Orbital Complications of Acute Sinusitis: Evaluation, Management, and Outcome

1978 ◽  
Vol 86 (2) ◽  
pp. ORL-221-ORL-230 ◽  
Author(s):  
Victor L. Schramm ◽  
Eugene N. Myers ◽  
John S. Kennerdell
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Age Groups ◽  
Orbital Cellulitis ◽  
Acute Sinusitis ◽  
Study Population ◽  
Orbital Complications

Acute orbital cellulitis is most commonly caused by sinusitis. This complication is based on the anatomy of the sinuses, orbit, and their venous connections. A series of 134 patients is reviewed to demonstrate the etiology and clinical course of orbital cellulitis. Antibiotic therapy alone does not prevent permanent complications. Surgical intervention is found necessary in all age groups and is required in 20% of the study population.

The Groote Schuur hospital classification of the orbital complications of sinusitis

1997 ◽  
Vol 111 (8) ◽  
pp. 719-723 ◽  
Author(s):  
S. Mortimore ◽  
P. J. Wormald
Keyword(s):  
Computed Tomography ◽  
Relative Frequency ◽  
Surgical Intervention ◽  
Acute Sinusitis ◽  
High Resolution Computed Tomography ◽  
Septal Group ◽  
Ready Availability ◽  
Clear Differentiation ◽  
Orbital Complications

AbstractThe complications of sinusitis have been well described. The most common classifications used for orbital complications have been that of Chandler et al. (1970) and Moloney et al. (1987). With the ready availability of high-resolution computed tomography (CT) scanners, limitations of these classifications have become apparent. The aims of this study were to determine the relative frequency of the various complications associated with acute sinusitis, to determine which groups of sinuses were most frequently involved and to correlate the orbital signs with a new proposed classification of orbital complications. Over a five-year period, 87 consecutive patients were admitted with acute sinusitis. Sixty-three patients (72.4 per cent) had one or more complications. When orbital complications were classified under the proposed classification, all patients with proptosis and/or decreased eye movement had post-septal infection. Visual impairment occurred only in the post-septal group. Most complications had a combination of sinus involvement with the maxillary/ethmoid/frontal combination being the most common. The authors propose a modification of Moloney's classification for orbital complications of acute sinusitis that allows a clear differentiation between pre- and post-septal infection and a radiological differentiation to be made between cellulitis/phlegmon and abscess formation. The latter is of importance when a decision is made on whether surgical intervention is appropriate or not.

Orbital Complications of Pediatric Sinusitis: Treatment of Periorbital Abscess

1997 ◽  
Vol 11 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Wolf Mann ◽  
Ronald G. Amedee ◽  
Jan Maurer
Keyword(s):  
Surgical Intervention ◽  
Acute Sinusitis ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Endonasal Surgery ◽  
Surgical Failure ◽  
Pediatric Sinusitis ◽  
Orbital Complications ◽  
Drainage Analysis

Twenty-six children requiring surgical intervention for orbital complications of acute sinusitis were treated at our institutions between 1985 and 1995. Twenty patients were successfully treated surgically utilizing endoscopic/microscopic endonasal surgery, or traditional external ethmoidectomy. However, six patients failed to respond to initial surgical attempts and ultimately required a revision. In one of these six patients the development of an intracranial abscess also necessitated a craniotomy for surgical drainage. Analysis of these six failures was performed with special attention given to the reasons for initial surgical failure and possible means for preventing revision surgeries.

scholarly journals Comparison of Prevalence of Periodontitis with Different Indices in Population of District Ghaziabad

2016 ◽  
Vol 04 (01) ◽  
pp. 023-030
Author(s):  
Vimal Kumar ◽  
Pallak Arora ◽  
Manish Khatri ◽  
Shivani Sharma ◽  
Sumit Malhotra ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Total Population ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sample Population ◽  
Age Group ◽  
Cross Sectional ◽  
Multi Stage ◽  
Younger Age ◽  
Study Population

Abstract Objective: To estimate the prevalence of periodontal disease with different indices. Methods & materials: The study population consisted of multistage stratified random sample of 1300 subjects from total population of district Ghaziabad. A cross-sectional study was conducted with multi stage stratified random sampling techniques to select the sample population. The subjects were divided into different age groups and the periodontal assessment was made on the basis of CPITN index and ESI Index. Results: The CPITN has shown to estimate incorrect periodontal disease prevalence because of its underestimation of the disease severity. A huge difference was noticed in the prevalence rate of periodontitis when subjects were examined with ESI index. Conclusion Periodontal disease was found to be highly prevalent in the study population and severity of disease increased with age. More number of subjects in younger age group were found to be healthy.

