Contralateral hemopneumothorax after penetrating thoracic trauma: A case report

paythelady.612 shared this article with you from Inoreader Contralateral hemopneumothorax after penetrating thoracic trauma: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3773-3778. doi: 10.12998/wjcc.v9.i15.3773. ABSTRACT BACKGROUND: Trauma is the leading cause of death in young adults up to the age of 45 years. Hemothorax is a frequent consequence of penetrating thoracic trauma, and is usually associated with pneumothorax and pneumoderma. Intercostal arterial bleeding or intrathoracic hemorrhage occurs after penetrating thoracic trauma, and uncontrolled bleeding is the main cause of death. CASE SUMMARY: In this case report, a patient who developed a right hemopneumothorax after penetrating thoracic trauma was examined. A 19-year-old male patient, who was brought to the emergency room with a penetrating stab injury to the posterior of the left hemithorax, was diagnosed with a right hemopneumothorax after physical examination and thoracic imaging. Chest tube thoracostomy was performed as the initial intervention. Bleeding control was achieved with right poster olateral thoracotomy in the patient, who developed massive hemorrhage after 1 h and hemodynamic instability. The patient recovered and was discharged on the fourth postoperative day. CONCLUSION: Contralateral hemopneumothorax that accounts for 30% of thoracic traumas and can be encountered in penetrating thoracic traumas requiring major surgery in 15-30% of cases was emphasized and the contralateral development mechanism was addressed. PMID:34046482 | PMC:PMC8130084 | DOI:10.12998/wjcc.v9.i15.3773 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Subchondral bone as a novel target for regenerative therapy of osteochondritis dissecans: A case report

paythelady.612 shared this article with you from Inoreader Subchondral bone as a novel target for regenerative therapy of osteochondritis dissecans: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3623-3630. doi: 10.12998/wjcc.v9.i15.3623. ABSTRACT BACKGROUND: Osteochondritis dissecans (OCD) is a rare disease of unclear cause characterized by subchondral bone damage and overlying cartilage defects. The current report presents the results of subchondral bone as a novel target for implantation of peripheral blood stem cells (PBSCs) in the treatment of OCD. CASE SUMMARY: A 16-year-old patient diagnosed with OCD underwent subchondral bone implantation of PBSCs. Four months later, the patient's visual analog scale scores, Western Ontario and McMaster University osteoarthritis index, and whole-organ magnetic resonance imaging score improved significantly, and regeneration of cartilage and subchondral bone was observed on magnetic resonance imaging. CONCLUSION: This is the first case of OCD treated with subchondral bone as an implantation target of PBSCs, which highlights the importance of subchondral bone for cartilage repair. This treatment could be a potential option for articular cartilage and subchondral bone recovery in OCD. PMID:34046461 | PMC:PMC8130072 | DOI:10.12998/wjcc.v9.i15.3623 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral posterior scleritis presenting as acute primary angle closure: A case report

paythelady.612 shared this article with you from Inoreader Bilateral posterior scleritis presenting as acute primary angle closure: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3779-3786. doi: 10.12998/wjcc.v9.i15.3779. ABSTRACT BACKGROUND: Scleritis is a rare disease and the incidence of bilateral posterior scleritis is even rarer. Unfortunately, misdiagnosis of the latter is common due to its insidious onset, atypical symptoms, and varied manifestations. We report here a case of bilateral posterior scleritis that presented with acute eye pain and intraocular hypertension, and was initially misdiagnosed as acute primary angle closure. Expanding the literature on such cases will not only increase physicians' awareness but also help to improve accurate diagnosis. CASE SUMMARY: A 53-year-old man was referred to our hospital to address a 4-d history of bilateral acute eye pain, headache, and loss of vision, after initial presentation to a local hospital 3 d prior. Our initial examination revealed bilateral cornea edema accompanied by a shallow anterior chamber and visu al acuity reduction, with left-eye amblyopia (> 30 years). There was bilateral hypertension (by intraocular pressure: 28 mmHg in right, 34 mmHg in left) and normal fundi. Accordingly, acute primary angle closure was diagnosed. Miotics and ocular hypotensive drugs were prescribed, but the symptoms continued to worsen over the 3-d treatment course. Further imaging examinations (i.e., anterior segment photography and ultrasonography) indicated a diagnosis of bilateral posterior scleritis. Methylprednisolone, topical atropine, and steroid eye drops were prescribed along with intraocular pressure-lowering agents. Subsequent optical coherence tomography (OCT) showed gradual improvements in subretinal fluid under the sensory retina, thickened sclera, and ciliary body detachment. CONCLUSION: Bilateral posterior scleritis can lead to secondary acute angle closure. Diagnosis requires ophthalmic accessory examinations (i.e., ultrasound biomicroscopy, B-scan, and OCT). PMID:34046483 | PMC:PMC8130077 | DOI:10.12998/wjcc.v9.i15.3779 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Critical prognostic value of the log odds of negative lymph nodes/tumor size in rectal cancer patients

