Gang Yang, Junjie Lv, Shaojun Yang, Chao Gu, Chenbing Wang, Lulu Weng, F. Ding
Objective: This study is to discuss CT performances and direct surgical strategy as well as therapeutic effect of patients who have rupture hemorrhage of intracranial anterior circulation aneurysm with complications of intracranial hematoma and cerebral hernia. Methods: CT performances and treatment of 14 patients who have rupture hemorrhage of intracranial anterior circulation aneurysm with complications of intracranial hematoma and cerebral hernia in our hospital from March, 2019 to March, 2021 were reviewed. The relationship between hematoma caused by intracranial anterior circulation aneurysm and position of the aneurysm was analyzed. Besides, surgical processing keys were discussed. Results: For all selected patients, intracranial hemorrhage is proved to be caused by rupture of aneurysm. Among them, there are 2 cases of anterior communicating aneurysms, 3 cases of posterior communicating aneurysms, and 9 cases of middle cerebral aneurysms. According to exploration, we found 1 case of multiple aneurysm, which is the combination of a middle cerebral aneurysm (the responsible aneurysm) and ipsilateral posterior communicating aneurysm. There were two cases of intraoperative rupture. In this study, 3 patients died. According to GOS grading at 3 months after the operation, there were 1 case of V-grade (good recovery), 3 cases of IV-grade (self-maintenance), 5 cases of III-grade (severe disabled), 2 cases of II-grade (persistent vegetative state) and 3 cases of I-grade (died). Conclusions: Emergency microsurgical treatment can lower the death rate of cerebral hernia caused by intracranial anterior circulation aneurysm with intracranial hematoma and recover the neurological functions to the maximum extent.
{"title":"Analysis on Emergency Microsurgical Treatment for Cerebral Hernia Caused by Intracranial Anterior Circulation Aneurysm with Intracranial Hematoma","authors":"Gang Yang, Junjie Lv, Shaojun Yang, Chao Gu, Chenbing Wang, Lulu Weng, F. Ding","doi":"10.4236/ojem.2021.93007","DOIUrl":"https://doi.org/10.4236/ojem.2021.93007","url":null,"abstract":"Objective: This study is to discuss CT performances and direct surgical strategy as \u0000well as therapeutic effect of patients who have rupture hemorrhage of \u0000intracranial anterior circulation aneurysm with complications of intracranial \u0000hematoma and cerebral hernia. Methods: CT performances and treatment of 14 \u0000patients who have rupture hemorrhage of intracranial anterior circulation \u0000aneurysm with complications of intracranial hematoma and cerebral hernia in our \u0000hospital from March, 2019 to March, 2021 were reviewed. The relationship between \u0000hematoma caused by intracranial anterior circulation aneurysm and position of the \u0000aneurysm was analyzed. Besides, surgical processing \u0000keys were discussed. Results: For all selected patients, \u0000intracranial hemorrhage is proved to be caused by rupture of aneurysm. Among them, \u0000there are 2 cases of anterior communicating aneurysms, 3 cases of posterior communicating \u0000aneurysms, and 9 cases of middle cerebral aneurysms. According to exploration, we found 1 case of multiple aneurysm, which \u0000is the combination of a middle cerebral aneurysm (the responsible aneurysm) and \u0000ipsilateral posterior communicating aneurysm. There were two cases of intraoperative \u0000rupture. In this study, 3 patients died. According to GOS grading at 3 months after \u0000the operation, there were 1 case of V-grade (good recovery), 3 cases of IV-grade \u0000(self-maintenance), 5 cases of III-grade (severe disabled), 2 cases of II-grade \u0000(persistent vegetative state) and 3 cases of I-grade (died). Conclusions: \u0000Emergency microsurgical treatment can lower the \u0000death rate of cerebral hernia caused by intracranial anterior circulation \u0000aneurysm with intracranial hematoma and recover the neurological functions to the \u0000maximum extent.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44780150","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}
O. Markovic, A. Divac, F. Lukic, D. Mrda, A. Vidović, M. Zdravković, B. Tošković
Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially poor medical outcome. In most cases, SRS is caused by neoplastic disorder. Acute promyelocytic leukaemia is a rare but important cause of SRS that physicians are required to assess for. We present a 28-year-old woman with APL and COVID-19 pneumonia, who successfully underwent embolisation of the splenic artery for spontaneously occurring splenic rupture during induction chemotherapy. After the intervention the patient completed induction chemotherapy and achieved complete remission. Our case demonstrates that emergent transcatheter arterial embolisation can be lifesaving even in the unfavourable condition of a patient with severe immune deficiency.