scholarly journals Comparative study between two empirical antibiotic regime in the management of childhood malignancy with fever

2015 ◽  
Vol 5 (2) ◽  
pp. 329-331 ◽  
Author(s):  
Laila Helaly ◽  
Md Zakir Hossain Sarker ◽  
MA Mannan ◽  
Md Tafazzal Hossain ◽  
Shafi Ahmed ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Study Drug ◽  
Successful Outcome ◽  
Medical College ◽  
Pediatric Hematology ◽  
Pediatric Cancer Patients ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Oncology Unit

Objective : The present prospective randomized clinical trial was carried out to assess whether combined cefepime and amikacin as empirical antibiotic therapy was more effective than combined ceftriaxone and gentamicin in the treatment of febrile neutropenic children with malignant diseases.Material & Methods : The study was conducted in the Pediatric Hematology and Oncology unit of BSMMU over a period of 2 years. (From January 2006 to December 2007) Hospitalised pediatric cancer patients who developed febrile neutropenia following chemotherapy or radiotherapy were the study population. A total 64 cases were consecutively included in the study and were randomly assigned to either cefepime & amikacin group (Group- A) or ceftriaxone & gentamicin group (Group-B). The Group-A received cefepime 1500 mg/m2/dose infused over 15 minutes in two divided doses intravenously(IV) while amikacin was administered as thrice daily dose of 200 mg/m2/dose. Patients of Group-B received ceftriaxone 1500 mg/m2/dose in two divided doses and gentamicin 60 mg/m2/dose thrice daily IV. The therapy was continued until absolute neutrophil counts reached >1000 neutrophils/mm3. The treatment outcome was considered successful if fever resolves within 4 days and does not recur within 7 days of completion of therapy. Of the 64 patients, 13 cases were excluded from the final analysis.Results : Bacteria were isolated from culture in only 16.7% of cases Group-A and 9.5% of group-B. Patients E. coli was the most common isolate found in blood specimen (37%). Following intervention, 90% of cefepime & amikacin group and 85.6% of ceftriaxone & gentamicin group improved absolute neutrophil count to >1000/mm3 of blood. Persistence of fever after start of study drug and duration of antibiotic therapy were significantly less in the former group than those in later group (p = 0.049 and p = 0.004 respectively). Only 1 patient of group B had recurrence of infection within 7 days of treatment completion. The mean duration of hospital stay was less in the former group (7.97 ± 2.61 days) than that in the latter group (11.00 ± 3.42 days) (p = 0.06). Evaluation of final outcome shows that majority (86.6%) of cefepime & amikacin group had successful outcome, while majority of ceftriaxone & gentamicin group (81%) failed to resolve infection with continuation of fever for > 4 days.Conclusion : The study concluded that combined cefepime and amikacin is a better option for empirical treatment of fever and neutropenia in children with malignancies than combined ceftriaxone and gentamicin (p<0.001).Northern International Medical College Journal Vol.5(2) 2014: 329-331

scholarly journals Healthcare use prior to suicide in the Stockholm County population 2011-2016

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Narusyte ◽  
K Kosidou ◽  
C Dalman
Keyword(s):  
Age Groups ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Healthcare Use ◽  
Stockholm County ◽  
Suicide Death ◽  
Death Registry ◽  
County Population ◽  
Study Population ◽  
One Year

