This study evaluated 25 patients with late onset congenital aqueductal stenosis hydrocephalus. The patients ranged from 5-64 years old and most were male. Common presenting symptoms were headache, visual disturbances, and gait disturbances. MRI and CT scans showed dilated ventricles. All patients underwent ventriculoperitoneal shunt placement. Most patients (80%) improved after surgery, while some developed complications like subdural hematomas. Late onset aqueductal stenosis hydrocephalus can present in adulthood and proper diagnosis through imaging and treatment with shunts can improve outcomes.
BLOOD TRANSFUSIONS ARE ASSOCIATED WITH MORTALITY IN PEDIATRIC PATIENTS WITH S...Texas Children's Hospital
Restrictive thresholds for red blood cell (RBC) transfusion have not been shown to be inferior to liberal transfusion thresholds after cardiac surgery in pediatric or adult patients.1,2
RBC transfusions are associated with readmission due to heart failure (HF) in adults after aortic valve replacements, and with increased risk of right ventricle-pulmonary artery conduit failure in pediatric patients.3,4
Data are limited about RBC transfusions in pediatric patients with HF.
Contributors, complications, and causative factors for central venous cathete...Texas Children's Hospital
Central venous catheter (CVC) use is common in the management of critically ill children, especially those with congenital or acquired heart disease (CHD).
Prior studies suggest that the presence of a CVC augments the risk of deep vein thrombosis (DVT) in adults and children.
In recent years, the reported incidence of VTE in children has increased dramatically.
How CVC-associated DVTs contribute to morbidity and mortality in this high risk patient population is unknown
ANEMIA IS ASSOCIATED WITH GREATER MORBIDITY AND RESOURCE UTILIZATION IN PEDIA...Texas Children's Hospital
This study analyzed data from over 2,400 pediatric hospital admissions for systolic heart failure without congenital heart disease. It found that anemia was present in 26% of admissions and was associated with younger patient age, more systemic comorbidities like kidney and liver failure, and greater resource utilization including longer hospital stays and higher costs. While anemia was linked to worse outcomes like cardiac death on initial analysis, this association did not remain significant after accounting for other clinical factors. Overall, the study suggests anemia represents greater illness burden for pediatric heart failure patients and optimizing anemia management may help improve their outcomes.
OUTCOME OF TUNNELED CATHETERS IN HEMODIALYSIS PATIENTS: FIVE YEARS SINGLE CE...IJSIT Editor
Introduction: The tunneled hemodialysis catheters(THCs) are preferred for the patients who are expected to
poor survival and the attempts to arteriovenous fistulas (AVF) are failure. In our study,in hemodialysis
patients who are implemented tunneled catheter it is evaluated the mean duration for the catheters , their
complications and the factors which affect the period of the catheters.
Methods: At the Antalya Research and Education Center Hemodialysis Unit it is retrospectively evaluated the
data of 297 hemodialysis patients who are implemented tunneled catheter during 5 years .
Results: The mean duration time of the tunneled catheters has been 224.9+162.9 days. The duration time of
right internal jugular vein(RIJV) is considerably higher than left internal jugular vein(LIJV) and subclavian
veins (235.8+96.6 days). In diabetic hemodialysis patients, the duration time of the catheter is rather lower
than the other end stage renal disease reasons(184.4±72.1 days).
Conclusions: THCs must be considered as an alternative but not a permanent vascular access in hemodialysis
patients. Because of relatively short duration times than AVF, high infection risks and thrombosis , it must be
used only in patients who have problems with the creating permanent vascular access or patients with
expected low survival time. Moreover, it must be taken into consideration the duration time of the catheter is
low in diabetic hemodialysis patients. According to our results, catheter duration time was longer in RIJV than
in other insertion sites and RIJV must be preferred as first place to placement of THCs.
This study surveyed 46 hemodialysis patients about arrhythmia symptoms and willingness to use an implantable cardiac monitor. The key findings were:
1) Arrhythmia symptoms were common, with 74% reporting at least one symptom such as heart palpitations or feeling like passing out.
2) Acceptability of the implantable cardiac monitor was high, with 59% of symptomatic patients and 50% of asymptomatic patients willing to consider it.
3) The main reason patients gave for not wanting the monitor was simply not wanting an implanted device, not concerns about the procedure or complications.
FIBRILACION AURICULAR EN URGENCIAS THE After Studyjasar
- The study derived and validated a complex model and simplified model to predict 30-day mortality for patients presenting to the emergency department with atrial fibrillation.
- The complex model considered age, vital signs, laboratory results, comorbidities, bleeding risk, and secondary diagnoses, achieving c-statistics of 0.88-0.87.
- The simplified 6-variable TrOPs-BAC model included troponin result, other diagnosis, pulmonary disease, bleeding risk, age over 75, and congestive heart failure, with c-statistics of 0.81 in both cohorts.
This document summarizes a study comparing clinical characteristics of hypertensive intracerebral hemorrhage (ICH) in young patients versus older patients. The study found that young patients had higher blood pressures, smaller hemorrhage volumes, lower rates of ventricular extensions, and a different distribution pattern of ICH locations. Mortality was lower in young patients but they had more disabling outcomes. The findings suggest there are age-related differences in the pathogenesis of hypertensive ICH.
