Dietrich Doll, Matthias Maak, Philipp Mörsdorf, Myriam Braun-Münker, Christina Oetzmann von Sochaczewski
Introduction: Significant variations in incidence rates have been observed in the analysis of anecdotal Pilonidal Sinus Disease (PSD) incidents worldwide. Objective: This study examines the accuracy of PSD incidence estimates and the variations associated with study size from 1833 to the present. Material and Methods: A comprehensive search was conducted in global literature databases, including PubMed, Embase, Science Direct, and others, to gather any PSD incidence data reported between 1833 and 2023. Results: The study sizes ranged from 26 to 82,217,837 individuals, with incidence rates varying from 8 to 30,000 cases per 100,000 persons. Notably, in study populations below 200,000 individuals, the incidence rate ranged from 8 to 30,000 cases per 100,000 persons. However, this range narrowed when studying populations exceeding 200,000 persons, with incidence rates ranging from 7 to 300 cases per 100,000 persons. Limitations: No limitations were identified in this study. Conclusion: The findings suggest reliable PSD incidences can be calculated with study populations exceeding 200,000 individuals. In such cases, the variability of incidence rates decreases as study size increases, although other known and unknown factors continue to influence the outcomes.
{"title":"Study Size Impact on Accuracy of the Worldwide Incidence of Pilonidal Sinus","authors":"Dietrich Doll, Matthias Maak, Philipp Mörsdorf, Myriam Braun-Münker, Christina Oetzmann von Sochaczewski","doi":"10.32391/ajtes.v8i2.391","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.391","url":null,"abstract":"Introduction: Significant variations in incidence rates have been observed in the analysis of anecdotal Pilonidal Sinus Disease (PSD) incidents worldwide. \u0000Objective: This study examines the accuracy of PSD incidence estimates and the variations associated with study size from 1833 to the present. \u0000Material and Methods: A comprehensive search was conducted in global literature databases, including PubMed, Embase, Science Direct, and others, to gather any PSD incidence data reported between 1833 and 2023. \u0000Results: The study sizes ranged from 26 to 82,217,837 individuals, with incidence rates varying from 8 to 30,000 cases per 100,000 persons. Notably, in study populations below 200,000 individuals, the incidence rate ranged from 8 to 30,000 cases per 100,000 persons. However, this range narrowed when studying populations exceeding 200,000 persons, with incidence rates ranging from 7 to 300 cases per 100,000 persons. \u0000Limitations: No limitations were identified in this study. \u0000Conclusion: The findings suggest reliable PSD incidences can be calculated with study populations exceeding 200,000 individuals. In such cases, the variability of incidence rates decreases as study size increases, although other known and unknown factors continue to influence the outcomes.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"76 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Monzon, Willem Brinkert, Henrike Heitmann, Marius Dettmer, Dietrich Doll, Ville Vänni
Introduction: The incidence of penetrating neck injuries is experiencing an upward trend. Given that hemorrhaging stands as one of the most preventable causes of fatality in traumatic situations, the prospect of employing a foley catheter (FC) to manage bleeding following penetrating neck injuries has led to contemplation on its integration into standardized protocols for bleeding control (BC), both in prehospital and in-hospital settings. Furthermore, inquiries into establishing standardized schedules for its application have arisen. Material and Methods: A meticulous search strategy was conducted utilizing the NCBI Medical Subject Heading (MeSH) term "foley*" and various combinations such as "foley" AND "trauma"; "foley" AND "neck"; "foley" AND "penetrating"; "catheter" AND "balloon" AND "trauma"; "gunshot" AND "neck"; "hemorrhage*" AND "neck" across multiple databases. These databases include MEDLINE, PubMed, PubMed Central, Scopus, Ovid, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). Additionally, comprehensive searches using these terms were performed on Google, Google Scholar, and ResearchGate. The references cited in documents retrieved from these searches, covering 1833 to 2023, were thoroughly scrutinized. Results: 15 relevant articles were identified, and pertinent data were extracted from these studies. Historically, the use of FC was confined to immediate bleeding control; however, it has now extended its application into prehospital, emergency room (ER), and intraoperative settings. The primary success rate of FC stands at n=229 out of 274 cases (84%). FC serves as a valuable tool to bridge the gap in time before reaching the ER or operating room (OR), facilitating necessary radiological studies or interventions, especially when more severe injuries necessitate prioritization. Typically, FC was retained for 24-48 hours, but instances of prolonged applications up to 240 hours have been documented. Notably, it includes the definitive management of venous neck bleeding injuries, contingent upon excluding significant arterial defects through CTA. Late rebleeding stands at a low rate of 6% (14 out of 229 cases). Conclusion: Using FC is a pertinent strategy in managing neck injuries resulting from bleeding from penetrating wounds. Its substantial primary success rate in prehospital and ER phases surpasses the success rates achieved solely through pressure or chitosan dressing. Post-primary bleeding control, the presence of FC facilitates examinations and radiological interventions. Determining the optimal duration for FC placement remains a subject for consideration, leaning toward 2-3 days, if not longer. FC is progressively solidifying its role in Selective Non-Operative Management (SNOM) for hemorrhagic penetrating neck injuries. Consequently, a Foley catheter should be an essential tool in the possession of every prehospital and ER physician. Further delineation of criteria establishing the suitability of
