Fifteen-year Review Research Articles

Histological pattern of nephrectomy specimens: A fifteen-year review

Background: Nephrectomy is the surgical removal of all or part of a diseased kidney in a living person. Pathological assessment of the tissue specimen is required in most cases for eventual diagnosis and disease prognostication. Objective: To demonstrate the pathological patterns of nephrectomy specimens in Nnewi, South East Nigeria. Methods: The data of all the nephrectomy specimens submitted to the Department of Histopathology of the Nnamdi Azikiwe University Teaching Hospital, Nnewi, as well as Triple Green Diagnostic Clinics Ltd, Nnewi, from 2007 to 2021 were retrospectively reviewed. Their pathological features were analyzed. Results: Of the 153 nephrectomy specimens, 141 that had complete data were used for the study. Those that had neoplastic lesions were 84(59.6%), while 57(40.4%) were non-neoplastic. Of the neoplastic lesions, 79 (94%) were malignant and renal cell carcinoma (RCC) accounted for 60%, with a mean age of 48.8±18.1 years and median age 52.5 years. RCC occurred commonly in the sixth decade of life (26%) with male preponderance (56%) and predominantly involving the left kidney (64%). Clear cell variant of renal cell carcinoma was the most common (52%), followed by papillary variant (34%). Nephroblastoma was the most common malignancy in the first decade with a modal age of 2years. Chronic pyelonephritis was the most common non-neoplastic lesions. Conclusion: Nephrectomy is done for a wide range of renal pathology, with more done for neoplastic conditions than non-neoplastic ones.

Injury patterns of equine-related trauma: A fifteen-year review of hospital admissions to a level 1 trauma center

ABSTRACT Objective Little information exists about horse-related injury admissions to Level 1 trauma centers in the Western United States. This study describes injury patterns in this population, to reveal potential areas for injury prevention initiatives. Methods A retrospective database review of 512 non-fatal equine-related injuries over a 15-year period was conducted, using a Level 1 hospital trauma registry. To determine patterns of injury, patients injured by riding or being near a horse were classified according to age, sex, helmet use, abbreviated injury score, anatomical region injured, and length of stay. Results Equine-related injury was more frequent among females than males, the anatomical region most at risk among adults was the lower extremity (including pelvis), and among children and youth, the head. 75% of head-injured patients were not wearing a helmet at the time of injury and those with the most severe head injuries were least likely to be wearing a helmet. Conclusion Preventable equine-related injuries occur across all ages, are more frequent among females, and affect all regions of the body. Despite head-injury risks associated with horse activities, helmet use was not common among most of the injured. Decreasing the risk of these injuries requires use of appropriate protective equipment and enhanced education campaigns aimed at those in the horse industry and the general public.

Pediatric Chagas disease in the non-endemic area of Madrid: A fifteen-year review (2004-2018).

BackgroundChagas disease (CD) has become an emerging global health problem in association with the immigration of individuals from endemic areas (in LatinAmerica) to other countries.Spain is the country in Europe with the highest number of CD cases. Concerning pediatric CD, treatment is not only better tolerated by younger children but also has greater cure possibilities. The aim of this study was to describe clinical and epidemiological aspects of CD in a pediatric population diagnosed of 10 hospitals in the Community of Madrid during the 2004–2018 period, as well as the safety and efficacy of CD treatment on this population.Methodology/Principal findingsA multicenter, retrospective, descriptive study was conducted. The studied population included all identified children under the age of 18 with a diagnosis of CD. Diagnosis was performed with a positive parasitological test (with subsequent confirmation) or confirmed persistence of positive serology beyond 9 months, for children younger than one year-old, and with two different positive serological tests, for children older than one.Fifty-one children were included (59% male; 50.9% born in Spain). All mothers were from Latin America. The median age at diagnosis was 0.7 months for those under one year of age, and 11.08 years for those older than one year-old. Only one case presented a symptomatic course (hydrops faetalis, haemodynamic instability at birth, ascites, anaemia). For 94% treatment was completed. Considering patients who received benznidazole (47), AE were recorded in 48,9%. Among the 32 patients older than one year-old treated with benznidazole, 18 (56.25%) had adverse events whereas in the 15 under one year, 5(33,3%) did. Eigtheen (78.2%) of the patients with benznidazole AE were older than one year-old(median age 11.4 years). Of the patients treated with nifurtimox (9), AE were reported in 3 cases (33,3%).Cure was confirmed in 80% of the children under one year-old vs 4.3% in those older (p<0.001). Loss to follow- up occurred in 35.3% of patients.Conclusions/SignificancesScreening programs of CD since birth allow early diagnosis and treatment, with a significantly higher cure rate in children treated before one year of age, with lower incidence of adverse events. The high proportion of patients lost to follow-up in this vulnerable population is of concern.

