To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patien...To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann＇s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.展开更多
AIM: To study the effect of hepatitis virus infection on cirrhosis and liver function markers in HIV-infected hemophiliacs.METHODS: We have analyzed the immunological, liver function and cirrhosis markers in a cohort ...AIM: To study the effect of hepatitis virus infection on cirrhosis and liver function markers in HIV-infected hemophiliacs.METHODS: We have analyzed the immunological, liver function and cirrhosis markers in a cohort of hemophiliacs co-infected with human immunodeficiency virus (HIV) and hepatitis viruses.RESULTS: There was no difference in immunological markers among co-infected patients and patients infected with HIV only and those co-infected with one or more hepatitis virus. Although liver function and cirrhosis markers remained within a normal range, there was a worsening trend in all patients co-infected with hepatitis virus C (HCV), which was further exacerbated in the presence of additional infection with hepatitis virus B (HBV).CONCLUSION: Co-infection with HIV, HBV and HCV leads to worsening of hyaluronic acid and liver function markers. Increases in serum hyaluronic acid may be suggestive of a predisposition to liver diseases.展开更多
Objective: To compare the sensitivity and specificity of thecervical/urethral swabs with voided urine specimens for thedetection of genitourinary tract infection with Chlamydia tra-chomatis and determine whether urine...Objective: To compare the sensitivity and specificity of thecervical/urethral swabs with voided urine specimens for thedetection of genitourinary tract infection with Chlamydia tra-chomatis and determine whether urine specimens can replacethe cervical/urethral swabs in detection of C. thachomatis. Methods: The matched cervical/urethral swabs and voidedurine specimens were collected from 569 patients of STD clinics.Polymerase chain reaction (PCR) assay specific for C. tra-chomatis plasmid DNA and rapid antigen testing (Clear viewassay) was used to detect C trachomatis. Standard criteria thatdefined 'true' positive included: 1) positive PCR results both incervical/urethral swab and voided urine specimen or 2) positivevoided urine results both by PCR assay and clear view test or 3)positive results in both PCR assay of cervical/urethral swab andclear view test of voided urine. For statistical analysis, thechi-square test was used. Results: The prevalence of C trachomatis in patients withsymptoms was 12.1% (28/231) in women and 10.4%(10/96) inmen, with no significant difference between them (x^2=0.21,P>0.05). The prevalence of C trachomatis in patients with nosymptoms was 11.0% (11/100) in women and 15.5% (22/142) inmen, with a significant difference existing between them. (x^2=4.0, P<0.05). No significant difference (P>0.05) existed betweenPCR testing of swabs (sensitivity 87.3%; specificity 99.2%) andPCR testing of urine (sensitivity 88.7%: specificity 98.8%). Asfor clear view assay, sensitivity was 60.6% and specificity was100%. Conclusions: PCR assay is superior to clear view in detectingC trachomatis. Although both PCR testing of swabs and PCRtesting of urine specimens both have high sensitivity and speci-ficity, urine specimen testing is more cost-effective, practical andnoninvasive. Thus urine specimens can take the place of theswabs in PCR testing for chlamydia.展开更多
Objective： To analyze the results of clinical and bacteriological examinations in patients with crush syndrome who suffered infectious complications after an earthquake in Sichuan, China. Methods： Atotal of 313 bac...Objective： To analyze the results of clinical and bacteriological examinations in patients with crush syndrome who suffered infectious complications after an earthquake in Sichuan, China. Methods： Atotal of 313 bacteriological samples among 147 patients with crush syndrome were collected. Infectious complications, results of microbiological examinations, potential risk factors of infection and mortality were analyzed statistically. Results： In the obtained database, 112 out of the 147 （75.7%） patients had infectious complications, in which, wound infection, pulmonary infection, and sepsis were most common. The time under the rubble and the time from injury to treatment were related to the occurrence of wound infec- tion （P=0.013, odds ratio 2.25;P=0.017, odds ratio 2.31）. Sep- sis and wound infection were more common in patients who underwent fasciotomy or amputation than in those who did not （P=O.O01 ）. Conclusion： Quick rescue and injury treatment can decrease the infection risk in crush syndrome patients. It is better to obtain microorganic proofs before applying antibiotics, and bacteriological and drug sensitivity data should be taken into account, especially considering that most of these infections are hospital-acquired and drug resistance. Emphasizing the accuracy and efficiency of wound management in emergency situations, cautiously assessing the indications for fasciotomy to avoid open wounds from unnecessary osteofascial compartment de- compression incisions may decrease the incidence of in- fection and ameliorate the prognosis.展开更多
文摘To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann＇s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.
