scholarly journals Sigmoid volvulus: Treatment options and volvulus recurrence

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Sabri Selcuk Atamanalp ◽  
Rifat Peksoz
Keyword(s):  
Surgical Management ◽  
Treatment Options ◽  
Treatment Method ◽  
Sigmoid Volvulus ◽  
Single Center ◽  
Mortality And Morbidity ◽  
The World ◽  
Operative Decompression

Sigmoid Volvulus (SV) is principally treated with non-operative decompression, whereas it may require surgical management in some situations. Depending upon the treatment method, SV recurs in about one fourth of the cases, which doubles the mortality and morbidity rates. In this paper, we discuss the management and related recurrence of SV in the light of the largest single-center SV series over the world.

Does Length Matter? A Comparison of Rapid Rhino™ Nasal Packings for the Treatment of Epistaxis

2019 ◽  
Vol 33 (6) ◽  
pp. 723-729 ◽  
Author(s):  
Seraina M. Kunz ◽  
David Holzmann ◽  
Yves Waser ◽  
Christian Meerwein ◽  
Marcel Deggeller ◽  
...  
Keyword(s):  
Treatment Options ◽  
Treatment Method ◽  
Hospitalization Rate ◽  
The Other ◽  
Recurrence Rates ◽  
Double Lumen ◽  
Single Lumen ◽  
The World ◽  
Patient Stay ◽  
Broad Variety

Background Epistaxis is the most common otorhinolaryngologic emergency around the world. A broad variety of treatment options is available; ranging from conservative measures such as cauterization and nasal packings to surgery. For posterior epistaxis, nasal packings are usually the preferred initial treatment method. There are 2 different models of the widely used Rapid Rhino™ packing available at our department; the 7.5 cm, single-lumen, and the 9 cm, double-lumen variant with 2 separately inflatable balloons. Identifying whether one packing is superior to the other will help with the choice of the best possible treatment. Objective The goal of this study was to determine whether the new, double-lumen model had advantages compared to its shorter counterpart. Methods All patients treated with Rapid Rhino™ packings for spontaneous epistaxis between December 2005 and October 2017 were analyzed for various parameters such as recurrence rates, hospitalization rate, and duration of in-patient stay. The groups were divided by model and whether patients were treated before or after the introduction of the double-lumen version (December 2010). Results A total of 865 cases of patients treated with Rapid Rhino™ packs were analyzed. Before December 2010, 210 of 372 cases (56%) were hospitalized, whereas afterwards it was only 48% (235/493; P = .01). The duration of the in-patient stay decreased from 3.7 to 3.1 days ( P < .01). There was no difference in recurrence rates. Conclusion The introduction of the double-lumen, 9 cm Rapid Rhino™ packing has led to a decrease of in-patient time and to less hospitalizations. Therefore, it should be preferred to the shorter, single-lumen model in the treatment of posterior epistaxis.

scholarly journals Management of Hypertension in High-Risk Ethnic Minority with Heart Failure

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
M. Demede ◽  
A. Pandey ◽  
L. Innasimuthu ◽  
G. Jean-Louis ◽  
S. I. McFarlane ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trials ◽  
African American ◽  
Randomized Clinical Trials ◽  
Medical Condition ◽  
Treatment Options ◽  
Mortality And Morbidity ◽  
Obstructive Sleep ◽  
Co Morbidity ◽  
The World

Hypertension (HTN) is the most common co-morbidity in the world, and its sequelae, heart failure (HF) is one of most common causes of mortality and morbidity in the world. Current understanding of pathophysiology and management of HTN in HF is mainly based on studies, which have mainly included whites. Among racial groups, African-American adults have the highest rates (44%) of hypertension in the world and are more resistant to treatment. There is an emerging consensus on the significance of racial disparities in the pathophysiology and treatment options of hypertension and heart failure. However, African Americans had been underrepresented in all the trials until the initiation of the A-HEFT trial. Since the recognition of obstructive sleep apnea (OSA) as an important medical condition, large clinical trials have shown benefits of OSA treatment among patients with HTN and HF. This paper focuses on the pathophysiology, causes of secondary hypertension, and treatment of hypertension among African-American patients with heart failure. There is increasing need for randomized clinical trials testing innovative treatment options for African-American patients.

scholarly journals The NF-κB transcriptional footprint is essential for SARS-CoV-2 replication

