6 research outputs found
Squamous cell carcinoma with rhabdoid phenotype and osteoclastâlike giant cells in a renalâpancreas transplant recipient
Squamous cell carcinoma (SCC) is the commonest nonâmelanotic malignant skin tumour encountered after solidâorgan transplantation. In this setting it is associated with a worse prognosis than sunâdamageâinduced SCC. Rhabdoid cells and osteoclastic giant cells are infrequently seen in SCC. This case highlights the unusual occurrence of rhabdoid cells and osteoclastic giant cells in a postâtransplant SCC
Incidence and predictors of adverse events and outcomes for adult critically ill patients transferred by paramedics to a tertiary care medical facility
Objective: The aim of this study was to determine the incidence of adverse events and patientsâ outcomes in interâfacility critical care transfers by paramedics.
Methods: We conducted a retrospective cohort study of adults undergoing interâfacility transfer to a tertiary medical facility by paramedics. We included all patients transferred between 1st June, 2011 and 31st December, 2014. The primary outcome is inâtransit adverse event and the secondary outcome is inâhospital mortality. Multiple logistic regression models were fitted to assess predictor variables for adverse events and inâhospital mortality.
Results: The incidence of adverse events was 13.7% (31/227 patients had inâtransit adverse event); the most common adverse events reported were desaturation and hypotension. A unit increase in risk score for transported patients (RSTP) significantly increased the occurrence of adverse events (adjusted odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.07â1.72 and adjusted P = 0.01). Compared to medical patients, cardiac patients were less likely to develop adverse events (adjusted OR: 0.117, 95% CI: 0.02â0.52 and adjusted P < 0.01). The inâhospital mortality was 30.4% and 30-day survival was 68.1%. For two patients whose age differed by 1 year, the older patient was more likely to die (adjusted OR: 1.03, 95% CI: 1.01â1.05 and P < 0.01) and a unit increase in RSTP significantly increased occurrence of inâhospital mortality (adjusted OR: 1.30, 95% CI: 1.0â1.60 and P = 0.01).
Conclusion: The incidence of adverse events was 13.7%. The most common observed adverse events were desaturation and hypotension. Inâhospital mortality was 30.4% and 30-day survival was 68.1%