scholarly journals Abdominal disturbances in children with Covid-19

2021 ◽  
Vol 5 (2) ◽  
pp. 874-875
Author(s):  
Ferizate Dika-Haxhirexha ◽  
Sevdije Koxha ◽  
Ledia Qatipi ◽  
Shqiponja Turkeshi ◽  
Aulona Haxhirexha

Covid-19 continues to spread at an unprecedented pace, sparing no country in the world and including almost all ages. Although at the beginning of the pandemic, it was thought that the virus did not affect children, however over time, in different countries, more and more cases of children with Covid-19 begun to appear, though rarely among them were recorded any victims.  However, the clinical picture of infections with this virus in children was much more challenging than in adults.  In this article, we will present the case of three children of ages 4 to 14 years, with signs of acute abdomen, respectively with acute abdominal pain, fever, vomiting, and in whom acute appendicitis was suspected. In all three patients, anamnestic data showed positive family members infected with covid-19.   All three children were sent to the surgery ward for follow-up and further treatment.  The laboratory analyzes in all of them resulted in increased values ​​of both erythrocyte sediment and CRP, while only in one of them the values ​​of LDH and transaminases (AST, ALT) were also increased.  Ultrasonographic examination of the abdomen in two children showed the presence of a small amount of free fluid in the abdomen and mesentery thickening with several packets of enlarged lymph nodes. Radiography of the lungs did not show pulmonary lesions in any of the children. Body temperature ranged from 37.2 to 38.50C, while urine was within the normal range.  All children were hospitalized and kept under observation for several consecutive days. At the same time, they were treated with antibiotics of the group of cephalosporins of the third generation, as well as with antipyretics (paracetamol). As their condition improved and the abdominal pain subsided completely, they were released from the hospital with instructions to continue the rest and taking vitamins at home in the form of ready-made preparations for children. Conclusion: While the Covid-19 pandemic is rapidly spreading and not sparing even children, pediatricians and surgeons must be very cautious in treating children with acute abdominal pain since infections with Covid-19, and not surgical diseases, might be the real cause of these concerns.   

2001 ◽  
pp. 13-17
Author(s):  
Serhii Viktorovych Svystunov

In the 21st century, the world became a sign of globalization: global conflicts, global disasters, global economy, global Internet, etc. The Polish researcher Casimir Zhigulsky defines globalization as a kind of process, that is, the target set of characteristic changes that develop over time and occur in the modern world. These changes in general are reduced to mutual rapprochement, reduction of distances, the rapid appearance of a large number of different connections, contacts, exchanges, and to increase the dependence of society in almost all spheres of his life from what is happening in other, often very remote regions of the world.


2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Mohd Rohaizat Hassan ◽  
Syed Sharizman Syed Abdul Rahim ◽  
Mohammad Saffree Jeffree

  The COVID -19 pandemic has hit the world for a period of a year and a half; it has been a triple crisis, with medical, economic, and psychological consequences. After 18 months of going through a pandemic, this includes not only facing the transmission of SARS CoV-2 virus but also restricted movements. Communities are now facing pandemic fatigue starting as early as the third wave of increased cases in September 2020. Pandemic fatigue is the stage when the initial enthusiasm and eagerness to tackle the crisis is replaced by feelings of exhaustion. In a simple definition, pandemic fatigue is understood as demotivation to follow recommended protective behaviours. It is a natural and expected reaction to sustained and unresolved adversity in people’s lives, evolving gradually over time and affected by several emotions, experiences, and perceptions as well as the cultural, social, structural, and legislative environment.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 17-18
Author(s):  
Fredrik Borgsten ◽  
Xenia Gatopoulou ◽  
Marta Pisini ◽  
Magnus Tambour ◽  
Frida Schain ◽  
...  

