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Reduced delay in diagnosis of odontogenic keratocysts with malignant transformation:A case report

World Journal of Clinical Cases 2020年第11期8卷 2374-2379页

作者： Xiao-Juan Luo Ming-Liang Cheng Chun-Ming Huang Xiao-Ping Zhao Center of Stomatology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND In rare cases,odontogenic keratocysts(ODs)transform into squamous cell carcinoma.Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to years.In this article,we report a case of malignancy derived from OD with a five-day delay in diagnosis.CASE SUMMARY A 54-year-old woman was referred to Tongji Hospital in Wuhan,China with complaints of moderate pain,recurrent swelling,and pus discharge around her left maxillary lateral incisor for over 10 years.Physical examination revealed a fistula at the palatine-side mucoperiosteum of the left maxillary lateral incisor and enlarged lymph node in the left neck.Cone beam computed tomography revealed a cystic lesion with massive bone destruction from the left maxillary central incisor to the left secondary maxillary premolar and local bony destruction in the left first mandibular molar.The patient was clinically diagnosed with OD.Enucleation rather than marsupialization was performed given the risk factors of long history,recent aggravated pain,and massive bony destruction.Malignant transformation of OD was confirmed by pathologists 3 d after the operation.Radical surgery was performed,and lymph node metastasis was observed.The patient was subjected to postoperative radiotherapy and synchronous chemotherapy,and no local recurrence or distant metastasis was noted at one-year follow-up.CONCLUSION Our case suggests that clinicians should be aware of the malignant transformation of OD,especially when patients present with a long history,massive cyst,chronic inflammation,recent persistent infections,aggravated pain,numbness around the cystic lesion,and lymph node enlargement.

关键词： Odontogenic keratocysts Malignant transformation Primary intraosseous squamous cell carcinoma delay in diagnosis Enucleation Case report

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Impact of time to diagnosis on the occurrence of cardiogenic shock in MIS‑C post‑COVID-19 infection

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World Journal of Pediatrics 2023年第6期19卷 595-604页

作者： Said Bichali Mathilde Bonnet Marie‑Emilie Lampin Jean‑Benoit Baudelet Heloise Reumaux Olivia Domanski Thameur Rakza Alexandre Delarue Morgan Recher Jerome Soquet Francois Dubos Stephane Leteurtre Ali Houeijeh Francois Godart Pediatric Cardiology Univ.LilleCHU Lille2 Avenue Oscar Lambret59000 LilleFrance Pediatric Intensive Care Univ.LilleCHU Lille59000 LilleFrance ULR 2694‑Metrics:Evaluation des Technologies de Sante et des Pratiques Medicales Univ.Lille59000 LilleFrance Pediatric Rhumatology Univ.LilleCHU Lille59000 LilleFrance Cardiac Surgery Univ.LilleCHU Lille59000 LilleFrance Pediatric Emergency Univ.LilleCHU Lille59000 LilleFrance

Background In multisystem inflammatory syndrome in children(MIS-C),diagnostic delay could be associated with severity.This study aims to measure the time to diagnosis in MIS-C,assess its impact on the occurrence of cardiogenic shock,and specify its determinants.Methods A single-center prospective cohort observational study was conducted between May 2020 and July 2022 at a tertiary care hospital.Children meeting the World Health Organization MIS-C criteria were included.A long time to diagnosis was defined as six days or more.Data on time to diagnosis were collected by two independent physicians.The primary outcome was the occurrence of cardiogenic shock.Logistic regression and receiver operating characteristic curve analysis were used for outcomes,and a Cox proportional hazards model was used for determinants.Results Totally 60 children were assessed for inclusion,and 31 were finally analyzed[52%males,median age 8.8(5.7-10.7)years].The median time to diagnosis was 5.3(4.2-6.2)days.In univariable analysis,age above the median,time to diagnosis,high C-reactive protein,and high N-terminal pro-B-type natriuretic peptide(NT-proBNP)were associated with cardiogenic shock[odds ratio(OR)6.13(1.02-36.9),2.79(1.15-6.74),2.08(1.05-4.12),and 1.70(1.04-2.78),respectively].In multivariable analysis,time to diagnosis≥6 days was associated with cardiogenic shock[adjusted OR(aOR)21.2(1.98-227)].Time to diagnosis≥6 days had a sensitivity of 89% and a specificity of 77% in predicting cardiogenic shock;the addition of age>8 years and NT-proBNP at diagnosis≥11,254 ng/L increased the specificity to 91%.Independent determinants of short time to diagnosis were agediagnosis≥6 days was independently associated with cardiogenic shock in MIS-C.Early diagnosis and treatment are crucial to avoid the use of inotropes and limit morbidity,especially in older children.

关键词： COVID-19 delay in diagnosis Heart failure MIS-C SARS-CoV-2

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Consultation, diagnosis and Treatment delays for Breast Cancer among Patients Followed up at the YaoundéGeneral Hospital, Cameroon

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Open Journal of Obstetrics and Gynecology 2020年第11期10卷 1580-1589页

作者： Jean Dupont Kemfang Ngowa Angèle Kabeyene Richard Ngarvounsia Etienne Atenguena Yvan Sinclair Ngaha Tchawe Anny Ngassam Christiane Nsahlai Junie Metogo Jovanny Fouogue Tsuala Pierre Marie Tebeu Department of Obstetrics/Gynecology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Obstetrics/Gynecology Unit Yaoundé Cameroon Department of Pathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé General Hospital Medical Oncology Unit Yaoundé Cameroon Department of Obstetrics/Gynecology Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. Materials and Methods: This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the initial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). Results:

关键词： Breast Cancer delay in Consultation delay in diagnosis delay in Treatment

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