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Cureus Jul 2024Pott's puffy tumors are assumed to be infrequent concomitant intra- and extracranial abscesses, mainly secondary to complicated frontal sinusitis during infancy. Due to...
Pott's puffy tumors are assumed to be infrequent concomitant intra- and extracranial abscesses, mainly secondary to complicated frontal sinusitis during infancy. Due to the close proximity to the superior sagittal sinus, there is a risk of developing venous infections, thrombosis, and morbidity. In this case report, we present a case of an 11-year-old girl who presented with headache and face edema. After recognizing the Pott's puffy tumor pattern on the CT scan and brain MRI, the neurosurgical approach involved pus evacuation and frontal sinus blockage, and the patient received antibiotic therapy and was evaluated for total recovery. To our knowledge, the prompt diagnosis and treatment of such conditions are paramount to avoid complications, and differential diagnosis should be encouraged in medical practice.
PubMed: 38957509
DOI: 10.7759/cureus.63686 -
JGH Open : An Open Access Journal of... Jul 2024The traditional gut-centric view of coeliac disease is evolving as immune and genetic insights underscore the central importance of a systemic, T cell immune response to... (Review)
Review
The traditional gut-centric view of coeliac disease is evolving as immune and genetic insights underscore the central importance of a systemic, T cell immune response to gluten in disease pathogenesis. As the field increasingly recognize the limitations of small intestinal histology as the diagnostic standard, data supporting the accuracy of an immune (serologic) diagnosis of coeliac disease - well demonstrated in children - are growing for adults. Novel biomarkers such as interleukin-2 that identify the gluten-specific T cell demonstrate high sensitivity and specificity for coeliac disease and offer the potential for a diagnostic approach that avoids the need for gluten challenge. Asymptomatic disease and manifestations outside the gut pose considerable challenges for diagnosis using a case-finding strategy and enthusiasm for population screening is growing. The gluten-free diet remains a highly restrictive treatment and there is a paucity of controlled data to inform a safe gluten intake threshold. Ongoing symptoms and enteropathy are common and require systematic evaluation. Slowly-responsive disease is prevalent in the older patient diagnosed with coeliac disease, and super-sensitivity to gluten is an emerging concept that may explain many cases of nonresponsive disease. While there is great interest in developing novel therapies for coeliac disease, no drug has yet been registered. Efficacy studies are generally assessing drugs in patients with treated coeliac disease who undergo gluten challenge or in patients with nonresponsive disease; however, substantial questions remain around specific endpoints relevant for patients, clinicians and regulatory agencies and optimal trial design. Novel immune tools are providing informative readouts for clinical trials and are now shaping their design.
PubMed: 38957478
DOI: 10.1002/jgh3.13107 -
Neurosurgical Focus: Video Jul 2024Hemispherectomy is an effective procedure used in the treatment of drug-resistant hemispheric epilepsy, especially in the pediatric population. A number of resective and...
Hemispherectomy is an effective procedure used in the treatment of drug-resistant hemispheric epilepsy, especially in the pediatric population. A number of resective and disconnective techniques are used, and selection of surgical strategy is paramount to achieving successful results. Notably, disconnective (or functional) hemispherotomy maximizes the benefits of safe, surgical disconnection while minimizing hemispheric tissue resection, thereby avoiding some of the perioperative factors contributing to morbidity in traditional anatomical hemispherectomy procedures. In this video, the authors outline the principal surgical steps of disconnective hemispherotomy and highlight important technical factors leading to optimal outcomes in patients with refractory, oftentimes catastrophic, hemispheric epilepsy. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID2436.
PubMed: 38957432
DOI: 10.3171/2024.4.FOCVID2436 -
Journal of Nutrition and Metabolism 2024Feeding is crucial for very low birth weight neonates to grow and develop properly. This study aims to determine the time to achieve full enteral feeding and predictors...
BACKGROUND
Feeding is crucial for very low birth weight neonates to grow and develop properly. This study aims to determine the time to achieve full enteral feeding and predictors among neonates admitted at Felege Hiwot Comprehensive Specialized Hospital.
METHODS
An institutional retrospective follow-up study design was conducted among 332 very low birth weight neonates from July 1, 2018, to June 30, 2021. Samples were selected through a computer-generated simple random sampling method, and the data were entered into Epi data version 4.6 and then exported to STATA version 16 for analysis. Kaplan-Meier with the log-rank test was used to test for the presence of difference in survival among predictor variables. Model goodness of fit and assumptions were checked by the Cox-Snell residual and the global test, respectively. Variables with value <0.25 in the bi-variable analysis were fitted to the multivariable Cox-proportional hazard model. Finally, the adjusted hazard ratio (AHR) with 95% CI was computed, and variables with a value less than 0.05 in the multivariable Cox regression analysis were considered significant predictors of time to reach full enteral feeding.
