scholarly journals Retrospective study of polytrauma patients’s medical records that presented abdominal trauma, comperad to abdominal trauma and extra-abdominal injuries

2021 ◽  
Vol 43 ◽  
pp. e56944
Author(s):  
Izadora Gabriela Coutinho ◽  
Thiago Henriqque Crema ◽  
Bruno Felipe Viotto Petta ◽  
Carlos Edmundo Rodrigues Fontes
Keyword(s):  
Abdominal Trauma ◽  
Medical Records ◽  
Statistical Significance ◽  
Abdominal Injury ◽  
University Hospital ◽  
Morbidity Rate ◽  
Abdominal Injuries ◽  
Regional University ◽  
Polytrauma Patients ◽  
Trauma Victims

This study sought to retrospectively assess the relationship between intra and extra-abdominal injuries in polytrauma patients undergoing laparotomy at the Regional University Hospital of Maringá between 2017 and 2018.This study was based on 111 electronic medical records from the Brazilian public health system “SUS”, admitted to the hospital due to trauma and undergoing laparotomy, comparing two groups: abdominal injury without extra-abdominal injury (WoEI) and abdominal injury with extra-abdominal injury (WiEI).A total of 111 medical records were analyzed, 57 from 2017 and 54 from 2018. Of these 111records, 43 (39%) were trauma victims with only abdominal injuries and 68 (61%) trauma victims with abdominal and extra-abdominalinjuries. Most patients were male (85%), with an average age of 33 years, ranging from 14 to 87 years. In statistical analysis, according to the T-test, there was significance (p > 0.05) between the WoEI and WiEI groups for data collected regarding death rates and hospitalization days. As for the morbidity rate and difference between genders (male and female), there was no statistical significance (p < 0.05). Polytrauma patients are exposed to greater kinetic energy, with more severe conditions and therefore required more in-hospital care.

scholarly journals Glycemic control in diabetes mellitus in patients assisted by a university hospital in the state of Piauí (Brazil)

2020 ◽  
Vol 11 (4) ◽  
pp. 505
Author(s):  
Jose A. NERY-NETO ◽  
Andrew O. SANTOS ◽  
Larissa C. SILVA ◽  
Elison C. HOLANDA ◽  
Maria C. BRITO ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Medical Records ◽  
Fasting Glucose ◽  
Statistical Significance ◽  
Fasting Blood Glucose ◽  
University Hospital ◽  
Postprandial Blood Glucose ◽  
Glucose Measurement

Objectives: To investigate glycemic control in outpatient clinics at a university hospital, as well as to correlate HbA1c with fasting glucose and post-prandial glycemia, in order to assess which variable best correlates with an HbA1c. Methods: This is a descriptive cross-sectional study, with data that were collected from electronic medical records, from the random consultation of the medical of the blood glucose measurement. To check glycemic control, the parameters defined by the Brazilian Diabetes Society (2017-2018) were used: fasting glucose <100 mg / dL, HbA1c <7% and postprandial glucose <160 mg / dL. A statistical analysis was performed with the aid of the SPSS® program (version 13.0), adopting p <0.05 as the level of statistical significance. Results: 250 medical records were applied, with the average age of the participants being 60.1 ± 12.9 years (87 men and 163 women). A fasting glycemia was altered beyond the recommended in 80.8% of the individuals evaluated, HbA1c in 45.2% of the cases and 66% of the participants in the study possessed postprandial glycemia in addition to the recommended goals. The correlation between HbA1c/fasting blood glucose (rs= 0.74) and HbA1c/postprandial blood glucose (rs = 0.60) was, respectively, strong and moderate. Conclusions: With this study, it was possible to verify that a significant portion of the limits of use did not have good glycemic control. The correlation between fasting glucose and HbA1c confirmed that HbA1c is the best parameter for monitoring blood glucose levels in diabetes mellitus. In addition, the fasting blood glucose / HbA1c correlation showed greater strength in the postprandial blood glucose / HbA1c correlation.

