Saint Mary's Hospital Research Articles

Liver Transplantation at a Small Volume Center—The Role of Network System

IntroductionLiver transplantation (LT) is typically performed at specialized, high-volume centers. However, some smaller centers also offer liver transplantation services, but their outcomes and safety have been a subject of debate. To overcome these difficulties, we tried to build a Catholic medical center (CMC) network to share our experiences and overcome the lack of volume. In this study, we reviewed the overall outcome of patients undergoing LT at a small-volume procedure center, with a focus on patient and graft survival rates. MethodsBetween July 2014 and September 2021, 60 adults underwent LT at Bucheon Saint Mary's Hospital. The overall outcomes were analyzed in terms of perioperative outcomes, complications, and overall survival rate. In addition, the patients were divided into a benign end-stage liver disease (ESLD) group (n =44) and a hepatocellular carcinoma (HCC) group (n = 16). The baseline characteristics, perioperative outcomes, complications, and overall survival rate were analyzed between the two groups. ResultsOf a total of 60 LT, living donor liver transplantation (LDLT) was 26, and deceased donor liver transplantation (DDLT) was 34. LDLT was 14 (31.8%) in the ESLD group and 12 (75.0%) in the HCC group. The overall 1-year, 3-year, 5-year survival rates were 86.7%, 79.7%, and 77.7%, respectively. The survival difference was not statistically significant (p=0.214) between the two groups. ConclusionWe suggests that with appropriate patient selection and adequate resources, LT can be safely performed at smaller centers, with the assistance of the CMC network, thus expanding access to this life-saving procedure.

Evaluating the impact of a social medicine course delivered in a local‐global context: A 10‐year multi‐site analysis

AbstractAmidst the COVID‐19 pandemic and social uprisings demanding social and racial equity worldwide, there is an increasing demand for health justice training for health workers. However, there are scant evidence‐based assessments of the impact of such courses. Between 2010 and 2020, SocMed—a 501(c)3 non‐profit social justice organization—offered two distinct courses about health equity, the social determinants of health, and social medicine to health workers through the University of Minnesota in Minneapolis, Minnesota and Saint Mary Hospital Lacor in Gulu, Uganda. This study assesses the immediate impact of the SocMed curriculum on participants measured by a pre‐course and post‐course survey. In Minnesota, paired pre‐course and post‐course survey responses (mean n = 69; SD = 23) spanned years 2016–2019, while Uganda paired pre‐course and post‐course survey responses (mean n = 64; SD = 21) spanned years 2012–2013 and 2017–2019. Findings indicate that the course improved participants’ knowledge in all 24 of the topics in the Minnesota course and 42 of 44 topics in the Uganda course (significant at p < 0.05).

Opportunistic Colonoscopy Cancer Screening Pays off in Romania—A Single-Centre Study

Colorectal cancer (CRC) is the third most diagnosed cancer in men (after prostate and lung cancers) and in women (after breast and lung cancer). It is the second cause of cancer death in men (after lung cancer) and the third one in women (after breast and lung cancers). It is estimated that, in EU-27 countries in 2020, colorectal cancer accounted for 12.7% of all new cancer diagnoses and 12.4% of all deaths due to cancer. Our study aims to assess the opportunistic colorectal cancer screening by colonoscopy in a private hospital. A secondary objective of this study is to analyse the adenoma detection rate (ADR), polyp detection rate (PDR), and colorectal cancer (CRC) detection rate. We designed a retrospective single-centre study in the Gastroenterology Department of Saint Mary Hospital. The study population includes all individuals who performed colonoscopies in 2 years, January 2019–December 2020, addressed to our department by their family physician or came by themselves for a colonoscopy. One thousand seven hundred seventy-eight asymptomatic subjects underwent a colonoscopy for the first time. The mean age was 59.0 ± 10.9, 59.5% female. Eight hundred seventy-three polyps were found in 525 patients. Five hundred and twenty-five had at least one polyp, 185 patients had two polyps, 87 had three polyps, and 40 patients had more than three polyps. The PDR was 49.1%, ADR 39.0%, advanced adenomas in 7.9%, and carcinomas were found in 5.4% of patients. In a country without any colorectal cancer screening policy, polyps were found in almost half of the 1778 asymptomatic patients evaluated in a single private center, 39% of cases adenomas, and 5.4% colorectal cancer. Our study suggests starting screening colonoscopy at the age of 45. A poor bowel preparation significantly impacted the adenoma detection rate.

