ABSTRACT
BACKGROUND: Omental infarction (OI) is an infrequent cause of acute abdominal pain and there is no consensus on whether conservative or surgical treatment is the best strategy when performing positive CT diagnosis. OBJECTIVES: To assess which of the two treatments is the most commonly adopted and compare outcomes in terms of success rate in resolution of symptoms and hospital length of stay. ELIGIBILITY CRITERIA: Case report and case series of patients with abdominal pain and positive diagnosis by CT of omental infarction. DATA SOURCES: PubMed, Science Direct and Google Scholar in combination with cross-referencing searches and manual searches of eligible articles from January 2000 to June 2018. PARTICIPANTS: Patients older than 18 years of age. METHODS: Patient characteristics and results were summarized descriptively. Categorical variables were assessed by chisquare test or Fischer's exact test, and continuous variables by the Wilcoxon-Mann-Whitney or Kruskal-Wallis test. Risk factors for failure of the conservative management were identified using multivariate logistic regression. RESULTS: 90 articles were included in the final analysis (146 patients). 107 patients (73.3%) received conservative treatment with a failure rate of 15.9% (patients needing surgery) and 39 patients (26.7%) received surgery as first treatment. The mean hospital length of stay was 5.1 days for the conservative treatment group and 2.5 days for the surgery group with statistically significant differences (p = 0.00). Younger age and white blood cells count ≥12000/µl were predictive factors of conservative treatment failure. CONCLUSIONS: Although conservative treatment is effective in most patients, surgery has advantages in terms of hospital length of stay.
ABSTRACT
INTRODUCTION: The emotional experience of patients must be ascertained to ensure patient-centred care during hospitalisation. Improving this experience has a positive impact on patient prognosis. Therefore, in order to provide comprehensive care, therefore, patient emotional care needs must be known. The objective of this study was to produce a transcultural translation and validation of the Patient Evaluation of Emotional Care during Hospitalisation (PEECH) questionnaire. MATERIAL AND METHOD: The PEECH consists of three sections resulting in four subscales: level of security, level of knowledge, level of personal value, and level of connection. The questionnaire was translated into Spanish. An expert panel revised the translation until they were satisfied with the outcome. It was then back-translated and submitted to the author for approval. For its validation, 132 hospitalised patients completed the questionnaire. Expert judgement was used to analyse the content validity and factor analysis in order to confirm the construct validity. The Cronbach alpha coefficient was used to measure the internal consistency of the four subscales. RESULTS: In the confirmatory factor analysis of the four subscales, the weights of all questions were significant (>0.5), with the exception of Q7 (0.416) and Q18 (0.439), which nevertheless met the minimum interpretation level for the structure. In accordance with this criterion, the four subscales were justified. CONCLUSION: The Spanish version of the PEECH questionnaire is a valid and reliable tool to evaluate the perception of emotional care in hospitalised patients. The information gathered can contribute to providing comprehensive care for patients in hospital.
Subject(s)
Cross-Cultural Comparison , Emotion-Focused Therapy , Health Care Surveys , Inpatients/psychology , Translations , Communication Barriers , Female , Health Care Surveys/statistics & numerical data , Humans , Knowledge , Language , Male , Reproducibility of Results , Self ConceptABSTRACT
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Subject(s)
Humans , Critical Care/ethics , Intensive Care Units/ethics , Ethics, Clinical , Humanization of Assistance , Ethics, InstitutionalABSTRACT
OBJECTIVE: We have studied the impact of early biliary drainage (surgical or endoscopical) on morbidity-mortality of acute cholangitis. PATIENTS AND METHODS: During a five-year period (1988-1992) 106 patients were diagnosed of acute cholangitis (clinically, echographically and microbiologically). RESULTS: Surgical intervention was performed in 78% of the patients, endoscopic biliary drainage in 18% and in 4% medical treatment alone. In 65% of cases, biliary drainage was performed during the eight hours after diagnosis. Overall mortality rate was 3, 7% (4 patients). CONCLUSIONS: Our results suggest that early biliary drainage of acute cholangitis is the most important factor in order to achieve a low mortality rate.
