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Sample records for early puerperal complications

  1. Early hospital discharge and early puerperal complications.

    Science.gov (United States)

    Ramírez-Villalobos, Dolores; Hernández-Garduño, Adolfo; Salinas, Aarón; González, Dolores; Walker, Dilys; Rojo-Herrera, Guadalupe; Hernández-Prado, Bernardo

    2009-01-01

    To evaluate the association between time of postpartum discharge and symptoms indicative of complications during the first postpartum week. Women with vaginal delivery at a Mexico City public hospital, without complications before the hospital discharge, were interviewed seven days after delivery. Time of postpartum discharge was classified as early (25 hours). The dependent variable was defined as the occurrence and severity of puerperal complication symptoms. Out of 303 women, 208 (68%) were discharged early. However, women with early discharge and satisfactory prenatal care had lower odds of presenting symptoms in early puerperium than women without early discharge and inadequate prenatal care (OR 0.36; 95% confidence intervals = 0.17-0.76). There was no association between early discharge and symptoms of complications during the first postpartum week; the odds of complications were lower for mothers with early discharge and satisfactory prenatal care.

  2. Puerperal complications of episiotomies at Ahmadu Bello University ...

    African Journals Online (AJOL)

    Objectives: To establish the epidemiological variables associated with episiotomies and their puerperal complications at Ahmadu Bello University Teaching Hospital Zaria, in order to institute appropriate management including preventive measures. Design: A prospective cohort study. Setting: Ahmadu cello University ...

  3. Early puerperal laparoscopic sterilization--a new technique.

    Directory of Open Access Journals (Sweden)

    Parulekar S

    1985-07-01

    Full Text Available This paper describes the results of 23 cases of puerperal laparoscopic sterilization performed within 72 hours of delivery. A new method was employed to avoid injury to the uterine fundus and to make the tubes more accessible. Before insertion of the Veress needle, the anterior and posterior lips of the cervix were held with forceps and Hulka′s uterine manipulator was introduced into the uterine cavity. The uterus was pulled down toward the introitus by applying traction to the sponge-holding forceps. Pneumoperitoneum of 3-4 liters was induced through use of a Veress needle, followed by introduction of a Storz single puncture operative laparoscope through an incision in the lower umbilical fold. Tubal occlusion was achieved with silastic bands. The average time required for sterilization from induction of general anesthesia was 6 minutes. There was no instance of injury to the uterine fundus, nor were there any cases of uterine perforation, injury to other pelvic structures, laceration of the cervix, or puerperal sepsis. At the time of follow-up 15 days after the procedure, all patients were in satisfactory condition. It is concluded that this method can enhance postpartum family planning programs. Since it can be carried out within the 1st 48 hours after delivery, the routine hospital stay of 3 days does not have to be prolonged as a result of sterilization.

  4. Leukocyte blood count during early puerperium and its relation to puerperal infection†.

    Science.gov (United States)

    Dior, Uri P; Kogan, Liron; Elchalal, Uriel; Goldschmidt, Neta; Burger, Ayala; Nir-Paz, Ran; Ezra, Yossef

    2014-01-01

    To describe the white blood cell (WBC) and neutrophil counts in early puerperium and to investigate their contribution to the diagnosis of puerperal bacterial infection. A retrospective cohort analysis through which clinical and laboratory data were collected from 67 695 term live births. Total leukocyte and neutrophil blood count percentiles were established for febrile parturients (FP) with puerperal fever (≥38 °C) and for non-FP (NFP), and stratified by mode of delivery. Rates of positive bacterial cultures were compared according to the total leukocyte and neutrophil blood counts. Mean WBC counts of parturients delivering vaginally and by cesarean section were 12.62 × 10(3) and 12.71 × 10(3)/µL for NFP, and 14.38 × 10(3) and 12.74 × 10(3)/µL for FP, respectively. The proportions of parturients with a WBC count of ≥15 × 10(3)/µL were 36.4% for FP and 21.8% for NFP (p leukocyte count in 57.6% of FP and in 30.6% of NFP (p leukocytes and neutrophils. Leukocytosis and non-extreme neutrophilia were not found to reliably associate with bacterial infection, and their value in determining antibiotic therapy is questioned.

  5. Evaluation of measles-rubella vaccination for mothers in early puerperal phase.

    Science.gov (United States)

    Hisano, Michi; Kato, Tatsuo; Inoue, Eisuke; Sago, Haruhiko; Yamaguchi, Koushi

    2016-02-24

    The postpartum period is an ideal opportunity to vaccinate mothers with inadequate immunity to vaccine-preventable diseases including measles and rubella. A prospective study of measles-rubella (MR) vaccination in the early puerperal phase was conducted in 171 mothers, who had insufficient antibody titers when screened for immunity to measles (≤ 1:4 on the neutralization test [NT]) or rubella (≤ 1:16 on the hemagglutination inhibition [HI] test) during pregnancy. To evaluate the efficacy of MR vaccination in the postpartum period, we determined their post-vaccination antibody titers and immune responses to vaccination, and investigated the association between these and their prolactin (PRL) levels and Th1/Th2 ratios at the time of vaccination. We also examined the passage of viral RNA and antigen into breast milk. Of the 169 participants who completed the study schedule, 117 and 101 had low antibody titers against measles and rubella, respectively. In the measles-seronegative group, the antibody-positive rate was 87% on the NT assay, and the NT geometric mean antibody titer was 11.4 (95% confidence interval [CI], 10.0-13.0). In the rubella-seronegative group, the antibody-positive rate was 88% on the HI test assay, and the HI geometric mean antibody titer was 64.0 (95% CI, 53.9-76.0). There was no association between the post-vaccination antibody titers and the PRL levels or Th1/Th2 ratios at the time of vaccination. In the rubella-seronegative group, subjects with higher Th1/Th2 ratios showed higher rates of responsiveness than those with lower ratios (P=0.045). Although measles virus RNA was isolated from the breast milk of two vaccinated mothers, breastfeeding was not associated with clinical disease in any infants. MR vaccination in the early puerperal phase is considered an effective way to prevent the diseases, regardless of the mother's immunological status and hormonal milieu. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. EARLY COMPLICATIONS IN BARIATRIC SURGERY:

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    Marco Aurelio SANTO

    Full Text Available ContextBariatric surgery has proven to be the most effective method of treating severe obesity. Nevertheless, the acceptance of bariatric surgery is still questioned. The surgical complications observed in the early postoperative period following surgeries performed to treat severe obesity are similar to those associated with other major surgeries of the gastrointestinal tract. However, given the more frequent occurrence of medical comorbidities, these patients require special attention in the early postoperative follow-up. Early diagnosis and appropriate treatment of these complications are directly associated with a greater probability of control.MethodThe medical records of 538 morbidly obese patients who underwent surgical treatment (Roux-en-Y gastric bypass surgery were reviewed. Ninety-three (17.2% patients were male and 445 (82.8% were female. The ages of the patients ranged from 18 to 70 years (average = 46, and their body mass indices ranged from 34.6 to 77 kg/m2.ResultsEarly complications occurred in 9.6% and were distributed as follows: 2.6% presented bleeding, intestinal obstruction occurred in 1.1%, peritoneal infections occurred in 3.2%, and 2.2% developed abdominal wall infections that required hospitalization. Three (0.5% patients experienced pulmonary thromboembolism. The mortality rate was 0,55%.ConclusionThe incidence of early complications was low. The diagnosis of these complications was mostly clinical, based on the presence of signs and symptoms. The value of the clinical signs and early treatment, specially in cases of sepsis, were essential to the favorable surgical outcome. The mortality was mainly related to thromboembolism and advanced age, over 65 years.

  7. Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma ...

    African Journals Online (AJOL)

    Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma in a Cameroonian Woman. ... F Fouelifack Ymele, P Nana, JH Fouedjio, E Bechem, RE Mbu. Abstract. Non-puerperal uterine inversion is a rare condition that occurs as a complication of intrauterine tumors, especially giant submucosal leiomyomas.

  8. EARLY POSTOPERATIVE COMPLICATIONS AFTER RADICAL CYSTECTOMY

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    V. O. Mager

    2014-08-01

    Full Text Available Radical cystectomy (RCE is associated with a considerable number of early postoperative complications as before. Based on 10 years’ experience, this paper demonstrates the frequency (33.9 % and types of early complications following RCE, as well as postoperative mortality (5.5 % and its resulting causes. Although postoperative mortality is relatively low today, the frequency of early postoperative complications remains high as before.

  9. La investigación antigua de la fiebre puerperal: galimatías científico y objeto de reflexión = Early research on puerperal fever: Scientific imbroglio and object of reflection

    Directory of Open Access Journals (Sweden)

    Volcy, Charles

    2012-04-01

    Full Text Available Esta revisión versa sobre las primeras investigaciones acerca de una de las enfermedades sobresalientes en la historia de la medicina: la fiebre puerperal, asesina de parturientas entre los siglos XVII y XIX. Aborda la controversia en torno a su naturaleza fisiológica y contagiosidad, y analiza, desde diversas perspectivas, el rechazo a que fue sometido el doctor Ignaz Philipp Semmelweis, descubridor de su modo de transmisión. Finalmente, hace alusión a la validación de sus resultados y conclusiones mediante análisis estadísticos modernos así como a la interpretación filosófica de su modelo de descubrimiento y de inferencia.

  10. Acute puerperal uterine inversion : Case report | Mbaluka | East ...

    African Journals Online (AJOL)

    Acute puerperal uterine inversion is a rare potentially life-threatening complication of the third stage of labour that should be expeditiously managed to avert maternal mortality. A 21-year primigravida who was admitted in labour had a spontaneous vertex delivery and her third stage of labour was complicated by uterine ...

  11. Puerperal uterine inversion managed by the uterine balloon ...

    African Journals Online (AJOL)

    The uterine inversion is a rare and severe puerperal complication. Uncontrolled cord traction and uterine expression are the common causes described.We report a case of uterine inversion stage III caused by poor management of the third stage of labor. It was about a 20 years old primigravida referred in our unit for ...

  12. Risk factors and antibiogram of organisms causing puerperal sepsis ...

    African Journals Online (AJOL)

    Background: Puerperal sepsis is a common pregnancy related complication and is one of the leading causes of maternal morbidity and mortality in Sub Saharan Africa. There is paucity of regional data on the antibiogram and risk factors associated with this condition, Aim: To determine the risk factors, aetiological organisms ...

  13. Effects of massage treatment combined with topical cactus and aloe on puerperal milk stasis.

    Science.gov (United States)

    Meng, Shan; Deng, Qingchun; Feng, Chunyu; Pan, Yinglian; Chang, Qing

    2015-01-01

    Puerperal milk stasis is one of the most common puerperal complication that directly affects breastfeeding. Massage treatment with topical cactus and aloe for puerperal milk stasis might be a superior treatment, and it does not affect breastfeeding. The intervention group was treated with massages with cactus and aloe cold compresses, and the control group was treated with massage treatment or cactus and aloe cold compresses alone. We evaluated the efficacies of the treatments through comparisons of the feeding patterns, hardness, and pain after treatment between the three groups. We found that breastfeeding rates were significantly increased in the massage combine with combined with cactus and aloe cold compress group (P aloe cold compress group than in the massage or cold compress group (P aloe topical effectively improved the pain status, hard lump of puerperal milk stasis and increase breastfeeding rate.

  14. Concurrent puerperal hysterectomy with Ascaris lumbricoides infestation: coincidence or consequence?

    Science.gov (United States)

    Zapardiel, Ignacio; Peiretti, Michele; Godoy-Tundidor, Sonia

    2010-04-01

    The most common etiology of postpartum hemorrhage is uterine atony, although hematologic disorders may be present. A 36-year-old nulliparous woman underwent puerperal hysterectomy caused by uncontrolled postpartum hemorrhage. One day after discharge, she vomited in the emergency room a 24-cm long Ascaris lumbricoides. Infestation during gestation may cause hematologic disorders that could complicate pregnancy outcome. Copyright 2010 Mosby, Inc. All rights reserved.

  15. PUERPERAL COMPLICATIONS OF EPISIOTOMIES AT AHMADU ...

    African Journals Online (AJOL)

    Kateee

    2003-07-01

    Jul 1, 2003 ... such as Argentina, it is routinely performed on all nulliparous and primiparous births (1). The World Health. Organisation recommends an episiotomy rate of ... for women who have past history of lower genital tract surgeries and for women who require assisted vaginal deliveries. For other women in labour, ...

  16. [Early endocrine complications in childhood cancer survivors].

    Science.gov (United States)

    Sánchez González, Cristina; Andrades Toledo, Mónica; Cárdeno Morales, Álvaro; Gutiérrez Carrasco, Ignacio; Ramírez Villar, Gema Lucía; Pérez Hurtado, José María; García García, Emilio

    2016-10-21

    The treatment of childhood cancers has increased survival rates, but also the risk of sequelae, such as endocrine complications. The objective of this study is to evaluate the endocrine disorders in survivors of childhood malignant tumors within the first years after treatment and analyze the variables related to their appearance. A retrospective medical record review of patients referred to pediatric endocrinology after treatment of malignancy. Outcome measures were frequency and types of endocrine dysfunction and new-onset obesity. Clinical and laboratory evaluations were performed every 6 months. Statistics tests were: chi square and multiple logistic regression. Fifty five patients (26 women) were included with an age at diagnosis of tumour (mean±standard deviation) 6.0±4.4 years and followed up for 6.8±3.6 years. Thirty endocrine disorders were diagnosed in 26 patients (47.3%), 17 women (P=.01). Eleven adolescents had primary hypogonadism (26.2% to 0.6±0.5 years of follow-up) in relation to local irradiation (adjusted odds ratio [OR] 3.99, P=.005). Eleven patients had a pituitary disorder (20.0%) 5.2±2.4 years after diagnosis in relation to brain irradiation (OR 1.54, P=.039). Six children (10.9%) had primary hypothyroidism from 3.2±1.0 years of follow-up. Two children developed obesity. Endocrine disorders are frequently seen within the first years after diagnosis of a childhood cancer, so hormonal evaluation should start early and be repeated periodically. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  17. Early bowel complications following radiotherapy of uterine cervix carcinoma

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    Kim, Won Dong [College of Medicine, Chungbuk National Univ., Cheongju (Korea, Republic of)

    1999-06-01

    This study evaluated early bowel complications in cervix cancer patients, following external radiotherapy (ERT) and high dose rate intracavitary radiation (HDR ICR). Factors affecting the risk of developing early bowel complications and its incidence are analyzed and discussed. The study is the retrospective review of 66 patients who received radiotherapy at Chungbuk National University Hospital from April 1994 to December 1998. The patients underwent 41.4 or 50.4 Gy ERT according to FIGO stage and tumor size, then A point dose was boosted to 71.4 or 74.4 Gy using a remotely controlled after loading Buchler HDR ICR. The EORTC/RTOG morbidity criteria were used to grade early bowel complications, which are valid from day 1, the commencement of therapy, through day 90. The actuarial incidence, severity of complications were investigated and clinical pretreatment factors relevant to complications were found through univariate (Wilcoxon) and multivariate (Cox proportional hazard model) analysis. Of the 66 patients, 30 patients (46%) developed early bowel complications; 25 patients (38%) with grade 1 or 2, 4 patients (6%) with grade 3 and 1 patient (2%) with grade 4. The complications usually began to occur 3 weeks after the commencement of radiotherapy. The actuarial incidence of early bowel complications was 41% at 10 weeks. The early bowel complications were associated significantly with an old age and a history of previous abdomino-pelvic surgery. All three patients who had a protracted overall treatment time (about 2 weeks) due to severe bowel complication, suffered from pelvic recurrences. Forty six percent of patients experienced early bowel complications, most of which were grade 1 or 2 and relieved spontaneously or by medication. The patients with an old age or a previous surgery have a high probability of early complications and they may be less compliant with planned radiotherapy. So more careful precaution is necessary for these patients.

  18. Early vascular complications after pediatric liver transplantation

    NARCIS (Netherlands)

    Sieders, E; Peeters, PMJG; Ten Vergert, EM; de Jong, KP; Porte, RJ; Zwaveling, JH; Bijleveld, CMA; Slooff, MJH

    Vascular complications have a detrimental effect on the outcome after liver transplantation. Most studies focus exclusively on hepatic artery thrombosis (HAT), The current study analyzed the incidence, consequences, and risk factors for HAT, portal vein thrombosis (PVT), and venous outflow tract

  19. [Early complications following open radical prostatectomy

    DEFF Research Database (Denmark)

    Roder, M.A.; Gruschy, L.; Brasso, K.

    2009-01-01

    INTRODUCTION: Radical prostatectomy has been offered as curative treatment for localized prostate cancer at Rigshospitalet since August 1995. We here report on postoperative complications in 719 patients operated during the 12-year-period from August 1995 to August 2007 with special emphasis...... patients (1,1%). One patient died within 30 days after surgery. CONCLUSION: Our results demonstrate that radical prostatectomy can be performed with a minimal mortality and an acceptable morbidity Udgivelsesdato: 2009/4/27...

  20. Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report

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    Perquin Denise

    2010-01-01

    Full Text Available Abstract Introduction Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy. Case presentation A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture. Conclusion We report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.

  1. Indications and early post-operative complications of major limb ...

    African Journals Online (AJOL)

    ... the body (52.8%), in the lower limbs (84.9%) and below knee amputation was the commonest (58.7%). The early post-operative complication rate was 66%, the commonest complication was wound infection while the mortality rate was 5.7%. No patient (0%) was fitted with prosthesis prior to discharge or during follow up.

  2. Critical pneumonia complicating early-stage pregnancy.

    Science.gov (United States)

    Mercieri, Marco; Di Rosa, Roberta; Pantosti, Annalisa; De Blasi, Roberto Alberto; Pinto, Giovanni; Arcioni, Roberto

    2010-03-01

    We present a case of community-acquired methicillin-resistant Staphylococcus aureus necrotizing pneumonia, Panton-Valentine leukocidin positive, in a woman at 14 weeks of pregnancy. To our knowledge, this is the first case reporting this critical lung infection occurring during an early phase of pregnancy. This case study alerts physicians to the increasing worldwide spread of these uncommon yet virulent and potentially lethal infections. In our patient, antibiotic therapy with linezolid plus rifampin started at 14 weeks of pregnancy had a successful outcome without inducing toxicity or teratogenesis in the fetus.

  3. SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION: EARLY POSTOPERATIVE COMPLICATIONS

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    M.Sh. Khubutia

    2014-01-01

    Full Text Available Aim: evaluation of the incidence of early postoperative complications after simultaneous pancreas-kidney transplantation.Materials and methods. The analysis of early postoperative complications after simultaneous pancreas-kidney transplantation is presented in the paper, the most rational diagnostic algorithms, non-surgical and surgical complications’ treatment; the outcomes of the SPKT are reported.Results. 15,6% of patients experienced surgical complications, 12,5% – immunological complications, 12,5% – infectious complications, 6,25% – complications of the immunosuppressive therapy. 1-year patient survival after SPKT was 91,4%; pancreas graft survival – 85,7%; kidney graft survival – 88,6%.Conclusion. The incidence of early postoperative complications after simultaneous pancreas-kidney transplantation remains signifi cant in spite of progressive improvement of simultaneous pancreas-kidney transplantation due to surgical technique improvement, introduction of new antibacterial and immunosuppressive agents. Data, we recovered, fully correspond to the data obtained from the global medical community.

  4. Early detection of diabetes after pregnancy complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Nielsen, Jane Hyldgård; Overgaard, Charlotte; Olesen, Christinna Rebecca

    Title: Early detection of diabetes after pregnancy complicated by gestational diabetes Background: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. 40% of women with a history gestational diabetes mellitus (GDM...... of health consequences for women. Aims: Examine the extent of participation in follow-up screening in the Danish Region of North Jutland, and the possible consequences of nonattendance. Methods: A register based study. In Danish national registers 2171 birthing women whose pregnancy was complicated by GDM...

  5. Puerperal seizures: not the usual suspects | Hayes | Southern ...

    African Journals Online (AJOL)

    Abstract. We present a case of puerperal seizures and neonatal flaccidity due to abuse and abrupt withdrawal from zolpidem, following an elective Caesarean delivery at term. Keywords: zolpidem, puerperal seizures, withdrawal ...

  6. Clinical analysis on the early complications after carotid endarterectomy

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    Mao-zhen BU

    2015-04-01

    Full Text Available Objective To analyze the influencing factors of early complications after carotid endarterectomy (CEA, in order to evaluate the early safety after CEA. Methods A total of 396 patients with carotid stenosis underwent 407 CEAs, and the complications within 30 d after CEA were analyzed. Univariate and backward multivariate Logistic regression analysis were used to evaluate the related risk factors for major adverse events within 30 d after CEA.  Results The success rate of 407 CEAs was 100%. Major complications within 30 d after CEA occurred in 18 cases (4.42%, including 5 cases (1.23% of death, 8 cases (1.97% of ischemic stroke and 5 cases (1.23% of cerebral hemorrhage. Secondary complications occurred in 98 cases (24.08%. Logistic regression analysis revealed smoking (P = 0.039 and modified Rankin Scale (mRS score on admission ≥ 3 (P = 0.001 were the independent risk factors for early adverse events (within 30 d after CEA.  Conclusions CEA is a safe surgical method with a low incidence rate of postoperative complications, which could be decreased by improving surgical skills and gathering surgical experiences. Smoking and mRS score on admission ≥ 3 can increase the risk of CEA. DOI: 10.3969/j.issn.1672-6731.2015.04.009

  7. Clinico-pathological pattern and early post-operative complications ...

    African Journals Online (AJOL)

    Background: Gastro-Duodenal Perforations are one of the commonest causes of mortality and morbidity in conditions that require emergency surgery. The main objective of this study was to determine the clinico-pathological pattern and evaluate factors for early post operative complications of Gastro-duodenal perforations ...

  8. Complications of otitis media - The importance of early recognition

    NARCIS (Netherlands)

    Albers, FWJ

    Objective: The purpose of this study was to determine the factors that are important for the early diagnosis of intracranial and intratemporal complications of otitis media. Study design: The study design was a retrospective follow-up study. Setting: The study took place at a tertiary referral

  9. A Retrospective Analysis of Factors Affecting Early Stoma Complications.

    Science.gov (United States)

    Koc, Umit; Karaman, Kerem; Gomceli, Ismail; Dalgic, Tahsin; Ozer, Ilter; Ulas, Murat; Ercan, Metin; Bostanci, Erdal; Akoglu, Musa

    2017-01-01

    Despite advances in surgical techniques and products for stoma care, stoma-related complications are still common. A retrospective analysis was performed of the medical records of 462 consecutive patients (295 [63.9%] female, 167 [36.1 %] male, mean age 55.5 ± 15.1 years, mean body mass index [BMI] 25.1 ± 5.2) who had undergone stoma creation at the Gastroenterological Surgery Clinic of Turkiye Yuksek İhtisas Teaching and Research Hospital between January 2008 and December 2012 to examine the incidence of early (ie, within 30 days after surgery) stoma complications and identify potential risk factors. Variables abstracted included gender, age, and BMI; existence of malignant disease; comorbidities (diabetes mellitus, hypertension, coronary artery disease, chronic respiratory disease); use of neoadjuvant chemoradiotherapy; permanent or temporary stoma; type of stoma (loop/end stoma); stoma localization; and the use of preoperative marking of the stoma site. Data were entered and analyzed using statistical software. Descriptive statistics, chi-squared, and Mann-Whitney U tests were used to describe and analyze all variables, and logistic regression analysis was used to determine independent risk factors for stoma complications. Ostomy-related complications developed in 131 patients (28.4%) Of these, superficial mucocutaneous separation was the most frequent complication (90 patients, 19.5%), followed by stoma retraction (15 patients, 3.2%). In univariate analysis, malignant disease (P = .025), creation of a colostomy (P = .002), and left lower quadrant stoma location (P toma complication. Only stoma location was an independent risk factor for the development of a stoma complication (P = .044). The rate of stoma complications was not significantly different between patients who underwent nonemergent surgery (30% in patients preoperatively sited versus 28.4% not sited) and patients who underwent emergency surgery (27.1%). Early stoma complication rates were higher

  10. The value of early CT in complicated childhood pneumonia

    International Nuclear Information System (INIS)

    Tan Kendrick, A.P.; Ling, Ho; Subramaniam, Ramnath; Joseph, Vijeyakaran T.

    2002-01-01

    Objective. To investigate the value of CT in complicated childhood pneumonia and its role in early intervention when chest radiography (CXR) is non-contributory. Materials and methods. Forty-two immunocompetent children, aged 1-11 years, admitted for community-acquired pneumonia from October 1997 to September 1999, had 42 contrast-enhanced CT scans and frontal chest radiographs on the same day, which were assessed independently. CT was performed when the patient remained unwell and the CXR images showed failure of resolution despite 7-10 days of antibiotics and/or drainage with urokinase therapy. Results. Compared to CT, CXR revealed suboptimal accuracy rates of lobar involvement (84%), chest tube placement (73%), fluid loculation (42%), abscess formation (40%) and bronchopleural fistulae (33%). It could not assess parenchymal or pleural complications such as cavitary necrosis, early abscess formation, empyemas or pericardial effusions. On the basis of the CT findings and poor clinical progress, 16 patients underwent surgical intervention with the aid of video-assisted thorascopic surgery (VATS). The CT features correlated well with surgical findings. Ten cases required pleural decortication while six with destructive or necrotic lung lesions had surgical resection. Debridement was difficult when the pleura had become thick and fibrotic. Streptococcus pneumoniae was the offending organism in 81% of cases. The right side was affected in 67% of cases. Conclusions. In complicated childhood pneumonia, CT is far superior to CXR in revealing pleural and parenchymal complications, which may require early surgical intervention. (orig.)

  11. Expanding Disease Spectrum Associated With Puerperal Mastitis

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    Gregg L. McAdoo

    1997-01-01

    Full Text Available Background: Staphylococcus aureus and the β-hemolytic streptococci are the commonest causes of puerperal mastitis which tends to be a localized disease process. This report describes 2 cases attributable to these bacteria that resulted in extramammary involvement and augmented morbidity.

  12. Puerperal seizures: not the usual suspects

    African Journals Online (AJOL)

    2011-01-24

    Jan 24, 2011 ... during the course of their pregnancy.2 Benign forms of sleep disturbance may respond to simple interventions, but more severe insomnia may have a significant impact on patients' quality of life and ability to function. Zolpidem, a sedative-. Puerperal seizures: not the usual suspects. Hayes ID, FCARCSI.

  13. Tratamento da endometrite puerperal com antibioticoterapia parenteral exclusiva Treatment of puerperal endometritis using a regimen with exclusive parenteral antibiotics

    Directory of Open Access Journals (Sweden)

    Geraldo Duarte

    2005-08-01

    educational levels. The patients were submitted to a regimen of exclusive parenteral antibiotic, only during the hospitalization period (ATP-EX group. These results were compared with results obtained in a historical cohort in the same hospital (20 cases submitted to a regimen of hospital parenteral antibiotic therapy complemented with ambulatory oral treatment (ATP+VO group. The patients were evaluated clinically on the occasion of periodic return visits in order to identify cases of recurrence and infectious complications. RESULTS: one patient from the ATP+VO group needed to be readmitted to the hospital on the 6th day after her discharge from the hospital with a diagnosis of endometritis recrudescence. No complications were observed among patients from ATP-EX group. CONCLUSION: for the treatment of puerperal endometritis, there was no additional advantage in using supplementary oral antibiotic therapy after patient discharge. The results using exclusive parenteral antibiotic treatment during hospitalization time indicate that it is effective and can be safely used in a population of low socioeconomic level.

  14. Orthopedic complications of linear morphea: Implications for early interdisciplinary care.

    Science.gov (United States)

    Schoch, Jennifer J; Schoch, Bradley S; Werthel, Jean David; McIntosh, Amy L; Davis, Dawn M R

    2018-01-01

    Linear morphea of the limb primarily affects children, and extracutaneous manifestations are common. Orthopedic surgeons are often essential in the care of patients with linear morphea, yet there are few reports outlining specific orthopedic complications in this population. We sought to improve the understanding of orthopedic complications in linear morphea of the limb. Between 1999 and 2014, 51 children were evaluated for linear morphea of an extremity. Twenty-six (51%) had documented orthopedic manifestations. Outcome measures included limb length discrepancy, angular malalignment, limb atrophy, and orthopedic surgical intervention. Joint contractures were most common, affecting 88% of patients, followed by limb atrophy, angular deformity, and limb length discrepancy; 14% required surgical intervention. Despite the use of systemic immunosuppressive therapy in many patients, approximately half of patients with linear morphea of an extremity have orthopedic disease. Early orthopedist involvement is crucial to improve limb alignment and preserve function. © 2017 Wiley Periodicals, Inc.

  15. Radiodiagnostic aspects of non-puerperal mastitis

    Energy Technology Data Exchange (ETDEWEB)

    Overhagen, H. van; Zonderland, H.M.; Lameris, J.S.

    1988-09-01

    The term non-puerperal mastitis describes a number of inflammatory diseases which can develop in a non-lactating breast. The clinical diagnosis NPM can be very difficult. However, mammography combined with ultrasound examination may lead to the correct diagnosis. In the mammogram a poorly marginated area of increased density can be seen, in case of an abscess there is a more circumscribed lesion. On ultrasound examination there is a well-circumscribed or ill-defined echo-poor lesion. The through transmission is not descreased and septa are frequently observed. If the radiological features correlate with the results of aspiration and cytological examination, the diagnosis NPM can be made and surgical intervention can be avoided. We describe the value of mammography and ultrasound examination in the diagnosis of non-puerperal mastitis in a group of six patients.

  16. Early or late surgery for endocarditis with neurological complications.

    Science.gov (United States)

    Oh, Timothy Hou Teng; Wang, Tom Kai Ming; Pemberton, James A; Raudkivi, Peter J

    2016-06-01

    The European Society of Cardiology 2015 guidelines advise urgent surgery for endocarditis complicated by cerebral embolism or transient ischemic events (1B evidence). Nevertheless, the timing of surgery remains contentious. This study aimed to review our experience of early versus delayed surgery in a selected cohort. Our surgical database was examined for patients with a discharge diagnosis of endocarditis from 2005 to 2011. Selection was limited to patients who fulfilled the Duke criteria and underwent brain imaging for a clinically diagnosed preoperative neurological event. Patients were categorized as early surgery (≤7 days of clinical or cerebral imaging diagnosis of stroke) or delayed surgery (>7 days after diagnosis). Thirty-nine patients were identified: 20 in the early group (mean age 52 ± 15 years, diagnosis-to-surgery time 4 ± 2 days) and 19 in the delayed group (mean age 45 ± 15 years, diagnosis-to-surgery time 17 ± 11 days). There were no statistical differences in preoperative risks, operative data (cardiopulmonary bypass and crossclamp times) or postoperative neurological and mortality outcomes between the 2 groups. The size of the cerebral lesion was not a significant predictor of postoperative hemorrhagic or neurological outcome. Multivariate analysis did not show any independent predictor of mortality during follow-up (mean 51 ± 27 months). There was no difference in long-term survival, freedom from reoperation, or recurrent endocarditis between the 2 groups. This study showed no statistical excess of mortality or neurological outcomes after early surgical intervention, regardless of the preoperative cerebral lesion size. © The Author(s) 2016.

  17. EARLY POSTOPERATIVE COMPLICATIONS IN ROUX-EN-Y GASTRIC BYPASS.

    Science.gov (United States)

    Stoll, Aluisio; Rosin, Leandro; Dias, Mariana Fernandes; Marquiotti, Bruna; Gugelmin, Giovana; Stoll, Gabriela Fanezzi

    Roux-en-Y gastric bypass is one of the most common bariatric surgery and leads to considerable weight loss in the first months. To quantify the main early postoperative complications in patients submitted to the gastric bypass. Observational retrospective cohort. Data of 1051 patients with class II obesity associated with comorbidities or class III obesity submitted to the gastric bypass with 30 days of follow-up starting from the date of the surgery. The age average was 36 years with a predominance of females (81.1%). The mean preoperative body mass index was 43 kg/m². The major complication was fistula (2.3%), followed by intestinal obstruction (0.5%) and pulmonary embolism (0.5%). Death occurred in 0.6% of the cases. In the period of 30 days after surgery the overall complication rate was 3.8%; reoperation was necessary in 2.6% and death occurred in 0.6%. Fistula was the main complication and the leading cause of hospitalization in intensive care unit, reoperation and death. Bypass gástrico em Y-de-Roux é uma das operações bariátricas mais comuns e leva a perdas consideráveis de peso já nos primeiros meses. Quantificar as principais complicações pós-operatórias precoces em pacientes submetidos ao bypass gástrico. Coorte retrospectiva observacional. Amostra de 1051 pacientes portadores de obesidade grau II associada à comorbidades ou grau III submetidos ao bypass gástrico com acompanhamento de 30 dias a partir da data da operação. A idade média dos pacientes foi de 36 anos com predominância de mulheres (81,1%). O índice de massa corporal pré-operatório médio foi de 43 kg/m². A principal complicação foi fístula (2,3%), seguida de obstrução intestinal (0,5%) e tromboembolismo pulmonar (0,5%). Óbito ocorreu em 0,6% dos casos. No período de 30 dias de pós-operatório a taxa geral de complicações foi de 3,8%; a de reoperação de 2,6% e óbito em 0,6%. A fístula foi a principal complicação e a principal causa de internamento em

  18. Non-Puerperal Uterine Inversion: A Case Report

    OpenAIRE

    Fofie, C O; Baffoe, P

    2010-01-01

    Non-puerperal uterine inversion is rare. A 42-year old woman presented with lower abdominal pain, offensive vaginal discharge and a huge protruding mass per vaginum. A clinical diagnosis of non-puerperal uterine inversion was made and she successfully underwent vaginal hysterectomy. A high index of suspicion is required to make a prompt diagnosis.

  19. Non-puerperal uterine inversion: A case report | Fofie | Ghana ...

    African Journals Online (AJOL)

    Non-puerperal uterine inversion is rare. A 42-year old woman presented with lower abdominal pain, offensive vaginal discharge and a huge protruding mass per vaginum. A clinical diagnosis of non-puerperal uterine inversion was made and she successfully underwent vaginal hysterectomy. A high index of suspicion is ...

  20. Effect of smoking on early complications after elective orthopaedic surgery

    DEFF Research Database (Denmark)

    Møller, Ann; Pedersen, Tom Søndergård; Villebro, Nete

    2003-01-01

    of postoperative complications, particularly those relating to wound healing, cardiopulmonary complications, and the requirement of postoperative intensive care. A delay in discharge from hospital was usual for those suffering a complication. In those patients requiring prolonged hospitalisation (>15 days......) the proportion of smokers with wound complications was twice that of non-smokers....

  1. EARLY COMPLICATIONS IN BARIATRIC SURGERY: incidence, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Marco Aurelio SANTO

    2013-03-01

    Full Text Available Context Bariatric surgery has proven to be the most effective method of treating severe obesity. Nevertheless, the acceptance of bariatric surgery is still questioned. The surgical complications observed in the early postoperative period following surgeries performed to treat severe obesity are similar to those associated with other major surgeries of the gastrointestinal tract. However, given the more frequent occurrence of medical comorbidities, these patients require special attention in the early postoperative follow-up. Early diagnosis and appropriate treatment of these complications are directly associated with a greater probability of control. Method The medical records of 538 morbidly obese patients who underwent surgical treatment (Roux-en-Y gastric bypass surgery were reviewed. Ninety-three (17.2% patients were male and 445 (82.8% were female. The ages of the patients ranged from 18 to 70 years (average = 46, and their body mass indices ranged from 34.6 to 77 kg/m2. Results Early complications occurred in 9.6% and were distributed as follows: 2.6% presented bleeding, intestinal obstruction occurred in 1.1%, peritoneal infections occurred in 3.2%, and 2.2% developed abdominal wall infections that required hospitalization. Three (0.5% patients experienced pulmonary thromboembolism. The mortality rate was 0,55%. Conclusion The incidence of early complications was low. The diagnosis of these complications was mostly clinical, based on the presence of signs and symptoms. The value of the clinical signs and early treatment, specially in cases of sepsis, were essential to the favorable surgical outcome. The mortality was mainly related to thromboembolism and advanced age, over 65 years. Contexto A cirurgia bariátrica tem mostrado ser o método mais eficaz de tratamento da obesidade grave. No entanto, sua aceitação como terapia padrão-ouro ainda é questionada. As complicações cirúrgicas observadas no início do período p

  2. Morbidade febril puerperal em pacientes infectadas pelo HIV Puerperal morbidity in HIV-positive women

    Directory of Open Access Journals (Sweden)

    Andrea De Marcos

    2003-04-01

    Full Text Available OBJETIVO: avaliar as taxas de morbidade febril puerperal em pacientes infectadas pelo HIV e sua correlação com a via de parto, duração do trabalho de parto, tempo de rotura de membranas, número de células CD4+ e carga viral do HIV periparto. MÉTODOS: foram incluídas 207 gestantes infectadas pelo HIV, com seguimento pré-natal e parto entre maio de 1997 e dezembro de 2001, sendo 32 submetidas a parto vaginal e 175 a cesárea. Do total de pacientes, 62,8% foram submetidas a cesárea eletiva. A idade média no grupo analisado foi de 27,4 anos, 25,6% eram nulíparas e 26% primíparas, com idade gestacional média de 37,8 semanas no momento do parto. A contagem média de células CD4+ foi de 481 células /mm³ e da carga viral do HIV de 49.100 cópias/mL, ambas no final da gestação. RESULTADOS: a morbidade febril puerperal ocorreu em 34 pacientes, sendo 33 pós-cesárea e 1 pós-parto vaginal. O tipo mais comum de intercorrência infecciosa pós-cesárea foi infecção de cicatriz cirúrgica (13% dos casos de infecção. Os fatores analisados, como duração do trabalho de parto, tempo de rotura de membranas, contagem de células CD4+ ou carga viral do HIV periparto, não interferiram na taxa de morbidade febril puerperal. CONCLUSÕES: A incidência de morbidade febril puerperal foi de 16,8%, sendo mais freqüente pós-cesárea (18,9% que pós-parto vaginal (3,1%. Os demais fatores não mostraram relação significativa com a taxa de morbidade febril puerperal.PURPOSE: the morbidity in HIV-positive patients due to puerperal fever was studied and correlated to the method and duration of labor, the duration of premature rupture of the membranes, CD4+ cell count and the viral load (VL at peridelivery. METHODS: a total of 207 HIV-positive women with prenatal examinations and deliveries between May 1997 and December 2001 were enrolled. Of these, 32 had natural childbirth and 175 had a cesarean section. Of the total of enrolled patients, 62

  3. Puerperal and intrapartum group A streptococcal infection.

    Science.gov (United States)

    Anteby, E Y; Yagel, S; Hanoch, J; Shapiro, M; Moses, A E

    1999-01-01

    OBJECTIVE: To determine the demographic and clinical variables characteristic of non-epidemic intrapartum or puerperal group A streptococcal (GAS) infection. METHODS: The records of 47 patients diagnosed with intrapartum or puerperal GAS infection over a 6 1/2 year period at Hadassah-University Hospital-Mt. Scopus, Jerusalem were reviewed. Data regarding 25,811 women, the general population of women that delivered during that period, were obtained from their computerized medical records. Frequency distributions, t-test, chi-square, and Spearman's Rank Correlation were used, as appropriate, to analyze and compare demographic and clinical variables associated with development of GAS infection, its clinical course and subsequent development of septic shock. RESULTS: Mean age of mothers with GAS infection was higher than that of our general pregnant population (30.4 versus 27.4 years, P = 0.0019), and a higher proportion of GAS infected patients (30% versus 12%, P < 0.005) experienced PROM. Thirty-one (66%) women had fever as their sole presenting symptom, eight (17%) had fever and abdominal pain, seven (15%) had fever and abnormal vaginal bleeding, and one patient (2%) presented with a rash. Three patients (6%) developed a septic shock. Two of these patients presented with symptoms more than 14 days after delivery. CONCLUSIONS: We describe the characteristics of non-epidemic intrapartum or puerperal GAS infection. Data from our study and review of the literature suggest that some patients who develop septic shock may present later in the puerperium than patients with an uncomplicated GAS infection. PMID:10598916

  4. Estudio piloto del trastorno mental puerperal severo

    OpenAIRE

    Ana Lucrecia Ramírez; Camilo Alberto Pérez

    1994-01-01

    Este trabajo se realizó para definir los diagnósticos clínicos de 25 pacientes hospitalizadas por trastorno mental puerperal severo en instituciones de salud mental del Departamento de Antioquia, entre febrero de 1992 y octubre de 1993 y determinar si existe asociación significativa entre los diagnósticos más frecuentes y algunas variables demográficas, obstétricas y psiquiátricas. A cada paciente se le hizo una...

  5. Sociocultural factors in puerperal infectious morbidity among Navajo women.

    Science.gov (United States)

    Boyce, W T; Schaefer, C; Harrison, H R; Haffner, W H; Lewis, M; Wright, A L

    1989-03-01

    From 1980 to 1982, a sample of 968 pregnant Navajo women in New Mexico was enrolled in a prospective study of biologic and sociocultural factors in puerperal infectious morbidity. Past studies have independently implicated both genital infection and psychosocial stressors in perinatal complications, but, to the authors' knowledge, no previous work has concurrently investigated the interactive effects of genital pathogens and psychosocial processes. Endocervical cultures for Mycoplasma hominis and Chlamydia trachomatis were obtained during prenatal visits, and structured interviews were conducted assessing social support and the degree of cultural traditionality, in this context a proxy measure of acculturative stress. The incidences of postpartum fever, endometritis, and premature rupture of membranes were significantly associated with the concurrence of two factors: the presence of genital tract M. hominis and a highly traditional cultural orientation. When demographic and conventional obstetric risk factors were controlled for, women with both M. hominis and high traditionality experienced infectious complications at a rate twice that of women with either factor alone. Among the plausible explanations for this result is the possibility that acculturative stress undermines physiologic resistance to infectious genital tract disease.

  6. [Efficacy and safety of lactulose on the treatment of puerperal constipation].

    Science.gov (United States)

    Meng, Shan; Pan, Yinglian; Deng, Qingchun; Wang, Lina; Chang, Qing

    2015-07-28

    To observe the therapeutic effects and security of oral lactulose solution on treatment of puerperal constipation. A total of 200 patients with puerperal constipation who received regular antenatal cares from early pregnancy in our department and delivered in our hospital from January 2013 to October 2013, were randomly divided into two groups. The patients in control group (n = 100) received defecation habits training, diet management and drinking adequate water etc. The patients in therapy group (n = 100) received 20 ml oral lactulose solution, twice a day and constantly treatment for 4 weeks. The frequency of defecation per week were recorded (including before treatment, period during the treatment, and the first week after finish the whole treatment). The adverse reactions and recurrence of constipation after treatment were analyzed. The frequency of defecation per week in the therapy group was higher than that in the control group at the first week after treatment (t = 2.178, P = 0.869), and significantly increase in the fourth week (t = 8.390, P = 0.000). The efficiency of the lactulose groups was 92%, and the control group was 21% (χ² = 112.530, P = 0.000). The total recurrence of constipation in lactulose group was lower than that in the control group by follow up 120 days (4% vs 18%, χ² = 10.010, P = 0.001). Oral lactulose solution is effective and safe for puerperal consipation.

  7. Early experience with laparoscopic lavage in acute complicated diverticulitis.

    Science.gov (United States)

    Horesh, Nir; Zbar, Andrew P; Nevler, Avinoam; Haim, Nadav; Gutman, Mordechai; Zmora, Oded

    2015-01-01

    Contemporary surgical management of complicated diverticulitis is controversial. Traditionally, the gold standard has been resection and colostomy, but recently peritoneal lavage and drainage without resection in cases of purulent peritonitis have been suggested. This study aims to review our initial experience with laparoscopic peritoneal lavage for complicated diverticulitis. Retrospective review of all patients who underwent emergent peritoneal lavage and drainage for acute complicated diverticulitis. Five-hundred-thirty-eight patients admitted for acute diverticulitis between 2007 and 2012 were recorded in the database. Thirty seven underwent emergent surgery of which 10 had peritoneal lavage and drainage without colonic resection for complicated diverticulitis causing peritonitis. Peritoneal lavage and drainage resulted in the resolution of acute symptoms in all cases. In long-term follow-up, 3 (30%) patients required elective resection owing to symptomatic disease, two of these due to recurrent diverticulitis, and one owing to complicated fistula following the procedure. Peritoneal lavage is a feasible option for complicated diverticulitis with purulent non-fecal peritonitis, but a significant portion of the patients may require elective resection. Comparative studies with emergent resection are needed to determine the role of peritoneal lavage in complicated diverticulitis. © 2015 S. Karger AG, Basel.

  8. Reduced Incidence of Early Complications of Surgical Wounds in Laparoscopic Surgery

    Directory of Open Access Journals (Sweden)

    B. KHORASANI

    2006-07-01

    Full Text Available Background:The incidence of early wound related complications is assessed in laparoscopic versus open abdominal surgeries. Complications of surgical wounds(esp.wound infections are considered as a major problem in surgery wards. Complications of surgical wounds are classified as early and late.Common and early complications are hematoma, seroma and wound infection. Methods: The medical records of 104 elective laparoscopic (A and 106 diagnosis matched open surgeries (B including apendectomy,cholecystectomy,ventral hernia repair,and bariatric surgery were prospectively reviewed.Study data included patients` sex, age, wound class, type of operation, and occurrence of early wound related complications. Surgical wounds were evaluated for presence of early complications during the post-op period and 10 to 15 days after the operation. Results: The two groups were not different regarding age, sex and wound classes.No patients in group A and 7 patients in group B developed wound infection (p<0.05.Incidence of hematoma was similar in the two groups;one case in each.No patient in the two groups experienced seroma nor wound dehiscence.Gender,age and wound classes were not associated with higher rates of wound complications.Conclusions:Laparoscopic surgery significantly reduced the incidence of early wound complications,especially wound infection,and is a safe and effective alternative to conventional open procedures.

  9. Early and Late Neurological Complications after Cardiac Transplantation

    Directory of Open Access Journals (Sweden)

    Mehmet Balkanay

    2011-08-01

    Full Text Available The clinical use of cyclosporine as an immunosuppressant improved the recipient’s life span and revolutionized the field of cardiac transplantation. But most of the immunesuppressant drugs including cyclosporine may cause neurological and many other side effects. In this article we present three cases, from 58 patients, undergoing cardiac transplantation at our hospital from 1989 to 2008 in whom developed transient neurological complications.

  10. Causes of puerperal and neonatal sepsis in resource-constrained settings and advocacy for an integrated community-based postnatal approach.

    Science.gov (United States)

    Miller, Anne E; Morgan, Christopher; Vyankandondera, Joseph

    2013-10-01

    Puerperal sepsis and neonatal sepsis are important causes of mortality and morbidity in low-income countries. To help improve global guidelines on postpartum care by reviewing existing data on microbiologic causes of sepsis among mothers, newborns, and mother-newborn pairs. An extensive literature review of peer-reviewed publications from resource-constrained settings was conducted using PubMed. Primary research studies containing microbiologic data on puerperal sepsis or combined maternal and neonatal sepsis published since 1980. Study characteristics and results were analyzed. Data regarding causative microorganisms were tabulated and discussed in the main text. Diagnostic evaluation of microorganisms causing puerperal sepsis was difficult, with few studies linking microorganisms causing infection in individual mother-newborn pairs. The most frequent microorganisms associated with puerperal sepsis were Neisseria gonorrhoeae and Chlamydia trachomatis. The most frequent microorganisms associated with neonatal sepsis were Escherichia coli, Staphylococcus aureus, and Klebsiella species. Management tools for community-based care of mothers with puerperal sepsis-including early detection, initiation of broad-spectrum antibiotic treatment, and timely referral-should be added to those currently in use for neonatal sepsis. Further research is required to address acceptability, feasibility, and impact of community-based presumptive treatment. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Computed tomography findings of early abdominal postoperative complications

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: zisinrivka@clalit.org.il; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)

    2007-06-15

    Various surgical approaches are used for different abdominal pathological conditions. Postoperative complications occur not infrequently and vary according to the type of the surgery and the clinical context. Nowadays, multidetector computed tomography (MDCT) provides superb anatomic detail and diagnostic accuracy for various intraabdominal pathological processes, even if clinically unsuspected, and it thus has become an essential diagnostic tool for evaluating postoperative insults. Other advantages of abdominal MDCT include its accessibility and its speed, which allow scanning of uncooperative, marginally stable patients. Computed tomography (CT)-guided percutaneous (PC) drainage of postoperative collections is another advantage of CT. Therefore, although CT requires transportation of a critically ill, postoperative patient, it is recommended in any suspicious clinical setting because several conditions require prompt management and a correct diagnosis is crucial. In assessing a patient for suspected postoperative complications, several points should be taken into consideration, including the relevant clinical and laboratory data, the surgical findings, the type of the surgery, the time elapsed since surgery, and the operative technique (either open laparotomy of laparoscopic procedure). (author)

  12. Early Complications of Prosthetic Inguinal Hernia Repair | Fadlalla ...

    African Journals Online (AJOL)

    Results: tension-free mesh repair was done for 87 males and 4 females. Three patients developed seroma, two patients developed haematoma and one patient developed superficial wound infection. Early recurrence (6 months) was not seen in this study. Conclusions: mesh repair for inguinal hernia is a simple, safe and ...

  13. Early sac shrinkage predicts a low risk of late complications after endovascular aortic aneurysm repair

    NARCIS (Netherlands)

    F.M.V. Bastos Gonçalves (Frederico); H. Baderkhan (H.); H.J.M. Verhagen (Hence); A. Wanhainen (A.); E. Björck (Erik); R.J. Stolker (Robert); S.E. Hoeks (Sanne); A.R. Mani (Ali)

    2014-01-01

    textabstractBackground Aneurysm shrinkage has been proposed as a marker of successful endovascular aneurysm repair (EVAR). Patients with early postoperative shrinkage may experience fewer subsequent complications, and consequently require less intensive surveillance. Methods Patients undergoing EVAR

  14. Maternal complications in pregnancy and wheezing in early childhood

    DEFF Research Database (Denmark)

    Zugna, Daniela; Galassi, Claudia; Annesi-Maesano, Isabella

    2015-01-01

    complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥ 30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes.......04 (95% CI: 0.97-1.13) and 1.24 (95% CI: 0.86-1.79) for diabetes; 1.08 (95% CI: 1.05-1.11) and 1.19 (95% CI: 1.12-1.26) for overweight; 1.12 (95% CI: 1.08-1.17) and 1.16 (95% CI: 0.97-1.39) for obesity. No heterogeneity was found in RR estimates among the cohorts, except for diabetes and recurrent...... wheezing (P=0.027). CONCLUSIONS: Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring....

  15. Surgical apgar score predicts early complication in transfemoral amputees

    DEFF Research Database (Denmark)

    Wied, Christian; Foss, Nicolai Bang; Kristensen, Morten T

    2016-01-01

    AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013......) performed approximately 10 cm below the knee joint. All TTA procedures were performed with sagittal flaps. TFA procedures were performed in one stage with amputation approximately 10 cm above the knee joint, performed with anterior/posterior flaps. Trained residents or senior consultants performed...... to the author until after the calculation of SAS. The SAS results were arranged into four groups (SAS 0-4, SAS 5-6, SAS 7-8 and SAS 9-10). The cohort was then divided into two groups representing low-risk (SAS ≥ 7) and high-risk patients (SAS

  16. Intercostal Artery Laceration: Rare Complication of Thoracentesis and Role of Ultrasound in Early Detection

    Directory of Open Access Journals (Sweden)

    Wissam Mansour

    2017-01-01

    Full Text Available Hemothorax is a rare but potentially fatal postthoracentesis complication. Early clinical signs may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further bleeding. Following procedure, early bedside ultrasound findings can be vital for early detection. We report a case of massive hemothorax in a 63-year-old male following therapeutic thoracentesis. Diagnosis was made following highly suggestive sonographic findings prompting thoracotomy and lacerated intercostal artery cauterization.

  17. Estudio piloto del trastorno mental puerperal severo

    Directory of Open Access Journals (Sweden)

    Ana Lucrecia Ramírez

    1994-01-01

    Full Text Available

    Este trabajo se realizó para definir los diagnósticos clínicos de 25 pacientes hospitalizadas por trastorno mental puerperal severo en instituciones de salud mental del Departamento de Antioquia, entre febrero de 1992 y octubre de 1993 y determinar si existe asociación significativa entre los diagnósticos más frecuentes y algunas variables demográficas, obstétricas y psiquiátricas. A cada paciente se le hizo una entrevista estructurada para establecer el diagnóstico clínico según el Manual Diagnóstico y Estadístico de los trastornos mentales (DSM III A. Los dos diagnósticos más frecuentes se cruzaron con las variables; ellos fueron: episodio maníaco de trastorno afectivo bipolar (TAB (14 pacientes; 56% y trastorno psicótico sin especificar (TPSE (7 pacientes; 28%. No se halló asociación significativa entre estos diagnósticos, y las variables en consideración. Sí se la demostró entre hospitalización en los primeros 15 días del posparto y cualquiera de los siguientes: Trastornos Afectivos, Trastornos Psicóticos y TPSE (P< 0.05. Se propone la existencia de un subgrupo de los trastornos mentales puerperales, específico de este período, en el cual predominan los síntomas delirantes, alucinatorios, de confusión y perplejidad y cuya aparición tiene lugar en los 15 primeros días del posparto.

  18. Early Non-Immunological Post Transplant complications: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Jabur Wael

    2008-01-01

    Full Text Available To assess non-immunological complications affecting renal transplant patients in the first six months after transplantation in Al-Karama hospital, Baghdad, Iraq, we studied 68 patients (49 males, 19 females attending the clinic during the year 2006. Forty six (67% patients received kidneys from related and 22 (33% from unrelated donors. The patients revealed the following complications: post transplant hypertension in 28 (41% patient, infection (mostly bacterial in 27 (37%, new onset diabetes in 11 (16%, calcineurin inhibitor toxicity in 10 (14%, anemia in 8 (12%, surgical complications in 7 (10%, slow graft recovery in 4 (6%, cardiovascular complications in 3 (4%, and Kaposi sarcoma in 2 (2.9%.Transient hyperglycemia, hypertension, infection and diabetes mel-litus were the commonest early complications of renal transplantation. The incidence of complications is comparable to the average reported in the literature, especially in this region of the world.

  19. Spinal fusion for scoliosis in Rett syndrome with an emphasis on early postoperative complications.

    Science.gov (United States)

    Gabos, Peter G; Inan, Muharrem; Thacker, Mihir; Borkhu, Buttugs

    2012-01-15

    Retrospective case-control study. To examine the postoperative complications of posterior spinal fusion in a population of patients with Rett syndrome (RS). Scoliosis is a common feature of RS, a progressive neurologic disorder affecting almost exclusively females. Despite this, there is little published information regarding the surgical treatment of scoliosis in this disorder. Sixteen consecutive female patients with RS treated by posterior spinal fusion and unit rod instrumentation for progressive scoliosis between 1995 and 2003 were evaluated. Only patients with a minimum of 2-year follow-up were included. Preoperative medical conditions and postoperative complications were recorded. As a control group, we randomly selected 32 spastic quadriplegic patients who underwent the identical procedure during the same time period, selected from our database and matched according to age, level of neurologic impairment, and medical complexity. There was a high rate of early medical complications in the RS patients, with 28 major and 37 minor complications. Only 1 patient did not have a major medical complication, and every patient had at least 1 minor gastrointestinal and/or respiratory complication. Major respiratory complications occurred in 10 patients (63%) and comprised 61% of all major complications. Major gastrointestinal complications occurred in 6 patients (37%) and comprised 21% of all major complications. Other major complications included disseminated intravascular coagulopathy (1 patient), subacute bacterial endocarditis (1 patient), sacral decubiti requiring surgical debridement (2 patients), and extensive bilateral heterotopic ossification of the hips (1 patient). There were no cases of instrumentation failure, pseudarthrosis, deep infection, or need for rod revision. Postoperative complication scores were similar to those in patients with spastic quadriplegic pattern cerebral palsy. Spinal fusion for scoliosis in RS can give a satisfactory technical result

  20. Influence of early neurological complications on clinical outcome following lung transplant.

    Science.gov (United States)

    Gamez, Josep; Salvado, Maria; Martinez-de La Ossa, Alejandro; Deu, Maria; Romero, Laura; Roman, Antonio; Sacanell, Judith; Laborda, Cesar; Rochera, Isabel; Nadal, Miriam; Carmona, Francesc; Santamarina, Estevo; Raguer, Nuria; Canela, Merce; Solé, Joan

    2017-01-01

    Neurological complications after lung transplantation are common. The full spectrum of neurological complications and their impact on clinical outcomes has not been extensively studied. We investigated the neurological incidence of complications, categorized according to whether they affected the central, peripheral or autonomic nervous systems, in a series of 109 patients undergoing lung transplantation at our center between January 1 2013 and December 31 2014. Fifty-one patients (46.8%) presented at least one neurological complication. Critical illness polyneuropathy-myopathy (31 cases) and phrenic nerve injury (26 cases) were the two most prevalent complications. These two neuromuscular complications lengthened hospital stays by a median period of 35.5 and 32.5 days respectively. However, neurological complications did not affect patients' survival. The real incidence of neurological complications among lung transplant recipients is probably underestimated. They usually appear in the first two months after surgery. Despite not affecting mortality, they do affect the mean length of hospital stay, and especially the time spent in the Intensive Care Unit. We found no risk factor for neurological complications except for long operating times, ischemic time and need for transfusion. It is necessary to develop programs for the prevention and early recognition of these complications, and the prevention of their precipitant and risk factors.

  1. Scrub typhus masquerading as HELLP syndrome and puerperal sepsis in an asymptomatic malaria patient.

    Science.gov (United States)

    Karim, Habib Md Reazaul; Bhattacharyya, Prithwis; Kakati, Sonai Datta; Borah, Tridip Jyoti; Yunus, Md

    2016-01-01

    Scrub typhus and malaria can involve multiple organ systems and are notoriously known for varied presentations. However, clinical malaria or scrub typhus is unusual without fever. On the other hand, altered sensorium with or without fever, dehydration, hemorrhage and hemolysis may lead to low blood pressure. Presence of toxic granules and elevated band forms in such patients can even mimic sepsis. When such a patient is in the peripartum period, it creates a strong clinical dilemma for the physician especially in unbooked obstetric cases. We present such a case where a 26-year-old unbooked female presented on second postpartum day with severe anemia, altered sensorium, difficulty in breathing along with jaundice and gum bleeding without history of fever. Rapid diagnostic test for malaria was negative and no eschar was seen. These parameters suggested a diagnosis of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet) syndrome with or without puerperal sepsis. Subsequently she was diagnosed as having asymptomatic malaria and scrub typhus and responded to the treatment of it. The biochemical changes suggestive of HELLP syndrome also subsided. We present this case to emphasize the fact that mere absence of fever and eschar does not rule out scrub typhus. It should also be considered as a differential diagnosis in patients with symptoms and signs suggesting HELLP syndrome. Asymptomatic malaria can complicate case scenario towards puerperal sepsis by giving false toxic granules and band form in such situations.

  2. Non-puerperal uterine inversion due to submucous myoma in a woman: a case report.

    Science.gov (United States)

    Kirbas, Ayse; Daglar, Korkut; Kara, Ozgur; Sucak, Ayhan; Caglar, Turhan

    2016-07-01

    Uterine leiomyomas are the most common benign tumor of the female reproductive tract. Their incidence during pregnancy is approximately 2 percent and they are associated with some complications such as preterm labor, placental abruption, fetal malpresentation, obstructed labor, cesarean delivery, and postpartum hemorrhage. They may develop anywhere within the muscular wall of the uterus, including submucosal, intramural, or subserosal areas. Some of the submucous myomas may be pedunculated and eventually may protrude through the cervical canal to the vagina. They later become necrotic and sometimes infected. Vaginal myomectomy is recommended as the initial treatment of choice for a prolapsed, pedunculated myoma except when other indications require an abdominal procedure. Inversion is a condition in which the uterus turns inside out with prolapse of the fundus through the cervix. It is seen in acute and chronic forms. Chronic inversion may follow an incomplete obstetric inversion unnoticed or left uncared. Herein, we present, a case of infected non-puerperal uterine inversion due to submucous leiomyoma that was originating from fundus and the diagnostic dilemma it presents in the after puerperal stage. © 2016 Old City Publishing, Inc.

  3. Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gerdin, E. [Univ. Hospital, Dept. of Obstetrics and Gynecology, and Gynecologic Oncology, Uppsala (Sweden); Cnattingius, S. [Univ. Hospital, Dept. of Social Medicine, Uppsala (Sweden); Johnson, P. [Univ. Hospital, Dept. of Obstetrics and Gynecology, Uppsala (Sweden)

    1995-08-01

    Objective: To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods: In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files. Results: Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 23-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy. Conclusion: The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients. (au) 29 refs.

  4. Early and late complications in the reconstructed mandible with free fibula flaps.

    Science.gov (United States)

    van Gemert, Johannes T M; Abbink, Jan H; van Es, Robert J J; Rosenberg, Antoine J W P; Koole, Ron; Van Cann, Ellen M

    2018-03-01

    Evaluation of mandibular reconstructions with free fibula flaps. Identification of factors associated with major recipient site complications, that is, necessitating surgical intervention under general anaesthesia. Seventy-nine reconstructions were included. The following factors were analyzed: fixation type, number of osteotomies, site of defect (bilateral/unilateral), surgeon, sex, ASA classification, continuous smoking, pathological N-stage, age, defect size, flap ischemic time, and postoperative radiotherapy. Proportional hazards regression was used to test the effect on the time between reconstruction and intervention. Sixty-nine (87%) of the 79 fibula flaps were successful at the last follow-up. Forty-eight major recipient site complications occurred in 41 reconstructions. Nineteen complications required surgical intervention within six weeks and were mostly vascular problems, necessitating immediate intervention. These early complications were associated with defects crossing the midline, with an estimated relative risk of 5.3 (CI 1.1-20, P = 0.01). Twenty-nine complications required surgical intervention more than 6 weeks after the reconstruction. These late complications generally occurred after months or years, and were associated with smoking, with an estimated relative risk of 2.8 (CI 1.0-8.3, P = 0.05). Fibula flaps crossing the midline have a higher risk of early major recipient site complications than unilateral reconstructions. Smoking increases the risk of late complications. © 2018 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.

