Pneumatic dilation(PD)is considered to be a safe and effective first line therapy for achalasia.The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a...Pneumatic dilation(PD)is considered to be a safe and effective first line therapy for achalasia.The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation.It has been reported that delayed management of perforation for more than 24 h is associated with high mortality.Surgery is the treatment of choice within 24 h,but the management of delayed perforation remains controversial.Hereby,we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia.She completely recovered after intensive medical care.A review of the literature is also discussed.展开更多
Background:A delay presentation for human immunodeficiency virus(HIV)patient’s care(that is late engagement to HIV care due to delayed HIV testing or delayed linkage for HIV care after the diagnosis of HIV positive)i...Background:A delay presentation for human immunodeficiency virus(HIV)patient’s care(that is late engagement to HIV care due to delayed HIV testing or delayed linkage for HIV care after the diagnosis of HIV positive)is a critical step in the series of HIV patient care continuum.In Ethiopia,delayed presentation(DP)for HIV care among vulnerable groups such as tuberculosis(Tb)/HIV co-infected patients has not been assessed.We aimed to assess the prevalence of and factors associated with DP(CD4<200 cells/μl at first visit)among Tb/HIV co-infected patients in southwest Ethiopia.Methods:A retrospective observational cohort study collated Tb/HIV data from Jimma University Teaching Hospital for the period of September 2010 and August 2012.The data analysis used logistic regression model at P value of≤0.05 in the final model.Results:The prevalence of DP among Tb/HIV co-infected patients was 59.9%.Tb/HIV co-infected patients who had a house with at least two rooms were less likely(AOR,0.5;95%CI:0.3–1.0)to present late than those having only single room.Tobacco non-users of Tb/HIV co-infected participants were also 50%less likely(AOR,0.5;95%CI:0.3–0.8)to present late for HIV care compared to tobacco users.The relative odds of DP among Tb/HIV co-infected patients with ambulatory(AOR,1.8;95%CI,1.0–3.1)and bedridden(AOR,8.3;95%CI,2.8–25.1)functional status was higher than with working status.Conclusions:Three out of five Tb/HIV co-infected patients presented late for HIV care.Higher proportions of DP were observed in bedridden patients,tobacco smokers,and those who had a single room residence.These findings have intervention implications and call for effective management strategies for Tb/HIV co-infection including early HIV diagnosis and early linkage to HIV care services.展开更多
文摘Pneumatic dilation(PD)is considered to be a safe and effective first line therapy for achalasia.The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation.It has been reported that delayed management of perforation for more than 24 h is associated with high mortality.Surgery is the treatment of choice within 24 h,but the management of delayed perforation remains controversial.Hereby,we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia.She completely recovered after intensive medical care.A review of the literature is also discussed.
基金This research was funded by Jimma University and was received by Hailay Gesesew.The funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript。
文摘Background:A delay presentation for human immunodeficiency virus(HIV)patient’s care(that is late engagement to HIV care due to delayed HIV testing or delayed linkage for HIV care after the diagnosis of HIV positive)is a critical step in the series of HIV patient care continuum.In Ethiopia,delayed presentation(DP)for HIV care among vulnerable groups such as tuberculosis(Tb)/HIV co-infected patients has not been assessed.We aimed to assess the prevalence of and factors associated with DP(CD4<200 cells/μl at first visit)among Tb/HIV co-infected patients in southwest Ethiopia.Methods:A retrospective observational cohort study collated Tb/HIV data from Jimma University Teaching Hospital for the period of September 2010 and August 2012.The data analysis used logistic regression model at P value of≤0.05 in the final model.Results:The prevalence of DP among Tb/HIV co-infected patients was 59.9%.Tb/HIV co-infected patients who had a house with at least two rooms were less likely(AOR,0.5;95%CI:0.3–1.0)to present late than those having only single room.Tobacco non-users of Tb/HIV co-infected participants were also 50%less likely(AOR,0.5;95%CI:0.3–0.8)to present late for HIV care compared to tobacco users.The relative odds of DP among Tb/HIV co-infected patients with ambulatory(AOR,1.8;95%CI,1.0–3.1)and bedridden(AOR,8.3;95%CI,2.8–25.1)functional status was higher than with working status.Conclusions:Three out of five Tb/HIV co-infected patients presented late for HIV care.Higher proportions of DP were observed in bedridden patients,tobacco smokers,and those who had a single room residence.These findings have intervention implications and call for effective management strategies for Tb/HIV co-infection including early HIV diagnosis and early linkage to HIV care services.
