Aida Gavranović, Kenan Ljuhar, Nejra Jonuz Gušić, Riada Blažević, Amela Ramadani Podžo Ramadani Podžo, Amna Palikuća, Tatjana Jevtić, B. Lenjani
Background: Sudden cardiac arrest is the third leading cause of death in Europe. A significant number of out-of-hospital sudden cardiac arrests are associated with acute myocardial infarction. Cardiac arrest is a complication of an acute myocardial infarction caused by malignant rhythm disorder, in most cases ventricular tachycardia or ventricular fibrillation. They result in sudden death in 25%-50% of patients with prior acute myocardial infarction. Sudden cardiac arrest in these patients occurs during the first hours after the onset of symptoms. Aim: show from the total number of out-of-hospital reanimations in the given period in canton Sarajevo the number of successful reanimations (return of spontaneous circulation – ROSC) and the number of successful reanimations in patients that went in to sudden cardiac arrest with prior acute myocardial infarction. Show the out-of-hospital management of these patients. Material and Methods: retrospective descriptive study that includes all out-of-hospital sudden cardiac arrest in the period from 1 January 2019 to the 31 December 2021 in canton Sarajevo that are associated with acute myocardial infarction in which there was the return of spontaneous circulation (ROSC). All patients from above-mentioned period were included in the study, without exclusion criteria related to their age, gender. Data was extracted from data registry of the Centre for education of the Emergency Medical Center of canton Sarajevo. Conclusion: Acute myocardial infarction still stays associated with a high level of mortality and represents one of the leading public health problems. Despite all advances in the field of diagnostics and treatment of patients with AMI that resulted in significant reduction of mortality in time.
{"title":"Cardiac Arrest in Patients with Acute Myocardial Infarction","authors":"Aida Gavranović, Kenan Ljuhar, Nejra Jonuz Gušić, Riada Blažević, Amela Ramadani Podžo Ramadani Podžo, Amna Palikuća, Tatjana Jevtić, B. Lenjani","doi":"10.32391/ajtes.v8i2.345","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.345","url":null,"abstract":"Background: Sudden cardiac arrest is the third leading cause of death in Europe. A significant number of out-of-hospital sudden cardiac arrests are associated with acute myocardial infarction. Cardiac arrest is a complication of an acute myocardial infarction caused by malignant rhythm disorder, in most cases ventricular tachycardia or ventricular fibrillation. They result in sudden death in 25%-50% of patients with prior acute myocardial infarction. Sudden cardiac arrest in these patients occurs during the first hours after the onset of symptoms. \u0000Aim: show from the total number of out-of-hospital reanimations in the given period in canton Sarajevo the number of successful reanimations (return of spontaneous circulation – ROSC) and the number of successful reanimations in patients that went in to sudden cardiac arrest with prior acute myocardial infarction. Show the out-of-hospital management of these patients. \u0000Material and Methods: retrospective descriptive study that includes all out-of-hospital sudden cardiac arrest in the period from 1 January 2019 to the 31 December 2021 in canton Sarajevo that are associated with acute myocardial infarction in which there was the return of spontaneous circulation (ROSC). All patients from above-mentioned period were included in the study, without exclusion criteria related to their age, gender. Data was extracted from data registry of the Centre for education of the Emergency Medical Center of canton Sarajevo. \u0000Conclusion: Acute myocardial infarction still stays associated with a high level of mortality and represents one of the leading public health problems. Despite all advances in the field of diagnostics and treatment of patients with AMI that resulted in significant reduction of mortality in time. ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"109 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820315","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: The deployment of health information systems has been a global response to healthcare's transformation and digitalization. The need and potential of these systems within healthcare have been tremendously driven by the global instability that has affected several interrelated sectors, highlighting the urgency and importance of this research.[1] Health information systems (HIS) are critical systems deployed to help organizations and all stakeholders within the healthcare arena eradicate disjointed information and modernize health processes by integrating different health functions and departments across the healthcare arena for better healthcare delivery.[2] This study aims to underscore the invaluable insights of the Shkodra Regional Hospital's healthcare staff regarding Hospital Information Systems. We aim to identify potential problems that may arise before their implementation, such as resistance to change, lack of training, and system compatibility issues, emphasizing the crucial role of healthcare staff in this process. Material and Methods: 168 participants were involved in this study, representing 42.96% of the total nurses. Data were collected through a 47-item self-administered questionnaire, which included sections on demographics, current system usage, perceived benefits and challenges, and readiness for system adoption. The questionnaire was designed based on the 'Acceptance Model of a Hospital Information System' developed by Handayani et al. [3] Results: Encouragingly, 88-92% of the study participants expressed their strong readiness and enthusiasm to embrace HIS as part of their work. This overwhelmingly positive attitude bodes exceptionally well for the system's potential success. Conclusions: The study's findings underscore the significant potential for successfully implementing HIS at Shkodra Regional Hospital. Despite the challenges nurses may anticipate when using HIS, the study revealed a remarkable willingness to adapt. Approximately 90% of the participants expressed their readiness to accept HIS, demonstrating their commendable adaptability and the potential for a smooth transition to the new system.