A fifteen-year review of skin allergy testing in Irish patients with symptomatic rhinitis.

ObjectiveOur objective was to review skin prick allergy testing (SPAT) results in patients with symptomatic rhinitis in an Irish population.MethodsA fifteen-year retrospective review of our database of symptomatic patients with rhinitis was performed. All patients who had SPAT performed during this interval were included. Data was analysed in terms of demographics and dominant allergens.Results1158 patients were included. 617 Females vs 541 Males. Age range five to eighty-five years old. Mean age thirty-four years. 49% of our patients tested positive to at least one aeroallergen. The most common allergens were dust mites (23%) and timothy grass (22%). Patients born during the Irish pollen season (April–July) were between 5 and 7 times more likely to be sensitive to timothy and ryegrass pollens compared to others tested. 241 patients had both SPAT and serum allergen specific IgE testing (SASIgET) performed; positive results were consistent between both groups.ConclusionResults demonstrated that half of our patients with symptomatic rhinitis had allergen sensitisation. Dust mites and grass were the main allergens in our area. Our nurse led clinic has allowed efficient patient education and the development of a unique Irish SPAT database. Retesting a patient with a known allergy test result it is not indicated.

Fifteen-Year Review of the American Board of Plastic Surgery Maintenance of Certification Tracer Data: Clinical Practice Patterns and Evidence-Based Medicine in Zygomatico-Orbital Fractures.

From 2005 to 2020, the American Board of Plastic Surgery collected data on 20 common plastic surgery operations as part of the Maintenance of Certification process. These data allow the authors to examine national trends in zygomatico-orbital fracture repair over a 15-year period. Tracer data for zygomatico-orbital fracture repair were reviewed in cohorts from 2005 to 2013 and 2014 to 2020. Results were categorized based on their presence in evidence-based medicine articles published during this period. Differences between years were assessed using the t test or chi-square test as appropriate. Four hundred thirty patients were included as of March of 2020. Average age was 37 years (range, 6 to 85 years), and 76 percent were male. Operations took place on average 10 days from injury. There were significant decreases in the use of subciliary (31.9 percent versus 10.0 percent; p < 0.001), gingival buccal (84.3 percent versus 56.4 percent; p < 0.001), and lateral brow (45.2 percent versus 22.3 percent; p < 0.001) incisions, with an increase in lower lid external incisions (15.2 percent versus 30.9 percent; p < 0.001); 2.7 percent of patients had a complication requiring readmission and 4.5 percent required reoperation. The incidence of postoperative diplopia was 7.7 percent, and the infection rate was 1.7 percent. This article reviews the American Board of Plastic Surgery tracer data for zygomatico-orbital fracture repair. The Maintenance of Certification tracer data provide a national database with longer follow-up and more specific information than comparable databases. Analysis of these data over time enables the authors to describe practice trends and gives surgeons the opportunity to compare their outcomes to national norms.

Discussion: Fifteen-Year Review of the American Board of Plastic Surgery Maintenance of Certification Tracer Data: Clinical Practice Patterns and Evidence-Based Medicine in Zygomatico-Orbital Fractures.

Discussion: Fifteen-Year Review of the American Board of Plastic Surgery Maintenance of Certification Tracer Data: Clinical Practice Patterns and Evidence-Based Medicine in Zygomatico-Orbital Fractures.

Performance and Utilization of a Laboratory-Developed Nucleic Acid Amplification Test (NAAT) for the Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in a Low-Prevalence Area.

