Complications Associated with 327 Foreign Bodies of the Pharynx, Larynx, and Esophagus

1997 ◽  
Vol 106 (4) ◽  
pp. 301-304 ◽  
Author(s):  
Bhuvanesh Singh ◽  
Gady Har-El ◽  
Manoj Kantu ◽  
Frank E. Lucente
Keyword(s):  
Older Patients ◽  
Foreign Bodies ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Risk ◽  
Perioperative Period ◽  
Pulmonary Complications ◽  
Retropharyngeal Abscess ◽  
Delayed Presentation ◽  
Upper Aerodigestive Tract

We intended to identify the types and incidence of complications associated with foreign bodies (FBs) impacted in the upper aerodigestive tract (UADT) and to ascertain factors predisposing to the development of these complications. The design was a retrospective cohort study of 327 patients with UADT foreign bodies admitted to a tertiary care center. The overall incidence (7.6%) and types of complications varied by age. Complications developed in 4.8% of 208 patients 10 years of age and under, with pulmonary complications being most common. In contrast, complications occurred in 12.6% of 119 older patients, with retropharyngeal abscess being the most common (p < .0001). Delayed presentation (>24 hours after the onset of symptoms) was the only factor associated with an increase in the incidence of complications in the younger patients (p = .02). In contrast, pharyngeal location of the FB (p = .0004), the FB's being a fish bone (p = .006), and radiolucency (p = .02) were all associated with an increased incidence of complications in patients over 10 years of age. A significant risk for complications is present for patients admitted for the management of FBs in the UADT. Older patients with sharp FBs are at greatest risk. In this group of patients, close observation in the perioperative period is required, especially if there is evidence of mucosal injury.

scholarly journals An Unusually Large Object Removed From the Upper Esophagus in a Patient With Self Harm Syndrome

2020 ◽  
pp. 014556132095370
Author(s):  
Michael J. Lai ◽  
Jace Morganstein ◽  
Nathan Deckard ◽  
Yekaterina Koshkareva
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Tertiary Care ◽  
Trauma Surgery ◽  
Care Hospital ◽  
Upper Aerodigestive Tract ◽  
Large Object ◽  
Toilet Paper ◽  
History Of ◽  
Self Harm

A 32-year-old female with a history of bipolar disorder and schizophrenia was transported to our tertiary-care hospital after swallowing a large toilet paper holder bracket. Removal of the large foreign body required coordination between anesthesiology, otolaryngology, and trauma surgery. A tracheostomy airway was established, and the object was removed transorally. The object was found to be a toilet paper holder bracket measuring 7.5 cm × 5.4 cm × 5.4 cm with a 2.6 cm screw protruding from the end. A review of articles describing the removal of foreign bodies from the upper aerodigestive tract found our object to be the largest foreign body ingestion described in literature. One report suggested that 18% of adult patients with foreign body ingestions had primary neuropsychiatric disorders. Our patient’s psychiatric disorder was a major underlying factor leading to the ingestion, with our patient reporting hallucinations instructing her to ingest household objects.

scholarly journals Incidence and risk factors for retinopathy of prematurity at a medical college hospital in rural Tamil Nadu, India

2020 ◽  
Vol 7 (11) ◽  
pp. 2119
Author(s):  
Sengodi Elumalai ◽  
Rajasekaran Kathavarayan ◽  
Venkatesh Govindasamy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Blood Transfusion ◽  
Retinopathy Of Prematurity ◽  
Tamil Nadu ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Risk ◽  
College Hospital

Background: The objective of the research was to evaluate the incidence of retinopathy of prematurity (ROP), association of prenatal and postnatal risk factors, pattern of ROP and treatment outcomes among infants admitted to neonatal intensive care unit (NICU) of tertiary care center located in Thiruvannamalai, Tamil Nadu.Methods: A retrospective study done in all infants admitted between April 2019 and March 2020 who met the criteria for ROP screening with gestational age (GA) less than or equal to 36 weeks or birth weight less than 2000 grams or with GA more than 36 weeks and birth weight more than 2000 gram with significant risk factors like intrauterine growth restriction, respiratory distress syndrome, sepsis, long term oxygen use, phototherapy, blood transfusion and maternal anemia. Treatment was offered to infants with stage 3 ROP and stage 2 in zone 2 with or without plus disease. Qualified infants were treated with argon laser photocoagulation within 72 hours of diagnosis. They were followed until the disease was successfully treated.Results: Out of total 3121 neonates, 717 neonates met the screening criteria. Incidence of ROP was found to be 33% (n=237). 46.4% (n=110) of ROP belongs to 32-36 weeks GA. 42.6% (n=101) of ROP belongs to 1500-2000 gm birth weight.Conclusions: Incidence of ROP is quite high in high risk neonates in our unit. Significant risk factors are long term oxygen use, blood transfusion and sepsis.

