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Malmquist M, Rabe H, Malmborg P, Gale G, Ideström M, Sigurdsson GV, Hasséus B, Wold AE, Saalman R. Frequent Occurrence of Perianal Disease and Granuloma Formation in Patients with Crohn's Disease and Coexistent Orofacial Granulomatosis. Dig Dis Sci 2023:10.1007/s10620-023-07821-8. [PMID: 36646935 DOI: 10.1007/s10620-023-07821-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 01/01/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Orofacial granulomatosis (OFG) is an inflammatory disorder of the perioral region and oral cavity. Crohn's disease (CD) in conjunction with OFG (CD-OFG), has been suggested to constitute a phenotype of CD with distinct features at diagnosis. AIMS The aim of this project was to investigate whether the distinct phenotypic features of CD-OFG persist in the years following the initial diagnosis of CD. METHODS Clinical data were extracted from medical records covering the first 5 years post-diagnosis for a cohort of patients with CD-OFG, and were compared to those of references with CD without OFG. RESULTS The clinical characteristics of our cohort of patients with CD-OFG (N = 25) were evaluated in comparison to references with CD without OFG (ratio 1:2). Five years post-diagnosis, more patients with CD-OFG had a phenotype with perianal disease (cumulative incidence: 16/25, 64% vs 13/50, 26%, P = 0.002) and intestinal granulomas (cumulative incidence: 22/25, 88% vs 24/50, 48%, P = 0.0009) than patients in the CD reference group. The patients with CD-OFG were also more likely to have undergone perianal surgery (12/25, 48% vs 4/50, 8%, P = 0.0002). At the end of the observation period, more of the patients with CD-OFG were receiving combination therapy, i.e., immunomodulators and tumor necrosis factor antagonists, than those in the CD reference group (9/25, 36% vs 5/50, 10%, P = 0.01). CONCLUSION The results support the notion that CD in conjunction with OFG represents a specific phenotype of CD that is characterized by frequent perianal disease, pronounced intestinal granuloma formation and a need for extensive therapy.
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Affiliation(s)
- Marianne Malmquist
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
- Department of Pediatrics, The Central Hospital of Växjö, Strandvägen 8, 352 34, Växjö, Sweden.
| | - Hardis Rabe
- Department of Infectious Disease, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Petter Malmborg
- Sachsska Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Gita Gale
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Maja Ideström
- Department of Women's and Children's Health, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Medicine, Uppsala University Children's Hospital, Uppsala, Sweden
| | - Gudmundur Vignir Sigurdsson
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Bengt Hasséus
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Agnes E Wold
- Department of Infectious Disease, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Robert Saalman
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Gale G, Ostman S, Saalman R, Telemo E, Jontell M, Hasséus B. Immunophenotype in orofacial granulomatosis with and without Crohn's disease. Med Oral Patol Oral Cir Bucal 2014; 19:e584-591. [PMID: 25350593 PMCID: PMC4259375 DOI: 10.4317/medoral.20187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/22/2014] [Indexed: 01/29/2023] Open
Abstract
Objectives: The aim of this investigation was to characterise and compare the inflammatory infiltrates in patients with orofacial granulomatosis solely (OFG-S) and OFG with coexisting Crohn’s disease (OFG+CD).
Study Design: Biopsy specimens with granulomas were obtained from patients with OFG-S (n=11) and OFG+CD (n=11) and immunostained with antibodies against CD1a, CD3, CD4, CD8, CD11c, CD20, CD68 and mast cell tryptase, followed by quantitative analysis.
Results: Analyses of the connective tissue revealed a significantly higher number of CD3-expressing T cells and CD11c-expressing dendritic cells in the connective tissue of patients with OFG-S compared to patients with OFG+CD. Mast cells displayed a high level of activation, although no significant difference was detected when comparing the two groups.
Conclusions: The results show a different composition of the inflammatory infiltrate in patients with OFG-S compared to patients with OFG+CD. The present observations support that partly divergent immune mechanisms are involved in these two different subcategories of OFG.
Key words:Granulomas, autoimmunity, T cells, B cells, dendritic cells, children, adults.
