Pathology Slide Review in Vulvar Cancer Does Not Change Patient Management

ISRN Surgery ◽

10.1155/2014/385386 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Maaike Beugeling ◽

Patricia C. Ewing-Graham ◽

Zineb Mzallassi ◽

Helena C. van Doorn

Keyword(s):

Patient Management ◽

Linear Extension ◽

Chart Review ◽

Vulvar Cancer ◽

Retrospective Chart Review ◽

Residual Tumor ◽

Tumor Type ◽

Tertiary Centre ◽

Pathology Reports ◽

Depth Of Infiltration

Hypothesis. Pathology slide review in vulvar cancer is only necessary in a restricted number of cases. Methods. A retrospective chart review of all cases of vulvar cancer treated in a tertiary centre between January 1, 2000, and April 1, 2006. Histopathology reports from the referring and tertiary centre were compared. Results. 121 pathology reports from 112 patients were reviewed. Of the original reports, 56% were deemed adequate, commenting on tumor type and depth of infiltration; of the reviews, 83% were adequate. Conclusion. There were no discrepancies that influenced patient management. We suggest that vulvar cancer biopsies need to be reviewed only when the tumor is less than 10 mm in linear extension, when the infiltration is 1 mm or less, when there is no residual tumor on inspection, and in any nonsquamous cancer.

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Cholecystectomy for Biliary Hyperkinesia

The American Surgeon ◽

10.1177/000313481908500232 ◽

2019 ◽

Vol 85 (2) ◽

pp. 219-222 ◽

Cited By ~ 2

Author(s):

Joshua Gazzetta ◽

Betty Fan ◽

Paul Bonner ◽

John Galante

Keyword(s):

Laparoscopic Cholecystectomy ◽

Chart Review ◽

Gallbladder Disease ◽

Retrospective Chart Review ◽

Biliary Colic ◽

Study Cohort ◽

Final Pathology ◽

Pathology Reports ◽

Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

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Pilot Study: Outcomes of the Full Abdominopelvic Ultrasound Protocol for Diagnosis of Acute Appendicitis in Children: A Retrospective Chart Review

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479320917402 ◽

2020 ◽

Vol 36 (6) ◽

pp. 530-534

Author(s):

Robert Dima ◽

Yongdong Wang ◽

Sarah Zuccolo ◽

Michelle Palmer ◽

Kerry Cheong

Keyword(s):

Pilot Study ◽

Acute Appendicitis ◽

Emergency Room ◽

Teaching Hospital ◽

Patient Management ◽

Chart Review ◽

Retrospective Chart Review ◽

Sonographic Evaluation ◽

Suspected Acute Appendicitis ◽

Rule Out

Objective: Sonographic evaluation for acute appendicitis in children often involves an exhaustive protocol, for which the therapeutic yield has not been formally evaluated. The purpose of the study was to pilot a retrospective chart review of children receiving an abdominopelvic sonogram upon presenting with suspected acute appendicitis. Methods: An annual retrospective chart review was designed to review abdominopelvic sonograms to rule out appendicitis and specifically performed at a Canadian children’s teaching hospital. Studies were excluded if the requisition stated multiple clinical concerns or if the patient was >18 years at the time of the sonogram. Results: Based on 230 patient cases reviewed, alternative diagnostic sonographic findings were found in 141 (61%) charts. Only 18 patient cases (8%) demonstrated both alternative sonographic findings as well as a change in management by the emergency room physician. Conclusion: Alternative diagnostic findings, based on a complete abdominopelvic sonogram, were common (61%) in this chart review but rarely changed patient management.

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Relationship Between the Neutrophil to Lymphocyte Ratio and Parathyroid Adenoma Size in Patients With Primary Hyperparathyroidism

International Surgery ◽

10.9738/intsurg-d-15-00044.1 ◽

2015 ◽

Vol 100 (7-8) ◽

pp. 1185-1189 ◽

Cited By ~ 3

Author(s):

Sezgin Zeren ◽

Faik Yaylak ◽

Isa Ozbay ◽

Zulfu Bayhan

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Chart Review ◽

Retrospective Chart Review ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Calcium Phosphorus ◽

