Association of clinicodemographic factors and tissue biopsy results among patients with thyroid nodules at the Southern Philippines Medical Center

Objective@#To compare selected clinicodemographic factors of patients with thyroid nodules who underwent thyroid surgeries with their tissue biopsy results and determine any association between clinicodemographic factors and tissue biopsy results.@*Methods@#Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: 251 patients with thyroid nodules.@*Results@#Of 251 patients with thyroid nodules, the majority (218; 86.9%) were females while 33 (13.1%) were males. The average age in years was 41.5±13.3 The same population also had malignant outcomes at 79.3%. Most of the patients did not have family history of thyroid malignancy (54%) and had no palpable cervical lymph nodes at presentation (75.9%). Furthermore, there was no distant metastasis at presentation for both lungs (97.7%) and bones (98.9%). There were no significant differences in tissue biopsy results when correlated with age (df=249; t=-.144; p = .886), duration of goiter (df=249; t=-.829; p = .408), and distant metastasis at presentation for lungs (Z=-5.977; p = .052) and bones (Z=-.457; p = .648). Significant differences were only evident for clinicodemographic factors such as sex (Z=-2.570; p = .010), family history (Z=-2.239; p = .020), palpable cervical lymph nodes at presentation (Z=-5.977; p = .000), and the following comorbidities: pulmonary tuberculosis (Z=-2.388; p = .017) and bronchial asthma (Z=-2.148; p = .032) and smoking history (Z=-3.455; p=.001). Furthermore, having no palpable cervical lymph nodes at presentation were associated with malignant tissue biopsy results (B=3.616; p=.001). Patients without palpable cervical lymph nodes at presentation were 37.204 times [OR=37.204] more likely to have benign biopsy results [95% CI: 4.705 – 294.168].@*Conclusion@#There are greater odds of having benign biopsy results for patients without palpable cervical lymph nodes at presentation.

Nursing of patients undergoing skin tissue biopsy on head and face / 现代临床护理

Objective To summarize the experience in nursing patients undergoing skin biopsy on head and face . Method One hundred and twenty patients with head facial dermatosis undergoing skin tissue biopsy were nursed from August 2012 to October 2013. Result All operation for biopsy were completed smoothly, with the cure rate at the first phase 100.0%, healing time 5~7 days, averaged (7.0 ± 3.0)d and no complications. Conclusion For those patients having undergone facial skin tissue biopsy, the nursing measures like psychological nursing, health education before operation, preoperative relief of mental disorder, postoperative wound nursing and health education, prevention of complications are critical for their recovery.

Diagnostic effect and influential factors of intro-operative tissue puncture biopsy for mass in pancreatic head / 中华肝胆外科杂志

Objective To evaluate the diagnostic effect of intro-operative tissue puncture biopsy and find its influential factors.Methods The clinical data of 94 patients with pancreatic mass treated in our hospital from July 1994 to December 2007 and undergoing intro-operative tissue puncture biopsy were retrospectively analyzed.Results The sensitivity,the specificity,the positive predictive value and the negative predictive value were 74.6%,93.8%,98.0%and 46.9%,respectively.The single factor analysis showed that the size of pancreatic mass,the number of puncture and complicating with pancreatic fibrosis or not were related to the diagnosis of tissue puncture.The multiple factor analysis showed that the size of pancreatic mass(P=0.014)and the number of puncture(P=0.020)were crucial to the diagnosis of puncture.The sensitivity and specificity of intro-operative tissue puncture biopsy for the pancreatic mass less than 25 mm were lower than that for the mass larger than 25 mm (P=0.000).The sensitivity and specificity would be increased as the number of puncture increased (P=0.000).For the mass less than 25 mm,increasing the humber of puncture would improve the sensitivity(P=0.002).Conclusion Intro-operative tissue puncture biopsy is a simple and accurate procedure for differentiating the pancreatic mass.The sensitivity and specificity could be improved by increasing the number of puncture,especially for the patients with pancreatic mass less than 25 mm.

Diabetic Foot Infection: Microbiologic Analysis Based on Deep Tissue Biopsy

BACKGROUND: The annual prevalence of foot ulcer in Korea is 99.5 per 100,000 people with diabetes and 49.8 cases among them go through amputation. Moreover, amputation due to uncontrolled infection accounts for 50% of all non-traumatic limb amputations. Therefore, reliable microbiological documentation is important. MATERIALS AND METHODS: We enrolled 74 patients with diabetic foot infection, who referred to Korea University Hospital from September 2006 to March 2007. Deep tissue biopsies were taken from the base of ulcer after surgical debridement and cleansing at admission. We analyzed the microbiological differences according to the sex, age, type and duration of diabetes, glycemic control, presence of neuropathy or angiopathy, diabetic nephropathy, osteomyelitis, transcutaneous oxygen tension and prior antibiotic use. RESULTS: Gram-positive aerobic bacteria were the most common organisms isolated (76.4%), followed by Gram-negative aerobic bacteria (33.3%) and fungus (2.0%). Of the Gram-positive aerobes, methicillin-resistant Staphylococcus aureus (MRSA) was found most frequently (29.4%). The clinical and laboratory findings showed no significant clinical differences between gram-positive and gram-negative infections. Moreover, there was no difference in clinical findings between methicillin-susceptible and methicillin-resistant S. aureus infections. Mixed infection was not common (average, 1.2 organisms with each diabetic foot infection). Of note, mixed infection was more frequently found in patients with prior antibiotic use. CONCLUSION: MRSA was the most common pathogen in diabetic foot infection among patients referred to tertiary hospital. There was no significant difference of clinical and laboratory findings with regard to gram stain results and methicillin resistance in S. aureus. Mixed infection was not common, but broad spectrum antibiotics are recommended for severe diabetic foot infection with prior antibiotic exposure.

Diabetic Foot Infection: Microbiologic Analysis Based on Deep Tissue Biopsy

BACKGROUND: The annual prevalence of foot ulcer in Korea is 99.5 per 100,000 people with diabetes and 49.8 cases among them go through amputation. Moreover, amputation due to uncontrolled infection accounts for 50% of all non-traumatic limb amputations. Therefore, reliable microbiological documentation is important. MATERIALS AND METHODS: We enrolled 74 patients with diabetic foot infection, who referred to Korea University Hospital from September 2006 to March 2007. Deep tissue biopsies were taken from the base of ulcer after surgical debridement and cleansing at admission. We analyzed the microbiological differences according to the sex, age, type and duration of diabetes, glycemic control, presence of neuropathy or angiopathy, diabetic nephropathy, osteomyelitis, transcutaneous oxygen tension and prior antibiotic use. RESULTS: Gram-positive aerobic bacteria were the most common organisms isolated (76.4%), followed by Gram-negative aerobic bacteria (33.3%) and fungus (2.0%). Of the Gram-positive aerobes, methicillin-resistant Staphylococcus aureus (MRSA) was found most frequently (29.4%). The clinical and laboratory findings showed no significant clinical differences between gram-positive and gram-negative infections. Moreover, there was no difference in clinical findings between methicillin-susceptible and methicillin-resistant S. aureus infections. Mixed infection was not common (average, 1.2 organisms with each diabetic foot infection). Of note, mixed infection was more frequently found in patients with prior antibiotic use. CONCLUSION: MRSA was the most common pathogen in diabetic foot infection among patients referred to tertiary hospital. There was no significant difference of clinical and laboratory findings with regard to gram stain results and methicillin resistance in S. aureus. Mixed infection was not common, but broad spectrum antibiotics are recommended for severe diabetic foot infection with prior antibiotic exposure.