Background In the last decades the introduction of novel drugs has greatly improved the prognosis of multiple myeloma (MM) patients. We have investigated healthcare resource utilization and sickness absence-associated productivity loss over time in a population-wide, retrospective registry study in Sweden. Methods 8,693 patients were identified in the National Cancer Register with a MM diagnosis from July 2001 to December 2015 and followed until 2016. Specialized healthcare usage (inpatient admissions and outpatient visits) were obtained from the Patient Register and costs were estimated by weighted DRG codes. For patients under 66 years of age, sickness absence and salary information were obtained by linkage to the LISA Register. Analyses were performed separately on patients who underwent autologous stem cell transplantation (ASCT) (n=1,425) and on non-transplanted patients (n=7,012) and stratified by diagnosis periods 2001-2005, 2006-2010 and 2011-2015 to reflect increased introduction of effective drugs into clinical care. Median age was 60 years in the ASCT group and 75 years in the non-ASCT group. Results The number of MM patients that underwent ASCT increased over time (n= 282 in 2001-2006 to n= 592 in 2011-2015). MM patients diagnosed most recently had improved overall survival (OS), with five-year OS rate increasing from 52% to 58% to 62% for patients diagnosed in 2001-2005, 2006-2010 and 2011-2015, respectively (p<0.0001). Patients diagnosed during 2011-2015 spent on average 20% and 9% less total time in specialized healthcare than patients diagnosed during 2001-2005 and 2006-2010, respectively (adjusting for sex, age at ASCT, weighted comorbidity score at ASCT and per follow-up year and education at ASCT). This decrease was driven by less usage and time in both inpatient and outpatient care. Adjusted sickness absence time decreased by 41% and 38% in the third follow-up year for patients diagnosed during 2011-2015 compared to patients diagnosed during 2001-2005 and 2006-2010, respectively. Productivity loss costs represented about 45% of total costs (healthcare resource costs ~55%) in the first two follow-up years, but decreased over time. The cumulative median per person cost (healthcare- and productivity-related) over the three follow-up years post-diagnosis decreased by 21% in 2011-2015 (€52,273) compared to 2001-2005 (€66,182), despite an 8% increase in three-year OS over the same period. The number of non-ASCT MM patients also increased over time (n=2,053 in 2001-2005 to n= 2,587 in 2011-2015). Median survival increased from 2.5 years to 3.4 years for patients diagnosed during 2001-2005 compared to 2011-2015. Average total time spent in specialized healthcare was reduced by 29% and 12% for patients diagnosed during 2011-2015, compared to patients diagnosed during 2001-2005 and 2006-2010, respectively (adjusting for sex, age at diagnosis, weighted CCS at diagnosis, weighted CCS per follow-up year and education at diagnosis). This was associated with decreased need for inpatient care and a shift towards more outpatient usage. By the third follow-up year, the adjusted sickness absence time in patients diagnosed during 2011-2015 was reduced by 44% and 23% compared to patients diagnosed in 2001-2005 and 2006-2010, respectively. Productivity loss accounted for approximately 15% of total costs (healthcare resource costs ~85%) and was stable over follow-up years. The cumulative median per-person cost (healthcare- and productivity-related) over three follow-up years was similar for patients diagnosed in 2001-2005 (€25,621) and 2011-2015 (€26,592), despite a 12% increase in three-year OS over the same period. Conclusion The availability of new treatment options for MM patients in Sweden over time was associated with less healthcare usage, less time spent in healthcare and lower productivity loss due to sickness absence for both ASCT and non-ASCT-treated patients. These improved clinical and economic outcomes provide policy makers, healthcare providers and physicians with invaluable real-world insights for cost-benefit considerations in the continued development and introduction of effective treatments for MM. Figure 1 Disclosures Borgsten: Janssen: Current Employment. Gatopoulou:Janssen: Current Employment. Pisini:Janssen: Current Employment. Tambour:Janssen: Current Employment, Current equity holder in publicly-traded company. Schain:Schain Research: Current Employment, Current equity holder in private company, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Divested equity in a private or publicly-traded company in the past 24 months, Ended employment in the past 24 months. Jones:Schain Research: Current Employment. Kwok:Schain Research: Other: Internship . Hjortsberg:Janssen: Current Employment.


Author(s):  
Garth Myers

The third chapter examines global urbanism as postcolonial. It concentrates on colonialism’s role in physically, ecologically and culturally re-structuring cities around the world, emphasizing the colonial shaping of urban landscapes –parks and botanical gardens - in Zanzibar and Port of Spain. The chapter shows the divergent, contested and reshaped character of the urban ecologies of these two settings in post-colonial times. British colonialism’s urban parks and gardens in both settings are the focus. Robert Orchard Williams, who served as curator of the botanic gardens of both colonies, serves as a foil for reflecting on the colonial legacy’s different refractions in these two post-colonial settings. The chapter also shows the agency of ordinary people in changing the environmental-spatial structure over time.


1986 ◽  
Vol 149 (1) ◽  
pp. 57-62 ◽  
Author(s):  
P. R. Joyce ◽  
J. A. Bushnell ◽  
J. W. B. Walshe ◽  
J. B. Morton

Of 105 patients admitted to a surgical ward with acute abdominal pain, 18 were considered to be without evidence of any organic aetiology for this symptom. These ‘non-organic’ patients were almost all female and differed from the ‘organic’ patients in state anxiety and in the illness behaviour questionnaire scales of psychological versus somatic perception, denial and affective disturbance. The two groups of patients could be differentiated on the basis of scores derived from the Illness Behaviour Questionnaire, and the State-Trait Anxiety Inventory.


