scholarly journals A retrospective study of suspected pyometra causing systemic illness in 348 dogs

2020 ◽  
Vol 19 (2) ◽  
pp. 141-152
Author(s):  
Surapa Rungphattanachaikul ◽  
◽  
Areerath Akatvipat ◽  
Michael Pheng Chuan Chia ◽  
Kannika Na Lampang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Treatment Outcomes ◽  
Mortality Factor ◽  
Hospital Treatment ◽  
Improve Treatment ◽  
Operative Planning ◽  
Time Periods ◽  
The Cost

A retrospective study was used to investigate the prevalence, mortality rate, treatment outcomes, risk factors for death, and accompanying costs for canine pyometra cases reported in 2016 to 2018 from a single vet teaching hospital in Thailand. The prevalence of canine pyometra was 375 cases from 35,138 of canine outpatients (1.07%) with 348 cases undergoing surgery at the hospital. Mongrel dogs were most affected (37.33%) followed by Poodles (14.67%) and Shih Tzus (12.27%). The median age of pyometra cases was 7 years (range of 11 months to 16 years). The mortality rate was 10.63 % (37/ 348 dogs). Mortalities occurred in 3 dogs prior to surgery. Post-operative mortalities were reported in 24 dogs, and 10 dogs with undefined time periods. The main contributing mortality factor was uterine rupture (adjusted OR 7.38 (95% CI =2.73,19.93)). The cost of hospital treatment per case ranged between 93 to 939 United States Dollars. Surgical ovariohysterectomy is an effective treatment and preventative procedure for pyometra. Comprehensive and careful pre-operative and sufficient post-operative planning is recommended to improve treatment outcomes.

scholarly journals Different Presentation and Outcomes in the Surgical Treatment of Advanced MRONJ in Oncological and Nononcological Patients Taking or Not Corticosteroid Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Paolo Garzino Demo ◽  
Alessandro Bojino ◽  
Fabio Roccia ◽  
Maria Chiara Malandrino ◽  
Stefan Cocis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Surgical Treatment ◽  
Treatment Outcomes ◽  
Corticosteroid Therapy ◽  
Good Practice ◽  
Maxillofacial Surgery ◽  
Osteonecrosis Of The Jaw ◽  
Severe Side Effect ◽  
Antiresorptive Drugs

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect caused by antiangiogenic antiresorptive drugs used to treat various oncological and non oncological diseases. The clinical and radiological characteristics of MRONJ depend on the type of causative drug, the time of administration, and its dosage. Proven systemic risk factors like anemia, uncontrolled diabetes, corticosteroid therapy, and chemotherapy in neoplastic diseases (e.g., high doses of methotrexate up to 30 mg daily) significantly increase the chances of acquiring MRONJ. The risk factors themselves can affect treatment outcomes. Although the main scientific societies have recently disseminated good practice rules on the patient’s prevention, diagnosis, and management, there are still no guidelines on shared therapeutic strategies. In general, if conservative treatment fails, surgical treatment is considered, including local debridement, osteoplasty, and marginal or segmental osteotomy. In literature, cohorts of heterogeneous patients with MRONJ have been analyzed for a long time, resulting in a lack of uniformity of information and difficulties interpreting the data. According to the American Association of Oral and Maxillofacial Surgeons criteria, this retrospective study evaluates the surgical treatment outcomes of 64 patients with stage II-III MRONJ, evaluated at the Department of Maxillofacial Surgery of the University of Turin (Italy). The first objective of this retrospective study is to evaluate treatment results for stages II-III in all cases; the second objective is to evaluate the same results by dividing the sample into different cohorts of patients: first, based on the underlying pathology, i.e., oncological and non oncological, and secondly, based on the drug or combination of drugs they took.

scholarly journals Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations

2017 ◽  
Vol 05 (05) ◽  
pp. E389-E394 ◽  
Author(s):  
Sherine Khater ◽  
Gabriel Rahmi ◽  
Guillaume Perrod ◽  
Elia Samaha ◽  
Hedi Benosman ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Mortality Rate ◽  
Ureteral Obstruction ◽  
Mortality Rates ◽  
The Other ◽  
Significant Difference ◽  
Before And After ◽  
Over The Scope Clip ◽  
Time Periods ◽  
Second Period

Abstract Background and study aims Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period (P = 0.002). There was no mortality in the second period versus 8 % in the first one (P = 0.23). Conclusions OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.

scholarly journals Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Khaled Gomaa ◽  
Ahmed R. Abdelraheim ◽  
Saad El Gelany ◽  
Eissa M. Khalifa ◽  
Ayman M. Yousef ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
Control Group ◽  
Site Infection ◽  
Incidence Risk