前言部署医疗信息系统是全球应对医疗转型和数字化的一项举措。医疗信息系统（HIS）是部署在医疗领域的关键系统，通过整合医疗领域的不同医疗功能和部门，帮助医疗机构和所有利益相关者消除信息脱节，实现医疗流程现代化，从而更好地提供医疗服务。我们的目的是找出在系统实施前可能出现的问题，如抵制变革、缺乏培训和系统兼容性问题，并强调医护人员在这一过程中的关键作用。材料与方法：168 名参与者参与了此次研究，占护士总数的 42.96%。数据通过一份 47 个项目的自填式问卷收集，其中包括人口统计学、当前系统使用情况、感知到的益处和挑战以及采用系统的准备情况等部分。问卷是根据 Handayani 等人开发的 "医院信息系统接受模型 "设计的：令人鼓舞的是，88%-92% 的研究参与者表示，他们已做好准备，并热衷于将医院信息系统作为其工作的一部分。这种压倒性的积极态度预示着该系统有可能取得成功。结论：研究结果强调了在斯库台地区医院成功实施 HIS 系统的巨大潜力。尽管护士们在使用 HIS 系统时可能会遇到各种挑战，但研究结果显示，他们非常愿意适应。约 90% 的参与者表示愿意接受 HIS 系统，这表明他们的适应能力值得称赞，并有可能顺利过渡到新系统。
{"title":"Perceptions of Health Personnel Regarding the Utilization of Health Information Systems.","authors":"Edra Fresku, J. Kraja, M. Marku","doi":"10.32391/ajtes.v8i2.402","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.402","url":null,"abstract":"Introduction: The deployment of health information systems has been a global response to healthcare's transformation and digitalization. The need and potential of these systems within healthcare have been tremendously driven by the global instability that has affected several interrelated sectors, highlighting the urgency and importance of this research.[1] \u0000Health information systems (HIS) are critical systems deployed to help organizations and all stakeholders within the healthcare arena eradicate disjointed information and modernize health processes by integrating different health functions and departments across the healthcare arena for better healthcare delivery.[2] \u0000This study aims to underscore the invaluable insights of the Shkodra Regional Hospital's healthcare staff regarding Hospital Information Systems. We aim to identify potential problems that may arise before their implementation, such as resistance to change, lack of training, and system compatibility issues, emphasizing the crucial role of healthcare staff in this process. \u0000Material and Methods: 168 participants were involved in this study, representing 42.96% of the total nurses. Data were collected through a 47-item self-administered questionnaire, which included sections on demographics, current system usage, perceived benefits and challenges, and readiness for system adoption. The questionnaire was designed based on the 'Acceptance Model of a Hospital Information System' developed by Handayani et al. [3] \u0000Results: Encouragingly, 88-92% of the study participants expressed their strong readiness and enthusiasm to embrace HIS as part of their work. This overwhelmingly positive attitude bodes exceptionally well for the system's potential success. \u0000Conclusions: The study's findings underscore the significant potential for successfully implementing HIS at Shkodra Regional Hospital. Despite the challenges nurses may anticipate when using HIS, the study revealed a remarkable willingness to adapt. Approximately 90% of the participants expressed their readiness to accept HIS, demonstrating their commendable adaptability and the potential for a smooth transition to the new system.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"113 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820415","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}
Chandramouli Gonuguntla, Raja Shekhar Kasukurthi, Sai Smaran Thota, Rajesh Menda
Introduction: "Periarthritis" and "adhesive capsulitis" have been used synonymously with frozen shoulder. The condition known as "frozen shoulder," which has an unknown cause, is characterized by a delayed, spontaneous restoration of all shoulder joint movements to some extent or entirely over several months to a year. Various treatment methods have been employed to manage periarthritis shoulder, with varying outcomes. The Aim: To evaluate the functional outcomes and pain relief of periarthritis shoulder treated with intra-articular steroid injection and manipulation under anesthesia. Material and Methods: A prospective study was conducted on adults with periarthritis shoulder admitted, evaluated, and followed up on 30 periarthritis shoulder cases using intra-articular steroid injection and manipulation over three months. Results: In our study, most of the patients were females and elderly, with diabetics being more prone to periarthritis of the shoulder. The range of movements improved, and pain was relieved in all 30 patients. Excellent results were found in 26 cases (86.6%) by DASH Score criteria. Conclusion: Intra-articular steroid injection and manipulation of the shoulder in periarthritis shoulder with follow-up for 12 weeks resulted in the study finding a significant improvement in the range of shoulder movement, pain, and function in patients with shoulder periarthritis. Keywords: Periarthritis shoulder; intra-articular steroid injection; Range of movement.
