scholarly journals Necrotizing enterocolitis in the preterm: newborns medical and nutritional Management in a Single-Center Study

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Giovanni Savarino ◽  
Maurizio Carta ◽  
Marcello Cimador ◽  
Antonio Corsello ◽  
Mario Giuffrè ◽  
...  
Keyword(s):  
Survival Rate ◽  
Enteral Nutrition ◽  
Necrotizing Enterocolitis ◽  
Morbidity Rate ◽  
Nutritional Management ◽  
Fasting Period ◽  
Mortality And Morbidity ◽  
Population Average ◽  
Severity Of The Disease ◽  
Preterm Newborns

AbstractNecrotizing enterocolitis (NEC) is a typical disorder of preterm newborns, with a high mortality and morbidity rate. The therapeutic and nutritional management of disease depends on several factors. Its prognosis is linked, in addition to the severity of the disease and the need for surgery, to a correct enteral feeding in these patients. This study aims to identify the clinical characteristics of 18 patients with NEC, evaluating the different therapeutic paths undertaken, the type of formula used and the survival rate of this population. Average time of enteral nutrition before the NEC onset was 11,3 ± 11,6 days, with an average fasting period since the onset of 24 ± 18.9 days. 77.8% of patients received surgery and resumed enteral nutrition 17.7 ± 17.9 days after the intervention. The overall survival rate of our cohort was 55.5%. More prospective studies are needed to evaluate the long-term outcomes of survived children with NEC.

scholarly journals Necrotizing Enterocolitis in Full Term Neonates: Is There Always an Underlying Cause?

2013 ◽  
Vol 2 (3) ◽  
pp. 29 ◽  
Author(s):  
Olivier Abbo ◽  
Luke Harper ◽  
Jean-Luc Michel ◽  
Dushka Ramful ◽  
Audrey Breden ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Enteral Nutrition ◽  
Necrotizing Enterocolitis ◽  
Full Term ◽  
Overall Survival Rate ◽  
Term Neonates ◽  
Underlying Causes ◽  
The Mean ◽  
Maternal Disease

Objective: To review our experience with full-term neonates with necrotizing enterocolitis (NEC) and to compare its characteristics to those published in the literature.Design: Retrospective review of all neonates born after 35 weeks of gestation managed in Reunion Island for NEC from 2000 to 2012.Results: Among the 217 diagnosed NEC, 27 patients (12.4%) were full term neonates, who were born at a mean gestational age of 36.8 ±1.7 weeks. The mean onset of the disease was 12.1±11.2 days after birth. Twenty patients had underlying causes (15 organic pathologies of the child, 3 isolated maternal disease, and 2 infections); 7 had idiopathic NEC. Surgery was required in 12 patients (37.5%) at 23.2±20 days after birth. NEC affected most of the time the colon (n=6) and the rectum (n=3). Overall survival rate was 88.8% (24/27). Two patients required partial non-enteral nutrition for1.3 and 2.1 years.Conclusions: NEC in full term neonates is a rare pathology. The onset of the disease in our experience was slightly later than described in the literature, but remains earlier than in the premature population. In some cases, no obvious cause can be found, suggesting a different pathogenesis. Further investigations are required in order to better understand this pathology. The goal will be to find measures to reduce global mortality.

Drug-Induced Agranulocytosis: A Mini Review

2016 ◽  
Vol 2 (1) ◽  
pp. 57-59
Author(s):  
Pavithra D ◽  
Praveen D ◽  
Vijey Aanandhi M
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Genetic Manipulation ◽  
White Blood Cells ◽  
Deep Infection ◽  
Morbidity Rate ◽  
Drug Induced ◽  
Serious Adverse Event ◽  
Mortality And Morbidity ◽  
The Individual

Agranulocytosis is also known to be granulopenia, causing neutropenia in circulating blood streams .The destruction of white blood cells takes place which leads to increase in the infection rate in an individual where immune system of the individual is suppressed. The symptoms includes fever, sore throat, mouth ulcers. These are commonly seen as adverse effects of a particular drug and are prescribed for the common diagnostic test for regular monitoring of complete blood count in an admitted patient. Drug-induced agranulocytosis remains a serious adverse event due to occurrence of severe sepsis with deep infection leading to pneumonia, septicaemia, and septic shock in two/third of the patient. Antibiotics seem to be the major causative weapon for this disorder. Certain drugs mainly anti-thyroid drugs, ticlopidine hydrochloride, spironolactone, clozapine, antileptic drugs (clozapine), non-steroidal anti-inflammatory agents, dipyrone are the potential causes. Bone marrow insufficiency followed by destruction or limited proliferative bone marrow destruction takes place. Chemotherapy is rarely seen as a causative agent for this disorder. Genetic manipulation may also include as one of the reason. Agranulocytosis can be recovered within two weeks but the mortality and morbidity rate during the acute phase seems to be high, appropriate adjuvant treatment with broad-spectrum antibiotics are prerequisites for the management of complicated neutropenia. Drugs that are treated for this are expected to change as a resistant drug to the patient. The pathogenesis of agranulocytosis is not yet known. A comprehensive literature search has been carried out in PubMed, Google Scholar and articles pertaining to drug-induced agranulocytosis were selected for review.