Abstract Background Suicide is a major public health problem. A detailed description of healthcare use prior to suicide can serve to improve prevention strategies. The aim of the study was to describe the patterns of primary, specialized outpatient, and inpatient healthcare use from two weeks and up to one year prior to suicide in Stockholm County. Methods The study population included all 15 year or older suicide victims who died in Stockholm County 2011-2016 (n = 1950) identified through National Cause of Death Registry. Data on number of visits and contacts with healthcare among suicide victims were obtained from VAL healthcare use registry in Stockholm County. Healthcare use was depicted from one year to up to two weeks prior to suicide death. Results Preliminary results showed that there were 65% and 57% of women and men, respectively, who had at least one contact with healthcare during the last two weeks before suicide death. Measured one year prior to suicide, there were 93% of women and 85% of men who had at least one contact with healthcare. Among those who had at least one contact with healthcare two weeks prior to suicide, there were 16% of women and 12% of men who were hospitalized, 55% of women and 47% of men who had a contact with specialized outpatient care, and 32% of women and 27% of men who had a contact with primary healthcare. The proportion of those who did not have any contact with healthcare during the six months prior to suicide decreased gradually with increasing age among men (23% at ages of 15-24 years old and 7% at ages of 65 and older). There were on average 7% of women in all age groups who did not have any contact with healthcare during the six months prior to suicide. Conclusions The majority of the suicide victims had a contact with healthcare during the last year prior to suicide death. The findings suggest that suicide prevention efforts may target improved tools for clinically-based risk assessment. Key messages The majority of the suicide victims had at least one contact with healthcare during the last year prior to suicide death. Those who did not have any contact with healthcare during six months prior to suicide were more likely to be young men.

A COMPREHENSIVE STUDY ON ACUTE NON-TRAUMATIC ABDOMINAL EMERGENCIES

2021 ◽  
pp. 14-16
Author(s):  
Md. Quamar Zubair ◽  
A. K. Jha Suman
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Accurate Diagnosis ◽  
Postoperative Patient ◽  
Correct Treatment ◽  
Abdominal Emergencies ◽  
Comprehensive Study

Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of nontraumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.

Characteristics, outcomes, and risk factors of ICANS after axicabtagene ciloleucel: Does age matter?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19556-e19556
Author(s):  
Kitsada Wudhikarn ◽  
Radhika Bansal ◽  
Arushi Khurana ◽  
Matthew Hathcock ◽  
Michael Ruff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Older Patients ◽  
Clinical Course ◽  
International Prognostic Index ◽  
Age Groups ◽  
Central Nervous System Involvement ◽  
Microvascular Disease ◽  
B Cell Lymphoma ◽  
Younger Patients

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]

SEPTIC ARTHRITIS IN INFANTS AND CHILDREN: A REVIEW OF 117 CASES

PEDIATRICS ◽  
1966 ◽  
Vol 38 (6) ◽  
pp. 966-971 ◽  
Author(s):  
John D. Nelson ◽  
Wayne C. Koontz
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Age Groups ◽  
Infants And Children ◽  
Joint Fluid ◽  
Hemophilus Influenzae ◽  
In Infants And Children

A review of 117 cases of septic arthritis in infants and children revealed that the concept of staphylococci and streptococci as the major etiologic organisms should be modified to stress the frequency of Hemophilus influenzae in the 6-month to 2-year age bracket and to emphasize the variety of bacteria that must be anticipated in individual cases. Suggestions are made for increasing the frequency of bacteriologic diagnoses and for initiating the antibiotic therapy of patients with septic arthritis based upon age groups and observations of bacterial stains of joint fluid.

Mycobacterium mageritense infection following mastectomy and breast reconstruction requiring triple antibiotic therapy and surgical debridement

2021 ◽  
Vol 14 (2) ◽  
pp. e237618 ◽  
Author(s):  
Christie Alyce Joya ◽  
Cara Deegan ◽  
Todd D Gleeson
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Intervention ◽  
Treatment Guidelines ◽  
Perforator Flap ◽  
Published Data ◽  
Gastrointestinal Distress ◽  
Deep Inferior Epigastric Perforator ◽  
Infectious Disease Specialists ◽  
Systemic Symptoms ◽  
Early Surgical Intervention

A 40-year-old woman was referred to infectious disease specialists for a Mycobacterium mageritense skin infection following mastectomy and bilateral reconstruction with deep inferior epigastric perforator flap. Her case demonstrates the difficulty in treating non-tuberculosis mycobacterial infections, especially the rarely seen species. She failed to respond to dual antibiotic therapy containing imipenem-cilastin despite reported sensitivity. Additionally, her course was complicated by intolerance to various regimens, including gastrointestinal distress, a drug rash with eosinophilia and systemic symptoms, and tendinopathy. With few published data, no treatment guidelines, and limited medications from which to choose for M. mageritense, her treatment posed a challenge. She ultimately required aggressive surgical intervention and a triple therapy antibiotic regimen. The duration of our patient’s treatment and the extent of her complications suggest a potential need for early surgical intervention in postsurgical wounds infected with M. mageritense that do not respond to conventional treatment.

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