyword(s):  
Higher Education ◽  
Point Of View ◽  
Education Sector ◽  
University Governance ◽  
Study Population ◽  
Palestinian Universities ◽  
The University ◽  
Relationship Of

The study aimed to identify the governance standards and requirements in private Palestinian universities in light of the requirements for accreditation, quality and Palestinian classification of universities from the point of view of their employees and the relationship of which to the level of performance. The study was conducted in the universities of Palestine and Gaza. For collecting data, a questionnaire was designed based on previous studies related to university governance, the issue of governance, its principles, obstacles and stages of implementation. The questionnaire consisted of (42) items, covering the standards of governance in light of the requirements of accreditation, quality and requirements of the Palestinian classification of universities. The study population included the majority of workers, where the questionnaire was distributed to a random sample of (182) individuals. The study concluded that there was a positive relationship between the independent variables (governance standards, accreditation and quality requirements, and the Palestinian university classification) and the dependent variable represented by the performance of private Palestinian universities. The study recommended the need to develop a comprehensive and clear plan, either at the level of the higher education sector or Palestinian universities to spread and strengthen the culture of governance of Palestinian universities and to expedite the issuance of a governance guide for private Palestinian universities. A governance committee, at the level of the higher education sector or at the university level, should also be formed to follow up the implementation of governance standards at the universities and to make private Palestinian universities work on raising the level of practicing Governance principles. Keywords: governance, university governance standards, performance of private Palestinian universities.

Clinical Classification of Acquired Concomitant Esotropia

2021 ◽  
Vol 238 (04) ◽  
pp. 482-487
Author(s):  
Sara Gisselbaek ◽  
Nicole Hoeckele ◽  
Georges Klainguti ◽  
Pierre-François Kaeser
Keyword(s):  
Large Angle ◽  
The Elderly ◽  
Ophthalmological Examination ◽  
Clinical Classification ◽  
Adolescents And Adults ◽  
Long Term Follow Up ◽  
Retinal Correspondence

Abstract Background Classification and management of acquired concomitant esotropia is controversial. We sought to establish a simple clinical classification in order to determine in which cases further investigations in search of underlying pathologies are necessary. Patients and Methods Observational retrospective study of the files of 175 consecutive patients examined in our unit between 2009 and 2018 for acute convergent strabismus. One hundred and nine patients were selected, after exclusion of infantile, incomitant, or mechanical esotropias, residual esotropias, and patients examined on a single occasion. All patients received a complete orthoptic and ophthalmological examination. We grouped the patients according to their common characteristics. Results We established the following categories: 1. Acute esotropia of large angle (20 to 45 prism diopters [PD]), accompanied by mild hyperopia (mean 1.2 D) in children (n = 16) and moderate myopia (mean 3.7 D) in adolescents and adults (n = 13). 2. Decompensated micro-esotropia, which is distinguished from the other categories by the presence of abnormal retinal correspondence (n = 33). 3. Decompensated esophoria, with intermittent deviations of 5 to 30 PD, esotropia being compensated part of the time (n = 25). 4. Esotropia present only at a distance in patients over 50 years of age (n = 20). 5. Small-angle esotropia (< 15 PD) greater at a distance, associated with oculomotor cerebellar syndrome (n = 2). Complementary examinations (MRI or CT scan) were performed on 21 patients, leading to the discovery of a posterior fossa astrocytoma in a 4-year-old boy. Conclusions The recognition of decompensated micro-esotropia and esophoria, as well as distance esotropia of the elderly, avoids unnecessary additional investigations, which are indicated in any type of acute comitant strabismus if associated with any neurological sign or symptom (e.g., headaches, nausea, vertigo, imbalance, poor coordination, nystagmus, or papilledema). In the absence of neurological findings, there is no consensus about the indication of neuroimaging in large-angle acquired concomitant esotropia, but long-term follow-up of patients that do not undergo neuroimaging is strongly recommended in order to identify later occurring intracranial diseases. This is of particular importance with children.

scholarly journals Urgent and non-emergent telehealth care for seniors: Findings from a multi-site impact study

