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1
Elmatri, Houssein H., and Nabeia A. Gheryani. "Head and neck infection, clinicopathological outline." International Journal of Otorhinolaryngology and Head and Neck Surgery 8, no. 2 (January 25, 2022): 85. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20220136.
Повний текст джерелаАнотація:
<p><strong>Background: </strong>Despite the antimicrobial drugs, a significant percentage of head and neck infection still can be recorded, this study try to identify the causes of recorded cases of head and neck infection in antibiotics era by focusing on the clinical presentation and the predisposing factors. <strong></strong></p><p><strong>Methods:</strong> A retrospective study was conducted in the department of otolaryngology in university of Benghazi including 84 patients who were diagnosed as head and neck infection. Clinical data, risk factors and managements were discussed in this study. </p><p><strong>Results:</strong> The 84 patients with deep cervical infection were studied. The mean age of our patients was 33 years, most of them were males. Some had other co-diseases. Their main complains was severe throat pain. The most common space involved was peritonsillar space and the most common source of infection was tonsillar infection. Only third of the cases showed positive culture results. The most common organism cultured was <em>Staphylococci</em>. The range of hospital stay was 4-11 days. There was no mortality in our series of patients.</p><p><strong>Conclusions:</strong> Cervical infection is associated with high rate of morbidity and mortality specially in immune-compromised patients, therefore early detection of the disease followed by quick and appropriate management are life-saving measurements. All patients need early broad-spectrum intravenous antibiotics, and most of them need different surgical intervention. As bad oral hygiene, smoking and low immunity are the major risk factors for neck infection, education of the community, especially in rural area, is required.</p>
2
Dahlan, Rully Hanafi, Sevline Estethia Ompusunggu, and Farid Yudoyono. "Cervical Spine Trauma Management." Neurologico Spinale Medico Chirurgico 1, no. 2 (August 7, 2018): 14. http://dx.doi.org/10.15562/nsmc.v1i2.92.
Повний текст джерелаАнотація:
The incidence of spine injury following accidents are still very high in developing countries. Many problems occur after the accident including primary intervention on the scene, transportation to the public primary hospital, the referral system, and finally, the management at the central hospital.Cervical spinal cord injuries represent 20-33% of total spinal injuries with the prevalence of the subaxial levels. In patients with a preoperative neurological deficit due to spine trauma, in case of spinal cord compression or instability, surgery is often the treatment of choice to grant a chance of neurological recovery, early mobilization, and faster return to usual daily activities compared to the conservative treatment. In the past, many authors suggested a delayed surgical treatment to reduce postoperative complications rate, but recent studies have shown that an early decompression (<72 h) may facilitate a postoperative neurological improvement probably due to the prevention of the secondary mechanisms of damage in acute SCI.In the context of the advanced management of spinal injuries, the main points of the focused assessment, the important waypoints of a full classification of the skeletal and spinal cord injury, the principles of early prioritization and decision making, the outline of the surgical strategy including indications, timing, approaches, technique and post-operative care, and the outline principles of rehabilitation. The authors in this paper try to summarize and create a guideline of management, based on experience in a regional centre.
3
Novak, Vesna, Ivan Stefanovic, Aleksandar Kostic, Misa Radisavljevic, Martin Novak, Boban Jelenkovic, and Luka Berilazic. "Cervical epidural hematoma: Case report." Srpski arhiv za celokupno lekarstvo 142, no. 9-10 (2014): 589–91. http://dx.doi.org/10.2298/sarh1410589n.
Повний текст джерелаАнотація:
Introduction. Cervical epidural hematoma is a rare phenomenon in children. MRI scan of the cervical spine is the method of choice in establishing diagnosis and a quick evacuation of hematoma and decompression. Case Outline. We present a case of 11-year-old boy whose lower extremities were paralysed after a trivial injury of the cervical spine which he sustained while playing. Seven days after the injury, severe clinical symptoms appeared, and MRI of the spine showed the presence of cervical epidural hematoma. Conclusion. Cervical epidural hematoma in children is very rare. Adequate neurological examination, diagnostics and urgent surgical intervention are of paramount importance for accomplishing good results. Early and persistent rehabilitation are the condition for achieving maximal recovery.
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Powell, Melanie E. B. "Modern Radiotherapy and Cervical Cancer." International Journal of Gynecologic Cancer 20, Suppl 2 (September 2010): S49—S51. http://dx.doi.org/10.1111/igc.0b013e3181f7b241.
Повний текст джерелаАнотація:
For most cervical cancers, radiotherapy is the mainstay of treatment. The introduction of concurrent chemotherapy to radiation at the end of the 20th century led to a significant improvement in disease survival. Now, techniques such as intensity-modulated radiotherapy, which allow a high degree of conformity to the tumor, offer the opportunity to further improve outcome by reducing treatment-related toxicity and also to potentially improve local control by an increase in tumor dose.This review will outline the history and current state of play of cervical radiotherapy.
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Radulovic, Danilo, Ljiljana Vujotic, Irena Cvrkota, Vojislav Bogosavljevic, and Igor Jovanovic. "Spontaneous regression of cervical disc herniation in a patient with myelopathy." Srpski arhiv za celokupno lekarstvo 146, no. 7-8 (2018): 445–46. http://dx.doi.org/10.2298/sarh170504023r.
Повний текст джерелаАнотація:
Introduction. The aim of this work was to present a rare case of spontaneous regression of a herniated cervical disc in a patient with myelopathy. Case outline. A 31-year-old women presented with two weeks? history of neck pain associated with numbness in her body and all four extremities. Magnetic resonance imaging (MRI) of the cervical spine showed a large posterior medial disc extrusion at the C5?C6 spinal segment, causing myelopathy. The patient refused discectomy that was recommended. She received symptomatic treatment in the form of analgesics, a muscle relaxant, and a hard cervical collar. A follow-up MRI of the cervical spine, performed after 11 months, revealed almost complete regression of disc herniation. The patient?s symptoms subsided completely after one year. Conclusion. In some cases of cervical disc herniation with myelopathy, especially in patients with mild neurological deficit, symptomatic therapy should be considered.
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Swain, Amlan, Seelora Sahu, and Bhanu Swain. "Cervical spine movement during intubation." Journal of Neuroanaesthesiology and Critical Care 04, no. 04 (February 2017): S76—S80. http://dx.doi.org/10.4103/jnacc-jnacc-65.16.
Повний текст джерелаАнотація:
AbstractThere have been growing concerns following documented instances of neurological deterioration in patients with cervical spine injury as a result of intubation. A significant body of evidence has since evolved with the primary objective of ascertaining the safest way of securing the endotracheal tube in patients with suspected and proven cervical injury. The search for a mode of intubation producing the least movement at the cervical spine is an ongoing process and is limited by logistic and ethical issues. The ensuing review is an attempt to review available evidence on cervical movements during intubation and to comprehensively outline the movement at the cervical spine with a wide plethora of intubation aids. Literature search was sourced from digital libraries including PubMed, Medline and Google Scholar in addition to the standard textbooks of Anaesthesiology. The keywords used in literature search included ‘cervical spine motion,’ ‘neurological deterioration,’ ‘intubation biomechanics,’ ‘direct laryngoscopy,’ ‘flexible fibreoptic intubation,’ ‘video laryngoscopes’ and ‘craniocervical motion.’ The scientific information in this review is expected to assist neuroanaesthesiologists for planning airway management in patients with neurological injury as well as to direct further research into this topic which has significant clinical and patient safety implications.
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Wadhwa, Rachna, Pragati Ganjoo, Pallavi Ahluwalia, and Daljit Singh. "Delayed esophageal perforation after cervical spine surgery: A lesser known devil." Indian Journal of Clinical Anaesthesia 8, no. 1 (March 15, 2021): 144–47. http://dx.doi.org/10.18231/j.ijca.2021.029.