Abstract Background Surgical site infection (SSI) is one of the commonest complications following cesarean section (CS) with a reported incidence of 3–20%. SSI causes massive burdens on both the mother and the health care system. Moreover, it is associated with high maternal morbidity and mortality rate of up to 3%. This study aims to determine the incidence, risk factors and management of SSI following CS in a tertiary hospital. Methods This was an observational case control retrospective study which was conducted at Minia maternity university hospital, Egypt during the period from January 2013 to December 2017 (Five years). A total of 15,502 CSs were performed during the studied period, of these, 828 cases developed SSI following CS (SSI group). The control group included 1500 women underwent cesarean section without developing SSI. The medical records of both groups were reviewed regarding the sociodemographic and the clinical characteristics. Results The incidence of SSI post-cesarean section was 5.34%. Significant risk factors for SSI were; chorioamnionitis (adjusted odds ratio (AOR) 4.51; 95% CI =3.12–6.18), premature rupture of membranes (PROM) (AOR 3.99; 95% CI =3.11–4.74), blood loss of > 1000 ml (AOR 2.21; 95% CI =1.62–3.09), emergency CS (AOR 2.16; 95% CI =1.61–2.51), duration of CS of > 1 h (AOR 2.12; 95% CI =1.67–2.79), no antenatal care (ANC) visits (AOR 2.05; 95% CI =1.66–2.37), duration of labor of ≥24 h (AOR 1.45; 95% CI =1.06–2.01), diabetes mellitus (DM) (AOR 1.37; 95% CI =1.02–2.1 3), obesity (AOR 1.34; 95% CI =0.95–1.84), high parity (AOR 1.27; 95% CI = 1.03–1.88), hypertension (AOR 1.19; 95% CI = 0.92–2.11) and gestational age of < 37 wks (AOR 1.12; 95% CI = 0.94–1.66). The mortality rate due to SSI was 1.33%. Conclusions The obtained incidence of SSI post CS in our study is relatively lower than other previous studies from developing countries. The development of SSI is associated with many factors rather than one factor. Management of SSI is maninly medical but surgical approach may be needed in some cases. Registration Local ethical committee (Registration number: MOBGYN0040).

Nanomedicines for enhanced permeability and retention (EPR)-stratified patients have the potential to improve treatment outcomes

2021 ◽  
Author(s):  
Moataz Dowaidar
Keyword(s):  
Clinical Trials ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Survival Rates ◽  
The United States ◽  
Improve Treatment ◽  
Enhanced Permeability And Retention ◽  
Wide Range ◽  
The Cost

Nanomedicines are being tasked with boosting the efficacy of existing immunotherapies. Understanding the pathophysiology of the targeted tumors is critical for devising the optimum strategy. The corticosteroid dexamethasone has recently been discovered to promote tumor perfusion and nanomedicine accumulation. Only a limited percentage of patients, however, respond to immune checkpoint blockage (ICB). In the United States, for example, it is believed that ICB therapy is ineffective for about 87 percent of cancer patients. The care of enhanced permeability and retention (EPR)-stratified patients has the potential to improve treatment outcomes. Treating patients with several metastatic foci with varying amounts of EPR impact could increase nanomedicine impact in cancer patients, but only losartan has yet to reach clinical trials. Other medication repurposing techniques have been proposed for the increased efficacy of small medicines and antibodies, but they are still in clinical trials and need to be tested in human patients. The treatment of these patients could improve the effectiveness of nanomedi-based immunotherapy and reduce the toxicity of chemotherapy and radiation therapy. This could have a positive effect on cancer patients' survival rates and quality of life, as well as on the cost of treatment. The potential of nanomedicines to deliver a wide range of immunomodulating drugs and modulate their action in space

Latent classes in diagnoses among psychiatric inpatients predicting mortality and imprisonment – a nationwide cohort study

2017 ◽  
Vol 39 ◽  
pp. 93-98 ◽  
Author(s):  
H.K. Carlsen ◽  
S. Steingrimsson ◽  
M.I. Sigurdsson ◽  
S. Sigfússon ◽  
A. Magnússon
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Psychiatric Inpatients ◽  
Hospital Treatment ◽  
Latent Classes ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
One Year ◽  
First Admission

AbstractPurposeIdentify risk factors of death or imprisonment within classes defined by demographic factors and diagnoses within one year of first psychiatric admission.MethodsNationwide data was obtained from hospital registers from psychiatric hospitals in Iceland 1983–2007. Mortality and cause of death as well as information about imprisonments during the study period, and discharge diagnoses for the first year after initial admission were obtained for each individual. Individuals aged 18 during the study period with at least one year of follow-up were included. Latent Class Analysis was used to identify groups with distinguishable risk of either being alive, dead or having been imprisoned at the end of follow-up.ResultsAmong psychiatric patients, 4677 were included, average age was 27 years (range 18–43). Four latent classes were identified with different risks of adverse outcomes. Class B (16%), predominantly males with substance use disorder (SUD) diagnoses, had highly increased risk of imprisonment and death accounting for 85 and 34% of these outcomes, respectively. Class A (12%), all with alcohol use disorder, had similar mortality rate as the general population and no imprisonments. Class C (23%) were younger at first admission with some SUD and increased risk of mortality. Class D (46%) had increased mortality rate, SUDs were rare but depression common.ConclusionsRisk of mortality and criminal trends among psychiatric inpatients can be described as distinct clusters of risk factors present at first admission to a psychiatric hospital. Treatment and interventions to reduce mortality and criminality should take these risk differences into account.

Sign in / Sign up

Export Citation Format

Share Document