scholarly journals Surgical treatment of pneumothorax in patients with COVID-19 – results and management

Folia Medica ◽  
2021 ◽  
Vol 63 (5) ◽  
pp. 663-669
Author(s):  
Angel Uchikov ◽  
Lyubomir Paunov ◽  
Atanas Batashki ◽  
Emanuil Yordanov ◽  
Kiril Atliev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Presentation ◽  
Adverse Outcome ◽  
Demographic Data ◽  
Severe Pneumonia ◽  
University Hospital ◽  
Lethal Outcome ◽  
Adequate Treatment ◽  
Disease Clinic ◽  
The Mean

Introduction: The new coronavirus, SARS-CoV-2, provokes infection with different clinical presentation. It involves an asymptomatic condition, mild variants with fever and dry cough to severe pneumonia, adynamia and respiratory failure with lethal outcome. The fibrotic lung tissue after the inflammatory process is a background for development of a secondary pneumothorax. Although it rarely causes lethal outcomes in COVID-19 patients, pneumothorax requires early diagnosis and adequate treatment to prevent any complications and decrease mortality rate. Aim: The aim of this study was to analyse the results of surgical treatment of hospitalized COVID-19 patients with pneumothorax in terms of demographic data, concomitant diseases, complications, and outcome. Materials and methods: Longitudinal prospective study was carried out with 26 patients with pneumothorax as a result of SARS-CoV-2 infection. They were treated at the Intensive Care Unit of the Infectious Disease Clinic and at the Second Clinic of Surgery, St George University Hospital in Plovdiv over a 6-month period from September 2020 to February 2021. Results: Seventeen of the patients were men and nine – women. Twenty-four of all patients underwent thoracentesis and two of them had a video-assisted thoracoscopy. The mean age of the studied patients with pneumothorax and COVID-19 was 66.77±12.61 years, which shows that it is the patients of advanced age with concomitant diseases that are at a higher risk of serious complications and adverse outcome. Of the hospitalized 1245 patients with COVID-19, 385 (30.92%) passed away. Of all hospitalized patients with SARS-CoV-2, 26 (2.08%) developed pneumothorax. Sixteen of them (62%) passed away. The possibility of a lethal outcome for intubated patients increased more than twice. Conclusions: The pneumothorax as a complication of COVID-19 carries high mortality and severely worsens the prognosis for these patients.

Evaluation of Allergic Reactions Following Intravenous Infusion of Polyvalent Antivenom in Snakebite Patients

2021 ◽  
Vol 20 ◽  
Author(s):  
Ghafar-Ali Mahmoudi ◽  
Maryam Ahadi ◽  
Ali Fouladvand ◽  
Bareza Rezaei ◽  
Zahra Bodagh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Adverse Reactions ◽  
Standard Treatment ◽  
Clinical Presentation ◽  
Demographic Data ◽  
Maculopapular Rash ◽  
Clinical Feature ◽  
Allergic Reactions ◽  
Related Data ◽  
The Mean

Background: Antivenom is a gold-standard treatment for snakebite envenoming. However, adverse reactions to snake antivenom are common in many parts. Objective: The aim of this study was to evaluate the allergic reactions following intravenous administration of antivenom sera. Methods: This was retrospective study, conducted snakebites patients referred to the Rahimi Hospital in Khorramabad. The files of these patients were accessed for demographic data, snakebite-related data, treatment provided, clinical presentation and allergic reaction status as a result of antivenom treatment. Results: 141 cases were investigated including 73.8% male and 26.2% female patients. The mean age of the patients was 38.1±17.1years. Age group 30-39 years accounted for highest number of snakebite cases (24.1%). A majority of victims (89.4%) were from the rural areas. Most of the patients (51.8%) were bitten in the spring and highest number of snakebite were reported in May (39.1%). The most common site of snakebite was lower extremities (50.4%) and upper extremities (44.7%). Among clinical feature of snakebite, pain was the most prevalent in 135 cases (95.7%) followed by swelling (83.7%). The mean antivenom vials used were 6.5±3.7 vials. Allergic reactions occurred in 6 patients (4.26%); reactions were mild in 5 patients and sever in 1patient. The commonest presentation was maculopapular rash (1.4%) and the least common were headache (0.71%), nausea (0.71%), fever (0.71) and hypotension (0.71%). Conclusion: Snakebite is one of the significantlife-threatening environmental events.Immediate antivenom treatment can reduce mortality however, patients should be carefully monitored for adverse allergic reactions.

scholarly journals Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Shoulder Arthroscopy ◽  
Demographic Data ◽  
Epidemiological Data ◽  
University Hospital ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Orthopedic Patients ◽  
Male To Female