Повний текст джерелаАнотація:
Theanteriorapproach to the cervical spine is commonly utilized for a variety of degenerative, neoplastic, traumatic, and infectious indications. The distinctive anatomy of the anterior neck presents a unique set of hazards. We encountered a case of delayed esophageal perforation after cervical spine surgery, who presented to us forty-two days post-surgery. Although, timely detection and management of esophageal perforation has a good prognosis, associated vascular complications added on to airway management challenges. We outline the issues with diagnosis and key aspects of airway management in this patient.
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Leonetti, John P., W. Scott Jellish, Patricia Warf, and Elizabeth Hudson. "Intraoperative Vagal Nerve Monitoring." Ear, Nose & Throat Journal 75, no. 8 (August 1996): 489–96. http://dx.doi.org/10.1177/014556139607500807.
Повний текст джерелаАнотація:
A variety of benign and malignant neoplasms occur in the superior cervical neck, parapharyngeal space or the infratemporal fossa. The surgical resection of these lesions may result in postoperative iatrogenic injury to the vagus nerve with associated dysfunctional swallowing and airway protection. Anatomic and functional preservation of this critical cranial nerve will contribute to a favorable surgical outcome. Fourteen patients with tumors of the cervical neck or adjacent skull base underwent intraoperative vagal nerve monitoring in an attempt to preserve neural integrity following tumor removal. Of the 11 patients with anatomically preserved vagal nerves in this group, seven patients had normal vocal cord mobility following surgery and all 11 patients demonstrated normal vocal cord movement by six months. In an earlier series of 23 patients with tumors in the same region who underwent tumor resection without vagal nerve monitoring, 18 patients had anatomically preserved vagal nerves. Within this group, five patients had normal vocal cord movement at one month and 13 patients demonstrated normal vocal cord movement at six months. This paper will outline a technique for intraoperative vagal nerve monitoring utilizing transcricothyroid membrane placement of bipolar hook-wire electrodes in the vocalis muscle. Our results with the surgical treatment of cervical neck and lateral skull base tumors for patients with unmonitored and monitored vagal nerves will be outlined.
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Peng, Baogan. "Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo." July 2015 18;4, no. 4;18 (July 14, 2015): E583—E595. http://dx.doi.org/10.36076/ppj.2015/18/e583.
Повний текст джерелаАнотація:
Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients’ subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with BarréLiéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment. Key words: Cervical vertigo, dizziness, whiplash injury, neck pain, cervical spondylosis, manual therapy, vestibular rehabilitation, vertebrobasilar insufficiency
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Virk, J. S., A. Majithia, R. K. Lingam, and A. Singh. "Cervical osteophytes causing vocal fold paralysis: case report and literature review." Journal of Laryngology & Otology 126, no. 9 (June 29, 2012): 963–65. http://dx.doi.org/10.1017/s0022215112001259.
Повний текст джерелаАнотація:
AbstractObjectives:To increase awareness of cervical osteophytes as an extremely rare cause of recurrent laryngeal nerve palsy; to outline the clinical approach to patients with unilateral vocal fold paralysis and to provide an update on the current management of osteoarthritis and osteophytes.Case report:An elderly man presented with right unilateral vocal fold immobility and a small phonatory gap. By a diagnosis of exclusion, a cervical osteophyte at the level of the sixth and seventh cervical vertebrae was shown to be the cause. The patient responded to speech therapy and no further intervention was required.Method:A literature review, using Medline, identified only one previously published case of vocal fold paralysis due to osteophytes secondary to osteoarthritis.Conclusion:The aetiology of unilateral paralysis of the hemilarynx must be fully investigated, as the innervating system has a protracted course, particularly on the left side. Degenerative cervical spine disease, although rare, should be considered as part of the differential diagnosis.
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McCormack, Mary, David Gaffney, David Tan, Kathy Bennet, Adriana Chavez-Blanco, and Marie Plante. "The Cervical Cancer Research Network (Gynecologic Cancer InterGroup) roadmap to expand research in low- and middle-income countries." International Journal of Gynecologic Cancer 31, no. 5 (February 25, 2021): 775–78. http://dx.doi.org/10.1136/ijgc-2021-002422.
Повний текст джерелаАнотація:
Cervical cancer is a global health problem which disproportionally affects women in low- and middle- income countries. The World Health Organization recently launched its global strategy to eliminate this disease in the next two decades. For those women diagnosed today with cervical cancer better strategies are needed to improve outcome and reduce treatment-related morbidity. Clinical trials are critical to shaping future treatment, and much has been achieved already. However, such opportunities are limited in low resource settings, and the Cervical Cancer Research Network is dedicated to expanding access to new technologies in surgery, radiation, and medical oncology. In this article we review the status of the trials portfolio and outline future objectives, including the launch of a number of research grants for aspiring or established researchers in low- and middle-income settings
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Nuranna, Laila, Nessyah Fatahan, Alfu Nikmatul Laily, and Gatot Purwoto. "Knowledge and behavior of Indonesian general practitioners on cervical cancer early detection." Majalah Obstetri & Ginekologi 28, no. 1 (June 26, 2020): 20. http://dx.doi.org/10.20473/mog.v28i12020.20-23.
Повний текст джерелаАнотація:
Objective: Outline the correlation between cervical cancer-related knowledge and voluntary enrollment on early detection of cervical cancer.Material and Methods: Cross sectional design was performed. The inclusion is general practitioner women which currently married. Knowledge and behavior were assessed using questionnaire.Results: Among 367 respondents who filled the questionnaire, 77.4% of them (284) satisfy the inclusion criteria. 56% has high knowledge, and 42.3% has adequate knowledge. Moreover, 62.7% subjects ever performed cervical cancer early detection to themselves; 39.8% with VIA (visual inspection with acetic acid) and 46.5% with Papsmear and/or HPV DNA. Proportion of no early detection history with low and adequate knowledge 1.9 and 1.5 times simultaneously higher than proportion of no early detection with high knowledge. There is no significant correlation between level of knowledge and early detection history.Conclusion: There was no significant correlation between the level of knowlegde and voluntary enrollment for early detection of cervical cancer for general practitioners in Indonesia.
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Kakushkin, N. "I. M. Lvov. Narrowing of the external opening of the cervix and its improvement in a simplified way Borissowicz'a. (Weekly, 1894, No. 29, p. 485)." Journal of obstetrics and women's diseases 8, no. 10 (September 22, 2020): 934. http://dx.doi.org/10.17816/jowd810934.
Повний текст джерелаАнотація:
Making a brief outline of the pathology of narrowing of the cervical drip, the author points out the narrowing of the external opening, as a common cause (96%) of infertility in women and as a cause, together with inflammatory changes in the neck, painful months. When reducing the contraction, the author often resorts to cutting the neck (Sims) and praises this method.
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Prablek, Marc Andrew, Melissa LoPresti, Brandon Bertot, Shaine Alaine Morris, David Bauer, Sandi Lam, and Vijay Ravindra. "Evaluation of cervical spine pathology in children with Loeys-Dietz syndrome." Surgical Neurology International 13 (March 18, 2022): 96. http://dx.doi.org/10.25259/sni_48_2022.
Повний текст джерелаАнотація:
Background: Loeys-Dietz syndrome (LDS) is a genetic connective tissue disorder associated with multiple musculoskeletal anomalies, including cervical spine instability. We sought to examine the nature of imaging for cervical spine instability in children with LDS due to likely pathogenic or pathogenic variants in TGFBR1, TGFBR2, TGFB2, SMAD3, or TGFB3. Methods: A retrospective chart review was conducted, examining relevant data for all children with LDS screened at our institution from 2004 through 2021. Cervical spine X-rays were used to assess cervical instability, cervical lordosis, and basilar impression. Results: A total of 39 patients were identified; 16 underwent cervical spine screening (56.25% male). Median age at initial screening was 7 years (Q1-Q3: 3.75–14, range: 0.1–19). Six of 16 patients evaluated (37.5%) had radiographical evidence of cervical instability. Mean angles of cervical lordosis were 20° (SD = 14.1°, range = 4°–33°) and 17.3° (SD = 16.4°, range = 2°–41°), respectively. Three patients demonstrated radiographical basilar impression. Radiographic progression of cervical instability was seen in one case. All but two were managed conservatively with observation, one patient underwent surgical fixation and fusion of C1-2, the other underwent complex cervical reconstruction anterior and posterior instrumentation. Conclusion: Cervical spine evaluation is important in this cohort; we identified 37.5% had evidence of cervical spine instability, and many had concurrent spinal pathology. From our experience, we agree with the recent advisement for screening at diagnosis and for those previously diagnosed that have not undergone screening. Future study may outline more specific screening practices.
