scholarly journals Helicobacter Pylori Infection is Associated with an Increased Stress Ulcer Risk in Brainstem Hemorrhage Patients with Robot-Aided Stereotactic Hematoma Aspiration

2021 ◽  
Author(s):  
Xiang Mao ◽  
Guanggui Chen ◽  
Lei Ye ◽  
Hongwei Cheng ◽  
Baiyun Liu
Keyword(s):  
Intensive Care Unit ◽  
Duodenal Ulcer ◽  
Intensive Care ◽  
Gastrointestinal Bleeding ◽  
Previous History ◽  
Icu Stay ◽  
Increased Risk ◽  
History Of ◽  
H Pylori ◽  
The Relationship

Abstract Background: Whether H. pylori infection in brainstem hemorrhage patients is related to the occurrence of SU has not been reported. The purpose of this study is to explore the relationship between H. pylori infection and the occurrence of SU, and whether it is necessary to eradicate H. pylori infection during treatment. Methods: This retrospective study was conducted in our patients in Neurocritical Care Unit (NICU), Intensive Care Unit (ICU), and Emergency Intensive Care Unit (EICU) between May, 2017-July, 2020. Patients were eligible for the study if they were admitted to a participating ICU for brainstem hemorrhage with gastrointestinal bleeding and with an ICU stay of at least 3 days. Patients were ineligible if their ICU stay was less than 72 hours, and patients with a previous history of gastric or duodenal ulcer were excluded from the study. All patients were performed with robot-aided stereotactic hematoma aspiration and gastric tube indwelling. Results: In the study, 65 patients were enrolled. Of these, 7 patients were excluded because their ICU stay lasted less than 72 hours or because they had previous history of gastric or duodenal ulcer. A further 5 patients were excluded because they required blood transfusion for bleeding on admission. Thus, 53 patients constituted the study group. Conclusions: This study showed brainstem hemorrhage patients infected by H. pylori were at increased risk of gastrointestinal bleeding, suggesting that H. pylori has a major role in the pathogenesis of acute SU in brainstem hemorrhage patients.

scholarly journals Characteristics of Disclosing Childhood Victimization and Risk of Revictimization in Young Adulthood

2019 ◽  
pp. 088626051988993 ◽  
Author(s):  
Michelle P. Desir ◽  
Canan Karatekin
Keyword(s):  
Young Adulthood ◽  
Previous History ◽  
Adverse Outcomes ◽  
Support Networks ◽  
Negative Reaction ◽  
Childhood Victimization ◽  
Increased Risk ◽  
History Of ◽  
The Relationship ◽  
Hispanic White

Experiencing victimization in childhood increases risk of adulthood revictimization, and it is important to understand what may contribute to such risk. One factor that may help to explain the increased risk of future victimization is disclosure. However, the literature is mixed as to whether disclosure of prior victimization is helpful for protecting against adverse outcomes, and much of the research on disclosure focuses solely on sexual victimization. The current study examines the relationship between various forms of childhood and adulthood victimization and whether disclosure moderates this relationship. In addition, this study investigates whether characteristics of disclosure are associated with revictimization risk. The sample included 275 undergraduates ( M age = 19.52 years; 75.6% female, 77.5% non-Hispanic White or Caucasian). Participants reported on previous history of various forms of childhood and adulthood victimization. They also reported whether or not they had disclosed childhood victimization, and, if so, characteristics related to disclosure. Results revealed that number of childhood victimization experiences significantly predicted number of adulthood victimization experiences, and nearly every type of childhood victimization significantly increased risk of experiencing each type of adulthood victimization. Disclosure did not moderate the relationship between childhood and adulthood victimization. Participants who disclosed were more likely to disclose crime and peer/sibling victimization and disclose to parents or friends. Positive reactions to disclosure were more common than negative reactions; however, 75% of disclosers received at least one negative reaction. Finally, revictimized individuals received more overall negative reactions than nonrevictimized individuals. They also received more reactions characterized by the person they disclosed to trying to take control of their decisions or treating them differently. Results highlight the importance of examining relationships between various forms of victimization, considering how characteristics of disclosure relate to risk of revictimization, and the importance of educating potential support networks about appropriate responses to disclosure.

scholarly journals Mortality from thyroid cancer in patients with hyperthyroidism: the Theagenion Cancer Hospital experience

2008 ◽  
Vol 159 (6) ◽  
pp. 799-803 ◽  
Author(s):  
Kalliopi Pazaitou-Panayiotou ◽  
Petros Perros ◽  
Maria Boudina ◽  
George Siardos ◽  
Apostolos Drimonitis ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Previous History ◽  
Distant Metastases ◽  
Northern Greece ◽  
Hot Nodule ◽  
Increased Risk ◽  
History Of ◽  
The Relationship ◽  
Diagnosis Of Thyroid Cancer ◽  
Autonomous Adenoma

