Albanian Journal of Trauma and Emergency Surgery最新文献

{"title":"Effectiveness of the Oakland Score for Safe Discharge of Patients with Acute Lower Gastrointestinal Bleeding: A Validation Study","authors":"Nurhayat Başkaya, Rohat Ak, Rümeysa İnci, Burak Alper Mollaoğlu, Melis Rezai, Muhammet Zahit Tursun, A. U. Seyhan","doi":"10.32391/ajtes.v8i2.394","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.394","url":null,"abstract":"Background: Acute lower gastrointestinal bleeding (LGIB) presents a significant challenge in emergency medicine, necessitating tools for effective risk stratification and management. The Oakland Score, developed to predict safe discharge and mortality in LGIB patients, offers potential utility but requires validation in diverse clinical settings. \u0000Material and Methods: This retrospective study analyzed 365 patients presenting with LGIB at Kartal Dr. Lütfi Kırdar City Hospital between January 1, 2021, and January 1, 2022. We evaluated the Oakland Score's effectiveness in predicting safe discharge and mortality, employing statistical analyses to determine the score's predictive accuracy and identify critical thresholds. \u0000Results: Among the study population, 60.27% presented with hematochezia, with a diverse age and gender distribution. Invasive procedures were performed in 42.47% of cases, and cardiovascular diseases were prevalent in 51.78%. The average Oakland Score was significantly lower for discharged patients (18.22) compared to those hospitalized (21.90), with a critical discharge threshold identified at a score of 16. The Oakland Score also demonstrated a sensitivity of 77% and specificity of 52.3% for predicting discharge outcomes, and a critical value of 24 for increased mortality risk, substantiating its predictive value. \u0000Conclusions: The Oakland Score effectively predicts safe discharge and mortality among LGIB patients in a Turkish hospital setting. With defined critical thresholds for clinical decision-making, it stands as a valuable tool for optimizing patient management and resource allocation in emergency departments.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"31 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819346","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":"Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia. A Case Report.","authors":"Lutfi Alia, T. Bushati, L. Berdica","doi":"10.32391/ajtes.v8i2.397","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.397","url":null,"abstract":"Introduction; Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a sporadic but underdiagnosed pulmonary disorder at the benign end of the neuroendocrine cell proliferation spectrum of preinvasive lesions of the lungs. This disease is characterized by hyperplasia of bronchiolar and bronchial pulmonary neuroendocrine cells. DIPNECH can be primary or reactive. \u0000In the WHO - IASLP classification of lung tumors (1999, 2004, 2005, 2015), DIPNECH is considered a preneoplastic lesion in the spectrum of pulmonary tumors. According to the WHO classification, the definition of DIPNECH is purely histological.   \u0000The DIPNECH was initially described in 1992 by Aguayo et al., who reported six non-smoking patients with cough, exertional dyspnea, wheezing, less frequent hemoptysis, and a mixed obstructive/restrictive defect on pulmonary function tests. This disease has a predilection for non-smoking middle-aged women (female to male ratio is approximately 10:1)  \u0000In this article, we present a 62-year-old, non-smoker woman presented with respiratory symptoms ascribable to DIPNECH. After surgery, the morphological study of lung specimens confirmed the DIPNECH, multiple tumors, one peripheral carcinoid, and obliterative bronchiolitis in the right middle pulmonary lobe.  \u0000Conclusions: DIPNECH remains a rare pulmonary condition and is considered a preneoplastic lesion in the spectrum of pulmonary tumors. According to the WHO classification, the definition of DIPNECH is purely histological. While most patients experience a relatively uneventful clinical course, this condition may be associated with tumors, carcinoid tumors, and airway obstruction (Aguayo-Miller disease).","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"124 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819929","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":"Perceptions of the third-Year Students Attending the Bachelor Study Programs, Regarding their Readiness to Face the Labor Market. A cross-Sectional Study.","authors":"J. Kraja, Mario Çurçija, Edra Fresku, Samanda Shtjefni","doi":"10.32391/ajtes.v8i2.384","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.384","url":null,"abstract":"Introduction: The educational environment is an essential component of student learning. The study of the academic environment is crucial to providing a learning quality, a student-centered program for the nursing and midwifery fields. \u0000Our study aims to identify the perceptions of the third-year students of bachelor's study programs in nursing, midwifery, and physiotherapy regarding readiness to face the labor market and how they differ based on the study program.  \u0000Material and Methods: A total of 132 (73.74%) students participated in this study out of 179 students who had a whole the third year, 28 (87.5) were in bachelor in physiotherapy out of 32 students, 32 (82.05) were in bachelor in midwifery out of 39 students, and 72 (66.66) were in bachelor in nursing out of 108 students. All students continued their studies in the 2022-2023 academic year. Two tools were used in this study: a demographic questionnaire and the assessment of the adequacy level of preparedness for work used by Günner (Güner., 2015a). \u0000Results: Only 57.74% of students are ready to face the labor market. Activities of education and preparation regarding the Contribution of the clinical environment to education, Mentoring, Library resources, Laboratory environments, Technological resources, and Social resources for the nursing study program need to show a connection with the general readiness to work. \u0000Conclusions: The study highlighted students' need for more confidence to face the work, primarily related to clinical training.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"111 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820295","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":"Wernicke’s Encephalopathy from Hyperemesis Gravidarum. A Case Report","authors":"Teuta Dalipi, Suzana Klenkoski, Gazmend Mehmeti, Rezeart Dalipi","doi":"10.32391/ajtes.v8i2.408","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.408","url":null,"abstract":"Introduction: Wernicke's encephalopathy (WE) is a potentially reversible, yet serious neurological emergency due to vitamin B1 (thiamine) deficiency. It is a rare but known complication of hyperemesis gravidarum. Prolonged vomiting in pregnancy results in thiamine depletion. Most frequently Wernicke's encephalopathy is found among persons suffering from chronic alcoholism. It can also occur in any medical condition producing malnourishment and causing thiamine deficiency including gastric bypass, a variety of gastrointestinal disorders, malignant diseases, anorexia nervosa, hyperthyroidism and prolonged intravenous feeding. Magnetic resonance imaging (MRI) is sensitive and specific for diagnosis and follow up evaluation. Most patients present with the triad of ocular signs, ataxia, and confusion. It can be associated with life-threatening complication like central pontine myelinolysis. Although early recognition and treatment with thiamine can reverse the symptoms, the mortality rate remains 10-20% due to underdiagnosis. It is frequently not identified until autopsy. Here we stress upon the importance of early diagnosis and prompt treatment of WE. \u0000The aim of this report is to present case of Wernicke's encephalopathy induced by hyperemesis gravidarum. The course of the disease, clinical signs, diagnostic tools, treatment and its results are presented. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"60 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819228","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":"Primary Pancreatic Lymphoma with Active Gastric Bleeding. A Clinical Case and Review Literature.","authors":"Gjergj Andrea, Henri Beqiri, Sara Ferizaj, Fjoralba Mulgeci, A. Dogjani","doi":"10.32391/ajtes.v8i2.400","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.400","url":null,"abstract":"Introduction: Primary pancreatic lymphoma is a rare clinical entity representing <0.5% of pancreatic cancers and 1% of extranodal lymphomas. Due to the lack of evidence of cases in the literature, their clinicopathological features, differential diagnosis, optimal therapy, and outcomes should be better defined. \u0000We will present a case of a 41-year-old woman who presented symptoms such as nausea, epigastric pain, red blood vomiting, and melena.  \u0000At laparotomy, a large necrotic mass was found in the body and tail of the pancreas, infiltrating the stomach and spleen. A biopsy of the mass confirmed large B-cell lymphoma. The patient was diagnosed and started chemotherapy. \u0000Conclusion: Primary pancreatic lymphoma is a rare clinical entity often misdiagnosed as pancreatic adenocarcinoma on presentation. Its clinical manifestations, radiological features, and biochemical signs are usually non-specific. It is based on a precise diagnosis made possible by histologic examination. Combined therapy remains the most optimal treatment approach for PPL but needs further evaluation. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"48 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819443","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":"Antiphospholipid Syndrome in a Male Patient Presenting with Abdominal Pain","authors":"Ardit Çollaku, Blerina Dhamo, Erjon Dushi, R. B. Celep","doi":"10.32391/ajtes.v8i2.392","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.392","url":null,"abstract":"Introduction: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by antiphospholipid antibodies (aPL), leading to a hypercoagulable state and an increased risk of thrombotic events. While abdominal complications have been reported as the initial presentation of APS in some cases, these instances are predominantly observed in female patients. Here, we present a case of a 49-year-old male patient who presented with complaints and a CT scan mimicking intestinal