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Retrospective Case-note Review (retrospective + case-note_review)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Mid-term outcome of endovascular revascularization for chronic mesenteric ischaemia,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2010
N. V. Dias
Background: This study aimed to assess mid-term outcome after endovascular revascularization of chronic occlusive mesenteric ischaemia (CMI) and to identify possible predictors of mortality. Methods: Consecutive patients undergoing primary elective stenting for CMI between 1995 and 2007 were registered prospectively in a database. Patients with acute ischaemia were excluded. Retrospective case-note review and data analysis were performed. Results: Forty-three patients (10 men) were treated for stable (n = 30) or exacerbated (n = 13) CMI. Their median (interquartile range (i.q.r.)) age was 70 (60,79) years. Revascularization was successful in 47 of 49 vessels. The superior mesenteric artery (SMA), either alone (n = 34) or in combination with the coeliac trunk (n = 6), was the predominant target vessel. No patient died within 30 days. Median follow-up was 43 (i.q.r. 25,63) months and the estimated (s.e.) 3-year overall survival rate was 76(7) per cent. Two patients died from distal SMA occlusive disease and intestinal infarction after 6 and 18 months respectively. Previous stroke (P = 0·016), male sex (P = 0·057) and age (P = 0·066) were associated with mid-term mortality on univariable, but not multivariable analysis. Reintervention was needed in 14 patients, achieving a 3-year cumulative rate of freedom from recurrent symptoms of 88(5) per cent. Conclusion: Endovascular treatment provided high early and mid-term survival rates in this series of patients with CMI, with low complication rates. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Sexual abuse in children and adolescents with intellectual disability

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2001
R. Balogh
Abstract The present authors conducted a study of the occurrence of victimization and the perpetration of sexual abuse among 43 in-patients with intellectual disability aged between 9 and 21 years who were admitted to a child and adolescent psychiatric in-patient department over a period of 5 years. A retrospective case-note review was employed that explored the nature and severity of abuse in relation to the age, gender and level of disability. The prevalence of abuse or abusive behaviour, i.e. 14% of 300 admissions, did not change over time. In 13 out of the 43 cases, the issue of sexual abuse was identified after admission. Victimization alone occurred in 21 cases, perpetration alone in six cases, and both victimization and perpetration in 16 cases. Fifty per cent of the victims had been abused by a member of their close or extended family. Most cases (62%) were adolescents. There was only one instance of a victim being abused by a female. However, there were five girls who were perpetrators, all of whom had previously been victims. By contrast, 11 out of the 17 male perpetrators had been victims. Despite difficulties of disclosure, it was possible to establish that severely disabled patients had suffered sexual abuse. The present data support theories which (1) recognize gender differences in sexual abuse patterns and (2) have a developmental perspective, incorporating the influence of adolescence. [source]

Management of aortic aneurysm infected with Salmonella

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2003
R. B. Hsu
Background: This study reviewed the clinical outcomes of patients with an aortic aneurysm infected with Salmonella treated by a single centre over 6 years. Methods: Data were collected by a retrospective case-note review. Results: Between September 1995 and December 2001, 121 patients with non-typhoid Salmonella bacteraemia were treated, of whom 24 patients had an aortic aneurysm infected with Salmonella. Ten had a suprarenal and 14 an infrarenal aortic infection. The most common responsible pathogen was group C Salmonella (12 patients). All of the 20 patients who had combined medical and surgical therapy survived, whereas two of four who had medical therapy alone died. There were two late deaths during a mean follow-up of 23 (range 3,63) months. Conclusion: The incidence of aortic infection in patients with non-typhoid Salmonella bacteraemia was high in Taiwan. Timely surgical intervention and prolonged intravenous antibiotic therapy resulted in excellent outcomes. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Surgical workload and outcome after resection for carcinoma of the oesophagus and cardia,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2002
E. W. Gillison
Background: Performing cancer surgery in high-volume centres may lead to improved outcomes. This study explored the relationship between annual workload and outcome following resection for carcinoma of the oesophagus and cardia. Methods: The study was a retrospective case-note review of 1125 patients who had surgery for cardio-oesophageal cancer in the West Midlands region of England. Outcome measures were 30-day mortality and long-term survival. Results: The overall 30-day mortality rate was 10·0 per cent with a median survival of 14 months and a 5-year survival rate of 17·2 per cent. Increasing age, advanced stage of disease and emergency resection independently affected outcome adversely. Forty-one infrequent operators (fewer than four resections per year) performed 146 resections (13·0 per cent), 18 intermediate operators (between four and 11 resections per year) performed 488 resections (43·4 per cent) and five frequent operators (12 or more resections per year) performed 491 resections (43·6 per cent). The 30-day mortality rate was greatest in the infrequent group (15·1 per cent) compared with both the intermediate group (6·6 per cent; adjusted odds 0·40, P = 0·004) and the frequent group (11·8 per cent; odds 0·73, P = 0·28). There were no differences in survival rates between the groups, and no difference in outcome between high- and low-volume hospitals. Conclusion: In this unselected population-based series there was little evidence of a trend of improving 30-day mortality rate with increasing workload, or between workload and long-term survival. © 2002 British Journal of Surgery Society Ltd [source]