scholarly journals EP.WE.48Emergency appendicectomy during COVID-19 pandemic – A single UK centre experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Adebimpe Aladeojebi ◽  
Ning Lo ◽  
Sam GD ◽  
Hrishikesh Salgaonkar ◽  
Achilleas Tsiamis ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elective Surgery ◽  
Surgical Site Infections ◽  
Treatment Modalities ◽  
Study Cohort ◽  
Minimal Risk ◽  
Control Cohort ◽  
Presenting Symptoms ◽  
Operations Control ◽  
Novel Coronavirus

Abstract Background In December 2019 following an outbreak of Novel coronavirus infection (COVID-19) in Wuhan, China, it spread rapidly overwhelming the healthcare systems globally. With little knowledge of COVID-19 virus, very few published reports on surgical outcomes; hospitals stopped elective surgery, whilst emergency surgery was offered only after exhausting all conservative treatment modalities. This study presents our experience of outcomes of emergency appendectomies performed during the pandemic. Methods Prospectively we collected data on 132 patients in peak pandemic period from 1st March to 5th June 2020 and data compared with 206 patients operated in similar period in2019. Patient demographics, presenting symptoms, pre-operative events, investigations, surgical management, postoperative outcomes and complications were analysed. Results Demographics and ASA grades of both cohorts were comparable. In study cohort 84.4% and 96.7% in control cohort had laparoscopic appendicectomy. Whilst the study cohort had 13.6% primary open operations, control cohort had 5.3%. Mean length of stay and early post-operative complications (<30 days) were similar in both cohorts apart from surgical site infections (p = 0.02) and one mortality in study cohort. Conclusion In these overwhelming pandemic times, although conservative treatment of acute appendicitis is an option, a proportion of patients will need surgery. Our study shows that with careful planning and strict theatre protocols, emergency appendicectomy can be safely offered with minimal risk of spreading COVID-19 infection. These observations warrant further prospective randomised studies.

scholarly journals External hemorrhoidal disease in child and teenage: Clinical presentations and risk factors

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Turan Yıldız ◽  
Dilek Bingol Aydın ◽  
Zekeriya İlce ◽  
Aysel Yucak ◽  
Erol Karaaslan
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Conservative Treatment ◽  
Pediatric Surgery ◽  
Positive Family History ◽  
Hemorrhoidal Disease ◽  
Treatment Modalities ◽  
Presenting Symptoms ◽  
Skin Tag ◽  
Clinical Presentations

Objective: Hemorrhoidal disease (HD), though mostly seen in adults, has recently emerged as a common problem among children. However, the diagnosis and treatment of HD in children is mostly based on the data obtained in adult studies. In this study, we aimed to evaluate risk factors, diagnostic and treatment modalities in the children diagnosed with external HD. Methods: The study was conducted at Sakarya University Medical School Pediatric Surgery Department between January 2012 and July 2018. We reviewed children who were diagnosed as having HD at Pediatric Surgery clinic. Age, gender, presenting symptoms, physical examination findings, risk factors, and treatment outcomes were evaluated for each patient. Results: The study included 56 patients with a mean age of 140.8±45.2 months. The patients comprised 48 (85.7%) boys and 8 (14.3%) girls. Constipation and a positive family history were the most common risk factor (n=33; 58.9%, n=29; 51.8%, respectively). Conservative treatment was performed in 53 (94.6%) patients. Recurrence was observed in 5 (8.9%) and skin tag was detected in 6 (10.7%) patients. Conclusions: External HD mostly occurs in boys in their second decade of life. Positive family history and constipation were the most common risk factors in our patients. Conservative treatment is sufficient for the management of external HD in children because of its low recurrence rates. doi: https://doi.org/10.12669/pjms.35.3.442 How to cite this:Yildiz T, Aydin DB, Ilce Z, Yucak A, Karaaslan E. External hemorrhoidal disease in child and teenage: Clinical presentations and risk factors. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.442 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Current Understanding of Novel Coronavirus: Molecular Pathogenesis, Diagnosis, and Treatment Approaches

