scholarly journals Neurotrauma in the Syrian War: Analysis of 41,143 cases from July 2013-July 2015

2021 ◽  
Author(s):  
Nida Fatima ◽  
Hani Mowafi ◽  
Mahmoud Hariri ◽  
Houssam Alnahhas ◽  
Anas Al-Kassem ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Neurosurgical Procedures ◽  
Penetrating Injuries ◽  
Median Length ◽  
Factors Associated ◽  
Demographic Group ◽  
Administrative Dataset ◽  
Crush Injuries

Abstract Introduction Despite nearly a decade of conflict, little is known about trauma and injuries resulting from the Syrian war. Methods Secondary analysis was conducted of an administrative dataset of patient presentations to a network of 95 war-affected hospitals in Syria from July 2013 - July 2015. Logistic regression was performed to identify factors associated with mortality of neurotrauma patients. Results Of 193,618 overall trauma presentations, 41,143 were for neurotrauma (37,410 head trauma, 1,407 spinal trauma and 3,133 peripheral nervous system). There were 31,359 males (76.2%) and 9,784 females (23.8%). Males aged 19-30 years (10,113; 24.6%) were the largest single demographic group. Presumed non-combatants including females, elders and children under 13 years (16,214; 39.4%) were the largest group of patients overall. There were 16,881 (41.0%) presentations with blunt injuries (blunt/crush injuries) and 21,307 (51.8%) patients with penetrating injuries (shrapnel, cut, gunshot). A total of 36,589 patients (89.6%) were treated and discharged from the hospital, 2,100 (5.1%) were transferred to another facility, 2,050 patients (5.0%) died in-hospital, 26 remained in the hospital (0.1%), 108 (0.3%) had unknown disposition. The median length of hospital stay was 1 day. There were 4,034 (9.7%) neurosurgical procedures documented. Patients with combined neurotrauma and general trauma suffered 30 times higher mortality than neurotrauma alone (aOR: 30.4; 95%CI: 20.8-44.2, p<0.0001). Conclusion The Syrian War resulted in large volumes of neurotrauma patients. Presumed non-combatants comprised 39.4% of patients who survived to treatment at a facility. Further study is needed on long-term needs of neurotrauma victims of the Syrian war.

scholarly journals Neurotrauma in the Syrian War: Analysis of 41,143 cases from July 2013-July 2015

2021 ◽  
Author(s):  
Nida Fatima ◽  
Mowafi ◽  
M MD Mahmoud Hariri ◽  
Alnahhas ◽  
F MSc MD Anas Al-Kassem ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Neurosurgical Procedures ◽  
Penetrating Injuries ◽  
Median Length ◽  
Factors Associated ◽  
Demographic Group ◽  
Administrative Dataset ◽  
Crush Injuries

Abstract Introduction: Despite nearly a decade of conflict, little is known about trauma and injuries resulting from the Syrian war.Methods: Secondary analysis was conducted of an administrative dataset of patient presentations to a network of 95 war-affected hospitals in Syria from July 2013 - July 2015. Logistic regression was performed to identify factors associated with mortality of neurotrauma patients. Results: Of 193,618 overall trauma presentations, 41,143 were for neurotrauma (37,410 head trauma, 1,407 spinal trauma and 3,133 peripheral nervous system). There were 31,359 males (76.2%) and 9,784 females (23.8%). Males aged 19-30 years (10,113; 24.6%) were the largest single demographic group. Presumed non-combatants including females, elders and children under 13 years (16,214; 39.4%) were the largest group of patients overall. There were 16,881 (41.0%) presentations with blunt injuries (blunt/crush injuries) and 21,307 (51.8%) patients with penetrating injuries (shrapnel, cut, gunshot). A total of 36,589 patients (89.6%) were treated and discharged from the hospital, 2,100 (5.1%) were transferred to another facility, 2,050 patients (5.0%) died in-hospital, 26 remained in the hospital (0.1%), 108 (0.3%) had unknown disposition. The median length of hospital stay was 1 day. There were 4,034 (9.7%) neurosurgical procedures documented. Patients with combined neurotrauma and general trauma suffered 30 times higher mortality than neurotrauma alone (aOR: 30.4; 95%CI: 20.8-44.2, p<0.0001).Conclusion: The Syrian War resulted in large volumes of neurotrauma patients. Presumed non-combatants comprised 39.4% of patients who survived to treatment at a facility. Further study is needed on long-term needs of neurotrauma victims of the Syrian war.