  5. Early complications and short-term failures of zirconia single crowns and partial fixed dental prostheses.

    Science.gov (United States)

    Pihlaja, Juha; Näpänkangas, Ritva; Raustia, Aune

    2014-10-01

    Ceramic single crowns fabricated from newer materials, especially zirconia, have shown relatively high survival rates. However, early reversible complications may increase the risk of an irreversible failure later. The purpose of the study was to evaluate the early complications and short-term failures of zirconia single crowns and partial fixed dental prostheses (FDPs) made by predoctoral dental students. Data were collected from the patient records. Altogether, 264 zirconia single crowns and 120 FDPs (342 abutments and 190 pontics) were fabricated for 173 patients between 2007 and 2010. Early complications were recorded during the prosthetic treatment phase, and short-term failures were recorded during the first year in use. The most frequent early complications were localized gingival irritation (1.9% of single crowns and 2.5% of FDP) and postoperative tooth sensitivity (0.4% of single crowns and 3.3% of FDPs). Pulp exposure during preparation was recorded in 3 abutment teeth of the FDPs. The most frequent short-term failure was chipping of the veneering porcelain (0.8% for single crowns, 0.8% for FDPs). One crown lost cementation because of poor retention (0.4%), and 2 FDPs failed because of framework fractures (1.7%). The most frequent early complications were localized gingival irritation and postoperative tooth sensitivity, and the most frequent short-term failure was chipping of the veneering porcelain. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  6. Mammographic and sonographic spectrum of non-puerperal mastitis

    NARCIS (Netherlands)

    M.H. Lequin (Maarten); J. van Spengler (J.); R. van Pel; C.H.J. van Eijck (Casper); H. van Overhagen (H.)

    1995-01-01

    textabstractThe goal of this study was to explore possible specific mammographic and sonographic features in women with non-puerperal mastitis (NPM), in order to make an accurate diagnosis and prevent unnecessary surgical procedures. From a group of 93 patients with NPM diagnosed between 1987 and

  7. Non puerperal uterine inversion secondary to leiomyoma uteri ...

    African Journals Online (AJOL)

    Background: Non Puerperal Uterine inversion is very rare. Only 150 cases have been reported in the literature over a period of 126 years. Methods: This is a case of a 44yr old grandmultiparous woman who developed a protrusion from her vagina, after earlier diagnosis of Leiomyoma uteri and scheduled for hysterectomy.

  8. The Nature of Puerperal Psychosis at Muhimbili National Hospital ...

    African Journals Online (AJOL)

    Eighty six in-patients suffering from puerperal psychosis within six weeks after childbirth were prospectively investigated in Muhimbili National Hospital during two years. Formal psychiatric history, mental status evaluation, research and diagnostic criteria including ICD 10 and clinical progression were employed for ...

  9. Incidence and bacteriological pattern of puerperal infections within ...

    African Journals Online (AJOL)

    About three quarters of Staphylococcus aureus and Escherichia coli infections are resistant to ceftriaxone, while more than half these infections are resistant to gentamicin. Conclusion: The incidence of puerperal infection in Redemption Hospital, Liberia, within the first 120 hours after Caesarean section is 21%.

  10. Puerperal infection after caesarean section at Chris Hani ...

    African Journals Online (AJOL)

    Objectives. To determine the incidence of puerperal sepsis after caesarean section (CS) at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. Methods. A longitudinal descriptive study was done on women undergoing CS, with follow-up for readmission or development of sepsis, including telephone ...

  11. Puerperal infection after caesarean section at Chris Hani ...

    African Journals Online (AJOL)

    Methods. A longitudinal descriptive study was done on women undergoing CS, with follow-up for readmission or development of sepsis, including telephone calls 14 days after delivery. Puerperal sepsis was defined as fever (temperature ≥38°C) with vaginal bleeding, malodorous discharge or pain. Women who ...

  12. Skin manifestations in sulfur mustard exposed victims with ophthalmologic complications: Association between early and late phase

    Directory of Open Access Journals (Sweden)

    Somayeh Hejazi, MD

    Full Text Available Context: Sulfur mustard (SM was used during the Iraq-Iran war (1980–1988. Exposed veterans continue to suffer from its ocular, skin, and respiratory complications. Objective: We aimed to evaluate associations between early (at the time of acute exposure and decades later skin manifestations in individuals with severe ophthalmologic complications secondary to sulfur mustard exposure. Materials and methods: One hundred forty-nine veterans with severe ocular injuries were evaluated for acute and chronic skin complications. Logistic regression models were used to examine the associations between early and late skin manifestations. Results: Late skin complaints were observed in nearly all survivors who had early skin lesions (131 out of 137; 95.62%. Seven out of 12 patients (58.33% who did not have early skin lesions ultimately developed late skin complications. There was a significant relationship between the presence of lesions at the time of exposure and developing late skin complaints (two-sided Fisher's exact test, OR = 15.59, p < 0.001. There was an association between having at least one early skin lesion and occurrence of late skin complications. Survivors with blisters at the time of chemical exposure were more likely to complain of itching (95% CI: 3.63–25.97, p < 0.001, burning (OR = 11.16; 95% CI: 2.97–41.89, p < 0.001, pigmentation changes (OR = 10.17; 95% CI: 2.54–40.75, p = 0.001, dryness (OR = 6.71, 95% CI: 1.22–37.01, p = 0.03 or cherry angioma (OR = 2.59; 95% CI:1.21–5.55, p = 0.01 during the late phase. Using multivariate logistic models, early blisters remained significantly associated with latent skin complaints. Of note, the genitalia and great flexure areas were the most involved anatomical sites for both early and late skin lesions in SM exposed survivors. Conclusion: According to this study, the presence of blisters at the time of exposure to SM is the most important predictor of developing

  13. Early operative management of complicated appendicitis is associated with improved surgical outcomes in adults.

    Science.gov (United States)

    Symer, Matthew M; Abelson, Jonathan S; Sedrakyan, Art; Yeo, Heather L

    2018-04-19

    There is no consensus on the ideal management of complicated appendicitis. The New York State Planning and Research Cooperative database was used to identify all patients admitted with complicated appendicitis and undergoing appendectomy within 1-year. Primary outcome was any complication. Secondary outcomes included length of stay (LOS), hospital charges, and laparoscopy use. Outcomes were compared in appendectomy before or after 48h from admission. 31,167 patients ≥18yo were identified for analysis, 28,015(89.9%) underwent early appendectomy. Early appendectomy patients were more likely to be White (69.8% vs. 64.2% p < 0.01), and commercially insured (53.1% vs. 45.4%, p < 0.01). Of the 3152 undergoing delayed surgery, 1610(51.1%) had surgery later during the index admission, 715(22.7%) were readmitted urgently and underwent appendectomy, and 827(26.2%) had elective appendectomy. Patients undergoing delayed surgery had more complications (OR 1.34 95%CI 1.23-1.45), readmissions (OR 1.55 95%CI 1.42-1.70), high hospital charges (OR 4.79 95%CI 4.35-5.27), and prolonged LOS (OR 6.12 95%CI 5.61-6.68). In this population-level study of complicated appendicitis we found more complications, longer LOS, and higher charges in patients undergoing delayed surgery. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Skin manifestations in sulfur mustard exposed victims with ophthalmologic complications: Association between early and late phase.

    Science.gov (United States)

    Hejazi, Somayeh; Soroush, Mohammadreza; Moradi, Ahmad; Khalilazar, Sara; Mousavi, Batool; Firooz, Alireza; Younespour, Shima

    2016-01-01

    Sulfur mustard (SM) was used during the Iraq-Iran war (1980-1988). Exposed veterans continue to suffer from its ocular, skin, and respiratory complications. We aimed to evaluate associations between early (at the time of acute exposure) and decades later skin manifestations in individuals with severe ophthalmologic complications secondary to sulfur mustard exposure. One hundred forty-nine veterans with severe ocular injuries were evaluated for acute and chronic skin complications. Logistic regression models were used to examine the associations between early and late skin manifestations. Late skin complaints were observed in nearly all survivors who had early skin lesions (131 out of 137; 95.62%). Seven out of 12 patients (58.33%) who did not have early skin lesions ultimately developed late skin complications. There was a significant relationship between the presence of lesions at the time of exposure and developing late skin complaints (two-sided Fisher's exact test, OR = 15.59, p sulfur mustard exposure.

  15. Clostridium perfringens infection complicating periprosthetic fracture fixation about the hip: successful treatment with early aggressive debridement.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-07-13

    Periprosthetic fracture and infection are both challenges following hip arthroplasty. We report the case of an 87 year old female who underwent open reduction and internal fixation of a periprosthetic femoral fracture. Her post-operative course was complicated by infection with Clostridium perfringens. Early aggressive antibiotic treatment and surgical debridement were successful, and allowed retention of the original components.

  16. [Efficacy observation of electroacupuncture intervention on severe acute pancreatitis at early stage complicated with intestinal paralysis].

    Science.gov (United States)

    Luo, Yan-Hong; Zhong, Guang-Wei; Zhao, Shuang-Ping; Tang, Hong-Mei; Zhang, Li-Na

    2011-02-01

    To explore the clinical efficacy of electroacupuncture intervention on severe acute pancreatitis (SAP) at early stage complicated with intestinal paralysis. Sixty-eight cases of SAP were randomly divided into observation group (48 cases) and control group (20 cases). In observation group, according to the course of sickness, the early-stage subgroup (30 cases, hospitalized in 3 d) and late-stage subgroup (18 cases, hospitalized in 3-7 d) were subdivided. In control group, the conventional treatment was applied. In observation group, based on the same treatment as control group, electroacupuncture was supplemented at Zhongwan (CV 12), Zusanli (ST 36), Neiguan (PC 6), Hegu (LI 4), etc. Acute physiology and chronic health evaluation (APACHE) II scores, the recovery time of intestinal paralysis and laboratory indices, complications, operation transfer rate, death rate and the admission time were compared among groups after treatment. The total effective rate was 83.3% (25/30) in early-stage subgroup, which was superior to 72.2% (13/18) in late-stage subgroup and 65.0% (13/20) in control group (P complications, operation transfer rate, death rate and admission time were all lower remarkably than those in late-stage subgroup and control group (P 0.05). The clinical efficacy of electroacupuncture intervention on SAP complicated with intestinal paralysis is superior remarkably to that of conventional treatment, and the efficacy of electroacupuncture intervention at early stage is better than that at late stage.

  17. Early complications following radical surgical treatment of patients with gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Kostić Zoran

    2006-01-01

    Full Text Available Background/Aim. Surgical treatment of patients with gastric adenocarcinoma means the total excision of a tumor and the pathways of its spreading with the risk of operational complications as low as possible. The aim of this study was to evaluate the type and frequency of early postoperative complications and mortality after a radical surgical treatment of patients with gastric adenocarcinoma. Methods. Complication rates and postoperative mortality were studied in 70 consecutive patients in whom a radical surgical procedure, gastrectomy (total or subtotal with D2 lymphadenectomy, was performed. In the early postoperative period, the frequencies of general and specific complications were detected. The frequencies of complications were compared between the groups of patients according to the defined clinical, operative and pathohistological paramethers. Results. The overall morbidity and mortality rates were 27.14% and 5.71%, respectively Pancreatic fistula in five, and pleural effusion in three patients were the most frequently registered complications. Three of four deaths occured in patients older than 70 years, with the stage III and IV of the disease, and in all of them total gastrectomy with splenectomy was performed. A statistically significant difference (p < 0.05 in complication rates was found between the groups of patients with and without splenectomy and with the tumors > 5 cm and ≤ 5 cm. Conclusion. Radical surgical treatment of patients with gastric adenocarcinoma might be done with an acceptable morbidity and mortality if it is performed by the surgeons with the experience in D2 lymphadenectomy technique. A diameter of the tumor > 5 cm, and splenectomy, and/or splenopancreatectomy are the most important risk factors for the occurrence of complications and modifications of D2 lymphadenectomy technique with limited indications for splenic and/or pancreas resection can improve treatment results. An individual approach and the

  18. Associations Between Social Support and Postpartum Depression in Puerperal Mothers

    Directory of Open Access Journals (Sweden)

    Patricia Alvarenga

    2013-11-01

    Full Text Available This study assesses the relationship between social support and maternal depression in puerperal mothers in the first month postpartum. Participants were 77 puerperal mothers divided into two groups. The clinical group comprised 39 mothers with considerable levels of depressive symptomatology according to the Beck Depression Inventory (BDI. The non-clinical group comprised mothers with a minimum level according to the BDI. Mothers also completed the Medical Outcomes Study social support scale. Significant differences were found between the two groups on all factors of the MOS social support scale, with the clinical group scoring lower than the non-clinical group on all of them, showing consistency with other literature findings.

  19. Puerperal and cycloid psychoses. Results of a retrospective study.

    Science.gov (United States)

    Lanczik, M; Fritze, J; Beckmann, H

    1990-01-01

    Puerperal psychoses are traditionally considered to be nosologically unspecific. They are defined exclusively by their occurrence close to delivery. Attempts to further diagnostically subdivide puerperal psychoses have been prevented to date by the influence of Kraepelin's dichotomy. New possibilities of nosological differentiation arose out of Kasanin's (1933) description of schizoaffective psychoses and out of Leonhard's differentiated nosology (1986). The objective of the present, retrospective study was to apply Leonhard's nosology to 42 postpartal psychoses. Five diagnostic groups could be identified: 6 cases of manic-depressive disorder, 7 cases of pure depression, 8 cases of pure melancholia, 2 cases of unsystematic schizophrenia, and 19 cases of cycloid psychoses. For this reason we consider that the concept of the cycloid psychoses is appropriate for the characterization of a large proportion of childbed psychoses.

  20. Dental complications of rickets in early childhood: case report on 2 young girls.

    Science.gov (United States)

    Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

    2014-04-01

    Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

  1. Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma ...

    African Journals Online (AJOL)

    Ashdin Publishing. Clinics in Mother and Child Health. Vol. 8 (2011), Article ID C110602, 3 pages doi:10.4303/cmch/C110602. Case Report. Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma in a Cameroonian Woman. F. Fouelifack Ymele,1 P. Nana,1,2 J. H. Fouedjio,1,2 E. Bechem,2 and R. E. Mbu1,2.

  2. Tromboflebitis extensa como causa de fiebre insidiosa puerperal

    OpenAIRE

    Charco Roca, Luisa María; Bonmatí García, Lorena; Rubio Postigo, Gem

    2015-01-01

    Los eventos tromboembólicos son factores contribuyentes esenciales de morbilidad y mortalidad materna. La enfermedad tromboembólica complicada en el periodo puerperal a menudo se presenta con fiebre de causa desconocida y un dolor abdominal que puede confundirse con síntomas del postparto (1). El diagnostico de estos procesos deben hacerse por tomografía axial computerizada (TAC) (1,2). La terapia antiinflamatoria, antibiótica y anticoagulante oportuna y eficaz puede mejorar significativament...

  3. An audit of early complications of radical cystectomy using Clavien-Dindo classification

    Directory of Open Access Journals (Sweden)

    Nitesh Patidar

    2016-01-01

    Full Text Available Introduction: Despite the major improvements in surgical technique and perioperative care, radical cystectomy (RC remains a major operative procedure with a significant morbidity and mortality. The present study analyzes the early complications of RC and urinary diversion using a standardized reporting system. Materials and Methods: Modified Clavien-Dindo classification was used to retrospectively assess the peri-operative course of 212 patients who had RC with urinary diversion between October 2003 and October 2014 at a single institution. The indications for surgery were muscle invasive urothelial carcinoma, high-grade nonmuscle invasive bladder cancer (BC, and Bacillus Calmette-Guerin-resistant nonmuscle invasive BCs. Data on age, sex, comorbidities, smoking history, American Society of Anaesthesiologists score, and peri-operative complications (up to 90 days were captured. Statistical analysis was performed using SPSS 20.0 software (Chicago, USA. Results: The mean age was 56.15 ΁ 10.82. Orthotopic neobladder was created in 113 patients, ileal conduit in 88 patients, and cutaneous ureterostomy in 11 patients. A total of 292 complications were recorded in 136/212 patients. 242 complications (81.16% occurred in the first 30 days, with the remaining 50 complications (18.83% occurring thereafter. The rates for overall complication were 64.1%. The most common complications were hematologic (21.6%. Most of the complications were of Grade I and II (22.9% and 48.9%, respectively. Grade IIIa, IIIb, IVa, IVb, and V complications were observed in 10.2%, 8.9%, 3.4%, 2.7%, and 2.7% of the patients, respectively. Conclusions: RC and urinary diversion are associated with significant morbidity. This audit would help in setting a benchmark for further improvement in the outcome.

  4. Early complications after stapled transanal rectal resection performed using the Contour® Transtar™ device.

    Science.gov (United States)

    Martellucci, J; Talento, P; Carriero, A

    2011-12-01

    This study evaluated the early results (with particular reference to complications) of stapled transanal rectal resection (STARR) carried out using the CCS-30 Contour® Transtar™ device. The procedure was performed in a single centre on patients with obstucted defecation caused by rectocele or rectal intussusception. From July 2007 to February 2009, 133 patients were treated. Preoperatively, all underwent clinical examination, transanal ultrasonography, anorectal manometry and cinedefaecography. Obstructed defaecation syndrome was assessed using the Cleveland Clinic Constipation Score (CCC-S). Early postoperative complications and those occurring within 6 months were recorded. The median follow-up period was 19 (range 12-30) months. The mean ± standard deviation preoperative CCC-S of 19.4 ± 7.1 decreased to 10.1 ± 9.0 postoperatively. The early complication rate was 15.7% and included rectovaginal fistula (n = 1), rectal perforation (n = 1), posterior dehiscence (n = 4), further surgery for retained staples (n = 2), postoperative bleeding (n = 2) and postoperative impaired continence (n = 11). STARR using the Contour Transtar device seems to be effective for treating obstructed defaecation. However, serious complications may occur. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  5. Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial.

    Science.gov (United States)

    Abdollahi, Ali Akbar; Mehranfard, Shahzad; Behnampour, Nasser; Kordnejad, Abdol Mohamad

    2015-06-01

    After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol), early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS) of pain and Kristin Swain's check list was applied to evaluate the severity of bleeding and hematoma. None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference. Based on the findings of this study, changing patients' position can be safe and they can be ambulated early after angiography.

  6. Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Ali Akbar Abdollahi

    2015-06-01

    Full Text Available Introduction: After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. Methods: In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol, early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS of pain and Kristin Swain’s check list was applied to evaluate the severity of bleeding and hematoma. Results: None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference.Conclusion: Based on the findings of this study, changing patients’ position can be safe and they can be ambulated early after angiography.

  7. Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda.

    Science.gov (United States)

    Ngonzi, Joseph; Tornes, Yarine Fajardo; Mukasa, Peter Kivunike; Salongo, Wasswa; Kabakyenga, Jerome; Sezalio, Masembe; Wouters, Kristien; Jacqueym, Yves; Van Geertruyden, Jean-Pierre

    2016-08-05

    Maternal mortality is highest in sub-Saharan Africa. In Uganda, the WHO- MDG 5 (aimed at reducing maternal mortality by 75 % between 1990 and 2015) has not been attained. The current maternal mortality ratio (MMR) in Uganda is 438 per 100,000 live births coming from 550 per 100,000 in 1990. This study sets out to find causes and predictors of maternal deaths in a tertiary University teaching Hospital in Uganda. The study was a retrospective unmatched case control study which was carried out at the maternity unit of Mbarara Regional Referral Hospital (MRRH). The sample included pregnant women aged 15-49 years admitted to the Maternity unit between January 2011 and November 2014. Data from patient charts of 139 maternal deaths (cases) and 417 controls was collected using a standard audit/data extraction form. Multivariable logistic regression analysis was used to assess for the factors associated with maternal mortality. Direct causes of mortality accounted for 77.7 % while indirect causes contributed 22.3 %. The most frequent cause of maternal mortality was puerperal sepsis (30.9 %), followed by obstetric hemorrhage (21.6 %), hypertensive disorders in pregnancy (14.4 %), abortion complications (10.8 %). Malaria was the commonest indirect cause of mortality accounting for 8.92 %. On multivariable logistic regression analysis, the factors associated with maternal mortality were: primary or no education (OR 1.9; 95 % CI, 1.0-3.3); HIV positive sero-status (OR, 3.6; 95 % CI, 1.9-7.0); no antenatal care attendance (OR 3.6; 95 % CI, 1.8-7.0); rural dwellers (OR, 4.5; 95 % CI, 2.5-8.3); having been referred from another health facility (OR 5.0; 95 % CI, 2.9-10.0); delay to seek health care (delay-1) (OR 36.9; 95 % CI, 16.2-84.4). Most maternal deaths occur among mothers from rural areas, uneducated, HIV positive, unbooked mothers (lack of antenatal care), referred mothers in critical conditions and mothers delaying to seek health care. Puerperal sepsis is

  8. Radiological and clinical features of adult non-puerperal mastitis

    Science.gov (United States)

    Tan, H; Li, R; Liu, H; Gu, Y; Shen, X

    2013-01-01

    Objective: To describe the radiological and clinical features of adult non-puerperal mastitis and to determine the most accurate method of preventing unnecessary surgical procedures. Methods: Clinical and imaging findings were retrospectively reviewed in 51 females with non-puerperal mastitis, which was confirmed by biopsy/surgical pathology. All 51 patients had pre-operative MRI; 45 patients also had sonograms and 25 also had mammograms, pre-operatively. Results: Of the 51 cases with non-puerperal mastitis, 94.1% (48/51) were confirmed as having acute or chronic inflammation, and the other 3 had plasma cell mastitis; areola papillaris inflammation was found in 39.2% (20/51) of the cases. Overall, 6 of the 25 cases that were examined with mammography and 2 of the 45 cases that were examined with sonography appeared normal, but all 51 lesions were positively identified on MRI. Asymmetrical density (12/25) on mammograms and solitary or separated/contiguous, clustered, hypoechoic mass-like lesions (31/45) on ultrasound were the most common signs of non-puerperal mastitis. On enhanced MRI, 90.2% (46/51) of patients showed non-mass-like enhanced lesions. Multiple regional enhancements in the pattern of distribution (32/46) and separated or contiguous, clustered, rim-like enhancements in the pattern of internal enhancement (29/46) were the most common manifestations in non-mass-like enhanced lesions. Of the 51 patients, mastitis Type 1 and Type 2 in the time–signal intensity curve were detected in 47.1% and 51.0% of the patients, respectively. The breast imaging reporting and data system categories with the highest number of patients were Category 0 (9/25) on mammography, Category 4a on sonography (18/45) and Category 4a on MRI (29/51). Conclusion: The findings from mammography and ultrasound are non-specific; therefore, using MR can be helpful in the diagnosis, especially in the presence of non-mass-like enhancements that are multiple, regional, separated, or

  9. Early Complications in Proximal Femoral Nailing Done for Treatment of Subtrochanteric Fractures

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    B Kanthimathi

    2012-03-01

    Full Text Available AIM: To analyse the early complications following the use of PFN in subtrochanteric fractures. Background: Osteosynthesis with PFN in subtrochanteric fracture features the advantages of high rotational stability of the head–neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. However, the use of the nail requires technical expertise and is accompanied by some risks of error which can lead to osteosynthesis failure. METHODS: Between May 2009 and May 2011, 50 consecutive patients with PFN fixations for subtrochanteric fractures were observed for intraoperative and postoperative complications. RESULTS: We identified intraoperative technical difficulties in four patients and six patients showed postoperative complications. CONCLUSION: When subtrochanteric fractures are to be stabilised with a PFN, the precise and expert technical performance of implantation is the basic surgical requirement. Good reduction with minimal dissection and the use of an appropriate implant is necessary to avoid treatment failure.

  10. Blunt splenic trauma: splenectomy increases early infectious complications: a prospective multicenter study.

    Science.gov (United States)

    Demetriades, Demetrios; Scalea, Thomas M; Degiannis, Elias; Barmparas, Galinos; Konstantinidis, Agathoklis; Massahis, John; Inaba, Kenji

    2012-01-01

    The purpose of this study was to evaluate the effect of the method of splenic injury management on early infectious complications. Prospective observational, multicenter study which included all patients with blunt splenic injury surviving at least 72 hours. Epidemiologic and clinical data, grade of splenic injury, method of splenic management, and infectious complications during the initial hospitalization were collected according to a standardized collecting datasheet. Logistic regression analysis was used to identify independent risk factors for infectious complications. During a 22-month period, 269 eligible patients were enrolled in the study. Overall, 105 (39.0%) patients were observed; 48 (17.8%) underwent successful angioembolization, 19 (7.1%) underwent splenorrhaphy, and 97 (36.1%) underwent splenectomy. Multivariate analysis adjusting for age, hypotension on admission, Glasgow Coma Scale, Injury Severity Score, Abbreviated Injury Scale, laparotomy, grade of splenic injury, and associated solid and hollow viscus injuries, showed that splenectomy had a significantly higher incidence of infectious complications than splenic preservation (adjusted odds ratio [95% confidence interval], 9.62 [3.04-30.30]; p < 0.001). A regression model analysis identified splenectomy, hypotension on admission, associated hollow viscus injury, and high Injury Severity Score as independent risk factors for infectious complications. Forward logistic regression analysis, which included only the 176 patients with grades III to V splenic injuries, identified splenectomy as the most significant independent risk factors for infection (adjusted odds ratio [95% confidence interval], 16.67 [3.76-71.43]; p < 0.001). Splenectomy is an independent risk factor for early infectious complications. Splenic-preserving techniques should be considered more liberally.

  11. Neonatal Infected Subgaleal Hematoma: An Unusual Complication of Early-onset E. coli Sepsis

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    Hung-Yang Chang

    2015-04-01

    Full Text Available Subgaleal hematoma (SGH is an uncommon but potentially lethal medical emergency in newborns. Delay in diagnosis may lead to mortality and morbidity. Infection of an SGH is extremely rare. We report an infected SGH with abscess formation as a complication of early-onset Escherichia coli sepsis in a term neonate. The patient was discovered to have SGH soon after birth. Early-onset E. coli sepsis developed on Day 3 of life. The SGH became infected, with abscess formation 1 week later. The infected SGH was probably due to direct hematogenous spreading of sepsis. The patient was successfully treated without complications. Clinicians should be aware that SGH is a potential site of infection and infection may be caused either by direct hematogenous extension or from traumatic scalp lesions. Appropriate antibiotic treatment and surgical debridement are necessary when an infected SGH occurs.

  12. The importance of early diagnosis and treatment of kaposiform hemangioendothelioma complicated by Kasabach-Merritt phenomenon.

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    Vivas-Colmenares, Grecia V; Ramirez-Villar, Gema L; Bernabeu-Wittel, Jose; Matute de Cardenas, Jose A; Fernandez-Pineda, Israel

    2015-01-01

    Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor that may be complicated by Kasabach-Merritt phenomenon (KMP), a profound thrombocytopenia resulting from platelet trapping within a vascular tumor, either KHE or tufted angioma (TA). Typical features also include low fibrinogen and elevated D-dimers. It is well known that KMP is not caused by infantile hemangiomas. Management of vascular tumors complicated by KMP is challenging, and it is common for referral centers to receive patients in critical medical condition after multimodality treatment failure of vascular anomalies. Our aim is to communicate the importance of early diagnosis and treatment of KHE associated with KMP. A full-term male newborn with KHE complicated by KMP is reported. Treatment with vincristine, aspirin and ticlopidine normalized the coagulation parameters within one week, requiring a total of six doses of vincristine, seven months of ticlopidine and 17 months of aspirin. Early diagnosis and treatment of KHE complicated by KMP may allow the administration of fewer doses of vincristine and avoid the use of corticosteroids.

  13. Factors Affecting the Occurrence of Complications in the Early Stages After Dental Implant Placement: A Retrospective Cohort Study.

    Science.gov (United States)

    Okamoto, Toshihiro; Hoshi, Keika; Fukada, Kenji; Kataoka, Toshiyuki; Kumasaka, Akira; Kaibuchi, Nobuyuki; Fukuzawa, Satoshi; Ando, Tomohiro

    2018-03-19

    To evaluate the background factors related to the occurrence of complications in the early stages after dental implant placement. A total of 289 outpatients who received dental implants were retrospectively evaluated for the presence or absence of complications. Background factors, including age, sex, implant width, implant length, implant site, number of implants placed, Periotest values at the time of implant placement, presence/absence of systemic disease (particularly diabetes), and the use of anticoagulation therapy, were compared between patients with and without complications. Logistic regression analysis was performed to identify significant risk factors for the occurrence of complications after dental implant placement. Complications in the early stages after dental implant placement occurred in 25 (8.65%) patients. The patients with complications were older than those without complications (P = 0.003). In addition, the incidence of complications was significantly higher in patients with systemic diseases (P = 0.004) and in those receiving anticoagulation therapy (P = 0.005). Logistic regression analysis revealed that age was a significant risk factor (P = 0.025) for early-stage complications, whereas the number of implants, presence of diabetes, and the use of anticoagulation therapy were not significant risk factors. Our results show that age is a significant factor influencing the occurrence of complications in the early stages after dental implant placement. Therefore, clinicians should consider this factor when developing their treatment strategies.

  14. [Early postoperative complications in patients with aneurysm of the abdominal aorta treated with vascular prosthesis].

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    Grabowska-Gaweł, Anna

    2004-07-01

    Type and frequency of early postoperative complications were analyzed in a group of 226 patients (190 men and 36 women) at the age of 45 to 83 (mean age 65.3 +/- 8.2) who were operated as planned due to aneurysm of abdominal part of aorta. Patients were divided into two groups (I and II) depending on method of analgesia. Group I which constituted 173 patients operated at associated general and extrameningeal analgesia and group II constituted 53 patients operated at general analgesia. The division into groups was unintentional and was due to the fact that general analgesia was carried out in patients with contraindication of extrameningeal catheter use or technical troubles with its appliance. Patients of both groups were divided into groups (A and B) depending on type of complication or cause of death (A--cardiogenic, B--extracardiac). The followed up group is characterized by increased incidence in men than in women (5:1), the age of both sexes is not significantly different respectively men and women 65.5 and 65.2 years. In most cases, patients suffered from arterial hypertension (20.4%), ischaemic heart disease and myocardial infarction (21.2%) and chronic obstructive lung disease (12%). Early postoperative complications without lethal outcome occurred in 76 patients (33.6%), in 7.5% they included cardiogenic complications, while in 26% extracardiac complications, among which acute ischaemia of lower extremities (8.8%) and postoperative pulmonary complications (5.7%) were the most dominating. The observed group is characterized by relatively high postoperative mortality (9.3%). 4% of patients died due to cardiogenic reasons, while 5.3% of patients died due to extracardiac reasons. The most common cause of death in the last group was infection and embolism of mesentery (3.6%). Strong relation between preoperative loading, operation time, time of aorta occlusion, type of grafted prosthesis and frequency as well as type of postoperative complications was confirmed

  15. Apendicite aguda no ciclo gravídico-puerperal: um estudo de 13 casos Acute appendicitis in the gravidic-puerperal cycle: a study of 13 cases

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    Expedito Fernandes Gurgel

    1998-05-01

    Full Text Available Descrevemos 13 casos de apendicite no ciclo gravídico-puerperal, atendidos na Maternidade Escola Januário Cicco em Natal, no período de 8 anos (jan/89 a dez/96. Todos os casos foram avaliados por uma equipe de obstetras e cirurgiões e a decisão de executar a apendicectomia foi tomada conjuntamente. Onze pacientes eram gestantes (4 no 1º trimestre, 6 no 2º e 1 no 3º e 2 puérperas. A incidência foi 1/3.422 partos, a idade das gestantes variou entre 18 e 30 anos, sendo a maioria nulíparas. No quadro clínico a queixa mais freqüente foi a dor abdominal forte ou moderada, localizada em todo o abdome. A incisão de Rock Daves foi a de eleição, exceto no caso em que a paciente era assintomática e a apendicite foi um achado durante uma cesárea. O apêndice estava roto em 6 casos e dentre eles, 2 apresentaram abscesso de parede abdominal e 1 paciente abortou. Em 9 gestantes a gravidez evoluiu sem intercorrências, culminando com partos a termo. Não houve complicações nas pacientes operadas no puerpério ou naquela apendicectomizada durante a cesárea. Constatou-se associação positiva entre a incidência de perfuração do apêndice e o aumento do intervalo de tempo do início da dor ao ato cirúrgico. Foi observado um aumento da incidência de perfuração quando a dor se expandia por todo o abdome. A precocidade diagnóstica e terapêutica é fundamental no prognóstico destas pacientes.The present study describes 13 cases of appendicitis in the gravidic-puerperal cycle, at the Maternidade Escola Januário Cicco, from Jan/89 to Dec/96. The cases were assisted by a team of obstetricians and surgeons. Eleven patients were pregnant (4 in the 1st trimester, 6 in the 2nd and 1 in the 3rd and 2 were in the puerperal period. The incidence was 1/3.422; the age ranged from 18 to 30 years and the majority was nulliparous. The most frequent symptom was abdominal pain (intense or moderate. The appendix was perforated in 6 cases, 2 of them with

  16. Deep Brain Stimulation for Parkinson's Disease with Early Motor Complications: A UK Cost-Effectiveness Analysis.

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    Tomasz Fundament

    Full Text Available Parkinson's disease (PD is a debilitating illness associated with considerable impairment of quality of life and substantial costs to health care systems. Deep brain stimulation (DBS is an established surgical treatment option for some patients with advanced PD. The EARLYSTIM trial has recently demonstrated its clinical benefit also in patients with early motor complications. We sought to evaluate the cost-effectiveness of DBS, compared to best medical therapy (BMT, among PD patients with early onset of motor complications, from a United Kingdom (UK payer perspective.We developed a Markov model to represent the progression of PD as rated using the Unified Parkinson's Disease Rating Scale (UPDRS over time in patients with early PD. Evidence sources were a systematic review of clinical evidence; data from the EARLYSTIM study; and a UK Clinical Practice Research Datalink (CPRD dataset including DBS patients. A mapping algorithm was developed to generate utility values based on UPDRS data for each intervention. The cost-effectiveness was expressed as the incremental cost per quality-adjusted life-year (QALY. One-way and probabilistic sensitivity analyses were undertaken to explore the effect of parameter uncertainty.Over a 15-year time horizon, DBS was predicted to lead to additional mean cost per patient of £26,799 compared with BMT (£73,077/patient versus £46,278/patient and an additional mean 1.35 QALYs (6.69 QALYs versus 5.35 QALYs, resulting in an incremental cost-effectiveness ratio of £19,887 per QALY gained with a 99% probability of DBS being cost-effective at a threshold of £30,000/QALY. One-way sensitivity analyses suggested that the results were not significantly impacted by plausible changes in the input parameter values.These results indicate that DBS is a cost-effective intervention in PD patients with early motor complications when compared with existing interventions, offering additional health benefits at acceptable incremental

  17. Deep Brain Stimulation for Parkinson's Disease with Early Motor Complications: A UK Cost-Effectiveness Analysis.

    Science.gov (United States)

    Fundament, Tomasz; Eldridge, Paul R; Green, Alexander L; Whone, Alan L; Taylor, Rod S; Williams, Adrian C; Schuepbach, W M Michael

    2016-01-01

    Parkinson's disease (PD) is a debilitating illness associated with considerable impairment of quality of life and substantial costs to health care systems. Deep brain stimulation (DBS) is an established surgical treatment option for some patients with advanced PD. The EARLYSTIM trial has recently demonstrated its clinical benefit also in patients with early motor complications. We sought to evaluate the cost-effectiveness of DBS, compared to best medical therapy (BMT), among PD patients with early onset of motor complications, from a United Kingdom (UK) payer perspective. We developed a Markov model to represent the progression of PD as rated using the Unified Parkinson's Disease Rating Scale (UPDRS) over time in patients with early PD. Evidence sources were a systematic review of clinical evidence; data from the EARLYSTIM study; and a UK Clinical Practice Research Datalink (CPRD) dataset including DBS patients. A mapping algorithm was developed to generate utility values based on UPDRS data for each intervention. The cost-effectiveness was expressed as the incremental cost per quality-adjusted life-year (QALY). One-way and probabilistic sensitivity analyses were undertaken to explore the effect of parameter uncertainty. Over a 15-year time horizon, DBS was predicted to lead to additional mean cost per patient of £26,799 compared with BMT (£73,077/patient versus £46,278/patient) and an additional mean 1.35 QALYs (6.69 QALYs versus 5.35 QALYs), resulting in an incremental cost-effectiveness ratio of £19,887 per QALY gained with a 99% probability of DBS being cost-effective at a threshold of £30,000/QALY. One-way sensitivity analyses suggested that the results were not significantly impacted by plausible changes in the input parameter values. These results indicate that DBS is a cost-effective intervention in PD patients with early motor complications when compared with existing interventions, offering additional health benefits at acceptable incremental cost

  18. [Early complications of pneumatic dilatation in the treatment of primary motility disorders of the esophagus].

    Science.gov (United States)

    Sala, T; Ponce, J; Pertejo, V; Linares, M; Garrigues, V; Berenguer, J

    1990-04-01

    We analyze the incidence and evolution of the early complications of 96 consecutive patients with primary esophagus motor disorders, treated with pneumatic dilatation under endoscopic control (1.4 sessions per patient). In 4 (0.042/patient, 0.029/dilatation) patients the esophagus was perforated; the diagnosis was made in the first 24 hours; pneumomediastinum was a constant finding in the radiological exploration. In three cases the complication was suspected because of the apparition of sustained thoracic pain after the dilatation maneuver and in one case the presentation symptom was bleeding of cardial mucosa, larger than usual, at the end of the dilatation. The four patients evolved favorably with conservative treatment (avoidance of oral food intake, gastroesophageal aspiration, antibiotic therapy and parenteral nutrition).

  19. Does the obesity paradox apply to early postoperative complications after hip surgery? A retrospective chart review.

    Science.gov (United States)

    Shaparin, Naum; Widyn, James; Nair, Singh; Kho, Irene; Geller, David; Delphin, Ellise

    2016-08-01

    There is evidence that very obese patients (body mass index [BMI] >40 kg/m(2)) undergoing hip replacement have longer average hospital stays, as well as higher rates of complications and readmission compared with patients with normal BMI. However, there are sparse data describing how overweight and obese patients fare in the period immediately after hip replacement surgery compared with patients with low or normal BMI. In this study, we sought to explore the association of BMI with the rate of early postoperative complications in patients undergoing total hip arthroplasty. A proprietary hospital software program, Clinical Looking Glass was used to query the Montefiore Medical Center database and create a list of patients with International Classification of Diseases, Ninth Revision code 81.51 (hip replacement) from the period of January 1, 2010, through December 31, 2012. The medical records of patients with length of stay 5 or more days were reviewed to evaluate the reason for the extended stay. The primary outcome studied was the association between BMI and occurrence of early complications in patients who had undergone total hip replacement surgery. Logistic regression was used to calculate adjusted odds ratio (OR) and 95% confidence interval (CI) for the association of BMI and early postoperative complications. Of the 802 patients undergoing hip replacement surgery within our time frame, 142 patient medical records were reviewed due to their length of stay of ≥5 days. Overall complication rate in the analyzed patients demonstrated a J-curve distribution pattern, with the highest morbidity being 23.5% in the underweight group, the second highest in the normal-weight group (17.3%), and decreasing to nadir in the overweight (8.0%) and obese class I (10.0%) and then higher again in classes II (14.3%) and III (16.7%). Adjusted ORs demonstrated the same J distribution pattern similar to the pattern observed in the univariate analysis. Of the variables studied

  20. Early Complications in Hip and Knee Arthroplasties in a Safety Net Hospital vs a University Center.

    Science.gov (United States)

    Jergesen, Harry E; Yi, Paul H

    2016-04-01

    Indigent populations face unique challenges that may increase surgical risk and adversely affect the outcomes of hip and knee arthroplasties. This study examines whether there is a difference in early postoperative complications in patients treated in a safety net hospital and in a nearby university center. A retrospective review was undertaken of 533 consecutive hip and knee arthroplasties performed by a single experienced surgeon in a safety net hospital and in a university medical center from 2008 to 2012. Patients were followed for a minimum of 2 years. The primary outcomes evaluated were total complications, deep infections, and reoperations. Statistical comparison of the data from the 2 patient groups was carried out using Fisher exact test. Despite the lower percentage of index revision procedures in the safety net group (8% vs 20.5%; P = .0003), the incidence of adverse outcomes was higher in this group than in the university group: for total complications, 12.3% vs 4.9% (P = .003); for deep infections, 3.2% vs 0.6% (P = .025); and for reoperations, 7.5% vs 2.6% (P = .009). For primary procedures in particular, differences in the incidences of these outcomes were even more significant. In this study, early complications were more frequent in patients who underwent hip and knee arthroplasties in a safety net hospital compared with those who underwent the same procedures in a nearby university center. Future prospective studies are warranted to determine which patient-related or care process-related factors should be optimized to improve arthroplasty outcomes in vulnerable, safety net populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Laparoscopic Conversion of Gastric Bypass Complication to Sleeve Gastrectomy: Technique and Early Results.

    Science.gov (United States)

    Chen, Chung-Yen; Lee, Wei-Jei; Lee, Hui-Ming; Chen, Jung-Chien; Ser, Kong-Han; Lee, Yi-Chih; Chen, Shu-Chun

    2016-09-01

    Laparoscopic gastric bypass is a commonly performed bariatric surgery for the treatment of morbid obesity. Revision surgery for patients who have gastric bypass complications is a challenge for bariatric surgeon. Our aim is to present the early results of the conversions of gastric bypass complications to sleeve gastrectomies. From January 2001 to April 2015, 49 of 2382 gastric bypasses underwent revisional surgery to convert gastric bypasses to sleeve gastrectomies. The demographic data, surgical parameters, and outcomes were studied. The mean age of the study group was 35.0 years (range 20 to 55), and the average body mass index (BMI) prior to the reoperation was 25.3 kg/m(2). Seven patients had previous laparoscopic Roux-en-Y gastric bypasses (LRYGBs), and 42 had laparoscopic single anastomosis (mini-) gastric bypasses (LSAGBs). The main reasons for the revisions were malnutrition (58 %), weight regain (10 %), intolerance (18 %), and others (14 %). The revisional surgeries had longer operative times, greater blood loss, and longer flatus passage times than the primary gastric bypass surgeries. Four patients (8.1 %) developed major complications during revisional surgery, including three (6.1 %) cases of leakage and one (2.0 %) case of internal bleeding. No mortality was noted. After conversion to sleeve gastrectomy, the body weights of the patients remained stable, and all patients improved in terms of malnutrition, including anemia, hypoalbuminemia, and secondary hyperparathyroidism. Conversion to sleeve gastrectomy is an effective and safe option for patients with gastric bypass complications. The conversions to sleeve gastrectomy resulted in significant improvements in malnutrition and maintained weight loss at the early follow-ups.

  2. Clinical evaluation of C-reactive protein and procalcitonin for the early detection of postoperative complications after laparoscopic sleeve gastrectomy

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    Agata Frask

    2017-05-01

    Full Text Available Introduction : Among the most common early complications after bariatric surgery are anastomosis leak and bleeding. In order to react quickly and perform accurate treatment before the clinical signs appear, early predictors should be found. In the study C-reactive protein (CRP and procalcitonin (PCT levels were investigated. Characterized by a relatively short half-life, they can predict surgical complications. Aim : To develop and implement certain standards for early detection of complications. Material and methods : The study involved 319 adults who underwent laparoscopic sleeve gastrectomy (LSG as a surgical intervention for morbid obesity at the Department of General Surgery of Ceynowa Hospital in Wejherowo. Every patient had CRP and PCT levels measured before the surgery and on the 1st and 2nd postoperative day (POD. Results : Early postoperative complications occurred in 19 (5.96% patients. Septic and non-septic complications occurred in 3 and 16 patients respectively. Among the patients with septic postoperative complications CRP level increased significantly on the 2nd POD compared to the remainder (p = 0.0221. Among the patients with non-septic postoperative complications CRP level increased significantly on the 1st and 2nd POD compared to the remainder. Among the patients with septic and non-septic postoperative complications PCT level increased significantly on the 2nd POD compared to the remainder. Conclusions : The CRP and PCT level are supposed to be relevant diagnostic markers to predict non-septic and septic complications after LSG.

  3. Clinical evaluation of C-reactive protein and procalcitonin for the early detection of postoperative complications after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Frask, Agata; Orłowski, Michał; Dowgiałło-Wnukiewicz, Natalia; Lech, Paweł; Gajewski, Krzysztof; Michalik, Maciej

    2017-06-01

    Among the most common early complications after bariatric surgery are anastomosis leak and bleeding. In order to react quickly and perform accurate treatment before the clinical signs appear, early predictors should be found. In the study C-reactive protein (CRP) and procalcitonin (PCT) levels were investigated. Characterized by a relatively short half-life, they can predict surgical complications. To develop and implement certain standards for early detection of complications. The study involved 319 adults who underwent laparoscopic sleeve gastrectomy (LSG) as a surgical intervention for morbid obesity at the Department of General Surgery of Ceynowa Hospital in Wejherowo. Every patient had CRP and PCT levels measured before the surgery and on the 1 st and 2 nd postoperative day (POD). Early postoperative complications occurred in 19 (5.96%) patients. Septic and non-septic complications occurred in 3 and 16 patients respectively. Among the patients with septic postoperative complications CRP level increased significantly on the 2 nd POD compared to the remainder (p = 0.0221). Among the patients with non-septic postoperative complications CRP level increased significantly on the 1 st and 2 nd POD compared to the remainder. Among the patients with septic and non-septic postoperative complications PCT level increased significantly on the 2 nd POD compared to the remainder. The CRP and PCT level are supposed to be relevant diagnostic markers to predict non-septic and septic complications after LSG.

  4. Evaluation of early and late complications in patients with congenital lobar emphysema: A 12 year experience

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    Nazem Masood

    2010-01-01

    Full Text Available Background: Congenital lobar emphysema (CLE is characterised by over distension of one lobe and pressure on the adjacent lobe and mediastinum. In this study, we review the pathological results of our paediatric patients with CLE, highlighting the early and late complications that occurred in these patients. Patients and Methods: In a prospective study from 1996 to 2008, we evaluated 30 patients with CLE diagnosis. Variables collected included sex, age at the time of diagnosis, radiological diagnostic method, type of treatment, pathological analysis, surgical findings and early postoperative complications. Parents were asked to refer to our clinic for follow-up and evaluation of late complications. Results: Thirty patients and males accounted for majority of the study population (n = 20, 67%. The mean age of male and female patients (at admission was 7.2 ± 2.3 and 4.7 ± 1.2 months respectively (P = not significant. The main diagnostic method was chest x-ray (CXR in all patients. Abnormal bronchial cartilage was found in 71% of patients. The most affected lobe was left upper lobe (50%. Associated anomalies were seen in four patients. Early postoperative periodhadtwo cases of pneumothoraces. At six month follow up, five (25% males and four females (40% had delayed weight gain. Permanent oxygen dependency was seen in two patients. Twenty- six patients underwent thoracotomy. Mortality rate was 13%. Base deficit at the time of admission was greater in those patients who eventually died, (-8.6 ± 1.2 versus -3.1 ± 0.4 (P = 0.0003. There were two deaths in the bilobar involvement group and two in the unilobar involvement group (P = 0.07, near significant. Conclusion: This study confirms that the number of affected lobes and base deficit at the time of admission were associated with significantly increased mortality.

  5. Early blood purification therapy of severe acute pancreatitis complicated by acute lung injury.

    Science.gov (United States)

    Guo, H; Suo, D-W; Zhu, H-P; Sun, X-M; Chen, J

    2016-03-01

    Severe acute pancreatitis (SAP) can often be complicated by acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), leading to increased mortality. Early blood purification clears inflammatory cytokines and promotes immune function recovery. Here we evaluated the usefulness of this therapy in SAP complicated by ALI. 32 patients received routine treatment (control group), whereas other 32 patients received routine treatment and early blood purification therapy (study group). We evaluated respiratory indexes (PaO2, PaO2/FiO2, alveolar-arterial oxygen difference, intrapulmonary arteriovenous shunt percentage, and respiratory rate), blood biochemical (creatinine, blood urea nitrogen, alanine aminotransferase, and lactate levels) and inflammatory (CRP, IL-10, TNF-α, and IL-10/TNF-α ratio) markers, and prognostic outcomes (multiple organ dysfunction syndrome [MODS] and APACHE II scores) before and 72 hours after the treatment. We also documented mechanical ventilation use, occurrence of MODS and ARDS, and mortality rates. There were no deaths. Mechanical ventilation was used in a similar percentage of patients in either group. Treatment in study group led to a faster and better recovery of respiratory indexes, and less pronounced changes in the levels of blood urea nitrogen and alanine aminotransferase. Inflammatory markers also normalized better in the study group. Furthermore, MODS and APACHE II scores decreased to a greater extent in the study group, paralleled by a lower occurrence of MPDS and ARDS. Early blood purification therapy improves respiratory function and inflammatory markers in patients with SAP complicated by ALI, and decreases the occurrence of MODS and ARDS.

  6. Early Complications Associated with the Thompson Approach to the Proximal Radius.

    Science.gov (United States)

    Perretta, Donato J; Brock, Kenneth M; Tejwani, Nirmal C

    2016-11-01

    The purpose of this study was to investigate the early complications associated with the dorsal approach to the proximal radius. This approach, also called the Thompson approach, is used relatively infrequently for the treatment of forearm fractures. It is primarily reserved for proximal one-third radius fractures where a volar plate may not be placed sufficiently proximal for adequate fixation. A retrospective chart review was performed on forearm fractures performed at our institution. Over a period from January 2008 to May 2014 a total of 120 patients underwent fixation for radius shaft fractures either isolated or associated with ulna fractures; of these 120 patients, 11 were found to have utilized the Thompson approach to the proximal radius. Demographic data was collected, along with fracture pattern, and associated complications in the first 2 weeks after surgery. The average age of the patients was 31 years (range: 20 to 46 years). Ten patients were male and one was female. The mean follow-up time was 15 weeks (range: 1 to 52 weeks). The stated indication for the dorsal approach was a proximal location of the radius fracture in 10 cases and presence of dorsal open wounds in one patient. In all cases, the posterior interosseous nerve was identified and protected. The average distance from the fracture to the radial head articular surface was 72 mm (range: 34 mm to 132 mm). Four fractures were open, and seven were closed injuries. There were two postoperative posterior interosseous nerve palsies, along with one compartment syndrome requiring fasciotomy. There were no wound complications. There was an overall complication rate of 27%. Postoperative posterior interosseous nerve palsy was the most common complication in this series, occurring in 18% of the patients in spite of identification and protection of the nerve throughout the procedure. High vigilance for compartment syndrome must also be maintained after fixation of any forearm fracture, as it occurred

  7. Iatrogenia institucional y muerte materna. Semmelweis y la fiebre puerperal

    Directory of Open Access Journals (Sweden)

    Oswaldo Salaverry García

    Full Text Available La fiebre puerperal es una enfermedad que asume carácter epidémico en el siglo XVIII como consecuencia de dos factores: las masas trabajadoras urbanas generadas por la revolución industrial, y la progresiva hegemonización y medicalización de la atención del parto en grandes hospitales públicos. La mortalidad materna institucionalizada alcanza cifras superiores al 30%, en tanto con la atención por parteras es menor al 2%. Semmelweis, médico húngaro, postula que los médicos contaminaban a las parturientas por insuficiente higiene luego de realizar necropsias, e implanta medidas profilácticas en el Hospital de Viena, las cuales reducen dramáticamente la mortalidad, pero sus ideas son rechazadas por que afectan el proceso de institucionalización de la medicina basado en el altruismo y honor, por los que supuestamente era imposible que causen daño a sus pacientes. Es obligado a retirarse del Hospital de Viena, y continua su lucha en Budapest, pero el rechazo y la incomprensión de sus colegas por su doctrina afecta su salud mental. Muere en un asilo, pocos años antes que Pasteur y Koch demuestren las bacterias causantes de enfermedades como la fiebre puerperal.

  8. Iatrogenia institucional y muerte materna: semmelweis y la fiebre puerperal

    Directory of Open Access Journals (Sweden)

    Oswaldo Salaverry García

    Full Text Available La fiebre puerperal es una enfermedad que asume carácter epidémico en el siglo XVIII como consecuencia de dos factores: las masas trabajadoras urbanas generadas por la revolución industrial, y la progresiva hegemonización y medicalización de la atención del parto en grandes hospitales públicos. La mortalidad materna institucionalizada alcanza cifras superiores al 30%, en tanto con la atención por parteras es menor al 2%. Semmelweis, médico húngaro, postula que los médicos contaminaban a las parturientas por insuficiente higiene luego de realizar necropsias, e implanta medidas profilácticas en el Hospital de Viena, las cuales reducen dramáticamente la mortalidad, pero sus ideas son rechazadas por que afectan el proceso de institucionalización de la medicina basado en el altruismo y honor, por los que supuestamente era imposible que causen daño a sus pacientes. Es obligado a retirarse del Hospital de Viena, y continua su lucha en Budapest, pero el rechazo y la incomprensión de sus colegas por su doctrina afecta su salud mental. Muere en un asilo, pocos años antes que Pasteur y Koch demuestren las bacterias causantes de enfermedades como la fiebre puerperal.

  9. [Rare complication following oesophagectomy: early peptic ulcer perforation of the tubal stomach].

    Science.gov (United States)

    Géczi, Tibor; Paszt, Attila; Simonka, Zsolt; Furák, József; Lázár, György

    2011-10-01

    We report the case of a 45-year-old male patient who developed an acute peptic ulcer perforation of the tubal stomach on the second postoperative day after oesophagectomy. The patient underwent emergency surgery (perforation was closed with a Graham patch) followed by treatment in intensive care, and was finally discharged on the 19th postoperative day. Gastric pull-up is a surgical technique that is widely used to re-establish the continuity of the gastrointestinal tract after oesophagectomy. Various early and late complications of reconstruction with the tubal stomach are well-known, such as gastric necrosis, gastritis, gastric ulcer, as well as benign and malignant tumors. The precise etiology of gastric tube ulceration is not known yet, however, it can develop not only in the late, but also in the early postoperative period, as well.

  10. Osteonecrosis in Systemic Lupus Erythematosus: An Early, Frequent, and Not Always Symptomatic Complication

    Directory of Open Access Journals (Sweden)

    Paola Caramaschi

    2012-01-01

    Full Text Available Osteonecrosis may complicate the course of systemic lupus erythematosus and may contemporaneously affect multiple joints. The major risk factor associated with the development of osteonecrosis is the use of glucocorticoid at high doses. Recent studies using serial MRI, which represents the “gold standard” for the early detection of osteonecrosis, yielded some interesting findings about the natural history of this clinical entity. Osteonecrosis in the majority of the cases is asymptomatic and occurs early in the course of the disease. Its later occurrence is associated with lupus flare that requires the increase of corticosteroid dose. The optimal treatment of osteonecrosis is controversial. In case of silent osteonecrosis involving a small area conservative strategy is usually adequate. When lesions are symptomatic surgical treatment as core decompression or free vascularized fibular grafting is required; extracorporeal shockwave treatment may represent an alternative therapeutic approach. When the lesion has a medium-large dimension or involves a weight-bearing area bone collapse is a common complication requiring total joint replacement. Coadministration of bisphosphonate or warfarin with high doses of corticosteroid might be a promising preventive strategy of osteonecrosis.

  11. Complications and the effect of varicocelectomy on semen analysis, fertility, early ejaculation and spontaneous abortion

    Directory of Open Access Journals (Sweden)

    Shamsa Ali

    2010-01-01

    Full Text Available Varicocele is still an enigma. Its effects on semen analysis, fertility and, more re-cently, early ejaculation and spontaneous abortion in spouses are not yet fully understood. In this retrospective study, we evaluated these four parameters (semen analysis, fertility, early ejacu-lation and spontaneous abortion among spouses in relation to varicocele and varicocelectomy during a 13-year period. A total of 1,711 patients with varicocele underwent varicocelectomy by high inguinal method (251 cases, subinguinal method (1,375 cases, scrotal method (34 cases, and subinguinal method with local anesthesia (38 cases. Our complication rate was acceptable. Sperm count, motility and morphology increased three months post operation in 55, 51, and 46%, respectively (P value 0.000, 0.000, and 0.015, respectively. Paternity was 56% after one year of post varicocelectomy follow-up. Only 7 out of 82 azoospermic men had sperm in their semen after varicocelectomy and only one of them with mild spermatogenic hypoplasia became a father. The spontaneous abortion rate in the spouses of respondents was 59%. Early ejaculation improved in 75% of the respondents. In conclusion, varicocelectomy does not improve sperm parameters in all men, but it improves pregnancy rate, early ejaculation, and scrotal pain.

  12. Prediction of complications in early-onset pre-eclampsia (PREP): development and external multinational validation of prognostic models

    NARCIS (Netherlands)

    Thangaratinam, Shakila; Allotey, John; Marlin, Nadine; Dodds, Julie; Cheong-See, Fiona; von Dadelszen, Peter; Ganzevoort, Wessel; Akkermans, Joost; Kerry, Sally; Mol, Ben W.; Moons, Karl G. M.; Riley, Richard D.; Khan, Khalid S.; Sundararajah, Raajkumar; Nejad, Avideah; Khan, Rehan; Burrell, Celia; Gupta, Manish; Oon, Vincent; Kadir, Rezan; Ramsey-Marcelle, Zeudi; Page, Louise; Thilaganathan, Baskaran; Martin, Bill; Bakour, Shagaf Haj; Morsi, Hassan; Churchill, David; O'Mahony, Fidelma; Powell, Karen; Srinivasan, Jayasree; Mohajer, Michele; Quenby, Siobhan; Thirumalaikumar, Lakshmi; Konje, Justin; Thornton, Jim; Bugg, George; Mackenzie, Shonag; Ullal, Aarti; Smith, Marie; Arya, Rita; Cunnigham, Simon; Walker, James; Simpson, Nigel; Page, Joanne; Oxby, Claire; Watkins, Karen; Tuffnell, Derek; Bober, S.; Wijesiriwardana, A.; Brandon, Helene; El-Badawy, Saif; Brigham, Sara; Shorinola, Lanre; Khunda, Aethele; Kalla, Shaku; Agha, Mohammed M. Abdullah; Poku, Stephen; Olawo, Ayo; Amu, Johnson; Banfield, Philip; Majoko, Franz; Alcide, Julia; Rajeswary, Jyothi; Salloum, Marwan; Rees, Alexandra; Oteri, Odiri; Ikhena, Sunday; Creswell, Janet; Dawood, Feroza; Agarwal, Umber

    2017-01-01

    Unexpected clinical deterioration before 34 weeks gestation is an undesired course in early-onset pre-eclampsia. To safely prolong preterm gestation, accurate and timely prediction of complications is required. Women with confirmed early onset pre-eclampsia were recruited from 53 maternity units in

  13. Immediate and early complications of the open Latarjet procedure: a retrospective review of a large consecutive case series.

    Science.gov (United States)

    Gartsman, Gary M; Waggenspack, Wame N; O'Connor, Daniel P; Elkousy, Hussein A; Edwards, T Bradley

    2017-01-01

    Immediate and early postoperative complications of the Latarjet procedure are not well documented in the literature. The purpose of this study was to report the procedure-related complications of our large consecutive case series of 3 surgeons at a single high-volume center. We conducted a retrospective chart review of 416 Latarjet procedures performed on 400 patients (16 patients had bilateral procedures) who underwent surgery by the 3 senior authors from October 2002 to July 2015. Immediate and early complications included hardware problems, infection, and neurologic injury. In addition, the patient's age and history of prior instability surgery were noted and evaluated as risk factors for complication. The overall complication rate was 5.0% (21 complications in 19 procedures). Thirteen neurologic injuries (3.1%) occurred to the axillary (7), musculocutaneous (4), and suprascapular (2) nerves, including 2 patients with multiple nerves affected. All but 2 patients had complete resolution of symptoms at time of last follow-up. Six infections (1.4%) developed, including 3 superficial infections treated with oral antibiotics and 3 deep infections requiring irrigation and débridement with intravenous antibiotics. Two early hardware-related complications (0.05%) were also noted. Increased age was associated with a higher complication rate. History of prior surgery was not associated with increased complications in our series. This study highlights the procedural complications of the Latarjet procedure. Neurologic injury was the most common complication in our series, with complete or near-complete recovery in 11 of 13 patients. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  14. Phoenix dactylifera seeds ameliorate early diabetic complications in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Abdelaziz, Dalia H A; Ali, Sahar A; Mostafa, Mahmoud M A

    2015-06-01

    In Arabic folk medicine, the seeds of Phoenix dactylifera L. (Arecaceae) have been used to manage diabetes for many years. Few studies have reported the antidiabetic effect of P. dactylifera seeds; however, their effect on diabetic complications is still unexplored. The present study investigates the protective effect of P. dactylifera seeds against diabetic complications in rats. The aqueous suspension of P. dactylifera seeds (aqPDS) (1 g/kg/d) was orally administered to streptozotocin-induced diabetic rats for 4 weeks. The serum biochemical parameters were assessed spectrophotometrically. Furthermore, oxidative stress was examined in both liver and kidney tissues by assessment of thiobarbituric acid reactive substances (TBARS), nitric oxide (NO), reduced glutathione, superoxide dismutase (SOD), glutathione S-transferase, and catalase. Oral administration of aqPDS significantly ameliorated the elevated levels of glucose (248 ± 42 versus 508 ± 60 mg/dl), urea (32 ± 3.3 versus 48.3 ± 5.6 mg/dl), creatinine (2.2 ± 0.35 versus 3.8 ± 0.37 mg/dl), ALT (29.6 ± 3.9 versus 46.4 ± 5.9 IU/l), and AST (73.3 ± 13 versus 127.8 ± 18.7 IU/l) compared with the untreated diabetic rats. In addition to significant augmentation in the activities of antioxidant enzymes, there was reduction in TBARS and NO levels and improvement of histopathological architecture of the liver and kidney of diabetic rats. The aqPDS showed potential protective effects against early diabetic complications of both liver and kidney. This effect may be explained by the antioxidant and free radical scavenging capabilities of P. dactylifera seeds.