{"title":"Management of Periarthritis Shoulder by Intra-Articular Steroid Injection and Shoulder Joint Manipulation","authors":"Chandramouli Gonuguntla, Raja Shekhar Kasukurthi, Sai Smaran Thota, Rajesh Menda","doi":"10.32391/ajtes.v8i2.382","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.382","url":null,"abstract":"Introduction: \"Periarthritis\" and \"adhesive capsulitis\" have been used synonymously with frozen shoulder. The condition known as \"frozen shoulder,\" which has an unknown cause, is characterized by a delayed, spontaneous restoration of all shoulder joint movements to some extent or entirely over several months to a year. Various treatment methods have been employed to manage periarthritis shoulder, with varying outcomes. \u0000The Aim: To evaluate the functional outcomes and pain relief of periarthritis shoulder treated with intra-articular steroid injection and manipulation under anesthesia. \u0000Material and Methods: A prospective study was conducted on adults with periarthritis shoulder admitted, evaluated, and followed up on 30 periarthritis shoulder cases using intra-articular steroid injection and manipulation over three months. \u0000Results: In our study, most of the patients were females and elderly, with diabetics being more prone to periarthritis of the shoulder. The range of movements improved, and pain was relieved in all 30 patients. Excellent results were found in 26 cases (86.6%) by DASH Score criteria. \u0000Conclusion: Intra-articular steroid injection and manipulation of the shoulder in periarthritis shoulder with follow-up for 12 weeks resulted in the study finding a significant improvement in the range of shoulder movement, pain, and function in patients with shoulder periarthritis. \u0000Keywords: Periarthritis shoulder; intra-articular steroid injection; Range of movement. ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"71 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819092","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. Lenjani, A. Dogjani, Edlira Harizi, Aida Gavranović, Kenan Ljuhar, Besim Mehmedi, Arberije Fazliu, Kledisa Harizi, Dardan Lenjani
Introduction: Emergency medicine is a dynamic specialty that offers various medical cases and situations. Emergency medicine doctors treat patients from all age groups and with a large spectrum of physical and mental disorders. Emergency medicine is the specialty of treating illnesses or injuries requiring immediate medical attention. Emergency medicine doctors assess and treat patients in the emergency department, regardless of their illness or injury type. Their main focus is to stabilize patients as quickly as possible and determine the best next step in treating many patients simultaneously, with life-threatening conditions being the main priority. Emergency physicians treat all medical conditions of all age groups, such as cardiology, neurological, pulmonological, nephrological, endocrinological, hematological, gastrointestinal, orthopedic, gynecological-obstetrical, dermatological, psychiatric, traumatological, and accidental conditions. Efforts should be made to reduce the accumulation of ED with a solid organizational culture; rather than adopting “generic” approaches, interventions should be selected and implemented to address the unique challenges of each hospital ED. Emergency medicine can potentially improve patient care and outcomes; however, establishing evidence-based protocols and a multidisciplinary approach to patient management are essential. Creating long-term health policies to regulate the referral system through the national plan and document would regulate the three levels of health care to stop the overcrowding of the hospital's ED.
