scholarly journals Brain Abscess of Otorhinolaryngologic Origin: Study of 80 Cases in the Neurosurgery Department of Conakry University Hospital Center

2021 ◽  
Vol 2 (2) ◽  
pp. 047-051
Author(s):  
BL Fatoumata ◽  
SI Sory ◽  
AH Ghislain ◽  
CA Youssouf ◽  
DH Abdoul Bachir ◽  
...  

Introduction: Brain abscesses are serious conditions that can be life-threatening if left untreated. The objective of our study was to determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of cerebral abscesses of otorhinolaryngological origin in our department. Methods and Materials: This was a retrospective study of 80 cerebral abscess files of otorhinolaryngological origin collected over a period of 5 years (January 2014-December 2018) at the neurosurgery department of Conakry University Hospital Center. Results: Abscesses of otorhinolaryngological origin represented 72% of all abscesses. The mean age was 14.7 years with a sex ratio of 4. The clinical picture was dominated by fever (92%), focal signs (55%) and intracranial hypertension (46%). The entrance door was 84% sinus. The frontal site was predominant, 44 cases. Eighty-two percent of patients underwent surgery and 18% were treated with antibiotic therapy alone. The evolution was favorable in 75% of the cases with a mortality rate of 15%. Conclusion: Brain abscesses are a medical-surgical emergency. The forms of otorhinolaryngologic origin are dominated by sinusitis. Despite the therapeutic difficulties, the prognosis remains acceptable in our study, 15% of deaths.

2002 ◽  
Vol 22 (1) ◽  
pp. 73-81 ◽  
Author(s):  
François Vrtovsnik ◽  
Raphaël Porcher ◽  
Catherine Michel ◽  
Gilles Hufnagel ◽  
Guillaume Queffeulou ◽  
...  

Background Dialysis is becoming increasingly frequent in patients over 75 years of age. Age is a superimposed comorbid factor commonly associated with poor prognosis in these patients. Objective To analyze the survival of 292 patients aged over 75 years on initiation of peritoneal dialysis (PD) from September 1982 to September 1999. Design Retrospective study. Setting Nephrology department in a University Hospital. Results Mean age was 81.5 years (range 75 – 92 years); 178 patients were over 80 years and 60 patients were over 85 years. Sex ratio was 136F/156M. Ninety-day mortality rate was 12%. Excluding the first 3 months, median patient survival was 21.6 months; 226 patients died on PD and 24 were shifted to hemodialysis. Survival was inversely correlated with the Charlson combined comorbidity index (CCI), but independent of predialysis hemoglobin and serum albumin levels. Over three selected periods, 1982 – 1989, 1989 – 1995, and 1995 – 1999, an increase was found in mean age (79.7 ± 3.3, 82.6 ± 3.9, and 81.8 ± 4.4 years; p < 0.001), CCI (7.6 ± 1.59, 8.0 ± 1.52, and 8.5 ± 1.63; p = 0.01), and predialysis creatinine clearance (6.2 ± 2.3, 6.4 ± 2.4, and 9.8 ± 3.8 mL/minute; p < 0.001). Median survival was similar in the various selected periods (21.0, 21.5, and 25.4 months). The incidence of peritonitis decreased from 0.63 to 0.21 episodes per patient year. Conclusion From 1982 to 1999, mean age and comorbidity increased on initiation of dialysis in elderly patients, with no increase in mortality. Survival in elderly patients on PD was related to the age–comorbidity index.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Irina Mamisoa Ranaivo ◽  
Fandresena Arilala Sendrasoa ◽  
Malalaniaina Andrianarison ◽  
Moril Sata ◽  
Onivola Raharolahy ◽  
...  

Introduction. The child’s skin diseases are common and very diverse. Many studies concerning pediatric dermatoses have been carried out in Africa and the rest of the world. Few epidemioclinical data reflect these skin diseases in children, especially in the east coast of Madagascar. We aim to describe the pattern skin diseases among children seen at the University Hospital Center Morafeno, Toamasina, Madagascar. Patients and Methods. A retrospective study over a 3-year period from January 2017 to December 2019 was conducted in children seen in the Dermatology Department of University Hospital Center Morafeno, Toamasina, with skin diseases. Results. During the study period, 347 children out of the 1584 new patients were retained with a sex ratio of 0.86. The mean age was 6.4 years old. The main diseases identified were skin infectious diseases (43, 23%), allergic dermatoses (24.21%), and autonomous dermatosis (15.56%). Conclusion. Our study revealed the importance of infectious and allergic dermatoses in Toamasina. It is necessary to carry out simple preventive actions such as hygiene.


