Although the development of the 2009 Sp A classification criteria by Assessment of Spondylo Arthritis international Society（ASAS） represents an important step towards a better definition of the early disease stage p...Although the development of the 2009 Sp A classification criteria by Assessment of Spondylo Arthritis international Society（ASAS） represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis（ax Sp A）, the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including Sp A. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having ax Sp A in central China. The results showed that clinical manifestations of ax Sp A could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from ax Sp A according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.展开更多
Background The burden of perioperative complications following pediatric surgery in sub-Saharan Africa is high.Assessment of the patterns and determinants of such complications and their relationship to perioperative ...Background The burden of perioperative complications following pediatric surgery in sub-Saharan Africa is high.Assessment of the patterns and determinants of such complications and their relationship to perioperative mortality are important in identifying indicators of poor outcomes.In this study,we aim to define predictors of perioperative mortality at a tertiary hospital in Nigeria.Methods This was a retrospective review of medical records between January 2014 and December 2023.We included patients aged 15 years and below,who had general pediatric,oncological or urological surgery under general anesthesia.Information extracted included biodata,diagnosis,American Society of Anesthesiology(ASA)classification of physical status,time of death after surgery,cause of death,and duration of surgery.Data were processed using univariate and multivariate statistical analysis.Results A total of 1621 patients were analyzed.The 30-day perioperative mortality rate was 2.96%(296 per 10000 patients).Jejuno-ileal atresia,gastrochisis,and bladder exstrophy were associated with the highest mortality rates,well above 50%.Logistic regression identified neonatal age,ASA class greater than II,prolonged surgery,and repeated surgical procedures as significant predictors of mortality.Sepsis and intestinal or anastomotic failure were identified as the most common direct causes of death.Conclusions Neonatal age,ASA class greater than II and prolonged and repeated surgery are significant predictors of mortality in children's surgery in our practice.Efforts should be made to combat sepsis and provide physiologic support and intensive care provision to improve outcomes.展开更多
文摘Although the development of the 2009 Sp A classification criteria by Assessment of Spondylo Arthritis international Society（ASAS） represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis（ax Sp A）, the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including Sp A. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having ax Sp A in central China. The results showed that clinical manifestations of ax Sp A could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from ax Sp A according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.
文摘Background The burden of perioperative complications following pediatric surgery in sub-Saharan Africa is high.Assessment of the patterns and determinants of such complications and their relationship to perioperative mortality are important in identifying indicators of poor outcomes.In this study,we aim to define predictors of perioperative mortality at a tertiary hospital in Nigeria.Methods This was a retrospective review of medical records between January 2014 and December 2023.We included patients aged 15 years and below,who had general pediatric,oncological or urological surgery under general anesthesia.Information extracted included biodata,diagnosis,American Society of Anesthesiology(ASA)classification of physical status,time of death after surgery,cause of death,and duration of surgery.Data were processed using univariate and multivariate statistical analysis.Results A total of 1621 patients were analyzed.The 30-day perioperative mortality rate was 2.96%(296 per 10000 patients).Jejuno-ileal atresia,gastrochisis,and bladder exstrophy were associated with the highest mortality rates,well above 50%.Logistic regression identified neonatal age,ASA class greater than II,prolonged surgery,and repeated surgical procedures as significant predictors of mortality.Sepsis and intestinal or anastomotic failure were identified as the most common direct causes of death.Conclusions Neonatal age,ASA class greater than II and prolonged and repeated surgery are significant predictors of mortality in children's surgery in our practice.Efforts should be made to combat sepsis and provide physiologic support and intensive care provision to improve outcomes.
