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Christiane Ermina Sophia Rudolph, Alexander Katalinic
AIM: Vaccines against human papillomaviruses are covered by statutory health insurances in Germany since March 2007. A reduction of cervical and other HPV-associated cancers is expected. Incidence rates of HPV-associated cancers preceding the introduction of vaccines are unknown. These, however, are important for assessing the effects of HPV vaccines. The aim of the present study was to bridge this knowledge gap. METHODS: Based on cancer registry data from seven federal states, average yearly incidence rates for cervical, anogenital, oropharyngeal cancers and cancers of the oral cavity were calculated for the period 2003 to 2007...
June 22, 2018: Das Gesundheitswesen
Maya L Henry, Stephanie M Grasso
Speech-language pathologists play a crucial role in the assessment and treatment of individuals with primary progressive aphasia (PPA). The speech-language evaluation is a critical aspect of the diagnostic and rehabilitative process, informing differential diagnosis as well as intervention planning and monitoring of cognitive-linguistic status over time. The evaluation should include a thorough case history and interview and a detailed assessment of speech-language and cognitive functions, with tasks designed to detect core and associated deficits outlined in current diagnostic criteria...
July 2018: Seminars in Speech and Language
Sebastian Hempel, Pamela Püttmann, Christoph Kahlert, Lena Seifert, Sören Torge Mees, Thilo Welsch, Jürgen Weitz, Marius Distler
INTRODUCTION: Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery and is associated with extended hospitalisation, increased medical costs, and reduced quality of life. The aim of the present study was to assess the treatment of POPF in Germany, with a special focus on outpatient drain management in patients with clinically relevant POPF (CR-POPF). METHODS: A questionnaire evaluating postoperative management once a CR-POPF is diagnosed - especially focusing on ambulatory drain management - was developed and sent to 211 German hospitals performing > 12 pancreatic operations per year...
June 2018: Zentralblatt Für Chirurgie
Yannick Hurni, Andrea Poretti, Jacques Schneider, Raphael Guzman, Gian Paolo Ramelli
INTRODUCTION:  Hydrocephalus can be progressive or spontaneously arrested. In arrested hydrocephalus, the balance between production and absorption of the cerebrospinal fluid is restored. Patients are mostly asymptomatic, and no surgical treatment is necessary for them. METHODS:  We performed a two-center consecutive case series study, aimed at investigating the safety of nonsurgical management of hydrocephalus in selected pediatric patients. We retrospectively selected all consecutive patients, suspected to suffer from arrested hydrocephalus and referred to our two institutions between January 2011 and December 2013...
June 22, 2018: Neuropediatrics
Shaneel Shah, Umberto Benedetto, Massimo Caputo, Gianni D Angelini, Hunaid A Vohra
OBJECTIVES: Existing evidence comparing the outcomes of coronary artery bypass graft (CABG) surgery versus percutaneous coronary intervention (PCI) in patients with poor left ventricular function (LVF) is sparse and flawed. This is largely due to patients with poor LVF being underrepresented in major research trials and the outdated nature of some studies that do not consider drug-eluting stent PCI. METHODS: Following strict inclusion criteria, 717 patients who underwent revascularization by CABG or PCI between 2002 and 2015 were enrolled...
June 22, 2018: European Journal of Cardio-thoracic Surgery
Mônica Gisele Costa Pinheiro, Francisco Arnoldo Nunes de Miranda, Clélia Albino Simpson, Francisca Patrícia Barreto de Carvalho, Cáthia Alessandra Varela Ataide, Ana Luisa Brandão de Carvalho Lira
OBJECTIVE: To analyze the concept of patient discharge in leprosy. METHODS: Theoretical study guided in the methodological framework of concept analysis. A bibliographical survey was held from December 2015 to January 2016 using the following bases: SCOPUS, CINAHL, PubMed, LILACS, SCIELO and BDENF, by use of the descriptors "Leprosy" and "Patient Discharge", resulting in 13 studies. RESULTS: The following were identified as possible uses for the concept: discharge by cure, drug use discharge, bacteriological discharge and post-discharge...
