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  1. Article ; Online: Relationship between gut-specific autonomic testing and bowel dysfunction in spinal cord injury patients.

    Emmanuel, A V / Chung, E A L / Kamm, M A / Middleton, F

    Spinal cord

    2009  Volume 47, Issue 8, Page(s) 623–627

    Abstract: Study design: Investigation of bowel function in 55 patients and 26 healthy volunteers using radiological, anorectal physiological and laser Doppler blood flow monitoring.: Objectives: Bowel dysfunction is common after spinal cord injury (SCI). We ... ...

    Abstract Study design: Investigation of bowel function in 55 patients and 26 healthy volunteers using radiological, anorectal physiological and laser Doppler blood flow monitoring.
    Objectives: Bowel dysfunction is common after spinal cord injury (SCI). We aimed to determine whether hindgut testing of autonomic innervation provides insight into presence of symptoms, altered motor function (transit) and level of injury.
    Setting: St Mark's Hospital, UK and The Spinal Injuries Unit, Royal National Orthopaedic Hospital, UK.
    Methods: A total of 55 patients with chronic complete SCI and 26 healthy volunteers were studied. Twenty-four patients had lesions above T5 and 31 had lesions below T5. Thirty-five patients complained of constipation: 75% (18/24) of patients with lesions above T5 and 55% (17/31) of those with lesions below T5. Gut transit, rectal electrosensitivity and rectal blood flow were measured.
    Results: Slow gut transit occurred in 65% of patients and in all the 35 patients complaining of constipation. Delay was pancolonic. All patients had an elevated sensory threshold. The threshold was significantly higher in those with subjective constipation (P<0.01), slow transit (P<0.04) and high SCI (P=0.046). Mucosal blood flow was lower in SCI patients with constipation (P<0.04) and slow transit (P<0.03). It was higher than normal in high-SCI volunteers (P=0.056), reflecting loss of sympathetic inhibition.
    Conclusions: In SCI, subjective constipation correlates closely with slow gut transit. Delay is pancolonic, regardless of the site of lesion. Sensory testing provides evidence for completeness of lesion, offering further evidence for pain transmission through sympathetic pathways. Studies in SCI patients provide further evidence of mucosal blood flow as a marker of altered autonomic innervation.
    MeSH term(s) Adult ; Autonomic Nervous System/physiopathology ; Constipation/etiology ; Constipation/physiopathology ; Female ; Gastrointestinal Transit/physiology ; Humans ; Intestinal Diseases/etiology ; Intestinal Diseases/physiopathology ; Intestine, Large/blood supply ; Intestine, Large/physiopathology ; Laser-Doppler Flowmetry ; Male ; Manometry ; Middle Aged ; Pain Threshold ; Spinal Cord Injuries/complications ; Spinal Cord Injuries/physiopathology ; Young Adult
    Language English
    Publishing date 2009-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 1316161-1
    ISSN 1476-5624 ; 1362-4393
    ISSN (online) 1476-5624
    ISSN 1362-4393
    DOI 10.1038/sc.2009.14
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Autonomic dysreflexia: a medical emergency.

    Bycroft, J / Shergill, I S / Chung, E A L / Choong, E A L / Arya, N / Shah, P J R

    Postgraduate medical journal

    2005  Volume 81, Issue 954, Page(s) 232–235

    Abstract: Autonomic dysreflexia is an important clinical diagnosis that requires prompt treatment to avoid devastating complications. The condition may present itself to all members of medical and surgical specialties, who may not be accustomed to treating it. It ... ...

    Abstract Autonomic dysreflexia is an important clinical diagnosis that requires prompt treatment to avoid devastating complications. The condition may present itself to all members of medical and surgical specialties, who may not be accustomed to treating it. It is the clinician's responsibility to have a basic understanding of the pathophysiology of the condition and the simple steps required to treat it.
    MeSH term(s) Acute Disease ; Autonomic Dysreflexia/diagnosis ; Autonomic Dysreflexia/etiology ; Autonomic Dysreflexia/therapy ; Emergencies ; Emergency Treatment ; Humans
    Language English
    Publishing date 2005-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1136/pgmj.2004.024463
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Imported tertian malaria resistant to primaquine.