This document discusses guidelines for a clinical practice guideline on perioperative care. It summarizes discussions between guideline writing committees on how to address controversies surrounding certain clinical trials. Specifically, it was agreed that the controversial DECREASE trials led by Poldermans would be excluded from systematic reviews and recommendations. Nonretracted publications from these trials could be cited but not used as the basis for recommendations. The committees aimed to balance transparency with the availability of new evidence in developing their guidelines.
BLOOD TRANSFUSIONS ARE ASSOCIATED WITH MORTALITY IN PEDIATRIC PATIENTS WITH S...Texas Children's Hospital
Restrictive thresholds for red blood cell (RBC) transfusion have not been shown to be inferior to liberal transfusion thresholds after cardiac surgery in pediatric or adult patients.1,2
RBC transfusions are associated with readmission due to heart failure (HF) in adults after aortic valve replacements, and with increased risk of right ventricle-pulmonary artery conduit failure in pediatric patients.3,4
Data are limited about RBC transfusions in pediatric patients with HF.
Contributors, complications, and causative factors for central venous cathete...Texas Children's Hospital
Central venous catheter (CVC) use is common in the management of critically ill children, especially those with congenital or acquired heart disease (CHD).
Prior studies suggest that the presence of a CVC augments the risk of deep vein thrombosis (DVT) in adults and children.
In recent years, the reported incidence of VTE in children has increased dramatically.
How CVC-associated DVTs contribute to morbidity and mortality in this high risk patient population is unknown
ANEMIA IS ASSOCIATED WITH GREATER MORBIDITY AND RESOURCE UTILIZATION IN PEDIA...Texas Children's Hospital
This study analyzed data from over 2,400 pediatric hospital admissions for systolic heart failure without congenital heart disease. It found that anemia was present in 26% of admissions and was associated with younger patient age, more systemic comorbidities like kidney and liver failure, and greater resource utilization including longer hospital stays and higher costs. While anemia was linked to worse outcomes like cardiac death on initial analysis, this association did not remain significant after accounting for other clinical factors. Overall, the study suggests anemia represents greater illness burden for pediatric heart failure patients and optimizing anemia management may help improve their outcomes.
OUTCOME OF TUNNELED CATHETERS IN HEMODIALYSIS PATIENTS: FIVE YEARS SINGLE CE...IJSIT Editor
Introduction: The tunneled hemodialysis catheters(THCs) are preferred for the patients who are expected to
poor survival and the attempts to arteriovenous fistulas (AVF) are failure. In our study,in hemodialysis
patients who are implemented tunneled catheter it is evaluated the mean duration for the catheters , their
complications and the factors which affect the period of the catheters.
Methods: At the Antalya Research and Education Center Hemodialysis Unit it is retrospectively evaluated the
data of 297 hemodialysis patients who are implemented tunneled catheter during 5 years .
Results: The mean duration time of the tunneled catheters has been 224.9+162.9 days. The duration time of
right internal jugular vein(RIJV) is considerably higher than left internal jugular vein(LIJV) and subclavian
veins (235.8+96.6 days). In diabetic hemodialysis patients, the duration time of the catheter is rather lower
than the other end stage renal disease reasons(184.4±72.1 days).
Conclusions: THCs must be considered as an alternative but not a permanent vascular access in hemodialysis
patients. Because of relatively short duration times than AVF, high infection risks and thrombosis , it must be
used only in patients who have problems with the creating permanent vascular access or patients with
expected low survival time. Moreover, it must be taken into consideration the duration time of the catheter is
low in diabetic hemodialysis patients. According to our results, catheter duration time was longer in RIJV than
in other insertion sites and RIJV must be preferred as first place to placement of THCs.
This study surveyed 46 hemodialysis patients about arrhythmia symptoms and willingness to use an implantable cardiac monitor. The key findings were:
1) Arrhythmia symptoms were common, with 74% reporting at least one symptom such as heart palpitations or feeling like passing out.
2) Acceptability of the implantable cardiac monitor was high, with 59% of symptomatic patients and 50% of asymptomatic patients willing to consider it.
3) The main reason patients gave for not wanting the monitor was simply not wanting an implanted device, not concerns about the procedure or complications.
FIBRILACION AURICULAR EN URGENCIAS THE After Studyjasar
- The study derived and validated a complex model and simplified model to predict 30-day mortality for patients presenting to the emergency department with atrial fibrillation.
- The complex model considered age, vital signs, laboratory results, comorbidities, bleeding risk, and secondary diagnoses, achieving c-statistics of 0.88-0.87.
- The simplified 6-variable TrOPs-BAC model included troponin result, other diagnosis, pulmonary disease, bleeding risk, age over 75, and congestive heart failure, with c-statistics of 0.81 in both cohorts.
This document summarizes a study comparing clinical characteristics of hypertensive intracerebral hemorrhage (ICH) in young patients versus older patients. The study found that young patients had higher blood pressures, smaller hemorrhage volumes, lower rates of ventricular extensions, and a different distribution pattern of ICH locations. Mortality was lower in young patients but they had more disabling outcomes. The findings suggest there are age-related differences in the pathogenesis of hypertensive ICH.
