Peritonitis in horses: 55 cases (2004–2007)

2011 ◽  
Vol 59 (2) ◽  
pp. 181-193 ◽  
Author(s):  
Nóra Nógrádi ◽  
Balázs Tóth ◽  
Katherine Macgillivray

Factors associated with the outcome of peritonitis in horses are seldom described. The objectives of this study were to determine the common clinical signs and clinicopathologic findings and to reveal prognostic factors associated with the outcome of peritonitis in equine patients. Data were examined in a retrospective manner in 55 horses diagnosed with and treated for peritonitis. The most common clinical and clinicopathologic findings were tachycardia (94%), increased amount of peritoneal fluid on ultrasound (84%), altered mucous membranes (82%), bacteria noted on the direct smear (67%), hyperfibrinogenaemia (58%) and left shift (40%). The most commonly isolated organism was E. coli (37%). Survival rates were as follow: 78% in the whole study, 81% in the abdominal lavage group, 93% in the medically and 46% in the surgically managed groups. Complications were more common in the non-survivor group (P < 0.001). Initial haematocrit and surgical interventions were strongly associated with non-survival in the multivariate logistic regression model (P = 0.049, OR: 1.07 and P = 0.01, OR: 9.87, respectively). Prognosis of peritonitis without gastrointestinal rupture depends on the initial hydration status, surgical interventions and development of secondary complications, while other clinical and clinicopathologic findings do not appear to correlate with survival. Prospective evaluation of hydration and perfusion parameters and abdominal lavage warrants further investigation.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.


2021 ◽  
Vol 9 (5) ◽  
pp. 963
Author(s):  
Jiun-Ling Wang ◽  
Wen-Chien Ko ◽  
Chih-Hsin Hung ◽  
Ming-Fang Cheng ◽  
Hui-Ying Wang ◽  
...  

Sequence type (ST) 131 is a multidrug-resistant pandemic lineage of E. coli responsible for extraintestinal infections. Few surveillance data of ST131 included all antimicrobial-susceptible and -resistant isolates or focused on community-acquired urinary tract infection (UTI). From a population-based surveillance pool of 2997 outpatient urine E. coli isolates, 542 were selected for detection of ST131 based on ciprofloxacin and/or cefotaxime resistance. Pulsed-field gel electrophoresis (PFGE) was performed on all ST131 isolates to further determine their relatedness. The estimated overall ST131 prevalence in this community UTI cohort increased from 11.2% (in 2002–2004), 12.2% (in 2006–2008), 13.6% (in 2010–2012), to 17.4% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-resistant group, ST131 increased from 33.3% in 2002–2004 to 72.1% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-susceptible group, ST131 was found in 24.3% overall without significant increase in its prevalence over time. PFGE showed emergence of a cluster of ciprofloxacin-resistant/cefotaxime-resistant ST131 carrying Gr. 1 CTX-M ESBL in 2014–2016, especially 2016. Multivariate analysis revealed that age (≥65 y.o) and ciprofloxacin resistance were independent factors associated with ST131. This longitudinal surveillance showed that ciprofloxacin-resistant/cefotaxime-susceptible ST131 has been circulating in the community since 2002 but ciprofloxacin-resistant/cefotaxime-resistant ST131 increased rapidly in the later years.


Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1017
Author(s):  
Julian Zipfel ◽  
Meizer Al-Hariri ◽  
Isabel Gugel ◽  
Alexander Grimm ◽  
Volker Steger ◽  
...  

Most sporadic peripheral nerve sheath tumors in adults are schwannomas. These tumors usually present with significant pain but can also cause neurological deficits. Symptomatology is diverse, and successful surgical interventions demand interdisciplinarity. We retrospectively reviewed 414 patients treated between 2006 and 2017 for peripheral nerve sheath tumors. We analyzed clinical signs, symptoms, histology, and neurological function in the cohort of adult patients with schwannomas without a neurocutaneous syndrome. In 144 patients, 147 surgical interventions were performed. Mean follow-up was 3.1 years. The indication for surgery was pain (66.0%), neurological deficits (23.8%), significant tumor growth (8.8%), and suspected malignancy (1.4%). Complete tumor resection was achieved on 136/147 occasions (92.5%). The most common location of the tumors was intraspinal (49.0%), within the cervical neurovascular bundles (19.7%), and lower extremities (10.9%). Pain and neurological deficits improved significantly (p ≤ 0.003) after 131/147 interventions (89.1%). One patient had a persistent decrease in motor function after surgery. Complete resection was possible in 67% of recurrent tumors, compared to 94% of primary tumors. There was a significantly lower chance of complete resection for schwannomas of the cervical neurovascular bundle as compared to other locations. The surgical outcome of sporadic schwannoma surgery within the peripheral nervous system is very favorable in experienced peripheral nerve surgery centers. Surgery is safe and effective and needs a multidisciplinary setting. Early surgical resection in adult patients with peripheral nerve sheath tumors with significant growth, pain, neurological deficit, or suspected malignancy is thus recommended.


