Diagnosis And Management
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Amanda Regio Pereira ◽  
Pascale Guitera ◽  
Peter M Ferguson ◽  
Sydney Ch’ng ◽  
Sergio Hirata

Aishwarya Ullal ◽  
Arun P. Ajith

<p class="abstract">Presentations of Sino nasal lesions may be indistinguishable and therefore represent diagnostic and therapeutic dilemma due similarities of non-neoplastic and neoplastic lesions at initial presentation may lead to a significant delay in the diagnosis. This case series has been reported to through light on four different case scenarios that presented to us, their diagnosis and management. This was a case series of four unusual cases of the sinonasal and sinoorbital region that presented with symptoms of nasal obstruction, rhinnorhea, epistaxis, radiological and diagnostic nasal endoscopy was performed. Using functional endoscopic sinus surgery and lynch Howarth method the lesions were excised. As sino nasal and sinoorbital lesions present with similar clinical features accurate diagnostic procedures such as nasal endoscopy and radiological investigations, histopathological investigations play an important role in the management of the lesions.  </p>

2021 ◽  
Vol 8 ◽  
Giv Heidari-Bateni ◽  
Jean-Bernard Durand ◽  
Cezar Iliescu ◽  
Greg Gladish ◽  
Anita Deswal ◽  

Objectives: To assess the clinical impact of Cardiovascular Magnetic Resonance (CMR) in clinical decision making of cancer patients with a suspected cardiomyopathy in a tertiary cancer center.Background: Cardiomyopathies of diverse etiologies are frequently encountered in a Cardio-Oncology practice. The clinical impact of CMR after a presumptive diagnosis of cardiomyopathy has not been studied in cancer patients.Methods: We reviewed data on cancer patients with presumptive diagnosis of cardiomyopathy who underwent CMR in a tertiary cancer center. The clinical impact of CMR was defined as either change in clinical diagnosis or management post CMR results. Univariate and multivariate logistic regression models were used to assess whether any of the baseline characteristics were predictive of the clinical impact of CMR.Results: A total of 110 consecutive patients were identified. Clinical impact of CMR was seen in 68 (62%) patients. Change in the clinical diagnosis and management was seen in 56 (51%) and 41 (37%) of patients, respectively. The most common change was prevention of endomyocardial biopsy in 26 patients (24%). Overall, patients with higher left ventricular ejection fraction (LVEF) by echocardiography (echo), clinical impact was influenced more by CMR (LVEF of 37.2 ± 12.3% vs. 51.5 ± 11.6%, p &lt; 0.001). Cancer diagnosis of multiple myeloma was associated with change in the management post CMR (adjusted OR of 25.6, 95% CI 4.0–162.4, p = 0.001). Suspicion of infiltrative cardiomyopathy was associated with a higher likelihood of change in diagnosis. Having an LVEF≥40 by echo was associated with change in diagnosis and management by CMR.Conclusions: Utilization of CMR has a significant clinical impact in cancer patients with suspected cardiomyopathy. Patients with cancer diagnosis of multiple myeloma, suspicion of infiltrative cardiomyopathy and those with higher LVEF by echo seem to benefit more from CMR.

2021 ◽  
Vol 27 (5) ◽  
pp. 366-369
TT Chan ◽  
William CY Leung ◽  
CK Chan ◽  
Heinz KT Lo ◽  
Winnie WY Tso ◽  

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 956
Francesca Destro ◽  
Anna Maria Caruso ◽  
Cecilia Mantegazza ◽  
Luciano Maestri ◽  
Milena Meroni ◽  

Children with intellectual disability/neurodevelopmental delay (ID-ND) commonly ingest foreign bodies (FB) and often present complications due to peculiar aspects of their condition. The aim of this paper is to report the experience of two centers in the management of ID-ND patients after FB ingestion and to discuss a possible algorithm for clinical practice. We retrospectively evaluated data of patients managed for FB ingestion (period: 2017–2021), focusing on those with ID-ND, specifically demographics and baseline diagnosis, elements related to the event, symptoms, time to endoscopy, FB location, endoscopic details, and follow-up. A total of 457 patients were managed in the study period and 19 had ID-ND (mean age 9.8 ± 3.5 years, 15 males). A total of 16/19 (84.2%) were symptomatic and required an operative approach. Recurrent ingestions and multiple FB were found in 2 and 11 patients, respectively. Endoscopy (mean time 65.6 ± 41 min) was effective in 14 cases (73.6%) and 6 patients (31.6%) developed a complication. FB ingestion in ID-ND patients represents a challenging condition for the clinician and a potentially dangerous situation. It should be addressed specifically by a multidisciplinary team considering a tailored diagnostic and management protocol.

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