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Benazzi, Stefano, Cinzia Fornai, Laura Buti, Michel Toussaint, Francesco Mallegni, Stefano Ricci, Giorgio Gruppioni, Gerhard W. Weber, Silvana Condemi, and Annamaria Ronchitelli. "Cervical and crown outline analysis of worn Neanderthal and modern human lower second deciduous molars." American Journal of Physical Anthropology 149, no. 4 (October 17, 2012): 537–46. http://dx.doi.org/10.1002/ajpa.22155.
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Persad, R. V., and M. L. Forman. "An analysis of the determinants of negative cone biopsies." International Journal of Gynecologic Cancer 1, no. 3 (April 1991): 121–24. http://dx.doi.org/10.1111/j.1525-1438.1991.tb00026.x.
Повний текст джерелаАнотація:
Between January and December 1989, 608 colposcopies were performed under the waiting list initiative at St Mary's Hospital in Manchester on patients seen for the first time after an abnormal cervical smear. Following colposcopy, 100 of these patients were subjected to cone biopsies for the management of cervical intra-epithelial neoplasia (CIN). The negative cone biopsy rate was 9%. The authors outline the reasons for its occurrence following a review of all the histologic and cytologic material for this group. The main reason for the negative cone biopsies in this series was the disappearance of the abnormal epithelium, presumably due to fortuitous complete excision or regression of the lesion following colposcopic punch biopsy.
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Feng, Chunyang, Junxue Dong, Weiqin Chang, Manhua Cui, and Tianmin Xu. "The Progress of Methylation Regulation in Gene Expression of Cervical Cancer." International Journal of Genomics 2018 (2018): 1–11. http://dx.doi.org/10.1155/2018/8260652.
Повний текст джерелаАнотація:
Cervical cancer is one of the most common gynecological tumors in females, which is closely related to high-rate HPV infection. Methylation alteration is a type of epigenetic decoration that regulates the expression of genes without changing the DNA sequence, and it is essential for the progression of cervical cancer in pathogenesis while reflecting the prognosis and therapeutic sensitivity in clinical practice. Hydroxymethylation has been discovered in recent years, thus making 5-hmC, the more stable marker, attract more attention in the field of methylation research. As markers of methylation, 5-hmC and 5-mC together with 5-foC and 5-caC draw the outline of the reversible cycle, and 6-mA takes part in the methylation of RNA, especially mRNA. Furthermore, methylation modification participates in ncRNA regulation and histone decoration. In this review, we focus on recent advances in the understanding of methylation regulation in the process of cervical cancer, as well as HPV and CIN, to identify the significant impact on the prospect of overcoming cervical cancer.
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Nayar, Ritu, and David C. Wilbur. "The Pap Test and Bethesda 2014." Acta Cytologica 59, no. 2 (2015): 121–32. http://dx.doi.org/10.1159/000381842.
Повний текст джерелаАнотація:
The history of ‘The Bethesda System' for reporting cervical cytology goes back almost 3 decades. This terminology and the process that created it have had a profound impact on the practice of cervical cytology for laboratorians and clinicians alike. The Bethesda conferences and their ensuing output have also set the stage for standardization of terminology across multiple organ systems, including both cytology and histology, have initiated significant research in the biology and cost-effective management for human papillomavirus-associated anogenital lesions, and, finally, have fostered worldwide unification of clinical management for these lesions. Herein, we summarize the process and rationale by which updates were made to the terminology in 2014 and outline the contents of the new, third edition of the Bethesda atlas and corresponding website.
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Bijle, Mohammed Nadeem, Sreekanth Kumar Mallineni, and James Tsoi. "Qualitative and Quantitative Micro-CT Analysis of Natal and Neonatal Teeth." Children 9, no. 4 (April 14, 2022): 560. http://dx.doi.org/10.3390/children9040560.
Повний текст джерелаАнотація:
The objective of this study was to characterize natal and neonatal teeth using micro-computed tomography. A total of 4 natal and 11 neonatal teeth were used for the analysis. The reconstructed scans were assessed for the maximum enamel/dentin thickness and mineral density (MD). The scanned specimens were 3D reconstructed to qualitatively determine the surface topography. The dentin thickness was two-fold greater than enamel thickness for both natal and neonatal teeth (p < 0.05). The cervical third enamel MD remained undetermined in natal and neonatal teeth. The dentin MD at the cervical third for neonatal teeth was significantly lower than the incisal and middle third dentin (p < 0.05). Similarly, the dentin MD at the cervical third of neonatal teeth was significantly lower than the cervical third dentin MD of natal teeth (p < 0.05). Our qualitative analysis suggests that the cervical thirds of both natal and neonatal teeth are peculiar of an anomalous structure, with neonatal teeth showing an irregular outline. Under the conditions of the present study, it can be concluded that the neonatal teeth studied exhibited a distinguishable aberrant structure compared to the natal teeth. Therefore, the natal teeth unfold as a more organized, three-dimensional structure compared to the neonatal teeth.
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Bailey, Christopher S., Charles G. Fisher, Michael C. Boyd, and Marcel F. S. Dvorak. "En bloc marginal excision of a multilevel cervical chordoma." Journal of Neurosurgery: Spine 4, no. 5 (May 2006): 409–14. http://dx.doi.org/10.3171/spi.2006.4.5.409.
Повний текст джерелаАнотація:
✓ The purpose of this case report is to demonstrate that an en bloc resection with negative surgical margins can be successfully achieved in a case of a seemingly unresectable C-2 chordoma if appropriate preoperative staging and planning are performed. The management of chordomas is controversial and challenging because of their location and often large size at presentation. Because chordomas are malignant and will aggressively recur locally if intralesional resection is conducted, wide or true en bloc resection is generally recommended. The literature indicates, however, that surgeons are reluctant to perform wide or even marginal resections because of the lesion’s complex surrounding anatomy and the risk of significant neurological compromise when a tumor abuts the dura mater or neural tissues. In this report the authors outline the successful en bloc resection of a large C1–3 chordoma and discuss the importance of preoperative staging and planning.
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Reges, Danyelle Sadala, Marcela Mazzeo, Rafael Rosalino, Vivian Dias Baptista Gagliardi, Leandro Gama Cerqueira, and Rubens José Gagliardi. "Cervical arterial dissection: clinical characteristics in a neurology service in São Paulo, Brazil." Arquivos de Neuro-Psiquiatria 77, no. 9 (September 2019): 632–37. http://dx.doi.org/10.1590/0004-282x20190108.
Повний текст джерелаАнотація:
ABSTRACT Cervical arterial dissection accounts for only a small proportion of ischemic stroke but arouses scientific interest due to its wide clinical variability. Objective: This study aimed to evaluate its risk factors, outline its clinical characteristics, compare treatment with antiaggregation or anticoagulation, and explore the prognosis of patients with cervical arterial dissection. Methods: An observational, retrospective study using data from medical records on patients with cervical arterial dissection between January 2010 and August 2015. Results: The total number of patients was 41. The patients' ages ranged from 19 to 75 years, with an average of 44.5 years. The most common risk factor was smoking. Antiaggregation was used in the majority of patients (65.5%); 43% of all patients recanalized in six months, more frequently in patients who had received anticoagulation (p = 0.04). Conclusion: The presence of atherosclerotic disease is considered rare in patients with cervical arterial dissection; however, our study found a high frequency of hypertension, smoking and dyslipidemia. The choice of antithrombotic remains controversial and will depend on the judgment of the medical professional; the clinical results with anticoagulation or antiaggregation were similar but there was more recanalization in the group treated with anticoagulation; its course was favorable in both situations. The recurrence of cervical arterial dissection and stroke is considered a rare event and its course is favorable.
