Postpartum depression and its risk factors in women with a potentially life‐threatening complication

2020 ◽  
Author(s):  
Deepthi Nayak ◽  
Dhamotharan Karuppusamy ◽  
Dilip Kumar Maurya ◽  
Sitanshu Sekhar Kar ◽  
Balaji Bharadwaj ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postpartum Depression ◽  
Life Threatening ◽  
Life Threatening Complication

scholarly journals Risk factors for mortality of diffuse alveolar hemorrhage in systemic lupus erythematosus: a systematic review and meta-analysis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Mengdi Jiang ◽  
Ruxuan Chen ◽  
Lidan Zhao ◽  
Xuan Zhang
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Meta Analysis ◽  
Diffuse Alveolar Hemorrhage ◽  
Concurrent Infection ◽  
Systemic Lupus ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractBackgroundDiffuse alveolar hemorrhage (DAH) is a rare but life-threatening complication of systemic lupus erythematosus (SLE). The current knowledge of the prognostic factors for SLE-associated DAH is controversial. This meta-analysis was undertaken to investigate the relevant risk factors for mortality in SLE-associated DAH.MethodsStudies were searched from PubMed, EMBASE, and Web of Science databases published up to May 27, 2020, and were selected or removed according to the inclusion and exclusion criteria. Two reviewers extracted data independently from the enrolled studies, and the odds ratios (OR) or the standardized mean difference (SMD) was utilized to identify and describe the prognostic factors for mortality.ResultsEight studies encompassing 251 patients with SLE-associated DAH were included in the meta-analysis. No significant publication bias was shown. Age at the diagnosis of DAH (SMD = 0.35, 95% confidence interval (CI) (0.08, 0.61),P = 0.01,I2 = 0.0%) was found to be an independent risk factor of mortality. Longer lupus disease duration (SMD = 0.28, 95% CI (0.01, 0.55),P = 0.042,I2 = 0.0%), concurrent infection (OR = 2.77, 95% CI (1.55, 4.95),P = 0.001,I2 = 37.5%), plasmapheresis treatment (OR = 1.96, 95% CI (1.04, 3.70),P = 0.038,I2 = 14.6%), and mechanical ventilation (OR = 6.11, 95% CI (3.27, 11.39),P < 0.0001,I2 = 23.3%) were also related to poor survival, whereas no noticeable relationships were revealed between survival and concurrent lupus nephritis (OR = 5.45, 95% CI (0.52, 56.95),P = 0.16,I2 = 58.4%) or treatment of cyclophosphamide (CTX) (OR = 0.74, 95% CI (0.16, 3.41),P = 0.70,I2 = 75.5%).ConclusionsOlder age at the diagnosis of DAH, longer disease duration of SLE, concurrent infection, plasmapheresis treatment, and mechanical ventilation were found related to increased mortality in patients with SLE-associated DAH according to our meta-analysis. However, due to limited studies with heterogeneity, these results should be interpreted cautiously. Notably, severe diseases rendered the requirement of plasmapheresis treatment and mechanical ventilation are themselves associated with poor outcome. Randomized trials of therapeutics are needed to determine the most efficacious strategies for SLE-associated DAH for better management of this life-threatening complication.

scholarly journals Risk factors of preoperative Hirschsprung-associated enterocolitis

2019 ◽  
Vol 13 (S11) ◽  
Author(s):  
Dicky Yulianda ◽  
Andy Indra Sati ◽  
Akhmad Makhmudi ◽  
Gunadi
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Maternal Education ◽  
Neonatal Period ◽  
Hirschsprung Disease ◽  
Albumin Level ◽  
Distended Abdomen ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Early Late

Abstract Background Hirschsprung-associated enterocolitis (HAEC) is a life-threatening complication of Hirschsprung disease (HSCR), that might occur preoperatively. We investigated the risk factors of preoperative HAEC. Method We retrospectively reviewed all medical records of HSCR patients admitted at Dr. Sardjito Hospital, Indonesia from March 2012 until March 2015. Diagnosis of HAEC was determined using the Delphi scoring system. Results Sixty-one HSCR patients were involved in this study, of whom 48 were males and 13 females. Eighteen percent (11/61) patients had a preoperative HAEC. The most common findings of the HAEC score found in our patients were distended abdomen (100%) and dilated loops of bowel (100%), followed by lethargy (72.7%), cut-off sign in rectosigmoid with absence of distal air (72.7%), leukocytosis (72.7%), and shift to left (63.6%). There was no association between gender, age of HSCR diagnosis, early/late diagnosis during neonatal period, aganglionosis type, albumin level nor body mass index with preoperative HAEC (p = 0.69, 0.76, 0.33, 1.0, 0.86, and 0.50, respectively). In addition, the maternal age, gestational age, and maternal education level also did not correlate with the development of preoperative HAEC (p = 0.71, 0.59, and 0.32, respectively). Conclusion The incidence of preoperative HAEC in our hospital is considered relatively moderate, with the most common findings of distended abdomen and dilated loops of bowel. None of the identified risk factors have an association with the development of HAEC in our patients.

