scholarly journals Surgical congenital anomalies in Albania: incidence, prenatal diagnosis and outcome

2019 ◽  
Vol 2 (1) ◽  
pp. e000012
Author(s):  
Ilirjana Bakalli ◽  
Elmira Kola ◽  
Robert Lluka ◽  
Ermela Celaj ◽  
Durim Sala ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Mortality Rate ◽  
Predictive Factor ◽  
Congenital Anomalies ◽  
Surgical Techniques ◽  
Premature Babies ◽  
Incidence And Mortality ◽  
Second Period ◽  
Negative Predictive Factor ◽  
Made In

IntroductionSignificant progress has been made in the diagnosis and management of congenital anomalies (CA). In our study, we aimed to evaluate prenatal diagnosis, trend of surgical CA, mortality rate and the factors affecting their prognosis in our country.MethodsWe enrolled in our study all children with CA who underwent surgery from January 2008 to December 2017. We compared prenatal diagnosis, incidence and mortality for two 5-year periods: the first period in 2008–2012 and the second period in 2013–2017.ResultsDuring the study period, a total of 321 cases with CA were presented, with an incidence of 0.69–1.18 per 1000 live births. Intestinal, anal and esophageal atresia remain the most important CAs (23%, 18% and 16%), followed by diaphragmatic hernia and gastroschisis (10% and 7%). Comparing the incidence for the two periods, we did not find statistical differences (p=0.73), but the mortality rate has been reduced from 31.4% during the first period to 24.6% during the second period (p=0.17). Prenatal diagnosis has increased: 28% in the second period compared with 10% in the first period (p<0.001), without significantly affecting the prognosis (p=0.09). Birth of premature babies resulted in a significantly negative predictive factor for the prognosis of these anomalies (p=0.0002).ConclusionIncidence of CA has not changed over the years in our country. Advances in intensive care, surgical techniques and parenteral nutrition made in recent years have significantly increased the survival of neonates born with surgical CA. Birth of premature babies was a significantly negative predictive factor for the prognosis of these anomalies.

Prenatal regenerative fetoscopic interventions for congenital anomalies

BMJ ◽  
2020 ◽  
pp. m1624 ◽  
Author(s):  
Rodrigo Ruano
Keyword(s):  
Prenatal Diagnosis ◽  
Regenerative Medicine ◽  
Congenital Anomalies ◽  
Urinary Tract Obstruction ◽  
Surgical Techniques ◽  
Experimental Proof ◽  
Congenital Diseases ◽  
Life Saving ◽  
Lower Urinary Tract Obstruction ◽  
Fetal Organs

Abstract Fetal intervention has progressed in the past two decades from experimental proof-of-concept to practice-adopted, life saving interventions in human fetuses with congenital anomalies. This progress is informed by advances in innovative research, prenatal diagnosis, and fetal surgical techniques. Invasive open hysterotomy, associated with notable maternal-fetal risks, is steadily replaced by less invasive fetoscopic alternatives. A better understanding of the natural history and pathophysiology of congenital diseases has advanced the prenatal regenerative paradigm. By altering the natural course of disease through regrowth or redevelopment of malformed fetal organs, prenatal regenerative medicine has transformed maternal-fetal care. This review discusses the uses of regenerative medicine in the prenatal diagnosis and management of three congenital diseases: congenital diaphragmatic hernia, lower urinary tract obstruction, and spina bifida.

Opportunistic Colorectal Cancer Screening using Colonoscopy. Comparative Results between two Historical Cohorts in Bucharest, Romania

2015 ◽  
Vol 24 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Elena Mirela Ionescu ◽  
Tudor Nicolaie ◽  
Serban Ion Gologan ◽  
Ana Mocanu ◽  
Cristina Ditescu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Advanced Adenoma ◽  
Detection Rates ◽  
Incidence And Mortality ◽  
Organized Screening Program ◽  
History Of ◽  
Comparative Results ◽  
Asymptomatic Individuals ◽  
Second Period

