Journal of Acute Disease

Number 12(5), 2023

173-178
Efficacy of Willis covered stent of intracranial pseudoaneurysms in the internal carotid artery: A systematic review and meta-analysis

Authors: Li Lin, Shao-Wei Xiang, Yan-Ling Sun, Yuan Chen, Zhe Wu, Zhi-Feng Ning, Ding-Wen Shen, Xue-Qin Sima, Qi-Qiang Wen, Gui-Lai Wei, Qing-Yong He

Abstract

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Objective: To evaluate the efficacy of a novel coated stent in the treatment of intracranial pseudoaneurysm. Methods: MEDLINE, EMBASE, and PubMed databases were searched for literature published between 1990 and April 2022 according to PRISMA guidelines. All studies with ≥10 patients reporting successful implantation of Willis covered stent, therapeutic effect, complications, and postoperative follow-up were included. The combined incidence and corresponding 95% confidence intervals were assessed using a generalized linear mixed method and random effects model. Results: Five studies (116 patients with pseudoaneurysms) were included. The experimental groups in the selected studies showed a combined technical success rate of 81.03% (OR=18.31, 95% CI=9.39-35.69, I2=79%, P<0.001). Clinical follow-up showed that the complete cure rate was as high as 94.4% after the follow-up (OR=106.81, 95% CI=39.08-291.88, I2=0%, P=0.71). Conclusions: Willis covered stent is feasible, safe, and effective in the treatment of intracranial pseudoaneurysm.

179-185
Intention and hesitancy to receive a booster dose of COVID-19 vaccine among pregnant women using a health belief model: A cross-sectional study

Authors: Anmar Al-Taie, Zekiye Yilmaz, Ahmet Yiğit Çakiroğlu, Gülnihal Candan, Selin Bildirici

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Objective: To examine the pattern of COVID-19 infection and vaccination, and to explore pregnant women's willingness and reluctance to accept a booster dose of the COVID-19 vaccine. Methods: This was a cross-sectional, descriptive study with a convenient sample size using a structured questionnaire among pregnant women attending the gynecology and obstetrics department at Acıbadem Mehmet Ali Aydinlar Hospital, Istanbul, Türkiye. The Health Belief Model scale was used to assess the intention and reluctance to accept a booster dose of the COVID-19 vaccine. Results: A total of 145 participants, with a mean age of (33.5±4.8) years, and a gestational age of (30.9±7.3) weeks, were enrolled in this study. 88.8% Received full doses of the Pfizer-BioNTech vaccination. 47.8% Participants suffered from vaccine adverse effects. Health Belief Model demonstrated a significant finding of perceived susceptibility (P<0.001), perceived severity of COVID-19 complications (P<0.001), and perceived benefits regarding a booster COVID-19 vaccination (P<0.001). Conclusions: Most pregnant women who received the COVID-19 immunization express a significant intention to receive a booster dose, regardless of the adverse effects experienced from the previous doses. However, a small percentage of the study sample express hesitancy about receiving the booster dose.

186-191
Mechanical ventilation and outcomes in COVID-19 patients admitted to intensive care unit in a low-resources setting: A retrospective study

Authors: Sarakawabalo Assenouwe, Tabana Essohanam Mouzou, Ernest Ahounou, Lidaw Déassoua Bawe, Awèréou Kotosso, Koffi Atsu Aziagbe, Eyram Makafui Yoan Amekoudi, Mamoudou Omourou, Chimene Etonga Anoudem, Komi Séraphin Adjoh

Abstract

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Objective: To describe the strategies and outcomes of mechanical ventilation in a poorly equipped facility. Methods: This retrospective descriptive study included patients with COVID-19 who were admitted to the intensive care unit (ICU) and mechanically ventilated between September 1, 2020, and May 31, 2021. Data were collected from medical records and databases. Results: 54 Patients aged (62.9±13.3) years were included. Among these cases, 79.6% had at least one comorbidity. On admission, all patients had hypoxia. The median peripheral oxygen saturation in room air was 76% (61%, 83%). Non-invasive ventilation (NIV) was performed in 75.9% of the patients, and invasive mechanical ventilation (IMV) in 68.5%. IMV was performed on patients due to severe coma (8.1%), failure of standard oxygen therapy (27.0%), and failure of NIV (64.9%). An arterial blood gas test was performed in 14.8% of the patients. NIV failed in 90.2% of cases and succeeded in 9.8%. IMV was successful in 5.4% of cases, vs. 94.6% of mortality. The overall mortality rate of patients on ventilation in the ICU was 88.9%. The causes of death included severe respiratory distress syndrome (85.2%), multiple organ failure (14.8%), and pulmonary embolism (13.0%). Conclusions: The ventilation management of COVID-19 patients in the ICU with NIV and IMV in a scarce resource setting is associated with a high mortality rate. Shortcomings are identified in ventilation strategies, protocols, and monitoring. Required improvements were also proposed.

