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Complete cost-effectiveness of diabetes supervision for that underserved in america: A planned out review.
64, 95%CI = 1.07 - 6.03) of obstetric VVF than women with "sufficient" score on the MHAI. Conclusion and Global Health Implications Inadequate access to essential obstetric care increases the risk of VVF. Copyright © 2020 Rupley et al.We are thrilled to present this special collection of articles entitled "Current and Emerging Issues in Global Health." This special collection pursued three main goals. First, the collection presents an opportunity for innovation. Second, it presents an opportunity to engage the field and community around a common theme. Finally, the collection provides a reality-check for the journal editors to support the field in evaluating the extent to which we have collectively attempted to confront the global maternal and child health (MCH) issues of our time regardless of where in the world we live. Unique to this special collection is the geographical spread of the article submissions. We have articles and contributions from researchers and research groups from three continents in a single edition Africa, Asia and North America, making the articles opportunities for cross-fertilization of ideas across the global North and South. Public health is passing through a seismic transformation. Whether at the global, national, state, and local levels, disease outbreaks, patient demographics, and health technology have changed the global health landscape in a way never imagined. Our hope is that papers in this special collection will spark new ideas for invention, improved patient care, and transform population health. Copyright © 2020 Salihu and Azuine.Isolated spinal intramedullary involvement by neurocysticercosis is extremely rare. We report a case of a Hispanic female with right-sided weakness, magnetic resonance imaging showing cervical intramedullary lesion. selleck chemicals llc Surgery was performed due to the progressive nature of symptoms. The cervical cord lesion was completely removed; pathology was consistent with degenerated cysticercosis. Progressive clinical improvement with physiotherapy was achieved. Although rare, especially in the absence of intracranial lesions, the diagnosis should be considered in appropriate patient population as it usually presents a peripherally enhancing cystic lesion. © 2020 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.Objective At present, early detection of spinal osteomyelitis is a challenge. Patients may present with non-specific symptoms and diagnostic imaging studies may be obtained for seemingly unrelated complaints. Paraspinal fat stranding on body computed tomography (CT) as a sign of osteomyelitis is easily overlooked and has not been reported in the literature to our knowledge. The purpose of this study is to review findings on body CT that points to unsuspected spinal osteomyelitis. Material and Methods A retrospective review of patients with spinal osteomyelitis who also had concomitant chest, abdominal, or pelvic CT scans between August 2013 and February 2017 yielded 10 patients who had confirmed osteomyelitis (ages between 51 and 75, mean age 64.8). Images and medical records were reviewed. Results The age of the patients ranged from 51 to 75 years (median value, 64). All patients had multiple underlying medical illnesses, and half of them had a known preceding infection such as sepsis or urinary tract infection. At presentation, three patients had a fever and two patients had neurologic deficits. Seven out of eight patients had elevated C-reactive protein and erythrocyte sedimentation rate, five patients had leukocytosis, and four patients had positive blood cultures. Paravertebral fat stranding and endplate erosions were observed in 9 and 6 cases, respectively, on initial body CT for unrelated indications, and subsequent magnetic resonance imaging confirmed osteomyelitis discitis. Conclusion Clinically significant, but initially unsuspected, spinal pathology such as osteomyelitis may present on body CT scans. Earlier diagnosis of spinal osteomyelitis can be made by performing a focused evaluation of the paraspinal soft tissues and including osteomyelitis in the differential diagnosis, particularly in high-risk patients. © 2020 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.We report a case of a partial anomalous left pulmonary artery sling in an adult patient as an incidental finding on computed tomography. There is a normal bifurcation of the pulmonary trunk into right and left pulmonary arteries with anomalous origin of the left upper lobe pulmonary artery from the right pulmonary artery. The anomalous vessel passes between the trachea and esophagus forming a partial left pulmonary artery sling without airway compression. © 2020 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.Hypertrophic cardiomyopathy (HCM) is a common form of cardiomyopathy and a leading cause of sudden death in the young. Magnetic resonance imaging (MRI) is an established pre-operative tool for the evaluating of patients suspected with HCM for morphological assessment and identifying patients at risk of sudden death. Echocardiography and MRI are equally used in the post-treatment assessment of cardiac function and morphology. link2 In this report, we present the comparative role of these two modalities in pre- and post-operative imaging assessment in our patients, treated surgically with the left ventricular myomectomy. Relative merits of MRI and echocardiography are presented and discussed. © 2020 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.Chondrosarcomas are tumors consisting of osseous or cartilaginous stroma. They are not an uncommon pathology; however, primary pulmonary chondrosarcomas arising in lung