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Affiliation(s)
- Gita Gale
- Department of Oral Medicine and Pathology, Institute of Odontology The Sahlgrenska Academy, University of Gothenburg, Box 450, SE405 30 Gothenburg, Sweden,
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Bankvall M, Sjöberg F, Gale G, Wold A, Jontell M, Östman S. The oral microbiota of patients with recurrent aphthous stomatitis. J Oral Microbiol 2014; 6:25739. [PMID: 25626771 PMCID: PMC4221501 DOI: 10.3402/jom.v6.25739] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Specific pathogenic bacteria have been implicated in recurrent aphthous stomatitis (RAS), a chronic inflammatory condition characterised by ulcerations in the oral mucosa. However, the aetiology behind this condition still remains unclear. OBJECTIVE The buccal microbiota of patients with RAS was compared to that of control subjects to investigate its potential role for this condition. DESIGN Buccal swabs were obtained from non-ulcerative areas of 60 patients, of whom 42 patients had lesions at the time of sampling, and 60 healthy age- and gender-matched controls. Bacterial DNA was extracted and analysed by Terminal-Restriction Fragment Length Polymorphism, using enzymatic digestion of the polymerase chain reaction-amplified 16S rRNA gene, yielding a series of peaks, each representing a bacterial taxon. RESULTS Two peaks, 60 and 489, were more prevalent in patients with RAS than controls. Conversely, peaks 58 and 490 were less common in patients than controls. When the patients were divided into subgroups, we found that the observed differences in peak-pattern were related to the presence of lesions during sampling. CONCLUSIONS The microbiota of the non-inflamed buccal mucosa differed between patients and controls. The differences were most pronounced in patients who presented with lesions during sampling, suggesting that a disturbance in the normal buccal microbiota triggers the presence of lesions or that presence of lesions alters the microbiota.
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Affiliation(s)
- Maria Bankvall
- Department of Oral Medicine & Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Fei Sjöberg
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Gita Gale
- Department of Oral Medicine & Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Agnes Wold
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Mats Jontell
- Department of Oral Medicine & Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Sofia Östman
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Sweden;
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Gale G, Östman S, Saalman R, Telemo E, Jontell M, Hasseus B. OI0385 Orofacial granulomatosis immunophenotypes in patients with or without Crohn disease. Oral Surg Oral Med Oral Pathol Oral Radiol 2014. [DOI: 10.1016/j.oooo.2014.01.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gale G, Östman S, Rekabdar E, Torinsson Naluai Å, Högkil K, Hasséus B, Saalman R, Jontell M. Characterisation of a Swedish cohort with orofacial granulomatosis with or without Crohn's disease. Oral Dis 2014; 21:e98-104. [DOI: 10.1111/odi.12236] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/03/2014] [Accepted: 03/05/2014] [Indexed: 12/30/2022]
Affiliation(s)
- G Gale
- Department of Oral Medicine and Oral Pathology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - S Östman
- Department of Infectious Diseases The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - E Rekabdar
- Genomics Core Facility The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - Å Torinsson Naluai
- Genomics Core Facility The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - K Högkil
- Eastman Institute Public Dental Health Stockholm Sweden
| | - B Hasséus
- Department of Oral Medicine and Oral Pathology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - R Saalman
- Department of Paediatrics Institute of Clinical Sciences The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - M Jontell
- Department of Oral Medicine and Oral Pathology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
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Lange B, Halpern S, Gale G, Kramer S. Trimethoprim-sulfamethoxazole and nystatin prophylaxis in children with acute lymphoblastic leukemia. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/08880018409141739] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ferdman B, Jureidini SB, Gale G, Mink R. Severe left ventricular dysfunction and arrhythmias as complications of gram-positive sepsis: rapid recovery in children. Pediatr Cardiol 1998; 19:482-6. [PMID: 9770579 DOI: 10.1007/s002469900365] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Severe left ventricular dilatation and dysfunction in children may be associated with poor outcome in as many as 45% of cases. The prognosis for children with poor left ventricular function or arrhythmias associated with septic shock may be better, however, this has been inadequately studied. We report the favorable outcome of three children who presented with Gram-positive sepsis and significant cardiovascular compromise-two with severely dilated, poorly contractile left ventricle, and one with mild left ventricular dysfunction and incessant, malignant, and rapid atrial and ventricular arrhythmias. Our experience with these patients shows that complete and rapid resolution of these complications may be achieved with aggressive therapy.
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Affiliation(s)
- B Ferdman
- Department of Pediatrics, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, 1465 South Grand Boulevard, Saint Louis, MO 63104, USA
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Gale G, Franck LS. Toward a standard of care for parents of infants in the neonatal intensive care unit. Crit Care Nurse 1998; 18:62-4, 66-74. [PMID: 9934051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- G Gale
- Children's Hospital, Oakland, Calif., USA
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Gale G, VandenBerg KA. Kangaroo care. Neonatal Netw 1998; 17:69-71. [PMID: 9791453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
This method of holding infants has rapidly evolved as a practice in intensive care nurseries to support parenting. Research documenting its physiologic and developmental benefits is increasing. More research is needed to demonstrate the effectiveness of this procedure as a component of developmental care in nurseries.
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Affiliation(s)
- G Gale
- Alta Bates Medical Center, Berkeley, California, USA
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Abstract
We report a case of childhood acute mixed lineage leukemia (AMLL) with a translocation t(6;14)(q25;q32) as the main clonal abnormality. A comparison of this case with another one with similar cytogenetics and clinical findings may suggest that t(6;14)(q25;q32) is a non-random occurrence in childhood AMLL.