Pathology Reports ◽

The Relationship ◽

Phosphorus Levels

The aim of our study was to evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and adenoma size in parathyroidectomized patients who underwent a parathyroidectomy. The neutrophil to lymphocyte ratio has recently become popular as a biomarker for malignant diseases or for estimating tumor size preoperatively. This study aimed to estimate the relationship between adenoma size and NLR. Furthermore, we assessed whether a higher level of NLR is correlated with the presence of parathyroid carcinoma. A retrospective chart review was performed for patients with parathyroid adenoma who underwent parathyroidectomy between January 2012 and August 2014. Data related to age, sex, NLR, parathyroid hormone level (PTH), preoperative calcium, phosphorus, adenoma size, and pathology reports were collected. The neutrophil to lymphocyte ratio was significantly correlated with calcium levels, PTH levels, parathyroid adenoma size, and the presence of cancer. However, there was no correlation between NLR and age, sex, and phosphorus levels. This study is the first to document a positive correlation between NLR and parathyroid adenoma size, as well as the presence of cancer, in patients who underwent surgery as a result of primary hyperparathyroidism.

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Radiation-Associated Sarcoma of the Neck: Case Series and Systematic Review

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418789966 ◽

2018 ◽

Vol 127 (10) ◽

pp. 735-740 ◽

Cited By ~ 2

Author(s):

Lawrence Williams ◽

Lyubov Tmanova ◽

Wojciech K. Mydlarz ◽

Brandi Page ◽

Jeremy D. Richmon ◽

...

Keyword(s):

Systematic Review ◽

Surgical Resection ◽

Chart Review ◽

Case Series ◽

Soft Tissue Sarcomas ◽

Retrospective Chart Review ◽

Cochrane Library ◽

Adjuvant Radiation ◽

Tumor Type ◽

Neck Masses

Introduction: Radiation-associated soft tissue sarcomas of the neck (RASN) constitute a rare and aggressive tumor type. Methods: A retrospective chart review at the authors’ institution revealed 3 patients with RASN. A systematic review of the literature was also conducted using MEDLINE, Ovid, the Cochrane Library, and Embase. Results: Patients within the authors’ institutional chart review presented from 6 to 26 years after neck radiation with neck masses. All patients underwent surgical resection with clear margins, and adjuvant radiation was offered when feasible. Patients had no evidence of disease at most recent follow-up. A total of 867 articles were screened for systematic review, revealing 9 articles detailing outcomes of RASN. Studies were small and heterogeneous, precluding pooled data. The importance of complete surgical extirpation was noted. Conclusions: Complete surgical resection appears to be the mainstay of therapy, but there are limited data on management and outcomes of patients with RASN.

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311. The Role of Transthoracic Echocardiography in Staphylococcus aureus Bacteremia; A Retrospective Chart Review

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.354 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S152-S152

Author(s):

Bruce M Aldred ◽

Dimitri M Drekonja

Keyword(s):

Staphylococcus Aureus ◽

Transthoracic Echocardiography ◽

Patient Management ◽

Chart Review ◽

Medical Center ◽

Retrospective Chart Review ◽

National Guidelines ◽

Management Decisions ◽

Staphylococcus Aureus Bacteremia ◽

And Performance

Abstract Background Evaluation for endocarditis is an essential step in the management of patients with Staphylococcus aureus bacteremia (SAB). A common approach, consistent with preeminent national guidelines, is to perform transthoracic echocardiography (TTE) followed by transesophageal echocardiography (TEE) in the majority of patients with SAB. It is unclear how often patient management decisions are influenced by the results of TTE versus TEE. Methods This retrospective chart review of 180 subjects evaluated adult veterans at a single large Veterans Affairs medical center who had SAB and completed both TTE and TEE. Institution-specific guidelines at this medical center, which were in place throughout the study time period, recommended completion of both TTE and TEE for all patients diagnosed with SAB if able to tolerate both studies. The timing of key patient-management decisions was correlated to the timing of each patient’s TTE and TEE. It was then inferred whether each decision would have been informed by TTE alone versus TTE plus subsequent TEE. Management decisions included: initiation of synergistic antibiotics, documentation of antibiotic treatment duration, consultation of specialists such as Cardiology or Cardiac Surgery, and performance of valve surgery. Results Preliminary results show that management decisions were typically not performed until patients had undergone both echocardiography studies. In 18% of patients, management was deemed to be influenced in any capacity following TTE, compared to 91% following both TTE and TEE. Conclusion Our findings question the utility of performing a TTE in patients with SAB who are planned to also undergo a subsequent TEE. Disclosures All Authors: No reported disclosures

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