{"title":"Foley Catheter Following Penetrating Neck Trauma. A Definitive Therapy to Stop the Bleeding?","authors":"B. Monzon, Willem Brinkert, Henrike Heitmann, Marius Dettmer, Dietrich Doll, Ville Vänni","doi":"10.32391/ajtes.v8i2.406","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.406","url":null,"abstract":"Introduction: The incidence of penetrating neck injuries is experiencing an upward trend. Given that hemorrhaging stands as one of the most preventable causes of fatality in traumatic situations, the prospect of employing a foley catheter (FC) to manage bleeding following penetrating neck injuries has led to contemplation on its integration into standardized protocols for bleeding control (BC), both in prehospital and in-hospital settings. Furthermore, inquiries into establishing standardized schedules for its application have arisen. \u0000Material and Methods: A meticulous search strategy was conducted utilizing the NCBI Medical Subject Heading (MeSH) term \"foley*\" and various combinations such as \"foley\" AND \"trauma\"; \"foley\" AND \"neck\"; \"foley\" AND \"penetrating\"; \"catheter\" AND \"balloon\" AND \"trauma\"; \"gunshot\" AND \"neck\"; \"hemorrhage*\" AND \"neck\" across multiple databases. These databases include MEDLINE, PubMed, PubMed Central, Scopus, Ovid, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). Additionally, comprehensive searches using these terms were performed on Google, Google Scholar, and ResearchGate. The references cited in documents retrieved from these searches, covering 1833 to 2023, were thoroughly scrutinized. \u0000Results: 15 relevant articles were identified, and pertinent data were extracted from these studies. Historically, the use of FC was confined to immediate bleeding control; however, it has now extended its application into prehospital, emergency room (ER), and intraoperative settings. The primary success rate of FC stands at n=229 out of 274 cases (84%). FC serves as a valuable tool to bridge the gap in time before reaching the ER or operating room (OR), facilitating necessary radiological studies or interventions, especially when more severe injuries necessitate prioritization. Typically, FC was retained for 24-48 hours, but instances of prolonged applications up to 240 hours have been documented. Notably, it includes the definitive management of venous neck bleeding injuries, contingent upon excluding significant arterial defects through CTA. Late rebleeding stands at a low rate of 6% (14 out of 229 cases). \u0000Conclusion: Using FC is a pertinent strategy in managing neck injuries resulting from bleeding from penetrating wounds. Its substantial primary success rate in prehospital and ER phases surpasses the success rates achieved solely through pressure or chitosan dressing. Post-primary bleeding control, the presence of FC facilitates examinations and radiological interventions. Determining the optimal duration for FC placement remains a subject for consideration, leaning toward 2-3 days, if not longer. FC is progressively solidifying its role in Selective Non-Operative Management (SNOM) for hemorrhagic penetrating neck injuries. Consequently, a Foley catheter should be an essential tool in the possession of every prehospital and ER physician. Further delineation of criteria establishing the suitability of ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Art Zylbeari, E. Masha, Zamira Bexheti, Gazmend Zylbeari, M. Zdravkovska, Lutfi Zylbeari
Introduction: Chronic kidney disease (CKD) is a heterogeneous group of disorders that manifest differently with a multifactorial etiology. In addition to known factors such as diabetes, high blood pressure, genetic predisposition, age, gender, race, physical inactivity, obesity, and MIA, in recent years, high concentrations of homocysteine have also been considered as an independent risk factor in the acceleration of the progression of CKD, which, together with arterial hypertension, apparently affect the acceleration of the progress of chronic renal diseases. Materials and Methods: In a cohort-prospective study, 100 patients were treated (40 women with an average age of 55.40±8.20 years and 60 men with an average age of 56.00±9.50 years) with CKD in the third stage (stage III and b b) with a GFR of 30- 59 ml/min/ 1.73m2 determined according to the formula modification of diet in renal disease (MDRD- GFR in ml/min for 1.73 m2=175 x Serum creatinine (Cr) -1.154 x age-0.203x1.212 (if the patient is black) x 0.742 (if female) treated in the internal medicine clinic at the Clinical Hospital in Tetovo, in the period January-2023-December-2023 randomized according to gender, age, nationality, primary kidney disease… Results: The results obtained at the beginning of the study for all the examined parameters and those obtained after 12 months, both from the patients with Chronic disease and the control group of healthy individuals, are presented in the text below. A significant difference was observed between the patients and the control group with p<0.0001. Conclusion: CKD is a frequent occurrence worldwide (1 in 10 inhabitants or 10 of the world's population suffers from CKD; therefore, it is necessary to implement preventive and therapeutic measures aimed at early detection, prevention, and treatment of that disease as a conclusion of our paper, we can confirm that there is a strong connection between HHcy and high blood pressure and that together they contribute to the acceleration and progression of CKD; therefore their treatment with folate, vitamin B12, vitamin B6 should be started at an early stage of the disease to prevent the rapid progression of CKD.