paythelady.612 shared this article with you from Inoreader Critical prognostic value of the log odds of negative lymph nodes/tumor size in rectal cancer patients Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 May 26;9(15):3531-3545. doi: 10.12998/wjcc.v9.i15.3531. ABSTRACT BACKGROUND: The number of negative lymph nodes (NLNs) and tumor size are associated with prognosis in rectal cancer patients undergoing surgical resection. However, little is known about the prognostic significance of the NLN count after adjusting for tumor size. AIM: To assess the prognostic impact of the log odds of NLN/tumor size (LONS) in rectal cancer patients. METHODS: Data of patients with stage I-III rectal cancer were extracted from the Surveillance, Epidemiology, and End Results Program database. These patients were randomly divided into a training cohort and a validation cohort. Univariate and multivariate Cox regression analyses were used to determine the prognostic value of the LONS. The optimal cutoff values of LONS were calculated using the "X-tile" program. Stratified analysis of the effect of LONS on cancer-specific su rvival (CSS) and overall survival (OS) were performed. The Kaplan-Meier method with the log-rank test was used to plot the survival curve and compare the survival data among the different groups. RESULTS: In all, 41080 patients who met the inclusion criteria were randomly divided into a training cohort (n = 28775, 70%) and a validation cohort (n = 12325, 30%). Univariate and multivariate analyses identified the continuous variable LONS as an independent prognostic factor for CSS [training cohort: Hazard ratio (HR) = 0.47, 95% confidence interval (CI): 0.44-0.51, P < 0.001; validation cohort: HR = 0.46, 95%CI: 0.41-0.52, P < 0.001] and OS (training cohort: HR = 0.53, 95%CI: 0.49-0.56, P < 0.001; validation cohort: HR = 0.52, 95%CI: 0.42-0.52, P < 0.001). The X-tile program indicated that the difference in CSS was the most significant for LONS of -0.8, and the cutoff value of -0.4 can further distinguish patients with a bette r prognosis in the high LONS group. Stratified analysis of the effect of the categorical variable LONS on CSS and OS revealed that LONS was also an independent predictor, independent of pN stage, pT stage, tumor-node-metastasis stage, site, age, sex, the number of examined lymph nodes, race, preoperative radiotherapy and carcinoembryonic antigen level. CONCLUSION: LONS is associated with improved survival of rectal cancer patients independent of other clinicopathological factors. PMID:34046453 | PMC:PMC8130081 | DOI:10.12998/wjcc.v9.i15.3531 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of the Treatment of Rhinogenic Headache Caused by Intranasal Contact

xlomafota13 shared this article with you from Inoreader Effectiveness of the Treatment of Rhinogenic Headache Caused by Intranasal Contact Via ear nose throat Ear Nose Throat J. 2021 Jun 2:1455613211019706. doi: 10.1177/01455613211019706. Online ahead of print. ABSTRACT OBJECTIVES: The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical treatment of headache caused by contact points (CPs) between the nasal septum and inferior or middle turbinate. METHODS: The research was designed as a prospective clinical case-series study. The patients with CP headaches were offered to choose between 2 treatme nt options, surgery and medical treatment. Two groups of surgically treated patients (surgery groups 1 and 2, depending on whether there is a contact between nasal septum and inferior turbinate or middle turbinate) were evaluated and compared for headache intensity and frequency. Headache intensity was measured using a visual analog scale value from 0 to 10; the frequency of headache was expressed as the number of days during 1 month with a headache (before surgery, 1 month, and 6 months after surgery). A comparison was also made between surgically and nonsurgically treated patients. RESULTS: We found more intensive and frequent headache in patients who had CP between the nasal septum and the middle turbinate (P = .038 and P = .003, respectively). A significant reduction in headache intensity and frequency was found in both groups of surgically treated patients 6 months after surgery; however, this reduction was more significant in patients with mucosal contact b etween nasal septum and middle turbinate. The nonsurgical treatment made a significant reduction of headache intensity and frequency at 1-month follow-up (P = .012 and P = .031, respectively), but not at 6-month follow-up (P = .114 and P = .088, respectively). CONCLUSION: Surgery gave a statistically significant reduction in the intensity and frequency of headache, which was assessed 6 months after surgery. Surgery was found as superior to nonsurgical treatment in the therapy of CP headache. PMID:34077274 | DOI:10.1177/01455613211019706 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Phase II randomized study of preoperative calcitriol to prevent hypocalcemia following thyroidectomy