{"title":"Successful Treatment of Spontaneous Rupture of the Spleen by Embolization of Splenic Artery in a Patient with Acute Promyelocytic Leukaemia and COVID-19 Infection","authors":"O. Markovic, A. Divac, F. Lukic, D. Mrda, A. Vidović, M. Zdravković, B. Tošković","doi":"10.4236/ojem.2021.93008","DOIUrl":"https://doi.org/10.4236/ojem.2021.93008","url":null,"abstract":"Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially \u0000poor medical outcome. In most cases, SRS is caused by neoplastic disorder. Acute \u0000promyelocytic leukaemia is a rare but important cause of SRS that physicians are \u0000required to assess for. We present a 28-year-old woman with APL and COVID-19 pneumonia, \u0000who successfully underwent embolisation of the splenic artery for spontaneously \u0000occurring splenic rupture during induction chemotherapy. After the intervention \u0000the patient completed induction chemotherapy and achieved complete remission. Our \u0000case demonstrates that emergent transcatheter arterial embolisation can be lifesaving \u0000even in the unfavourable condition of a patient with severe immune deficiency.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44428611","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 capacity of a cold atmospheric-pressure air plasma (CAAP) device for advanced first aid is presented. Using swine as an animal model, two trials: 1) a large, curved cut in hindquarters area and 2) amputation of a front leg, were performed. Cold atmospheric-pressure air plasma effluent, which carries reactive oxygen species (ROS) atomic oxygen (OI), is applied for wound treatments. Swift hemostasis of the wounds by the CAAP treatment was demonstrated. The pressure applied by a finger on the cut arteries in trial 1 and the tourniquet applied in trial 2 could be removed immediately after the treatment and there was no re-bleed in both cases. CAAP hemostasis mechanism was explored via in-vitro tests. The tests on sodium citrate mixed blood-droplet samples show that 1) the heat delivered by the CAAP has no impact on the observed clot formation, 2) plasma effluent activates platelets to promote coagulation state and cascade, and 3) the degree of clotting increases with the total amount of applied OI by means of the CAAP effluent. It took only 16 s of the CAAP treatment to reach full clotting, which was considerably shortened from the natural clotting time of about 25 minutes. The tests on smeared blood samples show that the reduction of the platelet count and the increase of RBC count are proportional to the amount of applied OI. A plausible CAAP hemostasis mechanism is concluded from the in vitro test results and the animal model trials.
{"title":"Hemostasis Efficacy and Mechanism of Cold Atmospheric Air Plasma","authors":"S. Kuo","doi":"10.4236/ojem.2021.93009","DOIUrl":"https://doi.org/10.4236/ojem.2021.93009","url":null,"abstract":"The capacity of a cold atmospheric-pressure air \u0000plasma (CAAP) device for advanced first aid is presented. Using swine as an animal model, two trials: 1) a large, curved cut in hindquarters area and \u00002) amputation of a front leg, were performed. \u0000Cold atmospheric-pressure air plasma effluent, which carries reactive \u0000oxygen species (ROS) atomic oxygen (OI), is applied for wound treatments. Swift \u0000hemostasis of the wounds by the CAAP treatment was demonstrated. The pressure \u0000applied by a finger on the cut arteries in trial 1 and the tourniquet applied \u0000in trial 2 could be removed immediately after the treatment and there was no \u0000re-bleed in both cases. CAAP hemostasis mechanism was explored via in-vitro tests. The tests \u0000on sodium citrate mixed blood-droplet samples show that 1) the heat \u0000delivered by the CAAP has no impact on the observed clot formation, 2) plasma effluent \u0000activates platelets to promote coagulation state and cascade, and 3) the degree \u0000of clotting increases with the total amount of applied OI by means of the CAAP \u0000effluent. It took only 16 s of the CAAP \u0000treatment to reach full clotting, which was considerably shortened from the natural clotting time of about 25 \u0000minutes. The tests on smeared blood samples show that the reduction of \u0000the platelet count and the increase of RBC count are proportional to the amount \u0000of applied OI. A plausible CAAP hemostasis mechanism is concluded from the in \u0000vitro test results and the animal model trials.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41861981","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}
Objective: The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. Methods: This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. Results: Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. Conclusions: The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.
