Shoemakerbolton6758

Forty-eight patients reported discomfort directly linked to stoma during their professional activities. The causes mentioned were physical in 6 cases and psychological in 3 cases. Six patients were moved into more adapted working positions.

the management of patients with digestive stomas should aim to an adequate social and professional reintegration. This can only be done by involving the occupational physician, the psychologist, the stoma therapist and the associations.

the management of patients with digestive stomas should aim to an adequate social and professional reintegration. This can only be done by involving the occupational physician, the psychologist, the stoma therapist and the associations.Malignant melanoma of the vulva is a rare and aggressive tumour with dismal prognosis. It tends to recur and metastasize early. Surgical excision with or without regional lymph node dissection is still the treatment of choice with adjuvant therapy decided on a case by case. Furthermore, HIV infection has been associated with more aggressive disease. Herein we present a 45-year-old HIV-infected female patient on antiretroviral therapy who presented with vulval ulcer for one year. On examination, she had ulcerated nodule on the labia majora. Radiology showed vulvovaginal tumour without involvement of the adjacent organs. Malignant melanoma was confirmed on both the incisional biopsy and vulvectomy. She responded poorly to radiotherapy. Furthermore, she presented with recurrence and metastatic disease a month after surgery. She was lost to follow-up clinic.Sepsis results in intense disturbances in homoeostasis and is responsible for considerable morbidity and mortality in early infancy. Owing to insufficiency on part of infant to develop adequate inflammatory response to localize the infection, they usually progress to disseminated systemic infection, pneumonia and/or meningitis. We present the case of a 26 weeks preterm boy with acute digital ischemia in right index finger progressing to impending gangrene as a manifestation of septicemia. Use of topical nitroglycerin patch with meticulous monitoring successfully alleviated the impending peripheral gangrene without any adverse effects.Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. Data on the optimal choice of acute myocardial infarction (AMI)´s revascularization in the context of polyarteritis nodosa (PAN) is limited to case reports and is still an open question. The present report describes a rare case of a young male patient followed for PAN presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the AMI was a complication of his vasculitis. This case indicates that coronary artery involvement should be carefully monitored during the chronic phase of PAN. The pathophysiology of AMI in PAN patients should be kept in mind and the interventional approach must be performed according to the angiographic findings to avoid complications.Millions of patients, with suspected complex neurogenetic disorders, living in resource limited regions around the world have no access to genetic testing despite the rapidly expanding availability and decreasing costs of genetic testing in first world nations. The barriers to increasing availability of genetic testing in resource limited nations are multifactorial but can be attributed, in large part, to a lack of awareness of the power of genetic testing to lead to a rapid, cost-effective, diagnosis that potentially will have profound clinical implications on treatment and patient outcomes. We report our experience with whole exome sequencing (WES) done for the first time in 5 patients of African descent with a suspected neurogenetic disorder living in a resource limited setting on the Eastern Caribbean island of Barbados. A diagnostic pathogenic mutation was found in 3 patients in the SCN1A, STXBP1 and SCN4A, who clinically were diagnosed with Dravet syndrome, Lennox-Gastaut syndrome, paramytonia and seizures respectively. A variant of undetermined significance was found in a patient with global developmental delays, hypotonia, with abnormal eye movements. In one patient WES was non-diagnostic. This result highlights the high yield of WES in carefully selected patients with a neurologic disease and the need for increase access to genetic testing in resource limited settings globally.Macrophage activation syndrome (MAS) is a rare immunologic syndrome, rapidly fatal in the absence of specific etiological treatment. It is defined by clinical, biological and cyto-histological criteria. Numerous etiologies have been described in MAS, the association with Hodgkin lymphoma (LH) is exceptional. We report the case of a young woman in whom a macrophage activation syndrome reveals a Hodgkin's lymphoma.

breast cancer is associated with serious morbidity, low quality of life and mortality. Prevention through early screening remains one of the most optimal strategies against breast cancer. The primary objective of this analysis was to determine the prevalence of breast cancer screening using the clinical breast examination (CBE) and breast self-examination (BSE) methods among women aged 15-49 years, and the secondary objective was to explore demographic and socio-economic factors associated with clinical breast examination (CBE) and breast self-examination (BSE) breast cancer screening methods.

the study used Demographic Health Survey data collected in 2014. The study participants were Basotho women aged 15-49 years. STATA 17 was employed for developing logistic regressions and weighting for sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance.

variables that were associated with significantly increased odds of having you had a breast cancer either self-examination or clinical test in last 12 months were i) visiting a health centre in the past 12 months [odd ratio (OR) 1.21 (95% confidence interval [CI] 1.02, p = 1.43); p = 0.025]; ii) completion of primary level education [1.27 ((1.10; 1.49); 0.001]; iii) being aware of breast cancer [2.18 (1.78;2.65); 0.001]; and iv) age [35-39 years 1.40 (1.10;1.78);0.007]; while district of origin [Butha - Buthe 0.63 (0.46; 0.85); 0.003] was significantly associated with decreased odds of the outcome.