Estimating Physical Work-Load on ED Clinicians and Staff Using Real-Time Location Systems

Clinicians' work pressure and burnout turned out as an important factor in modern hospitals which urges us to search for rapid and accurate methods to proxy the workload. By using RFID technology, we hope to monitor the physical pressure on the clinical staff of the emergency department (ED) at the Mayo Clinic Saint Mary's Hospital. The data collected will be used to determine the workload and pressure put on various staff members. A real-time location system (RTLS) has been used to monitor and track the movements of the hospital team and compute active vs. sedentary time for staff. Risk thresholds for the sedentary time from a previous study were utilized to visualize trends in staff sedentary time. Members of the ED team are under great stress at all times; we use RFID technology to get a better understanding of how much their work environment contributes to the pressure of their jobs.

Sleep time differs among people who co-use cocaine and cannabis compared to people who only use cocaine

ObjectivePeople who use cocaine experience numerous sleep problems and often use cannabis to mitigate these problems. However, co-using cocaine and cannabis may result in worse sleep outcomes when compared to using cocaine only. The current study examined group differences in subjective sleep outcomes among people who use cocaine and people who co-use cocaine and cannabis. MethodsParticipants were 82 individuals with cocaine use disorder who were enrolled in a randomized clinical trial for cocaine treatment. Sleep outcomes, assessed at baseline prior to treatment, were measured with the Saint Mary's Hospital Sleep Questionnaire and included total sleep time, perceived sleep quality, difficulty falling asleep, and daytime alertness. Analysis of covariance and Kruskal-Wallis tests were used to compare sleep outcomes between participants with urine samples that tested positive for both cocaine and cannabis at baseline, those who tested positive for cocaine only, and those who tested negative for all drugs. ResultsTotal reported sleep time was highest among those with a drug negative urine, followed by those with a cocaine positive urine and those who tested positive for cocaine and cannabis. There were no differences in perceived sleep quality, difficulty falling asleep, or daytime alertness between groups. ConclusionsPeople who co-use cocaine and cannabis may report reduced sleep time relative to those who only use cocaine. Co-use of cannabis may exacerbate sleep difficulties in people who use cocaine by decreasing total sleep time, although it is important to note that the groups each reported similar sleep quality. Implications for treatment and directions for future research are discussed.

Knowledge and practice of nurses towards prevention of hospital acquired infections and its associated factors

BackgroundHospital acquired infections (HAIs) are the common conditions among hospitalized patients and health care workers (HCWs). HAI prolongs hospitalization; increases cost of treatment and contribute to death. This study aims to assess knowledge, practice and associated factors with prevention of HAIs among nurses in Aksum Saint Mary hospital, Northern Ethiopia. MethodFacility based cross-sectional study was conducted from April 25 - June15, 2019 among 139 nurses in Aksum Saint Mary hospital. A pretested and structured self-administered questionnaire was used for data collection. Data were entered using EPI info version 7.0 statistical software and analyzed using SPSS version 20 statistical package. Bivariate and multivariate logistic regression was also carried out to identify factors associated with the dependent variable. A p-value less than 0.05 were used to declare statistical significance. Result139 (97.2%) nurses participated in the study. 52.5 % of the nurses had good knowledge; similarly 48.6 % of them had good practice on prevention of HAIs. Work experience [AOR = 2.3, 95% CI (1.54–3.91)] and having formal training [AOR = 1.6, 95 % CI (1.15–3.82)] were significantly associated with knowledge. While, educational status [AOR = 2.4, 95 % CI (1.6–4.06)], work experience [AOR = 1.82, 95 % CI (1.08–2.78)] and availability of guidelines [AOR.= 2.6, 95 % CI (2.26–4.37)] were found to be significantly associated with practice. Conclusion and recommendationNurses’ knowledge and practice regarding to prevention of HAIs was found to be inadequate. Being more experienced and attending formal training showed a positive association with knowledge; while having higher educational status, being more experienced and reading guidelines on prevention of HAIs were found to be associated with good practice. Continuing educational programs, in-service training and ensuring availability of the necessary guidelines are essential steps to improve knowledge and practice of nurses regarding to prevention of HAIs.