{"title":"Study on the Treatment Strategy of Batches of the Wounded and Partial First-Aid Procedures in Public Emergencies in Tertiary General Hospitals","authors":"Chenyu Wang, Xiantao Huang, X. Zhao, Limin Pan, Yu-ling Jia, Tian Tian, Lijun Gao","doi":"10.4236/OJEM.2021.92004","DOIUrl":"https://doi.org/10.4236/OJEM.2021.92004","url":null,"abstract":"Objective: The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. Methods: This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. Results: Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. Conclusions: The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47460735","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}
Hyponatremia is a severe electrolyte disturbance associated with substantial morbidity and mortality. It often poses a diagnostic and therapeutic challenge. Accurate assessment of patient fluid-volume status is central to effective management. This pilot study aimed to evaluate the usefulness of the Cheetah NICOM bioreactance system and apelin in early differentiation between hypo- and euvolemia in patients with severe hyponatremia. Methods: Patients > 50 years of age with a serum sodium ≤ 125 mmol/L were eligible for inclusion after written informed consent. Blood- and urine analyses of cardiovascular load (NT-proBNP), osmotic stress (copeptin, apelin, osmolality, sodium), mineralocorticoid status (aldosterone, renin) and sympathetic activity (methoxycathecholamines) were analysed at baseline and after isotonic sodium chloride infusion. Bedside bioreactance examination was used to visualise parameters, including stroke volume before and after passive leg raise test. Classification of volume status was made retrospectively blinded for biomarker and bioreactance results. Results: 8 patients (4 hypovolemic and 4 euvolemic), 79 years old, median plasma sodium 120 mmol/L were included. At the Emergency Department volume status was misclassified in all hypo- and in 2 of 4 euvolemic patients. Apelin was significantly higher in hypovolemic patients ((299 vs. 175 ng/ml), p = 0.021). All hypovolemic, but none of the euvolemic, patients had a level above 250 ng/ml. Copeptin did not differ between groups. All patients in the hypovolemic group increased their stroke volume after passive leg raise. Conclusions: Apelin seems to be a promising future biomarker in the early management of severe hyponatremia. Bioreactance measurements may offer a supplement to bedside evaluation of volume status.
{"title":"Bioreactance and Apelin in the Management of Severe Hyponatremia","authors":"K. Olsson, M. Löndahl, O. Melander, P. Katzman","doi":"10.4236/OJEM.2021.91001","DOIUrl":"https://doi.org/10.4236/OJEM.2021.91001","url":null,"abstract":"Hyponatremia is a severe electrolyte disturbance associated with substantial morbidity and mortality. It often poses a diagnostic and therapeutic challenge. Accurate assessment of patient fluid-volume status is central to effective management. This pilot study aimed to evaluate the usefulness of the Cheetah NICOM bioreactance system and apelin in early differentiation between hypo- and euvolemia in patients with severe hyponatremia. Methods: Patients > 50 years of age with a serum sodium ≤ 125 mmol/L were eligible for inclusion after written informed consent. Blood- and urine analyses of cardiovascular load (NT-proBNP), osmotic stress (copeptin, apelin, osmolality, sodium), mineralocorticoid status (aldosterone, renin) and sympathetic activity (methoxycathecholamines) were analysed at baseline and after isotonic sodium chloride infusion. Bedside bioreactance examination was used to visualise parameters, including stroke volume before and after passive leg raise test. Classification of volume status was made retrospectively blinded for biomarker and bioreactance results. Results: 8 patients (4 hypovolemic and 4 euvolemic), 79 years old, median plasma sodium 120 mmol/L were included. At the Emergency Department volume status was misclassified in all hypo- and in 2 of 4 euvolemic patients. Apelin was significantly higher in hypovolemic patients ((299 vs. 175 ng/ml), p = 0.021). All hypovolemic, but none of the euvolemic, patients had a level above 250 ng/ml. Copeptin did not differ between groups. All patients in the hypovolemic group increased their stroke volume after passive leg raise. Conclusions: Apelin seems to be a promising future biomarker in the early management of severe hyponatremia. Bioreactance measurements may offer a supplement to bedside evaluation of volume status.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43539802","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}
Jovana Lalatović, Jelena Golubović, Matija Miljević, F. Lukic, Sandra Jeličić, Nemanja Kraišnik, Aleksandra Aleksić, Z. Kalaba, B. Vidović, B. Tošković, Bogdan Crnokrak, Jovana Mrda, M. Zdravković, D. Mrda
Retroperitoneal hemorrhage is a possible complication that has been noticed in COVID-19 patients on anticoagulant therapy. The data related to treatment and outcomes in this condition are scarce. We present a case series of four COVID-19 patients with lumbar artery bleeding, who were treated with transcatheter arterial embolization using embolization particles. The procedure was executed without any complications, and hemostasis was achieved in all four patients. Despite the patients survived the procedure, one patient died due to respiratory failure three weeks after the procedure, and one died due to hypovolemic shock two days later. Considering the ongoing state of COVID-19 pandemic, it is essential to be aware of transcatheter arterial embolization as a safe and effective procedure for treating retroperitoneal hemorrhage in COVID-19 patients.