our findings suggest that raising awareness about breast cancer is the most effective method of improving breast cancer screening among women in Lesotho.

our findings suggest that raising awareness about breast cancer is the most effective method of improving breast cancer screening among women in Lesotho.The COVID-19 pandemic had caused significant morbidity and mortality, with over a million deaths recorded to date. Mortality recorded among severe-critically ill patients admitted to intensive care units (ICU) has been significantly high, especially in most COVID-19 epicenters. Reports on the unique clinical characteristics and outcomes from the ICU admissions are on-going with isolated studies in Africa. This study was a retrospective single-centre study involving all polymerase chain reaction (PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients admitted to the medical intensive care unit (MICU) of the department of medicine and therapeutics, Korle-Bu Teaching Hospital, over the period of 13th April - 28th June 2020. Twenty-two (22) patients in total fulfilled the inclusion criteria and are included in this report. Patients' socio-demographic characteristics, clinical and laboratory parameters outcomes as well as treatment modalities employed were extracted from their respectns for COVID-19 treatment, except for empirically symptoms-guided treatments and management of mild to critically ill patients. Early use of systemic corticosteroids for severe to critically ill patients in the ICU using S/F ratio and CRP levels may improve outcomes.Cemento-osseous dysplasia is a benign fibro-osseous lesion affecting the alveolar bone. It is classified into three forms periapical, focal or florid dysplasia. It is often asymptomatic and fortuitously discovered during a routine radiological examination. However, it may become symptomatic after superinfection, after patient's exposure to oral bacterial flora. We here report a case of florid cemento-osseous dysplasia associated with actinomycosis of bone in a 53-year-old Tunisian woman. This superinfection has been rarely reported in the literature; Boolean Searching on PubMed for the keywords "cemento-osseous dysplasia AND actinomyces" displays a single article (Smith et al. 2011). The treatment of actinomycosis infection often requires long-term antibiotic therapy, sometimes associated with surgical debridement, as in the case of this patient who underwent piezosurgery to treat dysplasia and necrotic bone.Background Overactive bladder (OAB) is defined as urgency (a sudden compelling desire to pass urine with or without urge incontinence) usually associated with frequency and nocturia. OAB is a chronic condition that affects quality of life (QoL) significantly in patients. Acupuncture can help in the treatment of OAB for patients who cannot take certain medications. Case A 32-year-old a female patient was diagnosed with OAB. She came to the department of medical acupuncture with a chief complaint of frequent urination for 15 years. Urinalysis test results were normal. Before acupuncture, a bladder ultrasound (US) showed a postvoid residual volume (PVR) of 53 mL, and a uroflowmetry test showed a maximum flow rate of 20.6 mL/s, with an average flow rate of 12.1 mL/s and a voided volume of 71 mL. Her OAB Symptom Score (OABSS) was 13 and the King's Health Questionnaire result was (KHQ) was 87. She was treated with electroacupuncture (EA). Results After 12 EA sessions, 3 times per week, this patient's bladder US showed a PVR of 3 mL; a uroflowmetry test showed a maximum flow rate of 30.5 mL/s, with an average flow rate of 15.3 mL/s and a voided volume of 120 mL. Her OABSS score was 7. Her KHQ score was 0. Conclusions OAB can be treated with EA to improve QoL, as seen by this patient's decreasing OABSS and KHQ scores, reduced PVR, and increase the voided volume.Objective To assess provider perceptions regarding battlefield acupuncture (BFA) and integrative medicine at a single Veterans Health Administration facility. Materials and Methods A total of 87 allopathic and osteopathic providers trained to provide BFA were invited to participate in a self-report web-based questionnaire assessing provider BFA perceptions and practice. Mixed methodology was used to analyze closed- and open-ended survey responses. Results Sixty-six providers completed the survey. On average, most providers reported 3-4 BFA treatments per patient (43.2%) and 1-2 weeks of pain relief per treatment (51.4%). A positive correlation was found between post-BFA complementary and alternative medicine (CAM) attitude and (1) average total patients treated with BFA (r b = 0.41, n = 37, P = 0.01) and (2) percentage of patients treated experiencing meaningful pain relief (r = 0.47, n = 35, P = 0.003). Epigenetic inhibitor clinical trial A positive shift in CAM attitudes was observed [F(1, 59) = 25.5, P  less then  0.001, η p 2 = 0.302]. An overworked schedule was the most salient theme across open-ended questions addressing barriers to practice.