This document discusses guidelines for a clinical practice guideline on perioperative care. It summarizes discussions between guideline writing committees on how to address controversies surrounding certain clinical trials. Specifically, it was agreed that the controversial DECREASE trials led by Poldermans would be excluded from systematic reviews and recommendations. Nonretracted publications from these trials could be cited but not used as the basis for recommendations. The committees aimed to balance transparency with the availability of new evidence in developing their guidelines.
1) A study of 455 patients undergoing transradial cardiac catheterization found that the rate of radial artery occlusion (RAO) was significantly higher when a 6-French sheath was used (30.5%) compared to a 5-French sheath (13.7%).
2) Multivariate analysis identified female sex, younger age, presence of peripheral artery disease, and use of a 6-French sheath as independent predictors of RAO.
3) For patients who developed symptomatic RAO, treatment with low molecular weight heparin showed a higher rate of recanalization (55.6%) compared to patients who did not receive anticoagulation (13.5%).
Same Wrist Intervention via the Cubital (Ulnar) Artery in Case of Radial Puncture Failure for Percutaneous Cardiac Catheterization or Intervention: The Multicenter Prospective SWITCH Registry
This study analyzed the causes of stroke in 50 young patients aged 15-35 years at a tertiary hospital in Pakistan. The most common cause of stroke was infective meningitis (34%), predominantly tuberculosis meningitis. The second most common cause was cardioembolism (20%), mainly due to valvular heart disease. Other major causes included hypertension (14%), pregnancy-related conditions (12%), and systemic lupus erythematosus (4%). Infective meningitis, particularly tuberculosis, was found to be the leading cause of stroke in young patients in this study.
Access vs non-access site bleeding and risk of subsequent mortality and MACE
This study aimed to analyze the incidence and prognostic impact of access site versus non-access site bleeding in patients undergoing percutaneous coronary intervention (PCI). The meta-analysis included 38 studies and over 520,000 patients. It found that access site bleeding occurred in 11.2% of patients while non-access site bleeding occurred in 10.2% of patients. However, non-access site bleeding was associated with a higher crude mortality rate of 8.3% compared to 2.8% for access site bleeding. Further analyses confirmed that non-access site bleeding carried a greater risk of subsequent mortality and major adverse cardiac events than access site bleeding. The
This study investigated the incidence and causes of acute kidney injury (AKI) in children admitted to the pediatric intensive care unit (PICU) of a hospital in Bangalore, India using the pediatric RIFLE (pRIFLE) criteria. The main findings were:
1) The incidence of AKI was 26.1%, with most cases being stage 'Risk'. AKI was most common in children under 1 year of age.
2) The leading cause of AKI was infections such as dengue, sepsis, and pneumonia.
3) Risk factors for developing AKI included hypotension, use of nephrotoxic drugs, sepsis, and need for mechanical ventilation. The majority (68%)
Stroke related pneumonia _ APSR 2019 - Phuc Duc Dangdangphucduc
From 2014 to 2016, 508 stroke patients were studied to identify risk factors for stroke-associated pneumonia (SAP). 13.4% of patients developed SAP. Risk factors for SAP included hemorrhagic stroke, low Glasgow Coma Scale scores (3-8), high NIH Stroke Scale scores (>15), diabetes, and low Guttman Upper Swallowing Screen scores (0-14). For hemorrhagic strokes, additional risk factors were large hematoma volumes (≥30ml), subarachnoid hemorrhage, and midline deviation ≥5mm. The Guttman Upper Swallowing Screen was a better predictor of SAP than the NIH Stroke Scale.
This study reviewed data from the ELSO registry on 44 patients who received extracorporeal membrane oxygenation (ECMO) for peripartum cardiomyopathy (PPCM) between 2007-2016. Overall survival to discharge was 56.8% and 75% were weaned off ECMO. Higher pre-ECMO ventilation rates and use of vasopressors/inotropes were associated with decreased survival, as was ECMO cannula site bleeding. The study concludes ECMO can be a viable option for PPCM patients when clinically indicated based on the survival rates observed.
Reversal of warfarin associated coagulopathy prothrombin complex concentratesTÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Our project, our experience and our results at December 31 st 2013
Il nostro progetto, la nostra esperienza ed i nostri risultati aggiornati al 31.12.2013
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
This document discusses strategies and protocols for optimizing hemoglobin levels in patients through patient blood management. It begins by outlining the high rates of preoperative anemia seen in various surgical specialties, from 25% to over 50% depending on the procedure. Preoperative anemia is associated with increased risks of mortality, morbidity, length of hospital stay, blood transfusions, and healthcare costs. The document emphasizes the importance of treating preoperative anemia to improve surgical outcomes and lower transfusion rates. It promotes the use of patient blood management strategies that include early anemia screening and treatment, as well as alternatives to allogeneic blood transfusions when possible.
