scholarly journals It's Fournier's gangrene still dangerous?

2009 ◽  
Vol 56 (1) ◽  
pp. 77-80
Author(s):  
S. Bilali ◽  
E. Celiku ◽  
V. Bilali
Keyword(s):  
Clinical Symptoms ◽  
Early Recognition ◽  
Fournier’S Gangrene ◽  
University Hospital ◽  
Prognostic Indicators ◽  
Fournier's Gangrene ◽  
Significant Difference ◽  
Radical Debridement ◽  
Aggressive Debridement ◽  
The University

Background: Fournier's gangrene is known to have an impact in the morbidity and despite antibiotics and aggressive debridement, the mortality rate remains high. Objectives: To assess the morbidity and mortality in the treatment of Fournier's gangrene in our experience. Methods: The medical records of 14 patients with Fournier's gangrene who presented at the University Hospital Center 'Mother Teresa' from January 1997 to December 2006 were reviewed retrospectively to analyze the outcome and identify the risk factor and prognostic indicators of mortality. Results: Of the 14 patients, 5 died and 9 survived. Mean age was 54 years (range from 41-61): it was 53 years in the group of survivors and 62 years in deceased group. There was a significant difference in leukocyte count between patients who survived (range 4900-17000/mm3) and those died (range 20.300- 31000/mm3). Mean hospital stay was about 19 days (range 2-57 days). Conclusion: The interval from the onset of clinical symptoms to the initial surgical intervention seems to be the most important prognostic factor with a significant impact on outcome. Despite extensive therapeutic efforts, Fournier's gangrene remains a surgical emergency and early recognition with prompt radical debridement is the mainstays of management.

scholarly journals Which Role for Hyperbaric Oxygen Therapy in the treatment of Fournier’s gangrene? A Retrospective Study.

2020 ◽  
Author(s):  
Roberta Tutino ◽  
Francesco Colli ◽  
Giovanna Rizzo ◽  
Leo Licari ◽  
Gaetano Gallo ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Stay ◽  
Fournier’S Gangrene ◽  
University Hospital ◽  
Surgical Operation ◽  
Fournier's Gangrene ◽  
Great Loss ◽  
Hospital Stays ◽  
Hyperbaric Therapy ◽  
The University

Abstract Background: In Fournier’s gangrene the surgical debridement plus broad-spectrum antimicrobial therapy is the mainstay treatment but can cause a great loss of tissue. Moreover, the local poor blood supply, the infection and the damage to the vessels can delay the healing. Consequently, the disease needs long hospital stays and, despite all, has high mortality rate. The aim of our study is to investigate the improvement offered by hyperbaric therapy in Fournier’s gangrene.Methods: We retrospectively evaluated data on 23 consecutive patients admitted for Fournier’s gangrene at the University hospital “P.Giaccone” of Palermo from 2011 to 2018. The relation between hyperbaric therapy, hospital stay and mortality was evaluated. Factors related to mortality were also examined.Results: The use of hyperbaric therapy was offered to 13(56.5%) patients. Hospital stay was longer in patients treated with HBOT[mean11(C.I.0.50-21,89)vs25(C.I.18.02-31.97);p=0.02]. Mortality occurred in three patients(13.1%), two of whom treated with HBOT. Mortality was not statistically related to sex(p=0.20), BMI(p=0.53), renal failure (p=1.00), diabetes(p=0.49), age>65 years old(p=0.55), simplified FGSI>2(p=0.05), higher ASA scores(>=4)(p=0.47), symptoms at admission lasting since more than 72 hours (p=0.28), HBOT(p=1.00), need of colostomy(p=0.06), several operations(p=1.00), several operations plus HBOT(P=1.00). Conversely, the delay between admission and surgical operation was statistically related to mortality, 1.7 days(C.I.0.9-3.5) in survivals vs 6.8 days(C.I.3.5-13.4) in death patients(p=0.001).Conclusions: Our study proves that a delay in the treatment of patients with Fournier’s gangrene has a correlation with the mortality rate, while the use of HBOT seems to not improve the survival rate, increasing the hospital stay instead.