  15. The Ins2Akita mouse as a model of early retinal complications in diabetes.

    Science.gov (United States)

    Barber, Alistair J; Antonetti, David A; Kern, Timothy S; Reiter, Chad E N; Soans, Rohit S; Krady, J Kyle; Levison, Steven W; Gardner, Thomas W; Bronson, Sarah K

    2005-06-01

    This study tested the Ins2(Akita) mouse as an animal model of retinal complications in diabetes. The Ins2(Akita) mutation results in a single amino acid substitution in the insulin 2 gene that causes misfolding of the insulin protein. The mutation arose and is maintained on the C57BL/6J background. Male mice heterozygous for this mutation have progressive loss of beta-cell function, decreased pancreatic beta-cell density, and significant hyperglycemia, as early as 4 weeks of age. Heterozygous Ins2(Akita) mice were bred to C57BL/6J mice, and male offspring were monitored for hyperglycemia, beginning at 4.5 weeks of age. After 4 to 36 weeks of hyperglycemia, the retinas were analyzed for vascular permeability, vascular lesions, leukostasis, morphologic changes of micro- and macroglia, apoptosis, retinal degeneration, and insulin receptor kinase activity. The mean blood glucose of Ins2(Akita) mice was significantly elevated, whereas the body weight at death was reduced compared with that of control animals. Compared with sibling control mice, the Ins2(Akita) mice had increased retinal vascular permeability after 12 weeks of hyperglycemia (P microglia, but no changes in expression of Muller cell glial fibrillary acidic protein. Increased apoptosis was identified by immunoreactivity for active caspase-3 after 4 weeks of hyperglycemia (P cell bodies in the retinal ganglion cell layer (P retinal complications of diabetes.

  16. Early hospital readmission for gastrointestinal-related complications predicts long-term mortality after pancreatectomy.

    Science.gov (United States)

    Hicks, Caitlin W; Tosoian, Jeffrey J; Craig-Schapiro, Rebecca; Valero, Vicente; Cameron, John L; Eckhauser, Frederic E; Hirose, Kenzo; Makary, Martin A; Pawlik, Timothy M; Ahuja, Nita; Weiss, Matthew J; Wolfgang, Christopher L

    2015-10-01

    The purpose of this study was to investigate the prognostic significance of early (30-day) hospital readmission (EHR) on mortality after pancreatectomy. Using a prospectively collected institutional database linked with a statewide dataset, we evaluated the association between EHR and overall mortality in all patients undergoing pancreatectomy at our tertiary institution (2005 to 2010). Of 595 pancreatectomy patients, EHR occurred in 21.5%. Overall mortality was 29.4% (median follow-up 22.7 months). Patients with EHR had decreased survival compared with those who were not readmitted (P = .011). On multivariate analysis adjusting for baseline group differences, EHR for gastrointestinal-related complications was a significant independent predictor of mortality (hazard ratio 2.30, P = .001). In addition to known risk factors, 30-day readmission for gastrointestinal-related complications following pancreatectomy independently predicts increased mortality. Additional studies are necessary to identify surgical, medical, and social factors contributing to EHR, as well as interventions aimed at decreasing postpancreatectomy morbidity and mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. [Thrombotic microangiopathy in pregnancy complicated by acute hemorrhagic-necrotic pancreatitis during early puerperium].

    Science.gov (United States)

    Redechová, S; Féderová, L; Hammerová, L; Filkászová, A; Horváthová, D; Redecha, M

    2014-06-01

    Authors in the article describe a case of a patient with thrombotic thrombocytopenic purpurain 37 weeks gestation complicated by acute severe hemorrhagic-necrotic pancreatitis during the early puerperium. Case report. Ist Department of gynaecology and obstetrics of the Comenius University Bratislava. 33-years-old patient in the 37 weeks gestation was admitted to our department with the signs of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets). Due to the worsening clinical status, we have performed caesarean section. After the transient stabilization of the patient's clinical status, the hemolysis with severe thrombocytopenia reappeared. Based on the clinical signs of abdominal pain and computer tomography, the diagnosis of acute hemorrhagic-necrotic pancreatitis was set. The primary diagnosis was thrombotic thrombocytopenic purpura. Therefore, therapeutic plasma exchange was performed with consequent improvement of the patients clinical state. Normalization of the platelet count was achieved after 4.plasma exchanges. Consequently 5 plasma exchanges were performed. However, one month later, the disease relapsed. Therapeutic plasma exchanges were needed again (4x), with anti CD 20 administration. This therapy had good clinical outcome, without the need for further plasma exchanges. Thrombotic thrombocytopenic purpura is highly lethal disease. Early diagnosis, treatment, and multidisciplinary approach are essential.

  18. Investigating Early and Late Complications in Conventional and LigaSure Hemorroidectomy

    Directory of Open Access Journals (Sweden)

    M Zare

    2014-06-01

    Full Text Available Introduction: The traditional Milligan-Morgan and the Ferguson operations are still the most used for patients with symptomatic haemorrhoids of III and IV degrees. Nowadays LigaSure is used as a new technique to decrease the complications resulting from conventional hemorroidectomy. In this study, patients were investigated on the basis of the following main outcomes: mean operative time, postoperative pain (score and duration, bleeding loss in operation, early (within the first month after surgery and late (after the first month complications in conventional as well as LigaSure hemorroidectomy. Methods: it is an analytical study conducted on 101 patients aged 19–80 years old of both males and females with III and IV-degree hemorrhoids who had been gone to Shahid Sadoughi hospital between 2011 and 2012. Forty-three patients were treated by conventional diathermy and fifty -eight by LigaSure. Patients received analgesic administration for about 24 hours after operations and, after hospital discharge. In fact, analgesia was administered until 5 days (three times a day. All patients were required to record pain from the first postoperative day until the 28th postoperative day on a self-administered NAS scale (0–10. Results: Patients completed a questionnaire face to face one week, one month, six, and twelve months after the operation. The mean operative time, bleeding loss in operation and return to work were significantly shorter in LS group, whereas there were no difference in hospital stay period, anal stenosis, healing time of wound and retention of urinary. A statistically significant difference in pain score was observed three and four days after the operation. Finally, patients with LigaSure haemorrhoidectomy recovered from pain earlier than those with conventional diathermy. Conclusions: although LigaSure proposes additional costs, it is an effective instrument in order to treat hemorrhoids of III and IV degrees.

  19. Early diagnosis of diabetic vascular complications: impairment of red blood cell deformability

    Science.gov (United States)

    Shin, Sehyun; Ku, Yunhee; Park, Cheol-Woo; Suh, Jang-Soo

    2006-02-01

    Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day-to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemodialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy control (P = 0.0001). The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all

  20. Hypertensive phase and early complications after Ahmed glaucoma valve implantation with intraoperative subtenon triamcinolone acetonide

    Directory of Open Access Journals (Sweden)

    Turalba AV

    2014-07-01

    Full Text Available Angela V Turalba,1,2 Louis R Pasquale1,2 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Objective: To evaluate intraoperative subtenon triamcinolone acetonide (TA as an adjunct to Ahmed glaucoma valve (AGV implantation. Design: Retrospective comparative case series. Participants: Forty-two consecutive cases of uncontrolled glaucoma undergoing AGV implantation: 19 eyes receiving intraoperative subtenon TA and 23 eyes that did not receive TA.Methods: A retrospective chart review was performed on consecutive pseudophakic adult patients with uncontrolled glaucoma undergoing AGV with and without intraoperative subtenon TA injection by a single surgeon. Clinical data were collected from 42 eyes and analyzed for the first 6 months after surgery.Main outcome measures: Primary outcomes included intraocular pressure (IOP and number of glaucoma medications prior to and after AGV implantation. The hypertensive phase (HP was defined as an IOP measurement of greater than 21 mmHg (with or without medications during the 6-month postoperative period that was not a result of tube obstruction, retraction, or malfunction. Postoperative complications and visual acuity were analyzed as secondary outcome measures. Results: Five out of 19 (26% TA cases and 12 out of 23 (52% non-TA cases developed the HP (P=0.027. Mean IOP (14.2±4.6 in TA cases versus [vs] 14.7±5.0 mmHg in non-TA cases; P=0.78, and number of glaucoma medications needed (1.8±1.3 in TA cases vs 1.6±1.1 in the comparison group; P=0.65 were similar between both groups at 6 months. Although rates of serious complications did not differ between the groups (13% in the TA group vs 16% in the non-TA group, early tube erosion (n=1 and bacterial endophthalmitis (n=1 were noted with TA but not in the non-TA group.Conclusions: Subtenon TA injection during AGV implantation may decrease the

  1. [An attempt at optimization of diagnosis for patients in puerperium treated due to eclampsia and systemic complications in the Department of Anesthesiology and Intensive Therapy in the Silesian Medical Academy in Katowice].

    Science.gov (United States)

    Skorupa, A; Dyaczyńska-Herman, A

    1995-12-01

    Conditions under which episodes of eclampsia occurred in puerperal, who were than admitted to the Intensive Care Units for treatment are presentation the paper. Multidirectional diagnostic procedures introduced in those 30 patients are discussed. In the analysed group of patients various types of organ complications were diagnosed. The paper underlines value and benefits of the interdisciplinary consultation in diagnostic procedure in cases of dramatic and rapidly occurring complications overlapping existing puerperal status.

  2. Perioperative complications and early follow-up with 100 TVT-SECUR procedures.

    Science.gov (United States)

    Neuman, Menahem

    2008-01-01

    Our objective was to evaluate the complications and early follow-up of the tension-free vaginal tape (TVT)-SECUR, a new minimally invasive anti-incontinence operative procedure. A prospective, observational, and consecutive patient series was conducted. Perioperative and 12-month postoperative data were prospectively collected for the first 50 patients against the next consecutive 50 patients, among which TVT-SECUR specific surgical measurements were adopted (Canadian Task Force classification 2). In private hospital operative theatres, the TVT-SECUR operation was performed. Patients with urodynamically proved stress urinary incontinence were enrolled in this study after detailed informed consent was given. The TVT-SECUR, in the hammock shape to mimic the TVT-obturator placement, yet with no skin incisions, required neither bladder catheterization nor intraoperative diagnostic cystoscopy. The clinical and surgical data of 100 consecutive patients with TVT-SECUR were collected prospectively. Two patients had urinary obstructions and needed surgical tape-tension relief. One patient had a 50 mL paravesical self-remitting hematoma. At the first-month postoperative follow-up appointment, the objective therapeutic failure rate for the TVT-SECUR procedure among the 50 patients was 20.0% (10 patients). But when the tape was placed close to the urethra with no space allowed in between, the failure rate in the second patient group went down to 8.0% (4 patients); yet no further postoperative bladder outlet obstruction was diagnosed. Four (8.0%) patients in the first group had vaginal wall penetration with the inserters, requiring withdrawal, reinsertion, and vaginal wall repair. This was avoided with the second patient group by facilitating the inserters' introduction by widening the submucosal tunnel to 12 mm. Six (12.0%) other patients in the first group needed postoperative trimming of a vaginally extruded tape segment, performed in the office with satisfactory results

  3. KNOWLEDGE OF PUERPERAL MOTHERS ABOUT THE GUTHRIE TEST.

    Science.gov (United States)

    Arduini, Giovanna Abadia Oliveira; Balarin, Marly Aparecida Spadotto; Silva-Grecco, Roseane Lopes da; Marqui, Alessandra Bernadete Trovó de

    2017-01-01

    This study aimed to assess the knowledge of puerperal mothers about the Guthrie test. A total of 75 mothers who sought primary care between October 2014 and February 2015 were investigated. The form was applied by the main researcher and the data was analyzed, using descriptive statistics with Microsoft Office Excel, and Statistical Package for Social Sciences (SPSS) programs. Association tests and statistical power were applied. Among the 75 mothers, 47 (62.7%) would have liked to receive more information about the newborn screening, especially regarding the correct sample collection period, followed by the screened morbidities. Most participants (n=55; 85.9%) took their children to be tested between the third and the seventh day of birth, as recommended by the Brazilian Health Ministry. Fifty-four women (72%) were unable to name the morbidities screened by the test in Minas Gerais, and they were also unaware that most have genetic etiology. The health professional who informed the mother about the Guthrie test was mainly the physician. This information was given prenatally to 57% of the cases, and to 43 % at the time of discharge from the hospital. The association test showed that mothers with higher education have more knowledge about the purpose and importance of the Guthrie test. The statistical power was 83.5%. Maternal knowledge about the Guthrie test is superficial and may reflect the health team's usual practice.

  4. Early signs and symptoms of intracranial complications of otitis media in pediatric and adult patients: A different presentation?

    NARCIS (Netherlands)

    van der Poel, N. A.; van Spronsen, E.; Dietz de Loos, D. A.; Ebbens, F. A.

    2017-01-01

    The aim of this study was to review the clinical presentation and early signs and symptoms of otogenic intracranial complications (OIC) in children and adults. retrospective chart review. The medical records of all children and adults admitted in our center with OIC during the period 2008-2017 were

  5. Puerperous pulmonary thromboembolism: Incidence, clinical features, treatment and outcome, study of 13 cases

    Directory of Open Access Journals (Sweden)

    Chuang CAI

    2013-01-01

    Full Text Available Objective  To explore the clinical features, treatment and outcome of puerperium pulmonary thromboembolism (PTE. Methods  To count the cases of spontaneous labor and cesarean section, as well as the incidence of PTE, treated in the First Affiliated Hospital of Guangzhou Medical University from Jan. 2006 to Nov. 2011, and retrospectively analyze the data of hospitalized parturients with PTE. Results  A total of 5052 cases of spontaneous delivery were collected at the obstetric ward, of which 2910 cases (57.6% were cesarean sections and 2142 cases (42.4% were vaginal delivery. On the duration of hospital stay, 13 cases (0.26% were diagnosed as puerperal PTE by CT pulmonary angiography, of which 11 cases occurred within 3 days after delivery. The incidence of puerperal PTE was significantly higher in cases with cesarean section than in those with vaginal delivery (0.38% vs0.09%, P=0.043. The most common symptoms of puerperal PTE were breathless (76.9%, cough (53.8%, pleuritic chest pain (23.1% and fever (30.8%. The clinical symptoms were improved by anticoagulation therapy (11 cases or thrombolysis (2 cases with zero mortality. Conclusions  The incidence of puerperal PTE in the hospital the authors served is 0.26%. Puerperal PTE should be considered especially to those parturients with sudden dyspnea, chest tightness or pleuritic chest pain within 3 days after cesarean section.

  6. Early versus delayed post-operative bathing or showering to prevent wound complications.

    Science.gov (United States)

    Toon, Clare D; Sinha, Sidhartha; Davidson, Brian R; Gurusamy, Kurinchi Selvan

    2015-07-23

    their wounds, irrespective of the location of the wound and whether or not the wound was dressed. We excluded trials if they included patients with contaminated, dirty or infected wounds and those that included open wounds. We also excluded quasi-randomised trials, cohort studies and case-control studies. We extracted data on the characteristics of the patients included in the trials, risk of bias in the trials and outcomes from each trial. For binary outcomes, we calculated the risk ratio (RR) with 95% confidence interval (CI). For continuous variables we planned to calculate the mean difference (MD), or standardised mean difference (SMD) with 95% CI. For count data outcomes, we planned to calculate the rate ratio (RaR) with 95% CI. We used RevMan 5 software for performing these calculations. Only one trial was identified for inclusion in this review. This trial was at a high risk of bias. This trial included 857 patients undergoing minor skin excision surgery in the primary care setting. The wounds were sutured after the excision. Patients were randomised to early post-operative bathing (dressing to be removed after 12 hours and normal bathing resumed) (n = 415) or delayed post-operative bathing (dressing to be retained for at least 48 hours before removal and resumption of normal bathing) (n = 442). The only outcome of interest reported in this trial was surgical site infection (SSI). There was no statistically significant difference in the proportion of patients who developed SSIs between the two groups (857 patients; RR 0.96; 95% CI 0.62 to 1.48). The proportions of patients who developed SSIs were 8.5% in the early bathing group and 8.8% in the delayed bathing group. There is currently no conclusive evidence available from randomised trials regarding the benefits or harms of early versus delayed post-operative showering or bathing for the prevention of wound complications, as the confidence intervals around the point estimate are wide, and, therefore, a clinically

  7. Delayed recognition of Wolfram syndrome frequently misdiagnosed as type 1 diabetes with early chronic complications.

    Science.gov (United States)

    Zmyslowska, A; Borowiec, M; Fichna, P; Iwaniszewska, B; Majkowska, L; Pietrzak, I; Szalecki, M; Szypowska, A; Mlynarski, W

    2014-01-01

    Improvements in diagnostic methods and greater genetic awareness have brought remarkable progress in the recognition of monogenic forms of diabetes, including Wolfram syndrome (WFS). WFS is diagnosed based on clinical criteria of coexistence of diabetes mellitus and optic atrophy, and confirmed by molecular analysis; however, the condition is still sometimes misdiagnosed. To begin to understand the reasons for misdiagnosis, we conducted a retrospective analysis of WFS patients who were originally misdiagnosed. The medical histories of 13 pediatric patients with clinical misdiagnosis of type 1 diabetes and early chronic complications made in the years 1995-2010 and who were subsequently correctly diagnosed with WFS based on genetic testing in 2008-2011 were analyzed. The average age of the patients at diabetes onset was 5 (4.4-6.3) years, and the mean HbA1c level at diagnosis was 9.1±2.3%. Initially, all of these patients were treated as having type 1 diabetes with progressive visual impairment despite good metabolic control (mean HbA1c 7.5±1.3%). Diagnosis of optic atrophy was made at an average age of 9 (5.9-11.5) years, which corresponds to 4 years after diabetes recognition (p=0.002). At the time of genetic analysis, the average age of the patients was 16 (12-18.7) years, which corresponds to 7 years after recognition of coexistence of diabetes mellitus and optic atrophy (p=0.007). Delays of at least 7 years occurred before recognition of WFS among a cohort of pediatric patients with diabetes. All patients with WFS were primarily misdiagnosed as having type 1 diabetes. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  8. Meningitis neonatal e infección puerperal por Streptococcus pneumoniae: Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Cecilia Ortiz Rodríguez

    2003-06-01

    Full Text Available Las infecciones neonatales causadas por Streptococcus pneumoniae constituyen un fenómeno raro, poco reportado en la literatura médica; en el presente trabajo se describe el caso de una meningoencefalitis purulenta de aparición precoz, en un neonato nacido por parto eutócico, a termino y de buen peso. Se aisló el microorganismo en la sangre y en el líquido cefalorraquídeo del recién nacido, así como en los loquios de la madre. Las 3 antibiotipias fueron idénticas. La evolución del niño fue desfavorable, el cual falleció a las 81 horas de vida, en un cuadro de fallo multiorgánico. La necropsia corroboró el diagnóstico. La madre desarrolló una endometritis puerperal a los 4 días, con buena evolución.Neonatal infections caused by Streptococcus pneumoniae are a rare phenomenon that is barely reported in the medical literature. The present paper describes a case of early purulent meningoencephalitis occurred in an adequate birthweight neonate born to term eutocic delivery. The microorganism was isolated in the newborn's blood and cerebrospinal fluid as well as in his mother's lochia. The three antibiotypes were identical. The newborn did not recover and died after 81 hours due to a multiple organ failure. Necropsy confirmed the diagnosis. The mother developed puerperal endometritis after 4 days but did recover.

  9. Improved Early Cleft Lip and Palate Complications at a Surgery Specialty Center in the Developing World.

    Science.gov (United States)

    Park, Eugene; Deshpande, Gaurav; Schonmeyr, Bjorn; Restrepo, Carolina; Campbell, Alex

    2018-01-01

    To evaluate complication rates following cleft lip and cleft palate repairs during the transition from mission-based care to center-based care in a developing region. We performed a retrospective review of 3419 patients who underwent cleft lip repair and 1728 patients who underwent cleft palate repair in Guwahati, India between December 2010 and February 2014. Of those who underwent cleft lip repair, 654 were treated during a surgical mission and 2765 were treated at a permanent center. Of those who underwent cleft palate repair, 236 were treated during a surgical mission and 1491 were treated at a permanent center. Two large surgical missions to Guwahati, India, and the Guwahati Comprehensive Cleft Care Center (GCCCC) in Assam, India. Overall complication rates following cleft lip and cleft palate repair. Overall complication rates following cleft lip repair were 13.2% for the first mission, 6.7% for the second mission, and 4.0% at GCCCC. Overall complication rates following cleft palate repair were 28.0% for the first mission, 30.0% for the second mission, and 15.8% at GCCCC. Complication rates following cleft palate repair by the subset of surgeons permanently based at GCCCC (7.2%) were lower than visiting surgeons ( P cleft care delivery in the developing world can lead to decreased complication rates.

  10. Early anterior cruciate ligament reconstruction can save meniscus without any complications

    Directory of Open Access Journals (Sweden)

    Chang-Ik Hur

    2017-01-01

    Conclusions: Early ACL reconstruction had excellent clinical results and stability as good as delayed reconstruction without the problem of knee motion, muscle power, and postural control. Moreover, early reconstruction showed the high possibility of meniscal repair. Therefore, early ACL reconstruction should be recommended.

  11. Common complications of deep lamellar keratoplasty in the early phase of the learning curve

    Directory of Open Access Journals (Sweden)

    Hosny M

    2011-06-01

    Full Text Available Mohamed HosnyOphthalmology Department, Faculty of Medicine, Cairo University, Cairo, EgyptPurpose: To evaluate and record the common complications that face surgeons when they perform their first few series of deep lamellar keratoplasty and measures to avoid these.Setting: Dar El Oyoun Hospital, Cairo, Egypt.Methods: Retrospective study of the first 40 eyes of 40 patients carried out by two corneal surgeons working in the same center. All patients were planned to undergo a deep anterior lamellar keratoplasty using the big bubble technique. Twelve patients suffered from keratoconus while 28 patients had anterior corneal pathologies. Recorded complications were classified as either intraoperative or postoperative.Results: Perforation of Descemet's membrane was the most common intraoperative complication. It occurred in nine eyes (22.5%: five eyes (12.5% had microperforations while four eyes (10% had macroperforations, three eyes (7.5% had central perforations, and six eyes (15% had peripheral perforations. Other complications included incomplete separation of Descemet's membrane and remnants of peripheral stromal tissue. Postoperative complications included double anterior chamber which occurred in four eyes (10% and Descemet's membrane corrugations. Postoperative astigmatism ranged from 1.25 to 4.5 diopters with a mean of 2.86 diopters in the whole series, but in the six cases with identified residual stroma in the periphery of the host bed, the astigmatism ranged from 2.75 to 4.5 diopters with a mean of 3.62 diopters.Conclusion: Deep lamellar keratoplasty is sensitive to procedural details. Learning the common complications and how to avoid them helps novice surgeons to learn the procedure faster.Keywords: deep lamellar keratoplasty, complications, big bubble technique

  12. Acute pancreatitis as an unusual early post-operative complication following laparoscopic sleeve gastrectomy

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    Ankush Sarwal

    2018-01-01

    Full Text Available Laparoscopic sleeve gastrectomy (LSG at present one of the most commonly performed surgical treatments for morbid obesity worldwide. There are some complications regarding this procedure in the literature. This report presents a patient who developed acute pancreatitis immediate post-LSG. Patient was referred to our institute on 10th post-operative day with a complaint of fever, nausea, abdominal pain and leucocytosis. A diagnostic laparoscopy showed pancreatitis. Post-operatively, the patient was managed on treatment line of acute pancreatitis and recovered well. LSG is a common procedure in bariatric, and the most common complications are leakage and bleeding from the suture line. However, we encountered pancreatitis after LSG which is a rarely reported complication after LSG. We hypothesise that the development of acute pancreatitis in patients undergoing LSG is not well recognised and reported.

  13. The Presence of Postoperative Infectious Complications is Associated with the Risk of Early Postoperative Clinical Recurrence of Crohn's Disease.

    Science.gov (United States)

    Guo, Zhen; Cao, Lei; Guo, Feilong; Gong, Jianfeng; Li, Yi; Gu, Lili; Zhu, Weiming; Li, Jieshou

    2017-09-01

    The purpose of the study was to identify risk factors for early clinical and surgical recurrence in Crohn's disease (CD) patients who underwent intestinal resection. This was a retrospective study. Consecutive patients who underwent intestinal resection with a primary anastomosis from January 2011-December 2014 were enrolled. Gender, age at surgery, clinical phenotypes of CD, serum albumin and C-reactive protein level the day before surgery, smoking status at surgery, anastomosis technique, number of anastomoses, details of postoperative complications, the postoperative prophylactic treatment were assessed to figure out risk factors for postoperative clinical and surgical recurrence within 1 year after the initial resection by univariate and then multivariate analysis. Two hundred and thirty-seven patients were analyzed. The risk of early postoperative clinical recurrence was 2.99 times higher in patients suffered postoperative infectious complications [odds ratio (OR) 2.99; 95% CIs, 1.42-6.32; p = 0.004], while never-smoking was found to be a protective factor for early clinical recurrence (OR 0.326; 95% CIs, 0.18-0.59; p risk factor (OR 6.77; 95% CIs, 1.61-28.5; p = 0.009). Smoker at surgery was also a risk factor for early surgical recurrence (OR 5.41; 95% CIs, 1.36-21.5; p = 0.017). The presence of postoperative infectious complications was identified as a possible risk factor for early postoperative clinical recurrence after resection in CD patients.

  14. Predicting adverse obstetric outcome after early pregnancy events and complications: a review

    DEFF Research Database (Denmark)

    van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B

    2009-01-01

    pregnancy with an OR > 2.0 after complications in the index pregnancy are the risk of LBW and very low birthweight (VLBW) after a threatened miscarriage, the risk of pregnancy-induced hypertension, pre-eclampsia, placental abruption, preterm delivery (PTD), small for gestational age and low 5-min Apgar...... score after detection of an intrauterine haematoma, the risk of VPTD and intrauterine growth restriction after a crown-rump length discrepancy, the risk of VPTD, LBW and VLBW after a vanishing twin phenomenon and the risk of PTD, LBW and low 5-min Apgar score in a pregnancy complicated by severe...

  15. [The effects of music therapy on postpartum blues and maternal attachment of puerperal women].

    Science.gov (United States)

    Lee, Sun Mi

    2010-02-01

    The purpose of this study was to determine the effects of music therapy on postpartum blues and maternal attachment of puerperal women. The research design was a nonequivalent control group non-synchronized design. The participants were puerperal women who agreed to participate in this study and through a convenience sampling, 60 puerperal women were recruited (30 in the experimental group, 30 in the control group). After measuring postpartum blues and maternal attachment, music therapy was provided to the experimental group over 40 min, once a day, and for 8 days. Then, postpartum blues and maternal attachment for the experimental and control group were measured again on the 8th day. The data were analyzed using the SPSS WIN 12.0 Program. The first hypothesis that "the degree of postpartum blues for the experimental group who participated in music therapy would be lower than that of the control group" was accepted (t=4.350, pmusic therapy would be higher than that of the control group" was accepted (t=4.828, pmusic therapy has positive influences on decreasing postpartum blues and increasing maternal attachment of puerperal women.

  16. How do we reduce maternal deaths due to puerperal sepsis in ...

    African Journals Online (AJOL)

    Puerperal sepsis remains one of the leading causes of maternal deaths in South Africa and a large number of these deaths are avoidable. The National Committee on Confidential Enquiry into Maternal Deaths (NCCEMD) identified these avoidable factors which included missed diagnoses, lack of appreciation of the ...

  17. Comparison of Early Results and Complications between Multi-and Single-Port Sleeve Gastrectomy: A Randomized Clinical Study

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    Seyed Vahid Hosseini

    2017-05-01

    Full Text Available Background: In recent years, laparoscopic sleeve gastrectomy (LSG has become more acceptable for obese patients. Single-port sleeve gastrectomy (SPSG is more popular since each abdominal incision carries the risk of bleeding, hernia, and internal organ injury as well as exponentially affecting cosmesis. This cross-sectional study aimed at comparing multi-port sleeve gastrectomy (MPSG and SPSG in terms of their early results and complications. Methods: Out of129 obese patients candidated for LSG, 102 patients were assigned to 2 groups of SPSG and MPSG. Complications and demographic data such as body mass index (BMI, age, gender, operation time, and hospital stay were measured. All surgeries were carried out between2013 and 2015 in Shiraz, Iran. Data analysis was performed using SPSS, version 16 for Windows (SPSS Inc., Chicago, IL. The continuous and categorical variables were compared using the Student t-test and the Chi-square test or the Fisher exact test, respectively. Results: The patients’ data from both groups were similar in terms of age, intraoperative and postoperative bleeding volume, and length of hospital stay. Mean BMI was 42.8±0.7 in the SPSG group and 45.3±1.2 in the MPSG group. Duration of surgery was significantly lower in the SPSG group (P<0.001. Only 1 patient from the SPSG group and 5 patients from the MPSG group had bleeding as an early complication. Conclusion: The differences in each complication between the groups were not statistically significant. SPSG seems to be safe and is the same as MPSG in terms of major postoperative complications. Trial Registration Number: IRCT201512229936N12

  18. Postoperative medical complications are the main cause of early death after emergency surgery for colonic cancer

    DEFF Research Database (Denmark)

    Iversen, L.H.; Bulow, S.; Christensen, Ib Jarle

    2008-01-01

    independent risk factors were age at least 71 years, male sex, American Society of Anesthesiologists grade III or more, palliative outcome, tumour perforation, splenectomy and adverse intraoperative surgical events. Postoperative surgical complications were noted in 20.4 per cent of the patients but had...

  19. Complicated Pancreatitis

    NARCIS (Netherlands)

    Bakker, O.J.

    2015-01-01

    Research questions addressed in this thesis: What is the accuracy of serum blood urea nitrogen as early predictor of complicated pancreatitis? ; What is difference in clinical outcome between patients with pancreatic parenchymal necrosis and patients with extrapancreatic necrosis without necrosis

  20. Depressão puerperal - uma revisão de literatura

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    Elda Terezinha da Silva

    2005-08-01

    Full Text Available O puerpério é uma fase de profundas alterações no âmbito social, psicológico e físico da mulher, sendo assim, aumentam os riscos para o aparecimento dos transtornos psiquiátricos. Os distúrbios psiquiátricos puerperais se classificam em Depressão Puerperal, Psicose Puerperal e Tristeza Pós-Parto que se diferem entre si em diversos aspectos. O presente artigo discutirá acerca dos transtornos psíquicos puerperais, com ênfase na Depressão Puerperal. A Depressão Puerperal é um transtorno mental de alta prevalência e que provoca alterações emocionais, cognitivas, comportamentais e físicas. A sua etiologia é determinada por uma combinação de fatores que devem ser abordados no diagnóstico e terapêutica. O quadro depressivo puerperal surge na maioria das vezes, nas duas primeiras semanas após o parto. A Depressão Pós-Parto é uma síndrome psiquiátrica importante que em geral repercute na interação mãe-filho e praticamente de forma negativa e promove um desgaste progressivo na relação com os familiares.A saúde mental é um componente fundamental da saúde humana, portanto promovê-la é um dever dos profissionais envolvidos no cuidado humano.

  1. High Early Major Complication Rate After Revision for Mechanically Assisted Crevice Corrosion in Metal-on-Polyethylene Total Hip Arthroplasty.

    Science.gov (United States)

    McGrory, Brian J; Jorgensen, Anna H

    2017-12-01

    Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type. Major orthopedic complications occurred in 7 of 27 patients (25.9%), each after the original revision surgery. Five additional major complications occurred in subsequent surgeries. Postoperative hip dislocation occurred in 6 of 27 (22.2%), deep infection occurred in 3 of 27 (11.1%), and aseptic acetabular loosening, seroma requiring irrigation and debridement, pulmonary embolism, periprosthetic fracture, and reintubation each occurred in 1 of 27 (3.7%). Harris hip scores improved significantly with surgery (P = .0002), but overall, scores were lower for those who had major complications (70.9 vs 89.2), and only 20 of 27 patients (74.1%) had good or excellent outcomes. Symptomatic MACC is a potentially devastating diagnosis, because of decreased soft tissue and bone viability associated with adverse local tissue reaction. This leads to a high early major complication rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Early and late endocrinologic complications of the hematopoetic stem cell transplantation performed for hematologic malignancies

    Directory of Open Access Journals (Sweden)

    Murat Albayrak

    2012-03-01

    Full Text Available Hematopoietic stem cell transplantation (HSCT is usedfor various hematologic malignancies seen in childrenand adults. There may be several complications before,during, and after the HSCT. Just one of them is endocrinologiccomplications, since endocrine system (particularlythe pituitary gland, thyroid gland, adrenal glands, andgonads is highly sensitive against various stress. Chemotherapyand/or total body irradiation used as preparativeregimens and immunosuppressive agents (especiallycorticosteroids used for the graft-versus-host diseasecan cause hormonal disorders. Time elapsed after theHSCT, transplantation type (autologous or allogeneic,preparative regimen choice, age, and gender determinesthe complications. A multidisciplinary management containinga specialist of endocrinology for these patients ispreferred. In this report, we reviewed the endocrinologiccomplications that observed after the HSCT in childrenand adults referring to the recent literatures. J Clin ExpInvest 2012; 3(1: 149-156

  3. Early and late complications after liver transplantation for propionic acidemia in children: a two centers study.

    Science.gov (United States)

    Charbit-Henrion, F; Lacaille, F; McKiernan, P; Girard, M; de Lonlay, P; Valayannopoulos, V; Ottolenghi, C; Chakrapani, A; Preece, M; Sharif, K; Chardot, C; Hubert, P; Dupic, L

    2015-03-01

    Propionic acidemia (PA) is a severe metabolic disorder with cardiac and neurologic complications and a poor quality of life. Liver transplantation (LT) was thus proposed in PA to increase enzyme activity. We studied retrospectively LT in PA in two European centers. Twelve patients underwent 17 LTs between 1991 and 2013. They developed severe, unusual and unexpected complications, with high mortality (58%). When present, the cardiomyopathy resolved and no acute metabolic decompensation occurred allowing dietary relaxation. Renal failure was present in half of the patients before LT and worsened in all of them. We suggest that cardiac and renal functions should be assessed before LT and monitored closely afterward. A renal sparing immunosuppression should be used. We speculate that some complications may be related to accumulated toxicity of the disease and that earlier LT could prevent some of these consequences. As kidney transplantation has been performed successfully in methylmalonic acidemia, a metabolic disease in the same biochemical pathway, the choice of the organ to transplant could be further discussed. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. Subthalamic nucleus-deep brain stimulation for early motor complications in Parkinson's disease-the EARLYSTIM trial: early is not always better.

    Science.gov (United States)

    Mestre, Tiago A; Espay, Alberto J; Marras, Connie; Eckman, Mark H; Pollak, Pierre; Lang, Anthony E

    2014-12-01

    Subthalamic nucleus deep brain stimulation (STN-DBS) has revolutionized the management of disabling motor complications in Parkinson's disease. The EARLYSTIM trial applied this treatment to patients who had been experiencing motor complications for less than three years. STN-DBS significantly improved all primary and secondary outcome measures while best medical therapy failed to provide any improvement at the two-year follow-up time point. On face value these results strongly favor the application of STN-DBS far earlier than is currently applied, when patients are just beginning to experience problems with motor complications. Here we review the application of early DBS and the EARLYSTIM trial from the perspectives of clinical issues, health economics and study design and patient expectation of benefit. We conclude that the most relevant issue is not when to operate but on whom and that early is not always better. © 2014 International Parkinson and Movement Disorder Society. © 2014 International Parkinson and Movement Disorder Society.

  5. A Meta-Analysis of Early Versus Delayed Surgery for Valvular Infective Endocarditis Complicated by Embolic Ischemic Stroke.

    Science.gov (United States)

    Mihos, Christos G; Pineda, Andres M; Santana, Orlando

    2016-01-01

    An embolic ischemic stroke occurs in 10% to 40% of patients with valvular infective endocarditis (IE) and confers significant morbidity. The optimal timing of valve surgery in this population is not well defined. With the use of PubMed, EMBASE, Ovid, and Cochrane databases, a systematic review identified 14 studies through October 2015 that compared early versus delayed surgery for valvular IE complicated by an ischemic stroke. Early surgery was defined as 3 days or less in one, 7 days or less in eight, and 14 days or less in five studies. Risk ratios (RRs) were calculated by the Mantel-Haenszel method under a fixed- or random-effects model, for the outcomes of perioperative stroke, operative mortality, and 1-year survival. A total of 833 patients (early surgery, 330; delayed surgery, 503) were included. The majority of operations were for aortic and/or mitral valve IE, with prosthetic valve IE present in 0% to 60%. Infection with Staphylococcus aureus ranged from 19% to 66%, and heart failure prevalence at the time of operation was 24% to 66%. Early surgery was associated with an increased risk of operative mortality (RR, 1.72; 95% confidence interval [CI], 1.27-2.34; P = 0.0005), which was significant regardless of surgery within the first 7 days (RR, 2.19; 95% CI, 1.45-3.31; P = 0.0002) or 14 days (RR, 1.72; 95% CI, 1.12-2.64; P = 0.01) after stroke. Surgical timing did not affect the risk of perioperative ischemic or hemorrhagic stroke or 1-year survival. In patients with valvular IE complicated by ischemic stroke, early surgery is associated with an increased risk of operative mortality, with no observed benefit in 1-year survival.

  6. Outpatient versus Inpatient Primary Cleft Lip and Palate Surgery: Analysis of Early Complications.

    Science.gov (United States)

    Kantar, Rami S; Cammarata, Michael J; Rifkin, William J; Plana, Natalie M; Diaz-Siso, J Rodrigo; Flores, Roberto L

    2018-05-01

    Fiscal constraints are driving shorter hospital lengths of stay. Outpatient primary cleft lip surgery has been shown to be safe, but outpatient primary cleft palate surgery remains controversial. This study evaluates outcomes following outpatient versus inpatient primary cleft lip and palate surgery. The American College of Surgeons National Surgical Quality Improvement Program Pediatric database was used to identify patients undergoing primary cleft lip and palate surgery between 2012 and 2015. Patient clinical factors and 30-day complications were compared for outpatient versus inpatient primary cleft lip and palate surgery. Univariate and multivariate analyses were performed. Three thousand one hundred forty-two patients were included in the primary cleft lip surgery group and 4191 in the primary cleft palate surgery group. Patients in the cleft lip surgery group with structural pulmonary abnormalities had a significantly longer hospital length of stay (β, 4.94; p = 0.001). Patients undergoing outpatient surgery had a significantly higher risk of superficial (OR, 1.99; p = 0.01) and deep wound dehiscence (OR, 2.22; p = 0.01), and were at a significantly lower risk of reoperation (OR, 0.36; p = 0.04) and readmission (OR, 0.52; p = 0.02). Outpatient primary cleft lip surgery is safe and has a complication profile similar to that of inpatient surgery. Outpatient primary cleft palate surgery is common practice in many U.S. hospitals and has a significantly higher rate of wound complications, and lower rates of reoperation and readmission. In properly selected patients, outpatient palatoplasty can be performed safely. Therapeutic, III.

  7. Left Lung Torsion: Complication of Lobar Resection for an Early Stage Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Wissam Mansour

    2016-01-01

    Full Text Available Lobar torsion is a fatal but fortunately rare occurrence following lung resection. Early clinical signs and radiographic features may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further parenchymal necrosis and deadly gangrene. We report a case of left lower lobe torsion in a 76-year-old female following elective upper lobectomy for underlying lung adenocarcinoma. Diagnosis was made following highly suggestive radiographic findings prompting bronchoscopy and revision thoracotomy. An emergency detorsion failed to restore lung viability and was followed by completion pneumonectomy. The patient recovered and was discharged on the seventh postoperative day.

  8. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  9. Low expression of soluble human leukocyte antigen G in early gestation and subsequent placenta-mediated complications of pregnancy.

    Science.gov (United States)

    Marozio, Luca; Garofalo, Anna; Berchialla, Paola; Tavella, Anna Maria; Salton, Loredana; Cavallo, Franco; Benedetto, Chiara

    2017-09-01

    Abnormal placentation is a common pathogenic mechanism of many placenta-mediated complications of late pregnancy, including pre-eclampsia, fetal growth restriction, stillbirth, and placental abruption. During successful placentation, the trophoblast (which is a semi-allograft) is not rejected by decidual immune cells because of maternal immune tolerance, mainly induced by human leukocyte antigen G (HLA-G). Deficient HLA-G expression seems to be associated with the development of complications of pregnancy. The aim of this study was to determine whether low soluble HLA-G (sHLA-G) levels in maternal blood at the beginning of pregnancy may be associated with subsequent placenta-mediated complications. For this retrospective case-control study, 117 cases of placenta-mediated complications of pregnancy and 234 controls with uneventful pregnancy were selected. Plasma sHLA-G levels were measured at 11-13 weeks' gestation by the enzyme-linked immunosorbent assay method in blood samples previously obtained at first-trimester prenatal screening for chromosomal fetal abnormalities. Women who subsequently developed placenta-mediated complications had significantly lower sHLA-G levels at the beginning of pregnancy (median, 43.08 IU/mL) than controls (median, 49.10 IU/mL; P = 0.008). An sHLA-G level lower than 43.50 IU/mL at the end of the first trimester was associated with a twofold increased risk of developing a pregnancy complication (odds ratio, 1.82; 95% confidence interval, 1.22-2.73). The strongest association, although only moderately strong, was observed with severe pre-eclampsia (odds ratio, 2.66; 95% confidence interval, 1.08-6.56). Placenta-mediated complications of pregnancy may be associated with low sHLA-G levels in the first trimester, suggesting a potential role of sHLA-G in the early stages of placentation. © 2017 Japan Society of Obstetrics and Gynecology.

  10. Medical Complications of the Critically Ill Newborn: A Review for Early Intervention Professionals.

    Science.gov (United States)

    McNab, Theresa C.; Blackman, James A.

    1998-01-01

    Provides early-intervention professionals with a basic familiarity and understanding of some of the newest technologies employed in the neonatal intensive care units for neonates with respiratory distress syndrome, persistent fetal circulation, retinopathy of prematurity, intraventricular hemorrhage, and periventricular leukomalacia. Early…

  11. A novel index for quantifying the risk of early complications for patients undergoing cervical spine surgeries.

    Science.gov (United States)

    Passias, Peter G; Diebo, Bassel G; Marascalchi, Bryan J; Jalai, Cyrus M; Horn, Samantha R; Zhou, Peter L; Paltoo, Karen; Bono, Olivia J; Worley, Nancy; Poorman, Gregory W; Challier, Vincent; Dixit, Anant; Paulino, Carl; Lafage, Virginie

    2017-11-01

    OBJECTIVE It is becoming increasingly necessary for surgeons to provide evidence supporting cost-effectiveness of surgical treatment for cervical spine pathology. Anticipating surgical risk is critical in accurately evaluating the risk/benefit balance of such treatment. Determining the risk and cost-effectiveness of surgery, complications, revision procedures, and mortality rates are the most significant limitations. The purpose of this study was to determine independent risk factors for medical complications (MCs), surgical complications (SCs), revisions, and mortality rates following surgery for patients with cervical spine pathology. The most relevant risk factors were used to structure an index that will help quantify risk and anticipate failure for such procedures. METHODS The authors of this study performed a retrospective review of the National Inpatient Sample (NIS) database for patients treated surgically for cervical spine pathology between 2001 and 2010. Multivariate models were performed to calculate the odds ratio (OR) of the independent risk factors that led to MCs and repeated for SCs, revisions, and mortality. The models controlled for age ( 65 years old), sex, race, revision status (except for revision analysis), surgical approach, number of levels fused/re-fused (2-3, 4-8, ≥ 9), and osteotomy utilization. ORs were weighted based on their predictive category: 2 times for revision surgery predictors and 4 times for mortality predictors. Fifty points were distributed among the predictors based on their cumulative OR to establish a risk index. RESULTS Discharges for 362,989 patients with cervical spine pathology were identified. The mean age was 52.65 years, and 49.47% of patients were women. Independent risk factors included medical comorbidities, surgical parameters, and demographic factors. Medical comorbidities included the following: pulmonary circulation disorder, coagulopathy, metastatic cancer, renal failure, congestive heart failure

  12. MRI Manifestation and Early Diagnosis of Bone Infarct: A Rare Complication of Steroid Therapy for Pemphigus

    Directory of Open Access Journals (Sweden)

    UC Parashari

    2011-07-01

    Full Text Available The objective of the study was to analyse the magnetic resonance imaging (MRI manifestation of bone infarction and explore the value of such imaging in early diagnosis. In bone infarction, aseptic osteonecrosis occurs in the metaphysis and diaphysis of long bones. The “Double line” sign in MRI is most characteristic of this lesion and is seen as high signal intensity in the inner zone along with lowsignal-intensity line in the outer zone in a T2 weighted image. In clinically suspected patients, MRI can be used for early diagnosis. Here we describe a case of pemphigus resulting from steroid therapy leading to development of bone infarction in the metadiaphyseal region of the femur and tibia.

  13. Are early pregnancy complications more common in women with hyperemesis gravidarum?

    Science.gov (United States)

    Morgan, Sinead R; Long, Lisa; Johns, Jemma; Angwin, Chloe; Maitra, Supriya; Ross, Jackie A

    2017-04-01

    Ultrasound evaluation is usually requested for women presenting with hyperemesis gravidarum (HG) in early pregnancy. This is to check viability as well as to diagnose multiple pregnancies and exclude gestational trophoblastic disease (GTD). The aim of this retrospective case control study was to evaluate the early pregnancy outcomes in women with HG and to compare them with an asymptomatic control group. 790 women referred with HG between 2002 and 2014 were matched for gestational age and maternal age with an asymptomatic patient attending for a reassurance or dating scan. A higher proportion of women with HG had ongoing pregnancies compared with controls and conversely, embryonic demise was less frequent in the HG group. The risk of twin pregnancy was doubled in the HG group compared to controls. There was no evidence of an increase in the prevalence of GTD. There appears to be a limited role for ultrasound in women who present with HG alone.

  14. Morbidade puerperal em portadoras e não-portadoras do vírus da imunodeficiência humana Puerperal morbidity in HIV-infected and non-infected women

    Directory of Open Access Journals (Sweden)

    Frederico José Amédeé Péret

    2007-05-01

    (82 and HIV non-infected women (123. Postpartum morbidity evaluation was performed from birth delivery up to 15 days postpartum. Morbidity was categorized as minor (postpartum hemorrhage, fever and endometritis or major (blood transfusion, deep alterations of the surgical wound and indication for surgical intervention, and was evaluated both according to the presence or absence of HIV infection and the mode of delivery. Continuous variables were analyzed by the Student’s t-test, and categorical variables were analyzed by chi2 and Fisher’s exact test using Epi-Info 2000 (CDC, Atlanta. RESULTS: puerperal morbidity was observed in 18 patients from the HIV group (22% and in 17 patients from the control group (14% with predominance of minor morbidity, without statistical significance, except for an increased risk of endometritis in the HIV group (RR=1.05; CI 95%:1.01-1.10. No significant difference was observed concerning the mode of delivery between the two groups. There were only two major morbidities: blood transfusion and necrotizing fasciitis. CONCLUSIONS: HIV-infected and non-infected puerperal women have a similar morbidity, despite the lower morbidity in the HIV non-infected group and the increased risk of endometritis in the HIV group. Clinical puerperium follow-up is a strategic control tool for an early identification of maternal morbidity.

  15. Unilateral Subthalamic Nucleus Stimulation in the Treatment of Asymmetric Parkinson"s Disease with Early Motor Complications.

    Science.gov (United States)

    Sobstyl, Michal; Zabek, Miroslaw; Zaczynski, Artur; Gorecki, Wojciech; Mossakowski, Zbigniew; Brzuszkiewicz-Kuzmicka, Grazyna

    2017-01-01

    The aim of this study was to assess the results of unilateral subthalamic nucleus (STN) stimulation for the treatment of Parkinson"s disease (PD) with marked asymmetry of parkinsonian motor symptoms and early motor complications. The clinical series consisted of 32 consecutive PD patients, in whom unilateral STN stimulation was performed. All patients were assessed according to the Unified Parkinson"s Disease Rating Scale (UPDRS), and Hoehn and Yahr staging. The patients were assessed preoperatively, and at 12, and 24 months after unilateral STN stimulation. 22 patients were followed for 2 years. Medication off/stimulation on total UPDRS motor scores were improved by 29% when compared to the baseline medication off motor scores. The contralateral motor scores improved by 49%, whereas the axial motor scores by 18% in medication off/stimulation on condition. The duration and severity of levodopa induced dyskinesia were reduced respectively by 73% and by 77%. The daily levodopa dose was decreased by only 10%. Unilateral STN stimulation is a safe and effective procedure for selected patients with marked asymmetry Parkinson"s disease motor symptoms and early motor complications.

  16. Early-onset Infectious Complications among Penetrating and Severe Closed Traumatic Brain Injury in Active Duty Deployed during OIF and OEF, 2008-2013

    Science.gov (United States)

    2015-02-01

    indicating an early-onset infectious complication, most commonly pneumonia followed by systemic infection. However, closed TBI patients developed a...classification was defined as bacteria resistant to ≥ 3 classes of antibiotics. As a group, 14.0% of severe closed and penetrating TBI patients had at least...one ICD-9-CM diagnosis indicating an early-onset infectious complication, most commonly pneumonia followed by systemic infection. However, closed

  17. Intraoperative iodinated contrast swallow with CT-scan delayed control for detection of early complications in laparoscopic gastric bypass: A case series of 260 cases

    Directory of Open Access Journals (Sweden)

    Vincenzo Consalvo, M.D.

    2017-01-01

    Conclusions: This study gives a contribute to the existing issue of fast track in bariatric surgery for the early diagnosis of complications and patients' readmission or non-discharge. In conclusion, the use of intraoperative iodinated water soluble contrast swallow and abdominal CT-scan at 48 h was a safe and accurate test in order to detect and treat any potential early surgical complication in LRYGB.

  18. The Importance of Physiotherapy in the Puerperal Period of the Woman

    OpenAIRE

    PAVLOVÁ, Lenka

    2011-01-01

    The theme of this thesis is The importance of physiotherapy in the puerperal period in women. As far as pregnancy is concerned, not only is available excellent health care important for women, but there are a large number of organizations that provide advisory services, exercises for pregnant women, and antenatal education for mothers-to-be. Unfortunately, this care usually ends soon after childbirth and women in puerperium, who go through many physical and mental changes, are not given such ...

  19. RESEARCHES CONCERNING THE HISTOCHEMISTRY AND MICROBIAL FLORA OF THE PUERPERAL UTERUS IN COWS

    OpenAIRE

    GROZA, I.; RAPUNTEAN, GH.; MICLAUS, V.; OGNEAN, L.

    2002-01-01

    The microbial population represents a group of heterogeneous germs comprising several different species which live and act together in the same place. The communities of micro-organisms, as independent population groups, are better adapted for growing than a unique species. The microbial flora of the puerperal uterus differs from case to case, being represented both as bacteria admitted as pathogenic and particular tropism for the uterine morphological structures and opportunist bacteria whic...

  20. Impact of collateral circulation on early outcome and risk of hemorrhagic complications after systemic thrombolysis.

    Science.gov (United States)

    Brunner, Freimuth; Tomandl, Bernd; Hanken, Katrin; Hildebrandt, Helmut; Kastrup, Andreas

    2014-12-01

    In stroke patients, collateral flow can rapidly be assessed on computed tomography angiography (CTA). In this study, the impact of baseline collaterals on early outcome and risk of symptomatic intracerebral hemorrhages after systemic thrombolysis in patients with proximal arterial occlusions within the anterior circulation were analyzed. Collateralization scores were determined on the CT angiography source images (0 = absent; 1 ≤ 50%, 2 > 50% but collateral filling) of patients with distal intracranial carotid artery and/or M1 segment occlusions treated from 2008 to December 2011. A collateral score of 0 to 1 was designated as poor and 2 to 3 as good collateral vessel status. Outcome variables included in hospital mortality, favorable outcome at discharge (modified Rankin score ≤ 2), and rates of symptomatic intracerebral hemorrhage based on the European-Australasian Acute Stroke Study II definition. Among 246 subjects (mean age of 74 years; median National Institutes of Health Stroke Scale N at admission 14), 205 patients (83%) had good collaterals, whereas 41 patients (17%) had poor collaterals, respectively. Patients with poor collaterals had significantly higher rates of in-hospital mortality (41% vs. 12%, P collaterals. The grade of collateralization was independently associated with in-hospital mortality (P collaterals have a poor early functional outcome and high rates of symptomatic intracerebral hemorrhage after systemic thrombolysis. Since similar findings have also been reported after endovascular therapy, strategies to improve collateral blood flow should be assessed in this patient population. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  1. Early complications in patients with multiple injuries and polytraumatism with special regard to traumatic fat embolism.

    Science.gov (United States)

    Kroupa, J; Unger, K

    1988-01-01

    In the introductory part contemporary data concerning fat embolism occurrence and mortality, as taken from the world literature, are evaluated. Thus, the author opens the whole complicated problem of post-mortem examination findings with a different extent of fat embolization (most often in the lungs, rarely in organs belonging to the area supplied by the systemic blood circulation) on the one hand and the fat embolism clinical syndrome on the other hand. The clinical syndrome is a rare phenomenon in comparison with the relatively frequent morphological abduction findings of a more serious character (of the 2nd and higher degree). The evaluation of fat embolism as the main cause of death cannot be based only on the morphological findings, ascertained at the post-mortem examination in the organs of patients who died of injury consequences. At the same time, however, the question is open of evaluating the fat embolism syndrome as the contrary of the fulminant form of fat embolism to the classical fat embolism syndrome as it manifests itself in practice after the free interval. The author sees the mentioned contrary in the fact that the diagnosis of the fulminant fat embolism syndrome resulting in death within a few hours is mainly based on the microscopical findings of fat embolism in the capillaries of the organs whereas that of the classical fat embolism syndrome is possible not only clinically but can be confirmed also macroscopically and microscopically, morphologically and histologically in the cases of death of such injured patients. The morphological confirmation of the classical fat embolism syndrome after an accidental death within some weeks after the injury and after the clinical course of the classical syndrome has, however, time limits as far as the macroscopical findings but especially the microscopical evidence of fat embolism are concerned. In this part of the study many statements of the author are based on the occurrence of 208 patients with fat

  2. CT-guided percutaneous gastrostomy: success rate, early and late complications; CT-gesteuerte perkutane Gastrostomie: Technischer Erfolg, Frueh- und Spaetkomplikationen

    Energy Technology Data Exchange (ETDEWEB)

    Gottschalk, A.; Voelk, M. [Radiologie, Bundeswehrkrankenhaus Ulm (Germany); Strotzer, M. [Radiologie, Klinikum Hohe Warte (Germany); Feuerbach, S.; Rogler, G. [Radiologie, Klinikum der Universitaet Regensburg (Germany); Seitz, J. [Radiologie, MVZ Dr. Neumaier und Kollegen (Germany)

    2007-04-15

    Purpose: Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG. CT-guided percutaneous gastrostomy (PG) represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT-guided percutaneous gastrostomy. Materials and Methods: CT-guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT-guided PG were analyzed retrospectively. Complications were grouped into four categories: Major and minor complications as well as early and late complications. Results: In 95.2 % of all cases (79/83), CT-guided PG was successful in the first attempt. Within the first 3 days, 5 major complications including 4 tube dislocations and one case of peritonitis were found in 4/79 patients (5.1 %). One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomachache, were observed in 31 patients (39.2 %). Three days after CT-guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8.7 % (7/79). Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed. 29.1 % of the patients (23/79) experienced late minor complications. (orig.)

  3. Risk factors vary early preterm birth and perinatal complications after assisted reproductive technology.

    Science.gov (United States)

    Chistyakova, G; Gazieva, I; Remizova, I; Ustyantseva, L; Lyapunov, V; Bychkova, S

    2016-10-01

    We conducted a study of markers of endothelial dysfunction and angiogenesis regulation, as well as the identification of the main lymphocyte populations, activated CD3  +  CD95 + -cells and cytokine-producing CD4  +  IFN-γ + -, CD4  +  IL-4 +  -lymphocytes in the 1st trimester of gestation in women with ART-induced pregnancy and spontaneous pregnancy. We used the same indicators to assess the immune status of ELBW infants at birth and at the post-conceptual age of 38-40 weeks. It was determined that the risk factors of very early preterm delivery are: threatened miscarriage, chronic placental insufficiency, endothelial dysfunction, increased spontaneous production of intracellular cytokines. Adverse perinatal outcomes in ELBW infants from ART-induced pregnancy are associated with lower anthropometric measures, low Apgar scores high level of inflammatory infections (pneumonia), grade II intraventricular hemorrhage, movement disorders in the form of lower paraparesis. Immune status of those infants is characterized by the increase in the number of CD8 + - and CD3 - CD16  +  CD56 +  -lymphocytes, the expression level of Fas-receptor by T-cells, and the increased production of intracellular and serum IFNγ against the decrease in the number of CD4 + -cells, which indicates enhancing of cytotoxic effector potential and proinflammatory orientation of cell responses.

  4. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network.

    Science.gov (United States)

    Parmar, K L; Zammit, M; Smith, A; Kenyon, D; Lees, N P

    2011-08-01

    The study aimed to identify the incidence of early stoma problems after surgery for colorectal cancer to identify predisposing factors and to assess the effect on discharge from hospital and the greater need for community stoma care. A prospective study of 192 patients was carried out over a six-month period in the 13 units of the Greater Manchester and Cheshire Cancer Network. Stoma problems were categorized into fistula, leakage, pancaking, necrosis, retraction, separation, stenosis, skin problems, parastomal hernia, suboptimal stoma site and need for resiting or refashioning. Differences in incidence between units (anonymized) were analysed, and the effect of stoma complications on length of hospital stay and the need for additional community stoma care was determined. One hundred and ninety-two patients with stomas were included, of which 52 (27.1%) were identified as being problematic (range 0-66.7% between units). Significant risk factors included stoma type (colostomy) (P stoma length (P = 0.006), higher BMI (P = 0.043), emergency surgery (P = 0.002) and lack of preoperative site marking (P stomas were associated with longer hospital stay (P care (P Stoma type, stoma length, body mass index, emergency surgery and lack of preoperative marking were significant risk factors. Overall complication rates compare favourably with other studies. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  5. Posterior versus lateral approach for hemiarthroplasty after femoral neck fracture: Early complications in a prospective cohort of 583 patients.

    Science.gov (United States)

    Svenøy, Stian; Westberg, Marianne; Figved, Wender; Valland, Haldor; Brun, Ole Christian; Wangen, Helge; Madsen, Jan Erik; Frihagen, Frede

    2017-07-01

    To compare early complications after the posterior and the direct lateral (transgluteal) approach, when using hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly. A prospective clinical study from four Norwegian hospitals, consisting of 583 patients with 1year follow-up. All the hospitals used the same uncemented femoral stem and bipolar heads. Data were collected for gender, age, surgical approach, prosthetic dislocation, postoperative infection, perioperative fracture, duration of surgery, ASA score, diabetes, alcoholism, cognitive failure, BMI, 30-day mortality and 1-year mortality. Mean age was 83 years (SD 7.8) and 434/583 (74%) were female. There were no relevant differences between the treatment groups. A higher risk was found for prosthetic dislocation in the posterior group compared to the lateral group (15/186 (8%) vs. 4/397 (1%); RR=8.0, 95% CI 2.7-23.8, p-valueapproach was identified. There were no differences between the approach groups for other complications. There was an 8-fold increased risk for prosthetic dislocations after the posterior approach compared to lateral approach. There was a high risk for recurrent prosthetic dislocations and a subsequent risk for further surgeries and a poor end result. The potential advantages of the posterior approach have not been demonstrated after femoral neck fractures and we advise against its continued use. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Prolonged second stage of labour, maternal infectious disease, urinary retention and other complications in the early postpartum period.

    Science.gov (United States)

    Stephansson, O; Sandström, A; Petersson, G; Wikström, A-K; Cnattingius, S

    2016-03-01

    To study the association between duration of second stage of labour and risks of maternal complications (infection, urinary retention, haematoma or ruptured sutures) in the early postpartum period. Population-based cohort study. We included 72 593 mothers with singleton vaginal deliveries at ≥37 weeks of gestation in cephalic presentation, using the obstetric database from the Stockholm-Gotland region in Sweden, 2008-12. Logistic regression analysis. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated and adjustments were made for maternal age, body mass index, height, smoking, cohabitation, gestational age, labour induction, epidural analgesia and oxytocin augmentation. Rates of any complication varied by parity from 7.3% in parous women with previous caesarean section, 4.8% in primiparas and 1.7% in parous women with no previous caesarean section. Compared with a second stage caesarean were 2.27 (1.78-2.90), 2.97 (2.09-4.22), 3.65 (2.25-5.94) and 3.16 (1.44-6.94), respectively. The adjusted ORs for women with previous caesarean were for 1 to caesarean deliveries. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  7. Pan-European early switch/early discharge opportunities exist for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections.

    Science.gov (United States)

    Nathwani, D; Eckmann, C; Lawson, W; Stephens, J M; Macahilig, C; Solem, C T; Simoneau, D; Chambers, R; Li, J Z; Haider, S

    2014-10-01

    The objective of this study was to document pan-European real-world treatment patterns and healthcare resource use and estimate opportunities for early switch (ES) from intravenous (IV) to oral antibiotics and early discharge (ED) in hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTIs). This retrospective observational medical chart review study enrolled 342 physicians across 12 European countries who collected data from 1542 patients with documented MRSA cSSTI who were hospitalized (July 2010 to June 2011) and discharged alive (by July 2011). Data included clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and oral antibiotic use, and ES and ED eligibility according to literature-based and expert-validated criteria. The most frequent initial MRSA-active antibiotics were vancomycin (50.2%), linezolid (15.1%), clindamycin (10.8%), and teicoplanin (10.4%). Patients discharged with MRSA-active antibiotics (n = 480) were most frequently prescribed linezolid (42.1%) and clindamycin (19.8%). IV treatment duration (9.3 ± 6.5 vs. 14.6 ± 9.9 days; p MRSA cSSTI could be eligible for ES and ED, resulting in substantial reductions in IV days and bed-days, with potential savings of €2000 per ED-eligible patient. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

  8. Early rise in C-reactive protein is a marker for infective complications in laparoscopic colorectal surgery.

    LENUS (Irish Health Repository)

    Nason, Gregory J

    2014-02-01

    Infective complications are the most significant cause of morbidity associated with elective colorectal surgery. It can sometimes be difficult to differentiate complications from the normal postoperative course. C-reactive protein (CRP) is an acute phase reactant which has been reported to be predictive of postoperative infective complications.