parenchyma are extremely rare, with few cases published in literature. Herein, we present a case with biopsy-proven primary pulmonary chondrosarcoma after exclusion of primary origin elsewhere. In the case presented in this report, we demonstrate the clinical presentations, pulmonary function tests, and the radiological findings of this rare tumor in a young male patient. Further, we present a brief review of existing literature for patients with similar pathology. © 2020 Published by Scientific Scholar on behalf of Journal of Clinical Imaging Science.Background Vertebral osteomyelitis caused by Stenotrophomonas maltophilia is very rare. There are only two cases reported in literature. Here, we present a 48-year-old immunocompetent male who, following a lumbar microdiscectomy, developed postoperative spondylodiscitis due to S. maltophilia that mimicked a cotton granuloma. Case Report Two months ago, a 48-year-old male underwent a lumbar L4-L5 microdiscectomy, he newly presented with the left thigh and leg pain of 4 weeks duration. Laboratory studies revealed a CRP of 26 mg/l, an ESR of 6 mm (1st h), and total leukocyte count of 7.85 thousand/ul. The MRI T2 images showed a focal hyperintense lesion in the left lateral recesses at the L4-L5 level; the accompanying hypointense-smooth margin resembled a cotton granuloma. At surgery, we found a localized epidural collection of pus; S. maltophilia was isolated from the culture. His symptoms gradually improved, and symptoms fully resolved with 3 months of subsequent antibiotic therapy. Conclusion S. maltophilia causing vertebral osteomyelitis is extremely rare and can sometimes mimic a cotton granuloma. MR diagnosis, surgical decompression, and obtaining cultures are requisite to direct appropriate antibiotic therapy. Copyright © 2020 Surgical Neurology International.Background Our hypothesis was that by identifying certain preoperative predictive factors, we could favorably impact clinical outcomes in patients undergoing decompressive surgery for lumbar spinal stenosis (LSS). Methods In this retrospective study, there were 65 patients (2016-2018) with symptomatic LSS who underwent decompressive laminectomy without fusion. Their clinical outcomes were assessed utilizing the Oswestry Disability Index (ODI). Multiple preoperative variables were studied to determine which ones would help predict improved outcomes gender, age, body mass index (BMI), general/neurological examination, smoking, and drug therapies (anxiolytics and/or antidepressants). Results All patients demonstrated statistically significant improvement on the ODI. Multivariate analysis revealed that those with higher preoperative BMI had significantly lower ODI on 1-year follow-up examinations, reflecting poorer outcomes. Postoperatively, 44 patients (67%) exhibited lower utilization of anxiolytic medications, 52 patients (80%) showed reduced use of antidepressant drugs, and pain medications utilization was reduced in 33 patients (50%). Conclusion Decompressive laminectomy without fusion effectively managed LSS. It reduced patients' use of pain, anxiety, and antidepressant medications. In addition, we found that increased preoperative BMIs contributed to poorer postoperative outcomes (e.g., ODI values). Copyright © 2020 Surgical Neurology International.Background Subependymal giant cell astrocytomas (SEGAs) appear approximately in 10% of patients with tuberous sclerosis. These tumors are most commonly diagnosed in childhood and adolescence, with in utero diagnosed SEGAs being an extremely rare entity. Case Description We present the case of a congenital SEGA detected in an antenatal ultrasound and further investigated with fetal magnetic resonance imaging (MRI) scans at 22 and 32 weeks of gestational age. At 9 days of age, the child underwent craniotomy and partial excision of the tumor, followed by a second more extensive operation 13 days later. The patient was subsequently administered mammalian target of rapamycin inhibitor (everolimus). Conclusion In the latest follow-up MRI, at the age of two, the SEGA remained unchanged. Management of these tumors in neonates is challenging, mainly due to high morbidity and mortality of surgical treatment in these ages. Copyright © 2020 Surgical Neurology International.Background Invasive pain procedures can be valuable tools to manage chronic pain. Here, we compared the costs of three procedures used to address chronic pain; punctate midline myelotomy (PMM), placement of a spinal cord stimulator (SCS), or placement of an intrathecal pain pump (ITPP). Case Description This retrospective chart review yielded 9 patients with chronic pain syndromes; 3 had PMM, 3 had SCS, and 3 had ITPP procedures. Variables studied included; pain type, the procedures performed, and the cost of each procedure. The Wilcoxon rank-sum and one-way analysis of variance were used to compare the three groups (P less then 0.05). link3 PMM was performed for patients with chronic nonmalignant visceral pain and SCS was utilized for failed back syndrome, while ITPP was placed in two patients with chronic visceral cancer pain and one patient with chronic somatic cancer pain. The mean length of stay was significant shorter for SCS and PMM versus ITPP (e.g., 1, 3.6 ± 0.6 and 15 ± 5.6 days). The mean procedure costs were significantly higher for SCS versus PMM and ITPP (105,234, $71,087, and $79,333); for the latter PMM and ITPP, procedural costs were not significantly different. Conclusion For the three pain procedures discussed in this report, PMM is the most cost-effective as it obviates the need for efficacy trials, and there are no implant device costs, no medication refills, no maintenance costs, and no complication management costs. Copyright © 2020 Surgical Neurology International.
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