scholarly journals Factors predictive of complicated appendicitis in children

2021 ◽  
Vol 8 (12) ◽  
pp. 3511
Author(s):  
Chandra Prakash Roushan ◽  
Ganesh Kumar Sah ◽  
Prince Mandal ◽  
Dinesh Prasad Koirala ◽  
Geha Raj Dahal

Background: Clinical features of acute appendicitis are often overlapping with other abdominal pathology in children. This increases the risk of complicated appendicitis (CA). It is still difficult to identify CA preoperatively. The study aims to identify pre operative risk factors in children for CA.Methods: A prospective study was conducted in pediatric surgery unit of department of general surgery of a university hospital of Kathmandu, Nepal. All children up to 16 years diagnosed and operated for appendicitis were included in the study. Based on intraoperative findings and histopathological examination (HPE), patients were grouped in simple appendicitis (SA) and CA. Pre-operative clinical and laboratory variables of between simple and CA were compared. P£0.05 was considered as significant.Results: A total of 73 children were included out of which 61 (83.6%) had SA and 12 (16.4%) had CA. Mean age of participants was 12.8±2.9 years. More than half (64.4%) of the participants were male. The median duration of symptoms was 2 days. In bivariate analysis, gender, serum Na, duration of symptoms and rebound tenderness were significantly associated with severity of appendicitis. In multivariate analysis, rebound tenderness (OR-15.36) and duration of symptoms (OR-9.96) were found to be associated with CA.Conclusions: Male patients, rebound tenderness, longer duration of symptoms and hyponatremia can be used to predict CA. Duration of symptoms and rebound tenderness are independent risk factors for CA.

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Nabiha Bouafia ◽  
Asma Ammar ◽  
Olfa Ezzi ◽  
Asma Ben Chiekh ◽  
Mohamed Mahjoub ◽  
...  

In haematology-oncology, intensified procedures have been associated with higher risk of healthcare associated infections (HAIs).This study aimed to estimate the incidence and to identify risk factors of HAIs in a haematology-oncology unit in a Tunisian university hospital. We conducted a prospective study, during 06 months from Mars through September 2016 in the department of hematology- oncology in a tertiary teaching hospital in Tunisia. Patients, admitted for ≥48 h, were followed until hospital discharge. The (CDC) criteria for site-specific infections were used to define HAIs. Bivariate and multivariate analyses were performed to identify risk factors of HAIs. P


2020 ◽  
Vol 48 (12) ◽  
pp. 1426-1430
Author(s):  
Hüseyin Bilgin ◽  
Elvan Sayın ◽  
Hande Perk Gürün ◽  
Elif Tükenmez-Tigen ◽  
Nurver Ülger Toprak ◽  
...  

2020 ◽  
Author(s):  
Beatriz Elena Ariza ◽  
Yulieth Ximena Torres ◽  
Diana Salgado ◽  
Magda Cepeda ◽  
Carlos Gomez ◽  
...  

Objectives To determine the prevalence of antibodies to SARS-CoV-2 and the incidence of seroconversion in the first month of follow-up among interns, residents, and medical doctors attending patients at a University Hospital, to explore for associations of seroprevalence and seroconversion with risk factors and symptoms compatible with COVID-19, and to explore the concordance of CLA, LFA, and ELFA. Design or methods We conducted a cross-sectional and a prospective study among medical doctors and medical trainees at Hospital Universitario San Ignacio in Bogota (Colombia) during June, July, and August to assess seroprevalence and seroconversion rates in this population was performed using CLA IgG for SARS-CoV-2. LFA IgG and IgM and ELFA IgM were also determined to explore concordance with CLA IgG. Results At baseline, 8 (2.28% 95%CI 1.16-4.43%) individuals were IgG positive for SARS-CoV-2 by CLA. At the end of the study, 21 (5.98% 95%CI 3.94-8.97%) individuals seroconverted by CLA IgG. In all, 29 individuals had IgG by CLA and of these 11 (3.13% 95%CI 1.76-5.52%) were asymptomatic. No associations with risk factors for infection were identified. CLA had moderate concordance with LFA IgG and ELFA, but minimal with LFA IgM. Conclusions Our report is one of the first in Latina America on seroprevalence and seroconversion rates in medical healthcare workers. It emphasizes the importance of avoiding focusing only on symptomatic individuals to screen this population for SARS-CoV-2 infection, since of all individuals that have evidence of previous infection many (37.93%) may be pre-symptomatic or asymptomatic and may contribute to infection/disease spread.