ileus. However, no mechanical or other evident cause of ileus could be found on the explorative laparotomy. After an uneventful postoperative hospitalization and being discharged in good condition, the patient was readmitted within two weeks, and this time, an extensive small bowel resection due to ischemia was done. After going home in a good and stable condition, he presents again, but this time with cerebral ischemia. \u0000Further investigations led to the APS diagnosis. With this case, we want to emphasize the importance of being aware of and considering the diagnosis of APS, especially in cases with repeated, unexplained abdominal pain and non-typical complaints, even in male patients. An early diagnosis could prevent a more complex disease complication. \u0000Conclusion: This case underscores the importance of considering APS in the differential diagnosis of unexplained abdominal pain, particularly in male patients with a history of thrombotic events or elevated aPL levels. Heightened awareness of APS in the emergency setting can facilitate timely diagnosis and appropriate management, ultimately optimizing patient care and outcomes.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819595","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":"Influence of Prematurity and Glutation S-Transferase Gene Polymorphisms on the Degree of Asthma Control in Children","authors":"Selma Dizdar, V. Mišanović, Mirela Mačkić- Đurović, Almedina Moro","doi":"10.32391/ajtes.v8i2.409","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.409","url":null,"abstract":"Introduction: asthma is the most common chronic inflammatory disease of the respiratory tract in children. The clinical manifestation of asthma is closely related to the pathomorphological changes presenting the basis of the disease, and it concerns the difficult air flow through the lower airways during the expiratory phase of breathing. Inadequate treatment of children who have asthma affects the appearance of remodeling of the lower airways and, in the most severe cases, permanent reduction of the lung function values. \u0000The Aim is to determine the influence of prematurity and GSTT1 and GSTM1 gene polymorphisms on the degree of asthma control. \u0000Materials and Methods: The research was designed as a clinical, cohort, observational, retrospective-prospective study. It included 200 patients divided into two groups of one hundred respondents each. The first group of respondents consisted of premature children hospitalized at the Department of Neonatal Intensive Care of the CCUS Pediatric Clinic due to respiratory problems caused by immaturity. In contrast, the second group consisted of at-term-born children monitored through the Pulmonary Counselling of the Pediatric Clinic. \u0000Results: The male and female genders were equally represented. In the premature children group, respiratory support was used in 60/100 (60%) cases. GSTT1 polymorphism was proven in 150 respondents, and GSTM1 polymorphism in 98. Fisher's test showed that gestational age at birth significantly influenced asthma control: the test value was 11.281, p=0.019. \u0000Conclusion: gestation weeks at birth have a statistically significant effect on the degree of asthma control at older age. Although poorly controlled asthma and uncontrolled asthma were more prevalent in children with positive GSTT1 and GSM1 gene polymorphisms, we could not demonstrate a statistically significant influence of the mentioned polymorphisms on the degree of asthma control.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"12 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819636","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":"The Liver Abscess after Laparoscopic Cholecystectomy. A Case Report.","authors":"Endrit Shehi, Johana Vruho, A. Dogjani","doi":"10.32391/ajtes.v8i2.405","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.405","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy is the gold standard in the management of symptomatic gallstones. However, it is estimated that there are 2–15 cases of hepatic abscesses per 100,000 people in the U.S., mostly of bacterial etiology, and approximately half of these are caused by cholangitis. \u0000Given the infrequency of cholangitis-induced pyogenic hepatic abscesses and the 0.4 % incidence of choledocholithiasis in post-cholecystectomy patients, pyogenic hepatic abscesses secondary to post-cholecystectomy choledocholithiasis comprise a rare entity. \u0000A hepatic abscess occurring post-laparoscopic cholecystectomy is a known complication that can manifest months or even years after the surgery. \u0000This case involves a 56-year-old female patient who presented with a 10-day history of abdominal pain and discomfort, primarily in the right hypochondrium, accompanied by fever unresponsive to antibiotics and antipyretics. The appropriate treatment approach was chosen based on clinical signs, abscess size, and the patient's overall condition. \u0000Conclusion: This case shows the late complications arising from gallstone spillage into the abdominal cavity during laparoscopic cholecystectomy. It underscores the importance of careful laparoscopic exploration, especially in gallbladder perforation and stone spillage