Medicine
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Observational Study
Validation of the mortality in emergency department sepsis (MEDS) score in a Singaporean cohort.
The emergency department (ED) serves as the first point of hospital contact for most septic patients. Early mortality risk stratification using a quick and accurate triage tool would have great value in guiding management. The mortality in emergency department sepsis (MEDS) score was developed to risk stratify patients presenting to the ED with suspected sepsis, and its performance in the literature has been promising. ⋯ On secondary analysis, MEDS score was superior to both APACHE II and SOFA scores in predicting 72-hour mortality, with AUC of 0.88 (95% CI 0.82-0.95), 0.81 (95% CI 0.72-0.89), and 0.79 (95% CI 0.71-0.87), respectively. In predicting 30-day IHM, MEDS score ≥12, APACHE II score ≥23, and SOFA score ≥5 performed at sensitivities of 76.1%, 67.4%, and 76.1%, and specificities of 83.3%, 73.9%, and 65.0%, respectively. The MEDS score performed well in its ability for mortality risk stratification in a Singaporean ED cohort.
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Case Reports
Mature ovarian cystic teratoma with "sack of marbles" appearance on magnetic resonance imaging: A case report.
Mature ovarian cystic teratoma is a cystic fatty tumor. Presence of floating fat balls in an ovarian cystic teratoma looking like a "sack of marbles" on magnetic resonance imaging (MRI) is a rare finding. ⋯ The aim of this case report was to present "sack of marbles" appearance on MRI, which will impress other doctors and improve the diagnosis of such diseases.
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Case Reports
Primary carcinosarcoma of the ureteropelvic junction associated with ureteral duplication: A case report.
Primary carcinosarcoma of the upper urinary tract is rare. Ureteral duplication is one of the most common urinary tract malformations. Additionally, the association between ureteral duplication and malignancy is unknown. To the best of our knowledge, no cases of malignant tumors diagnosed as carcinosarcoma with ureteral duplication have been reported. We herein report the case of a patient with carcinosarcoma of the ureteropelvic junction associated with incomplete ureteral duplication. ⋯ Carcinosarcoma can arise from ureteral duplication. Although the majority of carcinosarcomas of the upper urinary tract are diagnosed at an advanced stage and have a poor prognosis, some can have a less aggressive course. Further studies are needed to determine the association between ureteral duplication and malignancy.
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Case Reports
The consequence of endotracheal intubation in a 95-years old man for 839 days: A case report.
The benefits of prolonged endotracheal intubation (ETI) in comparison to early tracheotomy is still over the controversy. Little information is available in concern to prolonged ETI more than years. We report the consequence of oral ETI in a 95-year old man for 839 days. ⋯ During prolonged ETI, more attention should focus on airway humidification, proper cuff pressure and optimal time for tube exchange in order to avoid severe complications.
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Observational Study
HPV testing on vaginal/cervical nurse-assisted self-samples versus clinician-taken specimens and the HPV prevalence, in Adama Town, Ethiopia.
This study aimed to determine the feasibility of vaginal/cervical nurse-assisted self-sampling (NASS) and the agreement between human papilloma virus (HPV) tests on self-samples versus clinician-taken (CT) specimens. Women participated voluntarily for cervical cancer screening at St. Aklesia Memorial Hospital. ⋯ There was a strong statistical association between HR HPV positivity and visual inspection with acetic acid- positive (P < .001). The NASS for HPV testing could be seen as an alternative option and might be acceptable to Ethiopian women. The overall HR HPV prevalence was comparable with Sub-Saharan countries in the general population.