Intoxicated ED Patients: A 5-Year Follow-Up of Morbidity and Mortality

Objective: Cryptococcal meningitis is an important cause of morbidity and mortality in HIV infected individuals. In the era of universal antiretroviral therapy incidence of immune reconstitution inflammatory syndrome (IRIS) related cryptococcal meningitis has increased. Detection of serum cryptococcal antigen in asymptomatic PLHIV (People Living With HIV) and pre-emptive treatment with fluconazole can decrease the burden of cryptococcal disease. We conducted this study to find the prevalence of asymptomatic cryptococcal antigenemia in India and its correlation with mortality in PLHIV. Method and material: This was a prospective observational study. HIV infected ART naïve patients with age of ≥ 18 years who had CD4 counts ≤ 100 /µL were included and serum cryptococcal antigen test was done. These patients were followed for six months to look for the development of Cryptococcal meningitis and mortality. Results: A total of 116 patients were analysed. Asymptomatic cryptococcal antigenemia was detected in 5.17% patients and it correlated with increased risk of cryptococcal meningitis and mortality on follow-up in PLHIV. Conclusion: Serum cryptococcal positivity is correlated with increased risk of Cryptococcal meningitis and mortality in PLHIV. We recommend the screening of asymptomatic PLHIV with CD4 ≤ 100/µL for serum cryptococcal antigen, so that pre-emptive treatment can be initiated to reduce morbidity and mortality.

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Soluble CD40 Ligand Is Predictive of Cardiovascular Morbidity and Mortality at Two-Year Follow-Up in Patients on Haemodialysis From North-Western Tuscany

High Blood Pressure & Cardiovascular Prevention ◽

10.2165/00151642-200714030-00119 ◽

2007 ◽

Vol 14 (3) ◽

pp. 145-196

Author(s):

G B Desideri ◽

L Ghiadoni ◽

F Cipollone ◽

A Mezzetti ◽

G Passacquale ◽

...

Keyword(s):

Cd40 Ligand ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Soluble Cd40 Ligand ◽

Cardiovascular Morbidity And Mortality ◽

North Western

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Participants' Opinion about Conduct of Morbidity and Mortality Conferences in Surgical Practice in a Tertiary Hospital, Ethiopia

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i3.6 ◽

2020 ◽

Vol 30 (3) ◽

Author(s):

Berhanetsehay Teklewold ◽

Tilahun Deresse ◽

Goytom Kinfe ◽

Henok Teshome

Keyword(s):

Patient Safety ◽

Multidisciplinary Team ◽

Addis Ababa ◽

Univariate Analysis ◽

Tertiary Hospital ◽

Morbidity And Mortality ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Morbidity And Mortality Conferences

BACKGROUND: Morbidity and mortality conference has both educational and quality improvement purposes. However clear evidences for the effectiveness of the morbidity and mortality conferences in improving patient safety is lacking.METHODS: A facility based cross sectional study was conducted at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, to assess participants’ opinion on benefits and functioning of morbidity and mortality conferences. Univariate analysis was used to determine the influence of professional type on participants’ opinion about the morbidity and mortality conferences.RESULT: A total of 98 participants completed the survey. The majority of the participants agreed that there was a structured system of case identification (67.3%), meeting format (72.4%), the conferences were conducted every month (79.6%), it is blame free (71.4%) and system of care was focus of discussion (70%). Most (88.8%) participants agreed that the conferences were important for improvement of patient safety and quality of care, whereas 67.3% of the participants believed that there is no written term of reference and prior dissemination of agendas. Only 40% agreed that there is multidisciplinary team involvement. Fifty one percent of them disagreed that there is a follow up on the implementation of the forwarded recommendations.CONCLUSION: Even though the majority of the participants were satisfied with the mortality and morbidity conferences, most disagreed on the presence of written term of reference, earlier dissemination of agendas, multidisciplinary team involvement and follow up on the implementation of the forwarded recommendations.

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Patterns of coronary heart disease morbidity and mortality in the sexes: A 26-year follow-up of the Framingham population

American Heart Journal ◽

10.1016/0002-8703(86)90155-9 ◽

1986 ◽

Vol 111 (2) ◽

pp. 383-390 ◽

Cited By ~ 1084

Author(s):

Debra J Lerner ◽

William B Kannel

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Morbidity And Mortality

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Infection Versus Hematoma Following Surgical Treatment of Proximal Femoral Fractures in Geriatric Patients

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151458517750515 ◽

2018 ◽

Vol 9 ◽

pp. 215145851775051 ◽

Cited By ~ 2

Author(s):

Franz Müller ◽

Michael Galler ◽

Christina Roll ◽

Bernd Füchtmeier

Keyword(s):

Staphylococcus Aureus ◽

Surgical Treatment ◽

Geriatric Patients ◽

Femoral Fractures ◽

Morbidity And Mortality ◽

Control Group ◽

Postoperative Phase ◽

High Morbidity ◽

Proximal Femoral Fractures

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.

