scholarly journals Five Years of Humanitarian Missions in São Tomé and Príncipe

2016 ◽  
Author(s):  
Cristina Caroça ◽  
João Paço
Keyword(s):  
Chart Review ◽  
Healthcare Access ◽  
Sensorineural Deafness ◽  
Retrospective Chart Review ◽  
Return To School ◽  
Governmental Organization ◽  
Private Healthcare ◽  
The Past ◽  
Sao Tome And Principe ◽  
Language Problems

INTRODUCTION: Since February 2011, a group of otolaryngologists from CUF Infante Santo Hospital, a private healthcare unit in Portugal, invited by a non-governmental organization to provide equipment and properly skilled professionals to help and treat otolaryngology diseases in São Tomé and Príncipe. These missions included surgical procedures, consultation and hearing evaluation. METHODS: This work is a retrospective chart review of all otolaryngology cases performed during these missions since 2011 to 2016, and what we done during mission. RESULTS: During these missions, we have found some common pathologies. Deafness is the most prevalent after which follows the lymphoid tissue of oropharynx pathology. On these 18 missions a total of 1057 otolaryngology assessments were conducted. The main surgery was oral cavity with adenoidectomy and tonsillectomy. The results of all audiological tests performed during these 18 missions, reveal an increase of sensorineural deafness. DISCUSSION: These missions’ purpose is to allow healthcare access to all, to identify people with hearing and language problems and to adapt prosthetics, if possible, mainly for children and young adults.We have witnessed a considerable improvement on the children to whom we have adapted prosthetics. Some of them return to school, have friends and became more social. As the result of this work, we conclude that all Humanitarian Missions must be adapted to each country’s needs as we have done over the past five years.

The risk of thrombotic events in patients with primary versus secondary hepatic malignancies who are undergoing surgical resection

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15178-15178
Author(s):  
T. J. Yates ◽  
M. Abouljoud ◽  
A. Lambing ◽  
P. Kuriakose
Keyword(s):  
Surgical Resection ◽  
Metastatic Disease ◽  
Chart Review ◽  
Malignant Disease ◽  
Retrospective Chart Review ◽  
Secondary Malignancies ◽  
The Past ◽  
Increased Risk ◽  
Thrombotic Complications ◽  
Hepatic Malignancies

15178 Background: The increased risk of thromboses is well documented in patients with malignancies, and those undergoing abdominal surgery. Furthermore, patients requiring hepatic resection for underlying malignant disease have been reported to be at increased risk for thrombotic complications. However, guidelines for thromboprophylaxis in this patient population are still under investigation. A cursory review performed at our institution determined the incidence of thrombotic events to be comparable to that reported in the literature. We, therefore, went further to study if there was a difference in the risk of thromboses between those undergoing resection for primary hepatic cancer, versus metastatic disease. Methods: We performed a retrospective chart review of patients undergoing surgical resection for hepatic malignancies. The primary end point was to determine whether there was a difference in the incidence of thrombotic events between primary and secondary malignancies. Results: A total of 99 patients at our institution underwent surgical resection for either primary or secondary hepatic malignancies in the past 5 years. There were 7 patients who developed thrombotic events within three months of their resection. Of these patients, all 7 underwent resection for secondary hepatic malignancies. Based on the nature of this study, and its lack of standardized thromboprophylaxis, statistical analysis was not performed. Conclusions: Patients undergoing surgical resection of hepatic malignancies appear to be at increased risk of thrombotic events, and may require more specific standardization of their thromboprophylaxis. Furthermore, based on our observation it appears those associated with metastatic disease may derive an even greater benefit from this. Future prospective studies will be required to evaluate this difference in thromboses, and to better define the guidelines for thromboprophylaxis. No significant financial relationships to disclose.

A Retrospective Chart Review of the Hematologic Consequences of Roux-en-y Gastric Bypass Surgery.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3772-3772
Author(s):  
Christina L. Costantino ◽  
Susan Kruse ◽  
David H. Henry
Keyword(s):  
Chart Review ◽  
Bypass Surgery ◽  
Reticulocyte Count ◽  
Gastric Bypass Surgery ◽  
Retrospective Chart Review ◽  
Duodenal Mucosa ◽  
The Past ◽  
B12 Deficiency ◽  
Post Menopausal

