B. Lenjani, N. Baftiu, B. Krasniqi, Shpresa Makolli, Dardan Lenjani, V. Mišanović, Kenan Ljuhar, A. Dogjani
Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. Taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. In a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. The aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. Emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. The integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. This has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. When applied to MCI responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.
{"title":"Access and Emergency Medical Care for Massive or Multiple Injuries","authors":"B. Lenjani, N. Baftiu, B. Krasniqi, Shpresa Makolli, Dardan Lenjani, V. Mišanović, Kenan Ljuhar, A. Dogjani","doi":"10.32391/ajtes.v7i1.298","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.298","url":null,"abstract":"Access and emergency medical care for massive or multiple injuries is an comprehensive interdisciplinary challenge. Taking care of the growing causes of emergency care levels as well as cross-sectoral collaboration in the management of multiple incidents, reducing disease, disability, and mortality in the population with multiple disorders. In a disaster or extraordinary situation with mass casualties is a state in which the health care system is overloaded and the ability to provide emergency health care is considerably hindered. The aim of this review is to present the current state of knowledge on what we, the authors, say are the central aspects of trauma management of mass casualty incidents. Emergency planning and methodology are related to accidental states, elementary medical staff disasters, medical equipment, drilling material, concretizing assessment tools, monitoring, mass incident prevention. In terms of implementing a good action plan, effective collaboration between state agencies such as fire departament and law enforcement is necessary in identifying and directing critically ill patients to designated trauma centres. The integration of emergency systems for incident management, through providing resources like, medical equipment, drugs, autoambulances, ongoing education and training. This has the impact of increasing knowledge of medical emergency procedures that would help reduce the risk of consequences of mass incidents. When applied to MCI responses, damage-control principles reduce resource utilization and optimze surge capacity, consequently reducing the rate of mortality.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44514372","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}
Alma Mizdrak, Arzija Pašalić, Elmedina Mrkulić, Amina Lučkin, Zineta Mulaosmanović
Introduction: Knowledge of all safety factors: teamwork, employee satisfaction, work environment, stress awareness, risk perception and attitude are the basis for improving the safety performance of health care providers - health professionals. The aim of the research is to analyze the risk perception of health professionals on aspects of occupational safety in relation to the workplace during the COVID-19 pandemic. Methods: A descriptive cross-sectional study included health professionals of all profiles from the Sarajevo Canton. It was conducted in the period from November to the end of December 2021. Respondents voluntarily and anonymously filled out a survey questionnaire, distributed electronically in the Google forms form. Results: The research included 266 health professionals of all profiles employed in health care institutions at the primary, secondary and tertiary levels of health care. Conclusion: The concept of risk perception of health professionals in a pandemic should be viewed as a group rather than an individual phenomenon.perception
{"title":"Risk Assessment and Perception of Healthcare Professionals in the Age of the Covid-19 Pandemic.","authors":"Alma Mizdrak, Arzija Pašalić, Elmedina Mrkulić, Amina Lučkin, Zineta Mulaosmanović","doi":"10.32391/ajtes.v7i1.316","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.316","url":null,"abstract":"Introduction: Knowledge of all safety factors: teamwork, employee satisfaction, work environment, stress awareness, risk perception and attitude are the basis for improving the safety performance of health care providers - health professionals. The aim of the research is to analyze the risk perception of health professionals on aspects of occupational safety in relation to the workplace during the COVID-19 pandemic. \u0000Methods: A descriptive cross-sectional study included health professionals of all profiles from the Sarajevo Canton. It was conducted in the period from November to the end of December 2021. Respondents voluntarily and anonymously filled out a survey questionnaire, distributed electronically in the Google forms form. \u0000Results: The research included 266 health professionals of all profiles employed in health care institutions at the primary, secondary and tertiary levels of health care. \u0000Conclusion: The concept of risk perception of health professionals in a pandemic should be viewed as a group rather than an individual phenomenon.perception","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45862638","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. Dumani, A. Ibrahimi, E. Likaj, L. Dibra, A. Refatllari, Devis Pellumbi, A. Baboci