Pattern of intra-peritoneal intra-abdominal injuries in polytrauma patients admitted to general surgery department at El-Demerdash Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Kamal Ahmed ◽  
Mohammad Ahmad Abd-erRazik Awad-Allah ◽  
Joseph Ellia Fahmy Hermina
Keyword(s):  
General Surgery ◽  
University Hospital ◽  
Organ Injury ◽  
Abdominal Organ ◽  
Abdominal Injuries ◽  
Major Health Problem ◽  
Major Health ◽  
Polytrauma Patients ◽  
The Mean ◽  
Surgery Department

Abstract Background Severe or major trauma is a worldwide pandemic and one of the leading causes of death and disability. Polytrauma always involves young, productive individuals and represents a substantial burden on the society. Aim of the Work To detect the incidence and the pattern of intra-abdominal injuries in polytraumatized patients admitted to the general surgery department at El-Demerdash Hospital and to estimate the trauma burden in General Surgery Department Ain Shams University. Patients and Methods Retrospective study of records of polytrauma patients admitted to general surgery department at El-Demerdash Hospital from the period of January 2018 to June 2018. Results In the specified study period of 6 months from 1/1 /2018 to 31/6 /2018, the ER department of Ain Shams University hospital (El-Demerdash hospital) received 3,328 cases of trauma out of which 40 cases were admitted at General Surgery Department with incidence rate 1.2% of total polytrauma patients admitted in the hospital in various departments. There were 37.5% of patients with intra-abdominal collection with no documented organ injury. Most common intra-abdominal organ injured was spleen 17.5% then liver the largest intra-abdominal organ 5% and stomach 5%, least to be injured were bowel loops 2.5%. Conclusion Polytrauma is a major health problem and a major cause of death in Egypt. 40 trauma cases were admitted to general surgery department. 80% of them were males and 20% were females. The mean age of trauma victims was 33.3 years old. 42.5% of them had surgeries. The study recorded 7.5% fatalities.

scholarly journals Increasing incidence of non-HBV- and non-HCV-related hepatocellular carcinoma: single-institution 20-year study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuko Nagaoki ◽  
Hideyuki Hyogo ◽  
Yuwa Ando ◽  
Yumi Kosaka ◽  
Shinsuke Uchikawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Medical Records ◽  
Screening Method ◽  
The Other ◽  
University Hospital ◽  
Single Institution ◽  
Regional University ◽  
Cryptogenic Hepatitis ◽  
Malignant Liver

Abstract Background We previously reported on the trends in the etiologies of hepatocellular carcinoma (HCC) diagnosed in patients between 1995 and 2009. The aims of our updated study were to evaluate the incidence, nonhepatitis B and nonhepatitis C viral (NBNC) etiologies, and clinical characteristics of HCCs occurring in patients between 1992 and 2018. Methods The study enrolled 2171 consecutive patients with HCC between 1992 and 2018. Their medical records were reviewed. The patients were divided into two groups, patients with early diagnoses from 1992 to 2009 and those with late diagnoses from 2010 to 2018. Results NBNC-HCC occurred in 514 patients (23.6%). The percentage of patients with HCC who had NBNC-HCC increased from 26.5% in 2009 to 46.3% in 2018. Patients with NBNC-HCC were older (median ages from 67 to 73 years). Type 2 diabetes mellitus (48.5–60.3%: P = 0.008), hypertension (48.5–57.4%: P = 0.047), and hyperlipidemia (39.2–53.8%: P = 0.001) increased significantly in recent years. The median FIB-4 index decreased (4.37–3.61: P = 0.026) and the median platelet count increased (15.1–17.9 × 104/μL: P = 0.013). Among the 514 patients with NBNC-HCC, 194 underwent hepatic resection for nonalcoholic steatohepatitis (NASH) (15%), alcoholic liver disease (ALD) (29%), and cryptogenic hepatitis (56%). Cirrhosis was detected in 72%, 39%, and 16% of patients with NASH, ALD, and cryptogenic hepatitis, respectively. The prevalence of cirrhosis in patients with NASH was significantly higher than the prevalence of cirrhosis in the other groups (P < 0.001). Overall, 70% of the non-malignant liver tissue of patients with NBNC-HCC was not involved with cirrhosis. On the other hand, the median FIB-4 index in patients with cryptogenic HCC was 2.56, which was a significantly lower value than those values in the other groups of patients. The FIB-4 index considered as one of useful screening of HCC. Conclusions The prevalence of NBNC-HCC has increased rapidly even in a regional university hospital. Metabolic syndrome may be an important risk factor for HCC. HCC was also found in patients with non-cirrhotic livers. The FIB-4 index may be a useful screening method for HCC in patients with NBNC.

