Outcome of Pseudoaneurysm Repair: A Single Tertiary Center Experience in Pahang, Malaysia

Introduction: Symptomatic arterial pseudoaneurysm is not an uncommon emergent vascular case presenting to a tertiary hospital. These are mainly associated with infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and mortality present a challenge to the surgeons managing these cases. Materials and method: We retrospectively reviewed all case notes of all pseudoaneurysm repair done at our centre from Jan 2015 to May 2017. Results: A total of 20 cases were treated surgically, with majority 16(80%) had ligation of the affected arteries. The rest were managed with reconstruction of the arteries with synthetic graft. In 7 patients (35%), the aetiology was identified as iatrogenic intravenous drug injection. Staphylococcus aureus remained the main causative organism with Treponema Pallidum and Burkholderia pseudomallei as the other organisms identified in the cultures. Our 3 patients with graft reconstruction had long term oral antibiotics upon discharge. Conclusion: Majority of pseudoaneurysms presented to our center results in ligation of the artery. Repair of mycotic aneurysm needs careful consideration as graft infection remains a lethal complication and no consensus is available regarding the duration of post-operative antibiotic cover.

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Sources and prevention of graft infection during long term ex situ liver perfusion

Transplant Infectious Disease ◽

10.1111/tid.13623 ◽

2021 ◽

Author(s):

Dilmurodjon Eshmuminov ◽

Matteo Mueller ◽

Silvio D. Brugger ◽

Lucia Bautista Borrego ◽

Dustin Becker ◽

...

Keyword(s):

Liver Perfusion ◽

Graft Infection ◽

Ex Situ

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Long-term success of flexible endoscopic septal division with the stag beetle knife for Zenker’s diverticulum: a tertiary center study

Diseases of the Esophagus ◽

10.1093/dote/doaa019 ◽

2020 ◽

Vol 33 (11) ◽

Author(s):

Sauid Ishaq ◽

Keith Siau ◽

Minhong Lee ◽

Haleema Sultan ◽

Shalmani H Mohaghegh ◽

...

Keyword(s):

Cox Regression ◽

Multivariable Analysis ◽

Zenker’S Diverticulum ◽

Long Term Outcome ◽

Zenker's Diverticulum ◽

Tertiary Center ◽

Symptom Remission ◽

Treatment Naïve ◽

Symptom Recurrence

Summary Objectives Flexible endoscopic septum division is an established treatment for Zenker’s diverticulum (ZD); however, long-term outcome data are lacking. We aimed to evaluate the long-term efficacy of flexible endoscopic septal division (FESD) using the stag beetle knife for ZD and identify predictors of symptom recurrence. Methods Patients undergoing the procedure between 2013 and 2018 were prospectively enrolled. Procedures were performed by a single operator. Symptom severity pre- and postprocedure was recorded using the dysphagia, regurgitation, and complications scale. Symptom recurrence was defined as a total score > 1 after the index procedure. Time-to-event analyses were performed using Kaplan–Meier plots, with multivariable analyses performed using Cox regression models. Results Altogether, 65 patients (mean age 74.0 years, 60% male) were included. Previous stapling had been performed in 44.6% of patients. Over the mean posttreatment follow-up period of 19 months, 5.6% of the treatment naïve group and 34.5% of the recurrent group underwent repeated FESD (P = 0.003), with rates of symptom remission and improvement of 75.4% and 92.7%, respectively. Recurrence at 48 months was higher in patients with recurrent ZD (84.7%) than in treatment-naïve patients (10.7%). On multivariable analysis, recurrent disease (hazard ratio [HR] 20.8, P = 0.005) and younger age (HR 0.96/year, P = 0.047) were associated with symptom recurrence. Conclusions In patients with treatment-naïve ZD, flexible endoscopic septal division is safe and provides durable symptom remission. However, in patients with poststapling recurrence, the risk of recurrence is high and time-dependent.

