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Thyroid Malignancy in Multinodular Goiter: A Prevalence Study in a High-Volume Tertiary Care Center 甲状腺恶性多结节性甲状腺肿:一个高容量三级保健中心的患病率研究
Pub Date : 2023-03-20 DOI: 10.1055/s-0043-1761501
Sree Lekshmy Beena, U. Govindan, Serbin Mohammed
Abstract Introduction  Goiter is one of the most common endocrine neoplasms found globally and its incidence varies in each country. Evaluation includes clinical, laboratory, radiological, and pathological tests to rule out malignancy. Surgery may be indicated in cases when the patient develops compressive symptoms, risks of malignancy, or cosmetic deformity. Thyroid malignancies account for only 1 to 2% of all malignancies. Irrespective of size, 9 to 13% of preoperative pathological evaluations revealed malignancy. Objective  To study the prevalence of thyroid malignancy in patients presenting with multinodular goiter (MNG) undergoing thyroidectomy in the Department of General Surgery, Government Medical College, Thiruvananthapuram, India. Material and Methods  This prevalence study was conducted in the Department of General Surgery, Government Medical College, Thiruvananthapuram, India, for a year, between March 2017 and February 2018. All patients with MNG undergoing thyroidectomy in the Department of General Surgery during this period were selected. A total of 651 patients were included in the study after obtaining informed consent. Results A total of 651 patients were studied, out of which 91 patients (13.9%) had malignancy. Among the total, 529 were females and 122 were males. Total malignancies reported were 91 and in those, males were around 31.9% and females around 68.1%. But when comparing incidence of malignancy in MNG, it was found to be higher in males (23.8%) than females (11.7%). Out of 91 patients with malignancy, 77 patients were found to have papillary carcinoma thyroid. Most of the papillary carcinoma thyroid occurred between 41 and 50 years of age, although it can occur in younger patients too. Palpable cervical lymphadenopathy is seen in 34 cases (37.4%) of thyroid malignancies. Conclusion  Proportion of thyroid malignancy in MNG at Government Medical College, Thiruvananthapuram, is 13.9%. Females are more commonly affected than males. Papillary carcinoma is the most common differentiated malignancy associated. Cervical lymph nodal metastasis is seen in 37.4% of thyroid malignancies. The risk of malignancy in MNG should not be underestimated as significant numbers of patients with thyroid malignancies present with MNG.
甲状腺肿是全球最常见的内分泌肿瘤之一,其发病率在每个国家都有所不同。评估包括临床、实验室、放射学和病理检查,以排除恶性肿瘤。当患者出现压迫症状、恶性肿瘤风险或美容畸形时,可能需要手术。甲状腺恶性肿瘤仅占所有恶性肿瘤的1%至2%。不论大小,9 - 13%的术前病理检查显示为恶性肿瘤。目的了解印度蒂鲁凡得琅政府医学院普通外科多结节性甲状腺肿(MNG)行甲状腺切除术患者甲状腺恶性肿瘤的发生率。材料和方法本流行病学研究于2017年3月至2018年2月在印度Thiruvananthapuram政府医学院普外科进行,为期一年。选取在此期间在普外科行甲状腺切除术的所有MNG患者。在获得知情同意后,共有651名患者被纳入研究。结果651例患者中,恶性肿瘤91例(13.9%)。其中女性529人,男性122人。恶性肿瘤报告总数为91例,其中男性约占31.9%,女性约占68.1%。但当比较MNG的恶性肿瘤发生率时,发现男性(23.8%)高于女性(11.7%)。91例恶性肿瘤中,77例为甲状腺乳头状癌。大多数甲状腺乳头状癌发生在41岁至50岁之间,尽管它也可能发生在年轻患者中。34例(37.4%)甲状腺恶性肿瘤可触及颈部淋巴结病变。结论蒂鲁凡得琅邦政府医学院MNG患者甲状腺恶性肿瘤比例为13.9%。女性比男性更容易受到影响。乳头状癌是最常见的恶性肿瘤。37.4%的甲状腺恶性肿瘤有颈淋巴结转移。恶性肿瘤的风险在MNG不应被低估,因为显著数量的患者甲状腺恶性肿瘤存在与MNG。
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引用次数: 0
