Intrasellar psammomatous meningioma: a case report and review of the literature
Published on: 18th January, 2022
OCLC Number/Unique Identifier: 9396189210
Intrasellar meningioma (IM) is a rare occurrence that is difficult to distinguish preoperatively from the most common non-functioning pituitary adenoma. Here we describe a case of psammomatous IM occurring in a 68-year-old woman, presented with visual defects. On magnetic resonance imaging (MRI) she was found to have an intrasellar mass with suprasellar extension that was approached with transsphenoidal surgery. Subtle radiological hints, namely dural tail sign, intralesional calcifications and a marked and homogenous early enhancement of IM on MRI after gadolinium administration, may aid clinicians in achieving an accurate pre-operative diagnosis and choosing the proper surgical approach. The clinical and neuroradiological features of IM described in the literature has been reviewed.
Neurotoxicity related exposure to ambient nanoparticles
Published on: 18th January, 2022
OCLC Number/Unique Identifier: 9396207094
Air pollution exposure is among the most prevalent reasons for environmentally-induced oxidative stress and inflammation, both of which are implicated in the central nervous system (CNS) diseases. The CNS has emerged as an important target for adverse health effects of exposure to air pollutants, where it can cause neurological and neurodevelopmental disorders. Air pollution includes various components of gases, particulate matter (PM), ultrafine particulate (UFPs), metals, and organic compounds. An important source of PM and UFPM in the ambient air is associated with air pollution-related trafficking, and primarily diesel exhaust particles (DEPs). Controlled animal studies and epidemiological studies show that exposure to air pollution, and in particular urban air pollution or DEPs, may lead to neurotoxicity. In specific, exposure to air pollutants as an important factor may be in neurodevelopmental disorders (eg Autism) and neurological disorders (eg.., Alzheimer’s Disease (AD)). The most noticeable effects of exposure to air pollutants in animals and humans are oxidative stress and neurodegeneration. Studies in rats exposed to DEPs showed microglial activity, increased lipid peroxidation, and neuronal accumulation in various areas of the brain, especially the olfactory bulb (OB) and the hippocampus (HI). Disorders of adult neurogenesis were also found. In most cases, the effects of DEP are more pronounced in male mice, probably due to lower antioxidant capacity due to less expression of paraoxonase 2.
Outpatient operative hysteroscopy: evaluation of patient satisfaction and acceptance
Published on: 18th January, 2022
OCLC Number/Unique Identifier: 9396216754
Aims: To examine patient satisfaction of an outpatient operative hysteroscopy performed by both doctors and nurse hysteroscopists. Secondly, compare satisfaction, complications, and failure rate of these procedures performed by doctors and nurse hysteroscopists.Methods: In this retrospective study, the charts of 80 women who attended the service over one year were examined. Women were included if either an endometrial polyp or submucosal leiomyoma required removal using an endoscopic morcellator. All women had signed a consent form for the procedure. Results: In total 67/80 (84%) patients were satisfied with the service. Nurse hysteroscopists completed most procedures 59/80 (74%). Satisfaction ratings were not recorded for 13/80 (16%) consultations, completed by doctors. There was no difference in satisfaction and complication rates between doctors and nurse hysteroscopists. A total of five patients required repeat endoscopic morcellation, three completed by doctors and two completed by nurse hysteroscopists. For this group, satisfaction and complication ratings did not change.Conclusion: High patient satisfaction and low complication rates were found. Nurse hysteroscopists performed more procedures, providing a safe and useful service. Few patients required repeat morcellation procedures.
Predictors of positive treatment response to PTNS in women with overactive bladder
Published on: 18th January, 2022
OCLC Number/Unique Identifier: 9396180874
Percutaneous tibial nerve stimulation (PTNS) is a non-invasive treatment for overactive bladder (OAB). PTNS involves peripheral neuromodulation that uses electrical stimulation to target the spinal cord roots, mainly S3, which controls bladder function. Neuromodulation is postulated to be the effect of cross-signaling between sympathetic and parasympathetic post ganglionic nerve terminals and synapses, causing alteration of nerve signals involved in the voiding reflex. de Groat, et al. described this neurophysiological process and the neural circuits involved in controlling the lower urinary tract [1]. Stimulation of peripheral nerves and subsequent “cross-talk” at the level of the postganglionic neuroeffector junctions can modulate transmission and facilitate detrusor inhibition [2].
Uncommon first diagnosis of metastatic papillary thyroid carcinoma with “signet-ring” cells morphology through pericardial effusion
Published on: 20th January, 2022
OCLC Number/Unique Identifier: 9396216816
Malignant pericardial effusion is a usual and crucial exacerbation in malignancies. In some cases, pericardial effusion may be the first manifestation of the disease. Neoplastic pericarditis is extremely rare in thyroid cancer. Hereby, we describe the case of a 54-year-old man submitted to the hospital for chest pain and dyspnea. Clinical and radiological examinations were suggestive of pericardial effusion and mediastinal lymphadenopathy. The patient underwent pericardial drainage and surgical biopsy of a paratracheal lymph node. Pericardial biopsies were also taken. Histology study was compatible with metastatic papillary thyroid carcinoma with “signet-ring” cell morphology. Extended study of thyroid gland and function was performed and he was referred to oncologists for further treatment. Clinical presentation and histology are discussed emphasizing the rare correlation between pericardial pathology and metastatic thyroid carcinomas as the first diagnosis. Histopathologic findings of “signet-ring” cell morphology are very challenging for a differential diagnosis between thyroid carcinoma and other metastatic adenocarcinomas.