Prevalence of dry eye disease among healthy Egyptian population

Purpose The aim was to study the prevalence and related risk factors of dry eye disease (DED) in a random population sample from Cairo and upper Egypt. Materials and methods A clinic-based, cross-sectional, observational, multicenter study was conducted on eyes of healthy individuals accompanying ophthalmological patients coming for ocular examination in outpatient clinics of Ain Shams University Hospital and Al Watany Eye Hospital, Cairo; Saint Mary Hospital, Qena; and Aswan Eye center, Aswan, Egypt. Eyes were selected by systematic random sampling. Two questionnaires were used: the Ocular Surface Disease Index and another one covering medical history and risk factors for DED. External ocular examination, tear film break-up time, and Schirmer’s tests were done. Diagnosis of DED was established on an Ocular Surface Disease Index score of 50 or above associated with at least one of DED symptoms together with either tear film break-up time of less than or equal to 5 s or Schirmer’s test measurement of less than or equal to 10 mm. Results A total of 603 eyes were included; 290 of which were of male participants and 313 were of female ones. The age range was 18–94 years, with a mean age of 50.06±19.06 years. The prevalence of DED was 77.6% (468 eyes). There was a statistically highly significant difference in DED prevalence among all age groups (P Conclusion DED was quite common among our studied subjects, and most of them had associated blepharitis. Smoking was also a major risk factor. Moreover, DED was more common in female sex. There was a statistically significant difference in DED prevalence among the age groups.

Outcomes in Patients With Severe West Nile Neuroinvasive Disease.

To assess the long-term outcomes of patients hospitalized with severe West Nile neuroinvasive disease. Retrospective cohort. Patients admitted to a referral center (Saint Mary's Hospital, Mayo Clinic). Twenty-six patients with West Nile neuroinvasive disease were identified by retrospective search of electronic database of Saint Mary's Hospital from January 1999 to November 2016. Retrospective electronic medical records review and prospective telephone follow-up. Functional disability and cognitive outcomes were evaluated with the modified Rankin Scale and the Telephone Interview for Cognitive Status scores. Data on the time that the patient returned home after the hospitalization for West Nile neuroinvasive disease and the time of return to work were also collected. We identified 26 patients (81% males), 59 ± 17 years old. After a median hospital stay of 14.5 days (3-126), four patients died and 90% of survivors had a modified Rankin Scale of 3-5. Two additional patients died, and 80% of survivors had a modified Rankin Scale of 0-2 after a median follow-up of 73 months (1-144). Seven patients had cognitive impairment, which was severe in two of them. The combination of encephalitis and acute flaccid paralysis at presentation was associated with lower likelihood of returning home within 1 month after discharge (p < 0.01). Patients who required mechanical ventilation were more likely to have a modified Rankin Scale of 3-5 at last follow-up (p = 0.03), less likely to return home within 1 month of discharge (p < 0.01), less likely to return to their jobs (p < 0.01), and showed a trend toward having cognitive impairment (p = 0.05). Despite having poor outcomes at discharge, most West Nile neuroinvasive disease survivors with severe early disability can recover functional independence in the long term, justifying aggressive support during the acute phase and extensive rehabilitation efforts.

Prevalence of, and risk factors for erectile dysfunction in male type 2 diabetic outpatient attendees in Enugu, South East Nigeria.

Context:Erectile dysfunction (ED) is a strong predictor of poor quality of life in men with type 2 Diabetes mellitus (T2DM). Several studies evaluating ED in men with diabetes mellitus have been carried out, but few of these have been done in Nigeria. In Enugu, South East Nigeria, paucity of studies on this subject was observed.Aims:This study aims to determine the prevalence and predictors of ED in men with T2DM attending the diabetes clinics.Settings and Design:A descriptive cross-sectional study of men with T2DM in UNTH and Saint Mary's Hospital, Enugu, was carried out. The systematic sampling method was used to recruit participants.Subjects and Methods:Data collection from participants and their hospital records was done using semi-structured questionnaire. ED was assessed using the 5 items, international index of erectile function questionnaire.Statistical Analysis Used:Data analysis was done using SPSS version 20 and results presented as texts and tables. P value was set at <0.05.Results:A total of 325 participants with mean age of 57.8 ± 13.2 years were involved out of which 94.7% had ED. The proportion of participants with ED had increased with its severity. Predictors of ED included poor glycemic control, longer duration of diabetes, overweight/obesity, and older age. Poor ED health-seeking behavior and treatment were noted.Conclusions:The prevalence of ED is high. Lifestyle interventions targeted at improving glycemic control and weight loss may reduce the burden of this complication. We recommend objective ED screening using standard but brief instruments as part of routine evaluation of men with T2DM.

