scholarly journals ENVENIMATIONS VIPERINES

2021 ◽  
Vol 9 (09) ◽  
pp. 432-437
Author(s):  
N. Tajellijiti ◽  
◽  
H. Errifaiy ◽  
N. Boukoub ◽  
Y. Elouardi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hypovolemic Shock ◽  
Public Health Problem ◽  
Cost Of Care ◽  
Symptomatic Therapy ◽  
Essential Components ◽  
Life Threatening ◽  
Biological Criteria ◽  
Definition Of ◽  
General Sign

Rational:The viper envenomations are a real public health problem in Morocco more deaths are reported each year. It is a medical-surgical emergency which can be daunting and life-threatening, as well as the patients functional prognosis. Patients and Methods or Material and Methods:We present 24 cases of serious viper envenomation, on a retrospective study extended over a period of 9 years from 2010 to 2019, and through a literature review we clarify the following aspects: epidemiological, pathophysiological, clinical and therapeutic. Inclusion criteria: The presence of traces of hooks with at least one locoregional and / or general sign of envenomation. The actual presence of the snake in question and / or its description by a witness or the victim. Results:This is a retrospective study that interested 12 men and 13 women, mean age 41 years. The bites were due to vipers, the species was known cerastescerastes type in two cases, MacroviperaMauritanica in one case. 13 patients had a consumptive coagulopathy table with two cases of ischemic stroke, one case of hypovolemic shock and 4 cases of hemorrhagic shock, ten patients had compartment syndrome treated by emergency fasciotomy discharge.11 patients received anti venom serum with clinical improvement and reduction of complications. Discussion:The poison of vipers is a chemical proteinaceous with two essential components: the toxins and enzymes. These proteins are responsible for the observed symptoms. The severity of envenomation is related to the plasma concentration of the venom. The definition of early clinical and biological criteria of gravity has envenomation better assess and clarify the therapeutic indications. Processing viper envenomation considerably simplified over the past decade. The medical care is based on a symptomatic therapy component associated with a specific serum therapy. On early treatment with these specific immunoglobulins from the onset of signs of grades II or III envenomation reduces morbidity, sequelae and the total cost of care. Conclusion:Improving the prognosis of envenomation involves information education and good care that can only be achieved through close collaboration between.

scholarly journals Retrospective study of outcome in patients with scorpion sting using prazosin with/without dobutamine

2015 ◽  
Vol 7 (2) ◽  
pp. 61-63
Author(s):  
L Venugopal ◽  
H Anilkumar ◽  
Dilip M Ram Pure ◽  
L Suresh Kumar ◽  
G Rajashekharappa
Keyword(s):  
Retrospective Study ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Public Health Problem ◽  
Left Ventricular ◽  
Major Public Health Problem ◽  
Scorpion Sting ◽  
Early Use ◽  
Life Threatening ◽  
Severe Degree

Introduction: Scorpion sting is a major public health problem in India with severe life threatening complications. Toxin can cause autonomic overstimulation leading to hypertension, arrhythmias and pulmonary edema with left ventricular dysfunction. Prazosin has been the ideal antidote for patients with mild to moderate envenomation. In patients with severe envenomation, dobutamine is found to be very useful to prevent morbidity and mortality.Materials and Methods: Retrospective study was done on patients admitted from March 2011 to November 2013 with a history of scorpion bite and adults aged between 20-60 yrs were included. All the patients were subjected to grading of envenomation as mild, moderate and severe degree. Prazosin was given to all 80 patients and dobutamine was given to those who did not show response to prazosin.Results: Majority of patients were in the age group of 31-40 years followed by 21-30 years. Mean age was 31.23±7.23 years. Fifty four patients (67.5%) were male and twenty six (32.5%) were female. 28 patients had mild envenomation, 36 had moderate envenomation and 16 had severe envenomation. 83.33% of patients responded to dobutamine infusion in prazosin resistant cases in our study.Conclusion: Early use of dobutamine should be considered in patients with severe envenomation with left ventricular dysfunction to prevent morbidity and mortality. 2D echo has to be considered to assess left ventricular dysfunction and need for early use of dobutamine.Asian Journal of Medical Sciences Vol.7(2) 2015 61-63