The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopy performed in an orthopedic department of a university hospital in Poland. This study compared the data on all shoulder and knee arthroscopy procedures performed in two different periods: The period of the COVID-19 pandemic in Poland (from March 4, 2020, to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019, to October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration. The total number of arthroscopy procedures conducted in the evaluated period in 2020 was approximately 8.6% higher than that in the corresponding 2019 period. The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019. The male-to-female ratio was shown to be lower at .85 during the pandemic, having decreased from 1.5 in 2019. The COVID-19 pandemic did not reduce the number of arthroscopy performed at our center, and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.

scholarly journals The Development of Large Radicular Cysts in Endodontically Versus Non-Endodontically Treated Maxillary Teeth

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 991
Author(s):  
Ruth Schvartzman Cohen ◽  
Tomer Goldberger ◽  
Ina Merzlak ◽  
Igor Tsesis ◽  
Gavriel Chaushu ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Alveolar Bone ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
Maxillofacial Surgery ◽  
Endodontic Treatment ◽  
Oral And Maxillofacial Surgery ◽  
Maximal Dimension ◽  
Endodontically Treated Teeth ◽  
The Mean

Background and Objectives: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and maxillary sinus floors. The aim of this study was to evaluate the effect of previous root canal treatment on the clinical presentation of large maxillary radicular cysts. Materials and Methods: All cases of radicular cysts treated at the Oral and Maxillofacial Surgery Department of a tertiary public hospital over a period of six years (2012–2018) were evaluated. Histologically confirmed radicular cysts of the maxilla with a maximal dimension of over 15 mm were included. Demographic data of the patients, clinical presentation and radiographic features of the lesions were analyzed. Results: A total of 211 inflammatory cysts were treated in the study period, of these 54 histologically diagnosed radicular cysts in the maxilla were found to have a maximal dimension of over 15 mm. The mean age of patients with large maxillary radicular cysts was 43.3 years, 57.6% of which were male and 42.4% female. The lateral incisor was the most common tooth affected (46.3%). The mean size of the large radicular cysts was 25 mm. Then, 83.8% of the cysts were observed in teeth with previous endodontic treatment. Teeth without endodontic treatment presented clinically with significantly fewer acute symptoms in comparison to teeth with previous endodontic treatment. Conclusions: the vast majority (83.8%) of large maxillary radicular cysts were associated with endodontically treated teeth. Previous endodontic treatment was correlated to increased frequency of clinical symptoms.

scholarly journals Our results in the treatment of tarsal dislocations

2020 ◽  
Vol 148 (9-10) ◽  
pp. 554-559
Author(s):  
Maksim Kovacevic ◽  
Marijana Kovacevic ◽  
Sanja Maric ◽  
Nenad Lalovic ◽  
Milivoje Dostic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Result ◽  
Functional Results ◽  
High Energy ◽  
University Hospital ◽  
Adequate Treatment ◽  
Tarsometatarsal Dislocation ◽  
Excellent Functional Result ◽  
The University ◽  
Non Surgical Treatment

Introduction/Objective. Tarsal dislocations are rare injuries. Usually, they are caused by high-energy trauma. Depending on the type of dislocation, surgical treatment or closed reduction is used. In this study, 13 patients are presented with the aim to analyze the type of feet dislocations, their treatment, and outcome. Methods. Tarsal dislocation cases treated in the University Hospital in Foca were analyzed during the period 2009?2016. All the cases were clinically and radiographically examined and monitored on control examinations at least three years. The mobility of joints was measured and pain existence was estimated by visual analogue scale. Results. All 13 patients with tarsal dislocation were male. Four patients were treated surgically (two patients with tarsometatarsal and one with cuboid and navicular dislocation) and other patients had non-surgical treatment. In 10 patients, an excellent functional result has been achieved and in two patients with tarsometatarsal dislocation a good functional result. In one patient with cuboidal dislocation satisfactory functional result has been achieved. Conclusion. Out of the 13 reviewed patients with tarsal dislocations, functional results were rated as excellent in 10 dislocations, good in two, and satisfactory in one. Diagnosis and treatment of foot dislocations are demanding, but a favorable functional outcome can be expected with an adequate treatment of these injuries.