xlomafota13 shared this article with you from Inoreader Phase II randomized study of preoperative calcitriol to prevent hypocalcemia following thyroidectomy Via Head & Neck Abstract Background A prospective, stratified, randomized, double-blind, placebo-controlled study was conducted to observe the impact of preoperative calcitriol supplementation on serum calcium levels following total thyroidectomy. Methods Subjects were randomized 1:1 to receive 1 μg calcitriol or placebo for 1 week preceding thyroidectomy. The primary outcome measure was change in serum calcium from baseline to 18 h post-thyroidectomy. Subjects were also assessed for incidence of symptomatic hypocalcemia, length of stay, readmission for hypocalcemia, and intravenous calcium supplementation. Results Forty-seven patients underwent thyroidectomy; 23 received preoperative calcitriol supplementation, and 24 received placebo. Repeated measures regression demonstrated no difference in postoperative serum calcium over time (p = 0.22). There were no occurrences of hypocalcemia, intravenous calcium supplementation, or readmission in either group. No difference was observed in length of stay (p = 0.38). One patient in the calcitriol group developed Grade 3 hypercalcemia. Conclusions Preoperative calcitriol supplementation had no impact on postoperative serum calcium levels compared to placebo. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Objective Evaluation of Technical Dexterity in Robotic Hepaticojejunostomy: Assessment of HPB Fellows Using Cumulative Sum (CUSUM) Analytics

xlomafota13 shared this article with you from Inoreader Objective Evaluation of Technical Dexterity in Robotic Hepaticojejunostomy: Assessment of HPB Fellows Using Cumulative Sum (CUSUM) Analytics Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background The development of technical dexterity is a critical for surgeons in training. This study describes and assesses the feasibility of an objective method for the evaluation of procedure-specific technical dexterity in hepatopancreatobiliary (HPB) surgery using cumulative sum (CUSUM) analysis. Methods Dry-lab HPB procedures were divided into procedural steps with binary outcomes (success or failure). Two HPB fellows completed 20 dry lab hepaticojejunostomy procedures. Participant progress was tracked over time with CUSUM analytics to establish a learning curve for procedural proficiency. Results The CUSUM charts for 20 consecutive dry-lab hepaticojejunostomy procedures were analyzed. A learning curve was created and used to identify areas of weakness to facilitate improvement in technical proficiency. Conclusions CUSUM is effective tool for objective evaluation of technical dexterity offering both simplicity and adaptability. We demonstrate its use and feasibility for surgical education and plan to expand its' application to assess residents performing general surgery procedures. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Robot‐assisted Kidney Transplantation Is a Safe Alternative Approach for Morbidly Obese Patients with End‐stage Renal Disease

xlomafota13 shared this article with you from Inoreader Robot‐assisted Kidney Transplantation Is a Safe Alternative Approach for Morbidly Obese Patients with End‐stage Renal Disease Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Many centers deny obese patients with a body mass index (BMI) >35 access to kidney transplantation due to increased intraoperative and postoperative complications. Methods From August 2017 to December 2019, 73 consecutive cases of kidney transplantation in morbidly obese patients were enrolled at a single university at the initiation of a robotic transplant surgery program. Outcomes of patients who underwent robotic assisted kidney transplant (RAKT) were compared to frequency-matched patients undergoing open kidney transplant (OKT). Results A total of 24 morbidly obese patients successfully underwent RAKT, and 49 obese patients received an OKT. The RAKT group developed fewer surgical site infections (SSI) than the OKT group. Graft function, creatinine, and glomerular filtration rate (GFR) were similar between groups 1 year after surgery. Graft and patient survival were 100% for both groups. Conclusions RAKT offers a safe alternative for morbidly obese patients, who may otherwise be denied access to OKT. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidence of Anosmia among Covid 19 patients in India