Comparison of Body Temperature Between 5min and 10min Glass Mercury Thermometers in Under-5 Children in Axum Saint Mary Hospital, Central Zone of Tigray, Ethiopia

Background: Evaluation of body temperature is one of the oldest known diagnostic methods and still an important sign of health and disease. Since rectal and oral temperature measurement are uncomfortable, less hygienic and unacceptable in many cultures; axillary has been method of choice in many countries like Ethiopia. In children decisions concerning investigation and treatment may base on results of temperature alone. Although accuracy of axillary temperature measurement is affected by a number of factors, device dwell time and device type are common. Objective: is to compare body temperature among 5 and 10 Min glass-mercury thermometer. Method: Experimental study design was used to compare body temperature among 5Minand 10Min GMT. A total of 98 samples were taken. The GMT (5 and 10min) was taken at the same axilla simultaneously. A statistical significance (p 0.75) and all the MD were fall in the limit of agreement in Bland-Altman plot. Conclusion and Recommendations: Even a statistical significant (p<0.000) difference was observed in 5 min with 10min GMT the strong correlation, their good agreement and clinical insignificant, some important advantages of 5 Min GMT makes better than 10 Min. Their variation in temperature is not likely to change any clinical decision. So health professionals should use 5Min GMT for measuring body temperature in under-5 febrile illness except for neonate. Moreover researchers should repeat the study using core temperature as gold standard for comparison.

Three dimensional meibography for diagnosis of dry eye syndrome

PurposeThe dysfunction of meibomian glands which secrete components of lipid layer in tears is currently pointed out as one of the main causes occurring dry eye. The distribution of that is more than 70% in Asian, especially. This brought out the importance for the dysfunction of meibomian glands. Our study was aimed to confirm the efficacy of 3D meibography to evaluate the structures of meibomian glands.MethodsThis study is a cross sectional study for patients who had diagnosed as dry eye disease associated with the dysfunction of meibomian glands at Seoul Saint Mary's Hospital from July to October, 2014. To confirm the structure of dry eye patients, 3D images using 3D OCT (optical coherence tomography) and 2D images using infrared camera were obtained. Patients who had the drop‐out lesion in 3D and 2D images were divided as two groups, and differences between them were analyzed. At the same time, to find the clinical signification for structural changes of meibomian glands, all patients had an ocular surface and a tear function examination to define the degree of dry eye.ResultsAs compared between 3D and 2D images for dry eye patients who had the drop‐out lesion on meibomian glands, 3D images was more useful for diagnosis of dry eye than 2D, especially in dry eye related with mild meibomian gland disease.ConclusionsOur study confirmed that the structural change of meibomian glands was reflected in optical coherence tomography 3D images. Especially, 3D meibography was more powerful than 2D infrared camera to find out the real state of drop‐out lesion on meibomian glands. But, there was no statistical significance between the location of drop‐out lesions; such as near lid margin, middle area, near superior conjunctival fornix, and clinical features in these study.