{"title":"Emergency Doctor in the Reanimation Room and Solution of Medical Problems","authors":"B. Lenjani, A. Dogjani, Edlira Harizi, Aida Gavranović, Kenan Ljuhar, Besim Mehmedi, Arberije Fazliu, Kledisa Harizi, Dardan Lenjani","doi":"10.32391/ajtes.v8i2.410","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.410","url":null,"abstract":"Introduction: Emergency medicine is a dynamic specialty that offers various medical cases and situations. Emergency medicine doctors treat patients from all age groups and with a large spectrum of physical and mental disorders. Emergency medicine is the specialty of treating illnesses or injuries requiring immediate medical attention. Emergency medicine doctors assess and treat patients in the emergency department, regardless of their illness or injury type. Their main focus is to stabilize patients as quickly as possible and determine the best next step in treating many patients simultaneously, with life-threatening conditions being the main priority. Emergency physicians treat all medical conditions of all age groups, such as cardiology, neurological, pulmonological, nephrological, endocrinological, hematological, gastrointestinal, orthopedic, gynecological-obstetrical, dermatological, psychiatric, traumatological, and accidental conditions. Efforts should be made to reduce the accumulation of ED with a solid organizational culture; rather than adopting “generic” approaches, interventions should be selected and implemented to address the unique challenges of each hospital ED. Emergency medicine can potentially improve patient care and outcomes; however, establishing evidence-based protocols and a multidisciplinary approach to patient management are essential. Creating long-term health policies to regulate the referral system through the national plan and document would regulate the three levels of health care to stop the overcrowding of the hospital's ED. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819653","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}
Bledi Masati, Asfloral Haxhiu, Marsel Dhima, Tomi Punmira, Gentian Zikaj, A. Ibrahimi, A. Dogjani
Introduction: Ventral hernia is one of the most common general surgical pathologies. An incisional hernia will develop in 10–15% of patients with an abdominal incision, and the risk increases to up to 23% in those who develop surgical site infections. Ventral hernia repairs are mostly elective (90%) procedures, but the repair methods are highly variable. Popularized in Europe by Rives and Stoppa, the retromuscular technique has proven to be very effective, with a 94.2% probability of having the lowest odds for recurrence and a 77.3% probability of having the lowest odds for SSI. The study aimed to evaluate our experience at a secondary care center performing Rives-Stoppa repair for abdominal ventral and incisional hernias. Materials and Methods: Between April 2019 and August 2021, 46 patients in the practice at a secondary regional hospital, Teni Konomi, Korce, Albania, underwent a Rives-Stoppa incisional hernia repair. Results: There were 14 (31%) males and 32(69%) females (age range 31-75). Most incisional hernias were midline xiphoid-pubic incision and supraumbilical, with several subcostals (2 right and 1 left) hernias.At the time of repair, most incisional hernias were symptomatic and evident on physical exam. In four cases, the hernia sac was incarcerated at the presentation time. Conclusion: The Rives-Stoppa technique has excellent long-term results and low morbidity in patients with large primary or recurrent incisional hernias. It is the gold standard for most surgeons. Keywords: Incisional Hernia, mesh, polypropylene, abdominal wall surgery, rectus muscle
{"title":"The Benefit of Open Rives-Stoppa Procedure in Complex Incisional Hernia.","authors":"Bledi Masati, Asfloral Haxhiu, Marsel Dhima, Tomi Punmira, Gentian Zikaj, A. Ibrahimi, A. Dogjani","doi":"10.32391/ajtes.v8i1.381","DOIUrl":"https://doi.org/10.32391/ajtes.v8i1.381","url":null,"abstract":"Introduction: Ventral hernia is one of the most common general surgical pathologies. An incisional hernia will develop in 10–15% of patients with an abdominal incision, and the risk increases to up to 23% in those who develop surgical site infections. \u0000Ventral hernia repairs are mostly elective (90%) procedures, but the repair methods are highly variable. \u0000Popularized in Europe by Rives and Stoppa, the retromuscular technique has proven to be very effective, with a 94.2% probability of having the lowest odds for recurrence and a 77.3% probability of having the lowest odds for SSI. \u0000The study aimed to evaluate our experience at a secondary care center performing Rives-Stoppa repair for abdominal ventral and incisional hernias. \u0000Materials and Methods: Between April 2019 and August 2021, 46 patients in the practice at a secondary regional hospital, Teni Konomi, Korce, Albania, underwent a Rives-Stoppa incisional hernia repair. \u0000Results: There were 14 (31%) males and 32(69%) females (age range 31-75). \u0000Most incisional hernias were midline xiphoid-pubic incision and supraumbilical, with several subcostals (2 right and 1 left) hernias.At the time of repair, most incisional hernias were symptomatic and evident on physical exam. In four cases, the hernia sac was incarcerated at the presentation time. \u0000Conclusion: The Rives-Stoppa technique has excellent long-term results and low morbidity in patients with large primary or recurrent incisional hernias. It is the gold standard for most surgeons. \u0000Keywords: Incisional Hernia, mesh, polypropylene, abdominal wall surgery, rectus muscle","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"9 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139523839","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}