简介慢性肾脏病（CKD）是一组表现各异的多因素疾病。除了已知的糖尿病、高血压、遗传易感性、年龄、性别、种族、缺乏运动、肥胖和 MIA 等因素外，近年来，高浓度同型半胱氨酸也被认为是加速 CKD 进展的独立危险因素，它与动脉高血压一起明显影响慢性肾脏疾病的加速进展。材料和方法：在一项队列前瞻性研究中，100 名患者（40 名女性，平均年龄（55.40±8.20）岁；60 名男性，平均年龄（56.00±9.50）岁）均为 CKD 第三期（III 期和 b b 期），其 GFR 为 30- 59 ml/min/ 1.73 m2，根据肾病饮食调整公式（MDRD- GFR ml/min for 1.73 m2=175 x 血清肌酐（Cr）-1.154 x 年龄-0.203x1.212（如果患者为黑人）x 0.742（如果患者为女性），在 2023 年 1 月至 2023 年 12 月期间在泰托沃临床医院内科诊所接受治疗，根据性别、年龄、国籍、原发性肾脏疾病等因素随机分组......结果：慢性病患者和健康人对照组在研究开始时和 12 个月后所有检查参数的结果如下。患者和对照组之间存在明显差异，P<0.0001。结论作为本文的结论，我们可以确认 HHcy 和高血压之间存在密切联系，它们共同导致了慢性肾脏病的加速和进展；因此，应在疾病的早期阶段开始使用叶酸、维生素 B12 和维生素 B6 进行治疗，以防止慢性肾脏病的快速进展。
{"title":"The Influence of the Cooperation of Hyperhomocysteinemia and Arterial Hypertension. A Risk Factor on the Acceleration of the Progress of Chronic Renal Diseases","authors":"Art Zylbeari, E. Masha, Zamira Bexheti, Gazmend Zylbeari, M. Zdravkovska, Lutfi Zylbeari","doi":"10.32391/ajtes.v8i2.385","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.385","url":null,"abstract":"Introduction: Chronic kidney disease (CKD) is a heterogeneous group of disorders that manifest differently with a multifactorial etiology. In addition to known factors such as diabetes, high blood pressure, genetic predisposition, age, gender, race, physical inactivity, obesity, and MIA, in recent years, high concentrations of homocysteine have also been considered as an independent risk factor in the acceleration of the progression of CKD, which, together with arterial hypertension, apparently affect the acceleration of the progress of chronic renal diseases. \u0000Materials and Methods: In a cohort-prospective study, 100 patients were treated (40 women with an average age of 55.40±8.20 years and 60 men with an average age of 56.00±9.50 years) with CKD in the third stage (stage III and b b) with a GFR of 30- 59 ml/min/ 1.73m2 determined according to the formula modification of diet in renal disease (MDRD- GFR in ml/min for 1.73 m2=175 x Serum creatinine (Cr) -1.154 x age-0.203x1.212 (if the patient is black) x 0.742 (if female) treated in the internal medicine clinic at the Clinical Hospital in Tetovo, in the period January-2023-December-2023 randomized according to gender, age, nationality, primary kidney disease… \u0000Results: The results obtained at the beginning of the study for all the examined parameters and those obtained after 12 months, both from the patients with Chronic disease and the control group of healthy individuals, are presented in the text below. \u0000A significant difference was observed between the patients and the control group with p<0.0001. \u0000Conclusion: CKD is a frequent occurrence worldwide (1 in 10 inhabitants or 10 of the world's population suffers from CKD; therefore, it is necessary to implement preventive and therapeutic measures aimed at early detection, prevention, and treatment of that disease as a conclusion of our paper, we can confirm that there is a strong connection between HHcy and high blood pressure and that together they contribute to the acceleration and progression of CKD; therefore their treatment with folate, vitamin B12, vitamin B6 should be started at an early stage of the disease to prevent the rapid progression of CKD.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"33 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Cardiovascular implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices, are crucial for managing various cardiac conditions. However, their implantation is associated with a range of potential complications. This article investigates the incidence, types, and risk factors of complications arising from CIED implantation. Around 180.000 pacemakers are implanted every year in the USA [1]. Keeping in mind that pacemakers are implanted mainly in the elderly, the increasing proportion of this age group translates to a progressive increase in yearly implantations. A review of pacemakers implanted in adults shows an age interval of 69-86 years old, with 30-40% of patients >80 years old [2,3]. In a case series article, 218 patients were included in those undergoing permanent pacemaker implantation in the UHC "Mother Theresa" Tirana. Data were retrospectively collected from patients