scholarly journals Multidisciplinary Management of Primary Sacral Tumors: A Tertiary Care Center’s Experience and Literature Review

2021 ◽  
Author(s):  
Venugopal Sarath Chander ◽  
Ramachandran Govindasamy ◽  
Venkata Ramakrishna Tukkapuram ◽  
Swaroop Gopal ◽  
Satish Rudrappa
Keyword(s):  
Literature Review ◽  
Tertiary Care ◽  
Multidisciplinary Management ◽  
Sacral Tumors

scholarly journals Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis

2020 ◽  
Vol 7 (9) ◽  
Author(s):  
Takaaki Kobayashi ◽  
Alexandre R Marra ◽  
Marin L Schweizer ◽  
Patrick Ten Eyck ◽  
Chaorong Wu ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Infectious Disease Consultation ◽  
Significant Difference ◽  
The Impact

Abstract Background Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known about the impact of IDC in candidemia. Methods We conducted a retrospective observational cohort study of candidemia patients at a large tertiary care hospital between 2015 and 2019. The crude mortality rate was compared between those with IDC and without IDC. Then, we systematically searched 5 databases through February 2020 and performed a meta-analysis of the impact of IDC on the mortality of patients with candidemia. Results A total of 151 patients met the inclusion criteria, 129 (85%) of whom received IDC. Thirty-day and 90-day mortality rates were significantly lower in the IDC group (18% vs 50%; P = .002; 23% vs 50%; P = .0022, respectively). A systematic literature review returned 216 reports, of which 13 studies including the present report fulfilled the inclusion criteria. Among the 13 studies with a total of 3582 patients, IDC was performed in 50% of patients. Overall mortality was 38.2% with a significant difference in favor of the IDC group (28.4% vs 47.6%), with a pooled relative risk of 0.41 (95% CI, 0.35–0.49). Ophthalmology referral, echocardiogram, and central line removal were performed more frequently among patients receiving IDC. Conclusions This study is the first systematic literature review and meta-analysis to evaluate the association between IDC and candidemia mortality. IDC was associated with significantly lower mortality and should be considered in all patients with candidemia.

Laryngeal Langerhans Cell Histiocytosis: A Case Report and Literature Review

2020 ◽  
pp. 000348942095488
Author(s):  
Allen S. Zhou ◽  
Lei Li ◽  
Thomas L. Carroll
Keyword(s):  
Literature Review ◽  
Langerhans Cell Histiocytosis ◽  
Medical Center ◽  
Tertiary Care ◽  
Rare Condition ◽  
Surgical Excision ◽  
Langerhans Cell ◽  
Histopathological Analysis ◽  
Current Case ◽  
Tertiary Care Medical Center

Objective: To describe a case of laryngeal Langerhans cell histiocytosis, discuss its characteristic features and management, and provide a review of the available literature. Methods: A patient presenting to a tertiary care medical center with dyspnea and hoarseness is described. A literature review of laryngeal Langerhans cell histiocytosis cases was performed through a search of articles indexed in the National Institutes of Health PubMed system. Results: We report a case of a 69-year old male, who presented with a laryngeal mass highly suspicious for laryngeal squamous cell carcinoma, was treated with laser excision, and was subsequently found to have laryngeal Langerhans cell histiocytosis upon histological analysis. Including our current case, we found six prior reported cases of laryngeal Langerhans cell histiocytosis in the literature. Of the six cases, four were in adults, while two were in children. Dyspnea is a common presenting complaint present in all cases. Smoking may be a potential risk factor. Conclusions: Laryngeal Langerhans cell histiocytosis is a rare condition and an important consideration in the differential diagnosis of patients presenting with a laryngeal mass and symptoms of dyspnea or hoarseness. Biopsy and histopathological analysis are key to the diagnosis. Surgical excision and radiotherapy are successful treatments used in clinical practice.

scholarly journals A randomized clinical study to compare pre-emptive analgesic efficacy of clonidine and diclofenac sodium in patients undergoing major surgeries at a tertiary care hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Prachi Jain ◽  
Uma Bhosale ◽  
Shashank Desai
Keyword(s):  
Clinical Study ◽  
Literature Review ◽  
Rating Scale ◽  
Diclofenac Sodium ◽  
Tertiary Care ◽  
Analgesic Efficacy ◽  
Care Hospital ◽  
Pain Scores ◽  
Randomized Clinical Study ◽  
Study Results

