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Retrospective Case Study (retrospective + case_study)
Selected AbstractsPossible Emergence of Drug-Resistant Variants of Babesia gibsoni in Clinical Cases Treated with Atovaquone and AzithromycinJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2009M. Sakuma Background: There is no well-established treatment strategy for Babesia gibsoni infection. A new therapeutic protocol using atovaquone (ATV) and azithromycin (AZM) has been proposed, but there is concern about the possible induction of relapse and the emergence of ATV-resistant variants after treatment. Objective: To evaluate the clinical use of combination therapy with ATV and AZM as a first-line treatment of clinical B. gibsoni infection in dogs, and to investigate the emergence of ATV-resistant variants. Animals: Eight B. gibsoni naturally infected dogs showing signs of acute onset of disease. Methods: Retrospective case study. Eight clinical cases received combination therapy with ATV and AZM at Kagoshima University Veterinary Teaching Hospital during 2007,2008, and their clinical courses and clinicopathological parameters were evaluated. In addition, alterations in the cytochrome b (CYTb) gene of B. gibsoni were analyzed by polymerase chain reaction and DNA sequencing techniques. Results: All of the dogs responded well to the treatment, with rapid improvement in their clinical condition and hematological parameters. However, 5 of the 8 dogs relapsed after treatment. Analysis of the CYTb gene strongly suggested the emergence of ATV-resistant variants after treatment. Conclusions and Clinical Importance: The combination of ATV and AZM can be used as a first-line treatment for dogs with babesiosis, but relapses occur. Attention should be paid to the possible in vivo selection of drug-resistant variants. [source] Prognostic Indicators of Occult Metastases in Oral CancerTHE LARYNGOSCOPE, Issue 7 2002Mario Russolo MD Abstract Objective We evaluated the importance of several tumor factors related to predicting the presence of occult metastases in the oral cavity. Study Design Retrospective case study. Methods The study comprises 29 patients treated at the Department of Otorhinolaryngology (University of Trieste, Cattinara Hospital, Trieste, Italy) between January 1990 and December 2000, who had T1-T2 carcinoma of the oral cavity that had or had not extended to the oropharynx and were clinically evaluated as N0 neck. The patients all underwent surgery with removal of tumor and neck dissection. Four tumor-related parameters were examined with the aim of evaluating their predictivity of metastasis: tumor class, degree of keratinization, degree of differentiation according to Brooler's histopathological grading, and invasive cell grading (ICG). With the exception of tumor class, these parameters were evaluated both in the biopsy and in the surgical specimen and the findings were then compared. We evaluated existing correlations between each individual parameter and the histopathological presence of micrometastases (pN+) and extracapsular spread revealed when specimens from the neck were examined. Results There was a highly significant correlation between ICG equal to or greater than 13 (range, 5,20) and the presence of occult metastases (P = .0017). On the basis of our findings, the ICG parameter correctly identified 9 of 10 (pN+) patients and could have reduced overtreatment from 65.5% to 17.2% in histopathologically negative necks (pN0). Conclusion It would appear that with a delay in programming a neck dissection so as to consider ICG in combination with thickness, as in seven recent patients, identification of locoregional occult metastases (pN+) might be more precise. [source] Inverting Papilloma of the Temporal BoneTHE LARYNGOSCOPE, Issue 1 2002Anna M. Pou MD Abstract Objectives Inverting papilloma of the temporal bone is exceedingly rare. The objective is to familiarize the clinician with the clinical presentation and prognosis of this entity. Study Design Retrospective case study and literature review. Methods Published reports of inverting papillomas originating in the temporal bone were reviewed in conjunction with two cases presenting at the University of Texas Medical Branch (Galveston, TX). Results Inverting papillomas of the temporal bone are frequently associated with persistent middle ear effusion and ipsilateral sinonasal tumors and display a higher incidence of malignancy. Conclusions Successful management of these tumors requires an aggressive surgical resection. Adjuvant radiation therapy is recommended in patients with malignant changes. [source] Could Prolonged Air Travel Be Causally Associated with Subclavian Vein Thromboembolism?JOURNAL OF TRAVEL MEDICINE, Issue 1 2002Theodore Teruya Background: Air travel associated with venous thromboembolism has recently achieved public awareness due to intense media coverage. The interest has focused on deep vein thrombosis (DVT) of the lower limbs with pulmonary embolism. The World Health Organization (WHO) is planning several international multicenter trials to study the problem and, if it exists, try to find a means for prevention. Methods: This is a case presentation of acute venous thromboembolism of the upper limbs associated with long-haul flights. Five patients were admitted to Straub Hospital in Honolulu after 5 to 10 hours' flight. Results: Patient 1 had a previous shoulder injury with DVT; patient 2 had chronic atrial fibrillation; patients 3 and 5 had clavicular fractures; and patient 4 had a subclavian vein compression. Conclusion: It is not