Post-traumatic arteriovenous fistulae of the extremities: a case series

2021 ◽  
Author(s):  
Zia Ur Rehman ◽  
Suleman Yousaf
Keyword(s):  
Case Series ◽  
Limb Ischemia ◽  
Venous Ulcer ◽  
University Hospital ◽  
Arterial Reconstruction ◽  
Penetrating Injuries ◽  
Operative Morbidity ◽  
Endovascular Interventions ◽  
Post Traumatic ◽  
Salvage Rate

Post-traumatic AVF can lead to congestive heart failure, and limb ischemia. The objective of the study is to determine presentations, interventions and outcomes (morbidity and mortality) of the patients treated with traumatic AVF at a university hospital between Jan 1995 to December 2018. Nine patients (M: F 8:1) with median age of 30 [IQR 24.5] years were included in the study. They presented as ‘missed injuries’ with median delay of 4 [IQR 55.25] months. Most had penetrating injuries and presented with painful limb swelling, pain and venous ulcer. Superficial femoral (33.3%) and popliteal (22.2%) vessels were the most involved vessels. Seven (77.7%) patients had surgery while two (22.2%) had endovascular interventions. Arterial reconstruction with interposition vein (44.4%) or with prosthetic (11.1%) grafts was done. There was no peri-operative morbidity or 30-day mortality. All patients had smooth recovery with 100% limb salvage rate. Continuous..

Frequency of limb salvage after infra-inguinal bypasses for chronic limb-threatening ischemia in diabetics: a retrospective study

2021 ◽  
pp. 1-11
Author(s):  
Zia Ur Rehman
Keyword(s):  
Limb Salvage ◽  
Retrospective Chart Review ◽  
Limb Ischemia ◽  
Common Femoral Artery ◽  
University Hospital ◽  
Diabetic Patients ◽  
Middle Income ◽  
The Mean ◽  
Set Up ◽  
Salvage Rate

Abstract Objective: To assess number of limb salvaged among diabetic patients with chronic limb-threatening ischemia after infra-inguinal bypass surgeries at low to middle income country (LMIC) hospital. Methods: It was a retrospective chart review of the diabetic patients who underwent infra-inguinal bypass for lower leg revascularization for chronic limb-threatening ischemia at the Section of Vascular Surgery, Aga Khan University Hospital, Karachi (Pakistan) from Jan 2008 till April 2019. Results: Thirty two patients met the inclusion criteria. The mean age was 62.5 ±7.3 years and 18 (56.3%) were male. Ten (31.3%) patients presented with rest pain, 13(40.6%) with gangrene and 9 (28.1%) patients presented with non-healing ulcer. The most common inflow site was common femoral artery 20 (62.5%). The most frequent outflow sites were above and below knee popliteal arteries; 10 (31.3%) patients each. Twenty (62.5%) patients had suitable veins for reconstruction with autologous graft. The limb salvage rate was 90.6%. Three (9.4%) patients had nonfatal MI. There was no perioperative mortality. Conclusion: Diabetic patients with chronic limb-threatening ischemia had salvage rate of 90.5% after infra-inguinal bypass surgeries in our set up comparable to those described in literature. Keywords: Diabetes mellitus, diabetic foot, arteriopathy, critical limb ischemia, amputation. Continuous...

scholarly journals Role of Hybrid Interventions in Management of Critical Lower Limb Ischemia

2020 ◽  
pp. 229-237
Author(s):  
Samy R. Zekilah ◽  
Adel H. Kamhawy ◽  
Hassan A. Hassan ◽  
Mohamed A. El-heniedy ◽  
Ahmed M. Ismael
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
University Hospital ◽  
Tissue Loss ◽  
Hybrid Technique ◽  
Lower Limb Ischemia ◽  
Endovascular Interventions ◽  
Ischemic Ulcer ◽  
Work Up