Pulmonary Embolism: Treatment Outcomes and Prognostic Factors of Mortality in University Hospital

2021 ◽  
Vol 104 (2) ◽  
pp. 225-232
Keyword(s):  
Pulmonary Embolism ◽  
Prognostic Factors ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Treatment Outcomes ◽  
Sofa Score ◽  
Clinical Presentation ◽  
University Hospital ◽  
The Mean ◽  
Overall Mortality

Objective: To determine the treatment outcomes, and to identify the prognostic factors of hospital mortality of pulmonary embolism (PE) patients. Materials and Methods: A retrospective cohort study was conducted in a 1,400-bed university hospital. Demographic, Medical history, clinical data and treatment outcomes were collected. Logistic regression was performed to identify prognostic factors for all-cause of hospital mortality. Results: One hundred fifty-eight patients with PE were included, 47.5% were male and the mean age was 59.2±14.7 years. The most common of clinical presentation are dyspnea 125 (79.1%), tachycardia 72 (45.6%), and hypotension 39 (24.7%). Forty patients (25.3%) had acute massive PE. The overall mortality rate (MR) was 19.6% and intensive care unit (ICU) MR was found in 34.5%. The prognostic factors of mortality were massive PE (adjusted odds ratio [AOR] 5.44, 95% confidence interval [CI] 1.10 to 27.06, p=0.039), cancer (AOR 4.45, 95% CI 1.52 to 12.98, p=0.006), respiratory failure (AOR 3.63, 95% CI 1.10 to 12.10, p=0.019), and SOFA score of 5 or greater (AOR 3.46, 95% CI 1.11 to 10.80, p=0.032). Conclusion: PE is associated with high mortality in hospital, especially in ICU. The prognostic factors for hospital mortality were massive PE, respiratory failure, cancer comorbidity and SOFA score of 5 or greater. Keywords: Pulmonary embolism, Prognostic factor, Mortality, Treatment outcomes

scholarly journals Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy Procedures in a University Hospital Department in Poland

2021 ◽  
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Shoulder Arthroscopy ◽  
Demographic Data ◽  
Epidemiological Data ◽  
University Hospital ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Orthopedic Patients ◽  
Male To Female

Abstract Background: The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopies performed in an orthopedic department of a university hospital in Poland.Methods: This study compared the data on shoulder and knee arthroscopy procedures performed in two different periods: the period of the COVID-19 pandemic in Poland (from March 4, 2020 to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019–October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration.Results: The total number of arthroscopy procedures conducted in the evaluated period in 2020was approximately 8.6% higher than that in the corresponding 2019 period.The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019.The male-to-female ratio was shown to be lower at 0.85 during the pandemic, having decreased from 1.5 in 2019Conclusions: The COVID-19 pandemic did not reduce the number of arthroscopies performed at our center and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.

Changes in the clinical presentation of chronic otitis media from the 1970s to the 1990s

1998 ◽  
Vol 112 (11) ◽  
pp. 1034-1037 ◽  
Author(s):  
Eero Vartiainen
Keyword(s):  
Surgical Treatment ◽  
Otitis Media ◽  
Clinical Presentation ◽  
Age Groups ◽  
Chronic Otitis Media ◽  
University Hospital ◽  
Sex Distribution ◽  
Male Predominance ◽  
Number Of Patients ◽  
Significant Change

AbstractClinical features of 1123 patients with chronic otitis media referred to a Finnish university hospital for surgical treatment over a 20-year period were analyzed. The number of patients declined by 48 per cent from the period 1976–1985 to 1986–1995. The decline was evident in all age groups but the proportion of children increased significantly from 14 per cent in 1976–1985 to 20 per cent in 1986–1995. A male predominance was noted with the exception of patients with sequelae of otitis in whom the sex distribution was equal. In cholesteatomatous ears, no significant change occurred in the type or size of cholesteatomas or in the incidence of ossicular destruction. Likewise, no significant change was noted in the size of perforations or in the incidence of ossicular destruction in patients with dry eardrum perforations. However, hearing levels of patients treated 1976–1985 were significantly worse than those of patients 1986–1995. Severe complications caused by the disease were rare during both periods.

scholarly journals Acute Tennis Injuries in the Recreational Tennis Player

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097367
Author(s):  
Peter Kaiser ◽  
Kerstin Stock ◽  
Stefan Benedikt ◽  
Todd Ellenbecker ◽  
Tobias Kastenberger ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Demographic Data ◽  
Case Series ◽  
Tennis Player ◽  
University Hospital ◽  
Body Region ◽  
Meniscal Tears ◽  
Acute Injuries ◽  
Tendon Ruptures