June 7, 2018: Revista Gaúcha de Enfermagem
Callum J Donaldson, Stuart L Mitchell, Lee H Riley, Khaled Kebaish
STUDY DESIGN: Case report and literature review. OBJECTIVE: To characterize the rare presentati on of myelopathy occurring secondary to alkaptonuria and to evaluate the available evidence regarding its treatment. SUMMARY OF BACKGROUND DATA: Alkaptonuria is an autosomal recessive genetic condition with an estimated incidence of 1 in 250,000 to 1 in 1,000,000 people. Mutation of the enzyme homogentisate 1,2-dioxygenase leads to the production of high levels of homogentisic acid (HGA), with subsequent deposition in ligaments, cartilage, and menisci...
June 21, 2018: Spine
Jennifer Gunberg Ross, Brittany Beckmann, Christina Goumas
The millennial generation shows a strong preference for informatics and technology-rich educational environments. The purpose of this descriptive, qualitative study was to understand baccalaureate nursing students' perceptions of the use of Facebook as a platform to present patient case study data. After following a simulated patient on Facebook and developing a teaching plan based on data collected from the patient's Facebook page, undergraduate nursing students completed a survey to determine their perceptions of this teaching strategy...
June 21, 2018: Nursing Education Perspectives
Kristin Torre, Janelle Ricketts, Soheil S Dadras
We report a case of a 68-year-old white woman presenting with 5 sebaceous neoplasms, ranging from sebaceous adenoma to sebaceoma on histopathology. Despite the lack of a personal cancer history, her multiple sebaceous neoplasms and a paternal history of colon cancer prompted testing her sebaceous adenomas for microsatellite instability (MSI) by immunohistochemistry. The results showed retained nuclear expressions of MLH1 and PMS2 while MSH2 and MSH6 proteins were absent. The tumor infiltrating lymphocytes expressed both MSH2 and MSH6, providing reliable internal positive controls...
June 14, 2018: American Journal of Dermatopathology
Ilona Okhremchuk, Anh Tuan Nguyen, Bernard Fouet, Jean-Jacques Morand
An 83-year-old man presented to the dermatology department for an ulcerated skin lesion of the back that had been increasing in size during the past 11 years. The physical examination revealed a well-defined, fleshy, reddish plaque measuring 10 × 20 cm in diameter with erosions and black areas on the surface. The patient underwent surgical excision with margins of 10 mm followed by a skin graft. Histologic section showed a lesion composed of 2 intimately intermingled epithelial and mesenchymal components associated with a basal cell carcinoma (BCC)...
June 14, 2018: American Journal of Dermatopathology
Bethany A Croker, James P Scurry, Frances M Petry, Gayle Fischer
OBJECTIVES: The aims of this case series were to present a series of patients with clinical and histopathological findings consistent with a recently described condition vestibular sclerosis (VS) and to contribute to the current discussion of whether VS is a subset of lichen sclerosus (LS) or a distinct entity. MATERIALS AND METHODS: This case series of 6 women for a 12-month period was initiated from an ongoing collaboration between a gynecological dermatologist and an anatomical pathologist specializing in gynecological dermatopathology...
July 2018: Journal of Lower Genital Tract Disease
Robert A Egan
BACKGROUND: Susac syndrome (SS) classically presents with the clinical triad of retinal artery occlusion, sensorineural hearing loss, and encephalopathy and the neuroimaging triad of white matter lesions, deep gray matter lesions, and leptomeningeal disease. However, patients can present with an incomplete clinical or neuroimaging triads making diagnosis difficult in certain situations. A standard treatment paradigm also is lacking in this illness. It is important for neuro-ophthalmologists to recognize clinical and radiographic findings that are pathognomonic for this syndrome and have a basic understanding of the available treatment options...
June 21, 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Ramiro Marinho, Mara Sousa, Filipa Machado, Sara Fonseca, Luísa Guedes
Cerebrospinal fluid cutaneous fistula is a rare but potentially serious complication of epidural analgesia. We report the case of a patient submitted to total knee arthroplasty under subarachnoid block and placement of lumbar epidural catheter for post-operative analgesia. The epidural catheter was found exteriorised on the fourth post-operative day, and the patient presented with a moderate fluid leak from the puncture site that was confirmed to be cerebrospinal fluid by cytological and chemical analysis. The initial therapeutic approach consisted of bed rest, hydration and prophylactic antibiotic therapy for 3 days, but it was ineffective as the leak persisted...