Tuberculosis (TB) is a significant global health problem. In low-prevalence areas and low clinical suspicion, nucleic acid amplification tests (NAAT) for direct detection of Mycobacterium tuberculosis complex (MTBC) can speed therapy initiation and infection control. An NAAT assay (TBPCR) targeting MTBC IS6110 is used for detecting MTBC in our low-prevalence population. Fifteen-year review of patient records identified 146 patients with culture-positive pulmonary tuberculosis (PTB) or extrapulmonary tuberculosis (EPTB). Laboratory-developed TBPCR was retrospectively compared with standard stain and cultures for PTB and EPTB diagnoses. TBPCR assay was used in 57% of patients with PTB and 33% of patients with EPTB. TBPCR detected 88.4% of all TB (smear-positive, 97%; smear-negative, 79%) with 100% specificity. Low bacterial load was indicated in TBPCR-negative PTB (P = .002) and EPTB (P < .008). TBPCR performance was optimum but significantly underused. Guidelines are proposed for mandated use of TBPCR that capture patients with clinically suspected PTB. Focused TBPCR use in low prevalence populations will benefit patient care, infection prevention, and public health.

Analysis of the welfare implications of power-sector restructuring in West Bengal, India

This paper analyses the welfare implications of power-sector reform in a situation where public-sector and private-sector utilities co-exist, based on restructuring of the power-sector in India's West Bengal state. The fifteen-year review period covers parts of both pre-restructuring and post-restructuring. The panel data analysis spanning four consumer categories indicates a negative impact of system de-integration on welfare due to the rise in transmission costs and increased tariff rates that result in a fall in both consumer and producer surplus. The paper also studies the effect of the reform on the capacity of supply to meet demand.

The epidemiology and clinical spectrum of melioidosis in a teaching hospital in a North-Eastern state of Malaysia: a fifteen-year review.

BackgroundOver the last two decades, many epidemiological studies were performed to describe risks and clinical presentations of melioidosis in endemic countries.MethodsWe performed a retrospective analysis of 158 confirmed cases of melioidosis collected from medical records from 2001 to 2015 in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, in order to update the current status of melioidosis clinical epidemiology in this putatively high risk region of the country.ResultsPrincipal presentations in patients were lung infection in 65 (41.1 %), skin infection in 44 (27.8 %), septic arthritis/osteomyelitis in 20 (12.7 %) and liver infection in 19 (12.0 %). Bacteremic melioidosis was seen in most of patients (n = 121, 76.6 %). Focal melioidosis was seen in 124 (78.5 %) of patients and multi-focal melioidosis was reported in 45 (28.5 %) cases. Melioidosis with no evident focus was in 34 (21.5 %) patients. Fifty-four (34.2 %) patients developed septic shock. Internal organ abscesses and secondary foci in lungs and/or soft tissue were common. A total of 67 (41 %) cases presented during the monsoonal wet season. Death due to melioidosis was reported in 52 (32.9 %) patients, while relapses were occurred in 11 (7.0 %). Twelve fatal melioidosis cases seen in this study were directly attributed to the absence of prompt acute-phase treatment. Predisposing risk factors were reported in most of patients (n = 133, 84.2 %) and included diabetes (74.7 %), immune disturbances (9.5 %), cancer (4.4 %) and chronic kidney disease (11.4 %). On multivariate analysis, the only independent predictors of mortality were the presence of at least one co-morbid factor (OR 3.0; 95 % CI 1.1–8.4), the happening of septic shock (OR 16.5; 95 % CI 6.1–44.9) and age > 40 years (OR 6.47; 95 % CI 1.7–23.8).ConclusionsMelioidosis should be recognized as an opportunistic nonfatal infection for healthy person. Prompt early diagnosis and appropriate antibiotics administration and critical care help in improved management and minimizing risks for death.

Atypical presentation of Legionella pneumonia among patients with underlying cancer: A fifteen-year review

Immunocompromised patients, especially those receiving treatment with corticosteroids and cytotoxic chemotherapy are at increased risk for developing Legionella pneumonia. The aim of this study was to determine clinical and radiographic characteristics of pulmonary infection due to Legionella in persons undergoing treatment for cancer and stem cell transplant (SCT) recipients. Retrospective review of Legionella cases at MSKCC over a fifteen-year study period from January 1999 and December 2013. Cases were identified by review of microbiology records. During the study period, 40 cases of Legionella infection were identified; nine among these were due to non-pneumophila species. Most cases occurred during the summer. The majority [8/9, (89%)] of patients with non-pneumophila infection had underlying hematologic malignancy, compared to 18/31 (58%) with Legionella pneumophila infections. Radiographic findings were varied-nodular infiltrates mimicking invasive fungal infection were seen only among patients with hematologic malignancy and hematopoietic stem cell transplant (SCT) recipients and were frequently associated with non-pneumophila infections (50% vs 16%; P=0.0594). All cases of nodular Legionella pneumonia were found incidentally or had an indolent clinical course. Legionella should be considered in the differential diagnosis of nodular lung lesions in immunocompromised patients, especially those with hematologic malignancy and SCT recipients. Most cases of nodular disease due to Legionella are associated with non-pneumophila infections.

