Ewing’s sarcoma of the head and neck in children Vaccani, J.P.; Forte, V.; de Jong, A.L. ...
International journal of pediatric otorhinolaryngology,
05/1999, Letnik:
48, Številka:
3
Journal Article
Recenzirano
Objective: The purpose of this paper was to review our experience with Ewing’s sarcoma of the head and neck in children.
Design: Retrospective chart review.
Setting: The Hospital for Sick Children, ...Toronto, Ont., Canada.
Methods: Between 1986 and 1996, 70 cases of Ewing’s sarcoma were identified. The medical records, roentgenographic and pathology reports were reviewed retrospectively. The gender, age of presentation, location and clinical presentation of the tumor were noted in the cases involving the head and neck. The treatment and follow-up of these patients were recorded.
Results: Of the 70 cases of Ewing’s, five involved the head and neck (7.1%). The age of presentation ranged from 7.5 to 14 years. An enlarging mass in the mandible was the mode of presentation in three of the five children. Two patients had metastases at initial presentation. All patients received combination treatment regimens with chemotherapy initially, followed by adjuvant surgery and/or radiation. Follow-up ranged from 2 to 11 years. Three of five patients died of metastatic disease. Two are alive and well with no evidence of disease.
Conclusions: Ewing’s sarcoma occurs infrequently in the head and neck in children. An enlarging mass in the mandible is the most frequent mode of presentation. This tumor is treated systemically with high dose chemotherapy and locally with surgical excision where possible. In lesions that are initially unresectable and/or show a poor response to chemotherapy, radiation is used for local control. A good prognosis can be expected if the disease has not metastasized.
P386 OBESITY AND CARDIOMYOPATHY Giofrè, F; Pelle, M; Zaffina, I ...
European heart journal supplements,
05/2022, Letnik:
24, Številka:
Supplement_C
Journal Article
Recenzirano
Odprti dostop
Abstract
Background
Obesity cardiomyopathy is a heart failure unexplained by others etiologies that can vary from a subclinical left ventricular dysfunction to overt dilated cardiomyopathy.
Aim
To ...evaluate the changes in echocardiogram in both normotensive and hypertensive obese and to evaluate obesity and/or hypertension impact on cardiomyopathy.
Methods
383 subjects (236F–147M) were enrolled. They were divided into two groups based on BMI: non–obese subjects (BMI<30kg/m2) and obese subjects (BMI>30kg/m2). The obese subjects were divided in different degrees (groups) of obesity according with obesity classification: group 1= BMI >30<35, 2= BMI >35<40, 3= BMI >40 kg/m2. 208 of 383 enrolled subjects were hypertensive. All subjects underwent to an echocardiogram with evalutation of left atrial diameter (LAD), left ventricular end–diastolic diameter (LVEDD), left ventricular end–systolic diameter (LVESD), ventricular septum, cardiac mass and left ventricular mass index (LVMI).
Results
Obese subjects showed a progressive increase in left atrial diameter (LAD)(P = 0.000), left ventricular end–diastolic diameter (LVEDD)(P = 0.000), left ventricular end–systolic diameter (LVESD)(P = 0.001), ventricular septum (P = 0.000) and cardiac mass (P = 0.000) according to the degree of obesity. Subjects in the 3° group of obesity showed higher value of LAD and LVESD when compared with subjects in first two groups (P = 0.000; P = 0.032; P = 0.000; P = 0.001, respectively). Similarly, subjects in the 3° group of obesity showed higher value of ventricular septum and cardiac mass when compared with the first two groups of obesity (P = 0.005; P = 0.002; P = 0.000; P = 0.005; respectively). LAD, LVEDD, LVESD, ventricular septum and cardiac mass were positively related with the obesity degree. In order to avoid that echocardiographic modifications were caused by hypertension, data were adjusted for hypertension so linear regression documented that degree of obesity predicts echocardiographic changes (LAD, LVEDD, LVESD) better than hypertension.