2021 ◽  
pp. 1357633X2110043
Author(s):  
Paul Bernstein ◽  
Kelly J Ko ◽  
Juhi Israni ◽  
Alexandria O Cronin ◽  
Michael M Kurliand ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
Geographic Region ◽  
Impact Study ◽  
Healthcare Organizations ◽  
Global Pandemic ◽  
Classification Of Diseases ◽  
Episodes Of Care ◽  
Study Population

Introduction The global pandemic has raised awareness of the need for alternative ways to deliver care, notably telehealth. Prior to this study, research has been mixed on its effectiveness and impact on downstream utilization, especially for seniors. Our multi-institution study of more than 300,000 telehealth visits for seniors evaluates the clinical outcomes and healthcare utilization for urgent and non-emergent symptoms. Methods We conducted a retrospective cohort study from November 2015 to March 2019, leveraging different models of telehealth from three health systems, comparing them to in-person visits for urgent and non-emergent needs of seniors based on International Classification of Diseases, 10th edition diagnoses. The study population was adults aged 60 years or older who had access to telehealth and were affiliated with and resided in the geographic region of the healthcare organization providing telehealth. The primary outcomes of interest were visit resolution and episodes of care for those that required follow-up. Results In total, 313,516 telehealth visits were analysed across three healthcare organizations. Telehealth encounters were successful in resolving urgent and non-emergent needs in 84.0–86.7% of cases. When visits required follow-up, over 95% were resolved in less than three visits for both telehealth and in-person cohorts. Discussion While in-person visits have traditionally been the gold standard, our results suggest that when deployed within the confines of a patient’s existing primary care and health system provider, telehealth can be an effective alternative to in-person care for urgent and non-emergent needs of seniors without increasing downstream utilization.

scholarly journals Transanal endorectal pull-through in children as the treatment for Hirschsprung’sd in Aceh, Indonesia

2019 ◽  
Vol 6 (5) ◽  
pp. 1443
Author(s):  
Muntadhar M. Isa ◽  
Dian A. Syahputra ◽  
Muhammad Bayu Z. Hutagalung
Keyword(s):  
Bowel Resection ◽  
Clinical Classification ◽  
Significant Relation ◽  
Invasive Treatment ◽  
Short Segment ◽  
Total Cost ◽  
Age At Surgery ◽  
The Mean ◽  
Pull Through

Background: One-stage pull-through operation has become increasingly popular for the treatment of Hirschsprung's disease. The advantages of total transanal pull-through include minimal resection of the dilated ganglionic part of the colon, shorter hospital stay, decreased total cost, lower risk of adhesive intestinal obstruction.Methods: A retrospective study of patients with HD underwent transanal endorectal pull-through (TERPT) procedure treated at Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia between January 2010 – December 2013. We assessed patients characteristic, outcome and complication including Hirsch sprung associated enterocolitis (HAEC).Results: A total 77 patients were included in this study. The mean age was 13.01 months (range from 11 days – 8 years old). Most of the patients (55.8%) were male and female (44.2%). Clinical classification of HD: short segment 74 patients (96.1%) and ultra-short segment 3 patients (3.9%). The mean of bowel resection length in TERPT procedure was 18.64 cm (range from 7–25 cm). There is no mortality associated with TERPT procedure. Hirsch sprung associated enterocolitis (HAEC) occurred in 43 subjects (54.5%). Statistical analysis showed the significant relation between age at surgery and HAEC (p= 0.000) and no significant relationship between gender (p=0.425) and bowel resection length (p=0.780) with HAEC.Conclusions: Transanal endorectal pull-through procedure has been shown as an effective minimally invasive treatment in resolving obstructive symptoms in ultra–short segment of HD patients. The number of HAEC incidence among HD patients underwent TERPT significantly increased with older age of children. 

scholarly journals Endoscopic Findings of Early Stage Vocal Fold Cancer

1995 ◽  
Vol 1 (4) ◽  
pp. 185-194
Author(s):  
Peter Kitzing
Keyword(s):  
Vocal Fold ◽  
Early Stage ◽  
Precancerous Lesions ◽  
Vocal Folds ◽  
Histologic Diagnosis ◽  
High Tendency ◽  
Epithelial Lesions ◽  
Invasive Carcinomas

To describe early cancerous and precancerous lesions of the laryngeal vocal folds as well as of the most common differential diagnoses, based on a series of microlaryngoscopic photographs. Some introductory remarks about terminology and the classification of epithelial lesions of the vocal folds are included. The paper ends with some comments as to the management of epithelial thickenings (or leukoplakias) of the vocal folds. Malignancy should be suspected as long as it has not been ruled out by histologic diagnosis on adequate biopsies, which is the only way to correctly evaluate the character of such lesions. Precancerous lesions should be controlled by regular follow up examinations as carefully as invasive carcinomas (posttreatment), because there is a high tendency for recurrences or for later development of malignancy in these cases.