F. Mulita, E. Liolis, L. Tchabashvili, Konstantinos Tasios, Vasileios Papanikos, Christos Tsilivigkos, Andreas Antzoulas, G. Verras
Background: Thyroid surgery is the most common operation in the field of endocrine surgery. The aim of this study was to compare the use of LigaSure vessel (LS) and Harmonic scalpel (HS) in 1599 total thyroid surgeries between January 2008 and December of 2022, with regards of analysis of surgical complications, duration of hospital stay and operative surgical time. Methods: In this retrospective study patients have been categorized into two groups: Group A included 718 patients from January 2008 to May 2013 when LigaSure vessel was used, and the Group B included 881 patients from June 2013 to December 2022 when Harmonic scalpel was used. A summary of the total number of postoperative complications cases, surgical time and the duration of hospital stay between the two groups is presented. Results: There was no significant difference in the sex, age, and mean operating time between the two groups (P>0.05). Either major bleeding or wound infection occurred in 4 (0.6%) or 14 (1.9%) of the patients undergoing thyroidectomy when LS was used compared to 4 (0.5%) or 15 (1.7%) of the patients undergoing thyroid surgery when HS was used (P> 0.05 and P> 0.05, respectively). In addition, either hypoparathyroidism or temporary recurrent laryngeal nerve palsy was observed in 91 (12.7%) or 39 (5.4%) of the Group A patients compared with 98 (11.1%) or 44 (5%) of the Group B patients (P> 0.05 and P> 0.05, respectively). Conclusion: The current study demonstrates that thyroidectomy can be safely performed with both devices without increasing the risk of complications.
{"title":"Comparison of postoperative complications using Harmonic scalpel and LigaSure in thyroid surgery","authors":"F. Mulita, E. Liolis, L. Tchabashvili, Konstantinos Tasios, Vasileios Papanikos, Christos Tsilivigkos, Andreas Antzoulas, G. Verras","doi":"10.32391/ajtes.v8i1.362","DOIUrl":"https://doi.org/10.32391/ajtes.v8i1.362","url":null,"abstract":"Background: Thyroid surgery is the most common operation in the field of endocrine surgery. The aim of this study was to compare the use of LigaSure vessel (LS) and Harmonic scalpel (HS) in 1599 total thyroid surgeries between January 2008 and December of 2022, with regards of analysis of surgical complications, duration of hospital stay and operative surgical time. \u0000Methods: In this retrospective study patients have been categorized into two groups: Group A included 718 patients from January 2008 to May 2013 when LigaSure vessel was used, and the Group B included 881 patients from June 2013 to December 2022 when Harmonic scalpel was used. A summary of the total number of postoperative complications cases, surgical time and the duration of hospital stay between the two groups is presented. \u0000Results: There was no significant difference in the sex, age, and mean operating time between the two groups (P>0.05). Either major bleeding or wound infection occurred in 4 (0.6%) or 14 (1.9%) of the patients undergoing thyroidectomy when LS was used compared to 4 (0.5%) or 15 (1.7%) of the patients undergoing thyroid surgery when HS was used (P> 0.05 and P> 0.05, respectively). In addition, either hypoparathyroidism or temporary recurrent laryngeal nerve palsy was observed in 91 (12.7%) or 39 (5.4%) of the Group A patients compared with 98 (11.1%) or 44 (5%) of the Group B patients (P> 0.05 and P> 0.05, respectively). \u0000Conclusion: The current study demonstrates that thyroidectomy can be safely performed with both devices without increasing the risk of complications.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"21 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139610655","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: Gallstone ileus (GI) is a rare complication of cholelithiasis and is one of the most irregular forms of all mechanical bowel obstructions. It is, however, a more common cause of non-strangulating mechanical small bowel obstruction, accounting for 1% to 4% of all patients and up to 25% in the elderly. The diagnosis is often delayed since symptoms may be intermittent, and investigations may fail to identify the cause of the obstruction. As a result, gallstone ileus continues to be associated with relatively high rates of morbidity and mortality. The cornerstone of healing is the removal of the stone that represents obstruction. As is the case with cholelithiasis, women are more frequently affected. Material and Methods: This article aims to review the incidence of gallstone ileus in our country in the literature, addressing the pathophysiology, clinical presentation, radiological findings, and treatment