scholarly journals Case series of acute appendicitis association with SARS-CoV-2 infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlsea Prichard ◽  
Matthew Canning ◽  
Kindra McWilliam-Ross ◽  
John Birbari ◽  
William Parker ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Retrospective Review ◽  
Surgical Intervention ◽  
Case Series ◽  
Single Institution ◽  
Chi Square ◽  
Surgical Interventions ◽  
Asymptomatic Patients ◽  
High Prevalence ◽  
Chi Square Analysis

Abstract Background Describe the indications for surgical interventions in asymptomatic patients with SARS-CoV-2. We are unaware of previous reports of an association between SARS-CoV-2 and acute appendicitis. Methods We performed a single institution retrospective review of SARS-CoV-2 pre-procedure testing and indications for surgical intervention. Statistical comparisons were performed using Chi Square analysis or two-tailed Student T test. Results We report a high prevalence of SARS-CoV-2 in both all testing and pre-procedure testing during the enrollment period. We observe a high prevalence of acute appendicitis among patients identified to be SARS-CoV-2 positive during pre-procedure testing and without recognized symptoms of COVID19. Conclusion We report a previously unrecognized association between SARS-CoV-2 and acute appendicitis.

Surgical Treatment of Chronic Hand Ischemia: A Systematic Review and Case Series

2019 ◽  
Vol 24 (03) ◽  
pp. 359-370
Author(s):  
David L. Colen ◽  
Oded Ben-Amotz ◽  
Thibaudeau Stephanie ◽  
Arman Serebrakian ◽  
Martin J. Carney ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Surgical Intervention ◽  
Case Series ◽  
Ulnar Artery ◽  
Pharmacologic Therapy ◽  
Cold Intolerance ◽  
Algorithmic Approach ◽  
Surgical Interventions ◽  
Hand Ischemia

Background: Chronic hand ischemia refers to progressive, non-acute ischemic symptoms such as cold intolerance, rest pain, ulceration, tissue necrosis, and digit loss and poses a significant challenge in management. Conservative treatment begins with medical optimization and pharmacologic therapy, but when symptoms persist, surgical intervention may be required. Various operations exist to improve circulation including sympathectomy, arterial bypass, or venous arterialization. The purpose of this study is to systematically review published outcomes and present our experience with each surgical technique. Methods: A systematic review of literature regarding surgical treatment of chronic hand ischemia published between 1990 and 2016 was conducted using PRISMA guidelines. A retrospective-review of surgical interventions for chronic hand ischemia from 2010 to 2016 was then conducted. Primary outcomes included improvement in pain, wound-healing, and development of new ulcerations. Results: The review included 38 eight studies, showing all three techniques were effective in treating chronic hand ischemia. Sympathectomy had the lowest rate of new ulcerations (0.8%); bypass had the highest rate of healing existing ulcerations (89%). Arterialization was associated with consistent pain improvement pain (100%) but more complications (30.8%). Our series included 18 patients with 21 affected hands, 18 sympathectomies, 6 ulnar artery bypasses, and 1 arterialization. Most hands had improvement of wounds (89.5%) and pain (78.9%). No patients developed new ulcerations, but one required secondary amputation. Conclusions: When conservative measures fail to improve chronic hand ischemia, surgical intervention is an effective last line treatment. An algorithmic approach can determine the best operation for patients with chronic hand ischemia.

scholarly journals Prevalence, Risk Factors, Burden and Prevention of Low Back Pain among Nurses at University College Hospital, Ibadan, Nigeria

2020 ◽  
pp. 34-45
Author(s):  
Iyabode Adetoro Gbadamosi ◽  
Elizabeth Urenna Ike
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Chi Square ◽  
College Hospital ◽  
Clinical Nurses ◽  
High Prevalence ◽  
University College ◽  
Chi Square Analysis

Background: Low Back Pain (LBP) and its negative effects on the nurses’ quality-of-life are worrisome. Studies on LBP among nurses are scanty in Nigeria. Study assessed prevalence, risk-factors, burdens and prevention of LBP among clinical nurses at University College Hospital, Nigeria. Methods: Descriptive cross-sectional study that utilized quota and convenience sampling techniques in selecting 406 nurses. Self-administered structured questionnaire was used for data collection. Data were analyzed using descriptive statistics and Chi-Square test. Level of Significance, p≤0.05.  Results: Mean age of respondents was 39.51±8.525. Prevalence of LBP was very high (83.7%) among clinical nurses in the study setting. Risk-factors identified by respondents include some nursing activities, perceived stress and lack of job satisfaction. Analgesic use, movement restriction, low productivity, and psychological concern were among the burdens of LBP identified by the respondents. Preventive measures suggested include training of nurses on relaxation techniques, proper use of body mechanism/proper posture, and provision of mechanical assistive turning/lifting devices. Chi-square analysis showed that gender (χ2 =6.450, p=0.022) and nursing procedures were significantly associated with prevalence of LBP among clinical nurses in the facility. Conclusions: High prevalence of LBP among clinical nurses of the facility has negative consequences on the general well-being of the victims, the profession, the clients/patients, the facility and the entire society. There is urgent need to put policies and strategies in place to curb high prevalence of LBP and its consequences on the clinical nurses in the facility as identified in the study. 