Ischemic stroke in relation to brain polymethylmethacrylate embolism after percutaneous kyphoplasty: a case report 缺血性卒中与经皮后凸成形术后脑聚甲基丙烯酸甲酯栓塞的关系:1例报告
Pub Date : 2023-03-17 DOI: 10.32457/ijmss.v10i1.2055
A. M. Martín Fuentes, David López Salas, Ana Abarquero Diezhandino, Daniel Bustamante Recuenco, Francisco Javier Ortega García
Kyphoplasty is one of the minimally invasive interventions which provides pain relief in osteoporotic or malignancy related vertebral compression fractures. Severe complications associated with percutaneous kyphoplasty or vertebroplasty are rare, and usually related to cement leakage out of the vertebral body (Lamy et al., 2014). We report the case of an 83-year old female who suffered an ischemic stroke during the immediate post-operative period after a three-level percutaneous kyphoplasty (L2-L3-L4) due to a paradoxical embolism via an atrial septal heart defect.
后凸成形术是减轻骨质疏松或恶性肿瘤相关椎体压缩性骨折疼痛的微创治疗方法之一。经皮后凸成形术或椎体成形术的严重并发症很少见,通常与椎体骨水泥渗漏有关(Lamy et al., 2014)。我们报告一例83岁的女性,由于房间隔心脏缺损的矛盾栓塞,在三段经皮后凸成形术(L2-L3-L4)后立即发生缺血性中风。
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引用次数: 0
Behavior Problems in Children With Epilepsy (Age 6– 14 years) : A Prospective Observational Study 6 - 14岁癫痫患儿的行为问题:一项前瞻性观察研究
Pub Date : 2023-03-15 DOI: 10.1055/s-0043-1761503
R. Solanki, P. Ghanghoriya, Deepti Sisodia, M. Lazarus
Abstract Background  Epilepsy's psychological effects are variable, some may experience a few mental health issues while some may experience serious problems such as anxiety, depression, attention deficit hyperkinetic disorder (ADHD), and mood disorders. Hence, there is a need to screen these problems at an early age for timely intervention. So, our study was conducted to determine the prevalence of emotional and behavioral problems in children with epilepsy. Methods  This was a prospective observational study on 111 children, 6 to 14 years of age. The overall prevalence of emotional and behavioral problems in childhood was determined by calculating the percentage of children with child behavior checklist score indicative of specific emotional and behavioral problems. The prevalence for specific morbidities was also calculated and reported separately for each condition. Results were presented in the form of tables, charts, graphs, and narratives. Results  The overall prevalence of emotional and behavioral problems in children was 38.7%. Attention problem (13.5%), aggressive behavior (10.8%), social problems (8.1%), and withdrawal/depression (6.3%) were the four leading syndromes. The prevalence of emotional and behavioral problems was significantly associated with the age of onset of epilepsy, type of epilepsy, frequency of seizures, and antiepileptic drug therapy used by child. Conclusion  As there is a higher prevalence of emotional and behavioral problems in children with epilepsy, age of onset, frequency of seizure, and duration of diseases were found to be significantly associated with the occurrence of behavioral problems. Therefore, prompt and early screening for these problems, as well as integrated management consisting of pharmacotherapy, behavioral modification, parental education and counselling, psychotherapy and psychoeducation would help to reduce their effect in these patients.