options. A literature search was done on gallstone ileus for 2005-2018. Results: The patients in the study presentation were both genders and older. They all came to INP because of abdominal pain and general nausea. All had CRP elevation present. Leukocytosis was present in only 2/3 of patients. AST was elevated in one patient and ALT in 2. All changes in laboratory parameters indicate the instability of marker changes and, consequently, the unreliability of use alone without other diagnostic methods. A CT scan was performed on all three patients, but one still needed to be uploaded to the system at the time of writing. Conclusions: Ileus due to gallstones is a rare disease. It is an uncommon cause of mechanical small bowel obstruction. It is a rare complication of chronic cholecystitis and occurs when a gallstone passes through a fistula between the gallbladder and small bowel before becoming impacted at the ileocecal valve. The use of radiological imaging is invaluable in the diagnosis of gallstone ileus. These authors recommend a low threshold for investigation. There is evidence for using AXR as a quick first-line investigation; however, CT scanning is a powerful and gold-standard tool to diagnose the condition and guide its management.
{"title":"The Gallstone Ileus, a Retrospective Study and Review of the Literature","authors":"N. Arslani","doi":"10.32391/ajtes.v8i1.355","DOIUrl":"https://doi.org/10.32391/ajtes.v8i1.355","url":null,"abstract":"Introduction: Gallstone ileus (GI) is a rare complication of cholelithiasis and is one of the most irregular forms of all mechanical bowel obstructions. It is, however, a more common cause of non-strangulating mechanical small bowel obstruction, accounting for 1% to 4% of all patients and up to 25% in the elderly. \u0000The diagnosis is often delayed since symptoms may be intermittent, and investigations may fail to identify the cause of the obstruction. As a result, gallstone ileus continues to be associated with relatively high rates of morbidity and mortality. \u0000The cornerstone of healing is the removal of the stone that represents obstruction. As is the case with cholelithiasis, women are more frequently affected. \u0000Material and Methods: This article aims to review the incidence of gallstone ileus in our country in the literature, addressing the pathophysiology, clinical presentation, radiological findings, and treatment options. A literature search was done on gallstone ileus for 2005-2018. \u0000Results: The patients in the study presentation were both genders and older. They all came to INP because of abdominal pain and general nausea. All had CRP elevation present. Leukocytosis was present in only 2/3 of patients. AST was elevated in one patient and ALT in 2. All changes in laboratory parameters indicate the instability of marker changes and, consequently, the unreliability of use alone without other diagnostic methods. A CT scan was performed on all three patients, but one still needed to be uploaded to the system at the time of writing. \u0000Conclusions: Ileus due to gallstones is a rare disease. It is an uncommon cause of mechanical small bowel obstruction. It is a rare complication of chronic cholecystitis and occurs when a gallstone passes through a fistula between the gallbladder and small bowel before becoming impacted at the ileocecal valve. The use of radiological imaging is invaluable in the diagnosis of gallstone ileus. These authors recommend a low threshold for investigation. There is evidence for using AXR as a quick first-line investigation; however, CT scanning is a powerful and gold-standard tool to diagnose the condition and guide its management. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"30 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139610684","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}
S. Kuçi, A. Ibrahimi, Marsela Goga, E. Likaj, S. Dumani, A. Kaçani, A. Veshti
Introduction: In recent years, contemporary minimally invasive cardiac surgery techniques have been used in many cardiac surgical clinics. With the expansion of minimally invasive operations, ECMO, and some interventional therapies, the current cardiac surgical landscape requires a thorough knowledge of peripheral cannulation techniques. A venous cannulation that is not flawlessly performed can lead to serious life-threatening complications in several steps. The technique we describe step by step is the current gold standard in terms of safety and efficacy: from the use of ultrasound for ultrasound-guided puncture to the safe advancement of super stiff guidewires using a sentinel catheter and concluding with smooth insertion of the venous cannula over the stiff guidewire up to the SVC. Moreover, a list of bailout maneuvers to solve complications and a report of institutional clinical experience since adopting this technique are presented. Conclusion: In our experience, however, the fact is that patients' perceptions and expectations have changed. Patients increasingly ask for a therapeutic approach that leaves the sternum intact. Those doctors who want to meet this new challenge must realize that minimal incisions in cardiac surgery require excellent technical skills. For this reason, doctors should become familiar with current study data.