Surgery Combined With Peritonectomy Procedures and Intraperitoneal Chemohyperthermia in Abdominal Cancers With Peritoneal Carcinomatosis: A Phase II Study

2003 ◽  
Vol 21 (5) ◽  
pp. 799-806 ◽  
Author(s):  
O. Glehen ◽  
F. Mithieux ◽  
D. Osinsky ◽  
A.C. Beaujard ◽  
G. Freyer ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Complete Resection ◽  
Morbidity Rate ◽  
Term Survival ◽  
Mortality And Morbidity ◽  
Peritonectomy Procedures ◽  
Experienced Team

Purpose: To evaluate the tolerance of peritonectomy procedures (PP) combined with intraperitoneal chemohyperthermia (IPCH) in patients with peritoneal carcinomatosis (PC), a phase II study was carried out from January 1998 to September 2001. Patients and Methods: Fifty-six patients (35 females, mean age 49.3) were included for PC from colorectal cancer (26 patients), ovarian cancer (seven patients), gastric cancer (six patients), peritoneal mesothelioma (five patients), pseudomyxoma peritonei (seven patients), and miscellaneous reasons (five patients). Surgeries were performed mainly on advanced patients (40 patients stages 3 and 4 and 16 patients stages 2 and 1) and were synchronous in 36 patients. All patients underwent surgical resection of their primary tumor with PP and IPCH (with mitomycin C, cisplatinum, or both) with a closed sterile circuit and inflow temperatures ranging from 46° to 48°C. Three patients were included twice. Results: A macroscopic complete resection was performed in 27 cases. The mortality and morbidity rates were one of 56 and 16 of 56, respectively. The 2-year survival rate was 79.0% for patients with macroscopic complete resection and 44.7% for patients without macroscopic complete resection (P = .001). For the patients included twice, two are alive without evidence of disease, 54 and 47 months after the first procedure. Conclusion: IPCH and PP are able to achieve unexpected long-term survival in patients with bulky PC. However, one must be careful when selecting the patients for such an aggressive treatment, as morbidity rate remains high even for an experienced team.

Perinatal outcomes after previable preterm premature rupture of membranes before 24 weeks of gestation

2018 ◽  
Vol 46 (5) ◽  
pp. 555-565 ◽  
Author(s):  
Verena Kiver ◽  
Vinzenz Boos ◽  
Anke Thomas ◽  
Wolfgang Henrich ◽  
Alexander Weichert
Keyword(s):  
Survival Rate ◽  
Pregnancy Termination ◽  
Treatment Options ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Mortality And Morbidity ◽  
Membrane Rupture ◽  
Preterm Premature Rupture

Abstract Objective: A current descriptive assessment of perinatal outcomes in pregnancies complicated by previable preterm premature rupture of membranes (pPPROM) at <24 weeks of gestation, after expectant treatment. Study design: Maternal and short-term neonatal data were collected for patients with pPPROM. Results: Seventy-three patients with 93 fetuses were hospitalized with pPPROM at 15–24 weeks’ gestation. Among these patients, 27.4% (n=20) chose pregnancy termination, 27.4% (n=20) miscarried and 45.2% (n=33) proceeded to live births. After a median latency period of 38 days, ranging from 1 to 126 days, 24 singletons and 20 multiples were live-born, of whom 79.5% (n=35) survived the perinatal period. The main neonatal sequelae were pulmonary hypoplasia (29.5%; n=13), connatal infection (56.8%; n=25), intraventricular hemorrhage (25%; n=11; resulting in five neonatal deaths) and Potter’s syndrome (15.9%; n=7). Nine newborns died, within an average of 2.8 days (range, 1–10 days). The overall neonatal survival rate was 51.5% – including miscarriages but not elective terminations. The intact survival rate was 45.5% of all live-born neonates. Conclusions: Even with limited treatment options, overall neonatal survival is increasing. However, neonatal mortality and morbidity rates remain high. The gestational age at membrane rupture does not predict neonatal outcome.

scholarly journals Effectiveness of COVID-19 Vaccines against Delta (B.1.617.2) Variant: A Systematic Review and Meta-Analysis of Clinical Studies