癫痫的心理影响是多种多样的,有些人可能会出现一些心理健康问题,而有些人可能会出现严重的问题,如焦虑、抑郁、注意缺陷多动障碍(ADHD)和情绪障碍。因此,有必要在早期筛查这些问题,以便及时干预。因此,我们的研究是为了确定癫痫患儿情绪和行为问题的患病率。方法对111例6 ~ 14岁儿童进行前瞻性观察研究。儿童情绪和行为问题的总体患病率是通过计算儿童行为检查表得分表明特定情绪和行为问题的儿童百分比来确定的。还计算了每种情况下特定发病率的患病率并分别报告。结果以表格、图表、图形和叙述的形式呈现。结果儿童情绪和行为问题的总体患病率为38.7%。注意问题(13.5%)、攻击行为(10.8%)、社交问题(8.1%)和戒断/抑郁(6.3%)为主要症状。情绪和行为问题的患病率与癫痫发病年龄、癫痫类型、发作频率和儿童使用的抗癫痫药物治疗显著相关。结论癫痫患儿情绪和行为问题发生率较高,发病年龄、发作次数、病程与行为问题的发生有显著关系。因此,及时和早期筛查这些问题,以及包括药物治疗,行为矫正,父母教育和咨询,心理治疗和心理教育在内的综合管理将有助于减少这些患者的影响。
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引用次数: 0
Uncommon Events of Fall and Mood Changes Observed in Post-COVID-19 Patients: A Case Series covid -19后患者观察到的罕见跌倒事件和情绪变化:一个病例系列
Pub Date : 2023-03-01 DOI: 10.1055/s-0043-1761411
Srutarshi Ghosh, S. Mukhopadhyay
Abstract Coronavirus disease 2019 (COVID-19) infection in some patients has been documented to cause acute central nervous system (CNS) affection, or CNS depression, even in the absence of demonstrable hypoxia. These observations indicate that there may be some direct effect of the virus on CNS. In this case series of cured post-COVID-19 cases, mood changes like elation, depression, and emotionally labile state have been reported in three previously healthy individuals. The mood changes are waning very slowly in them with the passage of time. All of them also sustained fall sometime following acute COVID-19. Fall is considered to be an event indicating frailty and old age, and there is no mood change associated with fall in that population. Here, the three cases are being reported because neither fall nor mood changes during post-COVID-19 phase have been reported as yet to the best of our knowledge. The case series is worth reporting to generate awareness about the matter in the scientific community and also to indicate that further research in this field is required either to accept or to reject any correlation between COVID-19 infection and fall or mood change in otherwise healthy individuals, which can even be due to some direct effect of the virus on CNS.
一些患者的冠状病毒病2019 (COVID-19)感染即使在没有明显缺氧的情况下也会引起急性中枢神经系统(CNS)影响或中枢神经系统抑制。这些观察结果表明,该病毒可能对中枢神经系统有一些直接影响。在这一系列治愈的covid -19后病例中,据报道,三名以前健康的个体出现了兴高采烈、抑郁和情绪不稳定状态等情绪变化。随着时间的推移,他们的情绪变化会慢慢减弱。他们都在急性COVID-19后的某个时候出现了跌倒。跌倒被认为是一种表明身体虚弱和年老的事件,在这些人群中没有与跌倒相关的情绪变化。在这里,报告这三例病例是因为据我们所知,尚未报告covid -19后阶段的跌倒或情绪变化。该病例系列值得报道,以提高科学界对此事的认识,并表明需要在该领域进行进一步研究,要么接受要么拒绝接受COVID-19感染与其他健康个体的跌倒或情绪变化之间的任何相关性,这甚至可能是由于病毒对中枢神经系统的某种直接影响。
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引用次数: 0
Perioperative Outcome of COVID-19-Positive Parturient Posted for Cesarean Section—Our Experience in a Tertiary Care Hospital in Northern India 新冠肺炎阳性产妇剖宫产围手术期结局——我们在印度北部三级医院的经验
Pub Date : 2023-03-01 DOI: 10.1055/s-0043-1761606
Megha Soni, M. Kumari, Niharika Grover, R. Taneja, L. Parashar
Abstract Introduction  There is insufficient data regarding the severity of coronavirus disease 2019 (COVID-19) infections in pregnant women. This study assessed the outcome of COVID-19-positive parturient after cesarean section, correlation of maternal mortality with COVID-19 severity, association of comorbid parturients with severe COVID-19, and number of patients requiring general anesthesia. Materials and Methods  This single-center, retrospective observational study was performed on reverse transcriptase polymerase chain reaction confirmed COVID-19-positive 89 parturients posted for elective or emergency cesarean section. Data was collected from medical records of our hospital regarding COVID-19 severity, maternal mortality, need for admission in intensive care unit, gestational age, maternal comorbidities, indication for cesarean section, type of