{"title":"Percutaneous Cannulation for Minimally Invasive Cardiac Surgery: The Safest and Effective Technique for the Future.","authors":"S. Kuçi, A. Ibrahimi, Marsela Goga, E. Likaj, S. Dumani, A. Kaçani, A. Veshti","doi":"10.32391/ajtes.v8i1.376","DOIUrl":"https://doi.org/10.32391/ajtes.v8i1.376","url":null,"abstract":"Introduction: In recent years, contemporary minimally invasive cardiac surgery techniques have been used in many cardiac surgical clinics. \u0000With the expansion of minimally invasive operations, ECMO, and some interventional therapies, the current cardiac surgical landscape requires a thorough knowledge of peripheral cannulation techniques. A venous cannulation that is not flawlessly performed can lead to serious life-threatening complications in several steps. The technique we describe step by step is the current gold standard in terms of safety and efficacy: from the use of ultrasound for ultrasound-guided puncture to the safe advancement of super stiff guidewires using a sentinel catheter and concluding with smooth insertion of the venous cannula over the stiff guidewire up to the SVC. Moreover, a list of bailout maneuvers to solve complications and a report of institutional clinical experience since adopting this technique are presented. \u0000Conclusion: In our experience, however, the fact is that patients' perceptions and expectations have changed. Patients increasingly ask for a therapeutic approach that leaves the sternum intact. Those doctors who want to meet this new challenge must realize that minimal incisions in cardiac surgery require excellent technical skills. For this reason, doctors should become familiar with current study data. \u0000 \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139610857","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: Carotid endarterectomy (CEA) operations have been more frequent in our practice in recent years, primarily for asymptomatic patients. In this article, we present our experience in this field. Ojectives. Primary endpoints were death and stroke within 30 days of the procedure for asymptomatic patients. Secondary endpoints were acute myocardial infarction within 30 days of the process and peripheral nerve injury in all patients. Patients and Method: This is a retrospective review of our recent experience. Data of 219 consecutive CEA, 177 in asymptomatic patients, operated on from January 2004- February 2009 by our equip are collected; all the patients were diagnosed with Duplex scanner and confirmed with multi-slice CT scanner angiography. Endarterectomy was performed either with loco-regional or general anesthesia with selective use of a shunt. Combined anti-aggregation with Clopidogrel and Aspirin was the rule at discharge. Patients were controlled for new neurological and cardiac events 30 days after the operation. Results: One asymptomatic patient had a major stroke and died. In this group, the stroke and mortality rate is 1,69%. No peri-operative new acute myocardial infarction happened in any patient. Peripheral nerve lesions occurred in 2,7 %of all procedures. Conclusions: CEA is a safe treatment for asymptomatic internal carotid stenoses in the hands of an experienced vascular surgeon. Our results for asymptomatic carotid stenoses are according to international guidelines' recommendations.
