scholarly journals Surgical Ciliated Cyst Secondary to Orthognathic Surgery: Report of three cases and review of the literature

2021 ◽  
Author(s):  
Alberto Díez-Montiel ◽  
Armentia ◽  
Raul Antunez-Conde ◽  
Navarro-Cuéllar ◽  
Tousidonis ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Case Reports ◽  
Rare Complication ◽  
World Health ◽  
Lytic Lesion ◽  
Pubmed Database ◽  
Posterior Maxilla ◽  
Delayed Complication ◽  
The Difference ◽  
Health Organization

Abstract Background: Surgical ciliated cysts (SCC) of the maxilla appear as a delayed complication after surgery in the maxillary sinus, midface osteotomies, traumatic tooth extraction, and maxillary fractures. They are defined as a lytic lesion with entrapment of the pseudostratified columnar epithelium.Report of three cases: We present three patients in which after orthognathic surgery a slowly enlarging asymptomatic swelling mass was developed. On CT, all the cases presented lytic expansive lesions in the alveolar ridge. In the three cases, lesions were completely excised, and upon histological examination, ciliated pseudostratified columnar epithelium with goblet cells was found so they were diagnosed as SCC. An exhaustive review of the medical literature was conducted. The PubMed database was searched for PubMed Central (PMC). 44 references were found, reporting 1555 cases: 11 series and 33 case reports, being the largest series from the Asian countries. The mean age was 46.5 years, and more frequently described in male patients. The most frequent form of presentation was as unilateral unilocular cysts in the posterior maxilla. They were described most frequently after a Caldwell-Luc approach. The average latency time was of 19.9 years.Conclusion: SCC is a rare complication after orthognathic surgery, but large series have been published, so maybe it could be interesting to include these cysts in the next Edition of the World Health Organization Classification of the Head and Neck Tumors: Odontogenic and Maxillofacial Bone Tumors, making clear the difference between SCC and mucoceles to avoid future confusions.

scholarly journals Transplant Drugs against SARS, MERS and COVID-19

2020 ◽  
Vol 1 (2) ◽  
pp. 71-84
Author(s):  
René Hage ◽  
Carolin Steinack ◽  
Fiorenza Gautschi ◽  
Macé M. Schuurmans
Keyword(s):  
Treatment Option ◽  
Calcineurin Inhibitor ◽  
Virus Disease ◽  
Case Reports ◽  
Calcineurin Inhibitors ◽  
World Health ◽  
Current Evidence ◽  
Pubmed Database ◽  
Health Organization ◽  
Meta Analyses

There is an urgent need to develop drugs and vaccines to counteract the effects of the new coronavirus SARS-CoV-2 and adequately treat the corona virus disease (COVID-19). As these drugs are still under investigation, research also focuses on existing medication with proven effectiveness in other coronaviral diseases. The advantages of existing therapeutic drugs that are currently approved (for other indications) are the known safety profile, general availability and relatively lower costs involved in extending the purpose to a new disease. Calcineurin inhibitors (CNI) are drugs that have shown effectiveness in several coronaviral diseases, and are well-known and widely used drugs in transplant medicine. The aim of this narrative review is to present the current evidence of CNI in coronaviral diseases, the biophysiology of CNI and to suggest possible ways to study CNI as a new treatment option for COVID-19. We searched original papers, observational studies, case reports, and meta-analyses published between 2000 and 2020 in English in the PubMed database and Google Scholar using the keywords: (coronavirus), (treatment), (MERS), (SARS), (COVID-19), (tacrolimus), (ciclosporin), (cyclosporin) AND (calcineurin inhibitor). We excluded studies in patients with clear indications for immunosuppressive therapy. Additionally, we searched in the preprint servers and the World Health Organization bulletin. Ten studies were identified and included. Calcineurin inhibitor therapy has been suggested to be effective for coronaviral diseases in different settings. The results are summarized in a table. CNI should be investigated as a first treatment option based on evidence of direct antiviral effects and its properties preventing severe systemic hyperinflammation, as has been observed in COVID-19 with predominantly pulmonary immunopathological changes.

scholarly journals Presenting Psychiatric and Neurological Symptoms and Signs of Brain Tumors before Diagnosis: A Systematic Review

