scholarly journals Intra-abdominal hypertension in the ICU – a prospective epidemiological study

2015 ◽  
Vol 88 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Georgi M. Arabadzhiev ◽  
Valentina G. Tzaneva ◽  
Katya G. Peeva
Keyword(s):  
Elective Surgery ◽  
Treatment Options ◽  
Point Of View ◽  
University Hospital ◽  
Abdominal Pressure ◽  
Medical Patients ◽  
Invasive Treatment ◽  
Abdominal Hypertension ◽  
Significant Difference ◽  
The University

The aim of this prospective study is to examine the frequency and the severity of intra-abdominal hypertension in a mixed ICU of the University hospital.Methods: A closed system for intravesical intermittent measurement of IAP was constructed.Results: The frequency and the severity of IAH were examined in the period from June 2009 to December 2012 in 240 ICU patients divided into 3 groups (patients submitted to elective surgery, emergency surgery, and medical patients) in the University Hospital. In the elective surgery group there was 12.5% IAH, while in the emergency group IAH was 43.75%, and in the medical patients it was 42.5%. There was no statistical significant difference in the frequency of IAH among the mixed population of patients we examined and those studied by other authors with the same type of population.Conclusions. The standardized measurement of intra-abdominal pressure is fundamental for defining intra-abdominal hypertension and abdominal compartment syndrome. The measurement of intra-abdominal pressure should be a part of the basic monitoring of patients at risk of intra-abdominal hypertension. Our point of view is that before there are indications for a surgical decompression, less invasive treatment options should be optimized.

scholarly journals On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions

2011 ◽  
Vol 49 (4) ◽  
pp. 474-478
Author(s):  
M.B. Soyka ◽  
G. Nikolaou ◽  
K. Rufibach ◽  
D. Holzmann
Keyword(s):  
Retrospective Cohort ◽  
Health Care Systems ◽  
Financial Burden ◽  
Treatment Options ◽  
University Hospital ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The World ◽  
Care Systems ◽  
The University

Background: Epistaxis represents one of the most common emergencies in ENT clinics around the world. It creates great physical and emotional stress to the patient as well as a financial burden on health-care systems. A lot of research has been performed with regard to aetiology and possible treatment, however, not much effort has been put into analysing the effectiveness of common treatment forms. It is the objective of this study to clarify which of these treatment forms is reliable. Study design: Retrospective cohort study. Level of evidence: 2b. Methods: Between 03/2007 and 04/2008, all epistaxis therapies including relapses and treatment failures at the University Hospital of Zurich have been documented using a computerised questionnaire. Different treatments were compared to each other. Results: An analysis of 678 interventions in 537 patients was performed with emphasis on failure proportions and time to occurrence. The estimated failure proportions of coagulation in anterior epistaxis accounts for 14%. Successful treatment of epistaxis in posterior bleedings could be achieved in 62% by packing and in 97% by surgery with a statistically significant difference between the respective groups. Conclusion: Using our treatment options, anterior epistaxis can be cured reliably by cauterisation. Surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.

Intra-abdominal hypertension in early post-kidney transplantation period is associated with impaired graft function

2020 ◽  
Vol 35 (9) ◽  
pp. 1619-1628
Author(s):  
Vincent Dupont ◽  
Alexandre Debrumetz ◽  
Adrien Leguillou ◽  
David Morland ◽  
Alain Wynckel ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Venous Pressure ◽  
Previous History ◽  
Graft Function ◽  
University Hospital ◽  
Abdominal Pressure ◽  
Function Recovery ◽  
Abdominal Hypertension ◽  
History Of ◽  
The University

