Phyllodes Tumor of Breast:A 17 Years Audit of 260 Patients with Biopsy Proven Phyloldes Tumor Treated in our Institute

Phyllodes are rare breast neoplasms with higher rate of local and systemic recurrence. This study presents the results of an audit of all cases of biopsy proven phyllodes tumor presenting to breast services in Liquat National University Hospital Karachi, Pakistan, from 1993 to 2010. Total 260 female patients were retrospectively audited, 151 had benign, 35 borderline and 74 had malignant histology. Mean follow up duration for all types was 2 years. The mean age for benign lesions was 28, for borderline 36.8 and for malignant lesions 41 years. For all histopathological types the mean tumor size was 6.2 cm. It was 5.4 cm for benign, 7.8 cm for borderline and 11.2 cm for malignant lesions. 200/260 (76.9%) patients had breast conservation while 60/260 (23.0%) had mastectomy. Histopathology type and grade has statistically significant relationship with recurrence ( p value .0001 % ) Overall recurrence rate was 20/260 (7.69%) with one patient with malignant phyllodes having recurrence 6 times despite clear margins and two patients with borderline phyllodes having recurrence twice . Tumor recurred in 2/151(1.3% ) of benign , 5.7% borderline ( 2/35 ) and 21.6% malignant ( 16/74 ) cases .Malignant group had 8 (10.8% ) systemic and 12 (16.2%)local recurrences. All patients with local recurrence and involved margins had reexcision except for 2 who had mastectomy with muscles involved posteriorly during the first surgery where re-excision was not possible. mortality rate for malignant phyllodes was 5.4 % ( 4/74 deaths as a result of systemic recurrence ) Conclusion: Phyllodes tumor is an aggressive disease, in our series, grade and type of tumor on histopathology is the significant risk factor for local and systemic recurrence with rate reaching up 21.6% for local and 10.8% for systemic recurrence in malignant lesions.

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A Clinicopathologic and Epidemiologic Study of Chronic White Lesions in the Oral Mucosa

Ear Nose & Throat Journal ◽

10.1177/014556131709600804 ◽

2017 ◽

Vol 96 (8) ◽

pp. E13-E17

Author(s):

Sampurna Ghosh ◽

Sudipta Pal ◽

Soumya Ghatak ◽

Somnath Saha ◽

Surajit Biswas ◽

...

Keyword(s):

Oral Mucosa ◽

Epidemiologic Study ◽

Significant Risk ◽

Significant Risk Factor ◽

Premalignant Lesions ◽

Excision Biopsy ◽

Severe Dysplasia ◽

Cross Sectional ◽

Malignant Lesions ◽

Tobacco Chewing

Invasive oral squamous cell carcinoma is often preceded by the presence of clinically identifiable premalignant changes of the oral mucosa, including white lesions. We conducted a cross-sectional, observational study to assess the clinicopathologic and epidemiologic aspects of chronic oral mucosal white lesions to determine the necessity of early biopsy in these cases. Our study population was made up of 77 patients—50 males and 27 females, aged 15 to 70 years (mean: 42.9)—who presented with white lesions persisting for at least 4 weeks. All but 3 patients underwent a biopsy; the 3 exceptions were diagnosed with smear-proven candidiasis. Patients with moderate or severe dysplasia underwent an excision biopsy. The buccal mucosa was the single most common site of white lesions, occurring in 15 patients (19.5%), although 21 patients (27.3%) exhibited a diffuse involvement of the oral mucosa. Of the 77 patients, 59 (76.6%) had concerning findings: premalignant lesions in 45 patients (58.4%) and malignant lesions in 14 (18.2%). Also, dysplasia was seen in 8 patients (10.4%), all of whom had premalignant lesions. Tobacco chewing (p = 0.008) and betel quid chewing (p = 0.029) were significantly associated with the development of premalignant and malignant lesions; a longer duration of tobacco chewing (≥10 yr) was significantly associated with a higher risk of malignant but not premalignant lesions (p = 0.031). Finally, illiteracy was a significant risk factor for premalignant and malignant lesions (p = 0.03). Our findings support the necessity of biopsy in every case. Early detection of oral carcinoma by biopsy of all oral white lesions would not only prevent patients from undergoing disfiguring surgery and chemoradiation, but it also would increase the 5-year survival rate.

