BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not decreased.Perforating peptic ulcer(PPU)is a severe form of th...BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not decreased.Perforating peptic ulcer(PPU)is a severe form of the disease.AIM To assess trends in the incidence,presentation,and outcome of PPU over a period of 40 years.METHODS This was a single-centre,retrospective,cohort study of all patients admitted to Levanger Hospital,Norway,with PPU from 1978 to 2017.The patients were identified in the Patient Administrative System of the hospital using International Classification of Diseases(ICD),revision 8,ICD-9,and ICD-10 codes for perforated gastric and duodenal ulcers.We reviewed the medical records of the patients to retrieve data.Vital statistics were available for all patients.The incidence of PPU was analysed using Poisson regression with perforated ulcer as the dependent variable,and sex,age,and calendar year from 1978 to 2017 as covariates.Relative survival analysis was performed to compare long-term survival over the four decades.RESULTS Two hundred and nine patients were evaluated,including 113(54%)men.Fortysix(22%)patients were older than 80 years.Median age increased from the first to the last decade(from 63 to 72 years).The incidence rate increased with increasing age,but we measured a decline in recent decades for both sexes.A significant increase in the use of acetylsalicylic acid,from 5%(2/38)to 18%(8/45),was observed during the study period.Comorbidity increased significantly over the 40 years of the study,with 22%(10/45)of the patients having an American Society of Anaesthesiologists(ASA)score 4-5 in the last decade,compared to 5%(2/38)in the first decade.Thirty-nine percent(81/209)of the patients had one or more postoperative complications.Both 100-day mortality and long-term survival were associated with ASA score,without significant variations between the decades.CONCLUSION Declining incidence rates occurred in recent years,but the patients were older and had more comorbidity.The ASA score was associated with both short-term mortality and long-term survival.展开更多
Background: Chronic exposure to inhaled anaesthetic agents poses an occupational hazard related to the practice of anaesthesia. Therefore, this study sought to find out the perception of anaesthesia providers on expos...Background: Chronic exposure to inhaled anaesthetic agents poses an occupational hazard related to the practice of anaesthesia. Therefore, this study sought to find out the perception of anaesthesia providers on exposure to inhalational anaesthetics, evaluate their knowledge on the effects of chronic exposure and strategies to reduce chronic exposure to operating room inhalational anaesthetic agents. Method: This cross-sectional survey was conducted by administering a self-administered questionnaire to 71 anaesthesia providers in Ghana who attended the annual refresher course of the faculty of Anaesthesia, West African College of Surgeons, in 2016. Data collected were analysed and presented as frequencies and percentages. Results: Halothane and isoflurane were the most frequently used inhalational agents by the respondents. Majority (90.1%) of the respondents perceived they are exposed to inhalational anaesthetics in their working environment. Majority of the anaesthetic providers cited poorly functioning scavenging systems (28.2%) and use of paediatric Ayre’s T-piece (28.2%) as sources of exposure to inhalational anaesthetics. All respondents admitted making attempts to reduce their exposure to inhalational anaesthetics. Majority of the respondents mentioned teratogenicity (77.5%) and hepatotoxicity (67.6%) as effects of chronic exposure to inhaled anaesthetic agents. Conclusion: Anaesthesia providers in Ghana perceived they are chronically exposed to inhalational anaesthetic agents in their work environment. They are aware of the sources of inhalational anaesthetic agent exposure, associated health risks and strategies required to reduce chronic exposure to inhaled anaesthetic agents.展开更多
此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已...此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已获得WHO和WFSA成员支持,此标准适用于世界各地的麻醉工作者,旨在为麻醉工作者、专业组织、医院、机构管理者和政府提供指导和帮助,以维持和提高麻醉安全和质量。此标准涵盖专业内容、设施设备、用药及静脉输液、监测和麻醉实施等方面。高度推荐标准与强制标准作用等同,包括(但不仅限于):训练有素的、警惕的麻醉工作者持续在场,通过临床观察及脉搏血氧饱和度持续监测组织氧合及灌注;间断监测血压;通过听诊和二氧化碳检测确认气管内插管(如果有)的正确位置;应用WHO手术安全核查单;麻醉结束时完善交接系统。此国际标准仅为最低标准,而我们的目标是以所能达到的最高标准来实施麻醉,所以实际标准最好超过本文所介绍的标准。展开更多
