scholarly journals Acute Management, Diagnosis, and Follow-Up of Suspected Perioperative Hypersensitivity Reactions in Flanders 2001-2018

2019 ◽  
Vol 7 (7) ◽  
pp. 2194-2204.e7 ◽  
Author(s):  
Didier G. Ebo ◽  
Athina L. Van Gasse ◽  
Ine I. Decuyper ◽  
Astrid Uyttebroek ◽  
Luc A. Sermeus ◽  
...  
Keyword(s):  
Hypersensitivity Reactions ◽  
Acute Management ◽  
Management Diagnosis

Device clinic and follow-up

2018 ◽  
pp. 341-352
Author(s):  
Nicola Meldrum ◽  
Andrew Mitchell
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Implantable Cardioverter Defibrillator ◽  
Cardiac Resynchronization ◽  
History Taking ◽  
Resynchronization Therapy ◽  
Cardioverter Defibrillator ◽  
Additional Information ◽  
Advantages And Disadvantages ◽  
Management Diagnosis

This chapter describes the device clinic. Requirements for a suitable facility, including maintaining patient dignity, are covered, and the development of remote follow-up is defined, including advantages and disadvantages. The follow-up schedule is covered, and history taking and examination are covered. Pacemaker testing and interrogation are shown, to aid the physician in management, diagnosis, and optimization of programming. Implantable cardioverter defibrillator (ICD) follow-up is also described, with all additional information required for follow-up described. Finally, cardiac resynchronization therapy (CRT) follow-up differences from standard pacemaker checks are covered.

scholarly journals Comparative Study of Internal Fixation of the Ulna and Distal Ulna Resection in Patients Older Than 70 Years With Distal Radius and Distal Metaphyseal Ulna Fractures

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 540-546
Author(s):  
Jorge G. Boretto ◽  
Ezequiel E. Zaidenberg ◽  
Gerardo L. Gallucci ◽  
Alejandro Sarme ◽  
Pablo De Carli
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
The Elderly ◽  
Acute Management ◽  
Distal Ulna ◽  
Radiographic Appearance ◽  
Patient Demographics ◽  
Ulna Fractures

Background: Acute management of fractures of the distal ulna that are associated with fractures of the distal radius remains difficult, particularly in the elderly. Methods: In this study, we investigated whether internal fixation of the distal ulna is associated with a higher rate of complications than resection of the distal ulna in patients older than 70 years. Twenty-four consecutive patients were included in this study, 12 of whom had undergone open reduction and internal fixation (ORIF) of the distal ulna, and 12 who had undergone distal ulna resection. Patients were retrospectively assessed for range of motion, grip strength, pain, and radiographic appearance. The functional outcome was evaluated by the Mayo Wrist Score. Complications were classified according to the Classification of Surgical Complications. Results: There were no differences in patient demographics between the 2 groups, except patient age. Clinical evaluation showed no difference at follow-up; however, there were significantly more complications associated with ORIF compared with resection. Conclusions: The results from our study show that women older than 70 years with fracture of the distal radius and distal ulna have a higher rate of complications if ORIF of the distal ulna is performed. Patients should be warned, by surgeons, of this in cases where ORIF of the distal ulna is suggested.

Acute Management of Traumatic Hemi-Section of the Female Pelvis with One-Year Follow-up

2010 ◽  
Vol 76 (8) ◽  
pp. 116-117
Author(s):  
C. Sage Claydon ◽  
Paul J. Schenarts ◽  
Scott G. Sagraves
Keyword(s):  
Acute Management ◽  
Female Pelvis ◽  
One Year

scholarly journals Acute Management of Deep Facial Burns

Folia Medica ◽  
2021 ◽  
Vol 63 (6) ◽  
pp. 847-857
Author(s):  
Katia I. Kalinova ◽  
Ralitsa D. Raycheva ◽  
Neli Petrova ◽  
Petar A. Uchikov
Keyword(s):  
Surgical Approach ◽  
Demographic Data ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Acute Management ◽  
Late Sequelae ◽  
Medical Chart Review ◽  
Facial Burns ◽  
Total Body

Introduction: Management of deep facial burns is a serious challenge for many reasons: a considerable anatomic and functional diversity is concentrated in a small space, a uniform treatment does not exist, late sequelae are frequent and may be severe, and the literature on the subject is ambiguous. Aim: To analyse management of deep facial burns. Patients and methods: A retrospective medical chart review was conducted for 569 patients with deep facial burns hospitalized between January 2005 and January 2015. Demographic data, type, depth and size of burns, chronology and type of surgical treatment, length of hospital stay, and type and incidence of late sequelae were analysed and compared. Results: Over 10 years, 596 patients with deep facial burns, 216 (36.24%) females and 380 (63.76%) males, aged from 5 months to 95 years (mean 39.5±26 years) were treated. The most common burn agents were hot liquids and flames. The mean total body surface area (TBSA) burned was 17±13.3%. Concomitant eye injury was detected in 63 (10.6%) patients. Priority was given to the early, meticulous, staged surgical approach aimed at sparing the survived tissues and rapid wound closure. Follow-up ranged from 3 months to 5 years. Late functional sequelae were documented for 50 (8.38%) patients and ocular sequelae - for 33 (5.54%) of them. There was no incidence of secondary corneal perforation or definitive loss of vision. Conclusions: Adequate and up-to-date acute management of deep facial burns based on early, judicious, surgical approach could limit initial damage and reduce late sequelae.

