THE EDUCATIONAL PROGRAMS OF BLOOD TRANSFUSIONTHERAPY FOR MEDICAL DOCTORS: THE ROLE OF HIROSAKI UNIVERSITY HOSPITAL AND AOMORI PREFECTURAL JOINT COMMITTEE OF BLOOD TRANSFUSION

(1) Background: Anaemia is a common finding in patients with colon cancer and is commonly corrected by blood transfusion prior to surgery. However, the prognostic role of perioperative transfusions is still debated. The aim of the present study was to investigate the role of preoperative anaemia and preoperative blood transfusion in influencing the prognosis in colon cancer. (2) Patients and Methods: Patients undergoing elective surgery for colon cancer at a tertiary referral university hospital between January 2010 and December 2018 were included in a retrospective review of a prospectively collected database. Univariate and regression analyses were performed to identify the prognostic role of preoperative anaemia and preoperative transfusions in this homogeneous cohort of patients. (3) Results: A total of 780 patients were included in the final analysis. The estimated five-year overall survival rate was significantly worse in the anaemic group (83.8% in non-anaemic patients, 60.6% in mild anaemic patients, 61.3% in moderate anaemic patients and 58.4% in severe anaemic patients; log-rank < 0.001 vs. non-anaemic patients). Anaemic status was found to be an independent adverse prognostic factor (hazard ratio (HR): 1.46; 95% confidence interval (CI): 1.02–2.07) during multivariate analysis. Among moderate to severe anaemic patients, no significant association was found between preoperative transfusions and the risk of mortality or recurrence. (4) Conclusions: Preoperative anaemia, regardless of its severity, and not preoperative blood transfusion, was independently associated with a worse prognosis after surgery in patients with colonic cancer.

Download Full-text

The role of diabetic educational programs in glycemic control in patients attending to our day hospital

Endocrine Abstracts ◽

10.1530/endoabs.49.ep623 ◽

2017 ◽

Author(s):

Mariana Tome ◽

Pinillos Guillermo Martinez de ◽

Fernando Garcia ◽

Eyvee Arturo Cuellar ◽

Ignacio Fernandez ◽

...

Keyword(s):

Glycemic Control ◽

Educational Programs ◽

Day Hospital

Download Full-text

Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200089 ◽

2020 ◽

Vol 78 (8) ◽

pp. 494-500 ◽

Cited By ~ 4

Author(s):

Adalberto STUDART-NETO ◽

Bruno Fukelmann GUEDES ◽

Raphael de Luca e TUMA ◽

Antonio Edvan CAMELO FILHO ◽

Gabriel Taricani KUBOTA ◽

...

Keyword(s):

Neurological Diseases ◽

Neuromuscular Disorders ◽

Neurological Symptoms ◽

University Hospital ◽

Special Treatment ◽

Nasal Swabs ◽

Neurological Exam ◽

Neurological Conditions ◽

De Medicina

ABSTRACT Background: More than one-third of COVID-19 patients present neurological symptoms ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing neurological conditions may require special treatment and may be associated with worse outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably underrecognized. Objective: The aim of this study was to report the reasons for requesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists performed the neurological exam, assessed all available data to diagnose the neurological condition, and requested additional tests deemed necessary. Difficult diagnoses were established in consensus meetings. After diagnosis, neurologists were involved in the treatment. Results: Neurological consultations were requested for 89 out of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most neurological consultations in a COVID-19-dedicated hospital were requested for severe conditions that could have an impact on the outcome. First-line doctors should be able to recognize neurological symptoms; neurologists are important members of the medical team in COVID-19 hospital care.

Download Full-text

The role of blood inflammatory markers in the diagnosis of appendicitis in children: a prospective study from a University Hospital in Greece

Gazzetta Medica Italiana Archivio per le Scienze Mediche ◽

10.23736/s0393-3660.18.03636-7 ◽

2020 ◽

Vol 178 (11) ◽

Author(s):

George Sakellaris ◽

Dimitra Dimopoulou ◽

Maria Niniraki ◽

Anastasia Dimopoulou ◽

Athanasios Alegakis ◽

...

Keyword(s):

Prospective Study ◽

Inflammatory Markers ◽

University Hospital ◽

A Prospective Study

Download Full-text

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.851 ◽

2019 ◽

pp. 1

Author(s):

Ayse Filiz Gokmen Karasu ◽

Seda Ates ◽

Tugba Gurbuz ◽

Nurhan Sahin ◽

Taha Takmaz ◽

...