2014 ◽  
Vol 53 (4) ◽  
pp. 283-293 ◽  
Author(s):  
Katarina Boričić ◽  
Snežana Simić ◽  
Nađa Vasiljević ◽  
Jelena Marinković

AbstractIntroduction. The pandemic of obesity in adolescents is one of the challenges of public health.Aim. The aim of this study was to examine the association of overweight with demographic, socioeconomic and lifestyle factors among Serbian adolescents.Method. A cross-sectional study of 2139 adolescents aged 10 to 19 years was carried out. Data used in this study were from the 2006 Health Survey. In accordance with the international sex- and age-specific Body Mass Index cut-off points, all participants were classified as being normal weight or overweight, including obese. The association between the risk factors and overweight were examined using a multivariate logistic regression model.Results. The study showed that 28.9% of boys and 17.0% of girls were overweight, while 14.5% of boys and 8.1% of girls were obese. Boys were more likely to be overweight/obese, compared with girls. Being younger (p< 0.01 for 14 to 15 years) and (p< 0.01, for 16 to 19 years), engaging in physical activities that last less than 7 hours a week, in such a manner that they breathe quickly and become sweaty, (p< 0.01) and skipping breakfast (p< 0.05) were risk factors significantly associated with overweight among adolescents. No significant association was found with wealth index.Conclusion. These findings should be an integral part of further preventive interventions, especially oriented towards younger adolescents, who are physically inactive, have a habit of skipping breakfast and are boys.


2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986527 ◽  
Author(s):  
Thang Vu Hong ◽  
Duc Nguyen Ba ◽  
Lambert Skoog ◽  
Van Ta Thanh ◽  
Edneia Tani

Little is known about breast cancer in Vietnamese women. Previous studies have reported the frequencies of prognostic factors of breast cancer in this population. The aim of this study was to examine the prognostic factors associated with the survival rates of patients with breast cancer treated at the National Cancer Hospital, Hanoi, Vietnam. We recruited 248 women with operable breast cancer treated with surgery and adjuvant therapy. Tumor tissue samples were stained by many immunohistochemical approaches and analyzed for estrogen receptor, progesterone receptor, and HER2 gene amplification status. A Cox model was used to determine the relationship between survival and the prognostic factors. The disease-free survival rate, overall survival rate, and cancer-specific survival rate were 75.8%, 80.6%, and 86.4%, respectively, at 5 years and 62.3%, 68.1%, and 78.9%, respectively, at 10 years. The lung was the most common metastatic site. Women with factors associated with a poor prognosis (eg, advanced clinical stage, high tumor grade, progesterone receptor [PR] negativity, HER2 amplification) had significantly lower survival rates. Patients with PR-negative breast cancer had significantly worse survival rates compared to those who were PR positive, according to multivariate analysis (hazard ratio = 1.77, 95% confidence interval: 1.01-3.11, P = .045); however, there was only a statistically significant difference in postmenopausal patients. The PR was a prognostic factor in postmenopausal women with breast cancer, but not in premenopausal women.


2021 ◽  
Vol 10 (21) ◽  
pp. 5192
Author(s):  
Mónica Romero Nieto ◽  
Sara Maestre Verdú ◽  
Vicente Gil ◽  
Carlos Pérez Barba ◽  
Jose Antonio Quesada Rico ◽  
...  

This study aimed to identify the factors associated with the presence of extended-spectrum ß-lactamase-(ESBL) in patients with acute community-acquired pyelonephritis (APN) caused by Escherechia coli (E. coli), with a view of optimising empirical antibiotic therapy in this context. We performed a retrospective analysis of patients with community-acquired APN and confirmed E. coli infection, collecting data related to demographic characteristics, comorbidities, and treatment. The associations of these factors with the presence of ESBL were quantified by fitting multivariate logistic models. Goodness-of-fit and predictive performance were measured using the ROC curve. We included 367 patients of which 51 presented with ESBL, of whom 90.1% had uncomplicated APN, 56.1% were women aged ≤55 years, 33.5% had at least one mild comorbidity, and 12% had recently taken antibiotics. The prevalence of ESBL-producing E. coli was 13%. In the multivariate analysis, the factors independently associated with ESBL were male sex (OR 2.296; 95% CI 1.043–5.055), smoking (OR 4.846, 95% CI 2.376–9.882), hypertension (OR 3.342, 95% CI 1.423–7.852), urinary incontinence (OR 2.291, 95% CI 0.689–7.618) and recurrent urinary tract infections (OR 4.673, 95% CI 2.271–9.614). The area under the ROC curve was 0.802 (IC 95% 0.7307–0.8736), meaning our model can correctly classify an individual with ESBL-producing E. coli infection in 80.2% of cases.


