Thyroid surgery in children: our experience

2021 ◽  
Vol 100 (1) ◽  
Keyword(s):  
Retrospective Analysis ◽  
Thyroid Surgery ◽  
Paediatric Surgery ◽  
Regional Lymph Nodes ◽  
Extended Surgery ◽  
Postoperative Hypoparathyroidism ◽  
Children's Diseases ◽  
Node Metastases ◽  
The Mean ◽  
Patients Experience

Introduction: Thyroid surgery in children is a rare operation. The aim of our paper is to point out the specifics of thyroid surgery in children. Methods: Retrospective analysis of patients hospitalized at the Department of Paediatric Surgery, Faculty of Medicine, Comenius University and National Institute of Children’s Diseases in Bratislava during a 10-year period (2007−2016) who underwent thyroid surgeries. Results: The retrospective analysis included 81 patients: 66 (81%) girls and 15 (19%) boys. The mean age of the patients was 14 years ±8 months (range 4−18 years). The most common indications for thyroid surgery were: a nodule in 36 (44.4%) patients, Graves Basedow thyrotoxicosis in 19 (23.5%) patients, and suspected thyroid carcinoma in 11 (13.6%) patients. Cervical lymph node metastases (mts) were diagnosed in 9 (11.1%) patients, and distant pulmonary metastases in 5 (6.17%) patients. Total thyroidectomy (TTE) was performed in 43 (53%) patients, total lobectomy (TL) in 20 (24.7%) patients. Extended surgery on regional lymph nodes was performed in 9 (11.1%) patients. Eight (9.9%) patients underwent reoperation. A total of 12 (14.8%) patients experienced postoperative complications. Unilateral transient recurrent laryngeal nerve (RLN) paralysis occurred in 2 patients, and permanent in one patient. Transient postoperative hypoparathyroidism with hypocalcaemia was reported in 8 (9.9%) patients; no permanent condition of this type was observed. Conclusion: Multidisciplinary collaboration ensures that optimal surgical results are achieved in the patients. Experience of the surgeon performing thyroid surgery in children remains crucial.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: A multivariate analysis of 5846 consecutive patients

Surgery ◽  
2003 ◽  
Vol 133 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Oliver Thomusch ◽  
Andreas Machens ◽  
Carsten Sekulla ◽  
Jörg Ukkat ◽  
Michael Brauckhoff ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Surgical Technique ◽  
Thyroid Surgery ◽  
Postoperative Hypoparathyroidism ◽  
The Impact

scholarly journals The Problems and Needs of Patients Diagnosed with Cancer and Their Caregivers

2020 ◽  
Vol 18 (1) ◽  
pp. 87
Author(s):  
Anna Lewandowska ◽  
Grzegorz Rudzki ◽  
Tomasz Lewandowski ◽  
Sławomir Rudzki
Keyword(s):  
Cancer Patients ◽  
Medical Information ◽  
Unmet Needs ◽  
Public Healthcare ◽  
Literature Analysis ◽  
The Public ◽  
The Mean ◽  
High Level ◽  
Patients Experience

(1) Background: As the literature analysis shows, cancer patients experience a variety of different needs. Each patient reacts differently to the hardships of the illness. Assessment of needs allows providing more effective support, relevant to every person’s individual experience, and is necessary for setting priorities for resource allocation, for planning and conducting holistic care, i.e., care designed to improve a patient’s quality of life in a significant way. (2) Patients and Methods: A population survey was conducted between 2018 and 2020. Cancer patients, as well as their caregivers, received an invitation to take part in the research, so their problems and needs could be assessed. (3) Results: The study involved 800 patients, 78% women and 22% men. 66% of the subjects were village residents, while 34%—city residents. The mean age of patients was 62 years, SD = 11.8. The patients received proper treatment within the public healthcare. The surveyed group of caregivers was 88% women and 12% men, 36% village residents and 64% city residents. Subjects were averagely 57 years old, SD 7.8. At the time of diagnosis, the subjects most often felt anxiety, despair, depression, feelings of helplessness (46%, 95% CI: 40–48). During illness and treatment, the subjects most often felt fatigued (79%, 95% CI: 70–80). Analysis of needs showed that 93% (95% CI: 89–97) of patients experienced a certain level of need for help in one or more aspects. (4) Conclusions: Patients diagnosed with cancer have a high level of unmet needs, especially in terms of psychological support and medical information. Their caregivers also experience needs and concerns regarding the disease. Caregivers should be made aware of the health consequences of cancer and consider appropriate supportive care for their loved ones.