Introduction; Trauma is the leading cause of death in United States in the younger population. National Trauma Data Bank in 2017 reported that 140 000 Americans dies and 80 000 are permanently disabled as a result of trauma each year. Cardiac trauma is identified in less than 10% of all trauma admissions but is associated with a much higher mortality than other organ system injuries. Considering the lethality of this type of injury, better guidelines should exist to direct management. We have analyzed data from pub med, surgery books, reviews and original presentations from many institutions to present actuality in management strategies of cardiac injuries. Cardiac injuries are classified penetrating and blunt. Penetrating trauma includes stab or guns wounds. All patients with a penetrating wound anywhere near the heart should be considered to have a cardiac injury. The penetrating cardiac traumas is a surgical emergency while the blunt injuries treatment consists mainly in observation. With early aggressive management only 1/3 of patient that arrive at hospital can be saved and this number can arise to more than 70 % if the patient survives until operating room. The results of treatment depend from infrastructural health system to the clinical presentation of the patients. Penetrating cardiac wounds mortality varies 5 % to 76 %. Blunt cardiac injuries are encountered mostly during motor vehicle accidents. The incidence of cardiac injuries in blunt trauma is 2.3-4.6 %. Overall mortality varies 11.4-24.5 %. Myocardial contusion is the most frequent type of blunt cardiac injuries. The diagnose of the cardiac trauma include: clinical assessment, physical examinations, chest radiographs, echocardiography, cardiac enzymes, ECG, CT scan and even chest drainage. Despite many diagnostic tools we have, it is very important the right management of these tools and the time. Conclusion: The surgery teams should be familiar with the management of the cardiac injuries and continuing education about this topic is the success key to manage better these emergencies.
{"title":"Cardiac Trauma. Management Strategies short panoramic View.","authors":"S. Dumani, A. Ibrahimi, E. Likaj, L. Dibra, A. Refatllari, Devis Pellumbi, A. Baboci","doi":"10.32391/ajtes.v7i1.318","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.318","url":null,"abstract":"Introduction; Trauma is the leading cause of death in United States in the younger population. National Trauma Data Bank in 2017 reported that 140 000 Americans dies and 80 000 are permanently disabled as a result of trauma each year. Cardiac trauma is identified in less than 10% of all trauma admissions but is associated with a much higher mortality than other organ system injuries. Considering the lethality of this type of injury, better guidelines should exist to direct management. We have analyzed data from pub med, surgery books, reviews and original presentations from many institutions to present actuality in management strategies of cardiac injuries. \u0000Cardiac injuries are classified penetrating and blunt. Penetrating trauma includes stab or guns wounds. All patients with a penetrating wound anywhere near the heart should be considered to have a cardiac injury. The penetrating cardiac traumas is a surgical emergency while the blunt injuries treatment consists mainly in observation. \u0000With early aggressive management only 1/3 of patient that arrive at hospital can be saved and this number can arise to more than 70 % if the patient survives until operating room. The results of treatment depend from infrastructural health system to the clinical presentation of the patients. Penetrating cardiac wounds mortality varies 5 % to 76 %. Blunt cardiac injuries are encountered mostly during motor vehicle accidents. The incidence of cardiac injuries in blunt trauma is 2.3-4.6 %. Overall mortality varies 11.4-24.5 %. Myocardial contusion is the most frequent type of blunt cardiac injuries. \u0000The diagnose of the cardiac trauma include: clinical assessment, physical examinations, chest radiographs, echocardiography, cardiac enzymes, ECG, CT scan and even chest drainage. Despite many diagnostic tools we have, it is very important the right management of these tools and the time. \u0000Conclusion: The surgery teams should be familiar with the management of the cardiac injuries and continuing education about this topic is the success key to manage better these emergencies. ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45080568","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}
Anil Reddy, Mohammad Fazelul Rahman Shoeb, S. Nasiruddin, H. M. Abhijith
Background: Patients with right lower abdominal pain in whom routine investigations and sonography are negative, is challenging to the surgeons. In many patient’s laparotomy is the only alternative.Laparoscopy is defined as the technique in which abdomino-pelvic cavity is visualized through small openings in the wall of abdomen through instruments. In patients with RIF pain, only diagnostic laparoscopy can be considered as the gold standard and provide correct diagnosis and concurrently may prove to be therapeutic Aim: The Aim of the study is to evaluate role of laparoscopy in right lower abdominal pain with uncertain diagnosis. Settings and Design: In this prospective study, patients with right lower abdominal pain with uncertain clinical diagnosis, USG abdomen and laboratorial investigation, coming to surgery OPD of our institute, over a period of 24 months were considered for Diagnostic Laparoscopy. Material and Methods: Diagnostic laparoscopy was performed in 174 patients. These patients presented with right lower abdominal pain and undergone investigations for the same. Results: Laparoscopy yielded positive findings in 170 (97.7%) of these patients. Appendicitis and gynaecological pathology, abdominal tuberculosis, were the major findings. Therapeutic procedures were performed in 165 patients (laparoscopically 158). There was only one complication in this series, in which patient developed surgical site infection on post-operative day 2. So, the patients who had remained as undiagnosed otherwise, were diagnosed and given appropriate treatment. Conclusion: This study establishes role of Diagnostic Laparoscopy as a safe and one of the most prolific investigative tools in undiagnosed right lower abdominal pain.
