Subject(s)
Delayed Emergence from Anesthesia/etiology , Echinococcosis, Hepatic/surgery , Hypernatremia/chemically induced , Postoperative Complications/chemically induced , Saline Solution, Hypertonic/adverse effects , Anesthesia Recovery Period , Combined Modality Therapy , Crystalloid Solutions , Delayed Emergence from Anesthesia/blood , Echinococcosis, Hepatic/drug therapy , Female , Fluid Therapy , Humans , Hyperglycemia/drug therapy , Hyperglycemia/etiology , Hypotonic Solutions/therapeutic use , Insulin/therapeutic use , Isotonic Solutions/administration & dosage , Postoperative Complications/blood , Saline Solution, Hypertonic/administration & dosage , Young AdultABSTRACT
PURPOSE: The purpose of this study was to debate the epidemiologic and clinical features of primitive biliary peritonitis (PBP) as much as a rare pathology; and especially to obtain a more comprehensive view of factors associated with a severe prognosis. METHOD: It is a retrospective survey of 15 patients, collected from 2000 to 2003. Only primitive biliary peritonitis has been included. RESULT: It is a series of 15 patients, 6 men and 9 women, with a mean age of 62 years. Biliary lithiasis was incriminated in 14 cases. Clinical picture was an acute peritonitis in every case. Six patients were operated on by median incision, the others by costal one. The death rate is of 26,6%, all death were a direct complication of PBP. Factors associated with a higher mortality are an IGS II score superior or equal than 31 and a number of organ failures superior or equal to 3. CONCLUSION: PBP is a rare and severe pathology that concerns aged women. Biliary lithiasis is the main etiology. Treatment is essentially surgical, in association with active per-operative resuscitation.
Subject(s)
Bile , Peritonitis , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Peritonitis/diagnosis , Peritonitis/surgery , Retrospective StudiesABSTRACT
OBJECTIVE: Our purpose was to characterize the risk factors of eclampsia in women with preeclampsia. PATIENTS AND METHODS: A case-control study was conducted at Monastir hospital to investigate risk factors for eclampsia between 1st January 1995 and 30th June 2000. Cases were matched to preeclamptic controls on a 2:1 ratio. Univariate analysis was used to determine which of the independent variables were significantly different between the groups. Those with significant differences were then entered into multiple logistic regression analysis to determine the characteristics that were independently related to eclampsia. RESULT: A total of 41 cases of eclampsia were ascertained from deliveries. The ratio of eclampsia cases to number of deliveries over the study period was 1.87 per 1000. The first seizures occurred at home in 59% of the cases. Univariate analysis revealed statistical significance for the following variables associated with eclampsia: systolic hypertension > or =160 mmHg and diastolic > or =110 mmHg, headache, visual symptoms, vivid deep tendon reflexes, proteinuria >3+ or >3 g d(-1), uric acid concentration > or =350 micromol l(-1), serum creatinine concentration >100 micromol l(-1) and aminotransferase aspartate >30 IU l(-1). A history of abortion appears to be the protective factor against eclampsia. However, with subsequent multivariate analysis, only vivid deep tendon reflexes and elevated uric acid concentration remained significant. CONCLUSION: These data indicate a need for improved prenatal care and medical attention focused on prodroms of eclampsia as well as the detection of preeclampsia to reduce the incidence of eclampsia.
Subject(s)
Eclampsia/epidemiology , Adult , Analysis of Variance , Aspartate Aminotransferases/blood , Case-Control Studies , Creatinine/urine , Female , Headache/etiology , Headache/physiopathology , Humans , Hypertension/etiology , Hypertension/physiopathology , Infant, Newborn , Logistic Models , Pre-Eclampsia/epidemiology , Pre-Eclampsia/physiopathology , Pregnancy , Proteinuria , Reflex, Stretch/physiology , Risk Factors , Seizures/physiopathology , Uric Acid/blood , Vision Disorders/etiology , Vision Disorders/physiopathologySubject(s)
Anesthesia/mortality , Hospital Mortality , France , Hospitals, University , Humans , Quality Assurance, Health CareABSTRACT
The traumatic rupture of the aortic isthmus is one of the worst complication due to high speed motor vehicle accidents. When death is not the immediate consequence of this lesion, the initial clinical signs are not very clear. The present article demonstrates the case of a 23-year-old patient, victim of a car accident. A traumatic aortic rupture was actually diagnosed after the unusual discovery of a mesenteric infarct. In this case report, the mesenteric infarct mechanism can be controversed, and an emphasis should be put on an early aortic lesion diagnosis and repair in order to avoid any ischaemic complications.