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External Ventricular Drain Infection

Journal of Neurosurgery ◽

10.3171/jns-07/07/0248 ◽

2007 ◽

Vol 107 (1) ◽

pp. 248 ◽

Cited By ~ 3

Author(s):

George K. C. Wong ◽

Wayne W. S. Poon

Keyword(s):

Major Trauma ◽

Independent Predictor ◽

External Ventricular Drain ◽

Significant Risk ◽

Significant Risk Factor ◽

External Ventricular Drainage ◽

Infection Rates ◽

The Mean ◽

The Relationship ◽

Shed Light

Object The authors explored the relationship among the duration of external ventricular drainage, revision of external ventricular drains (EVDs), and cerebrospinal fluid (CSF) infection to shed light on the practice of electively revising these drains. Methods In a retrospective study of 199 patients with 269 EVDs in the intensive care unit at a major trauma center in Australasia, the authors found 21 CSF infections. Acinetobacter accounted for 10 (48%) of these infections. Whereas the duration of drainage was not an independent predictor of infection, multiple insertions of EVDs was a significant risk factor. Second and third EVDs in previously uninfected patients were more likely to become infected than first EVDs. An EVD infection was initially identified a mean of 5.5 ±0.7 days postinsertion (standard error of the mean); these data—that is, the number of days—were normally distributed. Conclusions This pattern of infection is best explained by EVD-associated CSF infections being acquired by the introduction of bacteria on insertion of the drain rather than by subsequent retrograde colonization. Elective EVD revision would be expected to increase infection rates in light of these results, and thus the practice has been abandoned by the authors' institution.

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Predictors of Survival in Atypical Meningiomas

Cancers ◽

10.3390/cancers13081970 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1970

Author(s):

Michele Da Broi ◽

Paola Borrelli ◽

Torstein R. Meling

Keyword(s):

Neurological Outcome ◽

Significant Risk ◽

Significant Risk Factor ◽

University Hospital ◽

Neurological Deficits ◽

Karnofsky Performance Scale ◽

Free Survival ◽

Neurological Outcomes ◽

Progression Of Disease ◽

Atypical Meningiomas

Introduction: Predictors of survival and progression of disease in atypical meningiomas are less well documented in the literature compared to benign meningiomas. Higher grade meningiomas tend to recur often and one of the most critical aspects is how to best deal with relapses. Methods: A total of 77 consecutive patients who underwent craniotomy for atypical meningioma between 1990–2010 at Oslo University Hospital (OUH) were reviewed. Results: Median age at surgery was 62.21 [interquartile range (IQR): 22.87] years. Fifty-one patients (66.2%) had neurological deficits at presentation. Fifty-four patients (70.1%) underwent gross total resection (GTR). Thirty-nine patients (50.7%) had improved/stable neurological outcomes at 6–12 months. Twenty-two patients (28.6%) underwent retreatment, of whom 20 (26.0%) were subjected to resection followed by adjuvant radiotherapy. Overall survival (OS) was significantly longer in patients <65 years (p < 0.001), with preoperative Karnofsky performance scale (KPS) score of ≥ 70 (p = 0.006), and who required no retreatment (p = 0.033). GTR significantly prolonged the retreatment-free survival rate (p < 0.001). STR carried almost a six-fold greater risk of neurological outcome deterioration (p = 0.044). Conclusions: GTR significantly prolonged retreatment-free survival but had no significant impact on OS. STR was a significant risk factor for deteriorated neurological outcome. Age, preoperative KPS, and retreatment were all strong predictors of OS. Median time-to-retreatment (TTR) did not shorten significantly throughout repeated surgeries.