{"title":"Our Experience in Carotid Endarterectomy. A Retrospective Study","authors":"E. Nuellari, E. Prifti","doi":"10.32391/ajtes.v8i1.357","DOIUrl":"https://doi.org/10.32391/ajtes.v8i1.357","url":null,"abstract":"Introduction: Carotid endarterectomy (CEA) operations have been more frequent in our practice in recent years, primarily for asymptomatic patients. In this article, we present our experience in this field. \u0000Ojectives. Primary endpoints were death and stroke within 30 days of the procedure for asymptomatic patients. Secondary endpoints were acute myocardial infarction within 30 days of the process and peripheral nerve injury in all patients. \u0000Patients and Method: This is a retrospective review of our recent experience. Data of 219 consecutive CEA, 177 in asymptomatic patients, operated on from January 2004- February 2009 by our equip are collected; all the patients were diagnosed with Duplex scanner and confirmed with multi-slice CT scanner angiography. Endarterectomy was performed either with loco-regional or general anesthesia with selective use of a shunt. Combined anti-aggregation with Clopidogrel and Aspirin was the rule at discharge. Patients were controlled for new neurological and cardiac events 30 days after the operation. \u0000Results: One asymptomatic patient had a major stroke and died. In this group, the stroke and mortality rate is 1,69%. No peri-operative new acute myocardial infarction happened in any patient. Peripheral nerve lesions occurred in 2,7 %of all procedures. \u0000Conclusions: CEA is a safe treatment for asymptomatic internal carotid stenoses in the hands of an experienced vascular surgeon. Our results for asymptomatic carotid stenoses are according to international guidelines' recommendations. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"62 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139611472","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}
S. Kuçi, A. Ibrahimi, Marsela Goga, Fation Hamiti, E. Bejko, Stavri Llazo, J. Burimi, Esmerilda Bulku
Introduction: Atrial fibrillation (AF) is the most common complication of cardiac surgery, occurring in 10-40% of patients. Postoperative AF (POAF) refers to new-onset AF in a patient without a history of AF that occurs within the first four weeks after cardiac surgery. While POAF can be transient and without consequences, it may lead to severe complications, increasing mortality and morbidity in the postoperative period. Risk factors can be patient-related, intraoperative, and postoperative. This study aimed to estimate the frequency of AF in patients after CABG combined with valvular replacement or not. Identification of patients vulnerable to arrhythmia will allow targeting of those most likely to benefit from prophylactic therapy. Material and Methods: The presented study is a prospective study of 100 patients undergoing elective CABG from February to April 2022 with a mean age of 66 ± 13 years, 30% women, undergoing CABG at the University Hospital Centre “Mother Teresa” Tirana, that developed POAF. Results: Postoperative atrial fibrillation occurred in sixteen patients (16%) at a median of 3.7 days after cardiac surgery (2nd – 7th day). 94% (15) of POAF occurred in CABG only, and 6% (1) in the combined intervention (AVR et CABG). Conclusion: AF is the most common complication after CABG. The occurrence is not dependent on the type of intervention (only CABG or combined with valve replacement), the number of vessels that underwent bypass grafting, or the type of vessel. Electrolytic imbalance should be assessed during the postoperative course of patients who undergo CABG.
{"title":"Atrial Fibrillation following CABG Surgery. Our Experience with 100 Patients","authors":"S. Kuçi, A. Ibrahimi, Marsela Goga, Fation Hamiti, E. Bejko, Stavri Llazo, J. Burimi, Esmerilda Bulku","doi":"10.32391/ajtes.v8i1.380","DOIUrl":"https://doi.org/10.32391/ajtes.v8i1.380","url":null,"abstract":"Introduction: Atrial fibrillation (AF) is the most common complication of cardiac surgery, occurring in 10-40% of patients. Postoperative AF (POAF) refers to new-onset AF in a patient without a history of AF that occurs within the first four weeks after cardiac surgery. While POAF can be transient and without consequences, it may lead to severe complications, increasing mortality and morbidity in the postoperative period. Risk factors can be patient-related, intraoperative, and postoperative. \u0000This study aimed to estimate the frequency of AF in patients after CABG combined with valvular replacement or not. Identification of patients vulnerable to arrhythmia will allow targeting of those most likely to benefit from prophylactic therapy. \u0000Material and Methods: The presented study is a prospective study of 100 patients undergoing elective CABG from February to April 2022 with a mean age of 66 ± 13 years, 30% women, undergoing CABG at the University Hospital Centre “Mother Teresa” Tirana, that developed POAF. \u0000Results: Postoperative atrial fibrillation occurred in sixteen patients (16%) at a median of 3.7 days after cardiac surgery (2nd – 7th day). 94% (15) of POAF occurred in CABG only, and 6% (1) in the combined intervention (AVR et CABG). \u0000Conclusion: AF is the most common complication after CABG. The occurrence is not dependent on the type of intervention (only CABG or combined with valve replacement), the number of vessels that underwent bypass grafting, or the type of vessel. Electrolytic imbalance should be assessed during the postoperative course of patients who undergo CABG. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"22 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139610564","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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