  9. Re-usable low density polyethylene aRm glove foR pueRpeRal ...

    African Journals Online (AJOL)

    2008-07-07

    Jul 7, 2008 ... Re-usable low density polyethylene aRm glove foR. pueRpeRal intRauteRine exploRation. o.n. MakindE, B.t. arEMo, B. arEMo, E.o. akinkunMi, f.a. Balogun, g.o. osinkolu and. W.o. siyanBola. abstRaCt. Objective: to design a long arm glove that can be used within a puerperal uterus to prevent the.

  10. Puerperal sepsis caused by liver abscess: case report

    Directory of Open Access Journals (Sweden)

    Flávio Xavier Silva

    Full Text Available Abstract Introduction: sepsis is a serious public health problem, affecting millions of people in the world each year, with a high mortality rate (one out of four patients and an increasing incidence. Sepsis is one of the main causes of maternal mortality and an important cause of admission to obstetric intensive care units. Case description: In this study, the authors report the case of a woman having been submitted to cesarean section three days before presenting clinical signs of sepsis and septic shock caused by a liver abscess. The patient had a set of complications secondary to shock, such as thrombocytopenia, coagulopathy, toe ischemia and acute kidney failure. The patient had cholelithiasis and recurrent pain in the right hypochondrium during pregnancy. During hospitalization, the mechanism involved in the development of hepatic abscess was infection of the biliary tract. The patient was treated in an obstetric intensive care unit with antibiotics and drainage of the liver abscess. Progress was favorable and the patient was discharged in good health. Discussion: pyogenic liver abscess during pregnancy and puerperium is a serious condition which represents a diagnostic and therapeutic challenge, with few cases reported. The normally nonspecific clinical and laboratory findings can lead to a late diagnosis, which increases the risk of maternal morbidity and mortality.

  11. [HIV infection in the child after materno-fetal transmission: early treatment with azidothymidine and prevention of secondary infectious complications].

    Science.gov (United States)

    Michel, G; Vallée, D; Thuret, I; Chambost, H; Tamalet, C; de Boisse, P; Leclaire, M; Farnarier, C; Kaplanski, S; Perrimond, H

    1992-01-01

    Twenty-four perinatally HIV infected children received early treatment as soon as the diagnosis of viral contamination was established. In 13 cases (group 1), this diagnosis was based on a viremia and/or antigenemia during the first 6 months of life. In 11 cases (group 2), children were more than 15 months-old and had a positive HIV antibody test. Therapy included azidothymidine (AZT, 400 mg/m2/d) and the prevention of secondary infectious complications with intravenous immunoglobulin and cotrimoxazole. With a median follow-up of 26 months, we reported no case of severe secondary infection and no case of encephalopathy. Hematological side effects of AZT were rarely observed. Only one patient developed anemia. In all other cases, the only hematological abnormality was macrocytosis of red blood cells. Before treatment, the mean value of T4 cells age-adjusted count was 96, 86 and 91%, respectively, for groups 1, 2 and the entire study group. At the time of analysis, these values were 64, 62 and 63% respectively. This decrease was statistically significant for group 1 and for the entire study group, but did not reach statistical significance for group 2. These data show that AZT is probably insufficient as a long-term therapy for HIV infected children. Other therapeutic approaches need to be developed in the future, notably the combination of anti-retroviral drugs.

  12. Protective Role of Maternal P.VAL158MET Catechol-O-methyltransferase Polymorphism against Early-Onset Preeclampsia and its Complications

    Directory of Open Access Journals (Sweden)

    Krnjeta Tijana

    2016-09-01

    Full Text Available Background: Up until now there have been contradictory data about the association between p.Val158Met catechol-O-methyltransferase (COMT polymorphism and risk of preeclampsia (PE. The goal of this study was to assess the potential correlation between p.Val158Met COMT polymorphism and risk of early-onset PE, risk of a severe form of early-onset PE, as well as risk of small-for-gestationalage (SGA complicating PE.

  13. Dose-Volume Histogram Predictors of Chronic Gastrointestinal Complications After Radical Hysterectomy and Postoperative Concurrent Nedaplatin-Based Chemoradiation Therapy for Early-Stage Cervical Cancer

    International Nuclear Information System (INIS)

    Isohashi, Fumiaki; Yoshioka, Yasuo; Mabuchi, Seiji; Konishi, Koji; Koizumi, Masahiko; Takahashi, Yutaka; Ogata, Toshiyuki; Maruoka, Shintaroh; Kimura, Tadashi; Ogawa, Kazuhiko

    2013-01-01

    Purpose: The purpose of this study was to evaluate dose-volume histogram (DVH) predictors for the development of chronic gastrointestinal (GI) complications in cervical cancer patients who underwent radical hysterectomy and postoperative concurrent nedaplatin-based chemoradiation therapy. Methods and Materials: This study analyzed 97 patients who underwent postoperative concurrent chemoradiation therapy. The organs at risk that were contoured were the small bowel loops, large bowel loop, and peritoneal cavity. DVH parameters subjected to analysis included the volumes of these organs receiving more than 15, 30, 40, and 45 Gy (V15-V45) and their mean dose. Associations between DVH parameters or clinical factors and the incidence of grade 2 or higher chronic GI complications were evaluated. Results: Of the clinical factors, smoking and low body mass index (BMI) (<22) were significantly associated with grade 2 or higher chronic GI complications. Also, patients with chronic GI complications had significantly greater V15-V45 volumes and higher mean dose of the small bowel loops compared with those without GI complications. In contrast, no parameters for the large bowel loop or peritoneal cavity were significantly associated with GI complications. Results of the receiver operating characteristics (ROC) curve analysis led to the conclusion that V15-V45 of the small bowel loops has high accuracy for prediction of GI complications. Among these parameters, V40 gave the highest area under the ROC curve. Finally, multivariate analysis was performed with V40 of the small bowel loops and 2 other clinical parameters that were judged to be potential risk factors for chronic GI complications: BMI and smoking. Of these 3 parameters, V40 of the small bowel loops and smoking emerged as independent predictors of chronic GI complications. Conclusions: DVH parameters of the small bowel loops may serve as predictors of grade 2 or higher chronic GI complications after postoperative

  14. Muscle function of the pelvic floor in healthy, puerperal women with pelvic floor dysfunction.

    Science.gov (United States)

    Castro-Pardiñas, M A; Torres-Lacomba, M; Navarro-Brazález, B

    2017-05-01

    To understand the function of the pelvic floor muscles (PFM) at different ages in healthy women and in puerperal women with pelvic floor dysfunctions (PFD) and to ascertain whether there are differences among them. A descriptive cross-sectional study was conducted between June 2014 and September 2016 and included 177 women, 70 of whom had no symptoms of PFD, 53 primiparous mothers in late postpartum and 54 with PFD. The function of the PFM was measured through vaginal palpation (quality of the contraction); manometry (force); dynamometer (tone, strength, and response to stretching), and surface electromyography (neuromuscular activity and resistance). The healthy women showed superior values for PFM tone, maximum strength, neuromuscular activity and resistance than the puerperal mothers and the women with PFD (P.05). The muscle function of the healthy women did not vary significantly with age, except in the case of tone, which was lower in the women older than 46 years (P=.004). Age and births decrease the baseline tone of the PFM in healthy women. Therefore, lower strength, resistance and neuromuscular activity appear to be the main difference between the PFM of women with PFD and the PFM of healthy women. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Prevalence and risk factors associated with postpartum depression in puerperal women consulting in primary care].

    Science.gov (United States)

    Póo F, Ana María; Espejo S, Claudio; Godoy P, Claudia; Gualda de la C, Micaela; Hernández O, Tamara; Pérez H, Claudia

    2008-01-01

    Mood disorders are common in Chile. Among these, post partum depression (PPD) deranges the maternal and family relationships. To determine the prevalence and risk factors associated with PPD in puerperal women in Temuco, Chile. The Edinburgh Postnatal Depression Scale was administered to 73 puerperal women aged 15 to 32 years, between 40 to 45 days after delivery. To detect risk factors, 20 women with and 20 women without post partum depression (PPD) were interviewed and their clinical records were reviewed to assess their perinatal care. The prevalence of PPD in the whole sample was 50.7%. The individual psychological risk factors detected were a feeling of discomfort with their body after giving birth, a personal history of mental health problems and a high level of overload associated to child care. An individual physical risk factor was alcohol consumption during pregnancy. Family risk factors were a poor relationship with the father of the child during pregnancy, a history of mental health problems in close family members, a history of family violence and a poor relationship with parents during puerperium. Having more children was a sociodemographic risk factor. Post partum depression is common. The characterization of risk factors should lead to the implementation of preventive strategies.

  16. Association between early Helicobacter pylori eradication and a lower risk of recurrent complicated peptic ulcers in end-stage renal disease patients.

    Science.gov (United States)

    Chang, Shen-Shong; Hu, Hsiao-Yun

    2015-01-01

    End-stage renal disease (ESRD) patients exhibit an increased incidence of peptic ulcer disease. Helicobacter pylori plays a central role in the development of peptic ulcers. The effect of early H pylori eradication on the recurrence of complicated peptic ulcer disease in ESRD patients remains unclear. The aim of the present study was to explore whether early H pylori eradication therapy in ESRD patients can reduce the risk of recurrent complicated peptic ulcers.We conducted a population-based cohort study and recruited patients with ESRD who had developed peptic ulcers. We categorized patients into early (time lag ≦120 days after peptic ulcer diagnosis) and late H pylori eradication therapy groups. The Cox proportional hazards model was used. The endpoint was based on hospitalization for complicated recurrent peptic ulcers.The early and late H pylori eradication therapy groups consisted of 2406 and 1356 ESRD patients, respectively, in a time lag of 120 days. After adjusting for possible confounders, the early eradication group exhibited a lower rate of complicated recurrent peptic ulcer disease (hazard ratio [HR] = 0.76, 95% confidence interval [CI] = 0.64-0.91, P = 0.003) in a time lag of ≦120 days, but a similar rate of complicated recurrent peptic ulcer disease in time lags of ≦1 year (HR = 0.97, 95% CI 0.79-1.19, P = 0.758) and 2 years (HR = 1.11, 95% CI 0.86-1.44, P = 0.433) compared with the late eradication group.We recommend administering H pylori eradication within 120 days after peptic ulcer diagnosis to H pylori infected ESRD patients who have developed peptic ulcers.

  17. Association Between Early Helicobacter pylori Eradication and a Lower Risk of Recurrent Complicated Peptic Ulcers in End-Stage Renal Disease Patients

    Science.gov (United States)

    Chang, Shen-Shong; Hu, Hsiao-Yun

    2015-01-01

    Abstract End-stage renal disease (ESRD) patients exhibit an increased incidence of peptic ulcer disease. Helicobacter pylori plays a central role in the development of peptic ulcers. The effect of early H pylori eradication on the recurrence of complicated peptic ulcer disease in ESRD patients remains unclear. The aim of the present study was to explore whether early H pylori eradication therapy in ESRD patients can reduce the risk of recurrent complicated peptic ulcers. We conducted a population-based cohort study and recruited patients with ESRD who had developed peptic ulcers. We categorized patients into early (time lag ≦120 days after peptic ulcer diagnosis) and late H pylori eradication therapy groups. The Cox proportional hazards model was used. The endpoint was based on hospitalization for complicated recurrent peptic ulcers. The early and late H pylori eradication therapy groups consisted of 2406 and 1356 ESRD patients, respectively, in a time lag of 120 days. After adjusting for possible confounders, the early eradication group exhibited a lower rate of complicated recurrent peptic ulcer disease (hazard ratio [HR] = 0.76, 95% confidence interval [CI] = 0.64–0.91, P = 0.003) in a time lag of ≦120 days, but a similar rate of complicated recurrent peptic ulcer disease in time lags of ≦1 year (HR = 0.97, 95% CI 0.79–1.19, P = 0.758) and 2 years (HR = 1.11, 95% CI 0.86–1.44, P = 0.433) compared with the late eradication group. We recommend administering H pylori eradication within 120 days after peptic ulcer diagnosis to H pylori infected ESRD patients who have developed peptic ulcers. PMID:25569660

  18. Intraoperative and early postoperative complications using the buccal fat pad during cleft palate surgery in East Indonesia

    Directory of Open Access Journals (Sweden)

    Eveline Vere Konijnendijk

    2016-06-01

    Full Text Available Six baby’s with cleft are born in Indonesia every hour. There is no standardized treatment of cleft in East Indonesia. Closure is an important aspect during cleft lip and palate surgery. Various techniques have been advocated to gain tissue for closure of cleft area. Mostly these techniques may only provide a small amount of additional length. For lager defects they may be use the local flaps or the buccal fat pad flap. The aim of this study is gain more information about intraoperative and early postoperative complications using the buccal fat pat during cleft palate surgery in East Indonesia. The mouth can be divided in six parts therefor the LAHSAL index will be used. This LAHSAL system is a diagrammatic classification of cleft lip and palate. The LAHSAL system is being used for this study as this system classifies the cleft primarily on location and also on the cleft being complete or incomplete, which can be significant for the research. After diagnosis and classification, the following patient data was obtained: patient age, weight, gender, type of surgery (primary or following, i.e. when the surgery is a correction of a previous treatment, if a bone graft is needed for closure, history of maxillofacial surgery or orthodontics, operation technique, operation duration, type of an aesthesia (local or general, radiographical records and light photos. These data were collected during the pre-operative consultation, about 24 hours before surgery. It was the policy of the team to admit and see all patients one day prior to surgery for counselling, postoperative instructions and evaluating the patient's facial defect.

  19. Double-bundle anterior cruciate ligament reconstruction with and without remnant preservation - Comparison of early postoperative outcomes and complications.

    Science.gov (United States)

    Nakayama, Hiroshi; Kambara, Syunichiro; Iseki, Tomoya; Kanto, Ryo; Kurosaka, Kenji; Yoshiya, Shinichi

    2017-10-01

    To compare the early postoperative outcomes and complications of double-bundle anterior cruciate ligament (ACL) reconstruction with and without remnant preservation. The study population comprised 125 consecutive knees that underwent double-bundle ACL reconstruction using hamstring autograft. Among the 125 knees, remnant preservation was indicated for 50 knees, while standard double-bundle reconstruction was performed in the remaining 75 knees. Postoperative evaluations included heel-height difference (HHD) at periodical follow-ups, number of knees requiring arthroscopic debridement due to problematic extension loss within six months, re-injury within one year, graft status upon second-look arthroscopy, and clinical examinations by Lysholm score and KT measurement at one year. All patients could be followed up for a minimum of one year after surgery. When the results obtained from both groups were compared, HHD values were significantly larger in the preservation group at three and six months, and the rate of knees requiring arthroscopic debridement was also higher in this group (12% versus 4.0%). Graft status on second-look arthroscopy was considered to be good for 92% of the knees in the preservation group versus 59% in the non-preservation group. Re-injury rates within one year were 2.0% in the preservation group and 5.3% in the non-preservation group. No significant differences in clinical examinations were found between the groups at one year. Remnant preservation in double-bundle hamstring autograft ACL reconstruction may enhance tissue healing; however, retention of the remnant with its full volume resulted in an increased incidence of postoperative problematic extension loss. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Time course of changes in proinflammatory cytokines in infants born to women with complicated pregnancy in relation to the course of an early adaptation period

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    G. V. Yakornova

    2015-01-01

    Full Text Available Objective: to estimate the time course of changes in proinflammatory cytokines during early neonatal adaptation in infants born to women with complicated pregnancy. The authors examined 57 full-term infants born to women with complicated pregnancy, including 12 babies with the uncomplicated course of an early neonatal period, 24 neonates with the initial manifestations of maladjustment, and 21 infants with the complicated course of an early adaptation period that culminated in perinatal abnormality. A comparison group included 42 babies with the physiological course of an early adaptation period. The umbilical cord and peripheral blood levels of IL-ip, IL-6, and TNF-a were determined by an enzyme immunoassay on 1-3 and 5-7 days of life. The highest umbilical cord blood concentrations of IL-6 and TNF-a were noted in the uncomplicated course of an early neonatal period. At the same time, the level of IL-6 decreased within the first week of fife and that of TNF-a was unchanged. The concentration of IL-ip did not differ from that in the healthy babies. With the initial manifestations of maladjustment, the umbilical cord blood content of IL-ip was comparable with that in the healthy infants, the elevation in the concentrations of IL-6 and TNF-a was less pronounced than that in the neonates with an uncomplicated adaptation period. There was a statistically significantly increase in IL-ip, IL-6, and TNF-a levels in the dynamics of an early neonatal period. Obvious early maladjustment culminating in a disease was accompanied by elevated umbilical cord blood IL-ip and IL-6 levels with no changes in TNF-a. IL-6 hyperproduction persisted as long as 5—7 days of fife; the level of TNF-a significantly increased in the dynamics of an early neonatal period and that of IL-ip decreased at 5—7 days of fife.

  1. Early experience using an online reporting system for interventional radiology procedure-related complications integrated with a digital dictation system.

    Science.gov (United States)

    Gupta, Sanjay; Patel, Jay; McEnery, Kevin; Wallace, Michael J; Ahrar, Kamran; Suitor, Chuck; Hicks, Marshall E

    2011-08-01

    The absence of user-friendly systems for reporting complications is a major barrier to improving quality assurance (QA) programs in interventional radiology (IR) services. We describe the implementation of a QA application that is completely integrated with the radiology dictation system. We implemented an IR QA process as a module within the electronic medical record and radiologist dictation system applications used at our institution. After a radiologist completes a dictation, he or she must select from a drop-down list of complications before proceeding to the next case. Delayed QA events can be entered using the same applications. All complication entries are sent to a database, which is queried to run reports. During the study period, all the 20,034 interventional procedures were entered in the QA database, 1,144 complications were reported, 110 (9.6%) of which were classified as major. Although majority of the complications (996) were entered at the time of dictation, 148 complications (12.9%) were entered afterwards. All major complications were referred to the IR peer review committee, and 30 of these were discussed in the morbidity and mortality meetings. We studied post-lung-biopsy pneumothorax and chest tube rates and initiated a quality improvement process based on the results.The integration of the IR QA reporting system into the workflow process and the mandatory requirements for completion has the potential to minimize the work effort required to enter complication data, and improve participation in the QA process.

  2. [Early complications of endoscopic retrograde cholangiopancreatography performed from January 1998 to December 2000 at the Daniel Alcides Carrion National Hospital "ELCALLAO", Peru].

    Science.gov (United States)

    Gomez Ponce, Regina Luz

    2002-01-01

    The aim of this study was to determine the procedure characteristics of ERCP, indications and frequency of complications, as well as analyzing the associated risk factors. ERCPs carried out from January 1998 to December 2000 in the Gastroenterology Service of Daniel Alcides Carri n Hospital were evaluated retrospectively; 17 risk factors were analyzed. A total of 202 ERCPs were carried out in 182 patients, of which 70.3% were patients aged under 60 years and 66.5% were female patients. The most frequent indication was bile duct stone suspect (59.4%). Therapeutic ERCPs were carried out in 49.5% of total ERCPs, diagnostic ERCPs were 33.2%, and failure ERCPs 17.3%. Post-ERCP complications occurred in 5.9% (12 cases), and the most frequent were: acute pancreatitis 3.4% and hemorrhage 1%. There was no mortality case related with complications. A risk factor related with the procedure: pancreatic cannulation or pancreatic contrast injections reached the highest statistic significance (p= 0.063). Therapeutic or failed ERCPs presented significant higher frequency of complications than diagnostic ERCPs: (p=0.0085 and p=0.0381). the frequency of early post-ERCP complications is 5.9%, and has a direct relation with therapeutic or failed ERCPs. This marks a difference with regards to diagnostic ERCPs. There was no mortality, and pancreatic cannulation or pancreatic contrast injections would be able to determine the development of complications.

  3. Estado puerperal

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    Luiz Henrique Mazzonetto Mestieri

    2007-05-01

    Full Text Available O infanticídio – “lato sensu” – entendido como o assassinato de crianças nos primeiros anos de vida, é praticado em todos os continentes e por pessoas com diferentes níveis de complexidade cultural desde a antiguidade. Existe ampla evidência histórica para documentar a impressionante propensão de alguns pais a matarem seus próprios filhos sob a pressão de condições estressantes.

  4. A family history of serious complications due to BCG vaccination is a tool for the early diagnosis of severe primary immunodeficiency.

    Science.gov (United States)

    Roxo-Junior, Pérsio; Silva, Jorgete; Andrea, Mauro; Oliveira, Larissa; Ramalho, Fernando; Bezerra, Thiago; Nunes, Altacílio A

    2013-09-10

    Severe Combined Immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency (PID). Complications of BCG vaccination, especially disseminated infection and its most severe forms, are known to occur in immunodeficient patients, particularly in SCID. A carefully taken family history before BCG injection as well as delaying vaccination if PID is suspected could be a simple and effective method to avoid inappropriate vaccination of an immunodeficient child in some cases until the prospect of newborn screening for SCID has been fully developed. We describe a patient with a very early diagnosis of SCID, which was suspected on the basis of the previous death of two siblings younger than one year due to severe complications secondary to the BCG vaccine. We suggest that a family history of severe or fatal reactions to BCG should be included as a warning sign for an early diagnosis of SCID.

  5. Puerperal depression: the valuation given by the multidisciplinary health care team and perception of users

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    Lucas Bondezan Alvares

    2015-12-01

    Full Text Available Objective: the main objective of the present study was investigating two situations: how does the insert of discussion about postpartum depression (PD in Basic Health Units (inner city of Sao Paulo and measure the relevance that the multidisciplinary health team attribute to the issue. Method: it was a qualitative analysis. In this study health professionals and puerperal women were given a semi- structured questionnaire for the diagnosis and survey of reality. Results: the results showed no specific attention in PD at this city, including lack of spaces to discuss others issues, except the clinical obstetrical attention and dental care for pregnant women in prenatal care educational activities. From this fact it was possible to offer Continuing Education action and further evaluation to identify the impact. Conclusion: we conclude the need for investment in educational spaces of attention for pregnant women with to character information, but also time dedicated pregnant take your questions and also talk about their emotions and feelings.

  6. Non-puerperal mastitis masking pre-existing breast malignancy: Importance of follow-up imaging

    International Nuclear Information System (INIS)

    An, Jin Kyung; Woo, Jeong Joo; Lee, Seung A

    2016-01-01

    Mastitis is an inflammatory condition of the breast with common symptoms of pain, swelling, erythema, warmth, and fever. Diagnosis of mastitis is easily made on the basis of typical symptoms and ultrasonographic findings, such as diffusely increased echogenicity of the parenchyma and subcutaneous fat, or skin thickening. However, when it occurs in women middle-aged or older, associated malignancy should be considered. In our cases, we detected irregular hypoechoic malignant masses after the disappearance of inflammatory changes. Therefore, when non-puerperal women have inflammatory signs on their breast, follow-up imaging should be performed. In particular, in the case of persistent or growing palpability after the recovery of breast inflammation, percutaneous core biopsy and short-term follow-up with ultrasonography should be considered to exclude the associated malignancy

  7. Non-puerperal mastitis masking pre-existing breast malignancy: Importance of follow-up imaging

    Energy Technology Data Exchange (ETDEWEB)

    An, Jin Kyung; Woo, Jeong Joo; Lee, Seung A [Eulji General Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    Mastitis is an inflammatory condition of the breast with common symptoms of pain, swelling, erythema, warmth, and fever. Diagnosis of mastitis is easily made on the basis of typical symptoms and ultrasonographic findings, such as diffusely increased echogenicity of the parenchyma and subcutaneous fat, or skin thickening. However, when it occurs in women middle-aged or older, associated malignancy should be considered. In our cases, we detected irregular hypoechoic malignant masses after the disappearance of inflammatory changes. Therefore, when non-puerperal women have inflammatory signs on their breast, follow-up imaging should be performed. In particular, in the case of persistent or growing palpability after the recovery of breast inflammation, percutaneous core biopsy and short-term follow-up with ultrasonography should be considered to exclude the associated malignancy.

  8. Gastrocolic Fistula Presented as an Early Complication of Gastric Surgery in a 42-year-old Man.

    Science.gov (United States)

    Zahedi, Mohammad Javad; Shafiei Pour, Sara; Dehghani, Masood; Eslami, Nazanin

    2017-04-01

    Currently, surgery is less needed for the treatment of refractory peptic ulcer disease (PUD) or its complications. So, the complications of PUD surgery have been clearly declined. Here in, we present a 42-year-old man with chronic watery diarrhea and significant weight loss during 2 years after gastrojejunostomy for the treatment of obstructive PUD. Small bowel gastrointestinal series showed rapid transit without passage of contrast in the parts of small bowel. The patient was scheduled for exploratory laparotomy. During the surgery a large fistula was detected between the stomach and transverse colon, which was repaired. At the follow-up 6 months after the surgery, the patient did not have any history of recurrence of diarrhea and had 10 kg weight gain. Gastrocolic fistula is a very rare complication of surgical management of PUD. Barium enema is the most helpful imaging procedure for the diagnosis of gastrocolic fistula and surgery after correction of nutritional status is suggested especially for malnourished patients.

  9. Comparison of early and late intravenous gamma globulin treatment of Kawasaki disease on fever and cardiovascular complications.

    Science.gov (United States)

    Mohammadzadeh, Iraj; Noei, Somayyeh; Babazadeh, Kazem; Zamani, Hassan; Barari-Savadkoohi, Rahim; Alizadeh-Navaei, Reza

    2016-01-01

    Cardiac involvement was the major leading cause of death in patients with Kawasaki and IVIG administration reduces cardiac complications. The objective of this study was to determine the frequency of cardiovascular complications and duration of fever with regard to the time of intravenous immunoglobulin (IVIG) administration of patients with Kawasaki disease. This follow-up study was done on all patients with Kawasaki disease who were hospitalized at Amirkola Children's Hospital between 2006 and 2011. Diagnosis of Kawasaki was clinical and included fever more than 5 days with 4 of 5 signs containing mucosal changes, scaling and skin rash, bilateral nonexudative conjunctivitis, cervical lymph adenopathy and edema in lower extremities. After diagnosis of Kawasaki, all patients received standard treatment (intravenous immunoglobulins and aspirin) and undergoing cardiac echocardiography in 2 weeks, 2 months and 6 months. Information including age, sex, sign of diseases, laboratory findings, and cardiac complications in echocardiography were recorded. This study was performed on 100 patients (61 boys and 39 girls) with Kawasaki disease. The mean age of children was 2.8±2.6 years. Cardiac complication rate was 47% at the onset of the disease and had reached to 7% at the end of the sixth month (P=0.000). Distribution of cardiovascular complications in the second week, the second month and the sixth month after treatment was not significantly different according to the start of time of treatment (p>0.05). Duration of fever in patients who received treatment before 10 th day (1.5±1.3) did not have significant difference (P=0.78) with patients who received after 10 th day (1.6±0.9). Result shows that most of patients (99%) responded to the treatment with IVIG and ASA and cardiovascular complication ratio decreased. There was not significant relationship between duration of fever and time of IVIG treatment initiation.

  10. Early mobilization after ilio-inguinal lymph node dissection for melanoma does not increase the wound complication rate

    NARCIS (Netherlands)

    Wevers, K. P.; Poos, H. P. A. M.; van Ginkel, R. J.; van Etten, B.; Hoekstra, H. J.

    Aim: Ilio-inguinal lymph node dissection for stage III melanoma is accompanied by a substantial amount of wound complications. Our treatment protocols changed in time in terms of postoperative bed rest prescriptions, being in chronological order Group A: 10 days with a Bohler Braun splint, Group B:

  11. Asymptomatic and early pseudoaneurysm of posterior superior pancreaticoduodenal artery and right gastric artery complicating acute pancreatitis: A case report

    Directory of Open Access Journals (Sweden)

    Savino Occhionorelli

    2016-01-01

    Conclusion: It is important to be aware of pancreatitis-related arterial pseudoaneurysms, as they have a mortality of 90% if not recognized and treated, not only in chronic but also in acute pancreatitis, and to work out a scheduled follow-up with abdominal computed tomography or pancreatic contrast-enhanced ultrasound in order to control and prevent late onset complications.

  12. Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood

    DEFF Research Database (Denmark)

    Samuelsson, Ulf; Anderzén, Johan; Gudbjörnsdottir, Soffia

    2016-01-01

    AIMS: To compare metabolic control between males and females with type 1 diabetes during adolescence and as young adults, and relate it to microvascular complications. METHODS: Data concerning 4000 adolescents with type 1 diabetes registered in the Swedish paediatric diabetes quality registry, an...

  13. Appendicostomy in Preschool Children with Anorectal Malformation: Successful Early Bowel Management with a High Frequency of Minor Complications

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    Pernilla Stenström

    2013-01-01

    Full Text Available Aim. The aim of this study is to evaluate postoperatively bowel symptoms of antegrade colon enema through appendicostomies in preschool children with anorectal malformation (ARM. Method. 164 children with ARM operated on with posterior sagittal anorectal plasty were included. The malformations were classified according to Krickenbeck classification. Seventeen children in preschool age had an appendicostomy. The bowel symptoms according to the Krickenbeck follow-up were analysed pre- and postoperatively. All complications were registered. A questionnaire on the use of the appendicostomy was answered. Results. The median age (range at the time of the appendicostomy was 4 (1–6 years. The observation time was 5 (0.5–14 years. The main indications for appendicostomy were incontinence and noncompliance to rectal enemas. Postoperatively there was a significant decrease in soiling and constipation (P<0.001. The total complication rate was 43% with infections (29%, stenosis (12%, and retrograde leakage (0. The median time required for giving enema in the appendicostomy was 45 minutes (range: 15–120 once a day varying from 2 times/week to 3 times/day. And: complications are less frequent than in older children. Conclusion. Appendicostomy in preschool children with ARM is a way to achieve fecal cleanness before school start. The infection rate was high, but other complications are less frequent than in older children.

  14. A comparison between early maternal and neonatal complications of restrictive episiotomy and routine episiotomy in primiparous vaginal delivery

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    Azar Danesh Shahraki

    2011-01-01

    Conclusions: Restrictive episiotomy results in low maternal complications. Therefore, avoiding routine episiotomy in unnecessary conditions would increase the rate of intact perineal and minor perineal trauma and reduce postpartum delivery pain with no adverse effects neither on maternal nor neonatal morbidities.

  15. Extended complications of urethroplasty

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    Hosam S. Al-Qudah

    2005-08-01

    Full Text Available INTRODUCTION: An extensive study of complications following urethroplasty has never been published. We present 60 urethroplasty patients who were specifically questioned to determine every possible early and late complication. MATERIALS AND METHODS: Retrospective chart review of urethroplasty patients between August 2000 and March 2004. An "open format" questioning style allowed maximal patient reporting of all complications, no matter how minor. RESULTS: 60 patients underwent 62 urethroplasties (24 anterior anastomotic, 19 buccal mucosal and 10 fasciocutaneous, 9 posterior anastomotic with mean follow-up of 29 months. Early complications occurred in 40%, but only 3% were major (rectal injury and urosepsis. Early minor complications included scrotal swelling, scrotal ecchymosis and urinary urgency. Late complications occurred in 48%, but only 18% were significant (erectile dysfunction, chordee and fistula. Late minor complications included a feeling of wound tightness, scrotal numbness and urine spraying. Fasciocutaneous urethroplasty caused the most significant complications, and buccal mucus urethroplasty the least, while also resulting in the lowest recurrence rate (0%. CONCLUSIONS: Serious complications after urethroplasty (3% early and 18% late appear similar to those reported elsewhere, but minor bothersome complications appear to occur in much higher numbers than previously published (39% early and 40% late. While all the early complications were resolved and most (97% were minor, less than half of the late complications were resolved, although most (82% were minor. These complication rates should be considered when counseling urethroplasty patients, and generally tend to support the use of buccal mucosal onlay urethroplasty as it had the lowest rate of serious side effects.

  16. May Renal Resistive Index Be an Early Predictive Tool of Postoperative Complications in Major Surgery? Preliminary Results

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    Enrico Giustiniano

    2014-01-01

    Full Text Available Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI, measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70 and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3% showed RRI > 0.70. The total rate of adverse event was 27 (18.6% in RRI ≤ 0.7 group and 19 (31.7% in RRI > 0.7 group (P=0.042. Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P=0.016, septic shock (P=0.003, and acute renal failure (P=0.001 subgroups. Patients with RRI > 0.7 showed longer ICU stay (P=0.001 and lasting of mechanical ventilation (P=0.004. These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02–4.02, P=0.044 and in cardiothoracic (OR 2.62 95% CI 1.11–6.16, P=0.027 population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5–7.01; P=0.002.

  17. Hellp síndrome puerperal, uma patologia quase invisível

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    Henri Augusto Korkes

    2016-10-01

    Full Text Available Introdução: A síndrome HELLP é uma complicação grave da gravidez caracterizada por hemólise, aumento de enzimas hepáticas e baixa contagem de plaquetas, ocorrendo em 0,5% a 0,9% de todas as gestações. Cerca de 30% dos casos podem ocorrer após o parto, e a escassez de sintomas a tornam uma patologia fatal. Objetivo: Apresentar um caso clínico de Síndrome HELLP Puerperal com níveis pressóricos normais durante a gestação. Metodologia: O caso foi acompanhado no serviço de Obstetrícia e posteriormente na Unidade de Terapia Intensiva (UTI do Hospital Santa Lucinda de Sorocaba. A descrição do relato de caso foi embasada na literatura. Relato de Caso: Paciente de 24 anos, G2P2A0, puérpera de parto normal, não apresentou nenhuma patologia durante a gestação e foi acompanhada no serviço de baixo risco. No primeiro dia pós-parto, queixou-se de sangramento gengival. Ao exame físico apresentou pressão arterial elevada (160x100mmHg e quadro de icterícia. Foram solicitados exames laboratoriais que confirmaram HELLP com aumento de enzimas hepáticas, plaquetopenia e sinais de hemólise com hiperbilirrubinemia e anemia. A paciente evoluiu com falência renal e necessidade de diálise. Permaneceu sob cuidados intensivos por 8 dias, apresentando melhora clínica e normalização dos exames complementares. Conclusão: A HELLP Síndrome ou a pré-eclâmpsia ocorridas no período puerperal possuem índices elevados e alarmantes de mortalidade. Ressaltamos com esse relato a importância de se manter os profissionais assistentes sempre atentos para esse diagnóstico, que embora seja pouco frequente na prática clínica e muitas vezes pobre em sintomatologia é potencialmente fatal.

  18. Utility of Tissue Inhibitor Metalloproteinase-1 and Osteopontin as Prospective Biomarkers of Early Cardiovascular Complications in Type 2 Diabetes.

    Science.gov (United States)

    El-Din, Doaa Samir Salah; Amin, Ahmed Ibrahim; Egiza, Ahmed Osman

    2018-02-15

    This work investigated associations between tissue inhibitor metalloproteinase-1 and diabetic cardiovascular diseases in type 2 diabetic patients; also it investigated the role of osteopontin in the diagnosis of type 2 cardiovascular diabetes complications. These were examined on eighty subjects, divided into three groups as follows: twenty volunteer healthy control subjects, thirty type 2 diabetes mellitus (DM) patients, and thirty cardiovascular, diabetic patients. Full clinical measurements were carried out, and the expression level of tissue inhibitor metalloproteinase-1 in blood samples was analysed by real-time PCR, using gene-specific primer pairs. Also osteopontin concentrations had been measured by the enzyme-linked immunosorbent assay. Data were tested statistically by parametric tests. The concentrations of osteopontin and the expression levels of tissue inhibitor metalloproteinase-1 were significantly increased in diabetic and cardiovascular diabetic groups compared to control group also they were significantly increased in the cardiovascular diabetic group compared to the diabetic group. Tissue inhibitor metalloproteinase-1 and osteopontin concentrations were significantly increased in diabetic patients with cardiovascular complications than other groups.

  19. Association between hospital procedure volume and early complications after pacemaker implantation: results from a large, unselected, contemporary cohort of the German nationwide obligatory external quality assurance programme.

    Science.gov (United States)

    Nowak, Bernd; Tasche, Karl; Barnewold, Linda; Heller, Günther; Schmidt, Boris; Bordignon, Stefano; Chun, K R Julian; Fürnkranz, Alexander; Mehta, Rajendra H

    2015-05-01

    Several studies demonstrated an inverse relationship between cardioverter-defibrillator implantation volume and complication rates, suggesting better outcomes for higher volume centres. However, the association of institutional procedural volume with patient outcomes for permanent pacemaker (PPM) implantation remains less known, especially in decentralized implantation systems. We performed retrospective examination of data on patients undergoing PPM from the German obligatory quality assurance programme (2007-12) to evaluate the relationship of hospital PPM volume (categorized into quintiles of their mean annual volume) with risk-adjusted in-hospital surgical complications (composite of pneumothorax, haemothorax, pericardial effusion, or pocket haematoma, all requiring intervention, or device infection) and pacemaker lead dislocation. Overall 430 416 PPM implantations were documented in 1226 hospitals. Systems included dual (72.8%) and single (25.8%) chamber PPM and cardiac resynchronization therapy (CRT) devices (1.1%). Complications included surgical (0.92%), and ventricular (0.99%), and atrial (1.22%) lead dislocation. Despite an increase in relatively complex procedures (dual chamber, CRT), there was a significant decrease in the procedural and fluoroscopy times and complications from lowest to highest implantation volume quintiles (P for trend <0.0001). The greatest difference was observed between the lowest (1-50 implantations/year-reference group) and the second-lowest (51-90 implantations/year) quintile: surgical complications [odds ratio (OR) 0.69; confidence interval (CI) 0.60-0.78], atrial lead dislocations (OR 0.69; CI 0.59-0.80), and ventricular lead dislocations (OR 0.73; CI 0.63-0.84). Hospital annual PPM volume was directly related to indication-based implantation of relatively more complex PPM and yet inversely with procedural times and rates of early surgical complications and lead dislocations. Thus, our data suggest better performance and lower

  20. Not the Ceiling, but the Floor: Innovative Harlem Early Childhood Education Effort Complicated by Varying Government Regulations

    Science.gov (United States)

    Costa, Kristina

    2012-01-01

    This case study was produced in conjunction with the Center for American Progress's accompanying report on these issues, "Increasing the Effectiveness and Efficiency of Existing Public Investments in Early Childhood Education." This report establishes a set of policies and administrative changes on the federal level that will begin to…

  1. Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: A prospective observational study in adults

    NARCIS (Netherlands)

    M.E. van Genderen (Michel); J. Paauwe (Jaap); J. de Jonge (Jeroen); R.J.P. van der Valk (Ralf); A.A.P. Lima (Alexandre ); J. Bakker (Jan); J. van Bommel (Jasper)

    2014-01-01

    textabstractIntroduction: Altered peripheral perfusion is strongly associated with poor outcome in critically ill patients. We wanted to determine whether repeated assessments of peripheral perfusion during the days following surgery could help to early identify patients that are more likely to

  2. Postoperative Early Major and Minor Complications in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Meta-Analysis and Systematic Review.

    Science.gov (United States)

    Osland, Emma; Yunus, Rossita Mohamad; Khan, Shahjahan; Alodat, Tareq; Memon, Breda; Memon, Muhammed Ashraf

    2016-10-01

    Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage obesity-related chronic disease. The aim of this meta-analysis and systematic review was to compare the "early postoperative complication rate i.e. within 30-days" reported from randomized control trials (RCTs) comparing these two procedures. RCTs comparing the early complication rates following LVSG and LRYGB between 2000 and 2015 were selected from PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane database. The outcome variables analyzed included 30-day mortality, major and minor complications and interventions required for their management, length of hospital stay, readmission rates, operating time, and conversions from laparoscopic to open procedures. Six RCTs involving a total of 695 patients (LVSG n = 347, LRYGB n = 348) reported on early major complications. A statistically significant reduction in relative odds of early major complications favoring the LVSG procedure was noted (p = 0.05). Five RCTs representing 633 patients (LVSG n = 317, LRYGB n = 316) reported early minor complications. A non-statically significant reduction in relative odds of 29 % favoring the LVSG procedure was observed for early minor complications (p = 0.4). However, other outcomes directly related to complications which included reoperation rates, readmission rate, and 30-day mortality rate showed comparable effect size for both surgical procedures. This meta-analysis and systematic review of RCTs suggests that fewer early major and minor complications are associated with LVSG compared with LRYGB procedure. However, this does not translate into higher readmission rate, reoperation rate, or 30-day mortality for either procedure.

  3. Venous thromboembolism in pregnant and puerperal women in Denmark 1995-2005

    DEFF Research Database (Denmark)

    Virkus, R.A.; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas

    2011-01-01

    and in the postnatal period as compared to non-pregnant women. This was a historical controlled national cohort study. The National Registry of Patients identified relevant diagnoses. These data were linked to The National Registry of Medical Products Statistics for information about current use of oral contraceptives....... Danish women 15 to 49 years old during the period January 1995 through December 2005 were included in the study. In total 819,751 pregnant women were identified of whom 727 had a diagnosis of VTE. The absolute risk of VTE per 10,000 pregnancy-years increased from 4.1 (95% CI, 3.2 to 5.2) during week 1......–11 up to 59.0 (95% CI: 46.1 to 76.4) in week 40 and decreased in the puerperal period from 60.0 (95% CI:47.2–76.4) during the first week after birth to 2.1 (95% CI:1.1 to 4.2) during week 9–12 after birth. Compared with non-pregnant women, the incidence rate ratio rose from 1.5 (95% CI:1.1 to1...

  4. [Congenital megacolon in neonates and infants: impact of early, one-stage repair on morbidity and surgical complications].

    Science.gov (United States)

    Calisti, A; Molle, P H; Vallasciani, S

    2004-01-01

    Hirschsprung's disease (HD) is a major cause of congenital bowel obstruction in children. Classical management includes stoma creation, a pull-through procedure, and restoration of bowel continuity. Colostomy may be also pulled through directly at second operation. Since the first report of a single stage (SS) primary pull-through without colostomy for HD, in 1980, several patients have been treated according to this procedure, even in neonatal period. All of them had a favourable outcome with better compliance of families and less hospital stay. The Authors reviewed the clinical records of 22 patients selected among 36 treated for HD between 1992 and 2000; in all, disease extended to rectum-sigma-descendent; all cases of "total aganglionosis" or "ultra short" cases were excluded. Fifteen patients underwent SS repair: 11 neonates were operated at mean age of 69 days (range 14-172). In four infants diagnosis was made later (mean age 15 +/- 9 months) and SS repair was performed 8 days after (range 4-14). Seven patients underwent multiple stage (MS) repairs for clinical reasons: pull-through of the previous colostomy was performed at mean age of 171 days (range 47-330). A Duhamel procedure with an Endo-GIA linear stapler was performed in all No differences in gestational age or birth weight were found in both groups. Complications were observed only in the MS group (2 related to colostomy, 1 to postoperative adhesions). The Authors conclude that primary SS treatment of HD is safe and effective even in newborn patient, reduce familiar stress and hospital stay. The lower morbidity and complication rates could be explained by the limited bowel manipulation. Accurate histological-hystochemical diagnosis and meticulous preoperative bowel management should be part of the management.

  5. Early Complications of Immediate Loading in Edentulous Full-Arch Restorations: A Retrospective Analysis of 88 Cases.

    Science.gov (United States)

    Cercadillo-Ibarguren, Iñaki; Sánchez-Torres, Alba; Figueiredo, Rui; Valmaseda-Castellón, Eduard

    To describe the clinical outcomes and complications related to provisional prostheses after full-arch implant-supported rehabilitation by means of an immediate loading protocol. This retrospective cohort study included patients who were consecutively treated with full-arch implant-supported restorations with a minimum of four implants (Replace Select Tapered TiUnite, Nobel Biocare AB) per arch and conical abutments (multi-unit, Nobel Biocare AB) by means of an immediate loading protocol. The surgical procedures were performed between May 2006 and June 2014 by a single oral surgeon. Demographic, surgical, and prosthetic variables were collected, and biologic and mechanical complications were registered. A total of 61 maxillae (57%) and 46 mandibles (43%) were treated in 88 patients (40 men and 48 women) with a mean age of 62.4 years. A total of 558 implants were placed, 295 in postextraction sockets. A total of 331 implants (59.3%) were placed in the maxilla and 227 (40.7%) in the mandible. Within a 9-month period, 18 prostheses (16.8%) fractured (15 maxillary and 3 mandibular); in nine of these patients the opposing dentition was a full-arch, implant-supported restoration, and in the remaining nine patients, it was natural dentition. Six (1.1%) maxillary and three (0.5%) mandibular implants failed. A high implant survival rate is expected in the short term following this immediate loading protocol. Fracture of the provisional prosthesis is a common finding, affecting 17% of patients, and is significantly more prevalent in patients with bruxism and in maxillary prostheses.

  6. Circulating CD3+CD4+CD161+ Cells Are Associated with Early Complications after Autologous Stem Cell Transplantation in Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Sung-Eun Lee

    2018-01-01

    Full Text Available The aim of this study was to explore if measurement of pretransplant circulating CD161-expressing cells, in addition to clinical risk factors, could predict mucositis and infections in patients with multiple myeloma (MM undergoing autologous stem cell transplantation (ASCT. To determine if CD161-expressing cells are likely to predict early complications, namely, mucositis (≥grade 3, infections, and cytomegalovirus (CMV reactivation, we prospectively examined CD161-expressing cells (CD3+CD4+CD161+ and CD3+CD8+CD161+ in peripheral blood samples from 108 patients with MM undergoing ASCT. After adjusting for factors identified by univariate analysis that predicted mucositis (≥grade 3, infection before engraftment, and CMV reactivation, multivariate analyses revealed that the low proportion of CD3+CD4+CD161+ cells in peripheral blood was an independent predictor of mucositis (≥grade 3 (P=0.020, infections before engraftment (P=0.014, and CMV reactivation (P=0.010. In addition, we found that female sex and decreased glomerular filtration rate were independent factors for predicting mucositis. Female sex and severe pulmonary comorbidity were independent factors for predicting infection before engraftment. We found that the proportion of circulating CD3+CD4+CD161+ cells is useful for predicting the occurrence of early complications, including mucositis and infections, after ASCT in patients with MM.

  7. Early shunt complications in 46 children with hydrocephalus Complicações precoces de válvula de hidrocefalia em 46 crianças

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    Moisés Heleno Vieira Braga

    2009-06-01

    Full Text Available OBJECTIVE: To determine the causes of early shunt complications in 46 children with hydrocephalus. METHOD: A retrospective study was conducted on 46 children submitted to ventriculoperitoneal shunt surgery between February 2005 and February 2007. RESULTS: Thirteen (28% patients presented complications, which were due to infection in 9 (69% and to malfunction of the shunt system in 4 (31%.The mean number of surgical procedures performed on patients who presented complications was 2.8 per patient, with a total of 46 surgeries in this group. All patients with infectious complications were identified during their hospital stay. CONCLUSIONS: Infection was the most common complication. The infection rate was proportional to the length of hospital stay. All patients with hydrocephalus due to tumors or myelomeningocele presented complications. A higher incidence of infections was observed in children older than 2 years.OBJETIVO: Determinar e as causas das complicações precoces nas válvulas de hidrocefalia de 46 crianças. MÉTODO: Um estudo retrospectivo foi realizado com 46 crianças submetidas a colocação de válvula de hidrocefalia no período de fevereiro de 2005 a fevereiro de 2007. RESULTADOS: Obtivemos 13 (28% pacientes com complicações sendo 9 (69% causadas por infecção e 4 (31% por mal funcionamento da válvula de hidrocefalia. A média de procedimentos cirúrgicos realizados nos pacientes com complicações foi de 2,8 por paciente, sendo o total de 46 cirurgias neste grupo. Todos os pacientes com complicações infecciosas foram detectados durante a internação hospitalar. CONCLUSÕES: Infecção foi a complicação mais comum. O índice de infecção foi proporcional ao tempo de permanência hospitalar. Todos os pacientes portadores de hidrocefalia secundária a tumores ou mielomeningocele complicaram. As crianças maiores de 2 anos de idade tiveram maior incidência de infecções.

  8. Recurrent lung atelectasis from fibrin plugs as a very early complication of bronchial thermoplasty: a case report.

    Science.gov (United States)

    Facciolongo, Nicola; Menzella, Francesco; Lusuardi, Mirco; Piro, Roberto; Galeone, Carla; Castagnetti, Claudia; Cavazza, Alberto; Carbonelli, Cristiano; Zucchi, Luigi; Salsi, Pier Paolo

    2015-01-01

    Bronchial thermoplasty (BT) is a new therapeutic option for severe refractory asthma not controlled despite high dose inhaled corticosteroids plus long-acting bronchodilators and omalizumab in selected cases. Risk of pulmonary atelectasis after BT in severe asthma has been described in literature, but no details have been reported on the possible mechanisms of the complication. A 49-year-old male with severe uncontrolled asthma was referred to BT. One hour after the first procedure, acute respiratory failure occurred with PaO2/FiO2 bronchial epithelial cells. The originality of our case report is related to the recurrence of bronchial plugging with lobar atelectasis within one and five hours respectively, after two sequential BT procedures. At the histological evaluation the bronchial plugs appeared very different from the typical mucoid asthma plugs, being composed prevalently by fibrin. It can be hypothesized that intense thermal stimulation of the bronchial mucosa may represent a strong boost for inflammation in susceptible patients, with microvascular alteration induced directly by heat or through the release of mediators. Although in severe asthma a risk of atelectasis from the classical asthma mucoid plugs may be expected, the peculiarity of our case resides in the formation of fibrin plugs whose direct correlation with BT should be considered.

  9. Early appropriate parenteral antimicrobial treatment of complicated skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Napolitano, Lena M

    2008-01-01

    Complicated skin and soft tissue infections (cSSTIs) are a major clinical problem, in part because of the increasing resistance of infecting bacteria to our current antibiotic therapies. Prompt appropriate treatment of infections in hospitalized patients reduces the mortality rate. Furthermore, appropriate and timely antibiotic therapy improves outcomes for cSSTIs caused by methicillin-resistant Staphylococcus aureus (MRSA). This review delineates factors to consider in the choice of initial antibiotic treatment for cSSTIs and describes the antimicrobial agents available or under clinical development for the treatment of cSSTIs caused by MRSA. Review of the pertinent literature and recommendations. The choice of antimicrobial agent for empiric treatment of cSSTIs should be guided by the site and type of infection, the presence of an immunocompromised state or neutropenia, and risk factors for hospital-acquired MRSA (HA-MRSA) or community-associated MRSA (CA-MRSA) infection. Most CA-MRSA strains remain susceptible to ciprofloxacin, clindamycin, gentamicin, and trimethoprim/sulfamethoxazole, although resistance to clindamycin can emerge during treatment. Of the agents available for the treatment of HA-MRSA cSSTIs, vancomycin has been the reference standard, but clinical failures have been reported increasingly. Alternative agents for HA-MRSA include linezolid, which has been well-studied for treatment of cSSTIs, as well as daptomycin and tigecycline. A number of antibiotic agents are undergoing clinical trials or are under development for the treatment of cSSTIs caused by MRSA. Severe and progressive cSSTIs should be treated promptly with appropriate antibiotic agents. The choice of agent should be guided by a number of factors, including suspected CA-MRSA or HA-MRSA infection. Available agents should be evaluated carefully for efficacy in the treatment of MRSA cSSTIs.

  10. Prevalence of toxoplasmosis, HIV, syphilis and rubella in a population of puerperal women using Whatman 903® filter paper

    Directory of Open Access Journals (Sweden)

    José Mauro Madi

    Full Text Available OBJECTIVES: to determine the seroprevalence rate of toxoplasmosis, HIV, syphilis and rubella in a population of puerperal women. METHODS: a prospective, cross-sectional study was performed from February 2007 to April 2008 at Hospital Geral, Universidade de Caxias do Sul in a population of 1,510 puerperal women. Women that gave birth to live born or stillborn infants were included in the study; maternal and perinatal variables were analyzed. Descriptive statistics and Pearson's chi-square with occasional Fisher's correction were used for comparisons. Alpha was set in 5%. RESULTS: a total of 148 cases of congenital infection (9.8% were identified: 66 cases of syphilis (4.4%, 40 cases of HIV (2.7%, 27 cases of toxoplasmosis (1.8% and 15 cases of rubella (1.0%. In ten cases there was co-infection (four cases of HIV and syphilis, two cases of HIV and rubella, one case of HIV and toxoplasmosis, two cases of rubella and syphilis, and one case of toxoplasmosis and rubella. In a comparison between puerperal women with and without infection there was no statistical significance in relation to incidence of abortions, small for gestational age, prematurity, live births and stillbirths, and prenatal care. Need of neonatal intensive care unit (NICU, maternal schooling, maternal age higher than 35 years and drug use (alcohol, cocaine and crack had statistical significance. CONCLUSION: the prevalence rate of infections was 9.8%. Need of NICU, maternal schooling lower than eight years, maternal age higher than 35 years and drug use were significantly associated with occurrence of congenital infection.

  11. Prevalence of toxoplasmosis, HIV, syphilis and rubella in a population of puerperal women using Whatman 903 filter paper.

    Science.gov (United States)

    Madi, José Mauro; Souza, Ricardo da Silva de; Araújo, Breno Fauth de; Oliveira Filho, Petrônio Fagundes de; Rombaldi, Renato Luís; Mitchell, Charles; Lorencetti, Jucemara; Marcon, Nathalia Oliva

    2010-01-01

    to determine the seroprevalence rate of toxoplasmosis, HIV, syphilis and rubella in a population of puerperal women. a prospective, cross-sectional study was performed from February 2007 to April 2008 at Hospital Geral, Universidade de Caxias do Sul in a population of 1,510 puerperal women. Women that gave birth to live born or stillborn infants were included in the study; maternal and perinatal variables were analyzed. Descriptive statistics and Pearson's chi-square with occasional Fisher's correction were used for comparisons. Alpha was set in 5%. a total of 148 cases of congenital infection (9.8%) were identified: 66 cases of syphilis (4.4%), 40 cases of HIV (2.7%), 27 cases of toxoplasmosis (1.8%) and 15 cases of rubella (1.0%). In ten cases there was co-infection (four cases of HIV and syphilis, two cases of HIV and rubella, one case of HIV and toxoplasmosis, two cases of rubella and syphilis, and one case of toxoplasmosis and rubella). In a comparison between puerperal women with and without infection there was no statistical significance in relation to incidence of abortions, small for gestational age, prematurity, live births and stillbirths, and prenatal care. Need of neonatal intensive care unit (NICU), maternal schooling, maternal age higher than 35 years and drug use (alcohol, cocaine and crack) had statistical significance. the prevalence rate of infections was 9.8%. Need of NICU, maternal schooling lower than eight years, maternal age higher than 35 years and drug use were significantly associated with occurrence of congenital infection.

  12. RESEARCHES CONCERNING THE HISTOCHEMISTRY AND MICROBIAL FLORA OF THE PUERPERAL UTERUS IN COWS

    Directory of Open Access Journals (Sweden)

    I GROZA

    2002-07-01

    Full Text Available The microbial population represents a group of heterogeneous germs comprising several different species which live and act together in the same place. The communities of micro-organisms, as independent population groups, are better adapted for growing than a unique species. The microbial flora of the puerperal uterus differs from case to case, being represented both as bacteria admitted as pathogenic and particular tropism for the uterine morphological structures and opportunist bacteria which are quite numerous. Here are some of the microbial identified species: Streptococcus spp., E.coli, C.pyogenes . These exercise the pathogenic action under certain circumstances such as: the existence of these germs in big quantities, virulence and the high rate of pathogenity, the low resistence of the body. The experimental and epidemiological observations have proved the fact that autochthonous microorganisms (the normal, permanent microflora, adapted to develop in certain natural habitats, exercise a barrier function which protects the animal organisms from the implantation of several microorganisms which penetrate in the outer environment. The necrotic processes at the level of the uterine mucous membrane were at different stages of evolution in all the cases in question with big or even huge differences from one geographical area to another one. In some geographical areas the alternative processes were obvious only at the surface of the mucous membrane, with the affecting of the cells and area placed close under the basic membrane, while the epithelium although it seemed obviously affected, was not detached from the basic membrane. The cells of the uterine mucous membrane seemed detached here and there either under the form of groups taking up small areas, or in big areas alternating with zones where the epithelium was still partially preserved and, eventually extensive areas, completely without mucuos membrane, where even traits of cells at the level

  13. Postpartum practices of puerperal women and their influencing factors in three regions of Hubei, China

    Directory of Open Access Journals (Sweden)

    Chen Banghua

    2006-11-01

    Full Text Available Abstract Background 'Sitting month' is a Chinese tradition for women's postpartum custom. The present study aims to explore the postpartum dietary and health practices of puerperal women and identify their influential factors in three selected regions of Hubei, China. Methods A cross-sectional retrospective study was conducted in the selected urban, suburban and rural areas in the province of Hubei from 1 March to 30 May 2003. A total of 2100 women who had given birth to full-term singleton infants in the past two years were selected as the participants. Data regarding postpartum practices and potentially related factors were collected through questionnaire by trained investigators. Results During the puerperium, 18% of the participants never ate vegetables, 78.8% never ate fruit and 75.7% never drank milk. Behaviour taboos such as no bathing, no hair washing or teeth brushing were still popular among the participants. About half of the women didn't get out of the bed two days after giving birth. The average time they stayed in bed during this period was 18.0 h. One third of them didn't have any outdoor activities in that time periods. The educational background of both women and their spouses, location of their residence, family income, postnatal visit, nutrition and health care educational courses were found to be the influencing factors of women's postpartum practices. Conclusion Traditional postpartum dietary and health behaviours were still popular among women in Hubei. Identifying the factors associated with traditional postpartum practices is critical to develop better targeting health education programs. Updated Information regarding postpartum dietary and health practices should be disseminated to women.

  14. Psicosis puerperal. Panorama general sobre su diagnóstico, etiología e interpretación

    Directory of Open Access Journals (Sweden)

    P.J. González-Castro

    2016-01-01

    Mediante este artículo se desea realizar una revisión histórica y clínica sobre el debate acerca del diagnóstico, la etiología y las diferentes interpretaciones de los quiebres psicóticos desencadenados en el periodo puerperal a fin de poder brindar un panorama general sobre esta patología que cobra cada vez más interés en la psiquiatría, en la psicología y en la obstetricia.

  15. Early versus Late Application of Subthalamic deep brain Stimulation to Parkinson's disease patients with motor complications (ELASS): protocol of a multicentre, prospective and observational study.

    Science.gov (United States)

    Jiang, Lulu; Poon, Wai Sang; Moro, Elena; Xian, Wenbiao; Yang, Chao; Zhu, Xian Lun; Gu, Jing; Cai, Xiaodong; Liu, Jinlong; Mok, Vincent; Liu, Yanmei; Xu, Shaohua; Guo, Qiyu; Chen, Wanru; Chen, Ling

    2017-11-16

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established surgical treatment for Parkinson's disease (PD). However, there is currently no consensus on the best timing for this surgery. The aim of our study is to compare the therapeutic efficacy of bilateral STN DBS in patients with PD with early and late motor complications. 200 patients with PD will be enrolled in this multicentre, prospective, observational study, and will be followed up for 4 years. Patients with PD who meet the criteria for STN DBS surgery will be allocated to either the early stimulation group or the late stimulation group based on the duration of their motor complications. The primary outcome will be changes in quality of life from baseline to 4 years, measured using the 39-item Parkinson's Disease Questionnaire Summary Index. The secondary outcomes include changes in motor function measured using Movement Disorder Society-revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, self-reported experiences of daily living measured using MDS-UPDRS Part I B and Part II, good 'on' time recorded by the patients using a diary and safety profile of both groups. The study received ethical approval from the Medical Ethical Committee of the First Affiliated Hospital, Sun Yat-sen University. The results of this study will be published in peer-reviewed journals and presented at international conferences. NCT01922388; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor positive early stage breast cancer

    International Nuclear Information System (INIS)

    Fowble, B.; Fein, D.A.; Hanlon, A.L.; Eisenberg, B.L.; Hoffman, J.P.; Sigurdson, E.R.; Daly, M.B.; Goldstein, L.J.

    1995-01-01

    -specific survival for axillary node positive patients with tam. There was no significant survival benefit with tam for node negative patients in this retrospective series. Tam had little adverse effect on cosmesis except for patients receiving treatment to the breast and regional nodes. Tam did not increase the risk of complications, i.e., pneumonitis, rib fracture, arm edema, however, breast edema and cellulitis were more common in patients receiving tam

  17. Reduction in incidence of early fatal complications of high-dose chemotherapy with autologous hematopoietic stem cell transplantation in Hodgkin lymphoma patients

    Directory of Open Access Journals (Sweden)

    N. V. Zhukov

    2014-07-01

    Full Text Available Traditionally, the concern of fatal complication is a major obstacle to transfer patients with unfavorable course of Hodgkin’s lymphoma tonational transplantation centers. Early mortality after high-dose chemotherapy with autologous hematopoietic stem cell transplantation(HSCT in the Russia, Ukraine and Belarus was assessed in this retrospective multicenter study.Patients and methods. The study included 372 patients with unfavorable course of Hodgkin’s lymphoma received HSCT between 01.1990and 06.2013: 35.5 % patients with primary resistance, 30.6 % with early relapse, 33.1 % with late relapse and 0.8 % during consolidation offirst complete remission.Results. During first 100 days after HSCT died 14 (3.8 % patients, during first year – 31 (8.4 % patients. During the study period a significant decrease in the 100-day and 1-year mortality rate was observed (p < 0.0001 for both. Among patients received HSCT in 1990–1995, 1996–2000, 2001–2005 and 2006–2013 the 100-day mortality was 19.4 %, 6.3 %, 1.1 % and 0.6 %, respectively. 1-year mortality for the same intervals was 32.3 %, 14.7 %, 4.5 % and 1.9 %, respectively.Conclusions. Currently HSCT in patients with unfavorable course of Hodgkin's lymphoma in national transplant centers, accompanied by an extremely low risk of fatal toxicity.

