OBJECTIVES: Hospitalized patients are vulnerable to sleep disturbances because of environmental stresses including noise. While most previous studies on hospital noise and sleep have been performed for medical machines in intensive care units, there is a limited data for patients hospitalized in medical wardrooms. The purpose of present study was to measure noise level of medical wardrooms, identify patient-perceived sources of noise, and to examine the association between noise levels and sleep disturbances in hospitalized patients. METHODS: Noise dosimeters were used to measure noise level in 29 inpatient wardrooms at a university hospital. Sleep pattern and disturbance were assessed in 103 hospitalized patients, using the Pittsburgh Sleep Quality Index (PSQI) and Leeds Sleep Evaluation Questionnaire. RESULTS: The mean equivalent continuous noise level for 24 hours was 63.5 decibel A (dBA), which was far higher than 30 dBA recommended by the World Health Organization for hospital wardrooms. Other patients sharing a room were perceived as the most common source of noise by the patients, which was usually preventable. Of the patients in the study, 86% had bad sleep as assessed by the PSQI. The sleep disturbance was significantly correlated with increasing noise levels in a dose response manner. CONCLUSIONS: Systemic organizational interventions are needed to keep wardrooms private and quiet to reduce sleep disturbance.
Humans ; Inpatients ; Intensive Care Units ; Noise* ; World Health Organization ; Surveys and Questionnaires

Head and neck sarcomas account for about 1% of malignant head and neck tumors, and histiocytic sarcomas (HSs) account for less than 1% of all hematolymphoid neoplasms. These rare hematopoietic neoplasms are the result of a malignant proliferation of cells. They have morphological and immunophenotypic features of mature tissue histiocytes, which play a major role in processing and presenting antigens to T or B lymphocytes. The mesenchymal differentiation of HSs has not been reported. We describe a case of HS with rhabdoid differentiation in a 55-year-old man who presented with a 3×2.5×2 cm mass in the left supraclavicular area. To the best of our knowledge, this is the first report worldwide of a primary HS with rhabdoid differentiation.
B-Lymphocytes ; Head* ; Hematologic Neoplasms ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Middle Aged ; Neck* ; Sarcoma

BACKGROUND AND OBJECTIVES: The incidence of recurrence after surgery of congenital cholesteatoma is increasing due to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. There is no general consensus on the risk factors affecting recurrence. In this study, analyzing clinical characteristics of recurred cases from a tertiary hospital, we investigated risk factors for the recurrence of congenital cholesteatoma after surgery. SUBJECTS AND METHOD: From 1999 to 2016, data were collected from retrospective chart reviews of patients who have undergone surgeries for congenital cholesteatoma at Hospital. We analyzed data about clinical characteristics and recurrence according to the age at diagnosis, location, stage and type of disease, pneumatization of mastoid, ossicular erosion, and surgical techniques. RESULTS: Sixty-eight patients underwent surgery for congenital cholesteatoma. The average age at operation was 4.8 years. Recurrence was detected in 7 cases of the 68 patients, with the recurrence rate of 10.3%. Sex, age, cholesteatoma type, location, stage, mastoid pneumatization, and operation method did not show significant differences between the recurred group and the non-recurred group in the univariated analysis. CONCLUSION: The recurrence rate of congenital cholesteatoma after primary operation was 10.3%. In this study, there was no statistically significant risk factor for postoperative recurrence of congenital cholesteatoma.
Cholesteatoma* ; Consensus ; Diagnosis ; Humans ; Incidence ; Mastoid ; Methods ; Physicians, Primary Care ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Tertiary Care Centers