Abstract Roux-en-y gastric (RYGB) bypass surgery has become increasingly common as a procedure to control overweight/obesity. Due to the resulting bypass of significant amounts of gastric and duodenal mucosa, patients may develop anemia. We reviewed charts of 28 patients who had undergone RYGB surgery in the past 5 years who were referred to us for evaluation. Eighteen of these patients had no hematologic consequences as a result of the surgery. Five patients were anemic but were excluded because they had other causes for anemia than the bypass surgery: myeloma (1), pregnancy (1), breast cancer (1), and heavy menstruation (2). The remaining 5 patients however revealed hematologic abnormalities an average of approximately 23 months following RYGB surgery. In our retrospective chart review, we found anemia most commonly caused by iron deficiency although 1 patient had B12 deficiency, and we suggest periodic follow up of patients months to years after such surgery to screen for anemia from potential malabsorption of iron or B12 from this surgical alteration of gastrointestinal anatomy. Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Months since RYGB & first heme evaluation 24 months 28 months 39 months 11 months 11 months Pre/Post Menopausal pre pre pre pre pre Hemoglobin 8 12.9 9.8 6.7 9.9 B12 165 501 233 340 660 Ferritin 14 9 7 <1 5 Folate 20.8 >24.0 16.3 16.4 >24.0 Creatinine 0.6 0.9 0.9 1.0 0.8 WBC 7.7 8.5 9 6.9 5.6 Platelets 364 300 473 378 462 Reticulocyte Count 1.00% 1.30% 1.20% 1.30% 1.30%

scholarly journals 662. Tick Borne-Associated Thrombocytopenia Among United States Veterans in Long Island New York

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S239-S239
Author(s):  
Olga Kaplun ◽  
Beth Lemaitre ◽  
Zeena Lobo ◽  
George Psevdos
Keyword(s):  
New York ◽  
Chart Review ◽  
Medical Center ◽  
Long Island ◽  
Febrile Illness ◽  
Retrospective Chart Review ◽  
Veterans Affairs ◽  
Babesia Microti ◽  
The Past ◽  
History Of

Abstract Background Long Island, New York, is highly endemic for tick borne illnesses (TBI) with rising numbers of cases in the past years. Thrombocytopenia is a known complication of babesiosis caused by Babesia microti, anaplasmosis caused by Anaplasma phagocytophilum, and ehrlichiosis caused by Ehrlichia chaffeensis. We identified cases of thrombocytopenia attributed to TBI in our institution. Methods Retrospective chart review of patients diagnosed with babesiosis, anaplasmosis, and ehrlichiosis from 2000 to 2017 at Northport Veterans Affairs Medical Center. Demographics, method of diagnosis (PCR/serologies), CBC/chemistries, treatment choices, and outcomes were analyzed. Results Thirty-two veterans (VETS) were identified with the following TBI: Babesiosis 22, Ehrlichiosis 6, Anaplasmosis 4. The majority of cases (19) were from Suffolk County, Long Island. The median (MED) age of this group was 62 years (range 31–89). Ninety-one percent were Caucasian, 9% Black. 37.5% had history of tick bite. The MED temperature on presentation was 101.9°F (range 97.6–105.2°F). 56% had HTN, 6% DM, 37% HLD, 9% hepatitis C, 3% HIV. Laboratory studies: MED platelet count 88,000/µL (36,000–161,000); MED hemoglobin 12 gm/dL (5.6–15.6); MED ALT 41 IU/L (6–330); MED LDH 335 IU/L (193–1,322). Twelve VETS had positive C6 peptide. The peak MED B. microti parasitemia was 1.4% (0.1–3%). PCR tests were available in the later years of the study period: three were positive for E. chaffeensis, two for A. phagocytophilum, and 14 for B. microti. The majority of the cases (19) were observed after year 2010. Morulae were seen in only one case. Haptoglobin in eight VETS was undetectable. One veteran with history of splenectomy and babesiosis with 3% parasitemia required exchange transfusion with 12 units of PRBCs. Two other babesiosis cases required regular transfusion of PRBCs. 20 babesiosis cases were treated with azithromycin-atovaquone and two with clindamycin-primaquine. Doxycycline was used in the other cases. One patient developed NSTEMI and required coronary stent placement. Platelet counts returned to baseline levels with treatment. No deaths occurred. Conclusion The incidence of TBI in Long Island, New York is rising. PCR testing for TBI can be utilized in our VETS presenting with febrile illness and thrombocytopenia to help identify the possible tick borne pathogen during the months of high tick activity. Disclosures All authors: No reported disclosures.