Abstract Background Moderate hyperhydration is often achieved in the early post-kidney transplantation period. Whether this strategy could lead to the development of intra-abdominal hypertension (IAH) has never been assessed so far. We aimed to study the incidence of IAH after kidney transplantation and its association with graft function recovery. Methods We conducted a prospective monocentric study among patients undergoing kidney transplantation at the University Hospital of Reims between May 2017 and April 2019. Intravesical pressure (IVP) was monitored every 8 h from Day 0 to 3. Results A total of 107 patients were enrolled. Among 55 patients included in the analysis, 74.5% developed IAH. Body mass index >25 kg/m2 was associated with IAH development {odds ratio [OR] 10.4 [95% confidence interval (CI) 2.0–52.9]; P = 0.005}. A previous history of peritoneal dialysis was protective [OR 0.06 (95% CI 0.01–0.3); P = 0.001]. IAH Grades III and IV occurred in 30.9% of patients and correlated with higher Day 3 creatininaemia (419.6 ± 258.5 versus 232.5 ± 189.4 μmol/L; P = 0.02), higher delayed graft function incidence (41.2 versus 7.9%; P = 0.04), lower Kirchner index measured using scintigraphy (0.47 ± 0.09 versus 0.64 ± 0.09; P = 0.0005) and decreased Day 30 estimated glomerular filtration rate (35.8 ± 18.8 versus 52.5 ± 21.3, P = 0.05). IAH patients had higher fluid balance (P = 0.02). Evolution of IVP correlated with weight gain (P < 0.01) and central venous pressure (P < 0.001). Conclusions IAH is frequent after kidney transplantation and IAH Grades III and IV are independently associated with impaired graft function. These results question current haemodynamic objectives and raise for the first time interest in intra-abdominal pressure monitoring in these patients. Clinical Trial Notation ClinicalTrials.gov identifier: NCT03478176

scholarly journals Comparing the first and second waves of COVID-19 in a tertiary university hospital in Barcelona

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1197
Author(s):  
Yolima Cossio ◽  
Marta-Beatriz Aller ◽  
Maria José Abadias ◽  
Jose-Manuel Domínguez ◽  
Maria-Soledad Romea ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Healthcare Systems ◽  
University Hospital ◽  
Emergency Rooms ◽  
Daily Number ◽  
Patient Demographics ◽  
Significant Difference ◽  
The University ◽  
Hospital Wards ◽  
Second Wave

Background: Hospitals have constituted the limiting resource of the healthcare systems for the management of the COVID-19 pandemic. As the pandemic progressed, knowledge of the disease improved, and healthcare systems were expected to be more adapted to provide a more efficient response. The objective of this research was to compare the flow of COVID-19 patients in emergency rooms and hospital wards, between the pandemic's first and second waves at the University Hospital of Vall d’Hebron (Barcelona, Spain), and to compare the profiles, severity and mortality of COVID-19 patients between the two waves. Methods: A retrospective observational analysis of COVID-19 patients attending the hospital from February 24 to April 26, 2020 (first wave) and from July 24, 2020, to May 18, 2021 (second wave) was carried out. We analysed the data of the electronic medical records on patient demographics, comorbidity, severity, and mortality. Results: The daily number of COVID-19 patients entering the emergency rooms (ER) dropped by 65% during the second wave compared to the first wave. During the second wave, patients entering the ER were significantly younger (61 against 63 years old p<0.001) and less severely affected (39% against 48% with a triage level of resuscitation or emergency; p<0.001). ER mortality declined during the second wave (1% against 2%; p<0.000). The daily number of hospitalised COVID-19 patients dropped by 75% during the second wave. Those hospitalised during the second wave were more severely affected (20% against 10%; p<0.001) and were referred to the intensive care unit (ICU) more frequently (21% against 15%; p<0.001). Inpatient mortality showed no significant difference between the two waves. Conclusions: Changes in the flow, severity and mortality of COVID-19 patients entering this tertiary hospital during the two waves may reflect a better adaptation of the health care system and the improvement of knowledge on the disease.

Single Centre Experience in Patients with Primary Hyperparathyroidism: Sporadic, Lithium-associated and in Multiple Endocrine Neoplasia

2019 ◽  
Vol 128 (10) ◽  
pp. 693-698
Author(s):  
Sabine Dillenberger ◽  
Detlef K. Bartsch ◽  
Elisabeth Maurer ◽  
Peter Herbert Kann
Keyword(s):  
Primary Hyperparathyroidism ◽  
Multiple Endocrine Neoplasia ◽  
University Hospital ◽  
Primary Surgery ◽  
Endocrine Neoplasia ◽  
Single Centre Experience ◽  
Significant Difference ◽  
History Of ◽  
The University

