scholarly journals Decompression illness treated at the Geneva hyperbaric facility 2010–2016: A retrospective analysis of local cases

2020 ◽  
Vol 50 (4) ◽  
pp. 370-376
Author(s):  
Julian Thaler ◽  
◽  
Rodrigue Pignel ◽  
Marie-Anne Magnan ◽  
Michel Pellegrini ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
High Rate ◽  
Musculoskeletal Symptoms ◽  
Decompression Illness ◽  
Unfavourable Outcome ◽  
Hyperbaric Chamber ◽  
Short Term ◽  
Term Outcome ◽  
Treatment Centre ◽  
Hyperbaric Medicine

(Thaler J, Pignel R, Magnan M-A, Pellegrini M, Louge P. Decompression illness treated at the Geneva hyperbaric facility 2010–2016: A retrospective analysis of local cases. Diving and Hyperbaric Medicine. 2020 December 20;50(4):370–376. doi: 10.28920/dhm50.4.370-376. PMID: 33325018.) Introduction: The Geneva hyperbaric chamber is the main treatment centre for decompression illness (DCI) in Switzerland. The characteristics, symptomatology, treatment and short-term outcome of divers treated at this chamber have not previously been investigated. Methods: This was a retrospective study of patients treated with hyperbaric oxygen (HBO) for DCI from 2010 to 2016. Data were analysed to provide a description of the cases and statistical analysis for possible factors associated with an unfavourable outcome. Results: One hundred and thirty-five patients were treated for DCI. Ninety-two were included in the study. Sixty-four presented with neurological and 28 with mild DCI. One hundred and thirty-five patients were treated for DCI. Ninety-two were included in the study. Sixty-four presented with neurological and 28 with mild DCI. Patients with mild DCI mainly had musculoskeletal symptoms (79%). Patients with neurological DCI mainly had spinal (55%), followed by vestibular (36%) symptoms. Arterial gas embolism was diagnosed in 30% of cases. Diving depths ranged between 15 and 142 metres, and dive times between two and 241 min. Median time to treatment was 6 h. Patients with neurological DCI had a high rate (25%) of persisting deficits after treatment. Older age was associated with an unfavourable outcome in univariate but not in multivariate analysis. No adverse effects of HBO were observed. For spinal DCI, a high Boussuges score was associated with persisting deficits after treatment. Conclusions: Our findings are consistent with other series. Severe DCI was associated with a high rate of persisting deficits. No single factor was associated with a negative outcome. A Boussuges score > 7 had sensitivity of 90% and positive predictive value 53% for predicting an unfavourable outcome in spinal DCI.

γ’/total fibrinogen ratio is associated with short-term outcome in ischaemic stroke

2011 ◽  
Vol 105 (03) ◽  
pp. 430-434 ◽  
Author(s):  
Elim Cheung ◽  
Lonneke de Lau ◽  
Heleen den Hertog ◽  
Frank Leebeek ◽  
Diederik Dippel ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischaemic Stroke ◽  
Linear Regression Analysis ◽  
Prognostic Significance ◽  
Multiple Linear Regression Analysis ◽  
Unfavourable Outcome ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Unit Increase

SummaryFibrinogen γ’ (γ’) is a natural isoform of fibrinogen, and alters the rate of formation and the properties of clots. It could therefore affect outcome after ischaemic stroke. The prognostic significance of γ’ fibrinogen levels is, however, still unclear. It was the objective of this study to assess levels of γ’ in ischaemic stroke, and its association with short-term outcome. We included 200 ischaemic stroke patients and 156 control persons. Total fibrinogen and γ’ levels were measured; outcome at discharge was assessed by means of the modified Rankin Scale score (defined as unfavourable when >2). We compared levels between patients and controls using multiple linear regression analysis, and logistic regression analysis was used to assess the relationship between levels and outcome. All analyses were adjusted for age and sex. Mean γ’ levels were significantly higher in patients with ischaemic stroke than in controls (0.37 vs. 0.32 g/l, p<0.001), and patients also had a higher γ’/total fibrinogen ratio (0.102 vs. 0.096, p=0.19). The γ’/total fibrinogen ratio is associated with unfavourable outcome in patients with ischaemic stroke (odds ratio per unit increase of γ’/total fibrinogen ratio 1.27, 95% confidence interval 1.09–1.47). Our study shows that patients with ischaemic stroke have increased levels of fibrinogen γ’ and suggests a trend towards an increased γ’/total fibrinogen ratio in ischaemic stroke. Increased fibrinogen γ’ relative to total fibrinogen levels are associated with unfavourable outcome in the early phase after stroke.