基金Supported by the Shanghai Public Health Center Research Fund
文摘AIM: To study the effect of hepatitis virus infection on cirrhosis and liver function markers in HIV-infected hemophiliacs.METHODS: We have analyzed the immunological, liver function and cirrhosis markers in a cohort of hemophiliacs co-infected with human immunodeficiency virus (HIV) and hepatitis viruses.RESULTS: There was no difference in immunological markers among co-infected patients and patients infected with HIV only and those co-infected with one or more hepatitis virus. Although liver function and cirrhosis markers remained within a normal range, there was a worsening trend in all patients co-infected with hepatitis virus C (HCV), which was further exacerbated in the presence of additional infection with hepatitis virus B (HBV).CONCLUSION: Co-infection with HIV, HBV and HCV leads to worsening of hyaluronic acid and liver function markers. Increases in serum hyaluronic acid may be suggestive of a predisposition to liver diseases.
文摘Objective: To compare the sensitivity and specificity of thecervical/urethral swabs with voided urine specimens for thedetection of genitourinary tract infection with Chlamydia tra-chomatis and determine whether urine specimens can replacethe cervical/urethral swabs in detection of C. thachomatis. Methods: The matched cervical/urethral swabs and voidedurine specimens were collected from 569 patients of STD clinics.Polymerase chain reaction (PCR) assay specific for C. tra-chomatis plasmid DNA and rapid antigen testing (Clear viewassay) was used to detect C trachomatis. Standard criteria thatdefined 'true' positive included: 1) positive PCR results both incervical/urethral swab and voided urine specimen or 2) positivevoided urine results both by PCR assay and clear view test or 3)positive results in both PCR assay of cervical/urethral swab andclear view test of voided urine. For statistical analysis, thechi-square test was used. Results: The prevalence of C trachomatis in patients withsymptoms was 12.1% (28/231) in women and 10.4%(10/96) inmen, with no significant difference between them (x^2=0.21,P>0.05). The prevalence of C trachomatis in patients with nosymptoms was 11.0% (11/100) in women and 15.5% (22/142) inmen, with a significant difference existing between them. (x^2=4.0, P<0.05). No significant difference (P>0.05) existed betweenPCR testing of swabs (sensitivity 87.3%; specificity 99.2%) andPCR testing of urine (sensitivity 88.7%: specificity 98.8%). Asfor clear view assay, sensitivity was 60.6% and specificity was100%. Conclusions: PCR assay is superior to clear view in detectingC trachomatis. Although both PCR testing of swabs and PCRtesting of urine specimens both have high sensitivity and speci-ficity, urine specimen testing is more cost-effective, practical andnoninvasive. Thus urine specimens can take the place of theswabs in PCR testing for chlamydia.
文摘Objective： To analyze the results of clinical and bacteriological examinations in patients with crush syndrome who suffered infectious complications after an earthquake in Sichuan, China. Methods： Atotal of 313 bacteriological samples among 147 patients with crush syndrome were collected. Infectious complications, results of microbiological examinations, potential risk factors of infection and mortality were analyzed statistically. Results： In the obtained database, 112 out of the 147 （75.7%） patients had infectious complications, in which, wound infection, pulmonary infection, and sepsis were most common. The time under the rubble and the time from injury to treatment were related to the occurrence of wound infec- tion （P=0.013, odds ratio 2.25;P=0.017, odds ratio 2.31）. Sep- sis and wound infection were more common in patients who underwent fasciotomy or amputation than in those who did not （P=O.O01 ）. Conclusion： Quick rescue and injury treatment can decrease the infection risk in crush syndrome patients. It is better to obtain microorganic proofs before applying antibiotics, and bacteriological and drug sensitivity data should be taken into account, especially considering that most of these infections are hospital-acquired and drug resistance. Emphasizing the accuracy and efficiency of wound management in emergency situations, cautiously assessing the indications for fasciotomy to avoid open wounds from unnecessary osteofascial compartment de- compression incisions may decrease the incidence of in- fection and ameliorate the prognosis.