2021 ◽  
Vol 9 ◽  
pp. 205031212110011
Author(s):  
Thabit Alotaibi ◽  
Abdulrhman Abuhaimed ◽  
Mohammed Alshahrani ◽  
Ahmed Albdelhady ◽  
Yousef Almubarak ◽  
...  

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.


1985 ◽  
Vol 34 (3-4) ◽  
pp. 179-184 ◽  
Author(s):  
K.T.M. Schneider ◽  
K. Vetter ◽  
R. Huch ◽  
A. Huch

AbstractAcute polyhydramnios in the second trimestr is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycytemia on the recipient twin. Contrary to the chronic hydramnios, there is no increase in malformations. In view of the high mortality rate (100%, according to most authors), the clinical management has to be reconsidered. During the years 1979 to 1983, 10 cases of acute polyhydramnios have been observed at the University Hospital in Zurich. This corresponds to an incidence of 9% in our twin population. All cases investigated were MZ twin pregnancies. With the exception of one patient, who underwent an abortion, all women were hospitalized, had bed rest and received recurrent removals of amniotic fluid and prophylactic tocolysis. The mean gestational age at the time of diagnosis was 23 4/7 weeks and at delivery 30 3/7 weeks. In two cases – one of which is presented in detail – with an unintentional puncture of a placental vessel, the recurrence of the hydramnios did not appear. Eight of 18 newborns survived. No malformations were found. Bed rest, tocolysis and recurrent amniocenteses seem to have a positive influence on the prolongation and outcome of the gestation in acute polyhydramnios.


2019 ◽  
Vol 74 (12) ◽  
pp. 3579-3587 ◽  
Author(s):  
A Filleron ◽  
M E Laurens ◽  
G Marin ◽  
H Marchandin ◽  
O Prodhomme ◽  
...  

Abstract Background Acute haematogenous bone and joint infections (AHBJI) represent a diagnostic and therapeutic emergency in children, with significant potential sequelae in the case of delayed treatment. Although historically the recommendations for treatment have been based on surgery and prolonged antibiotic therapy, recent studies have demonstrated that short-course antibiotic therapy is also effective. Objectives We evaluated a short-term antibiotic protocol for both osteomyelitis and septic arthritis in a 6 year retrospective study at the University Hospital of Montpellier. Methods This protocol was based on an initial intravenous treatment with a re-evaluation after 48 h and an early switch to oral therapy in the case of a favourable clinical course for a minimum total duration of 15 days. Antibiotics were selected based on local microbiological epidemiology and systematically adapted to bacteriological results. Results One hundred and seventy-six cases of AHBJI were included, comprising 56 patients with osteomyelitis, 95 with septic arthritis and 25 who had both of these. The aetiological agent was identified in 42% of the cases, with the main pathogens being Staphylococcus aureus (39%) and Kingella kingae (27%). The mean intravenous treatment duration was 4 days, while the total treatment duration was 15 days. There were no treatment failures, mild sequelae occurred in 1% of the cases and the secondary surgical revision rate was 7%. Conclusions The results of this study are comparable to those reported for evaluations of prolonged antibiotic therapy protocols, thus indicating that a common short-term antimicrobial therapy for the management of both osteomyelitis and septic arthritis (minimum of 15 days) is a viable option for treating AHBJI in children. Further prospective studies to confirm these findings are hence warranted.


2016 ◽  
Vol 6 (2) ◽  
pp. 0-0
Author(s):  
P. Bortnik ◽  
P. Wieczorek ◽  
P. Załęski ◽  
P. Kosierkiewicz ◽  
A. Siemiątkowski ◽  
...  

Odontogenic phlegmon of the mouth floor—Ludwig's angina (phlegmonae fundi cavi oris seu angina Ludovici)—is a rare, life-threatening, local complication in most cases of odontogenic inflammation. This study presents the case of a patient treated in the Department of Maxillofacial and Plastic Surgery of the University Hospital in Białystok due to phlegmon of the mouth floor resulting from odontogenic inflammation with a dynamic course. Quick diagnostics, surgical intervention as well as antibiotic therapy contributed to its efficient and successful treatment.


Author(s):  
Tanjona A. Ratsiatosika ◽  
Marie Valerie Rajaonarivony ◽  
Romuald Randriamahavonjy ◽  
Lantonirina Rainibarijaona ◽  
Jean Eustache Fanomezantsoa ◽  
...  

