Recurrent giant fibrovascualr oesophageal polyp: Benefits and pitfalls of a multimodal approach.
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ABSTRACT:
SUBMITTER: Quijano Y
PROVIDER: S-EPMC8163960 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Introduction Fibrovascular polyps (FVPs) are rare benign tumors originating in the cervical esophagus, and, rarely, in the hypopharynx. A case of FVP from the larynx has not yet been described in the literature. Objectives To discuss a unique case of FVP originating in the larynx. Resumed Report A 58-year-old woman presented with a 6-month history of progressive dysphagia. Endoscopic exams identified an elongated polypoid lesion originating from the mucosa of the epiglottis and the right pharyngoepiglottic fold. Excision of this mass under direct laryngoscopy revealed an 11.5 × 0.8-cm polypoid lesion, histologically diagnosed as an FVP. Conclusion The location of this FVP is important because, despite being a benign tumor, it carries a potentially lethal risk of upper airway obstruction.
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Project description:Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly that is usually incidentally found in middle-aged patients. Though initially asymptomatic, LAAA can cause some serious complications: atrial tachyarrhythmia, thromboembolism, peripheral compression, and cardiac dysfunction. Multimodal imaging technologies, especially echocardiography and computed tomography (CT) scanning play an important role in the diagnosis of LAAA. Transthoracic echocardiography (TTE) is generally used for preliminary evaluation and diagnosis of the aneurysm. CT scanning can further confirm the diagnosis by demonstrating the spatial structure relationships and eliminating the possibility of other cardiac tumors. The following case study pertains to a 54-year-old patient with recurrent chest tightness and atrial tachycardia. The patient was diagnosed with a giant LAAA by multimodal imaging technology, and the aneurysm was surgically removed under cardiopulmonary bypass. After 4 years of follow-up, the patient reported living a healthy life without chest discomfort, complications, or medication. Multimodal imaging can provide important information for the diagnosis and treatment of left atrial appendage aneurysms, and aneurysm resection can be an effective therapeutic approach with a good long-term prognosis.
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Project description:AimsDespite general awareness that screening for atrial fibrillation (AF) could reduce health hazards, large-scale implementation is lagging behind technological developments. As the successful implementation of a screening programme remains challenging, this study aims to identify facilitating and inhibiting factors from healthcare providers' perspectives.Methods and resultsA mixed-methods approach was used to gather data among practice nurses in primary care in the southern region of the Netherlands to evaluate the implementation of an ongoing single-lead electrocardiogram (ECG)-based AF screening programme. Potential facilitating and inhibiting factors were evaluated using online questionnaires (N = 74/75%) and 14 (of 24) semi-structured in-depth interviews (58.3%). All analyses were performed using SPSS 26.0. In total, 16 682 screenings were performed on an eligible population of 64 000, and 100 new AF cases were detected. Facilitating factors included 'receiving clear instructions' (mean ± SD; 4.12 ± 1.05), 'easy use of the ECG-based device' (4.58 ± 0.68), and 'patient satisfaction' (4.22 ± 0.65). Inhibiting factors were 'time availability' (3.20 ± 1.10), 'insufficient feedback to the practice nurse' (2.15 ± 0.89), 'absence of coordination' (54%), and the 'lack of fitting policy' (32%).ConclusionLarge-scale regional implementation of an AF screening programme in primary care resulted in a low participation of all eligible patients. Based on the perceived barriers by healthcare providers, future AF screening programmes should create preconditions to fit the intervention into daily routines, appointing an overall project lead and a General Practitioner (GP) as a coordinator within every GP practice.
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Project description:Esophageal fibrovascular polyp is rare in esophageal neoplasms and usually very large. Here, we present a case of giant esophageal fibrovascular polyp. The patient had dysphagia and choking sensation at presentation. She underwent positron emission-computed tomography (PET-CT), endoscopy, endoscopic ultrasonography, and fine needle aspiration. She was clinically diagnosed as having an esophageal benign tumor and underwent endoscopic submucosal dissection. The polyp was successfully resected; however, the process was very difficult, and the lesion was too large to pass through the upper esophagus. Finally, we removed the lesion surgically. Fibrovascular polyps are often large, and if endoscopic resection is chosen, it is necessary to consider the difficulties that may be encountered during resection, before initiating treatment.
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