Eight-year Experience Research Articles

Efficacy and safety of induction chemotherapy in oral cavity cancer: An eight-year experience at a Portuguese reference center.

Induction chemotherapy has been described as an option in locally advanced oral cavity squamous cell carcinoma when the surgical morbidity is expected to be high. This work aimed to evaluate the outcome and safety of induction chemotherapy in this setting. We performed a retrospective and observational study including patients with oral cavity squamous cell carcinoma, treated with induction chemotherapy between January 2010 and December 2018. Outcomes included induction chemotherapy toxicity, treatment response, disease-free survival and overall survival. A total of 108 oral cavity squamous cell carcinoma patients were included. Ninety-six (88.9%) had stage IV disease, while 12 (11.1%) had stage III. Eighty-four patients (80.8%) achieved at least a partial response to induction chemotherapy at clinical evaluation, and 75 (72.1%) at radiological evaluation. Seventy-eight patients have been proposed for subsequent definitive treatments, with no differences obtained in prognosis, when comparing surgical to non-surgical approaches. In patients treated with definitive treatments, improved five-year disease-free survival was obtained if at least a clinical (56.3%; p=0.001) or radiological (52.9%; p=0.001) partial response was achieved after induction chemotherapy. Similarly, superior five-year overall survival was verified for those achieving at least clinical (51.1%; p<0.0001) or radiological (52.6%; p=0.001) partial response. Also, accomplishing a pathologic complete response (n=22.6%) significantly improved disease-free survival (p=0.039) and overall survival (p=0.005). Grade 3 and 4 toxicities were observed in 52 patients (41.8%). Responses to induction chemotherapy predicted prognosis in our population, however important toxicities were observed. Further studies are necessary to identify induction chemotherapy response predictors and subgroups who may benefit from this approach.

Clinical Profile, Complications and Trends of Ocular Anaesthesia in a Multi-tier Ophthalmology Network in India: An Eight-Year Experience.

To describe the clinical profile, complications and trends of ocular anaesthesia in a multi-tier ophthalmology network in India. This retrospective hospital-based study included 417,622 patients presenting between January 2013 and December 2020. Patients who were administered either topical, local or general anaesthesia for ocular surgery in at least one eye were included as cases. The data were collected using an electronic medical record system. Among the 417,622 patients, local anaesthesia was administered to 280,638, (67.2%) patients and was the most commonly administered type followed by topical anaesthesia in 84,117 (20.14%) patients. The most common complication encountered in administering local anaesthesia was retrobulbar haemorrhage in 103 (0.037%) patients followed by lid haematoma in 49 (0.017%) patients. Tooth damage occurred in 40 (0.076%) patients followed by delayed recovery in 30 (0.057%) patients during general anaesthesia. The trend of local anaesthesia decreased (83.48% vs 53.36%), whereas the trend of topical anaesthesia increased (8.61% vs 32.42%) over the study period. There is a notable trend towards the adoption of less invasive anaesthetic methods, particularly in common surgeries such as cataract, intravitreal injection, and vitreoretinal surgery. However, despite this trend, a significant proportion of oculoplastic/orbital surgeries, trauma, and strabismus surgeries continue to be performed under general anaesthesia. These observations underscore the ongoing evolution of ocular anaesthesia practices, reflecting advancements in surgical techniques and patient preferences.

Bricks, Mud and Lime Mortars in Heritage Restoration: A case study

This paper is based upon an extensive eight-year experience in the restoration of monuments from the World Heritage Site Patan Darbar Square to Tripureshwor Mahadev Temple, Sattals, and Garden Area and the Sama Center, representing historically significant Malla, Shah and Rana period architectures respectively, after the Gorkha earthquake of 2015. These monuments date back from 6th to the 20th century. All structures employ a masonry system as the structural system. The main materials observed in these heritages were burnt clay bricks, stones, mud mortars, and lime mortars. This study examines the technical aspects such as material properties (compressive strength, bending strength, mechanical properties), and composition of mortars according to their use in different locations and types of structures, even within the same building. The study acknowledges the Department of Archaeology’s preservation and monument act, highlighting the potential for material reuse in heritage restoration. The primary aim of this study is to comprehensively understand and analyze the strength of antiquated materials and traditional mortars used in historical construction and restoration. It provides practical recommendations for future preservation efforts.