scholarly journals Diagnostic aspects of closed abdominal injuries

2016 ◽  
Vol 97 (6) ◽  
pp. 892-897
Author(s):  
I S Malkov ◽  
V A Filippov ◽  
V N Korobkov ◽  
Kh M Khalilov ◽  
M R Tagirov ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Diagnostic Algorithm ◽  
Diagnostic Value ◽  
Diagnostic Techniques ◽  
Diagnostic Methods ◽  
Abdominal Injury ◽  
Abdominal Injuries ◽  
Surgical Department ◽  
Abdominal Organs ◽  
Radiologic Study

Aim. To study diagnostic value of various diagnostic methods for patients with closed abdominal injury, to develop a diagnostic algorithm to make a reasonable conclusion about the amount and severity of injuries of the abdomen.Methods. Various diagnostic methods used in closed abdominal injuries from 120 patients admitted to Surgical Department №2 of Kazan city clinical hospital №7 from 2007 to 2015 were analyzed. Majority of victims (65%) with closed abdominal trauma were males aged 20 to 50 years.Results. Efficiency of diagnostic program for patients with closed abdominal injury used in clinical practice was studied. In a closed abdominal trauma, injury of abdominal organs was detected in 52.5% of patients. 71.4% of those injuries were isolated and 28.6% were concomitant. According to frequency of injuries liver took the first place 15 (23.8%), followed by spleen on the second place (14; 22.2%) and kidneys (12; 19.1%) and intestine (12; 19.1%) on the third, bladder on the fourth (7; 11.1%), and pancreas on the fifth place (3; 4.8%). Importance of radiological methods and laparoscopy was demonstrated. Clinical examination and laboratory diagnostic techniques allow making a timely diagnosis in only 40% of victims. Informativity of radiologic study was 64%. The accuracy of ultrasound in damaged kidneys was 100%, that in rupture of liver was 72%, of spleen, 69%, and of the intestine (0%). Diagnostic accuracy of laparoscopy was 98.9%.Conclusion. Experience and extensive acquaintance with modern literature allowed the authors to present the algorithm of examination of patients with suspected closed abdominal trauma.

Abdominal Trauma and Complications

2019 ◽  
Author(s):  
Alia Aunchman ◽  
Ajai K Malhotra
Keyword(s):  
Abdominal Trauma ◽  
Damage Control ◽  
Abdominal Injury ◽  
Morbidity And Mortality ◽  
Lower Grade ◽  
Solid Organ ◽  
Abdominal Injuries ◽  
Hollow Viscus ◽  
Contrast Enhanced Ct ◽  
Operative Exploration