Prevention of workplace violence in ED nursing using the implementation of an educational program and a new reporting tool
Published on: 7th January, 2022
The Emergency Department (ED) is a place that regularly deals with acute scenarios and people that are generally sensitive in nature. In a fast-paced environment such as this, people can be emotionally charged and react in different ways. Unfortunately, nurses in the ED tend to be most affected. Literature shows that workplace violence incidents that occur tend to involve ED nurses. Furthermore, ED nurses are more inclined to have an attitude that makes them think that any acts of transgression are “part of the job” and incidents usually go underreported. Moreover, reporting tools are usually difficult to use and tend to be a barrier to reporting workplace violence. In this evidence-based project, ED nurses will participate in an educational prevention program that will help equip them with the knowledge and awareness that is needed to decrease the incidence of workplace violence. Furthermore, a new, easy-to-use reporting tool will be implemented for ED staff. An implementation of an easier reporting tool and an education prevention program on the incidence of workplace violence will help reduce the number of future incidents of workplace violence. The purpose of this evidence-based project is to create a “zero tolerance” workplace culture for ED nurses that ultimately decreases the incidence of workplace violence. Based on research, an educational program and new reporting tool will be implemented at an urban community hospital in Westchester. Included is a purpose statement, and operational and conceptual definition, PICO questions, and an evidence-based practice protocol for workplace violence.
Squamous cell carcinoma in a retrorectal cystic hamartoma
Published on: 20th January, 2022
OCLC Number/Unique Identifier: 9395224616
Retrorectal cystic hamartomas (HCR) (“tailgut cyst” in English-language literature) are congenital cystic tumors derived from vestiges of the hindgut. Its incidence is low, being more frequent in adult women. They are variable in size, uni or multiloculated. They can be lined with several types of epithelia (squamous, transitional, mucinous,...) in a same cyst and can contain mucus. Lesions usually present during adulthood due to pain, discomfort, rectal bleeding, infection, or malignant transformation. The incidence of malignancy is low, being adenocarcinoma and neuroendocrine the most frequent tumors associated to HCR. We present a case of HCR associated with squamous cell carcinoma and discuss aspects of the treatment.
Applications of convolutional neural networks in chest X-ray analyses for the detection of COVID-19
Published on: 20th January, 2022
OCLC Number/Unique Identifier: 9391752257
Throughout global efforts to defend against the spread of COVID-19 from late 2019 up until now, one of the most crucial factors that has helped combat the pandemic is the development of various screening methods to detect the presence of COVID-19 as conveniently and accurately as possible. One of such methods is the utilization of chest X-Rays (CXRs) to detect anomalies that are concurrent with a patient infected with COVID-19. While yielding results much faster than the traditional RT-PCR test, CXRs tend to be less accurate. Realizing this issue, in our research, we investigated the applications of computer vision in order to better detect COVID-19 from CXRs. Coupled with an extensive image database of CXRs of healthy patients, patients with non-COVID-19 induced pneumonia, and patients positive with COVID-19, convolutional neural networks (CNNs) prove to possess the ability to easily and accurately identify whether or not a patient is infected with COVID-19 in a matter of seconds. Borrowing and adjusting the architectures of three well-tested CNNs: VGG-16, ResNet50, and MobileNetV2, we performed transfer learning and trained three of our own models, then compared and contrasted their differing precisions, accuracies, and efficiencies in correctly labeling patients with and without COVID-19. In the end, all of our models were able to accurately categorize at least 94% of the CXRs, with some performing better than the others; these differences in performance were largely due to the contrasting architectures each of our models borrowed from the three respective CNNs.
Fatal acute necrotizing pancreatitis in a 15 years old boy, is it multisystem inflammatory syndrome in children associated with COVID-19; MIS-C?
Published on: 13th January, 2022
OCLC Number/Unique Identifier: 9396181492
Acute pancreatitis in childhood is not common and viral and bacterial infections, bile duct diseases, medications, systemic diseases, trauma, metabolic diseases, and hyperlipidemia are among the most common causes in them. Acute necrotizing pancreatitis is even rarer. The clinical presentation of Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C) includes fever, severe illness, and the involvement of two or more organ systems, in combination with laboratory evidence of inflammation and with or without laboratory or epidemiologic evidence of SARS-CoV-2 infection. We present a case of a 15 years old boy with fatal acute necrotizing pancreatitis that fulfilled MIS-C definition based on RCPCH (Royal College of Pediatrics and Child Health) and CPSP (Canadian Pediatric Surveillance Program) criteria.
Impact of the COVID-19 infection on the “benign” nature of the illness of Schönlein-Henoch
Published on: 11th January, 2022
OCLC Number/Unique Identifier: 9391761803
The incidence of COVID-19 in children has been variable. Although now the number of infected children worldwide, and in particular nationally, is small, they are not protected from the infection. Moreover, in the most severe cases septic shock, metabolic acidosis, irreversible bleeding, and coagulation dysfunction have been registered.In February 2021 a 17-year-old boy showed for examination with complaints of pain in the upper part of the abdomen, accompanied by involvement of the ankle joints, the appearance of a rash on the lower extremities with the characteristic of hemorrhagic vasculitis, and a positive test for COVID-19. The characteristics of the skin purpura, the abdominal pain, and the arthralgia led us to the diagnosis of Schönlein-Henoch purpura. The verification of past COVID-19 infection was done by the established high titer of specific IgG antibodies. The clinical evolution of the disease went beyond its generally accepted benign nature - the first manifestation of the illness had been followed by four more relapses, which necessitated new hospitalizations and a change in the therapeutic approach.COVID-19 infection is the cause of a more aggressive course of vasculitis.
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