Three dimensional meibography for diagnosis of dry eye syndrome

PurposeThe dysfunction of meibomian glands which secrete components of lipid layer in tears is currently pointed out as one of the main causes occurring dry eye. The distribution of that is more than 70% in Asian, especially. This brought out the importance for the dysfunction of meibomian glands. Our study was aimed to confirm the efficacy of 3D meibography to evaluate the structures of meibomian glands.MethodsThis study is a cross sectional study for patients who had diagnosed as dry eye disease associated with the dysfunction of meibomian glands at Seoul Saint Mary's Hospital from July to October, 2014. To confirm the structure of dry eye patients, 3D images using 3D OCT (optical coherence tomography) and 2D images using infrared camera were obtained. Patients who had the drop‐out lesion in 3D and 2D images were divided as two groups, and differences between them were analyzed. At the same time, to find the clinical signification for structural changes of meibomian glands, all patients had an ocular surface and a tear function examination to define the degree of dry eye.ResultsAs compared between 3D and 2D images for dry eye patients who had the drop‐out lesion on meibomian glands, 3D images was more useful for diagnosis of dry eye than 2D, especially in dry eye related with mild meibomian gland disease.ConclusionsOur study confirmed that the structural change of meibomian glands was reflected in optical coherence tomography 3D images. Especially, 3D meibography was more powerful than 2D infrared camera to find out the real state of drop‐out lesion on meibomian glands. But, there was no statistical significance between the location of drop‐out lesions; such as near lid margin, middle area, near superior conjunctival fornix, and clinical features in these study.

PP14.7 – 2997: Screening osteoporosis in patients with antiepileptic drug using urine N-telopeptide of collagen type I

Objective Antiepileptic drug (AED) can affect bone metabolism. But pediatric neurologists ignore the fact because of shorter use of AED in children than in adults. We tried to find out results of reduced bone mineral density (BMD) after use of AED and appropriate screening methods for osteoporosis. Methods This retrospective study was conducted in total 63 patients with epilepsy who visit the Department of Pediatrics of Catholic University Bucheon Saint Mary's Hospital from January 2013 to December 2014. We measure BMD by dual photon absorptiometry and check urine N-telopeptide of collagen type I (NTx) level for bone turnover marker. Results In whole study population, 37 urine NTx level elevated higher than normal range. Among positive urine NTx group, 17 patients had results of reduced BMD after use of AED. Patients with valproic acid (VPA) were 18, oxcarbazepine (OCZ) 28, levetiracetam (LEV) 26, topiramate (TPM) 9 and lamotrigine (LTG) 8. Due to preceding number including multidrug therapy cases, patients with single VPA were 9, single OCZ 19, single LEV 8, single TPM 0 and single LTG 0. Positive urine NTx number of VPA, OCZ, LEV, TPM and LTG group was 9, 21 (P=0.02), 12, 5 and 4 respectively. Positive urine NTx number single VPA, single OCZ and single LEV group was 4, 16 (P=0.01) and 3 respectively. Conclusion Some patient had reduced BMD after use of AED. The incidence of positive urine NTx was significantly different between the patients with OCZ and those with other AEDs in both monotherapy and multitherapy. We suggest using urine NTx for bone turnover marker in pediatric patients with AED.

A qualitative evaluation of the expanded program on immunization at Saint Mary's Hospital Lacor: Determinants of timely childhood vaccine receipt

Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): Seventy-eight percent of the sample was female with a mean age of 38 years old. Seventy-eight percent of the participants were on antiretroviral therapy (ART) at the time of the interviews. The perceived role of the FBOs was described by the following themes: 1) rare disclosure due to HIV-related stigma within the FBOs. Higher stigma was attributable to HIV-related preaching focused on abstinence and vigilance of promiscuity. PLWHA were less inclined to disclose HIV status and sought help within the organizations. 2) Insufficient support from the organizations. Regardless of HIV disclosure status, PLWHA felt the support was limited and impractical. 3) Higher social capital led to better HIV health outcomes. PLWHA engaging community-based organizations (CBO) or HIV support groups beyond the FBOs have a higher rate of disclosure and self-efficacy, as well as perceived lower stigma. Summary/Conclusion: FBOs can contribute to care of HIV by providing HIV-specific support such as stigma reduction, promoting HIV testing and ART, bridging people to HIV support groups or CBOs. Instead of providing direct HIV-related services, organizing and linking people to available community services and resources can expand its role as a valuable social capital in HIV care and treatment in resource-limited settings.

