Maxillofacial Fractures : Epidemiological Pattern and Treatment Modalities : Experience at King Hussein Medical Center

2018 ◽  
Vol 25 (1) ◽  
pp. 32-36
Author(s):  
Hytham Al-Rabadi ◽  
Ahmad S. Aladwan ◽  
Hind Nsour
Keyword(s):  
Medical Center ◽  
Treatment Modalities ◽  
Maxillofacial Fractures ◽  
Epidemiological Pattern

scholarly journals Nasopharyngeal Lymphoma: A 22-Year Review of 35 Cases

2019 ◽  
Vol 8 (10) ◽  
pp. 1604 ◽  
Author(s):  
Hsueh ◽  
Yang ◽  
Gau ◽  
Kuan ◽  
Ho ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
Medical Center ◽  
Demographic Data ◽  
B Cell Lymphoma ◽  
Neck Mass ◽  
Treatment Modalities ◽  
Primary Malignancy ◽  
Barr Virus ◽  
Mantle Cell ◽  
Epstein Barr

Nasopharyngeal (NP) lymphoma is a rare primary malignancy of the head and neck and represents a minority of malignancies originating from the nasopharynx. For this reason, there are limited data regarding epidemiologic and treatment outcomes. This is a retrospective review of patients diagnosed with NP lymphoma from 1995 to 2017 at a tertiary medical center. The patients’ demographic data, clinical presentations, treatment modalities, Epstein–Barr virus (EBV)-encoded small RNA (EBER) staining, and outcomes were investigated. We considered a total of 35 patients, including 20 males and 15 females, diagnosed with NP lymphoma. The age ranged from 17 to 88 years (mean = 59.6). The common presentations were nasal obstruction, epistaxis, and neck mass. In our study, the most common pathological diagnosis of NP lymphoma was diffuse large B cell lymphoma (DLBCL) (n = 17), followed by NK/T cell lymphoma (NKTCL) (n = 9). Other pathologic diagnoses included extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma), small lymphocytic lymphoma, mantle cell lymphoma. There were 13 cases showing EBER positivity, including 7 cases of NKTCL, 5 cases of DLBCL, and 1 case of post-transplant lymphoproliferative disorder (PTLD). Most patients received chemotherapy alone, while some patients received both chemotherapy and radiotherapy. Seven patients had local recurrence, and fewer than half of the patients (n = 16) were alive at the time of the study (mean follow-up duration: 54.4 months). The five-year overall survival was 50.4%. NP lymphoma is very rare, and the most common pathologic type is DLBCL. EBER positivity is found in both NKTCL and DLBCL. Identifying more effective therapeutic agents is extremely important to improve patients’ survival.

scholarly journals Epidemiological pattern of maxillofacial fractures in northern China

Medicine ◽  
2020 ◽  
Vol 99 (9) ◽  
pp. e19299 ◽  
Author(s):  
Liu Xiao-Dong ◽  
Wang Qiu-Xu ◽  
Liu Wei-Xian
Keyword(s):  
Northern China ◽  
Maxillofacial Fractures ◽  
Epidemiological Pattern

Thyroid Lymphoma: A Single Institution's Experience

2005 ◽  
Vol 133 (6) ◽  
pp. 888-896 ◽  
Author(s):  
Francis P. Ruggiero ◽  
Elizabeth Frauenhoffer ◽  
Brendan C. Stack
Keyword(s):  
Medical Center ◽  
Aerodigestive Tract ◽  
Treatment Modalities ◽  
Primary Lymphoma ◽  
Thyroid Lymphoma ◽  
Intervention Treatment ◽  
Penn State ◽  
Male Preponderance ◽  
History Of ◽  
Thyroid Malignancies