scholarly journals Fournier’s gangrene. A clinical review

2016 ◽  
Vol 88 (3) ◽  
pp. 157 ◽  
Author(s):  
Ariana Singh ◽  
Kamran Ahmed ◽  
Abdullatif Aydin ◽  
Muhammad Shamim Khan ◽  
Prokar Dasgupta
Keyword(s):  
Mortality Rate ◽  
High Mortality ◽  
Early Recognition ◽  
Care Pathway ◽  
Disease Process ◽  
Fournier’S Gangrene ◽  
Prognostic Indicators ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Clinical Awareness

Introduction and Hypothesis: Fournier’s gangrene is a rare, necrotising fasciitis of the external genitalia, perineal or perianal regions. The disease has a higher incidence in males and risk factors for development include diabetes, HIV, alcoholism and other immune-compromised states. The aggressive disease process is associated with a high mortality rate of 20-30%. In addition, the increasing age and prevalence of diabetes in the population, begs the need for increased clinical awareness of Fournier’s gangrene with emphasis on early diagnosis and management. This review aims to highlight the relevant research surrounding Fournier’s gangrene, in particular the various prognostic indicators and management strategies. Methods: A search was conducted on the MEDLINE database for all applicable research; clinical reviews, retrospective studies and case reports. In addition to which a search of the European Association of Urology, the British Association for Urological Surgeons and the British Medical Journal was conducted for the most recent recommendations. Results: Immediate broad-spectrum antibiotic therapy and urgent surgical debridement are the core managerial principles of Fournier’s gangrene. The use of adjunctive therapies such as hyperbaric oxygen and vacuum assisted closure are supported in some aspects of the literature and disputed in others. The lack of randomized controlled studies limits the use of these potential additional therapies to patients unresponsive to conventional management. The value of unprocessed honey as a topical antimicrobial agent has been highlighted in the literature for small lesions in uncomplicated patients. Conclusion: Fournier’s gangrene is a urological emergency with a high mortality rate despite advances in the medical and surgical fields. The aggressive nature of the infection advocates the need for early recognition allowing immediate surgical intervention. The opposing results of available research as well as the lack of high quality evidence surrounding emergent therapies prevents their routine use in the management of Fournier’s gangrene. The absence of a specific care pathway may hinder efficient management of Fournier’s gangrene, thus based on current guidelines a management pathway is suggested.

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.

scholarly journals AB185. SOH21AS226. The management of Fournier’s Gangrene in an Irish university hospital: a case series

2021 ◽  
Vol 5 ◽  
pp. AB185-AB185
Author(s):  
Lynda Condell ◽  
Morgan Peter McMonagle ◽  
Megan Power-Foley
Keyword(s):  
Case Series ◽  
Fournier’S Gangrene ◽  
University Hospital ◽  
Fournier's Gangrene

The Prevalence of Rotavirus and Adenovirus in Children 0-5 years old Suffering from Acute Diarrhea in the University Hospital Center of Mother and Child (UHC-MC) in N’Djamena, Chad

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Fombotioh Ndifor ◽  
Abakar Idriss Lawane ◽  
Nadjioroum Ngam-Asra ◽  
Mouktar Abaya Adoum ◽  
Brahim Boy Otchom ◽  
...  
Keyword(s):  
Viral Infection ◽  
Acute Diarrhea ◽  
Clinical Symptoms ◽  
Public Health Problem ◽  
University Hospital ◽  
Test Kit ◽  
Mother And Child ◽  
Fresh Stool ◽  
The University ◽  
Hospital Center

Acute diarrhea is one of the leading causes of morbidity and mortality in children from 0-5 months old, especially in Africa and many developing countries. Rotavirus and Adenovirus have been recognized as the common pathogens for this public health problem. However, little or no investigation has been carried out on the two viruses in Chad. In view of this fact, we decided to study the prevalence of Rotavirus and Adenovirus in children suffering from acute diarrhea at the University Hospital Center of Mother and Child (UHC-MC). Fresh stool samples were collected from 440 children ages 0-5 years (225 females and 2015 males). They were brought for medical consultation from March 2019- September 2019 at the pediatric department. Specimens were analyzed and Rotavirus and Adenovirus were detected using Rapid Immunochromatographic Test kit (Vikia BioMerieux, France). Out of the 440 children examined, 228 had viral infection with a prevalence of 51.81%. Based on gender infection, females 140 (62.22%) were significantly more infected than males 88(40.93%). Prevalence of mono infection of Rotavirus in children 110 (48.24%) was higher than that of Adenovirus 74(32.45%). More males had Rotavirus infection 60(68.18%) than girls 50 (37.71%). Co-infection was found to be 44 (19.29%). Distribution of viral infection indicated that children between 6-11 months had the highest viral burden 101(77.69%). Among clinical symptoms recorded, dehydration was the highest in children 84(61.76%). Due to the high prevalence of Rotavirus and Adenovirus discovered, we suggest that vaccines for the two viruses should be included in the national immunization program.