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An Outbreak of Pyodermas Among Neonates Caused by Ultrasound Gel Contaminated With Methicillin-SusceptibleStaphylococcus Aureus

Infection Control and Hospital Epidemiology ◽

10.1086/501729 ◽

2000 ◽

Vol 21 (12) ◽

pp. 761-764 ◽

Cited By ~ 52

Author(s):

Klaus Weist ◽

Constanze Wendt ◽

Lyle R. Petersen ◽

Hans Versmold ◽

Henning Rüden

Keyword(s):

Hip Joint ◽

Case Control Study ◽

Tertiary Care ◽

Significant Risk ◽

Significant Risk Factor ◽

Case Control ◽

University Hospital ◽

Good Physical Condition ◽

Rapd Pcr ◽

Control Study

Objective:To investigate an outbreak of methicillin-susceptibleStaphylococcus aureus(MSSA); infections in a neonatal clinic.Design:Prospective chart review, environmental sampling, and genotyping by two independent methods: pulsed-field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). A case-control study was performed with 31 controls from the same clinic.Setting:A German 1,350-bed tertiary-care teaching university hospital.Results:There was a significant increase in the incidence of pyodermas with MSSA 10 neonates in good physical condition with no infection immediately after birth developed pyodermas. A shared spatula and ultrasound gel were the only identified infection sources. The gel contained MSSA and was used for hip-joint sonographies in all neonates. PFGE and RAPD-PCR patterns from 6 neonates and from the gel were indistinguishable and thus genetically related clones. The case-control study revealed no significant risk factor with the exception of cesarean section (P=.006). The attack rate by days of hip-joint sonography between April 15 and April 27, 1994, was 11.8% to 40%.Conclusions:Inappropriate hygienic measures in connection with lubricants during routine ultrasound scanning may lead to nosocomialS aureusinfections of the skin. To our knowledge this source ofS aureusinfections has not previously been described.

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Risk factors for hypertensive crisis in children with acute glomerulonephritis

Paediatrica Indonesiana ◽

10.14238/pi56.2.2016.101-6 ◽

2016 ◽

Vol 56 (2) ◽

pp. 101

Author(s):

Sherly Yuniarchan ◽

Risky Vitria Prasetyo ◽

Ninik Asmaningsih Soemyarso ◽

Mohammad Sjaifullah Noer

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Pediatric Population ◽

Hypertensive Crisis ◽

Significant Risk ◽

Significant Risk Factor ◽

P Value ◽

Acute Glomerulonephritis ◽

Female Ratio

Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN). Some factors have been suggested to affect blood pressure (BP) in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age); and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years). We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17) years), with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6%) children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5%) and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021). Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.

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Laryngeal Papillomatosis in Adults: Assessment for Ten Years at the ENT Department of the National University Hospital of Fann (Dakar, Senegal)

International Journal of Otolaryngology ◽

10.1155/2020/2782396 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

N. Ndour ◽

S. Maiga ◽

A. Houra ◽

R. E. A. Deguenonvo ◽

C. Ndiaye ◽

...

Keyword(s):

Benign Tumor ◽

University Hospital ◽

Malignant Degeneration ◽

Age Group ◽

Laryngeal Papillomatosis ◽

Common Benign Tumor ◽

National University ◽

Laryngeal Dyspnea ◽

The Mean ◽

The Moment

Objectives. The aim of this study was to describe the epidemiological, diagnostic, and therapeutic aspects of adult laryngeal papillomatosis in Senegal. Patients and Methods. This is a retrospective descriptive study of patients aged above 18 years with laryngeal papillomatosis and followed at the ENT department of the NUH of Fann between 01 January 2009 and 31 December 2018. Results. The mean age at diagnosis was 37.74 years and a sex ratio of 0.93. The 20–29 age group was the most represented (45.2%). The average consultation delay was 8.34 years. All patients had dysphonia at the moment of the diagnostic and in 35.5% of cases, and it was associated with laryngeal dyspnea. Glottis localization was present in all our patients, i.e., 100% of the cases. A tracheotomy was performed in 9.67% of cases. All of our patients have had their papilloma peeled per endoscopic with tweezers. No cases of malignant degeneration were found in our study. Conclusion. Laryngeal papillomatosis is the most common benign tumor of the larynx in both children and adults. Despite the progress of endoscopy and antiviral treatments, its treatment poses many problems in our undermedicalized countries.