anesthesia, duration of surgery, neonatal birth weight, neonatal mortality, Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score, and neonatal intensive care unit (NICU) admission. Assessment of maternal outcome was the primary objective. Secondary objectives of this study were to correlate maternal outcome with COVID-19 severity, to find association of comorbid parturients with severe COVID-19 and to estimate number of patients requiring general anesthesia. Results  Out of 89 patients, 79 patients had mild COVID-19 disease were on room air and 6 patients required preoperative oxygen supplementation, and 4 patients diagnosed to have severe COVID-19 pneumonia were on mechanical ventilator preoperatively. Four cases were operated under general anesthesia and remaining 85 parturients were operated under regional anesthesia. Out of four parturients with severe COVID-19 pneumonia, three patients did not survive in postoperative period due to refractory hypoxemia. In eight patients, spinal anesthesia was repeated due to inadequate effect. Fourteen neonates (16.09%) required NICU stay after cesarean delivery. Conclusions  Parturients with severe COVID-19 disease had higher mortality. No statistically significant association was found between number of comorbidities and severity of COVID-19. The results of this study will guide us regarding further management and prognostication of COVID-19-positive parturients posted for cesarean section.
关于孕妇感染冠状病毒病2019 (COVID-19)严重程度的数据不足。本研究评估了剖宫产术后COVID-19阳性产妇的结局、孕产妇死亡率与COVID-19严重程度的相关性、重症患儿合并症的相关性以及需要全身麻醉的患者人数。材料与方法对89例经逆转录酶聚合酶链反应确诊为covid -19阳性、择期或急诊剖宫产的产妇进行单中心、回顾性观察研究。从我院病历中收集有关COVID-19严重程度、孕产妇死亡率、重症监护病房入院需求、胎龄、孕产妇合并症、剖宫产指征、麻醉类型、手术时间、新生儿出生体重、新生儿死亡率、外貌、脉搏、面部表情、活动和呼吸(APGAR)评分、新生儿重症监护病房(NICU)入院情况的数据。评估产妇结局是主要目的。本研究的次要目的是将产妇结局与COVID-19严重程度联系起来,发现合并症患儿与严重COVID-19的关联,并估计需要全身麻醉的患者数量。结果89例患者中,79例轻症患者术前使用室内空气,6例术前需补充氧气,4例重度肺炎患者术前使用机械呼吸机。全麻4例,区域麻醉85例。在4例重症COVID-19肺炎患儿中,有3例患者因难治性低氧血症在术后未能存活。8例患者因效果不佳而重复行脊髓麻醉。14例(16.09%)新生儿剖宫产后需入住新生儿重症监护病房。结论重症COVID-19患儿死亡率较高。合并症的数量与COVID-19的严重程度之间没有统计学意义的关联。本研究结果将指导我们对剖宫产术中covid -19阳性患者的进一步管理和预后。
{"title":"Perioperative Outcome of COVID-19-Positive Parturient Posted for Cesarean Section—Our Experience in a Tertiary Care Hospital in Northern India","authors":"Megha Soni, M. Kumari, Niharika Grover, R. Taneja, L. Parashar","doi":"10.1055/s-0043-1761606","DOIUrl":"https://doi.org/10.1055/s-0043-1761606","url":null,"abstract":"Abstract Introduction  There is insufficient data regarding the severity of coronavirus disease 2019 (COVID-19) infections in pregnant women. This study assessed the outcome of COVID-19-positive parturient after cesarean section, correlation of maternal mortality with COVID-19 severity, association of comorbid parturients with severe COVID-19, and number of patients requiring general anesthesia. Materials and Methods  This single-center, retrospective observational study was performed on reverse transcriptase polymerase chain reaction confirmed COVID-19-positive 89 parturients posted for elective or emergency cesarean section. Data was collected from medical records of our hospital regarding COVID-19 severity, maternal mortality, need for admission in intensive care unit, gestational age, maternal comorbidities, indication for cesarean section, type of anesthesia, duration of surgery, neonatal birth weight, neonatal mortality, Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score, and neonatal intensive care unit (NICU) admission. Assessment of maternal outcome was the primary objective. Secondary objectives of this study were to correlate maternal outcome with COVID-19 severity, to find association of comorbid