Ascitis y cirrosis. guías 2009 update6 2009Daejam Geum
This document provides guidelines for the management of adult patients with ascites due to cirrhosis. It summarizes the evaluation and diagnosis process. Key points include:
- Abdominal paracentesis with ascitic fluid analysis is recommended for patients with clinically apparent new-onset ascites to confirm the diagnosis and determine the cause.
- Routine tests of coagulation do not accurately predict bleeding risk in patients with cirrhosis. Prophylactic transfusions before paracentesis are not recommended.
- Ascitic fluid should be analyzed to determine if the fluid is due to portal hypertension or another cause. Further testing may be done if initial screening tests yield abnormal results.
Women presenting with STEMI symptoms received an EKG over 7 minutes later than men, on average, after entering the emergency department. Of the 188 patients admitted with STEMI over a 3 year period, 45 (24%) were female. This delay in receiving an EKG for women was associated with worse left ventricular function post-hospitalization compared to men, indicating increased cardiac injury from delayed treatment. While women's STEMI symptoms have been reported as atypical sometimes, this study found that women presented with typical chest pain and shortness of breath symptoms but still experienced delays in the initial diagnostic EKG evaluation.
This study examined 2,112 patients admitted to the National Institute of Cardiovascular Diseases in Dhaka with heart failure. The average age was 46 years old, most were male. Common presenting symptoms were shortness of breath, leg edema, and orthopnea. Hypertension and diabetes were common comorbidities. The leading causes of heart failure were ischemic cardiomyopathy and chronic ischemic heart disease. The study aims to identify clinical presentations of heart failure patients to help determine best treatment approaches.
The document summarizes economic analyses that have found transradial procedures to be more cost-effective than transfemoral procedures. Several studies are highlighted, including a registry analysis finding lower total inpatient costs and shorter length of stay for transradial PCI. A meta-analysis found transradial procedures were associated with lower complication rates and costs. For STEMI patients, studies demonstrated transradial procedures were linked to shorter hospital stays. The conclusions state that transradial access can improve value by enhancing outcomes and reducing length of stay, creating value across clinical scenarios.
This document describes a study examining acute care and one-year outcomes of patients experiencing first-ever acute ischemic stroke in Mexico. The study analyzed data from 1,040 patients enrolled in the PREMIER registry from 59 hospitals across Mexico. Key findings include:
- The most common risk factors were hypertension (64%), obesity (51%), and diabetes (35%).
- Diagnostic procedures and acute treatments like IV thrombolysis were underutilized, with only 0.5% receiving thrombolysis despite 17% arriving within 3 hours of onset.
- The 30-day case fatality rate was 15% and the one-year mortality rate was 29%. At one year, 47% had low or no
This study analyzed 107 cases of acute pancreatitis treated at a hospital in Islamabad, Pakistan over one year. Gallstones were found to be the most common cause, accounting for 36.5% of cases. Alcohol was a factor in 11.2% of cases. In 46.7% of cases, no clear cause was identified. Based on the Ranson score, 35.5% of cases were considered severe. The average hospital stay was 8.9 days and mortality rate was 8.4%, with all deaths occurring in severe cases. The authors conclude that while the causes and severity of acute pancreatitis in Pakistan are generally similar to other countries, gallstones are a relatively more common cause than alcohol compared to Western
The SPRINT study compared an intensive blood pressure treatment target of less than 120 mm Hg to a standard target of less than 140 mm Hg in 9,361 patients at high risk for cardiovascular events but without diabetes. At 1 year, the mean systolic blood pressure was 121.4 mm Hg in the intensive group and 136.2 mm Hg in the standard group. After a median follow up of 3.26 years, the primary composite outcome of heart attack, acute coronary syndrome, stroke, heart failure or cardiovascular death occurred less frequently in the intensive group compared to the standard group. All-cause mortality was also lower in the intensive group, though rates of some adverse events were higher.
Fatty liver index correlates with non-alcoholic fatty liver disease, but not ...Enrique Moreno Gonzalez
Fatty liver index (FLI) was recently established to predict non-alcoholic fatty liver disease (NAFLD) in general population, which is known to be associated with coronary artery atherosclerotic disease (CAD).
This study aims to investigate whether FLI correlates with NAFLD and with newly diagnosed CAD in a special Chinese population who underwent coronary angiography.
This document discusses the use of ultrasound in diagnosing scrotal pathologies. It summarizes a study of 75 patients who underwent scrotal ultrasound exams. The most common sonographic finding was varicocele (37.33%), followed by hydrocele (16%). Varicocele most commonly affected men ages 21-30 and was usually found on the left side. Masses like cysts were most common in men ages 51-60 and usually affected the right testis. Hydroceles were most common in men ages 51-60. Epididymitis/orchitis mostly affected men ages 11-20. The study concludes that ultrasound is an effective tool for diagnosing various scrotal abnormalities.
Ultrasonography Diagnosis of Scrotal Pathologiesiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
1) A study of 455 patients undergoing transradial cardiac catheterization found that the rate of radial artery occlusion (RAO) was significantly higher when a 6-French sheath was used (30.5%) compared to a 5-French sheath (13.7%).
2) Multivariate analysis identified female sex, younger age, presence of peripheral artery disease, and use of a 6-French sheath as independent predictors of RAO.