who underwent CIED implantation. The primary complications assessed included infection, lead dislodgement, device malfunction, hematoma, and vascular complications. Statistical analysis was performed to identify significant risk factors associated with these complications. Conclusions: This article underscores the importance of meticulous procedural techniques, thorough patient assessment, and post-implantation monitoring to minimize the risks associated with CIED implantation. Enhanced understanding of these complications can lead to improved patient outcomes and the development of strategies to mitigate risks in clinical practice. Keywords: permanent pacemaker implantation (ppm), cardiac implantable electronic device (cied), long-term care, postoperative complication
{"title":"Complications of Implantation of Cardiovascular Implantable Electronic Device","authors":"Ormir Shurdha, Endri Hasimi, Mirald Gina","doi":"10.32391/ajtes.v8i2.403","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.403","url":null,"abstract":"Introduction: Cardiovascular implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices, are crucial for managing various cardiac conditions. However, their implantation is associated with a range of potential complications. \u0000This article investigates the incidence, types, and risk factors of complications arising from CIED implantation. \u0000Around 180.000 pacemakers are implanted every year in the USA [1]. Keeping in mind that pacemakers are implanted mainly in the elderly, the increasing proportion of this age group translates to a progressive increase in yearly implantations. \u0000A review of pacemakers implanted in adults shows an age interval of 69-86 years old, with 30-40% of patients >80 years old [2,3]. \u0000In a case series article, 218 patients were included in those undergoing permanent pacemaker implantation in the UHC \"Mother Theresa\" Tirana. \u0000Data were retrospectively collected from patients who underwent CIED implantation. The primary complications assessed included infection, lead dislodgement, device malfunction, hematoma, and vascular complications. Statistical analysis was performed to identify significant risk factors associated with these complications. \u0000Conclusions: This article underscores the importance of meticulous procedural techniques, thorough patient assessment, and post-implantation monitoring to minimize the risks associated with CIED implantation. Enhanced understanding of these complications can lead to improved patient outcomes and the development of strategies to mitigate risks in clinical practice. \u0000Keywords: permanent pacemaker implantation (ppm), cardiac implantable electronic device (cied), long-term care, postoperative complication","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"77 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that can arise anywhere within the gastrointestinal tract. Approximately 70 % are in the Stomach, representing 1 – 3 % of all gastrointestinal malign neoplasms. GISTs originate from the Cajal interstitial cells or their stem cell precursors within the myenteric plexus of the muscularis propria. Histologically, GIST presents three different architectural patterns: a. composed of epitheloid cells embedded in a thin reticular stroma; b. by spindle cells with a fascicular or storiform arrangement immersed in a thin reticular stroma focally myxoid, and c. the mixed forme. This study describes a 72-year-old man who, in the computed tomography, presented a gross appearance as pancreatic cystic neoplasia. Clinicians should be aware that this condition might be mistaken for a primary pancreatic malignancy. The diagnostic Workup includes endoscopy with ultrasonography, cross-sectional imaging studies, and histopathological examination. Conclusions: The reported case illustrates that the retroperitoneum might be the place of initial presentation of a cystic gastric GIST and that only an accurate pathological evaluation can establish the diagnosis and origin. Clinicians must know this condition might be mistaken for a primary pancreatic malignancy. Early surgical resection is the gold standard of treatment for primary GIST.