xlomafota13 shared this article with you from Inoreader Incidence of Anosmia among Covid 19 patients in India Via Otolaryngology Indian Abstract The pandemic COVID-19 has relentlessly caused havoc to human life since its outbreak in December 2019. The disease has been a challenge for all. The clinical manifestations of Covid-19 ranges from no symptoms at all to severe acute respiratory distress syndrome. Anosmia being one of the important clinical features of COVID-19 has always been overlooked by the Indian population. This formed the background for this study. Aim To identify the incidence of anosmia reported in COVID- 19 patients in India. Materials and Methods Literature search was carried out from January 2020 to March 2021 in databases like PUBMED and Google Scholar using the key words "ANOSMIA", "HYPOSMIA" and "OLFACTORY DYSFUNCTION" in conjunction with "COVID-19", "SARS-COV-2", and "CORONAVIRUS". Boolean operators were used to narrow and broaden the search. The search yielded sixteen eligible articles. Result The scrutiny of the 16 articles reveal ed an incidence range of anosmia from 9.2% to 82% and an average anosmia incidence rate of 30.19%. The cumulative incidence rate of anosmia in those studies where objective analysis was done is 52.2% and 16.4% for subjective analysis. Discussion The prevalence of anosmia in Indian population is found to be much lesser than that reported by European countries due to ethnicity or negligence. Objective evaluation of anosmia in COVID-19 patients increases the incidence of anosmia drastically. Hence objective evaluations such as UPIST, SNIFFING STICK test, etc. is to be promoted. This study also Emphasises the lack of common gold standard testing for olfaction like vision and hearing. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A novel scoring system based on small vestibular schwannomas to determine consideration for cochlear implantation

xlomafota13 shared this article with you from Inoreader A novel scoring system based on small vestibular schwannomas to determine consideration for cochlear implantation Via Clinical Otolaryngology Abstract Simultaneous translabyrinthine tumor resection and cochlear implantation is a promising treatment method with hearing rehabilitation for sporadic vestibular schwannomas. Size of vestibular schwanomma, distance to modiolus, residual hearing and promontory stimulation electrical brainstem response audiometry are important preoperative predictive factors for determining a positive post tumour resection electrically evoked auditory brain stem response. The presence of an electrically evoked auditory brain stem response with an intracochlear test electrode after tumour resection was used to determine whether a patient received a cochlear implant Positive electrically evoked auditory brain stem responses measured with an intracochlear test electrode after tumour resection seem to correlate well with auditory perception with a cochlear implant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Locoregional Recurrence in p16‐Positive Oropharyngeal Squamous Cell Carcinoma After TORS

xlomafota13 shared this article with you from Inoreader Locoregional Recurrence in p16‐Positive Oropharyngeal Squamous Cell Carcinoma After TORS Via The Laryngoscope Objective To analyze the patterns, risk factors, and salvage outcomes for locoregional recurrences (LRR) after treatment with transoral robotic surgery (TORS) for HPV-associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC). Study Design Retrospective analysis of HPV+ OPSCC patients completing primary TORS, neck dissection, and NCCN-guideline-compliant adjuvant therapy at a single institution from 2007 to 2017. Methods Features associated with LRR, detailed patterns of LRR, and outcomes of salvage therapy were analyzed. Disease-free survival (DFS) and overall survival (OS) were calculated for subgroups of patients receiving distinct adjuvant treatments. Results Of 541 patients who completed guideline-indicated therapy, the estimated 5-year LRR rate was 4.5%. There were no identifiable clinical or pathologic features associated with LRR. Compared to patients not receiving adjuvant therapy, those who received indicated adjuvant radiation alone had a lower risk of LRR (HR 0.28, 95% CI [0.09–0.83], P = .023), but there was no difference in DFS (P = .21) and OS (P = .86) between adjuvant therapy groups. The 5-year OS for patients who developed LRR was 67.1% vs. 93.9% for those without LRR (P < .001). Patients who initially received adjuvant chemoradiation and those suffering local, in-field, and/or retropharyngeal node recurrences had decreased disease control after salvage therapy. Conclusion LRR rates are low for HPV+ OPSCCs completing TORS and guideline-compliant adjuvant therapy. Patients without indication for adjuvant therapy more often suffer LRR, but these recurrences are generally controllable by salvage therapy. Improved understanding of the patterns of recurrence most amenable to salvage therapy may guide treatment decisions, counseling, and adjuvant therapy de-escalation trials. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.