parturients with severe COVID-19 and to estimate number of patients requiring general anesthesia. Results  Out of 89 patients, 79 patients had mild COVID-19 disease were on room air and 6 patients required preoperative oxygen supplementation, and 4 patients diagnosed to have severe COVID-19 pneumonia were on mechanical ventilator preoperatively. Four cases were operated under general anesthesia and remaining 85 parturients were operated under regional anesthesia. Out of four parturients with severe COVID-19 pneumonia, three patients did not survive in postoperative period due to refractory hypoxemia. In eight patients, spinal anesthesia was repeated due to inadequate effect. Fourteen neonates (16.09%) required NICU stay after cesarean delivery. Conclusions  Parturients with severe COVID-19 disease had higher mortality. No statistically significant association was found between number of comorbidities and severity of COVID-19. The results of this study will guide us regarding further management and prognostication of COVID-19-positive parturients posted for cesarean section.","PeriodicalId":34302,"journal":{"name":"International Journal of Recent Surgical and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88788874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Hospital-Based Study of Factors Associated with COVID-19-Related Deaths in Western Uttar Pradesh 北方邦西部与covid -19相关死亡相关因素的医院研究
Pub Date : 2023-03-01 DOI: 10.1055/s-0043-1761470
Krishnamurthy Krishnamurthy, M. Bashir, A. Tripathi, Ishi Jain
Abstract Background  The COVID-19 pandemic has rapidly affected mortality in India and public health efforts must focus on preventing the avoidable fatalities during this pandemic. Understanding various clinical characteristics of the deceased patients of COVID-19 along with the estimation of time interval between the onset of symptoms and admission in hospital and various factors associated with COVID-19 related deaths could inform public health interventions focusing on preventing deaths due to COVID-19. Materials and Methods  The present study was a retrospective hospital-based cross-sectional study conducted in Subharti Medical College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India. The duration of the study was 21 months. Data of COVID-19 deaths were collected from the Medical Record Department of Chhatrapati Shivaji Subharti Hospital, Meerut, which is a dedicated Level-3 COVID Hospital. Results  Total Deaths due to COVID-19 were 298. Out of 298 deaths, 205 were males and 93 were females. The maximum number of deaths were in May 2021. When the duration of oxygen support was 1 to 5 days in 44.97% of the deceased, less than 1 day were 17.11% and more than 5 days were 17.11. The duration of ventilator support was less than 1 day in 39.26% of the deceased, 1 to 3 days in 39.3%, and more than 3 days in 21.14% of the deceased. The most common symptom associated with COVID-19 deceased was fever with breathlessness both in males and females. The most common co-morbid condition associated with COVID-19 deaths was hypertension with diabetes mellitus both in males and females. Conclusion  From the present study, we conclude that the majority of deaths were males. The maximum number of deaths due to COVID-19 was in May 2021, both in males and females. The most common symptom associated was fever with breathlessness and most common comorbid condition associated with deaths of COVID patients were hypertension with diabetes mellitus. The duration of oxygen support was 1 to 5 days in the majority of the patients. The duration of ventilator support was less than 1 day in the majority of patients.
