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Cergole-Novella MC, Matsuda EM, de Souza MB, Colpas DR, Carmo AMDS, Daros VDSMG, Campos IB. Recurrent community-acquired pneumococcal meningitis in adults with and without identified predisposing factors. Braz J Microbiol 2024:10.1007/s42770-024-01292-3. [PMID: 38438832 DOI: 10.1007/s42770-024-01292-3] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
Bacterial meningitis is still a significant public health concern, with high morbidity and mortality rates. Despite this, it is still a rare event that requires the bacterial invasion of the meninges. However, some predisposing factors can trigger recurrent episodes of meningitis. This study is aimed at determining the clinical characteristics and the molecular epidemiology of episodes of recurrent community-acquired meningitis with and without predisposing factors. For this purpose, we performed a retrospective study of our laboratory database during the period of 2010 to 2020. Additionally, using molecular tools developed in our previous works, the epidemiology of the pathogens causing these episodes was analyzed using cerebrospinal fluid samples, especially in the absence of isolated strains. We observed a total of 1,779 meningitis cases and 230 were caused by Streptococcus pneumoniae. Of those, 16 were recurrent meningitis episodes (16/1,779; 0.9%) from seven patients. Pneumococcus was the main agent responsible in these recurrent episodes and only two episodes were caused by Haemophilus influenzae. The mean age of these patients was 20 years old and three had predisposing factors which could have led to contracting meningitis. The samples presented different pneumococcal serotypes. Most of them were non-vaccine-covered serotypes and antibiotic susceptible strains. Therefore, it was demonstrated how the practical employment of molecular tools, developed for research, when applied in the routine of diagnosis, can provide important information for epidemiological surveillance. Furthermore, it was shown how pneumococcus was the leading cause of recurrent community-acquired meningitis without predisposing factors, suggesting that pneumococcal vaccination may be necessary, even in those groups of individuals considered to be less susceptible.
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Affiliation(s)
- Maria Cecilia Cergole-Novella
- Adolfo Lutz Institute, Santo André Regional Center, Avenida Ramiro Colleoni, 240 - Vila Dora, Santo André, SP, 09040-160, Brazil
| | - Elaine Monteiro Matsuda
- City Hall of Santo André, Santo André Health Secretary, Rua Primeiro de Maio, 133 - Centro, Santo André, SP, 09015-030, Brazil
| | - Mariana Brena de Souza
- Adolfo Lutz Institute, Santo André Regional Center, Avenida Ramiro Colleoni, 240 - Vila Dora, Santo André, SP, 09040-160, Brazil
| | - Daniela Rodrigues Colpas
- Adolfo Lutz Institute, Santo André Regional Center, Avenida Ramiro Colleoni, 240 - Vila Dora, Santo André, SP, 09040-160, Brazil
| | - Andréia Moreira Dos Santos Carmo
- Adolfo Lutz Institute, Santo André Regional Center, Avenida Ramiro Colleoni, 240 - Vila Dora, Santo André, SP, 09040-160, Brazil
| | | | - Ivana Barros Campos
- Adolfo Lutz Institute, Santo André Regional Center, Avenida Ramiro Colleoni, 240 - Vila Dora, Santo André, SP, 09040-160, Brazil.
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Li G, Wang Q. Analysis of the clinical characteristics and predisposing factors for neurological deficit with Hangman fractures. J Orthop Surg Res 2023; 18:179. [PMID: 36890563 PMCID: PMC9996926 DOI: 10.1186/s13018-023-03650-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 02/25/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Hangman fracture is the second most common injury of the upper cervical spine, and neurological deficit with Hangman fracture is not rare. To our knowledge, few reports have statistically analyzed the predisposing factors for this injury. The objective of this study was to describe the clinical characteristics of neurological deficit associated with Hangman fracture and evaluate its risk factors. METHODS In this retrospective study, 97 patients with Hangman fractures were included. Data on the age, sex, injury etiology, neurological deficits, and associated injuries were obtained and evaluated. The pretreatment parameters, anterior translation and angulation of C2/3, presence of the posterior vertebral wall (PVW) fractures of C2, and presence of spinal cord signal changes were measured. Twenty-three patients with neurological deficits after Hangman fractures comprised group A, and 74 patients without neurological deficit comprised group B. Student's t-test or a nonparametric test and the chi-square test were used to evaluate the differences between groups. Binary logistic regression analysis was used to identify the risk factors for neurological deficit. RESULTS Among the 23 patients in group A, 2 were American Spinal Injury Association (ASIA) scale B, 6 were C, and 15 were D, and spinal cord magnetic resonance imaging signal change was observed at the level of C2-C3 disc, C2, or both. Patients with the combination of PVW fractures and ≥ 50% significant translation or angulation of C2/3 were significantly more likely to have a neurological deficit. Both factors remained significant in binary logistic regression analysis. CONCLUSIONS Neurological deficit after Hangman fractures always presents clinically as a partial neurological impairment. The combination of PVW fractures with ≥ 1.8 mm of translation or ≥ 5.5° of angulation of C2/3 was the predisposing factor for neurological deficit with Hangman fractures.