192-197
Diagnostic value of ABCD2 and ABCD3-I risk scoring systems in determining one-month risk of stroke in patients with transient ischemic attack: An observational study

Authors: Tuncay Aslan, Serkan Emre Eroğlu, Mehmet Muzaffer İslam, Serdar Özdemir, Gökhan Aksel, Abdullah Algın

Abstract

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Objective: To compare the diagnostic value of the ABCD2 and ABCD3-I scoring systems in predicting the development of a 30-day neurological event in adult patients with transient ischemic attack (TIA) presenting to the emergency department. Methods: The study was observational and prospective and was conducted in a single center. The diagnostic values of the ABCD2 and ABCD3-I scores in predicting a neurological event within one month were compared in patients diagnosed with TIA in the emergency department. Results: A statistically significant difference was observed between groups with or without stroke within one month in terms of both the ABCD2 and ABCD3-I scores (P=0.044 and P=0.029, respectively). There was no statistically significant difference between the patients with and without a recurrent TIA within one month in relation to the ABCD2 score (P=0.934), but a statistically significant difference was found in the ABCD3-I scores of these groups (P<0.001). Conclusions: Both the ABCD2 and ABCD3-I scoring systems could predict ischemic stroke within 30 days of TIA, the ABCD3-I score is more effective than the ABCD2 score in the prediction of TIA recurrence.

198-203
Cardiovascular sequelae in post-COVID-19 patients with moderate to severe CT severity score: A follow-up study

Authors: Niharika Agarwal, Anamika Goyal, Nikhil Pursnani, Garima Kanaujia, Akanksha Semwal, Prabhat Agrawal, Abhishek Raj

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Objective: To study cardiovascular sequelae of post-COVID-19 patients with moderate to severe computed tomography (CT) severity score. Methods: A prospective, non-randomized, observational study was conducted on 100 post-COVID-19 patients with moderate to severe CT severity scores from January 2021 to December 2021. Fifty- nine were male [mean age (54.1±12.2) years] and 41 were female [mean age (46.9±15.1) years]. Patients with previous cardiovascular disease, previous chronic lung disease, and pre-existing primary or secondary pulmonary hypertension were excluded. Patients were examined, and serial electrocardiogram and 2D echocardiography were performed to detect any cardiovascular abnormality. Results: Post-COVID-19 patients had persistent symptoms, the most common being fatigue (59%). Most of these symptoms were relieved on follow-up. A rise in systolic, diastolic blood pressure, and pulse rate was observed. The electrocardiographic evaluation revealed ST-T segment changes, sinus tachycardia, ventricular hypertrophy, and arrhythmias among a considerable number of patients. On echocardiography, left ventricular diastolic dysfunction was most common (43%). Pulmonary hypertension, as evidenced by elevated pulmonary artery systolic pressure, was seen in 15% of patients. Conclusions: The present findings reveal an increased incidence of cardiovascular complications after recovery from COVID-19 infection in those without pre-existing cardiovascular or chronic lung disease.

204-212
Pathological and immunohistochemical findings of lungs, heart, liver, and kidneys, and unexpected findings of fungi and parasites in lungs of deceased COVID-19 patients: A case series

Authors: Mehmet N. Yakar, Bişar Ergün, Aylin Erol, Özde Gökbayrak, Tekincan Ç. Aktaş, Özlem Ulusan Bağcı, Fırat Bayraktar, Eyüp S. Uçan, Begüm Ergan, Bilgin Cömert, Ayşe Caner, Safiye Aktaş, Ali N. Gökmen

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Objective: To define histopathologic and immunohistochemical features of the lungs, heart, liver, and kidneys in patients who died from coronavirus disease 2019 (COVID-19), and to determine the presence of SARS-CoV-2 in all tissues, as well as the presence of fungi and parasites in lung tissues. Methods: This retrospective case study was conducted in the intensive care units of Dokuz Eylül University Hospital, and patients (≥18 years) who died due to COVID-19 between October 2020 and April 2021 were included. The biopsy samples of the patient's lung, heart, liver, and kidney tissues were studied. Results: In the study, we enrolled 12 patients (mean age: 70 years; 50% male). Alveolar epithelial cell damage and diffuse alveolar damage were predominant in lung tissues. Lobular lymphocyte infiltration, centrilobular sinusoidal dilatation, and microvesicular steatosis in the liver, together with pigmented cast, non-isometric vacuolar degeneration, and capillary plugging in the kidneys, were commonly found among the patients. SARS-CoV-2 nucleocapsid protein antibodies were detected in three lung and two kidney tissues, and so did angiotensin-converting enzyme 2 receptor positivity in one lung and more than half of the kidney tissues. The RT-PCR tests were positive in three lungs and one kidney tissue. After DNA isolation from lung tissues, Pneumocystis jirovecii was detected in nine patients, Aspergillus fumigatus in two, Microsporidia in three, and Cryptosporidium in two. Conclusions: SARS-CoV-2 is a multisystemic disease. Fungi and parasites should be investigated in critically ill COVID-19 patients prescribed corticosteroids.

213-214
Penetrating soft palate injury by lollypop candy stick

Authors: Shalendra Singh, Sushrut Avinash Kulkarni, Nitesh Agrawal, Abhishek Mishra

Abstract

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Number of views: 20

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