The number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: data from a multiethnic Latin American cohort

2014 ◽  
Vol 74 (6) ◽  
pp. 1019-1023 ◽  
Author(s):  
Manuel F Ugarte-Gil ◽  
Eduardo Acevedo-Vásquez ◽  
Graciela S Alarcón ◽  
Cesar A Pastor-Asurza ◽  
José L Alfaro-Lozano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Latin American ◽  
Lupus Erythematosus ◽  
Crossover Design ◽  
Systemic Lupus ◽  
Case Crossover ◽  
Damage Accrual ◽  
The Mean ◽  
Patients Experience

PurposeTo determine the association between the number of flares systemic lupus erythematosus (SLE) patients experience and damage accrual, independently of other known risk factors.MethodsSLE patients (34 centres, nine Latin American countries) with a recent diagnosis (≤2 years) and ≥3 evaluations were studied. Disease activity was ascertained with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and damage with the SLICC/ACR Damage Index (SDI). Flare was defined as an increase ≥4 points in the SLEDAI between two study visits. An ambidirectional case- crossover design was used to determine the association between the number of flares and damage accrual.Results901 patients were eligible for the study; 500 of them (55.5%) experienced at least one flare, being the mean number of flares 0.9 (SD: 1.0). 574 intervals from 251 patients were included in the case-crossover design since they have case and control intervals, whereas, the remaining patients did not. Their mean age at diagnosis was 27.9 years (SD: 11.1), 213 (84.9%) were women. The mean baseline SDI and SLEDAI were 1.3 (1.3) and 13.6 (8.1), respectively. Other features were comparable to those of the entire sample. After adjusting for possible confounding variables, the number of flares, regardless of their severity, was associated with damage accrual (SDI) OR 2.05, 95% CI 1.43 to 2.94, p<0.001 (OR 2.62, 95% CI 1.31 to 5.24, p=0.006 for severe and OR 1.91, 95% CI 1.28 to 2.83, p=0.001for mild-moderate).ConclusionsThe number of flares patients experience, regardless of their severity, increases the risk of damage accrual, independently of other known risk factors.

scholarly journals Discordance Rate of HER2 Status in Primary Gastric Carcinomas and Synchronous Lymph Node Metastases: A Multicenter Retrospective Analysis

2014 ◽  
Vol 15 (12) ◽  
pp. 22331-22341 ◽  
Author(s):  
Antonio Ieni ◽  
Valeria Barresi ◽  
Rosario Caltabiano ◽  
Alessia Caleo ◽  
Luca Bonetti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Retrospective Analysis ◽  
Lymph Node Metastases ◽  
Her2 Status ◽  
Gastric Carcinomas ◽  
Discordance Rate ◽  
Node Metastases

scholarly journals Simultaneous surgery for primary and nodes in carcinoma penis: a rural tertiary medical centre experience and results

2017 ◽  
Vol 4 (10) ◽  
pp. 3466
Author(s):  
Senthil Kumar A. C. ◽  
Rajesh S.
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Retrospective Analysis ◽  
Wound Infection Rate ◽  
Medical Centre ◽  
Previous Therapy ◽  
Simultaneous Surgery ◽  
Simultaneous Procedure ◽  
The Mean ◽  
Carcinoma Penis