{"title":"Acquisition of Diagnostic Laparoscopy in undiagnosed Right Lower Abdominal Pain Patients.","authors":"Anil Reddy, Mohammad Fazelul Rahman Shoeb, S. Nasiruddin, H. M. Abhijith","doi":"10.32391/ajtes.v7i1.303","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.303","url":null,"abstract":"Background: Patients with right lower abdominal pain in whom routine investigations and sonography are negative, is challenging to the surgeons. In many patient’s laparotomy is the only alternative.Laparoscopy is defined as the technique in which abdomino-pelvic cavity is visualized through small openings in the wall of abdomen through instruments. In patients with RIF pain, only diagnostic laparoscopy can be considered as the gold standard and provide correct diagnosis and concurrently may prove to be therapeutic \u0000Aim: The Aim of the study is to evaluate role of laparoscopy in right lower abdominal pain with uncertain diagnosis. \u0000Settings and Design: In this prospective study, patients with right lower abdominal pain with uncertain clinical diagnosis, USG abdomen and laboratorial investigation, coming to surgery OPD of our institute, over a period of 24 months were considered for Diagnostic Laparoscopy. \u0000Material and Methods: Diagnostic laparoscopy was performed in 174 patients. These patients presented with right lower abdominal pain and undergone investigations for the same. \u0000Results: Laparoscopy yielded positive findings in 170 (97.7%) of these patients. Appendicitis and gynaecological pathology, abdominal tuberculosis, were the major findings. Therapeutic procedures were performed in 165 patients (laparoscopically 158). There was only one complication in this series, in which patient developed surgical site infection on post-operative day 2. So, the patients who had remained as undiagnosed otherwise, were diagnosed and given appropriate treatment. \u0000Conclusion: This study establishes role of Diagnostic Laparoscopy as a safe and one of the most prolific investigative tools in undiagnosed right lower abdominal pain.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45543131","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. Qyra, E. Puca, N. Çomo, A. Harxhi, A. Strakosha
Introduction; An increasing number of intravenous drug users are seen in now days. Intravenous drug users (IDUs) are a group of subjects who inject different drugs, generally in the extremities. This way of taking drugs, apart from leading to an addiction, on the other hand also serves as the possibility of taking or spreading infections. The aim of this paper is to provide a brief overview of IDUs patients, who were presented to the emergency department of the infectious diseases service, and required further hospitalization, during the period January 2012 - December 2015. Material and methods: The study is retrospective and was carried out in the emergency department of the infectious disease service and the infectious disease service as well. During the period January 2012 – December 2015, 26 patients were hospitalized in our hospital as IDUs. There were 20 male patients. The average age of the patients was 32 years. The main clinical symptoms were fever, dyspnea, chest pain, pain in the extremities, edema of the extremities, necrotic ulcers at the injection site, jaundice in the sclera, confusional state. The resulting diagnoses were viral infections (HIV/AIDS infection, viral hepatitis), septic conditions (endocarditis, fasciitis), skin infections (cellulitis, S. aureus infections), pulmonary infections. Conclusions: Viral, bacterial and fungal infectious diseases are quite frequent among the people of this community. This is related to the way of life (poor social economic conditions, poor hygiene), risky sexual behaviors and the use of syringes from one person to another. The screening of this community is important to prevent any infectious disease.