Abstract Purpose It is assumed that primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia (MEN) and lithium-associated pHPT (LIHPT) are associated with multiple gland disease (MGD), persistence and recurrence. The studies purpose was to determine frequencies, clinical presentation and outcome of sporadic pHPT (spHPT), LIHPT and pHPT in MEN. Additional main outcome measures were the rates of MGD and persistence/recurrence. Methods Retrospective analysis of medical records of 682 patients with pHPT who had attended the University Hospital of Marburg between 01–01–2004 and 30–06–2013. All patients were sent a questionnaire asking about their history of lithium medication. Results Out of 682 patients, 557 underwent primary surgery (532 spHPT, 5 LIHPT, 20 MEN), 38 redo-surgery (31 spHPT, 7 MEN), 55 were in follow-up due to previous surgery (16 spHPT, 1 LIHPT, 38 MEN) and 37 were not operated (33 spHPT, 1 LIHPT, 3 MEN). Primary surgeries were successful in 97.4%, revealed singular adenomas in 92.4%, double adenomas in 2.9% and MGD in 3.4% of the cases. Rates of MGD in MEN1 (82.35%) were significantly higher than in spHPT (3.8%), while there was no significant difference between LIHPT (20%) and spHPT. Rates of persistence/recurrence did not significantly differ due to type of surgery (bilateral/unilateral) or type of HPT (spHPT/LIHPT/MEN). Conclusions History of lithium medication is rare among pHPT patients. While MGD is common in MEN1, rates of MGD, persistence or recurrence in LIHPT were not significantly higher than in spHPT.

scholarly journals Seasonal variability in the incidence of carcinomatous meningitis

2015 ◽  
Vol 122 (3) ◽  
pp. 543-546 ◽  
Author(s):  
Angelos Koutras ◽  
Minas Sakellakis ◽  
Thomas Makatsoris ◽  
Charalabia Psachoulia ◽  
Maria Kardari ◽  
...  
Keyword(s):  
Seasonal Variability ◽  
Warm Season ◽  
Cold Climate ◽  
University Hospital ◽  
Carcinomatous Meningitis ◽  
Warm Climate ◽  
Significant Difference ◽  
The University ◽  
Official Data ◽  
Median Interval

OBJECT The aim of the study was to investigate whether there are seasonal differences in the occurrence of carcinomatous meningitis (CM), with a greater prevalence of the disease in months with higher temperatures. METHODS The authors searched the records of all patients with a diagnosis of CM from 1998 until 2013 at the University Hospital of Patras, Greece. The date of hospitalization was extracted for each patient. The cases were divided into 2 categories depending on the time of CM diagnosis. Based on the official data regarding the annual temperature distribution in this region, the authors divided the patients into 2 groups. The first group consisted of cases diagnosed with CM from October 15 to April 15 (cold climate and shorter daytime duration), whereas the second group comprised patients diagnosed between April 15 and October 15 (warm climate and longer daytime duration). RESULTS Overall, 44 confirmed cases of CM were found. The most common type of malignancy associated with the development of CM was breast cancer (27 patients), while the second most common tumor was lung carcinoma (11 patients). The median interval between the time of initial cancer diagnosis and CM was 4.5 years. Thirty-one patients were diagnosed with CM during the period between April 15 and October 15, while the remaining 13 patients developed CM between October 15 and April 15, a significant difference (p = 0.01). CONCLUSIONS Significantly more patients developed CM during the warm season of the year. To the authors' knowledge, this is the first study to provide evidence for the potential seasonal variability in CM incidence. However, these results should be validated prospectively in larger cohorts.

Pathophysiology and management of raised intra-abdominal pressure in the critically ill

2016 ◽  
Author(s):  
Inneke E. De laet ◽  
Manu L. N. G. Malbrain
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Treatment Options ◽  
Abdominal Pressure ◽  
Organ Function ◽  
Organ Systems ◽  
Abdominal Hypertension ◽  
The World ◽  
Icu Management ◽  
Abdominal Compartment

The deleterious effects of raised intra-abdominal pressure (IAP) on organ function and mortality have been known for decades, even centuries. Interest in this phenomenon has revived since the 1980s and, recently, the World Society for the Abdominal Compartment Syndrome has published new consensus definitions and guidelines. This chapter will focus on the new definitions for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS), identify risk factors for the development of IAH/ACS, provide guidelines for IAP monitoring (including when to start, how to measure, and when to stop), and discuss both surgical and medical treatment options for both IAH and ACS. The effect of increased IAP on different organ systems is explained and suggestions on how to adjust ICU management of the patient with IAH are offered.

scholarly journals The prevalence of urinary incontinence and its impact on quality of life among the university female staff in South Africa

2011 ◽  
Vol 67 (2) ◽  
Author(s):  
L. Skaal ◽  
M.K. Mashola
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Negative Impact ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Invasive Treatment ◽  
Cross Sectional ◽  
University Women ◽  
The University

