scholarly journals Risk factors of preoperative Hirschsprung-associated enterocolitis

2019 ◽  
Vol 13 (S11) ◽  
Author(s):  
Dicky Yulianda ◽  
Andy Indra Sati ◽  
Akhmad Makhmudi ◽  
Gunadi
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Maternal Education ◽  
Neonatal Period ◽  
Hirschsprung Disease ◽  
Albumin Level ◽  
Distended Abdomen ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Early Late

Abstract Background Hirschsprung-associated enterocolitis (HAEC) is a life-threatening complication of Hirschsprung disease (HSCR), that might occur preoperatively. We investigated the risk factors of preoperative HAEC. Method We retrospectively reviewed all medical records of HSCR patients admitted at Dr. Sardjito Hospital, Indonesia from March 2012 until March 2015. Diagnosis of HAEC was determined using the Delphi scoring system. Results Sixty-one HSCR patients were involved in this study, of whom 48 were males and 13 females. Eighteen percent (11/61) patients had a preoperative HAEC. The most common findings of the HAEC score found in our patients were distended abdomen (100%) and dilated loops of bowel (100%), followed by lethargy (72.7%), cut-off sign in rectosigmoid with absence of distal air (72.7%), leukocytosis (72.7%), and shift to left (63.6%). There was no association between gender, age of HSCR diagnosis, early/late diagnosis during neonatal period, aganglionosis type, albumin level nor body mass index with preoperative HAEC (p = 0.69, 0.76, 0.33, 1.0, 0.86, and 0.50, respectively). In addition, the maternal age, gestational age, and maternal education level also did not correlate with the development of preoperative HAEC (p = 0.71, 0.59, and 0.32, respectively). Conclusion The incidence of preoperative HAEC in our hospital is considered relatively moderate, with the most common findings of distended abdomen and dilated loops of bowel. None of the identified risk factors have an association with the development of HAEC in our patients.

scholarly journals Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gunadi ◽  
Afnandito Valeno Risky Sukarelawanto ◽  
Azmi Ritana ◽  
Naisya Balela ◽  
Wayan Julita Krisnanti Putri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Educational Level ◽  
Medical Records ◽  
Hirschsprung Disease ◽  
Scoring Method ◽  
Multicenter Studies ◽  
Mother’S Age ◽  
Pull Through ◽  
Definitive Surgery ◽  
Larger Sample

Abstract Background Hirschsprung-associated enterocolitis (HAEC) is the most severe and potentially lethal complication of Hirschsprung disease (HSCR) which might occur following definitive surgery. Our objectives were: 1) to compare the incidence of HAEC after Duhamel and Soave procedures using different cut-off values of the HAEC scoring method; and 2) to associate them with the risk factors, including sex, aganglionosis type, mothers’ age at childbirth, gestational age, and mothers’ educational level. Methods Medical records of patients with HSCR who underwent Soave and Duhamel procedures in our institution, Indonesia (January 2012 – December 2016) were reviewed retrospectively. Two cut-off values of the HAEC scoring system (i.e., ≥10 and ≥ 4) were utilized. Results Eighty-three patients with HSCR were recruited in this study (Soave: 37 males and 7 females vs. Duhamel: 28 males and 11 females; p = 0.18). The incidence of HAEC after surgery was 14/83 (16.9%) and 38/83 (45.8%) for cut-off values of ≥10 and ≥ 4, respectively (p = 0.00012), and tended to have an association with sex (p = 0.09). Although it was not statistically significant (p = 0.07), the frequency of HAEC after Soave procedure tended to be higher in patients with their mother’s age of ≤35 years at childbirth than those with their mother’s age of > 35 years (OR = 7.9; 95% CI = 0.9–72.1). Multivariate analysis indicated none of the risk factors were associated with the frequency of HAEC after definitive surgery. Conclusions The lower cut-off value of ≥4 might increase the possibility to diagnose HAEC, particularly the mild cases. The incidence of HAEC after definitive surgery was not associated with any risk factors in our cohort patients. Further multicenter studies with a larger sample size are necessary to confirm our findings.

scholarly journals Prevalence and Risk Factors For Retinopathy of Prematurity Among Infants in Minilk-II Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study, 2020.