2019 ◽  
Vol 2 (2) ◽  
pp. 94
Author(s):  
Tutik Qomaria ◽  
Mohamad Fatekurohman ◽  
Dian Anggraeni

<p>According to the World Health Organization (WHO) cardiovascular disease is a disease caused by impaired heart and blood vessel function. There are many types of cardiovascular disease, but the most common and most well-known are coronary heart disease and stroke. Stroke is a syndrome characterized by symptoms and / or rapidly developing clinical signs in the form of focal and global brain functional disorders lasting more than 24 hours (unless there are surgical interventions or bringing death), which are not caused by other causes besides vascular causes. The number of stroke patients in Indonesia in 2013 based on the diagnosis of health personnel (Nakes) was 1.236.825 (7,0%), while based on the diagnosis of symptoms was 2.137.941 (12,1%). In this study the factors that can affect the survival of stroke sufferers were analyzed using the Cox proportional hazard regression model, the dependent variable was the length of time the patient was treated and the independent variables were gender, age, hypertension status, cholesterol status, Diabetes Militus (DM) status, stroke type, and Body Mass Index (BMI). The result showed that age, DM status, and type of stroke were the most influential factors on the survival of stroke patients at Balung Regional Hospital.</p><strong>Keywords : </strong>stroke disease, survival analysis, Cox proportional hazard model


2021 ◽  
Vol 10 (22) ◽  
pp. 5308
Author(s):  
Renana Yemini ◽  
Ruth Rahamimov ◽  
Ronen Ghinea ◽  
Eytan Mor

With scarce organ supply, a selection of suitable elderly candidates for transplant is needed, as well as auditing the long-term outcomes after transplant. We conducted an observational cohort study among our patient cohort >60 years old with a long follow up. (1). Patients and Methods: We used our database to study the results after transplant for 593 patients >60 years old who underwent a transplant between 2000–2017. The outcome was compared between live donor (LD; n = 257) recipients, an old-to-old (OTO, n = 215) group using an extended criteria donor (ECD) kidney, and a young-to-old (YTO, n = 123) group using a standard-criteria donor. The Kaplan−Meir method was used to calculate the patient and graft survival and Cox regression analysis in order to find risk factors associated with death. (2). Results: The 5- and 10-year patient survival was significantly better in the LD group (92.7% and 66.9%) compared with the OTO group (73.3% and 42.8%) and YTO group (70.9% and 40.6%) (p < 0.0001). The 5- and 10-year graft survival rates were 90.3% and 68.5% (LD), 61.7% and 30.9% (OTO), and 64.1% and 39.9%, respectively (YTO group; p < 0.0001 between the LD and the two DD groups). There was no difference in outcome between patients in their 60’s and their 70’s. Factors associated with mortality included: age (HR-1.060), DM (HR-1.773), IHD (HR-1.510), and LD/DD (HR-2.865). (3). Conclusions: Our 17-years of experience seems to justify the rational of an old-to-old allocation policy in the elderly population. Live-donor transplant should be encouraged whenever possible. Each individual decision of elderly candidates for transplant should be based on the patient’s comorbidity and predicted life expectancy.


2017 ◽  
Vol 10 (2) ◽  
pp. 87-89
Author(s):  
Paulina Tr. Vladova ◽  
Sergey D. Iliev ◽  
Savelina L. Popovska

Summary According to the consensus and the recommendations of the European Neuroendocrine Tumor Society (ENETS), the frequency of appendicular neuroendocrine tumors (NETs) is 0.15-0.6/100 000 a year. They are found a little more often in women aged between 40 and 50. Neuroendocrine neoplasms of the appendix are about 30 to 80% of all appendicular tumors. Their evolution is usually asymptomatic. They are diagnosed accidentally during a conventional or laparoscopic appendectomy. In the past, the surgical approach used to depend on the localization of the tumor. Currently, its localization is not a significant factor in the choice of a surgical approach. Our purpose wass to present the consensus guideline and the recommendations of ENETS 2017 for surgical procedures in neuroendocrine neoplasms of the appendix and analyze the difference in the survival rate in different surgical interventions. The literature overview includes studies on surgical treatment of neuroendocrine neoplasms of the appendix and takes into consideration the last consensus guideline of ENETS 2017 on the topic. ENETS recommends a simple appendectomy in well- differentiated appendix tumors smaller than 2 cm, regardless of their localization. Right hemicolectomy is performed for in tumors sized between 1 cm and 2 cm with positive resection lines, with deep mesoappendiceal invasion, high proliferation activity (G2) and vascular invasion. For tumors over larger than 2 cm – right hemicolectomy is recommended. Although current studies have pointed out no significant differences in survival rates between appendectomy for neuroendocrine neoplasms of the appendix and right hemicolectomy, ENETS 2017 suggests that the latest consensus guidelines should be followed.


2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.


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