Background: Historically surgery for nodes in carcinoma penis was done as staged procedure due to fear of higher morbidity and longer hospital stay. However, in view of the established safety of the simultaneous procedure, very few centres do simultaneous surgery for nodes and primary in cancer penis.Methods: A retrospective analysis of all the simultaneous surgeries for nodes and primary for carcinoma penis done at our hospital, during the period April 2015 to March 2017 were done and various parameters were calculated and compared with historical standards of various series.Results: The various parameters namely wound morbidity, hospital stay and complications were analysed and compared with historical standards. A total of 15 patients during the above mentioned were found to be suitable for the analysis after having excluded patients who had previous therapy and inoperable tumours. The mean follows up period was 12 months (ranging from 8 to 20 months). The mean hospital stay was 15 days (range from 12 days to 25 days). The skin margin necrosis rate was 6.67%, wound infection rate was 6.67% and there were no perioperative deaths. The same was compared with historical standards.Conclusions: Simultaneous surgery for primary and nodes in carcinoma penis is safe and the standard results are reproducible in a rural tertiary medical centre like ours.

scholarly journals Reduced global warming from CMIP6 projections when weighting models by performance and independence

2020 ◽  
Vol 11 (4) ◽  
pp. 995-1012
Author(s):  
Lukas Brunner ◽  
Angeline G. Pendergrass ◽  
Flavio Lehner ◽  
Anna L. Merrifield ◽  
Ruth Lorenz ◽  
...  
Keyword(s):  
Climate Change ◽  
Retrospective Analysis ◽  
Climate Models ◽  
Cmip5 Models ◽  
Future Climate Change ◽  
Historical Period ◽  
Climate Change Scenarios ◽  
Uncertainty Range ◽  
Future Warming ◽  
The Mean

Abstract. The sixth Coupled Model Intercomparison Project (CMIP6) constitutes the latest update on expected future climate change based on a new generation of climate models. To extract reliable estimates of future warming and related uncertainties from these models, the spread in their projections is often translated into probabilistic estimates such as the mean and likely range. Here, we use a model weighting approach, which accounts for the models' historical performance based on several diagnostics as well as model interdependence within the CMIP6 ensemble, to calculate constrained distributions of global mean temperature change. We investigate the skill of our approach in a perfect model test, where we use previous-generation CMIP5 models as pseudo-observations in the historical period. The performance of the distribution weighted in the abovementioned manner with respect to matching the pseudo-observations in the future is then evaluated, and we find a mean increase in skill of about 17 % compared with the unweighted distribution. In addition, we show that our independence metric correctly clusters models known to be similar based on a CMIP6 “family tree”, which enables the application of a weighting based on the degree of inter-model dependence. We then apply the weighting approach, based on two observational estimates (the fifth generation of the European Centre for Medium-Range Weather Forecasts Retrospective Analysis – ERA5, and the Modern-Era Retrospective analysis for Research and Applications, version 2 – MERRA-2), to constrain CMIP6 projections under weak (SSP1-2.6) and strong (SSP5-8.5) climate change scenarios (SSP refers to the Shared Socioeconomic Pathways). Our results show a reduction in the projected mean warming for both scenarios because some CMIP6 models with high future warming receive systematically lower performance weights. The mean of end-of-century warming (2081–2100 relative to 1995–2014) for SSP5-8.5 with weighting is 3.7 ∘C, compared with 4.1 ∘C without weighting; the likely (66%) uncertainty range is 3.1 to 4.6 ∘C, which equates to a 13 % decrease in spread. For SSP1-2.6, the weighted end-of-century warming is 1 ∘C (0.7 to 1.4 ∘C), which results in a reduction of −0.1 ∘C in the mean and −24 % in the likely range compared with the unweighted case.

scholarly journals Clinico-pathologic study of oral lesions in pediatric and adolescents in Sudan; a 7-years retrospective study

2021 ◽  
pp. 42-49
Keyword(s):  
Retrospective Study ◽  
Retrospective Analysis ◽  
Benign Lesion ◽  
Benign Tumors ◽  
Oral Lesions ◽  
Pathologic Study ◽  
Malignant Lesions ◽  
The Mean

