Medicina
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Background and Objectives: Lower extremity amputations (LEAs) represent a significant health problem. The aim of our study was to analyse the type and trends of diabetes-related LEAs in patients hospitalized in one surgical centre in Bucharest between 2018 and 2021. The second aim was to assess the impact of the COVID-19 pandemic on the trends of LEAs. ⋯ There was a statistically significant increase in the rate of major LEAs in the pandemic vs. pre-pandemic period (37% vs. 24.4%, p < 0.001). Conclusions: In our study, the total number of LEAs decreased throughout the analysed period, but there was an increase in the rate of major LEAs in the pandemic vs. pre-pandemic period. Being over 65 years of age, leucocytosis, sepsis at presentation, and diabetic polyneuropathy were important risk factors for the necessity of LEA in complicated diabetes-related foot disease.
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Observational Study
The Impact of Point-of-Care Ultrasound on the Diagnosis and Management of Small Bowel Obstruction in the Emergency Department: A Retrospective Observational Single-Center Study.
Background and Objectives: Small bowel obstruction (SBO) requires prompt diagnosis and management. Due to its advantages, POCUS can be beneficial when assessing SBO. However, it is still doubtful whether POCUS performed by an emergency doctor can prolong the time of patients with SBO in the emergency department (ED). ⋯ Five non-POCUS patients died during hospitalization; none died in the POCUS group, but the difference was not statistically significant (p = 0.063). Conclusions: POCUS significantly reduced time to diagnosis and ED LOS. Further exploration is needed to assess long-term outcomes and the cost-effectiveness of integrating POCUS into ED practice.
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Comparative Study
A Comparative Analysis of Toxicology and Non-Toxicology Care in Intoxicated Patients with Acute Kidney Injury.
Background and Objectives: Intoxicated patients with acute kidney injury (AKI) experience high morbidity and mortality. While prior studies suggest that toxicology care settings improve outcomes, the impact of care settings on patients with AKI remains unclear. This study aimed to compare the outcomes of intoxicated patients with AKI managed in toxicology versus non-toxicology care settings. ⋯ Additionally, hospital stays were consistently longer in the AKI group than in the non-AKI group across all age groups. Conclusions: Hospital length of stay and mortality did not differ significantly between toxicology and non-toxicology care settings for intoxicated patients with AKI. However, both hospital length of stay and mortality were notably higher in patients with AKI compared to those without AKI.
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Clinical Trial
Patient Age Predicts Nasal Septal Deviation in Orthognathic Surgery: A Non-Randomized Clinical Trial of 102 Participants.
Background and Objectives: Orthognathic surgery is used to restore a correct anatomical and functional relationship between the jaws, with postoperative nasal septal deviation (NSD) being a common complication of Le Fort I osteotomy (LF-IO). The aim of this study was to evaluate the occurrence of NSD after LF-IO and to identify possible risk factors. Materials and Methods: Pre- and postoperative cone beam computed tomography (CBCT) scans from 2018 to 2023 of 102 patients after LF-IO were analyzed. ⋯ Gender, cranial and caudal movements of the maxilla had no influence on the results of the NSDs. Conclusions: LF-IO has an influence on NSD and can both intensify and attenuate it. In addition, the risk of an increase in nasal deviation after this surgical procedure rises with the patient's age and decreases with anterior displacement of the maxilla.
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Case Reports
Return to Performance of a Soccer Player with an Adductor Longus Injury: A Case Report.
Context: There is limited information on the quantification of external load and reconditioning programs during adductor longus injuries in soccer. Case Presentation: This case report describes a male professional soccer player (LaLiga) returning to performance following an adductor longus muscle injury during the 2022/2023 season. The player suffered the injury during a change of direction in a match. ⋯ Therefore, objective performance criteria for making return-to-play decisions based on the use of GPS was determined. In addition, the return to play (RTP) was on the 20th day after the injury, and then four RTPs were recorded in the following 6 weeks after the injury occurred, without re-injury. Conclusions: The approach to the competition performance profile, through the quantification of the external load during the rehabilitation process of the injured player, allowed us a safe return to competition and continued competition with a 6-week follow-up.