Keyword(s):

Endometrial Thickness ◽

Transvaginal Ultrasound ◽

Thickness Measurement ◽

University Hospital ◽

Postmenopausal Bleeding ◽

Pathological Study ◽

Endometrial Polyps ◽

Endometrial Sampling ◽

Proliferative Endometrium

Objective: We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.Study Design: This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&C (dilatation & curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.Results: Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient groupConclusion: Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.

Download Full-text

Coagulopathy and its effect on treatment and mortality in patients with traumatic intracranial hemorrhage

Acta Neurochirurgica ◽

10.1007/s00701-021-04808-0 ◽

2021 ◽

Author(s):

Janne Kinnunen ◽

Jarno Satopää ◽

Mika Niemelä ◽

Jukka Putaala

Keyword(s):

Intracranial Hemorrhage ◽

Multivariable Analysis ◽

International Normalized Ratio ◽

University Hospital ◽

Lower Mortality ◽

Traumatic Intracranial Hemorrhage ◽

Hemorrhage Volume ◽

Anticoagulant Medication ◽

Admission Glasgow Coma Scale

Abstract Background The role of coagulopathy in patients with traumatic brain injury has remained elusive. In the present study, we aim to assess the prevalence of coagulopathy in patients with traumatic intracranial hemorrhage, their clinical features, and the effect of coagulopathy on treatment and mortality. Methods An observational, retrospective single-center cohort of consecutive patients with traumatic intracranial hemorrhage treated at Helsinki University Hospital between 01 January and 31 December 2010. We compared clinical and radiological parameters in patients with and without coagulopathy defined as drug- or disease-induced, i.e., antiplatelet or anticoagulant medication at a therapeutic dose, thrombocytopenia (platelet count < 100 E9/L), international normalized ratio > 1.2, or thromboplastin time < 60%. Primary outcome was 30-day all-cause mortality. Logistic regression analysis allowed to assess for factors associated with coagulopathy and mortality. Results Of our 505 patients (median age 61 years, 65.5% male), 206 (40.8%) had coagulopathy. Compared to non-coagulopathy patients, coagulopathy patients had larger hemorrhage volumes (mean 140.0 mL vs. 98.4 mL, p < 0.001) and higher 30-day mortality (18.9% vs. 9.7%, p = 0.003). In multivariable analysis, older age, lower admission Glasgow Coma Scale score, larger hemorrhage volume, and conservative treatment were independently associated with mortality. Surgical treatment was associated with lower mortality in both patients with and without coagulopathy. Conclusions Coagulopathy was more frequent in patients with traumatic intracranial hemorrhage presenting larger hemorrhage volumes compared to non-coagulopathy patients but was not independently associated with higher 30-day mortality. Hematoma evacuation, in turn, was associated with lower mortality irrespective of coagulopathy.

Download Full-text

The Prognostic Role of LRIG Proteins in Endometrial Cancer

Cancers ◽

10.3390/cancers13061361 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1361

Author(s):

Zoia Razumova ◽

Husam Oda ◽

Igor Govorov ◽

Eva Lundin ◽

Ellinor Östensson ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Prognostic Factor ◽

Confidence Interval ◽

Initial Study ◽

Surface Proteins ◽

University Hospital ◽

Study Cohort ◽

Risk Of Death

Endometrial cancer (EC) is the most common gynecologic malignancy in Sweden and it has various prognostic factors. The LRIG family is a group of three integral surface proteins with a similar domain organization. The study aimed to explore LRIG family as prognostic factor proteins in EC. The initial study cohort included 100 women with EC who were treated at the Department of Women’s and Children’s Health, Karolinska University Hospital Solna, between 2007 and 2012. We assessed the associations between LRIG protein expression and type, grade, and stage of EC, as well as progression-free and overall survival. Immunohistochemistry results revealed that most women in the analytical sample had >50% LRIG1-, LRIG2- and LRIG3-positive cells. A statistically significant association was observed between having a high number of LRIG3-positive cells and superior overall survival (incidence rate ratio = 0.977; 95% confidence interval: 0.958–0.996, p = 0.019). Moreover, positive LRIG3 staining of the cell membrane was associated with reducing in the risk of death (hazard ratio = 0.23; 95% confidence interval: 0.09–0.57). Our results show that LRIG3 expression might be a prognostic factor in EC. The role of LRIG1 and LRIG2 expression remains to be further investigated.

Download Full-text