Immuno ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 30-66
Author(s):  
Niraj Kumar Jha ◽  
Madhan Jeyaraman ◽  
Mahesh Rachamalla ◽  
Shreesh Ojha ◽  
Kamal Dua ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Functional Outcomes ◽  
Cellular Therapy ◽  
Treatment Modalities ◽  
Unknown Etiology ◽  
Huge Number ◽  
The World ◽  
To Come ◽  
Novel Coronavirus ◽  
Nano Medicine

An outbreak of “Pneumonia of Unknown Etiology” occurred in Wuhan, China, in late December 2019. Later, the agent factor was identified and coined as SARS-CoV-2, and the disease was named coronavirus disease 2019 (COVID-19). In a shorter period, this newly emergent infection brought the world to a standstill. On 11 March 2020, the WHO declared COVID-19 as a pandemic. Researchers across the globe have joined their hands to investigate SARS-CoV-2 in terms of pathogenicity, transmissibility, and deduce therapeutics to subjugate this infection. The researchers and scholars practicing different arts of medicine are on an extensive quest to come up with safer ways to curb the pathological implications of this viral infection. A huge number of clinical trials are underway from the branch of allopathy and naturopathy. Besides, a paradigm shift on cellular therapy and nano-medicine protocols has to be optimized for better clinical and functional outcomes of COVID-19-affected individuals. This article unveils a comprehensive review of the pathogenesis mode of spread, and various treatment modalities to combat COVID-19 disease.

scholarly journals Trends in orthopaedic antimicrobial prophylaxis in the UK between 2005 and 2011

2013 ◽  
Vol 95 (7) ◽  
pp. 495-502 ◽  
Author(s):  
RS Aujla ◽  
DJ Bryson ◽  
A Gulihar ◽  
GJ Taylor
Keyword(s):  
Orthopaedic Surgery ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Elective Surgery ◽  
Antimicrobial Prophylaxis ◽  
Trauma Surgery ◽  
Surgical Site Infections ◽  
Freedom Of Information ◽  
Infection Rates ◽  
Freedom Of Information Act ◽  
The Uk

Introduction Antimicrobial prophylaxis remains the most powerful tool used to reduce infection rates in orthopaedics but the choice of antibiotic is complex. The aim of this study was to examine trends in antimicrobial prophylaxis in orthopaedic surgery involving the insertion of metalwork between 2005 and 2011. Methods Two questionnaires (one in 2008 and one in 2011) were sent to all National Health Service trusts in the UK using the Freedom of Information Act. Results In total, 87% of trusts that perform orthopaedic surgery responded. The use of cefuroxime more than halved between 2005 and 2011 from 80% to 36% and 78% to 26% in elective surgery and trauma surgery respectively. Combination therapy with flucloxacillin and gentamicin rose from 1% to 32% in elective and 1% to 34% in trauma surgery. Other increasingly popular regimes include teicoplanin and gentamicin (1% to 10% in elective, 1% to 6% in trauma) and co-amoxiclav (3% to 8% in elective, 4% to 14% in trauma). The majority of changes occurred between 2008 and 2010. Over half (56%) of the trusts stated that Clostridium difficile was the main reason for changing regimes. Conclusions In 2008 a systematic review involving 11,343 participants failed to show a difference in surgical site infections when comparing different antimicrobial prophylaxis regimes in orthopaedic surgery. Concerns over C difficile and methicillin resistant Staphylococcus aureus have influenced antimicrobial regimes in both trauma and elective surgery. Teicoplanin would be an appropriate choice for antimicrobial prophylaxis in both trauma and elective units but this is not reflected in its current level of popularity.

scholarly journals 526. Clinical Presenting Characteristics of Pediatric COVID-19 Infection in a Tertiary Care Children’s Hospital in Detroit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S330-S330
Author(s):  
Jocelyn Y Ang ◽  
Nirupama Kannikeswaran ◽  
Basim Asmar
Keyword(s):  
Mechanical Ventilation ◽  
Severe Disease ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Pediatric Emergency ◽  
Study Cohort ◽  
Mild Disease ◽  
Presenting Symptoms ◽  
Patient Disposition

