HAZARDS OF TITANIUM MESH CRANIOPLASTY – OUR EXPERIENCE

2021 ◽  
pp. 65-67
Author(s):  
S. I. Sadique ◽  
Md. Shahbaz Alam ◽  
Md. Shahid Alam
Keyword(s):  
Removal Rate ◽  
Economic Status ◽  
Skull Defect ◽  
Titanium Mesh ◽  
Common Procedure ◽  
Study Analyse ◽  
Co Morbidity ◽  
Causative Factors ◽  
Defect Repair ◽  
Overall Mortality

INTRODUCTION: Titanium is biologically inert, hard, rigid, strong, durable, light-weight, resistant to infection, easy to handle and relatively inexpensive, hence frequently used as the material of choice for cranioplasty. But at the same time there is signicant rate of complications, most commonly infection, poor cosmesis, hematoma, headache, seizure and implant exposure necessitating re-operation and implant removal. MATERIALS AND METHODS: The present study was conducted in the department of neurosurgery, Bangur Institute of Neurosciences(B.I.N), Kolkata & SSKM Hospital, IPGME & R, Kolkata from January 2019 to December 2020. The study design was non-randomized prospective observational study. The period of study was 2 years. The sample size was 30. OBSERVATIONS AND RESULTS: Total 30 patients underwent cranioplasty. Their mean age was 38 years (range, 20-62 years) with a male:female ratio of 3:2. Ten patients developed postoperative complications, making a cranioplasty complication rate of 33.34%. Out of 10 patients, 5 (50%) required further surgical procedure including 4 cases of cranioplasty removal, the overall removal rate of 13.34%. Overall mortality was nil. CONCLUSION: Titanium mesh cranioplasty though a very common procedure used for correction of craniectomy skull defect is not totally free from complication. Our present study analyse the various causative factors which may lead to complications and implant failure. We have to be very judicious in the use of materials and other modalities used for skull defect repair depending upon the current materials available, the patient's general condition, co-morbidity, their economic status and modality of surgery.

scholarly journals DECREASING PREVALENCE OF THE ACUTE/SUBACUTE CLINICAL FORM OF PARACOCCIDIOIDOMYCOSIS IN MATO GROSSO DO SUL STATE, BRAZIL

2014 ◽  
Vol 56 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Larissa Rodrigues Fabris ◽  
Úrsulla Vilella Andrade ◽  
Aline Ferreira Dos Santos ◽  
Ana Paula da Costa Marques ◽  
Sandra Maria do Valle Leone de Oliveira ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Age Distribution ◽  
Epidemiological Data ◽  
Infection Prevalence ◽  
Age Group ◽  
Clinical Form ◽  
Mato Grosso ◽  
Co Morbidity ◽  
Mato Grosso Do Sul ◽  
Overall Mortality

With the objective to evaluate the behavior of paracoccidioidomycosis in the last three decades, clinical and epidemiological data of 595 patients admitted to clinical services of the Federal University of Mato Grosso do Sul from 1980 to 2009 were investigated. Gender, age distribution, clinical form, comorbidity with tuberculosis or AIDS, and mortality were compared by decades of clinical admission. It was shown that during the three decades there was a decrease in women percentage, and the same manner occurred a reduction in participants in the age group of 20 to 39 years. Moreover, the acute/subacute forms have been diminished in the period. These fluctuations are closely related and can be simultaneously analyzed. Increased AIDS co-infection prevalence from the first to the second decade was also revealed, coinciding with the appearance of the retroviral epidemic and stabilizing during the third decade. No change in the tuberculosis co-infection rate was observed (overall = 6.9%). It reinforces the importance of this co-morbidity. The overall mortality rate remained steady at 6.7%, not varying significantly from one decade to another. The persistent mortality rate calls attention to the importance of this neglected disease.

scholarly journals Morbidity pattern and outcome of children admitted to a paediatric intensive care unit of Eastern India

2017 ◽  
Vol 4 (2) ◽  
pp. 486
Author(s):  
Bandya Sahoo ◽  
Sibabratta Patnaik ◽  
Reshmi Mishra ◽  
Mukesh Kumar Jain
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gastrointestinal Diseases ◽  
Medical Advice ◽  
Eastern India ◽  
Medical Sciences ◽  
Against Medical Advice ◽  
Co Morbidity ◽  
Paediatric Critical Care ◽  
Overall Mortality

Background: In developing countries, there is scarce data on paediatric critical care. This makes modification of practices to improve outcome, difficult. The above study was done to highlight the lack of facilities and concept of pediatric critical in the eastern part of India so that modification of management can lead to better outcome of critically ill children.Methods: A retrospective study of the demography, clinical profile, diagnosis, treatment and outcome of children admitted to the PICU of Kalinga Institute of Medical Sciences from January 2014 to December 2015 was done. Results: A total of 848 children were admitted to the PICU with male and female children being 61.3% and 38.7% respectively. Diagnoses included infectious diseases (20.7%), respiratory disease (19.1%), central nervous system diseases (14.3%), cardiovascular diseases (10.8%), gastrointestinal diseases (7%), surgical problems (4.7%) haematological (4%), renal (3.3%), poisonings (1.4%), and others (14.3%). Out of 848 admitted children, 4.1% died and (1.4%) left against medical advice (8.5%) children received mechanical ventilation, among which (62.5%) improved, 34.7% died and 2.8% children left against medical advice. Multiorgan dysfunction syndrome (MODS) and co-morbidity were present in 25% and 22% respectively. The proportion of death among patients admitted to PICU was 4.1%.Conclusions: The leading cause of admission was infectious and respiratory diseases. Children with MODS and co-morbidity had higher mortality. The overall mortality rate in our PICU was low. We conclude, a well-equipped intensive care unit with modern and innovative facilities leads to a good outcome. 