RESULTS
A total of 332 neonates were followed for 2,132 person days of risk time and 167 (50.3%) of very low birth weight neonates started full enteral feeding. The overall incidence rate of full enteral feeding was 7.8 per 100 person day observations. The median survival time was 7 days. Very low birth weight neonates delivered from pregnancy-induced hypertension-free mothers (AHR: 2.1; 95% CI: 1.12, 3.94), gestational age of ≥33 weeks (AHR: 5,; 95% CI: 2.29, 11.13), kangaroo mother care initiated (AHR: 1.4; 95% CI: 1.01, 2.00), avoiding prefeed residual aspiration (AHR: 1.42; 95% CI: 1.002-2.03), and early enteral feeding (AHR: 1.5; 95% CI: 1.03, 2.35) were significant predictors of full enteral feeding.
CONCLUSIONS
According to this study, the time to achieve full enteral feeding was relatively short. Therefore, healthcare professionals should emphasize achieving full enteral feeding and address hindering factors to save the lives of VLBW neonates.
PubMed: 38957371
DOI: 10.1155/2024/9384734 -
Ethiopian Journal of Health Sciences Jan 2024Tooth gemination is a single enlarged or joined tooth with a normal tooth count when the anomalous tooth is counted as one. Mandibular second premolars show an elevated...
BACKGROUND
Tooth gemination is a single enlarged or joined tooth with a normal tooth count when the anomalous tooth is counted as one. Mandibular second premolars show an elevated variability of crown morphology. Only nine cases of isolated second premolar macrodontia have been reported in the literature.
CASE DESCRIPTION
This case report presents the clinical and radiographic findings and conservative treatment of an atypical and rare case of localized bilateral molarization of mandibular second premolars.
CONCLUSION
Dental professionals should acquire deeper knowledge about anomalies and plan treatment carefully to avoid unexpected complications during dental procedures caused by morphological ignorance.
Topics: Humans; Bicuspid; Mandible; Female; Male; Tooth Abnormalities
PubMed: 38957336
DOI: 10.4314/ejhs.v34i1.11 -
Right anterior mini thoracotomy for redo cardiac surgery: case series from North America and Europe.Frontiers in Cardiovascular Medicine 2024Right anterior mini thoracotomy (RAMT) for aortic valve replacement (AVR) is a minimally invasive procedure that avoids sternotomy. Herein, we report the outcomes of...
BACKGROUND
Right anterior mini thoracotomy (RAMT) for aortic valve replacement (AVR) is a minimally invasive procedure that avoids sternotomy. Herein, we report the outcomes of patients who underwent redo-cardiac via a RAMT approach for AVR.
METHODS
This case series reports the clinical outcomes of 14 consecutive redo operations, done in Calgary (Canada) and Gdansk (Poland) between 2020 and 2023. Primary outcomes were 30-day mortality and disabling stroke. Secondary outcomes included surgical times, hemodynamics, permanent pacemaker implantation (PPM), length of ICU and hospital stay, new post-operative atrial fibrillation (POAF), post-operative blood transfusion, incidence of acute respiratory distress syndrome (ARDS), rate of continuous renal replacement therapy (CRRT) and/or dialysis, and chest tube output in the first 12-hours after surgery.
RESULTS
Nine patients were male, and the mean age was 64.36 years. There were no deaths, while one patient had a disabling stroke postoperatively. Mean cardiopulmonary bypass and cross clamp-times were 136 min and 90 min, respectively. Three patients needed a PPM, 3 patients needed blood transfusions, and 2 developed new onset POAF. Median lengths of ICU and hospital stays were 2 and 12 days, respectively. There was no incidence of paravalvular leak greater than trace and the average transvalvular mean gradient was 12.23 mmHg.
CONCLUSION
The number of patients requiring redo-AVR is increasing. Redo-sternotomy may not be feasible for many patients. This study suggests that the RAMT approach is a safe alternative to redo-sternotomy for patients that require an AVR.
PubMed: 38957329
DOI: 10.3389/fcvm.2024.1427930 -
Journal of Experimental Orthopaedics Jul 2024This study assessed rotational mismatch between components after total knee arthroplasty (TKA) in the supine and standing positions and aimed to investigate the effect...
PURPOSE
This study assessed rotational mismatch between components after total knee arthroplasty (TKA) in the supine and standing positions and aimed to investigate the effect of rotational mismatch in the standing position on postoperative patient-reported outcome measures (PROMs).
METHODS
Seventy-one patients (71 knees) who underwent TKA for medial knee osteoarthritis were used to investigate rotational mismatches between components. Rotational mismatches between components were examined on postoperative standing whole-leg and supine knee radiographs using a three-dimensional-to-two-dimensional model image registration technique, and the angles between the reference axes of the components were measured. Component alignment was evaluated using postoperative computed tomography images, and a questionnaire (2011 version of the Knee Society Score: [KSS 2011]) was mailed to investigate postoperative PROMs.