The Feasibility and Safety of Day Case Brain Tumour Biopsy: An Eight-Year Experience in the United Kingdom

The Feasibility and Safety of Day Case Brain Tumour Biopsy: An Eight-Year Experience in the United Kingdom

Early and Mid-Term Outcomes of Primary Repair After Atrioventricular Canal Defect: A Single-Center Eight-Year Experience.

Surgical repair techniques and management of patients with atrioventricular septal defect (AVSD) have progressed over the last few decades. Early and definitive interventions have become the choice of treatment for these patients. Based on this background, we aimed to review the early and mid-term outcomes of primary AVSD repair. A total of 53 patients with a mean age of 3.45 ± 5.67 years underwent definitive repair for AVSD between January 2014 and June 2021. The clinical data including age, type of defect, associated co-anomalies, symptoms, pulmonary hypertension, etc. were collected and assessed retrospectively. Mitral regurgitation (MR) as a clinical outcome was assessed at 0, 1, 2, and 5 years. Among the recruited patients, 35 (66.1%) were male and 18 (33.9%) were female. Of 53 patients, repair for the complete defect was done in 38 (71.69%) patients, repair for intermediate/partial defect was done in 15 (23.1%) patients, and one patient underwent repair for incomplete type. Other associated co-anomalies were anterior mitral leaflet (12 (22.6%)), atrial and ventricular septal defect (VSD) (30 (56.6%)), and patent ductus arteriosus (PDA) (11 (20.8%)). Different procedures for surgical repair included patch closure, cleft repair, and polytetrafluoroethylene (PTFE) VSDclosure. After repair, the mean follow-up period was 46.73 ± 27.37 months. Overall mortality was 3.78% (2/53), and two patients underwent reintervention due to symptomatic severe MR. A definitive and timely correction of AVSD shows satisfactory early and mid-term results.

Dorsal bony spur in pediatric split cord malformations: eight-year experience from a tertiary care hospital.

Dorsal spurs in Type I split cord malformations (SCM-I) are infrequent findings. The pathogenesis of the same is debatable. The objective of this study is to analyze our experience with SCM-I patients having dorsal bony spurs. Retrospective analysis of SCM patients operated from 2010 to 2017 was performed. Their demographic profile, clinic-radiological features, operative findings, and outcome following surgery were recorded. Twenty-four cases of Type I SCM harboring dorsal bony spurs were identified with mean age of 4.96years. The commonest split site was lumbar, documented in 62.5%. Scoliosis was observed in 58.3%. Pre-operative neurological deficits were seen in 66.6% cases with asymmetric weakness of limbs seen in 16.6%. There was no new neurological deficit observed post-operatively. This is the largest series of dorsal spurs occurring in SCM, reported in literature so far. Meticulous pre-operative evaluation and imaging are important to identify dorsal spurs for appropriate management and good clinical outcome. Differentiating dorsal spur from ventral spur is important as it has a bearing on surgical approach.

Clinical characteristics and management outcomes of Guillain-Barré syndrome: eight-year experience at a tertiary center in jordan - a retrospective cohort study.

This retrospective study looks at adult patients admitted to a major tertiary referral hospital in the north of Jordan between 2013 and 2021. A total of 30 patients met the inclusion/exclusion criteria. Males were predominantly affected (70%) with a male-to-female ratio of 2.33. Acute inflammatory demyelinating polyradiculoneuropathy variant was encountered in 60% of cases, whereas axonal variants, namely, acute motor axonal neuropathy and acute motor axonal and sensory neuropathy variants were seen in about 23% of cases. ICU admission was reported in 37% of patients and 6.7% required mechanical ventilation. Most patients had a favorable outcome with a GBS disability score of three or better at out-patient follow-up visits. Our cohort of patients showed a significant deviation in disease expression from that reported in other parts of the globe. This deviation was obvious in more prominent male predominance, frequencies of different GBS variants, and more favorable short-term morbidity/mortality outcomes. However, larger multicenter prospective studies are needed for confirmation of these results.