{"title":"Infections in Intravenous Drug Users in the Perspective of Infectious Emergencies","authors":"E. Qyra, E. Puca, N. Çomo, A. Harxhi, A. Strakosha","doi":"10.32391/ajtes.v7i1.299","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.299","url":null,"abstract":"Introduction; An increasing number of intravenous drug users are seen in now days. Intravenous drug users (IDUs) are a group of subjects who inject different drugs, generally in the extremities. This way of taking drugs, apart from leading to an addiction, on the other hand also serves as the possibility of taking or spreading infections. \u0000The aim of this paper is to provide a brief overview of IDUs patients, who were presented to the emergency department of the infectious diseases service, and required further hospitalization, during the period January 2012 - December 2015. \u0000Material and methods: The study is retrospective and was carried out in the emergency department of the infectious disease service and the infectious disease service as well. During the period January 2012 – December 2015, 26 patients were hospitalized in our hospital as IDUs. There were 20 male patients. The average age of the patients was 32 years. The main clinical symptoms were fever, dyspnea, chest pain, pain in the extremities, edema of the extremities, necrotic ulcers at the injection site, jaundice in the sclera, confusional state. The resulting diagnoses were viral infections (HIV/AIDS infection, viral hepatitis), septic conditions (endocarditis, fasciitis), skin infections (cellulitis, S. aureus infections), pulmonary infections. \u0000Conclusions: Viral, bacterial and fungal infectious diseases are quite frequent among the people of this community. This is related to the way of life (poor social economic conditions, poor hygiene), risky sexual behaviors and the use of syringes from one person to another. The screening of this community is important to prevent any infectious disease.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43507316","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}
The aim of this study is to evaluate the outcomes of the surgical treatment in patients with osteoporosis with moderate or severe hallux valgus regarding the correction of Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA) compared to non-osteoporotic patients. Materials and Methods: The timeline of the study was from 2015 to 2020 with 20 patients with the mean age of 61.6±4.1 within the osteoporotic group and 63.5±5.0 within the non-osteoporotic group. 12 osteotomies in osteoporotic patients and eight osteotomies in non-osteoporotic patients were seen at follow-up after 2 years after surgery. Preoperative bone density of T-Score 2.5 SD or more below is named osteoporosis and IMA and was used to define patient groups; mild hallux valgus was defined with IMA of 11-16 degrees, moderate hallux valgus was defined with IMA from 16 to twenty degrees, and severe hallux valgus was defined with IMA from 20 degrees or more. Results: No statistical differences were found in HVA, IMA and between the osteoporotic patients and non-osteoporotic patients preoperatively, postoperatively, and therefore the final follow-up in mild to moderate hallux valgus. The mean AOFAS score ameliorated from 52.6 preoperatively to 89.1. Regarding satisfaction, ~ 83 you look after patients were very satisfied or satisfied. No evidence of complications and every one of the patients resulted with complete union of the osteotomy. Conclusion: We believed that the surgical treatment is a safe, effective procedure for the correction of elderly patients with osteoporosis. In patients with moderate and severe hallux valgus the results of osteotomy have not any specific difference between the osteoporotic and non-osteoporotic groups
{"title":"Hallux Valgus in Osteoporosis.","authors":"J. Ruci, Eduart Gjika","doi":"10.32391/ajtes.v7i1.300","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.300","url":null,"abstract":"The aim of this study is to evaluate the outcomes of the surgical treatment in patients with osteoporosis with moderate or severe hallux valgus regarding the correction of Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA) compared to non-osteoporotic patients. \u0000Materials and Methods: The timeline of the study was from 2015 to 2020 with 20 patients with the mean age of 61.6±4.1 within the osteoporotic group and 63.5±5.0 within the non-osteoporotic group. 