scholarly journals Eosinophilia: A Poor Predictor ofStrongyloidesInfection in Refugees

2013 ◽  
Vol 24 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Prenilla Naidu ◽  
Stephanie K Yanow ◽  
Kinga T Kowalewska-Grochowska
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Refugee Camps ◽  
Tropical Diseases ◽  
Negative Group ◽  
Positive Group ◽  
The Past ◽  
Canadian Data ◽  
Poor Predictor ◽  
Laboratory Results

BACKGROUND: Canada resettles 10,000 to 12,000 refugees annually. Despite this being a highly vulnerable population, there are little Canadian data on subclinical tropical diseases harboured in this population over the past 20 years.OBJECTIVES: To determine the seroprevalence and predictors ofStrongyloidesinfection in refugees arriving in Edmonton, Alberta.METHODS: A retrospective chart review of all refugees seen at the New Canadians Clinic between March 2009 and April 2010 was performed. Demographic, symptom and physical examination data were collected from the charts. Laboratory results were obtained from the electronic laboratory records.RESULTS: A total of 350 subjects were studied. The overall seroprevalence of strongyloidiasis was 4.6%. Equivocal results were found in 6.3%. In the positive group, the majority were male (62.5%); 75% were born in Africa (P=0.004) and 81.2% lived in refugee camps in Africa (P=0.002). Eosinophilia was present in 25% of the positive subjects (P=0.05), in none of the equivocal group and in 8.7% of the negative group.DISCUSSION: Persistent asymptomaticStrongyloidesinfection is maintained for years through autoinfection. Traditionally, eosinophilia was used as one of the key tools to diagnose chronic but stable diseases, but it was shown to have a poor predictive value for strongyloidiasis in returning expatriates as well as in those presenting with a disseminated form of the disease. It is important to raise awareness of the severe limitations of eosinophilia as a marker for strongyloidiasis when managing patients who either are immunocompromised, or about to start immunosuppressive therapy.CONCLUSIONS: The present study indicated that eosinophilia is a poor predictor of seropositivity and, thus,Strongyloidesinfection. Residence in Africa (birth/refugee camps) proved to be a significantly better predictor ofStrongyloidesseropositivity.

Nasal Mucormycosis: Our experience with 24 cases

2020 ◽  
Vol 74 (4) ◽  
pp. 37-40
Author(s):  
Satvinder Singh Bakshi ◽  
Soumyajit Das ◽  
Seepana Ramesh ◽  
Suriyanarayanan Gopalakrishnan
Keyword(s):  
Liposomal Amphotericin ◽  
Chart Review ◽  
Hematologic Malignancy ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
First Line ◽  
The Past ◽  
Increased Risk ◽  
Shed Light

<b>Background:</b> Mucormycosis is a rare fungal infection affecting people with impaired immunity. The aim of this study is to shed light on the epidemiology, incidence, and outcome of patients with mucormycosis hospitalized at a tertiary care center in Pondicherry. <br><b>Methods:</b> We conducted a retrospective chart review between January 2008 and January 2018. All patients with proven or probable mucormycosis were included. <br><b>Results:</b> A total of 24 patients were included. Their median age was 49 years and the majority were males. Comorbidities included mainly hematologic malignancy and diabetes mellitus. A liposomal amphotericin B formulation alone or in combination with other antifungals was used as a first line agent in all patients. <br><b>Conclusion:</b> The incidence of mucormycosis has significantly increased over the past 10 years at our institution, most likely due to increased risk factors.

scholarly journals Symptomatic versus asymptomatic pyeloplasties: A single institution review

2014 ◽  
Vol 8 (11-12) ◽  
pp. 428 ◽  
Author(s):  
Peter Metcalfe ◽  
Mark Assmus ◽  
Darcie Kiddoo
Keyword(s):  
Chart Review ◽  
Ureteropelvic Junction Obstruction ◽  
De Novo ◽  
Retrospective Chart Review ◽  
Loss Of Function ◽  
Single Institution ◽  
Indication For Surgery ◽  
The Past ◽  
Screening Strategies