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Affiliation(s)
- Guangzhou Li
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan Province, China
| | - Qing Wang
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan Province, China.
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Korkut E, Peksoz R, Disci E, Atamanalp SS. Factors affecting recurrence in sigmoid volvulus. Pak J Med Sci 2023; 39:150-153. [PMID: 36694777 PMCID: PMC9842996 DOI: 10.12669/pjms.39.1.6882] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/29/2022] [Accepted: 10/25/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives Recurrence is a relatively common outcome following endoscopic decompression in sigmoid volvulus (SV). This study aims to evaluate the factors affecting recurrence in SV. Methods In 434 patients with SV treated between June 1986 and January 2022, probable recurrence-affecting factors including age, age of SV onset, gender, dietary habit, defecation habit, altitude of living area, and SV attack count were analyzed in prospectively collected data. Results Of 434 patients, 111 (25.6%) had recurrent SV with mean 1.6 ± 2.3 of volvulus episodes (range: 1-21 attacks). SV recurrence demonstrated a significant linear increase with age (14.3%, 17.1%, 21.5%, and 29.9%, respectively, in young, middle aged, mature, and elderly patients, p < 0.001). Recurrent SV was also significantly higher in male gender (28.5% vs 12.7%, p = 0.004), high-fiber diet habit (32.9% vs 17.7%, p < 0.001), and living at high altitude (26.9% vs 12.5%, p = 0.047). Although SV recurrence was higher in patients with chronic constipation, the difference was not significant (36.7% vs. 20.3%, p = 0.594). When compared with that of the patients with mature onset or elderly onset patients, SV attack count was significantly higher in young-onset cases (1.3 ± 0.9 and 1.1 ± 0.3 vs 4.6 ± 6.9, p < 0.001). Conclusion Elderliness, early-onset, maleness, high-fiber diet habit, high altitude, and most likely chronic constipation may be the practical clinical parameters of recurrent SV. These parameters, as well as the presence of previous SV episode history, must be considered in the decision-making process in the elective treatment of SV.
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Affiliation(s)
- Ercan Korkut
- Ercan Korkut MD, Assistant Professor, Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Rifat Peksoz
- Rifat Peksoz MD, Assistant Professor, Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Esra Disci
- Esra Disci MD, Assistant Professor, Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Sabri Selcuk Atamanalp
- Sabri Selcuk Atamanalp MD, Professor, Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Cao Y, Wang YB, Liu XY, Fan Y, Xie W. [Three cases of liver failure concurrent with endogenous endophthalmitis]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:702-704. [PMID: 34371543 DOI: 10.3760/cma.j.cn501113-20191220-00473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Y Cao
- Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Y B Wang
- Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - X Y Liu
- Department of Ophthalmology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Y Fan
- Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - W Xie
- Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
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Nakanishi R, Konishi T, Nakaya E, Zaitsu Y, Mukai T, Yamaguchi T, Nagasaki T, Akiyoshi T, Nagayama S, Fukunaga Y. Predisposing factors and clinical impact of high-output syndrome after sphincter-preserving surgery with covering ileostomy for rectal cancer: a retrospective single-center cohort study. Int J Clin Oncol 2021; 26:118-25. [PMID: 32902781 DOI: 10.1007/s10147-020-01781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Ileostomy-related high-output syndrome has become a major cause of postoperative morbidity after rectal cancer surgery. This study aimed to clarify the predisposing factors and clinical impact of high-output syndrome. METHODS Clinical parameters that were associated with high-output syndrome and clinical impact of high-output syndrome on nutritional status, electrolyte abnormality and renal dysfunction were retrospectively investigated in consecutive patients with rectal cancer undergoing resection with covering ileostomy during 2016-2017. RESULTS High-output syndrome developed in 44/195 eligible patients (22.6%). Multivariable analysis revealed that neoadjuvant (chemo)radiotherapy [odds ratio (OR): 2.4; 95% confidence interval (CI) 1.1-5.2; P = 0.02], postoperative complications (OR: 2.2; 95% CI 1.0-4.6; P = 0.049), postoperative maximal white blood cell ≥ 10,000 cells/μl (OR: 4.0; 95% CI 1.9-8.8; P = 0.0004), and postoperative maximal C-reactive protein ≥ 10 mg/dl (OR: 2.4; 95% CI 1.1-5.2; P = 0.02) were independently associated with high-output syndrome. High-output syndrome was associated with increased renal dysfunction at the time of ostomy closure (29.6% versus 11.9%, patients with high-output syndrome vs. without high-output syndrome, P = 0.008), but not with nutritional imbalance or electrolyte abnormalities. High-output syndrome (OR: 2.5; 95% CI 1.1-5.9; P = 0.03) and postoperative maximal C-reactive protein ≥ 10 mg/dl (OR: 2.4; 95% CI 1.0-5.6; P = 0.04) were independently associated with renal dysfunction at ostomy closure. CONCLUSION Preoperative (chemo)radiotherapy, postoperative inflammatory response, and postoperative complications predisposed to high-output syndrome, and it significantly impacted postoperative renal dysfunction. Active monitoring and early intervention are warranted to prevent renal dysfunction in patients with these factors.