scholarly journals Clinicopathological Features of Young Versus Older Patients With Breast Cancer at a Single Pakistani Institution and a Comparison With a National US Database

2019 ◽  
pp. 1-6 ◽  
Author(s):  
Sana Zeeshan ◽  
Basim Ali ◽  
Khabir Ahmad ◽  
Anees B. Chagpar ◽  
Abida K. Sattar
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Older Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Biology ◽  
Lymph Node Involvement ◽  
Clinicopathological Characteristics ◽  
University Hospital ◽  
Axillary Lymph

PURPOSE The age at which women present with breast cancer varies widely among nations, and breast cancer may behave differently in younger women. Differences in clinicopathological characteristics based on age have not been well characterized in Pakistani patients with breast cancer. METHODS We conducted a retrospective review of patients with symptoms of breast cancer presenting to Aga Khan University Hospital (AKUH), a large tertiary care center in Pakistan, between 2001 and 2010; we compared young (≤ 40 years) versus older (> 40 years) patients in terms of their clinicopathological characteristics. We also compared this Pakistani cohort with the US population using data from the National Cancer Database (NCDB). RESULTS A total of 1,334 patients with breast cancer presented to our center over the 10-year review period. The median age at diagnosis was 50 years, compared with 60 years for patients in the NCDB. In the AKUH cohort, younger patients were significantly more likely than their older counterparts to present with metastatic disease (13.1% v 10.8%; P < .01). They also were more likely to present with higher-grade tumors (grade 3: 40.1% v 28.3%; P < .001), have triple hormone receptor–negative phenotype (25.4% v 14.1%, P < .001), and have positive axillary lymph node involvement (70.9% v 57.5%; P < .001) compared with older women. Younger and older patients in the AKUH cohort tended to present with higher-stage disease ( P < .001) and were more likely to have triple hormone receptor–negative disease ( P < .001), compared with all patients in the NCDB and with those of Indo-Pakistani origin. CONCLUSION Young Pakistani women, similar to their Western counterparts, present with more advanced disease and more aggressive tumor biology than their older counterparts.

Causes of death in older patients with cancer: Experience of a tertiary care center in Lebanon

2019 ◽  
Vol 10 (2) ◽  
pp. 365-367
Author(s):  
Tarek Assi ◽  
Ziad Bakouny ◽  
Chris Labaki ◽  
Elie El Rassy ◽  
Aline Khazzaka ◽  
...  
Keyword(s):  
Older Patients ◽  
Causes Of Death ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Patients With Cancer ◽  
Cancer Experience

Cytomegalovirus Retinitis Outcomes in HIV-Infected and Non–HIV Patients at a Tertiary Care Center

2017 ◽  
Vol 1 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Anton Orlin ◽  
Jennifer Nadelmann ◽  
Mrinali Gupta ◽  
Sarju Patel ◽  
Donald J. D’Amico ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Risk ◽  
Final Visual Acuity ◽  
Tertiary Care Center ◽  
Hiv Patients ◽  
Cmv Retinitis

Purpose: To describe cytomegalovirus (CMV) retinitis outcomes in HIV-infected and non–HIV patients at a tertiary care center. Participants: Twenty-six eyes from 20 patients with active CMV retinitis were included in this study. Patients were immunocompromised due to HIV or secondary to immunosuppressive therapy for malignancy and organ transplantation. Methods: This is a retrospective, observational study of patients with newly diagnosed active CMV retinitis. The main outcomes included the incidence of visual acuity loss, the loss of visual acuity to 20/200 or worse, and the loss of 3 lines of vision or more. Secondary outcomes included the identification of risk factors for these visual results and the development of various complications such as retinal detachment (RD) and cataract formation. Results: In all, 51.9% (n = 14) of eyes lost vision from baseline at most recent follow-up and 34.6% (n = 9) lost 3 lines or more of vision, 34.6% (n = 9) of the eyes lost significant vision at most recent follow-up and had a final vision of 20/200 or worse, and 22.73% of phakic eyes underwent cataract surgery, whereas 23.1% (n = 6) of eyes developed RD. Patients presenting with a CD4+ T-cell count <100 cells/µL were more likely to lose vision when compared to those presenting with a count >100 cells/µL ( P = .0440). Although not statistically significant, patients who were immunocompromised due to HIV were less likely to lose 3 or more lines of vision ( P = .1881) and less likely to have a final visual acuity of 20/200 or worse ( P = .1881), when compared to patients who were immunocompromised due to other reasons. There was also a nonsignificant trend for eyes affected by a larger area of CMV retinitis at baseline (>25%) to have a final visual acuity of 20/200 or worse when compared to eyes with CMV retinitis involving <25% of the total retina ( P = .089). We did not detect trends or associations between any other risk factors tested and visual outcomes. We did not identify an association between HIV status and baseline area or zone affected by CMV retinitis. Conclusions: Our cohort demonstrated that CMV retinitis remains a vision-threatening problem among patients who are immunocompromised due to HIV or other conditions. Immunocompromised patients are still at a significant risk of vision loss and complications from CMV retinitis and should be managed by a multidisciplinary team of physicians. In the immediate future, improved therapies are necessary to achieve immune recovery in patients, particularly for those remaining chronically immunosuppressed.