Background: Urinary incontinence (UI) is a common problem among females and has been associated with significant decreased quality of  life. Few  women  seek  help  for  this  condition  with  only  a  few  who consult physiotherapy treatment.Purpose: To determine the prevalence of urinary incontinence and its impact on quality of life among the university women in South Africa.Method:  A  quantitative  cross-sectional  study design  with  145  women  ran-domly selected from the university. A questionnaire was used to determine UI Diagnosis; Impact on Qol and treatment seeking tendencies. BMI was meas-ured objectively. ethical clearance was obtained from University. Data was analysed using SPSS 17.0Results:  Forty  six(32%)  women  reported  to  having  UI.  Risk  factors  associated  with  UI  included  age,  race,  and  obesity. UI had a significant negative impact on quality of life and only 4.4% of participants with UI consulted physio-therapy for this condition.Conclusion: There is a high prevalence of UI among the women at this university with a significant impact on quality of life.The role of Physiotherapy in management of UI has been demonstrated and there is therefore a need to empower women with non-invasive treatment options, like physiotherapy.

scholarly journals Rhythms and prognosis of patients with cardiac arrest, emphasis on pseudo-pulseless electrical activity: another reason to use ultrasound in emergency rooms in Colombia

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
German Devia Jaramillo ◽  
Norberto Navarrete Aldana ◽  
Zaira Rojas Ortiz
Keyword(s):  
Cardiac Arrest ◽  
Electrical Activity ◽  
Cardiac Activity ◽  
Pulseless Electrical Activity ◽  
Cardiac Arrest Patient ◽  
University Hospital ◽  
Bedside Ultrasound ◽  
Emergency Rooms ◽  
Significant Difference ◽  
The University

Abstract Background The cardiac arrest is still an emergency with a bad prognosis. The growing adoption of bedside ultrasound allowed to classify PEA in two groups: the true PEA and the pseudo-PEA. pPEA is used to describe a patient who has a supposed PEA in the absence of pulse, with evidence of some cardiac activity on the bedside ultrasound. Objective This work aims to assess the bedside ultrasound use as a predictor for ROSC and survival at discharge in cardiac arrest patients and compare the pseudo-pulseless electrical activity to other cardiac arrest rhythms, including shockable rhythms. Materials and methods This is an observational, historic cohort study carried out in the emergency room of the University Hospital Mayor Méderi. Data were collected from all the adult patients treated for cardiac arrest from June 2018 to 2019. An ultrasound was performed to every cardiac arrest patient. Results Of a total of 108 patients, the median of the age was 71 years, 65.8% were male subjects, and the most frequent cause for cardiac arrest was the cardiogenic shock (32.4%). ROSC was observed in 41 cases (37.9%) and survival at discharge was 18 cases (16.7%). VF/VT and pPEA were the two rhythms that showed the highest ROSC and survival at discharge. For the pPEA group, we were able to conclude that the cardiac activity type is related to ROSC. Conclusion There is a significant difference for ROSC and survival at discharge prognosis among the cardiac arrest rhythms, with better outcomes for VF/VT and pPEA. Among patients with PEA, a routine ultrasound assessment is recommended. The type of cardiac activity recorded during the ultrasound of the cardiac arrest patient might be related to the ROSC and survival at discharge prognosis.

scholarly journals Influence of Gender in Selecting Fixed and Removable Prosthesis

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 268-272
Author(s):  
Abigail Ranasinghe ◽  
Keerthi Sasanka ◽  
Raghu Sandhya
Keyword(s):  
Tooth Loss ◽  
University Hospital ◽  
Negative Effects ◽  
Chi Square ◽  
Fixed Partial Denture ◽  
Masticatory Efficiency ◽  
Significant Difference ◽  
Removable Prosthesis ◽  
Chi Square Test ◽  
The University

Tooth loss is a common dental problem. Impairment of oral functions and masticatory efficiency is a result of tooth loss. The negative effects of tooth loss can be managed by the fixed and removable prosthesis. This study was conducted to determine the influence of gender in selecting prosthesis. This study was a retrospective observational study conducted in a university hospital in Chennai. Data collection was done with the help of the electronic dental record of the university- Dental information archiving software (DIAS). It records all patients data from initial visit to last visit chronologically. This was followed by Excel tabulation. Data was analysed using SPSS Software. The association of study variables was calculated using the Chi-Square test. Within the limits of the study, female patients were willing for replacement of teeth than male patients (55%). There was a significant difference in choosing the type of prosthetic treatment. It was seen that fixed partial denture was chosen over removable prosthesis (59.8%).

Sign in / Sign up

Export Citation Format

Share Document