Groundbreaking outpatient activity in medical entomology in France: An eight-year experience in a french university hospital

IntroductionArthropods are known to impair human health in various manners, acting as infectious disease vectors, or as simple nuisances. Even though considerable research is being produced in medical entomology, no reports on patient management in clinical entomology units are available in the literature. Patients and MethodsWe retrospectively surveyed all the records from patients having consulted in our outpatient clinical entomology unit in Nice University Hospital from 2012 to 2020. For each patient, physical examination findings and treatment data were analyzed. ResultsA total of 518 patients were analyzed in this study. Most were diagnosed with arthropod infestation (55.8%), the most common being Sarcoptes scabiei (35%), bedbugs (23%), Pyemotes dermatitis (17.6%) and flea infestation (15.9%). Along with symptomatic treatments, targeted environmental measures could be proposed for infested patients. For many of our patients, on the other hand, active infestation was ruled out. ConclusionGiven today’s lack of expertise in medical entomology, we advocate for the creation of medical entomology units in university hospitals, not only allowing fair and proportionate multidisciplinary management of patients in whom arthropod infestation is suspected, but also generating cost savings.

Evaluation of an enhanced recovery after lung surgery (ERALS) program in lung cancer lobectomy: An eight-year experience

IntroductionEnhanced recovery after lung surgery (ERALS) protocols have proven useful in reducing postoperative stay (POS) and postoperative complications (POC). We studied the performance of an ERALS program for lung cancer lobectomy in our institution, aiming to identify which factors are associated with a reduction of POC and POS. MethodsAnalytic retrospective observational study conducted in a tertiary care teaching hospital involving patients submitted to lobectomy for lung cancer and included in an ERALS program. Univariable and multivariable analysis were employed to identify factors associated with increased risk of POC and prolonged POS. ResultsA total 624 patients were enrolled in the ERALS program. The median POS was 4 days (range 1–63), with 2.9% of ICU postoperative admission. A videothoracoscopic approach was used in 66.6% of cases, and 174 patients (27.9%) experienced at least one POC. Perioperative mortality rate was 0.8% (5 cases). Mobilization to chair in the first 24h after surgery was achieved in 82.5% of cases, with 46.5% of patients achieving ambulation in the first 24h. Absence of mobilization to chair and preoperative FEV1% less than 60% predicted, were identified as independent risk factors for POC, while thoracotomy approach and the presence of POC predicted prolonged POS. ConclusionsWe observed a reduction in ICU admissions and POS contemporaneous with the use of an ERALS program in our institution. We demonstrated that early mobilization and videothoracoscopic approach are modifiable independent predictors of reduced POC and POS, respectively.

P060: Spectrum of genetic alterations for hereditary paraganglioma-pheochromocytoma syndrome testing: Eight-year experience from a single diagnostic laboratory

P060: Spectrum of genetic alterations for hereditary paraganglioma-pheochromocytoma syndrome testing: Eight-year experience from a single diagnostic laboratory

Predictors of Mortality in Bicycle-Related Trauma: An Eight-Year Experience in a Level One Trauma Center.

Bicycle-related trauma has increased during the last decades, mainly due to the antipollution environmental policies. This study investigates the outcome of bicycle-related trauma in our level-one trauma center over a period of eight years. Data from 446 consecutive bicycle-related trauma patients admitted to our trauma center from 2011 to 2019 were selected and retrospectively analyzed. The sample was divided into three age groups: &lt;18 years, 18-54 years, and ≥55 years. Mortality rates were obtained for the overall population and patients with an Injury Severity Score (ISS) ≥ 25. Month and seasonal patients' distribution was described to provide an epidemiological overview of bike-related trauma over the years. Patients ≥ 55 years showed a lower pre-hospital and in-hospital GCS (p ≤ 0.001), higher levels of lactates (p &lt; 0.019) and higher ISS (p ≤ 0.001), probability of death (p ≤ 0.001), and overall mortality (p ≤ 0.001). The head and chest Abbreviated Injury Scale (AIS) ≥ 3 injuries were predictors of mortality, especially in patients over 55 years (p &lt; 0.010). Bicycle-related trauma was more frequent during the summer (34%), particularly in July and August. Age over 55 years old, head and chest injuries, and an ISS &gt; 25 were independent predictors of mortality.