scholarly journals Bleeding after Hysterectomy: Recommendations and What to Expect

2022 ◽  
Author(s):  
Eugen Ancuța ◽  
Radu Zamfir ◽  
Gabriel Martinescu ◽  
Eduard Crauciuc ◽  
Dumitru Sofroni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incidence Rate ◽  
Surgical Management ◽  
Postoperative Hemorrhage ◽  
Gynecological Surgery ◽  
Knowledge And Skills ◽  
Treatment Practice ◽  
Life Threatening ◽  
Management Techniques ◽  
Life Threatening Complication

Bleeding after gynecological surgery remains an infrequent life-threatening complication, demanding appropriate medical and surgical management. Classified as early/“reactionary” and delayed/secondary, unexpected postoperative hemorrhage may arise regardless of the route or subtype of hysterectomy. Timely recognition and prompt intervention to arrest bleeding are essential strategies for the suitable outcome of the patient. The present chapter presents an overview on different aspects of bleeding after hysterectomy such as incidence rate, risk factors, mechanisms, and management techniques aiming to expand knowledge and skills in recognizing and treating this unpredicted potentially serious problem. Furthermore, we intend to offer a guide toward standardizing treatment practice across bleeding issues following hysterectomy considering clear recommendations and algorithms.

scholarly journals Manejo nutricional em pacientes com risco de síndrome de realimentação

2020 ◽  
Vol 34 (4) ◽  
pp. 414-417
Author(s):  
Matheus Horta Sad ◽  
Bruna Fernanda Camargo Silva Parra ◽  
Ricardo Ferrer ◽  
Antônio Valério da Silva Júnior ◽  
Flávia Julie do Amaral Pfeilsticker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Nutrition Therapy ◽  
Refeeding Syndrome ◽  
Magnesium Supplementation ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
History Of ◽  
Low Body Mass Index ◽  
Life Threatening Complication

Refeeding syndrome (RS) is a life-threatening complication that occurs after prolonged starvation in malnourished patients or after severe catabolic events. It usually happens in the first 72 hours after the beginning of either enteral or parenteral nutrition and can affect one third of the patients. The most important risk factors are low body mass index (BMI), unintentional weight loss, none or low caloric supply for at least 5 days, history of alcohol or drug abuse and baseline electrolyte disturbances. Thiamine and electrolyte (phosphate, potassium and magnesium) supplementation is mandatory. The initiation and progression of nutrition therapy must be gradual with low amount of calories in the first days, with daily electrolyte monitoring. In the case of low electrolyte levels, especially hypophosphatemia, diet infusion should be reduced and slowly increased over 48 hours. RS deserves special attention the nutrition team to be prevented, identified and treated early.

scholarly journals Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

2018 ◽  
Vol 06 (03) ◽  
pp. E271-E273 ◽  
Author(s):  
Vijeta Pamudurthy ◽  
Raju Abraham ◽  
Thomas Betlej ◽  
Ashish Shah ◽  
Dong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Severe Pain ◽  
Splenic Injury ◽  
Interventional Procedure ◽  
Endoscopic Retrograde ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
High Index Of Suspicion

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP. The exact causes of splenic injury are unknown, although several mechanisms are postulated. A literature review of splenic injuries post-ERCP shows that there are only 3 cases with post-ERCP splenic decapsulation. Our patient is the first one in whom splenic decapsulation occurred without any risk factors or technical difficulties during the procedure. A high index of suspicion for splenic injury is required in any patient who has severe pain, anemia, or hemorrhagic shock after ERCP.

scholarly journals Methadone, Metoclopramide and Metronidazole Interaction Causing Torsades de Pointes

2021 ◽  
Vol 11 (1) ◽  
pp. 101-105 ◽  
Author(s):  
Karthik Gnanapandithan ◽  
Nishrutha Karthik ◽  
Jaime Gerber
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Torsades De Pointes ◽  
Qtc Interval ◽  
Hospital Personnel ◽  
Qtc Prolongation ◽  
Continuous Reinforcement ◽  
Iatrogenic Complication ◽  
Life Threatening ◽  
Life Threatening Complication

There are several classes of medications that can cause prolongation of the corrected QT (QTc) interval and potentially Torsades de Pointes (TdP). Most of these medications are commonly used in the emergency department, and interaction between these medications increases the risk of this iatrogenic complication. We describe a patient on methadone therapy who developed TdP after she received metoclopramide and metronidazole. Interaction between different classes of medications can increase the risk of QTc prolongation and TdP. Awareness of this condition and its risk factors need continuous reinforcement among all hospital personnel to reduce the risk of this life-threatening complication.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

Behavioral Emergencies and Crises

2010 ◽  
pp. 739-762
Author(s):  
Phillip M. Kleespies ◽  
Justin M. Hill
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
High Risk ◽  
Work Environment ◽  
Emotional Impact ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Behavioral Emergencies ◽  
And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

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