June 22, 2018: Scandinavian Journal of Pain
Luca Ferrario, Pietro Zerbi, Maria Rachele Angiolini, Alberto Agarossi, Eliana Riggio, Andrea Bondurri, Piergiorgio Danelli
INTRODUCTION: Leiomyomatosis peritonealis disseminata (LPD) is an uncommon disease featured by the presence of multiple nodules of smooth muscle cells scattered in the abdominal cavity. To date only about 150 cases have been reported in literature. We report a case of recurrent LPD after laparotomy. CASE PRESENTATION: In March 2016 a 36-year-old female, with a history of multiple previous laparoscopic myomectomies, consulted her gynaecologist complaining abdominal pain; a MRI was performed and reported multiple pelvic masses, subsequently excised during laparotomy...
June 18, 2018: International Journal of Surgery Case Reports
Yizhuo Yang, Zhongyu Liu, Lei Song, Hui Liu, Lian Li, Yuanguang Meng
INTRODUCTION: Retroperitoneal ectopic pregnancy (REP) is a rare type of gestation that is difficult to diagnose and treat. To date, only several published cases are available and no specific guideline has been developed to manage this disease. As the lesions are located closely to the large retroperitoneal blood vessels, surgical resection of the gestational tissue might incur risks such as associated hemorrhage, injury of blood vessels or nerves. On the other hand, the therapeutic effect of conservative treatment using methotrexate is not satisfactory...
June 9, 2018: International Journal of Surgery Case Reports
Naoki Murakami, Yasuhiko Fukuya
INTRODUCTION: Schwannomas are benign tumors derived from Schwann cells. However, schwannomas in the soft palate is considered rare. PRESENTATION OF CASE: We report a case of a 17-year-old girl who presented with a 20-mm nodular lesion in the soft palate. After surgical resection, a buccinator musculomucosal flap was used for soft palate reconstruction. At 6 months post-operation, velopharyngeal insufficiency was not observed. DISCUSSION: In this report, palatal muscles are examined, and the necessity of palatal muscle preservation and reconstruction of the defect in the soft palate mucosa after surgical resection of a schwannoma in the soft palate is presented...
June 8, 2018: International Journal of Surgery Case Reports
John Kandulu, Peter Thorburn, Jody Biggs, Kirsten Verburg
Use of chemical agricultural inputs such as nitrogen fertilisers (N) in agricultural production can cause diffuse source pollution thereby degrading the health of coastal and marine ecosystems in coastal river catchments. Previous reviewed economic assessments of N management in agricultural production seldom consider broader environmental impacts and uncertain climatic and economic conditions. This paper presents an economic risk framework for assessing economic and environmental trade-offs of N management strategies taking into account variable climatic and economic conditions...
June 19, 2018: Journal of Environmental Management
Evan M Mistur, Gordon Kingsley, Daniel C Matisoff, Yehyun An
Employing a case of a state transportation agency, we examine how complex institutions which integrate outsourcing within a bureaucratic process adapt to environmental regulatory changes. In 2012, two endangered species of bats were located outside of their established ranges in northern Georgia. These discoveries required the Georgia Department of Transportation (GDOT) to comply with a new set of federal regulations relating to those species when developing its projects. This article examines how GDOT adapted to new and unforeseen regulations in the face of environmental uncertainty...
June 19, 2018: Journal of Environmental Management
Joanna Maria Sadowska, Jordi Guillem-Marti, Montserrat Espanol, Christoph Stähli, Nicola Döbelin, Maria-Pau Ginebra
Biomaterials can interact with cells directly, that is, by direct contact of the cells with the material surface, or indirectly, through soluble species that can be released to or uptaken from the surrounding fluids. However, it is difficult to characterise the relevance of this fluid-mediated interaction separately from the topography and composition of the substrate, because they are coupled variables. These fluid-mediated interactions are amplified in the case of highly reactive CaPs such as biomimetic calcium deficient hydroxyapatite (CDHA), particularly in static in vitro cultures...
June 19, 2018: Acta Biomaterialia
Shunsunke Nomura, Yasuo Aihara, Kosaku Amano, Seiichiro Eguchi, Kentaro Chiba, Takashi Komori, Takakazu Kawamata
Malignant craniopharyngioma or anaplastic craniopharyngioma was first reported in 1987 by Akachi. It has a malignant clinical and histological feature; remarkably rapid progression, atypical pathology like squamous cell carcinoma and poor prognosis. To date seventeen cases of malignant craniopharyngioma have been reported and of these cases, most were of secondary malignant tumor in nature. With respect to traditional benign craniopharyngioma, adjunctive treatment after gross total removal is not necessary, but in the case of malignant types of the tumor, adjunctive treatment is important...
June 19, 2018: World Neurosurgery
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