Success rate and myeloid toxicity of carboplatin desensitization protocol in low grade glioma patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20012-20012
Author(s):  
S. Berrak ◽  
D. B. Beker ◽  
C. Canpolat ◽  
F. B. Cakir
Keyword(s):  
Febrile Neutropenia ◽  
Success Rate ◽  
Gradual Increase ◽  
Median Number ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Hypersensitivity Reactions ◽  
Glial Tumors ◽  
Desensitization Protocol

20012 The effectiveness of carboplatin and vincristine chemotherapy in the treatment of low grade glial tumors is well established. This study was retrospectively designed to investigate the success rate and myeloid toxicity of carboplatin desensitization in a group of patients with carboplatin allergy. A total of 45 patients followed between October 1998-January 2007 with low grade glial tumors were included into study. Patients with severe hypersensitivity reactions (including anaphylaxis) were given 6-step desensitization protocol with gradual increase in concentration of carboplatin over 6 hours. Weekly absolute neutrophil count (ANC) and number of febrile neutropenia episodes of each patient during treatment period were collected from patient files. Among 45 patients, eight were switched to desensitization protocol. They had received a median of 6 courses (range 1–29) of carboplatin before developing their first allergic reaction. A median number of 15 courses of desensitizations (range 3–40) were given to these patients. Desensitization was successful in 6 patients. Age, gender, diagnosis were found to be similar in patients with and without carboplatin allergy. Regarding myeloid toxicity, mean percentage of follow-up weeks with ANC values below 1,500/mm3 in patients with and without desensitization were 0.42±0.04 and 0.21±0.02, respectively (p=0.009). Mean percentage of weeks with ANC values below 500/mm3 were not significant between two groups (p=0.28). However, desensitization protocol was not found to have an impact on number and presence of febrile neutropenia episodes. In conclusion, desensitization protocol might be an alternative to complete scheduled treatment in low grade glioma patients with hypersensitivity to carboplatin. Although, the percentage of low ANC weeks seemed to be statistically higher, insignificance of febrile neutopenia episodes in our patients demonstrated safety of desensitization protocol in terms of myeloid toxicity. No significant financial relationships to disclose.

scholarly journals P14 Acute management of traumatic anterior shoulder dislocations during COVID-19: are we meeting published national standards for treatment during the pandemic?

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Richard L Donovan ◽  
Amir Abdelmalek ◽  
Mark A A Crowther ◽  
Iain Packham ◽  
Richard Donovan
Keyword(s):  
Conscious Sedation ◽  
Care Pathway ◽  
Case Note ◽  
National Standards ◽  
Care Pathways ◽  
Acute Management ◽  
National Guidelines ◽  
Retrospective Case ◽  
Face To Face

Abstract Background BESS/BOA Patient Care Pathways provide national guidelines for acute management of traumatic anterior shoulder dislocations with respect to emergency reduction and clinic follow-up. COVID-19 posed challenges in terms of analgesia choice for reductions and altered follow-up arrangements. This study aimed to assess variance from the care pathway. Methodology We performed a retrospective case note analysis of all emergency presentations with acute traumatic anterior shoulder dislocations at the MTC in Bristol. We compared 01 Apr to 31 May in 2019 to the same period in 2020 to analyse the effects of the COVID-19 pandemic on the management of these injuries. Data parameters collated included examinations and imaging pre- and post-reduction, choice of analgesia, follow-up rates, referral to physiotherapy, and further imaging requested. Results We identified 32 patients in 2019, and 24 in 2020. Use of Entonox fell during the pandemic in favour of Penthrox. Use of conscious sedation (requiring full PPE) remained around 20%. Pre- and post-reduction orthogonal radiographs was near 100% in both cohorts. Referral to follow-up was 88% in 2019 but fell to 38% in 2020. Of those assessed in clinic during COVID-19, fewer were mobilised early or referred to outpatient physiotherapy compared to the previous year. Conclusions The acute management of anterior shoulder dislocations during the early COVID-19 pandemic faced two main challenges: choice of suitable analgesia whilst minimising AGPs; and limiting access to ’face-to-face’ follow-up to minimise hospital attendances. A key concern was a significant decrease in patient follow-up, thus limiting the access to optimal aftercare such as physiotherapy and further imaging.

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