Lavender aromatherapy as sleep aid

Lavandula angustifolia Miller (synonym L. officinalis) and other species are found throughout the Mediterranean, Arabian peninsula, Russia, Africa, Europe, and the United States. A member of the Lamiaceace (mint) family, the plant has been used to treat insomnia. Linalyl acetate and linalool are active constituents that contribute to its calming and sedative properties. Lavandula angustifolia Miller (synonym L. officinalis) and other species are found throughout the Mediterranean, Arabian peninsula, Russia, Africa, Europe, and the United States. A member of the Lamiaceace (mint) family, the plant has been used to treat insomnia. Linalyl acetate and linalool are active constituents that contribute to its calming and sedative properties. Studies evaluating the efficacy of lavender aromatherapy for insomnia are limited to single- and researcher-blind trials. In one study, 67 Taiwanese women aged 45 to 55 years underwent lavender aromatherapy twice weekly or sleep hygiene education as a control for 12 weeks. Patients with a Pittsburgh Sleep Quality Index (CPSQI; Chinese version) score greater than 5, indicating poor sleep quality, were included. The lavender group had a significant decrease from baseline CPSQI scores, with the control group unchanged.3.Evid Based Complement Alternat Med. 2012; (2012): 740-813Google Scholar Lavender aromatherapy is well tolerated, with no documented drug interactions or contraindications. A restful sleep in the hospital is often a challenge for patients and may result in the use of medications. A randomized study in 64 critical care-unit patients with ischemic heart disease evaluated sleep quality using Saint Mary's Hospital Sleep Questionnaire, which quantifies sleep scores based on 11 items. Scores were assessed before and after three nights of either 9 hours of lavender aromatherapy or no intervention. The lavender aromatherapy group had significantly better sleep quality.4.Iran J. Nurs Midwifery Res. 2010; 15: 234-239PubMed Google Scholar Another study of 50 patients had 3 mL of 100% lavender oil placed within 3 feet of their bedside in a glass jar for inhalation from 10:00 pm to 6:00 am, and the control group received usual care. The lavender group had significantly lower blood pressure readings between 12:00 am and 4:00 am, and their average overall sleep score was higher though not significant.5.Am J. Crit Care. 2014; 23: 24-29Crossref Scopus (54) Google Scholar Inhalational dosing includes six drops (120 mg) for a 20-L bath or two to four drops of lavender essential oil in two to three cups of boiling water or automatic diffuser. Lavender aromatherapy is well tolerated, with no documented drug interactions or contraindications. Topical administration has resulted in mild dermatitis and photosensitivity.1.Holist Nurs Pract. 2009; 23: 57-64Crossref PubMed Scopus (56) Google Scholar, 2.J Herbal Pharmacother. 2004; 4: 63-78Crossref Google Scholar Conclusion: blinding is a challenge in lavender aromatherapy studies, and evidence for its use is limited. First, discuss appropriate sleep hygiene when counseling patients with sleep disturbances. Advise patients to maintain a regular sleep pattern; limit use of the bed to sleep and intimacy; engage in relaxing activities before bed; avoid caffeine, alcohol, and nicotine 4 to 6 hours before bedtime; and last, avoid extremes in temperature, noise, and light.6.Am Fam Physician. 2009; 79: 125-130PubMed Google Scholar Lavender aromatherapy can be safely used to help promote sleep. Tell patients to exercise caution with use of other sedative products, and warn of potential dermatitis if added to bath water.

Elevation of serum lactate dehydrogenase in patients with pectus excavatum.

IntroductionPectus excavatum is the most common congenital chest wall deformity and the depression of the anterior chest wall, which compresses the internal organs. The aim of the present study is to investigate the effects of pectus excavatum on blood laboratory findings.Material and MethodsFrom March 2011 to December 2011, 71 patients with pectus excavatum who visited Seoul Saint Mary Hospital for Nuss procedure were reviewed and analyzed. The blood samples were routinely taken at the day before surgery and pectus bar removal was usually performed in 2 to 3 years after Nuss procedure. To investigate the effects on blood laboratory findings, preoperative routine blood laboratory data and postoperative changes of abnormal laboratory data were analyzed.ResultsOnly lactate dehydrogenase (LDH), one of 26 separate routine laboratory tests, was abnormal and significantly elevated than normal value (age <10, p = 0.008; age ≥10, p < 0.001). However, there was no significant correlation between LDH levels and severities of pectus excavatum. The symmetric subgroup had significantly higher LDH level than the asymmetric subgroup (p <0.001) and there was a significant decrease of LDH level after correction of deformity (p = 0.017).ConclusionIn conclusion, only LDH, one of the routine laboratory tests, was significantly elevated than normal value, which was thought to be caused by etiologies of pectus excavatum and the compression of the internal organs. Further studies on LDH including isoenzyme studies in patients with pectus excavatum will be needed, and these studies will provide a deeper and wider comprehension of pectus excavatum.