scholarly journals Long-term sequelae of Pneumococcal Sepsis in children: a systematic review

2021 ◽  
Author(s):  
Adeteju A Ogunbameru ◽  
Rafael N Miranda ◽  
Joanna Bielecki ◽  
Beate Sander
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Factors Associated ◽  
Pneumococcal Sepsis ◽  
Increased Risk ◽  
Meta Analyses

Background: Long-term sequelae associated with pneumococcal sepsis (PS) in pediatric patients in existing literature is currently unclear. Aim: To review the evidence on sequelae and prognostic factors associated with PS among pediatric patients. Method: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. We screened six databases from their inception to January 15, 2021. Study population were neonates, infants, children and adolescents less than 18 years old with suspected or confirmed PS disease. Outcomes included sequelae types, prognostic factors, pooled death estimate and length of hospital stay (LOS) for survivors and deceased patients. Quality of studies was assessed using Joanna Briggs Institute appraisal checklists. Results: We screened 981 abstracts, and 24 full-text articles for final review. Septic shock was the most prevalent physical sequelae reported (13%, n=1492 patients). No functional, cognitive or neurological sequelae were reported in included studies. Meta-analysis of pooled mortality estimate was 14.6% (95%CI: 9.9 -19.4%). Prognostic factors associated with increased risk of PS sequelae and death included pediatric risk of mortality score ≥ 10 and co-infection with meningitis. LOS for survivors and non-survivors ranged between 5-30 days and 1-30 days. Nine included studies met at least 50% of the quality assessment criteria. Conclusion: Physical sequelae and death are the PS sequelae types currently identified in existing literature. Lack of information about other possible sequelae types suggests the long-term consequences of PS disease maybe underreported, especially in resource-limited settings. Future studies should consider exploring reasons for the existing of this knowledge gap.

scholarly journals Study protocol for the COPE study: COVID-19 in Older PEople: the influence of frailty and multimorbidity on survival. A multicentre, European observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040569 ◽  
Author(s):  
Angeline Price ◽  
Fenella Barlow-Pay ◽  
Siobhan Duffy ◽  
Lyndsay Pearce ◽  
Arturo Vilches-Moraga ◽  
...  
Keyword(s):  
Observational Study ◽  
Smoking Status ◽  
Angiotensin Receptor Blockers ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Ratio Test ◽  
Short Term ◽  
Primary Analysis ◽  
And Gender

IntroductionThis protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed with COVID-19 in a European, multicentre setting.Methods and analysisOver a 3-month period we aim to recruit a minimum of 500 patients across 10 hospital sites, collecting baseline data including: patient demographics; presence of comorbidities; relevant blood tests on admission; prescription of ACE inhibitors/angiotensin receptor blockers/non-steroidal anti-inflammatory drugs/immunosuppressants; smoking status; Clinical Frailty Score (CFS); length of hospital stay; mortality and readmission. All patients receiving inpatient hospital care >18 years who receive a diagnosis of COVID-19 are eligible for inclusion. Long-term follow-up at 6 and 12 months is planned. This will assess frailty, quality of life and medical complications.Our primary analysis will be short-term and long-term mortality by CFS, adjusted for age (18–64, 65–80 and >80) and gender. We will carry out a secondary analysis of the primary outcome by including additional clinical mediators which are determined statistically important using a likelihood ratio test. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values.Ethics and disseminationThis study has been registered, reviewed and approved by the following: Health Research Authority (20/HRA1898); Ethics Committee of Hospital Policlinico Modena, Italy (369/2020/OSS/AOUMO); Health and Care Research Permissions Service, Wales; and NHS Research Scotland Permissions Co-ordinating Centre, Scotland. All participating units obtained approval from their local Research and Development department consistent with the guidance from their relevant national organisation.Data will be reported as a whole cohort. This project will be submitted for presentation at a national or international surgical and geriatric conference. Manuscript(s) will be prepared following the close of the project.