Outcomes of Early Surgical versus Non-Surgical Management of Pediatric Hand Friction Injuries Caused by Treadmills

2021 ◽  
Author(s):  
Elika Ridelman ◽  
Paulette I Abbas ◽  
Beth A Angst ◽  
Justin D Klein ◽  
Christina M Shanti
Keyword(s):  
Surgical Intervention ◽  
Case Series ◽  
Complete Healing ◽  
Hospital Length Of Stay ◽  
Home Exercise ◽  
Recent Experience ◽  
Surgical Interventions ◽  
Additional Surgery ◽  
Hand Friction

Abstract Introduction Pediatric hand friction injuries caused by running treadmills are ever more prevalent due to the increasing presence of home exercise equipment. These and other related injuries have received recent attention in the media, leading to mass product recalls in some cases. These friction injuries are similar to deep thermal burns and these patients are usually cared for in the pediatric burn unit at our institution. We sought to describe our recent experience managing 22 patients with these injuries. Methods Patients were queried from our urban pediatric burn center database. After IRB approval, a retrospective chart review of all patients admitted for a treadmill-related hand injury over a 5-year period was performed. Data collected included patient demographics, initial treatment methods (surgical vs. non-operative), type of dressing used, hospital length of stay (LOS), and compliance with follow-up. We collected patient-centered outcomes included the time to healing and the need for subsequent surgical and/or non-surgical interventions to treat the sequelae of these injuries. Results Our center treated 22 hand friction injuries caused by treadmills over the 5-year period. Five patients (23%) underwent early surgical intervention (<30 days from injury), with a median time from injury of 7 days (IQR 1.75-13.5). This cohort required additional interventions to treat postoperative sequelae with 2 (40%) requiring additional surgery and 3 (60%) managed non-surgically. Of the 17 (77%) who were initially treatednon-operatively , 5 (29%) healed completely with dressing changes only and required no further treatment. Eleven (65%) had injury-related sequelae and were managed successfully with non-surgical interventions. Only 1 patient (6%) required scar modification by z-plasty. Average LOS was 14 hours and median number of weekly follow-up visits was 4 until complete healing. Conclusion Given the excellent outcomes observed in patients treated without acute surgical intervention in this case series, non-operative non-operative management appears to be feasible, safe and may reduce the need for operative intervention. These injuries, although small, are deep and require a prolonged period of dressing changes and aggressive therapy including post-healing time commitment to scar management in order to achieve best outcomes. Our study supports the need for increased community awareness of this type of injury.

Acute Appendicitis

2017 ◽  
Author(s):  
Michael P. Catanzaro ◽  
Rachel J. Kwon
Keyword(s):  
Acute Appendicitis ◽  
Study Design ◽  
Observational Studies ◽  
Surgical Intervention ◽  
Case Series ◽  
Historical Study ◽  
Evidence Based ◽  
Broad Spectrum Antibiotic ◽  
History Of ◽  
Based Medicine

This chapter provides a summary of a landmark historical study in surgery involving management and treatment of acute appendicitis. It describes the history of the disease, gives a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: observational studies in study design. Reginald H. Fitz’s insights over a century ago in a seminal case series regarding the nature of appendicitis, its potential sequelae, and the value of urgent surgical intervention changed the disease from a deadly one into one that can be easily cured by surgery. However, with the advent of modern broad spectrum antibiotic therapy, Fitz’s assertion that immediate surgical therapy is always mandated has recently come under question.

scholarly journals HOW OFTEN ARE STUDY DESIGN AND LEVEL OF EVIDENCE MISREPORTED IN THE PEDIATRIC ORTHOPAEDIC LITERATURE?