2021 ◽  
Author(s):  
Emebet Berhane Woldemariam ◽  
Hana Endale Aliyou ◽  
Yosef Tsige Redi
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Retinopathy Of Prematurity ◽  
Medical Records ◽  
Oxygen Therapy ◽  
Maternal Education ◽  
Cross Sectional ◽  
Childhood Blindness ◽  
Zone Ii ◽  
The Impact

Abstract Background: Retinopathy of prematurity (ROP) is defined as a vaso-proliferative retinal disorder that leads to childhood blindness; and persists as the main cause of preventable childhood blindness. The impact of ROP in developing countries is heavier as term infants can develop ROP because of inadequate awareness of the disease development and the risk factors. Hence, the aim of the study is assessing the prevalence and risk factors for retinopathy of prematurity in the specific study area.Methodology: An institutional based cross-sectional retrospective study was conducted on 301 samples of the pediatrics out-patient eye clinic medical records, at Minilik II referral hospital, from March to April 2020. Study subjects were selected using systematic random sampling method. Data was collected from medical records of all infants visiting the hospital for eye problems from January 2018 to December 2019, using a structured check list. The collected data was entered and cleaned using Epi data 6.4.2.0 and then exported & analyzed using SPSS version 25. Bivariate and multivariate analysis was computed to distinguish the statistically significant factors. Result: The prevalence of ROP among infants in this study showed 39(13%). Of these, more than half (56.4%) were Zone II + Stage 1, followed by Zone II + stage-2, and Stage-5; 12.8% and 10.2% respectively. Birth weight, oxygen therapy and sepsis were the factors significantly associated with ROP [AOR= 39.28; 95% CI: 3.204- 481.658], [AOR= 5.317; 95% CI:1.009- 28.019] and [AOR=9.805; 95% CI:1.592- 60.388] respectively. Conclusions: the prevalence of ROP in the current study is (13%). Birth weight, oxygen therapy and sepsis were the determinant risk factors for development of ROP. Regular ANC, and maternal education may be important to reduce the risk of low-birth weight, and sepsis that results in long-term oxygen therapy leading to childhood blindness.

scholarly journals Pharyngoesophageal Suturing Technique May Decrease the Incidence of Pharyngocutaneous Fistula following Total Laryngectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Mahmut Deniz ◽  
Zafer Ciftci ◽  
Erdogan Gultekin
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Total Laryngectomy ◽  
Pharyngocutaneous Fistula ◽  
Continuous Suture ◽  
Main Risk Factor ◽  
Significant Difference ◽  
Suturing Technique ◽  
Life Threatening ◽  
The Impact

Objectives. A pharyngocutaneous fistula (PCF) following total laryngectomy is associated with increased morbidity and severe life threatening complications. We aimed to review our experience with the PCF following total laryngectomy and determine the impact of previously reported risk factors on the development of PCF in our patients.Methods. The medical records of 20 patients who had a total laryngectomy operation were retrospectively analyzed. The association between the proposed risk factors and the incidence of the PCF was investigated.Results. Comparison of the suture techniques used for the closure of the pharynx (either continuous Cushing type or interrupted) yielded that primary interrupted sutures had a significantly higher incidence of PCF formation(p<0.05). Although it was not statistically significant, diabetes mellitus was also associated with increased PCF formation(p>0.05). No significant difference was observed between the PCF and non-PCF groups in terms of other proposed risk factors(p>0.05).  Conclusions. The main risk factor associated with PCF was found to be the type of pharyngeal closure technique. A vertical closure with a Cushing type continuous suture may be more successful than interrupted sutures in preventing a PCF.

scholarly journals Case Report: Management of Cholestasis Associated With Congenital Syphilis

2020 ◽  
Vol 8 ◽  
Author(s):  
Kotaro Ogawa ◽  
Koya Kawase ◽  
Tokio Sugiura ◽  
Toshihiro Yasui ◽  
Seiya Yamagata ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Management Practices ◽  
Neonatal Period ◽  
Congenital Syphilis ◽  
Specific Treatment ◽  
Histopathological Analysis ◽  
Standard Management ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Fat Soluble Vitamins

Cholestasis is a rare but life-threatening complication of congenital syphilis. However, standard management methods for this disease have not been established. Here, we report a case of congenital syphilis presenting with progressively worsening cholestasis, and we review the clinical features and management practices. In these cases, differentiation from other diseases presenting with cholestasis during the neonatal period, such as biliary atresia, is critical. In this regard, operative cholangiogram and histopathological analysis of the liver are required. Moreover, comprehensive genetic analysis can be useful. Although there is no specific treatment for cholestasis associated with congenital syphilis, appropriate nutritional management and supplementation with fat-soluble vitamins, especially vitamin K, should be provided. The severity of liver fibrosis may affect the prognosis of cholestasis associated with congenital syphilis. Therefore, attention should be paid to liver fibrosis in these patients.