BackgroundThyroid carcinoma has been reported in patients operated for different types of hyperthyroidism and the probability of a hot nodule being malignant seems to be low. The aim of the present study was to explore the relationship between thyroid cancer, hyperthyroidism and outcome in a large cohort of patients who presented to a tertiary cancer centre in Northern Greece.PatientsAmong 720 patients treated for thyroid cancer, 60 had a concomitant diagnosis of hyperthyroidism due to Graves' disease (n=14), solitary autonomous adenoma (n=17), or multinodular goiter (n=29). Adverse prognostic factors were common in patients with a previous history of hyperthyroidism at the time of diagnosis of thyroid cancer, including cases where the cancer was discovered coincidentally after thyroid surgery for hyperthyroidism and cases where tumor size was more than 10 mm.ResultsIn 10 out of 17 patients with hyperthyroidism due to solitary autonomous adenomas, the tumor was located within the hot nodule and two of these patients developed local and distant metastases and died from the disease 4 and 15 years after thyroidectomy.ConclusionClinicians managing patients with hyperthyroidism need to be aware of the possible increased risk of thyroid cancer in this patient group.

scholarly journals A Case of Pulmonary Tuberculosis Detected While Being Investigated with a Preliminary Diagnosis of Covid-19 Infection

2021 ◽  
pp. 80-81
Author(s):  
Taylan Çelik ◽  
Tayyar Ayberk Borak ◽  
Ender Ekin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Chest Pain ◽  
Pulmonary Tuberculosis ◽  
Respiratory Distress ◽  
Female Patient ◽  
Chest Radiography ◽  
Previous History ◽  
Left Lung ◽  
History Of

15-year-old female patient, who had no previous history of illness, had the complaint of intermittent cough and chest pain for 2 months. Two days ago, she applied to the hospital with difficulty in breathing added to her complaints. Tomography was planned due to the presence of pneumonic infiltration in the left lung in the chest radiography of the patient who was hospitalized in the intensive care unit due to respiratory distress.

scholarly journals Causes influencing the length of stay of cardiac surgery patients in the intensive care unit

2015 ◽  
Vol 1 (1) ◽  
pp. 40
Author(s):  
Nikoleta Dimitropoulou ◽  
Aggeliki Stamou ◽  
Christina Marvaki
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Coronary Artery ◽  
Demographic Characteristics ◽  
Average Hospital ◽  
Prolonged Stay ◽  
Icu Stay ◽  
History Of ◽  
Prolonged Icu Stay

Introduction: The incidence of postoperative morbidity has increased, a fact which may lead to prolonged hospitalization of the patient in the Intensive Care Unit (ICU) and generally in the hospital.Aim: The aim of the present study was to explore the complications after cardiac surgery responsible for the prolonged stay of patients in the ICU.Material and method: The studied sample consisted of 80 patients who were hospitalized in the Intensive Care Unit General Hospital of Athens from January 2013 to June 2014. For data collection a special registration form with information coming from the medical records of patients was used. Data analysis was performed by the IBM SPSS 21.0 (Statistical Package for Social Sciences).Results: Regarding to demographic characteristics Regarding the demographic characteristics and medical history of the studied sample, the majority were male (58.7%, n=47), with a mean age of 73 years and an average hospital stay of 3.3 days. The major causes of prolonged ICU stay was respiratory failure (20%, n=16), arrhythmias (17.5%, n = 14), bleeding (15%, n=12), myocardial infarction (11.3%, n=9), and pulmonary edema (10%,n=8). Τhe bivariate analysis showed statistical relationship to the level of 0,20 (p<0,20) between the prolonged ICU stay and age, coronary artery disease as the cause of entry, coronary artery bypass, diabetes melitus and chronic obstructive pulmonary disease.Conclusion: Patients with a history of heart failure, diabetes or obstructive pulmonary disease seems to have a greater chance for a prolonged ICU stay after cardiac surgery. Early recognition of demographic and clinical factors that may lead to the prolonged ICU stay can provide very important information about how to improve perioperative care of the patient.

scholarly journals GASTROINTESTINAL BLEEDING;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Mujtaba Jaffary ◽  
Nida ◽  
Saeed Ahmad Khan
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Gastrointestinal Bleeding ◽  
Mortality And Morbidity ◽  
Mechanically Ventilated ◽  
Icu Stay ◽  
Trust Hospital ◽  
Length Of Icu Stay ◽  
Duration Of Ventilation