  18. The role of extended field radiation therapy in early stage cervical carcinoma with para-aortic metastases - a study of survival impact and complication rates

    International Nuclear Information System (INIS)

    Chang, John H.C.; Cunningham, Mary J.; Morgan, Mark A.; King, Stephanie A.; Benjamin, Ivor; Rubin, Stephen C.; Mikuta, John; Stevens, Craig

    1997-01-01

    Purpose/Objective: Para-aortic lymph node metastases are found pathologically in ten to thirteen percent of all early stage cervical cancer patients at the time of radical hysterectomy. The treatment of these patients, technically with stage IVB disease, has been controversial. Since para-aortic nodal metastases preclude the need for radical hysterectomy, definitive radiation therapy is usually pursued. Extended field radiation therapy has improved survival in our previously reported series of patients with early stage cervical cancer and para-aortic metastases. In this report, we describe the results of additional follow up and included additional patients in order to study long term outcome, and complications associated with extended field radiation therapy. Materials and Methods: From January 1, 1960 to Nov 31, 1996, six hundred and forty-eight patients with clinically early stage carcinoma of the cervix were surgically explored at the Hospital of the University of Pennsylvania with the purpose of performing a radical hysterectomy. Approximately six percent of these patients were found to have histological documentation of para-aortic nodal metastases. Over ninety percent received extended field external beam radiation therapy with curative intent. This study describes the results in this treated population. Results: Approximately forty percent of those treated have survived greater than five years. Seven have been followed for more than ten years. Long term complications of treatment include radiation enteritis, cystitis, vesico-vaginal fistulae, enteric fistulae, and bowel obstruction. One treatment related death (multiple fistulas and sepsis) was documented at ten months after diagnosis and 6 months after radiation treatments. The major morbidity rate was approximately twenty percent. However, the majority of these patients underwent transperitoneal lymph node dissections and/or relatively high (>55Gy) doses to the PA nodes. Conclusions: Carcinoma of the

  19. Perceptions about the hospital environment from the perspective of high-risk puerperal women based on Florence Nightingale's theory

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    Ariane Thaise Frello Roque

    Full Text Available Objective: to understand the perceptions of high-risk puerperal women about the hospital environment based on Florence Nightingale's theory. High-risk postpartum period is the period of time when post-partum women care for their babies in the neonatal ICU, and experience high stress levels. Methods: it is a qualitative study with narrative approach based on Florence Nightingale's theory, conducted at a public institution in southern Brazil, from January to March 2010. Seven mothers over 18 years with newborns admitted to the neonatal ICU were the research subjects. Results: the contextualization of their narratives, the caring environment in which they experienced this particular stage in their lives, indicates that high-risk puerperal women seek ties and support. Conclusions: the challenge of spending an indefinite period of time in a strange environment, away from home, with their babies under the care of health professionals, while apart from their relatives, highlights the need for nursing care during this stage.

  20. Diagnosis of acute puerperal metritis by electronic nose device analysis of vaginal discharge in dairy cows.

    Science.gov (United States)

    Burfeind, O; Bruins, M; Bos, A; Sannmann, I; Voigtsberger, R; Heuwieser, W

    2014-07-01

    The objective of this study was to estimate the diagnostic accuracy of an electronic nose device using vaginal discharge samples to diagnose acute puerperal metritis (APM) in dairy cows. Uterine fluid was sampled manually with a gloved hand and under sterile conditions for electronic nose device analysis (day in milk (DIM) 2, 5, and 10) and bacteriologic examination (DIM 5), respectively, and on additional days, if APM was diagnosed during the daily clinical examinations. A dataset containing samples from 70 cows was used to create a model and to validate the APM status predicted by this model, respectively. Half of the dataset (n = 35; 14 healthy and 21 metritic cows) was provided with information regarding the APM diagnosis and contained all three measurements (DIM 2, 5, and 10) for each cow and was used as a training set whereas the second half was blinded (n = 35; 14 healthy and 21 metritic cows) and contained only the samples collected on DIM 5 of each cow and was used to validate the created prediction model. A receiver operating characteristic curve was calculated using the prediction results of the validation test. The best observed sensitivity was 100% with specificity of 91.6% when using a threshold value of 0.3. The calculated P-value for the receiver operating characteristic curve was less than 0.01. Overall, Escherichia coli was isolated in eight of 28 (28.6%) and 22 of 42 (52.4%) samples collected from healthy and metritic cows, respectively. Trueperella pyogenes and Fusobacterium necrophorum were isolated in 14 and six of 28 (50.0% and 21.4%) and 17 and 16 of 42 (40.5% and 38.1%) samples collected from healthy and metritic cows, respectively. The prevalence of Escherichia coli and Trueperella pyogenes was similar in the samples obtained from metritic cows used for the training set and the validation test. The results are promising especially because of the objective nature of the measurements obtained by the electronic nose device. Copyright

  1. Absceso mamario no puerperal por Finegoldia magna Nonpuerperal breast abscess caused by Finegoldia magna

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    L. Castello

    2007-06-01

    Full Text Available Finegoldia magna son cocos gram-positivos anaerobios estrictos, cuyas células se disponen en pares, tétradas y acúmulos. Forman parte de la flora normal de la piel, tractos gastrointestinal y genitourinario femeninos, y cavidad oral. La especie se caracteriza por ser asacarolítica y su principal fuente de energía la constituyen aminoácidos y peptonas. Por lo general se la aísla en cultivos polimicrobianos a partir de abscesos y otras infecciones de piel y partes blandas, huesos y articulaciones. En el caso descrito, F. magna fue recuperada en cultivo monomicrobiano, a partir de un absceso mamario no puerperal, que se agrega a los dos casos comunicados en la literatura. La identificación se realizó mediante la determinación de la sensibilidad a los discos de potencia especial, pruebas convencionales, y producción de enzimas sacarolíticas y proteol��ticas. Se efectuó la prueba de sensibilidad a los antimicrobianos por el método epsilométrico. Los agentes ensayados y los valores de CIM (µg/ml obtenidos fueron: penicilina, 0,064; cefalotina, 1; metronidazol, 0,25; minociclina, Finegoldia magna is a species of strictly anaerobic gram-positive cocci, arranged in pairs, tetrads, and clusters. These organisms are components of the normal flora of the skin, gastrointestinal and genitourinary female tracts, and oral cavity. They are asaccharolytic and their major energy sources are aminoacids and peptones. The species is usually isolated in polymicrobial cultures from abscesses, soft tissue infections, bone and joints. In the case herein presented, F. magna was recovered in pure culture from a nonpuerperal breast abscess, which adds to the two reported cases in related literature. Species identification was performed by special potency disks, standard bacteriological anaerobic tests, and production of saccharolytic and proteolytic enzymes. Antimicrobial susceptibility testing was performed by using the epsilometric test. The agents

  2. Reduction of postoperative complication rate with the use of early oral feeding in gynecologic oncologic patients undergoing a major surgery: a randomized controlled trial.

    Science.gov (United States)

    Minig, Lucas; Biffi, Roberto; Zanagnolo, Vanna; Attanasio, Anna; Beltrami, Carmen; Bocciolone, Luca; Botteri, Edoardo; Colombo, Nicoletta; Iodice, Simona; Landoni, Fabio; Peiretti, Michele; Roviglione, Giovanni; Maggioni, Angelo

    2009-11-01

    A randomized controlled trial was performed to assess the outcome of early oral postoperative feeding (EOF) compared with traditional oral feeding (TOF) in gynecologic oncology patients undergoing a complex laparotomy, including upper abdominal surgery. Patients aged 18-75 years, undergoing an elective laparotomy and with a preoperative suspicion of gynecologic malignancy, were eligible. Exclusion criteria included infectious conditions, intestinal obstruction, severe malnutrition, American Society of Anesthesiologists score C4, intestinal resection, and postoperative stay in the intensive care unit lasting 24 h. Patients allocated to EOF received liquid diet in the first postoperative day and then regular diet. Patients received traditional feeding scheme until resolution of postoperative ileus to start liquid diet. The primary end-point of the trial was length of hospital stay. Between January 1, 2007, and November 17, 2007, a total of 143 patients were randomized to receive either EOF or TOF. Hospital stay for patients who received EOF (n=71) was 4.7 vs. 5.8 days for the TOF group (n=72) (P=0.006). The mean level of postoperative satisfaction was significantly higher in the EOF group (82.8 vs. 71.7 mm, P B 0.001). Patients who received the TOF scheme had significantly higher overall postoperative complications (39 vs. 17% in EOF group, P=0.003) and infective complications (14% in TOF group vs. 3% in EOF group, P=0.017). Variables such as nausea and vomiting, analgesic and antiemetic requirement as well as level of pain and quality of life were not different between groups. On the basis of these findings, the policy of EOF should be used after a complex gynecologic oncologic laparotomy.

  3. Neurologic complications of bariatric surgery.

    Science.gov (United States)

    Kumar, Neeraj

    2014-06-01

    The increasing utilization of bariatric surgery has been accompanied by an increased incidence and awareness of related neurologic complications. The purpose of this review is to provide up-to-date information on the neurologic complications related to bariatric surgery. Neurologic complications related to bariatric surgery are predominantly due to nutrient deficiencies. Common early complications include Wernicke encephalopathy due to thiamine deficiency, and late complications include myelopathy or myeloneuropathy due to vitamin B12 or copper deficiency. Early recognition and prompt institution of treatment is essential to prevent long-term disability. Often, life-long supplementation may be required.

  4. Complications of nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Se Jin Park

    2011-08-01

    Full Text Available Nephrotic syndrome (NS is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox, thromboembolism (e.g., venous thromboembolism and pulmonary embolism, hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension, cardiovascular problems (e.g., hyperlipidemia, acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception. The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

  5. Avaliação da função hepática e do lipidograma no período puerperal e pós-puerperal e suas inter-relações com os distúrbios reprodutivos de fêmeas bovinas da raça Holandesa, criadas no Estado de São Paulo

    OpenAIRE

    Regiane Machado de Souza

    2005-01-01

    Com o objetivo de avaliar a influência do puerpério fisiológico e da fase pós-puerperal de vacas sadias na função hepática e no lipidograma , bem como avaliar as suas inter-relações com alguns distúrbios reprodutivos do puerpério recente (endometrite puerperal aguda e retenção dos anexos fetais); do puerpério tardio (catarros genitais de graus I e II e graus III e IV) e da fase pós puerperal (cisto ovariano e número de inseminações artificiais necessárias para que a vaca ficasse prenhe) foram...

  6. Early diagnosis of congenital vascular malformation as a condition to rapid prevention of complications – case study

    Directory of Open Access Journals (Sweden)

    Dominika Jaguś

    2017-06-01

    Full Text Available Klippel–Trénaunay syndrome is a rare congenital condition characterised by a triad of symptoms: capillary-lymphatic-venous malformations, varicose veins and venous malformations as well as soft tissue and skeletal hypertrophy of the affected limb. In this article, we present a case of a 5-year-old boy with extensive vascular malformations of the lower limbs and the buttock region. In this case, manifestation of all three symptoms was gradual. At the age of 4 years, the patient was admitted to the Department of Imaging Diagnostics for further diagnosis, where the triad characteristic for Klippel–Trénaunay syndrome and popliteal vein agenesis were diagnosed. Currently, a multidisciplinary team takes care of the boy in the Children’s Memorial Health Institute. Early and accurate diagnosis allows for rapid prevention of complications associated with Klippel–Trénaunay syndrome and enables patient-tailored treatment.

  7. Discordance between MRI and bone scan findings in a child with acute complicated osteomyelitis: scintigraphic features that contribute to the early diagnosis.

    Science.gov (United States)

    Mpalaris, V; Arsos, G; Iakovou, I; Dalpa, E; Karatzas, N

    2014-01-01

    Early diagnosis and prompt treatment of acute osteomyelitis are of paramount importance in children because they can prevent irreversible bone damage. Magnetic resonance imaging (MRI) with its superior spatial resolution and lack of ionizing radiation is routinely preferred over bone scan for this purpose. Increased blood flow, hyperemia and focally increased tracer uptake shown by "three phase" bone scan are the typical scintigraphic findings of acute osteomyelitis. In addition, diffuse uptake along the shaft of long bones and focal "cold" lesions are two special features that may be highly suggestive of infective periostitis, soft tissue sepsis and subperiosteal abscess formation, due to the loose attachment of periosteum to bone during childhood. We present a case of complicated osteomyelitis in a child with inconclusive MRI correctly diagnosed on the basis of these special scintigraphic findings resulting in treatment change from double i.v. Vancomycin--Ceftriaxone scheme to surgical intervention. Copyright © 2013 Elsevier España, S.L. y SEMNIM. All rights reserved.

  8. Early-switch/early-discharge opportunities for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections: proof of concept in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    El Houfi A

    2015-06-01

    Full Text Available Ashraf El Houfi,1 Nadeem Javed,2 Caitlyn T Solem,3 Cynthia Macahilig,4 Jennifer M Stephens,3 Nirvana Raghubir,5 Richard Chambers,6 Jim Z Li,7 Seema Haider81Dubai Hospital, Dubai, UAE; 2Rashid Hospital, Dubai, UAE; 3Pharmerit International, Bethesda, MD, USA; 4Medical Data Analytics, Parsippany, NJ, USA; 5Pfizer, New York, NY, USA; 6Pfizer, Collegeville, PA, USA; 7Pfizer, La Jolla, CA, USA; 8Pfizer, Groton, CT, USAObjectives: To describe real-world treatment patterns and health care resource use and to estimate opportunities for early-switch (ES from intravenous (IV to oral (PO antibiotics and early-discharge (ED for patients hospitalized in the United Arab Emirates (UAE with methicillin-resistant Staphylococcus aureus (MRSA complicated skin and soft tissue infections.Methods: This retrospective observational medical chart review study enrolled physicians from four UAE sites to collect data for 24 patients with documented MRSA complicated skin and soft tissue infections, hospitalized between July 2010 and June 2011, and discharged alive by July 2011. Data include clinical characteristics and outcomes, hospital length of stay (LOS, MRSA-targeted IV and PO antibiotic use, and ES and ED eligibility using literature-based and expert-validated criteria.Results: Five included patients (20.8% were switched from IV to PO antibiotics while being inpatients. Actual length of MRSA-active treatment was 10.8±7.0 days, with 9.8±6.6 days of IV therapy. Patients were hospitalized for a mean 13.9±9.3 days. The most frequent initial MRSA-active therapies used were vancomycin (37.5%, linezolid (16.7%, and clindamycin (16.7%. Eight patients were discharged with MRSA-active antibiotics, with linezolid prescribed most frequently (n=3; 37.5%. Fifteen patients (62.5% met ES criteria and potentially could have discontinued IV therapy 8.3±6.0 days sooner, and eight (33.3% met ED criteria and potentially could have been discharged 10.9±5.8 days earlier

  9. Early-switch/early-discharge opportunities for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections: proof of concept in the United Arab Emirates.

    Science.gov (United States)

    El Houfi, Ashraf; Javed, Nadeem; Solem, Caitlyn T; Macahilig, Cynthia; Stephens, Jennifer M; Raghubir, Nirvana; Chambers, Richard; Li, Jim Z; Haider, Seema

    2015-01-01

    To describe real-world treatment patterns and health care resource use and to estimate opportunities for early-switch (ES) from intravenous (IV) to oral (PO) antibiotics and early-discharge (ED) for patients hospitalized in the United Arab Emirates (UAE) with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections. This retrospective observational medical chart review study enrolled physicians from four UAE sites to collect data for 24 patients with documented MRSA complicated skin and soft tissue infections, hospitalized between July 2010 and June 2011, and discharged alive by July 2011. Data include clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and PO antibiotic use, and ES and ED eligibility using literature-based and expert-validated criteria. Five included patients (20.8%) were switched from IV to PO antibiotics while being inpatients. Actual length of MRSA-active treatment was 10.8±7.0 days, with 9.8±6.6 days of IV therapy. Patients were hospitalized for a mean 13.9±9.3 days. The most frequent initial MRSA-active therapies used were vancomycin (37.5%), linezolid (16.7%), and clindamycin (16.7%). Eight patients were discharged with MRSA-active antibiotics, with linezolid prescribed most frequently (n=3; 37.5%). Fifteen patients (62.5%) met ES criteria and potentially could have discontinued IV therapy 8.3±6.0 days sooner, and eight (33.3%) met ED criteria and potentially could have been discharged 10.9±5.8 days earlier. While approximately one-fifth of patients were switched from IV to PO antibiotics in the UAE, there were clear opportunities for further optimization of health care resource use. Over half of UAE patients hospitalized for MRSA complicated skin and soft tissue infections could be eligible for ES, with one-third eligible for ED opportunities, resulting in substantial potential for reductions in IV days and bed days.

  10. Postpartum complications

    International Nuclear Information System (INIS)

    Kronthal, A.J.; Kuhlman, J.E.; Fishman, E.K.

    1990-01-01

    This paper reports the CT findings of major postpartum complications and determine what role CT plays in their evaluation. The CT scans of nine patients with major postpartum complications were retrospectively reviewed. Patients had been referred to CT for evaluation of postpartum fever, abdominal pain, and elevated results of liver function tests. Complications identified at CT included hepatic infarctions (n = 2), endometritis (n = 2), postoperative wound abscess (n = 1), massive abdominal hemorrhage (n = 1), septic thrombophlebitis (n = 1), and renal vein thrombosis (n = 1). CT findings of hepatic infarction included wedge-shaped areas of decreased enhancement conforming to a vascular distribution

  11. Non-puerperal induced lactation: an infant feeding option in paediatric HIV/AIDS in tropical Africa.

    Science.gov (United States)

    Ogunlesi, Tinuade A; Adekanmbi, Folasade A; Fetuga, Bolanle M; Ogundeyi, Mojisola M

    2008-09-01

    A major problem in the management of infants exposed to HIV is the issue of feeding, which stems from the need to avoid transmission of the virus via breast milk. Other important issues in the nutrition of infants exposed to the virus include severe maternal illness, which makes suckling extremely difficult, and feeding orphans. Wet nursing is one of the recommended steps in addressing the feeding problems of such infants but for reasons of sociocultural disapproval, it appears not to be popular in traditional African settings. Non-puerperal induced lactation or re-lactation of a close relation, usually a grandmother, which hitherto has been used to rehabilitate severely malnourished motherless infants, may be equally useful. The procedure of re-lactation and the limitations of the method are highlighted. Also, the need to employ information, education and communication in improving the sociocultural acceptability of this veritable infant feeding method in tropical Africa is discussed.

  12. Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

    International Nuclear Information System (INIS)

    Garcia Egea, Jorge; Lara Guerrero, Isabel; Fustero Aznar, Jose Miguel; Hermoso Cuenca, Vicente; Velez Lomana, Abel

    2011-01-01

    The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatment included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic syndrome and reworsening of the edema leading to its admission in two occasions.(author)

  13. Puerperal Mastitis: a Reproductive Event of Importance Affecting Anti-Mucin Antibody Levels and Ovarian Cancer Risk

    Science.gov (United States)

    Cramer, Daniel W.; Williams, Kristina; Vitonis, Allison F.; Yamamoto, Hidemi S.; Stuebe, Alison; Welch, William R.; Titus, Linda; Fichorova, Raina N.

    2013-01-01

    Purpose Test the hypothesis that puerperal mastitis may alter immunity related to the mucin (MUC) family of glycoproteins and lower risk for ovarian cancer. Methods In two case-control studies conducted in New England between 1998–2008, we examined the association between self-reported mastitis and ovarian cancer in 1,483 women with epithelial ovarian cancer and 1,578 controls. IgG1 antibodies against (MUC1) CA15.3 and (MUC16) CA125 were measured using electrochemiluminescence assays in a subset of controls (n=200). Preoperative CA125 was recorded in 649 cases. The association between ovarian cancer and mastitis was assessed using unconditional logistic regression to calculate adjusted odds ratios, OR, and 95% confidence intervals (CI). Associations between mastitis and anti-CA15.3 and anti-CA125 antibodies and preoperative CA125 levels were evaluated using adjusted linear regression models. Results Prior mastitis was associated with a significantly lower risk for ovarian cancer: OR (and 95% CI) of 0.67 (0.48, 0.94) adjusted for parity, breastfeeding, and other potential confounders. The association was strongest with 2 or more episodes of mastitis; and risk declined progressively with increasing number of children and episodes of mastitis. Among controls, prior mastitis was associated with significantly higher anti-CA15.3 and anti-CA125 antibody levels and, among cases, with significantly lower preoperative CA125 levels. Conclusion Puerperal that mastitis may produce long-lasting anti-mucin antibodies that may lower the risk for ovarian cancer, plausibly through enhanced immune surveillance. Studying immune reactions related to MUC1 and MUC16 in the 10–20% of breastfeeding women who develop mastitis may suggest ways to duplicate its effects through vaccines based on both antigens. PMID:23925696

  14. Diphtheria Complications

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Diphtheria Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Diphtheria Home About Diphtheria Causes and Transmission Symptoms Complications ...

  15. Effect of treatment with single total-dose intravenous iron versus daily oral iron(III-hydroxide polymaltose on moderate puerperal iron-deficiency anemia

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2017-05-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 Fausta Chioma Emegoakor,1 Euzebus Chinonye Ezugwu,1 Lucky Osaheni Lawani,2 Leonard Ogbonna Ajah,1 Jude Anazoeze Madu,3 Hyginus Uzo Ezegwui,1 Frank Okechukwu Ezugwu4 1Department of Obstetrics and Gynaecology, University of Nigeria, Enugu Campus, 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, 3Department of Haematology, University of Nigeria, Nsukka, 4Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University, Enugu, Nigeria Background: Iron-deficiency anemia is the most common nutritional cause of anemia in pregnancy and is often responsible for puerperal anemia. Puerperal anemia can impair postpartum maternal and neonatal well-being. Objective: To determine the effect of treatment of moderate puerperal iron-deficiency anemia using a single intravenous total-dose iron dextran versus daily single dose oral iron(III-hydroxide polymaltose. Methodology: A randomized controlled study in which postpartum women with moderate iron-deficiency anemia were randomized into treatment with either a single total-dose intravenous iron dextran or with daily single doses of oral iron(III-hydroxide polymaltose tablets for 6 weeks. Effects on hemoglobin concentration using either method were compared at 6 weeks postpartum. Analysis was per protocol using SPSS version 17 for windows. P-values ≤0.05 were considered significant. Results: Two hundred eighty-four women were recruited for the study: 142 women received single total dose intravenous infusion of iron dextran while 142 received daily oral iron(III-hydroxide polymaltose tablets. Approximately 84.0% (237/282 completed the study and were analyzed including 81% (115/142 of those randomized to injectable iron therapy compared to 85.9% (122/142 of those randomized to oral treatment. The proportions of women who had attained hemoglobin concentration of at least 10 g/dL by the 6 weeks postpartum visit did not differ

  16. Puerperal ileal perforation secondary to endometriosis: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Judit Albareda

    2016-02-01

    Conclusion: Even though bowel endometriosis is a rare complication, it should be considered in the differential diagnosis of severe abdominal pain in late pregnancy or puerperium. A multidisciplinary management of these patients is needed.

  17. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications

    Directory of Open Access Journals (Sweden)

    Wadasadawala Tabassum

    2009-01-01

    Full Text Available Context: Accelerated partial-breast irradiation (APBI using various approaches is being increasingly employed for selected women with early breast cancer (EBC. Aims: To conduct a case-control study comparing disease control, cosmesis, and complications in patients with EBC undergoing APBI using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT. Settings and Design: Women with EBC fulfilling the American Brachytherapy Society (ABS criteria were selected as ′cases′ if treated with APBI or as ′controls′ if offered WBRT during the period from May 2000 to December 2004. Materials and Methods: APBI patients were treated with high-dose-rate brachytherapy (HDR to a dose of 34 Gy/10#/6-8 days. WBRT was delivered to the whole breast to a dose of 45 Gy/25# followed by tumor bed boost, either with electrons (15 Gy/6# or interstitial brachytherapy (HDR 10 Gy/1#. Results: At the median follow-up of 43.05 months in APBI and 51.08 months in WBRT there was no difference in overall survival (OS, disease-free survival (DFS, late arm edema, and symptomatic fat necrosis between the two groups. However, APBI resulted in increase in mild breast fibrosis at the tumor bed. Telangiectasias were observed in three patients of the APBI group. The cosmetic outcome was significantly better in the APBI group as compared to the WBRT group (P = 0.003. Conclusions: This study revealed equivalent locoregional and distant disease control in the two groups. APBI offered better overall cosmetic outcome, though at the cost of a slight increase in mild breast fibrosis and telangiectasias.

  18. Early

    Directory of Open Access Journals (Sweden)

    Kamel Abd Elaziz Mohamed

    2014-04-01

    Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

  19. Prediction of maternal complications and adverse infant outcome at admission for temporizing management of early-onset severe hypertensive disorders of pregnancy

    NARCIS (Netherlands)

    Ganzevoort, Wessel; Rep, Annelies; de Vries, Johanna I. P.; Bonsel, Gouke J.; Wolf, Hans

    2006-01-01

    OBJECTIVE: We explored the association between clinical parameters at admission and the subsequent development of major maternal complications or adverse infant outcome in women with hypertensive complications of pregnancy remote from term. STUDY DESIGN: We drew data from a randomized trial of

  20. [The influence of timing of surgery on mortality and early complications in femoral neck fractures, by surgical procedure: an analysis of 22,566 cases from the German External Quality Assurance Program].

    Science.gov (United States)

    Kostuj, T; Smektala, R; Schulze-Raestrup, U; Müller-Mai, C

    2013-02-01

    The current S2 guideline recommends treatment of a femoral neck fracture within the first 24 h; this becomes evident by the significant rise in general and early surgical complications, when the surgical treatment was delayed for more than 48 h. The influence of different surgical procedures was investigated. PATIENTS UND METHODS: A total of 22,566 records from the external Quality Assurance Program in North Rhine-Westphalia for treatment of femoral neck fractures in 2004/2005 (BQS specification 7.0 and 8.0) were risk-adjusted and evaluated. Surgery was performed within 48 h in 83.9% of the patients. A significant rise in general and early surgical complications was registered when the surgical treatment was delayed for more than 48 h. Mortality and general complications were significantly lower for percutaneous screw fixation. All kinds of joint replacement show significantly higher general and surgical complications. The analyzed data support the rating of femoral neck fracture as requiring the intervention of urgent early surgery, as stated in the guideline. Percutaneous screw fixation can be considered for immobile and multimorbid patients with undislocated fractures. Advantages of total hip replacement compared to hemiarthroplasty cannot be supported by the QS-NRW data.

  1. Antibiotic treatment patterns across Europe in patients with complicated skin and soft-tissue infections due to meticillin-resistant Staphylococcus aureus: a plea for implementation of early switch and early discharge criteria.

    Science.gov (United States)

    Eckmann, Christian; Lawson, Wendy; Nathwani, Dilip; Solem, Caitlyn T; Stephens, Jennifer M; Macahilig, Cynthia; Simoneau, Damien; Hajek, Petr; Charbonneau, Claudie; Chambers, Richard; Li, Jim Z; Haider, Seema

    2014-07-01

    This retrospective observational medical chart review aimed to describe country-specific variations across Europe in real-world meticillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infection (cSSTI) treatment patterns, antibiotic stewardship activity, and potential opportunities for early switch (ES) from intravenous (i.v.) to oral formulations and early discharge (ED) from hospital using standardised data collection and criteria and economic implications of these opportunities. Patients were randomly sampled from 12 countries (Austria, Czech Republic, France, Germany, Greece, Ireland, Italy, Poland, Portugal, Slovakia, Spain and the UK), aged ≥18 years, with documented MRSA cSSTI, hospitalised between 1 July 2010 and 30 June 2011, discharged alive by 31 July 2011. Of 1502 patients, 1468 received MRSA-targeted therapy. Intravenous-to-oral switch rates ranged from 2.0% to 20.2%, i.v. length of therapy from 10.1 to 18.6 days and hospital length of stay (LoS) from 15.2 to 25.0 days across Europe. Of 341 sites, 82.9% had antibiotic steering committees, 23.7% had i.v.-to-oral switch antibiotic protocols and 12.9% had ED protocols for MRSA cSSTI. ES and ED eligibility ranged from 12.0% (Slovakia) to 56.3% (Greece) and from 10% (Slovakia) to 48.2% (Portugal), respectively. Potential cost savings per ED-eligible patient ranged from €414 (Slovakia) to €2703 (France). MRSA cSSTI treatment patterns varied widely across countries, but further reductions in i.v. therapy, hospital LoS and associated costs could be realised. These data provide insight into clinical practice patterns across diverse European healthcare systems and identify potential opportunities for local clinicians and policy-makers to improve clinical care and cost-effectiveness of this therapeutic area. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Does uterine gauze packing increase the risk of puerperal morbidity in the management of postpartum hemorrhage during caesarean section: a retrospective cohort study.

    Science.gov (United States)

    Guo, Yu-Na; Ma, Jue; Wang, Xiao-Jin; Wang, Bing-Shun

    2015-01-01

    To compare the outcomes especially the puerperal morbidity of uterine gauze packing (UGP) with those of uterine balloon tamponade (UBT) in the management of postpartum hemorrhage (PPH) during caesarean section (c-section). It was considered success as no requirement for either a further therapy or hysterectomy for PPH. The postpartum infection risk was pragmatically measured as puerperal morbidity. The identified PPH subjects were subdivided into two groups for comparison, in which UGP or UBT was used as second-line therapy for women undergoing c-sections between January 2010 and September 2014. Of the 318 c-section subjects initially treated by basic managements for expected PPH, 99 cases underwent UGP and 66 UBT as the second-line therapies to stop persistent bleeding. The success rates of the UGP and UBT groups were 90.91 and 87.88%, respectively. Only one patient in UBT group resorted to hysterectomy. The respective rates of puerperal morbidity were 10.10 and 13.64%, with risk ratio of 0.74 (95% CI: 0.32, 1.72). There were no significant differences between the two groups even after the adjustment for potential confounding factors. UGP appears to be effective in treating PPH during c-section without an observed increase in the risk of potential postpartum infection when compared with UBT. UGP could be recommended as routine for patients who are not responding to conventional basic therapies in addressing PPH, along with the provision of appropriate training.

  3. Sonographic Diagnosis of Complicated Cholecystitis.

    Science.gov (United States)

    Shapira-Rootman, Mika; Mahamid, Ahmad; Reindorp, Nadir; Nachtigal, Alicia; Zeina, Abdel-Rauf

    2015-12-01

    Early detection of the complications of cholecystitis is important for clinical management, yet only a small percentage of patients have a correct diagnosis before surgery. The purpose of our study was to identify sonographic findings that are associated with complicated cholecystitis. Sonographic, surgical, and pathologic reports were reviewed for 70 patients who underwent early cholecystectomies from January 2010 to August 2014. Sonograms were assessed for 16 independent variables. Statistical analyses were performed to evaluate associations between various sonographic features and complicated cholecystitis. Sonographic signs associated with complicated cholecystitis (Pcholecystitis. In most cases, sonograms reflected severe inflammation, with multiple sonographic signs. Although multiple sonographic signs are associated with complicated cholecystitis, none of them is sensitive and specific enough to definitively diagnose it. Sonograms usually reflect severe inflammation, with numerous sonographic signs. Thus, in the right clinical context, sonograms of severe cholecystitis should alert radiologists to the possibility of complications. © 2015 by the American Institute of Ultrasound in Medicine.

  4. Complications in Hip Arthroscopy

    Science.gov (United States)

    Nakano, Naoki; Khanduja, Vikas

    2016-01-01

    Summary Background Recent developments in hip arthroscopic techniques and technology have made it possible in many cases to avoid open surgical dislocation for treating a variety of pathology in the hip. Although early reports suggest favourable results’ using hip arthroscopy and it has been shown to be a relatively safe procedure, complications do exist and can sometimes lead to significant morbidity. Methods This is a review article. The aim of this manuscript is to present the most frequent and/or serious complications that could occur at or following hip arthroscopy and some guidelines to avoid these complications. Conclusion Most complications of hip arthroscopy are minor or transient but serious complications can occur as well. A lot of complication e.g. acetabular labral puncture go unreported. Appropriate education and training, precise and meticulous surgical technique with correct instrumentation, the right indication in the right patient and adherence to advice from mentors and experienced colleagues are all essential factors for a successful outcome. Level of evidence: V. PMID:28066747

  5. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications

    OpenAIRE

    Wadasadawala Tabassum; Sarin Rajiv; Budrukkar Ashwini; Jalali Rakesh; Munshi Anusheel; Badwe Rajendra

    2009-01-01

    Context: Accelerated partial-breast irradiation (APBI) using various approaches is being increasingly employed for selected women with early breast cancer (EBC). Aims: To conduct a case-control study comparing disease control, cosmesis, and complications in patients with EBC undergoing APBI using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT). Settings and Design: Women with EBC fulfilling the American Brachytherapy Society (ABS)...

  6. Situação trabalhista da mulher no ciclo grávido-puerperal Situación laboral de la mujer en el ciclo grávido-puerperal Work situation of women in the gravidic-puerperal cycle

    Directory of Open Access Journals (Sweden)

    Maria Beatriz de Godoy

    2011-03-01

    Full Text Available Objetivo. Caracterizar a situação trabalhista de um grupo de mulheres no ciclo grávido-puerperal. Metodologia. Estudo transversal, realizado em 2005 numa Maternidade em Ribeirão Preto - Brasil, que atende exclusivamente pacientes do Sistema Único de Saúde. Participaram 122 puérperas que estiveram no mercado de trabalho no período da gestação. Resultados. Entre as participantes: 52.5% mantinham atividades remuneradas - sendo 45.3% atividade informal-. A gestação foi a razão para a demissão de 79.3% das mulheres. Quando terminem a licença de maternidade as mulheres terão que assumir os labores domésticos e familiares, fora das próprias do trabalho remunerado. Conclusão. A situação trabalhista da população de estudo não sempre é favorável para o exercício dos direitos civis, o que proporciona o desemprego e a deserção trabalhista.Objetivo. Caracterizar la situación laboral de un grupo de mujeres en el ciclo grávido-puerperal. Metodología. Estudio transversal, realizado en 2005 en una Maternidad en Ribeirao Preto - Brazil, que atiende exclusivamente pacientes del Sistema Único de Salud. Participaron 122 puérperas que estuvieron en el mercado de trabajo en el período de la gestación. Resultados. Entre las participantes: 52.5% mantenían actividades remuneradas -siendo 45.3% actividad informal-. La gestación fue la razón para el despido de 79.3% de las mujeres. Cuando terminen la licencia de maternidad las mujeres tendrán que asumir las labores domésticas y familiares, fuera de las propias del trabajo remunerado. Conclusión. La situación laboral de la población de estudio no siempre es favorable para el ejercicio de los derechos civiles, lo que propicia el desempleo y la deserción laboral.Objective. To characterized the work situation of women in the gravid-puerperal cycle. Methodology. Transversal study, performed in 2005 in a maternal unit in Riberirao Preto- Brazil that attends exclusively patients from

  7. Complications of ERCP.

    Science.gov (United States)

    Talukdar, Rupjyoti

    2016-10-01

    Even though considered safe, endoscopic retrograde cholangiopancreatography (ERCP) is among the endoscopic procedures associated with the highest rate of complications. Post ERCP pancreatitis (PEP) is the most common complication of ERCP. Several independent risk factors have been associated with PEP. Prophylactic PD stenting has been shown to be highly effective in preventing PEP. More recent studies have suggested that NSAIDs, especially rectal indomethacin, could by itself be effective in preventing PEP. However, head to head RCTs comparing PD stents with NSAIDs would be required to confirm this. Other complications include ERCP induced bleeding, perforation, and cholangitis. Bleeding is related to morphological, procedural, and patient related factors. Early identification and correction of the risk factors are of paramount importance in preventing bleeding. Risk of infection is particularly high during ERCP. It is important to ensure complete drainage of obstructed biliary system in order to reduce the risk of post-ERCP cholangitis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Effect of domperidone on insufficient lactation in puerperal women: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Osadchy, Alla; Moretti, Myla E; Koren, Gideon

    2012-01-01

    Background. There is a controversy within the medical community regarding the role of domperidone as a galactagogue and the drug has been removed from the US market owing to safety concerns. Objective. To perform a systematic review and meta-analysis of the available data assessing the effect of domperidone on breast milk production in women experiencing insufficient lactation. Study Selection. Randomized controlled trials (RCTs) examining the effect of domperidone on breast milk production of puerperal women were eligible for inclusion. Data Analysis. Absolute and relative changes from baseline were calculated for individual studies and pooled using a random effects model. Results. Three RCTs including 78 participants met the inclusion criteria. All showed a statistically significant increase in breast milk production following treatment with domperidone. The analysis of pooled data demonstrated a statistically significant relative increase of 74.72% (95%  CI = 54.57; 94.86, P < 0.00001) in daily milk production with domperidone treatment compared to placebo. No maternal or neonatal adverse events were observed in any of the trials. Conclusions. Evidence from a few small RCTs of moderate to high quality suggests that domperidone produces a greater increase in breast milk supply than placebo.

  9. Effect of Domperidone on Insufficient Lactation in Puerperal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Alla Osadchy

    2012-01-01

    Full Text Available Background. There is a controversy within the medical community regarding the role of domperidone as a galactagogue and the drug has been removed from the US market owing to safety concerns. Objective. To perform a systematic review and meta-analysis of the available data assessing the effect of domperidone on breast milk production in women experiencing insufficient lactation. Study Selection. Randomized controlled trials (RCTs examining the effect of domperidone on breast milk production of puerperal women were eligible for inclusion. Data Analysis. Absolute and relative changes from baseline were calculated for individual studies and pooled using a random effects model. Results. Three RCTs including 78 participants met the inclusion criteria. All showed a statistically significant increase in breast milk production following treatment with domperidone. The analysis of pooled data demonstrated a statistically significant relative increase of 74.72% (95%  CI=54.57; 94.86,P<0.00001 in daily milk production with domperidone treatment compared to placebo. No maternal or neonatal adverse events were observed in any of the trials. Conclusions. Evidence from a few small RCTs of moderate to high quality suggests that domperidone produces a greater increase in breast milk supply than placebo.

  10. Thrombophilia and Pregnancy Complications

    Directory of Open Access Journals (Sweden)

    Louise E. Simcox

    2015-11-01

    Full Text Available There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction. Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question.

  11. Learning curve for a modified Watson-Jones minimally invasive approach in primary total hip replacement: analysis of complications and early results versus the standard-incision posterior approach.

    Science.gov (United States)

    Laffosse, Jean-Michel; Chiron, Philippe; Accadbled, Franck; Molinier, François; Tricoire, Jean-Louis; Puget, Jean

    2006-12-01

    We analysed the learning curve of an anterolateral minimally invasive (ALMI) approach for primary total hip replacement (THR). The first 42 THR's with large-diameter heads implanted through this approach (group 1) were compared to a cohort of 58 THR's with a 28-mm head performed through a standard-incision posterior approach (group 2). No selection was made and the groups were comparable. Implant positioning as well as early clinical results were satisfactory and were comparable in the two groups. In group 1, the rate of intraoperative complications was significantly higher (greater trochanter fracture in 4 cases, cortical perforation in 3 cases, calcar fracture in one case, nerve palsy in one case, secondary tilting of the metal back in 2 cases) than in group 2 (one nerve palsy and one calcar crack). At 6 months, one revision of the acetabular cup was performed in group 1 for persistent pain, whereas in group 2, we noted 3 dislocations (2 were revised) and 2 periprosthetic femoral fractures. Our study showed a high rate of intra- and perioperative complications during the learning curve for an ALMI approach. These are more likely to occur in obese or osteoporotic patients, and in those with bulky muscles or very stiff hips. Postoperative complications were rare. The early clinical results are excellent and we may expect to achieve better results with a more standardised procedure. During the initial period of the learning curve, it would be preferable to select patients with an appropriate morphology.

  12. Dependence of early therapy results and complications on radiation dose values and their fractionation in pre-operative ''afterloading'' technique brachyradiotherapy applied to cervix uteri carcinoma patients

    International Nuclear Information System (INIS)

    Kaminska, G.; Kawczynska, M.

    1984-01-01

    The ''afterloading'' technique with use of Curietron (41 cases) or Selectron (43 cases) apparatus was applied in 83 cervix uteri carcinoma patients in phase 1b (79 cases) and 2a (4 cases). The Wertheim-Magis operation was performed after several weeks. Post-operative histologic investigation showed complete destruction of the tumour in 72% cases; persistent cancer cells in cervix uteri were stated in 11 patients (13%), while lymphatic node metastasis was seen in 14 patients (17%). Supplementary teleradiotherapy was performed in those cases. 39 patients (95%) of the 41 observed during 3 years survived without any cancer symptoms. No explicit relationship between dose administered to vaginal disc and cancer persistence frequency in the cervix uteri was stated. However, such relationship was stated for the dose in point A. In the group of 19 patients who received point A dose of the least 6000 rads, with average TDF value of 135, presence of cancer cells in cervix uteri was not stated in any of the cases. In 7 patients (17%) observed for over 3 years light and medium heavy postradiation complications were stated; in that 5 rectum side complications were stated in patients additionally irradiated from external fields, where the dose absorbed by rectum wall exceeded 8000 rads, with TDF - 150. No complications were observed when the dose was less than 5000 rads and TDF below 100. 16 refs., 1 fig. (author)

  13. Puerperal Fever and Neonatal Pleural Empyema and Bacteremia Caused by Group A Streptococcus

    Directory of Open Access Journals (Sweden)

    Laurance Lequier

    1998-01-01

    Full Text Available A term neonate developed early onset of sepsis and pleural empyema with group A streptococcus. Her mother also became septic with group A streptococcus in the early postpartum period. The infant required initial chest tube drainage. After reaccumulation of pleural fluid after removal of the chest tube, a thoracotomy with decortication was performed. The isolates of group A streptococcus were analyzed and found to be identical serotypes of the same bacterium. The serotyping revealed both to be M type 1, T pattern 1. Polymerase chain reaction detected the genomic sequence for streptococcal pyrogenic exotoxin A and B in both isolates. With the increase in invasive streptococcal infections in the community, serious perinatal infections may become more frequent.

  14. Cardiovascular Complications of Pregnancy

    Science.gov (United States)

    Gongora, Maria Carolina; Wenger, Nanette K.

    2015-01-01

    Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up. PMID:26473833

  15. Alterações de equilíbrio postural e qualidade de vida em mulheres no ciclo gravídico puerperal

    OpenAIRE

    Eufrásio, Laiane Santos

    2015-01-01

    INTRODUÇÃO: O ciclo gravídico-puerperal causa inúmeras transformações na vida da mulher, sejam elas físicas, hormonais, emocionais ou sociais. Tais alterações podem afetar o equilíbrio postural e a qualidade de vida dessas mulheres na gravidez, podendo persistir no pós-parto. OBJETIVO: Analisar alterações no equilíbrio postural e qualidade de vida em mulheres na gravidez e no pós-parto. METODOLOGIA: Este estudo foi composto por 47 mulheres participantes do Curso para Gestant...

  16. Semiótica de ser mãe adolescente: construção identitária de adolescentes em ciclo gravídico-puerperal

    OpenAIRE

    Rodrigues, Francisco Rafael de Araújo; Crespo, Sandrina Sofia da Silva; Silva, Edite Lopes da; Bruno, Raphael Camurça; Amaral, Letícia Reis

    2016-01-01

    A maternidade na adolescência como fenômeno cultural, quando estudada através de uma rede de significados, constitui excelente ensaio para compreensão humana. Objetivou-se identificar a regularidade semântica utilizada por adolescentes em ciclo gravídico-puerperal sobre ser mãe nesta fase da vida. Estudo descritivo, com 317 testes de associação livre de palavra com adolescentes em ciclo gravídico-puerperal, analisados por estatística descritiva e análise fatorial por correspondência. Os prece...

  17. The unsuitability of implantable Doppler probes for the early detection of renal vascular complications - a porcine model for prevention of renal transplant loss

    DEFF Research Database (Denmark)

    Amdisen, Chris; Jespersen, Bente; Møldrup, Ulla

    2017-01-01

    Abstract Background: Vascular occlusion is a rare, but serious complication after kidney transplantation often resulting in graft loss. We therefore aimed to develop an experimental porcine model for stepwise reduction of the renal venous blood flow and to compare an implantable Doppler probe....../3 (66%) reduction in renal blood flow. The implantable Doppler probe was not able to detect flow changes until there was total venous occlusion. Microdialysis detected changes in local metabolism after both arterial and venous occlusion; the implantable Doppler probe could only detect vascular...

  18. Immediate postpartum complications.

    Science.gov (United States)

    St George, L; Crandon, A J

    1990-02-01

    Two hundred and sixty-nine (5.4%) of the 4,998 patients who delivered in Westmead Hospital, New South Wales in 1985 had immediate postpartum complications. This analysis was compared with figures from a major institution in another state of Australia. Early detection and prompt management without procrastination was the key to a successful outcome in the fourth stage of labour (i.e. within 24 hours of delivery). Nearly three-quarters of the complications were due to postpartum haemorrhage (PPH). The contributory factors are analysed and discussed. Reappraisal of the indications for induction of labour, epidural analgesia and forceps delivery is necessary to reduce the incidence of postpartum haemorrhage. The study reinforces the need for undiminished vigilance in the fourth stage of labour even if the first 3 stages are uncomplicated.

  19. Early stenosis in a Gore-Tex graft connected to the left main: an emergency transradial angioplasty for a complication in a Cabrol procedure.

    Science.gov (United States)

    Uribe González, Jhonathan; Peña Duque, Marco A; Larraga, Miguel Puente

    2012-10-01

    This is a case report of a successful transradial percutaneous intervention in a stenosis in a Cabrol graft. Very few reports have been published about percutaneous interventional solutions to complications in this kind of graft, and none have used the transradial approach. The Cabrol technique is used to re-implant coronary arteries after aortic root replacement using a Dacron or Gore-Tex graft interposed between the aortic root graft and the native coronary artery. Due to the dearth of reports on interventional solutions to complications in Cabrol-Grafts, most interventional cardiologists have little to no experience in approaching postsurgical aortic composite graft-coronary (ostial, body, or distal) lesions percutaneously, when the anatomy has been altered by a Cabrol graft. This article will elaborate on the anatomical considerations essential for performing this type of angioplasty procedures in this type of grafting and it will present the transradial approach as feasible and an excellent option for this type of procedure. We report on a case of an emergency angioplasty to rescue a patient who had persisted with hemodynamic instability after 48 hours of a Cabrol procedure which had been performed to repair an aortic type A dissection, caused during an aortic valve replacement.

  20. Safe early discharge for patients undergoing high dose chemotherapy with or without stem cell transplantation: a prospective analysis of clinical variables predictive for complications after treatment

    NARCIS (Netherlands)

    Mank, Arno; van der Lelie, Johannes; de Vos, Rien; Kersten, Marie Jóse

    2011-01-01

    Aim. To identify which patient groups can be safely discharged early after high dose chemotherapy. Background. Until recently, the standard of care for patients with haematological malignancies who have been treated with high dose chemotherapy has been to hospitalise them until neutrophil recovery

  1. Neurological Complications of Bariatric Surgery.

    Science.gov (United States)

    Goodman, Jerry Clay

    2015-12-01

    Obesity has attained pandemic proportions, and bariatric surgery is increasingly being employed resulting in turn to more neurological complications which must be recognized and managed. Neurological complications may result from mechanical or inflammatory mechanisms but primarily result from micro-nutritional deficiencies. Vitamin B12, thiamine, and copper constitute the most frequent deficiencies. Neurological complications may occur at reasonably predictable times after bariatric surgery and are associated with the type of surgery used. During the early post-operative period, compressive or stretch peripheral nerve injury, rhabdomyolysis, Wernicke's encephalopathy, and inflammatory polyradiculoneuropathy may occur. Late complications ensue after months to years and include combined system degeneration (vitamin B12 deficiency) and hypocupric myelopathy. Bariatric surgery patients require careful nutritional follow-up with routine monitoring of micronutrients at 6 weeks and 3, 6, and 12 months post-operatively and then annually after surgery and multivitamin supplementation for life. Sustained vigilance for common and rare neurological complications is essential.

  2. Complications of cancer therapy

    International Nuclear Information System (INIS)

    Moskowitz, P.S.; Parker, B.R.

    1985-01-01

    The purpose of this chapter is to review systematically the toxicity of contemporary chemotherapy and irradiation on normal tissues of growing children. Whenever possible, the separate toxicity of chemotherapy, irradiation, and combination therapy is addressed. However, it is not always possible to quantitate specifically such reactions in the face of multiple drug therapy, which may enhance radiation injury or reactivate prior radiation injury. Prior detailed reviews have provided important sources of information concerning radiation injury for this more general discussion. The information provided will assist both the clinician and the radiologist in the recognition of early and late complications of therapy in pediatric oncology

  3. Complications of the surgical treatment early and tardy of supracondylar fractures of the humerus in children: a retrospective study of 111 patients treated at the Hospital Nacional de Ninos Carlos Saenz Herrera in the period January 2010 to January 2011

    International Nuclear Information System (INIS)

    Zuniga Blanco, Adrian

    2012-01-01

    Supracondylar fractures of the humerus up much of the emergency consultation of any pediatric orthopedic service, of them, Gartland III fractures are usually treated by closed reduction and percutaneous fixation with nails smooth. Often treatment has been delayed by factors such as the unavailability of an orthopedic specialist or local anesthesia or an operating room. At other times, the patient has come belatedly to consult. This retrospective study has analyzed whether a delay greater than 12 hours in the surgical treatment of supracondylar fractures of the humerus in children is associated with an increased risk of perioperative complications. Of 111 children who have been treated surgical in national children's hospital, underwent 59 surgeries before 12 hours from the trauma and 52 underwent surgery after 12 hours of trauma. The groups have developed without significant differences in terms of iatrogenic neurological injury, tract infection of the nails, vascular complications and compartment syndrome. Surgical time and hospital stay neither have had differences. In 2 cases of the tardy treatment group has been necessary to perform a opened reduction. As for the bad union, 9 cases (8%) have been of elbow varus radiological and clinical, of these 5 cases (4.5%) have occurred in the tardy treatment group and 4 cases (3,5) in the group early treatment. Findings of similar studies are confirmed in which the rate of perioperative complications is significantly unchanged if the surgical treatment is carried out before 12 hours or after 12 hours after the trauma. (author) [es

  4. Pulmonary complications of cystic fibrosis

    International Nuclear Information System (INIS)

    Ng, M.Y.; Flight, W.; Smith, E.

    2014-01-01

    The life expectancy of patients with cystic fibrosis (CF) has steadily increased over recent decades with a corresponding increase in the frequency of complications of the disease. Radiologists are increasingly involved with managing and identifying the pulmonary complications of CF. This article reviews the common manifestations of CF lung disease as well as updating radiologists with a number of less well-known complications of the condition. Early and accurate detection of the pulmonary effects of CF are increasingly important to prevent irreversible lung damage and give patients the greatest possibility of benefiting from the new therapies becoming available, which correct the underlying defect causing CF

  5. Lateral lumbar interbody fusion for the correction of spondylolisthesis and adult degenerative scoliosis in high-risk patients: early radiographic results and complications.

    Science.gov (United States)

    Waddell, Brad; Briski, David; Qadir, Rabah; Godoy, Gustavo; Houston, Allison Howard; Rudman, Ernest; Zavatsky, Joseph

    2014-01-01

    Lateral lumbar interbody fusion (LLIF) is not associated with many of the complications seen in other interbody fusion techniques. This study used computed tomography (CT) scans, the radiographic gold standard, to assess interbody fusion rates achieved utilizing the LLIF technique in high-risk patients. We performed a retrospective review of patients who underwent LLIF between January 2008 and July 2013. Forty-nine patients underwent nonstaged or staged LLIF on 119 levels with posterior correction and augmentation. Per protocol, patients received CT scans at their 1-year follow-up. Of the 49 patients, 21 patients with LLIF intervention on 54 levels met inclusion criteria. Two board-certified musculoskeletal radiologists and the senior surgeon (JZ) assessed fusion. Of the 21 patients, 6 patients had had previous lumbar surgery, and the cohort's comorbidities included osteoporosis, diabetes, obesity, and smoking, among others. Postoperative complications occurred in 12 (57.1%) patients and included anterior thigh pain and weakness in 6 patients, all of which resolved by 6 months. Two cases of proximal junctional kyphosis occurred, along with 1 case of hardware pullout. Two cases of abdominal atonia occurred. By CT scan assessment, each radiologist found fusion was achieved in 53 of 54 levels (98%). The radiologists' findings were in agreement with the senior surgeon. Several studies have evaluated LLIF fusion and reported fusion rates between 88%-96%. Our results demonstrate high fusion rates using this technique, despite multiple comorbidities in the patient population. Spanning the ring apophysis with large LLIF cages along with supplemental posterior pedicle screw augmentation can enhance stability of the fusion segment and increase fusion rates.

  6. Trombosis del sector ilio-cava: trombosis puerperal y trombosis en agenesia de la cava inferior Thrombosis of the ileo-caval sector: puerperal thrombosis and agenesia thrombosis of the inferior vena cava

    Directory of Open Access Journals (Sweden)

    Jorge García Egea

    2011-03-01

    Full Text Available La trombosis de la vena cava inferior supone alrededor del 15 % del total de los casos de trombosis venosa profunda. Se presenta un caso de una puérpera primigesta con parto por cesárea que presentó una trombosis con inicio en la vena ovárica derecha y extensión hasta la cava inferior. Fue tratada con heparina de bajo peso molecular en dosis anticoagulantes, reposo con extremidades elevadas y elastocompresión. Tras la evolución satisfactoria del proceso, con lisis parcial del trombo, se comenzó anticoagulación oral con acenocumarol durante 6 meses. El segundo paciente, un varón de 73 años, con antecedentes de hidatidosis hepática intervenida, presentó una trombosis de la cava inferior infrarrenal y agenesia del segmento retrohepático de la cava inferior. El enfermo sigue con tratamiento anticoagulante con acenocumarol, elastocompresión y cuidados higiénicos. Como secuela presentó un síndrome posflebítico con episodios de úlceras flebostásicas y reagudizaciones del edema, que han obligado a su hospitalización en dos ocasiones.The thrombosis of the inferior vena cava account for around the 15% of the cases of deep venous thrombosis. This is the case of a puerperal primigravida with a cesarean section labor presenting with a thrombosis initially in the right ovarian vein and then extension to the inferior vena cava. Treatment included low molecular weight heparin in anticoagulant doses; rest with elevation of the extremities and elastic bandage. After a satisfactory process evolution with partial lysis of the thrombus, the oral anticoagulation with Acenocumarol for 6 months was started. The second patient, a man aged 73 with backgrounds of an operated hepatic hydatidosis, had a thrombosis of the infrarenal inferior vena cava and agenesia of retrohepatic segment of the inferior vena cava. The patient remains with anticoagulant treatment including Acenocumarol, elastic bandage and hygienic care. As sequela he had a postphlebitic

  7. Mortes por doenças infecciosas em mulheres: ocorrências no ciclo gravídico-puerperal Deaths due to infectious diseases in women: occurrences in pregnancy and puerperium

    Directory of Open Access Journals (Sweden)

    Ruy Laurenti

    2009-01-01

    Full Text Available OBJETIVO: Descrever os óbitos por doenças infecciosas como causa básica ou múltipla, caracterizando os casos de doença infecciosa preexistente ou desenvolvida na gravidez, aqueles que são mortes maternas por causas obstétricas indiretas e os óbitos por Aids ou outras doenças infecciosas, ocorridos no ciclo gravídico puerperal, havendo dúvidas na classificação. MÉTODOS: Adotou-se a metodologia RAMOS (partindo-se da declaração de óbito -DO- original, dados reais são resgatados por entrevista domiciliar, consultas a prontuários hospitalares e laudos de autopsia; elaborando-se uma nova DO, com as reais causas de morte. População foi constituída pelos óbitos femininos de 10 a 49 anos, de residentes nas capitais brasileiras, do 1º semestre de 2002. As causas foram analisadas em básicas e múltiplas. RESULTADOS: Dos 7.332 óbitos, 917 apresentaram uma doença infecciosa como causa básica (Aids e tuberculose, principalmente. Em 37 casos, a falecida estava no ciclo gravídico puerperal ampliado (englobando, inclusive, mortes ocorridas de 43 dias até um ano pós-parto; 10 não foram classificadas como obstétricas indiretas permanecendo como infecciosas e 14 eram obstétricas indiretas. Quanto às causas múltiplas, para 791 mortes, cujas causas básicas não eram maternas nem infecciosas, houve 1.016 menções de doenças infecciosas (média de 1,28 menção/óbito. CONCLUSÃO: Como o número de mortes maternas é pequeno, recomenda-se, que investigações dos casos graves de complicações da gravidez, parto e puerpério que não faleceram (near-miss sejam feitas, pois, sendo mais numerosos, representam importante subsídio para estudos da mortalidade materna.OBJECTIVE: To describe deaths due to infectious diseases as an underlying or multiple cause, identifying cases of pre-existent infectious diseases or ones developed during pregnancy; deaths due to an indirect obstetric cause and deaths due to Aids or other infectious

  8. Complications of Measles (Rubeola)

    Science.gov (United States)

    ... of Measles Signs and Symptoms Transmission Photos of Measles Complications Frequently Asked Questions Top Things Parents Need to ... of age are more likely to suffer from measles complications. Infographic Common Complications Common measles complications include ear ...

  9. From folklore to scientific evidence: breast-feeding and wet-nursing in islam and the case of non-puerperal lactation.

    Science.gov (United States)

    Moran, Lia; Gilad, Jacob

    2007-12-01

    Breast-feeding practice has an important medical and socio-cultural role. It has many anthropological aspects concerning the "power structures" that find their expression in breast-feeding and the practices that formed around it, both socially, scientifically, and legally-speaking. Breast-feeding has been given much attention by religions and taboos, folklore, and misconception abound around it making it a topic of genuine curiosity. This paper aims at expanding the spectrum of folklore associated with breast-feeding. The paper deals with historical, religious, and folkloristic aspects of breast-feeding, especially wet-nursing, in Islam and focuses on an intriguing Islamic tale on breast-feeding - lactation by non-pregnant women (or non-puerperal lactation). Apparently, accounts of non-puerperal lactation are not restricted to Islam but have been documented in various societies and religions throughout centuries. Two medical situations - hyperprolactinemia and induced lactation, appear as possible explanations for this phenomenon. This serves as an excellent example for the value of utilizing contemporary scientific knowledge in order to elucidate the origin, anthropology and evolvement of ancient myth and superstition.

  10. Educação em saúde no ciclo gravídico-puerperal: sentidos atribuídos por puérperas

    Directory of Open Access Journals (Sweden)

    Eryjosy Marculino Guerreiro

    2014-01-01

    Full Text Available Estudo descritivo, qualitativo, que objetivou apreender os conteúdos das representações sociais de puérperas sobre a educação em saúde no ciclo gravídico-puerperal na atenção básica de saúde. Participaram 31 usuárias de Centros de Saúde da Família de Fortaleza, Ceará, maiores de 18 anos, no puerpério, com no mínimo seis consultas de pré-natal e uma consulta puerperal. Realizou-se análise lexical dos dados das entrevistas semiestruturadas, através do software ALCESTE. As representações das puérperas sobre a educação em saúde estão ligadas às práticas educativas institucionais, com destaque para as palestras, educação familiar e escolar, educação comunitária. Predomina a pedagogia tradicional, com transmissão de informações, pontuais e generalizadas. Faz-se necessário mudar a lógica pedagógica, expandindo-se as estratégias em grupos educativos com construção e compartilhamento de saberes.

  11. Efficacy of Non-steroidal Anti-inflammatory Drugs for the Treatment of Acute Puerperal Metritis in Dairy Cows

    Directory of Open Access Journals (Sweden)

    Alina Pohl

    2017-08-01

    Full Text Available Background: Acute puerperal metritis (APM is a potentially life threatening, painful disease and is often treated with third-generation cephalosporins (Machado et al., 2014; Stojkov et al., 2015. An increasing antibiotic resistance is well documented and associated with decreasing clinical efficacy, animal welfare and economic consequences (Thomson et al., 2004. Hence, there is the need to evaluate alternative therapies to antibiotics.Objective: The objective of this study was to assess the efficacy of ketoprofen for the treatment of APM compared with ceftiofur hydrochloride.Materials and Methods: A total of 610 dairy cows from 6 farms in Germany were enrolled. Inclusion criteria was a rectal temperature (RT ≥ 39.5 °C and a reddish-brown fetid vaginal discharge within the first 10 DIM. Cows meeting the inclusion criteria were randomly allocated to treatment with ketoprofen (3 mg/kg of body weight, n = 300 or treatment with ceftiofur (1 mg/kg of body weight, n = 310, both administered on 3 consecutive days. Rectal temperature was recorded daily for a period of 7 days after enrollment. Cows that showed RT ≥ 39.5 °C on day 4 to 7 after inclusion received an extended treatment (extT with ceftiofur for 3 (ketoprofen group or 2 (ceftiofur group more days. Between 21 and 40 DIM cows were examined with the metricheck device and vaginal discharge was categorized on a 5-point scale according to the presence of pus.Results: A total of 52 cows (35 from ketoprofen group, 17 from ceftiofur group were excluded from analysis due to missing protocol compliance (n = 37 or concurrent disease (n = 15. Cows initially treated with ketoprofen had higher odds of extT than cows treated with ceftiofur (61% vs 31%, OR 3.47, P < 0.01, n = 558. Occurrence of purulent vaginal discharge (PVD was similar for both treatment groups. However, cows with extT had 2.12 (P < 0.01, n = 438 times the odds of PVD than cows without extended treatment. Treatment group did not affect

  12. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor-positive early-stage breast cancer

    International Nuclear Information System (INIS)

    Fowble, Barbara; Fein, Douglas A.; Hanlon, Alexandra L.; Eisenberg, Burton L.; Hoffman, John P.; Sigurdson, Elin R.; Daly, Mary B.; Goldstein, Lori J.