Urgent and non-emergent telehealth care for seniors: Findings from a multi-site impact study

2021 ◽  
pp. 1357633X2098538
Author(s):  
Paul Bernstein ◽  
Kelly J Ko ◽  
Juhi Israni ◽  
Alexandria O Cronin ◽  
Michael M Kurliand ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
Geographic Region ◽  
Impact Study ◽  
Healthcare Organizations ◽  
Global Pandemic ◽  
Classification Of Diseases ◽  
Episodes Of Care ◽  
Study Population

Introduction The global pandemic has raised awareness of the need for alternative ways to deliver care, notably telehealth. Prior to this study, research has been mixed on its effectiveness and impact on downstream utilization, especially for seniors. Our multi-institution study of more than 300,000 telehealth visits for seniors evaluates the clinical and utilization outcomes for urgent and non-emergent symptoms. Methods We conducted a retrospective cohort study from November 2015 to March 2019, leveraging different models of telehealth from three health systems, comparing them to in-person visits for urgent and non-emergent needs of seniors based on International Classification of Diseases, 10th edition diagnoses. The study population was adults aged 60 years or older who had access to telehealth, and were affiliated with and resided in the geographic region of the healthcare organization providing telehealth. The primary outcomes of interest were visit resolution and episodes of care for those that required follow-up. Results In total, 313,516 telehealth visits were analysed across three healthcare organizations. Telehealth encounters were successful in resolving urgent and non-emergent needs in 84.0–86.7% of cases. When visits required follow-up, over 95% were resolved in less than three visits for both telehealth and in-person cohorts. Discussion While in-person visits have traditionally been the gold standard, our results suggest that when deployed within the confines of a patient’s existing primary care and health system provider, telehealth can be an effective alternative to in-person care for urgent and non-emergent needs of seniors without increasing downstream utilization.

The value of a novel model of remote monitoring alert classification of cardiac implantable devices

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Mendez Zurita ◽  
M Grande Osorio ◽  
C Gonzalez Matos ◽  
E Rodriguez Font ◽  
J Guerra Ramos ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Clinical Information ◽  
Implantable Devices ◽  
Classification Model ◽  
Healthcare Team ◽  
Clinical Criteria ◽  
Center Care ◽  
Initial Classification

Abstract Introduction Remote monitoring (RM) is commonly used in the follow-up of patients with cardiac implantable devices (CID). However, there are a significant amount of automatic alerts of low clinical relevance. An alert classification model designed to optimize the management of RM alert in CID receivers can improve the analysis. Purpose Assess the effectiveness of a local protocol for review and classification of MR alerts. Methods Retrospective study, single center. We included all patients with ICD +/− CRT in the RM program between september 2016 and december 2019. All transmission received were analyzed. The priority of the transmissions was established based on clinical criteria and device parameters, classified into 3 categories from lowest to highest priority: green, yellow and red. Each category involved a specific action protocol (Figure 1). The categorization by colors was initially carried out by a remote support center, based on data from the devices; and later, reviewed by arrhythmia nurse team who incorporated clinical information data. In case of discrepancy, the alert was again evaluated together with the cardiologist. The degree of concordance in the categorization of alerts was analyzed, as well as the transmission response time (TRT): support center- care team. Results In our center a total of 1013 patients were included (68±14 years old, 76% male), who completed 8755 remote transmissions. The initial classification of transmissions by the support center was: 6890 (78.7%) green, 1497 (17.1%) yellow and 368 (4.2%) red. Only 0.62% of transmissions required reclassification by the healthcare team. No alert initially classified as yellow or green should be reclassified to red. The TRT was 3.35 hours for the red transmissions and 5.6 hours for the yellow ones. Conclusion The categorization of alerts in our RM system allows an efficient and safe organization of assitance to patients with CID. Funding Acknowledgement Type of funding source: None

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