Background: Pre-emptive analgesia is a method to achieve analgesia even before exposure to a noxious stimulus The purpose of pre-emptive analgesia is to reduce pain caused due to surgical incision triggered inflammatory mechanism activation; and to ensure a good post-operative pain control so that there is no development of chronic pain. Clonidine is an α2 adrenergic agonist thus it decreases the sympathetic outflow, while Diclofenac is a non-steroidal anti-inflammatory agent. Our literature review showed that both clonidine (150 μg) and diclofenac are efficacious pre-emptive analgesics. Literature review also revealed that there is no study available to compare pre-emptive analgesic efficacy as well as safety of oral clonidine with diclofenac, therefore present study was designed to compare pre emptive analgesic efficacy of these two drugs.Methods: This randomized clinical study included 100 patients from surgical departments, of either sex, between 18 to 70 years age and of American society of anesthesiologists (ASA) I/II grade. Patients were randomly allocated to two groups and received either of the treatments 30 minutes prior to induction of anesthesia. Pain scores were recorded using visual analog scale, facial rating scale and behavioral rating scale at awakening and at 1, 2, 4, 6 and 24 hours. Postoperative analgesic requirement over 24 hours was recorded. Data were analyzed using OpenEpi statistical softwares.Results: Significantly lower pain scores were observed in clonidine group as compared to Diclofenac at 4 and 6 hours (p<0.05) on all the pain scales. Clonidine group also required less postoperative analgesic as compared to diclofenac (p<0.05).Conclusions: Study results are strongly suggestive of greater pre-emptive analgesic efficacy of clonidine over diclofenac in major surgeries done under spinal anesthesia.

Occult Malignancy in Adult Tonsillectomy for Benign Indication

2020 ◽  
pp. 000348942095247
Author(s):  
Noah Syme ◽  
Stefan Brettfeld ◽  
Ashley Dorneden ◽  
Von Samedi ◽  
Therese Bocklage ◽  
...  
Keyword(s):  
Literature Review ◽  
Chart Review ◽  
Tertiary Care ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pooled Analysis ◽  
Level Of Evidence ◽  
Occult Malignancy ◽  
Pathologic Analysis ◽  
Adult Tonsillectomy

Objective: National pathology guidelines recommend full pathologic analysis for all adult tonsillectomy specimens. We evaluated the available data on occult malignancy in adult tonsillectomy for benign indication, and created a screening system to reduce the risk of missed malignancies if routine histopathologic examination were to be discontinued. Study design: Retrospective chart review and systematic review of the literature. Setting: Tertiary care academic hospital and multi-hospital private healthcare system. Subjects and methods: A systematic literature review identified case series of adult tonsillectomy. Retrospective chart review at our institutions from 2000 to 2016 produced an additional case series. The pooled rate of occult malignancy was determined, and re-analyzed using criteria based on preoperative risk factors designed to identify patients requiring full pathologic analysis. The predicted effects of prospective application of the proposed criteria were calculated. Pooled occult malignancy prevalence was estimated. Results: Literature review and our own case series yielded 12,094 total cases. Occult malignancy prevalence in the combined data was 0.033%, representing four occult malignancies. Three out of the four would have been selected for full pathology preoperatively with use of the proposed criteria. Statistical analysis indicates that the predicted frequency of occult malignancy incidence in cases negative for the criteria is 0.01%, or 1/10,000. Conclusion: Application of the proposed criteria to adults undergoing tonsillectomy for benign indication identifies a subset of patients with an estimated incidence of occult malignancy similar to that reported for pediatric tonsillectomy, and potentially may permit safe elimination of pathologic analysis of their tonsil specimens. Level of Evidence: Pooled analysis of case series from the literature and a single institution, level 4.

scholarly journals Primary Pleural Benign Myxoid Schwannoma in an 18-Year-Old Female: A Case Report and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Hussam Abou Al-Shaar ◽  
Safi Qutob ◽  
Ahmed Abu-Zaid ◽  
Ayman Azzam ◽  
Tarek Amin ◽  
...  
Keyword(s):  
Literature Review ◽  
Adrenal Gland ◽  
English Literature ◽  
Tertiary Care ◽  
Vena Cava ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Contrast Enhanced ◽  
The Right ◽  
Enhanced Computed Tomography

Pleural schwannomas are exceedingly rare neoplasms of the thoracic cavity. To the best of our knowledge, less than 20 cases have been reported in the medical English literature. Herein, we report the case of primary pleural benign myxoid schwannoma in an 18-year-old female. The patient was originally referred to our tertiary care hospital for further management of right adrenal gland mass. Physical examination and all laboratory tests were normal. Contrast-enhanced computed tomography scan showed a4.2×3.2 cm, heterogeneous noncalcified mass involving the right adrenal gland region. The right renal vein and inferior vena cava were intact. There was no pleural effusion, ascites, or lymphadenopathy. No pelvic masses were identified. Patient was scheduled for surgical resection. On laparotomy, the mass was not found in its radiologically expected location, and the right kidney and right adrenal gland were intact. The right-sided lower part of diaphragm was opened, and the mass was interestingly found inside the thorax attached to the pleura, and resected successfully. A final histopathological diagnosis of primary pleural benign myxoid schwannoma was established. At a postoperative 6-month followup, there was no radiological evidence of tumor recurrence. Furthermore, literature review on pleural schwannomas is also presented.