BACKGROUND: Primary lymphoma of the thyroid gland is uncommon. METHODS: The tumor registry at the Penn State Milton S. Hershey Medical Center was searched for all patients carrying a diagnosis of thyroid lymphoma. All available records for these patients were examined and information regarding patient and tumor characteristics, clinical presentation, interventions, and survival were tabulated. RESULTS: The average age of patient in our series was 67.5 years. There was a 2.7:1 female to male preponderance. Thirteen (60%) patients presented with thyroid nodule(s). Eleven (50%) presented with aerodigestive tract obstructive symptoms. Sixteen (73%) patients had no pre-existing history of thyroid disease; none had known pre-existing Hashimoto's thyroiditis. CONCLUSIONS: The typical thyroid lymphoma patient is female and elderly with painless thyroid enlargement. Compressive symptoms of the aerodigestive tract are common at presentation and may require urgent intervention. Treatment modalities (XRT, CHOP chemotherapy) and outcomes are distinct from other thyroid malignancies. EBM RATING: C

Management of Posttraumatic Vertigo

2005 ◽  
Vol 132 (4) ◽  
pp. 554-558 ◽  
Author(s):  
Arne Ernst ◽  
Dietmar Basta ◽  
Rainer O. Seidl ◽  
Ingo Todt ◽  
Hans Scherer ◽  
...  
Keyword(s):  
Endolymphatic Hydrops ◽  
Medical Center ◽  
Round Window ◽  
Craniocervical Junction ◽  
Treatment Modalities ◽  
Round Window Membrane ◽  
Minor Trauma ◽  
Surgical Measures ◽  
Delayed Endolymphatic Hydrops ◽  
Head Neck

OBJECTIVE: To evaluate patients after blunt trauma of the head, neck, and craniocervical junction (without fractures) with vertigo and to report the results of treatment after extensive diagnostics. STUDY DESIGN: Prospective study of consecutive new cases with vertigo after trauma at different periods of onset. During 2000–2002, 63 patients were examined and treated. SETTING: Regional trauma medical center for the greater Berlin Area, tertiary referral unit. RESULTS: The primary disorders included labyrinthine concussion (18), rupture of the round window membrane (6), and cervicogenic vertigo (12). The secondary disorders included otolith disorders (5), delayed endolymphatic hydrops (12), and canalolithiasis (9). The patients were free of vertigo symptoms (except cervicogenic and otolith disorder) after treatment, which consisted of habituation training, medical and surgical therapy options. The follow-up was 1 year. CONCLUSION: Posttraumatic vertigo can be treated with a high success rate once the underlying disorder has been identified. The extent of the neurotological test battery determines the precision and quality of diagnostics. Surgical measures should be an integral part of treatment modalities if conservative treatment is not effective. SIGNIFICANCE: Minor trauma of the head, neck, and craniocervical junction can have major impact on the vestibular system at different sites. Patients need to be carefully diagnosed, even if the onset of vertigo occurs a few weeks or months after the initial trauma.

A single institution experience of lung cancer treatment in octogenarians

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18141-18141
Author(s):  
S. McCormack ◽  
A. Pleister ◽  
D. Young ◽  
P. Confer ◽  
G. A. Otterson
Keyword(s):  
Medical Center ◽  
Stage Iv ◽  
The Elderly ◽  
Study Data ◽  
Stage Iii ◽  
Disease Stage ◽  
Treatment Modalities ◽  
Seer Database ◽  
Surgical Disease ◽  
Ecog Ps

18141 Background: In the NCI’s SEER database nearly 15% of NSCLC patients were = 80 years during the years 1973–2003. As the “elderly” population increases, the percentage of octogenarians with NSCLC will increase. To better understand this population we investigated the patient and tumor characteristics and treatment modalities by stage in octogenarians with NSCLC over a recent 5 year period at The Ohio State University Medical Center. Methods: Patients aged 80 years and older with biopsy-proven NSCLC seen between 1998–2003 were included in the analysis. 74 patients met criteria for study. Data was gathered from the cancer registry and chart reviews. Characteristics included stage, histology, treatment, and co-morbid conditions (pulmonary and non-pulmonary co-morbidities, weight loss, and ECOG PS). PS was either explicitly stated or inferred from the records, or recorded as “unknown” when PS could not be determined. Results: The 74 patients averaged 82.8 years of age (range 80–91), with 53% males and 47% females (83 years of age with 56% males and 44% females from the SEER database). 46% of patients had “surgical” disease (Stage IA, IB, and IIB), 20.3% had stage III disease, 29.7% had stage IV disease, and 4.0% had indeterminate staging. 82.4% of “surgical” disease patients received some variety of treatment (70.6% surgery[S], 23.5% radiation[RT], and 12.5% chemo[Ch]); 80% of stage III patients received treatment (53.3% S, 40% RT, and 33.3% Ch); 50% of stage IV patients received treatment (0% S, 31.8% RT, and 40.9% Ch). Patients with an ECOG PS of 0–1, 2, 3–4, or “unknown” equaled 44.6%, 20.3%, 16.2%, and 18.9% respectively with 81.8%, 100%, 41.7%, and 78.6% of these patients receiving treatment. Conclusions: There is little data on treatment of the ‘extreme elderly.‘ Our analysis of this subset of the elderly reveals that most octogenarians seen at a referral center can receive treatment. The majority of “surgical” disease octogenarians received surgical resection of their primary tumor and the majority of all patients received some treatment. Further studies of outcomes based on staging, co-morbidities, and PS will be important in this population. Additional studies of this population in non-referral centers are of interest. No significant financial relationships to disclose.