scholarly journals Risk factors for mortality of diffuse alveolar hemorrhage in systemic lupus erythematosus: a systematic review and meta-analysis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Mengdi Jiang ◽  
Ruxuan Chen ◽  
Lidan Zhao ◽  
Xuan Zhang
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Meta Analysis ◽  
Diffuse Alveolar Hemorrhage ◽  
Concurrent Infection ◽  
Systemic Lupus ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractBackgroundDiffuse alveolar hemorrhage (DAH) is a rare but life-threatening complication of systemic lupus erythematosus (SLE). The current knowledge of the prognostic factors for SLE-associated DAH is controversial. This meta-analysis was undertaken to investigate the relevant risk factors for mortality in SLE-associated DAH.MethodsStudies were searched from PubMed, EMBASE, and Web of Science databases published up to May 27, 2020, and were selected or removed according to the inclusion and exclusion criteria. Two reviewers extracted data independently from the enrolled studies, and the odds ratios (OR) or the standardized mean difference (SMD) was utilized to identify and describe the prognostic factors for mortality.ResultsEight studies encompassing 251 patients with SLE-associated DAH were included in the meta-analysis. No significant publication bias was shown. Age at the diagnosis of DAH (SMD = 0.35, 95% confidence interval (CI) (0.08, 0.61),P = 0.01,I2 = 0.0%) was found to be an independent risk factor of mortality. Longer lupus disease duration (SMD = 0.28, 95% CI (0.01, 0.55),P = 0.042,I2 = 0.0%), concurrent infection (OR = 2.77, 95% CI (1.55, 4.95),P = 0.001,I2 = 37.5%), plasmapheresis treatment (OR = 1.96, 95% CI (1.04, 3.70),P = 0.038,I2 = 14.6%), and mechanical ventilation (OR = 6.11, 95% CI (3.27, 11.39),P < 0.0001,I2 = 23.3%) were also related to poor survival, whereas no noticeable relationships were revealed between survival and concurrent lupus nephritis (OR = 5.45, 95% CI (0.52, 56.95),P = 0.16,I2 = 58.4%) or treatment of cyclophosphamide (CTX) (OR = 0.74, 95% CI (0.16, 3.41),P = 0.70,I2 = 75.5%).ConclusionsOlder age at the diagnosis of DAH, longer disease duration of SLE, concurrent infection, plasmapheresis treatment, and mechanical ventilation were found related to increased mortality in patients with SLE-associated DAH according to our meta-analysis. However, due to limited studies with heterogeneity, these results should be interpreted cautiously. Notably, severe diseases rendered the requirement of plasmapheresis treatment and mechanical ventilation are themselves associated with poor outcome. Randomized trials of therapeutics are needed to determine the most efficacious strategies for SLE-associated DAH for better management of this life-threatening complication.

scholarly journals Bleeding after Hysterectomy: Recommendations and What to Expect

2022 ◽  
Author(s):  
Eugen Ancuța ◽  
Radu Zamfir ◽  
Gabriel Martinescu ◽  
Eduard Crauciuc ◽  
Dumitru Sofroni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incidence Rate ◽  
Surgical Management ◽  
Postoperative Hemorrhage ◽  
Gynecological Surgery ◽  
Knowledge And Skills ◽  
Treatment Practice ◽  
Life Threatening ◽  
Management Techniques ◽  
Life Threatening Complication

Bleeding after gynecological surgery remains an infrequent life-threatening complication, demanding appropriate medical and surgical management. Classified as early/“reactionary” and delayed/secondary, unexpected postoperative hemorrhage may arise regardless of the route or subtype of hysterectomy. Timely recognition and prompt intervention to arrest bleeding are essential strategies for the suitable outcome of the patient. The present chapter presents an overview on different aspects of bleeding after hysterectomy such as incidence rate, risk factors, mechanisms, and management techniques aiming to expand knowledge and skills in recognizing and treating this unpredicted potentially serious problem. Furthermore, we intend to offer a guide toward standardizing treatment practice across bleeding issues following hysterectomy considering clear recommendations and algorithms.

scholarly journals Manejo nutricional em pacientes com risco de síndrome de realimentação