Eight-year experience of maternal death surveillance in Morocco: qualitative study of stakeholders’ views at a subnational level

BackgroundSince 2009, Morocco has been implementing the Maternal Death Surveillance System (MDSS). The results obtained indicate significant regional variations in terms of implementation stage, completeness of maternal death reporting, and information use for action. The objective of this research is to better understand the contextual factors involved in the implementation process and use of MDSS, with a focus on the facilitators and barriers, as experienced by stakeholders in health regions. MethodsEvaluation research was conducted in 2017 based on a descriptive qualitative study using semi-structured in-depth interviews, in four out of the twelve health regions of Morocco. A total of thirty-one in-depth interviews were held with members of regional committees of maternal death reviews (RC-MDR) and other key informant staff. Interviews focused on participants’ views and their experiences with the MDSS since the introduction in 2009. We conducted thematic analysis relied on inductive and deductive approaches. Applying the Consolidated Framework for Implementation Research guided data analysis and reporting findings. FindingsEngaging leadership at all health system levels, regular training of district and regional MDSS coordinators and supportive supervision at a national level were the most important MDSS implementation facilitators. Reported barriers were essentially related to the review system: Irregular review meetings, blame culture, high turn-over of RC-MDR members, lack of analytical capacity to inform the review process and formulate recommendations, finally limited accountability for recommendation follow-up. While financial incentives boosted MDSS adoption, they were nonetheless a substantial barrier to its sustainability.ConclusionsThe MDSS is a complex process that requires taking numerous steps, including the commitment of multiple stakeholders with varying roles as well as information sharing across health system levels. Contextual factors that influence MDSS implementation at the sub-national level are to be considered. Horizontal and vertical communication about MDSS goals and feedback is crucial to strengthen stakeholders’ commitment, hence improving quality and use of MDSS. Furthermore, health regions should place emphasis on making high-quality recommendations in partnerships between the regional management teams, RC-MDR members and external stakeholders.

Prenatal Diagnosis of Structural Anomaly Among Singletons and Twins: Eight-Year Experience in a Chinese Tertiary Center.

This study was designed to reveal structural abnormalities in singleton and twin pregnancies in the Chinese population. This retrospective study spanned 8 years and included 1228 singleton pregnancies (112,919 examinees) and 49 twin pregnancies (1865 examinees) with structural anomalies diagnosed by ultrasound. Detailed descriptions of anomalies, gestational weeks at diagnosis, and maternal age were recorded. The odds ratio was evaluated in twin pregnancies with detectable structural anomalies. The annual average "ultrasound prevalence of fetal anomalies" among singleton and twin pregnancies were 1.09 and 3.06%, respectively. Mothers with twin anomalies were older (P < .001), and twin pregnancies were diagnosed with anomalies in earlier gestational weeks than singleton (P=.011). No differences were found in the types of anomalies between singleton and twin pregnancies. Central nervous system anomaly was the most common type in singleton and twin pregnancies. Twin pregnancies had higher rates of major anomalies than singleton (total OR 2.45), especially cardiovascular, central nervous, and gastrointestinal systems and ear/eye/face/neck disorders. Compared with singleton, twin pregnancies had higher odds of detectable structural anomalies. Twin pregnancies with structural anomalies were diagnosed at earlier gestational age and associated with older maternal age. Central nervous system anomaly was the most common type in singleton and twin pregnancies.

An Eight-year, Single-center Experience on Ultrasound Assisted Thrombolysis with Moderate-dose, Slow-infusion Regimen in Pulmonary Embolism.

