Irish journal of medical science
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Over the last decade Surgical Stabilisation of Rib Fractures (SSFR) gained popularity in our hospital. With increased numbers, we noted that frequently injuries were missed during primary/secondary survey and radiological imaging that were found during the surgical procedure. With this observation, the research question was formulated: What is the value of diagnostics thoracotomy or thoracoscopy during surgical stabilisation of rib fractures? ⋯ With the recent shift towards surgical stabilisation of rib fractures, an inspection thoracoscopy or thoracotomy during SSFR should be considered to minimise the incidence of missed intrathoracic injuries requiring early or late surgical treatment.
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To determine if alcohol consumption is a risk factor for obstructive sleep apnea (OSA) and nocturnal oxygen desaturation. ⋯ In this study, we found that alcohol consumption was an independent risk factor of OSA and OSA with hypoxia, and alcohol consumption was related to AHI significantly after adjustment, especially in female. In order to reduce the risk and severity of OSA, it is suggested that people should avoid drinking, and drinkers should abstain from drinking.
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Acute sigmoid volvulus (ASV) represents a small but significant portion of cases of large bowel obstruction, especially in the elderly and co-morbid. Given the characteristics of the patient cohort most commonly affected, a non-operative/conservative approach is often undertaken but is associated with a high rate of recurrence. ⋯ There is a high recurrence rate following non-operative management of acute sigmoid volvulus and consequently, a cumulative increase in the attendant significant morbidity and mortality with subsequent episodes. Given the relatively low complication rate of definitive surgery, even in those patients perceived to be high risk, we contend that all patients should be considered for early surgery to prevent the likely recurrence of sigmoid volvulus.
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COVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database (NHFD) in two large central London hospitals. ⋯ The impact of COVID-19 pandemic has not adversely affected the KPIs for the treatment of NOFF patients with significant improvement in numerous care domains. These findings may represent the efforts to ensure that these vulnerable patients are treated promptly to minimize their risks from the coronavirus.
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Elderly patients are at increased risk of developing acute kidney injury (AKI) following major surgery and rapid diagnosis is essential. ⋯ Plasma NGAL levels seem to represent an early and reliable marker for AKI in elderly patients undergoing laparotomic surgery with the potential to allow early diagnosis and prevent further renal deterioration. Further confirmatory studies are warranted.