scholarly journals Inferior Alveolar Nerve Injuries Associated with Mandibular Fractures at Risk: A Two-Center Retrospective Study

2014 ◽  
Vol 7 (4) ◽  
pp. 280-283 ◽  
Author(s):  
Paolo Boffano ◽  
Fabio Roccia ◽  
Cesare Gallesio ◽  
K. Karagozoglu ◽  
Tymour Forouzanfar
Keyword(s):  
At Risk ◽  
Retrospective Study ◽  
Medical Center ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Mandibular Fractures ◽  
Nerve Injuries ◽  
Mandibular Angle ◽  
Maxillofacial Fractures ◽  
Angle Fractures

The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments—Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement ( p = 0.03), isolated mandibular fractures ( p = 0.01), and angle fractures ( p = 0.004). A statistically significant association was also found between IAN injury and assaults ( p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions.

scholarly journals Impact of a Multi-disciplinary C. difficile Action Team

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S396-S397
Author(s):  
Emily Heil ◽  
Bharathi Sivasailam ◽  
SoEun Park ◽  
Jose Diaz ◽  
Erik Von Rosenvinge ◽  
...  
Keyword(s):  
Medical Center ◽  
Intervention Group ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Disciplinary Action ◽  
Treatment Modalities ◽  
Interventional Treatment ◽  
Post Intervention ◽  
Fecal Microbiota Transplant ◽  
Action Team

Abstract Background Clostridium difficile infection (CDI) is associated with increased length of hospital stay, morbidity, mortality, and cost of hospitalization. Early intervention by experts from multiple areas of practice such as gastroenterology (GI), infectious diseases (ID) and surgery can be essential to optimize care and increase utilization of novel treatment modalities such as fecal microbiota transplant (FMT) and minimally invasive, colon-preserving surgical management. Methods A multi-disciplinary C. difficile action team (MD-CAT) was implemented at University of Maryland Medical Center (UMMC) in March 2016 to engage appropriate specialty consultants in the care of CDI patients. The MD-CAT reviews positive C. difficile tests at UMMC and provides guidance and suggestions to the primary team including optimal antibiotic treatment (for CDI and any concomitant infection), and consultant involvement including ID, surgery, and GI, when appropriate. Using retrospective chart review, CDI patient management and outcomes were compared before and after implementation of the MD-CAT. Differences in the time to consults and frequency of interventional treatment was compared using Chi-square or Wilcoxon Rank-sum test. Results We compared 48 patients with CDI in the pre-intervention with 89 patients in the post-intervention period. Demographic and clinical characteristics of the groups were similar. MD-CAT intervention was associated with frequent (73%) modification or discontinuation of concomitant antibiotics. Median time to GI and ID consults was significantly shorter in the post group (P = 0.007 and P = 0.004, respectively). Five of 89 (5.6%) of patients received FMT or colon-preserving surgical intervention in the post-intervention group compared with no patients in the pre-intervention group. There was no difference in 30-day all-cause mortality or CDI recurrence between groups. Conclusion Early, multi-disciplinary action on patients with CDI increased the proportion of patients undergoing active specialty consultation and improved use of concomitant antibiotics. A larger sample size is needed to determine the effects of such a team on other clinical outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Metastatic Tumors of the Sinonasal Cavity: A 15-Year Review of 17 Cases