Factors Associated with Pulmonary Embolism Recurrence and the Benefits of Long-term Anticoagulant Therapy

2018 ◽  
Vol 17 (3) ◽  
pp. 205-211
Author(s):  
Francisco J.A. Sanchez ◽  
Jose L.A. Martínez ◽  
Mirem A.U. Echezarreta ◽  
Ione V. Garcia ◽  
Jorge R. Alvaro
Keyword(s):  
Pulmonary Embolism ◽  
Anticoagulant Therapy ◽  
Factors Associated

scholarly journals Intimate partner violence against women on the Colombia Ecuador border: a mixed-methods analysis of the liminal migrant experience

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Colleen Keating ◽  
Sarah Treves-Kagan ◽  
Ana Maria Buller
Keyword(s):  
Intimate Partner Violence ◽  
Mixed Methods ◽  
International Development ◽  
Partner Violence ◽  
Secondary Analysis ◽  
Intimate Partner ◽  
Psychological Consequences ◽  
Colombian Women ◽  
Restricted Mobility

Abstract Background Intimate partner violence (IPV) has serious long-term health and psychological consequences and is highly prevalent in Latin America and among displaced populations. Liminality - the ambiguous in-between state of individuals completing a migratory journey - represents a state of legal, economic, and physical insecurity. Through the framework of liminality, this analysis seeks to understand the unique challenges faced by displaced Colombian women in Ecuador including their experience of IPV. Methods We performed a secondary analysis of 15 in-depth interviews and 319 longitudinal surveys, conducted on the border of Ecuador and Colombia, following a sequential explanatory mixed-methods design. We analysed interviews thematically and mapped the main themes onto complementary quantitative variables. We conducted logistic regression with identified risk and protective factors (measured at time 1) and recent IPV (measured at time 2), controlling for demographic characteristics and IPV at time 1. Results Our mixed-methods analysis revealed four main mechanisms by which displacement influenced the social and economic realities of Colombian women years after crossing the border, compounding their risk of IPV and limiting their ability to escape it. Lack of legal residence and documentation, violence experienced along life course and migratory continuums which increased their risk for later revictimisation, social isolation including loss of support networks and restricted mobility and lastly, financial stress. Conclusions This research highlights the critical importance of supporting the economic and social integration of migrants and refugees in host communities, as well as the need to carefully consider migration-related vulnerabilities in IPV prevention and response interventions. As the regional refugee crisis grows, policy makers must consider how the long-term marginalisation of refugee women contributes to their victimisation. This research also supports the idea of incorporating gender synchronised, transformative IPV prevention and response programmes into migration-related and poverty alleviation international development efforts.

scholarly journals Review on Perioperative and Oncological Outcomes of Robotic Gastrectomy for Cancer

2021 ◽  
Vol 11 (7) ◽  
pp. 638
Author(s):  
Giuseppe Giuliani ◽  
Francesco Guerra ◽  
Lorenzo De Franco ◽  
Lucia Salvischiani ◽  
Roberto Benigni ◽  
...  
Keyword(s):  
English Language ◽  
Length Of Hospital Stay ◽  
Radical Gastrectomy ◽  
Robotic Gastrectomy ◽  
Relevant Evidence ◽  
Relative Paucity ◽  
Duration Of Surgery ◽  
High Level ◽  
Standard Laparoscopic Surgery

Background. Minimally invasive gastrectomy is currently considered a valid option to treat gastric cancer and is gaining increasing acceptance. Recent reports have suggested that the application of robots may confer some advantages over conventional laparoscopy, but the role of robotic surgery in clinical practice is still uncertain. We aimed to critically review the relevant evidence comparing robotic to standard laparoscopic surgery in performing radical gastrectomy. Methods. The Pubmed/Medline electronic databases were searched through February 2021. Paper conference and the English language was the only restriction applied to our search strategy. Results. According to the existing data, robotic gastrectomy seems to provide some benefits in terms of blood loss, rate of conversion, procedure-specific postoperative morbidity, and length of hospital stay. Robotic gastrectomy is also associated with a longer duration of surgery and a higher economic burden as compared to its laparoscopic counterpart. No significant differences have been disclosed in terms of long-term survivals, while the number of lymph nodes retrieved with robotic gastrectomy is generally higher than that of laparoscopy. Conclusions. The current literature suggests that robotic radical gastrectomy appears as competent as the conventional laparoscopic procedure and may provide some clinical advantages. However, due to the relative paucity of high-level evidence, it is not possible to draw definitive conclusions.

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