Roughness Effects During Focused Ion Beam Repair of X-Ray Masks with Polycrystalline Tungsten Absorbers

1992 ◽  
Vol 279 ◽  
Author(s):  
R. R. Kola ◽  
G. K. Celler ◽  
L R. Harriott
Keyword(s):  
Material Removal ◽  
Etch Rate ◽  
Focused Ion Beam ◽  
Removal Rate ◽  
Ion Beam ◽  
Sidewall Roughness ◽  
X Ray ◽  
Polycrystalline Tungsten ◽  
Absorber Material ◽  
Defect Repair

ABSTRACTTungsten is emerging as the absorber material of choice for x-ray masks due to recent advances in the deposition of low stress films. For a practical technology, the masks must be free from defects. These defects may be in the form of excess or missing absorber. Finely focused ion beams have been used for defect repair on x-ray masks, both for removal of excess absorber material by physical sputtering and for addition of absorber material by ion-induced deposition. The eifect of ion channeling in polycrystalline tungsten films is spatially nonuniform material removal during sputtering. Different grains will have significantly different sputtering yields, depending on their orientation with respect to the direction of the ion beam. The repaired features then suffer from roughness on the bottoms and sidewalls of the sputter craters. We have investigated the use of XeF2 assisted sputtering with a 20 keV Ga+ focused ion beam to reduce this roughness. The chemical etching component of the material removal lessens the directional dependence and therefore the roughness during defect repair. It was also found that chromium etch rate was reduced in the presence of XeF2 gas while the etch rate of W was enhanced so that the removal rate of Cr is much less than that of W. We can take advantage of this etch selectivity by using a thin Cr layer under the W absorber as an etch stop layer to eliminate the roughness at the bottom of the features and a thin layer of Cr on top of the W as an etch mask for reducing the sidewall roughness.

Socio-economic status and co-morbidity as risk factors for trauma

2014 ◽  
Vol 30 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Olof Brattström ◽  
Mikael Eriksson ◽  
Emma Larsson ◽  
Anders Oldner
Keyword(s):  
Risk Factors ◽  
Economic Status ◽  
Socio Economic Status ◽  
Co Morbidity

Mortality and hospitalization in myelodysplastic syndromes (MDS) using the SEER-Medicare linked database

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7091-7091
Author(s):  
K. Lindquist ◽  
M. Danese ◽  
K. Knopf ◽  
J. Mikhael
Keyword(s):  
Economic Status ◽  
Cox Models ◽  
Medicare Data ◽  
Diagnosis Codes ◽  
Kaplan Meier ◽  
Background Mortality ◽  
Co Morbidity ◽  
Independent Risk Factors ◽  
Ed Visits ◽  
Time Varying Covariates

7091 Background: Mortality in patients with MDS is high, and most require transfusions, emergency department (ED) visits, and hospitalizations. The relationship between these outcomes with the key complications of MDS (anemia, neutropenia, thrombocytopenia) has not been well studied. Methods: Patients who were ≥ 66 years at MDS diagnosis in 2001 or 2002 were identified from SEER registries. Those with both Medicare Part A and B were followed until death or the end of 2005. Mortality, transfusions, ED visits, and hospitalizations were based on Medicare data. The presence of complications was based on diagnosis codes, transfusions, and medication use. Kaplan-Meier incidence was estimated for each outcome. Factors associated with each outcome were based on multivariable Cox models with baseline age, gender, race, co-morbidity level, socio-economic status indicators, and time-varying covariates for each complication. Results: In 1,863 MDS patients, the 3-month incidence of transfusion, ED and hospitalization was 45%, 41%, and 62%, and 3-year incidence was 75%, 87%, and 91% respectively. Median survival was 22 months. The 3-year incidence of anemia, thrombocytopenia and neutropenia was 89%, 37%, and 15% respectively. See table for multivariate results. Conclusions: Starting shortly after diagnosis, MDS patients have high rates of transfusions, ED visits, and hospitalizations. Diagnoses of anemia, neutropenia, and thrombocytopenia are strongly associated with this utilization. The presence of anemia and thrombocytopenia are important independent risk factors for death. [Table: see text] [Table: see text]

scholarly journals A critical review and meta-analysis of the association between overt hyperthyroidism and mortality