{"title":"The Retroperitoneal Gastrointestinal Stromal Tumor, Simulating a Cystic Pancreatic Neoplasia. A Case Report.","authors":"Lutfi Alia, T. Bushati, L. Berdica","doi":"10.32391/ajtes.v8i2.396","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.396","url":null,"abstract":"Introduction: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that can arise anywhere within the gastrointestinal tract. Approximately 70 % are in the Stomach, representing 1 – 3 % of all gastrointestinal malign neoplasms. GISTs originate from the Cajal interstitial cells or their stem cell precursors within the myenteric plexus of the muscularis propria. \u0000Histologically, GIST presents three different architectural patterns: a. composed of epitheloid cells embedded in a thin reticular stroma; b. by spindle cells with a fascicular or storiform arrangement immersed in a thin reticular stroma focally myxoid, and c. the mixed forme. \u0000This study describes a 72-year-old man who, in the computed tomography, presented a gross appearance as pancreatic cystic neoplasia. Clinicians should be aware that this condition might be mistaken for a primary pancreatic malignancy. \u0000The diagnostic Workup includes endoscopy with ultrasonography, cross-sectional imaging studies, and histopathological examination. \u0000Conclusions: The reported case illustrates that the retroperitoneum might be the place of initial presentation of a cystic gastric GIST and that only an accurate pathological evaluation can establish the diagnosis and origin. Clinicians must know this condition might be mistaken for a primary pancreatic malignancy. Early surgical resection is the gold standard of treatment for primary GIST. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"15 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Muço, Amarildo Blloshmi, Engjellushe Jonuzi, A. Dogjani
Introduction: Infection is a significant cause of posttraumatic morbidity and prolonged hospitalization. Nosocomial infections are a frequent complication of trauma patients admitted to the intensive care unit (ICU). Trauma is predisposed to infections by various mechanisms, while intravascular catheters, endotracheal tubes, and urinary catheters create suitable environments for nosocomial infection during treatment. Following trauma, wound contamination with aerobic and anaerobic bacteria should always be suspected. Material and Methods: In this paper, we want to review the literature regarding the role of infectious disease (ID) specialists in the trauma team and compare it with the situation in our country. Discussion: Infections in trauma are developed because of endogenous bacteremia or as a result of exogenous bacteremia. Since infection significantly prolongs the hospitalization of trauma patients, the infection disease specialist plays a crucial role in preventing and treating infections in collaboration with the surgeon and other trauma team members. The duration of antibiotic treatment is significant. A shorter duration will result in fewer side effects and allergic reactions and reduce long-term antibiotic resistance. Conclusions: The infectious disease specialist is not a standalone figure but an integral part of the trauma team. Their role is not limited to implementing protocols and using appropriate antibiotics before, during, and after surgical procedures. They also closely follow the patients, identifying those with a greater predisposition to develop infections. This collaborative approach is crucial for successfully preventing and managing infections in trauma patients.
{"title":"The Role of the Infectious Disease Specialists in the Trauma Surgical Team.","authors":"E. Muço, Amarildo Blloshmi, Engjellushe Jonuzi, A. Dogjani","doi":"10.32391/ajtes.v8i2.401","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.401","url":null,"abstract":"Introduction: Infection is a significant cause of posttraumatic morbidity and prolonged hospitalization. Nosocomial infections are a frequent complication of trauma patients admitted to the intensive care unit (ICU). Trauma is predisposed to infections by various mechanisms, while intravascular catheters, endotracheal tubes, and urinary catheters create suitable environments for nosocomial infection during treatment. Following trauma, wound contamination with aerobic and anaerobic bacteria should always be suspected. \u0000Material and Methods: In this paper, we want to review the literature regarding the role of infectious disease (ID) specialists in the trauma team and compare it with the situation in our country. \u0000Discussion: Infections in trauma are developed because of endogenous bacteremia or as a result of exogenous bacteremia. Since infection significantly prolongs the hospitalization of trauma patients, the infection disease specialist plays a crucial role in preventing and treating infections in collaboration with the surgeon and other trauma team members. \u0000The duration of antibiotic treatment is significant. A shorter duration will result in fewer side effects and allergic reactions and reduce long-term antibiotic resistance. \u0000Conclusions: The infectious disease specialist is not a standalone figure but an integral part of the trauma team. Their role is not limited to implementing protocols and using appropriate antibiotics before, during, and after surgical procedures. They also closely follow the patients, identifying those with a greater predisposition to develop infections. This collaborative approach is crucial for successfully preventing and managing infections in trauma patients. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gjergj Andrea, P. Gjergo, Ardit Kaçani, Megi Çekini, A. Dogjani
Introduction: Ruptured splenic artery aneurysms (SAAs) are rare but life-threatening vascular emergencies. Prompt diagnosis and intervention are crucial for patient survival. We present a case of a 54-year-old male who presented with We describe the case of a 54-year-old male who presented with an acute onset of diffuse abdominal pain radiating to the left shoulder, tachycardia, and hemodynamic stability without signs of hypovolemic shock. The diagnostic process includes imaging examinations such as abdominal echo, AngioCT abdomen, and laboratory examinations. After 12 hours of observation, the head of the general surgery service and vascular surgeons consulted, and the decision was made to perform an exploratory laparotomy. The patient underwent laparotomy, which revealed hemoperitoneum and rupture of the splenic artery aneurysm, requiring Splenectomy. The patient had an uneventful postoperative course and was discharged home on postoperative day 7. Ruptured splenic artery aneurysms represent a challenging clinical scenario requiring prompt recognition and intervention. Surgical management remains the cornerstone of treatment, aiming to prevent life-threatening bleeding and preserve splenic function when feasible. Multidisciplinary collaboration and adherence to evidence-based practices are essential for optimizing patient outcomes in this rare but critical condition. Ongoing research and advancements in surgical techniques continue to refine the approach to splenic artery aneurysms, enhancing the quality of care provided to affected patients. Conclusion: This case report highlights the importance of a high index of suspicion for ruptured SAA in patients with suggestive clinical presentations. Prompt surgical intervention with appropriate technique selection is essential for optimal patient outcomes.