RESULTS
In the entire cohort, rotational mismatches in the supine and standing positions were similar ( = 0.9315). In 15% of patients, the mismatch was large (>5°) in the supine position but small (<5°) in the standing position (overestimated group). However, in 23% of patients, the mismatch was small (<5°) in the supine position and large (>5°) in the standing position (underestimated group). The underestimated group had severe preoperative varus deformity, resulting in external rotation of both femoral and tibial components. Rotational mismatch in the standing position ( = 0.0032) was a significant risk factor for unfavourable PROMs. Patients with a mismatch in the standing position had significantly lower scores than those without a mismatch ( = 0.0215), exceeding the minimal clinically important difference values.
CONCLUSIONS
The underestimated group is clinically important because the surgical procedure and intraoperative assessment of component placement are performed in the supine position. In cases of severe preoperative varus deformity, care should be taken not to place the component in malrotation to avoid rotational mismatch in the standing position.
LEVEL OF EVIDENCE
Ⅳ, Case series.
PubMed: 38957227
DOI: 10.1002/jeo2.12069 -
Frontiers in Public Health 2024Academic demands and stressors put nursing students at increasing risk of depression. The aims of the study examine the perceived level of depression and academic stress...
INTRODUCTION
Academic demands and stressors put nursing students at increasing risk of depression. The aims of the study examine the perceived level of depression and academic stress and investigate the association between these variables among nursing students in Saudi Arabia.
METHODS
A cross-sectional design was used in this study. Data was collected using depression subscale from DASS-21 scale and the Academic Stress Inventory scale.
RESULTS
A total of 237 students participated in the study. Nursing students perceived normal to mild levels of depression. Students perceived moderate levels of academic stress in all subscales, except for time management and test stress which were high. All academic stress subscales had a positive statistically significant correlation with depression. The regression model explains 49.0% of the variance in the depression scale and indicated that the main significant predictor of depression is studying in group stress, followed by self-inflected stress, study year, and sleep problem. The mean score of depression for first year students was significantly different than students in other study years.
DISCUSSION
Nurse educators should facilitate group formation and teach students about time-management, problem-solving, negotiation, and coping strategies to deal with academic expectations and demanding situations. Understanding the causes, limiting the exposure to negative influences, and seeking support as needed are important. To enhance the quality of sleep, students should maintain a consistent sleep schedule, while avoiding stimulating activities before bedtime. Future research should focus on a longitudinal study and other variables such as quality of life, satisfaction with the quality of teaching, and support from others.
Topics: Humans; Cross-Sectional Studies; Students, Nursing; Female; Saudi Arabia; Depression; Stress, Psychological; Young Adult; Surveys and Questionnaires; Adult; Education, Nursing, Baccalaureate; Adaptation, Psychological; Perception
PubMed: 38957210
DOI: 10.3389/fpubh.2024.1414469 -
Trauma Case Reports Aug 2024Hangman's fracture is a kind of unstable cervical spine injury which should be treated promptly to avoid life threatening consequences. Advanced neurological monitoring...
Hangman's fracture is a kind of unstable cervical spine injury which should be treated promptly to avoid life threatening consequences. Advanced neurological monitoring is essential during surgical intrervention. Resource limited setting, where advanced monitors like SSEP and MEP are not available makes it challenging to assess proper reduction of cervical spine without neurological compromise. Dexmedetomidine proved to be very useful drug to assess the neurological status intra operatively by awake sedation.
PubMed: 38957170
DOI: 10.1016/j.tcr.2024.101046 -
Rural and Remote Health Jun 2024An outbreak of gastroenteritis due to Salmonella Give, a very rarely identified serotype in human isolates in Greece, occurred in participants of a religious festival in...
INTRODUCTION
An outbreak of gastroenteritis due to Salmonella Give, a very rarely identified serotype in human isolates in Greece, occurred in participants of a religious festival in a rural area of southern Greece, in September 2022. The objectives of this study were to describe the outbreak in terms of epidemiology, identify the vehicle of transmission of the foodborne pathogen and recommend prevention measures.
METHODS
The outbreak was linked to the consumption of a local traditional recipe of roasted pork meat served by a street food vendor. In 2018, the same food item, served in a restaurant in the same region, was implicated in another S. Give outbreak.
RESULTS
Outbreak investigations revealed that outbreak-associated isolates, of food and human origin, belonged to the same S. Give strain. Significant deficiencies regarding food safety practices were identified.
CONCLUSION
Technical knowledge about pathogen transmission paths is important in order for both food handlers and consumers to follow hygiene and sanitary measures, mainly in cases of mass gatherings, where large quantities of food are prepared, handled, cooked and served. Efficient official supervision, mainly during summer festivals, is required in order to avoid recurrence of foodborne infections by different combinations of pathogens/food commodities.
Topics: Humans; Greece; Disease Outbreaks; Pork Meat; Male; Salmonella Food Poisoning; Female; Adult; Animals; Salmonella; Middle Aged; Gastroenteritis; Swine; Food Microbiology
PubMed: 38957085
DOI: 10.22605/RRH8391