AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in trea...
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AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism. RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles (CHLA) version, 33% used the Children's Oncology Group (COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center (P〈0.0001). CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic r
Introduction: The urachus or median umbilical ligament is a fibrous cord originating from the allantoic canal’s involution. It extends from the bladder dome to the posterior umbilicus. A partial or a total defect of ...
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Introduction: The urachus or median umbilical ligament is a fibrous cord originating from the allantoic canal’s involution. It extends from the bladder dome to the posterior umbilicus. A partial or a total defect of the urachus channel’s obliteration after the fifth month of gestation can be the origin of urachal abnormalities. A complication of symptomatic urachal anomalies occurs when the cyst fistulizes to adjacent viscera. We report the first case of a diverticulosis-related sigmoid-urachal-scrotal cyst in a 55-year-old patient. Case Report: A 55-year-old male visited the clinic with intermittent fever, lower abdominal pain, swelling in the groin and scrotal area. Abdominal examination revealed a diffuse tender in the lower abdomen and suprapubic area. Non-contrast abdominal CT imaging showed a cystic lesion with an air-fluid level and possibly debris positioned superiorly to the bladder at the abdominal wall. The sigmoid colon seemed attached to this cystic lesion. Air observed in the scrotum and subcutaneous. The damaged part of the sigmoid colon was repaired. Then the abscess was drained. Urachus was wholly resected and removed. After five days of follow-up, the patient was discharged without any problem. A severely inflamed urachus was found in pathology. Conclusion: Although it is rare and its symptoms are non-specific, the urachal abscess should be suspected if there is persistent fever and suprapubic pain, especially in patients with diverticula. It is recommended to remove it when the diagnosis is made, considering the complications that may occur.
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