    1996-01-01

    Purpose: To evaluate the impact of tamoxifen on breast recurrence, cosmesis, complications, overall and cause-specific survival in women with Stage I-II breast cancer and estrogen receptor positive tumors undergoing conservative surgery and radiation. Methods and Materials: From 1982 to 1991, 491 women with estrogen receptor positive Stage I-II breast cancer underwent excisional biopsy, axillary dissection, and radiation. The median age of the patient population was 60 years with 21% < 50 years of age. The median follow-up was 5.3 years (range 0.1 to 12.8). Sixty-nine percent had T1 tumors and 83% had histologically negative axillary nodes. Reexcision was performed in 49% and the final margin of resection was negative in 64%. One hundred fifty-four patients received tamoxifen and 337 patients received no adjuvant therapy. None of the patients received adjuvant chemotherapy. Results: There were no significant differences between the two groups for age, race, clinical tumor size, histology, the use of reexcision, or median total dose to the primary. Patients who received tamoxifen were more often axillary node positive (44% tamoxifen vs. 5% no tamoxifen), and, therefore, a greater percentage received treatment to the breast and regional nodes. The tamoxifen patients less often had unknown margins of resection (9% tamoxifen vs. 22% no tamoxifen). The 5-year actuarial breast recurrence rate was 4% for the tamoxifen patients compared to 7% for patients not receiving tamoxifen (p 0.21). Tamoxifen resulted in a modest decrease in the 5-year actuarial risk of a breast recurrence in axillary node-negative patients, in those with unknown or close margins of resection, and in those who underwent a single excision. Axillary node-positive patients had a clinically significant decrease in the 5-year actuarial breast recurrence rate (21 vs. 4%; p 0.08). The 5-year actuarial rate of distant metastasis was not significantly decreased by the addition of adjuvant tamoxifen in all

  13. Analysis of early effect of surgical treatment in patients with coronary heart disease complicated by moderate-to-severe ischemic mitral regurgitation

    Directory of Open Access Journals (Sweden)

    Jin WANG

    2012-04-01

    Full Text Available Objective To probe into the early effect of surgical treatment in coronary atherosclerotic heart disease (CAD patients with moderate-to-severe ischemic mitral regurgitation (IMR. Methods A total of 175 CAD patients with moderateto- severe IMR undergoing coronary artery bypass grafting (CABG from December 1999 to December 2010 were analyzed retrospectively. Based on the method applied during surgery, 108 patients were assigned to CABG group, undergoing CABG alone, and 67 to CABG+MVP/R group, undergoing CABG plus concomitant mitral valvuloplasty/repair (MVP/R. Differences between groups were compared in age, gender, numbers of the conduits, application of intra-aortic balloon pump (IABP and ventricular assist device (VAD, perioperative mortality, and other concomitant procedures (i.e. aortic valve replacement, resection of the heart wall aneurysm, repair of the septal defect repair. Differences within the groups were looked for in terms of left atrial diameter (LA, left ventricular ending diastolic diameter (LVEDD, left ventricular ejection fraction (LVEF, mitral regurgitation degree, systolic pulmonary artery pressure (sPAP, and cardiac function (NYHA classification, pre-operatively and post-operatively. Results  The differences between the groups showed no statistical significance in terms of age, gender, numbers of conduits, application of IABP and VAD, peri-operative mortality, and concomitant procedures (P > 0.05. LA, LVEDD, mitral regurgitation, sPAP, and cardiac function (NYHA classification after operation were improved obviously in both groups compared with that before operation (P 0.05. Conclusions The comprehensive and aggressive surgery did not result in more ideal early effect to CAD patients with moderate-to-severe IMR. Based on the total revascularization, we can choose simpler, safer, and more effective surgical methods.

  14. Complications of pneumoconiosis: Radiologic overview

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Jae Sup [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Jung, Jung Im, E-mail: jijung@catholic.ac.kr [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Kim, Hyo Rim [Department of Radiology, Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Ahn, Myeong Im; Han, Dae Hee [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Ko, Jeong Min [Department of Radiology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Park, Seog Hee; Lee, Hae Giu [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Arakawa, Hiroaki [Department of Radiology, Dokkyo University School of Medicine (Japan); Koo, Jung-Wan [Department of Occupational and Environmental Medicine, Seoul St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of)

    2013-10-01

    A wide spectrum of pulmonary complications occurs in patients with pneumoconiosis. Those complications include chronic obstructive pulmonary disease, hemoptysis, pneumothorax, pleural disease, tuberculosis, autoimmune disease, anthracofibrosis, chronic interstitial pneumonia, and malignancy. Generally, imaging workup starts with plain chest radiography. However, sometimes, plain radiography has limited role in the diagnosis of pulmonary complications of pneumoconiosis because of overlapping pneumoconiotic infiltration. Computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI) are potentially helpful for the detection of pulmonary complications in patients with pneumoconiosis. CT, with its excellent contrast resolution, is more sensitive and specific method than plain radiograph in the evaluation of pulmonary abnormalities. CT is useful in detecting lung parenchymal abnormalities caused by infection, anthracofibrosis, and chronic interstitial pneumonia. Also, CT is valuable in distinguishing localized pneumothorax from bullae and aiding the identification of multiloculated effusions. US can be used in detection of complicated pleural effusions and guidance of the thoracentesis procedure. MRI is useful for differentiating between progressive massive fibrosis and lung cancer. Radiologists need to be familiar with the radiologic and clinical manifestations of, as well as diagnostic approaches to, complications associated with pneumoconiosis. Knowledge of the various imaging features of pulmonary complications of pneumoconiosis can enhance early diagnosis and improve the chance to cure.

  15. Spontaneous ileal perforation complicating low anorectal malformation

    Directory of Open Access Journals (Sweden)

    TiJesuni Olatunji

    2015-01-01

    Full Text Available Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication.

  16. Echocardiography diagnosis of myocardial infarction complications

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-03-01

    Full Text Available Diagnosis and management of myocardial infarction complications are discussed in this article. These complications are associated with high level of mortality and surgery is a main treatment method. High level of suspicion and early diagnosis are essential for appropriate treatment and improvement of prognosis. Echocardiography is a main diagnostic method. Analysis of literature about contemporary management of mechanical complications of myocardial infarction has been performed, case reports are presented.

  17. Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson's disease with early motor complications (EARLYSTIM trial): secondary analysis of an open-label randomised trial.

    Science.gov (United States)

    Lhommée, Eugénie; Wojtecki, Lars; Czernecki, Virginie; Witt, Karsten; Maier, Franziska; Tonder, Lisa; Timmermann, Lars; Hälbig, Thomas D; Pineau, Fanny; Durif, Franck; Witjas, Tatiana; Pinsker, Marcus; Mehdorn, Maximilian; Sixel-Döring, Friederike; Kupsch, Andreas; Krüger, Rejko; Elben, Saskia; Chabardès, Stephan; Thobois, Stéphane; Brefel-Courbon, Christine; Ory-Magne, Fabienne; Regis, Jean-Marie; Maltête, David; Sauvaget, Anne; Rau, Jörn; Schnitzler, Alfons; Schüpbach, Michael; Schade-Brittinger, Carmen; Deuschl, Gunther; Houeto, Jean-Luc; Krack, Paul

    2018-03-01

    Although subthalamic stimulation is a recognised treatment for motor complications in Parkinson's disease, reports on behavioural outcomes are controversial, which represents a major challenge when counselling candidates for subthalamic stimulation. We aimed to assess changes in behaviour in patients with Parkinson's disease receiving combined treatment with subthalamic stimulation and medical therapy over a 2-year follow-up period as compared with the behavioural evolution under medical therapy alone. We did a parallel, open-label study (EARLYSTIM) at 17 surgical centres in France (n=8) and Germany (n=9). We recruited patients with Parkinson's disease who were disabled by early motor complications. Participants were randomly allocated (1:1) to either medical therapy alone or bilateral subthalamic stimulation plus medical therapy. The primary outcome was mean change in quality of life from baseline to 2 years. A secondary analysis was also done to assess behavioural outcomes. We used the Ardouin Scale of Behavior in Parkinson's Disease to assess changes in behaviour between baseline and 2-year follow-up. Apathy was also measured using the Starkstein Apathy Scale, and depression was assessed with the Beck Depression Inventory. The secondary analysis was done in all patients recruited. We used a generalised estimating equations (GEE) regression model for individual items and mixed model regression for subscores of the Ardouin scale and the apathy and depression scales. This trial is registered with ClinicalTrials.gov, number NCT00354133. The primary analysis has been reported elsewhere; this report presents the secondary analysis only. Between July, 2006, and November, 2009, 251 participants were recruited, of whom 127 were allocated medical therapy alone and 124 were assigned bilateral subthalamic stimulation plus medical therapy. At 2-year follow-up, the levodopa-equivalent dose was reduced by 39% (-363·3 mg/day [SE 41·8]) in individuals allocated bilateral

  18. [Immediate complications of surgical abortion].

    Science.gov (United States)

    Soulat, C; Gelly, M

    2006-04-01

    While medical abortion is now available in non hospital facilities, abortions by vacuum aspiration remain illegal in non hospital settings. It is therefore important to assess through the literature the real risks associated with this method. All the most recent and large-scale studies showed that legal abortion by vacuum aspiration is an extremely safe procedure. It is less risky than other medical or surgical procedures performed outside the hospital. According to the studies, the death rate varies from 0 to 0.7 per 100,000 abortions, and is smaller when the procedure is done under local anesthesia than general anesthesia. The overall early complication rate (hemorrhage, uterine perforation, cervical injury) is between 0.01 and 1.16%. Complications are not more frequent than with medical abortions. In view of these low complication rates, surgical abortion by vacuum aspiration could be performed outside the hospital setting in France, as it is the case in many other countries.

  19. Early postpartum eclampsia complicated by subarachnoid ...

    African Journals Online (AJOL)

    Adele

    made and treatment was commenced with magnesium sulphate. She received 5g intramuscularly (imi) in each buttock, 4g in 200ml of normal saline infused intravenously over 20 minutes, and a maintenance dose of 5g imi every four hours. Toxicity was ex- cluded by patellar tendon reflex testing. Blood tests were ordered ...

  20. A Rare Early Complication of Tracheostomy

    Directory of Open Access Journals (Sweden)

    Manjeet Singh Pawar

    2011-01-01

    Full Text Available A polytrauma patient on ventilator was admitted to ICU with open tracheostomy, GCS 8/15 and unequal pupils. After 10 days, he was weaned from the ventilator. The patient had respiratory problems i.e. expiratory stridor, shortness of breath, dysphonia and dyspnea on closing tracheostomy. It was diagnosed as a case of asthma, and the patient responded to salbutamol nebulization and intravenous steroid therapy. However, after some time, he desaturated and a plan for rapid sequence intubation was made. Endotracheal tube could not be negotiated beyond vocal cords, so an unprepared tracheostomy without proper equipment had to be immediately done by an anesthetist to save the patient’s life. CT scan revealed tracheal stenosis. This case demonstrates that patients with a short 15-days history of previous tracheostomy may have tracheal stenosis.

  1. Human Granulocytic Ehrlichiosis Complicating Early Pregnancy

    Directory of Open Access Journals (Sweden)

    Tyler Muffly

    2008-01-01

    Full Text Available Background. The goal of this case is to review the zoonotic infection, human granulocytic ehrlichiosis, presenting with pyrexia. Case. A 22-year-old multigravid female presented to the emergency department with a painful skin rash, high fever, and severe myalgias. The patient underwent a diagnostic evaluation for zoonotic infections due to her geographical and seasonal risk factors. Treatment of human granulocytic ehrlichiosis was successful though the patient spontaneously aborted presumably due to the severity of the acute illness. Conclusion. Treatment of human granulocytic ehrlichiosis in pregnancy presents unique challenges. Management of pyrexia during pregnancy is limited to external cooling in the setting of thrombocytopenia and elevated aminotransferases. Extensive counseling regarding teratogenic potential of medications allows the patient to weigh the pros and cons of treatment.

  2. ESCAPS study protocol: a feasibility randomised controlled trial of 'Early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm'.

    Science.gov (United States)

    Fletcher-Smith, Joanna C; Walker, Dawn-Marie; Sprigg, Nikola; James, Marilyn; Walker, Marion F; Allatt, Kate; Mehta, Rajnikant; Pandyan, Anand D

    2016-01-04

    Approximately 70% of patients with stroke experience impaired arm function, which is persistent and disabling for an estimated 40%. Loss of function reduces independence in daily activities and impacts on quality of life. Muscles in those who do not recover functional movement in the stroke affected arm are at risk of atrophy and contractures, which can be established as early as 6 weeks following stroke. Pain is also common. This study aims to evaluate the feasibility of a randomised controlled trial to test the efficacy and cost-effectiveness of delivering early intensive electrical stimulation (ES) to prevent post-stroke complications in the paretic upper limb. This is a feasibility randomised controlled trial (n=40) with embedded qualitative studies (patient/carer interviews and therapist focus groups) and feasibility economic evaluation. Patients will be recruited from the Stroke Unit at the Nottingham University Hospitals National Health Service (NHS) Trust within 72 h after stroke. Participants will be randomised to receive usual care or usual care and early ES to the wrist flexors and extensors for 30 min twice a day, 5 days a week for 3 months. The initial treatment(s) will be delivered by an occupational therapist or physiotherapist who will then train the patient and/or their nominated carer to self-manage subsequent treatments. This study has been granted ethical approval by the National Research Ethics Service, East Midlands Nottingham1 Research Ethics Committee (ref: 15/EM/0006). To our knowledge, this is the first study of its kind of the early application (within 72 h post-stroke) of ES to both the wrist extensors and wrist flexors of stroke survivors with upper limb impairment. The results will inform the design of a definitive randomised controlled trial. Dissemination will include 2 peer-reviewed journal publications and presentations at national conferences. ISRCTN1648908; Pre-results. Clinicaltrials.gov ID: NCT02324634. Published by the BMJ

  3. Rare complications of cesarean scar

    International Nuclear Information System (INIS)

    Mahajan, Divyesh; Kang, Mandeep; Sandhu, Manavjit Singh; Jain, Vanita; Kalra, Naveen; Khandelwal, Niranjan

    2013-01-01

    Cesarean scar pregnancy (CSP) and cesarean scar dehiscence (CSD) are the most dreaded complications of cesarean scar (CS). As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH) leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG) and confirmed on magnetic resonance imaging (MRI). These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions

  4. Rare complications of cesarean scar

    Directory of Open Access Journals (Sweden)

    Divyesh Mahajan

    2013-01-01

    Full Text Available Cesarean scar pregnancy (CSP and cesarean scar dehiscence (CSD are the most dreaded complications of cesarean scar (CS. As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG and confirmed on magnetic resonance imaging (MRI. These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions.

  5. The pattern of hepatobiliary complications among Egyptian sickle cell disease children

    Directory of Open Access Journals (Sweden)

    Dalia A. Saied

    2017-07-01

    Conclusion: Hepatobiliary complications are frequent among sickle cell disease children especially gallbladder diseases. Repeated clinical and ultrasound screening is needed for early detection and treatment of these complications.

  6. Maternal complications and cesarean section without indication: systematic review and meta-analysis

    Science.gov (United States)

    Mascarello, Keila Cristina; Horta, Bernardo Lessa; Silveira, Mariângela Freitas

    2017-01-01

    ABSTRACT OBJECTIVE The objective of this study was to determine the risks of severe acute maternal complications associated with cesarean section without medical indication. METHODS A systematic review was carried out with meta-analysis. The literature search was performed systematically, in multiple stages, in the PubMed, Lilacs, and Web of Science databases using the following descriptors: (postpartum period) and (cesarean section or natural childbirth) and ((morbidity or mortality) or (postpartum hemorrhage) or (puerperal infection) or (surgical infection) or (puerperal disorders)). The protocol of the study was registered at PROSPERO as CRD42016032933. A total of 1,328 articles were found; after selection, eight publications that met the study objective and inclusion criteria were selected, with information on 1,051,543 individuals. RESULTS The results obtained in the meta-analyses indicate that women with cesarean section have a higher chance of maternal death (OR = 3.10, 95%CI 1.92–5.00) and postpartum infection (OR = 2.83, 95%CI, 1.585.06), but they have a lower chance of hemorrhage (OR = 0.52, 95%CI 0.48–0.57). For the blood transfusion outcome, the group effect was not associated with the type of delivery (95%CI 0.88–2.81). CONCLUSIONS The quality of evidence was considered low for hemorrhage and blood transfusion and moderate for postpartum infection and maternal death. Thus, cesarean sections should be performed with caution and safety, especially when its benefits outweigh the risks of a surgical procedure. PMID:29166440

  7. Complications and Deaths - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - state data. This data set includes state-level data for the hip/knee complication measure, the Agency for Healthcare Research and Quality...

  8. Complications and Deaths - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - national data. This data set includes national-level data for the hip/knee complication measure, the Agency for Healthcare Research and...

  9. Complications and Treatments

    Science.gov (United States)

    ... Possible Complications Links to Other Websites People with sickle cell disease (SCD) start to have signs of the disease during the first year of life, usually around 5 months of age. Symptoms and complications of SCD are different for each ...

  10. Pregnancy Complications: Shoulder Dystocia

    Science.gov (United States)

    ... X Home > Complications & Loss > Pregnancy complications > Shoulder dystocia Shoulder dystocia Now playing: E-mail to a friend Please ... some women more likely than others to have shoulder dystocia? A pregnant woman may be at risk for ...

  11. Complications and Deaths - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - provider data. This data set includes provider data for the hip/knee complication measure, the Agency for Healthcare Research and Quality...

  12. Pregnancy Complications: Anemia

    Science.gov (United States)

    ... online community Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  13. Ureterovaginal fistula: A complication of a vaginal foreign body

    Directory of Open Access Journals (Sweden)

    Tsia-Shu Lo

    2018-02-01

    Conclusion: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.

  14. Abdominal CT findings of delayed postoperative complications

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: zisinrivka@clalit.org.il; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)

    2007-10-15

    Despite progress in surgical techniques and modern medical treatment, postoperative complications occur not infrequently and vary according to type of surgery, clinical setting, and time elapsed since surgery. In general, they can be divided into early and delayed complications. Delayed postoperative complications can be classified as specific and nonspecific. The common nonspecific delayed complications are incisional hernia and postoperative bowel obstruction. Bowel obstruction can be further categorized as obstruction related to benign or neoplastic etiology, the latter occurring in oncology patients in whom the primary surgery was related to an underlying abdominal neoplasm. Gossypiboma is another, fortunately rare, postoperative complication. Specific complications appear after specific operations and include the following: Splenosis - following splenectomy. Retained gallstones and spilled gallstones - following cholecystectomy, mainly laparoscopic. Dropped appendicolith and stump appendicitis - following appendectomy, mainly laparoscopic. Obturation obstruction by a bezoar - following gastric surgery. Afferent loop syndrome (ALS) - following Bilroth II gastrectomy. (author)

  15. VASCULAR COMPLICATIONS AFTER KIDNEY TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    M. Sh. Khubutia

    2013-01-01

    Full Text Available Aim: evaluation of the incidence and the pattern of vessel complications, efficacy of the prophylactic anticoagulation therapy after kidney transplantation. Materials and methods. From March 2007 till January 2013 421 patients: 230 men (54,6% and 191 women (45,4%; mean age 43,07 ± 11,62 undergone 429 kidney transplantations in the department of pancreas and kidney transplantation of the Scientific-Research Institute of Emergency Care named after N.V. Sklifosovsky. In order to evaluate the condition and the function of the kidney transplant ultrasound investigation (daily andacquisition(weekly wereused. In cases of kidney dysfunction and assumption of vessel complications we used computerized tomography. Besides, we used daily analysis of biochemical and clinical parameters of blood and urine. Results. The most common vessel complication was the thrombosis of the microvasculature of the kidney transplant due to acute humoral and combined rejection resistant to antirejection therapy (n = 9; 2,1%; in 4 cases there was a breakage of the transplant due to the acute rejection and the urgent transplantatectomy in an effort to save the patient; thrombosis of the transplantat artery occurred in 1 case (0,23%; we observed 2 cases (0,46% of the artery stenosis and 2 cases (0,46% of venous thrombosis. Conclusion. Summary frequency of vessel complications in our clinic, including thrombosis due to rejection, was 3,49%. It fully corresponds with data obtained from the global medical community. The incidence of great vessel thrombosis was less than 1% which indicates the adequate prophylactic anticoagulation therapy. For the benefit of early diacrisis of complications Doppler sonography is needed. In case of assumption of vessel complications urgent acquisition, computerized tomography and/ or angiography are to be held. 

  16. Complications After Cosmetic Surgery Tourism.

    Science.gov (United States)

    Klein, Holger J; Simic, Dario; Fuchs, Nina; Schweizer, Riccardo; Mehra, Tarun; Giovanoli, Pietro; Plock, Jan A

    2017-04-01

    Cosmetic surgery tourism characterizes a phenomenon of people traveling abroad for aesthetic surgery treatment. Problems arise when patients return with complications or need of follow-up care. To investigate the complications of cosmetic surgery tourism treated at our hospital as well as to analyze arising costs for the health system. Between 2010 and 2014, we retrospectively included all patients presenting with complications arising from cosmetic surgery abroad. We reviewed medical records for patients' characteristics including performed operations, complications, and treatment. Associated cost expenditure and Diagnose Related Groups (DRG)-related reimbursement were analyzed. In total 109 patients were identified. All patients were female with a mean age of 38.5 ± 11.3 years. Most procedures were performed in South America (43%) and Southeast (29.4%) or central Europe (24.8%), respectively. Favored procedures were breast augmentation (39.4%), abdominoplasty (11%), and breast reduction (7.3%). Median time between the initial procedure abroad and presentation was 15 days (interquartile range [IQR], 9) for early, 81.5 days (IQR, 69.5) for midterm, and 4.9 years (IQR, 9.4) for late complications. Main complications were infections (25.7%), wound breakdown (19.3%), and pain/discomfort (14.7%). The majority of patients (63.3%) were treated conservatively; 34.8% became inpatients with a mean hospital stay of 5.2 ± 3.8 days. Overall DRG-related reimbursement premiums approximately covered the total costs. Despite warnings regarding associated risks, cosmetic surgery tourism has become increasingly popular. Efficient patients' referral to secondary/tertiary care centers with standardized evaluation and treatment can limit arising costs without imposing a too large burden on the social healthcare system. 4. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  17. Complications relating to enteral and parenteral nutrition in trauma ...

    African Journals Online (AJOL)

    2014-11-01

    Nov 1, 2014 ... and infectious complications; and metabolic complications relating to PN, including hepatobiliary complications, i.e. cholestasis. Insulin therapy in patients receiving PN may prevent cholestasis.9. ESPEN suggests the early start of supplementary PN on day 2-3, while the American Society for Parenteral and ...

  18. Pediatric ventriculoperitoneal shunts and their complications: An analysis

    Directory of Open Access Journals (Sweden)

    Nitin Agarwal

    2017-01-01

    Conclusion: With this retrospective review of complications of VP shunts, age at initial shunt insertion and the interval between the age of initial shunt placement and onset of complications were the most important patient-related predictors of shunt failure. The different predominant etiological factors responsible for early and late shunt failure were infective and mechanical complications, respectively.

  19. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysi......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  20. Complications relating to enteral and parenteral nutrition in trauma ...

    African Journals Online (AJOL)

    Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...

  1. Perioperative complications in endovascular neurosurgery: Anesthesiologist's perspective

    Science.gov (United States)

    Sharma, Megha U.; Ganjoo, Pragati; Singh, Daljit; Tandon, Monica S.; Agarwal, Jyotsna; Sharma, Durga P.; Jagetia, Anita

    2017-01-01

    Background: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. Methods: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications. Information regarding hemodynamic alterations, temperature variability, fluid-electrolyte imbalance, coagulation abnormalities and alterations in the anesthesia course was specifically noted. Results: Among the important complications observed were aneurysm rupture (2.5%), vasospasm (6.67%), thromboembolism (4.16%), contrast reactions, hemodynamic alterations, electrolyte abnormalities, hypothermia, delayed emergence from anesthesia, groin hematomas and early postoperative mortality (5.14%). Conclusion: Awareness of the unique challenges of endovascular neurosurgery and prompt and appropriate management of the associated complications by an experienced neuroanesthesiologist is vital to the outcome of these procedures. PMID:28413524

  2. complications des otites moyennes chroniques complications of ...

    African Journals Online (AJOL)

    Ann Otolaryngol Chir Cervico Fac. 1995;112 :317-23. 15- Cabral D.A, Flodmark O, Farell K, Speert D.P. Prospective study of computed tomograph in acute bacterial meningitis. J Pediatr 1987;. 111: 201-5. 16- Geyik M.F, Kologlu O.F, Hosoglu S, Ayaz C. Acute bacterial menin- gitidis as a complication of otitis media and ...

  3. Cryptococcal meningitis complicating sarcoidosis

    NARCIS (Netherlands)

    Leonhard, Sonja E.; Fritz, Daan; van de Beek, Diederik; Brouwer, Matthijs C.

    2016-01-01

    Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. When analyzing our patients and 38 cases reported in the literature, we found

  4. Positividade para sífilis em puérperas: ainda um desafio para o Brasil Syphilis positivity in puerperal women: still a challenge in Brazil

    Directory of Open Access Journals (Sweden)

    Celeste S. Rodrigues

    2004-09-01

    Full Text Available OBJETIVO: Estudar os fatores associados à sorologia positiva para sífilis em puérperas atendidas em 24 centros cadastrados pelo Programa Nacional de Doenças Sexualmente Transmissíveis/ AIDS. MÉTODOS: Estudo transversal com amostra aleatória probabilística de 3 047 puérperas, tendo como critério de elegibilidade as gestantes admitidas para parto ou curetagem nos centros selecionados. Após a entrevista foi coletada alíquota de sangue para realização de teste do Venereal Disease Research Laboratory (VDRL. No caso de VDRL positivo, foi realizado o teste fluorescent treponemal antibody-absorption (FTA-abs. O evento considerado para análise foi a positividade para VDRL confirmada pelo FTA-abs. Na análise estatística foi estimada a razão de chances (OR com intervalo de confiança de 95%. A adequação do modelo foi feita pelo teste de Hosmer-Lemeshow. RESULTADOS: A prevalência de sífilis na amostra estudada foi de 1,7%. A análise multivariada mostrou que o maior risco de positividade para VDRL estava associado a renda familiar menor do que 1 salário mínimo, idade OBJECTIVE: To investigate the factors associated with positive syphilis serology results in puerperal women who were receiving care at 24 health centers accredited by Brazil's National Program on Sexually Transmitted Diseases and AIDS. METHODS: This cross-sectional study included a probabilistic random sample of 3 047 puerperal women. The eligibility criterion was being admitted for delivery or curettage in the selected centers. After an interview to collect demographic and clinical information, a blood sample was taken and then examined with the Venereal Disease Research Laboratory (VDRL slide test. With positive VDRL results, the fluorescent treponemal antibody-absorption test (FTA-Abs was used for confirmation. The event considered for analysis was positivity on the VDRL test, with confirmation by the FTA-Abs. For the statistical analysis, odds ratios and 95

  5. [Complications after refractive surgery abroad].

    Science.gov (United States)

    Terzi, E; Kern, T; Kohnen, T

    2008-05-01

    In this article a retrospective analysis of patients presenting at a German university following refractive surgery abroad is presented. A total of 20 cases of patients who had undergone treatment between 1998 and 2006 in China (1 case), Greece (1 case), Iran (1 case), Russia (2 cases), Switzerland (1 case), Slovakia (1 case), Spain (2 cases), South Africa (3 cases), Turkey (6 cases) and the USA (2 cases) were analyzed retrospectively. The following complications were observed: epithelial ingrowth into the interface with or without melting of the flap (6 cases), corneal ectasia (2 cases), dislocation of a phakic posterior chamber intraocular lens and prolapse into the anterior chamber with endothelial cell loss (1 case), secondary increase of intraocular pressure following implantation of a phakic intraocular lens (1 case), flap-related complications following laser-in-situ keratomileusis (LASIK) (2 cases), keratitis (1 case), dislocation of the complete flap (1 case), diffuse lamellar keratitis (DLK) grade IV (1 case), hyperopia as a consequence of radial keratotomy (1 case), and under correction/over correction and poor optical quality following laser epithelial keratomileusis (LASEK) and LASIK for high myopia (5 cases) with possible early corneal ectasia. There are four important problems arising from refractive surgery abroad, often referred to as "LASIK tourism": wrong indications, insufficient management of complications, lack of postoperative care and the health economic aspect.

  6. [Stomatologic complications of eating disorders].

    Science.gov (United States)

    Resch, Mária; Nagy, Agnes

    2012-11-11

    Since the 1990s numerous international experts have reported about the somatic complications of eating disorders including those having a dental and stomatological nature. Several reports emphasised that deformations in the oral cavity resulting from this grave nutritional disease typical of the young generation could already appear in the early stage and, therefore, dentists are among the first to diagnose them. Dentists are still often unaware of the importance of their role in multidisciplinary treatment. Even if they knew what the disease was about and recognised it on the basis of deformations in the oral cavity in time, their advice that their patients should brush their teeth more often would fail to eliminate the root cause of the problem. Not only the earliest possible treatment of the complications of the bingeing-purging mechanism and the maintenance of oral hygiene are important, but controlling and curing pathological habits with active participation of psychiatrists are also required to ensure full recovery. Due to the multidisciplinary nature of the disease, manifold communication is required. For this reason, publishing the dental ramifications of organic and systemic diseases at dental conferences and in technical journals, as well as providing information about oral complications of eating disorders for general practitioners and specialists are particularly important.

  7. Technical note: Intraobserver, interobserver, and test-retest reliabilities of an assessment of vaginal discharge from cows with and without acute puerperal metritis.

    Science.gov (United States)

    Sannmann, I; Heuwieser, W

    2015-08-01

    Acute puerperal metritis (APM) in dairy cows is a common disease occurring in the first 10 d after calving. According to a widely accepted definition, the diagnosis is primarily based on body temperature and sensorial assessment of vaginal discharge. The scope of this study was to evaluate the reliability for color, smell, and viscosity of vaginal discharge from healthy cows and cows with APM. Fifteen investigators evaluated 6 vaginal discharge samples 10 times. Subsequently, the investigators rated the health status of the cows and the diagnostic value of color, smell, and viscosity. In a final questionnaire, the investigators estimated their ability to diagnose APM correctly and the influence of experience. Reliability was tested using Cohen's kappa (κ). Our study revealed slight to moderate reliabilities concerning the assessment of vaginal discharge. Overall interobserver reliability for color, smell, and viscosity was κ=0.15, 0.27, and 0.44, respectively. Overall intraobserver reliability for color, smell, and viscosity was κ=0.35, 0.39, and 0.6, respectively. By means of a questionnaire, overall personal expertise to detect cows suffering from APM correctly as such was estimated to be 59%, whereas the diagnostic value of a combination of color, smell, and viscosity to detect cows with APM correctly was estimated to be 91.1% perfect. We found a discrepancy between reliability and the personal perception of diagnostic value. Our study shows that the sensorial assessment of color, smell, and viscosity of vaginal discharge in cows postpartum is subjective. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  8. Associação entre a autoefi cácia no ciclo gravídico puerperal e o tipo de aleitamento materno

    Directory of Open Access Journals (Sweden)

    Janaiana Lemos Uchoa

    2017-01-01

    Full Text Available Objetivos: analizar la asociación de los promedios de los puntajes de Breastfeeding Self-Efficacy-scale (Short-form de mujeres en el prenatal y el postparto con la clase de lactancia materna. Materiales y método: estudio longitudinal y cuantitativo, realizado en unidades básicas de salud de Pacatuba (Ceará, Brasil, con 50 mujeres con más de 30 semanas gestacionales, en el periodo de julio a noviembre del 2011. Fueron cuatro recolecciones: la primera realizada en la unidad de salud durante el embarazo y las otras tres en visita domiciliaria en el puerperio. Se utilizaron la escala en las dos primeras recolecciones y el formulario de salud infantil en las tres últimas. Resultados: se observó significancia estadística entre los promedios de los puntajes de la escala (p=0,009, en el dominio técnico (ρ=0,001, entre uso de leche artificial al nacer y la clase de lactancia posterior a la salida de la maternidad (ρ=0,001. En la maternidad, las madres de niños que amamantaban exclusivamente presentaron promedios de los dos puntajes de autoeficacia más elevados tanto en el prenatal como en el postparto (p<0,005. Conclusiones: urge la actuación de los profesionales de salud en estrategias de promoción de la lactancia materna pautadas en la autoeficacia, debiendo implementárselas en el ciclo gestacional-puerperal, pues es evidente que altos puntajes de autoeficacia están directamente relacionados con el mayor tiempo de lactancia materna.

  9. Oral piercings: immediate and late complications.

    Science.gov (United States)

    Vieira, Elma P; Ribeiro, Andre Luis Ribeiro; Pinheiro, João de Jesus V; Alves, Sérgio de M

    2011-12-01

    Oral piercings have a long history as part of religious, cultural, or sexual symbolism in many traditional tribes; currently, these ornaments have wide acceptance among young people. Several oral and systemic complications may be associated with this practice; however, limited data related to these complications can be obtained in the literature. This study includes 42 cases of oral piercings in 39 young adults, who were using or had used oral piercings, and the complications associated with their use. Immediate complications occurred in 29 cases, including excessive bleeding (69%) and pain (52.3%) as the most representative. Two cases of syncope were found. Late complications related to the piercing insertion site were observed in 97.6% of cases, with pain and swelling being present in 92.9% and 61.9% of cases, respectively. Dental pain and lacerations on the tongue represented the most prevalent complications associated with the surrounding tissues, accounting for 33.3% and 31% of cases. The use of oral piercings is related to a series of mainly local complications, and individuals who decide to use piercings should be aware of such complications. Individuals wishing to get a part of their body pierced should do so with qualified professionals and should regularly visit the dentist so that a regular control is achieved, thus ensuring the early detection of the adverse effects associated with this practice. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Complications of Rhinitis.

    Science.gov (United States)

    Keswani, Anjeni; Peters, Anju T

    2016-05-01

    Chronic rhinitis involves inflammation of the upper airways. An association with comorbid conditions, such as rhinosinusitis, asthma, and chronic obstructive pulmonary disease, has been commonly observed in epidemiologic studies. The underlying pathogenesis of these disorders may be similar. Complications of rhinitis include sleep disturbances, learning impairment, and decreased quality of life. It is vital to recognize the complications of rhinitis so that treatment strategies can address rhinitis as well as its comorbidities and complications in a coordinated manner. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Imaging of osteochondroma complications

    International Nuclear Information System (INIS)

    Gomes, Fernando Santos Emerich; Lewin, Fabio; Mariotti, Guilherme Cayres; Capasso Filho, Mauro; Yamaguchi, Claudia Kazue; Cruz, Rafael O.; Baptista, Pedro Pericles Ribeiro; Yonamine, Eduardo Sadao; Prospero, Jose Donato

    2007-01-01

    Osteochondroma is the most common entity beyond all the known osseous tumors. It is a lesion with a high enlargement capacity and a continuous growing in some cases, and it may determine complications, mainly due to mass effect. It may be present in a solitary or multiple forms, and the last one is related with a higher tendency to sarcomatous transformation, which is the most frightening complication. The purpose of the present study is to demonstrate, through an iconographic assay, the most common complications caused by the osteochondromas, making the correlation of its clinical and radiological aspects. (author)

  12. Management of tetanus complication

    Science.gov (United States)

    Somia, I. K. A.

    2018-03-01

    The mortality rate of tetanus is still high; it is because of various complications due to muscle spasms, autonomic dysfunction, as well as due to prolonged critical care. Management of tetanus with its complications is in intensive care facilities. Management goals include stopping toxin production, neutralization of unbound toxin, management of the airway, muscle spasm control, treatment of autonomic dysfunction and general supportive management. Currently, diazepam is still an effective medication to control of muscle spasm and rigidity. Therapy for autonomic dysfunction that supported by evidence is MgSO4. Also, general supportive management for long-term care remains necessary to prevent other complications such as thromboembolism, infection, malnutrition, and others.

  13. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysi......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction...... and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  14. [Complications of cocaine addiction].

    Science.gov (United States)

    Karila, Laurent; Lowenstein, William; Coscas, Sarah; Benyamina, Amine; Reynaud, Michel

    2009-06-20

    Addiction is a chronic relapsing disorder characterized by repetitive and compulsive drug-seeking behavior and drug abuse despite negative health or social consequences. Cocaine addiction is a significant worldwide public health problem, which has somatic, psychological, psychiatric, socio-economic and judicial complications. Some of the most frequent complications are cardiovascular effects (acute coronary syndrome, cardiac arrhythmias, increased blood pressure); respiratory effects (fibrosis, interstitial pneumonitis, pulmonary hypertension, alveolar haemorrhage, asthma exacerbation; emphysema), neurological effects (strokes, aneurysms, seizures, headaches); risk for contracting HIV/AIDS, hepatitis B and C, sexual transmitted disease and otolaryngologic effects. Other complications are not discussed here. The vast majority of studies indicate that there are cognitive deficits induced by cocaine addiction. Attention, visual and working memories, executive functioning are affected in cocaine users. Psychiatric complications found in clinical practice are major depressive disorders, cocaine-induced paranoia, cocaine-induced compulsive foraging and panic attacks.

  15. Postoperative rectal anastomotic complications

    Czech Academy of Sciences Publication Activity Database

    Polanecký, O.; Adámek, S.; Šedý, Jiří; Skořepa, J.; Hladík, P.; Šmejkal, M.; Pafko, P.; Lischke, R.

    2014-01-01

    Roč. 115, č. 12 (2014), s. 781-785 ISSN 0006-9248 Institutional support: RVO:67985823 Keywords : human * complication * anastomosis * rectum Subject RIV: FJ - Surgery incl. Transplants Impact factor: 0.439, year: 2014

  16. Complications of Sinusitis

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  17. Complications of Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  18. Pertussis (Whooping Cough) Complications

    Science.gov (United States)

    ... of Search Controls Search Form Controls Cancel Submit Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Pertussis Home About Pertussis Causes & Transmission Signs & Symptoms Complications ...

  19. Complications of Circumcision

    Directory of Open Access Journals (Sweden)

    Aaron J. Krill

    2011-01-01

    Full Text Available In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

  20. Complications of shoulder dystocia.

    Science.gov (United States)

    Dajani, Nafisa K; Magann, Everett F

    2014-06-01

    Complications of shoulder dystocia are divided into fetal and maternal. Fetal brachial plexus injury (BPI) is the most common fetal complication occurring in 4-40% of cases. BPI has also been reported in abdominal deliveries and in deliveries not complicated by shoulder dystocia. Fractures of the fetal humerus and clavicle occur in about 10.6% of cases of shoulder dystocia and usually heal with no sequel. Hypoxic ischemic brain injury is reported in 0.5-23% of cases of shoulder dystocia. The risk correlates with the duration of head-to-body delivery and is especially increased when the duration is >5 min. Fetal death is rare and is reported in 0.4% of cases. Maternal complications of shoulder dystocia include post-partum hemorrhage, vaginal lacerations, anal tears, and uterine rupture. The psychological stress impact of shoulder dystocia is under-recognized and deserves counseling prior to home discharge. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Postoperative surgical complications of lymphadenohysterocolpectomy.

    Science.gov (United States)

    Marin, F; Pleşca, M; Bordea, C I; Voinea, S C; Burlănescu, I; Ichim, E; Jianu, C G; Nicolăescu, R R; Teodosie, M P; Maher, K; Blidaru, A

    2014-03-15

    Rationale The current standard surgical treatment for the cervix and uterine cancer is the radical hysterectomy (lymphadenohysterocolpectomy). This has the risk of intraoperative accidents and postoperative associated morbidity. Objective The purpose of this article is the evaluation and quantification of the associated complications in comparison to the postoperative morbidity which resulted after different types of radical hysterectomy. METHODS AND RESULTS PATIENTS WERE DIVIDED ACCORDING TO THE TYPE OF SURGERY PERFORMED AS FOLLOWS: for cervical cancer - group A- 37 classic radical hysterectomies Class III Piver - Rutledge -Smith ( PRS ), group B -208 modified radical hysterectomies Class II PRS and for uterine cancer- group C -79 extended hysterectomies with pelvic lymphadenectomy from which 17 patients with paraaortic lymphnode biopsy . All patients performed preoperative radiotherapy and 88 of them associated radiosensitization. Discussion Early complications were intra-abdominal bleeding ( 2.7% Class III PRS vs 0.48% Class II PRS), supra-aponeurotic hematoma ( 5.4% III vs 2.4% II) , dynamic ileus (2.7% III vs 0.96% II) and uro - genital fistulas (5.4% III vs 0.96% II).The late complications were the bladder dysfunction (21.6% III vs 16.35% II) , lower limb lymphedema (13.5% III vs 11.5% II), urethral strictures (10.8% III vs 4.8% II) , incisional hernias ( 8.1% III vs 7.2% II), persistent pelvic pain (18.91% III vs 7.7% II), bowel obstruction (5.4% III vs 1.4% II) and deterioration of sexual function (83.3% III vs 53.8% II). PRS class II radical hysterectomy is associated with fewer complications than PRS class III radical hysterectomy , except for the complications of lymphadenectomy . A new method that might reduce these complications is a selective lymphadenectomy represented by sentinel node biopsy . In conclusion PRS class II radical hysterectomy associated with neoadjuvant radiotherapy is a therapeutic option for the incipient stages of cervical cancer

  2. Cryptococcal meningitis complicating sarcoidosis

    OpenAIRE

    Leonhard, Sonja E.; Fritz, Daan; van de Beek, Diederik; Brouwer, Matthijs C.

    2016-01-01

    Abstract Background: Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. Methods: We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. Results: When analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30?48); 27 of 33 reported cases (82%) had a history of sarcoidosis. Only...

  3. On complicity theory.

    Science.gov (United States)

    Kline, A David

    2006-04-01

    The received account of whistleblowing, developed over the last quarter century, is identified with the work of Norman Bowie and Richard DeGeorge. Michael Davis has detailed three anomalies for the received view: the paradoxes of burden, missing harm and failure. In addition, he has proposed an alternative account of whistleblowing, viz., the Complicity Theory. This paper examines the Complicity Theory. The supposed anomalies rest on misunderstandings of the received view or misreadings of model cases of whistleblowing, for example, the Challenger disaster and the Ford Pinto. Nevertheless, the Complicity Theory is important for as in science the contrast with alternative competing accounts often helps us better understand the received view. Several aspects of the received view are reviewed and strengthened through comparison with Complicity Theory, including why whistleblowing needs moral justification. Complicity Theory is also critiqued. The fundamental failure of Complicity Theory is its failure to explain why government and the public encourage and protect whistleblowers despite the possibility of considerable harm to the relevant company in reputation, lost jobs, and lost shareholder value.

  4. Complications of Radical Cystectomy and Orthotopic Reconstruction

    Directory of Open Access Journals (Sweden)

    Wei Shen Tan

    2015-01-01

    Full Text Available Radical cystectomy and orthotopic reconstruction significant morbidity and mortality despite advances in minimal invasive and robotic technology. In this review, we will discuss early and late complications, as well as describe efforts to minimize morbidity and mortality, with a focus on ileal orthotopic bladder substitute (OBS. We summarise efforts to minimize morbidity and mortality including enhanced recovery as well as early and late complications seen after radical cystectomy and OBS. Centralisation of complex cancer services in the UK has led to a fall in mortality and high volume institutions have a significantly lower rate of 30-day mortality compared to low volume institutions. Enhanced recovery pathways have resulted in shorter length of hospital stay and potentially a reduction in morbidity. Early complications of radical cystectomy occur as a direct result of the surgery itself while late complications, which can occur even after 10 years after surgery, are due to urinary diversion. OBS represents the ideal urinary diversion for patients without contraindications. However, all patients with OBS should have regular long term follow-up for oncological surveillance and to identify complications should they arise.

  5. Malposition and complications following venous catheterization

    International Nuclear Information System (INIS)

    Maffesanti, M.; Bortolotto, P.; Kette, F.

    1988-01-01

    Malposition and complications following central venous catheterization largely depend on the site of venous approach. Malpositions are very common after subclavian vein catheterization, and even more common after left jugular vein catheterization. On the contrary, their incidence after right jugular puncture is very low. Among complications, pneumothorax is quate common after subclavian vein catheterization, and migration of the catheter towards the heart after right jugular puncture. Vascular damages may occur in any approach: their early detection on chest radiographs very much depends on a rigorous technique. Radiology plays an important role in the early detection of malposition and complications, which is greatly facilitated by a few ml of contrast medium injected through the catheter

  6. ORBITAL CELLULITIS COMPLICATING SINUSITIS: A 15-YEAR ...

    African Journals Online (AJOL)

    Dr. NWaorgu

    venous connections. Complications are more frequent due to ethmoiditis and in adults the frontal sinus is frequently responsible. This report aims at drawing attention to the continued leading sinogenic origin of orbital cellulitis. It is hoped that this will prompt early diagnosis and treatment, and reduce morbidity and mortality.

  7. Primary congenital hypothyroidism complicated by persistent severe ...

    African Journals Online (AJOL)

    2013-12-24

    Dec 24, 2013 ... Case Study: Primary congenital hypothyroidism complicated by persistent severe anaemia in early infancy. 85. 2014 Volume 19 No 2. JEMDSA. Introduction. Although anaemia is a common finding in adults with hypothyroidism, there is a general paucity of studies on anaemia in infants with congenital ...

  8. Neurologic complications after solid organ transplantation.

    Science.gov (United States)

    Senzolo, Marco; Marco, Senzolo; Ferronato, Cecilia; Cecilia, Ferronato; Burra, Patrizia; Patrizia, Burra

    2009-03-01

    Neurologic complications are common after solid organ transplantation and are associated with significant morbidity. Approximately one-third of transplant recipients experiences neurologic alterations with incidence ranging from 10% to 59%. The complications can be divided into such of those common to all types of transplant and others of those specific to transplanted organ. The most common complication seen with all types of transplanted organ is neurotoxicity attributable to immunosuppressive drugs, followed by seizures, opportunistic central nervous system (CNS) infections, cardiovascular events, encephalopathy and de novo CNS neoplasms. Amongst immunosuppressants, calcineurin inhibitors are the main drugs involved in neurotoxicity, leading to complications which ranges from mild symptoms, such as tremors and paresthesia to severe symptoms, such as disabling pain syndrome and leukoencephalopathy. Neurologic complications of liver transplantation are more common than that of other solid organ transplants (13-47%); encephalopathy is the most common CNS complication, followed by seizures; however, central pontine myelinolysis can appear in 1-8% of the patients leading to permanent disabilities or death. In kidney transplanted patients, stroke is the most common neurologic complication, whereas cerebral infarction and bleeding are more typical after heart transplantation. Metabolic, electrolyte and infectious anomalies represent common risk factors; however, identification of specific causes and early diagnosis are still difficult, because of patient's poor clinical status and concomitant systemic and metabolic disorders, which may obscure symptoms.

  9. Tattoo complaints and complications

    DEFF Research Database (Denmark)

    Serup, Jørgen; Carlsen, Katrina Hutton; Sepehri, Mitra

    2015-01-01

    Tattoos cause a broad range of clinical problems. Mild complaints, especially sensitivity to sun, are very common and seen in 1/5 of cases. Medical complications are dominated by allergy to tattoo pigment haptens or haptens generated in the skin, especially in red tattoos but also in blue and green...... tattoos. Symptoms are major and can be compared to cumbersome pruritic skin diseases. Tattoo allergies and local reactions show distinct clinical manifestations, with plaque-like, excessive hyperkeratotic, ulcero-necrotic, lymphopathic, neuro-sensory, and scar patterns. Reactions in black tattoos...... are papulo-nodular and non-allergic and associated with the agglomeration of nanoparticulate carbon black. Tattoo complications include effects on general health conditions and complications in the psycho-social sphere. Tattoo infections with bacteria, especially staphylococci, which may be resistant...

  10. Post dengue neurological complication

    Directory of Open Access Journals (Sweden)

    Hizlinda Tohid

    2015-12-01

    Full Text Available Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE followed by an upper respiratory tract infection (URTI weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

  11. Complications associated with radiofrequency ablation of pulmonary veins.

    Science.gov (United States)

    Madrid Pérez, J M; García Barquín, P M; Villanueva Marcos, A J; García Bolao, J I; Bastarrika Alemañ, G

    Radiofrequency ablation is an efficacious alternative in patients with symptomatic atrial fibrillation who do not respond to or are intolerant to at least one class I or class III antiarrhythmic drug. Although radiofrequency ablation is a safe procedure, complications can occur. Depending on the location, these complications can be classified into those that affect the pulmonary veins themselves, cardiac complications, extracardiac intrathoracic complications, remote complications, and those that result from vascular access. The most common complications are hematomas, arteriovenous fistulas, and pseudoaneurysms at the puncture site. Some complications are benign and transient, such as gastroparesis or diaphragmatic elevation, whereas others are potentially fatal, such as cardiac tamponade. Radiologists must be familiar with the complications that can occur secondary to pulmonary vein ablation to ensure early diagnosis and treatment. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Complications of cosmetic tattoos.

    Science.gov (United States)

    De Cuyper, Christa

    2015-01-01

    Cosmetic tattoos, which are better known as permanent make-up, have become popular in the last decades. This same procedure can be used to camouflage pathological skin conditions, to mask scars and to complete the aesthetic results of plastic and reconstructive surgeries. The risks and complications of tattooing procedures include infections and allergic reactions. Scarring can occur. Fanning and fading of the colorants and dissatisfaction with colour and shape are not unusual. Different lasers can offer solutions for the removal of unwanted cosmetic tattoos, but complications due to the laser treatment, such as paradoxical darkening and scarring, can arise. © 2015 S. Karger AG, Basel.

  13. Sinogenic intracranial complications

    DEFF Research Database (Denmark)

    Kofoed, Mikkel Seremet; Fisker, Niels; Christensen, Anne Estmann

    2018-01-01

    We present two 11-year-old girls with chronic recurrent multifocal osteomyelitis, treated with adalimumab. Both developed severe intracranial complications to sinusitis. Patient 1 had been treated with adalimumab for 15 months when she developed acute sinusitis complicated by an orbital abscess...... and subcortical abscesses in combination with sinusitis. She was treated with endoscopic sinus surgery and intravenous antibiotics. Both patients had developed psoriasis and episodes of infection during treatment. They were non-septic and had low fever on presentation. None of the patients suffered any long...

  14. Nuevas orientaciones en el tratamiento de la infección puerperal generalizada por los antivirus en inyección intravenosa

    Directory of Open Access Journals (Sweden)

    José del Carmen Acosta

    1932-11-01

    Full Text Available El tratamiento de la infección puerperal ha sido tema de constante preocupación y estudio de los médicos de todas las épocas, desde Hipócrates hasta nuestros días; hubo en la antigüedad verdaderas epidemias que diezmaban los servicios hospitalarios y aún la clientela civil, como fué la estudiada por Mauriceau, en 1660, que causó una mortalidad de los dos tercios de las puérperas del Hotel Dieu de París, posteriormente se registraron epidemias semejantes, si no tan generalizadas, sí muy alarmantes, en Leipzig, Londres, Edimburgo, Berlín, etc., etc. En todas ellas, como era natural, se hicieron estudios diversos sobre su etiología y su tratamiento, que si todavía no han resuelto el problema, sí han contribuido grandemente a discriminar y simplificar los distintos puntos que abarca: hoy están clasificadas y claramente separadas las infecciones localizadas, de las generalizadas; él tratamiento de las primeras, especialmente en lo que se refiere a las endcmetritis, es un punto definitivamente adquirido con la aplicación de los filtrados o antivirus de Besredka, como lo demuestra el importante trabajo que sobre este asunto presentó a la Facultad el actual Jefe de Clínica del Servicio a mi cargo, Dr. Carlos J. Mojica; el pronóstico de esas formas en lo generales benigno, aun cuando la evolución pueda. prolongarse. por mas o menos días. En lo que respecta a las formas generalizadas, cuya etiología fué prevista por el gran sabio vienés Semmelweis (1847 y más tarde confirmada por los estudios de la éra pasteuríana, subsisten hoy como un espectro amenazador, porque la terapéutica empleada contra ellas sólo ha servido para demostrar nuestra impotencia y poner de manifiesto el completo fracaso de las drogas empleadas para combatirlas.

  15. Aspectos ultra-estruturais da fibra muscular cardíaca de ratas albinas durante o ciclo gravídico-puerperal

    Directory of Open Access Journals (Sweden)

    Liberatori Filho A.W.

    1999-01-01

    Full Text Available OBJETIVO. No presente estudo avaliamos, por intermédio da microscopia eletrônica de transmissão, a morfologia dos cardiomiócitos do ventrículo esquerdo de ratas albinas no decorrer do ciclo gravídico-puerperal. MÉTODOS. Obtida a prenhez, 77 ratas foram divididas ao acaso em dois grupos denominados, respectivamente, de: gestação (G e puerpério (P. Os animais pertencentes ao grupo gestação foram ainda subdivididos em quatro subgrupos, de acordo com a idade gestacional; 1o (G-A, 7o (G-B, 14o (G-C e 21o (G-D dias de prenhez. O grupo definido como puerpério foi também subdividido em três subgrupos; 7o (P-A, 14o (P-B e 21o (P-C dias de puerpério. Findo o período estabelecido para cada subgrupo, os animais foram sacrificados, sendo coletados fragmentos do terço médio do ventrículo esquerdo, os quais após processamento apropriado, permitiram observação adequada à microscopia eletrônica de transmissão. RESULTADOS. Os resultados obtidos demonstraram hipertrofia gradativos dos cardiomiócitos no decorrer da prenhez (aumento das miofibrilas, que ao final da gestação apresentaram-se entremeadas de numerosas mitocôndrias. As paredes dos capilares sangüíneos, progressivamente, tornaram-se mais delgadas, com aumento das vesículas de pinocitose no interior das células endoteliais. Revelou ainda, acentuadas dobras do sarcolema em nível dos túbulos T (túneis capilares. No grupo puerpério, notamos gradativa regressão nessas alterações, com retorno às características pré-gestacionais. Os achados demonstram a ocorrência de hipertrofia no decorrer da gestação. CONCLUSÃO. Durante a prenhez há hipertrofia em cardiomiócito do ventrículo esquerdo com regressão durante o puerpério.

  16. Neurological complications of Schistosoma infection.

    Science.gov (United States)

    Carod-Artal, Francisco Javier

    2008-02-01

    Schistosomiasis is a parasitic disease caused by blood flukes of the genus Schistosoma. Currently more than 200 million people worldwide are affected. Neuroschistosomiasis constitutes a severe presentation of the disease. Neurological symptoms result from the inflammatory response of the host to egg deposition in the brain and spinal cord. Neurological complications of cerebral schistosomiasis include delirium, loss of consciousness, seizures, dysphasia, visual field impairment, focal motor deficits and ataxia. Cerebral and cerebellar tumour-like neuroschistosomiasis can present with increased intracranial pressure, headache, nausea and vomiting, and seizures. Myelopathy (acute transverse myelitis and subacute myeloradiculopathy) is the most common neurological complication of Schistosoma mansoni infection. Schistosomal myelopathy tends to occur early after infection and is more likely to be symptomatic than cerebral schistosomiasis. The conus medullaris and cauda equina are the most common sites of involvement. Severe schistosomal myelopathy can provoke a complete flaccid paraplegia with areflexia, sphincter dysfunction and sensory disturbances. Schistosomicidal drugs, steroids and surgery are the currently available treatments for neuroschistosomiasis. Rehabilitation and multidisciplinary team care are needed in severely disabled patients.

  17. Anticoagulation in pregnancy complications

    NARCIS (Netherlands)

    Middeldorp, Saskia

    2014-01-01

    Women with acquired and inherited thrombophilia are thought to be at increased risk for pregnancy complications, including recurrent pregnancy loss and, depending on the type of thrombophilia, severe preeclampsia. This review discusses the associations between the types of thrombophilia and types of

  18. Atrial Fibrillation: Complications

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Complications Past Issues / Winter 2015 Table of Contents ... has two major complications—stroke and heart failure. Atrial Fibrillation and Stroke Click to enlarge image This illustration ...

  19. Measles and its Complications

    African Journals Online (AJOL)

    1974-05-15

    May 15, 1974 ... Abnormal intensity of lung markings (Fig. I) is a classical feature of even the mildest case. ... The bacterial invaders were studied by means of lung puncture.' Coagulase-positive staphylococci ... Spontaneous mediastinal emphysema is a rarely recorded complication of measles (Fig. 3). A recent review of ...

  20. Complicating Visual Culture

    Science.gov (United States)

    Daiello, Vicki; Hathaway, Kevin; Rhoades, Mindi; Walker, Sydney

    2006-01-01

    Arguing for complicating the study of visual culture, as advocated by James Elkins, this article explicates and explores Lacanian psychoanalytic theory and pedagogy in view of its implications for art education practice. Subjectivity, a concept of import for addressing student identity and the visual, steers the discussion informed by pedagogical…

  1. Treatment of complicated grief

    Directory of Open Access Journals (Sweden)

    Rita Rosner

    2011-11-01

    Full Text Available Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide.

  2. Complication with intraosseous access

    DEFF Research Database (Denmark)

    Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

    2013-01-01

    .5%), and extravasation (3.7%). Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively. CONCLUSION: In users' recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect...

  3. Medical complications following splenectomy.

    Science.gov (United States)

    Buzelé, R; Barbier, L; Sauvanet, A; Fantin, B

    2016-08-01

    Splenectomy is attended by medical complications, principally infectious and thromboembolic; the frequency of complications varies with the conditions that led to splenectomy (hematologic splenectomy, trauma, presence of portal hypertension). Most infectious complications are caused by encapsulated bacteria (Meningococcus, Pneumococcus, Hemophilus). These occur mainly in children and somewhat less commonly in adults within the first two years following splenectomy. Post-splenectomy infections are potentially severe with overwhelming post-splenectomy infection (OPSI) and this justifies preventive measures (prophylactic antibiotics, appropriate immunizations, patient education) and demands prompt antibiotic management with third-generation cephalosporins for any post-splenectomy fever. Thromboembolic complications can involve both the caval system (deep-vein thrombophlebitis, pulmonary embolism) and the portal system. Portal vein thrombosis occurs more commonly in patients with myeloproliferative disease and cirrhosis. No thromboembolic prophylaxis is recommended apart from perioperative low molecular weight heparin. However, some authors choose to prescribe a short course of anti-platelet medication if the post-splenectomy patient develops significant thrombocytosis. Thrombosis of the portal or caval venous system requires prolonged warfarin anticoagulation for 3 to 6 months. Finally, some studies have suggested an increase in the long-term incidence of cancer in splenectomized patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  5. Pulsative hematoma: A penile fracture complication

    Directory of Open Access Journals (Sweden)

    Nale Đorđe

    2007-01-01

    Full Text Available Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. Conclusion. Pulsative hematoma (pulsative diverticulum is a very rare, early complication of a conservatively treated penile fracture. Surgical treatment has an advantage over surgical one, which was confirmed by our case report.

  6. Neurological complications of chickenpox

    Directory of Open Access Journals (Sweden)

    Girija A

    2007-01-01

    Full Text Available Aim: To assess the neurological complications of chickenpox with prognosis. Background: The neurological complications occur in 0.03% of persons who get chickenpox. There is no universal vaccination against chicken pox in India. Most patients prefer alternate modalities of treatment. Hence these complications of chickenpox are likely to continue to occur. Study Design: A prospective study was conducted for 2 years (from March 2002 on the admitted cases with neurological complications after chickenpox (with rash or scar. Patients were investigated with CT/MRI, CSF study, EEG and nerve conduction studies and hematological workup. They were followed-up for 1 year and outcome assessed using modified Rankin scale. Results: The latency for the neurological complications was 4-32 days (mean: 16.32 days. There were 18 cases: 10 adults (64% and 8 children (36%. Cerebellar ataxia (normal CT/MRI was observed in 7 cases (32% (mean age: 6.85 years. One patient (6 years had acute right hemiparesis in the fifth week due to left capsular infarct. All these cases spontaneously recovered by 4 weeks. The age range of the adult patients was 13-47 years (mean: 27 years. The manifestations included cerebellar and pyramidal signs (n-4 with features of demyelination in MRI who recovered spontaneously or with methylprednisolone by 8 weeks. Patient with encephalitis recovered in 2 weeks with acyclovir. Guillain Barre syndrome of the demyelinating type (n-2 was treated with Intravenous immunoglobulin (IVIG and they had a slow recovery by a modified Rankin scale (mRs score of 3 and 2 at 6 months and 1 year, respectively. One case died after hemorrhage into the occipital infarct. There were two cases of asymmetrical neuropathy, one each of the seventh cranial and brachial neuritis. Conclusion: Spontaneous recovery occurs in post-chickenpox cerebellar ataxia. Rarely, serious complications can occur in adults. The demyelinating disorders, either of the central or peripheral

  7. Medical Management of Metabolic Complications of Liver Transplant Recipients

    OpenAIRE

    Barnard, Abbey; Konyn, Peter; Saab, Sammy

    2016-01-01

    Improved short- and long-term survival of liver transplant recipients has led to increased focus on complications of both the early and late posttransplant periods. A variety of metabolic complications have been observed in the post–orthotopic liver transplant population, including hypertension, hyperlipidemia, obesity, diabetes mellitus, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Although only a small proportion of patients experience metabolic complications prior to...

  8. Effect Of Complications Of Trabeculectomy On The Control Of ...

    African Journals Online (AJOL)

    Although 55 (78.6%) eyes had one early complication or the other, there were few long-term problems that could endanger the control of intraocular pressure. The most severe complication in terms of visual loss was endophthalmitis. The above findings suggest that trabeculectomy is relatively safe and effective in terms of ...

  9. [Complications of Gaucher's disease].