12 osteotomies in osteoporotic patients and eight osteotomies in non-osteoporotic patients were seen at follow-up after 2 years after surgery. Preoperative bone density of T-Score 2.5 SD or more below is named osteoporosis and IMA and was used to define patient groups; mild hallux valgus was defined with IMA of 11-16 degrees, moderate hallux valgus was defined with IMA from 16 to twenty degrees, and severe hallux valgus was defined with IMA from 20 degrees or more. \u0000Results: No statistical differences were found in HVA, IMA and between the osteoporotic patients and non-osteoporotic patients preoperatively, postoperatively, and therefore the final follow-up in mild to moderate hallux valgus. The mean AOFAS score ameliorated from 52.6 preoperatively to 89.1. Regarding satisfaction, ~ 83 you look after patients were very satisfied or satisfied. No evidence of complications and every one of the patients resulted with complete union of the osteotomy. \u0000Conclusion: We believed that the surgical treatment is a safe, effective procedure for the correction of elderly patients with osteoporosis. In patients with moderate and severe hallux valgus the results of osteotomy have not any specific difference between the osteoporotic and non-osteoporotic groups","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43898231","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}
M. Zeka, S. Kuçi, Blerim Arapi, A. Ibrahimi, Krenar Lilaj
Introduction: In open heart surgery such as Coronary artery Bypass Grafting, valve repair or replacement, or some congenital heart disease, patients are connected to the Cardiopulmonary bypass machine [1]. Cardiopulmonary bypass machine pumps the blood around the body while the heart is stopped and provides a bloodless field during cardiac surgery. Since an extracorporeal circuit is incorporated to the patient, there are observed abnormal physiological events during Cardiopulmonary bypass. These events include hemodilution, interstitial fluid accumulation, complement activation and depression of immune system. Cardiopulmonary bypass is associated with an acute phase reaction of protease cascades, leucocyte, and platelet activation that result in tissue injury [2, 3] and limited functional reserve. For many years was believed that Cardiopulmonary bypass under hypothermia is much safer. The main reason for “cooling body” is to protect the brain, heart and organs during cardiopulmonary bypass through reducing body metabolic rate [4]. During more recent years, according to many studies, it is shown that Cardiopulmonary bypass under Normothermia has much more advantages compared to Moderate Hypothermia. The aim of this study was to compare and examine which method has advantages in terms of clinical outcome, morbidity and mortality. Patients and methods. 60 patients were selected, who were scheduled for Coronary artery Bypass Grafting x 3, were enrolled in this study. Results: According to the primary variables (Troponin I, Lactic Acid) and also secondary variables of our study, resulted that Cardiopulmonary bypass in Normothermia has superiority compare to Moderate Hypothermia in patients that underwent Coronary artery Bypass Grafting. Conclusion: According to our data and literature [15, 16, 17], we concluded that Cardiopulmonary bypass in Coronary artery Bypass Grafting under Normothermia has advantages vs Moderate Hypothermia and Troponin I and Lactic Acid are very good biomarkers that show us if heart and organs perfusion/protection is adequate during this procedure.
{"title":"Troponin I, and Lactic Acid variations, during Cardiopulmonary Bypass under Moderate Hypothermia vs Normothermia.","authors":"M. Zeka, S. Kuçi, Blerim Arapi, A. Ibrahimi, Krenar Lilaj","doi":"10.32391/ajtes.v7i1.308","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.308","url":null,"abstract":"Introduction: In open heart surgery such as Coronary artery Bypass Grafting, valve repair or replacement, or some congenital heart disease, patients are connected to the Cardiopulmonary bypass machine [1]. Cardiopulmonary bypass machine pumps the blood around the body while the heart is stopped and provides a bloodless field during cardiac surgery. Since an extracorporeal circuit is incorporated to the patient, there are observed abnormal physiological events during Cardiopulmonary bypass. These events include hemodilution, interstitial fluid accumulation, complement activation and depression of immune system. Cardiopulmonary bypass is associated with an acute phase reaction of protease cascades, leucocyte, and platelet activation that result in tissue injury [2, 3] and limited functional reserve. For many years was believed that Cardiopulmonary bypass under hypothermia is much safer. The main reason for “cooling body” is to protect the brain, heart and organs during cardiopulmonary bypass through reducing body metabolic rate [4]. During more recent years, according to many studies, it is shown that Cardiopulmonary bypass under Normothermia has much more advantages compared to Moderate Hypothermia. \u0000The aim of this study was to compare and examine which method has advantages in terms of clinical outcome, morbidity and mortality. \u0000Patients and methods. 