3) For patients who developed symptomatic RAO, treatment with low molecular weight heparin showed a higher rate of recanalization (55.6%) compared to patients who did not receive anticoagulation (13.5%).
Same Wrist Intervention via the Cubital (Ulnar) Artery in Case of Radial Puncture Failure for Percutaneous Cardiac Catheterization or Intervention: The Multicenter Prospective SWITCH Registry
This study analyzed the causes of stroke in 50 young patients aged 15-35 years at a tertiary hospital in Pakistan. The most common cause of stroke was infective meningitis (34%), predominantly tuberculosis meningitis. The second most common cause was cardioembolism (20%), mainly due to valvular heart disease. Other major causes included hypertension (14%), pregnancy-related conditions (12%), and systemic lupus erythematosus (4%). Infective meningitis, particularly tuberculosis, was found to be the leading cause of stroke in young patients in this study.
Access vs non-access site bleeding and risk of subsequent mortality and MACE
This study aimed to analyze the incidence and prognostic impact of access site versus non-access site bleeding in patients undergoing percutaneous coronary intervention (PCI). The meta-analysis included 38 studies and over 520,000 patients. It found that access site bleeding occurred in 11.2% of patients while non-access site bleeding occurred in 10.2% of patients. However, non-access site bleeding was associated with a higher crude mortality rate of 8.3% compared to 2.8% for access site bleeding. Further analyses confirmed that non-access site bleeding carried a greater risk of subsequent mortality and major adverse cardiac events than access site bleeding. The
This study investigated the incidence and causes of acute kidney injury (AKI) in children admitted to the pediatric intensive care unit (PICU) of a hospital in Bangalore, India using the pediatric RIFLE (pRIFLE) criteria. The main findings were:
1) The incidence of AKI was 26.1%, with most cases being stage 'Risk'. AKI was most common in children under 1 year of age.
2) The leading cause of AKI was infections such as dengue, sepsis, and pneumonia.
3) Risk factors for developing AKI included hypotension, use of nephrotoxic drugs, sepsis, and need for mechanical ventilation. The majority (68%)
Stroke related pneumonia _ APSR 2019 - Phuc Duc Dangdangphucduc
From 2014 to 2016, 508 stroke patients were studied to identify risk factors for stroke-associated pneumonia (SAP). 13.4% of patients developed SAP. Risk factors for SAP included hemorrhagic stroke, low Glasgow Coma Scale scores (3-8), high NIH Stroke Scale scores (>15), diabetes, and low Guttman Upper Swallowing Screen scores (0-14). For hemorrhagic strokes, additional risk factors were large hematoma volumes (≥30ml), subarachnoid hemorrhage, and midline deviation ≥5mm. The Guttman Upper Swallowing Screen was a better predictor of SAP than the NIH Stroke Scale.
This study reviewed data from the ELSO registry on 44 patients who received extracorporeal membrane oxygenation (ECMO) for peripartum cardiomyopathy (PPCM) between 2007-2016. Overall survival to discharge was 56.8% and 75% were weaned off ECMO. Higher pre-ECMO ventilation rates and use of vasopressors/inotropes were associated with decreased survival, as was ECMO cannula site bleeding. The study concludes ECMO can be a viable option for PPCM patients when clinically indicated based on the survival rates observed.
Reversal of warfarin associated coagulopathy prothrombin complex concentratesTÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Our project, our experience and our results at December 31 st 2013
Il nostro progetto, la nostra esperienza ed i nostri risultati aggiornati al 31.12.2013
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
This document discusses strategies and protocols for optimizing hemoglobin levels in patients through patient blood management. It begins by outlining the high rates of preoperative anemia seen in various surgical specialties, from 25% to over 50% depending on the procedure. Preoperative anemia is associated with increased risks of mortality, morbidity, length of hospital stay, blood transfusions, and healthcare costs. The document emphasizes the importance of treating preoperative anemia to improve surgical outcomes and lower transfusion rates. It promotes the use of patient blood management strategies that include early anemia screening and treatment, as well as alternatives to allogeneic blood transfusions when possible.
Ascitis y cirrosis. guías 2009 update6 2009Daejam Geum
This document provides guidelines for the management of adult patients with ascites due to cirrhosis. It summarizes the evaluation and diagnosis process. Key points include:
- Abdominal paracentesis with ascitic fluid analysis is recommended for patients with clinically apparent new-onset ascites to confirm the diagnosis and determine the cause.
- Routine tests of coagulation do not accurately predict bleeding risk in patients with cirrhosis. Prophylactic transfusions before paracentesis are not recommended.
- Ascitic fluid should be analyzed to determine if the fluid is due to portal hypertension or another cause. Further testing may be done if initial screening tests yield abnormal results.
Women presenting with STEMI symptoms received an EKG over 7 minutes later than men, on average, after entering the emergency department. Of the 188 patients admitted with STEMI over a 3 year period, 45 (24%) were female. This delay in receiving an EKG for women was associated with worse left ventricular function post-hospitalization compared to men, indicating increased cardiac injury from delayed treatment. While women's STEMI symptoms have been reported as atypical sometimes, this study found that women presented with typical chest pain and shortness of breath symptoms but still experienced delays in the initial diagnostic EKG evaluation.