简介：脾动脉瘤（SAA）破裂是一种罕见但危及生命的血管急症。及时诊断和干预对患者的存活至关重要。我们介绍了一例 54 岁男性患者的病例。该患者起病急，腹部弥漫性疼痛并向左肩放射，心动过速，血流动力学稳定，无低血容量休克征象。诊断过程包括腹部回声、AngioCT 腹部等影像学检查和实验室检查。经过12小时的观察，普外科主任和血管外科医生会诊后，决定进行探查性开腹手术。患者接受了开腹手术，术中发现腹腔积血和脾动脉瘤破裂，需要进行脾切除术。 患者术后恢复顺利，术后第 7 天出院回家。脾动脉瘤破裂是一种具有挑战性的临床情况，需要及时识别和干预。手术治疗仍然是治疗的基石，目的是防止危及生命的出血，并在可行的情况下保留脾脏功能。在这种罕见但危急的情况下，多学科协作和坚持循证实践对于优化患者预后至关重要。不断进行的研究和手术技术的进步将继续完善脾动脉瘤的治疗方法，从而提高为患者提供的护理质量。结论：本病例报告强调了对临床表现可疑的患者高度怀疑 SAA 破裂的重要性。及时进行手术干预并选择适当的技术对于患者获得最佳治疗效果至关重要。
{"title":"Surgical Treatment of Ruptured Splenic Artery Aneurysm. A Clinical Case and Review Literature.","authors":"Gjergj Andrea, P. Gjergo, Ardit Kaçani, Megi Çekini, A. Dogjani","doi":"10.32391/ajtes.v8i2.398","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.398","url":null,"abstract":"Introduction: Ruptured splenic artery aneurysms (SAAs) are rare but life-threatening vascular emergencies. Prompt diagnosis and intervention are crucial for patient survival. \u0000We present a case of a 54-year-old male who presented with We describe the case of a 54-year-old male who presented with an acute onset of diffuse abdominal pain radiating to the left shoulder, tachycardia, and hemodynamic stability without signs of hypovolemic shock. \u0000The diagnostic process includes imaging examinations such as abdominal echo, AngioCT abdomen, and laboratory examinations. After 12 hours of observation, the head of the general surgery service and vascular surgeons consulted, and the decision was made to perform an exploratory laparotomy. \u0000The patient underwent laparotomy, which revealed hemoperitoneum and rupture of the splenic artery aneurysm, requiring Splenectomy. \u0000The patient had an uneventful postoperative course and was discharged home on postoperative day 7. \u0000Ruptured splenic artery aneurysms represent a challenging clinical scenario requiring prompt recognition and intervention. Surgical management remains the cornerstone of treatment, aiming to prevent life-threatening bleeding and preserve splenic function when feasible. Multidisciplinary collaboration and adherence to evidence-based practices are essential for optimizing patient outcomes in this rare but critical condition. Ongoing research and advancements in surgical techniques continue to refine the approach to splenic artery aneurysms, enhancing the quality of care provided to affected patients. \u0000Conclusion: This case report highlights the importance of a high index of suspicion for ruptured SAA in patients with suggestive clinical presentations. Prompt surgical intervention with appropriate technique selection is essential for optimal patient outcomes.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"113 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Ultrasound examination plays a significant role in the evaluation of patients with trauma and polytrauma because it is an examination that provides information for many regions and systems, such as in the case of abdominal trauma, cardio-thoracic trauma, and vascular and musculoskeletal injuries. Ultrasound examination is used to rapidly and accurately detect hemorrhages in the pericardial, pleural, and peritoneal cavities, turning it into a necessary examination in Advanced Trauma Life Support (ATLS). Ultrasound is also used in traumas such as pneumothorax, damage to parenchymal organs and abdominal cavity, as well as rib and sternum fractures. Material and Methods: This study considered and revised a systematic review of radiology and ultrasound specialty journals and clinical textbooks, the bibliographies of all identified articles, and meta-analyses about the role of ultrasound in trauma, especially FAST. Both prospective and retrospective studies for different types of trauma, such as abdominal trauma and thoracic trauma, trauma with unique injuries and polytrauma, and blunt and penetrating trauma, were included. Conclusions: Although a necessary non-invasive radiological examination, ultrasound has long-term limitations during the evaluation of trauma. Ultrasound limitations are divided into technical limitations, image quality, the inability of sonographic windows to acquire images, echogenic similarity, and lack of differentiation between structures and organs.