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Kiralj, Aleksandar, Nada Vuckovic, and Ivana Mijatov. "Congenital cervical bronchogenic cyst: A case report." Srpski arhiv za celokupno lekarstvo 143, no. 5-6 (2015): 317–21. http://dx.doi.org/10.2298/sarh1506317k.
Повний текст джерелаАнотація:
Introduction. Bronchogenic cysts are rare congenital anomalies of the embryonic foregut. They are caused by abnormal budding of diverticulum of the embryonic foregut between the 26th and 40th day of gestation. Bronchogenic cysts can appear in the mediastinum and pulmonary parenchyma, or at ectopic sites (neck, subcutaneous tissue or abdomen). So far, 70 cases of cervical localization of bronchogenic cysts have been reported. Majority of bronchogenic cysts have been diagnosed in the pediatric population. Bronchogenic cysts of the cervical area are generally asymptomatic and symptoms may occur if cysts become large or in case of infection of the cyst. The diagnosis is made based on clinical findings, radiological examination, but histopathologic findings are essential for establishing the final diagnosis. Treatment of cervical bronchogenic cyst involves surgical excision. Case Outline. Authors present a case of a 6-year-old female patient sent by a pediatrician to a maxillofacial surgeon due to asymptomatic lump on the left side of the neck. The patient had frequent respiratory infections and respiratory obstructions. Magnetic resonance imaging (MRI) of the neck was performed and a well-circumscribed cystic formation on the left side of the neck was observed, with paratracheal location. The complete excision of the cyst was made transcervically. Histopathological findings pointed to bronchogenic cyst. Conclusion. Cervical bronchogenic cysts are rare congenital malformations. Considering the location, clinical findings and the radiological features, these cysts resemble other cervical lesions. Surgical treatment is important because it is both therapeutic and diagnostic. Reliable diagnosis of bronchogenic cysts is based on histopathological examination.
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Póti, Zsuzsa, and Árpád Mayer. "Present radiochemotherapic approaches for advanced cervical cancer. Options for reduction of side-effects." Orvosi Hetilap 154, no. 21 (May 2013): 803–9. http://dx.doi.org/10.1556/oh.2013.29618.
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The advantages of cisplatin based radiochemotherapy have been proven for over one and a half decades, particularly in the treatment of advanced solid tumours. In head and neck, and cervical tumours results of prospective studies are available. Those showedthat both in the early and advanced stages, local control and overall survival rates are better than radiotherapy alone. The effect of cisplatin can be probably intensified with novel, more effective molecules, such as m-TOR inhibitors and tirapazamine. The authors review cisplatin and non-cisplatin based radiochemotherapy protocols, which improve previous treatment results. It should be considered, however, radiotherapy for cervical cancer can cause hematological, urogenital and intestinal toxicity, similarly to other combined treatments. The authors briefly outline international recommendations and their own experience for the prevention of these side-effects. Orv. Hetil., 2013, 154, 803–809.
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Chelariu-Raicu, Anca, Graziela Zibetti Dal Molin, and Robert L. Coleman. "The new world of poly-(ADP)-ribose polymerase inhibitors (PARPi) used in the treatment of gynecological cancers." International Journal of Gynecologic Cancer 30, no. 10 (September 14, 2020): 1608–18. http://dx.doi.org/10.1136/ijgc-2020-001789.
Повний текст джерелаАнотація:
The clinical development of poly-(ADP)-ribose polymerase inhibitors (PARPi) began with the treatment of ovarian cancer patients harboring BRCA1/2 mutations and continues to be expanded to other gynecological cancers. Furthermore, The Cancer Genome Atlas (TCGA) analysis of endometrial and cervical cancers offered rationale that PARPi may be an option for treatment based on the molecular profiles of these cancer types. This review summarizes the current indications of PARPi, such as its role in the treatment and maintenance of recurrent ovarian cancer and for first-line maintenance therapy in advanced ovarian cancer. We also outline new concepts for PARPi therapy in other gynecological cancers such as endometrial and cervical cancers based on recent clinical data. Finally, we present potential future directions to continue exploring the world of PARPi resistance and combining PARPi with other therapies.
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Bajaj, Anubha. "Clarion and Protuberant-Papillary Thyroid Carcinoma." Archives of Clinical and Experimental Pathology 1, no. 2 (December 24, 2022): 01–05. http://dx.doi.org/10.31579/2834-8508/006.
Повний текст джерелаАнотація:
Papillary thyroid carcinoma is a malignant thyroid neoplasm exhibiting histological subtypes as classic papillary carcinoma, tall cell, micro-carcinoma, follicular, oxyphilic, diffuse sclerosing, cribriform morular, solid or insular variant. Tumefaction enunciates distinctive nuclear features as altered nuclear magnitude and outline, nuclear enlargement or elongation, nuclear overlapping, and ground glass nuclei. Genomic fusions of BRAF, RET, PPARG, NTRK1, NTRK3, ALK, LTK, MET, FGFR2 or THADA genes may be observed. Initial disease representation emerges as 67% singular thyroid nodules, 13% thyroid nodules combined with cervical lymph node metastasis and 20% neoplasms confined singularly to lymph nodes
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Agarwal, Preeti, Fatima Khan, Vaibhav Gupta, and Devanshi Dubey. "Liquid based cytology and immunohistochemistry on cytosmears based diagnosis of letterer-siwe disease in a 40 year male." Indian Journal of Pathology and Oncology 8, no. 4 (November 15, 2021): 508–11. http://dx.doi.org/10.18231/j.ijpo.2021.105.
Повний текст джерелаАнотація:
: Histiocytes with coffee bean like nucleus are the diagnostic hallmark of Langerhans cell histiocytosis (LCH) supported with immunohistochemical (IHC) demonstration of fascin, CD1a and S-100. We report a case of Letterer-Siwe disease in a 40year male diagnosed on cytology and IHC on cytosmears along with cytomorphology in Liquid based cytology (LBC) smears. Forty year male presented with complains of low grade fever and reduced appetite from two years with a cervical swelling and discomfort from five months. Fine needle aspiration(FNA) from cervical lymph node showed sheets of histiocytes in background of mixed inflammatory cells. LBC smears highlighted fine chromatin, delicate nuclear outline with coffee bean like morphology. On IHC tumor cells were positive for S-100 and CD1a. CT thorax revealed consolidation in left lower lung, bone lesions were found on skeletal survey. Hence diagnosis of Letterer-Siwe disease was given. Patient responded well to systemic chemotherapy.
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Krauss, William E., Jonathan M. Bledsoe, Michelle J. Clarke, Eric W. Nottmeier, and Mark A. Pichelmann. "Rheumatoid Arthritis of the Craniovertebral Junction." Neurosurgery 66, suppl_3 (March 1, 2010): A83—A95. http://dx.doi.org/10.1227/01.neu.0000365854.13997.b0.
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Abstract BACKGROUND Rheumatoid arthritis (RA) is the most common inflammatory disease involving the spine. It has a predilection for involving the craniocervical spine. Despite widespread involvement of the cervical spine with RA, few patients need surgery. The 3 major spinal manifestations of RA in the cervical spine are basilar invagination, atlantoaxial instability, and subaxial subluxations. Surgical management of RA involving the craniovertebral junction remains a challenge despite a decline in severe cases and an improvement in surgical techniques. METHODS We conducted an exhaustive review of English-language publications discussing RA involving the craniovertebral junction. We paid special attention to publications detailing modern surgical management of these conditions. In addition, we outline our own surgical experience with such patients. RESULTS We discuss alternative surgical methods for treating basilar invagination, atlantoaxial instability, and concurrent subaxial subluxations. We detail our surgical technique for transoral odontoidectomy, occipital cervical fusion, and atlantoaxial fusion. We detail the use of spinal surgical navigation in both of these procedures. CONCLUSION Surgical management of RA remains a challenging field. There clearly has been a decrease in cases of mutilating RA involving the craniovertebral junction. Surgical techniques for managing these conditions have steadily improved.
