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Journal of Emergency Medicine, Trauma and Acute Care ; 2022(3), 2022.
Article in English | EMBASE | ID: covidwho-1969693


Background: Trauma is one of the leading causes of deaths worldwide for all age groups, especially in the younger age group. The purpose of the current study is to assess/analyze the factors for mortality in penetrating abdominal traumas with respect to the total number of intra-abdominal organs injured, related extra-abdominal injuries, gender, type of injury, time of arrival, and amount of blood transfusion needed during the pandemic. Methods: A retrospective study including 523 patients underwent laparotomy in Al-Emamien Al-Kadhimin Medical City from March 2020 to September 2021 for a penetrating abdominal injury due to blast injury, bullet, shrapnel injury, and stab wounds. The study population with penetrating abdominal traumas and indicative abdominal signs was subjected to exploratory laparotomy. Results: In this study, 465 (88.9%) males and 58 (11.1%) females participated;the highest rate was found in small bowel injuries (40.73%) followed by large bowel injuries (21.99%), whereas the lowest rate was found in gallbladder injury (1.34%). Chest injuries represent the highest rate among extra-abdominal injuries (18.36%), whereas head and neck represent the lowest rate (1.34%). Regarding the risk factors affecting the mortality rate, the highest rate of mortality was found in the case of gunshot (13.11%), followed by shrapnel (6.38%) and stab wound injuries (5.26%), which was the lowest. Conclusion: Penetrating abdominal injuries were the most common among males, small bowel injuries are the commonest organs affected by the penetrating abdominal injuries, shrapnel injuries were the commonest causes in our country, and the highest mortality rate was related to gunshot and number of organs affected and delay of arrival to the hospital and number of pints of blood received.

Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine ; 77(sup1):1-33, 2022.
Article in English | EMBASE | ID: covidwho-1886341
Journal of Clinical Oncology ; 40(4 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1700453


Background: During the COVID19 pandemic, many centres in the UK, shifted towards utilising hypofractionated radiotherapy (RT) to pancreas. We aim to report the UK experience hypofractionated (3-5 fractions) RT to the pancreas from 7 centres in the UK. Rates of toxicity, progression, death and potential prognostic factors were assessed. Univariate and multivariate Cox proportional hazards analyses were performed. Results: 92 patients from 7 centres were included in the analysis (median age 71 (range 49-88). 90% had performance status of 0-1. 66% had locally advanced disease. 53% had RT delivered over 3- 5 fractions (n = 49, median: 30Gy/5f, range:30- 40Gy in 3-5f). The rest had 15-fraction RT with or without concurrent chemotherapy (n = 43, median: 45Gy/15f, range: 36-45Gy/15f). Induction chemotherapy (CT) was used in 64% (FOLFIRINIOX -42/59). Median follow-up was 13 months from first treatment (induction CT or RT). Median overall survival (OS) among all patient was 17 months, (95% CI-14.5-19.5 months). On multivariable analysis, induction CT was the only predictor of improved PFS (median survival (MS) 12 vs 5 months;hazard ratio [HR] 0.23;95% confidence interval [CI]: 0.12-0.44, p < 0.001) and OS (MS 24 vs 11 months;HR 0.15;95% CI: 0.07 - 0.34, p < 0.001). There were no deaths. 4 patients had grade 3+ toxicities (transaminitis, cholecystitis and gall bladder perforation, small bowel obstruction and diarrhoea) -all had concurrent CT. Conclusions: Our survival outcome appears to be comparable with published data from CT + concurrent chemoradiotherapy. Induction CT appears to improve outcome. Careful selection of patients can help maximise advantage in this patient population.