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Shibata A, Kasai M, Hoshino A, Miyagawa T, Matsumoto H, Yamanaka G, Kikuchi K, Kuki I, Kumakura A, Hara S, Shiihara T, Yamazaki S, Ohta M, Yamagata T, Takanashi JI, Kubota M, Oka A, Mizuguchi M. Thermolabile polymorphism of carnitine palmitoyltransferase 2: A genetic risk factor of overall acute encephalopathy. Brain Dev 2019; 41:862-869. [PMID: 31351739 DOI: 10.1016/j.braindev.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 03/28/2019] [Revised: 06/10/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Acute encephalopathy is an acute brain dysfunction after preceding infection, consisting of multiple syndromes. Some syndromes, such as acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), are severe with poor outcome, whereas others, such as clinically mild encephalitis/encephalopathy with reversible splenial lesion (MERS), are mild with favorable outcome. Previous study reported the association of the thermolabile polymorphism in Carnitine Palmitoyltransferase 2 (CPT2) gene and severe syndromes of acute encephalopathy. To further explore the pathogenetic role of CPT2 in acute encephalopathy, we conducted a case-control association study of a typical thermolabile CPT2 polymorphism, rs2229291, in 416 patients of acute encephalopathy, including both severe and mild syndromes. METHODS The case cohort consisted of 416 patients, including AESD, MERS, and other syndromes. The control subjects were 100 healthy Japanese. rs2229291 was genotyped by Sanger sequencing. Genetic distribution was compared between the patients and controls using Cochran-Armitage trend test. RESULTS Minor allele frequency of rs2229291 was significantly higher in AESD (p = 0.044), MERS (p = 0.015) and entire acute encephalopathy (p = 0.044) compared to the controls. The polymorphism showed no significant association with influenza virus, or with outcome. CONCLUSIONS This study provided evidence that CPT2 is a susceptibility gene for overall acute encephalopathy, including both severe and mild syndromes, and suggested that impairment of mitochondrial metabolism is common to various syndromes of acute encephalopathy.
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Affiliation(s)
- Akiko Shibata
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Mariko Kasai
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ai Hoshino
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taku Miyagawa
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Matsumoto
- Department of Pediatrics, National Defense Medical College, Saitama, Japan
| | - Gaku Yamanaka
- Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
| | - Kenjiro Kikuchi
- Division of Neurology, Saitama Children's Medical Center, Saitama, Japan
| | - Ichiro Kuki
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | | | - Shinya Hara
- Department of Pediatrics, TOYOTA Memorial Hospital, Aichi, Japan
| | - Takashi Shiihara
- Department of Neurology, Gunma Children's Medical Center, Gunma, Japan
| | - Sawako Yamazaki
- Department of Pediatrics, Niigata Minami Hospital, Niigata, Japan
| | - Masayasu Ohta
- Department of Pediatrics, Aiseikai Memorial Ibaraki Welfare Medical Center, Ibaraki, Japan
| | | | - Jun-Ichi Takanashi
- Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Masaya Kubota
- Division of Neurology, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Oka
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Mizuguchi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Lee JY, Min YH. Relationships between determinants of adjuvant endocrine therapy adherence in breast cancer. BMC Womens Health 2018; 18:48. [PMID: 29551094 PMCID: PMC5858147 DOI: 10.1186/s12905-018-0522-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Interventions that promote adjuvant endocrine therapy (AET) adherence are critical to improve breast cancer survival. The development of interventions would benefit from a better understanding of the reasons for adherence and the causal relationships of determinants using theoretical or model approaches. The aim of the present study was to identify reasons for AET adherence in breast cancer patients with sequential relationships and inter-relationships. METHODS A total of 210 participants with estrogen receptor positive breast cancer who received AET completed a questionnaire assessing demographic/medical, psychological, and endocrine therapy (ET)-specific factors. A descriptive analysis was performed to identify meaningful variables. Selected variables were subjected to hierarchical regression and path analyses. The path model was tested and modified based on the research framework and the results of regression weights and model fit. RESULTS Analysis of sequential effects showed that ET-specific factors contributed the largest proportion of variance (13.4%) to predict AET adherence, followed by psychological factors (4.6%) and demographic/medical factors (3.1%). Analysis of inter-relationships showed that demographic/medical factors such as AET regimen type and cancer stage have direct effects on AET adherence, whereas psychological factors contribute indirectly through the mediating effects of ET-specific factors. CONCLUSION Assessments and interventions that encompass the patient's medication beliefs, self-efficacy, and depression are needed to promote AET adherence.