60 patients were selected, who were scheduled for Coronary artery Bypass Grafting x 3, were enrolled in this study. \u0000Results: According to the primary variables (Troponin I, Lactic Acid) and also secondary variables of our study, resulted that Cardiopulmonary bypass in Normothermia has superiority compare to Moderate Hypothermia in patients that underwent Coronary artery Bypass Grafting. \u0000Conclusion: According to our data and literature [15, 16, 17], we concluded that Cardiopulmonary bypass in Coronary artery Bypass Grafting under Normothermia has advantages vs Moderate Hypothermia and Troponin I and Lactic Acid are very good biomarkers that show us if heart and organs perfusion/protection is adequate during this procedure.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46617805","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}
The eye is an important component of facial aesthetics and blepharoplasty can play a vital role in facial harmonization and aging process. Regeneration of the periorbital area has always been a focus of plastic surgeons and especially facial surgeons. Dermatochalasis mostly found in older patients is characterized by excess eyelid skin. Hooded eyelids are the most common concern among patients interested in blepharoplasty. Blepharoplasty alone or combined with other cosmetic surgeries such as brow lifting or facial lifting or other facial and skin rejuvenation represents the best approach in these cases for optimal results. The key to a successful eyelid surgery is a careful analysis of the face, a carefully conceived surgical plan and meticulous operative technique.
{"title":"The Importance of Counseling, Planning and Choosing the Proper Surgical Technique for optimal Results in the upper Face.","authors":"V. Filaj, M. Fida, Erisa Kola, I. Kola","doi":"10.32391/ajtes.v7i1.322","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.322","url":null,"abstract":"The eye is an important component of facial aesthetics and blepharoplasty can play a vital role in facial harmonization and aging process. Regeneration of the periorbital area has always been a focus of plastic surgeons and especially facial surgeons. Dermatochalasis mostly found in older patients is characterized by excess eyelid skin. Hooded eyelids are the most common concern among patients interested in blepharoplasty. Blepharoplasty alone or combined with other cosmetic surgeries such as brow lifting or facial lifting or other facial and skin rejuvenation represents the best approach in these cases for optimal results. The key to a successful eyelid surgery is a careful analysis of the face, a carefully conceived surgical plan and meticulous operative technique.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46876986","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}
Mustafa Bajraktari, Blerim Arapi, G. Huti, Asead Abdyli, R. Domi
Background: Maternal hypotension is an unwanted consequence of the physiologic onset of spinal blockade, and causes both maternal and fetal effects. Maternal symptoms include nausea, vomiting, and a sense of ‘‘impending doom’’ from inadequate cerebral perfusion. Inadequate treatment of hypotension can ultimately end with the loss of consciousness and cardiovascular collapse. Materials and methods: We included 80 full term parturient (ASA I or II) with uncomplicated pregnancies. The patients were prospectively randomized into two groups. 