背景2019冠状病毒病大流行迅速影响了印度的死亡率,公共卫生工作必须把重点放在预防这次大流行期间可避免的死亡上。了解COVID-19死亡患者的各种临床特征、症状出现与入院时间间隔的估计以及与COVID-19相关死亡的各种因素,可以为预防COVID-19死亡的公共卫生干预提供信息。材料和方法本研究是在印度北方邦密鲁特斯瓦米·维韦坎和苏巴蒂大学苏巴蒂医学院和医院进行的一项回顾性的以医院为基础的横断面研究。研究时间为21个月。COVID-19死亡数据来自密鲁特Chhatrapati Shivaji Subharti医院病历部,该医院是一家专门的三级COVID-19医院。结果新冠肺炎死亡298例。在298名死者中,205名男性和93名女性。死亡人数最多的是2021年5月。氧支持时间为1 ~ 5天的占44.97%,不足1天的占17.11%,超过5天的占17.11%。39.26%的患者呼吸机支持持续时间小于1天,39.3%的患者为1 ~ 3天,21.14%的患者为3天以上。与COVID-19死亡相关的最常见症状是男性和女性的发烧和呼吸困难。与COVID-19死亡相关的最常见合并症是男性和女性的高血压合并糖尿病。从目前的研究,我们得出结论,大多数死亡是男性。2019冠状病毒病死亡人数最多的年份是2021年5月,男性和女性都是如此。最常见的相关症状是发烧伴呼吸困难,与COVID患者死亡相关的最常见合并症是高血压伴糖尿病。多数患者氧支持时间为1 ~ 5天。大多数患者的呼吸机支持时间少于1天。
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引用次数: 0
A Cross-Sectional Study on the Status of Contralateral Ear in Cases with Otitis Media Attending a Tertiary Care Center 三级保健中心中耳炎患者对侧耳状况的横断面研究
Pub Date : 2023-01-17 DOI: 10.1055/s-0042-1758521
Raghavan V. K., P. S., N. B., R. S
Abstract Background  As the aeration and drainage entrances in both ears are the same, the factors that produce otitis media in one ear may also affect the other. Also, the unsolved debate is that long-standing otitis media turns into chronic otitis media (COM). Hence, this study was conducted with the objective of assessing the incidence of abnormal findings in the contralateral ear (CLE) and to find the association between the type of COM of diseased ear with the findings of CLE. Materials and Methods  A hospital-based cross-sectional study was conducted among cases with unilateral COM who visited the outpatient department of otorhinolaryngology at Chettinad Hospital and Research Institute in Chennai between November 2021 and February 2022. The study comprised 200 COM cases in all. The medical history, otoscopic examination, pure-tone audiometry, and tympanometric findings of the patient were all documented. SPSS version 20 was used to conduct the analysis. Results  About 80% of the individuals with COM in one ear exhibited some abnormalities in the CLE. The type of COM in the afflicted ear is not linked with the otoscopic findings, type of hearing loss, tympanometric findings, or overall abnormalities in the CLE. This study's findings are comparable to those of several others. Conclusion  Though there is no association between type of COM and the pathological findings in the CLE, considering the huge burden of pathological findings noted in the CLE, all cases of unilateral COM should be screened for aberrant findings in the CLE.
