Background Viral infection is the most common cause of salivary gland swelling as mumps which mainly affects the parotid glands. Sialolithiasis is another cause of obstruction of the salivary duct. A tumor is another cause of swelling. Around 70% of salivary gland tumors arise from the parotid glands. Benign lesions represent 57% of these tumors. Three to 5% of all tumors affecting the head and neck are represented in the salivary gland. Ultrasonography is considered a basic diagnostic tool in all salivary gland swellings. Our study is to evaluate the role of ultrasound in the evaluation of salivary glands swellings in comparison with a computed tomography scan. Results A total of 80 patients aged more than 1 year old with swellings affecting the salivary glands were collected from the out-patient clinic during the period from February 2020 to February 2021. All patients underwent ultrasonography and computed tomography examination of the neck. All submandibular gland lesions presented with sialolithiasis (40 cases) (100%), and 20 cases (50%) of parotid gland swellings presented as inflammation without stone (16 cases (40%) of acute inflammation and 4 cases (10%) with recurrent inflammation), while 4 patients only presented as sialolithiasis. Neoplastic lesions were diagnosed in 16 cases of the parotid gland group. Stones less than 3 mm were detected only by computed tomography in 5 patients (12.5%) of the submandibular group. Twenty-eight cases (70%) with stones ranged in size between 3 and 6 mm. Only 11 cases (27.5%) with stones ranged in size more than 6 mm. Of the 16 parotid swellings diagnosed with neoplastic lesions, 14 parotid cases (87%) showed well-defined margins by computed tomography and ultrasonography. Conclusions Sonography is the basic diagnostic tool in salivary glands swellings. Ultrasonography should be the initial imaging modality. Only in special cases, such as stones that could not be detected by ultrasonography or a neoplastic lesion in a deep location, or bone infiltration, computed tomography neck should be performed.
Introduction: The array of unintended effects of targeted oncological treatments is still being elucidated. Cognizance of these effects is important since they allow early identification and intervention. Methods: We report a case of progressive reduction in kidney function following the introduction of the oral second generation Anaplastic Lymphoma Kinase (ALK) Inhibitor: Alectinib for the treatment of metastatic non-small cell carcinoma of the lung (NSCLC). Kidney biopsy findings suggested that the predominant manifestation was acute tubular injury, which resolved with cessation of Alectinib therapy and did not recur with the introduction of the third generation ALK inhibitor Lorlatinib. Conclusions: This case report adds to the Onco-Nephrology literature in relation to the potential nephrotoxic effects of ALK inhibitors.
In the domain of international construction projects, managing supply chains presents distinct challenges due to the intricate task of coordinating multiple stakeholders within diverse cultural, economic, and regulatory contexts. Prior research highlights the significance of incentive mechanisms and collaborative procurement practices, yet the effectiveness of these strategies in augmenting performance for international projects has not been extensively examined. This investigation explores the effects of financial and non-financial incentives on the performance of global construction projects, with a focus on the mediating role of cooperation. Data were gathered from Chinese international contractors and local suppliers and subsequently analyzed using Structural Equation Modeling. The results reveal two separate pathways of influence. Firstly, financial incentives exhibited substantial direct and indirect impacts on project performance; secondly, while non-financial incentives did not directly affect project performance, they significantly impacted cooperation levels, which in turn mediated the relationship between non-financial incentives and project performance. This study provides essential perspectives for managing international construction projects, emphasizing the critical need for the combined application of financial and non-financial incentives to foster cooperation and ultimately achieve superior project outcomes.
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