This study examined 2,112 patients admitted to the National Institute of Cardiovascular Diseases in Dhaka with heart failure. The average age was 46 years old, most were male. Common presenting symptoms were shortness of breath, leg edema, and orthopnea. Hypertension and diabetes were common comorbidities. The leading causes of heart failure were ischemic cardiomyopathy and chronic ischemic heart disease. The study aims to identify clinical presentations of heart failure patients to help determine best treatment approaches.
The document summarizes economic analyses that have found transradial procedures to be more cost-effective than transfemoral procedures. Several studies are highlighted, including a registry analysis finding lower total inpatient costs and shorter length of stay for transradial PCI. A meta-analysis found transradial procedures were associated with lower complication rates and costs. For STEMI patients, studies demonstrated transradial procedures were linked to shorter hospital stays. The conclusions state that transradial access can improve value by enhancing outcomes and reducing length of stay, creating value across clinical scenarios.
This document describes a study examining acute care and one-year outcomes of patients experiencing first-ever acute ischemic stroke in Mexico. The study analyzed data from 1,040 patients enrolled in the PREMIER registry from 59 hospitals across Mexico. Key findings include:
- The most common risk factors were hypertension (64%), obesity (51%), and diabetes (35%).
- Diagnostic procedures and acute treatments like IV thrombolysis were underutilized, with only 0.5% receiving thrombolysis despite 17% arriving within 3 hours of onset.
- The 30-day case fatality rate was 15% and the one-year mortality rate was 29%. At one year, 47% had low or no
This study analyzed 107 cases of acute pancreatitis treated at a hospital in Islamabad, Pakistan over one year. Gallstones were found to be the most common cause, accounting for 36.5% of cases. Alcohol was a factor in 11.2% of cases. In 46.7% of cases, no clear cause was identified. Based on the Ranson score, 35.5% of cases were considered severe. The average hospital stay was 8.9 days and mortality rate was 8.4%, with all deaths occurring in severe cases. The authors conclude that while the causes and severity of acute pancreatitis in Pakistan are generally similar to other countries, gallstones are a relatively more common cause than alcohol compared to Western
The SPRINT study compared an intensive blood pressure treatment target of less than 120 mm Hg to a standard target of less than 140 mm Hg in 9,361 patients at high risk for cardiovascular events but without diabetes. At 1 year, the mean systolic blood pressure was 121.4 mm Hg in the intensive group and 136.2 mm Hg in the standard group. After a median follow up of 3.26 years, the primary composite outcome of heart attack, acute coronary syndrome, stroke, heart failure or cardiovascular death occurred less frequently in the intensive group compared to the standard group. All-cause mortality was also lower in the intensive group, though rates of some adverse events were higher.
Fatty liver index correlates with non-alcoholic fatty liver disease, but not ...Enrique Moreno Gonzalez
Fatty liver index (FLI) was recently established to predict non-alcoholic fatty liver disease (NAFLD) in general population, which is known to be associated with coronary artery atherosclerotic disease (CAD).
This study aims to investigate whether FLI correlates with NAFLD and with newly diagnosed CAD in a special Chinese population who underwent coronary angiography.
This document discusses the use of ultrasound in diagnosing scrotal pathologies. It summarizes a study of 75 patients who underwent scrotal ultrasound exams. The most common sonographic finding was varicocele (37.33%), followed by hydrocele (16%). Varicocele most commonly affected men ages 21-30 and was usually found on the left side. Masses like cysts were most common in men ages 51-60 and usually affected the right testis. Hydroceles were most common in men ages 51-60. Epididymitis/orchitis mostly affected men ages 11-20. The study concludes that ultrasound is an effective tool for diagnosing various scrotal abnormalities.
Ultrasonography Diagnosis of Scrotal Pathologiesiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
This study evaluated outcomes of 44 neonates who underwent staged biventricular repair for left ventricular outflow tract obstruction, ventricular septal defect, and aortic arch obstruction. The first stage was a Norwood procedure. Stage one mortality was 9%. Interstage survival was 100% for nonsyndromic patients and 46% for syndromic patients. Twenty-four patients later underwent successful biventricular completion repair. The study found that genetic syndromes and prematurity significantly increased the risk of mortality. The staged approach allowed for repair using a larger conduit and delayed need for reintervention compared to previous studies.
Clinical and epidemiological profile of patients undergoing total hip arthro...David Sadigursky
Clinical and epidemiological profile of patients undergoing total hip arthroplasty.
Rheumatology and Orthopedic Medicine
Rheumatol Orthop Med, 2017 doi: 10.15761/ROM.1000120
Introduction: Stroke is an even more dramatic major public health problem in young people. Goal of the study: Contribute to the knowledge of strokes in young people. Methodology: This was a retrospective study carried out over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Neurology department of the University Hospital
Center of the Sino-Central African Friendship (CHUSCA) of Bangui.
CVST central venous sinus thrombosis.pptxajitjagtap13
Ppt covers extensively about CEREBRAL VENOUS SINUS THROMBOSIS.