2011 ◽  
Vol 165 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Frans Brandt ◽  
Anders Green ◽  
Laszlo Hegedüs ◽  
Thomas H Brix
Keyword(s):  
Critical Review ◽  
Meta Analysis ◽  
Co Morbidity ◽  
Statistical Heterogeneity ◽  
Pubmed Search ◽  
Design Characteristics ◽  
And Control ◽  
Overt Hyperthyroidism ◽  
Overall Mortality ◽  
Survival Case

BackgroundOvert hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in study design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis.MethodsBased on an electronic PubMed search, using the Medical Subject Heading words such as hyperthyroidism, thyrotoxicosis, and mortality or survival, case–control and cohort studies were selected and reviewed. Using meta-analysis, an overall relative risk (RR) of mortality was calculated.ResultsEight studies fulfilled the inclusion criteria, six of which showed an increased all-cause mortality; seven studies, including 31 138 patients and 4 00 000 person years at risk, allowed calculation of mortality in a meta-analysis. Based on this, the RR of overall mortality was 1.21 (95% confidence interval: 1.05–1.38). Analyses including studies considering setting, treatment, and control for co-morbidity did not significantly alter this finding. As the measured heterogeneity (I2) ranges from 89.1 to 98.3%, which is much higher than the 50% generally viewed on as a threshold, the statistical heterogeneity is very pronounced in the included studies.ConclusionIn patients diagnosed with hyperthyroidism, mortality is increased by ∼20%. Future studies need to address the cause of hyperthyroidism, impact of type of therapy, time dependency, as well as the potential influence of confounding or genetic susceptibility before the question of causality can be answered.

scholarly journals COVID-19 in Patients With Hematologic Malignancies: A Single Center Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Xuejun Alice Wang ◽  
Adam F. Binder ◽  
Usama Gergis ◽  
Lindsay Wilde
Keyword(s):  
Hematologic Malignancies ◽  
Smoking History ◽  
Third Wave ◽  
The Novel ◽  
Mild Disease ◽  
Patients With Cancer ◽  
Lymphoid Malignancies ◽  
Co Morbidity ◽  
Novel Coronavirus ◽  
Overall Mortality

Initial studies that described the novel coronavirus (COVID-19) reported increased morbidity and mortality in patients with cancer. Of this group, patients with hematologic malignancies (HM) had the highest disease severity and death rates. Subsequent studies have attempted to better describe how COVID-19 affects patients with HM. However, these studies have yielded variable and often contradictory results. We present our single-institution experience with patients with HM who were diagnosed with COVID-19 from March 2020 to March 2021. We report 62 total cases with 10 patients who died during this time. The overall mortality was 16.1%. Mortality during the first two waves of COVID was 27.8% and 25%. Mortality during the third wave of COVID was 10%. The median age of patients was 67 years (range 20-89 years). 55% of patients had lymphoid malignancies and the majority had active disease at the time of diagnosis with COVID-19. 87% of patients had more than one co-morbidity. Important co-morbidities included cardiovascular disease and smoking history. 38.7% of patients had asymptomatic or mild disease, 54.8% required hospitalization, and 17.5% required ICU level care. In patients who required ICU level care, the mortality was 60%.

Advanced skull defect repair

2019 ◽  
pp. 101
Author(s):  
V. I. Sharobaro ◽  
A. G. Gavrilov ◽  
Yu. V. Ivanov
Keyword(s):  
Skull Defect ◽  
Defect Repair

scholarly journals Surgical mortality in patients more than 80 years of age

2016 ◽  
Vol 98 (03) ◽  
pp. 177-180 ◽  
Author(s):  
AM Khan-Kheil ◽  
HN Khan
Keyword(s):  
Emergency Surgery ◽  
Considerable Proportion ◽  
Common Procedure ◽  
Urological Surgery ◽  
Large Teaching Hospital ◽  
Co Morbidity ◽  
American Society ◽  
The Uk ◽  
Surgery Mortality ◽  
American Society Of Anesthesiologists

Introduction Patients aged >80 years account for a considerable proportion of the population admitted to hospital under general surgeons. We aimed to establish the prevalence of mortality in patients aged >80 years who underwent emergency general, vascular and urological surgery within a 13-month period at a large teaching hospital in the UK. Materials and methods A retrospective analysis was carried out of all patients aged ≥80 years admitted on acute on-call emergency under general, vascular or urological surgeons. Patient demographics (including comorbidities and sex) were recorded. American Society of Anesthesiologists scores were reviewed from anaesthetic records. The outcome measure was 30-day mortality for those who had undergone emergency general, vascular or urological surgery. Results A total of 4,069 patients were admitted under general, vascular and urological surgeons during the study period. Of these patients, 521 were aged >80 years. Sixty-three patients underwent emergency surgery and 12 died <30 days after surgery (mortality = 19%). The most common procedure was laparotomy (20 cases). The most common co-morbidity was cardiac disease, which included hypertension, ischaemic heart disease, and hypercholesterolemia. A considerable proportion of patients also had malignant disease and arthritis. Conclusions The present study suggests that emergency surgery should not be denied to subjects aged >80 years based on age alone. Mortality varies according to the type of emergency procedure. Mortality was highest after laparotomy and vascular surgery whereas, for more routine procedures such as hernia repair and abscess drainage, survival was almost 100% after 30 days.

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