Results of Cemented Total Shoulder Replacement with a Minimum Follow-up of Ten Years

The purpose of this study was to assess the clinical and radiographic long-term outcomes of patients treated with a third-generation cemented total shoulder replacement and followed for at least ten years. The results of thirty-nine arthroplasties were analyzed clinically with use of the Constant score and on radiographs in two projections, with special regard to glenoid component loosening, at a mean of eleven years (range, ten to fifteen years) postoperatively. The mean Constant score was 27 points (range, 11 to 54 points) preoperatively and 61 points (range, 21 to 86 points) postoperatively (p < 0.0001). Mean shoulder flexion increased from 84° (range, 40° to 150°) preoperatively to 133° (range, 40° to 180°) postoperatively; mean abduction, from 77° (range, 40° to 110°) to 123° (range, 40° to 180°); and mean external rotation, from 11° (range, -20° to 40°) to 35° (range, 0° to 60°). No humeral components but 36% of the glenoid components were radiographically loose at the time of follow-up. Kaplan-Meier survivorship of the glenoid component was 100% after thirteen years with revision as the end point, whereas survivorship with radiographic loosening as the end point was only 48% after thirteen years. We found no correlation between glenoid loosening on radiographs and clinical findings such as the Constant score. Cranial migration of the humerus was seen in 69% of the cases. With the implants, cementation, and surgical technique utilized in this group of patients with primary glenohumeral osteoarthritis, radiographic loosening of the glenoid component and rotator cuff deficiency were very common at the ten to fifteen-year review. The follow-up was not long enough to fully identify the clinical sequelae of these findings.

A Fifteen-year Review of Lymphomas in a Nigerian Tertiary Healthcare Centre

In Africa, epidemiological data on the effect of the HIV epidemic on the occurrence of lymphomas are scanty. The 1990s witnessed the alarming rates of HIV/AIDS in Nigeria. The prevalence of HIV/AIDS in Nigeria increased from 1.8% in 1991 to 4.4% in 2005. The aim of this study was to determine whether there have been any changes in the frequency and pattern of lymphomas in view of the HIV/AIDS epidemic in the country. This is a retrospective study of all lymphoma cases diagnosed during 1991-2005. The prevalence of lymphomas declined from 1.4% to 0.7% of surgical biopsies during 1991-2005. There was a decline in the proportion of high-grade non-Hodgkin lymphoma and Burkitt's lymphoma from 79.1% and 45.8% respectively to 21.1% and 13.6% respectively. There is a suggestion that the HIV/AIDS epidemic in the country may not have influenced the pattern of occurrence of both major histomorphological types of lymphoma in Ibadan.

Apropos "Chikungunya Fever in the United States: A Fifteen-Year Review of Cases"

Apropos "Chikungunya Fever in the United States: A Fifteen-Year Review of Cases"

Peer led training and assessment in basic life support for healthcare students: A fifteen-year review

Purpose of the study: In 1995, the University of Birmingham, UK, School of Medicine and Dentistry replaced lecture-based basic life support (BLS) teaching with a peer-led, practical programme. We present here our 15-year experience.

Intercostal Artery–Based Rectus Abdominis Transposition Flap for Sternal Wound Reconstruction: Fifteen-Year Experience and Literature Review

Intercostal Artery–Based Rectus Abdominis Transposition Flap for Sternal Wound Reconstruction: Fifteen-Year Experience and Literature Review

Contribution of Vitreous Cytology to Final Clinical Diagnosis: Fifteen-Year Review of Vitreous Cytology Specimens from One Institution