Background: Women's fertility is early and high in Madagascar. Through this study, want to know the obstetric and neonatal risks in teenage primiparous pregnancies.Methods: Carried out a retrospective comparative study of teenage primiparous pregnancies who gave birth beyond 22 weeks of amenorrhea (SA) at the Zafisaona Gabriel Mahajanga university hospital between the period from January 1 to March 31, 2015. The control group is made up of first-time mothers aged 20 to 35 who gave birth in the same center.Results: The mean age of the patients was 16.77±1.12 years. In 43.1% of cases, the pregnancy was poorly followed. 22.41% of new-borns to adolescent mothers were hypotrophic at birth. Teenage primiparous pregnancies had a risk of poor pregnancy monitoring compared to their elders (RR: 2.17, 95% CI [1.35-3.47]) and a risk of giving birth to a low birth weight child (RR: 2.1, 95% CI [1.05-4.44]). The risk of preeclampsia, death in utero, caesarean section, instrumental extraction was identical between the two groups. Regarding the outcome of newborns, the frequency of premature birth, early neonatal infection, neonatal asphyxia, early neonatal death was not significant.Conclusions: Apart from fetal hypotrophy, adolescent girls have the same maternal, fetal and neonatal prognosis as their elders.


2021 ◽  
Vol 12 (1) ◽  
pp. 8-16
Author(s):  
Talita Leite dos Santos Moraes ◽  
Joana Monteiro Fraga de Farias ◽  
Brunielly Santana Rezende ◽  
Fernanda Oliveira de Carvalho ◽  
Michael Silveira Santiago ◽  
...  

Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.


Author(s):  
Mariana Cristina Lobato dos Santos ◽  
Barbara Bartuciotti Giusti ◽  
Clarissa Ayri Yamamoto ◽  
Suely Itsuko Ciosak ◽  
Regina Szylit

ABSTRACT Objective: To analyze the incidence and means of elderly suicide in Brazil. Method: Epidemiologic, cross-sectional, quantitative, and retrospective study. The data were obtained in a platform maintained by the Ministry of Health and analyzed. The mortality rate was calculated and means and percentages regarding the employed means of suicide were obtained. Results: In this period, 8,977 suicides took place among the population over 60 years. The highest suicide rates were concentrated in the population over 80, which presented a mean 8.4/100,000 for this period, and between 70 and 79 years, with a mean rate of 8.2/100,000. Considering the total elderly population over 60 years, this value reached 7.8/100,000, whereas in the general population this was 5.3/100,000. The values are always higher among the elderly population: the mean rate in the last five years among the elderly is 47.2% higher than the mean for the general population. The main mean of suicide was hanging (68%), followed by firearm (11%), self-intoxication (9%), falling from a high place (5%), and undefined or undetermined means (6%). Conclusion: Epidemiologic analyses bring visibility to the dyad aging and suicide, corroborating the pertinence of this theme.


2018 ◽  
Vol 4 (1) ◽  
pp. e000428
Author(s):  
Rhea Viola Mebert ◽  
Jolanta Klukowska-Roetzler ◽  
Stephan Ziegenhorn ◽  
Aristomenis Konstantinos Exadaktylos

BackgroundThe number of people conducting cycling and skating sports in Switzerland is rising; likewise, we notice an increase in patients visiting our emergency department for adults due to push scooter accidents. In 2001, our emergency department published the first article worldwide on push scooter-related injuries. Nearly two decades later, we want to review the interim period—collect data, compare it with other studies and evaluate the current impact of push scooter accidents in our adult patient population.ObjectiveTo investigate data on the incidence, severity, treatment and approximate costs of push scooter-related injuries in adults who presented to our emergency department from 2000 to 2017.Materials and methodsFor this descriptive retrospective study, data were collected in the Department of Emergency Medicine at Inselspital (University Hospital), Berne, Switzerland, from October 2000 to September 2017. We used two clinical reporting systems during that period: Qualicare from 2000 to April 2012 and Ecare from May 2012 to 2017.Results165 patients were included, aged 16–80 years. The accidents were mainly classified as unspecified falls in 139 cases (84.24%). 21 patients (12.73%) were wearing a helmet at the time of the accident, while the remaining 144 (87.27%) were not. The most common injuries suffered were fractures in 73 patients (44.24%). 92 patients (55.76%) sustained an impact to the head. The most common treatment was surgery in the operating theatre (59 patients, 35.76%). The mean total cost per case was SFr7566.65 (emergency room visit, hospital stay and outpatient controls for the initial case).ConclusionThe incidence of push scooter-related injuries in adults in our patient population is small but rising. Nevertheless, the resulting injuries are potentially life-threatening and can lead to persistent medical impairment.


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