Abstract Background There is limited data regarding the presenting clinical characteristics of COVID-19 in children. Our objective is to describe the clinical presentations and outcomes of COVID-19 infection early in the pandemic at our institution. Methods We performed a retrospective chart review of children up to 18 years who underwent testing for SARS CoV-2 from March 1st to May 10th 2020 at our pediatric emergency department. We abstracted patient’s demographics, clinical presentation, diagnostic studies and patient disposition. We classified the severity of clinical illness based on published criteria. We excluded patients diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. Results SARS CoV-2 testing was performed on 481 patients of whom 43 (8.9%) tested positive. Of these, 4 were diagnosed with MIS-C. Data of 39 patients were analyzed. Patients’ demographics, co-morbidities, presenting signs and symptoms and disposition are shown in Table 1. Age range was 47 days – 18 years. Infants representing one third (14/39; 35.9%) of our study cohort. There was equal sex distribution. Asthma or obesity was present in 17 (44%). The most common presenting symptoms included fever, cough, shortness of breath and diarrhea. Chest radiograph showed pneumonia in 12 (30.8%) patients. Two thirds (27/39; 69.2%) were asymptomatic or had mild disease; six patients (15.4%) had severe or critical illness (Figure 1). Nineteen (48%) patients were admitted to the general pediatric service. Eleven (28%) were admitted to the Intensive Care Units (ICU). The characteristics, presenting symptoms and interventions performed in the PICU cohort are shown in Table 2. Half of these patients required mechanical ventilation. There was one death in a 3 month old infant unrelated to SARS CoV-2. Majority of the infants required hospitalization (12/14; 85.7%), including 4 to the PICU (one each for non accidental trauma, ingestion, seizure and pneumonia). Table 1. Patient demographics, signs and symptoms of COVID-19 infection in Children Table 2: PICU patients: Characteristics, Interventions and pharmacotherapy Figure 1: Severity of Ill ness in the study cohort Conclusion Majority (17; 43%) of our children with COVID-19 had a mild disease. Eleven (28%) including 4 infants required critical care; 5 required mechanical ventilation. There was no COVID-19 related mortality. Larger studies are needed to further define the spectrum of COVID- 19 and risk factors associated with severe disease in children. Disclosures All Authors: No reported disclosures

scholarly journals Preoperative Considerations in Order to Resume Elective Surgery During COVID-19 Pandemic

2020 ◽  
Vol 25 (4) ◽  
pp. 42-43
Author(s):  
Bogdan I. Vintilă ◽  
Alina Simona Bereanu ◽  
Ioana R. Codru ◽  
Mihai Sava
Keyword(s):  
Elective Surgery ◽  
Interdisciplinary Collaboration ◽  
Health Care Facilities ◽  
Surgical Patient ◽  
The Novel ◽  
High Quality Medical Care ◽  
Therapeutic Procedures ◽  
Socio Economic Impact ◽  
Novel Coronavirus ◽  
Quality Medical Care

Abstract The alarming spread of the novel Coronavirus necessitated the cessation of elective therapeutic procedures in most health-care facilities. This strategy has limited the spread of the virus, but with a huge socio-economic impact. For this reason, the resumption of elective surgery in the context of the coronavirus pandemic is a difficult, but necessary process. Addressing this delicate situation requires interdisciplinary collaboration, so as to ensure high quality medical care for all patients, with consideration to protection of the staff involved in the care of the surgical patient.

scholarly journals Perspective: Did Covid-19 Change Non-small Cell Lung Cancer Surgery Approach?