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MESH Headings
- Acute Disease
- Adolescent
- Bone Marrow/pathology
- Chromosomes, Human, Pair 14/ultrastructure
- Chromosomes, Human, Pair 6/ultrastructure
- Female
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Leukemia, Biphenotypic, Acute/genetics
- Leukemia, Biphenotypic, Acute/pathology
- Translocation, Genetic
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Affiliation(s)
- J R Batanian
- Pediatrics Department, Saint Louis University Hospital, Missouri, USA
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Abstract
A neuroblastoma that presented as an adrenal cyst in a newborn infant is described. This is an extremely unusual presentation for neuroblastoma; it emphasizes the need for a high degree of suspicion when evaluating any abdominal mass in the newborn.
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Affiliation(s)
- T Weber
- Department of Pediatric Surgery, St Louis University School of Medicine, MO
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Gale G, Franck L, Lund C. Skin-to-skin (kangaroo) holding of the intubated premature infant. Neonatal Netw 1993; 12:49-57. [PMID: 8413138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Skin-to-skin holding has been reported to be a useful technique for helping mothers feel close to their nonintubated infants hospitalized in the NICU. This article describes our experience with skin-to-skin holding of 25 intubated infants in the NICU. We found this technique was safe for the intubated infant and promoted parental attachment, even in parents who were at high risk for attachment impairments. Our experience suggests that skin-to-skin holding with small intubated infants may offer some parents an effective method to overcome some of the barriers to attachment imposed by the infant's hospitalization. In addition, our observations raise several questions regarding parent-infant interaction.
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Abstract
Chromosome analysis is becoming an increasingly important tool in the diagnosis and treatment of childhood malignancies. This report illustrates a new translocation t(9;18) in a neonate with congenital acute nonlymphocytic leukemia, which predicted a bone marrow relapse in a normal appearing bone marrow.
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Sotelo-Avila C, Vogler CA, Gale G. Staging and treatment of Wilms' tumors. Mayo Clin Proc 1986; 61:756-7. [PMID: 3018391 DOI: 10.1016/s0025-6196(12)62779-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Sotelo-Avila C, Gonzalez-Crussi F, deMello D, Vogler C, Gooch WM, Gale G, Pena R. Renal and extrarenal rhabdoid tumors in children: a clinicopathologic study of 14 patients. Semin Diagn Pathol 1986; 3:151-63. [PMID: 3616219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The clinical and pathologic features of 14 children with rhabdoid tumors are presented. Eight patients had primary renal neoplasms and six had extrarenal tumors. The eight renal rhabdoid tumors were identified among 514 primary renal neoplasms collected at four pediatric institutions. Six patients were under 1 year of age; five children died of tumor-related causes, four of them within 4 months of diagnosis and one 17 months postnephrectomy. Another patient died of sepsis 12 days postnephrectomy. One is alive 13 months postnephrectomy, and one was lost to follow-up evaluation. The most common sites of metastasis were the lymph nodes (seven children) and the lungs (three patients). Three infants with renal rhabdoid tumors had, in addition, intracranial masses, two of which manifested clinically before the detection of the renal tumors, in one confirmed to be a primitive neuroectodermal tumor. Five of the 6 extrarenal tumors were identified among 155,926 surgical pathology specimens examined in the same children's hospitals over the same period of time; the remaining extrarenal rhabdoid tumor was received in consultation from a community hospital. The extrarenal rhabdoid tumors occurred in the dorsum of the right foot, liver, soft tissue of the right chest wall, left temporal lobe, left leg, and left thoracic paraspinal region. The ages ranged from 6 weeks to 15 years and two months. Three patients died of tumor-related causes within 4 months of diagnosis; one was a term stillborn. Two are alive, 1 month and 70 months postdiagnosis. Common sites for metastases included the lungs (three patients), and liver and lymph nodes (two children each). Patients with renal and extrarenal rhabdoid tumors are of similar age, have a similar clinical course, with early metastases and poor response to therapy. Primitive neuroectodermal intracranial tumors have been identified in several reported patients with renal rhabdoid tumors; similar brain tumors have not been documented in patients with extrarenal rhabdoid tumors. The histogenesis of this tumor remains unknown.
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Littman P, Rosenstock J, Gale G, Krisch RE, Meadows A, Sather H, Coccia P, DeCamargo B. The somnolence syndrome in leukemic children following reduced daily dose fractions of cranial radiation. Int J Radiat Oncol Biol Phys 1984; 10:1851-3. [PMID: 6593316 DOI: 10.1016/0360-3016(84)90261-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A group of children with acute lymphocytic leukemia was studied to investigate if a reduction in daily dose fraction of cranial radiation would reduce the incidence of somnolence syndrome. Thirty-one evaluable patients received 100 rad X 18 cranial radiation therapy. Sixty-six similar evaluable patients were given 180 rad X 10. Both groups received the same chemotherapy including intrathecal methotrexate. Clinically detectable somnolence appeared in 58% of ech group without significant differences in the overall frequency or severity of somnolence (p greater than 0.5). This study failed to substantiate a radiation dose fraction size dependence for somnolence syndrome in children with acute lymphocytic leukemia.
