De-implementation of Urinary Catheters in Neurosurgical Patients During the Operation and on the Ward: a Mixed-methods Study Protocol

BackgroundIndwelling urinary catheters (IDUCS) are frequently routinely inserted during transsphenoidal pituitary gland tumour surgery or spinal fusion surgery despite literature stating that there are no indications for using IDUCS during or after these surgeries. The aim of the study is to reduce the number of inappropriately inserted IDUCs in during or after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery with an operation time of <4 hours. Methods A pragmatic, before-and-after mixed-methods observational study including medical chart analysis, satisfaction surveys with patients and healthcare professionals and multidisciplinary group interviews to assess the effectiveness of and experiences with various non-invasive de-implementation strategies aimed to decrease the number of inappropriate IDUCS inserted during and after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery in a multicentre context. Discussion This paper presents the study protocol of a multi-centred before and after trial that aims to reduce inappropriate IDUC use after transsphenoidal pituitary gland tumour surgery and spinal fusion surgery, and thereby reducing UTIs, shortening hospital stay and increasing patient comfort. The results can be used to de-implement IDUCs after a broad range of surgeries on several wards.Trial registration The study has been submitted to the Dutch Trial Register (NTR).

Adenoid cystic carcinoma of nasal septum: A review of literature

Adenoid cystic carcinoma(ACC) is a common salivary gland tumour which constitutes about 10% of all salivary gland malignancies and 1% of all head & neck malignancies. It is a slow growing tumour with propensity for perineural invasion., It occurs most commonly in minor salivary glands, most commonly in oral cavity. It is the third most common malignancy of paranasal sinuses with most common site being maxillary sinus followed by nasal cavity, nasopharynx and ethmoid sinus. It is most commonly seen in 4 and 5 decade with female predominance. ACC arising from nasal septum is very rare with only 10 cases published in literature. In this paper we present a case of nasal septal adenoid cystic carcinoma with review of the literature.

Anti-tumor effects of rivoceranib against canine melanoma and mammary gland tumour in vitro and in vivo mouse xenograft models

Background Rivoceranib, a novel tyrosine kinase inhibitor, exhibits anti-tumour effects by selectively blocking vascular endothelial growth factor receptor-2 (VEGFR2) in cancer cells. Recently, the therapeutic effects of rivoceranib on solid tumours have been elucidated in human patients. However, the anti-tumour effects of rivoceranib against canine cancer remain unclear. Here, we investigated the anti-tumour effects of rivoceranib using in vitro and in vivo mouse xenograft models. Methods We performed cell proliferation, cell cycle, and migration assays to determine the effects of rivoceranib on canine solid tumour cell lines in vitro. Furthermore, apoptosis and angiogenesis in tumour tissues were examined using a TUNEL assay and immunohistochemistry methods with an anti-cluster of differentiation-31 antibody, respectively. Additionally, the expression levels of cyclin-D1 and VEGFR2 activity were determined using western blot analysis. Results Rivoceranib treatment showed anti-proliferative effects and mediated cell cycle arrest in the canine melanoma cell line (LMeC) and the mammary gland tumour (MGT) cell line (CHMp). In animal experiments, rivoceranib decreased the average volume of LMeC cells compared to that following control treatment, and similar results were observed in CHMp cells. Histologically, rivoceranib induced apoptosis and exerted an anti-angiogenic effect in tumour tissues. It also downregulated the expression of cyclin-D1 and inhibited VEGFR2 activity. Conclusion Our results show that rivoceranib inhibits proliferation and migration of tumour cells. These findings support the potential application of rivoceranib as a novel chemotherapeutic strategy for canine melanoma and MGTs.

Diagnosis and analysis of a sebaceous gland tumour of the external acoustic meatus in a Cocker Spaniel dog

Sebaceous gland tumour (SGT) is a rare tumour with a low incidence rate, which mainly occurs in the eyelid and periocular sebaceous gland. In 2019, our laboratory received a case involving a sebaceous gland tumour of the external auditory meatus for pathological diagnosis. It is a rare malignant tumour in the whole body. Data regarding a sebaceous gland tumour in the dogís external auditory meatus are few. This case is instructive for veterinary diagnosis and treatment. The dog recovered well after surgery at the outpatient department, and no recurrence was observed in the follow-up visit one year later. This study will help the identification of SGT in Spaniel dogs.

Salivary gland tumours: a hospital-based study on demographic and incidence pattern, histopathological types and treatment strategy

<p><strong>Background: </strong>Salivary gland tumours constitute 3-4% of all head and neck cancers (mostly benign). These tumours are epithelial (95%) or mesenchymal in origin. Pleomorphic adenoma is the most common benign salivary gland tumour and mucoepidermoid carcinoma (45%) is the most common malignant salivary gland tumour followed by adenoid cystic carcinoma (30%). The parotid, submandibular and the minor salivary glands of palate are commonly involved and the sublingual gland is rarely affected.</p><p><strong>Methods: </strong>Hospital based cross sectional study was done in a tertiary care centre during a period of 1 year, which included 21 patients (10 men and 11 women). Patients were analysed according to age, gender, food habits, histopathological type and site of the tumour and treatment strategy.</p><p><strong>Results: </strong>All the cases were from upper Assam province sharing a particular demographic pattern between 19-65 years. Peak incidence in males was fourth decade and females was third decade. Male female ratio was 0.9:1. Out of 21 cases, 14 were parotid gland tumours, 6 submandibular gland tumours and 1 minor salivary gland tumour. Most of the tumours were benign (16) and 5 were malignant.</p><p><strong>Conclusions: </strong>Two patients were of age 19 years which is conflicting the normal national incidence. All cases belonged to lower economic strata with decreased intake of beta carotene enriched food items. The most common site is parotid gland and most common tumour is pleomorphic adenoma which is in accordance to other studies. Benign cases were subjected to superficial parotidectomy and malignant cases to total parotidectomy with neck dissection.</p>