The Rise of Partnerships: From Local to Global

2018 ◽  
Author(s):  
Barbara Gray ◽  
Jill Purdy
Keyword(s):  
Nongovernmental Organizations ◽  
Public Services ◽  
Civic Society ◽  
Robust Solutions ◽  
Essential Components ◽  
Critical Issues ◽  
Definition Of ◽  
Societal Problems ◽  
Shared Norms ◽  
Multistakeholder Partnerships

Multistakeholder partnerships (MSPs) are formed to tackle knotty societal problems, promote innovation, provide public services, expand governance capabilities, set standards for a field, or resolve conflicts that impede progress on critical issues. Partnerships are viewed as collaboration among four types of stakeholders: businesses, governments, nongovernmental organizations (NGOs), and civic society. The objective of collaboration is to create a richer, more comprehensive appreciation of the iss/problem than any of the partners could construct alone by viewing it from the perspectives of all the stakeholders and designing robust solutions. Such partnerships are necessary because few organizations contain sufficient knowledge and resources to fully analyze issues and take action on them unilaterally. Five essential components of a rigorous definition of collaboration are presented: interdependence among partners, emergence of shared norms, wrestling with differences, respect for different competencies, and assuming joint responsibility for outcomes. Several examples of MSPs are provided.

scholarly journals A fatal toxic shock-like syndrome post COVID-19 infection in a child

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Houda Ajmi ◽  
Wissem Besghaier ◽  
Wafa Kallala ◽  
Abdelhalim Trabelsi ◽  
Saoussan Abroug
Keyword(s):  
Ejection Fraction ◽  
Pediatric Intensive Care ◽  
Fresh Frozen Plasma ◽  
Multiple Organ ◽  
Clinical Feature ◽  
Fresh Frozen ◽  
Life Threatening ◽  
High Doses ◽  
Definition Of ◽  
High Level

Abstract Background Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction. Case presentation We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal. Conclusion Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.

scholarly journals Melanosis coli in a peritoneal dialysis patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nor Fadhlina Zakaria ◽  
Nurul Izah Ahmad ◽  
Elmina Mokhtar ◽  
Wan Zul Haikal Hafiz Wan Zukiman ◽  
Anim Md Shah
Keyword(s):  
Peritoneal Dialysis ◽  
Chronic Diarrhea ◽  
Histopathological Examination ◽  
Hypovolemic Shock ◽  
Peritoneal Dialysis Patient ◽  
Electrolyte Imbalance ◽  
Case Presentation ◽  
Melanosis Coli ◽  
Life Threatening ◽  
Black Discoloration

Abstract Background Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion. Case presentation We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously. Conclusions The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.

Il modello sociale europeo. Valutazioni e contributi delle chiese e confessioni religiose d'Europa

2013 ◽  
pp. 21-33
Author(s):  
Marco Ricceri
Keyword(s):  
Social Model ◽  
Integration Process ◽  
Religious Congregations ◽  
Religious Traditions ◽  
European Social Model ◽  
The Social ◽  
Essential Components ◽  
Key Factor ◽  
National Welfare ◽  
Definition Of

The evolution of the European integration process and the foundation of the Union, invite us to consider the National welfare systems in a wider outlook: the European Social Model (ESM). Integration process and EU foundation are both essential components to the ESM and they receive constant impulse towards the adoption of modern practices and rules. Without reference to the European framework we run the risk to simplify the understanding of both specific features of the national welfare models and of the contribution given by the religious traditions to their development. It is at the European level that the Churches and the religious Congregations have been able to introduce several central elements in the new social policy guidelines valid for the all national systems. An analysis and assessment of the influence brought by the Churches to the E.U. becomes a key factor in a scientific analytical study. Chapter aims to discuss: a) approaches to the "Social Question" assumed by the European authorities; b) the social system as defined by the Lisbon Treaty (2007); c) a shared definition of the "European Social Model"; d) the influence of Religious Congregations to defining the E.U. principles; e) the support of the Churches towards a sustainable social and economic development.