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Affiliation(s)
- Joo Yun Lee
- College of Nursing, Gachon University, 191 Hambakmeo-ro, Yeonsu-gu, Incheon, 21936, South Korea
| | - Yul Ha Min
- College of Nursing, Gachon University, 191 Hambakmeo-ro, Yeonsu-gu, Incheon, 21936, South Korea.
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Babayani M, Salari S, Hashemi SJ, Ghasemi Nejad Almani P, Fattahi A. Onychomycosis due to dermatophytes species in Iran: Prevalence rates, causative agents, predisposing factors and diagnosis based on microscopic morphometric findings. J Mycol Med 2018; 28:45-50. [PMID: 29449074 DOI: 10.1016/j.mycmed.2017.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/18/2017] [Accepted: 12/15/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Onychomycosis (OM) or fungal nail infection is one of the most common fungal infections, which is increasingly prevalent. OM is caused by dermatophytes spp, yeasts and non-dermatophyte moulds (NDMs). The purpose of this study was to identify and determine the prevalence rates, predisposing factors and causative agents of OM using clinical symptoms and microscopic morphometric findings. MATERIALS AND METHODS In the present study, 180 patients suspected of OM were evaluated by direct microscopy using KOH 20%, culturing in Mycosel and Sabouraud dextrose agar media and Olysia software for identifying the causative fungi of OM. RESULTS From 180 referred patients, 118 (65.56%) had OM, of whom 79 (66.94%) were positive for infection with dermatophytes spp. Of the 79 cases, the commonest age group was 61-70 years (21%) with males being 46 (58.23%) and females being 33 (41.77%). Both the fingernail and toenail infections were most prevalent in male patients. Sex, diabetes and age above 60 years were significant predisposing factors for OM development. DLSO was observed as the only clinical pattern of OM and T. rubrum was the commonest dermatophyte isolate (49.34%). CONCLUSION This study showed that T. rubrum was the most common dermatophyte agent of OM in Iran.
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Affiliation(s)
- M Babayani
- Department of Medical Parasitology and Mycology, Kerman University of Medical Sciences, Kerman, Iran
| | - S Salari
- Students Research Committee, Kerman University of Medical Sciences, Kerman, Iran; Department of Medical Parasitology and Mycology, Kerman University of Medical Sciences, Kerman, Iran; Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - S J Hashemi
- Department of Medical Mycology and Parasitology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - A Fattahi
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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Adane M, Mengistie B, Mulat W, Kloos H, Medhin G. Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study. J Health Popul Nutr 2017; 36:9. [PMID: 28376916 PMCID: PMC5381138 DOI: 10.1186/s41043-017-0085-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/06/2017] [Indexed: 05/29/2023]
Abstract
BACKGROUND Information on health-seeking behavior and utilization of health facilities in slums of Addis Ababa is scarce, impeding the implementation of effective interventions. The purpose of this study is to assess the status of health facilities utilization and predictors for health-seeking behavior of mothers/caregivers of under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia. METHODS A community-based cross-sectional study design was employed in five rounds of surveys in seven kebeles in slums of Addis Ababa among 472 mothers/caregivers of 472 under-five children with acute diarrhea in reference to Andersen's behavioral model. Data were entered into EpiData Version 3.1 and analyzed using STATA Version 14.0. Descriptive statistics were used to examine patterns of health facilities utilization and multivariable logistic regression analysis was applied to identify predictors associated with health-seeking behavior. RESULTS Most mothers/caregivers (70.8%) sought care either at home (14.2%) or health facilities (56.6%), whereas 29.2% reported that they did not seek any care. Of those who consulted health facilities, government health facilities (76.9%) were more utilized than private (18.0%) and informal (5.1%) health facilities. Nearly all (93.9%) of the mothers/caregivers using government health facilities used health centers, and of those who took their children to private health facilities (60.9%) used clinics and 26.1% used pharmacies/drug vendors. Mothers/caregivers visiting health facilities obtained mainly oral rehydration salt (ORS) (39.8%) and home-recommended fluids (HRF) (40.3%), but few of them (11.9%) obtained ORS plus zinc supplementation. Predisposing factors of literacy of mothers/caregivers (adjusted odds ratio (AOR) = 2.4; 95% CI 1.4-4.1) and occupation (AOR = 2.6; 95% CI 1.5-4.6), the enabling factors of households monthly income of 50 United States Dollars (US$) and above (AOR = 2.9; 95% CI 1.5-5.6) and availability of nearest health facilities within 15 min walking distance (AOR = 3.3; 95% CI 1.7-6.6), and the need factors of recognizing danger signs of fever (AOR = 4.3; 95% CI 2.4-7.6) and vomiting (AOR = 3.3; 95% CI 1.8-5.9) were significantly associated with health-seeking behavior. CONCLUSIONS Increasing the proximity of health facilities in slums and health education and socioeconomic development programs targeting illiterate mothers/caregivers and poor households may promote and increase health-seeking behavior and the accessibility of health facilities for the treatment of acute diarrhea in under-five children in Addis Ababa slums.