Background: Epidemiological studies on tennis injuries are mainly conducted in either elite professional or junior players. Injury patterns might differ in the recreational tennis player. Purpose: To investigate acute injuries in the recreational tennis–playing population with an additional focus on acute injuries that require surgical treatment. Study Design: Case series; Level of evidence, 4. Methods: A retrospective data analysis was conducted among patients who sustained an acute tennis injury between January 2013 and December 2018 and who had treatment administered at a single university hospital. Demographic data, diagnosis, body region of the trauma, injury mechanism, and treatment methods were recorded. Data were evaluated using descriptive statistics. Results: A total of 449 patients sustained 467 injuries (148 female, 301 male; mean age, 43.6 years; range, 8.2-84.4 years). The injuries occurred throughout the year, with an increased prevalence in the summer months. Injuries occurred in the lower extremity in 59%, the upper extremity in 30%, and the head and trunk in 11%. The main reason for an injury was a twist of a specific joint (n = 194) or a fall (n = 102). Harmless contusion or strains were the most common injury (49%). Ankle sprains were the most common serious injury, occurring in 11% of patients. Fractures occurred in 54 cases (12%). Overall, 9% of patients were treated surgically (fractures, n = 13; meniscal tears, n = 8; Achilles tendon ruptures, n = 6), and surgery was advised to another 1% who did not receive surgery at the study hospital. Conclusion: Typical acute injuries in recreational tennis players differ from acute injuries in elite and junior players, with an increased fracture occurrence. The main causes of acute tennis injuries are falls and twists, with 10% of injuries needing surgical treatment, mainly for fractures, meniscal tears, and Achilles tendon ruptures.

scholarly journals Profile of Surgically-treated Metastatic Extremity Bone Tumours at a University Hospital in Hong Kong

2018 ◽  
Vol 24 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Dim Edwin Maduakonam ◽  
Yau Ching Hin Raymond ◽  
Ho Wai Yip Kenneth ◽  
Lam Ying Lee
Keyword(s):  
Hong Kong ◽  
Surgical Treatment ◽  
University Hospital ◽  
Bone Tumours ◽  
Postoperative Survival ◽  
Common Source ◽  
Spinal Compression ◽  
Orthopaedic Oncologist ◽  
The Mean

Background/Purpose Metastatic deposits in bones increase overall morbidity in cancer patients. The orthopaedic oncologist aims at controlling the skeletal morbidity as a way of reducing the overall morbidity in the survival period of the cancer patient. This study investigated the characteristics of metastatic extremity bone tumours requiring surgical treatment, with a view to setting a template for a local database of extremity metastatic bone tumours in Hong Kong. Methods A retrospective review of metastatic extremity bone tumours treated surgically at a university hospital in Hong Kong, from January 2006 to December 2015, is presented. Results In total, 126 patients were studied. The lung (28.6%) was the most common source of metastasis to the extremity bones. The femur (70.1%) was most commonly involved. Pathological fractures (47.4%) were the most common indications for surgery. Intramedullary nailing (57.3%) was the most common surgical treatment. The overall postoperative complication rate was 8.7%. The mean duration of follow-up was 10.8 ± 4.1 months. Furthermore, 79.4% of the patients died within the study period, with mean duration of postoperative survival of 6.1 ± 1.1 months. Spinal compression ( p = 0.001), indication for surgery ( p = 0.001), age of the patient ( p = 0.001), and option of surgical treatment ( p = 0.000319) were found to have significantly affected the duration of postoperative survival. Conclusion The surgical management of extremity bone metastasis is a key consideration in averting potentially crippling morbidity. Options of treatment need be carefully chosen in appropriate patients for a good outcome.

Therapy of liver cysts – experience of the Department of Surgery, University Hospital in Pilsen 2009−2018

2019 ◽  
Vol 98 (10) ◽  
Keyword(s):  
Demographic Data ◽  
Bile Leak ◽  
Laparoscopic Approach ◽  
University Hospital ◽  
Retrospective Evaluation ◽  
Liver Cysts ◽  
Predominant Symptom ◽  
Polycystic Liver ◽  
The Mean

Introduction: Liver cysts are present in about 5% of the population and are asymptomatic in most cases. Currently, liver cystic lesions are discovered arbitrarily during imaging assessments of the abdomen indicated for unrelated reasons. The final findings vary from solitary cysts to multiple lesions or eventually the polycystic liver disease which can result in liver transplantation. Most cases are congenital. In the case of a symptomatic manifestation, pressure pain in the upper right quadrant is the predominant symptom. The therapy is surgical; laparoscopic approach is preferred. Methods: A retrospective evaluation of the sample of 55 patients was conducted. The patients had been surgically treated at the Department of Surgery, University Hospital in Pilsen, from 01 Jan 2009 to 21 Dec 2017. The evaluation covered basic demographic data, the size of the dominant cyst, complications, hospitalization length, any relapse of the disease, etc. Results: In the presented period 62 surgeries of symptomatic liver cysts were performed, 55 of them by laparoscopy. The mean age of the patients was 61.7 years (32–83 years), women predominated (N=54, i.e. 87.1%). Complications occurred in 8 patients (12.9%); the most common was a bile leak. The mean length of hospitalisation was 4.5 days (2–20 days). In the follow-up period, 41 patients (66.1%) remained without any recidivism. Conclusion: Currently, the treatment of symptomatic liver cysts is laparoscopic, with fenestration being the standard approach. Due to potential complications centres with experience in liver surgery are prioritized.

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