Articles: ninos.
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J Coll Physicians Surg Pak · Mar 2021
Review Case ReportsMorel-Lavallée Lesion in a 35-year Female.
Morel-Lavallée lesion is a post-traumatic degloving cyst, usually filled with blood, lymph or necrotic tissue, which mostly develops in the area around greater trochanter. Early diagnosis and prompt treatment is essential to prevent further complications, such as compression of surrounding structures. X-rays have limited use and magnetic resonance imaging (MRI) is the modality of choice in diagnosing the lesion. ⋯ Given the chronicity of lesion and extensive tissue involvement, the patient underwent surgical excision of the lesion with favourable long-term outcomes. In this case report and literature review, we discuss the pathophysiology, clinical presentation, radiological findings and management options for Morel-Lavallée lesion. Key Words: Morel-Lavallée lesion, Post-traumatic cyst, Degloving Injury, Tangential cyst.
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Frailty is a dynamic condition that results in increased vulnerability to health stressors. Often associated with older adults, frailty is not limited to the geriatric population, although aging and disease burden often go hand in hand. This syndrome is recognized increasingly as an important factor in healthcare costs, rate of adverse outcomes, and overall resource utilization. ⋯ Cirrhosis is currently the 12th leading cause of death in the United States, and its incidence is anticipated to markedly increase in the coming years with the aging of our population. With the anticipated surge in disease prevalence, liver disease care will likely shift from specialist-driven to a multidisciplinary approach between primary care physicians, internists, and hepatologists to adequately care for these patients. This review serves as a guide for clinicians to learn about frailty, its role in cirrhosis, and the current tools to educate patients and families about the importance of nutrition and physical exercise within this population.
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Mayo Clinic proceedings · Mar 2021
ReviewDeployment of an Interdisciplinary Predictive Analytics Task Force to Inform Hospital Operational Decision-Making During the COVID-19 Pandemic.
In March 2020, our institution developed an interdisciplinary predictive analytics task force to provide coronavirus disease 2019 (COVID-19) hospital census forecasting to help clinical leaders understand the potential impacts on hospital operations. As the situation unfolded into a pandemic, our task force provided predictive insights through a structured set of visualizations and key messages that have helped the practice to anticipate and react to changing operational needs and opportunities. The framework shared here for the deployment of a COVID-19 predictive analytics task force could be adapted for effective implementation at other institutions to provide evidence-based messaging for operational decision-making. For hospitals without such a structure, immediate consideration may be warranted in light of the devastating COVID-19 third-wave which has arrived for winter 2020-2021.
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The aim of this study was to evaluate vitamin B12 levels in the patients diagnosed with neurofibromatosis type 1 (NF1) and to compare them with a healthy group. In this study, the files of the patients, who were admitted to the pediatric neurology outpatient clinic of a tertiary university hospital and were followed up after being diagnosed with neurofibromatosis type 1 during the 15-month period, were evaluated retrospectively (Study group). Demographic data, and laboratory test results (complete blood count, iron, iron-binding capacity, ferritin, vitamin B12 and folate) were recorded from the patient files. ⋯ Vitamin B12 levels were statistically significantly lower in the study group compared to the control group (p=0.012). This study is the first study evaluating vitamin B12 levels in NF1 patients. Key Words: Neurofibromatosis type 1, Neurofibromin, Nutrition, Vitamin B12.
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J Coll Physicians Surg Pak · Mar 2021
Comparison of Patients with and Without Hiatal Hernia Repair during Laparoscopic Sleeve Gastrectomy: Single-centre Experience.
To evaluate whether the concomitant repair of hiatal hernias during laparoscopic sleeve gastrectomy has an effect on the outcome of the surgery in patients with hiatal laxity and gastroesophageal reflux disease (GERD) symptoms during preoperative preparations. ⋯ Thirty-five patients were included in the study. The mean age of the included patients was 36.0 ± 9.8 (range, 21- 54) years, 80% of them were female. The preoperative median BMI was 43.9 (IQR, 41-50.7), and the postoperative mean BMI was 31.3 ± 5.1 (range, 23.2-40.6) Kg/m2. The median calculated RSI of the patients in the preoperative period was 8 (IQR, 2-13), and the postoperative median was 5.1 (IQR, 0-8) (p = 0.028). It was observed that 24 (68.6%) of the patients had improvement in their symptoms, 7 (20%) patients had worsening, 3 (8.6%) patients did not experience a change, and only one (2.9%) patient developed de novo GERD symptoms. Conclusion: No statistically significant difference was observed in individuals undergoing LSG and known to have GERD, hiatal hernia repair and cruroraphy in addition to LSG regarding reduction of GERD symptoms. Key Words: Sleeve gastrectomy, Reflux symptom index score, Gastroesophageal reflux disease.