scholarly journals Acute Stroke Care and Thrombolytic Therapy Use in a Tertiary Care Center in Lebanon

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mazen J. El Sayed ◽  
Tharwat El Zahran ◽  
Hani Tamim
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Delayed Presentation ◽  
Tertiary Care Center ◽  
Acute Stroke Care ◽  
Symptomatic Intracerebral Hemorrhage

Background. Thrombolytic therapy (rt-PA) is approved for ischemic stroke presenting within 4.5 hours of symptoms onset. The rate of utilization of rt-PA is not well described in developing countries.Objectives. Our study examined patient characteristics and outcomes in addition to barriers to rt-PA utilization in a tertiary care center in Beirut, Lebanon.Methods. A retrospective chart review of all adult patients admitted to the emergency department during a one-year period (June 1st, 2009, to June 1st, 2010) with a final discharge diagnosis of ischemic stroke was completed. Descriptive analysis was done followed by a comparison of two groups (IV rt-PA and no IV rt-PA).Results. During the study period, 87 patients met the inclusion criteria and thus were included in the study. The mean age was found to be 71.9 years (SD = 11.8). Most patients arrived by private transport (85.1%). Weakness and loss of speech were the most common presenting signs (56.3%). Thirty-three patients (37.9%) presented within 4.5 hours of symptom onset. Nine patients (10.3%, 95% CI (5.5–18.5)) received rt-PA. The two groups (rt-PA versus non rt-PA) had similar outcomes (mortality, symptomatic intracerebral hemorrhage, modified Rankin scale scores, and residual deficit at hospital discharge).Conclusion. In our setting, rt-PA utilization was higher than expected. Delayed presentation was the main barrier to rt-PA administration. Public education regarding stroke is needed to decrease time from symptoms onset to ED presentation and potentially improve outcomes further.

scholarly journals Study of risk, incidence and mortality associated with postoperative pulmonary complications using assess respiratory risk in surgical patients in catalonia score

2019 ◽  
Vol 6 (9) ◽  
pp. 3215 ◽  
Author(s):  
Kedar M. Tilak ◽  
Manjusha M. Litake ◽  
Krupa V. Shingada
Keyword(s):  
High Risk ◽  
Care Center ◽  
Preoperative Evaluation ◽  
Tertiary Care ◽  
Risk Groups ◽  
Pulmonary Complications ◽  
Surgical Patients ◽  
Risk Category ◽  
Postoperative Pulmonary Complications ◽  
Incidence And Mortality

Background: Postoperative pulmonary complications (PPCs) are one of the major complications that are seen in patients undergoing surgeries and are also a significant cause of increased duration of hospital stay and mortality. Owing to their high incidence the present study was done to assess the risk and incidence of PPCs using the assess respiratory risk in surgical patients in catalonia (ARISCAT) score and to observe the mortality related to PPCS.Methods: The study was done at a tertiary care center over a period of three month and 150 patients were involved. The patients were the categorized into three risk groups and were observed for development of any PPCs.Results: Out of the 150 patients that were studied, 29 developed some form of PPC. 21 out of these 29 (72.41%) patients were from the high-risk category. 11 out of the 29 patients died in a span of 30 days. Pneumonia was seen to be the most common PPC.Conclusions: ARISCAT score can be useful as a preoperative evaluation tool to classify patients into risk groups and predict the development of PPC in the high-risk groups and to take measures to reduce the risk of PPCs. We conclude from our study that anemia, emergency surgery and surgery with duration of more than 3 hours were significant factors contributing to both the incidence and mortality of PPCs irrespective of the risk group. 

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