A rare case of exomphalos with an umbilical cord teratoma

A healthy 34-year-old para 1 had a normal booking scan. At 20 weeks gestation, on the anomaly scan, a well-defined echogenic area was identified within the cord, adjacent to which...

Nephrology: The Flywheel of Medicine During the Last 60 Years

Nephrology: The Flywheel of Medicine During the Last 60 Years

Evaluation of changes in random blood glucose and body mass index during and after completion of chemotherapy in children with acute lymphoblastic leukemia

PurposeImproved survival of patients with childhood acute lymphoblastic leukemia (ALL) has drawn attention to the potential for late consequences of previous treatments among survivors, including metabolic syndrome. In this study, we evaluated changes in 3 parameters, namely, random blood glucose, body mass index (BMI), and Z score for BMI (Z-BMI), in children with ALL during chemotherapy and after completion of treatment.MethodsPatients newly diagnosed with ALL from January, 2005 to December, 2008 at Saint Mary's Hospital, The Catholic University of Korea, who completed treatment with chemotherapy only were included (n=107). Random glucose, BMI, and Z-BMI were recorded at 5 intervals: at diagnosis, before maintenance treatment, at completion of maintenance treatment, and 6 and 12 months after completion of maintenance treatment. Similar analyses were conducted on 2 subcohorts based on ALL risk groups.ResultsFor random glucose, a paired comparison showed significantly lower levels at 12 months post-treatment compared to those at initial diagnosis (P<0.001) and before maintenance (P<0.001). The Z-BMI score was significantly higher before maintenance than at diagnosis (P<0.001), but decreased significantly at the end of treatment (P<0.001) and remained low at 6 months (P<0.001) and 12 months (P<0.001) post-treatment. Similar results were obtained upon analysis of risk group-based subcohorts.ConclusionFor a cohort of ALL patients treated without allogeneic transplantation or cranial irradiation, decrease in random glucose and Z-BMI after completion of chemotherapy does not indicate future glucose intolerance or obesity.

An Unusual Left‐Sided Tunneled Catheter in a Hemodialysis Patient

Therapeutic Apheresis and DialysisVolume 16, Issue 1 p. 106-107 An Unusual Left-Sided Tunneled Catheter in a Hemodialysis Patient Chih-Chung Shiao, Chih-Chung Shiao Division of Nephrology, Department of Internal Medicine Saint Mary's Medicine, Nursing and Management College, Yilan, Taiwan. Email: [email protected]Search for more papers by this authorTung-Wei Chu, Tung-Wei Chu Division of Cardiovascular Surgery, Department of SurgerySearch for more papers by this authorJyi-Jyh Hung, Jyi-Jyh Hung Department of RadiologySearch for more papers by this authorPi-Jen Hong, Pi-Jen Hong Department of RadiologySearch for more papers by this authorChuan-Lan Yang, Chuan-Lan Yang Department of Nursing, Saint Mary's Hospital LuodongSearch for more papers by this authorJsun-Liang Kao, Jsun-Liang Kao Division of Nephrology, Department of Internal MedicineSearch for more papers by this author Chih-Chung Shiao, Chih-Chung Shiao Division of Nephrology, Department of Internal Medicine Saint Mary's Medicine, Nursing and Management College, Yilan, Taiwan. Email: [email protected]Search for more papers by this authorTung-Wei Chu, Tung-Wei Chu Division of Cardiovascular Surgery, Department of SurgerySearch for more papers by this authorJyi-Jyh Hung, Jyi-Jyh Hung Department of RadiologySearch for more papers by this authorPi-Jen Hong, Pi-Jen Hong Department of RadiologySearch for more papers by this authorChuan-Lan Yang, Chuan-Lan Yang Department of Nursing, Saint Mary's Hospital LuodongSearch for more papers by this authorJsun-Liang Kao, Jsun-Liang Kao Division of Nephrology, Department of Internal MedicineSearch for more papers by this author First published: 18 October 2011 https://doi.org/10.1111/j.1744-9987.2011.01014.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume16, Issue1February 2012Pages 106-107 RelatedInformation