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Affiliation(s)
- Metadel Adane
- Ethiopian Institute of Water Resources (EIWR), Addis Ababa University, Addis Ababa, Ethiopia
| | - Bezatu Mengistie
- College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Worku Mulat
- Department of Civil and Environmental Engineering, University of Connecticut, Storrs, USA
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Abstract
Objective: To report our experience with Fournier’s Gangrene (FG) over the past eight years and evaluate the predisposing factors which affect the mortality. Methods: Sixty-five patients who were admitted to emergency surgical unit of our institution presenting with FG between January 2006 and August 2014 were included. The anatomical site of infective gangrene, predisposing factors, etiological factors, and outcomes were retrospectively reviewed. Results: Our cases included 8 women and 57 men. The average age of men was 51±13.9 (range 19-75) and the average age of women was 63±10.5 (range 52-76). Average hospitalization time was 9.2±6.6 days (range 5-25) days. The most frequent comorbid disease was diabetes mellitus and the most frequent etiology was perianal abscess. Colostomy was performed in 11 patients, orchidectomy in two patients, cystostomy in two patients. Notably, all of the 8 (12.3%) patients who died from FG had diabetes and low socioeconomic status. A total of six patients who died required more than one surgical debridement. Conclusions: Fournier’s gangrene is a severe surgical emergency, with a high mortality rate. Low socioeconomic status, diabetes and more than one debridement play a major role in mortality and morbidity.
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Affiliation(s)
- Kerem Taken
- Kerem Taken, Department of Urology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Mehmet Resit Oncu
- Mehmet Resit Oncu, Department of Emergency, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Muslum Ergun
- Muslum Ergun, Department of Urology, State Hospital, Mus, Turkey
| | - Recep Eryilmaz
- Recep Eryilmaz, Department of Urology, State Hospital, Bitlis, Turkey
| | - Canser Yilmaz Demir
- Canser Yilmaz Demir, Department of Plastic Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Murat Demir
- Murat Demir, Department of Urology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Mustafa Gunes
- Mustafa Gunes, Department of Urology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
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Hayashi K, Ogawa S, Manabe SI, Hirata A, Yoshimura K. A classification system of intraocular lens dislocation sites under operating microscopy, and the surgical techniques and outcomes of exchange surgery. Graefes Arch Clin Exp Ophthalmol 2016; 254:505-13. [PMID: 26816295 PMCID: PMC4769725 DOI: 10.1007/s00417-016-3273-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/12/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose The aim of this study was to examine the recent status of intraocular lens (IOL) dislocation according to a classification system based on vertical dislocation position, as well as the surgical techniques and outcomes of IOL exchange surgery. Methods The medical records of 230 eyes from 214 consecutive patients who experienced IOL dislocation and underwent exchange surgery between 2006 and 2014 were reviewed. Vertical dislocation sites observed preoperatively under operating microscopy were examined, along with the surgical techniques and outcomes of IOL exchange. Results Dislocation sites included (1) the anterior chamber (12.2 %), (2) pseudophakodonesis (19.1 %), (3) the anterior vitreous cavity (47.4 %), (4) trap door-like dislocation (dangling in the peripheral vitreous cavity; 16.1 %), and (5) the retinal surface (5.2 %). The IOL retained in the anterior segment was moved onto the iris by pulling it up through the limbal side ports with an anterior vitrectomy (67.8 %), or by pushing it up from the pars plana with an anterior vitrectomy (26.5 %), while the IOL dropped on the retina was lifting it up from the retina after pars plana vitrectomy (5.7 %). Mean uncorrected and distance-corrected visual acuity significantly improved postoperatively (p < 0.0001). Major complications included a marked elevation in intraocular pressure (7.8 %), pupillary capture (6.5 %), and vitreous hemorrhage (2.6 %). Conclusions Based on the classification system, approximately 95 % of dislocated IOLs were retained in the anterior segment, and these IOLs were exchanged using an anterior approach through limbal incisions with an anterior vitrectomy. Visual acuity improved significantly, and serious complications were uncommon, probably because the IOL exchange techniques were standardized and simplified without pars plana vitrectomy.
