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Journal of Voice : Official Journal of... May 2024Though hemorrhagic vocal fold polyps are a common entity, hemorrhagic vocal fold cysts have not been previously described. In our study, we have evaluated patients who...
OBJECTIVES
Though hemorrhagic vocal fold polyps are a common entity, hemorrhagic vocal fold cysts have not been previously described. In our study, we have evaluated patients who were diagnosed on stroboscopy with "hemorrhagic" cysts.
METHODS
This 18-month retrospective study has received institutional ethics clearance. Using the database of our voice clinic, 14 patients diagnosed with hemorrhagic cysts by stroboscopy were reviewed. Age, sex, chief complaints, symptom duration, videostroboscopy findings, surgical details, and histopathology were noted.
RESULTS
Out of a total 14 patients, 12 were males with a mean age of presentation of 41 years. The duration of hoarseness ranged from 2-24 months. Videostroboscopy revealed a markedly decreased amplitude of the mucosal waves over a well-delineated ovoid or spheroid hemorrhagic lesion, which seemed tethered down by overlying vocal fold epithelium. All patients had operative findings of a well-encapsulated hemorrhagic lesion in the superficial lamina propria with anterior and posterior fibrotic bands. Histopathology of 13 patients was similar and revealed a hemorrhagic polypoidal lesion. A pseudo-capsule could be identified occasionally. These lesions seemed to be hemorrhagic pseudocysts, named "polyst" by us. In one male patient, the histopathology revealed a true vocal fold cyst (type C Koren) with hemorrhage.
CONCLUSIONS
A hemorrhagic pseudocyst (polyst) of the vocal fold has stroboscopic and surgical findings resembling a true vocal fold cyst with hemorrhage; however, histologically it resembles a hemorrhagic polyp. A true hemorrhagic cyst however is typically a type C Koren cyst with hemorrhage. Both these entities have not been previously described.
PubMed: 38705739
DOI: 10.1016/j.jvoice.2024.03.034 -
Journal of Perinatology : Official... May 2024Our objective is to analyse the observations related to intrauterine volvulus and assess how clinical manifestations and treatment strategies impact prognosis. We... (Review)
Review
Our objective is to analyse the observations related to intrauterine volvulus and assess how clinical manifestations and treatment strategies impact prognosis. We conducted a comprehensive search on Pubmed and ClinicalTrials.gov from inception to July 2022, using search terms like "intrauterine volvulus" or "foetal volvulus," supplemented by manual scrutiny of reference lists in relevant texts and articles. Our review encompassed 57 case reports/case series, involving 88 cases. The presence of foetal bradycardia during prenatal visits (p = 0.002) and the existence of meconium cyst or pseudocyst (p = 0.038) significantly influence survival rates. Preterm labour occurred more frequently among cases resulting in mortality (54% vs 21%; p = 0.055). Our study's limitations include the inability to access all reported cases and reliance solely on available data. We advocate for vigilant monitoring of foetuses exhibiting signs of intestinal obstruction, and consideration of an emergent caesarean section as a pre-emptive measure before foetal biophysical profile deterioration worsens.
PubMed: 38704480
DOI: 10.1038/s41372-024-01984-6 -
Journal of Racial and Ethnic Health... May 2024Healthcare disparities adversely affect clinical outcomes in racial and ethnic minorities. Chronic pancreatitis (CP) is a complex disorder, and pressures for time and...
BACKGROUND
Healthcare disparities adversely affect clinical outcomes in racial and ethnic minorities. Chronic pancreatitis (CP) is a complex disorder, and pressures for time and cost-containment may amplify the disparity for minorities in this condition. This study aimed to assess ethno-racial differences in the clinical outcomes of CP patients cared for at our institution.
METHODS
This is a study of CP patients with available ethno-racial information followed at our pancreas center. We reviewed their demographics, comorbidities, clinical outcomes, and resource utilization: pain, frequent flares (≥ 2/year), local complications, psychosocial variables, exocrine, and endocrine insufficiency, imaging, endoscopic procedures, and surgeries. The outcomes underwent logistic regression to ascertain association(s) with covariates and were expressed as odds ratio (95% confidence intervals).
RESULTS
Of the 445 CP patients, there were 23 Hispanics, 330 Non-Hispanic Whites, 47 Non-Hispanic Blacks, 16 Asian Americans, and 29 patients from Other/mixed races. Over a median follow-up of 7 years, no significant differences in the pain profile (p = 0.36), neuromodulator use (p = 0.94), and opioid use for intermittent (p = 0.34) and daily pain (p = 0.80) were observed. Frequent flares were associated with Hispanic ethnicity [2.98(1.20-7.36); p = 0.02], despite adjustment for smoking [2.21(1.11-4.41); p = 0.02)] and alcohol [1.88(1.06-3.35); p = 0.03]. Local complications (pseudocysts, mesenteric thrombosis, and biliary obstruction), exocrine and endocrine dysfunction, and healthcare resource utilization (cross-sectional imaging, endoscopic procedures, celiac blocks, or surgeries) were comparable across all ethno-racial groups.