cases. Detailed documentation of the operative procedure is crucial, as it aids in the prophylactic and symptomatic treatment of long-term complications such as abscess formation. \u0000 ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"57 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818950","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":"Perceptions of Health Personnel Regarding the Utilization of Health Information Systems.","authors":"Edra Fresku, J. Kraja, M. Marku","doi":"10.32391/ajtes.v8i2.402","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.402","url":null,"abstract":"Introduction: The deployment of health information systems has been a global response to healthcare's transformation and digitalization. The need and potential of these systems within healthcare have been tremendously driven by the global instability that has affected several interrelated sectors, highlighting the urgency and importance of this research.[1] \u0000Health information systems (HIS) are critical systems deployed to help organizations and all stakeholders within the healthcare arena eradicate disjointed information and modernize health processes by integrating different health functions and departments across the healthcare arena for better healthcare delivery.[2] \u0000This study aims to underscore the invaluable insights of the Shkodra Regional Hospital's healthcare staff regarding Hospital Information Systems. We aim to identify potential problems that may arise before their implementation, such as resistance to change, lack of training, and system compatibility issues, emphasizing the crucial role of healthcare staff in this process. \u0000Material and Methods: 168 participants were involved in this study, representing 42.96% of the total nurses. Data were collected through a 47-item self-administered questionnaire, which included sections on demographics, current system usage, perceived benefits and challenges, and readiness for system adoption. The questionnaire was designed based on the 'Acceptance Model of a Hospital Information System' developed by Handayani et al. [3] \u0000Results: Encouragingly, 88-92% of the study participants expressed their strong readiness and enthusiasm to embrace HIS as part of their work. This overwhelmingly positive attitude bodes exceptionally well for the system's potential success. \u0000Conclusions: The study's findings underscore the significant potential for successfully implementing HIS at Shkodra Regional Hospital. Despite the challenges nurses may anticipate when using HIS, the study revealed a remarkable willingness to adapt. Approximately 90% of the participants expressed their readiness to accept HIS, demonstrating their commendable adaptability and the potential for a smooth transition to the new system.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"113 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820415","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":"Cardiac Arrest in Patients with Acute Myocardial Infarction","authors":"Aida Gavranović, Kenan Ljuhar, Nejra Jonuz Gušić, Riada Blažević, Amela Ramadani Podžo Ramadani Podžo, Amna Palikuća, Tatjana Jevtić, B. Lenjani","doi":"10.32391/ajtes.v8i2.345","DOIUrl":"https://doi.org/10.32391/ajtes.v8i2.345","url":null,"abstract":"Background: Sudden cardiac arrest is the third leading cause of death in Europe. A significant number of out-of-hospital sudden cardiac arrests are associated with acute myocardial infarction. Cardiac arrest is a complication of an acute myocardial infarction caused by malignant rhythm disorder, in most cases ventricular tachycardia or ventricular fibrillation. They result in sudden death in 25%-50% of patients with prior acute myocardial infarction. Sudden cardiac arrest in these patients occurs during the first hours after the onset of symptoms.  \u0000Aim: show from the total number of out-of-hospital reanimations in the given period in canton Sarajevo the number of successful reanimations (return of spontaneous circulation – ROSC) and the number of successful reanimations in patients that went in to sudden cardiac arrest with prior acute myocardial infarction. Show the out-of-hospital management of these patients. \u0000Material and Methods: retrospective descriptive study that includes all out-of-hospital sudden cardiac arrest in the period from 1 January 2019 to the 31 December 2021 in canton Sarajevo that are associated with acute myocardial infarction in which there was the return of spontaneous circulation (ROSC). All patients from above-mentioned period were included in the study, without exclusion criteria related to their age, gender. Data was extracted from data registry of the Centre for education of the Emergency Medical Center of canton Sarajevo. \u0000Conclusion: Acute myocardial infarction still stays associated with a high level of mortality and represents one of the leading public health problems. Despite all advances in the field of diagnostics and treatment of patients with AMI that resulted in significant reduction of mortality in time. ","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":"109 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820315","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}