Topics of scope include
Introduction
Epidemiology
Risk factors
Clinical features
Diagnosis
And treatment of cvt.
Author is medicine resident at LTMGH, SION Mumbai.
Our Experience with Pre-Operative Haemostatic Assessment of Paediatric Patien...Dr Gav Terna
: In 2-4% of all patients requiring adenoidectomy, tonsillectomy or adenotonsillectomy, preoperative screening tests for coagulation disorders are indicated to detect surgical bleeding complications. But because of cost effect on the patients, the usefulness of these tests is being challenged. We therefore highlight our experience in Paediatric patients undergoing adenoidectomy, tonsillectomy or both in our Centre
This study assessed outcomes of arteriovenous fistulas (AVFs) created for hemodialysis access in 67 patients in Baghdad, Iraq over 6 months. Most fistulas were brachiocephalic (91.4%) and functioned initially. Complications included thrombosis (22.2%), aneurysms (4.5%), and steal syndrome (13.6%). Thrombosis was higher than reported rates, while aneurysms and steal syndrome were within typical ranges. The study concluded that initial AVF success was good, but late complications like thrombosis were a concern.
This document summarizes a study on Pap smear screening conducted in Bagalkot, India between 2015-2016. 240 women ages 20-60 received Pap smears. The most common finding was reactive cellular changes associated with inflammation (75.8% of cases). Other findings included low-grade squamous intraepithelial lesions (4.5%), atypical squamous cells of undetermined significance (3.3%), high-grade squamous intraepithelial lesions (2.1%), and atrophy (1.3%). The average age of women with epithelial abnormalities was 40 years old. Cases with abnormal findings received follow-up colposcopy and biopsy. This study aims to increase awareness of Pap smears and
Frequency of Anastomotic Leak in Early Versus Dealyed Oral Feeding after Elec...semualkaira
Intestinal stoma is usually performed as component of other surgical intervention for small and large bowel
pathologies. Of these temporary colostomy are commonest stomas
created for de-functioning of the distal anastomotic site to minimise the chances of leak. Colostomy is usually reversed at 8 to 12
weeks and Ileostomy closure is often considered a minor procedure but it is associated with significant morbidity and mortality
Frequency of Anastomotic Leak in Early Versus Dealyed Oral Feeding after Elec...semualkaira
Intestinal stoma is usually performed as component of other surgical intervention for small and large bowel
pathologies. Of these temporary colostomy are commonest stomas
created for de-functioning of the distal anastomotic site to minimise the chances of leak. Colostomy is usually reversed at 8 to 12
weeks and Ileostomy closure is often considered a minor procedure but it is associated with significant morbidity and mortality
1. Atrial septal defects can be classified into four main types based on their location: ostium secundum, ostium primum, sinus venosus, and coronary sinus defects.
2. Ostium secundum defects, which account for 75-85% of ASDs, involve a defect in the fossa ovalis. Ostium primum defects involve the lower portion of the atrial septum.
3. The likelihood of spontaneous closure of an ASD depends on its size, with defects larger than 8-10 mm being less likely to close compared to smaller defects.
1) Atrial septal defects (ASDs) are one of the most common types of congenital heart disease. They can be classified based on their location as ostium secundum, ostium primum, sinus venosus, or coronary sinus defects.
2) The size and age at diagnosis are important predictors of spontaneous closure, with smaller defects (<8mm) and those diagnosed before age 2 being more likely to close on their own. Larger defects rarely close spontaneously and may continue to increase in size over time.
3) If left unrepaired, ASDs can lead to complications in adulthood like heart failure, atrial arrhythmias, pulmonary hypertension, and paradoxical e
Study of Congenital Heart Diseases in Pediatric Patientinventionjournals
Introduction: Congenital heart disease is important cause of morbidity and mortality in pediatric practice. Objectives: - 1) To establish the diagnosis and find out incidence of CHD in various age group. 2) To study various mode of presentation of various CHDs. 3) To study morbidity and mortality in various CHDs in children. Methodology:- Total 60 cases of congenital heart diseases coming to K.T. Children hospital, Rajkot from July 2016 to November 2016 were studied. Informed consent and detailed history was taken followed by thorough clinical examination as per Performa attached. Echocardiography of all patients was done. School health cards were prepared for the patients having abnormal echocardiography and referred to higher centre for cardiologist opinion. Conclusion:- Correct diagnosis can be made with help of thorough history and clinical examination especially in acyanotic congenital heart diseases. Early diagnosis and timely referral of patient can greatly improve outcome of patients with CHDs.
This document discusses strategies and protocols for optimizing hemoglobin levels in patients through patient blood management. It begins by outlining the high rates of preoperative anemia seen in various surgical specialties. Preoperative anemia is associated with increased risks of transfusion, mortality, and morbidity. Allogeneic blood transfusions also carry various risks. Therefore, effective management of preoperative anemia through treatment of underlying causes and use of alternatives to transfusion can help optimize patient outcomes and reduce transfusion rates. The document advocates following principles of patient blood management to safely and effectively meet patient blood needs.
Clinical and ct aspects in padiatric patients and adultsgisa_legal
- The study examined 20 pediatric patients with COVID-19 infection confirmed by testing, analyzing their clinical features, lab results, and chest CT scans.
