Objective: To describe clinical and ethical dilemmas in patients presenting with head and neck (H&N) tumors to a field hospital in the "subacute" period following a typhoon.
Methods: We retrospectively reviewed charts of H&N patients presenting to an integrated Israeli-Filipino medical facility, which was operated more than 11 days.
Results: Of the 1,844 adult patients examined, 85 (5 percent) presented with H&N tumors. Of those, 70 (82 percent) were females, with a mean age of 43 ± 15 years. Thyroid neoplasms were the most common tumors (68, 80 percent). Despite limited resources, we contributed to the workup and treatment of several patients. To better illustrate our dilemmas, we present four key patients, in whom we favored diagnostic/therapeutic interventions in two, and opted to defer any intervention in two.
Conclusions: In a relief mission, despite the lack of clinical and pathological staging and questionable continuity of care, surgical interventions can be considered for therapeutic, palliative, and diagnostic purposes.
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http://dx.doi.org/10.5055/ajdm.2014.0172 | DOI Listing |
Sci Rep
January 2025
Department of Clinical laboratory, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17, YongWaiZheng Street, Nanchang, 330006, China.
Fever of unknown origin (FUO) caused by infection is a disease state characterized by complex pathogens and remains a diagnostic dilemma. Metagenomic next-generation sequencing (mNGS) technology is a promising diagnostic tool for identifying pathogenic microbes of FUO caused by infection. Little is known about the clinical impact of mNGS in the etiological diagnosis of FUO.
View Article and Find Full Text PDFKidney360
January 2025
Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Centre, 3901 Rainbow Blvd, MS3002, Kansas City, KS, USA.
Background: Patient involvement in research can help to ensure that the evidence generated aligns with their needs and priorities. In the Establishing Meaningful Patient-Centered Outcomes With Relevance for Patients with Polycystic Kidney Disease (EMPOWER PKD) project we aimed to identify patient-important outcomes and discuss the impact of PKD on patients.
Methods: Nine focus groups were held with adult patients with PKD, caregivers, and clinical or research experts in PKD.
Urogynecology (Phila)
January 2025
UConn Health, Farmington, CT.
Importance: The most used overactive bladder (OAB) medications are anticholinergics, which professional societies recommend avoiding in older patients given dementia risk. Cost prevents patients from switching to preferred beta-3 agonists. Mirabegron was the only beta-3 agonist eligible for the Centers for Medicare/Medicaid Services (CMS) 2023 Drug Negotiation Program (DNP).
View Article and Find Full Text PDFCureus
December 2024
Department of Pathology, General Hospital of Thessaloniki Agios Pavlos, Thessaloniki, GRC.
The term "gossypiboma" or "textiloma" is used to describe a mass of retained cotton matrix and the surrounding inflammatory response inside a body cavity following surgical intervention. The precise incidence of this phenomenon is uncertain, as cases are frequently underreported due to concerns related to medical malpractice. This rare complication poses a diagnostic dilemma due to the non-specific clinical and radiological features, which can result in significant morbidity and mortality.
View Article and Find Full Text PDFCureus
December 2024
Department of Surgery, Royal Oldham Hospital, Northern Care Alliance NHS Trust, Manchester, GBR.
Gallstone ileus (GSI) is a rare complication of gallstone disease. It occurs as a result of the passage of a stone from the biliary tract into the gastrointestinal tract via an abnormal pathway (bilio-enteric fistula). Chronic inflammatory processes result in gall bladder adhering and subsequently eroding into the intestines, leading to a fistula.
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