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.

FC04-02 - Traumatic experiences as a risk factor for suicide in adolescence

2011 ◽  
Vol 26 (S2) ◽  
pp. 1829-1829
Author(s):  
M. Delalle ◽  
K. Dodig-Ćurković ◽  
P. Filaković
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Early Recognition ◽  
Child And Adolescent Psychiatry ◽  
University Hospital ◽  
Traumatic Experience ◽  
Traumatic Experiences ◽  
Hospital Treatment ◽  
Control Group ◽  
Significant Difference

IntroductionToday, the general interpretation of the etiology of various psychopathological symptoms in adolescence does not talk about causes, but the risk factors.AimWe tried to determine whether traumatic experiences among adolescents represent a risk factor for suicide.MethodsThe study was conducted at the University Department for Child and Adolescent Psychiatry, University Hospital Osijek in 2006. and 2007. years.In the study period we included 100 patients, the experimental group consisted of 50 patients who were admitted to the department for attempted suicide in the order of admission to hospital treatment, the control group consisted of 50 patients admitted to the department for other psychiatric disorders, also in the order of admission to treatment / diagnosed according to DSM IV/.ResultsAge range of 13–18 years. There was no statistically significant difference between the two groups of subjects according to age (χ2 = 5289, df = 5, p = .382) and according to sex (χ2 = .694, df = 1, p = .405). In the suicidal group 38 patients (76%) reported traumatic experiences /most in family context/ while in nonsuicidal group 27 patients (54%) what is statistical difference (χ2 = 5319, df = 1, p = .021).ConclusionIn daily psychiatric work we must focus on adolescents who have experienced traumatic experiences and is therefore extremely important in anamnesis always ask for the lived traumatic experience. Family practitioners, specialists in educational institutions, parents and adolescents themselves have a role in early recognition of these risk factors.

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.

Correlation between severity of migraine attacks and IgE level in peripheral blood

2016 ◽  
Vol 40 (3) ◽  
Author(s):  
Maryam Hassanpour Moghadam ◽  
Hamidreza Ardalani ◽  
Alireza Alehashemi ◽  
Mahboobeh Adami Dehkordi ◽  
Mojtaba Meshkat
Keyword(s):  
Inflammatory Mediators ◽  
Peripheral Blood ◽  
Migraine Headache ◽  
Clinical Symptoms ◽  
Allergic Sensitization ◽  
Allergic Diseases ◽  
University Hospital ◽  
Migraine Headaches ◽  
Treatment And Prevention ◽  
Significant Difference

Abstract: The correlation between allergic diseases and migraine is partially due to a better understanding of inflammatory mediators with vasoactive function that play an important role in these diseases. This study aimed to evaluate the correlation between allergic sensitization and severity of migraine.: This study was carried out on 212 patients who suffered from migraine headache in a university hospital in Mashhad, Iran. All of these patients were evaluated for allergic rhinitis (AR) by measuring the IgE level in peripheral blood and assessing the clinical symptoms of AR. Prevalence of AR in migraine patients and degree of allergic sensitization was assessed in this study.: The prevalence of AR in migraine patients was 78.30%. Total IgE levels in the peripheral blood in migraine patients with AR were found to be significantly (p<0.0001) higher than those without migraines. There was a significant difference between severity of AR (higher level of IgE) and severity of migraine attacks (p<0.0001), but there was not any significant difference between severity of AR and other factors.: We propose that inflammatory mediators play a key role in triggering migraine attacks. Thus, effective treatment of AR in migraine patients plays an important role in treatment and prevention of migraine headaches.

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