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Berlowitz, David J., Brooke Wadsworth, and Jack Ross. "Respiratory problems and management in people with spinal cord injury." Breathe 12, no. 4 (November 30, 2016): 328–40. http://dx.doi.org/10.1183/20734735.012616.
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Spinal cord injury (SCI) is characterised by profound respiratory compromise secondary to the level of loss of motor, sensory and autonomic control associated with the injury. This review aims to detail these anatomical and physiological changes after SCI, and outline their impact on respiratory function. Injury-related impairments in strength substantially alter pulmonary mechanics, which in turn affect respiratory management and care. Options for treatments must therefore be considered in light of these limitations.Key pointsRespiratory impairment following spinal cord injury (SCI) is more severe in high cervical injuries, and is characterised by low lung volumes and a weak cough secondary to respiratory muscle weakness.Autonomic dysfunction and early-onset sleep disordered breathing compound this respiratory compromise.The mainstays of management following acute high cervical SCI are tracheostomy and ventilation, with noninvasive ventilation and assisted coughing techniques being important in lower cervical and thoracic level injuries.Prompt investigation to ascertain the extent of the SCI and associated injuries, and appropriate subsequent management are important to improve outcomes.Educational aimsTo describe the anatomical and physiological changes after SCI and their impact on respiratory function.To describe the changes in respiratory mechanics seen in cervical SCI and how these changes affect treatments.To discuss the relationship between injury level and respiratory compromise following SCI, and describe those at increased risk of respiratory complications.To present the current treatment options available and their supporting evidence.
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Magnani, Barbarajean, Beth Harubin, Judith F. Katz, Andrea L. Zuckerman, and William C. Strohsnitter. "See, Test & Treat: A 5-Year Experience of Pathologists Driving Cervical and Breast Cancer Screening to Underserved and Underinsured Populations." Archives of Pathology & Laboratory Medicine 140, no. 12 (December 1, 2016): 1411–22. http://dx.doi.org/10.5858/arpa.2016-0094-sa.
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Context.— See, Test & Treat is a pathologist-driven program to provide cervical and breast cancer screening to underserved and underinsured patient populations. This program is largely funded by the CAP Foundation (College of American Pathologists, Northfield, Illinois) and is a collaborative effort among several medical specialties united to address gaps in the current health care system. Objective.— To provide an outline for administering a See, Test & Treat program, using an academic medical center as a model for providing care and collating the results of 5 years of data on the See, Test & Treat program's findings. Design.— Sources include data from patients seen at Tufts Medical Center (Boston, Massachusetts) who presented to the See, Test & Treat program and institutional data between 2010 and 2014 detailing the outline of how to organize and operationalize a volunteer cancer-screening program. Results.— During the 5-year course of the program, 203 women were provided free cervical and breast cancer screening. Of the 169 patients who obtained Papanicolaou screening, 36 (21.3%) had abnormal Papanicolaou tests. In addition, 16 of 130 patients (12.3%) who underwent mammography had abnormal findings. Conclusions.— In general, women from ethnic populations have barriers that prevent them from participating in cancer screening. However, the CAP Foundation's See, Test & Treat program is designed to reduce those barriers for these women by providing care that addresses cultural, financial, and practical issues. Although screening programs are helpful in identifying those who need further treatment, obtaining further treatment for these patients continues to be a challenge.
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Tetreault, Lindsay, Philip Garwood, Aref-Ali Gharooni, Alvaro Yanez Touzet, Laura Nanna-Lohkamp, Allan Martin, Jefferson Wilson, et al. "Improving Assessment of Disease Severity and Strategies for Monitoring Progression in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 4]." Global Spine Journal 12, no. 1_suppl (December 31, 2021): 64S—77S. http://dx.doi.org/10.1177/21925682211063854.
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Study design Narrative Review. Objective To (i) discuss why assessment and monitoring of disease progression is critical in Degenerative cervical myelopathy (DCM); (ii) outline the important features of an ideal assessment tool and (iii) discuss current and novel strategies for detecting subtle deterioration in DCM. Methods Literature review Results Degenerative cervical myelopathy is an overarching term used to describe progressive injury to the cervical spinal cord by age-related changes of the spinal axis. Based on a study by Smith et al (2020), the prevalence of DCM is approximately 2.3% and is expected to rise as the global population ages. Given the global impact of this disease, it is essential to address important knowledge gaps and prioritize areas for future investigation. As part of the AO Spine RECODE-DCM (Research Objectives and Common Data Elements for Degenerative Cervical Myelopathy) project, a priority setting partnership was initiated to increase research efficiency by identifying the top ten research priorities for DCM. One of the top ten priorities for future DCM research was: What assessment tools can be used to evaluate functional impairment, disability and quality of life in people with DCM? What instruments, tools or methods can be used or developed to monitor people with DCM for disease progression or improvement either before or after surgical treatment? Conclusions With the increasing prevalence of DCM, effective surveillance of this population will require both the implementation of a monitoring framework as well as the development of new assessment tools.
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Wareham, James, Robert Crossley, Sarah Barr, and Alex Mortimer. "Cervical ICA pseudo-occlusion on single phase CTA in patients with acute terminal ICA occlusion: what is the mechanism and can delayed CTA aid diagnosis?" Journal of NeuroInterventional Surgery 10, no. 10 (February 6, 2018): 983–87. http://dx.doi.org/10.1136/neurintsurg-2017-013708.
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BackgroundSingle-phase CT angiography (CTA) forms the basis of hyperacute stroke imaging but many patients with terminal internal carotid artery (ICA) occlusion exhibit a pseudo-occlusion of the cervical ICA whereby a column of unopacified blood mimics a tandem cervical ICA lesion. We aimed to investigate the utility of a delayed phase acquisition to aid identification of a pseudo-occlusion and investigated the mechanism for this imaging artefact.MethodsThirteen patients with a pseudo-occlusion were compared with 13 patients without. CT, CTA, and digital subtraction angiographic images were reviewed by two interventional neuroradiologists for extension of thrombus into the ophthalmic segment, filling of the posterior communicating artery and ophthalmic artery, and for extension of contrast beyond the cervical segment and outline of the proximal clot surface by contrast on delayed imaging performed at 40 or 80 s.ResultsThose with a pseudo-occlusion demonstrated more frequent thrombus extension into the ophthalmic segment (100% vs 23%, P=0.0001), less frequent filling of the posterior communicating artery (15% vs 85%, P=0.0012), and less frequent filling of the ophthalmic artery (15% vs 92%, P=0.0002) compared with those without a pseudo-occlusion. Delayed CTA imaging showed contrast beyond the cervical segment and meeting the proximal clot face in 2/11 patients. Each of these two patients showed patency of the posterior communicating artery origin.ConclusionThrombus extension into the ophthalmic segment and patency of the posterior communicating artery and ophthalmic artery seem to govern whether a patient with a terminal ICA occlusion exhibits a pseudo-occlusion. Delayed imaging was of limited value in identification of a pseudo-occlusion.
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Nguyen, Anh B., Faye Z. Belgrave, and Barbara K. Sholley. "Development of a Breast and Cervical Cancer Screening Intervention for Vietnamese American Women." Health Promotion Practice 12, no. 6 (June 8, 2010): 876–86. http://dx.doi.org/10.1177/1524839909355518.