Reporting altered test results in hemolyzed samples: is the cure worse than the disease?

2017 ◽  
Vol 55 (8) ◽  
pp. 1112-1114 ◽  
Author(s):  
Giuseppe Lippi ◽  
Gianfranco Cervellin ◽  
Mario Plebani
Keyword(s):  
Laboratory Data ◽  
Turnaround Time ◽  
Reliable Data ◽  
Test Results ◽  
The Past ◽  
Laboratory Test Results ◽  
Performance Specifications ◽  
Life Threatening ◽  
The Many ◽  
Definition Of

AbstractThe management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement. This approach carries some advantages, namely the timely communication of potentially life-threatening laboratory values, but also some drawbacks. These especially include the challenging definition of validated performance specifications for hemolyzed samples, the need to producing reliable data with the lowest possible uncertainty, the short turnaround time for repeating most laboratory tests, the risk that the comments may be overlooked in short-stay and frequently overcrowded units (e.g. the emergency department), as well as the many clinical advantages of a direct communication with the physician in charge of the patient. Despite the debate remains open, we continue supporting the suggestion that suppressing data in unsuitable (hemolyzed) samples and promptly notifying the clinicians about the need to recollect the samples remains the most (clinically and analytically) safe practice.

scholarly journals Prevalence of Sexual Violence in Migrants, Applicants for International Protection, and Refugees in Europe: A Critical Interpretive Synthesis of the Evidence

2018 ◽  
Vol 15 (9) ◽  
pp. 1979 ◽  
Author(s):  
Lotte De Schrijver ◽  
Tom Vander Beken ◽  
Barbara Krahé ◽  
Ines Keygnaert
Keyword(s):  
Sexual Violence ◽  
Sexual And Reproductive Health ◽  
Ecological Model ◽  
Grey Literature ◽  
Public Health Problem ◽  
Future Research ◽  
Major Public Health Problem ◽  
International Protection ◽  
Critical Interpretive Synthesis ◽  
Definition Of

(1) Background: Sexual violence (SV) is a major public health problem, with negative socio-economic, physical, mental, sexual, and reproductive health consequences. Migrants, applicants for international protection, and refugees (MARs) are vulnerable to SV. Since many European countries are seeing high migratory pressure, the development of prevention strategies and care paths focusing on victimised MARs is highly needed. To this end, this study reviews evidence on the prevalence of SV among MAR groups in Europe and the challenges encountered in research on this topic. (2) Methods: A critical interpretive synthesis of 25 peer-reviewed academic studies and 22 relevant grey literature documents was conducted based on a socio-ecological model. (3) Results: Evidence shows that SV is highly frequent in MARs in Europe, yet comparison with other groups is still difficult. Methodologically and ethically sound representative studies comparing between populations are still lacking. Challenges in researching SV in MARs are located at the intrapersonal, interpersonal, community, societal, and policy levels. (4) Conclusions: Future research should start with a clear definition of the concerned population and acts of SV to generate comparable data. Participatory qualitative research approaches could be applied to better grasp the complexity of interplaying determinants of SV in MARs.

scholarly journals Rare Treatments for Rare Dyslipidemias: New Perspectives in the Treatment of Homozygous Familial Hypercholesterolemia (HoFH) and Familial Chylomicronemia Syndrome (FCS)

2021 ◽  
Vol 23 (11) ◽  
Author(s):  
Laura D’Erasmo ◽  
Simone Bini ◽  
Marcello Arca
Keyword(s):  
Familial Hypercholesterolemia ◽  
Treatment Options ◽  
New Drugs ◽  
Lipid Lowering ◽  
Homozygous Familial Hypercholesterolemia ◽  
Published Evidence ◽  
Novel Drugs ◽  
Life Threatening ◽  
History Of ◽  
Definition Of