80 patients received 1000 mL NaCl 0,9 % solution before the initiation of spinal anesthesia. Maternal systolic blood pressure was measured every 1 minutes (for first 10 minutes) and then every 3 minutes. One group received ephedrine infusion (1 mg/min) with rescue ephedrine boluses (10 mg), (usually defined as a maternal blood pressure ˂ 30% above baseline), (40 patients) and the other received rescue boluses alone (10 mg) , (usually defined as a maternal blood pressure ˂ 30% above baseline), (40 patients). Results: Gr 1 (Ephedrine infusion with rescue ephedrine boluses). The incidence of hypotension was at 8 patients (8/40 [20%]),(when an absolute value of less than 90 mmHg). Gr 2 (rescue boluses ephedrine alone). The incidence of hypotension was at 32 patients (32/40 [80%]), (when an absolute value of less than 90 mmHg). Group 2 had a higher incidence of hypotension compared with group 1 (32/40 [80%]) vs (8/40 [20%]). Neonatal outcomes were not different between the 2 groups. Conclusion: Prophylactic variable rate ephedrine infusion and rescue ephedrine bolus dosing is more effective than relying on rescue ephedrine bolus dosing with respect to limiting clinician workload and maternal symptoms during spinal anesthesia for cesarean delivery.Maternal hypotension
背景:母体低血压是脊髓阻滞生理性发作的不良后果，并引起母体和胎儿的影响。产妇的症状包括恶心、呕吐和脑灌注不足造成的“末日来临”感。对低血压治疗不当最终会导致意识丧失和心血管衰竭。材料和方法:我们纳入了80例无并发症妊娠的足月产妇(ASA I或II)。这些患者被前瞻性地随机分为两组。80例患者在开始脊髓麻醉前给予1000 mL NaCl 0.9%溶液。产妇收缩压每1分钟测量一次(前10分钟)，然后每3分钟测量一次。一组患者接受麻黄碱输注(1mg /min)，同时给予麻黄碱救援丸(10mg)(通常定义为孕妇血压比基线高小于30%)，(40例);另一组患者单独接受麻黄碱救援丸(10mg)(通常定义为孕妇血压比基线高小于30%)，(40例)。结果:Gr 1(麻黄碱输注配合抢救麻黄碱丸)。低血压发生率为8例(8/40[20%])，(当绝对值小于90 mmHg时)。第2组(单独使用麻黄碱)。低血压发生率为32例(32/40[80%])，(当绝对值小于90 mmHg时)。2组低血压发生率高于1组(32/40 [80%]vs(8/40[20%])。两组新生儿结局无差异。结论:在限制剖宫产腰麻期间临床医生工作量和产妇症状方面，预防性麻黄素可变速率输注和救援麻黄素小丸比依赖救援麻黄素小丸更有效。产妇低血压
{"title":"Ephedrine Infusion with Rescue Ephedrine Boluses versus Rescue Boluses alone for Preventing Hypotension during Spinal Anesthesia for Cesarean Delivery.","authors":"Mustafa Bajraktari, Blerim Arapi, G. Huti, Asead Abdyli, R. Domi","doi":"10.32391/ajtes.v7i1.315","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.315","url":null,"abstract":"Background: Maternal hypotension is an unwanted consequence of the physiologic onset of spinal blockade, and causes both maternal and fetal effects. Maternal symptoms include nausea, vomiting, and a sense of ‘‘impending doom’’ from inadequate cerebral perfusion. Inadequate treatment of hypotension can ultimately end with the loss of consciousness and cardiovascular collapse. \u0000Materials and methods: We included 80 full term parturient (ASA I or II) with uncomplicated pregnancies. The patients were prospectively randomized into two groups. 80 patients received 1000 mL NaCl 0,9 % solution before the initiation of spinal anesthesia. Maternal systolic blood pressure was measured every 1 minutes (for first 10 minutes) and then every 3 minutes. One group received ephedrine infusion (1 mg/min) with rescue ephedrine boluses (10 mg), (usually defined as a maternal blood pressure ˂ 30% above baseline), (40 patients) and the other received rescue boluses alone (10 mg) , (usually defined as a maternal blood pressure ˂ 30% above baseline), (40 patients). \u0000Results: Gr 1 (Ephedrine infusion with rescue ephedrine boluses). The incidence of hypotension was at 8 patients (8/40 [20%]),(when an absolute value of less than 90 mmHg). \u0000Gr 2 (rescue boluses ephedrine alone). The incidence of hypotension was at 32 patients (32/40 [80%]), (when an absolute value of less than 90 mmHg). \u0000Group 2 had a higher incidence of hypotension compared with group 1 (32/40 [80%]) vs (8/40 [20%]). \u0000Neonatal outcomes were not different between the 2 groups. \u0000Conclusion: Prophylactic variable rate ephedrine infusion and rescue ephedrine bolus dosing is more effective than relying on rescue ephedrine bolus dosing with respect to limiting clinician workload and maternal symptoms during spinal anesthesia for cesarean delivery.Maternal hypotension","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45961058","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}
A. Seferi, Florian Dashi, Ejona Lilamani, Livia Seferi, A. Rroji, R. Alimehmeti
Introduction; Epilepsy is one of the most common neurological chronic disorders, with an estimated prevalence of 0. 