Aims: To evaluate safety and efficacy of the hybrid technique in revascularization of multilevel lower limb arterial occlusive disease in patients with critical lower limb ischemia. Study Design: A prospective non comparative interventional study. Place and Duration of Study: It was conducted between February 2017 and June 2019 in the Department of Vascular Surgery, Tanta University hospital. Methodology: The study included 23 patients were treated with hybrid intervention techniques, and data were collected prospectively. Detailed history was taken and clinical examination was done for every patient along with routine laboratory investigations and radiological work up like duplex scanning with or without CT angiography. All patients were undergone hybrid interventions in an operating room with imaging facilities (mobile c-arm device) where both surgical and endovascular interventions were done simultaneously. Results: Twenty three patients were treated for unilateral critical lower limb ischemia using single session elective hybrid intervention. The patients age ranged from 46 to 76 (mean 62.6) with 19 males. 8 patients (34.8%) presented with ischemic rest pain and the remainder (65.2%) presented with tissue loss (ischemic ulcer or gangrene). most common inflow procedure was femoro-popliteal supragenicular bypass, and the commonest outflow procedure was tibial angioplasty. Technical success was achieved in 22 patients. Mean ABI was improved from 0.49 preoperatively to 0.84 in early post-operative measurements. Out of 23 limbs treated there were 20 limbs saved from amputation (87% limb salvage rate). We had three mortalities from other co-morbidities and four minor complications treated conservatively and resolved. Conclusion: Hybrid interventions were proved to be reasonable, effective and safe option for treatment of critical lower limb ischemia.

scholarly journals Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study

2021 ◽  
Vol 10 (4) ◽  
pp. 880
Author(s):  
Caterina Caminiti ◽  
Giuseppe Maglietta ◽  
Tiziana Meschi ◽  
Andrea Ticinesi ◽  
Mario Silva ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Case Series ◽  
Communicable Diseases ◽  
University Hospital ◽  
Negative Consequences ◽  
Non Communicable Diseases ◽  
Case Series Study ◽  
And Gender ◽  
Long Term Impact ◽  
Series Study

Background: Concern is growing about the negative consequences that response measures to the COVID-19 epidemic may have on the management of other medical conditions. Methods: A retrospective descriptive case-series study conducted at a large University-hospital in northern Italy, an area severely hit by the epidemic. Results: Between 23 February and 14 May 2020, 4160 (52%) COVID-19 and 3778 (48%) non-COVID-19 patients were hospitalized. COVID-19 admissions peaked in the second half of March, a period characterized by an extremely high mortality rate (27.4%). The number of admissions in 2020 was similar to 2019, but COVID-19 patients gradually occupied all available beds. Comparison between COVID-19 and non-COVID-19 admissions in 2020 revealed significant differences concerning all age classes and gender. Specifically, COVID-19 patients were older, predominantly male, and exhibited more comorbidities. Overall, admissions for non-communicable diseases (NCDs) in 2020 vs. 2019 dropped by approximately one third. Statistically significant reductions were observed for acute myocardial infarction (−78, −33.9%), cerebrovascular disease (−235, −41.5%), and cancer (−368, −31.9%). While the first two appeared equally distributed between COVID-19 and non-COVID-19 patients, chronic NCDs were statistically significantly more frequent in the former, except cancer, which was less frequent in COVID-19 patients. Conclusions: Prevention of collateral damage to patients with other diseases should be an integral part of epidemic response plans. Prospective cohort studies are needed to understand the long-term impact.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

scholarly journals Surgical management of Encapsulating Peritoneal Sclerosis (EPS) in children: international case series and literature review

2021 ◽  
Author(s):  
Videha Sharma ◽  
Zia Moinuddin ◽  
Angela Summers ◽  
Mohan Shenoy ◽  
Nicholas Plant ◽  
...  
Keyword(s):  
Case Series ◽  
Wound Management ◽  
Supplementary Information ◽  
Operative Morbidity ◽  
Post Surgery ◽  
Paediatric Patients ◽  
Stoma Formation ◽  
Gut Function ◽  
Health And Development ◽  
Secondary Closure

Abstract Background Encapsulating Peritoneal Sclerosis (EPS) is a rare phenomenon in paediatric patients with kidney failure treated with peritoneal dialysis (PD). This study highlights clinical challenges in the management of EPS, with particular emphasis on peri-operative considerations and surgical technique. Methods Retrospective analysis of all paediatric patients with EPS treated at the Manchester Centre for Transplantation. Results Four patients were included with a median duration of 78 months on PD. All patients had recurrent peritonitis (> 3 episodes), and all had symptoms within three months of a change of dialysis modality from PD to haemodialysis or transplant. In Manchester, care was delivered by a multi-disciplinary team, including surgeons delivering the adult EPS surgical service with a particular focus on nutritional optimisation, sepsis control, and wound management. The surgery involved laparotomy, lavage, and enterolysis of the small bowel + / − stoma formation, depending on intra-abdominal contamination. Two patients had a formal stoma, which were reversed at three and six months, respectively. Two patients underwent primary closure of the abdomen, whereas two patients had re-look procedures at 48 h with secondary closure. One patient had a post-operative wound infection, which was managed medically. One patient’s stoma became detached, leading to an intra-abdominal collection requiring re-laparotomy. The median length of stay was 25 days, and patients were discharged once enteral feeding was established. All patients remained free of recurrence with normal gut function and currently two out of four have functioning transplants. Conclusions This series demonstrates 100% survival and parenteral feed independence following EPS surgery. Post-operative morbidity was common; however, with individualised experience-based decision-making and relevant additional interventions, patients made full recoveries. Health and development post-surgery continued, allowing the potential for transplantation. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