2021 ◽  
Author(s):  
Benjamin E. Nilsson-Payant ◽  
Skyler Uhl ◽  
Adrien Grimont ◽  
Ashley S. Doane ◽  
Phillip Cohen ◽  
...  
Keyword(s):  
Transcription Factors ◽  
Large Scale ◽  
Cytokine Production ◽  
Antiviral Treatment ◽  
Treatment Options ◽  
Type I ◽  
Mortality And Morbidity ◽  
The World ◽  
Infected Cells

SARS-CoV-2, the etiological agent of COVID-19, is characterized by a delay in Type I interferon (IFN-I)-mediated antiviral defenses alongside robust cytokine production. Here we investigate the underlying molecular basis for this imbalance and implicate virus-mediated activation of NF-κB in the absence of other canonical IFN-I-related transcription factors. Epigenetic and single cell transcriptomic analyses show a selective NF-κB signature that was most prominent in infected cells. Disruption of NF-κB signaling through the silencing of the NF-κB transcription factors p65 or p50 resulted in loss of virus replication that was rescued upon reconstitution. These findings could be further corroborated with the use of NF-κB inhibitors, which reduced SARS-CoV-2 replication in vitro . These data suggest that the robust cytokine production in response to SARS-CoV-2, despite a diminished IFN-I response, is the product of a dependency on NF-κB for viral replication. IMPORTANCE The COVID-19 pandemic has caused significant mortality and morbidity around the world. Although effective vaccines have been developed, large parts of the world remain unvaccinated while new SARS-CoV-2 strains keep emerging. Furthermore, despite extensive efforts and large-scale drug screenings, no fully effective antiviral treatment options have been discovered yet. Therefore, it is of the utmost importance to gain a better understanding of essential factors driving SARS-CoV-2 replication in order to be able to develop novel approaches to target SARS-CoV-2 biology.

scholarly journals Surgery for constipation

2006 ◽  
Vol 53 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Johann Pfeifer
Keyword(s):  
Conservative Treatment ◽  
Chronic Constipation ◽  
Subtotal Colectomy ◽  
Treatment Options ◽  
Treatment Method ◽  
Sigmoid Volvulus ◽  
Preoperative Pain ◽  
Structural Disorders ◽  
Surgical Options ◽  
Diagnostic Trial

Patients with intractable chronic constipation should be evaluated with physiologic tests after structural disorders and extracolonic causes have been excluded. Conservative treatment options should be tried excessively. If surgery is indicated subtotal colectomy with IRA is the treatment method of choice. However, segmental resection may be a good option for isolated megasigmoid, sigmoidocele or recurrent sigmoid volvulus. In general patients with GID should not be offered any surgical options because of their anticipated poor results. Moreover, patients with psychiatric disorders should be actively discouraged from resection as they tend to have poorer prognosis. Patients must be counseled that preoperative pain and/or bloating will likely persist even if surgery normalizes bowel frequency. Patients with associated problems may be better served by having a stoma without resection as both a therapeutic maneuver and a diagnostic trial. Colectomy is no option to treat pain and/or abdominal bloating.

Treatment Options in COVID-19: The Role of Bioavailable Antiviral Ribonucleoside Analog on NHC in vitro

2020 ◽  
Author(s):  
Lara Bittmann
Keyword(s):  
World Health Organization ◽  
Clinical Picture ◽  
Treatment Options ◽  
World Health ◽  
Wuhan City ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization

On December 31, 2019, WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China. A novel coronavirus was identified as the cause by Chinese authorities on January 7, 2020 and was provisionally named "2019-nCoV". This new Coronavirus causes a clinical picture which has received now the name COVID-19. The virus has spread subsequently worldwide and was explained on the 11th of March, 2020 by the World Health Organization to the pandemic.

Study of Carbon Monoxide Intoxication in Fire Victimis

2018 ◽  
Vol 68 (12) ◽  
pp. 2932-2935
Author(s):  
Sofia David ◽  
Anton Knieling ◽  
Calin Scripcaru ◽  
Madalina Diac ◽  
Ion Sandu ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Inverse Correlation ◽  
Blood Samples ◽  
Mortality And Morbidity ◽  
Carbon Monoxide Intoxication ◽  
Gas Poisoning ◽  
The World ◽  
Fire Victims ◽  
In Fire