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Affiliation(s)
- Ken Hayashi
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan.
| | - Soichiro Ogawa
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Shin-Ichi Manabe
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Akira Hirata
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Koichi Yoshimura
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
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Choi MS, Chun JH, Lee KS, Rha YH, Choi SH. Clinical characteristics of lung abscess in children: 15-year experience at two university hospitals. Korean J Pediatr 2016; 58:478-83. [PMID: 26770223 PMCID: PMC4705328 DOI: 10.3345/kjp.2015.58.12.478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/03/2014] [Accepted: 12/12/2014] [Indexed: 12/01/2022]
Abstract
Purpose Information on the clinical features of lung abscess, which is uncommon in children, at hospitalizationis helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. Methods The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. Results Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. Conclusion The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics.
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Affiliation(s)
- Mi Suk Choi
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.; Department of Pediatrics, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji Hye Chun
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyung Suk Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Yeong Ho Rha
- Department of Pediatrics, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sun Hee Choi
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
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Shen T, Feng XW, Geng L, Zheng SS. Reversible sinusoidal obstruction syndrome associated with tacrolimus following liver transplantation. World J Gastroenterol 2015; 21:6422-6426. [PMID: 26034381 PMCID: PMC4445123 DOI: 10.3748/wjg.v21.i20.6422] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/26/2015] [Accepted: 04/09/2015] [Indexed: 02/06/2023] Open
Abstract
Sinusoidal obstruction syndrome (SOS), previously known as hepatic veno-occlusive disease, is a rare disorder in solid organ transplant patients, and is an uncommon complication after liver transplantation. Severe SOS with hepatic failure causes considerable mortality. Tacrolimus has been reported to be an offending agent, which potentially plays a role in the pathophysiological process of SOS. SOS due to tacrolimus has been reported in lung and pancreatic transplantations, but has never been described in a liver transplant recipient. Herein, we present a case of SOS after liver transplantation, which was possibly related to tacrolimus. A 27-year-old man developed typical symptoms of SOS with painful hepatomegaly, ascites and jaundice after liver transplantation, which regressed following withdrawal of tacrolimus. By excluding other possible predisposing factors, we concluded that tacrolimus was the most likely cause of SOS.
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Yi S, Shin DA, Kim KN, Choi G, Shin HC, Kim KS, Yoon DH. The predisposing factors for the heterotopic ossification after cervical artificial disc replacement. Spine J 2013; 13:1048-54. [PMID: 23541453 DOI: 10.1016/j.spinee.2013.02.036] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [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: 01/14/2012] [Revised: 12/08/2012] [Accepted: 02/18/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Heterotopic ossification (HO) is defined as a formation of bone outside the skeletal system. The reported HO occurrence rate in cervical artificial disc replacement (ADR) is unexpectedly high and is known to vary. However, the predisposing factors for HO in cervical ADR have not yet been elucidated. PURPOSE Investigation of the predisposing factors of HO in cervical arthroplasty and the relationship between degeneration of the cervical spine and HO occurrence. STUDY DESIGN Retrospective study to discover predisposing factors of HO in cervical arthroplasty. PATIENT SAMPLE A total of 170 patients who underwent cervical ADR were enrolled including full follow-up clinical and radiologic data. OUTCOME MEASURES Radiologic outcomes were assessed by identification of HOs according to McAfee's classifications. METHODS This study enrolled a total of 170 patients who underwent cervical ADR. Pre-existing degenerative change included anterior or posterior osteophytes, ossification of the anterior longitudinal ligament, posterior longitudinal ligament, or ligamentum nuchae. The relationships between basic patient data, pre-existing degenerative change, and HO were investigated using linear logistic regression analysis. RESULTS Among all 170 patients, HO was found in 69 patients (40.6%). Among the postulated predisposing factors, only male gender and artificial disc device type were shown to be statistically significant. Unexpectedly, preoperative degenerative changes in the cervical spine exerted no significant influence on the occurrence of HOs. The odds ratio of male gender compared with female gender was 2.117. With regard to device type, the odds ratios of Mobi-C (LDR medical, Troyes, France) and ProDisc-C (Synthes, Inc., West Chester, PA, USA) were 5.262 and 7.449, respectively, compared with the Bryan disc. CONCLUSIONS Definite differences in occurrence rate according to the gender of patients and the prosthesis type were identified in this study. Moreover, factors indefinably expected to influence HO in the past were not shown to be risk factors thereof, the results of which may be meaningful to future studies.