CONCLUSIONS
Although no significant differences in clinical outcomes, and health resource utilization were noted across ethno-racial groups, Hispanic ethnicity had significant association with CP flares. This study calls for further investigation of an understudied minority population with CP.
PubMed: 38702491
DOI: 10.1007/s40615-024-02017-w -
Child's Nervous System : ChNS :... May 2024Ventriculo-peritoneal shunt is the gold standard for non-obstructive hydrocephalus. Despite advances in material, infection prevention, and valve technologies, failure...
PURPOSE
Ventriculo-peritoneal shunt is the gold standard for non-obstructive hydrocephalus. Despite advances in material, infection prevention, and valve technologies, failure can still occur. The aim of this article is to present a comprehensive study based on the experience of a reference center in pediatric neurosurgery in Rio de Janeiro with the use of the ventriculo-gallbladder shunt as an alternative to peritoneal failure.
METHODS
A retrospective study was conducted from January 2018 to December 2023 of patients diagnosed with cerebrospinal fluid shunt dysfunction due to peritoneal failure and submitted to ventriculo-gallbladder shunt as an alternative in a reference center of Rio de Janeiro.
RESULTS
From 2018 to 2023, 18 peritoneal failures were diagnosed. Among them, 10 patients (55.5%) were selected for ventriculo-gallbladder shunt (VGS). Different causes were responsible for the hydrocephalus in these patients. VGS was placed at a mean age of 35.4 months. Four patients had temporary complications: 2 self-limited diarrheas in the first month and 2 shunt infections. After the resolution of the infection, a new VGS was placed successfully. The average follow-up was 18.8 months (follow-up 9-68 months) without further issues.
CONCLUSION
VGS is a viable option for patients facing peritoneal failure. This paper provides valuable insights into the surgical technique and outcomes associated with this alternative.
PubMed: 38698115
DOI: 10.1007/s00381-024-06427-3 -
Turkish Journal of Surgery Dec 2023Hydatid disease is a zoonotic parasitic disease which rarely involves pancreas primarily. Diagnosis of pancreatic hydatid cyst is a challenge and operative skills are...
Hydatid disease is a zoonotic parasitic disease which rarely involves pancreas primarily. Diagnosis of pancreatic hydatid cyst is a challenge and operative skills are important to avoid spillage of cyst's content. A 19-year-old male patient was admitted to hospital with recurrent abdominal pain which was on epigastrium and left upper quadrant of abdomen. Pain was not associated with nausea, vomiting or fever. An abdominal computed tomography (CT) scan was ordered. As a result of abdominal CT scan, there was a cystic area in tail of pancreas with a diameter of 5.6 cm which includes septa and there was calcification on borders of the cyst. Possible diagnosis were either pancreatic hydatid disease, pancreatic cyst adenoma or cystadenocarcinoma or pseudocyst of autoimmune pancreatitis. Whole body positron emission tomography (PET-CT) scan showed no other cyst or lesion other than pancreatic cyst. Hydatid disease indirect hemagglutination test has been studied and it was positive. Imaging studies and laboratory results were suggested hydatid disease and laparoscopic distal pancreatectomy has been applied. Primary pancreatic hydatid disease should be in differential diagnosis when newly appearing pancreatic cyst has been diagnosed, especially in endemic areas. Appropriate surgical technique has to be applied to avoid dissemination of cyst's content.
PubMed: 38694528
DOI: 10.47717/turkjsurg.2023.4768 -
In Vivo (Athens, Greece) 2024Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is frequently associated with the Epstein-Barr virus (EBV) and manifests as non-mass-forming microscopic...
BACKGROUND/AIM
Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is frequently associated with the Epstein-Barr virus (EBV) and manifests as non-mass-forming microscopic lesions within fibrin-rich lesions. Herein, we describe the cytological features of FA-DLBCL.
CASE REPORT
A 72-year-old man presented with a large retroperitoneal cystic mass that was treated by cyst aspiration and laparoscopic excision. Individually dispersed large, atypical cells in a necrotic background contained scant cytoplasm and hyperchromatic nuclei with irregular nuclear contours, frequent karyorrhectic debris, and mitotic figures. A fibrinous exudate with necrotic material attached to the inner surface of the cystic mass contained large, atypical cells that were individually scattered or arranged in small clusters. These were positive for cluster of differentiation 20 and Epstein-Barr virus-encoded RNA in situ hybridization.