{"title":"Transcatheter Arterial Embolization as a Treatment for Life-Threatening Retroperitoneal Hemorrhage in COVID-19 Patients on Anticoagulant Therapy","authors":"Jovana Lalatović, Jelena Golubović, Matija Miljević, F. Lukic, Sandra Jeličić, Nemanja Kraišnik, Aleksandra Aleksić, Z. Kalaba, B. Vidović, B. Tošković, Bogdan Crnokrak, Jovana Mrda, M. Zdravković, D. Mrda","doi":"10.4236/ojem.2021.94021","DOIUrl":"https://doi.org/10.4236/ojem.2021.94021","url":null,"abstract":"Retroperitoneal hemorrhage is a possible complication that has been noticed in COVID-19 patients on anticoagulant therapy. The data related to treatment and outcomes in this condition are scarce. We present a case series of four COVID-19 patients with lumbar artery bleeding, who were treated with transcatheter arterial embolization using embolization particles. The procedure was executed without any complications, and hemostasis was achieved in all four patients. Despite the patients survived the procedure, one patient died due to respiratory failure three weeks after the procedure, and one died due to hypovolemic shock two days later. Considering the ongoing state of COVID-19 pandemic, it is essential to be aware of transcatheter arterial embolization as a safe and effective procedure for treating retroperitoneal hemorrhage in COVID-19 patients.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627547","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}
Chang Lv, Xurui Li, Zhichao Ma, Cuiyan Wang, Jianguo Li
Objective: To use the etiology list of abdominal pain to help identify acute abdominal pain. Methods: to design a list of causes of acute abdominal pain as per the concept of system thinking, determine the five differential diagnosis directions of “local organ disease, adjacent organ disease, systemic disease, psychogenic disease, and female reproductive system disease”, and elaborate the application effect of the checklist in the diagnosis of acute abdominal pain by virtue of the analysis of one case of acute abdominal pain. Results: according to the list of causes of abdominal pain, the causes of acute abdominal pain were screened, and patients suffering from acute renal infarction (ARI) who presented with simple abdominal pain were diagnosed and treated timely. Conclusion: the etiology list is helpful to guide the diagnosis direction of acute abdominal pain, and make a rapid clinical diagnosis, so as to form a systematic thinking mode.