Background: Gastrointestinal bleeding (GIB) among patients with critical illness is one of the leading sources of mortality and morbidity. The prevalence of GIB differs from 15-50 percent during first 24 hours stay in intensive care unit. Mechanical ventilation is a most leading risk factor of GIB among patients admitted in ICU (intensive care unit). Objectives: The objective of the study is to know the prevalence and risk factors associated with gastrointestinal bleeding among mechanically ventilated patients. Study Deign: Retrospectively study. Setting: Ch Rehmat Ali Memorial Trust Hospital, Lahore. Period: 1st October 2017 to 31st March 2018. Materials and Method: A group of 120 patients in intensive care unit who received mechanical ventilation for a period of 48 hours or above were included. Results: Among 56 patients with gastrointestinal bleeding, mean age was 49.2±12.1, mean length of ICU stay was 29.2±16.6 and mean duration of ventilation was 30.2±20.5. Among 64 patients with no gastrointestinal bleeding, mean age was 51.9±15.0, mean length of ICU stay was 12.7±6.8 and mean duration of ventilation was 13.5±7.9. There were 12 (21.1%) mortalities among patients with gastrointestinal bleeding and 10 (15.6%) mortalities among patients with no gastrointestinal bleeding. Conclusion: Study concluded that length of ICU stay, duration of ventilation, renal failure, liver failure and mortalities were more among patients with gastrointestinal bleeding.

scholarly journals Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Jie Chen ◽  
Ying Hang
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Hemorrhage ◽  
Meta Analysis ◽  
Current Evidence ◽  
Gastrointestinal Lesions ◽  
History Of

Meta Analysis/Original Research Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a cause of coronavirus disease 2019 (COVID-19), mainly targets the respiratory system. However, recent studies also show its role in causing gastrointestinal hemorrhage, potentially affecting morbidity and mortality-related outcomes of the patients. There is still no consensus on the risk factors, characteristics, and the overall outcome of the gastrointestinal hemorrhage in COVID-19 patients. The main aim of this study was to summarize current evidence, assessing risk factors that promote the onset of gastrointestinal hemorrhage in COVID-19 patients, and to compare the incidences of the different sites of gastrointestinal lesions, the events of abdominal pain, diarrhea, intensive care unit admissions, and mortality between COVID-19 patients with or without gastrointestinal bleeding. Methods: A search of the academic literature was performed according to the PRISMA guidelines across five databases i.e., Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to analyze the influence of the history of drugs consumption, gastrointestinal bleeding, the different incidence of gastrointestinal lesions, events of abdominal pain, intensive care unit (ICU) admission, and mortality between COVID-19 patients with/without gastrointestinal bleeding. Results: Out of 458 studies, three eligible studies with 663 participants (mean age: 69.7 ± 4.3 years) were included. A meta-analysis showed a medium-to-large influence of the history of gastrointestinal bleeding (Hedge’s g: 1.01) and anticoagulant drug consumption (g: 0.33) on the gastrointestinal bleeding in COVID-19 patients. Moreover, the incidence of gastroduodenal ulcers was higher as compared to esophagitis (37.5% versus 9.9%). Conclusions: The study provides preliminary evidence regarding the risk factors associated with the onset of gastrointestinal hemorrhage among COVID-19 patients. The study also outlines the characteristics and the outcomes of gastrointestinal hemorrhage in COVID-19 patients. doi: https://doi.org/10.12669/pjms.37.5.4351 How to cite this:Chen J, Hang Y. Characteristics, risk factors and outcomes of gastrointestinal hemorrhage in COVID-19 patients: A meta-analysis. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4351 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

scholarly journals Considerations in the provision of teleconsultations for outpatient obstetric anaesthesia care during the Covid-19 pandemic

2021 ◽  
pp. 201010582199117
Author(s):  
Leonard Wei Wen Loh ◽  
Yingke He ◽  
Hairil Rizal Abdullah ◽  
Kai Lee Ng ◽  
Un Sam Mok
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Severe Illness ◽  
Continuing Care ◽  
Short Report ◽  
Obstetric Anaesthesia ◽  
Increased Risk ◽  
Process And Outcome ◽  
Risk Of Exposure ◽  
Anaesthesia Care

Evidence has emerged that pregnant women who contract coronavirus disease 2019 (Covid-19) are at increased risk of certain forms of severe illness as well as complications requiring intensive care unit admission and resultant mortality. Teleconsultations can facilitate continuing care for obstetric patients during the Covid-19 pandemic while reducing their risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this short report, we share our experience in the provision of teleconsultations for ambulatory obstetric anaesthesia patients in our high-risk obstetric anaesthesia clinic during the Covid-19 pandemic. Appropriate labour analgesia or anaesthesia plans were able to be formulated and communicated to the patients by teleconsultation, resulting in no delay or compromise in their peripartum care. Both patients and clinicians reported satisfaction with the teleconsultation process and outcome. The considerations and challenges in setting up a teleconsultation service as well as the factors in favour of teleconsultation are also explored.

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

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