2015 ◽  
Vol 122 (5) ◽  
pp. 1113-1119 ◽  
Author(s):  
Irene S. Kourbeti ◽  
Antonis F. Vakis ◽  
Panayiotis Ziakas ◽  
Dimitris Karabetsos ◽  
Evangelos Potolidis ◽  
...  

OBJECT The authors performed a prospective study to define the prevalence and microbiological characteristics of infections in patients undergoing craniotomy and to clarify the risk factors for post-craniotomy meningitis. METHODS Patients older than 18 years who underwent nonstereotactic craniotomies between January 2006 and December 2008 were included. Demographic, clinical, laboratory, and microbiological data were systemically recorded. Patient characteristics, craniotomy type, and pre- and postoperative variables were evaluated as risk factors for meningitis RESULTS Three hundred thirty-four procedures were analyzed (65.6% involving male patients). Traumatic brain injury was the most common reason for craniotomy. Almost 40% of the patients developed at least 1 infection. Ventilatorassociated pneumonia (VAP) was the most common infection recorded (22.5%) and Acinetobacter spp. were isolated in 44% of the cases. Meningitis was encountered in 16 procedures (4.8%), and CSF cultures were positive for microbial growth in 100% of these cases. Gram-negative pathogens (Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Enterobacter cloaceae, Proteus mirabilis) represented 88% of the pathogens. Acinetobacter and Klebsiella spp. demonstrated a high percentage of resistance in several antibiotic classes. In multivariate analysis, the risk for meningitis was independently associated with perioperative steroid use (OR 11.55, p = 0.005), CSF leak (OR 48.03, p < 0.001), and ventricular drainage (OR 70.52, p < 0.001). CONCLUSIONS Device-related postoperative communication between the CSF and the environment, CSF leak, and perioperative steroid use were defined as risk factors for meningitis in this study. Ventilator-associated pneumonia was the most common infection overall. The offending pathogens presented a high level of resistance to several antibiotics.


2019 ◽  
Author(s):  
Sofia Artemi ◽  
Panteleimon Vassiliu ◽  
Nikolaos Arkadopoulos ◽  
Maria - Eleni Smyrnioti ◽  
Pavlos Sarafis ◽  
...  

Abstract Objective: Erectile dysfunction can be caused iatrogenically, due to pelvic surgery. The purpose of this study was to evaluate sexual function at various times after pelvic surgery in male patients and to investigate the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. Results: The mean age of the participants was 66.16 ± 13.07 years old. Regarding comorbidity, 47.2% reported various cardiovascular problems, 20.8% hypertension, 9.4% diabetes mellitus and 5.7% depression. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p <0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function ( p <0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.


2013 ◽  
Vol 1 (2) ◽  
pp. 21
Author(s):  
Abdelmoneim E. Kheir ◽  
Ghada A. Jobara ◽  
Kamal M. Elhag ◽  
Mohamed Z. Karar

Sepsis is one of the most common causes of morbidity and mortality in newborns. Diagnosis of neonatal sepsis may be difficult because clinical presentations are often non-specific. The aim of this study was to evaluate the role of qualitative C-reactive protein in the diagnosis of neonatal sepsis, and examine the correlation between C-reactive protein, blood culture and risk factors for sepsis. This was a prospective study, conducted in the Neonatal Intensive Care Unit at Soba University Hospital, Sudan. A total of seventy babies with a clinical diagnosis of sepsis were included. Chi square test was used to determine the association between C-reactive protein and risk factors for sepsis and also the association between C-reactive protein and blood culture. Blood culture was positive in 41.4% of babies, and C-reactive protein was positive in 58% of babies with positive blood culture. There was significant association between C-reactive protein results and blood culture (P=0.00). In conclusion, we can assume that Creactive protein is a reliable diagnostic marker of neonatal sepsis, especially in developing communities with poor resources.


