Peterskennedy8955
Results 16.0% of individuals with type 2 diabetes underwent retinal screening which adhered to the NICE guidelines. Of the cohort which did not adhere, 59.5% experienced an interval greater than three months between diagnosis and first retinal screening and 64.3% experienced a screening interval greater than one year. Conclusions Diabetic retinopathy screening of individuals must be improved to meet the NICE standards. Interventions should be implemented to increase the awareness within general practitioners and practice nurses to ensure all people with diabetes receive their first retinal screen within the first three months of diagnosis with regular annual screening thereafter.Pericardial effusion is a common cardiac condition that can be lethal if left untreated. click here Patients who have pericardial effusion often present with dyspnea, chest discomfort, chest tightness, and cough. Cardiac arrhythmia as an initial presentation of pericardial effusion is not common. While the most common cardiac arrhythmia associated with pericardial effusion is atrial fibrillation, atrial flutter as a presenting symptom of malignant pericardial effusion has been described rarely. Herein, we present the case of an elderly man who had developed atrial flutter due to malignant cardiac effusion, which subsequently led to the diagnosis of lung cancer. Clinicians should broaden the differential diagnosis of patients who present with atrial flutter. Also, point-of-care ultrasound (POCUS) may help determine the etiology of a new-onset atrial flutter.Purpose Although surgical technique and patient variables are responsible for the recurrence of pterygium, the surgeon's experience has been sparsely studied. This retrospective study was designed to compare the surgical time, complications, and rates of recurrence after primary pterygium excision between consultant ophthalmologists and trainee residents. Material and methods In this retrospective study, we collected the data of 176 primary pterygium eyes, who were operated on with excision and sutureless/glueless conjunctival autograft either by the consultant (group A) or by the trainee (group B). The demographic profile, surgical time, complications, and recurrences between both groups were analyzed. Results Both the groups were comparable with regards to age, gender, religion, side of the eye, size of the pterygium, and duration of follow-up. The mean operative time was longer in group B (26.5+/-3.8 minutes) than group A (14.2+/-1.6 minutes). Though a relatively higher percentage of complications was observed in group B (12% vs. 9%), the difference was statistically not significant (Mann-Whitney U test, p-value 0.271). There was no statically significant difference in recurrence rate (6.8% vs 9.4%) between the groups. Conclusion With regards to the role of surgeon experience in primary pterygium excision using the sutureless and glueless conjunctival autografting technique, the residents did not have any statistically significant differences in their postoperative complications and recurrence rates. However, the surgical time was significantly higher in the resident group owing to the learning curve.
Differences among the top five races in Texas will be explored to determine if racial, geographic, and healthcare disparities exist in patients undergoing treatment for a primary malignant brain tumor.
Data were obtained from the Texas Cancer Registry from 1995 to 2013. SAS 9.3 (SAS Institute, Inc., Cary, NC) and SEER*Stat 8.3.2 (National Cancer Institute, Bethesda, MD) software were used to analyze death from malignant brain tumors and cause-specific survival. Survival rates were compared using Kaplan-Meier curves and Log-Rank tests. Hazard ratios were estimated using the Cox proportional hazards regression model.
Median survival was highest among Asians at 92 months (95% CI 72, 142) and least among Whites at 20 months (95% CI 19, 21). Patients living in the Upper Gulf Coast region of Texas had the longest survival time at 31 months (95% CI 29-35%), while those patients in the Texas Panhandle had the shortest survival time at 18 months (95% CI 14-23%). Patients with a poverty index of 0-5% had the highest median survival time of 32 months (95% CI 29-35%), as compared to patients with a poverty index of 10-20% who had a median survival of 22 months (95% CI 21-24%).
Ethnic minorities and higher socioeconomic class demonstrated survival advantage. White males had the worst survival of those with primary malignant brain tumors. Other significant factors affecting a patient's survival rate included geographic location, poverty index, sex, and age, thus suggesting a potential genetic and environmental influence.
Ethnic minorities and higher socioeconomic class demonstrated survival advantage. White males had the worst survival of those with primary malignant brain tumors. Other significant factors affecting a patient's survival rate included geographic location, poverty index, sex, and age, thus suggesting a potential genetic and environmental influence.Rubinstein-Taybi syndrome (RSTS; Online Mendelian Inheritance in Man® [OMIM®] #180849, #613684; Orpha 783 ) is a rare plurimalformative autosomal dominant genetic disorder that affects one in 100,000-125,000 newborns with equal male and female distribution. It is characterized by distinctive facial features, short stature, broad and often angulated thumbs and halluces, and moderate-to-severe intellectual disability. In addition to ocular, cardiac, renal, endocrinologic, neurological, and psychomotor abnormalities, RSTS individuals can present with several gastrointestinal symptoms such as feeding difficulties, gastroesophageal reflux, and constipation. Currently, therapeutic strategies for RSTS involves a multi-disciplinary approach focusing mainly on symptomatic management. Here, we present a case of young-onset Barrett's esophagus in a patient with Rubinstein-Taybi syndrome.Inherited platelet disorders (IPDs) are genetically heterogeneous rare disorders due to quantitative and/or qualitative abnormalities of the platelet. IPDs are often predisposed to significant medical complications. RAS guanyl-releasing protein-2 (RASGRP2) was recently identified as a gene affected in patients with platelet function defects and a bleeding complication. RASGRP2 codes for the protein CalDAG-GEFI RAS (guanyl-releasing protein-2), a guanine nucleotide exchange factor for small guanosine triphosphate(GTP)ase Rap1. We used Sanger sequencing to identify a novel function-disrupting homozygous mutation in RASGRP2 responsible for bleeding diathesis and platelet dysfunction in a patient.