Introduction: Historically, pyeloplasties have been performed after symptoms and radiographic confirmation of an ureteropelvic junction obstruction (UPJO). However, with prenatal ultrasonography, the approach to patients has fundamentally changed. Increasingly, patients are diagnosed and treated before the advent of morbidity, based on imaging findings alone. However, optimum screening strategies and thresholds for intervention vary significantly, are controversial, and are not founded on outcome-based evidence. We examined all pyeloplasties performed at our institution and reviewed their indication for surgery. We hypothesized that, despite ubiquitous screening for UPJO, most pyeloplasties had been performed secondary to symptoms and did not benefit from antenatal screening.Methods: A retrospective chart review was performed of all pyeloplasties performed at the Stollery Children’s Hospital, Edmonton, Alberta, over the past 8 years. Patients were categorized according to indication for surgery: symptomatic or asymptomatic.Results: Most (60%) of our pyeloplasties were performed for symptomatic indications. Furthermore, 12% of these patients had antenatally detected hydronephrosis that was thought to have resolved spontaneously during follow-up. Of our symptomatic patients, 37% were undergoing surveillance with the expectation for spontaneous resolution. Of the 29 patients who underwent pyeloplasty, 8 suffered a preoperative loss of function on renal scans; however, only 50% returned to within 90% of their original function.Conclusion: Despite active surveillance of antenatally detected hydronephrosis, most pyeloplasties at our institution were performed for de-novo symptoms. We believe that this simple observation reinforces that our current surveillance strategies are unable to predict and eliminate all morbidity from UPJO.

scholarly journals P.102 Expanded endoscopic endonasal approach for orbital apex decompression

2019 ◽  
Vol 46 (s1) ◽  
pp. S40
Author(s):  
K Yang ◽  
Y Ellenbogen ◽  
A Algird ◽  
D Sommer ◽  
K Reddy
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Orbital Apex ◽  
Endoscopic Endonasal ◽  
The Past ◽  
Stable Vision ◽  
Male Patients ◽  
The Mean

Background: The Endoscopic endonasal approach (EEA) has been gaining popularity in the past decade as an alternative to traditional transcranial and transorbital approaches. We have performed orbital apex decompression for a variety of pathological entities. Methods: We performed a retrospective chart review on patients who underwent EEA orbital apex decompression between January 1st 2010 and December 1st 2018 at McMaster University. Results: Eight patients underwent endoscopic endonasal orbital decompression at our center, including five male patients and three female patients. The mean age of our patients was 50.1 years. The different pathologies we treated included nasopharyngeal carcinoma, hemangioma, fibrous dysplasia, IgG4 disease, inverted papilloma, angioleiomyoma, and neuroendocrine paraganglioma. Five patients presented with visual symptoms. Postoperatively, one of these five patients improved to baseline, three had stable vision, another one had progressive visual decline despite surgical intervention. Conclusions: Endoscopic endonasal approach can be used as an alternative to decompress orbital apex pathologies in selected patients.

scholarly journals Mortality in a Heterogeneous Population of Low-Risk Febrile Neutropenic Patients Treated Initially with Cefazolin and Tobramycin

2009 ◽  
Vol 20 (4) ◽  
pp. e145-e152 ◽  
Author(s):  
Francesca Le Piane ◽  
Sandra AN Walker ◽  
Scott E Walker ◽  
Nina Lathia ◽  
Carlo De Angelis ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Health Sciences ◽  
Primary Objective ◽  
Prospective Data ◽  
Sunnybrook Health ◽  
The Past ◽  
All Cause Mortality ◽  
Neutropenic Patients

BACKGROUND: At Sunnybrook Health Sciences Centre in Toronto, Ontario, the recommended empiric regimen for febrile neutropenia has been cefazolin and tobramycin for at least 25 years. However, we had no objective data to reassure us that patient mortality had not increased over the past five years.METHODS: A retrospective chart review of 48 episodes occurring in 44 patients admitted for the treatment of febrile neutropenia secondary to chemotherapy in 2002, and initially managed with cefazolin and tobramycin was conducted. Prospective data from 48 episodes in 2007 had previously been collected. Patients who developed febrile neutropenia while in hospital were excluded. The primary objective of the present study was to compare the all-cause mortality in 2007 with that from 2002.RESULTS: There were no statistically significant differences between the groups (P>0.05). All-cause mortality in 2007 was 8.3% (four of 48) compared with 10.4% (five of 48) in 2002 (P=1). All deaths occurred in patients considered to be at high risk according to the Talcott score.CONCLUSION: Mortality has not increased in the past five years with the use of empiric cefazolin and tobramycin for the treatment of patients admitted with febrile neutropenia at Sunnybrook Health Sciences Centre. Rates are comparable with those reported in the literature for similar patients. The results of the present study provide reassurance that the regimen continues to be effective for lower-risk febrile neutropenic patients.

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