Conclusions
Our data suggested that the in obese subjects the severity of cardiomyopathy is correlated with degree of obesity and that the degree of obesity is a better predictor than hypertension for echocardiographic changes.
Atherosclerotic carotid artery disease (ACAD) is a rare but recognized cause of pulsatile tinnitus. Existing literature of reported cure for pulsatile tinnitus is reviewed. We found: (1) a male ...preponderance exists; (2) ipsilateral carotid endarterectomy (CEA) for tinnitus is 92% (12 of 13) effective; (3) proximal lesions lend themselves to CEA whereas distal lesions have been treated by stenting; (4) overall 68% (15 of 22) are cured by intervention; and (5) 89% (17 of 19) can expect immediate relief. We now present a case of bilateral pulsatile tinnitus relieved by bilateral carotid endarterectomy.
Muscle-flap salvage of prosthetic dural repair Chung, Connie; Forte, Antonio J.V; Momeni, Reza ...
Journal of plastic, reconstructive & aesthetic surgery,
02/2010, Letnik:
63, Številka:
2
Journal Article
Recenzirano
Summary Objective A critical element in the prevention of wound and cerebrospinal fluid (CSF) infections after craniotomies is the prevention of postprocedural CSF leaks. The salvage of infected ...prosthetic dural material in this milieu is not adequately addressed in the literature and is the subject of this study. Methods We performed a 7-year retrospective review of the Yale-New Haven Hospital patient records to identify successful salvage strategies in patients with relentless CSF leaks. Twenty data points were collected, including original diagnosis, nature of the procedure, presence of dural graft, definitive treatment of the leak, culture results and pre- and postoperative antibiotics. Results Thirteen patients experienced post-craniotomy CSF leaks that required surgical intervention. The most common cause of the original craniotomy (54% of patients) was an oncological aetiology, followed by ruptured aneurysms or haemorrhage in 31% of the patients. Of the 13 patients experiencing CSF leaks, 76% involved the posterior skull base, and therefore a trapezius muscle flap was used in 38% of the cases. The Bovine pericardial graft (10 our of 13), a nonautologous graft, was left intact, and CSF drainage procedures were employed in most patients Growth of Gram-positive organisms on cultures was found in 76% of the cases. The most frequent offenders were Staphylococcus aureus (five of the 13), coagulase-negative staphyloccocal species (two out of 13), and methicillin-resistant S. aureus (two out of 13). Vancomycin was administered in all cases preoperatively. All 13 patients who underwent open surgery for CSF leak had complete resolution of the leak without need for additional reconstructive surgical intervention. Conclusion Comprehensive method of treating CSF leaks in conjunction with the salvage of bovine pericardial dural grafts may be a viable clinical option.
Staphylococcal foodborne diseases resulting from consumption of food contaminated with staphylococcal enterotoxins (SEs) produced by certain strains of Staphylococcus aureus are the second most ...common foodborne illnesses in the world. Analytical methods are essential for routine monitoring purposes and safeguard public health. Different methods for SE detection have been proposed although their use in a complex matrix is often limited by the presence of substances that interfere with tests. In this article reverse passive latex agglutination (RPLA) and immunoblotting methods based on specific antibodies and currently available for SE detection have been compared. Culture filtrates from enterotoxin S. aureus strains isolated from cheese samples were identified by SET-RPLA. Then the culture filtrates identified as staphylococcal enterotoxin A and staphylococcal enterotoxin B by RPLA test were analyzed with immunoblotting. The results obtained suggest that either SET-RPLA or immunoblotting may be applied to culture filtrates for the detection of SEs with good correspondence of results. Although SET-RPLA represents a simple method for routine monitoring purposes, a positive result by a rapid method (RPLA) is only regarded as presumptive and must be confirmed by standard methods (Feng 1996), such as immunoblotting method.