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Affiliation(s)
- Seong Yi
- Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Sedaemun-gu, Seoul 120-752, South Korea
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Haile DB, Ayen WY, Tiwari P. Prevalence and assessment of factors contributing to adverse drug reactions in wards of a tertiary care hospital, India. Ethiop J Health Sci 2013; 23:39-48. [PMID: 23559837 PMCID: PMC3613814] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse drug reactions account for the highest proportion among the causes of morbidity and mortality in clinical wards and are posing a considerable challenge. Hence, the objective of this study was to find out the prevalence of adverse drug reactions and the factors which contribute to their prevalence. METHODS A prospective patient record review was carried out at a tertiary care hospital in North India from August 2010-May 2011. A total of 1033 subjects admitted to hospital for any kind of treatment were included while patients admitted in the ward because of adverse drug reactions were excluded. The ward where we collected the data includes multispecialty and cardiovascular wards. The causality, severity, and preventability of adverse drug reactions were assessed using Naranjo, modified Hartwig, and Schumock and Thornton criteria, respectively. Kolmogorov-Smyrnov, chi -square and multiple logistic regression tests were used to determine adverse drug reactions ascribed to drugs. RESULTS Out of 1033 patients whose records were assessed, 167(16.2%) experienced one or more adverse drug reactions. The metabolic systems, which accounted for 49(24.6%) were most frequently affected by adverse drug reactions, followed by gastrointestinal, 45(22.6%); hematological, 28(14.1%) and cutaneous, 21(10.6%) systems. The drug classes most frequently associated with the reactions were antibiotics 40(20.1%), diuretics 35(17.6%) and anticoagulants 30(15.1%). According to the selected preventability scale, 72(36.2%) adverse drug reactions were classified as probably or definitely preventable. About 165(83%) of the reactions were type A, which represents augmentation of the pharmacological action of a drug. Number of drugs, length of hospitalization and number of diagnosis were identified as significant predisposing factors for ADRs. CONCLUSION The result of this study suggested that adverse drug reactions were significant causes of superimposed health problems that occur following hospitalization. The major risk factors associated with ADR include number of drugs, length of hospitalization and number of diagnosis. Based on the findings a rigorous study is recommended to determine the burden and identify the risk factors of adverse drug reactions to target interventions.
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Affiliation(s)
| | - Wubeante Yenet Ayen
- Assistant Professor of Pharmaceutics, Department of Pharmacy, Jimma University,
| | - Pramil Tiwari
- Professor, department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Punjab India,
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Crosaz O, Legras A, Vilaplana-Grosso F, Debeaupuits J, Chermette R, Hubert B, Guillot J. Generalized dermatitis associated with Malassezia overgrowth in cats: A report of six cases in France. Med Mycol Case Rep 2013; 2:59-62. [PMID: 24432218 PMCID: PMC3885935 DOI: 10.1016/j.mmcr.2013.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 01/06/2013] [Accepted: 01/24/2013] [Indexed: 11/20/2022] Open
Abstract
We recently observed six cases of generalized dermatitis associated with Malassezia overgrowth in cats presented to the Veterinary College of Alfort, France. Elevated numbers of yeasts were observed in lesional skin by cytology and culture. Skin lesions occurred on the face, ventral neck, abdomen and ear canals and were characterized by some degree of alopecia, erythema and crusting. In most cases, pruritus was intense. The species M. pachydermatis was systematically isolated.