{"title":"Limitations of Ultrasound Examination in Trauma","authors":"Hajrina Asllanaj","doi":"10.32391/ajtes.v8i2.390","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.390","url":null,"abstract":"Introduction: Ultrasound examination plays a significant role in the evaluation of patients with trauma and polytrauma because it is an examination that provides information for many regions and systems, such as in the case of abdominal trauma, cardio-thoracic trauma, and vascular and musculoskeletal injuries. Ultrasound examination is used to rapidly and accurately detect hemorrhages in the pericardial, pleural, and peritoneal cavities, turning it into a necessary examination in Advanced Trauma Life Support (ATLS). Ultrasound is also used in traumas such as pneumothorax, damage to parenchymal organs and abdominal cavity, as well as rib and sternum fractures. \u0000Material and Methods: This study considered and revised a systematic review of radiology and ultrasound specialty journals and clinical textbooks, the bibliographies of all identified articles, and meta-analyses about the role of ultrasound in trauma, especially FAST. Both prospective and retrospective studies for different types of trauma, such as abdominal trauma and thoracic trauma, trauma with unique injuries and polytrauma, and blunt and penetrating trauma, were included. \u0000Conclusions: Although a necessary non-invasive radiological examination, ultrasound has long-term limitations during the evaluation of trauma. Ultrasound limitations are divided into technical limitations, image quality, the inability of sonographic windows to acquire images, echogenic similarity, and lack of differentiation between structures and organs. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"123 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arlind Zeqiri, B. Lenjani, Besa Zeka, Dardan Lenjani, Ilirian Lenjani, A. Dogjani
Introduction: Prehospital emergency medical services (EMS) are essential to emergency medical care. They provide emergency assessment and treatment for seriously ill or injured patients and transport them by ambulance to an emergency department. Adopting triage methods for systematically prioritizing patients according to how urgent patients need care, including Triage of requests for acute medical treatment, is a promising development in our healthcare system. In Kosovo, there is a gap between the effects of prehospital triage systems and the impact of using the same triage system in two or more EMS settings. In this quality improvement study, implementing the TT app intervention was associated with higher rates of inefficient Triage in prehospital settings. However, supporting EMS professionals in their decision-making by calculating the probability of an individual patient needing specialized care at the scene of injury is a new and promising approach to optimize Triage in the field. If we can fully realize the potential of this approach, it could significantly improve the efficiency and effectiveness of our emergency medical care, leading to better patient outcomes. Standards and most health professionals need to be educated and trained in this critical component of EMS. Education, education, and training for the three levels of health care should be an obligatory component to enhance the quality of emergency medical care for children and adults at risk. It is high time to develop and test a conceptual triage scheme or model that will rely on a triage system that responds to the conditions of our health system. Develop clinical guidelines, algorithms, and triage protocols at the three levels of health care. All healthcare professionals must be educated and trained in ongoing coaching, communication courses, BLS AED, Pediatric, PHTLS, Adult Advanced Life Support, ATLS, and International Trauma Life Support. Conclusion: Triage is vital in optimizing patient outcomes in the high-pressure EMS world. It is the process of rapidly assessing a patient's condition to determine the urgency of care and the most appropriate destination for definitive treatment. Done effectively, prehospital Triage ensures that patients receive the right level of care at the right time, maximizing their chances of survival and minimizing long-term complications.