Agenesis of the parotid gland is extremely rare with only few cases reported in the medical literature. This entity can be important to diagnose as occasionally the normal parotid gland can be ...mistaken for a tumor due to the facial asymmetry. In this article, we present the case of an isolated unilateral parotid gland agenesis in a young child. The entity is discussed along with important associated conditions that should be ruled out. These include amongst others first and second branchial arch anomalies, as well as the Levy-Hollister or lacrimo-auriculo-dentodigital syndrome.
It is known that warfarin treatment is problematic, due to its narrow therapeutic range and to the great interindividual variability. Numerous papers have shown the important contribution of CYP2C9 ...and VKORC1 genetic variants to this variability. Recently, a new SNP within the CYP4F2 gene was found associated with warfarin dose in the USA.
The aim of our work was to replicate this study in the Italian population and to assess the new CYP4F2 variant relative contribution in explaining warfarin dose variability with respect to CYP2C9 and VKORC1 genetic variants together with age and weight.
CYP4F2 rs2108622 genotyping was performed by allelic discrimination assay by TaqMan technology. Analysis of variance and multiple linear regression analyses were carried out to examine the contribution of genetic and nongenetic factors.
Our TT patients require 5.49 mg/day versus 2.93 mg/day of our CC patients. Analysis of variance indicates that about 7% of mean weekly warfarin dose variance is explained by CYP4F2 genotype. Our linear regression model including CYP4F2, CYP2C9 and VKORC1 genetic variants, age and weight, explains 60.5% of the interindividual variability.
Our data confirm and strengthen the role of this variant.
Abstract
Background
Obesity and Obstructive Sleep Apnea Syndrome (OSAS) has been recognized as two of the major cardiac risk factors and they often coexist in one patient. OSAS increase the risk of ...as myocardial infarction, heart failure and arrhythmias. On the other hand, obesity is and independent predictor of cardiovascular mortality since it causes insulin resistance, dyslipidemia, sympathetic hyperactivation, chronic inflammation and endothelial dysfunction.
Aim
To evaluate cardiometabolic profile, echocardiographic alterations and the presence of arrhythmias in obese patients with Obstructive Sleep Apnea Syndrome and non obese patients.
Patients and Methods
67 obese patients (37 male/30 female) and 52 non obese patients (40 male/12 female) were enrolled. All subjects underwent anthropometrical evaluation and a venous blood sample for biochemical and hormonal determinations including fasting plasma glucose, fasting plasma insulin, Hba1c and OGTT to 5 hours. The insulin resistance was evaluated by HOMA–IR. All the patients underwent echocardiographic examination, polysomnographic evaluation, in order to diagnose the OSAS, and a simultaneous 12–lead Holter ECG to evaluate the presence of nocturnal arrhythmias.
Results
As expected, we found a better antropometrics profile in non obese patients. Obese patients display a severe OSAS compared to non–obese patient as shown by higher values of AHI (26.37 ±24.95 vs 16.58 ±14.07; P < 0.05), TC90 (19.61 ±24.45 vs 8.63 ±17.80; P < 0.05) and ODI (40.55 ±27.41 vs 21.06 ±22.78; P < 0,05). In obese patients we also found a significant reduction of both ejection fraction (55.54 ±7.97 vs 66.52 ±8.95; P < 0.05) and A–wave (0.75 ±0.17 vs 0.83 ±0.19; P < 0.05). In 20% of obese patients, 12–lead Holter ECG showed the presence of cardiac pause > 3 sec during apnea. In obese population alone we demonstrated a significant negative correlation between AHI and E–wave (r= –0.3; P = 0.04) and a positive correlation with interventricular septum (r = 0.38; P = 0.01) and left ventricular mass (r = 0.32; P = 0.02). Post–hoc analysis shown how these findings maintained statistical significance even when the obese patients were stratified in subgroups according to the severity of OSAS.
Conclusions
Our data, even if preliminary, seem to indicate that OSAS is not only linked to obesity but it also acts as a negative factor on the cardiometabolic risk.
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