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Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

European Journal of Ophthalmology ◽

10.1177/1120672120976044 ◽

2020 ◽

pp. 112067212097604

Author(s):

Reem R Al Huthail ◽

Yasser H Al-Faky

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Tertiary Hospital ◽

Nasal Endoscope ◽

Long Term Follow Up ◽

Mean Size ◽

External Dacryocystorhinostomy ◽

The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

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Fr518 LONG-TERM SAFETY OF TOFACITINIB: REAL WORLD DATA FROM A TERTIARY CENTER

Gastroenterology ◽

10.1016/s0016-5085(21)01539-0 ◽

2021 ◽

Vol 160 (6) ◽

pp. S-342-S-343

Author(s):

Nathaniel A. Cohen ◽

Joshua M. Steinberg ◽

Alexa Silfen ◽

Cindy Traboulsi ◽

Jorie Singer ◽

...

Keyword(s):

Real World ◽

Real World Data ◽

World Data ◽

Tertiary Center

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Long-term and clinical profile of heart failure with recovered ejection fraction in a non-tertiary hospital

Medicina Clínica (English Edition) ◽

10.1016/j.medcle.2018.11.017 ◽

2019 ◽

Vol 152 (2) ◽

pp. 50-54

Author(s):

Virgilio Martínez-Mateo ◽

Manuel Fernández-Anguita ◽

Laura Cejudo ◽

Eugenia Martín-Barrios ◽

Antonio J. Paule

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Tertiary Hospital ◽

Clinical Profile

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Long‐term outcomes of primary sclerosing cholangitis: an Australian non‐transplant tertiary hospital perspective

Internal Medicine Journal ◽

10.1111/imj.14041 ◽

2019 ◽

Vol 49 (3) ◽

pp. 323-327 ◽

Cited By ~ 3

Author(s):

Elliot Freeman ◽

Ammar Majeed ◽

William Kemp ◽

Stuart K. Roberts

Keyword(s):

Primary Sclerosing Cholangitis ◽

Sclerosing Cholangitis ◽

Tertiary Hospital ◽

Long Term Outcomes ◽

Hospital Perspective

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Long-term Successful Antibiotic Therapy for Recurrent Aortic Graft Infection

European Journal of Case Reports in Internal Medicine ◽

10.12890/2018_000913 ◽

2018 ◽

pp. 1

Author(s):

Liana Dykman ◽

Leore Cohen ◽

Micha Rapoport

Keyword(s):

Antibiotic Therapy ◽

Graft Infection ◽

Aortic Graft ◽

Aortic Graft Infection

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Results of the Toxoplasmosis Screening in 9311 Pregnant Women in a Tertiary Center in Turkey

Flora the Journal of Infectious Diseases and Clinical Microbiology ◽

10.5578/flora.69026 ◽

2020 ◽

Vol 25 (3) ◽

pp. 332-338

Author(s):

Özgür Koçak ◽

Özgür Kan

Keyword(s):

Pregnant Women ◽

Acute Infection ◽

Congenital Toxoplasmosis ◽

Tertiary Hospital ◽

High Rate ◽

Central Anatolia ◽

Confirmatory Test ◽

Serological Examination ◽

Tertiary Center ◽

Avidity Test

Introduction: Toxoplasma gondii is an important parasite that can cause permanent sequelae to the fetus when infected during pregnancy in humans. Although the frequency of this parasite varies widely between countries, it is known that it is common in our country. The aim of this study was to determine the seroprevalence of toxoplasma in pregnant women admitted to a tertiary hospital in central Anatolia and to evaluate the pregnancy outcomes together with seroprevalence. Materials and Methods: A total of 9311 patients admitted to a tertiary hospital between January 2016 and December 2018 were included into the study. After serological examination, avidity test was performed in cases suggestive of acute infection. Amniocentesis was recommended to be performed by Polimeraze Chain Reaction (PCR) in patients with low avidity. Results: The frequency of Toxoplasma immunoglobulin (Ig) G and M seropositivity rates were 20.3% and 0.28%, respectively. Low avidity was found in approximately 27% of the patients with IgM positivity, and only 15.4% had low avidity by confirmatory test. One patient could not be reached during follow-up. PCR was performed in 4 patients whose low avidity value was confirmed by re-tests and all of their PCR results were reported negative. No cases of congenital toxoplasmosis were detected during the 3 years in our clinic. Conclusion: The inclusion of toxoplasma in routine screening programme is still controversial and differs between countries. Screening in areas with a high rate of toxoplasma, such as in our country, may be rational. If infection is detected, treatment may be recommended because it may reduce the transmission to the fetus.

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