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Hydroureteronephrosis in women with pelvic organ prolapse: a prospective cohort study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183773 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3664

Author(s):

Pushplata Kumari ◽

Emily Divya Ebenezer ◽

Caroline Salomi ◽

Vaibhav Londhe ◽

Aruna Nitin Kekre

Keyword(s):

Chronic Kidney Disease ◽

Risk Factor ◽

Pelvic Organ Prolapse ◽

Kidney Disease ◽

Prospective Observational Study ◽

Surgical Repair ◽

Significant Risk ◽

Significant Risk Factor ◽

Pelvic Organ ◽

The Mean

Background: Pelvic organ prolapses (POP) is a common problem in women. The prevalence of POP increase with age. The true prevalence and risk factor for developing hydroureteronephrosis (HUN) in women with pelvic organ prolapse is still unclear due to lack of prospective studies on sufficiently large cohorts. This prospective study was done to study the prevalence of HUN in women with POP and to identify the risk factors for developing HUN.Methods: In this prospective observational study 219 patients were recruited for surgical repair for pelvic organ prolapse for 2 years. Preoperatively, all patients had transabdominal scan to assess the uterus, adnexa and to look for Hydroureteronephrosis (HUN). Women with presence of HUN were followed postoperatively look for the resolution of HUN.Results: The prevalence of bilateral HUN was 6.85%. The mean age of women with HUN ranged from 51-69 years. Diabetes and hypertension were significant risk factor for development of HUN (OR 4.70, 95% CI -1.59-13.88 and OR 3.72, 95% CI- 1.23-11.1 respectively). There was a statistically significant correlation between chronic kidney disease and HUN. (OR 1 with 95%: CI 9.49-30.42). The correlation between stage of pelvic organ prolapse and HUN was not statistically significant (p = 0.062). There was a statistically significant correlation between the duration (2years -15 years) of POP to HUN. (OR 0.233, 95%0.13-0.419). Patients were followed up post operatively for resolution of HUN. HUN resolved in 9 women (60%) and persisted in 6 (40%).Conclusions: The prevalence of bilateral HUN in women with pelvic organ prolapse was 6.8%. Presence of hypertension, diabetes and chronic kidney disease was a risk factor for HUN. HUN resolved in 60% of women after pelvic reconstructive surgery.

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P1708EFFECT OF PREGNANCY ON KIDNEY TRANSPLANT RECIPIENTS: A PROPENSITY SCORE-MATCHED STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1708 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Toyofumi Abe ◽

Taniguchi Ayumu ◽

Kawamura Masataka ◽

Kato Taigo ◽

Tomoko Namba-Hamano ◽

...

Keyword(s):

Multivariate Analysis ◽

Risk Factor ◽

Kidney Transplant ◽

Graft Survival ◽

Significant Risk ◽

Significant Risk Factor ◽

P Value ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Pregnancy And Delivery

Abstract Background and Aims This study aimed to evaluate whether the experience of pregnancy and delivery would be associated with poor maternal outcome among kidney transplant recipients. Method A total of 401 female transplant recipients from the Osaka University Transplantation Group Database were included in this study. 73 women who underwent renal transplantation between 1970 and 2017 and became pregnant and delivered at Osaka University Kidney Transplant Group Hospitals. Multivariable logistic regression analysis was used to assess the impact of pregnancy and delivery on renal transplant recipient outcome after one-to-one propensity score (PS) matching for 12 variables including serum creatinine at one year post-transplant between the parous group and the nulliparous group. The outcomes were kidney graft survival and patient survival. Results In all patients before PS matching, 75 (18.7%) of the 401 patients died and 137 (34.2%) of the 401 patients lost their kidney grafts during the follow-up period. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.662 [95%CI, 0.265-1.656], p-value 0.378) and for death-censored graft survival (adjusted HR 1.224 [95%CI, 0.683-2.196], p-value 0.497). In the PS matched population, 14 (17.5%) of the 80 patients died and 31 (38.8%) of the 80 patients lost their grafts. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.611 [95%CI, 0.180-2.072], p-value 0.430) and for death-censored graft survival (adjusted HR 1.308 [95%CI, 0.501-3.416], p-value 0.584). Conclusion Pregnancy and delivery after kidney transplantation was not associated with poor kidney transplant outcome in recipients with adequate and stable graft function.

