Our results suggest that prematurity at birth is associated with a risk of developing schizophrenia in adulthood. When gestational age and maternal body weight were allowed for, there was no evidence that schizophrenics tend to have lower mean BW or smaller BHC.
Context:Adverse events (AEs) are a persistent and an important reason for Intensive Care Unit (ICU) admission. They lead to death, disability at the time of discharge, unplanned ICU admission (UIA), and prolonged hospital stay. They impose large financial costs on health-care systems.Aims:This study aimed to determine the incidence, patient characteristics, type, preventability, and outcome of UIA following elective surgical AE.Settings and Design:This is a single-center prospective study.Methods:Analysis of 15,372 elective surgical procedures was performed. We defined UIA as an ICU admission that was not anticipated preoperatively but was due to an AE occurring within 5 days after elective surgery.Statistical Analysis:Descriptive analysis using SPSS software version 18 was used for statistical analysis.Results:There were 75 UIA (0.48%) recorded during the 2-year study period. The average age of patients was 54.64 ± 18.02 years. There was no sex predominance, and the majority of our patients had an American Society of Anesthesiologist classes 1 and 2. Nearly 29% of the UIA occurred after abdominal surgery and 22% after a trauma surgery. Regarding the causes of UIA, we observed that 44 UIA (58.7%) were related to surgical AE, 24 (32%) to anesthetic AE, and 7 (9.3%) to postoperative AE caused by care defects. Twenty-three UIA were judged as potentially preventable (30.7%). UIA was associated with negative outcomes, including increased use of ICU-specific interventions and high mortality rate (20%).Conclusions:Our analysis of UIA is a quality control exercise that helps identify high-risk patient groups and patterns of anesthesia or surgical care requiring improvement.
Abdominal wall hernias after trauma have been recognized for more than a century, with the first case reported as occurring after a fall. Traumatic abdominal wall hernias (TAWHs) after blunt trauma are uncommon. The timing of definitive repair, early or delayed, is not clear. We report a case on TAWH and mesenteric avulsion, highlighting the reasons for immediate or delayed repair. A single case study can hardly be considered as a basis for profound changes in the management of post traumatic hernias. However, damage to all layers of the abdominal wall indicates high-energy trauma. In such cases, the damage is not, in all probability, limited to the integumentary system. For the moment, the timing of surgery in any TAWH should be considered differently according to the trauma, the wall defect, clinical and radiological findings, associated injuries, and the clinical status of the patient.
Introduction : Les chambres à cathéter implantables (CCI) se sont imposées comme outils indispensables dans la prise en charge des patients ayant besoin de traitement intraveineux de longue durée. L'objectif de ce travail est d'évaluer la pose des CCI sur le plan technique ainsi que les incidents et complications pouvant survenir au cours de la mise en place ou pendant la période d'utilisation. Matériel et méthode : Étude rétrospective sur six ans incluant toutes les CCI posées entre janvier 2003 et décembre 2008 dans le but d'instaurer une chimiothérapie pour cancer. Résultats : Cinq cent quatre-vingts CCI étaient placées, chez 412 hommes et 168 femmes, la moyenne d'âge des patients était de 43 ans avec des extrêmes de 16 et 76 ans. Quatrevingt-dix des sites étaient posés à droite et 10 % à gauche dont la moitié pour échec de la pose à droite. Le site de la pose était de 42 % en céphalique, 31 % en jugulaire externe, 17 % en jugulaire interne et 10 % en sous-clavier. La durée d'utilisation moyenne des cathéters était de sept mois avec des extrêmes de 10 jours et de 36 mois. Dix-sept pour cent des patients avaient présenté au moins une complication dominée par l'infection ou la thrombose. La mortalité liée au geste de pose était nulle dans notre série. Conclusion : En comparant nos résultats aux données de la littérature, nous recommandons l'utilisation de cathéter en polyuréthane, de préférer la voie jugulaire et la pose par un opérateur expérimenté.
Mots clés Site veineux implantable · Cathéter · ComplicationsAbstract Introduction: Implantable venous catheters have become indispensable tools in the management of patients requiring long-term intravenous treatment. The objective of this work is to evaluate the implantable venous catheter technique, and incidents and complications that may arise during installation or during use. Methods: Retrospective study over six years covering all implantable venous catheters laid between January 2003 and December 2008 in order to establish chemotherapy for cancer. Results: A total of 580 implantable venous catheters were placed in 412 men and 168 women. The average age of the patients was 43 years, with ages ranging from 16 to 76 years. Ninety percent of the catheters were placed on the right and 10% on the left, of which half were due to failure of insertion on the right. The sites of the insertion were 42% cephalic, 31% external jugular, 17% internal jugular, and 10% subclavicular. The average duration of catheter use was 7 months, with duration ranging from 10 days to 36 months. Seventeen percent of the patients presented at least a complication dominated by infection or thrombosis. In our series, there was no mortality due to the insertion. Conclusion: Comparing our results with that of the literature, we recommend the use of polyurethane catheter, to prefer the jugular route, and the insertion be done by an experienced operator.
The authors report an exceptional case of collision tumor comprised of a gastric calcified stromal tumor and a pancreatic adenocarcinoma. The pancreatic tumor was detected fortuitously on the histological exam of resection specimen.
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