Rare Case of Nasal Vault Oncocytic Cystadenoma

Background: Oncocytic Cystadenomas are a rare benign pathology often found to arise from the salivary glands, reported more commonly in minor salivary glands, but even more rarely in major salivary glands and the larynx. This is the first known report of a nasal vault oncocytic cystadenoma in a pediatric patient. Methods: Case Report and Literature Review. Case presentation: A 10-year-old female presented with a mass involving the left nasal vestibule that caused nasal obstruction and a visible external abnormality. MRI imaging revealed a cystic lesion in the anterior nasal cavity that was rim enhancing with a bright T2 signal that appeared to arise from the nasal mucosa. She was taken to the operating room for endoscopic-assisted removal of the lesion. Pathology showed an oncocytic cystadenoma. On follow-up clinic visit, she is doing well with no signs or symptoms of recurrence. Conclusion: The authors present the first reported case of a pediatric patient with nasal vault oncocytic cystadenoma. In other head and neck locations, these cysts are generally benign and only cause symptoms related to their location and proximity to other vital structures. Surgical endoscopic management was effective for resection

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Tracheostomy in the Extremely Premature Neonate: A Multi-Institutional Study.

Objective: (1) To describe characteristics associated with tracheostomy placement and (2) to describe associated in-hospital morbidity in extremely premature infants. Study Design: Pooled retrospective analysis of charts. Setting: Academic children’s hospitals. Subjects and Methods: The patient records of premature infants (23-28 weeks gestational age) who underwent tracheostomy between January 1, 2012, and December 31, 2017, were reviewed from 4 academic children’s hospitals. Demographics, procedural morbidity, feeding, respiratory, and neurodevelopmental outcomes at the time of transfer from the neonatal intensive care unit (NICU) were obtained. The contribution of baseline characteristics to mortality, neurodevelopmental, and feeding outcomes was also assessed. Results: The charts of 119 infants were included. The mean gestational age was 25.5 (95% confidence interval, 25.2-25.7) weeks. The mean birth weight was 712 (671-752) g. Approximately 50% was African American. The principal comorbidity was chronic lung disease (92.4%). Overall, 60.5% of the infants had at least 1 complication. At the time of transfer, most remained mechanically ventilated (94%) and dependent on a feeding tube (90%). Necrotizing enterocolitis increased the risk of feeding impairment (P =.002) and death (P =.03). Conclusions: Tracheostomy in the extremely premature neonate is primarily performed for chronic lung disease. Complications occur frequently, with skin breakdown being the most common. Placement of a tracheostomy does not seem to mitigate the systemic morbidity associated with extreme prematurity

Metabolomics reveals sex-specific pathways associated with changes in adiposity and muscle mass in a cohort of Mexican adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/172821/1/ijpo12887_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/172821/2/ijpo12887.pd