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Analysis of lymphocyte T(CD4+) cells expression on severe early childhood caries and free caries

Infectious Disease Reports ◽

10.4081/idr.2020.8760 ◽

2020 ◽

Author(s):

Muhammad Luthfi ◽

Priyawan Rachmadi ◽

Aqsa Sjuhada Oki ◽

Retno Indrawati ◽

Agung Sosiawan ◽

...

Keyword(s):

T Cells ◽

Early Childhood ◽

Early Childhood Caries ◽

Significant Risk ◽

Significant Risk Factor ◽

Cell Receptor ◽

P Value ◽

Cd4 Cells ◽

Severe Early Childhood Caries ◽

Childhood Caries

Early childhood caries (ECC) is still one of the many diseases found in children throughout the world. Cariogenic bacteria are a significant risk factor for ECC associated with early colonization and high levels of cariogenic microbes (Streptococcus mutans, S. mutans). Lymphocyte T (CD4+) cells known as helper T cells, are effector cells for mediated host immunity. Naive T cells (CD4+) must be activated to initiate effector function. This activation occurs through interaction with professional antigen- presenting cells (pro-APC), especially dendritic cells that lead to intracellular pathways that regulate T cell receptor (TCR) more specifically against antigen in T cells. Lymphocyte cells from samples were collected from severe early childhood caries (S-ECC) and Free caries aged 5 to 6 years. The subjects were instructed to gargle 10 mL of sterile NaCl 1.5% solution for 30 seconds, and expectorate it into a sterile glass then analyzing T lymphocyte cell (CD4+) expression using flow cytometry. Lymphocyte T (CD4+) cell expression at SECC (6.2525±64482) while in free caries (8.4138±1.10397) with P-value (P=0. 000). Conclusion of lymphocyte T (CD4+) cells expression at S-ECC is lower than that occurring in free caries.

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Oral Mucosal Lesions and DMFT Index Assessment in Rheumatoid Arthritis Patients in Birjand, Iran, in 2018

The Open Rheumatology Journal ◽

10.2174/1874312902014010034 ◽

2020 ◽

Vol 14 (1) ◽

pp. 34-39

Author(s):

Parvin Parvaei ◽

Afsaneh Dorri-giv ◽

Gholamreza Sharifzadeh ◽

Hakimeh Malakimoghadam ◽

Elham Atabati

Keyword(s):

Rheumatoid Arthritis ◽

Significant Risk ◽

Significant Risk Factor ◽

Index Score ◽

Common Finding ◽

Cross Sectional ◽

Oral Mucosal Lesions ◽

Dmft Index ◽

The Mean ◽

Mucosal Lesions

Introduction: Rheumatoid Arthritis (RA) may cause malfunction in the immune system and the inability to observe oral hygiene in patients due to physical deficits. A bacterial infection caused as such can constitute a significant risk factor for the development of systemic infection. The present study aimed to investigate the oral mucosal lesions, the DMFT index, and the Modified Gingival Index (MGI) in RA patients treated in Birjand city. Materials and Methods: This descriptive cross-sectional study was performed with 80 RA patients referred to rheumatology clinics of Birjand in 2018. Data were collected through observation, clinical examination, information forms, and medical records. After the patients were informed about the research purposes and signed consent forms for participation, they were examined at the rheumatology clinics. The collected data were analyzed in SPSS software (version 19). Results: Of the 80 patients, n = 64 (80%) had oral mucosal lesions. Dry mouth (66.3%) was the most common finding. The mean DMFT index score was 18.7. Conclusion: Oral mucosal lesions and the mean DMFT index score seem to be at high levels in RA patients, possibly due to the complications of the disease or the consumed medications.

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