5 – 1%. Partial focal epilepsy (PE) is one of the most common types of epilepsies that originates from a relatively limited number of neurons, whose malfunction generates epileptic attacks. Partial focal epilepsies make up 60% of the whole spectrum of epilepsies. Recent studies show that 25% of patient who suffer from PE show a resistance against medication. The duration of symptoms on the one hand and AED treatment on the other hand cause the cognitive dysfunctions in the patients suffering from epileptic seizures, especially children, to suffer progressive damage. Patients suffering from epilepsy have a cost that at the moment is difficult to calculate accurately, but it is still very high. Mesial Temporal lobe seizures are the most common form of partial epileptic seizures originating in the temporal lobe, and they are frequently resistant to anti-epileptic drug treatment. Materials and Methods, At Neurosurgical Department, University Hospital “Mother Theresa”, since 2013 there is a team consisting of different medical specialists, for the study and selection of candidates, who can benefit from surgery. At the same time, since many years now in neurological department there is already a successful tradition in the medicament treatment of epilepsy. The team of medical doctors in our Department, which makes the treatment of these diseases by means of surgery, is made up of: neuro-epileptologist, radiologists, neurologists, psychologists and neurosurgeons. During the period, from 2013 until the year 2021, 35 patients have undergone an operation. All the patients were considered, based on protocols, as pharmacoresistant. Conclusions; The post-surgical results were 80% of the patient’s seizure free and without need to use any antiepileptic treatment, meaning Engel 1. 15% of the patients were seizure free but with the need of antiepileptic treatment and meaning Engel 2 and 5% of patients were not able to be cured by achieving only a modification of the semiology of the crisis and frequency, meaning Engel 3. Anterior temporal lobectomy in majority of the cases is the best surgical treatment of drug-resistant HS-TLE and long-term seizure free patients in this group have been reported about 70% (62-83%).
{"title":"Surgical Treatment for mesial Temporal Lobe Epilepsy Associated with Hippocampal Sclerosis. Our Experience.","authors":"A. Seferi, Florian Dashi, Ejona Lilamani, Livia Seferi, A. Rroji, R. Alimehmeti","doi":"10.32391/ajtes.v7i1.311","DOIUrl":"https://doi.org/10.32391/ajtes.v7i1.311","url":null,"abstract":"Introduction; Epilepsy is one of the most common neurological chronic disorders, with an estimated prevalence of 0. 5 – 1%. Partial focal epilepsy (PE) is one of the most common types of epilepsies that originates from a relatively limited number of neurons, whose malfunction generates epileptic attacks. Partial focal epilepsies make up 60% of the whole spectrum of epilepsies. Recent studies show that 25% of patient who suffer from PE show a resistance against medication. The duration of symptoms on the one hand and AED treatment on the other hand cause the cognitive dysfunctions in the patients suffering from epileptic seizures, especially children, to suffer progressive damage. Patients suffering from epilepsy have a cost that at the moment is difficult to calculate accurately, but it is still very high. Mesial Temporal lobe seizures are the most common form of partial epileptic seizures originating in the temporal lobe, and they are frequently resistant to anti-epileptic drug treatment. \u0000Materials and Methods, At Neurosurgical Department, University Hospital “Mother Theresa”, since 2013 there is a team consisting of different medical specialists, for the study and selection of candidates, who can benefit from surgery. At the same time, since many years now in neurological department there is already a successful tradition in the medicament treatment of epilepsy. \u0000The team of medical doctors in our Department, which makes the treatment of these diseases by means of surgery, is made up of: neuro-epileptologist, radiologists, neurologists, psychologists and neurosurgeons. \u0000During the period, from 2013 until the year 2021, 35 patients have undergone an operation. All the patients were considered, based on protocols, as pharmacoresistant. \u0000Conclusions; The post-surgical results were 80% of the patient’s seizure free and without need to use any antiepileptic treatment, meaning Engel 1. 15% of the patients were seizure free but with the need of antiepileptic treatment and meaning Engel 2 and 5% of patients were not able to be cured by achieving only a modification of the semiology of the crisis and frequency, meaning Engel 3. \u0000Anterior temporal lobectomy in majority of the cases is the best surgical treatment of drug-resistant HS-TLE and long-term seizure free patients in this group have been reported about 70% (62-83%).","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47133993","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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