Objective: This study aims to determine the incidence, age, gender, sites and histological patterns of pediatric and adolescent oral lesions in a Sudanese population. Methods: A 7-year (2011 to 2017) retrospective analysis of pediatric and adolescent oral lesions in children younger than 18 years was carried out in Prof Ahmed Sulieman histopathology laboratory at the faculty of dentistry, university of Khartoum Results: within the study period, there were 479 pediatric and adolescence patients. There was male predilection for the lesions (53.9%). The mean age was 11.59±4.219 years. The mandible (n=139, 29%), followed by the maxilla (n=131, 27%) were the most common sites. The benign tumors (n=181, 37.7%) the most common lesions, and ameloblastoma was the commonest benign lesion. Conclusion: the results of the current study are in agreement with those reported in the literature concerning the most prevalent lesions in the pediatric and adolescence population. Most lesions were benign, and malignant lesions comprise only a very small part of the sample.

scholarly journals Clinical, morphological, and molecular genetic predictors of metastatic lesions in the regional lymph nodes in breast cancer

2018 ◽  
Vol 5 (3) ◽  
pp. 8-16
Author(s):  
Yu. A. Dergunova ◽  
V. V. Podionov ◽  
V. K. Bozhenko ◽  
V. V. Kometova ◽  
M. V. Dardyk
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Molecular Genetic ◽  
Regional Lymph Nodes ◽  
Genetic Characteristics ◽  
Metastatic Lesions ◽  
Genetic Predictors ◽  
Node Metastases ◽  
High Degree

Despite the sufficient amount of data accumulated in the literature, there are still no factors, on the basis of which it would be possible to estimate the regional lymph nodes status in breast cancer with a high degree of accuracy. The review presents literature data relating to the influence of clinicopathological, molecular-biological and genetic characteristics of primary tumor on lymph node metastases. Data of 66 foreign and Russian articles are included.

scholarly journals A Randomised Controlled Trial on the Efficacy and Safety of Oral Ketamine in Neonatal Circumcision

2021 ◽  
Author(s):  
Victor Ifeanyichukwu Modekwe ◽  
Jideofor Okechukwu Ugwu ◽  
Okechukwu Hyginus Ekwunife ◽  
Andrew Nwankwo Osuigwe ◽  
Jideofor Chukwuma Orakwe ◽  
...  
Keyword(s):  
Placebo Group ◽  
Controlled Trial ◽  
Controlled Study ◽  
Categorical Variables ◽  
Paediatric Surgery ◽  
Peripheral Oxygen Saturation ◽  
Double Blind ◽  
Oral Ketamine ◽  
The Mean ◽  
Neonatal Circumcision

Introduction: Procedural analgesia use in neonatal circumcision is not widespread in the developing world. An easy-to-administer, adequate and safe analgesia will encourage usage in neonatal circumcision. Orally administered ketamine may prove effective and safe, and may encourage procedural analgesia use in neonatal circumcision. Aim: To determine the analgesic efficacy of oral ketamine in Plastibell® neonatal circumcision. Materials and Methods: A hospital based randomised double blind controlled study was conducted at the paediatric surgery unit of the hospital, from March 2015 to December 2015. Total 121 neonates were sequentially recruited, and randomised into two groups. Group A received oral ketamine, and Group B received plain syrup (placebo) as procedural analgesia. Continuous pulse oximeter monitoring was done before, during and immediately after the procedure. The pre-procedural and intra-procedural peripheral oxygen saturation (SpO2) and Pulse Rate (PR) were determined at the various stages. Also, the Neonatal Infant Pain Scale (NIPS) scores were assessed during the stages of the procedure. Differences in mean scores were analysed. Mann-Whitney U test and Independent t-test were used to compare means of continuous variable, while Fisher’s exact test was used to compare categorical variables. Significance was set at p<0.05. Results: Sixty-one neonates received oral ketamine, while 60 received placebo. The intraoperative mean SpO2 were lower in the placebo group and significant at the tying stage with p=0.022. The mean intraoperative PR was higher in the placebo group and significant at dorsal-slit, tying and excision stages (p<0.05). The mean intraoperative NIPS scores were significantly higher in the placebo group. Conclusion: Oral ketamine provides effective and safe analgesia for neonatal Plastibell® circumcision in comparison to placebo.

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