    Na, D J / Han, J D / Cha, D Y / Song, I K / Choi, H W / Chung, E A / Park, C W / Choi, J S

    The Korean journal of internal medicine

    1999  Volume 14, Issue 2, Page(s) 86–89

    Abstract: In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant. The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection. To prevent relapses, ...

    Abstract In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant. The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection. To prevent relapses, a course of primaquine may be given as terminal prophylaxis to patients. Different strains of Plasmodium vivax vary in their sensitivity to primaquine and, recently, cases of relapse of Plasmodium vivax after this standard primaquine therapy were reported from various countries. We reported a case of primaquine resistant malaria which initially was thought to be relapsed caused by loss of terminal prophylaxis.
    MeSH term(s) Animals ; Antimalarials/therapeutic use ; Chloroquine/therapeutic use ; Drug Resistance ; Humans ; Malaria, Vivax/drug therapy ; Malaria, Vivax/parasitology ; Male ; Middle Aged ; Plasmodium vivax/drug effects ; Plasmodium vivax/growth & development ; Primaquine/therapeutic use ; Recurrence
    Chemical Substances Antimalarials ; Chloroquine (886U3H6UFF) ; Primaquine (MVR3634GX1)
    Language English
    Publishing date 1999-04-19
    Publishing country Korea (South)
    Document type Case Reports ; Journal Article
    ZDB-ID 639023-7
    ISSN 1226-3303
    ISSN 1226-3303
    DOI 10.3904/kjim.1999.14.2.86
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  4. Article ; Online: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection

    Nepogodiev D. / Bhangu A. / Glasbey J.C. / Li E. / Omar O.M. / Simoes J.F. / Abbott T.E. / Alser O. / Arnaud A.P. / Bankhead-Kendall B.K. / Breen K.A. / Cunha M.F. / Davidson G.H. / Di Saverio S. / Gallo G. / Griffiths E.A. / Gujjuri R.R. / Hutchinson P.J. / Kaafarani H.M. /
    Lederhuber H. / Loffler M.W. / Mashbari H.N. / Minaya-Bravo A. / Morton D.G. / Moszkowicz D. / Pata F. / Tsoulfas G. / Venn M.L. / Cox D. / Roslani A.C. / Alakaloko F. / de Vries J.-P.P. / Aaraj M.A. / Abbott S.J. / Abdalla M.O. / Abdelaal A.S. / Ademuyiwa A.O. / Aherne T.M. / Ali O.M. / Alkadeeki G.Z. / Almeida A.C. / Alrahawy M.M. / Ambler G.K. / Alameer E. / Andreani S.M. / De Andres-Asenjo B. / Antonanzas L.L. / Aoun S.G. / Ashoush F.M. / Augestad K.M. / Avellana R.B. / Ayeni F.A. / Ayorinde J.O. / Babu B.H. / Baig M.M. / Bajomo O.M. / Baker O.J. / Baker M.P. / Baldwin A.J. / Ban V.S. / Baron R.D. / Barranquero A.G. / Barry C.P. / DI Bartolomeo A. / Bass G.A. / Bath M.F. / Batjer H.H. / Beamish A.J. / Belgaumkar A.P. / Bence M.N. / Benson R.A. / Bernal-Sprekelsen J.C. / Bhama A.R. / Bhavaraju A.V. / Biffl W.L. / Blundell C.M. / Boddy A.P. / Borgstein A.B. / Bosanquet D.C. / Bosch K.D. / Bouhuwaish A.E. / Bozkurt M.A. / Brathwaite C.E. / Brown B.C. / Brown O.D. / Brown A.K. / Buarque I.L. / Bueno-Canones A.D. / Bulugma M.R. / Burke J.R. / Byrne M.H. / Cagigal-Ortega E.P. / Callcut R.A. / DI Candido F. / Canova M.E. / Carlos W.J. / Caruana E.J. / Cato L.D. / Catton A.B. / Ceretti A.P. / Chase T.J. / Chiara F.D. / Chowdhury A.H. / Chung E.A. / Cicerchia P.M. / Clough E.C. / Coleman N.L. / Collins C.G. / Collins M.L. / Colonna E.T. / Comini L.V. / Coughlin P.A. / Cruzado L.F.-G. / Davidson B.R. / Davies R.J. / Davies E.J. / Davis N.F. / Dawson B.E. / Dean B.J. / Delgado M.G.-C. / Diaz J.J. / Dickson K.E. / Diez-Alonso M.M. / Dixon J.R. / Doe M.J. / Drake T.D. / Drake F.T. / Duffy J.P. / Dunne D.F. / Dunne N.J. / Duran-Munoz-Cruzado V.M. / Durst A.Z. / Eardley N.J. / Edwards J.G. / Elfallal A.H. / Elfiky M.M. / Elliott J.A. / Emile S.H. / Emslie K.M. / Endorf F.W. / Engel J.L. / Enjuto D.T. / Etchill E.W. / Evans J.P. / Fahey B.A. / Faria C.S. / Feo C.V. / Ferguson H.J. / Fernandez B.D. / Fernandez A.G. / Fernandez A.J. / Fernandez-Pacheco B.C. / Fitzgerald J.E. / Fonsi G.B. / Font R.F. / Fowler A.L. / Fretwell K.R. / Fructuoso L.S. / Fusai G.K. / Garcia M.H. / Garcia-Urena M.A. / Gill C.K. / Gisbertz S.S. / Del Giudice R. / Giuffrida M.C. / Di Giuseppe M. / Gomez M.F. / Guariglia C.A. / Hainsworth A.J. / Hall B.J. / Hall J.R. / Hammond J.S. / Haqqani M.H. / Harrison E.M. / Hazelton J.P. / van Heinsbergen M. / Hill A.D. / Hing C.B. / Hirji S.A. / Ho M.W. / Holbrook C.M. / Holme T.J. / Hopkins J.C. / Hopkinson D.N. / Hossain F.S. / Hudson V.E. / Hughes J.L. / Hwang E.S. / Ibrahim M.A. / Isolani S.M. / Jenkinson M.D. / Jenny H.E. / Jeyaretna D.S. / Jones R.P. / Jones A.P. / Jonker P.K. / Jonsson M.L. / Joyce D.P. / Kalkwarf K.J. / Kamarajah S.K. / El Kassas M. / Kavanagh D.O. / Keatley J.M. / Khalefa M.A. / Khan J.S. / Kirmani B.H. / Kisiel A.P. / Kouris S.M. / Kowal M.R. / Labib P.L. / Larkin J.O. / Lauscher J.C. / Leclercq W.K. / Ledesma F.S. / Leite-Moreira A.M. / Leung E.Y. / Lewis S.E. / Lima M.J. / Lin D.J. / Liu H.H. / Lowery A.J. / 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G.S. / Mateo-Sierra O. / Martinez-Perez C. / Serrano Gonzalez J. / Hernandez Bartolome M.A. / Diaz Perez D. / Gutierrez Samaniego M. / Galindo Jara P. / Sharma N. / Smart N.J. / Keller D.S.

    an international cohort study

    2020  

    Abstract: Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and ... ...

    Abstract Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p<0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p<0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p<0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
    Keywords Adult ; Aged ; Betacoronavirus ; Coronavirus Infections ; Elective Surgical Procedures ; Emergency Medical Services ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia ; Viral ; Postoperative Complications ; Respiratory Tract Diseases ; Retrospective Studies ; Surgical Procedures ; Operative ; Young Adult ; covid19
    Subject code 610 ; 616
    Language English
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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