2021 ◽  
Vol 11 (3) ◽  
pp. 301
Author(s):  
Fatima Ghandour ◽  
Alessio Squassina ◽  
Racha Karaky ◽  
Mona Diab-Assaf ◽  
Paola Fadda ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neurological Symptoms ◽  
World Health ◽  
Exclusion Criteria ◽  
Comprehensive Description ◽  
Brain Tumor Diagnosis ◽  
Health Organization ◽  
Symptoms And Signs

Brain tumors can present with various psychiatric symptoms, with or without neurological symptoms, an aspect that complicates the clinical picture. However, no systematic description of symptoms that should prompt a neurological investigation has been provided. This review aims to summarize available case reports describing patients with brain tumors showing psychiatric symptoms before brain tumor diagnosis, in order to provide a comprehensive description of these symptoms as well as their potential relationship with delay in the diagnosis. A systematic literature review on case reports of brain tumors and psychiatric symptoms from 1970 to 2020 was conducted on PubMed, Ovid, Psych Info, and MEDLINE. Exclusion criteria comprised tumors not included in the World Health Organization (WHO) Classification 4th edition and cases in which psychiatric symptoms were absent or followed the diagnosis. A total of 165 case reports were analyzed. In a subset of patients with brain tumors, psychiatric symptoms can be the only manifestation or precede focal neurological signs by months or even years. The appearance of focal or generalized neurological symptoms after, rather than along with, psychiatric symptoms was associated with a significant delay in the diagnosis in adults. A timely assessment of psychiatric symptoms might help to improve early diagnosis of brain tumors.

scholarly journals Attribute Selection in Naive Bayes Algorithm Using Genetic Algorithms and Bagging for Prediction of Liver Disease

2020 ◽  
Vol 4 (1) ◽  
pp. 76-85
Author(s):  
Dwi Yuni Utami ◽  
Elah Nurlelah ◽  
Noer Hikmah
Keyword(s):  
Genetic Algorithms ◽  
Liver Disease ◽  
Naive Bayes ◽  
Confusion Matrix ◽  
Naïve Bayes ◽  
Attribute Selection ◽  
World Health ◽  
The Difference ◽  
Bayes Algorithm ◽  
Health Organization

Liver disease is an inflammatory disease of the liver and can cause the liver to be unable to function as usual and even cause death. According to WHO (World Health Organization) data, almost 1.2 million people per year, especially in Southeast Asia and Africa, have died from liver disease. The problem that usually occurs is the difficulty of recognizing liver disease early on, even when the disease has spread. This study aims to compare and evaluate Naive Bayes algorithm as a selected algorithm and Naive Bayes algorithm based on Genetic Algorithm (GA) and Bagging to find out which algorithm has a higher accuracy in predicting liver disease by processing a dataset taken from the UCI Machine Learning Repository database (GA). University of California Invene). From the results of testing by evaluating both the confusion matrix and the ROC curve, it was proven that the testing carried out by the Naive Bayes Optimization algorithm using Algortima Genetics and Bagging has a higher accuracy value than only using the Naive Bayes algorithm. The accuracy value for the Naive Bayes algorithm model is 66.66% and the accuracy value for the Naive Bayes model with attribute selection using Genetic Algorithms and Bagging is 72.02%. Based on this value, the difference in accuracy is 5.36%.Keywords: Liver Disease, Naïve Bayes, Genetic Agorithms, Bagging.

scholarly journals General Guidelines in the Management of an Obstetrical Patient on the Labor and Delivery Unit during the COVID-19 Pandemic

2020 ◽  
Vol 37 (08) ◽  
pp. 829-836 ◽  
Author(s):  
Angela J. Stephens ◽  
John R. Barton ◽  
Nana-Ama Ankumah Bentum ◽  
Sean C. Blackwell ◽  
Baha M. Sibai
Keyword(s):  
Health Care ◽  
Case Reports ◽  
Obstetric Care ◽  
World Health ◽  
Labor And Delivery ◽  
Health Crisis ◽  
Obstetrical Patient ◽  
Control And Prevention ◽  
Novel Coronavirus ◽  
Health Organization