Preoperative Angiography for Free Fibula Flap Harvest: A Case Series: L’angiographie préopératoire pour prélever un lambeau libre de la fibula : une série de cas

2021 ◽  
pp. 229255032199696
Author(s):  
Noor Alolabi ◽  
Haley Augustine ◽  
Forough Farrokhyar ◽  
Carolyn Levis
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Perioperative Complications ◽  
Case Series ◽  
Vascular Anatomy ◽  
Limb Ischemia ◽  
Free Fibula Flap ◽  
Retrospective Case ◽  
Fibula Flap ◽  
Free Fibula

Purpose: To assess if preoperative angiography of the lower extremity is necessary to detect abnormalities that alter operative planning of a free fibula flap (FFF). The secondary objective is to determine whether abnormalities are identified on physical examination. Methods: A retrospective case series of patients receiving preoperative lower extremity angiography for FFF was performed. Between November 2004 and July 2016, patients assessed for FFF reconstruction by a single surgeon were reviewed. Outcomes analyzed were preoperative physical examination, angiography findings, changes in operative plan, and perioperative complications including flap failure and limb ischemia. Level of agreement between physical examination and angiography findings was analyzed. Results: A total of 132 consecutive patients were assessed for FFF, of which 70 met the inclusion criteria. Mean age was 60.9 (range: 22-88) years old. All patients underwent aortic angiogram runoff, except for 2 who received computed tomography angiography. The surgical plan was altered based on angiography findings in 9 (12.9%) patients, and 7 (77.8%) of these cases had a normal physical examination. A further 6 (8.6%) patients had physical examination findings precluding the use of FFF, whereas imaging demonstrated the contrary. Physical examination demonstrated low predictability of aberrant vascular anatomy, with a sensitivity of 22.2%. There were no limb ischemia complications. Conclusions: Routine preoperative angiography of the lower extremity for all patients being evaluated for FFF is important to ensure safety and success of the procedure. Physical examination alone is insufficient to detect vascular abnormalities that may result in limb or flap compromise.

scholarly journals Post-traumatic inclusion cysts of the iris: a longterm prospective case series

2007 ◽  
Vol 85 (8) ◽  
pp. 893-896 ◽  
Author(s):  
Viney Gupta ◽  
Aparna Rao ◽  
Ankur Sinha ◽  
Neena Kumar ◽  
Ramanjit Sihota
Keyword(s):  
Case Series ◽  
Post Traumatic ◽  
Prospective Case Series

Sertraline as a treatment for PTSD: a systematic review and meta-analysis

2004 ◽  
Vol 21 (3) ◽  
pp. 100-103 ◽  
Author(s):  
Paul Mooney ◽  
Janette Oakley ◽  
Michael Ferriter ◽  
Raymond Travers
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Meta Analysis ◽  
Case Series ◽  
Group Differences ◽  
Post Traumatic Stress ◽  
Relevant Research ◽  
Randomised Control Trials ◽  
Post Traumatic

AbstractObjective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from ‘talking therapies’ to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD.Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD.Results: Five randomised control trials were identified, along with seven open trials and case series studies.Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on sub-group differences (eg. gender) is required.

scholarly journals Post-traumatic superolateral dislocation of condyle: A case series of 18 condyles with review of literature and a proposed classification.

2017 ◽  
Vol 7 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Dichen Palmo Bhutia ◽  
Divya Mehrotra ◽  
Nitin Mahajan ◽  
Debraj Howlader ◽  
Jagdish Gamit
Keyword(s):  
Case Series ◽  
Review Of Literature ◽  
Post Traumatic
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