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0013
Author(s):  
Drake G. LeBrun ◽  
Mininder S. Kocher ◽  
Keith D. Baldwin ◽  
Neeraj M. Patel
Keyword(s):  
Study Design ◽  
Observational Studies ◽  
Scientific Information ◽  
Case Series ◽  
Chi Square ◽  
Level Of Evidence ◽  
Orthopaedic Literature ◽  
Pediatric Orthopaedic ◽  
Chi Square Analysis ◽  
Study Designs

Background: Observational studies are the most commonly employed study designs in the pediatric orthopaedic literature. The differences between observational study designs are important but not widely understood, leading to potential discrepancies between the reported and actual study design. Study design misclassification is associated with a potential for misreporting level of evidence (LOE). Purpose: To determine the degree of study design and LOE misclassification in the pediatric orthopaedic literature. Methods: The Institute for Scientific Information (ISI) Web of Science was queried to identify all pediatric orthopaedic observational studies published from 2014-2017. Reported study design and LOE were recorded for each study. The actual study design and LOE were determined based on established clinical epidemiological criteria by reviewers with advanced epidemiological training. Studies with a discrepancy between reported and actual study design and LOE were identified. The following covariates were recorded for each study: subspecialty, inclusion of a statistician coauthor, sample size, journal, and journal impact factor. Chi-square analysis was used to identify factors associated with study design and LOE misreporting. Results: One thousand articles were screened, yielding 647 observational studies. Three hundred thirty-five publications (52%) did not clearly report a study design in either the abstract or manuscript text. Of those that did, 59/312 (19%) reported the incorrect study design (Figure 1). The largest discrepancy was in the 109 studies that were reported to be case series, among which 30 (27.5%) were actually retrospective cohort studies. Three hundred thirteen publications (48%) did not report a LOE. Of those that did, 95/334 (28%) reported the incorrect LOE (Figure 2). Thirty-three studies (19%) reported a LOE that was higher than the actual LOE and 62 (35%) under-reported the LOE. Conclusion: The majority of observational pediatric orthopaedic studies either did not report a study design or reported the wrong study design. Similarly, the majority of studies did not report or misreported their LOE. Greater epidemiological rigor in classifying and evaluating observational studies is required on the part of investigators, reviewers, and journal editors. [Figure: see text][Figure: see text]

Incidence and Management of Siaolocele Post-Parotidectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P38-P39 ◽  
Author(s):  
Robert L Witt
Keyword(s):  
Facial Nerve ◽  
Needle Aspiration ◽  
Single Institution ◽  
Superficial Parotidectomy ◽  
Chi Square ◽  
Chi Square Analysis ◽  
Total Parotidectomy

Objective (1)To determine if a post-parotidectomy sialocele occurs at a higher incidence with a partial superficial parotidectomy compared to a near complete parotidectomy; both with facial nerve dissection. (2)To determine if needle aspiration vs. observation yields more persistant sialoceles beyond 4 weeks. Methods Retrospective, single surgeon, single institution study comparing 100 consecutive partial superficial parotidectomy procedures and 20 consecutive near-total parotidectomy procedures for formation of post-operative sialocele. Study period 2004–2007. The first 18 sialoceles were treated with one or more needle aspirations. The last 21 sialoceles were treated with observation and no needle aspiration. Antibiotics were not used beyond the first week of surgery in either group. Chi Square analysis was performed. Results There were 39 sialoceles in the partial superficial parotidecotomy group (39/100–39%) and none in the near-total parotidectomy group (0/20–0%). (p<0.05). All sialoceles resolved by the end of the fourth post-operative week whether aspirated or not aspirated. Conclusions Sialoceles are common post-partial superficial parotidectomy and did not occur after near-total parotidectomy. Patients should be advised in the pre-operative counseling period of this possible event after partial superficial parotidectomy. Sialoceles after parotidectomy can generally be treated by observation. Needle aspiration and antibiotics are optional.

scholarly journals Problemy lecheniya patsientov s morbidnym ozhireniem

2011 ◽  
Vol 8 (1) ◽  
pp. 57-66 ◽  
Author(s):  
E G Starostina
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Surgical Intervention ◽  
Surgical Interventions ◽  
Patient Dissatisfaction ◽  
Treatment And Prevention ◽  
High Prevalence ◽  
Selection Of Patients ◽  
Selection Of

The article describes evidence-based approaches to treatment of morbid obesity, including surgical interventions designated for bodyweight reduction and provides comparative analysis of efficacy and safety of lifestyle interventions, medical treatment and various types of bariatric surgery. Detailed description of diagnosis, treatment and prevention of post-surgical vitamin and mineral deficiencies is given. Special attention is paid to high prevalence of mental disorders in patients with morbid obesity, their role in its development, their influence on outcomes of surgical intervention and potential patient dissatisfaction with its results. Necessity of thorough selection of patients for bariatric surgery is emphasized, with assessment of their mental state and proper organization of subsequent life-long follow-up after operation