Background & Aims: Even though Romania has one of the highest incidence and mortality in colorectal cancer (CRC) in Europe, there is currently no organized screening program. We aimed to assess the results of our opportunistic CRC screening using colonoscopy.Methods: A single center retrospective study to include all opportunistic screening colonoscopies performed in two 18 month periods (2007-2008 and 2012-2013) was designed. All asymptomatic individuals without a personal or family history of adenoma or CRC and with complete colonoscopy performed in these two time periods were included.Results: We included 1,807 individuals, 882 in the first period, 925 in the second period. There were 389 individuals aged below 50, 1,351 between 50 and 75 and 67 older than 75 years. There were 956 women (52.9%), with a mean age of 58.5 (median 59, range 23-97). The detection rates were 12.6% for adenomas (6.1% for advanced adenoma) and 3.4% for adenocarcinoma. Adenoma incidence (4.9% in subjects under 50, 14.7% in those aged 50 to 75, and 16.4% in those older than 75, p<0.0001) and size (6.3mm in subjects younger than 50, 9.2mm in those 50 to 75 and 10.8mm in those older than 75, p=0.015) significantly increased with age. Adenoma incidence increased in the second period (14.8% vs. 10.3%, p=0.005), while adenoma size decreased in the second period (8.4mm vs. 10mm, p=0.006). There were no procedure related complications.Conclusions: The neoplasia detection rate was 16% (12.6% adenoma, 3.4% adenocarcinoma). Adenoma incidence and size increased with age in both cohorts. In the second screening period significantly more and smaller adenomas were detected.

scholarly journals Long-Term Exposure to Fine and Coarse Particulate Matter and COVID-19 Incidence and Mortality Rate in Chile during 2020

2021 ◽  
Vol 18 (14) ◽  
pp. 7409
Author(s):  
Macarena Valdés Salgado ◽  
Pamela Smith ◽  
Mariel Opazo ◽  
Nicolás Huneeus
Keyword(s):  
Mortality Rate ◽  
Incidence Rate ◽  
Air Pollutants ◽  
Negative Binomial ◽  
Transport Model ◽  
Surface Concentration ◽  
Mortality Rates ◽  
Incidence And Mortality ◽  
Pm2.5 And Pm10

Background: Several countries have documented the relationship between long-term exposure to air pollutants and epidemiological indicators of the COVID-19 pandemic, such as incidence and mortality. This study aims to explore the association between air pollutants, such as PM2.5 and PM10, and the incidence and mortality rates of COVID-19 during 2020. Methods: The incidence and mortality rates were estimated using the COVID-19 cases and deaths from the Chilean Ministry of Science, and the population size was obtained from the Chilean Institute of Statistics. A chemistry transport model was used to estimate the annual mean surface concentration of PM2.5 and PM10 in a period before the current pandemic. Negative binomial regressions were used to associate the epidemiological information with pollutant concentrations while considering demographic and social confounders. Results: For each microgram per cubic meter, the incidence rate increased by 1.3% regarding PM2.5 and 0.9% regarding PM10. There was no statistically significant relationship between the COVID-19 mortality rate and PM2.5 or PM10. Conclusions: The adjusted regression models showed that the COVID-19 incidence rate was significantly associated with chronic exposure to PM2.5 and PM10, even after adjusting for other variables.

scholarly journals Relationship Between Depression and Strength Training in Survivors of the Ischemic Stroke

2014 ◽  
Vol 43 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Felipe José Aidar ◽  
Dihogo Gama de Matos ◽  
Ricardo Jacó de Oliveira ◽  
André Luiz Carneiro ◽  
Breno Guilherme de Araújo Tinôco Cabral ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Mortality Rate ◽  
Strength Training ◽  
Lower Limb ◽  
Control Group ◽  
Cerebral Vascular Accident ◽  
Training Assessment ◽  
Post Test ◽  
Experimental Group ◽  
Made In