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Abstract
A double-blind random study compared the effects of lorazepam and pantopon an intra-muscular premedication in healthy women for uterine curettage (D & C). Anxiety, as assessed by a self-rating test by the patient and by a trained observer, showed a significant reduction at one and one-half hours after lorazepam and a smaller reduction after pantopon, which was not significant. Sedation was satisfactory with no significant difference between the two drugs in the change before and after the premedication. Lorazepam showed much more amnesia than pantopon (p less than 0.001). The patients who had lorazepam required higher doses of thiopentone for the operation, and this, in part, led to longer intervals in recovery times after lorazepam. However, it is suggested that lorazepam itself was partly responsible for the longer recovery. Pantopon was followed by more nausea, vomiting and headaches, than lorazepam. The intra-muscular injection of lorazepam hurt more patients than did pantopon, but other local complications were negligible and comparable in both groups. The results of this study show that lorazepam produces better reduction of anxiety and much more amnesia than pantopon, with comparable sedation and much less nausea and vomiting. The only disadvantage of lorazepam is the lack of analgesia and, therefore, the need for more anaesthesia during the operation. The conclusion is that lorazepam is a very satisfactory premedication and warrants more use as such.
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Delarue NC, Pearson FG, Henderson RD, Cooper JD, Nelems JM, Gale G. Experience with surgical salvage in pulmonary tuberculosis: application to general thoracic surgery. Can J Surg 1975; 18:519-28. [PMID: 1053561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The diminishing incidence of pulmonary tuberculosis and the increasing effectiveness of drug therapy have resulted in an almost complete disappearance of surgical problems in the management of patients with this disease. However, the lessons learned from the management of such problems should not be forgotten, for they are equally applicable to the management of disabling and life-endangering problems in general thoracic surgical practice. "Salvage" situations develop when therapeutic requirements for control of disease are combined with factors affecting a patient's health so as to increase the surgical risk beyond the range usually considered acceptable. Attempts to salvage patients are indicated when treatment has failed to arrest disease, when life expectancy is threatened, or when return to normal activity is imperiled. Risk may be increased because of age, inadequate cardiopulmonary reserve, or chronic toxemia; in tuberculosis, risk may be increased because of positive sputum culture or resistance of organisms. Experience with 146 tuberculous patients has provided a basis for evaluation of the indications for resection, prophylactic and therapeutic thoracoplasty, and closure of bronchopleural fistulas in general thoracic surgical salvage. Both infection in residual spaces and bronchopleural fistulas are serious complications that can be controlled by thoracoplasty and pedicled muscle grafts. Prophylactic use of osteoplastic thoracoplasty and intercostal muscle grafts warrant more serious consideration. In established complications a "tailored" thoracoplasty can also be combined with an intercostal muscle graft.
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Delarue NC, Gale G, Ronald A. Multiple fluoroscopy of the chest: carcinogenicity for the female breast and implications for breast cancer screening programs. Can Med Assoc J 1975; 112:1405-13. [PMID: 1139485 PMCID: PMC1956229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The risk of radiation carcinogenesis has been established for breast tissue from experience with total body irradiation and multiple fluoroscopy of the chest with the patient prone. The doubling dose has been estimated to lie between 20 and 50 rads. Before undertaking radiologic screening programs for breast cancer, therefore, it is necessary to determine whether exposures below this range are safe. Of 792 women who had had tuberculosis and were followed for a minimum of 20 years, 451 had had multiple fluoroscopy while supine; 341 had not had fluoroscopy. The first group received a total radiation dose to the breast averaging 17 rads (141.5 fluoroscopies); the incidence of breast cancer in this group was not increased. Had fluoroscopy been performed with the patient prone the total radiation dose would have averaged 308 rads. The difference is thought to explain the increased incidence of breast cancer attributable to fluoroscopy given with the patient prone. Mid-breast exposure with mammography or xeroradiography varies between 3 and 6 rads. Repetitive screening would, therefore, appear safe provided total exposure did not exceed 20 rads. With this restriction there would appear to be no reason to curtail screening of women for breast cancer.
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Du Plessis LA, Marchand P, Fuller D, Joubert E, Gale G, Chesler E. Experience in 100 patients with Starrèdwards prosthetic valves in the mitral and aortic positions. S Afr Med J 1965; 39:944-8. [PMID: 5856741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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