Novel coronavirus disease 2019 (COVID-19) is a respiratory tract infection that was first identified in China. Since its emergence in December 2019, the virus has rapidly spread, transcending geographic barriers. The World Health Organization and the Centers for Disease Control and Prevention have declared COVID-19 as a public health crisis. Data regarding COVID-19 in pregnancy is limited, consisting of case reports and small cohort studies. However, obstetric patients are not immune from the current COVID-19 pandemic, and obstetric care will inevitably be impacted by the current epidemic. As such, clinical protocols and practice on labor and delivery units must adapt to optimize the safety of patients and health care workers and to better conserve health care resources. In this commentary, we provide suggestions to meet these goals without impacting maternal or neonatal outcomes. Key Points • Novel coronavirus disease 2019 (COVID-19) is a pandemic.• COVID-19 impacts care of obstetric patients.• Health care should be adapted for the COVID-19 pandemic.

Creating a global covenant for healthcare reform in nursing

2019 ◽  
Vol 30 (11) ◽  
pp. 543-546
Author(s):  
Catherine Best
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Healthcare Reform ◽  
Access To Healthcare ◽  
Determinants Of Health ◽  
World Health ◽  
The Everyday ◽  
Positive Action ◽  
The Difference ◽  
Health Organization

Social determinants of health continue to exist and perpetuate health inequalities. Catherine Best explores the contribution of nurses on an international scale, particularly in regards to solving inequality in access to healthcare Encouraging nursing to be a global profession has gained considerable momentum in recent years. For significantly longer, social determinants of health have featured in multiple national and international reports, and their devastating impacts on societies, both nationally and globally, are still being experienced. The time for rhetoric has long gone. Instead, unprecedented action is needed to bring this to the fore of all governments across the globe. The World Health Organization, International Council of Nurses and the United Nations have done much to raise awareness of the need for change and make it clear that the nursing profession can contribute to take positive action. The provision of good healthcare should not be reliant on where you live and work, but should be available to everyone. This article will explore the difference that nurses can make to the everyday lives of those we care for, and in improving equal access to healthcare for everyone.

scholarly journals SEIZURES WITH ANTI-SEIZURE DRUG

2017 ◽  
Vol 10 (12) ◽  
pp. 3 ◽  
Author(s):  
Keerthana Brattiya ◽  
Bhuvaneshwari K
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drugs ◽  
Rare Complication ◽  
Therapeutic Index ◽  
Refractory Status Epilepticus ◽  
World Health ◽  
Metal Ring ◽  
Causality Analysis ◽  
Toxic Reaction ◽  
Health Organization

This case study is to report and explore the etiology of a case of refractory seizures due to overdosage of phenytoin tablets. A case report from the Department of Neurology generated through voluntary adverse drug reaction (ADR)reporting stated phenytoin overdosage leading to refractory status epilepticus which did not respond to any of the antiepileptic drugs. A 33-year-old female patient with the history of consumption 15 tablets of phenytoin and a metal ring as part of a suicidal bid a month ago, presented with unconsciousness, persistent seizures, and gangrene of fingers. Magnetic resonance imaging showed generalized atrophic changes of the cerebrum and cerebellum. Electroencephalogram suggested multifocal onset status epilepticus. The patient did not respond to standard emergency treatment of status epilepticus with known antiepileptic drugs and was treated with thiopentone infusion under mechanical ventilation, which controlled her seizures as long as she was maintained under the infusion. Causality analysis using the World Health Organization scale categorizes this ADR as “possible”, as the patient is a known case of seizure disorder with additional cerebral changes. Hence, the disease could have had an influence over the toxic reaction. To conclude, seizures are a rare complication of phenytoin. Seizures can be prevented by evaluating therapeutic plasma concentration of phenytoin. In this case, the patient was on chronic treatment, and due to intentional toxicity, she progressed to a refractory state of seizures. This could have occurred because of the unique kinetic profile of phenytoin, small therapeutic index, genetic variation in drug metabolizing enzymes, and saturated sodium channels.

Is SARS-CoV-2 transmitted by asymptomatic and pre-symptomatic infected individuals?

