Irish journal of medical science
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Neoadjuvant therapy is an essential component of multimodality therapy for locally advanced breast adenocarcinoma (BC). Complete pathologic response (pCR) is a useful surrogate for long-term oncologic outcome. ⋯ pCR was more likely in patients with less advanced disease in BC. The presence of HER2 + or TNBC in BC also increases the likelihood of pCR. Neoadjuvant therapy stimulates the systemic inflammatory response; however, a reduced baseline NLR may be associated with increased pCR. Confirmation with larger datasets is required.
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The diagnosis of pneumothorax is usually made through clinical examination and radiography. Pulsed wave (PW) Doppler mode has not previously been used in the diagnosis of pneumothorax on chest USG. ⋯ PW Doppler is a useful tool in the diagnosis of pneumothorax. It has a high sensitivity and specificity for the detection of pneumothorax. It is also superior to both lung sliding and the barcode sign in detecting pneumothorax. The Dogan's sign can be used safely in the diagnosis of pneumothorax, together with lung sliding and the barcode sign.
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Treatment for bladder cancer includes radical cystectomy (RC) and urinary diversion; RC is associated with long-term morbidity, kidney impairment and mortality. ⋯ Patients with RC are at risk of progressive kidney function deterioration and elevated mortality and the main risk factors associated were age and preoperative eGFR. Regular monitoring of kidney function will permit early diagnosis and treatment.
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Histological chorioamnionitis (HCA) is a pathological condition defined as an acute inflammation of the amniochorionic membranes which has been linked to a wide range of adverse neonatal events. ⋯ Evaluation of the incidence of HCA and associated clinical parameters in this study showed a marked decrease in the incidence of HCA when compared to other studies. Strategies to reduce the incidence of HCA include reducing the length of labor via active labor management. We hypothesize that these findings are due to the consistent use of active labor management and our rural study population, but further investigation is required to confirm this.
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Refeeding syndrome is characterized by metabolic and electrolyte alterations that result from the initiation of feeding after a period of inadequate caloric intake. Especially, in the elderly with acute and/or chronic illness, nutritional deficiencies are common, and diminished oral intake with effects of catabolic status yields malnutrition. This study was conducted to evaluate refeeding hypophosphatemia and its consequences on outcomes in the oldest old critically ill patients. ⋯ Refeeding hypophosphatemia incidence was similar to previous studies, although study patients were the highest risk group. Outcome parameters including mortality rate and length of ICU stay were not different between patients with or without refeeding hypophosphatemia.