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Tumors of the Lateral and Third Ventricles: Follow-up Postoperative Morbidity and Mortality

Cerebellar Infarct. Midline Tumors. Minimally Invasive Endoscopic Neurosurgery (MIEN) - Advances in Neurosurgery ◽

10.1007/978-3-642-78801-7_9 ◽

1994 ◽

pp. 45-50

Author(s):

W. E. K. Braunsdorf ◽

H. M. Mehdorn ◽

G. Fritsch

Keyword(s):

Postoperative Morbidity ◽

Morbidity And Mortality

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846 Pulmonary Arterial Hypertension as a Sequela of Untreated Obstructive Sleep Apnea in a Patient with Prader-Willi Syndrome

SLEEP ◽

10.1093/sleep/zsab072.843 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A329-A329

Author(s):

Hina Emanuel ◽

Kevin Kaplan

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Systolic Dysfunction ◽

Morbidity And Mortality ◽

Prader Willi Syndrome ◽

Obstructive Sleep ◽

Pulmonary Arterial

Abstract Introduction Prader-Willi Syndrome (PWS) is a complex neurogenetic disorder characterized by hypotonia, behavioral problems, endocrinopathies, sleep and respiratory abnormalities. Morbidity and mortality in the PWS population is attributable to obesity, cardiovascular problems, and sleep apnea. We report a patient with PWS presenting with pulmonary arterial hypertension (PAH) due to untreated obstructive sleep apnea (OSA). Report of case(s) Our patient is a 17-year-old female with a past medical history of PWS, scoliosis, obesity (BMI 52.46), hypogonadotropic hypogonadism, and type II diabetes. Baseline echocardiogram (ECHO) performed at age 9 revealed an estimated right ventricular systolic pressure (eRVSP) of 32mmHg above right atrial pressure (RAP), tricuspid regurgitation (TR) at 2.8 m/sec with no interventricular septal flattening (IVSF) and right ventricle (RV) systolic dysfunction suggestive of mild PAH. Given significant scoliosis the patient did not qualify for growth hormone therapy. She underwent a polysomnogram (PSG) at age 14 showing severe obstructive sleep apnea; apnea-hypopnea index (AHI) of 22.6 (oAHI 22.6). Patient was subsequently lost to follow up until presenting in acute respiratory failure at age 17. She required endotracheal intubation and was extubated to bilevel PAP (BPAP) with inability to wean off BPAP. At that time an ECHO revealed eRVSP of 55 mmHg above RAP, IVSF, TR at 3.7 m/sec, and RV systolic dysfunction suggestive of moderate to severe PAH and developing right sided heart failure. A PAP titration PSG during this admission revealed hypoxemia with oxygen saturation less than 90% (O2 nadir 70%) 12.6% of total sleep time (TST) and hypoventilation (transcutaneous CO2 max of 57 mmHg with an elevation above 50 mmHg for 100% of TST). Using an inspiratory PAP (IPAP) of 24 cmH2O and expiratory PAP (EPAP) of 14 cmH20 with supplemental O2 of 4LPM the respiratory events and hypoxemia resolved but there was persistence of hypoventilation. Tadalafil was initiated for PAH and BPAP therapy for OSA. Follow up visits 4- and 8-weeks post discharge shows improving PAH (TR 3.6 m/sec, eRSVP 52 mmHg, and mild IVSF) due to BPAP and tadalafil therapies. Conclusion This case highlights the importance of treating OSA in patients with PWS to prevent cardiorespiratory complications and reduce morbidity and mortality. Support (if any) None

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En Bloc Resection of the Duodenum for Locally Advanced Right Colon Adenocarcinoma

The American Surgeon ◽

10.1177/000313480707301031 ◽

2007 ◽

Vol 73 (10) ◽

pp. 1063-1066 ◽

Cited By ~ 3

Author(s):

Ahmad N. Hakimi ◽

David K. Rosing ◽

Bruce E. Stabile ◽

Beverley A. Petrie

Keyword(s):

Colon Cancer ◽

Locally Advanced ◽

En Bloc Resection ◽

Bloc Resection ◽

Morbidity And Mortality ◽

Right Colon ◽

En Bloc ◽

Adjacent Structures ◽

Duodenal Invasion

Direct invasion of colorectal adenocarcinoma into adjacent structures occurs frequently, but only rarely is the duodenum involved. This study was undertaken to assess the safety and efficacy of en bloc resection of locally advanced right colon carcinoma invading the duodenum. A retrospective review of 49 patients with locally advanced colon cancer, surgically managed between 2000 and 2005, was performed. Forty-six patients underwent en bloc resection of colon and adjacent organs not involving the duodenum. Three patients with duodenal invasion underwent en bloc partial duodenectomy. The mean operative blood loss, length of stay, postoperative morbidity, and mortality compare favorably between these two groups of patients. Of the 46 patients with en bloc resection of other organs, 27 are alive at 12 to 60 months follow up. Two patients with duodenal invasion are alive without recurrence at 15 and 20 months follow up. En bloc resection of colon cancer invading the duodenum can be performed safely because morbidity and mortality rates are comparable to those attending extended resections of other locally advanced colon carcinomas. Overall survival in patients who underwent surgery with curative intent justifies en bloc duodenal resection in selected patients.

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