2019 ◽  
Vol 8 (4) ◽  
pp. 539 ◽  
Author(s):  
Miao-Hsu Chang ◽  
Ying-Ju Kuo ◽  
Ching-Yin Ho ◽  
Edward C. Kuan ◽  
Ming-Ying Lan
Keyword(s):  
Medical Center ◽  
Metastatic Cancer ◽  
Demographic Data ◽  
Academic Medical Center ◽  
Tumor Resection ◽  
Palliative Therapy ◽  
Previous History ◽  
Rare Condition ◽  
Treatment Modalities ◽  
Patient Demographic Data

Extranasal cancers that metastasize to the sinonasal cavity are very rare. To date, there are only limited reports regarding this rare condition within the literature. Therefore, we retrospectively reviewed all patients diagnosed with metastatic cancer of the sinonasal tract from 2003 to 2018 at a tertiary academic medical center. Patient demographic data, clinical presentation, treatment modalities, and outcomes were investigated. There were a total of 17 patients (9 males and 8 females) included in the analysis. The mean age was 56.8 years (range 27–80). The most common primary malignancies were hepatocellular carcinoma (n = 3) and gastrointestinal tract adenocarcinoma (n = 3). The most common site of metastasis was the nasal cavity (n = 8). Five patients received radical tumor resection and the others underwent radiotherapy, chemotherapy, or combined chemoradiotherapy. The 2-year survival was 28%. In summary, metastasis to the sinonasal cavity remains extremely rare. A high degree of suspicion regarding the possibility of metastatic spread to the sinonasal region is necessary for patients with a previous history of malignancy who present with new sinonasal symptoms. The treatment strategy of sinonasal metastatic cancer is usually palliative therapy and the prognosis remains poor. However, early detection and diagnosis, coupled with aggressive treatment, may improve patient quality of life.

Outcomes of Endoscopic and Surgical Pancreatic Necrosectomy: A Single Institution Experience

2019 ◽  
Vol 85 (9) ◽  
pp. 1017-1024
Author(s):  
Manuel Martinez ◽  
Joshua Cole ◽  
James Dove ◽  
Joseph Blansfield ◽  
Mohsen Shabahang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Medical Center ◽  
Univariate Analysis ◽  
Treatment Modalities ◽  
Kidney Dysfunction ◽  
Infected Necrosis ◽  
Pancreatic Necrosectomy ◽  
Multiple Treatment ◽  
Procedure Type

Pancreatic necrosis can be managed conservatively; however, infection of pancreatic necrosis usually dictates more aggressive management. Our study aimed to assess the outcomes of open pancreatic necrosectomy (OPN) and endoscopic pancreatic necrosectomy (EPN) in a single center. Data from patients undergoing pancreatic necrosectomy at the Geisinger Medical Center from January 1, 2007, to April 25, 2016, were collected and retrospectively analyzed. Cohorts were composed of EPN (n = 22) and OPN (n = 34) groups. The prevalence of preoperative respiratory failure, septic shock, and multiorgan dysfunction syndrome was higher in the OPN group. The OPN group presented with a higher Bedside Index Severity in Acute Pancreatitis score. Postoperative abscess, persistent kidney dysfunction, and death were more frequent in the OPN group. The EPN group had a higher read-mission rate. The results of the univariate analysis for complication and mortality demonstrated that higher mortality and persistent kidney dysfunction were associated with the procedure type, specifically OPN and with a higher Bedside Index Severity in Acute Pancreatitis score. Patients who presented with higher severity of disease underwent an OPN, whereas EPN often was performed successfully in a more benign clinical setting. However, patients with infected necrosis are served best in a tertiary medical facility where multiple treatment modalities are available.

scholarly journals Etiology, distribution, treatment modalities and complications of maxillofacial fractures

2014 ◽  
pp. e261-e269 ◽  
Author(s):  
N. Phamdang ◽  
I. Barthelemy ◽  
T. Orliaguet ◽  
A. Artola ◽  
JM. Mondie ◽  
...  
Keyword(s):  
Treatment Modalities ◽  
Maxillofacial Fractures
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