scholarly journals Traumatic stifle injury in 72 cats: a multicentre retrospective study

2021 ◽  
pp. 1098612X2110288
Author(s):  
Mario Coppola ◽  
Smita Das ◽  
George Matthews ◽  
Matteo Cantatore ◽  
Luis Silva ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
High Rate ◽  
Ligament Injury ◽  
Meniscal Injury ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up

Objectives The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome. Methods The medical records from seven veterinary hospitals of cats treated for traumatic stifle injury were reviewed. Long-term follow-up data were collected from referring veterinarians and using the Feline Musculoskeletal Pain Index, collected from owners. Results Seventy-two cats were included in the study. The most common combination of ligament injury involved both cruciate ligaments and the lateral collateral ligament (25.4%). Medial meniscal injury was more common (66.2%) than lateral meniscal injury (59.4%). A temporary transarticular pin was used intraoperatively to aid reduction in 23/73 (31.5%) surgeries. Postoperative immobilisation was applied in 41/72 (56.9%) cats with a mean duration of 4.8 weeks. Short-term complications occurred in 40/64 (62.5%) cats. Long-term complications occurred in seven (17.5%) cats. Overall outcome was excellent in 25/61 (41%) cats, good in 13/61 (21.3%) cats, fair in 11/61 (18%) cats and poor in 12/61 (19.7%) cats. Mean length of follow-up was 29.6 months (range 0.5–204). A significantly poorer outcome was observed in cats with medial meniscal injury and those undergoing revision surgery. Use of a transarticular pin when left in situ for postoperative immobilisation was associated with a poorer outcome (P = 0.043) and a higher risk of complications (P = 0.018). Postoperative immobilisation was not related to outcome. Conclusions and relevance Traumatic stifle injury in cats can lead to rupture of multiple ligaments causing significant instability of the joint. Surgical treatment is associated with a high rate of short-term complications, although long-term outcome may still be good to excellent in the majority of cats (62.3%). In cats where follow-up was available, postoperative immobilisation had no positive effect on outcome and may not be required. Leaving a transarticular pin for postoperative immobilisation is not recommended as it was significantly associated with a poorer outcome and a higher complication rate.

Abdominal decompression illness following repetitive diving: a case report and review of the literature

2019 ◽  
pp. 211-215
Author(s):  
Peter Beale ◽  
Levi Kitchen ◽  
W.R. Graf ◽  
M.E. Fenton ◽  
Keyword(s):  
Case Report ◽  
The Body ◽  
Decompression Illness ◽  
Review Of The Literature ◽  
Hyperbaric Chamber ◽  
Foreign National ◽  
Biochemical Effects ◽  
Elapsed Time ◽  
Nitrogen Bubbles ◽  
Abdominal Decompression

The complete pathophysiology of decompression illness is not yet fully understood. What is known is that the longer a diver breathes pressurized air at depth, the more likely nitrogen bubbles are to form once the diver returns to surface [1]. These bubbles have varying mechanical, embolic and biochemical effects on the body. The symptoms produced can be as mild as joint pain or as significant as severe neurologic dysfunction, cardiopulmonary collapse or death. Once clinically diagnosed, decompression illness must be treated rapidly with recompression therapy in a hyperbaric chamber. This case report involves a middle-aged male foreign national who completed three dives, all of which incurred significant bottom time (defined as: “the total elapsed time from the time the diver leaves the surface to the time he/she leaves the bottom)” [2]. The patient began to develop severe abdominal and back pain within 15 minutes of surfacing from his final dive. This case is unique, as his presentation was very concerning for other medical catastrophes that had to be quickly ruled out, prior to establishing the diagnosis of severe decompression illness. After emergency department resuscitation, labs and imaging were obtained; abdominal decompression illness was confirmed by CT, revealing a significant abdominal venous gas burden.

Influence of Sex on the Short-term Outcome of Elderly Patients With a First Acute Myocardial Infarction

Circulation ◽  
1995 ◽  
Vol 92 (5) ◽  
pp. 1133-1140 ◽  
Author(s):  
Héctor Bueno ◽  
M. Teresa Vidán ◽  
Aureliano Almazán ◽  
José L. López-Sendón ◽  
Juan L. Delcán
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Elderly Patients ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome
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