CJEM ◽  
2010 ◽  
Vol 12 (06) ◽  
pp. 485-490 ◽  
Author(s):  
Angela M. Mills ◽  
Anthony J. Dean ◽  
Judd E. Hollander ◽  
Esther H. Chen

ABSTRACT Objective: We aimed to use the consensus opinion of a group of expert emergency physicians to derive a set of emergency diagnoses for acute abdominal pain that might be used as clinically significant outcomes for future research. Methods: We conducted a cross-sectional survey of a convenience sample of emergency physicians with expertise in abdominal pain. These experts were authors of textbook chapters, peer-reviewed original research with a focus on abdominal pain or widely published clinical guidelines. Respondents were asked to categorize 50 possible diagnoses of acute abdominal pain into 1 of 3 categories: 1) unacceptable not to diagnose on the first emergency department (ED) visit; 2) although optimal to diagnose on first visit, failure to diagnose would not be expected to have serious adverse consequences provided the patient had follow-up within the next 2–7 days; 3) if not diagnosed during the first visit, unlikely to cause long-term risk to the patient provided the patient had follow-up within the next 1–2 months. Standard descriptive statistical analysis was used to summarize survey data. Results: Thirty emergency physicians completed the survey. Of 50 total diagnoses, 16 were categorized as “unacceptable not to diagnose in the ED” with greater than 85% agreement, and 12 were categorized as “acceptable not to diagnose in the ED” with greater than 85% agreement. Conclusion: Our study identifies a set of abdominal pain conditions considered by expert emergency physicians to be clinically important to diagnose during the initial ED visit. These diseases may be used as “clinically significant” outcomes for future research on abdominal pain.


1981 ◽  
Vol 15 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Ira B. Pauly

Fifteen years ago the author reviewed the world literature on male transsexualism (Pauly, 1965). Subsequently he summarized the results of sex reassignment surgery for male and female transsexuals (Pauly, 1968), and reviewed the literature on female transsexualism (Pauly, 1974). Very recently, Meyer and Reter (1979) concluded that ‘sex reassignment surgery confers no objective advantage in terms of social rehabilitation’ as compared with a group of individuals who sought sex reassignment but remained unoperated upon at follow-up. Both groups improved over time and led the Johns Hopkins Gender Identity Clinic to conclude that sex reassignment surgery would no longer be offered there. This report, and other non-surgical, psychotherapeutic approaches to gender dysphoric patients (Barlow et al. 1973; Barlow et al. 1979; Lothstein and Levine, 1980) call into question the justification for sex reassignment surgery. Therefore, it becomes important to update the results of sex reassignment surgery for transsexuals. Data on 283 male to female transsexuals and 83 female to male transsexuals are presented.


2017 ◽  
Vol 31 (3) ◽  
pp. 335-338
Author(s):  
Pramod J. Giri ◽  
Vaibhav S. Chavan

Abstract Chondroblastoma of spine is very rare condition. To best of our knowledge, fewer than 30 cases have been reported in the world literature. Almost all of them involved both anterior & posterior component of vertebra. There are only few reports with isolated posterior element involvement. Clinical presentation of paraparesis because of vertebral chondroblastoma is very rare. This case report presents 17 yr old male with chondroblastoma involving posterior thoracic vertebra presenting with quadriparesis which improved after successful treatment. Early diagnosis and complete excision with periodic follow up is necessary for treatment of this disease.


Author(s):  
May Abdullah S. Alanazi ◽  
Abdulaziz Muslih Muhaylan Alsharari ◽  
Ibrahim Awadh R. Alanazi ◽  
Abdulaziz Mashan R. Alanazi

Acute abdominal pain is one of the commonest prevalent grievances in children, and it frequently requires emergency room diagnosis and management. Abdominal pain in children differs with age, concomitant symptoms, and pain site. While most cases of acute abdominal embarrassment are self-limiting and benevolent, there are certain diseases that can be life-threatening and necessitate instant care, such as appendicitis, intussusception, or intestinal obstruction. To decide the cause of acute abdominal pain and recognize children with surgical conditions, scrupulous history taking and numerous physical checkups are mandatory.The most important and realistic first goal in the evaluation of acute AP is to distinguish between surgical and nonsurgical situations, which are further divided into urgent and non-urgent categories. A thorough history and physical examination, laboratory investigations to evaluate comorbidity, and imaging scans are usually used for these purposes. Management decisions should necessitate teamwork between the emergency room physician, a surgeon, and a radiologist. Consecutivereassessment and symptomatic treatment with hardworking follow-up are necessary for management as soon aspossible in urgent disorder.


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