The abdomen, including pelvis, is injured in 10 to 15% of significantly injured patients: 80% by blunt and 20% by penetrating mechanisms. Abdominal injuries can be subtle and hence missed. The majority of injuries, if detected early, can be treated, and hence, delay in diagnosis or underappreciation of the severity of intra-abdominal injury is responsible for significant preventable morbidity and even mortality. The initial management is the same as any trauma patient, with the greatest threats to life addressed first. If the patient is in shock and the source is intra-abdominal, urgent laparotomy is indicated along with damage control resuscitation. If the patient remains in shock in the operating room, abbreviated damage control laparotomy should be pursued. In stable patients with penetrating mechanism, if the penetration extends into the peritoneal cavity, operative exploration to identify and address any injury is the safest approach; however, more selective approaches are increasingly being pursued. In stable patients with blunt mechanism, a thorough evaluation, usually including IV contrast-enhanced CT (CECT) is pursued to diagnose, and equally importantly, exclude intra-abdominal injury. High-quality IV CECT has a very high negative predictive value for intra-abdominal injuries. In stable patients, injuries to spleen, liver, and kidney, irrespective of grade, are managed nonoperatively with or without angioembolization. Lower-grade pancreatic injuries are managed nonoperatively or with drainage, whereas higher-grade injuries (involving major ducts) usually require resection. Majority of gastrointestinal hollow viscus injuries are managed with repair, resection with anastomosis or diversion. Delays as short as 8 hours in definitive management of such injuries increase morbidity and mortality. Intra and retro peritoneal genitourinary injuries are repaired and extraperitoneal ones are managed without surgery. Retroperitoneal hematomas are managed based on mechanism, stability, and location. Abdominal trauma is associated with a host of complications that need to be detected early and managed appropriately to prevent delayed morbidity and mortality. This review contains 5 figures, 6 tables, and 60 references. Key Words: abdomen, complications, damage control, diaphragm, hollow viscus, trauma, solid organ, retroperitoneum

scholarly journals Management of pediatric blunt abdominal trauma: تدبير رضوح البطن الكليلة عند الأطفال

2021 ◽  
Vol 5 (4) ◽  
pp. 27-20
Author(s):  
Wassem Ameer Shater, Mohammad Ali Nasser, Ali Mohammad Allou Wassem Ameer Shater, Mohammad Ali Nasser, Ali Mohammad Allou
Keyword(s):  
Operative Treatment ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Surgical Intervention ◽  
Operative Management ◽  
Pancreatic Injury ◽  
University Hospital ◽  
Hospital Length Of Stay ◽  
Abdominal Injuries ◽  
Non Operative Management

Aim of study: Evaluating a non- operative treatment of pediatric blunt abdominal trauma and avoiding unnecessary surgical intervention in Tishreen University Hospital. Methods: During years (2016- 2020) a retroprospective study was conducted on 62 children who had isolated blunt abdominal trauma or associated with other injuries, most of them were managed by non- operative treatment but some required surgical management. Results: Non- operative management of pediatric blunt abdominal injuries was applied for 59 patients, three patients required a surgical procedure, the spleen was the most organ exposed to injury (40) child, followed by liver (26) child, kidney (4) and (1) pancreatic injury. Non- operative management was successful in most solid organs injuries with grades 1, 2 and 3, but it failed in 5 grade splenic injury. one out of two hollow viscus injuries required surgical intervention. There were no statistical differences between the study groups in age, gender and injury mechanism. Hospital length of stay was significantly longer in patients who underwent a laparotomy (6) days compared to other non- operative patients (3) days, one complication occurred during non- operative management as pseudocyst after pancreatic injury, (4) patient died in the non- operative group due to hemodynamic instability and associated severe cerebral injuries. Conclusion: It is safe to treat most children with blunt abdominal injuries non- operatively if monitoring is adequate with hemodynamic stability.

scholarly journals Analytical revisit to basics helps reduce unnecessary CT scan in children with abdominal trauma: A single institution experience

2018 ◽  
Vol 6 (2) ◽  
pp. 54-62
Author(s):  
Rizwan A. Khan ◽  
Mohd Hazique ◽  
Shagufta Wahab
Keyword(s):  
Ct Scan ◽  
Abdominal Trauma ◽  
Clinical Laboratory ◽  
Final Diagnosis ◽  
Abdominal Injury ◽  
Free Fluid ◽  
Abdominal Injuries ◽  
Blunt Abdominal Injury ◽  
Line Imaging ◽  
Sensitive Parameters