2019 ◽  
Author(s):  
Sofia Artemi ◽  
Panteleimon Vassiliu ◽  
Nikolaos Arkadopoulos ◽  
Maria - Eleni Smyrnioti ◽  
Pavlos Sarafis ◽  
...  

Abstract Objective: A pelvic surgery can cause erectile dysfunction. The purpose of this study was to evaluate erectile function at various times after pelvic surgery in male patients; to search the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. This prospective study used the erectile dysfunction IIEF scale. Results: The study population comprised of 106 male patients who had undergone minor pelvic surgery at least 9 months before and during the 2010–2016 period in the 4th Surgical Clinic. A control group of healthy males (N=106) who underwent no pelvic surgery matched for age was also used for reference values. The main age of the participants was 66.16 ±13.07 years old. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p<0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function (p<0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.


2019 ◽  
Author(s):  
Sofia Artemi ◽  
Panteleimon Vassiliu ◽  
Nikolaos Arkadopoulos ◽  
Maria - Eleni Smyrnioti ◽  
Pavlos Sarafis ◽  
...  

Abstract Objective: A pelvic surgery can cause erectile dysfunction. The purpose of this study was to evaluate erectile function at various times after pelvic surgery in male patients; to search the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. This prospective study used the erectile dysfunction IIEF scale. Results: The study population comprised of 106 male patients who had undergone minor pelvic surgery at least 9 months before and during the 2010–2016 period in the 4th Surgical Clinic. A control group of healthy males (N=106) who underwent no pelvic surgery matched for age was also used for reference values. The main age of the participants was 66.16 ±13.07 years old. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p<0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function (p<0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.


2021 ◽  
pp. 014556132110367
Author(s):  
Yi-Bo Huang ◽  
Fan Zhang ◽  
Hui-Ju Chen ◽  
Dong-Dong Ren ◽  
Hua-Peng Yu ◽  
...  

Objective: Accidental pharyngeal fishbone ingestion is a common complaint in ear, nose, and throat clinics. Approximately two-thirds of the accidentally ingested fishbones can be removed using tongue depressors and indirect laryngoscopy. However, the remaining third is challenging to identify and remove using these methods. These difficult fishbones require identification and removal via more advanced approaches. Video-guided laryngoscope is used to deal with difficult fishbones in our center. This study aimed to explore the risk factors for difficult fishbones. Methods: A prospective study was performed at a teaching hospital on 2080 patients. Univariate and multivariate analyses were performed to identify the risk factors. Results: The common fishbone locations were the tonsils (39.8%; defined as STEP-I), tongue base (37.1%), vallecula (13.3%; STEP-II), and hypopharynx (9.8%; STEP-III). With increasing STEP level, the ratio of difficult fishbones correspondingly increased (Z = 13.919, P < .001), and the proportions were 21.1%, 41.9%, and 70% in STEP-I, II, and III, respectively. In particular, fishbones in STEP-III (vs STEP-I) had a higher risk of difficult fishbones (odds ratio [OR]: 11.573, 95% CI: 7.987-16.769). Complaints of neck pain (yes vs no), foreign body sensation (yes vs no), and shorter length of fishbones always had a lower risk of difficult fishbones (OR: 0.455, 95% CI: 0.367-0.564; OR: 0.284, 95% CI: 0.191-0.422; OR: 0.727, 95% CI: 0.622-0.85). Missing teeth (yes vs no), swallowing behavior after fishbone ingestion (yes vs no), and male patients (vs female) had a higher risk of difficult fishbones (OR: 1.9, 95% CI: 1.47-2.456; OR: 1.631, 95% CI: 1.293-2.059; OR: 1.278, 95% CI: 1.047-1.56). Conclusions: Neck pain, foreign body sensation, fishbone length, patient age and sex, tooth status, and swallowing behavior after fishbone ingestion are independent risk factors for difficult fishbones.


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