文摘BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not decreased.Perforating peptic ulcer(PPU)is a severe form of the disease.AIM To assess trends in the incidence,presentation,and outcome of PPU over a period of 40 years.METHODS This was a single-centre,retrospective,cohort study of all patients admitted to Levanger Hospital,Norway,with PPU from 1978 to 2017.The patients were identified in the Patient Administrative System of the hospital using International Classification of Diseases(ICD),revision 8,ICD-9,and ICD-10 codes for perforated gastric and duodenal ulcers.We reviewed the medical records of the patients to retrieve data.Vital statistics were available for all patients.The incidence of PPU was analysed using Poisson regression with perforated ulcer as the dependent variable,and sex,age,and calendar year from 1978 to 2017 as covariates.Relative survival analysis was performed to compare long-term survival over the four decades.RESULTS Two hundred and nine patients were evaluated,including 113(54%)men.Fortysix(22%)patients were older than 80 years.Median age increased from the first to the last decade(from 63 to 72 years).The incidence rate increased with increasing age,but we measured a decline in recent decades for both sexes.A significant increase in the use of acetylsalicylic acid,from 5%(2/38)to 18%(8/45),was observed during the study period.Comorbidity increased significantly over the 40 years of the study,with 22%(10/45)of the patients having an American Society of Anaesthesiologists(ASA)score 4-5 in the last decade,compared to 5%(2/38)in the first decade.Thirty-nine percent(81/209)of the patients had one or more postoperative complications.Both 100-day mortality and long-term survival were associated with ASA score,without significant variations between the decades.CONCLUSION Declining incidence rates occurred in recent years,but the patients were older and had more comorbidity.The ASA score was associated with both short-term mortality and long-term survival.
文摘Background: Chronic exposure to inhaled anaesthetic agents poses an occupational hazard related to the practice of anaesthesia. Therefore, this study sought to find out the perception of anaesthesia providers on exposure to inhalational anaesthetics, evaluate their knowledge on the effects of chronic exposure and strategies to reduce chronic exposure to operating room inhalational anaesthetic agents. Method: This cross-sectional survey was conducted by administering a self-administered questionnaire to 71 anaesthesia providers in Ghana who attended the annual refresher course of the faculty of Anaesthesia, West African College of Surgeons, in 2016. Data collected were analysed and presented as frequencies and percentages. Results: Halothane and isoflurane were the most frequently used inhalational agents by the respondents. Majority (90.1%) of the respondents perceived they are exposed to inhalational anaesthetics in their working environment. Majority of the anaesthetic providers cited poorly functioning scavenging systems (28.2%) and use of paediatric Ayre’s T-piece (28.2%) as sources of exposure to inhalational anaesthetics. All respondents admitted making attempts to reduce their exposure to inhalational anaesthetics. Majority of the respondents mentioned teratogenicity (77.5%) and hepatotoxicity (67.6%) as effects of chronic exposure to inhaled anaesthetic agents. Conclusion: Anaesthesia providers in Ghana perceived they are chronically exposed to inhalational anaesthetic agents in their work environment. They are aware of the sources of inhalational anaesthetic agent exposure, associated health risks and strategies required to reduce chronic exposure to inhaled anaesthetic agents.
文摘此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已获得WHO和WFSA成员支持,此标准适用于世界各地的麻醉工作者,旨在为麻醉工作者、专业组织、医院、机构管理者和政府提供指导和帮助,以维持和提高麻醉安全和质量。此标准涵盖专业内容、设施设备、用药及静脉输液、监测和麻醉实施等方面。高度推荐标准与强制标准作用等同,包括(但不仅限于):训练有素的、警惕的麻醉工作者持续在场,通过临床观察及脉搏血氧饱和度持续监测组织氧合及灌注;间断监测血压;通过听诊和二氧化碳检测确认气管内插管(如果有)的正确位置;应用WHO手术安全核查单;麻醉结束时完善交接系统。此国际标准仅为最低标准,而我们的目标是以所能达到的最高标准来实施麻醉,所以实际标准最好超过本文所介绍的标准。