    Science.gov (United States)

    Modrego Pardo, P J; Garzarán, G; González, N; Baiges, J J; Gazulla, J

    1992-10-01

    We discuss two cases of Gaucher's disease of the adult with neurological complications. First of the patients came to Hospital due to sudden pain in dorso-lumbar region and motor weakness of lower extremities. In the neurological exploration there were no concluding objective deficit signs except an unstable deambulation. After several hours of rest, symptoms disappeared progressively. In the radiology of the raquis a crushed in the last three dorsal vertebral was seen; this finding together with the clinic the patient showed, suggested a mild and transitory medullar compression. Second patient suffered an intraparenchymatous brain hemorrhage on the course of a platelet depletion and with other mild coagulation disorders. This type of complication have never been described in Gaucher's disease.

  10. [Complications of liver cirrhosis].

    Science.gov (United States)

    Bratović, Ismet; Jazić, Altaira

    2003-01-01

    Increase in portal venous pressure after anatomical or functional obstruction of portal venous system represents the most important complication of liver cirrhosis. Important sequels of portal hypertension are not dependable of etiology of liver disease. They are: increased collateral circulation in portal system and low pressure venous system (esophageal and gastric varices, portal hypertensive gastropathy and colopathy, hemorrhoids, collateral circulation through anterior abdominal wall, increased lymphatic flow, ascites, splenomegaly with occasional hypersplenismus, hepatic encephalopathy, hepatorenal syndrome.

  11. Thromboembolic Complications Following Trauma

    Science.gov (United States)

    2009-12-01

    these physiologic derangements, it is estimated that hypercoagulable disorders, such as factor V Leiden and hyperhomocysteinemia, may be present in...risk factors of venous thrombosis. Hum Genet 2001;109:369-84. 3. Knudson MM, Ikossi DG. Venous thromboembolism after trauma. Curr Opin Crit Care...R E V I E W A R T I C L E Thromboembolic complications following trauma Daniel F. McLaughlin, Charles E. Wade, Howard R. Champion, Jose Salinas, and

  12. Características biomecânicas dos pés no período gravídico-puerperal: estudo de caso = Biomechanical characteristics of feet during pregnancy and puerperium: a case study

    Directory of Open Access Journals (Sweden)

    Wittkopf, Priscilla Geraldine

    2015-01-01

    Full Text Available Objetivos: A valiar as variações antropométricas e a distribuição de pressão plantar dos pés durante o ciclo gravídico - puerperal de uma paciente. Descrição do caso: Este estudo descritivo - exploratório analisou uma gestante por meio de oito avaliações, seis durante a gestação (na 26 ª, 28 ª, 30 ª, 32 ª, 34 ª e 36 ª semana da gestação e duas no puerpério (10 º e 50 º dia a pós o parto. Foram avaliadas seis variáveis antropomé tricas dos pés e tornozelos. Por meio do escaneamento dos pés, obteve - se indiretamente o ângulo da impressão plantar. O Sistema Pedar - Mobile (Novel GmbH, avaliou o índice do arco plantar e o pico de pressão máxima plantar tan to estátic o como din â mico. Durante o período gestacional o comprimento e o perímetro do mediopé direito apresentaram - se maiores do que o esquerdo. Ocorreu diminuição do ângulo plantar com a evolução da gestação. A variação do índice do arco plantar na tarefa estática mostrou variaçã o mínima em todo o período avaliado, enquanto na dinâmica demonstrou diminuição progressiva dos valores durante a gestação e aumento no período puerperal. As médias dos picos de pressão plantar na tarefa dinâmica foram mais elevadas durante o período gesta cional em comparaç ão ao puerpério. Conclusões: Estes dados mostram alterações nas características biomecânicas dos pés no ciclo gravídico - puerperal, ressaltando aumento na perimetria e diminuição do arco plantar

  13. Endoscopic management of post-bariatric surgery complications.

    Science.gov (United States)

    Boules, Mena; Chang, Julietta; Haskins, Ivy N; Sharma, Gautam; Froylich, Dvir; El-Hayek, Kevin; Rodriguez, John; Kroh, Matthew

    2016-09-16

    Understanding the technical constructs of bariatric surgery is important to the treating endoscopist to maximize effective endoluminal therapy. Post-operative complication rates vary widely based on the complication of interest, and have been reported to be as high as 68% following adjustable gastric banding. Similarly, there is a wide range of presenting symptoms for post-operative bariatric complications, including abdominal pain, nausea and vomiting, dysphagia, gastrointestinal hemorrhage, and weight regain, all of which may provoke an endoscopic assessment. Bleeding and anastomotic leak are considered to be early (complications, whereas strictures, marginal ulcers, band erosions, and weight loss failure or weight recidivism are typically considered late (> 30 d) complications. Treatment of complications in the immediate post-operative period may require unique considerations. Endoluminal therapies serve as adjuncts to surgical and radiographic procedures. This review aims to summarize the spectrum and efficacy of endoscopic management of post-operative bariatric complications.

  14. Normal tissue complication probability for salivary glands

    International Nuclear Information System (INIS)

    Rana, B.S.

    2008-01-01

    The purpose of radiotherapy is to make a profitable balance between the morbidity (due to side effects of radiation) and cure of malignancy. To achieve this, one needs to know the relation between NTCP (normal tissue complication probability) and various treatment variables of a schedule viz. daily dose, duration of treatment, total dose and fractionation along with tissue conditions. Prospective studies require that a large number of patients be treated with varied schedule parameters and a statistically acceptable number of patients develop complications so that a true relation between NTCP and a particular variable is established. In this study Salivary Glands Complications have been considered. The cases treated in 60 Co teletherapy machine during the period 1994 to 2002 were analyzed and the clinicians judgement in ascertaining the end points was the only means of observations. The only end points were early and late xerestomia which were considered for NTCP evaluations for a period of 5 years

  15. Influence of early goal-directed therapy using arterial waveform analysis on major complications after high-risk abdominal surgery : study protocol for a multicenter randomized controlled superiority trial

    NARCIS (Netherlands)

    Montenij, Leonard; de Waal, Eric; Frank, Michael; van Beest, Paul; de Wit, Ardine; Kruitwagen, Cas; Buhre, Wolfgang; Scheeren, Thomas

    2014-01-01

    Background:  Early goal-directed therapy refers to the use of predefined hemodynamic goals to optimize tissue oxygen delivery in critically ill patients. Its application in high-risk abdominal surgery is, however, hindered by safety concerns and practical limitations of perioperative hemodynamic

  16. Bacterial meningitis and neurological complications in adults

    Directory of Open Access Journals (Sweden)

    Parunyou Julayanont

    2016-04-01

    Full Text Available Bacterial meningitis is a leading cause of death from infectious disease worldwide. The neurological complications secondary to bacterial meningitis contribute to the high mortality rate and to disability among the survivors. Cerebrovascular complications, including infarction and hemorrhage, are common. Inflammation and increased pressure in the subarachnoid space result in cranial neuropathy. Seizures occur in either the acute or delayed phase after the infection and require early detection and treatment. Spreading of infection to other intracranial structures, including the subdural space, brain parenchyma, and ventricles, increases morbidity and mortality in survivors. Infection can also spread to the spinal canal causing spinal cord abscess, epidural abscess, polyradiculitis, and spinal cord infarction secondary to vasculitis of the spinal artery. Hypothalamic-pituitary dysfunction is also an uncommon complication after bacterial meningitis. Damage to cerebral structures contributes to cognitive and neuropsychiatric problems.  Being aware of these complications leads to early detection and treatment and improves mortality and outcomes in patients with bacterial meningitis.

  17. Keratomycosis complicating pterygium excision

    Directory of Open Access Journals (Sweden)

    Merle H

    2011-10-01

    Full Text Available Harold Merle1, Jérôme Guyomarch1, Jean-Christophe Joyaux1, Maryvonne Dueymes2, Angélique Donnio1, Nicole Desbois2 1Department of Ophthalmology, 2Laboratory of Microbiology, University Hospital of Fort-de-France, Martinique, French West Indies Abstract: The authors describe a case of keratomycosis that appeared after the exeresis of a pterygium. A 48-year-old patient had been referred with a red right eye associated with an abscess of the cornea along the ablation zone of the pterygium. The surgery had been performed a month beforehand. The abscess was 6 mm high and 4 mm wide. The authors instigated a treatment that included amphotericin B (0.25% after noticing a clinical aspect evoking a fungal keratitis and finding several septate filaments on direct examination. On day 10, a Fusarium dimerum was isolated on Sabouraud agar. After 15 days of treatment, the result was favorable and the size of the ulceration as well as the size of the abscess had progressively decreased. The antifungal treatment was definitively stopped at 14 weeks. Infectious-related complications of the pterygium surgery are rare and are essentially caused by bacterial agents. Secondary infections by fungus are rare. There have been two previous cases reported: one that appeared 15 years after radiotherapy and another that appeared at 3 weeks post surgery, consecutive to the use of mitomycin C. To the authors' knowledge, this is the first case of a keratomycosis due to F. dimerum reported that complicated the exeresis of a pterygium without the use of an adjuvant antihealing treatment. Pterygium surgery is a common procedure; nevertheless, ophthalmologists need to be aware of the existence of potential infectious complications. Keywords: keratitis, corneal abscess, Fusarium

  18. Cryptococcal meningitis complicating sarcoidosis.

    Science.gov (United States)

    Leonhard, Sonja E; Fritz, Daan; van de Beek, Diederik; Brouwer, Matthijs C

    2016-08-01

    Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. When analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30-48); 27 of 33 reported cases (82%) had a history of sarcoidosis. Only 16 of 40 patients (40%) received immunomodulating therapy at the time of diagnosis of cryptococcal meningitis. The diagnosis of cryptococcal meningitis was delayed in 17 of 40 patients (43%), mainly because of the initial suspicion of neurosarcoidosis. Cerebrospinal fluid (CSF) examination showed mildly elevated white blood cell count (range 23-129/mm). Twenty-nine of 32 cases (91%) had a positive CSF culture for Cryptococcus neoformans and 25 of 27 cases (93%) had a positive CSF C neoformans antigen test. CD4 counts were low in all patients in whom counts were performed (84-228/mL). Twelve patients had an unfavorable outcome (32%), of which 7 died (19%) and 24 patients (65%) had a favorable outcome. The rate of unfavorable outcome in patients with a delayed diagnosis was 7 of 17 (41%) compared to 5 of 28 (21%) in patients in whom diagnosis was not delayed. Cryptococcal meningitis is a rare but life-threatening complication of sarcoidosis. Patients were often initially misdiagnosed as neurosarcoidosis, which resulted in considerable treatment delay and worse outcome. CSF cryptococcal antigen tests are advised in patients with sarcoidosis and meningitis.

  19. Predicting complicated choledocholithiasis.

    Science.gov (United States)

    Kummerow, Kristy L; Shelton, Julia; Phillips, Sharon; Holzman, Michael D; Nealon, William; Beck, William; Sharp, Kenneth; Poulose, Benjamin K

    2012-09-01

    Management of choledocholithiasis and its complications is variable and often requires transfer to a specialty facility. This study links patient-specific characteristics with the outcome measure of complicated choledocholithiasis to identify high-risk patients who may require expedited treatment or transfer to a higher level of care. Patients with a discharge diagnosis of choledocholithiasis (CDL) were identified from the 2009 Nationwide Inpatient Sample (NIS). Patient characteristics were identified associated with the primary outcome measure of complicated choledocholithiasis (cCDL), defined as acute pancreatitis or cholangitis during the admission for CDL. Predictors of mortality were also evaluated. Analysis was performed using complex-sample univariate and adjusted analyses. We identified 123,990 discharges with a diagnosis of CDL. The overall incidence of CDL was 314 per 100,000 NIS discharges. Forty-one percent of CDL discharges were for cCDL (acute pancreatitis 31%, cholangitis 12%). Risk factors for cCDL included age (risk increased 0.8% per year), male gender (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.1-1.2), alcohol abuse (OR 1.5, CI 1.3-1.8), diabetes (OR 1.1, CI 1.0-1.2), hypertension (OR 1.1, CI 1.0-1.2), obesity (OR 1.2, CI 1.1-1.3), nonelective admission (OR 2.3, CI 2.0-2.6), and Asian/Pacific Islander race/ethnicity (OR 1.2, CI 1.0-1.5). Patients with cCDL had increased odds of mortality (OR 1.5, CI 1.2-2.0). Increased age, nonelective admission, and specific comorbid conditions are associated with cCDL, which has increased mortality. These factors can be used to identify patients needing timely access to treatment or transfer to a higher level of care. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Neurologic complications of metronidazole.

    Science.gov (United States)

    Sarna, Justyna R; Furtado, Sarah; Brownell, A Keith W

    2013-11-01

    Metronidazole (Flagyl®) is an antimicrobial agent commonly used in clinical practice. Although it is generally well tolerated with minimal side effects, there are a host of still under-recognized neurologic complications of metronidazole treatment. The following review is aimed at summarizing current literature pertaining to metronidazole-induced neurotoxicity including clinical syndromes, neuroradiological findings, prognosis and proposed pathophysiology. Recognition of the neurotoxic effects of metronidazole is critical as prompt discontinuation is generally associated with full clinical recovery and radiological resolution. Complications neurologiques du métronidazole. Le métronidazole (Flagyl®) est un agent antimicrobien utilisé couramment en pratique clinique. Bien qu'il soit généralement bien toléré et que ses effets secondaires soient minimes, il existe une myriade de complications neurologiques du traitement par le métronidazole qui ne sont pas toujours reconnues. Le but de cette revue constitue un sommaire de la littérature actuelle concernant la neurotoxicité induite par le métronidazole dont les syndromes cliniques, les constatations neuroradiologiques, le pronostic et l'hypothèse physiopathologique expliquant cette neurotoxicité. Il est important d'identifier ces effets neurotoxiques du métronidazole étant donné que l'arrět immédiat du traitement est généralement associé à une guérison clinique complète et à la disparition des signes radiologiques.

  1. Superior mesenteric vein thrombosis complicating appendicular masses

    International Nuclear Information System (INIS)

    Echitibi, Salma S.; Bashir, Masoud O.; Ahmad, Misba U.

    2003-01-01

    Mesenteric vein thrombosis (MVT) is rare. Its diagnosis is usually difficult and delayed. We report two patients who developed MVT as a complication of an appendicular mass. One of them had appendectomy and developed fever 10 days postoperatively. The other was treated conservatively. An abdominal computerized tomography(CT) scan with intravenous contrast was helpful in diagnosing superior MVT in both patients, which were not suspected. Intravenous contrast should be used when performing CT of an appendicular mass. Special interest should be directed at studying the superior mesenteric vein. Early diagnosis of our patients helped to start early medical treatment with anticoagulation. (author)

  2. Complications of decorative tattoo.

    Science.gov (United States)

    Shinohara, Michi M

    2016-01-01

    Decorative tattoo is a popular practice that is generally safe when performed in the professional setting but can be associated with a variety of inflammatory, infectious, and neoplastic complications, risks that may be increased with current trends in home tattooing. Modern tattoo inks contain azo dyes and are often of unknown composition and not currently regulated for content or purity. Biopsy of most (if not all) tattoo reactions presenting to the dermatologist is recommended, given recent clusters of nontuberculous mycobacterial infections occurring within tattoo, as well as associations between tattoo reactions and systemic diseases such as sarcoidosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. ACUTE APPENDICITIS COMPLICATING PREGNANCY

    Science.gov (United States)

    Sprong, David H.; Pollock, William F.

    1959-01-01

    Acute appendicitis occurs as a complication of pregnancy in about 0.1 per cent of cases. Diagnosis may be somewhat more difficult during the second and third trimesters dur to the displacement of viscera and the increased incidence of pyelitis and constipation. It is based on the same symptoms and signs as in nonpregnant patients. The treatment is immediate operation regardless of the stage of pregnancy. A McBurney incision is preferred and it is placed somewhat higher than usual in the later stages of pregnancy. When operation is done promptly there is little danger to either mother or fetus. PMID:13833485

  4. Lemierre's Syndrome Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    M. Thompson

    2007-01-01

    Full Text Available Lemierre's syndrome is an anaerobic suppurative thrombophlebitis involving the internal jugular vein secondary to oropharyngeal infection. There is only one previous case report in pregnancy which was complicated by premature delivery of an infant that suffered significant neurological damage. We present an atypical case diagnosed in the second trimester with a live birth at term. By reporting this case, we hope to increase the awareness of obstetricians to the possibility of Lemierre's syndrome when patients present with signs of unabating oropharyngeal infection and pulmonary symptoms.

  5. Management of complicated wounds.

    Science.gov (United States)

    Hendrix, Sam M; Baxter, Gary M

    2005-04-01

    Most injuries, including those with significant tissue loss, can be successfully managed with proper therapy. With delayed healing, potential causes for the delay, such as sequestra, foreign bodies, and excessive motion,should be determined and treated to permit complete wound resolution. Horses have the innate ability to heal rapidly; however, minor injuries can quickly turn into complicated wounds, given the severity of the inciting trauma and the less than ideal environment in which the horses are housed. Wound management must focus on a combination of timely surgical and medical intervention to ensure the best potential outcome.

  6. Neuromuscular complications of diabetes mellitus.

    Science.gov (United States)

    Bril, Vera

    2014-06-01

    Diabetes mellitus has become a modern global epidemic, with steadily increasing prevalence rates related to lifestyle such that 27% of individuals aged 65 years or older have diabetes mellitus, 95% of whom have type 2. This article reviews the effects of diabetes mellitus on the neuromuscular system. Diabetes mellitus leads to diverse forms of peripheral neuropathy as the major neuromuscular complication. Both focal and diffuse types of neuropathy can develop, with the most common form being diabetic sensorimotor polyneuropathy. Small fibers are damaged early in the development of diabetic sensorimotor polyneuropathy and are not assessed by nerve conduction studies. Small fiber damage occurs even in the prediabetes stage. No disease-modifying therapy for diabetic sensorimotor polyneuropathy is available at this time, but this complication can be limited in patients who have type 1 diabetes mellitus with strict glycemic control; the same outcome is not clearly observed in patients who have type 2 diabetes mellitus. Recently, the evidence base for symptomatic treatments of painful diabetic sensorimotor polyneuropathy underwent systematic review. Effective evidence-based treatments include some anticonvulsants (eg, pregabalin, gabapentin), antidepressants (eg, amitriptyline, duloxetine), opioids (eg, morphine sulfate, oxycodone), capsaicin cream, and transcutaneous electrical nerve stimulation. This article reviews the increasing prevalence of diabetes mellitus and diabetic sensorimotor polyneuropathy and discusses recent consensus opinion on the objective confirmation needed for the diagnosis in the clinical research setting. The evidence from clinical trials shows that intensive glycemic control reduces prevalence of diabetic sensorimotor polyneuropathy in patients with type 1 diabetes mellitus, but variable outcomes are observed in patients with type 2 diabetes mellitus. Finally, despite the lack of disease-modifying treatment, effective evidence-based therapy can

  7. Vascular complications associated with transcatheter aortic valve replacement.

    Science.gov (United States)

    Sardar, M Rizwan; Goldsweig, Andrew M; Abbott, J Dawn; Sharaf, Barry L; Gordon, Paul C; Ehsan, Afshin; Aronow, Herbert D

    2017-06-01

    Transcatheter aortic valve replacement (TAVR) is now an accepted pathway for aortic valve replacement for patients who are at prohibitive, severe and intermediate risk for traditional aortic valve surgery. However, with this rising uptrend and adaptation of this new technology, vascular complications and their management remain an Achilles heel for percutaneous aortic valve replacement. The vascular complications are an independent predictor of mortality for patients undergoing TAVR. Early recognition of these complications and appropriate management is paramount. In this article, we review the most commonly encountered vascular complications associated with currently approved TAVR devices and their optimal percutaneous management techniques.

  8. [Postoperative complications after larynx resection: assessment with video-cinematography].

    Science.gov (United States)

    Kreuzer, S; Schima, W; Schober, E; Strasser, G; Denk, D M; Swoboda, H

    1998-02-01

    In past decades, the surgical techniques for treating laryngeal carcinoma have been vastly improved. For circumscribed tumors, voice-conserving resections are possible and for extensive neoplasms, radical laryngectomy, sometimes combined with chemoradiation, has been developed. Postoperative complications regarding swallowing function are not uncommon. Radiologic examinations, especially pharyngography and videofluoroscopy, are most often used to evaluate patients with complications after laryngeal surgery. An optimized videofluoroscopic technique for evaluation of complications is described. The radiologic appearance of early and late complications, such as fistulas, hematomas, aspiration, strictures, dysfunction of the pharyngoesophageal sphincter, tumor recurrence, and metachronous tumors is demonstrated.

  9. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua

    2012-10-01

    Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

  10. Pediatric Liver Transplant: Techniques and Complications.

    Science.gov (United States)

    Horvat, Natally; Marcelino, Antonio Sergio Zafred; Horvat, Joao Vicente; Yamanari, Tássia Regina; Batista Araújo-Filho, Jose de Arimateia; Panizza, Pedro; Seda-Neto, Joao; Antunes da Fonseca, Eduardo; Carnevale, Francisco Cesar; Mendes de Oliveira Cerri, Luciana; Chapchap, Paulo; Cerri, Giovanni Guido

    2017-10-01

    Liver transplant is considered to be the last-resort treatment approach for pediatric patients with end-stage liver disease. Despite the remarkable advance in survival rates, liver transplant remains an intricate surgery with significant morbidity and mortality. Early diagnosis of complications is crucial for patient survival but is challenging given the lack of specificity in clinical presentation. Knowledge of the liver and vascular anatomy of the donor and the recipient or recipients before surgery is also important to avoid complications. In this framework, radiologists play a pivotal role on the multidisciplinary team in both pre- and postoperative scenarios by providing a road map to guide the surgery and by assisting in diagnosis of complications. The most common complications after liver transplant are (a) vascular, including the hepatic artery, portal vein, hepatic veins, and inferior vena cava; (b) biliary; (c) parenchymal; (d) perihepatic; and (e) neoplastic. The authors review surgical techniques, the role of each imaging modality, normal posttransplant imaging features, types of complications after liver transplant, and information required in the radiology report that is critical to patient care. They present an algorithm for an imaging approach for pediatric patients after liver transplant and describe key points that should be included in radiologic reports in the pre- and postoperative settings. Online supplemental material is available for this article. © RSNA, 2017.

  11. Complication of nose and paranasal sinus disease

    International Nuclear Information System (INIS)

    Kazmi, H.S.; Ali, S.; Ali, Z.

    2012-01-01

    Diseases of nose and paranasal sinuses can complicate to involve the orbit and other surrounding structures because of their close proximity. These diseases are usually infective or can be neoplastic in origin. Method: All the patients presenting in ENT or Eye Departments of Ayub Teaching Hospital during the one year study period who had complicated nose or paranasal sinus disease were included in the study. A detailed history and examination followed by CT scanning and laboratory investigations to assess the type and extent of the disease, was carried out. Results: Infections were the most common cause of complicated sinus disease 11 (75%). The rest of the 4 (25%) cases were tumours. 12 (80%) of the cases presented with proptosis. In 1 of these 12 cases, there was complete blindness. In 2 (13%) of the cases there was only orbital cellulitis. Two of these patients had facial swelling and 2 had nasal obstruction and presented as snoring. Two patients presented with history of weight loss and these patients had malignant tumour of the paranasal sinuses. One patient presented with early signs of meningitis. In 1 case sub periosteal scalp abscess (Pott's puffy tumour) was the only complication noted. Conclusion: Nose and paranasal sinus diseases can complicate to involve mostly the orbit, but sometimes brain, meninges and skull bones can also get involved. (author)

  12. Diabetic ketoacidosis complicating pregnancy.

    Science.gov (United States)

    Bryant, S N; Herrera, C L; Nelson, D B; Cunningham, F G

    2017-01-01

    Although diabetic ketoacidosis (DKA) in pregnancy can result in significant adverse consequences for both mother and fetus, the response to treatment, time course of recovery, and perinatal outcomes have not been well studied in pregnancy. We examined the precipitating factors, laboratory abnormalities, treatment strategies, and clinical recovery in pregnancies complicated by DKA. This is a retrospective cohort study of pregnancies complicated by DKA between October 1999 and June 2015. The diagnosis was verified by hyperglycemia; anion gap >12 mEq/L, pH diabetes (67%), and almost all presented with nausea and vomiting (97%). Over half had poor compliance with prescribed insulin. The initial mean blood glucose was 380 mg/dL, within 6 hours, it was <200 mg/dL. By 12 hours, the acidosis had resolved in 90% of patients. Nausea and vomiting is a prominent presenting feature of DKA in pregnancy. With aggressive insulin and resuscitation, hyperglycemia and acidosis improve rapidly. With current treatment, good perinatal outcomes can be expected.

  13. Central nervous system complications after liver transplantation.

    Science.gov (United States)

    Kim, Jeong-Min; Jung, Keun-Hwa; Lee, Soon-Tae; Chu, Kon; Roh, Jae-Kyu

    2015-08-01

    We investigated the diversity of central nervous system complications after liver transplantation in terms of clinical manifestations and temporal course. Liver transplantation is a lifesaving option for end stage liver disease patients but post-transplantation neurologic complications can hamper recovery. Between 1 January 2001 and 31 December 2010, patients who had undergone liver transplantation at a single tertiary university hospital were included. We reviewed their medical records and brain imaging data and classified central nervous system complications into four categories including vascular, metabolic, infectious and neoplastic. The onset of central nervous system complications was grouped into five post-transplantation intervals including acute (within 1 month), early subacute (1-3 months), late subacute (3-12 months), chronic (1-3 years), and long-term (after 3 years). During follow-up, 65 of 791 patients (8.2%) experienced central nervous system complications, with 30 occurring within 1 month after transplantation. Vascular etiology was the most common (27 patients; 41.5%), followed by metabolic (23; 35.4%), infectious (nine patients; 13.8%), and neoplastic (six patients). Metabolic encephalopathy with altered consciousness was the most common etiology during the acute period, followed by vascular disorders. An initial focal neurologic deficit was detected in vascular and neoplastic complications, whereas metabolic and infectious etiologies presented with non-focal symptoms. Our study shows that the etiology of central nervous system complications after liver transplantation changes over time, and initial symptoms can help to predict etiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Complicating Late Pregnancy

    Directory of Open Access Journals (Sweden)

    H. Mahesha Navada

    2011-01-01

    Full Text Available Chronic pelvic inflammatory disease (PID in the form of peritoneal abscess during pregnancy is almost unheard entity. Early and antenatal diagnosis may be difficult or may be revealed only during caesarean section. We report a case of peritoneal abscess secondary to pelvic inflammatory disease incidentally found at repeat caesarean section. It was managed by conservative surgical approach.

  15. Computed tomography findings of postoperative complications in lung transplantation

    International Nuclear Information System (INIS)

    Hochhegger, Bruno; Irion, Klaus Loureiro; Marchiori, Edson; Bello, Rodrigo; Moreira, Jose; Camargo, Jose Jesus; Universidade Federal do Rio de Janeiro

    2009-01-01

    Due to the increasing number and improved survival of lung transplant recipients, radiologists should be aware of the imaging features of the postoperative complications that can occur in such patients. The early treatment of complications is important for the long-term survival of lung transplant recipients. Frequently, HRCT plays a central role in the investigation of such complications. Early recognition of the signs of complications allows treatment to be initiated earlier, which improves survival. The aim of this pictorial review was to demonstrate the CT scan appearance of pulmonary complications such as reperfusion edema, acute rejection, infection, pulmonary thromboembolism, chronic rejection, bronchiolitis obliterans syndrome, cryptogenic organizing pneumonia, post transplant lymphoproliferative disorder, bronchial dehiscence and bronchial stenosis. (author)

  16. Readmissions Complications and Deaths - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Readmissions, Complications and Deaths - provider data. This data set includes provider data for 30-day death and readmission measures, the hip/knee complication...

  17. Hip complications following chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J. [Saint Bartholomew`s Hospital, London (United Kingdom)

    1995-12-01

    Chemoradiotherapy protocols are a recent development in the management of tumours where preservation of organ function is important. It is now recognized that such combined treatment may produce adverse effects below the accepted dose thresholds for either modality. This enhancement of toxicity is generally thought to reflect depletion of stem cells within the tissue concerned. We report four patients who have developed avascular necrosis or fractures of the hip following chemoradiotherapy for carcinoma of the vulva or anus. These complications developed after a radiation dose of 4500 cGy in 20 fractions. The possible role of cytotoxic agents in sensitizing bone to radiation damage is discussed, and a novel mechanism is proposed to account for this phenomenon. (author).

  18. Hip complications following chemoradiotherapy

    International Nuclear Information System (INIS)

    Jenkins, P.J.; Sebag Montefiore, D.J.; Arnott, S.J.

    1995-01-01

    Chemoradiotherapy protocols are a recent development in the management of tumours where preservation of organ function is important. It is now recognized that such combined treatment may produce adverse effects below the accepted dose thresholds for either modality. This enhancement of toxicity is generally thought to reflect depletion of stem cells within the tissue concerned. We report four patients who have developed avascular necrosis or fractures of the hip following chemoradiotherapy for carcinoma of the vulva or anus. These complications developed after a radiation dose of 4500 cGy in 20 fractions. The possible role of cytotoxic agents in sensitizing bone to radiation damage is discussed, and a novel mechanism is proposed to account for this phenomenon. (author)

  19. [Complications of peripheral regional anesthesia].

    Science.gov (United States)

    Neuburger, M; Büttner, J

    2011-11-01

    Peripheral regional anesthesia is a commonly used and safe procedure and eneral complications or side effects are generally rare. Nerve damage has an incidence allergies, dislocation of catheters and knotting or loops in catheters. Besides the general complications, there are some specific complications depending on the puncture site, such as pneumothorax or renal puncture.

  20. with pulmonary Complications

    Directory of Open Access Journals (Sweden)

    Majid Mirsadraee

    2013-05-01

    Full Text Available   Introduction: Data on imaging findings in pulmonary complications of chemical agents is scarce. The current study aimed to evaluate radiological findings of late onset pulmonary complications in chemical warfare victims (CWV and to guide pulmonologists in diagnosis of these subjects.   Materials and Methods: Ninety- three male CWV were enrolled in this prospective study, 20-25 years (mean=23 after exposure. Demographic and clinical data were recorded. High resolution computed Tomography (HRCT of the lung was performed during inspiration and expiration and was double reported blindly by two radiologists. Final diagnosis was made according to HRCT findings. The HRCT findings, final diagnosis, and distribution of the abnormalities were compared between subjects whom had been exposed to more complex chemical agents used during the second half of the war and simpler agents during the first half. Results: The most frequent HRCT findings were air trapping (56.7% and mosaic attenuation (35.1%. The distribution of abnormalities was mostly local (79.4% and bilateral (73% especially in lower regions (61.3%. The diagnosed respiratory diseases included bronchiolitis obliterans (43%, chronic obstructive pulmonary disease (COPD (27.9%, asthma (23.6%, bronchiectasis (13.9% and interstitial lung disease (ILD (9.6%. Frequency of subjects involved in the second half of the period of war was more than the first period (P-value < 0.05 but the HRCT findings were similar. Conclusions: Bronchiolitis obliterans with picture of focal bilateral air trapping was the most common finding in CWV but asthma appeared to have become a new problem in these subjects.

  1. Infections complicating cirrhosis.

    Science.gov (United States)

    Piano, Salvatore; Brocca, Alessandra; Mareso, Sara; Angeli, Paolo

    2018-02-01

    Patients with cirrhosis have a high risk of bacterial infections. Bacterial infections induce systemic inflammation that may lead to organ failure and acute-on-chronic liver failure (ACLF) resulting in a high risk of short term mortality. The early diagnosis and treatment of bacterial infections is essential to improve the patient's prognosis. However, in recent years, the spread of multidrug resistant (MDR) bacterial infections has reduced the efficacy of commonly used antibiotics such as third generation cephalosporins. In patients at high risk of MDR bacteria, such as those with nosocomial infections, the early administration of broad spectrum antibiotics has been shown to improve the prognosis. However, early de-escalation of antibiotics is recommended to reduce a further increase in antibiotic resistance. Strategies to prevent acute kidney injury and other organ failures should be implemented. Although prophylaxis of bacterial infections with antibiotics improves the prognosis in selected patients, their use should be limited to patients at high risk of developing infections. In this article, we review the pathogenesis and management of bacterial infections in patients with cirrhosis. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Neurological complications of cardiac surgery.

    Science.gov (United States)

    Gottesman, Rebecca F; McKhann, Guy M; Hogue, Charles W

    2008-11-01

    Neurological injury resulting from cardiac surgery has a range of manifestations from focal neurological deficit to encephalopathy or coma. As the safety of drug-eluting stents comes into question, more patients will likely undergo coronary artery bypass graft surgery. These projections, along with the growing proportions of elderly patients and those with comorbidities, portend the potential for rising rates of perioperative neurological complications. The risk for neurological injury may be determined by the type of procedure, by patient-specific characteristics, and by the extent of cerebral embolization and hypoperfusion during and after surgery. Changes in surgical techniques, including the use of off-pump surgery, have not decreased rates of brain injury from cardiac surgery. When appropriate, modern neuroimaging techniques should be used in postoperative patients to confirm diagnosis, to provide information on potential etiology, to direct appropriate therapy, and to help in prognostication. Management of postoperative medications and early use of rehabilitation services is a recommended strategy to optimize the recovery for individuals with neurological injury after cardiac surgery.

  3. [Complications of induced abortions].

    Science.gov (United States)

    Duprez, D; Fortuna, P

    1989-02-01

    All physicians should be aware of the possible complications of induced abortions if only because the procedure is so commonplace. Some 250,000 induced abortions occur annually in France, amounting to 24.4 abortions per 100 live births. The rates of different complications of induced abortions before 12 weeks are .5-5/1000 for uterine perforation, .5-3.4% for hemorrhage with or without placental retention, 1% for endometritis, .3% for salpingitis .5% for continuing pregnancy, and .006 to .3/10,000 for death. A well done curettage is preferable to a poorly performed aspiration procedure. If an aspiration is done, the practitioner should bear in mind that retention of 50-200 cc of blood clots may occur if dilatation is insufficient. Symptoms appear 1-5 days after the abortion and end with expulsion of the clots or aspiration. Curettage is useless, as the clots do not represent a true retention. Uterine contractions during the aspiration can occasionally prompt a premature decision that evacuation is complete. Retention is difficult to diagnose immediately after aspiration but can be sonographically confirmed after the 8th day. Aspiration should be done after the 6th week and before the 12th week. Aspiration before the 6th week is often painful and is associated with higher rates of partial retention and of complete failure. Endouterine aspiration, regardless of technical proficiency, establishes a pathway between the vagina and the uterine cavity, which exposes the latter to the risk of trauma, endometrial lesions, and perforation. Induced abortion promotes infection by 2 mechanisms. Latent infections that were not detected in the medical history or physical examination can emerge and cause endometritis, which should be treated by ice, rest, and antibiotics. Or contamination of the passage by an infected cervical mucus can lead to salpingitis, abscess, and pelviperitonitis, or even general peritonitis. More often, these conditions develop from inadequately treated

  4. Complicated childhood inguinal hernias in UITH, Ilorin

    Directory of Open Access Journals (Sweden)

    Kayode T Bamigbola

    2012-01-01

    Full Text Available Background: Complicated inguinal hernias pose a threat to the life of the child as well as increase the morbidity associated with management of an otherwise straightforward condition. The aim of this study was to determine the presentation, treatment and management outcome of complicated inguinal hernias in children. Materials and Methods: A retrospective study of all children 15 years and less managed for complicated inguinal hernia between 2002 and 2010. Data obtained included demographic characteristics, presentation, operative findings and outcome. Results: Complicated hernia rate was 13.9%.There were 41 children, 38 boys (92.7% and 3 girls. Ages ranged between 4 days and 15 years (Median = 90days. Most were infants (48.8%, n = 20 and neonates accounted for 19.5% (n = 8. Median duration of symptoms prior to presentation was 18 h (range = 2-96 h. Seven patients had been scheduled for elective surgery. Hernia was right sided in 68.3% (n = 28. Symptoms included vomiting (68.3%, abdominal distension (34.1% and constipation (4.9%; one patient presented with seizures. In 19 (46.3% patients hernia was reducible while 22(53.7% had emergency surgery. Associated anomalies included undescended testis (12.2%, umbilical hernia (14.6%. Intestinal resection rate was 7.3% and testicular gangrene occurred in 14.6%. Mean duration of surgery was 60.3 ± 26.7 min. Wound infection occurred in six patients (14.6%. Overall complication rate was 24.4%, 30% in infants. The mortality rate was 2.4% (n = 1. Conclusions: Morbidity associated with complicated inguinal hernia is high in neonates and infants. Delayed presentation is common in our setting. Educating the parents as well as primary care physicians on the need for early presentation is necessary.

  5. Documented complications of staple hemorrhoidopexy: a systematic review.

    Science.gov (United States)

    Porrett, Liesel J; Porrett, Jemma K; Ho, Yik-Hong

    2015-01-01

    A systematic review addressing reported complications of stapled hemorrhoidopexy was conducted. Articles were identified via searching OVID and MEDLINE between July 2011 and October 2013. Limitations were placed on the search criteria with articles published from 1998 to 2013 being included in this review. No language restrictions were placed on the search, however foreign language articles were not translated. Two reviewers independently screened the abstracts for relevance and their suitability for inclusion. Data extraction was conducted by both reviewers and entered and analyzed in Microsoft Excel. The search identified 784 articles and 78 of these were suitable for inclusion in the review. A total of 14,232 patients underwent a stapled hemorrhoidopexy in this review. Overall complication rates of stapled hemorrhoidopexy ranged from 3.3%-81% with 5 mortalities documented. Early and late complications were defined individually with overall data suggesting that early complications ranged from 2.3%-58.9% and late complications ranged from 2.5%-80%. Complications unique to the procedure were identified and rates recorded. Both early and late complications unique to stapled hemorrhoidopexy were identified and assessed.

  6. Postoperative pulmonary complications updating.

    Science.gov (United States)

    Langeron, O; Carreira, S; le Saché, F; Raux, M

    2014-01-01

    Postoperative pulmonary complications (PPCs) are a major contributor to the overall risk of surgery. PPCs affect the length of hospital stay and are associated with a higher in-hospital mortality. PPCs are even the leading cause of death either in cardiothoracic surgery but also in non-cardiothoracic surgery. Thus, reliable PPCs risk stratification tools are the key issue of clinical decision making in the perioperative period. When the risk is clearly identified related to the patient according the ARISCAT score and/or the type of surgery (mainly thoracic and abdominal), low-cost preemptive interventions improve outcomes and new strategies can be developed to prevent this risk. The EuSOS, PERISCOPE and IMPROVE studies demonstrated this care optimization by risk identification first, then risk stratification and new care (multifaceted) strategies implementation allowing a decrease in PPCs mortality by optimizing the clinical path of the patient and the care resources. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  7. Neuromuscular complications in cancer.

    Science.gov (United States)

    Grisold, W; Grisold, A; Löscher, W N

    2016-08-15

    Cancer is becoming a treatable and even often curable disease. The neuromuscular system can be affected by direct tumor invasion or metastasis, neuroendocrine, metabolic, dysimmune/inflammatory, infections and toxic as well as paraneoplastic conditions. Due to the nature of cancer treatment, which frequently is based on a DNA damaging mechanism, treatment related toxic side effects are frequent and the correct identification of the causative mechanism is necessary to initiate the proper treatment. The peripheral nervous system is conventionally divided into nerve roots, the proximal nerves and plexus, the peripheral nerves (mono- and polyneuropathies), the site of neuromuscular transmission and muscle. This review is based on the anatomic distribution of the peripheral nervous system, divided into cranial nerves (CN), motor neuron (MND), nerve roots, plexus, peripheral nerve, the neuromuscular junction and muscle. The various etiologies of neuromuscular complications - neoplastic, surgical and mechanic, toxic, metabolic, endocrine, and paraneoplastic/immune - are discussed separately for each part of the peripheral nervous system. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Renal complications of anaesthesia.

    Science.gov (United States)

    McKinlay, J; Tyson, E; Forni, L G

    2018-01-01

    Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury. As yet, there are no specific treatment options for the injured kidney, although there are several modifiable risk factors of which the anaesthetist should be aware. As well as the avoidance of potential nephrotoxins and appropriate volume balance, optimal anaesthetic management should aim to reduce the risk of postoperative renal complications. This may include careful ventilatory management and blood pressure control, as well as appropriate analgesic strategies. The choice of anaesthetic agent may also influence renal outcomes. Rather than concentrate on the classical management of acute kidney injury, this review focuses on the potential development of acute kidney injury peri-operatively, and the means by which this may be ameliorated. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

  9. Complications after radiation therapy for cervical carcinoma

    International Nuclear Information System (INIS)

    Saitoh, Masataka

    1981-01-01

    From 1966 to 1973, 215 patients with cervical cancer were treated at the Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University. The patients were divided into two groups. In the first group, 123 patients were treated by external radiation with Tele- 60 Co plus radium insertions (1966-1970). In the second group, 83 patients were treated with linear accelerator plus cesium insertions (1970-1973). The results on both of 5-year survival rate and appearance of radiation injuries were compared with two groups. There was no significant difference in the cure rate between those of groups. The incidence of pigmentation, edema and diarrhea (early complications) was higher and the diarrhea continued significantly longer in the second group. The incidence of rectal ulcer and rectostenosis (later complications) was significantly higher than former group. A study was made to lean the reason for the significant higher occurrence of rectal ulcer and rectostenosis. As a result, it was determined that later complication was more emphasized especially by ret dose given intracavitary radiation. In addition, it is thought that the dose rate, the dose volume and natural history such as the patients' age are also related to the severity of the complication. (J.P.N.)

  10. Complications after radiation therapy for cervical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, M. (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1981-04-01

    From 1966 to 1973, 215 patients with cervical cancer were treated at the Department of Obstetrics and Gynecology, School of Medicine, Iwate Medical University. The patients were divided into two groups. In the first group, 123 patients were treated by external radiation with Tele-/sup 60/Co plus radium insertions (1966-1970). In the second group, 83 patients were treated with linear accelerator plus cesium insertions (1970-1973). The results on both of 5-year survival rate and appearance of radiation injuries were compared with in the two groups. There was no significant difference in the cure rate between those groups. The incidence of pigmentation, edema and diarrhea (early complications) was higher and the diarrhea continued significantly longer in the second group. The incidence of rectal ulcer and rectostenosis (later complications) was significantly higher than former group. A study was made to learn the reason for the significantly higher occurrence of rectal ulcer and rectostenosis. As a result, it was determined that later complication was more emphasized especially by dose rate of intracavitary irradiation. In addition, it is thought that the dose rate, the dose volume and natural history such as the patients' age are also related to the severity of the complications.

  11. Chest complication after abdominal surgery

    International Nuclear Information System (INIS)

    Koh, B. H.; Choi, J. Y.; Hahm, C. K.; Kang, S. R.

    1981-01-01

    In spite of many advances in medicine, anesthetic technique and surgical managements, pulmonary problems are the most frequent postoperative complications, particularly after abdominal surgery. As postoperative pulmonary complications, atelectasis, pleural effusion, pneumonia, chronic bronchitis and lung abscess can be occurred. This study include evaluation of chest films of 2006 patients (927 male, 1079 female), who had been operated abdominal surgery from Jan. 1979 to June, 1980 in the Hanyang university hospital. The results were as follows: 1. 70 cases out of total 2006 cases (3.5%) developed postoperative chest complications, 51 cases (5.5%) in male, 19 cases (1.8%) in female. 2. The complication rate was increased according to the increase of age. The incidence of the postoperative complications over 40 years of age was higher than the overall average complications rate. 3. The most common postoperative pulmonary complication was pleural effusion, next pneumonia, atelectasis and pulmonary edema respectively. 4. The complication rate of the group of upper abdominal surgery is much higher than the group of lower abdominal surgery. 5. Complication rate was increased according to increase of the duration of operation. 6. There were significant correlations between the operation site and side of the complicated hemithorax

  12. Complicity and torture.

    Science.gov (United States)

    Shue, Henry

    2017-04-01

    One of the great merits of On Complicity and Compromise is that it wades into specific swamps where ordinary theorists fear to slog. It is persuasive that in general it can be right sometimes to be complicit in wrongdoing by others through causally contributing to the wrongdoing, but not sharing its purpose, if by being involved one can reasonably expect to lessen the extent of the wrong that would otherwise be suffered by the victims. I focus on whether the book's general thesis is applicable to torture, which depends on what torture and the torture situation are in fact like. I focus on the case to which the chapter several times refers: the innovative CIA paradigm of torture. First, to the extent that the paradigm, which is predominantly mental, or psychological, torture succeeds in its goal of producing regression to a compliant state, the physician would be unable to rely on the torture victim's expressions of preferences or interests as authentically his own. Second, since disorientation plays such a large role in the CIA's style of torture (adopted at Guantanamo by the military), the authorities would refuse to allow a stable relationship to be built up with any one doctor by any victim, making comprehension of the victim's preferences difficult. Third, even if the doctor could somehow judge what the victim's genuine interests were, the control of the situation is much too totalistic to allow the physician any action independent of what the torture regime requires. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Pulmonary complications of AIDS: radiologic features. [AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

    1984-07-01

    Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed.

  14. Individual Risk and Prevention of Complications:

    DEFF Research Database (Denmark)

    Serup, Jørgen

    2017-01-01

    Doctors who are consulted about health and tattoo risks have an important role in the prevention of an individual's tattoo complications. Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals. The risk is related to a person's health condition, level...... of insight, decision-making, and to the operation of tattooing, tattoo inks and utensils, tattoo parlour, and the aftercare. Tattooing is painful minor surgery performed without anesthesia. It can be associated with syncope. It is major needle trauma with histamine release and wheal and flare...... in the operation field. The skin barrier is broken. Bacterial infections come early. Chronically intermittent and mild complaints affect 4/10 of all the tattooed, and 2/10 have sensitivity to sun. Chronic complications with allergy in red tattoos and nodules due to pigment agglomeration and foreign body formation...

  15. Pulmonary complications of AIDS: radiologic features

    International Nuclear Information System (INIS)

    Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

    1984-01-01

    Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed

  16. Diagnostic utility of soluble triggering receptor expression on myeloid cells-1 in complicated parapneumonic pleural effusion

    Directory of Open Access Journals (Sweden)

    Adel H.A. Ghoneim

    2013-10-01

    In conclusion: Combination of classical criteria with pleural fluid sTREM-1 could be useful in discrimination between nonpurulent complicated and non complicated parapneumonic pleural effusions and hence early pleural drainage in patients with complicated parapneumonic effusions which may affect disease outcome.

  17. Gastrointestinal Complications After Bariatric Surgery

    OpenAIRE

    Ma, Irene T.; Madura, James A.

    2015-01-01

    Bariatric surgery is increasingly being performed in the medically complicated obese population as convincing data continue to mount, documenting the success of surgery not only in achieving meaningful weight loss but also in correcting obesity-related illnesses. Several surgical procedures with varying degrees of success and complications are currently being performed. This article discusses the short- and long-term gastrointestinal complications for the 4 most common bariatric surgical proc...

  18. Specific improvement measures to reduce complications and mortality after urgent surgery in complicated abdominal wall hernia.

    Science.gov (United States)

    Martínez-Serrano, M A; Pereira, J A; Sancho, J; Argudo, N; López-Cano, M; Grande, L

    2012-04-01

    Morbidity and mortality are increased after urgent surgery for complicated abdominal wall hernia. We analysed prospectively early morbidity and mortality after implementing specific management measures in patients undergoing urgent hernia repair. The study population included 244 patients with complicated abdominal wall hernia requiring surgical repair on an emergency basis over 1-year period. Patients were managed according to a protocol that included specific actions to be implemented in the pre-, intra- and postoperative periods. Outcomes of these patients were compared with those of 402 undergoing similar operations before development of the protocol. Patients in whom acute complication was the first hernia symptom had higher mortality (7.2% vs 2.5%; P = 0.07) and were consulted later than 24 h (49.4% vs 36%; P = 0.044). Patients consulting later than 24 h had higher mortality (8.1% vs 1.4%, P = 0.017). Femoral hernias exhibited specific characteristics and were associated with higher mortality (13% vs 1.6%; P = 0.001). Overall, both groups had similar mortality (4.5% vs 4.1%; P = 0.8); complications (38.8% vs 37.7%; P = 0.2), and bowel resection rates (12.2% vs 11.5%; P = 0.8). Excluding the group of femoral hernias, the measures achieved a lower rate of severe complications (21.2% vs 10.3%; P = 0.04) and a decrease in mortality (2.9% vs 0.6%; P = 0.05) after bowel resection. Specific measures for improvement of management and prevention of complications and mortality were effective in patients without femoral hernia. To reduce mortality, the best applicable measure is early detection and to prioritize the scheduled operation of femoral hernias and those affecting high risk patients. The implementation of preventive and educational programs in high risk patients is essential.

  19. Renal complications of Fabry disease in children.

    Science.gov (United States)

    Najafian, Behzad; Mauer, Michael; Hopkin, Robert J; Svarstad, Einar

    2013-05-01

    Fabry disease is an X-linked α-galactosidase A deficiency, resulting in accumulation of glycosphingolipids, especially globotriaosylceramide, in cells in different organs in the body. Renal failure is a serious complication of this disease. Fabry nephropathy lesions are present and progress in childhood while the disease commonly remains silent by routine clinical measures. Early and timely diagnosis of Fabry nephropathy is crucial since late initiation of enzyme replacement therapy may not halt progressive renal dysfunction. This may be challenging due to difficulties in diagnosis of Fabry disease in children and absence of a sensitive non-invasive biomarker of early Fabry nephropathy. Accurate measurement of glomerular filtration rate and regular assessment for proteinuria and microalbuminuria are useful, though not sensitive enough to detect early lesions in the kidney. Recent studies support the value of renal biopsy in providing histological information relevant to kidney function and prognosis, and renal biopsy could potentially be used to guide treatment decisions in young Fabry patients. This review aims to provide an update of the current understanding, challenges, and needs to better approach renal complications of Fabry disease in children.

  20. Postradiation therapy skin complications and aspects of their treatment

    International Nuclear Information System (INIS)

    Derveniece, A.; Hartmane, I.; Cema, I.; Strode, E.; Mikazans, I.

    2001-01-01

    X-ray is a common therapy for malignant skin cancers. 60-70 Gy is the necessary therapeutic dose for squamous cell carcinoma. Early and late postradiation complications are X-ray dermatitis, erosions, ulcers and atrophies. The therapy for complications includes topical antiseptics and antibacterial agents, debridement, dressing, and even plastic and reconstructive surgery. Capillary regrowth, immunosuppression, local ischemia and epithelialisation are to be considered. The aim of this study was to observe and compare the topical agents in treatment of postradiation skin compilations. Early compilations were treated effectively using Diaethonum ointment (prophylaxis and therapy), Fucicort cream, Linoladiol-HN cream. With late complications Chlorhexidine gluconate 0.05% solution, Iruxol and Desitin ointments showed good results, dealing with trophical ulcers. There is no universal drug for treating X-ray caused complications, in every case the therapy is to be considered individually. (authors)

  1. [Complications of acute otitis media].

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Lempinen, Laura; Jero, Jussi

    2012-01-01

    Most cases of acute otitis media (AOM) resolve even without antibiotic treatment. In the pre-antibiotic era, AOM complications were common and could lead to deafness and neurological sequelae. With the use of antibiotics, the complications have become less frequent, but they may still evolve. The possible increase in the occurrence of complications has to be considered if we start treating AOM more conservatively and if bacterial antibiotic resistance situation becomes more problematic. These rare but possibly lethal complications should be diagnosed and treated promptly. The need for cochlear implantation has to be evaluated soon after an episode of meningitis if deafness is suspected.

  2. [Neurological complication of influenza infections].

    Science.gov (United States)

    Brydak, Lidia B

    2002-01-01

    The aim of this study was to present neurological complications of influenza infections. Infections caused by influenza viruses can be very serious and may lead even to death resulted from the post-infectious complications. The most often occurring complications are pneumonia, bronchitis, bronchiolitis, myocarditis and otitis media. The other group is neurological post-influenza complications, including dementia, epileptic disorders, cerebrovascular disease, febrile convulsions, toxic encephalopathy, encephalitis, meningitis, subarachnoid hemorrhages, lethargic encephalitis, psychosis or increase in the number of cases of Parkinson's disease. The first way of prevention of influenza is vaccination that results in healthy, social and economic benefits.

  3. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    Directory of Open Access Journals (Sweden)

    Yael Baumfeld

    2017-06-01

    Conclusions: Our study demonstrated an increased rate of placental insufficiency associated complications in women with placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications.

  4. Medical Treatment of Tattoo Complications.

    Science.gov (United States)

    Serup, Jørgen

    2017-01-01

    Tattooing is a skin trauma and involves a special vulnus punctatum (with inserted tattoo ink, a vulnus venenatum), which should heal with no infection and no local complication. Local treatment in the healing phase ideally builds on the 'moist wound' principle using plastic film, hydrocolloids, silver dressing, and compression. Bacterial infections during healing are treated with oral antibiotics, and a list of first-line antibiotics is proposed. Notice is given to severe infections with affected general condition, and it is emphasized that intravenous antibiotic treatment must be instituted as early as possible to prevent septic shock and death. Hydrophilic antibiotics shall be given in high load and maintenance dose due to increased renal clearance of such antibiotics. Chronic allergic reactions of red tattoos respond little to local corticoids and are best treated with dermatome shaving. Laser removal is contraindicated due to the risk of photochemical activation of the allergy with anaphylaxis or worsening. Chronic reactions in black tattoos can be treated with local corticoids, dermatome shaving, and lasers as well. Systemic corticoid is used in allergic reactions in red tattoos and in cross-allergic reactions of other red tattoos as well as in black tattoo reactions associated with sarcoidosis and with cutaneous 'rush phenomenon' affecting any black tattoo. Systemic corticoid is also indicated in generalized eczema due to nickel allergy or another allergy challenged through tattooing or introduced by tattooing as a primary sensitization. The use of intralesional corticoid, antihistamines, and immunosuppressive medicines is discussed. A warning against the use of lactic acid and other caustic chemicals for tattoo removal is given, since such chemicals and commercial products cannot be dosed properly and very often result in disfiguring scarring. © 2017 S. Karger AG, Basel.

  5. Complications of presumed ocular tuberculosis.

    Science.gov (United States)

    Hamade, Issam H; Tabbara, Khalid F

    2010-12-01

    To determine the effect of steroid treatment on visual outcome and ocular complications in patients with presumed ocular tuberculosis. Retrospective review of patients with presumptive ocular tuberculosis. The clinical diagnosis was made based on ocular findings, positive purified protein derivative (PPD) testing of more than 15 mm induration, exclusion of other causes of uveitis and positive ocular response to anti-tuberculous therapy (ATT) within 4 weeks. Group 1 included patients who had received oral prednisone or subtenon injection of triamcinolone acetonide prior to ATT. Group 2 included patients who did not receive corticosteroid therapy prior to administration of ATT.   Among 500 consecutive new cases of uveitis encountered in 1997-2007 there were 49 (10%) patients with presumed ocular tuberculosis. These comprised 28 (57%) male and 21 (43%) female patients with a mean age of 45 years (range 12-76 years). Four (20%) patients in group 1 had initial visual acuity of 20/40 or better, in comparison to eight (28%) patients in group 2. At 1-year follow-up, six (30%) patients in group 1 had a visual acuity of 20/40 or better compared with 20 (69%) patients in group 2 (p = 0.007). Of 20 eyes (26%) in group 1 that had visual acuity of < 20/50 at 1-year follow up, 14 (70%) eyes developed severe chorioretinal lesion (p = 0.019). Early administration of corticosteroids without anti-tuberculous therapy in presumed ocular tuberculosis may lead to poor visual outcome compared with patients who did not receive corticosteroids prior to presentation. Furthermore, the severity of chorioretinitis lesion in the group of patients given corticosteroid prior to ATT may account for the poor visual outcome. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

  6. Preventing microvascular complications in type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Vijay Viswanathan

    2015-01-01

    Full Text Available Patients with complications of diabetes such as retinopathy, nephropathy, and cardiovascular complications have increased hospital stay with greater economic burden. Prevention of complications should be started before the onset of type 1 diabetes mellitus (T1DM by working on risk factors and thereafter by intervention upon confirmatory diagnosis which can prevent further damage to β-cells. The actual risk of getting microvascular complications like microalbuminuria and retinopathy progression starts at glycated hemoglobin (HbA1c level of 7%. As per the American Diabetes Association, a new pediatric glycemic control target of HbA1c 20 years as compared to patients <10 years of age. Screening of these complications should be done regularly, and appropriate preventive strategies should be followed. Angiotensin converting enzyme inhibitors and angiotensin II receptor blocker reduce progression from microalbuminuria to macroalbuminuria and increase the regression rate to normoalbuminuria. Diabetic microvascular complications can be controlled with tight glycemic therapy, dyslipidemia management and blood pressure control along with renal function monitoring, lifestyle changes, including smoking cessation and low-protein diet. An integrated and personalized care would reduce the risk of development of microvascular complications in T1DM patients. The child with diabetes who receives limited care is more likely to develop long-term complications at an earlier age. Screening for subclinical complications and early interventions with intensive therapy is the need of the hour.

  7. Comprehensive ultrasound assessment of complications post-liver transplantation.

    LENUS (Irish Health Repository)

    O'Brien, J

    2010-04-01

    Human liver transplantation for end-stage liver disease was first performed in 1963. Refinements in surgical technique and new immunosuppressive regimens have improved outcomes. Today, transplant patients have a 5-year survival rate of approximately 75%. Nevertheless, significant complications still occur. Ultrasonography (US), is the initial imaging modality of choice allowing bedside assessment for detection and follow-up of early and delayed graft complications, and facilitating interventional procedures. This review outlines the role of ultrasound in post-transplantation assessment.

  8. Radiological features of pulmonary complications in patients with AIDS

    International Nuclear Information System (INIS)

    Ruebesam, D.; Fuchs, H.F.

    1988-01-01

    Our experience with over 200 AIDS-patients emphasizes the good knowledge in radiological features of pulmonary complications in patients with AIDS for early diagnosis. We show the radiological appearance of the most frequent opportunistic infection of the lung, pneumocystis carinii pneumonia, and the different appearance of the other most frequently seen pulmonary complications as Kaposisarkoma, cytomegaly-virus-pneumonia, non-typical-mycobacteria-infection and tuberculosis. A synopsis over the most important symptoms is made for easier differential diagnosis. (orig.) [de

  9. Left ventricular pseudoaneurysm as a fatal complication of purulent pericarditis.

    Science.gov (United States)

    Sunkara, Bharath; Briasoulis, Alexandros; Afonso, Luis; Ramappa, Preeti

    2015-01-01

    We report a case of a 48-year-old man with purulent pericarditis by Streptococcus viridans, despite aggressive treatment with antibiotics and partial pericardiectomy was complicated by left ventricle pseudo-aneurysm resulting in a fatal outcome. The case highlights the course of complicated purulent pericarditis and the use of noninvasive imaging for assessing early signs of pseudoaneurysm and its typical progression. Published by Elsevier Inc.

  10. Management of Postoperative Complications Following Splenectomy

    Science.gov (United States)

    Qu, Yikun; Ren, Shiyan; Li, Chunmin; Qian, Songyi; Liu, Peng

    2013-01-01

    Complications of post-splenectomy, especially intra-abdominal hemorrhage can be fatal, with delayed or inadequate treatment having a high mortality rate. The objective of this study was to investigate the cause, prompt diagnosis, and outcome of the fatal complications after splenectomy with a focus on early diagnosis and management of hemorrhage after splenectomy. The medical files of patients who underwent splenectomy between January 1990 and March 2011 were reviewed retrospectively. The cause, characteristics, management, and outcome in patients with post-splenectomy hemorrhage were analyzed. Fourteen of 604 patients (1.19%) undergoing splenectomy had intraperitoneal hemorrhage: reoperation was performed in 13 patients, and 3 patients died after reoperation, giving the hospital a mortality rate of 21.43%; whereas, 590 of 604 patients (98%) had no hemorrhage following splenectomy, and the mortality rate (0.34%) in this group was significantly lower (P splenectomy, including pneumonia pancreatitis, gastric fistula, gastric flatulence, and thrombocytosis, in patients with postoperative hemorrhage were significantly higher than those without hemorrhage (P splenectomy, 14 patients with post-splenectomy hemorrhage were grouped into two groups: splenic trauma (n = 9, group I) and portal hypertension (n = 5, group II). The median interval between splenectomy and diagnosis of hemorrhage was 15.5 hours (range, 7.25–19.5 hours). No differences were found between groups I and II in terms of incidence of postoperative hemorrhage, time of hemorrhage after splenectomy, volume of hemorrhage, and mortality of hemorrhage, except transfusion. Intra-abdominal hemorrhage after splenectomy is associated with higher hospital mortality rate and complications. Early massive intraperitoneal hemorrhage is often preceded by earlier sentinel bleeding; careful clinical inquiry and ultrasonography are the mainstays of early diagnosis. PMID:23438277

  11. Intensive therapy of severe complications of influenza

    Directory of Open Access Journals (Sweden)

    V. I. Kozhokaru

    2012-01-01

    Full Text Available Definition of risk factors and clinical characteristics of heavy complications of influenza for working out of criteria of polymodal intensive therapy and resuscitation was the work purpose. Results of linical supervision by 114 sick heavy form of influenza with pulmonary and extra pulmonary complications are presented. All patients suffered from virus pneumonia and sharp defeat of lungs /sharp respirator distress-syndrome (OPL/ORDS. Pulmonary complications included bacterial (85, 96 % and micotic (2, 63 % pneumonia, thrombosis of legoch arteries (19,29 %, the sharp respiratory insufficiency, caused by the polyneuropathy of a critical condition of the patient (18,42 %, the exssudative pleuritis (9,65 %, spontaneous pheumothorax (4,39 %, spontaneous pheumomediastinum (2,69 %. Extra pulmonary complications concerned the swell of brain at 100 % of patients, including, with development of a brain coma (26,32 %, sepsis (85,96 %, including, with development of septic shock (68,42 %, syndrome of disseminated intravenous coagulation (49,12 %, multyorgan insufficiency (56,14 %, sharp heavy miocarditis (22,81 %, sharp nephritic insufficiency (18,42 %, sharp hepatic insufficiency (10,52 %. Early development of pathophysiological processes (the expressed infringements of a gas exchange and an acid-base condition, a secondary immunodeficiency, heamodynamical insufficiency,m etc. leads to underestimation of severity of the patient’s condition and to failer of algorithm of polymodal intensive therapy. Development of severe complications(sepsis, septic shock, sharp respirator distress-syndrome demands expansion for epidemic of specialized medicalstructures on rendering timely intensive therapy and resuscitation.