2021 ◽  
Vol 54 ◽  
Author(s):  
Abigail F. Melicor ◽  
Katrina Loren R. Rey ◽  
Leonila F. Dans
Keyword(s):  
Case Reports ◽  
Case Series ◽  
The Philippines ◽  
World Health ◽  
Current Evidence ◽  
Wide Confidence Interval ◽  
Cross Sectional ◽  
Viral Shedding ◽  
Asymptomatic Patients ◽  
Health Organization

KEY FINDINGSAsymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur.• Manifestations of COVID-19 are highly varied and may include asymptomatic cases, who do not manifest with anysigns and symptoms despite testing positive for COVID-19 by viral nucleic acid tests. Pre-symptomatic cases areinfected individuals who are still in their incubation period, hence do not exhibit any symptoms yet but eventuallydevelop symptoms.• As of June 2020, only 586 (2.8%) of the 20,990 active cases in the Philippines were classified as asymptomatic,but it is unclear whether cases are pre-symptomatic or carriers (true asymptomatic).• Based on 36 observational studies (case reports, case series, cross-sectional and cohort studies) and 9 statisticalmodeling analysis, asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur. However, 3studies reported no transmission from pre-symptomatic and asymptomatic cases.• Studies on viral load comparing symptomatic cases with pre-symptomatic and asymptomatic cases reportedcontradicting results. The duration of viral shedding was significantly longer for symptomatic patients comparedto asymptomatic patients but similar for asymptomatic and pre-symptomatic patients.• Therewas no difference in the transmission rates of symptomatic and asymptomatic cases. However,the estimatedinfectivity and probability of transmission was higherfor symptomatic cases compared to asymptomatic cases, butresults were imprecise due to a wide confidence interval.• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recognize thepossibility of pre-symptomatic and asymptomatic transmission. According to WHO, current evidence suggestsasymptomatic cases are less likely to transmit the virus than symptomatic cases.

scholarly journals Incidence of first stroke and ethnic differences in stroke pattern in Bradford, UK: Bradford Stroke Study

2017 ◽  
Vol 13 (4) ◽  
pp. 374-378 ◽  
Author(s):  
Hawraman Ramadan ◽  
Chris Patterson ◽  
Stuart Maguire ◽  
Ian Melvin ◽  
Kirti Kain ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Ethnic Disparities ◽  
Ethnic Origin ◽  
World Health ◽  
World Population ◽  
Large Artery ◽  
Stroke Incidence ◽  
The Difference ◽  
Artery Disease ◽  
Health Organization

Background Information on ethnic disparities in stroke between White and Pakistani population in Europe is scarce. Bradford District has the largest proportion of Pakistani people in England; this provides a unique opportunity to study the difference in stroke between the two major ethnic groups. Aim To determine the first-ever-stroke incidence and examine the disparities in stroke patterns between Whites and Pakistanis in Bradford. Methods Prospective 12 months study consisting of 273,327 adults (≥18 years) residents. Stroke cases were identified by multiple overlapping approaches. Results In the study period, 541 first-ever-strokes were recorded. The crude incidence rate was 198 per 100,000 person-years. Age adjusted-standardized rate to the World Health Organization world population of first-ever-stroke is 155 and 101 per 100,000 person-years in Pakistanis and Whites respectively. Four hundred and thirty-eight patients (81%) were Whites, 83 (15.3%) were Pakistanis, 11 (2%) were Indian and Bangladeshis, and 9 (1.7%) were of other ethnic origin. Pakistanis were significantly younger and had more obesity ( p = 0.049), and diabetes mellitus (DM) ( p = <0.001). They were less likely to suffer from atrial fibrillation ( p = <0.001), be ex- or current smokers ( p = <0.001), and drink alcohol above the recommended level ( p = 0.007) compared with Whites. In comparison with Whites, higher rates of age-adjusted stroke (1.5-fold), lacunar infarction (threefold), and ischemic infarction due to large artery disease (twofold) were found in the Pakistanis. Conclusions The incidence of first-ever-stroke is higher in the Pakistanis compared with the Whites in Bradford, UK. Etiology and vascular risk factors vary between the ethnic groups. This information should be considered when investigating stroke etiology, and when planning prevention and care provision to improve outcomes after stroke.

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