There is limited data on moderate-dose with slow-infusion thrombolytic regimen by ultrasound-asssisted-thrombolysis (USAT) in patients with acute pulmonary embolism (PE). In this study, our eight-year experience on USAT with moderate-dose, slow-infusion tissue-type plasminogen activator (t-PA) regimen in patients with PE at intermediate-high- and high-risk was presented, and short-, and long-term effectiveness and safety outcomes were evaluated. Our study is based on the retrospective evaluation of 225 patients with PE having multiple comorbidities who underwent USAT. High- and intermediate-high-risk were noted in 14.7% and in 85.3% of patients, respectively. Mean t-PA dosage was 35.4±13.3 mg, and the infusion duration was 26.6±7.7 h. Measures of pulmonary artery (PA) obstruction and right ventricle (RV) dysfunction were improved within days (p<0.0001 for all). During the hospital stay, major and minor bleeding and mortality rates were 6.2%, 12.4%, and 6.2%, respectively. Bleeding and unresolved PE accounted for 50% and 42.8% of in-hospital mortality, respectively. Age, rate, and duration of t-PA were not associated with in-hospital major bleeding and mortality. Oxygen saturation exceeded 90% in 91.2% of patients at discharge. During follow-up of median 962 (610-1894) days, high-risk status related to 30-day mortality, whereas age >65 years was associated with long-term mortality. Our real-life experience with USAT with moderate-dose, slow-infusion t-PA regimen in patients with PE at high-and intermediate-high risk demonstrated clinically relevant improvements in PA obstructive burden and RV dysfunction. Age, rate or infusion duration of t-PA was not related to major bleeding or mortality risk, whereas unresolved obstruction remained as a lethal issue.

Pedagogy Pro-Design and Climate Literacy: Teaching Methods and Research Approaches for Sustainable Architecture

There is a genuine concern that the current level of sustainability education provided in the mainstream architectural curricula is no longer sufficient to combat urgent climate challenges, and that a stronger interdisciplinary approach needs to be followed where architectural students are formed and empowered with a different pedagogical paradigm, better tools, and diverse sets of skills. This paper examines the various pedagogical approaches to the teaching and learning of environmental design principles and practice in architectural education with a focus on recurrent methods applied in specialist curricula in the UK. An in-depth analysis of a pedagogical case study based on the eight-year experience of the Architecture and Environmental Design MSc course at the University of Westminster is presented with reference to the pedagogical methods identified in the literature. A reflective exercise based on the specific methods adopted in the course and examples of students’ outputs and experiences allows a critical evaluation of the pedagogical case study. The paper concludes by highlighting the challenges and opportunities of introducing climate literacy at postgraduate level and the benefits of adopting a research-led approach based on collaborations with industry partners.

Evaluation of an enhanced recovery after lung surgery (ERALS) program in lung cancer lobectomy: An eight-year experience

IntroductionEnhanced recovery after lung surgery (ERALS) protocols have proven useful in reducing postoperative stay (POS) and postoperative complications (POC). We studied the performance of an ERALS program for lung cancer lobectomy in our institution, aiming to identify which factors are associated with a reduction of POC and POS. MethodsAnalytic retrospective observational study conducted in a tertiary care teaching hospital involving patients submitted to lobectomy for lung cancer and included in an ERALS program. Univariable and multivariable analysis were employed to identify factors associated with increased risk of POC and prolonged POS. ResultsA total 624 patients were enrolled in the ERALS program. The median POS was 4 days (range 1–63), with 2.9% of ICU postoperative admission. A videothoracoscopic approach was used in 66.6% of cases, and 174 patients (27.9%) experienced at least one POC. Perioperative mortality rate was 0.8% (5 cases). Mobilization to chair in the first 24h after surgery was achieved in 82.5% of cases, with 46.5% of patients achieving ambulation in the first 24h. Absence of mobilization to chair and preoperative FEV1% less than 60% predicted, were identified as independent risk factors for POC, while thoracotomy approach and the presence of POC predicted prolonged POS. ConclusionsWe observed a reduction in ICU admissions and POS contemporaneous with the use of an ERALS program in our institution. We demonstrated that early mobilization and videothoracoscopic approach are modifiable independent predictors of reduced POC and POS, respectively.