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Affiliation(s)
- Odile Crosaz
- Department of Parasitology, Mycology and Dermatology, CHUVA, Ecole Nationale Vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | - Audrey Legras
- Department of Parasitology, Mycology and Dermatology, CHUVA, Ecole Nationale Vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | | | - Julien Debeaupuits
- Department of Medicine, CHUVA, Ecole Nationale Vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | - René Chermette
- Department of Parasitology, Mycology and Dermatology, CHUVA, Ecole Nationale Vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | - Blaise Hubert
- Department of Parasitology, Mycology and Dermatology, CHUVA, Ecole Nationale Vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | - Jacques Guillot
- Department of Medicine, CHUVA, Ecole Nationale Vétérinaire d'Alfort, UPE, Maisons-Alfort, France
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Abstract
Microbial (non-viral) keratitis is a serious vision-threatening condition. The management of microbial keratitis in children is particularly complicated by the children's inability to cooperate during examinations and the lack of information prior to presentation. Predisposing factors vary according to geographical location and age. Corneal trauma is the leading cause for microbial keratitis in children, followed by systemic and ocular disease. Etiologic agents are most frequently Gram-positive and Gram-negative bacteria commonly found in contact lens-related microbial keratitis. Mycotic keratitis is a major risk factor in tropical weather conditions, particularly when associated with agricultural trauma. Early diagnosis, intensive drug treatment, and timely planned surgical intervention may effectively improve the outcome of pediatric microbial keratitis.
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Affiliation(s)
- Abdullah G. Al-Otaibi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Qu PF, Cui NQ, Wang H. Predisposing factors to infection secondary to severe acute pancreatitis: an analysis of 42 cases. Shijie Huaren Xiaohua Zazhi 2011; 19:3452-3457. [DOI: 10.11569/wcjd.v19.i33.3452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To conduct a systematic evaluation of predisposing factors to infection secondary to severe acute pancreatitis (SAP).
METHODS: The clinical data for 42 patients with infection secondary to SAP who were treated from January 2000 to January 2008 at Tianjin Nankai Hospital were retrospectively analyzed. Univariate and multivariate models were used to find predisposing factors to infection secondary to SAP.
RESULTS: The interval between onset and admission (effective treatment time), APACHE-Ⅱscore, CT score, PO2, intestinal function recovery time, and BE were significantly associated with the development of secondary infection in patients with SAP (OR = 2.846, 7.286, 34.833, 0.350, 24.273, 0.194, all P < 0.05).
CONCLUSION: The time from onset to admission, APACHE-Ⅱ score, CT score, PO2, intestinal function recovery time, and BE are predisposing factors to infection secondary to SAP.
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Nam MJ, Oh SJ, Oh CA, Kim DH, Bae YS, Choi MG, Noh JH, Sohn TS, Bae JM, Kim S. Frequency and predictive factors of lymph node metastasis in mucosal cancer. J Gastric Cancer 2010; 10:162-7. [PMID: 22076181 PMCID: PMC3204507 DOI: 10.5230/jgc.2010.10.4.162] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 10/18/2010] [Indexed: 12/19/2022] Open
Abstract
Purpose The incidence of lymph node metastasis has been reported to range from 2.6 to 4.8% in early stage gastric cancer with mucosal invasion (T1a cancer). Lymph node metastasis in early stage gastric cancer is known as an important predictive factor. We analyzed the prediction factors of lymph node metastasis in T1a cancer. Materials and Methods A total of 9,912 patients underwent radical gastrectomy due to gastric cancer from October 1994 to July 2006 in the Department Of Surgery at Samsung Medical Center. We did a retrospective analysis of 2,524 patients of these patients, ones for whom the cancer was confined within the mucosa. Results Among the 2,524 patients, 57 (2.2%) were diagnosed with lymph node metastasis, and of these, cancer staging was as follows: 41 were N1, 8 were N2, and 8 were N3a. Univariate analysis of clinicopathological factors showed that the following factors were significant predictors of metastasis: tumor size larger than 4 cm, the presence of middle and lower stomach cancer, poorly differentiated adenocarcinoma and signet-ring cell carcinoma, diffuse type cancer (by the Lauren classification), and lymphatic invasion. Multivariate analysis showed that lymphatic invasion and tumor larger than 4 cm were significant factors with P<0.001 and P=0.024, respectively. Conclusions The frequency of lymph node metastasis is extremely low in early gastric cancer with mucosal invasion. However, when lymphatic invasion is present or the tumor is larger than 4 cm, there is a greater likelihood of lymph node metastasis. In such cases, surgical treatments should be done to prevent disease recurrence.
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Affiliation(s)
- Myung Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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