{"title":"Application of Etiology List in Differential Diagnosis of Acute Abdominal Pain#","authors":"Chang Lv, Xurui Li, Zhichao Ma, Cuiyan Wang, Jianguo Li","doi":"10.4236/OJEM.2021.92006","DOIUrl":"https://doi.org/10.4236/OJEM.2021.92006","url":null,"abstract":"Objective: To use the etiology list of abdominal pain to help identify acute abdominal pain. Methods: to design a list of causes of acute abdominal pain as per the concept of system thinking, determine the five differential diagnosis directions of “local organ disease, adjacent organ disease, systemic disease, psychogenic disease, and female reproductive system disease”, and elaborate the application effect of the checklist in the diagnosis of acute abdominal pain by virtue of the analysis of one case of acute abdominal pain. Results: according to the list of causes of abdominal pain, the causes of acute abdominal pain were screened, and patients suffering from acute renal infarction (ARI) who presented with simple abdominal pain were diagnosed and treated timely. Conclusion: the etiology list is helpful to guide the diagnosis direction of acute abdominal pain, and make a rapid clinical diagnosis, so as to form a systematic thinking mode.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627686","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}
{"title":"Fever Outpatient Service of General Hospital Applies “1 + 3 + 3” Emergency Management Mode to Deal with COVID-19 Pandemic","authors":"Mei Zhang, Wen Yang","doi":"10.4236/ojem.2021.93011","DOIUrl":"https://doi.org/10.4236/ojem.2021.93011","url":null,"abstract":"","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627750","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}
{"title":"Perception of Effects of Shiftwork Questionnaire (PESQ) among Ambulance Service Staff in Saudi Arabia: An Exploratory Factor Analysis","authors":"Fawaz Albishri, L. Zamzami","doi":"10.4236/ojem.2021.93012","DOIUrl":"https://doi.org/10.4236/ojem.2021.93012","url":null,"abstract":"","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627784","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}
Context and Objectives: Acute coronary syndromes (ACS) constitute a major medical emergency. In Senegal, outside the capital Dakar, there is a lack of appropriate care structures. The objective of this work was to study the ACS treatment in the city of Ziguinchor. Methodology: This was a retrospective study of acute coronary syndromes’ cases admitted to the two-level two hos-pitals in the city of Ziguinchor from January 1, 2016 to December 31, 2019. We included all patients with acute angina pain at rest and/or electrocardiographic changes in at least two contiguous leads. The data were analysed using sphinx V5 software. Results: 57 cases were collected. The average age was 60.1 ± 14.1 years. There was a male predominance with a sex ratio of 3.7. The majority of patients arrived at the hospital by unsafe delivery (70.5%). Symptomatology was dominated by typical angina pain (50.8%). On the electro-cardiogram, a majority of acute coronary syndromes with ST segment shift were observed (70.2%). Doppler echocardiography found abnormalities in segmental kinetics in 69.8% of cases. The troponin dosage was performed in 7 patients, i.e. 12.3%. The average time of treatment was 3.4 ± 4.5 days. Medical treatment remained standard and no patient was thrombosed. The average hospitalization period was 5 ± 3.2 days. The hospital lethality was 7.2%. Conclusion: Acute coronary syndromes constitute a medical emergency. Diagnostic and therapeutic means are lacking in a city like Ziguinchor, hence the importance of good prevention.
{"title":"Acute Coronary Syndromes in Semi-Urban African Areas: Clinical Aspects and Management in Ziguinchor (Senegal)","authors":"S. Manga, Mame Diarra Mbaye, S. Sy, Q. T. Indafa","doi":"10.4236/ojem.2021.94018","DOIUrl":"https://doi.org/10.4236/ojem.2021.94018","url":null,"abstract":"Context and Objectives: Acute coronary syndromes (ACS) constitute a major medical emergency. In Senegal, outside the capital Dakar, there is a lack of appropriate care structures. The objective of this work was to study the ACS treatment in the city of Ziguinchor. Methodology: This was a retrospective study of acute coronary syndromes’ cases admitted to the two-level two hos-pitals in the city of Ziguinchor from January 1, 2016 to December 31, 2019. We included all patients with acute angina pain at rest and/or electrocardiographic changes in at least two contiguous leads. The data were analysed using sphinx V5 software. Results: 57 cases were collected. The average age was 60.1 ± 14.1 years. There was a male predominance with a sex ratio of 3.7. The majority of patients arrived at the hospital by unsafe delivery (70.5%). Symptomatology was dominated by typical angina pain (50.8%). On the electro-cardiogram, a majority of acute coronary syndromes with ST segment shift were observed (70.2%). Doppler echocardiography found abnormalities in segmental kinetics in 69.8% of cases. The troponin dosage was performed in 7 patients, i.e. 12.3%. The average time of treatment was 3.4 ± 4.5 days. Medical treatment remained standard and no patient was thrombosed. The average hospitalization period was 5 ± 3.2 days. The hospital lethality was 7.2%. Conclusion: Acute coronary syndromes constitute a medical emergency. Diagnostic and therapeutic means are lacking in a city like Ziguinchor, hence the importance of good prevention.","PeriodicalId":57857,"journal":{"name":"急诊医学(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70627438","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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