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ali Pormohammad ◽  
Mohammad Zarei ◽  
Saied Ghorbani ◽  
Mehdi Mohammadi ◽  
Saeideh Aghayari Sheikh Neshin ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Severe Infection ◽  
Vaccination Rate ◽  
Decision Makers ◽  
Morbidity Rate ◽  
Short Term ◽  
Mortality And Morbidity ◽  
Public Health Decision ◽  
Health Decision

The high transmissibility, mortality, and morbidity rate of the SARS-CoV-2 Delta (B.1.617.2) variant have raised concerns regarding vaccine effectiveness (VE). To address this issue, all publications relevant to the effectiveness of vaccines against the Delta variant were searched in the Web of Science, Scopus, EMBASE, and Medline (via PubMed) databases up to 15 October 2021. A total of 15 studies (36 datasets) were included in the meta-analysis. After the first dose, the VE against the Delta variant for each vaccine was 0.567 (95% CI 0.520–0.613) for Pfizer-BioNTech, 0.72 (95% CI 0.589–0.822) for Moderna, 0.44 (95% CI 0.301–0.588) for AstraZeneca, and 0.138 (95% CI 0.076–0.237) for CoronaVac. Meta-analysis of 2,375,957 vaccinated cases showed that the Pfizer-BioNTech vaccine had the highest VE against the infection after the second dose, at 0.837 (95% CI 0.672–0.928), and third dose, at 0.972 (95% CI 0.96–0.978), as well as the highest VE for the prevention of severe infection or death, at 0.985 (95% CI 0.95–0.99), amongst all COVID-19 vaccines. The short-term effectiveness of vaccines, especially mRNA-based vaccines, for the prevention of the Delta variant infection, hospitalization, severe infection, and death is supported by this study. Limitations include a lack of long-term efficacy data, and under-reporting of COVID-19 infection cases in observational studies, which has the potential to falsely skew VE rates. Overall, this study supports the decisions by public health decision makers to promote the population vaccination rate to control the Delta variant infection and the emergence of further variants.

scholarly journals Antibiogram signatures of non-cholera causing Vibrio species recovered from environmental niches in Eastern Cape, South Africa.

2021 ◽  
Author(s):  
Oluwakemi Victoria Ayodele ◽  
Anthony Ifeanyi Okoh
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Nalidixic Acid ◽  
Vibrio Parahaemolyticus ◽  
Inhibitory Concentration ◽  
Vibrio Vulnificus ◽  
Diffusion Method ◽  
Morbidity Rate ◽  
Antibiotic Resistant ◽  
Mortality And Morbidity ◽  
Vibrio Fluvialis

Abstract Background: The use of antibiotics globally has helped reduce mortality and morbidity rate due to its ability to effectively treat bacterial infections in both humans and animals. However, the menace of antimicrobial resistance has become a challenge to public health due to its increased mortality and morbidity rate. This study determined the antibiogram pattern of non-cholera causing Vibrio species against a panel of 11 antibiotics that are wildly used for treatment. Multiple antibiotic resistance phenotype, multiple antibiotic resistant indices and minimum inhibitory concentration (MIC) of test antibiotics were also determined.Results: Polymerase chain reaction (PCR) was used to confirm 100 isolates of Vibrio parahaemolyticus, 82 and 46 isolates of Vibrio vulnificus and Vibrio fluvialis respectively, collected from the culture collections of the Applied and Environmental Microbiology Research Group (AEMREG), University of Fort Hare. Thereafter, disc diffusion method was used to determine the antibiogram pattern of target non-cholera causing Vibrio species against a panel of 11 antibiotics that are of clinical importance. The highest rate of Vibrio parahaemolyticus resistance was observed against tetracycline (22 %) and nalidixic acid (16 %). Vibrio fluvialis also displayed highest rate of resistance against tetracycline (28 %) and nalidixic acid (28 %), while Vibrio vulnificus isolates exhibited highest rate resistance against imipenem (40 %) and tetracycline (22 %). A total of 38 MARP patterns were observed and the MAR indices ranged between 0.3 and 0.8. Against the resistant Vibrio parahaemolyticus and Vibrio fluvialis isolates, minimum inhibitory concentration ranged from 16 µg/ml to 2048 µg/ml for both tetracycline and nalidixic acid, while against Vibrio vulnificus isolates, minimum inhibitory concentration ranged from 8 µg/ml to 256 µg/ml for both imipenem and nalidixic acid. Conclusions: Results obtained from this study is an indication that antibiotic resistant bacteria that could pose as threat to health of humans and animals are present in the environment.

scholarly journals Coping Strategies and Health-Related Quality of Life in Pregnant Women with SARS-CoV-2 Infection

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1113
Author(s):  
Madalina Timircan ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Oana Suciu ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Rural Areas ◽  
Short Form ◽  
Depression Scale ◽  
Morbidity Rate ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Physical Burden