Carbon monoxide poisoning is the leading cause of mortality and morbidity of toxic origin in the world. Its insidious and polymorphic symptomatology makes it difficult to diagnose. It occurs accidentally, because of non-supervised domestic fires, or in fire victims. In fire victims, in particular, the differential diagnosis between carbon monoxide gas poisoning, inhalation of other toxic products of combustion like cyanide, oxygen deprivation, thermal burns and shock due to burns as a cause of death is not an easy task. The authors examined 107 fire victims that were autopsied at the Forensic Medicine from Iasi, Romania, in the last 10 years (2007-2016). Most cases were males (69.16%), young (0-9 years) or older than 60 with a burned surface of 91-100% in 68.22% of cases. Blood samples from the cadavers were collected in all cases in order to analyse carboxyhaemoglobin concentration and haemolysis. Toxicological analysis revealed a carboxyhaemoglobin level of maximum 95% but the majority of cases (70.72%) had a concentration inferior to 50%. An inverse correlation was identified between carboxyhaemoglobin concentration and haemolysis, an indicator of heat dissociation. Our study proves that many fire victims may die because of carbon monoxide intoxication prior to the extent of burns at a lethal potential.

The Vyredox and Nitredox Methods of in situ Treatment of Groundwater

1988 ◽  
Vol 20 (3) ◽  
pp. 149-163 ◽  
Author(s):  
Carol Braester ◽  
Rudolf Martinell
Keyword(s):  
Water Treatment ◽  
Surface Water ◽  
Traditional Method ◽  
Treatment Method ◽  
Nitrate Treatment ◽  
The Past ◽  
The World ◽  
Nitrate And Nitrite ◽  
Iron And Manganese

Nearly one fifth of all water used in the world is obtained from groundwater. The protection of water has become a high priority goal. During the last decades pollution of water has become more and more severe. Today groundwater is more and more used in comparison with surface water. Recently we have seen accidents, which can pollute nearly all surface water very quickly. Generally the groundwater is easier to protect, as well as cheaper to purify, and above all it is of better quality than the surface water. During the past two decades, alternatives to the traditional method of treating the water in filters have been developed, that is in situ water treatment i.e. the VYREDOX and NITREDOX methods. The most common problem regarding groundwater is too high content of iron and manganese, which can be reduced with the VYREDOX method. In some areas today there are severe problems with pollution by hydrocarbons and nitrate as well, and with modification of the VYREDOX treatment method it is used for hydrocarbon and nitrate treatment as well. The method to reduce the nitrate and nitrite is known as the NITREDOX method.

scholarly journals Radiation exposure dose of fluoroscopy-guided gastrointestinal procedures: A single-center retrospective study

2020 ◽  
Vol 08 (12) ◽  
pp. E1872-E1877
Author(s):  
Shiro Hayashi ◽  
Tsutomu Nishida ◽  
Shinji Kuriki ◽  
Li-sa Chang ◽  
Kazuki Aochi ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Balloon Dilatation ◽  
Exposure Dose ◽  
Sigmoid Volvulus ◽  
Tube Placement ◽  
Injection Sclerotherapy ◽  
Single Center ◽  
Endoscopic Injection ◽  
Dose Area Product ◽  
Esophageal Balloon

Abstract Background and study aims Fluoroscopy-guided gastrointestinal procedures (FGPs) are increasingly common. However, the radiation exposure (RE) to patients undergoing FGPs is still unclear. We examined the actual RE of FGPs. Patients and methods This retrospective, single-center cohort study included consecutive FGPs, including endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasound (EUS), enteral stenting, balloon-assisted enteroscopy, tube placement, endoscopic injection sclerotherapy (EIS), esophageal balloon dilatation and repositioning for sigmoid volvulus, from September 2012 to June 2019. We measured the air kerma (AK, mGy), dose area product (DAP, Gycm2), and fluoroscopy time (FT, min) for each procedure. Results In total, 3831 patients were enrolled. Overall, 2778 ERCPs were performed. The median AK, DAP, and FT were as follows: ERCP: 109 mGy, 13.3 Gycm2 and 10.0 min; self-expandable enteral stenting (SEMS): 62 mGy, 12.4 Gycm2 and 10.4 min; tube placement: 40 mGy, 13.8 Gycm2 and 11.1 min; balloon-assisted enteroscopy: 43 mGy, 22.4 Gycm2 and 18.2 min; EUS cyst drainage (EUS-CD): 96 mGy, 18.3 Gycm2 and 10.4 min; EIS: 36 mGy, 8.1 Gycm2 and 4.4 min; esophageal balloon dilatation: 9 mGy, 2.2 Gycm2 and 1.8 min; and repositioning for sigmoid volvulus: 7 mGy, 4.7 Gycm2 and 1.6 min. Conclusion This large series reporting actual RE doses of various FGPs could serve as a reference for future prospective studies.

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