Introduction. CT scan is regarded as the investigation choice for accurate depiction of blunt abdominal injuries in children and is considered as an inevitable tool in the armamentarium of the clinician before deciding for conservative management of these children. However over dependence on CT scan puts the patient to many disadvantages. The aim of this study to devise stratification criteria for the children with blunt abdominal injury and advise CT scan to the children only who really require it. Material and methods. All the children with blunt abdominal injury were studied prospectively over a period of two years. These children underwent clinical, biochemical and ultrasonographic assessment at presentation followed by CT abdomen. Efficacy of predefined clinical, biochemical and ultrasonographic parameters was compared with CT scan to triage the children with intra abdominal injury. Results. A total of 84 children were registered in the study based on final diagnosis of presence or absence of intra abdominal injury the children were divided in two groups. These groups were then compared for various clinical, laboratory and ultrasonographic parameters to predict intra abdominal injury. The children having isolated abdominal injury, tenderness, raised AST, ALT and amylase and free fluid on ultrasonography were found to have more chances of intrabdominal injury (p < 0.001). These parameters were the most sensitive parameters to predict intra abdominal injury and the cumulative sensitivity of these parameters was 99.7%. The CT abdomen was negative in 74.7% of the patients. Conclusion. Due to high negative rate of CT abdomen in children with abdominal trauma, its use as first line imaging investigation is questionable in all the children with abdominal trauma. We suggest that by utilizing clinical, biochemical and ultrasonographic parameters, the children at risk of intra abdominal injuries can identified with almost 100% accuracy mandating the use of CT scan only in these children.

P0203EARLY DETECTION OF BREAST ARTERIAL CALCIFICATION IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Basma Sultan ◽  
Hamdy Omar ◽  
Housseini Ahmed ◽  
Mahmoud Elprince ◽  
Osama Anter adly ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lipid Profile ◽  
Statistical Significance ◽  
University Hospital ◽  
Arterial Calcification ◽  
Control Group ◽  
Inpatient Ward ◽  
Stage 4 ◽  
Ckd Stage

Abstract Background and Aims Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. Conclusion Although it is difficult to determine the definite stage at which the risk of VC begins but in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3 and became significantly higher in stage 4. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

scholarly journals POS1281 HOW DOES OBESITY INFLUENCE THE FEATURES OF KNEE OSTEOARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 923.4-924
Author(s):  
H. Hachfi ◽  
D. Khalifa ◽  
M. Brahem ◽  
N. Ben Chekaya ◽  
M. Younes
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Impairment ◽  
Statistical Significance ◽  
Obese Group ◽  
University Hospital ◽  
Obese Patients ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Lequesne Index ◽  
The Mean

Background:Knee osteoarthritis and obesity are both major health problems. It is now admitted that the prevalence of knee osteoarthritis gets higher with obesity and that weight loss helps knee function and allows patients to avoid surgery.Objectives:The aim of this study was to study the influence of obesity on knee osteoarthritis features.Methods:A cross-sectional study was conducted in the university hospital Taher Sfar of Tunisia over a period of 6 months. Patients who had knee osteoarthritis confirmed by radiographs were included. Sociodemographic, clinical, radiological and therapeutic data were collected from medical records and visits. Obesity was defined by a body mass index (BMI) ≥30. Functional impairment was assessed by the Womac index and Lequesne index.Results:The study included 186 patients. There were 31 males and 155 femmes. The mean age was 60±10 years. The percentage of obese patients was 53,8%. The mean age was similar in both groups obese and non obese. There were more women in the obese group compared to the non obese group (p=0.0001), more patients who had diabetes mellitus and dyslipidemia (p=0.002). Non-obese patients had a shorter duration of symptoms with no statistical significance (p=0.151). Obese patients had more involvement of both knees (p<0.0001). Obesity did not have an impact on pain severity. Severity of radiological images (p=0,0001) were more frequent in obese patients. Functional impairment was similar in both groups. However, the percentage of patients having a very important functional impairment with Lequesne index was higher in obese patients (p<0.029). Obese patients also needed more physical therapy sessions (p=0.035).Conclusion:Knee osteoarthritis in obese patients is characterized with the femlae gender predominance, bilateral knee involvement, and a more severe images on radiographs. Thus the need for better control of weight and the importance of physical activity.References:[1]Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 2001; 25: 622–627.Disclosure of Interests:None declared

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