{"title":"Triage Prehospital EMS and Medical Care","authors":"Arlind Zeqiri, B. Lenjani, Besa Zeka, Dardan Lenjani, Ilirian Lenjani, A. Dogjani","doi":"10.32391/ajtes.v8i2.411","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.411","url":null,"abstract":"Introduction: Prehospital emergency medical services (EMS) are essential to emergency medical care. They provide emergency assessment and treatment for seriously ill or injured patients and transport them by ambulance to an emergency department. Adopting triage methods for systematically prioritizing patients according to how urgent patients need care, including Triage of requests for acute medical treatment, is a promising development in our healthcare system. In Kosovo, there is a gap between the effects of prehospital triage systems and the impact of using the same triage system in two or more EMS settings. In this quality improvement study, implementing the TT app intervention was associated with higher rates of inefficient Triage in prehospital settings. However, supporting EMS professionals in their decision-making by calculating the probability of an individual patient needing specialized care at the scene of injury is a new and promising approach to optimize Triage in the field. If we can fully realize the potential of this approach, it could significantly improve the efficiency and effectiveness of our emergency medical care, leading to better patient outcomes. Standards and most health professionals need to be educated and trained in this critical component of EMS. Education, education, and training for the three levels of health care should be an obligatory component to enhance the quality of emergency medical care for children and adults at risk. It is high time to develop and test a conceptual triage scheme or model that will rely on a triage system that responds to the conditions of our health system. Develop clinical guidelines, algorithms, and triage protocols at the three levels of health care. All healthcare professionals must be educated and trained in ongoing coaching, communication courses, BLS AED, Pediatric, PHTLS, Adult Advanced Life Support, ATLS, and International Trauma Life Support. \u0000Conclusion: Triage is vital in optimizing patient outcomes in the high-pressure EMS world. It is the process of rapidly assessing a patient's condition to determine the urgency of care and the most appropriate destination for definitive treatment. Done effectively, prehospital Triage ensures that patients receive the right level of care at the right time, maximizing their chances of survival and minimizing long-term complications. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"111 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Pjetri, Edona Haxhija, Arketa Pllumi (Guli), Z. Shabani, Nertila Podgorica
Introduction: The COVID - 19 has been a global public health concern from day one till now. The Aim is to assess students' knowledge, attitudes, and practices towards COVID-19. Material and Methods: This is a cross-sectional study. A validated, structured, anonymous, self-administered online questionnaire was used. The inclusion criteria were voluntary students from each Luigj Gurakuqi University faculty member. Two hundred fifty-seven students completed the questionnaire, which was created with the Microsoft Forms Office program and distributed via WhatsApp. Data were calculated through the SPSS program. Pearson correlation, ANOVA test, and simple independent test –T were applied to elaborate on the data collected. The study period is April-May 2022. Results: In this study, 257 students participated. Most of the participants were female (N=223; 87%). More than 86% of students responded positively regarding their knowledge about the symptoms of COVID-19. Regarding attitude and practice, 90% of students agreed that hand washing is necessary to prevent infection, while 98% believed wearing a mask would prevent disease. Conclusions: In general, they show positive attitudes and practices regarding COVID-19. Many say they would not hide it as information; they would seek medical help.
{"title":"The Assessment of Knowledge, Attitudes, and Practices of University’s Students Towards Covid 19","authors":"E. Pjetri, Edona Haxhija, Arketa Pllumi (Guli), Z. Shabani, Nertila Podgorica","doi":"10.32391/ajtes.v8i2.393","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.393","url":null,"abstract":"Introduction: The COVID - 19 has been a global public health concern from day one till now. \u0000The Aim is to assess students' knowledge, attitudes, and practices towards COVID-19. \u0000Material and Methods: This is a cross-sectional study. A validated, structured, anonymous, self-administered online questionnaire was used. The inclusion criteria were voluntary students from each Luigj Gurakuqi University faculty member. \u0000Two hundred fifty-seven students completed the questionnaire, which was created with the Microsoft Forms Office program and distributed via WhatsApp. Data were calculated through the SPSS program. Pearson correlation, ANOVA test, and simple independent test –T were applied to elaborate on the data collected. The study period is April-May 2022. \u0000Results: In this study, 257 students participated. Most of the participants were female (N=223; 87%). More than 86% of students responded positively regarding their knowledge about the symptoms of COVID-19. Regarding attitude and practice, 90% of students agreed that hand washing is necessary to prevent infection, while 98% believed wearing a mask would prevent disease. \u0000Conclusions: In general, they show positive attitudes and practices regarding COVID-19. Many say they would not hide it as information; they would seek medical help. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"106 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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