possible to draw any conclusions about the association between air flights and subclavian vein thrombosis from this small retrospective case study. Our objective was to indicate the possibility of such a relationship. [source] Management of hyperfunctioning single thyroid nodules in the era of minimally invasive thyroid surgeryANZ JOURNAL OF SURGERY, Issue 5 2009Charles Tan Both surgical excision and radioiodine ablation are effective modalities in the management of hyperfunctioning thyroid nodules. Minimally invasive thyroid surgery (MITS) using the lateral mini-incision approach has previously been demonstrated to be a safe and effective technique for thyroid lobectomy. As such MITS may offer advantages as a surgical approach to hyperfunctioning thyroid nodules without the need for a long cervical incision or extensive dissection associated with formal open hemithyroidectomy. The aim of the present study was to assess the safety and efficacy of MITS for the treatment of hyperfunctioning thyroid nodules. This is a retrospective case study. Data were obtained from the University of Sydney Endocrine Surgical Unit Database from 2002 to 2007. There were 86 cases of hyperfunctioning thyroid nodules surgically removed during the study period, of which 10 (12%) were managed using the MITS approach. The ipsilateral recurrent laryngeal nerve was identified and preserved in all cases with no incidence of temporary or permanent nerve palsy. The external branch of the superior laryngeal nerve was visualized and preserved in eight cases (80%). There were no cases of postoperative bleeding. There was one clinically significant follicular thyroid carcinoma in the series (10%). In nine of 10 cases (90%) normalization of thyroid function followed surgery. MITS is a safe and effective procedure, achieving the benefits of a minimally invasive procedure with minimal morbidity. As such it now presents an attractive alternative to radioiodine ablation for the management of small hyperfunctioning thyroid nodules. [source] Inter-Organisational Alliances and the Importance of Accounting for Value in Kind Transactions: Exploring the Role of Formal Management Accounting ControlsAUSTRALIAN ACCOUNTING REVIEW, Issue 2 2009Brian A. Burfitt This article examines the role of management accounting control practices in relation to inter-organisational alliances (IOAs) involving non-cash, ,value in kind' (VIK) transactions. The research is undertaken in the context of a retrospective case study of the Sydney 2000 Olympic Games which examines how SOCOG managed and accounted for over $360 million of VIK. The case study is based on both document study and interviews with individuals involved with this aspect of the Sydney 2000 Olympic Games. On combining previous research concerning both the lifecycle (Das and Teng 2002) and the nature of formal accounting controls (Dekker 2004) in IOAs, a lack of directly transferable expertise from traditional accounting practices in relation to the following aspects of the management and control of VIK , recognition, planning/budgeting, procedures/rules and performance monitoring , becomes evident. Given the potential economic significance of VIK transactions, this suggests a need for both further research and professional discourse in this area to ensure sufficient visibility of, and management planning and control for, VIK transactions. [source] Which children should we patch test?CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2007P. E. Beattie Summary Background., Allergic contact dermatitis (ACD) in childhood was considered rare until recently. However, reports are increasing, which may reflect an increased incidence and/or more frequent patch testing of children. It is also likely that allergen exposure in children has changed with time. Aims., To determine the most common contact allergens and the rate of positive patch-test reactions among children with suspected contact allergy. Methods., We carried out a retrospective case study of 114 children (66 girls and 48 boys) aged from 3 to 15 years (median 11.5) patch tested over a 3-year period. Indications for patch testing included uncontrolled or deteriorating atopic dermatitis, localized dermatitis or a history of reacting to a specific allergen. Results., Of 110 children for whom we had notes, 83 (75%) had a history of atopy. Positive reactions that were of current, past or possible relevance were seen in 61 children (54%); in 58 (52%) of 111 tested with the standard series (SS) and in 6 (10%) of 60 tested with the medicament series. None of the children patch tested to the corticosteroid (n = 47), shoe (n = 15), fragrance (n = 12), cosmetic (n = 10) or rubber (n = 5) series had a positive reaction. However, 11 (10%) reacted to rubber allergens within the SS and one of five to their own shoes. The lowest rate of relevant positive reactions was among those with deteriorating atopic dermatitis (22%) and facial (33%) or perioral dermatitis (40%), and the highest rate amongst those with eyelid (86%) or hand (71%) dermatitis. Nickel was the most common allergen (20%) in line with previous reports (82% female), followed by rubber chemicals (10%), fragrance (7.2%), cobalt (5.4%) and lanolin (wool alcohol) (4.5%). Conclusions., The reported incidence of ACD among children, in particular nickel and rubber allergy, appears to be increasing, which may relate to changing fashions and hobbies. Contact allergy should be considered in all children with dermatitis, particularly with eyelid or hand dermatitis, and patch testing carried out more frequently. [source] | ||||||||||