Background and Objectives: As maternal deaths associated with the SARS-CoV-2 infection remain at several times greater than the general population, significant factors that might contribute to the higher mortality and morbidity rate are the psychological impact of the disease and pregnancy itself. Therefore, the current study’s main objective was to assess how pregnant women react and cope with the stress of COVID-19 disease and how it influences their overall health and quality of life in healthcare facilities. Materials and Methods: In this cross-sectional study, we included 304 pregnant women who successfully completed standardized forms to assess our topics of interest, comprising of the Hospital Anxiety and Depression Scale, the Short Form Health Survey-12, the Coping Orientation to Problems Experienced Inventory scale, the CORE-Outcome Measure Questionnaire, and the Quality from the Patient’s Perspective questionnaire. Results: Unemployed, pregnant women living in poverty in the rural areas had higher SARS-CoV-2 infection rates during pregnancy. They faced higher anxiety levels and depression rates, with associated increased physical burden and exhaustion. However, these findings are not influenced by hospital care since it remained unchanged among COVID-19 and non-COVID-19 maternity units, excepting significantly lower technical competence scores of COVID-19 facilities. Conclusions: As the pandemic’s consequences emerge and additional outbreaks occur, care must prioritize the additional physical burden experienced by pregnant women who have contracted COVID-19, as well as psychological, emotional, and mental health support.

scholarly journals Investigation of association between ABO blood groups and COVID-19 clinical severity

2021 ◽  
Vol 8 (12) ◽  
pp. 673-676
Author(s):  
Arzu İrvem ◽  
Abdurrahman Sarmış ◽  
Özlem Akgün Doğan ◽  
Jale Yıldız ◽  
Zafer Habib ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Group ◽  
Blood Groups ◽  
Ct Imaging ◽  
Clinical Severity ◽  
Imaging Findings ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Important Center ◽  
Severity Of The Disease

Objective: COVID-19 has been detected in Turkey since March 11, 2020. Istanbul has become an important center of the pandemic in Turkey. Various risk factors for COVID-19 infection, mortality, and morbidity are under investigation. Recent studies have suggested that certain blood groups are risk factors for the disease. The aim of this study is the evaluation the relationship between blood groups and the risk of contracting COVID-19 disease, clinical severity of the disease, and CT (computed tomography) imaging findings. Material and Methods: Age, gender, blood group data, clinical severity and CT images of 300 patients who were positive with RT PCR (Reverse transcription-polymerase chain reaction) and were followed up in the clinic were retrospectively scanned and recorded. The clinical severity of the disease and CT imaging findings were scored, and the data were evaluated statistically. Results: While the incidence of COVID-19 was high in the A blood group, it was low in the 0 blood group. Although there was no significant difference between blood types and clinical severity, the involvement in the B blood group was more severe on CT imaging. Conclusion: People with A blood group should pay more attention to protection and isolation. Investigating this difference and underlying pathogenic mechanisms can guide science with advanced studies.

scholarly journals Open and laparoscopic approaches are associated with comparable 90-day morbidity and mortality following ERAS protocol

2020 ◽  
Author(s):  
Bhavin B. Vasavada ◽  
Hardik Patel
Keyword(s):  
Multivariate Analysis ◽  
Operative Time ◽  
Univariate Analysis ◽  
Operating Time ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Blood Products ◽  
Mortality And Morbidity ◽  
The Mean ◽  
Eras Protocol

ABSTRACTIntroductionThe aim of this study is to compare 90-day mortality and morbidity between open and laparoscopic surgeries performed in one centre since the introduction of ERAS protocols.Material and MethodsAll gastrointestinal surgeries performed between April 2016 and March 2019 at our institution after the introduction of ERAS protocols have been analysed for morbidity and mortality. The analysis was performed in a retrospective manner using data from our prospectively maintained database.ResultsWe performed 245 gastrointestinal and hepatobiliary surgeries between April 2016 and March 2019. The mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. The mean ASA score was 2.4, the mean operative time was 111 minutes and the mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall the 90-day mortality rate was 8.5% and the morbidity rate was around 9.79%. On univariate analysis morbidity was associated with a higher CDC grade of surgeries, a higher ASA grade, longer operating time, the use of more blood products, a longer hospital stay and open surgeries. HPB surgeries and luminal surgeries (non hpb gastrointestinal surgeries) were associated with 90 day post operative morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90-day mortality was predicted by the grade of surgeries, a higher ASA grade, longer operative time, the use of more blood products, open surgeries and emergency surgeries. However on multivariate analysis only the use of more blood products was independently associated with mortalityConclusionThe 90-day mortality and morbidity rates between open and laparoscopic surgeries after the introduction of ERAS protocol were similar.

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