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Haemato-Oncology
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Fungal spores are ubiquitous in the environment and are continuously inhaled, often leading to colonization of the respiratory tract. Invasive infection is less common but occurs in the context of prolonged neutropenia or patients with Gv HD, who have impaired immune reconstitution and are often taking multiple immunosuppressive agents.41-42 Acute fungal rhinosinusitis is an invasive infection with a high mortality usually caused by aspergillus species or pin moulds (mucorales).38 The initial symptoms include fever, nasal congestion, facial pain and epistaxis; examination of the oral cavity and nasal passages may reveal mucosal thickening or areas of necrotic tissue. Invasion of the palate, orbit, cavernous sinus, cranial nerves and brain can occur within hours, days or weeks depending on the specific organism and the depth of immunosuppression.43 Some patients have extension beyond the sinuses at presentation leading to visual disturbance, diplopia, facial numbness, altered cognition or seizures.
The Governor Vessel (GV)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Historically, acupuncturists viewed the GV channel as a network of veins as just described. However, modern science shows that neuromodulation at GV points influences nerve function that can influence blood distribution patterns within the CSVS. As such, despite its status as a singular vessel, the GV pathway represents an avenue for impacting brain and spinal cord function at least as much as the blood that bathes them. The preceding images and those that follow explore connections between GV points and the nervous system which are as, if not more, important to the clinical outcome resulting from treating these sites.
Early glycaemic variability increases 28-day mortality and prolongs intensive care unit stay in critically ill patients with pneumonia
Published in Annals of Medicine, 2022
Seong Ho Kim, Ji Young Kim, Eun Song Kim, Il Rae Park, Eun Yeong Ha, Seung Min Chung, Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee
There was no difference in the 28-day mortality and prolonged ICU stay between patients with and without DM. This can be explained by the adaptation of patients with diabetes to chronic hyperglycaemia, resulting in an increased threshold for stress hyperglycaemia-related adverse effects [12,30,31]. However, the risk of DM on the severity and prognosis of respiratory diseases has been emphasized and therefore should not be underestimated [32,33]. In addition, newly discovered hyperglycaemia is an important marker of in-hospital mortality rate and longer length of stay than HbA1c level [30,34]. Taken together, the presence of diabetes or HbA1c alone is insufficient to predict outcomes in critically ill patients. Therefore, the management of GV should be considered to achieve a better prognosis.
Glomus tumors of the head and neck: thirteen years’ institutional experience and management
Published in Acta Oto-Laryngologica, 2019
Sibel Alicura Tokgöz, Güleser Saylam, Ömer Bayır, Kemal Keseroğlu, Gökhan Toptaş, Emel Çadallı Tatar, İstemihan Akın, Mehmet Hakan Korkmaz
Glomus vagale. Three female and one male patients were diagnosed with GV tumor. Three patients underwent preoperative embolization without developing any complications. Tumors were classified according to the criteria described by Brown et al. Three patients had Stage 2 tumors, and one patient had Stage 3 tumor. All tumors were resected via the transcervical approach. Following resection, two patients had Xth cranial nerve, and one patient had XIIth cranial nerve and marginal mandibular nerve deficits. Also, preoperative embolization was undertaken in the patient with GC + GV tumor. Tumors were resected via the transcervical approach, and unilateral vocal cord paralysis occurred after surgery.
Effect of intravaginal gentian violet for acute vaginal candidiasis treated with a single dose oral fluconazole: a randomised controlled trial
Published in Journal of Obstetrics and Gynaecology, 2022
Chenchit Chayachinda, Manopchai Thamkhantho, Popchai Ngamsakulrungroj, Charussri Leeyaphan, Orwan Tulyaprawat
The randomised design with complete treatment adherence is the first strength of the study. Both interventions are simple and require a single administration resulting in high applicability of the study. GV can be an adjuvant treatment for the quicker resolution of symptom severity when its staining is acceptable. However, GV should be avoided if severely damaged mucosa/skin is present. The dose of 200 mg fluconazole being used in the present study is higher than that being recommended; however, no serious adverse effects have been reported according to our 10-year experience. The last limitation is that the outcome measures at two months are self-reported by telephone.