2020 ◽  
Vol 34 (4) ◽  
pp. 414-417
Author(s):  
Matheus Horta Sad ◽  
Bruna Fernanda Camargo Silva Parra ◽  
Ricardo Ferrer ◽  
Antônio Valério da Silva Júnior ◽  
Flávia Julie do Amaral Pfeilsticker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Nutrition Therapy ◽  
Refeeding Syndrome ◽  
Magnesium Supplementation ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
History Of ◽  
Low Body Mass Index ◽  
Life Threatening Complication

Refeeding syndrome (RS) is a life-threatening complication that occurs after prolonged starvation in malnourished patients or after severe catabolic events. It usually happens in the first 72 hours after the beginning of either enteral or parenteral nutrition and can affect one third of the patients. The most important risk factors are low body mass index (BMI), unintentional weight loss, none or low caloric supply for at least 5 days, history of alcohol or drug abuse and baseline electrolyte disturbances. Thiamine and electrolyte (phosphate, potassium and magnesium) supplementation is mandatory. The initiation and progression of nutrition therapy must be gradual with low amount of calories in the first days, with daily electrolyte monitoring. In the case of low electrolyte levels, especially hypophosphatemia, diet infusion should be reduced and slowly increased over 48 hours. RS deserves special attention the nutrition team to be prevented, identified and treated early.

Risk factors for post-thyroidectomy haematoma

2015 ◽  
Vol 130 (S1) ◽  
pp. S20-S25 ◽  
Author(s):  
M Perera ◽  
L Anabell ◽  
D Page ◽  
T Harding ◽  
N Gnaneswaran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Recent Literature ◽  
Chi Square ◽  
Operation Analysis ◽  
Same Day Discharge ◽  
Chi Square Test ◽  
Life Threatening ◽  
Independent Risk Factors ◽  
Review Current

AbstractBackground:There has been increasing emphasis on performing ‘same-day’ or ‘out-patient’ thyroidectomy to reduce associated costs. However, acceptance has been limited by the risk of potentially life-threatening post-operative bleeding. This study aimed to review current rates of post-operative bleeding in a metropolitan teaching hospital and identify risk factors.Method:Medical records of patients undergoing thyroidectomy between January 2007 and March 2012 were reviewed retrospectively. Pre-operative, operative and pathological data, and post-operative complication data, were examined.Results:The study comprised 205 thyroidectomy cases. Mean age was 51.6 years (standard deviation = 14.74), with 80 per cent females. Unilateral thyroidectomy was performed in 81 cases (39.5 per cent) and total thyroidectomy was performed in 74 cases (36.1 per cent; 5.3 per cent with concomitant lymph node dissection). Nine patients (4.4 per cent) suffered post-operative bleeding, of which six required re-operation. Analysis showed that post-operative systolic blood pressure of 180 mmHg or greater was associated with post-operative bleeding (p = 0.003, chi-square test).Conclusion:Rates of significant post-operative bleeding are consistent with recent literature. Post-operative hypertension, diabetes and high post-operative drain output were identified as independent risk factors on multivariate analysis; when identified, these may be caveats to same-day discharge of thyroidectomy patients.

Postpartum depression and its risk factors in women with a potentially life‐threatening complication

2020 ◽  
Author(s):  
Deepthi Nayak ◽  
Dhamotharan Karuppusamy ◽  
Dilip Kumar Maurya ◽  
Sitanshu Sekhar Kar ◽  
Balaji Bharadwaj ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postpartum Depression ◽  
Life Threatening ◽  
Life Threatening Complication

scholarly journals Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

2018 ◽  
Vol 06 (03) ◽  
pp. E271-E273 ◽  
Author(s):  
Vijeta Pamudurthy ◽  
Raju Abraham ◽  
Thomas Betlej ◽  
Ashish Shah ◽  
Dong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Severe Pain ◽  
Splenic Injury ◽  
Interventional Procedure ◽  
Endoscopic Retrograde ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
High Index Of Suspicion

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP. The exact causes of splenic injury are unknown, although several mechanisms are postulated. A literature review of splenic injuries post-ERCP shows that there are only 3 cases with post-ERCP splenic decapsulation. Our patient is the first one in whom splenic decapsulation occurred without any risk factors or technical difficulties during the procedure. A high index of suspicion for splenic injury is required in any patient who has severe pain, anemia, or hemorrhagic shock after ERCP.

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