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Community-based participatory research (CBPR) is a collaborative partnership approach to research that combines the efforts of researchers and stakeholders. CBPR can effectively be used to target local community populations in increasing knowledge and improving behaviors in cancer prevention as participants have a voice and active role in the research process. This article describes how CBPR was used in the development, implementation, and evaluation of a pilot intervention for breast and cervical cancer screening among a Vietnamese female population. The authors outline the use of CBPR in three phases: (a) the identification of preventive health topics important in the local Vietnamese community, (b) the development and administration of a survey to gain a deeper understanding of barriers to breast and cancer screening among Vietnamese women, and (c) the development of a culturally appropriate pilot intervention to promote cancer screening behavior among a local Vietnamese population. In Study 1, it was found that Vietnamese women experienced disparities in breast and cervical cancer screening. In Study 2, it was found that having health insurance and a regular physician were predictive of breast and cervical cancer screening. It was also found that participants had low levels of acculturation and lacked cancer screening knowledge. In Study 3, it was found that the culturally relevant intervention used in this study improved cancer screening–related outcomes in knowledge, self-efficacy, intention, and behavior.
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Balmagambetova, Saule, Andrea Tinelli, Ospan A. Mynbaev, Arip Koyshybaev, Olzhas Urazayev, Nurgul Kereyeva, and Elnara Ismagulova. "Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues." Current Pharmaceutical Design 26, no. 18 (June 10, 2020): 2073–86. http://dx.doi.org/10.2174/1381612826666200422094205.
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High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.
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Maric, Dusan, Vukadin Milankov, Ivica Lalic, Marko Bumbasirevic, and Dzihan Abazovic. "Calcification of cervical intervertebral disc in a child: A case report and review of literature." Srpski arhiv za celokupno lekarstvo 147, no. 5-6 (2019): 371–74. http://dx.doi.org/10.2298/sarh180323019m.
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Introduction. We report a case of calcification of a cervical intervertebral disk in a child. This is a rare condition, and has been described in about 400 cases worldwide. Children affected by it present with the onset of pain, muscle spasm, and the presence of calcification of a intervertebral disk on radiography. Our objective was to present a case of sudden onset of pain in the neck and torticollis. Case outline. In our case, the condition was diagnosed after trauma, presented with neck pain and spasm of the right sternocleidomastoid. Initial neck radiography was done, and after identifying the calcification in front of C4 and C5 vertebral bodies, CT analysis was conducted. When it was concluded that there is no compression on spine nerve roots, conservative course of treatment was followed. The child had full regression of symptoms after two weeks. Conclusion. Emergency personnel should bear in mind that, even though radiographical finding of a calcification shadow in front of the spine may raise concern, the nature of this disorder is benign in most cases, and responds very well to conservative treatment.
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Klein, Eric A., Tomasz M. Beer, and Michael Seiden. "The Promise of Multicancer Early Detection. Comment on Pons-Belda et al. Can Circulating Tumor DNA Support a Successful Screening Test for Early Cancer Detection? The Grail Paradigm. Diagnostics 2021, 11, 2171." Diagnostics 12, no. 5 (May 17, 2022): 1243. http://dx.doi.org/10.3390/diagnostics12051243.
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Multicancer Early Detection (MCED) represents a new and exciting paradigm for the early detection of cancer, which is the leading cause of death worldwide. Current screening tests, recommended for only five cancer types (breast, lung, colon, cervical, and prostate), are limited by a lack of complete adherence to guideline-based use and by the fact that they have cumulative high false positive rates. MCED tests agnostically detect cancer signals in the blood with good sensitivity and low false positive rates, can predict the cancer site of origin with high accuracy, can detect highly lethal cancers that have no current screening tests, and promise to improve cancer screening by improving efficiency and reducing the overall number needed to screen. Herein we outline this promise and clarify several published misconceptions about this field.
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Muntinga, Caroline L. P., Peggy J. de Vos van Steenwijk, Ruud L. M. Bekkers, and Edith M. G. van Esch. "Importance of the Immune Microenvironment in the Spontaneous Regression of Cervical Squamous Intraepithelial Lesions (cSIL) and Implications for Immunotherapy." Journal of Clinical Medicine 11, no. 5 (March 5, 2022): 1432. http://dx.doi.org/10.3390/jcm11051432.
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Cervical high-grade squamous intraepithelial lesions (cHSILs) develop as a result of a persistent high-risk human papilloma virus (hrHPV) infection. The natural course of cHSIL is hard to predict, depending on a multitude of viral, clinical, and immunological factors. Local immunity is pivotal in the pathogenesis, spontaneous regression, and progression of cervical dysplasia; however, the underlying mechanisms are unknown. The aim of this review is to outline the changes in the immune microenvironment in spontaneous regression, persistence, and responses to (immuno)therapy. In lesion persistence and progression, the immune microenvironment of cHSIL is characterized by a lack of intraepithelial CD3+, CD4+, and CD8+ T cell infiltrates and Langerhans cells compared to the normal epithelium and by an increased number of CD25+FoxP3+ regulatory T cells (Tregs) and CD163+ M2 macrophages. Spontaneous regression is characterized by low numbers of Tregs, more intraepithelial CD8+ T cells, and a high CD4+/CD25+ T cell ratio. A ‘hot’ immune microenvironment appears to be essential for spontaneous regression of cHSIL. Moreover, immunotherapy, such as imiquimod and therapeutic HPV vaccination, may enhance a preexisting pro-inflammatory immune environment contributing to lesion regression. The preexisting immune composition may reflect the potential for lesion regression, leading to a possible immune biomarker for immunotherapy in cHSILs.
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Snyder, Claire F., Craig C. Earle, Robert J. Herbert, Bridget A. Neville, Amanda L. Blackford, and Kevin D. Frick. "Preventive Care for Colorectal Cancer Survivors: A 5-Year Longitudinal Study." Journal of Clinical Oncology 26, no. 7 (March 1, 2008): 1073–79. http://dx.doi.org/10.1200/jco.2007.11.9859.
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Purpose To explore the mix of physician specialties that long-term survivors visit and how the mix relates to preventive care. Patients and Methods Using the Surveillance, Epidemiology, and End Results–Medicare database, we conducted a retrospective, longitudinal study of stage I to III Medicare fee-for-service colorectal cancer patients diagnosed in 1997. We examined physician visits and preventive care each year for 5 years, starting 366 days postdiagnosis, and how preventive service receipt related to the physician mix seen: primary care provider (PCP) only, oncologist only, both, or neither. Results A total of 1,541 patients met the eligibility criteria (mean age, 76; 43% male; 85% white). During 5 years, PCP visits increased from a mean of 4.2 to 4.7 (P < .0001), and oncology visits decreased from 1.3 to 0.5 (P < .0001). Survivor care by PCPs only increased from 44% to 62%, whereas shared care by PCPs and oncologists dropped from 37% to 21% (P < .0001). Survivors who saw both PCPs and oncologists were most likely to receive influenza vaccination, mammograms, and cervical cancer screening; survivors who saw PCPs only were most likely to receive cholesterol screening and bone densitometry. Higher socioeconomic status was associated with increased influenza vaccination, mammograms, and cervical cancer screening (P < .05). Over time, there was a decrease in mammography and cervical cancer screening and an increase in influenza vaccination (P < .05). Conclusion As oncologists become less involved in survivor care, cancer-related screening decreases significantly. These results support the need for survivorship care plans that explicitly outline the roles of PCPs and oncologists in sharing care for cancer survivors, and how these roles may change over time.
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Fehlings, Michael G., Lindsay A. Tetreault, K. Daniel Riew, James W. Middleton, and Jeffrey C. Wang. "A Clinical Practice Guideline for the Management of Degenerative Cervical Myelopathy: Introduction, Rationale, and Scope." Global Spine Journal 7, no. 3_suppl (September 2017): 21S—27S. http://dx.doi.org/10.1177/2192568217703088.