To assess the contribution of vitreous cytologic evaluation to the diagnosis of clinically undiagnosed vitritis. Retrospective chart review and database study. Two hundred seventy-eight eyes of 255 patients who had diagnostic vitrectomies. We performed a retrospective review of all patients who had vitreous cytology specimens between October 1990 and October 2005 at Vancouver General Hospital. We reviewed the patient charts to obtain the results of microbial and other laboratory testing and to determine the follow-up course. Categories of vitreous cytology specimen results and final clinical diagnosis in patients who had diagnostic vitrectomy specimens. We reviewed vitreous cytology results from diagnostic vitrectomies in 278 eyes of 255 patients. One patient had 3 diagnostic vitrectomies, 21 patients had 2 procedures, and 233 patients had a single procedure. We categorized the results of vitreous cytologic examination into 6 major categories: acute inflammation consistent with endophthalmitis (n = 33), primary intraocular lymphoma (PIOL; n = 14), granulomatous inflammation (n = 41), mixed chronic nonspecific inflammation (n = 76), hypocellular specimens (n = 50), and miscellaneous specimens (n = 64). We determined that cytologic diagnosis aided or confirmed a clinical diagnosis, or ruled out PIOL, in 126/228 (55.3%) specimens where patients were not lost to follow-up. Cytologic analysis of vitreous specimens in clinically undiagnosed vitritis is a useful procedure, particularly in the diagnosis of endophthalmitis and PIOL. It is also helpful in confirming granulomatous, nonspecific, and miscellaneous clinical diagnoses and in ruling out PIOL. In this series, it helped to suggest or confirm a diagnosis in the majority of our specimens.

9:37159. Infections in Spinal Deformity Surgery: A Fifteen-Year Review

9:37159. Infections in Spinal Deformity Surgery: A Fifteen-Year Review

Biliary atresia—a fifteen-year review of clinical and pathologic factors associated with liver transplantation

Purpose The aim of this study was to identify clinical and pathologic factors associated with liver transplantation in infants with biliary atresia initially treated with Kasai hepatic portoenterostomy (KHPE). Methods Institutional Review Board approval was obtained. Records of patients with biliary atresia diagnosed between January 1986 and December 2000 were reviewed. Patients were divided into those who never required transplantation, those who underwent transplant in the first year after KHPE, and those who required transplantation later in childhood. Analysis of variance (ANOVA) compared multiple factors among the 3 groups. Proportional analysis compared those who required transplantation against those who did not. Statistical significance was considered achieved if P was less than .05. Results Forty-five patients were identified. Survival after KHPE was 96% (43 of 45). Sixteen (37%) never required transplantation, 13 (30%) underwent transplant within 1 year after KHPE, and 14 (33%) underwent transplant more than 1 year after KHPE. ANOVA comparison showed that the duration of jaundice before KHPE as a predictor for liver transplantation approached significance ( P = .082). Proportional analysis found that a longer initial duration of jaundice before KHPE ( P = .016) and failure to establish biliary flow ( P = .033) were also significant predictive factors. An initial requirement for phototherapy ( P = .057) and ductules less than 200 μm in diameter ( P = .060) showed a trend toward predictor of liver transplantation. Conclusions A longer duration of jaundice before KHPE, failure to establish bile flow, requirement for phototherapy in the neonatal period, and ductules smaller than 200 μm are associated with liver transplant after KHPE.

A Comprehensive Analysis of Suicide in Federal Prisons: A Fifteen-Year Review

This study reports the findings of a retrospective analysis of psychological autopsies for all completed suicides in the Bureau of Prisons over a 15-year period. This study represents the most comprehensive data available about prison suicide. The data support the effectiveness of a structured suicide prevention program as well as the utility of psychological autopsies as a method of case review and data collection. Through an analysis of the psychological autopsy data, a number of basic demographic variables common to completed suicides were discovered which might be extrapolated to other prison populations. In addition, this methodology allowed high-risk populations to be identified, and a profile of inmates who committed suicide was constructed. Implications for future assessment and intervention strategies are discussed.

Social Psychology in Mexico: A Fifteen-Year Review

This article reviews the development of social psychology in Mexico by summarizing major trends in the field and their representation in La Psicologia Social en Mexico [Social Psychology in Mexico] and in the Revista de Psicologia Social y Personalidad [Journal of Social Psychology and Personality], both published by the Asociacion Mexicana de Psicologia Social [Mexican Association of Social Psychology, AMEPSO] between 1986 and 1998. Over the years, the Mexican Association of Social Psychology has facilitated the professional advancement of many psychologists, whose diverse research areas include applied psychology, environmental psychology, social psychology, cognitive psychology, Mexican ethnopsychology, developmental psychology, ecological psychology, personality, and gender relations. Special emphasis is placed on the discussion of the current state of psychological methodology in Mexico and the importance of designing culturally relevant instruments.