Abstract The Cerebral Vascular Accident is responsible for a significant increase in the mortality rate in individuals who have suffered this condition, regardless of the level of subsequent disability. This study aimed to analyze the influence of a strength training program on indicators of depression in survivors of the ischemic stroke. The study sample included subjects from both genders who were divided into two groups: an experimental group (EG) consisting of 11 subjects aged 51.7 8.0 years, and a control group (CG) consisting of 13 subjects aged 52.5 7.7 years. The EG underwent 12 weeks of strength training. Assessment was made in the pre-test before training and at the re-test after 12 weeks of training. We used the Beck Depression Inventory and evaluated 1RM. Significant differences in depression were found between post-test and pretest measurements (Δ% = -21.47%, p = 0,021) in the EG; furthermore, there were significant differences in all indicators of depression between the EG and CG after completing 12 weeks of training. There were significant gains in strength of the EG in relation to the CG. There was a negative correlation between the strength gains as determined with the 1RM test and the levels of depression, especially in lower-limb exercises. The results of this study suggest that improvements in strength are negatively correlated with levels of depression. Improvements in strength are therefore associated with a reduction in levels of depression.

scholarly journals Pancreatic trauma: proposal for management algorithm

2020 ◽  
Author(s):  
Daisuke Hashimoto ◽  
Tomohisa Yamamoto ◽  
So Yamaki ◽  
Kazuhito Sakuramoto ◽  
Rintaro Yui ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Mortality Rate ◽  
Pancreatic Duct ◽  
Conservative Management ◽  
Main Pancreatic Duct ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Pancreatic Trauma ◽  
Endoscopic Nasopancreatic Drainage ◽  
Nasopancreatic Drainage

IntroductionPancreatic trauma is potentially lethal despite recent improvements in surgical techniques and conservative management. However, no guidelines for the management of pancreatic trauma have been established. In this report, we propose an algorithm for the management of pancreatic trauma based on our experience of nine cases and a literature review.Case presentationThis study included nine patients with pancreatic trauma (five men and four women). The patients’ median age was 40 years (range, 17–75 years). The overall mortality rate was 22.2%, and the postoperative mortality rate was 16.7%. Superficial trauma was present in two patients. Deep trauma without injury to the main pancreatic duct was present in one patient, and this patient was treated successfully with endoscopic nasopancreatic drainage. Active bleeding was present in two patients and controlled by interventional radiology. Deep trauma with injury to the main pancreatic duct was present in six patients. Among them, one patient died after conservative treatment with endoscopic nasopancreatic drainage. The other five patients underwent surgery (pancreatic resection in four and necrosectomy in one).ConclusionThe herein-described algorithm recommends interventional radiology for active arterial bleeding, conservative management for trauma without ductal injury, and surgery for trauma with ductal injury. This algorithm may provide a basis for future establishment of guidelines.

scholarly journals Complications and Pitfalls in Maxillofacial Trauma

2014 ◽  
Vol 48 (2) ◽  
pp. 91-97
Author(s):  
Vidya Rattan ◽  
Sachin Rai ◽  
Shikha Yadav
Keyword(s):  
Treatment Failure ◽  
Surgical Procedure ◽  
Treatment Plan ◽  
Surgical Techniques ◽  
Maxillofacial Trauma ◽  
Trauma Surgeon ◽  
Form And Function ◽  
Fixation Devices ◽  
And Function ◽  
Made In

ABSTRACT Complications and pitfalls are unavoidable sequel of any surgical procedure. Although advances have been made in surgical techniques and fixation devices, these are far from ideal. The aim of trauma surgeon is to restore the patient to pre-injury form and function, but it may not be possible in each and every case. Treatment failure and poor outcome in a case of severe maxillofacial trauma is not uncommon. This is mainly dependent upon the extent of injury, delay in management, improper diagnosis, wrong treatment plan, poor execution of a treatment plan, wrong choice of fixation devices, inexperience of the surgeon and inability to seek help from other specialists, etc. The objective of this article is to discuss and analyze common complications and pitfalls along with the various methods and modalities to prevent and manage it. How to cite this article Rattan V, Rai S, Yadav S. Complications and Pitfalls in Maxillofacial Trauma. J Postgrad Med Edu Res 2014;48(2):91-97.

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