Повний текст джерелаАнотація:
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. Patients with DCM may present with common signs and symptoms of neurological dysfunction, such as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased tone, and sensory dysfunction. Clinicians across several specialties encounter patients with DCM, including primary care physicians, rehabilitation specialists, therapists, rheumatologists, neurologists, and spinal surgeons. Currently, there are no guidelines that outline how to best manage patients with mild (defined as a modified Japanese Orthopedic Association (mJOA) score of 15-17), moderate (mJOA = 12-14), or severe (mJOA ≤ 11) myelopathy, or nonmyelopathic patients with evidence of cord compression. This guideline provides evidence-based recommendations to specify appropriate treatment strategies for these populations. The intent of our recommendations is to (1) help identify patients at high risk of neurological deterioration, (2) define the role of nonoperative and operative management in each patient population, and (3) determine which patients are most likely to benefit from surgical intervention. The ultimate goal of these guidelines is to improve outcomes and reduce morbidity in patients with DCM by promoting standardization of care and encouraging clinicians to make evidence-informed decisions.
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Chang, Philip J., Arash Asher, and Sean R. Smith. "A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment." Cancers 13, no. 20 (October 16, 2021): 5191. http://dx.doi.org/10.3390/cancers13205191.
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Persistent pain following treatment for breast cancer is common and often imprecisely labeled as post-mastectomy pain syndrome (PMPS). PMPS is a disorder with multiple potential underlying causes including intercostobrachial nerve injury, intercostal neuromas, phantom breast pain, and pectoralis minor syndrome. Adding further complexity to the issue are various musculoskeletal pain syndromes including cervical radiculopathy, shoulder impingement syndrome, frozen shoulder, and myofascial pain that may occur concurrently and at times overlap with PMPS. These overlapping pain syndromes may be difficult to separate from one another, but precise diagnosis is essential, as treatment for each pain generator may be distinct. The purpose of this review is to clearly outline different pain sources based on anatomic location that commonly occur following treatment for breast cancer, and to provide tailored and evidence-based recommendations for the evaluation and treatment of each disorder.
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Berger, Thomas, Jørgen Breede Baltzer Petersen, Jacob Christian Lindegaard, Lars Ulrik Fokdal, and Kari Tanderup. "Impact of bowel gas and body outline variations on total accumulated dose with intensity-modulated proton therapy in locally advanced cervical cancer patients." Acta Oncologica 56, no. 11 (September 21, 2017): 1472–78. http://dx.doi.org/10.1080/0284186x.2017.1376753.
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Bhalla, A. "Strategies and Intervention for Cancer Screening at Village Level." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 232s. http://dx.doi.org/10.1200/jgo.18.93500.
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Background: Cancer is a leading cause of death globally. The World Health Organization estimates that 7.6 million people died of cancer in 2005 and 84 million people will die in the next 10 years if action is not taken. More than 70% of all cancer deaths occur in low- and middle-income countries, where resources available for prevention, diagnosis and treatment of cancer are limited or nonexistent. There are 3 common cancers found in wide range in India (oral, breast and cervical). In India the maximum people die due to oral cancer in men and breast cancer in female. Method: The current cancer screening and intervention approaches for the early prevention and detection of cancer, and to outline strategies for future interventions and research at village level. Results and Conclusion: The cancer screening plan is agreed upon by the stakeholders, it should be given the widest possible distribution within the country In resource constrained countries, a plan is more likely to be implemented if it includes fewer, yet sustainable interventions in line with evidence-based priorities, ranging from prevention to end-of-life care, with measurable process and outcome objectives that can be monitored and evaluated if basic information systems are in place. For example, prevention strategies (such as tobacco control and hepatitis B immunization), and treatment interventions linked to early diagnosis (awareness of early signs and symptoms) of a few cancer types (such as cervical and breast cancers) would be key feasible interventions.
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Jelinic, Maria, Sarah A. Marshall, Dennis Stewart, Elaine Unemori, Laura J. Parry, and Chen Huei Leo. "Peptide hormone relaxin: from bench to bedside." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 314, no. 6 (June 1, 2018): R753—R760. http://dx.doi.org/10.1152/ajpregu.00276.2017.
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The peptide hormone relaxin has numerous roles both within and independent of pregnancy and is often thought of as a “pleiotropic hormone.” Relaxin targets several tissues throughout the body, and has many functions associated with extracellular matrix remodeling and the vasculature. This review considers the potential therapeutic applications of relaxin in cervical ripening, in vitro fertilization, preeclampsia, acute heart failure, ischemia-reperfusion, and cirrhosis. We first outline the animal models used in preclinical studies to progress relaxin into clinical trials and then discuss the findings from these studies. In many cases, the positive outcomes from preclinical animal studies were not replicated in human clinical trials. Therefore, the focus of this review is to evaluate the various animal models used to develop relaxin as a potential therapeutic and consider the limitations that must be addressed in future studies. These include the use of human relaxin in animals, duration of relaxin treatment, and the appropriateness of the clinical conditions being considered for relaxin therapy.
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Beutels, Philippe, and Mark Jit. "A brief history of economic evaluation for human papillomavirus vaccination policy." Sexual Health 7, no. 3 (2010): 352. http://dx.doi.org/10.1071/sh10018.
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Background: This commentary discusses key issues for health economic evaluation and modelling, applied to human papillomavirus (HPV) vaccine programs. Methods: We outline some of the specific features of HPV disease and vaccination, and associated policy questions in light of a literature search for economic evaluations on HPV vaccination. Results: We observe that some policy questions could not be reliably addressed by many of the 43 published economic evaluations we found. Despite this, policy making on universal HPV vaccination followed shortly after vaccine licensure in many developed countries, so the role economic evaluation played in informing these decisions (pre-dating 2008) seems to have been fairly limited. For more recent decisions, however, economic evaluation is likely to have been used more widely and more intensively. Conclusions: We expect future cost-effectiveness analyses to be more instrumental in policy making regarding vaccines covering more HPV types, therapeutic HPV vaccines, and novel diagnostic tests for biomarkers of HPV infection and disease integrated with cervical screening programs.
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Green, Kristina, Hollie Walusz, and Stephanie Naylor. "Case study: An evidence based approach to the use of dry needling for a concussion within the cervicogenic pathway." Neurology 91, no. 23 Supplement 1 (December 4, 2018): S18.2—S18. http://dx.doi.org/10.1212/01.wnl.0000550695.45926.d3.
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Concussion management and treatment continues to be a popular topic of current literature. As discussion of concussion pathways continues to be highlighted, specific intervention strategies are gaining popularity as best treatment options. For patients that fall into the cervicogenic pathway of concussion, DN is an intervention modality that is becoming more prevalent in its use. This presentation will describe the common presentation of patients that fall within this concussion pathway and highlight how DN reduces pain and disability within this subset of patients. We will discuss the current evidence and efficacy of DN as an intervention tool in our clinical practice, specifically for the cervicogenic pathway of concussion. We will outline and demonstrate proper application procedures for DN within the cervical, occipital and temporal regions with discussion of safety considerations. We will then correlate this intervention tool with the use of outcome measures within clinical practice and tie it back to patient reported concussive symptoms. Finally, we will discuss the impact on time to resolution of symptoms DN can have in our patients. Learning Objectives: (1) Discuss the theory of Concussion Clinical Pathways. (2) Understand a specific clinical presentation of a patient within the Cervicogenic Pathway. (3) Define Dry Needling (DN). (4) Understand the utilization and pathophysiology behind DN in clinical practice. (5) Understand the proper application of DN in the cervical, occipital and temporal regions. (6) Recognize the benefit DN has on this specific pathway. (7) Recognize patients that can benefit from this intervention through the use of a case presentation.
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El-Swaify, Seif Tarek, Mazen A. Refaat, Sara H. Ali, Abdelrahman E. Mostafa Abdelrazek, Pavly Wagih Beshay, Menna Kamel, Bassem Bahaa, Abdelrahman Amir, and Ahmed Kamel Basha. "Controversies and evidence gaps in the early management of severe traumatic brain injury: back to the ABCs." Trauma Surgery & Acute Care Open 7, no. 1 (January 2022): e000859. http://dx.doi.org/10.1136/tsaco-2021-000859.