Nursing care of children with diarrhea: of primary and tertiary care - a literature review

2011 ◽  
Vol 5 (3) ◽  
pp. 828
Author(s):  
Marilia Cruz Gouveia Câmara ◽  
Ana Maria de Sá Barreto ◽  
Angélica De Godoy Torres Lima ◽  
Quitéria Claúdia da Silva ◽  
Sarah Mariana de Andrade Queiroz ◽  
...  
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Nursing Care ◽  
Preventive Care ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Health Team ◽  
Study Results ◽  
Review Study ◽  
Different Levels

ABSTRACTObjectives: to discuss the main causes of diarrhea in infants and the major nursing care provided from preventive care to assistance, for these patients and their families, at different levels of health care. Methodology: this is about a literature review study, using the database of SciELO and REUOL, books and manuals of the Ministry of Health from April to May 1984 to 2010, with the descriptors diarrhea, dehydration, children, nursing care, treatment and hospitalization, found in 42 articles of which 13 discarded for not agreeing with the objective of the study. Results: the child is a being who needs protection, respect and care from his parents and a humanized health team, as this should provide an integrated and systematic assistance. Conclusion: the nurse, to act at all levels of health care, must know their role in promoting the health of pediatric patients with diarrhea, reviewing concepts in pursuit of excellence of care. Descriptors: diarrhea, dehydration; child; nursing care.RESUMOObjetivos: discutir as principais causas da diarréia em crianças e os principais cuidados de enfermagem, desde preventivos até assistenciais, a esses pacientes e suas famílias, nos diferentes níveis de atenção à saúde. Metodologia: artigo do tipo revisão de literatura, utilizando-se a base de dados da SciELO e da REUOL, livros e manuais do Ministério da Saúde, entre o ano de 1984 a 2010, no período de abril a maio de 2010. Com os descritores diarréia, desidratação, criança, assistência de enfermagem, tratamento e hospitalização, foram encontrados 42 artigos dos quais descartamos 13, por não condizerem com o objetivo do estudo. Resultados: a criança é um ser que necessita de proteção, respeito e cuidado dos seus pais e de um atendimento humanizado da equipe de saúde, visto que esta deve oferecer uma assistência integrada e sistematizada. Conclusão: o enfermeiro, por atuar em todos os níveis de atenção à saúde, deve conhecer bem a sua atuação na promoção à saúde dos pacientes pediátricos com diarréia, revisando conceitos em busca da excelência da assistência. Descritores: diarréia; desidratação; criança; assistência de enfermagem.RESUMENObjetivos: discutir las principales causas de la diarrea en niños y los principales cuidados de enfermería, desde preventivos hasta asistenciales, a esos pacientes y sus familias, en los diferentes niveles de atención a la salud. Metodología: artigo tipo revisión de literatura, utilizándose de la base de datos SciELO y REUOL, libros y manuales del Ministerio de Salud, entre los años de 1984 y 2010, en el periodo de abril a mayo de 2010. Con los descriptores diarrea, deshidratación, niño, asistencia de enfermería, tratamiento y hospitalización fueron encontrados 42 artículos de los cuales omitimos 13, por no se adecuaren al objetivo del estudio. Resultados: el niño es un ser que necesita protección, respeto y cuidado de sus padres y de una atención humanizada del equipo de salud, una vez que esta debe ofrecer una asistencia integrada y sistematizada. Conclusión: el enfermero, por actuar en todos los niveles de atención a la salud, debe reconocer bien su actuación en la promoción a la salud de los pacientes pediátricos con diarreas, revisando conceptos en busca de la excelencia en la asistencia. Descriptores: diarrea, deshidratación; niño; asistencia de enfermería.

scholarly journals Pregnancy after Aortic Root Replacement in Marfan's Syndrome: A Case Series and Review of the Literature

2018 ◽  
Vol 08 (04) ◽  
pp. e234-e240 ◽  
Author(s):  
Dominique Williams ◽  
Kathryn Lindley ◽  
Melissa Russo ◽  
Jennifer Habashi ◽  
Harry Dietz ◽  
...  
Keyword(s):  
Literature Review ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Aortic Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Aortic Root Replacement ◽  
Marfan’S Syndrome ◽  
Marfan's Syndrome ◽  
Case Series Study

Objectives We sought to characterize pregnancy-related aortic complications in women with Marfan's syndrome who had prior aortic root replacement. Study Design This is a retrospective case series study and literature review of women with Marfan's syndrome with pregnancy after aortic root replacement. We surveyed women with Marfan's syndrome who had successful pregnancy after aortic root replacement using the Marfan Foundation Website and from two large tertiary care Marfan's clinics. Clinical data, counseling information, and details of pregnancy-related aortic complications were compiled. A literature review was performed assessing aortic outcomes in women with Marfan's syndrome with pregnancy after aortic surgery. Results Fourteen women with 20 pregnancies were identified. Two women had three pregnancies following root replacement for aortic dissection. There were no aortic dissections during the 20 pregnancies. In contrast, aortic dissection was frequently reported in the literature. Conclusions Women with Marfan's syndrome who become pregnant following aortic root replacement remain at risk for distal aortic dissection related to pregnancy. The exact risk is difficult to quantify but is not zero and women should be counseled accordingly.

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