CONCLUSION
We cytologically characterized FA-DLBCL as large, atypical cells that were individually scattered or arranged in small clusters in a necrotic background. To the best of our knowledge, we revealed the cytological features of FA-DLBCL.
Topics: Humans; Male; Aged; Lymphoma, Large B-Cell, Diffuse; Fibrin; Cysts; Herpesvirus 4, Human; Epstein-Barr Virus Infections; Retroperitoneal Neoplasms; Tomography, X-Ray Computed
PubMed: 38688594
DOI: 10.21873/invivo.13594 -
World Journal of Clinical Cases Apr 2024Lateral window approach for sinus floor lift is commonly used for vertical bone augmentation in cases when the residual bone height is less than 5 mm. However, managing...
BACKGROUND
Lateral window approach for sinus floor lift is commonly used for vertical bone augmentation in cases when the residual bone height is less than 5 mm. However, managing cases becomes more challenging when a maxillary sinus pseudocyst is present or when there is insufficient bone width. In this case, we utilized the bone window prepared during the lateral window sinus lift as a shell for horizontal bone augmentation. This allowed for simultaneous horizontal and vertical bone augmentation immediately after the removal of the maxillary sinus pseudocyst.
CASE SUMMARY
A 28-year-old female presented to our clinic with the chief complaint of missing upper left posterior teeth. Intraoral examination showed a horizontal deficiency of the alveolar ridge contour. The height of the alveolar bone was approximately 3.6 mm on cone beam computed tomography (CBCT). And a typical well-defined 'dome-shaped' lesion in maxillary sinus was observed on CBCT imaging. The lateral bony window was prepared using a piezo-ultrasonic device, then the bony window was fixed to the buccal side of the 26 alveolar ridge using a titanium screw with a length of 10 mm and a diameter of 1.5 mm. The space between the bony window and the alveolar ridge was filled with Bio-Oss, covered with a Bio-Gide collagen membrane, and subsequently sutured. Nine months later, the patient's bone width increased from 4.8 to 10.5 mm, and the bone height increased from 3.6 to 15.6 mm. Subsequently, a Straumann 4.1 mm × 10 mm implant was placed. The final all-ceramic crown restoration was completed four months later, and both clinical and radiographic examinations showed that the implant was successful, and the patient was satisfied with the results.
CONCLUSION
The bone block harvested from the lateral window sinus lift can be used for simultaneous horizontal bone augmentation acting as a shell for good two-dimensional bone augmentation.
PubMed: 38680257
DOI: 10.12998/wjcc.v12.i12.2109 -
Journal of Medical Case Reports Apr 2024Non-pancreatic pseudocysts are rare lesions that typically form from the omentum and mesentery. These cysts have a thick fibrotic wall made up of fibrous tissue and may...
INTRODUCTION
Non-pancreatic pseudocysts are rare lesions that typically form from the omentum and mesentery. These cysts have a thick fibrotic wall made up of fibrous tissue and may show signs of calcifications and inflammatory changes. The fluid inside them can vary, ranging from hemorrhage and pus to serous or sometimes chylous content. In most cases, these cysts appear as a result of trauma, surgery, or infection.
CASE PRESENTATION
A 35-year-old male patient from Ethiopia presented with swelling in his lower abdomen that had been present for 2 years. Initially, the swelling was small but gradually increased in size. The patient experienced frequent urination but no pain or difficulty during urination, urgency, intermittent urination, or blood in the urine. The swelling was initially painless but became painful 2 months prior to his presentation. Abdominal computed tomography scans revealed a well-defined, lobulated peritoneal lesion measuring 16 × 12 × 10 cm, consisting primarily of fluid-filled cysts with a thick, enhancing wall and septa. Additionally, there was a large, heterogeneous enhancing soft tissue component measuring 8 × 6 cm. As a result, the cystic mass was surgically removed in its entirety with partial removal of the bladder wall, and the patient was discharged in an improved condition.
CONCLUSION
Primary non-pancreatic pseudocysts are extremely rare lesions that must be differentiated from other possible causes of cystic lesions within the peritoneal or retroperitoneal regions. Surgeons should be aware of the potential occurrence of these lesions, which may have an unknown origin.
Topics: Humans; Male; Adult; Tomography, X-Ray Computed; Cysts; Peritoneal Diseases; Treatment Outcome
PubMed: 38679699
DOI: 10.1186/s13256-024-04503-5 -
Abdominal pseudocyst associated with infection of ventriculoperitoneal shunt by Cutibacterium acnes.Medicina Clinica Apr 2024
PubMed: 38677915
DOI: 10.1016/j.medcli.2024.01.035 -
Endoscopy Dec 2024
Topics: Humans; Pancreatic Pseudocyst; Drainage; Child, Preschool; Male; Stents; Endosonography
PubMed: 38657669
DOI: 10.1055/a-2299-2253