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Traumatic brain injury (TBI) accounts for around 30% of all trauma-related deaths. Over the past 40 years, TBI has remained a major cause of mortality after trauma. The primary injury caused by the injurious mechanical force leads to irreversible damage to brain tissue. The potentially preventable secondary injury can be accentuated by addressing systemic insults. Early recognition and prompt intervention are integral to achieve better outcomes. Consequently, surgeons still need to be aware of the basic yet integral emergency management strategies for severe TBI (sTBI). In this narrative review, we outlined some of the controversies in the early care of sTBI that have not been settled by the publication of the Brain Trauma Foundation’s 4th edition guidelines in 2017. The topics covered included the following: mode of prehospital transport, maintaining airway patency while securing the cervical spine, achieving adequate ventilation, and optimizing circulatory physiology. We discuss fluid resuscitation and blood product transfusion as components of improving circulatory mechanics and oxygen delivery to injured brain tissue. An outline of evidence-based antiplatelet and anticoagulant reversal strategies is discussed in the review. In addition, the current evidence as well as the evidence gaps for using tranexamic acid in sTBI are briefly reviewed. A brief note on the controversial emergency surgical interventions for sTBI is included. Clinicians should be aware of the latest evidence for sTBI. Periods between different editions of guidelines can have an abundance of new literature that can influence patient care. The recent advances included in this review should be considered both for formulating future guidelines for the management of sTBI and for designing future clinical studies in domains with clinical equipoise.
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Savic, Dejan, Slobodan Vojinovic, Mirjana Spasic, Zoran Peric, and Stevo Lukic. "Syringomyelia in demyelinating disease of the central nervous system: Report of two cases." Srpski arhiv za celokupno lekarstvo 139, no. 9-10 (2011): 657–60. http://dx.doi.org/10.2298/sarh1110657s.
Повний текст джерелаАнотація:
Introduction. Syringomyelia is a cavitary extension inside the spinal cord which can be either symptomatic or congenitally-idiopathic. Syringomyelia during the course of the disease in patients presenting with clinically definite multiple sclerosis was described earlier. Syringomyelia in patients presenting with a clinically isolated syndrome suggestive of multiple sclerosis is unusual. Case Outline. We present two patients presenting with demy-elinating disease of the central nervous system with syringomyelia in the cervical and thoracic spinal cord. We did not find classical clinical signs of syringomyelia in our patients, but we disclosed syringomyelia incidentally during magnetic resonance exploration. Magnetic resonance exploration using the gadolinium contrast revealed the signs of active demyelinating lesions in the spinal cord in one patient but not in the other. Conclusion. Syringomyelia in demyelinating disease of the central nervous system opens the question whether it is a coincidental finding or a part of clinical features of the disease. Differentiation of the significance of syringomyelia finding in these patients plays a role in the choice of treatment concept in such patients.
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Jotic, Ana, Snezana Jesic, Jovica Milovanovic, and Biljana Krstic. "Auricular acantholytic squamous cell carcinoma with neck metastasis and lethal outcome: Case report." Srpski arhiv za celokupno lekarstvo 143, no. 9-10 (2015): 599–603. http://dx.doi.org/10.2298/sarh1510599j.
Повний текст джерелаАнотація:
Introduction. Acantholytic squamous cell (adenosquamous) carcinoma of the skin are relatively rare subtype of squamous cell carcinoma, usually found in elderly on sun-exposed areas of the skin, predominately head, neck and upper extremities. Incidence of metastasis is 2-14%. Case Outline. A case of a 76-year-old male, with the signs of left-sided facial palsy and cervical mass on the same side, is presented. Five months prior to the visit, due to acantholytic squamous cell carcinoma, an excision of the ulceration of the superior third of the left auricle was performed. Patient underwent surgical treatment, after pathohistological and radiological confirmation of the infiltrative neck metastasis. Postoperatively, rapid locoregional progression of the disease was noted in the patient, with a lethal outcome. Conclusion. Squamous cell carcinoma (including acantholytic subtype) with lesions bigger than 4 cm in size in auricular-temporal region, signs of deep tissue invasion, and lymphovascular and perineural invasion have higher local metastatic potential. More frequent oncological check-ups with radiological examination are necessary in detecting locoregional metastasis.
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Levakov, Olivera, Aleksandar Jovanovic, Zoran Gajic, Tatjana Ros, Aleksandar Kopitovic, Branislava Gajic, and Ivan Levakov. "Trauma, possible cause of localized unilateral hyperhidrosis of the face?" Srpski arhiv za celokupno lekarstvo, no. 00 (2020): 81. http://dx.doi.org/10.2298/sarh181109081l.
Повний текст джерелаАнотація:
Introduction. Localized unilateral hyperhidrosis (LUH) is a rare disorder of unknown origin, with multiple possible triggering factors and unknown pathogenesis. Although there are cases of LUH of the face reported, this is the first to report isolated ipsilateral hyperhidrosis of the face after blunt force trauma. Case outline. A 54-year old Caucasian woman presented with localized unilateral facial hyperhidrosis (LUH) of five years duration. Ipsilateral blunt trauma of the temple that preceded the condition for three months was identified as the most probable cause. For sharp demarcation the Minor or ?starch-iodine? test is performed which revealed presence and extent of the facial sweating on the left side of the face. Treatment with Sol. 20% aluminium chloride hexahydrate (Retrargin sol.) was conducted with partial response. Conclusion. After ruling out underlying diseases as a cause of LUH, a prior trauma should be considered as a potential cause. The possible mechanism could be the lesion of sympathetic chain as a result of cervical traction due to a facial blunt force trauma, although it cannot be positively proven.
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Nikolic, Igor, Dragoslav Nestorovic, Nikola Repac, Sasa Knezevic, and Goran Tasic. "Intrathecal baclofen therapy and Covid-19 infection - report of three cases." Srpski arhiv za celokupno lekarstvo, no. 00 (2022): 76. http://dx.doi.org/10.2298/sarh211222076n.
Повний текст джерелаАнотація:
Introduction. Patients with severe spasticity are effectively treated with intrathecal baclofen therapy (ITB), but because of their invalidity, in case of infection, prognosis is poor. Case outline. We present three cases (two men and one woman) of patients treated with baclofen intrathecal therapy due to spasticity of all four extremities who underwent SARS-CoV2 virus infection. Two of them have multiple sclerosis, and one has trauma of the cervical segment of the spinal cord. In all three patients, the clinical presentation of Covid-19 infection occurred within six months of implantation of the pump for ITB. They were successfully treated in hospital with same dose of the drug and without exacerbation of neurological status. Barthel index and modified Rankin score were same before and after Covid-19 infection. In two cases Barthel index (BI) was 20, and in one 69; and modified Rankin score (mRS) was 3 in one case, and 5 in two cases. Conclusion. Patients with severe spasticity who require intrathecal baclofen therapy can be safely treated regardless of the pandemic.
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Zagorac, Slavisa, Radovan Mijalcic, Milos Vasic, Uros Dabetic, and Uros Novakovic. "Occipitocervical fusion as treatment of instability in Chiari malformation." Srpski arhiv za celokupno lekarstvo, no. 00 (2022): 41. http://dx.doi.org/10.2298/sarh220203041z.
Повний текст джерелаАнотація:
Introduction. Occipitocervical (OC) fusion is a method for fixation of the OC junction when there is instability of that segment. Arnold Chiari malformation is a congenital disorder where cerebellar tonsils descend through the foramen magnum, which can lead to cervicomedular compression and formation of syrinx. While treating this condition, for the purpose of decompression, the foramen magnum is expanded which can potentially harm the stability of the OC junction. Case outline. We are presenting the case of a 16 year old female who was surgically treated (suboccipital craniectomy and decompression) because of Arnold Chiari malformation type I. One-year post-op multislice computed tomography verified a slight enlargement of basion-axial and basion-dens intervals, with signs of spinal cord compression. Surgery was performed - occipitocervical fusion, canal decompression on C1 and C2 levels with a plate on occipital bone and screws placed in the third, fourth, and fifth cervical vertebra. Conclusion. Occipitocervical fusion is a complex surgical procedure (vital neurovascular structures), but it is a reliable method for treatment of instability of the OC junction.