摘要背景由于双耳通气、引流入口相同,导致一只耳朵中耳炎的因素也可能影响另一只耳朵。此外,长期中耳炎是否会转变为慢性中耳炎(COM)也是一个尚未解决的问题。因此,本研究的目的是评估对侧耳(CLE)异常发现的发生率,并发现病变耳的COM类型与CLE发现之间的关系。材料与方法对2021年11月至2022年2月在金奈Chettinad医院和研究所耳鼻喉科门诊就诊的单侧COM病例进行了基于医院的横断面研究。该研究共包括200例COM病例。患者的病史、耳镜检查、纯音听力学和鼓室测量结果均有记录。采用SPSS version 20进行分析。结果约80%的单耳COM患者的CLE有一定的异常。患耳的COM类型与耳镜检查结果、听力损失类型、鼓室测量结果或CLE的整体异常无关。这项研究的结果与其他几项研究的结果相当。结论虽然脊髓性骨裂的类型与CLE的病理表现没有相关性,但考虑到CLE的病理表现负担巨大,所有单侧脊髓性骨裂的病例都应筛查CLE的异常表现。
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引用次数: 0
Impact of Different Histopathological Factors on Recurrence and Survival in Operated Carcinoma Esophagus 不同组织病理因素对食管癌术后复发及生存的影响
Pub Date : 2023-01-17 DOI: 10.1055/s-0042-1758813
Ashutosh Kumar Singh, B. Singhal, S. Yadav, V. Kewlani
Abstract Background  Even with radical surgery, a significant percentage of patients of esophageal cancer experience recurrent disease. Aims  The aim of the current study is to define the impact of different histopathological factors on the recurrence and survival in carcinoma esophagus following surgery. Materials and Methods  A retrospective review of 182 patients of esophageal carcinoma, operated between January 2011 and December 2016, was done. In our study, 92 patients underwent upfront surgery and 90 took neo-adjuvant/perioperative treatment before planned surgery. To compare the proportion between two groups, chi-square test was used and to compare the median between the two groups, Mann—Whitney U test was used. Factors affecting the survival were analyzed using the Kaplan–Meier survival curve to compare the median survival time across groups log rank (Mantel–Cox) test was used. Results  Out of 182 patients, 55 patients developed recurrences, in which 19 were loco-regional and 36 were systemic. Patients with lymph node-positive disease on final histopathology had more recurrence than lymph node-negative (39.74%, 31/78) versus (23%, 24/104), p  = 0.01 (significant). Patients with features such as PNI-positive, poor differentiation, lymph node-positive, ENE, and higher stage disease had statistically significant, lower DFS and OS with p -value < 0.05. Patients with adenocarcinoma histology had more systemic recurrences and statistically significant lower DFS than SCC with p -value < 0.05. Conclusions  Systemic recurrences are more common. PNI, ENE, grade, lymph node-positive disease, and higher pathologic stage had statistically significant negative impact on both DFS and OS. On multivariate analysis, whereas ENE had an impact on DFS alone.
背景:即使根治性手术,仍有相当比例的食管癌患者复发。目的探讨不同组织病理因素对食管癌术后复发及生存的影响。材料与方法对2011年1月至2016年12月间行食管癌手术的182例患者进行回顾性分析。在我们的研究中,92例患者接受了术前手术,90例患者在计划手术前接受了新辅助/围手术期治疗。比较两组间的比例采用卡方检验,比较两组间的中位数采用Mann-Whitney U检验。采用Kaplan-Meier生存曲线分析影响生存的因素,比较各组中位生存时间,采用log rank (Mantel-Cox)检验。结果182例患者中复发55例,局部19例,全身36例。淋巴结阳性患者的复发率(39.74%,31/78)高于淋巴结阴性患者(23%,24/104),p = 0.01(有统计学意义)。pni阳性、分化差、淋巴结阳性、ENE、疾病分期高的患者有统计学意义,DFS和OS较低,p值< 0.05。组织学为腺癌的患者全身复发率高于鳞状细胞癌,DFS低于鳞状细胞癌,p值< 0.05。结论全身复发更为常见。PNI、ENE、分级、淋巴结阳性疾病和较高的病理分期对DFS和OS均有统计学意义的负影响。在多变量分析中,ENE仅对DFS有影响。
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引用次数: 0
Oral cavity cancer in patients from the department of head and neck surgery – chair and otorhinolaryngology service of the Hospital de Clínicas – National University of Asunción 来自Clínicas国立大学Asunción医院头颈外科和耳鼻喉科的口腔癌患者