  12. Classificação de óbitos em mulheres com vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida no ciclo gravídico-puerperal

    Directory of Open Access Journals (Sweden)

    Manuella Coutinho Brayner

    Full Text Available RESUMO: Objetivo: Reclassificar os óbitos de mulheres portadoras do vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida no ciclo gravídico-puerperal no Estado de Pernambuco, no período de 2000 a 2010. Métodos: Estudo descritivo exploratório, desenvolvido a partir das seguintes etapas: tradução para português do item “HIV and aids” do documento da Organização das Nações Unidas “The WHO application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: ICD MM, 2012”; elaboração de um algoritmo de classificação dos óbitos de mulheres portadoras do vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida no ciclo gravídico-puerperal; e reclassificação dos óbitos por um grupo de especialistas. Resultados: Dentre os 25 óbitos reclassificados, 12 foram devido ao vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida e a condição gravídica era coexistente; 9 foram reclassificados como morte materna obstétrica indireta, com o código O98.7, proposto pela Organização Mundial de Saúde; 2 como morte materna obstétrica direta/indireta; e 2 foram considerados indeterminados. Conclusão: A reclassificação apontou uma possível mudança de padrão de mortalidade materna, visto que a maioria dos óbitos foi atribuído ao vírus, podendo levar a uma redução dos óbitos por causas maternas. O algoritmo subsidiará o uso da nova classificação sobre morte materna e do vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida.

  13. Radiologist's perspective for the Meckel's diverticulum and its complications

    Science.gov (United States)

    Kotha, V K; Saboo, S S; Shanbhogue, A K P; Virmani, V; Marginean, E C; Menias, C O

    2014-01-01

    The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation. PMID:24611767

  14. Acute liver failure complicating viral hepatitis A

    Directory of Open Access Journals (Sweden)

    Daniel Rui Diniz-Santos

    Full Text Available Hepatitis A is one of the most frequent infectious liver diseases affecting children worldwide. The disease is usually mild and self-limited, and complications are very rare. Nevertheless, hepatitis A can sometimes cause acute liver failure (ALF, a severe, life-threatening condition. Herein is reported a case of a child who presented ALF during a course of hepatitis A. The need for early identification of possible ALF cases among hepatitis A patients, and for effective ways of evaluating such a possibility, are discussed. We also emphasize the importance of prevention measures, especially vaccination.

  15. Interventional radiological treatment of renal transplant complications: A pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Lezzi, Roberto; La, Torre Michele fabio; Santoro, Marco; Dattesi, Robrta; Nestola, Massimiliano; Posa, Alessandro; Romagnoli, Jacopo; CItterio, Franco; Bonomo, Lorenzo [' A. Gemelli' Hospital - Catholic University, Rome (Italy)

    2015-06-15

    Renal transplantation is the treatment of choice for patients with chronic renal failure, which produces a dramatic improvement in the quality of life and survival rates, in comparison to long-term dialysis. Nowadays, new imaging modalities allow early diagnosis of complications, and thanks to the recent developments of interventional techniques, surgery may be avoided in most cases. Knowledge in the types of renal transplant complications is fundamental for a correct pre-operative planning. In this article, we described the most common or clinically relevant renal transplant complications and explained their interventional management.

  16. A rare complication after renal transplantation: Forgotten stent

    Directory of Open Access Journals (Sweden)

    Mustafa Karabıcak

    2015-07-01

    Full Text Available In renal transplantation surgery, double J stents (DJS are often used to reduce complications, protect the anastomosis between ureter and bladder, provide drainage in ureteral obstructions and enhance healing if there is an ureter injury. Urinary tract infections, hematuria and irritative voiding symptoms are the early complications of DJS. Migration, fragmantation, encrustation and rarely sepsis are among the late complications of DJS. In this report we describe a renal transplantation case whose DJS stent was forgotten because the patient did not attend the regular follow-up and noticed 5 years after surgery.

  17. Pericarditis as complication of appendicitis.

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Rieu, P.N.M.A.; Nijveld, A.; Backx, A.P.C.M.; Meis, J.F.G.M.; Severijnen, R.S.V.M.

    2004-01-01

    Pericarditis as a complication of appendicitis is a rare event. In a 25-year period we encountered two pediatric cases with this severe complication due to (a)typical presentation of appendicitis resulting in small bowel obstruction, intraabdominal abscesses, constrictive pericarditis, and purulent

  18. Unusual complication of Crohn's disease

    International Nuclear Information System (INIS)

    Kulke, H.; Sommer, H.; Ehl, M.; Braun, H.

    1981-01-01

    In diagnosis and therapy of Crohn's disease the occurrence of typical complications is especially regarded. This may result in diagnosing not typical complications of other localizations too late so that therapeutical measures are without success. This is reported of a patient who, having suffered from Crohn's disease for 30 years, was suddenly struck by multiple abscesses of the lung. (orig.) [de

  19. Pulmonary complications in neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Randeep Guleria

    2012-01-01

    Full Text Available Pulmonary complications are a major cause of morbidity and mortality in neurosurgical patients. The common pulmonary complications in neurosurgical patients include pneumonia, postoperative atelectasis, respiratory failure, pulmonary embolism, and neurogenic pulmonary edema. Postoperative lung expansion strategies have been shown to be useful in prevention of the postoperative complications in surgical patients. Low tidal volume ventilation should be used in patients who develop acute respiratory distress syndrome. An antibiotic use policy should be put in practice depending on the local patterns of antimicrobial resistance in the hospital. Thromboprophylactic strategies should be used in nonambulatory patients. Meticulous attention should be paid to infection control with a special emphasis on hand-washing practices. Prevention and timely management of these complications can help to decrease the morbidity and mortality associated with pulmonary complications.

  20. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery

    DEFF Research Database (Denmark)

    Bradley, Katharine A; Rubinsky, Anna D; Sun, Haili

    2011-01-01

    Patients who misuse alcohol are at increased risk for surgical complications. Four weeks of preoperative abstinence decreases the risk of complications, but practical approaches for early preoperative identification of alcohol misuse are needed....

  1. Airway Complications After Lung Transplantation.

    Science.gov (United States)

    Frye, Laura; Machuzak, Michael

    2017-12-01

    Airway complications remain a significant source of morbidity and mortality after lung transplantation. The incidence of complications is wide-ranging depending on the definition of the event, and there is still no universally accepted grading system for airway findings after transplantation. Additionally, although surgical technique and organ preservation have improved, other modifiable risk factors remain unclear. The management is as wide-ranging as the definitions. A multimodality approach is often needed with airway stenting reserved for refractory cases and stent management by a transplant team with expertise in placement and management of long-term complications." Copyright © 2017. Published by Elsevier Inc.

  2. PEG tubes: dealing with complications.

    Science.gov (United States)

    Malhi, Hardip; Thompson, Rosie

    A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding.

  3. Gastrointestinal Complications After Bariatric Surgery.

    Science.gov (United States)

    Ma, Irene T; Madura, James A

    2015-08-01

    Bariatric surgery is increasingly being performed in the medically complicated obese population as convincing data continue to mount, documenting the success of surgery not only in achieving meaningful weight loss but also in correcting obesity-related illnesses. Several surgical procedures with varying degrees of success and complications are currently being performed. This article discusses the short- and long-term gastrointestinal complications for the 4 most common bariatric surgical procedures: laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch.

  4. Gastrointestinal Complications After Bariatric Surgery

    Science.gov (United States)

    Ma, Irene T.

    2015-01-01

    Bariatric surgery is increasingly being performed in the medically complicated obese population as convincing data continue to mount, documenting the success of surgery not only in achieving meaningful weight loss but also in correcting obesity-related illnesses. Several surgical procedures with varying degrees of success and complications are currently being performed. This article discusses the short- and long-term gastrointestinal complications for the 4 most common bariatric surgical procedures: laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. PMID:27118949

  5. Managing Complications of Calcaneus Fractures.

    Science.gov (United States)

    Clare, Michael P; Crawford, William S

    2017-03-01

    Calcaneus fractures remain among the most complicated fractures for orthopedic surgeons to manage because of the complexity of various fracture patterns, the limited surrounding soft tissue envelope, and the prolonged rehabilitation issues impacting function after successful treatment. Despite this, appropriate management of complications associated with calcaneus fractures is critical for the complete care of this injury, whether treated operatively or nonoperatively. The authors present the common complications encountered with fractures of the calcaneus and management thereof. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    Science.gov (United States)

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  7. Appendicitis in Pregnancy: Presentation, Management and Complications

    Directory of Open Access Journals (Sweden)

    Abdoulhossein Davoodabadi

    2016-06-01

    Full Text Available Background Diagnosis of acute appendicitis in pregnancy is difficult. Delay operation, increase complications. Objectives This study focused on early operation on base of careful history, precise physical examination, and rational close observation and evaluates its results with conventional investigation in pregnant women suspected acute appendicitis. Materials and Methods A cross sectional study in100 pregnant women and 100 aged matched non pregnant women underwent appendectomy during Sep 2011 - Dec 2014. The data were analyzed by chi-square test through SPSS 16.0. Results Age 16 - 37 years, mean age in pregnant women and no pregnant women were24.75 ± 4.4 and 27.56 ± 6.53 years (P > 0.05, respectively. 20 - 25 years age group, were more frequent = 44%. 70% patients were gravid 1, mean hospital stay in pregnant women, and non-pregnant women were 48 ± 6 and 85.2 ± 43.19 hours (P value < 0.001. respectively. acute appendicitis was confirmed histological in non-pregnant was 72%, but In pregnant women 62%, most cases were in the third Trimester 66% (n = 41. Peri umbilical pain, with migration to the right lower quadrant, was in 75% of patients. Right-lower-quadrant pain was the most common presenting symptom. Diagnosis (62% was made on base care full history and precise physical examination and close observation of 12 ± 8 hours. there were no maternal and fetal complications related to all of the appendectomies during the all trimester up to delivery period. Conclusions There are no diagnostic laboratory findings in acute appendicitis during pregnancy. Careful history and physical examination and close observation of 12 ± 8 hours are sufficient for surgery decision making. In spite of high negative appendectomy since it has no Surgical and obstetric complication, early Appendectomy without aggressive investigation recommend.

  8. Readmissions Complications and Deaths - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Readmissions Complications and Deaths measures - national data. This data set includes national-level data for 30-day death and readmission measures, the hip/knee...

  9. Readmissions Complications and Deaths - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Readmissions Complications and Deaths measures - state data. This data set includes state-level data for 30-day death and readmission measures, the hip/knee...

  10. [Hepatic complications in parenteral nutrition].

    Science.gov (United States)

    Müller, M J

    1996-01-01

    During parenteral nutrition hepatic complications are seen in about 15% of patients. They are characterized by steatosis, cholestasis and formation of sludge and bile stones. These hepatic complications depend on the duration as well as on the concept and mode of application of parenteral nutrition. They are more frequent after treatment periods of > 1-2 weeks, in response to a carbohydrate rich and low fat parenteral nutrition and in patients with extensive intestinal resection. Clinically, hepatic complications are frequently observed in new-borns and children, patients with inflammatory bowel disease, after ileum resection and in patients with hepatic malignancies. The exact pathophysiology of these phenomena is presently unknown. Enteral instead of parenteral nutrition, meeting the demand of nutrients, increasing fat supply (up to 50% of energy supply), "cyclic" parenteral nutrition and the addition of "semi-essential" nutrients (like L-glutamine, carnitin, cholin) are considered as possible strategies for the prevention and therapy of hepatic complications during parenteral nutrition.

  11. Hemodynamic Profiling in Complicated Pregnancies

    NARCIS (Netherlands)

    J.M.J. Cornette (Jérôme)

    2016-01-01

    textabstractIn order to permit a successful pregnancy outcome, the cardiovascular system must undergo substantial changes. This thesis addresses the hemodynamics in several pregnancy complications. A general overview of normal hemodynamic adaptation to pregnancy is provided . Several techniques of

  12. Pneumococcal Disease: Symptoms and Complications

    Science.gov (United States)

    ... sensitive to light) Confusion In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting. Pneumococcal bacteremia is a blood infection. Symptoms include: Fever Chills Low alertness Sepsis is a complication caused by the body’s overwhelming ...

  13. Benchmarking Complications Associated with Esophagectomy

    NARCIS (Netherlands)

    Low, Donald E.; Kuppusamy, Madhan Kumar; Alderson, Derek; Cecconello, Ivan; Chang, Andrew C.; Darling, Gail; Davies, Andrew; D'journo, Xavier Benoit; Gisbertz, Suzanne S.; Griffin, S. Michael; Hardwick, Richard; Hoelscher, Arnulf; Hofstetter, Wayne; Jobe, Blair; Kitagawa, Yuko; Law, Simon; Mariette, Christophe; Maynard, Nick; Morse, Christopher R.; Nafteux, Philippe; Pera, Manuel; Pramesh, C. S.; Puig, Sonia; Reynolds, John V.; Schroeder, Wolfgang; Smithers, Mark; Wijnhoven, B. P. L.

    2017-01-01

    Utilizing a standardized dataset with specific definitions to prospectively collect international data to provide a benchmark for complications and outcomes associated with esophagectomy. Outcome reporting in oncologic surgery has suffered from the lack of a standardized system for reporting

  14. [The complications of intestinal stoma in children].

    Science.gov (United States)

    Minaev, S V; Bykov, N I; Isaeva, A V; Kachanov, A V; Tovkan, E A; Filip'yeva, N V; Gerasimenko, I N

    To investigate the complications of intestinal stoma in children and to develop measures for decrease of their incidence. The study included 152 children with congenital and acquired gastrointestinal pathology requiring surgical treatment with the imposition of intestinal stoma. Atresia of intestinal tube was observed in 28 (18.4%) children, meconium ileus - in 10 (6.6%) cases, Hirschsprung's disease - in 11 (7.2%)cases, anorectal malformations - in 39 (25.7%) cases, multiple malformations - in 11 (7.2%) patients, necrotic enterocolitis - in 56 (36.8%) patients, other reasons - in 7 (4.6%) cases. The average age of patients was 12,3±7,2 days. There were 93 (61.2%) boys and 59 (38.8%) girls. Ileostomy, ileocolostomy and colostomy were made in 37 (24.3%), 46 (30.3%) and 69 (45.4%) cases respectively. Time of intestinal stoma function was 18-217 days. Early complications were dehiscence in the area of stoma in 4 (2.6%) children, evagination in 7 (4.6%) patients, marginal necrosis of stoma in 2 (1.3%) cases, retraction of stomy into abdominal cavity in 1 (0.6%) child and abdominal skin maceration in 8 (5.2%) patients. Remote complications included dermatitis around stomy in 35 (23.1%) children, stenosis of stoma in 9 (5.9%) cases, evagination of stoma in 12 (7.9%) patients. Also, 5 patients were unable to use the colostomy bag due to vicious overlaying of intestinal stoma. Using the colostomy bags «Coloplast» and skin care products around the stoma significantly reduced (pstoma depends on not only technical aspects but also obligatory care performance with timely correction of complications.

  15. Abdominal Complications after Severe Burns

    Science.gov (United States)

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...abdominal complications was 25%, with Curl- ng’s ulcer the most common malady (54% of the total), ollowed by esophageal lesions (17%), hemorrhagic

  16. Colocutaneous fistula complicating sigmoid diverticulitis

    OpenAIRE

    Charalabopoulos, Alexandros; Misiakos, Evangelos; Macheras, Anastasios

    2011-01-01

    Colocutaneous fistula is a very rare complication of colonic diverticular disease. Herein we describe a case with a fistula connecting the sigmoid with the left flank area complicating diverticulitis of the sigmoid colon. An 85-year-old female patient with a history of acute diverticulitis 3 months earlier, was admitted with a subcutaneous abscess in the left flank. The abscess was drained and subsequently a colocutaneous fistula was established. At operation the sigmoid colon with the fistul...

  17. Unusual Complications of Quinalphos Poisoning

    Directory of Open Access Journals (Sweden)

    Stalin Viswanathan

    2013-01-01

    Full Text Available This 40-year-old man was treated for suicidal quinalphos 25%EC consumption. He developed intermediate syndrome with normal response to repetitive nerve stimulation, pancreatitis with high enzyme elevations, and normal computed tomography and excreted black, brown, and orange urine sequentially over the first nine days of hospitalization. The last complication has not been previously reported with any organophosphate compound. He finally succumbed to complication of ventilator associated pneumonia related septic shock and ventricular tachycardia.

  18. Complicated variations in the early optical afterglow of GRB 090726

    Czech Academy of Sciences Publication Activity Database

    Šimon, Vojtěch; Polášek, Cyril; Jelínek, M.; Hudec, René; Štrobl, Jan

    2010-01-01

    Roč. 510, February (2010), A49/1-A49/5 ISSN 0004-6361 R&D Projects: GA ČR GA205/08/1207 Grant - others:GA ČR(CZ) GA102/09/0997; ESA(XE) ESA-PECS project No. 98058 Institutional research plan: CEZ:AV0Z10030501 Keywords : gamma-ray burst * radiation mechanisms * plasmas Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 4.410, year: 2010

  19. Severe hemorrhage complicating early transplant nephrectomy due to sepsis

    Directory of Open Access Journals (Sweden)

    Jacob A Akoh

    2016-01-01

    Full Text Available Compared to the general population, transplant patients receiving immuno- suppression have an increased risk of wound and systemic infection that might lead to hemorrhage. We present a case of severe bleeding from the external iliac artery secondary to a pelvic abscess following renal transplantation and transplant nephrectomy. A 73-year-old man received an extended criteria donor organ from a 49-year-old person who died from systemic sepsis. The patient bled from the Carrel′s patch while awaiting a computed tomographic scan- guided drainage of an infected peritransplant collection. At exploration, a nonviable allograft surrounded by about 1 L of thick pus was removed. Bleeding from a 2 mm hole in the Carrel′s patch was repaired by prolene suture as the external iliac vessels could not be mobilized due to a frozen pelvis. The patient died 72 h later from a massive bleed confirmed at postmortem to have originated from the external iliac artery distal to the anastomosis. Diversion of blood flow away from an affected area (with or without excision of the infected vessels through a bypass procedure probably represents the best option in avoiding such sequelae.

  20. Placenta associated pregnancy complications in pregnancies complicated with placenta previa.

    Science.gov (United States)

    Baumfeld, Yael; Herskovitz, Reli; Niv, Zehavi Bar; Mastrolia, Salvatore Andrea; Weintraub, Adi Y

    2017-06-01

    The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications (IUGR, preeclampsia, placental abruption and perinatal mortality). Our study included all deliveries that occurred at Soroka University Medical Center (Beer Sheva, Israel) between January 1998 and December 2013. Of them 1,249 were complicated by placenta previa and represented our study group. A composite outcome was created to include conditions associated with placental insufficiency. It included hypertensive disorders (i.e. gestational hypertension, mild and severe preeclampsia, HELLP and eclampsia), small for gestational age neonates and placental abruption. Patients with pregnancy complicated by placenta previa had significantly different obstetrical characteristics including bad obstetric history (8% vs. 4%, p placenta previa had higher rates of vaginal bleeding in the second half of pregnancy (3% vs. 0%, p placenta (4% vs. 0.5%, p placenta previa group (21% vs. 13%, p placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications. Copyright © 2017. Published by Elsevier B.V.

  1. The urinary proteome in diabetes and diabetes-associated complications

    DEFF Research Database (Denmark)

    Rossing, Kasper; Mischak, Harald; Rossing, Peter

    2008-01-01

    Diabetes represents one of the main chronic diseases worldwide. Diabetes and its associated complications may be detectable even at early stages in the urinary proteome. In this article we review the current literature on urinary proteomics applied to the study of diabetes and diabetic...... complications. Further, we present recent data that strongly indicate urinary proteome analysis may be a valuable tool in detecting diabetes-associated pathophysiological changes at an early stage, and also may enable assessment of disease progression and efficacy of therapy. Current data indicate that collagen......-derived peptides represent one of the main peptidic components in urine, which are consistently found at reduced levels in diabetes. It is tempting to speculate that this decrease in urinary collagen-derived peptides is related to an increase in extracellular matrix deposition which is a major complication...

  2. Anterior cruciate ligament reconstruction complicated by pyoderma gangrenosum

    OpenAIRE

    Bagouri, E; Smith, Jon; Geutjens, G

    2012-01-01

    We report a case of pyoderma gangrenosum as a complication of an anterior cruciate ligament reconstruction in a patient with inflammatory bowel disease, which was misdiagnosed initially as a post-operative wound infection. An early dermatology opinion and skin biopsy should be considered in cases of suspected infection where thorough surgical debridement and antimicrobial therapy has failed to improve the clinical picture.

  3. Imperforate hymen complicated by obstructive acute renal failure ...

    African Journals Online (AJOL)

    Imperforate hymen is a rare malformation (1/ 1000 female births). It is diagnosed most often during puberty. Early diagnosis of hematocolpos and evacuation is necessary to avoid any consequences. We report a rare case of an imperforate hymen complicated with acute urinary retention, hydronephrosis and renal failure in ...

  4. PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

    African Journals Online (AJOL)

    GB

    visits ensures best maternal and child health outcomes. The advantages of antenatal care particularly when provided by a skilled health worker includes early detection of complications and timely treatment, disease prevention through immunisation and micronutrient supplementation, birth preparedness and counselling for ...

  5. Complication rates of open transvesical prostatectomy according to ...

    African Journals Online (AJOL)

    2011-05-11

    May 11, 2011 ... Varkarakis I, Kyriakakis Z, Delis A, Protogerous V, Deliveliotis C. Long‑term results of open transvesical prostatectomy from contemporary series of patients. Urology 2004;64:306‑10. 10. Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, et al. Complications and early post‑operative outcome after ...

  6. PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

    African Journals Online (AJOL)

    GB

    report signifies the importance of early management of dental problems and awareness creation about self-injurious habits to prevent any long term complications. REFERENCES. 1. Kalyan SR, Sajjan G. Endodontic management of a foreign body. Contemp Clin. Dent, 2010; 1:180-2. 2. Balto H. A radiopaque object in the.

  7. Management of the complications of BPH/BOO

    Directory of Open Access Journals (Sweden)

    Mark J Speakman

    2014-01-01

    Full Text Available Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic, haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR. Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice.

  8. Bariatric surgery: A review of normal postoperative anatomy and complications

    International Nuclear Information System (INIS)

    Quigley, S.; Colledge, J.; Mukherjee, S.; Patel, K.

    2011-01-01

    The number of bariatric surgery procedures performed is increasing every year. Patients may be referred for radiological investigations to exclude complications not only in the early postoperative period but many months later. Radiologists who do not work in bariatric centres are therefore required to have an understanding of the complex normal anatomy and complications associated with bariatric surgery to interpret imaging studies correctly. The purpose of this article is to describe the surgical techniques and normal anatomy of the four bariatric operations performed today, review the most common problems encountered in this patient group, and to describe the imaging findings that allow the accurate diagnosis of complications. In particular, we focus on identification of the internal hernia, a grave complication of bariatric surgery often missed by radiologists.

  9. Bariatric surgery: A review of normal postoperative anatomy and complications

    Energy Technology Data Exchange (ETDEWEB)

    Quigley, S., E-mail: shaun.quigley@bartsandthelondon.nhs.uk [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Colledge, J. [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Mukherjee, S. [Bariatric Surgery Unit, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Patel, K. [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom)

    2011-10-15

    The number of bariatric surgery procedures performed is increasing every year. Patients may be referred for radiological investigations to exclude complications not only in the early postoperative period but many months later. Radiologists who do not work in bariatric centres are therefore required to have an understanding of the complex normal anatomy and complications associated with bariatric surgery to interpret imaging studies correctly. The purpose of this article is to describe the surgical techniques and normal anatomy of the four bariatric operations performed today, review the most common problems encountered in this patient group, and to describe the imaging findings that allow the accurate diagnosis of complications. In particular, we focus on identification of the internal hernia, a grave complication of bariatric surgery often missed by radiologists.

  10. COMPLICATIONS AFTER EXTRACTION OF IMPACTED THIRD MOLARS - LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2016-07-01

    Full Text Available Third molar surgery is the most common procedure performed by oral and maxillofacial surgeons worldwide. This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Complications, such as pain, dry socket, swelling, paresthesia of the lingual or inferior alveolar nerve, bleeding, and infection are most common. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anaesthetic technique. For the general dental practitioner, as well as the oral and maxillofacial surgeon, it is important to be familiar with all the possible complications after this procedure. This improves patient education and leads to prevention, early recognition and management.

  11. Toxic stress, inflammation and symptomatology of chronic complications in diabetes.

    Science.gov (United States)

    Downs, Charles A; Faulkner, Melissa Spezia

    2015-05-15

    Diabetes affects at least 382 million people worldwide and the incidence is expected to reach 592 million by 2035. The incidence of diabetes in youth is skyrocketing as evidenced by a 21% increase in type 1 diabetes and a 30.5% increase in type 2 diabetes in the United States between 2001 and 2009. The effects of toxic stress, the culmination of biological and environmental interactions, on the development of diabetes complications is gaining attention. Stress impacts the hypothalamus-pituitary-adrenal axis and contributes to inflammation, a key biological contributor to the pathogenesis of diabetes and its associated complications. This review provides an overview of common diabetic complications such as neuropathy, cognitive decline, depression, nephropathy and cardiovascular disease. The review also provides a discussion of the role of inflammation and stress in the development and progression of chronic complications of diabetes, associated symptomatology and importance of early identification of symptoms of depression, fatigue, exercise intolerance and pain.

  12. Urological complications after living-donor renal transplantation.

    Science.gov (United States)

    El-Mekresh, M; Osman, Y; Ali-El-Dein, B; El-Diasty, T; Ghoneim, M A

    2001-03-01

    To determine the incidence and management of urological complications after 1200 consecutive live-donor renal transplantations, all of which were carried out in one centre; the possible risk factors and the effect on patient and graft survival were also assessed. Data were retrieved from an electronic database; the incidence of urological complications was determined, and correlated with relevant risk factors by univariate and multivariate analysis. The effect on patient and graft survival was assessed using Kaplan-Meier statistics. There were 100 complications in 96 patients (8%); urinary leaks occurred in 37, ureteric strictures in 23 and lymphoceles causing ureteric obstruction in 17. Percutaneous needle biopsy was complicated by haematuria and clot anuria in six patients. Late complications included 11 cases of stones, four of bladder malignancy and two of haemorrhagic cystitis. There was evidence that the age of the recipients (effect on the incidence of urological complications. However, their development did not influence graft or patient survival. When there is meticulous attention to the technical details, renal transplantation should incur few urological complications. Early intervention with percutaneous drainage reduces morbidity and the likelihood loss of graft function. Proper and prompt management should not affect the graft and/or the patient's survival.

  13. Complications of minimally invasive cosmetic procedures: Prevention and management

    Directory of Open Access Journals (Sweden)

    Lauren L Levy

    2012-01-01

    Full Text Available Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT, soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care.

  14. Pulmonary complications in renal transplantation

    International Nuclear Information System (INIS)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin

    2003-01-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation

  15. Pulmonary complications in renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jung Bin; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Lee, Seung Rho; Hahm, Chang Kok; Joo, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-04-01

    To evaluate the radiographic and CT findings of pulmonary complications other than pulmonary edema arising from renal transplantation. Among 393 patients who had undergone renal transplantation at our hospital during a previous ten-year period, 23 with pulmonary complications other than pulmonary edema were included in this study. The complications involved were infection caused by CMV (n=6), bacteria (n=4), fungus (n=4), tuberculosis (n=2), varicella (n=1) or chlamydia (n=1), and malignancy involving lung cancer (n=4) or Kaposi's sarcoma (n=1). Two chest radiologists reviewed all images. The complications manifesting mainly as pulmonary nodules were lung cancer (4/4), tuberculosis (1/2), and Kaposi's sarcoma (1/1). Pulmonary consolidation was a main feature in bacterial infection (4/4), fungal infection (3/4), tuberculosis (1/2), chlamydial infection (1/1), and varicellar pneumonia (1/1). Ground-glass attenuation was a main CT feature in CMV pneumonia (4/6), and increased interstitial making was a predominant radiographic feature in CMV pneumonia (2/6). The main radiologic features described above can be helpful for differential diagnosis of the pulmonary complications of renal transplantation.

  16. Complications

    Science.gov (United States)

    ... time Give monthly Give in honor Give in memory Donate Now Why Give? Nearly 30 million battle diabetes and every 23 seconds someone new is diagnosed. Diabetes causes more deaths a year than breast cancer and AIDS combined. Your gift today will help us get ...

  17. Fasting: the history, pathophysiology and complications.

    Science.gov (United States)

    Kerndt, P R; Naughton, J L; Driscoll, C E; Loxterkamp, D A

    1982-11-01

    An appreciation of the physiology of fasting is essential to the understanding of therapeutic dietary interventions and the effect of food deprivation in various diseases. The practice of prolonged fasting for political or religious purposes is increasing, and a physician is likely to encounter such circumstances. Early in fasting weight loss is rapid, averaging 0.9 kg per day during the first week and slowing to 0.3 kg per day by the third week; early rapid weight loss is primarily due to negative sodium balance. Metabolically, early fasting is characterized by a high rate of gluconeogenesis with amino acids as the primary substrates. As fasting continues, progressive ketosis develops due to the mobilization and oxidation of fatty acids. As ketone levels rise they replace glucose as the primary energy source in the central nervous system, thereby decreasing the need for gluconeogenesis and sparing protein catabolism. Several hormonal changes occur during fasting, including a fall in insulin and T(3) levels and a rise in glucagon and reverse T(3) levels. Most studies of fasting have used obese persons and results may not always apply to lean persons. Medical complications seen in fasting include gout and urate nephrolithiasis, postural hypotension and cardiac arrhythmias.

  18. [Critical illness polyneuropathy and myopathy as neurological complications of sepsis].

    Science.gov (United States)

    Kollmar, R

    2016-03-01

    Intensive care unit acquired weakness (ICUAW) is a frequent and severe complication of intensive care management. Within ICUAW critical illness polyneuropathy (CIP) and myopathy (CIM) can be differentiated. The major symptom of ICUAW is progressive quadriparesis, which makes weaning from the respirator more difficult, can appear early after admission to an ICU and can often be detected several months after discharge from the ICU. The pathophysiology of ICUAW is multifactorial and complex. Potential therapeutic approaches are the early and sufficient therapy of mulitorgan dysfunction, optimal control of glucose levels as well as early and intensive physiotherapy. This review article discusses the data on incidence, pathophysiology, diagnostic approaches and prognosis of ICUAW.

  19. [Nomenclature and classification of complications. Standard procedure at the Heidelberg University Orthopedic Clinic].

    Science.gov (United States)

    Krämer, K L; Clauss, M

    1999-03-01

    In order to get a better data management of complications in orthopedic surgery and in order to get comparable statistics a standardisation of nomenclature and classification of complications is demanded since 1.1.1997. The Orthopedic University Clinic of Heidelberg started with a register of all early complications of all inpatients. According to a standardized nomenclature all occurred complications the doctors put in the data of complications in a database. These data were controlled, complemented and classified by members of the quality management group. This guideline consists of five parts: catalogue of diagnoses, general and special definitions, classification and an allocation table of diagnoses to grades of severity.

  20. Ações de cuidado desempenhadas pelo pai no puerpério Acciones del cuidados desempeñados por el papá durante el puerperio Actions in care carried out by the father in the puerperism

    Directory of Open Access Journals (Sweden)

    Eteniger Marcela Fernandes de Oliveira

    2009-09-01

    ; reconocen que su familia requiere de mayor dedicación y que ejercen el papel de proveedores al garantir la protección financeira de la familia.This qualitative, exploratory-descriptive research was conducted with 15 fathers, in Natal, RN. The aim was to analyze the actions conducted by the father during the puerperal period of his spouse. Data were collected by semistructured interviews, treated by analysis of content and analyzed according to the principles of symbolic interactionism. The results indicate one central theme - care actions in the home environment - and two categories caring for the spouse and the baby, providing financial support to the family. It is concluded that the men interact and participate in the puerperal period, while offering preventive advice, such as stimulating demabulation; demonstrate attitudes of dedication and worries with the child's health; consider that the paternal off work legal license does not attend their needs; and recognize that their spouse and the newborn requires more dedication and that they play a provider role while assuring the family´s financial support.

  1. Ophthalmic complications of bariatric surgery.

    Science.gov (United States)

    Guerreiro, Rui Azevedo; Ribeiro, Rui

    2015-01-01

    Obesity is increasing vastly in the world, and the number of bariatric surgeries being performed is also increasing. Patients being submitted to bariatric surgeries, especially malabsorptive procedures, have an increased risk of developing nutrient deficiencies, which can culminate in symptomatic hypovitaminosis, if supplementation is not done correctly. The eye and the optic system need an adequate level of several vitamins and minerals to perform properly, especially vitamin A, and this article wants to cover the main nutrients involved, the possible ophthalmic complications that can arise by their deficiency, and the management of those complications.

  2. Intracraneal complications after raquis surgery.

    Science.gov (United States)

    Sierra, J J; Malillos, M

    Intracraneal bleeding is a rare complication after raquis surgery. It is believed to occur as a drop in the intracraneal pressure after a loss of CSF secondary to an iatrogenic dural tear. We report a patient who after surgery for lumbar stenosis presented a subarachnoid haemorrhage, an intraparenchymal haematoma, and a subdural haematoma. To our knowledge, this is the first report in the literature with such complications after this type of surgery. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Sigmoid Volvulus Complicating Postpartum Period

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    Kelsey E. Ward

    2017-01-01

    Full Text Available Background. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. Case. A 19-year-old patient, gravida 1 para 0 at 41 0/7 weeks of gestation, admitted for late-term induction of labor underwent an uncomplicated primary low transverse cesarean delivery for arrest of descent. Her postoperative period was complicated by sudden onset of abdominal pain and the ultimate diagnosis of sigmoid volvulus. Conclusion. Prompt surgical evaluation of an acute abdomen in the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality.

  4. Cerebral Vasculitis Complicating Pneumococcal Meningitis

    Directory of Open Access Journals (Sweden)

    Ahmed Khedher

    2018-03-01

    Full Text Available Introduction: Cerebral vasculitis is an uncommon life-threatening complication of community-acquired bacterial meningitis. Patient and methods: We report the case of a 64-year-old woman with pneumococcal meningitis who developed parainfectious vasculitis causing ischaemic brain damage. Cerebral magnetic resonance imaging (MRI confirmed the diagnosis. Clinical and radiological recovery after delayed addition of corticosteroid was achieved. Discussion: This report shows that the onset of neurological deficits following pneumococcal meningitis can be caused by cerebral vasculitis. Underdosing with antibiotics and delayed adjunctive dexamethasone seem to favour this complication. There are no guidelines for treatment but high doses of steroids led to resolution in this case.

  5. LVAD pannus complicating destination therapy

    Directory of Open Access Journals (Sweden)

    Maya Ignaszewski

    2017-11-01

    Full Text Available Despite advances in technology, ventricular assist devices still experience a number of complications limiting their long-term use. We present a 73-year-old woman implanted with a left ventricular assist device (LVAD five years prior due to end-stage dilated cardiomyopathy, who died several weeks after admission to the hospital. Post-mortem examination revealed a large obstructing pannus in the LVAD inflow. As a result of increased LVAD use, complications such as infection, device thrombosis and pannus must be promptly recognized and managed appropriately to ensure the greatest chance of patient survival.

  6. Neurological complications following measles vaccination.

    Science.gov (United States)

    Allerdist, H

    1979-01-01

    In Hamburg 18 cases of neurological complications following vaccination with live measles virus vaccine (including 2 cases of abortive encephalopathy) have been observed between 1971--1978. A causal connection was assumed in 14 cases, that means an incidence of 1 neurological complication per 2,500 vaccinees and an incidence of 1 abortive encephalopathy per 17,650 vaccinees. These results differ from studies of various countries which used the same vaccine strain (Schwarz). Clinical symptoms, age distribution and incubation period are demonstrated. The prognosis seems to be good; the risk of vaccination compared to the risk following original measles is between 1:10 (convulsions) and 1:18 (encephalopathy).

  7. Puerperal women's satisfaction with their delivery La satisfacción de las puérperas con su parto A satisfação de puérperas com o seu parto

    Directory of Open Access Journals (Sweden)

    Ariane Garcia Cicuto

    2012-07-01

    Full Text Available Objective. To assess puerperal women's level of satisfaction with their delivery. Methodology. A descriptive study was developed at a teaching hospital in São José do Rio Preto (Brazil between July and December 2010. Participants were 200 puerperal women from the neonatal screening service, who completed the Delivery Experience and Satisfaction Questionnaire to measure their satisfaction level. Answer options for each question range between 1 and 10 (maximum satisfaction. Results. The puerperal women's mean age was 28 years; 96% had a partner; all women had participated in prenatal care; 82% were submitted to caesarean section. Satisfaction with pain management during labor ranged from 8.5 for caesarean section to 6 for normal birth. In comparison with the vaginal birth group, women subject to c-section showed greater satisfaction with postpartum pain intensity (8.7 versus 6.2 and less satisfaction with labor (6.0 versus 8.5 and delivery (7.1 versus 9.0. Conclusion. Without any difference per delivery type, women's satisfaction level with their delivery was high. Women who underwent caesarean section obtained higher satisfaction scores for postpartum pain management, while women who underwent vaginal birth manifested greater satisfaction with pain control during labor and delivery.Objetivo. Evaluar el nivel de satisfacción de las puérperas con sus partos. Metodología. Estudio descriptivo realizado en el hospital de enseñanza de São José do Rio Preto (Brasil, de juliodiciembre de 2010. Participaron 200 puérperas del servicio de tamizaje neonatal, que diligenciaron el instrumento Questionário de Experiência e Satisfação com o Parto para medir el nivel de satisfacción. Cada pregunta tiene opciones de respuesta entre 1 a 10 (máxima satisfacción. Resultados. El promedio de edad de las puérperas fue 28 años, el 96% tenía compañero, todas realizaron control prenatal, 82% fueron sometidas a cesárea. El nivel de satisfacci

  8. Novel treatments for complications after bariatric surgery.

    Science.gov (United States)

    Hernández, Julián; Boza, Camilo

    2016-01-01

    Bariatric surgery has been considered one of best treatments for obesity. As every surgical procedure-and any medical intervention, it is not exempt of complications, among which leaks, strictures, acute hemorrhages and fistulae highlight. Leaks are more common in the gastro-jejunal anastomosis (GJA) in the case of Roux-en-y Gastric Bypass (RYGB), while in Sleeve Gastrectomy (LSG) they locate in the stapler line. Stenosis can be seen in the gastro-jejunostomy in the RYGB and in the gastric tube in case of the LSG. For each of these complications, many innovative solutions have been developed, including new surgical devices. In spite of promising good results, evidence regarding utility and safeness of these technologies is still scarce. Self-expandable endoscopic stents have been used to treat leaks, with an overall success rate of 80-90 % and a migration rate of 15-35 %. The bear trap-like over-the-scope (Ovesco) clips have been used to treat GI hemorrhages, leaks and even fistulae, with a 70-80 % success rate, although more endoscopic sessions may be needed. Overstitch, an endosurgical suture devices, have been used to treat leaks, fistulae and perforations. Overall, technical success achievement approaches to 90 %, while clinical success ranges from 80 to 90 %, except for leaks closure, where a lower success rate has been observed. Despite of all of these advances, early diagnosis and treatment remains the main strategy to achieve success. In summary, novel therapies for complication management can be very useful, though further studies with larger series are still needed in order to confirm their efficacy and safeness.

  9. Diabetic retinopathy - ocular complications of diabetes mellitus.

    Science.gov (United States)

    Nentwich, Martin M; Ulbig, Michael W

    2015-04-15

    In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the working-age population. In the next 15 years, the number of patients suffering from diabetes mellitus is expected to increase significantly. By the year 2030, about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide (prevalence 7.7%), while in 2010 there were 285 million people with diabetes mellitus (prevalence 6.4%). This accounts for an increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e., exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.

  10. INFECTIOUS COMPLICATIONS IN PATIENTS WITH LUNG CANCER

    Directory of Open Access Journals (Sweden)

    Z. V. Grigoryevskaya

    2011-01-01

    Full Text Available Lung cancer (LC annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectiouscomplications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this categoryof patients and expand the possibilities of their specific antitumor treatment.

  11. [Vascular complications associated with lumbar spinal surgery].

    Science.gov (United States)

    Riedemann-Wistuba, M; Alonso-Pérez, M; Llaneza-Coto, J M

    2016-01-01

    Although there are currently less invasive techniques available for the treatment of spinal injuries, open surgery is still required in many cases. Vascular injuries occurring during lumbar spine surgery, although uncommon, are of great importance due to their potential gravity. Clinical manifestations vary from an acute hemorrhagic shock that needs urgent treatment to save the patient's life, to insidious injuries or an asymptomatic evolution, and should be studied to choose the best therapeutic alternative. Four cases are reported that represent this range of possibilities and emphasize the importance of a careful surgical technique during lumbar spine interventions, and the need for high clinical suspicion, essential for the early diagnosis of these vascular complications. The current therapeutic options are also discussed. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Prevention of the Musculoskeletal Complications of Hemophilia

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    E. C. Rodriguez-Merchan

    2012-01-01

    Full Text Available Hemophilia is an inherited disorder of clotting factor deficiencies resulting in musculoskeletal bleeding, including hemarthroses, leading to musculoskeletal complications. The articular problems of hemophiliac patients begin in infancy. These include: recurrent hemarthroses, chronic synovitis, flexion deformities, hypertrophy of the growth epiphyses, damage to the articular cartilage, and hemophilic arthropathy. The most commonly affected joints are the ankle, the knee, and the elbow. Hematologic prophylactic treatment from ages 2 to 18 years could avoid the development of hemophilic arthropathy if the concentration of the patient's deficient factor is prevented from falling below 1% of normal. Hemarthroses can be prevented by the administration of clotting factor concentrates (prophylaxis. However, high costs and the need for venous access devices in younger children continue to complicate recommendations for universal prophylaxis. Prevention of joint arthropathy needs to focus on prevention of hemarthroses through prophylaxis, identifying early joint disease through the optimal use of cost-effective imaging modalities and the validation of serological markers of joint arthropathy. Screening for effects on bone health and optimal management of pain to improve quality of life are, likewise, important issues. Major hemarthrosis and chronic hemophilic synovitis should be treated aggressively to prevent hemophilic arthropathy.

  13. A complicated case of deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Elena Cerutti

    2011-03-01

    Full Text Available We report a case of a patient with deep vein thrombosis (DVT and pulmonary thromboembolism (PTE associated to portal vein thrombosis (PVT, complicated by hospital-acquired pneumonia (HAP. The pathogenesis of DVT is multifactorial; among risk factors we can list: transitory situations (surgical interventions, infectious diseases with fever, traumas, acquired conditions (neoplasms, antiphospholipid syndrome or genetically determined situations (thrombophilia. PVT of the sovrahepatic veins is responsible for 5-10% of portal hypertension cases in adults and can be associated to local or systemic infections. PVT is present in 10% of patients with cirrhosis and often associated to cancers. It can also complicate a surgery abdominal intervention. HAP is defined as pneumonia that appears for the first time within 48 h of hospital admission. In Internal Medicine Departments the incidence is 7-10 cases/1.000 of hospital admissions, with an important impact in terms of both mortality and morbility. An early diagnosis, together with a correct identification of microbiologic agents in cause, allows a suitable antibiotic therapy with consequent improvement of clinical prognosis and a meaningful reduction of mortality. Main risk factors are: age, hospital and department. An important variable to be considered is the onset of pneumonia. The later is the onset of HAP (5 or more days from the admission to hospital, the more often is associated to multidrug resistant (MRD microorganisms, poorly responsive to antibiotic.

  14. Radiation Complications Following Breast Conserving Therapy.

    Science.gov (United States)

    Ikushima; Takegawa; Yasuda; Makimoto; Matsuzaki; Kashihara; Ueno; Sasa; Morimoto; Nishitani

    1998-10-25

    BACKGROUND: Breast conserving therapy is being established as a standard therapeutic procedure for early breast cancer in Japan. However, the indications of radiotherapy and a standardized therapeutic procedure have not been established yet. In this study, complications following radiotherapy were evaluated in patients who had previously undergone breast conserving therapy at Tokushima University Hospital. METHODS From October 1989 to March 1996, 60 women with stage I or II breast cancer underwent radiation therapy after breast conserving surgery, and all patients were followed-up for a median of 27 months. Radiation morbidity scoring of the breast and adjacent organs was performed using the toxity criteria of the Radiation Therapy Oncology Group (RTOG) and European Organization for Research andTreatment of Cancer (EORTC). RESULTS: Only 1 patient developed local recurrence, and no distant metastasisor death was observed. The cause of recurrence in 1 case was considered to be due to extended intraductal component. Although transient dermal reaction was induced by irradiation of the breast, no side effects that may cause cosmetic problems were found. No serious radiation complications were found in the lungs, ribs, heart or other adjacent organs. CONCLUSION: The adverse reactions caused by irradiation does not reduce the merit of combined use of radiation therapy in breast conserving therapy, and therefore, are not the hesitation factor in application of radiotherapy.

  15. Surgical complications of Ascaris lumbricoides in children

    Directory of Open Access Journals (Sweden)

    Raghu S Ramareddy

    2012-01-01

    Full Text Available Aim : To report the surgical complications of Ascaris lumbricoides infestation in children. Materials and Methods : This is a retrospective study and cases of intestinal ascariasis managed conservatively were excluded. Results : Sixteen children presented with Ascariasis sequelae, which included ileal volvulus (n=5, perforations (n=4, intussusception (n=1, biliary ascariasis (n-1 and impacted multiple worm boluses (n=5. Plain abdominal radiographs showed pneumoperitoneum (3, cigar bundle appearance (3 and multiple air and fluid levels (13. Sonography showed floating worms with free fluid (2, sluggish peristalsis and moderate free fluid (7 and intestinal worm bolus (11. The surgical procedures included milking of worms (in all, bowel resection (6, closure of perforation (3 and manual reduction of intussusception (1. Biliary ascariasis was managed conservatively and the progress monitored with sonography. There were 3 deaths all of whom had intestinal volvulus, bowel necrosis and toxemia. Conclusion : Sonography can be helpful in diagnosing the presence of worms, its complications and in evaluating response to treatment. Early surgical intervention in those with worm bolus, peritonism, and volvulus may salvage bowel and reduce mortality.

  16. Neurologic Complications of Celiac Disease

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-06-01

    Full Text Available Patients with celiac disease (CD [n=l 11] and controls (n=211 were questioned regarding neurologic disorders, their charts were reviewed, and they received neurologic evaluations, including brain imaging or EEG if indicated, in a study of neurologic complications of CD at Carmel Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.

  17. Anaesthetic complications in plastic surgery.

    Science.gov (United States)

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

    2013-05-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome.

  18. Anaesthetic complications in plastic surgery

    Directory of Open Access Journals (Sweden)

    Soumya Sankar Nath

    2013-01-01

    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  19. Unusual Complications of Incisional Hernia

    African Journals Online (AJOL)

    Incisional hernia (IH) represent a breakdown or loss of continuity of a fascia closure.[1] IH occur in 11-23% of laparotomies.[2] It enlarges over time and can give rise to such complications as pain, discomfort, bowel obstruction, incarceration and strangulation. Furthermore, IHs reduce the quality-of-life and the chances of ...

  20. Oral complications of cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dreizen, S.; Daly, T.E.; Drane, J.B.; Brown, L.R.

    1977-02-01

    Injury to surrounding tissues during radiotherapy for oral cancer can have devastating physical and psychologic consequences for the patient. Oral complications include xerostomia, dental decay, mucositis, taste loss, osteoradionecrosis, infection, and trismus. In many instances, these problems can be eradicated or controlled with appropriate treatment.

  1. Meningitis as cochlear implant complication

    Directory of Open Access Journals (Sweden)

    Kosanović Rade

    2009-01-01

    Full Text Available Over the last several decades, cochlear implantation has been fully proven as the treatment for profound hearing losses. The direct electrical stimulation of the spiral ganglion hair cells through the electrode inserted in the cochlear scala tympani is the essence of the cochlear implant (CI functioning. Modern technological development has introduced unexpected technical quality possibilities of the device itself, as well as coding strategies, which further enable improved patients' rehabilitation results. Nevertheless, in spite of cochlear implantation becoming a routine surgical procedure, which has been changing lives of thousands of profoundly deaf adults and children, it has possible complications. Though rare, these complications could lead to severe, even fatal consequences. Bacterial meningitis represents one of the most severe postoperative complications. In this article, our five-year experience with cochlear implantation is shown, compared to other, much bigger, experiences. Despite severity and a potentially fatal outcome of meningitis, it has rarely been seen, and the precise connection between surgical procedure and this complication is not yet clear. Do cochlear implants increase the risk of bacterial meningitis? Are deafness-associated factors predisposing the bacterial meningitis occurrence, independently from the implant? These are the questions that the Centers for Disease Control and Prevention (CDC, the Food and Drug Administration (FDA and the CI surgeons have been facing, as well as manufacturers and patients with their families.

  2. MIDLINE LETHAL GRANULOMA COMPLICATING PREGNANCY ...

    African Journals Online (AJOL)

    Kateee

    East African Medical Journal Vol. 80. No. 7 July 2003. MIDLINE LETHAL GRANULOMA COMPLICATING PREGNANCY: CASE REPORT. B.D.O. Saheeb, BDS, FWACS, FICS, FDS, RCS (Edin) Senior Lecturer/Consultant, and M.A. Ojo, BDS, MMed Sc, Dip Maxfac Rad, Associate Professor/Consultant. Department of oral ...

  3. Teaching Energy Geography? It's Complicated

    Science.gov (United States)

    Huber, Matt

    2016-01-01

    The premise of this essay is that energy geographies are complicated, and this in itself presents some pedagogical difficulties. As someone who wants students to critically examine and confront the complexity of energy systems, it can be frustrating when students react to demonstrate frustration, apathy, or even confusion. In what follows, I will…

  4. Spinal surgery: non surgical complications

    African Journals Online (AJOL)

    Adele

    Complications of Blood Transfusion. 3. • Incorrect blood product transfused (1 : 12,000). • Transfusion of a transmissible disease (1 : 400,000). • Acute haemolytic reaction. • Delayed haemolytic reaction. • Transfusion - related acute lung injury, ( using a leukocyte filter or leukocyte free blood should prevent this ). • Immune ...

  5. Hardware complications in scoliosis surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bagchi, Kaushik; Mohaideen, Ahamed [Department of Orthopaedic Surgery and Musculoskeletal Services, Maimonides Medical Center, Brooklyn, NY (United States); Thomson, Jeffrey D. [Connecticut Children' s Medical Center, Department of Orthopaedics, Hartford, CT (United States); Foley, Christopher L. [Department of Radiology, Connecticut Children' s Medical Center, Hartford, Connecticut (United States)

    2002-07-01

    Background: Scoliosis surgery has undergone a dramatic evolution over the past 20 years with the advent of new surgical techniques and sophisticated instrumentation. Surgeons have realized scoliosis is a complex multiplanar deformity that requires thorough knowledge of spinal anatomy and pathophysiology in order to manage patients afflicted by it. Nonoperative modalities such as bracing and casting still play roles in the treatment of scoliosis; however, it is the operative treatment that has revolutionized the treatment of this deformity that affects millions worldwide. As part of the evolution of scoliosis surgery, newer implants have resulted in improved outcomes with respect to deformity correction, reliability of fixation, and paucity of complications. Each technique and implant has its own set of unique complications, and the surgeon must appreciate these when planning surgery. Materials and methods: Various surgical techniques and types of instrumentation typically used in scoliosis surgery are briefly discussed. Though scoliosis surgery is associated with a wide variety of complications, only those that directly involve the hardware are discussed. The current literature is reviewed and several illustrative cases of patients treated for scoliosis at the Connecticut Children's Medical Center and the Newington Children's Hospital in Connecticut are briefly presented. Conclusion: Spine surgeons and radiologists should be familiar with the different types of instrumentation in the treatment of scoliosis. Furthermore, they should recognize the clinical and roentgenographic signs of hardware failure as part of prompt and effective treatment of such complications. (orig.)

  6. How to avoid sedation complications

    African Journals Online (AJOL)

    To ensure patient safety, it is crucial that the airway is safeguarded. The single most important responsibility is to protect it. An unobstructed airway, with intact protective reflexes and respiratory drive, is essential to avoid complications. In some procedures, e.g. dental, the airway may need to be shared with the surgeon.

  7. Complications of the arterial tourniquet

    African Journals Online (AJOL)

    2011-11-18

    Nov 18, 2011 ... Complications of tourniquet use are due to mechanical compression of underlying structures, as well as ... greatest beneath the cuff due to the combined effects of all three. Injury increases with greater .... padding, bad application of the tourniquet, and movement of a fully inflated tourniquet over bare skin.

  8. Is this ?complicated? opioid withdrawal?

    OpenAIRE

    Parkar, S.R.; Seethalakshmi, R; Adarkar, S; Kharawala, S

    2006-01-01

    Seven patients with opioid dependence admitted in the de-addiction centre for detoxification developed convulsions and delirium during the withdrawal phase. After ruling out all other possible causes of these complications, opioid withdrawal seemed to emerge as the most likely explanation. The unpredictability of the course of opioid dependence and withdrawal needs to be considered when treating patients with opioid dependence.

  9. Complications of Prematurity - An Infographic

    Science.gov (United States)

    Chandrasekharan, Praveen; Rawat, Munmun; Lakshminrusimha, Satyan

    2017-01-01

    Infographics or information graphics are easy-to-understand visual representation of knowledge. An infographic outlining the course of an extremely preterm infant and various potential complications encountered during a neonatal intensive care unit (NICU) stay was developed. This infographic can be used to discuss outcomes of prematurity during prenatal counseling and while the infant is in the NICU. PMID:29138522

  10. Thromboembolic complications in childhood nephrotic syndrome: a clinical profile.

    Science.gov (United States)

    Suri, Deepti; Ahluwalia, Jasmina; Saxena, Akshay K; Sodhi, Kushaljit S; Singh, Paramjeet; Mittal, Bhagwant R; Das, Reena; Rawat, Amit; Singh, Surjit

    2014-10-01

    Thromboembolism is a rare life-threatening complication of childhood nephrotic syndrome. We present the clinical profile and outcome of 34 children with 35 events of thromboembolic complications with nephrotic syndrome. Cerebral venous thrombosis (CVT) was the commonest complication seen in 11 (31.4 %) children followed by pulmonary thromboembolism and deep venous thrombosis in 9 (25.7 %) and 6 (16.6 %) children, respectively. Arterial thrombosis resulting in central nervous system infarcts was observed in 7 (20 %) children and 2 children had thrombosis of the peripheral arteries. Episodes were equal in steroid-resistant nephrotic syndrome and steroid-dependent nephrotic syndrome groups. Most of the thromboembolic complications occurred with relapse but 11.4 % of children developed intracranial thrombosis during remission. The most sensitive symptom of CVT was persistent headache while unexplained respiratory distress and hypoxemia pointed towards pulmonary thromboembolism. Hypoalbuminemia was seen in 82.8 % of children, while concurrent infection was seen in 31.4 %. Coexistence of genetic prothrombotic condition was identified and merits evaluation. Early heparin therapy followed by oral anticoagulants resulted in complete recovery in 91.1 % of children. Death occurred in 3 (8.5 %) children and autopsy revealed pulmonary thromboembolism in 2 children. Venous and arterial thrombotic complications can occur in children with nephrotic syndrome. A high index of suspicion is required as the clinical features may be subtle. Neuroimaging and angiographic techniques help in confirming diagnosis. Early aggressive heparin therapy followed by oral anticoagulants is necessary for a favorable outcome.

  11. Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography.

    Science.gov (United States)

    Ma, Lin; Lu, Qiang; Luo, Yan

    2016-01-28

    Living donor liver transplantation (LDLT) has been widely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrast-enhanced ultrasound (CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional gray-scale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT.

  12. Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis: case series.

    Science.gov (United States)

    Cillóniz, Catia; Rangel, Ernesto; Barlascini, Cornelius; Piroddi, Ines Maria Grazia; Torres, Antoni; Nicolini, Antonello

    2015-01-01

    In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis.

  13. A temible complication of ischemic stroke: pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Linda Iurato

    2015-12-01

    Pulmonary embolism is a major contributor to in-hospital death after stroke. Although the rate of clinically overt pulmonary embolism after stroke has been estimated to be less than 1%, pulmonary emboli account for up to 50% of early deaths after stroke. In daily practice, the clinical burden of pulmonary embolism in patient with stroke is, however, underestimated since the clinical symptoms of stroke may obscure the recognition of this complication. The aim of this article is to describe the clinical and therapeutic aspects of pulmonary embolism as complication after stroke.

  14. Risk factors for complicated diverticulitis: systematic review and meta-analysis

    OpenAIRE

    Bolkenstein, H. E.; van de Wall, B. J. M.; Consten, E. C. J.; Broeders, I. A. M. J.; Draaisma, W. A.

    2017-01-01

    Purpose The aim of this systematic review is to identify risk factors that can predict complicated diverticulitis. Uncomplicated diverticulitis is a self-limiting and mild disease, but 10% of patients with diverticulitis develop complications requiring further treatment. It is important to estimate the risk of developing complicated diverticulitis at an early stage to set the right treatment at initial presentation. Methods Embase, MEDLINE, and Cochrane databases were searched for studies rep...

  15. “Sickle Cell Disease in the Emergency Department: Atypical Complications and Management”

    OpenAIRE

    Brandow, Amanda M.; Liem, Robert

    2011-01-01

    Sickle cell disease is the most common inherited blood disorder in the United States. This disorder of hemoglobin structure leads to a chronic hemolytic anemia and complex chronic disease manifested by sudden, severe, and life-threatening complications. These acute complications can occur in any organ system beginning in early childhood and lasting throughout life. The intermittent nature and acuity of these complications lend the emergency department to be an important site of care. The hall...

  16. Automatic detection of diabetic foot complications with infrared thermography by asymmetric analysis

    NARCIS (Netherlands)

    Liu, C.; van Netten, Jaap J.; van Baal, Jeff G.; Bus, Sicco A.; van der Heijden, Ferdinand

    2015-01-01

    Early identification of diabetic foot complications and their precursors is essential in preventing their devastating consequences, such as foot infection and amputation. Frequent, automatic risk assessment by an intelligent telemedicine system might be feasible and cost effective. Infrared

  17. Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting

    OpenAIRE

    Chawla, Ashish; Bosco, Jerome Irai; Lim, Tze Chwan; Srinivasan, Sivasubramanian; Teh, Hui Seong; Shenoy, Jagadish Narayana

    2015-01-01

    Acute cholecystitis is a common cause of right upper quadrant pain in patients presenting at the emergency department. Early diagnosis and recognition of associated complications, though challenging, are essential for timely management. Imaging studies, including ultrasonography, computed tomography and magnetic resonance imaging, are increasingly utilised for the evaluation of suspected cases of cholecystitis. These investigations help in diagnosis, identification of complications and surgic...

  18. Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults

    DEFF Research Database (Denmark)

    Lancellotti, Patrizio; Nkomo, Vuyisile T; Badano, Luigi P

    2013-01-01

    . A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications...... of radiotherapy by cardiac imaging are also proposed....

  19. Superficial fascial system repair: an abdominoplasty technique to reduce local complications after caesarean delivery.

    Science.gov (United States)

    Al-Benna, Sammy; Al-Ajam, Yazan; Tzakas, Elias

    2009-05-01

    Abdominal incision complications are a major source of morbidity after caesarean delivery. Repair of the superficial fascial system may avert local complications after caesarean delivery by minimising tension to the skin and increasing the initial biomechanical strength of wound which has the potential to decrease early wound dehiscence and as a by-product correct suprapubic bulging.

  20. Analysis of complications in primary cleft lips and palates surgery.

    Science.gov (United States)

    Zhang, Zhaoqiang; Fang, Silian; Zhang, Qingbin; Chen, Lei; Liu, Yarui; Li, Kefeng; Zhao, Yan

    2014-05-01

    A series of retrospectively recorded patients with cleft lip and palate was uniquely investigated to demonstrate and analyze the complications after cleft repairing operations in a selected Chinese population. From January 2005 to January 2012, a selected group of 2100 patients with cleft lip and/or palate who have complete records were chosen from a large sample in the units. Complete data were retrieved, including sex, age, clinical classification, surgical modality, complications, and follow-up results. The complications were classified into 2 categories: early and long-term complications. After surgery, most patients with cleft lip remained in the hospital for 7 days and cleft palate repairs for 10 days. A standard regimen of antibiotics was administered for 3 to 5 days clinically. Of the 2100 patients, there were 1360 males and 760 females who had congenital cleft deformity with complete clinical records in the department of oral and maxillofacial surgery. The age distribution was as follows: 1600 patients in the group of 3 months to 2 years, 320 patients in the group of 2 to 10 years, 130 patients in the group of 11 to 19 years, and 50 patients in the group of older than 20 years. As to the treatment modality, cleft lips were repaired by rotation advancement method with various minor modifications or Tennison modality. The cleft palates were closed using the von Langenbeck, Veau/Wardill/Kilner, or Furlow technique. The overall complication rate was 16.8% of the patients. Of the early complications, there were 6 cases of asphyxia, 17 cases of pyrexia, 5 cases of edema of the respiratory tract, 8 cases of upper respiratory tract infection, 6 cases of bronchiolitis, 7 cases of pneumonia, 9 cases of diarrhea and vomiting, 6 cases of hemorrhage, 5 patients of odontoptosis, 11 cases of erosion of the corner of mouth, 5 cases of drowsiness, 11 cases of incision dehiscence, 9 cases of wound infection, 6 cases of palatal dehiscence/fistula, 3 cases of nostril floor