Primary Malignant Liver Tumors: eight-year experience in a Pediatric Hospital in Brazil. A cross-sectional study.

liver tumors are rare neoplasms in childhood (1-2%), and about 2/3 are malignant. Hepatoblastoma (HB) is the most frequent, followed by hepatocellular carcinoma (HCC). In both, the main treatment is surgical resection. Currently, chemotherapy and liver transplantation have improved outcomes. study of the epidemiological profile and evolution of liver cancer cases in a referral pediatric hospital. a retrospective survey of medical records of patients aged up to 18 years with a diagnosis of primary malignant hepatic neoplasm between 2012 and 2020, carried out in the largest exclusively pediatric hospital in Brazil. a total of 13 patients with malignant liver tumors (HB 12, HCC 1) were treated. Of the HB cases, 66,7% were male, with a mean age of 2 years and the main alteration in the palpable abdominal mass. Tumors involved an average of 3 liver segments, more in the right lobe (54%). Only one patient was treated with surgery without neoadjuvant therapy, another one underwent transplantation like the first treatment, and another 2 required liver transplantation as a rescue. The middle follow-up time of patients with HB was 39 months and only 1 case died due to febrile neutropenia. The 5-year overall and disease-free survival was 91.7% and 81.5%, respectively. Advanced staging at the time of diagnosis has always been a poor prognostic factor in patients with primary malignant liver tumors. However, the results and survival have improved with the advancement of chemotherapy, surgical technique, and liver transplantation.

Региональный опыт организации и проведения конкурса профессионального мастерства «Педагог-психолог» в Свердловской области

The article is aimed at describing the professional skill contest “Teacher-Psychologist” as one of the effective mechanisms for stimulating and supporting the professional development of the personnel potential of the psychological service in the education of the Sverdlovsk region. The paper pays attention to the peculiarities of the organization and conduct of the competition in the region, considers changes in the content of competitive tests, which vary in accordance with modern trends in the development of psychological science and psychological and pedagogical services in the education system and the specifics of the region. The analysis of the eight-year experience of the Teacher-Psychologist competition in the Sverdlovsk region allows us to note positive trends in the change of motivation and the level of professional competence of teachers-psychologists, which are reflected in the high performance of specialists of the Sverdlovsk region at the federal stage of the competition. Of great importance in achieving such high results is the training of contestants in the region, which is organized in the form of teamwork involving participants and winners of the federal stage of the competition, and is conducted under the guidance of the Chief Freelance Psychologist of the Sverdlovsk region, which ensures the success of the presentation of professional skills by the contestants.

Management of non-tubal ectopic pregnancies associated with cervical and uterine canal: single-centre eight-year experience

Aim: To discuss the diagnosis and treatment of non-tubal ectopic pregnancies (NTEP) associated with the cervical and uterine canal.Materials and Methods: In this cross-sectional retrospective study, we analyzed our hospital records in terms of cervical, angular (or cornual), scar, and cervico-isthmic NTEP from 2009 to 2017 and identified 112 cases between 5 and 13 weeks.Results: There were 70, 20, 17, and 5 women in the scar, cervical, angular (or cornual), and cervico-isthmic ectopic pregnancy groups; respectively. The gravity, parity, postoperative hospital stay length, admission complaints, previous cesarean section and treatment methods were compared among the four groups, a significant difference was found.Conclusion: The surgical approach can be considered as the first-line treatment option in NTEP associated with the cervical and uterine canal. Due to the high potential for complications, early diagnosis and timely referral to tertiary health centres are crucial.

Report of an eight-year experience with Camille’s transarticular technique of cervical spinal stabilization

We present our experience with Camille’s cervical transarticular screw fixation technique. During the period June 2012 to April 2020, 2422 screws were implanted in 321 patients by Camille’s transarticular cervical spinal screw fixation technique. The indications of screw implantation were radiculopathy/myelopathy related to cervical spondylosis in 258 cases, cervical OPLL in 54 cases and Hirayama disease in 9 cases. The follow-up ranged from 6 to 92 months. In the entire series, there were no nerve or vessel injury or any other intraoperative ‘complications’ related to screw implantation. There was no instance of screw pull out or screw failure. There was no metal implant related infection. Satisfactory arthrodesis of all the treated spinal segments was observed on investigations done at a minimum follow-up of 6 months.Camille’s transarticular screw fixation technique is a relatively simple surgical procedure and provides a safe, strong and reliable arthrodesis at the fulcrum of spinal movements.