Pub Date : 2022-12-30 DOI: 10.32457/ijmss.v9i4.2003
Evelio Legal Balmaceda, Marta Elizabeth Osorio Fleitas, José Ortiz Bogado, Carlos Mena Canata, Raúl Andrés Tornaco Maidana
Introduction: The oral cavity is continuously exposed to inhaled and ingested carcinogens (mainly tobacco and alcohol), and therefore it is the most common site for the origin of neoplasms in the head and neck region. Methods: A descriptive, retrospective, observational study of non-probabilistic sampling of consecutive cases was carried out. Adult patients with a clinical and pathological diagnosis of oral cavity cancer were included. Results: A series of 17 cases of oral squamous cell carcinoma was included, 13 men (76%) and 4 women (24%). The age of the individuals ranged between 32 and 73 years. 65% of the patients were smokers, and 71% reported consumption of alcoholic beverages. The tongue was the most frequent tumor location, 71% were in stage IV, and with a moderate degree of histological differentiation. Conclusion: Most of the patients in this study were males between 50 and 70 years of age. A high percentage of patients reported smoking, and an even higher percentage of alcohol consumption. The most frequently affected subsite is the tongue, in advanced stages and a moderate degree of differentiation.
口腔持续暴露于吸入和摄入的致癌物(主要是烟草和酒精)中,因此它是头颈部肿瘤最常见的起源部位。方法:对连续病例进行非概率抽样的描述性、回顾性、观察性研究。包括临床和病理诊断为口腔癌的成年患者。结果:17例口腔鳞状细胞癌,男性13例(76%),女性4例(24%)。这些人的年龄在32岁到73岁之间。65%的患者吸烟,71%的患者饮用酒精饮料。舌部是最常见的肿瘤部位,71%为IV期,组织学分化程度中等。结论:本组患者以50 ~ 70岁男性居多。有很高比例的患者报告吸烟,饮酒的比例甚至更高。最常受影响的亚部位是舌头,在晚期和中等程度的分化。
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引用次数: 0
Fecopneumothorax Secondary to a Late Traumatic Diaphragmatic Injury 创伤性膈肌损伤后继发的气胸
Pub Date : 2022-12-23 DOI: 10.32457/ijmss.v9i4.1963
Gustavo Dragustinovis-Hinojosa, Jorge Aurelio Gutiérrez González, Dario Eduardo Medina Muñoz, G. E. Muñoz Maldonado
Traumatic diaphragmatic hernias were first described by Ambroise Paré in 1579, who reported the case of an artillery captain, that presented an intestinal perforation that had caused a diaphragmatic hernia 1. The timely diagnosis of a traumatic diaphragmatic hernia can be a challenge , which requires extensive knowledge of the kinematics of trauma, as well as clinical and radiological evidence 2. We present the case of a 60-year-old male who presented blunt abdominal trauma due to a traffic accident, causing an undetected diaphragmatic hernia in his initial evaluation; months after de incident goes to the emergency room (ER) with hemodynamic instability and septic shock. A diagnosis of complicated diaphragmatic hernia and fecopneumothorax is made, for which he undergoes surgery.
创伤性膈疝最早由Ambroise par于1579年描述,他报告了一位炮兵上尉的病例,该病例表现为肠道穿孔,导致膈疝1。创伤性膈疝的及时诊断可能是一个挑战,这需要广泛的创伤运动学知识,以及临床和放射学证据2。我们提出的情况下,一个60岁的男性谁提出钝性腹部创伤由于交通事故,导致一个未被发现的膈疝在他的初步评估;事故发生几个月后,因血流动力学不稳定和感染性休克而去急诊室。诊断为复杂的膈疝和肺气胸,为此他接受了手术。
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引用次数: 0
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International Journal of Recent Surgical and Medical Sciences
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