A Retrospective Study of 12 Cases of Pyoderma Gangrenosum: Why We Should Avoid Surgical Intervention and What Therapy to Apply

2011 ◽  
Vol 77 (12) ◽  
pp. 1644-1649 ◽  
Author(s):  
Wioletta Barańska-Rybak ◽  
Monika Kakol ◽  
Matilda Naesstrom ◽  
Olivia Komorowska ◽  
Małgorzata Sokolowska-Wojdyło ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Skin Diseases ◽  
Surgical Intervention ◽  
Histopathological Examination ◽  
Case Series ◽  
Disease Process ◽  
Diagnosis And Treatment ◽  
Surgical Interventions ◽  
Case Series Study ◽  
Proper Diagnosis

Lesions of skin are ubiquitous in the medical field. The varying etiopathologies with similar presentation can pose a misleading picture, especially when faced with less common skin diseases. Furthermore, the misdiagnosis can cause detrimental effects on the patient's morbidity and mortality, which was seen in the case series study we performed on pyoderma gangrenosum. The history of 12 patients were analyzed in reference to the course of the disease, accompanying diseases, clinical picture, histopathological examination, surgical intervention before diagnosis, and treatment. Within this group of 12 patients, five were exposed to surgical interventions before diagnosis of pyoderma gangrenosum. The 5 patients were all exposed to prolonged aggravation of the disease process, followed by remission after proper diagnosis and treatment therapy. This study was done to improve the knowledge of surgeons about pyoderma gangrenosum considering the frequency of skin lesion cases in the surgical practice. Knowledge of the disease is essential to diagnose pyoderma gangrenosum in early stages to avoid interventions that may prolong or worsen the outcome. Surgical interventions in these patients should be avoided before proper diagnosis. The key to a better prognosis of pyoderma gangrenosum patients is often in the hands of surgeons.

scholarly journals Comparative study and outcome of open versus laparoscopic appendectomy: case series of 60 patients

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Neeraj Sharma ◽  
Mayank Mishra ◽  
Alok Tripathi ◽  
Vivekanand Rai
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Case Series ◽  
P Value ◽  
Chi Square ◽  
Early Return ◽  
Group I ◽  
Duration Of Surgery ◽  
Open Versus

Background: Laparoscopic appendectomy combines the advantages of diagnosis and treatment in one procedure with least morbidity. Patients are likely to have less postoperative pain and to be discharged from hospital and return to activities of daily living sooner than those who have undergone open appendectomy.Methods: This prospective study was carried out in the Department of Surgery, Heritage IMS, Varanasi, from May 2016 to May 2017. All the patients were randomly divided into two groups, Group I (Lap App) and Group II (Open App). All quantitative data was compared by independent sample test. All qualitative data was compared by chi-square test. A p-value <0.05 was considered statistically significant.Results: In present study 19 (63%) patients of open appendectomy and 19 (63%) patients of laparoscopic appendectomy were males. 11 (36%) patients of open appendectomy and 11 (36%) laparoscopic appendectomy were females.Conclusions: This study from May 2016 to April 2017 was done on 60 (30 lap and 30 open) patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Heritage Institute of Medical Sciences. In spite of drawback of the increase in duration of surgery, we conclude that laparoscopic appendectomy is better than the open method for acute appendicitis, with less post-operative pain and reduced duration of analgesics used, with lesser incidences of post-operative complications, shorter duration of hospital stays, early return to normal work.

scholarly journals Alvarado score: can it reduce unnecessary interventions for acute appendicitis in children?

2017 ◽  
Vol 23 (3) ◽  
pp. 115-120 ◽  
Author(s):  
V. Chisalau ◽  
C. Tica ◽  
S. Chirila ◽  
C. Ionescu
Keyword(s):  
Acute Appendicitis ◽  
Medical Records ◽  
Scoring System ◽  
Surgical Intervention ◽  
Alvarado Score ◽  
Surgical Interventions ◽  
Positive Diagnosis

AbstractThe purpose of the study is to compare the outcomes of surgical interventions for acute appendicitis with the values of the Alvarado score. We conducted the study on 572 patients that underwent surgical interventions for acute appendicitis. Retrospectively, based on the medical records, we calculated the MANTRELS score and compared the outcomes of the intervention with the values of the applied score. Almost one third of the patients with a MANTRELS score lower than 6 had negative appendectomies. These patients represent 60% of the total cases of negative appendectomies, while in the case of patients with a high score around 2% had negative appendectomies. We concluded that using this scoring system to assess the need of immediate surgical intervention is important and can increase the rate of positive diagnosis mainly by limiting the number of unnecessary interventions.

Sign in / Sign up

Export Citation Format

Share Document