2021 ◽  
Vol 8 ◽  
Author(s):  
Paola Ciriaco ◽  
Angelo Carretta ◽  
Alessandro Bandiera ◽  
Piergiorgio Muriana ◽  
Giampiero Negri
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Elective Surgery ◽  
Lung Cancer Surgery ◽  
Small Cell ◽  
Diagnostic Process ◽  
Small Cell Lung ◽  
Novel Coronavirus ◽  
Nsclc Patients

The novel coronavirus (Covid-19), as of January 2021, infected more than 85 million people worldwide, causing the death of about 1,840 million. Italy had more than 2 million infected and about 75,000 deaths. Many hospitals reduced their ordinary activity by up to 80%, to leave healthcare staff, wards, and intensive care unit (ICU) beds available for the significant number of Covid-19 patients. All this resulted in a prolonged wait for hospitalization of all other patients, including those with non-small cell lung cancer (NSCLC) eligible for surgery. The majority of thoracic surgery departments changed the clinical-therapeutic path of patients, re-adapting procedures based on the needs dictated by the pandemic while not delaying the necessary treatment. The establishment of Covid-19-free hub centers allowed some elective surgery in NSCLC patients but most of the operations were delayed. The technology has partly facilitated patients' visits through telemedicine when security protocols have prevented face-to-face assessments. Multidisciplinary consultations had to deal also with the priority of the NSCLC cases discussed. Interpretation of radiologic exams had to take into account the differential diagnosis with Covid-19 infection. All the knowledge and experience of the past months reveal that the Covid-19 pandemic has not substantially changed the indications and type of surgical treatment in NSCLC. However, the diagnostic process has become more complex, requiring rigorous planning, thus changing the approach with the patients.

Risk factors for incisional surgical site infections in elective surgery for colorectal cancer: focus on intraoperative meticulous wound management

Surgery Today ◽  
2013 ◽  
Vol 44 (7) ◽  
pp. 1242-1252 ◽  
Author(s):  
Keita Itatsu ◽  
Gen Sugawara ◽  
Yuji Kaneoka ◽  
Takehito Kato ◽  
Eiji Takeuchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Elective Surgery ◽  
Surgical Site Infections ◽  
Wound Management

scholarly journals Efficacy of conservative treatment modalities used in epistaxis

2004 ◽  
Vol 56 (1) ◽  
pp. 20-22
Author(s):  
Urvashi Razdan ◽  
R. M. Raizada ◽  
V. N. Chaturvedi
Keyword(s):  
Conservative Treatment ◽  
Treatment Modalities

scholarly journals Development of a Two Port Laparoscopic Appendectomy Technique at a Rural Hospital

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Hugo J. R. Bonatti
Keyword(s):  
Laparoscopic Appendectomy ◽  
New Technologies ◽  
Surgical Site Infections ◽  
Standard Technique ◽  
Rural Hospital ◽  
Study Cohort ◽  
Port Placement ◽  
Energy Device ◽  
Energy Devices ◽  
Number Of Patients

Background. Laparoscopic appendectomy (LA) is most commonly performed using two 5-mm and one 10/12-mm ports. Various attempts to reduce the number and size of ports have been made and new technologies such as single port LA have been introduced. Appendix and mesoappendix are usually divided with a stapler or energy device with electrocautery, clips, and endoloop being cheaper options.Patients and Methods. This study includes 51 consecutive LAs performed at a rural hospital. Patients were divided into 4 groups: group 1 was the standard technique group (n=12), group 2 served as a “try-out” (n=12), group 3 served as feasibility group (n=12), and group 4 was the final patient cohort in which the optimized technique was preferably used (n=15).Results. Median age of the study cohort was 35.4 (range: 6.2-80.6) years, and 55% of patients were male. Whereas in G1 all patients had standard port placement (10/12-mm, 2x5-mm), in an increasing number of patients in G2-4 only two 5-mm ports and the 2.3-mm Teleflex minigrasper were inserted. Usage of staplers and/or energy devices was reduced from 100% in G1 to 20% in G4, and in the majority of cases both the appendix and the vascular pedicle were secured with an endoloop. The new technique did not add time to the procedure or total OR time. No stump-leaks or surgical site infections were encountered in this series, and there were no conversions to open surgery. Cost savings when not using a stapler or energy device are approximately 400$ per case; the minigrasper added approximately 200$ to the case.Discussion. LA with use of two ports and a portless needle grasper is feasible in the majority of cases and was associated with high patient satisfaction and excellent cosmetic results. Avoiding energy devices and staplers is cost saving; the endoloop securely controls appendix and mesoappendix.

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