- Key findings included higher rates of procalcitonin elevation and coinfection compared to adults, as well as consolidation with surrounding halo signs on CT scans.
- The results suggest underlying coinfection may be more common in pediatric COVID-19 patients than adults, and consolidation with halo is a typical sign.
Clinical and ct features in pediatric patients with covid19 infection differe...gisa_legal
- The study examined 20 pediatric patients with COVID-19 infection confirmed by testing, analyzing their clinical features, lab results, and chest CT scans.
- Key findings included higher rates of procalcitonin elevation and coinfection compared to adults, as well as consolidation with surrounding halo signs on CT scans.
- The results suggest underlying coinfection may be more common in pediatric COVID-19 patients than adults, and consolidation with halo is a typical CT sign.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
1. Journal of Neurology & Stroke
Evaluation of Late Onset Congenital Aqueductal Stenosis
Hydrocephalus
Submit Manuscript | http://medcraveonline.com
Introduction
Aqueductal stenosis is responsible for 20% of cases of
hydrocephalus. Its incidence ranges from 0.5 to 1.0 in 1,000
births, with a recurrence risk in siblings of 1.0% to 4.5%. The
onset of symptoms is usually insidious and can occur at any time
from birth to adulthood. Associated malformations in neighboring
structuresarecommonThepresenceofthesemalformationshelps
to explain the intellectual, cognitive, and motor handicaps even
after the hydrocephalus is compensated by shunting. Aqueductal
obstruction constitutes three percent of adult hydrocephalus [1].
According to the histopathological classification of Russell
[1], non-tumoral aqueduct stenosis can be subdivided into
four types: Stenosis, Forking, Septum formation and Gliosis.
Congenital aqueductal stenosis can present later in adult age
due to compensation of CSF flow dynamics during childhood
and normalization of clinical symptoms are more important
in evaluating the benefits of treatment than in the decrease in
ventricular size.
Hydrocephalus secondary to aqueductal stenosis may present
at any age. Clinical course may vary, according to the patient’s
age and the anatomical deformation of the ventricular system.
Imaging with CT and MRI will show dilated third and lateral
ventricles with marked upward bowing of corpus callosum.
Treatment of hydrocephalus secondary to aqueductal stenosis
can be achieved with implantation of extracranial shunt, such as
ventriculo-peritoneal (VP) or ventriculoatrial shunts, or by the
means of neuroendoscopy (ETV) [1].
The most common shunt coplications include: infection,
obstruction and overdrainage Prognosis of patients with
aqueductal stenosis does not depend only on promptness and
efficacy of surgical treatment. Better outcome is observed in post-
natal than congenital hydrocephalus [1].
This study evaluates hydrocephalus due to late onset
congenital aqueductal stenosis regarding preoperative patients’
characteristics (demographic data and clinical presentations),
operativemanagement,andpostoperativepatients’characteristics
(complications and outcome).
Patients and Methods
This study included 25 patients with late onset congenital
Sylvius aqueductal stenosis admitted to the neurosurgery
department in Assiut University Hospital from march 2012 till
march 2013. In this study, the patients were subjected to the
following inclusion and exclusion criteria
A-Inclusion criteria:
• Patient complaining of manifestation of increased
intracranial pressure, gait disturbance, urinary troubles,
visual deterioration and/or disturbance of the conscious
level.
• (Age of the patient should exceed 4 years of age as there is
no universally agreement on the age of late onset aqueductal
stenosis).
Volume 5 Issue 1 - 2016
Neurosurgery Department, Assiut University Hospital, Assiut,
Egypt
*Corresponding author: Hassan Mohammed, Neurosurgery
Department, Assiut University Hospital, Assiut, Egypt, Email:
Received: December 19, 2015 | Published: July 11, 2016
Case Report
J Neurol Stroke 2016, 5(1): 00163
Abstract
Early onset hydrocephalus due to congenital aqueductal stenosis is well known
and fully studied. However, late onset one is not so. The present study is a trial to
give spotlight on the late onset type which may be clinically confusing with other
syndromes leading sometimes to mismanagement.
Our study included 25 patients with late onset congenital aqueductal stenosis
hydrocephalus. They verified into 18 males (72%) and 7 females (28%). Their
ages ranged from 5 years to 64 years. They presented with headache in 19 cases
(76%), visual disturbance in 11 cases (44%), gait disturbance in 8 cases (32%) and
disturbed level of consciousness in 4 cases (16%). Ventriculoperitoneal shunts
were done for all cases with improvement in 20 cases (80%), no improvement
in 3 cases (12%) and deterioration in 2 cases (8%). Post-shunt complications
occurred in 9 cases (32%) and include 6 cases with subdural hematoma (24%), 2
cases with infection (8%) and one case with shunt obstruction (4%).
Late onset aqueductal stenosis hydrocephalus is not uncommon cause of
hydrocephalus in our locality. Proper diagnosis and management of such patients
depended on the well manifest clinical data confirmed with the neuroimaging
studies became easy.
Keywords: Ventriculoperitoneal shunt; Aqueductal stenosis