Abstract Purpose of Review This review aims to summarize the most recent published literature concerning lomitapide and volanesorsen that are approved for the use in HoFH and FCS patients, respectively. Moreover, it will briefly revise the published evidence on novel, non-approved treatments that are under evaluation for the management of these rare forms of dyslipidemias Recent Findings The definition of rare dyslipidemias identifies a large number of severe disorders of lipid metabolism of genetic origin. Among them were homozygous familial hypercholesterolemia (HoFH) (OMIM #143890) and familial chylomicronemia syndrome (FCS) (OMIM #238600), which are characterized by a markedly impaired cholesterol- and triglyceride-containing lipoproteins metabolism. They are being particularly associated with poor health outcomes and quality of life. Considering the severity of these diseases, common lipid-lowering drugs are often ineffective or do not allow to achieve the recommended lipid targets to prevent the development of complications. Nowadays, several new drugs have been found to effectively treat HoFH and FCS with an acceptable safety profile. Summary Treating patients with HoFH and FCS remains very challenging. However, novel treatment options are emerging and might be considered in addition to conventional therapy for managing these diseases. These novel drugs will possibly change the natural history of these two rare and life-threatening diseases.

Life-threatening conditions in pericarditis of different etiologies: diagnosis and treatment

2019 ◽  
pp. 40-45
Author(s):  
A. Ya. Kosonogov ◽  
S. V. Nemirova ◽  
V. I. Pozdishev ◽  
A. B. Nikolskiy ◽  
K. A. Kosonogov ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Postoperative Period ◽  
Underlying Disease ◽  
Electrolyte Balance ◽  
Symptomatic Therapy ◽  
Electrolyte Disorders ◽  
Results Of Treatment ◽  
Cardiac Compression ◽  
Pericardial Diseases ◽  
Life Threatening

Purpose of the study: to analyze the etiology, diagnostic criteria and results of treatment of life-threatening conditions in pericarditis of different etiologies (based on our clinic materials).Materials and methods. The study included cases of hospitalization of patients with a diagnosis of «Pericarditis» and ICD-10 codes for pericardial diseases for the period from 2009 to 2018. In the course of the work, the history and clinical picture of the disease, laboratory and radiation research methods were analyzed. All patients started treatment of the underlying disease and performed symptomatic therapy, including those aimed at restoring hemodynamics and normalizing water and electrolyte disorders, stopping inflammation and auto-aggression of the immune system. When signs of compression/cardiac tamponade were detected, pericardiocentesis was performed, according to indications, drainage/fenestration of the cardiac sac, pericardiotomy were performed. In the postoperative period was carried out antibacterial and symptomatic therapy.Results. Life-threatening diseases of the pericardium accounted for 32,03% of all patients treated in the hospital for pericarditis. The most frequently detected signs of a hemodynamically significant compression and cardiac tamponade, less often purulent and constrictive P. Isolated 25 patients underwent closed drainage with pericardiocentesis, in 1 case the drainage was supplemented with f ibrinolytic therapy. Sanitation of the cavity and fenestration of the pericardium were carried out in 11 patients, pericardiotomy with notched drainage in 2 patients, thoracotomy with pericardiectomy – 4. In the postoperative period, the symptoms of inflammation were reduced, the level of cardiac enzymes decreased, the electrolyte balance stabilized. Most patients noted a distinct regression of the symptoms of pericarditis and cardiac compression. Recurrent P was noted in 5 cases, deaths occurred in 4 cases (8,16%).Conclusion. Early verification of the diagnosis and timely decompression of the heart with fractional evacuation of the exudate or pericardectomy with respect to the sequence of release of the heart chambers from adhesions and adhesions against the background of complex therapy allows to achieve positive dynamics, and fenestration of the cardiac bag with the formation of a sufficiently sized opening during recurrent fluid accumulation or intrapericardial fibrin. development of severe complications of pericarditis even in patients with multiple concomitant diseases evanii and oncopathology.

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