Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 6 Articles
Eccrine spiradenoma (ES) is an exceedingly rare sweat-gland tumor, it usually\npresents as a solitary lesion and painful nodule. ES is a kind of neoplasm with\ndistinct histological characteristics and nonspecific clinical manifestations.\nMost ES cases have a benign course; however, malignant transformation\nwould occur after a long period of latency. The diagnosis mostly depends on\nthe clinic symptom, histological features and immunohistochemistry. Here,\nwe report a case of ES and literature review. The aim of this study is to understand\nclinic and histological features for ES....
Background: Selection of the best lymph node for dissection is a controversial topic in clinical stage-I non-small\ncell lung cancer (NSCLC). Here, we sought to identify the clinicopathologic predictors of regional lymph node\nmetastasis in patients intraoperatively diagnosed with stage-I NSCLC.\nMethods: A retrospective review of 595 patients intraoperatively diagnosed as stage I non-small-cell lung cancer\nwho underwent lobectomy with complete lymph node dissection was performed. Univariate and multivariable\nlogistic regression analysis was performed to determine the independent predictors of regional lymph node\nmetastasis.\nResults: Univariate logistic regression and multivariable analysis revealed three independent predictors of the\npresence of metastatic hilar lymph nodes, five independent predictors for lobe specific mediastinal lymph nodes,\ntwo independent predictors for lobe nonspecific mediastinal lymph nodes and two independent predictors for\nskipping mediastinal lymph nodes.\nConclusions: A complete mediastinal lymph node dissection may be considered for patients suspected of nerve\ninvasion and albumin (> 43.1 g/L) or nerve and vascular invasions. Lobe-specific lymph node dissection should\nprobably be performed for patients suspected of pulmonary membrane invasion, vascular invasion, CEA (> 2.21 ng/\nmL), and tumor (> 1.6 cm) in the right lower lobe or mixed lobes. Hilar lymph node dissection should probably be\nperformed for patients suspected of having bronchial mucosa and cartilage invasion, vascular invasion, and CEA (>\n2.21 ng/mL)....
Background: The spectrum of salivary gland lesions is wide and the relative\nincidence of neoplastic and non-neoplastic lesions is variable in different studies.\nDespite the relatively common nature of salivary gland disorders, there\nis dearth of literature on these lesions, especially in sub-Saharan Africa. We\ntherefore embarked on this study to analyze the differential diagnosis of salivary\ngland lesions seen and managed at our institution. Methods: A retrospective\nreview of salivary gland disorders that presented at our facility from\nJanuary 2012 to December 2016 was done. Information on patientsâ?? demographic\ndetails, type and location of salivary gland lesion, histologic diagnosis\nand treatment were retrieved and analyzed with SPSS version 20. Result: A\ntotal of 65 patients were treated for salivary gland lesions of various types\nduring the study period...............
Background: Community Paramedics (CPs) require access to timely blood analysis in the field to guide treatment\nand transport decisions. Point of care testing (POCT), as opposed to laboratory analysis, may offer a solution, but\nlimited research exists on CP POCT. The purpose of this study was to compare the validity of two devices (Abbott i-\nSTAT® and Alere epoc®) by CPs in the community.\nMethods: In a CP programme responding to 6000 annual patient care events, a split sample validation of POCT\nagainst traditional laboratory analysis for seven analytes (sodium, potassium, chloride, creatinine, hemoglobin,\nhematocrit, and glucose) was conducted on a consecutive sample of patients. The difference of proportion of\ndiscrepant results between POCT and laboratory was compared using a two sample proportion test. Usability was\nanalysed by survey of CP experience, a linear mixed effects model of Systems Usability Scale (SUS) adjusted for CP\nclinical and POCT experience, an expert heuristic evaluation of devices, a review of device-logged errors, and coded\nobservations of POCT use during quality control testing.\nResults: Of 1649 episodes of care screened for enrollment, 174 required a blood draw, with 108 episodes (62.1%)\nenrolled from 73 participants. Participants had a mean age of 58.7 years (SD16.3); 49% were female. In 4 of 646 (0.\n6%) comparisons, POCT reported a critical value but the laboratory did not; with no statistically significant (p = 0.\n323) difference between i-STAT® (0.9%;95%CI:0.0,1.9%) compared with epoc® (0.3%;95%CI:0.0,0.9%). There were no\ninstances of the laboratory reporting a critical value when POCT did not. In 88 of 1046 (8.4%) comparisons the a\npriori defined acceptable difference between POCT and the laboratory was exceeded; occurring more often in\nepoc® (10.7%;95%CI:8.1,13.3%) compared with i-STAT® (6.1%;95%CI:4.1,8.2%)(p = 0.007). Eighteen of 19 CP surveys\nwere returned, with 11/18 (61.1%) preferring i-STAT® over epoc®. The i-STAT® had a higher mean SUS score (higher\nusability) compared with epoc® (84.0/100 vs. 59.6/100; p = 0.011). There were no statistically significant differences in\ndevice logged errors between i-STAT® and epoc® (p = 0.063).\nConclusions: CP programmes can expect clinically valid results from POCT. Device usability assessments should be\nconsidered with any local implementation as the two POCT systems have different strengths....
Previous studies exploring the association between arterial stiffness and prediabetes remain controversial. This study aimed to investigate the association of the different domains of prediabetes categorized by glycated hemoglobin A1c (A1c) 5.7-6.4%, impaired fasting glucose (IFG), fasting plasma glucose of 5.6-6.9 mmol/L, and impaired glucose tolerance (IGT), two-hour post-load glucose of 7.8-11.0 mmol/L, on arterial stiffness. These were measured by brachial-ankle pulse-wave velocity (baPWV). We enrolled 4938 eligible subjects and divided them into the following nine groups: (1) normoglycemic; (2) isolated A1c 5.7-6.4%; (3) isolated IFG; (4) IFG with A1c 5.7-6.4%; (5) isolated IGT; (6) combined IGT and IFG with A1c <5.7%; (7) IGT with A1c 5.7-6.4%; (8) combined IGT and IFG with A1c 5.7-6.4%; and (9) newly diagnosed diabetes (NDD). The baPWV values were significantly high in subjects with NDD��.....
Background: Staphylococcus aureus (S. aureus) is a common cause of bacteremia, which leads to significant morbidity\nand mortality. We investigated the relationship between time to positivity (TTP) and clinical outcomes in children with\nS.aureus bacteremia in the China.\nMethods: A retrospective study of Staphylococcus aureus bacteremia inpatient was performed in Childrenâ??s Hospital of\nChongqing Medical University in China between 29 January 2014 and 29 August 2017. TTP and clinical parameters\nwere determined and analyzed. The receiver operating characteristic (ROC) curves were plotted for optimal cut-off\nselection, multivariate logistic regression tests were performed to evaluate the association between TTP and clinical\noutcomes.............
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