Objectives: We had for aim to check the appropriateness of our practices according to French guidelines (17th consensus conference, SPILF 2008) and to identify variables associated with the delay before appropriate measures were implemented.
Methods: Our retrospective observational study (2009-2011) focused on acute bacterial meningitis (ABM) in adults. Data was collected on a standardized questionnaire from medical charts and nurse reports.
Results: We included 31 adults presenting with ABM; 29 (93.5%) received ceftriaxone or cefotaxime in the emergency department. Indications for corticosteroids and brain imaging complied with guidelines in respectively 71.0% and 83.9% of cases. The median delays (IQR) were: admission/lumbar puncture (LP), 2h43 [1h09-5h57]; admission/antimicrobials, 3h21 [1h34-5h11]. The indication of suspected ABM in the admission letter was associated with earlier LP (P=0.01), and was almost significantly associated also with faster initiation of adequate antibiotic therapy (P=0.05).
Conclusions: Suspicion of ABM mentioned in the admission letter was associated to a better management in the emergency department.
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http://dx.doi.org/10.1016/j.medmal.2013.05.009 | DOI Listing |
Cureus
December 2024
Emergency, Royal Victorian Eye and Ear Hospital, Melbourne, AUS.
Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by chronic headaches, cognitive difficulties, reduced quality of life, and rarely irreversible visual loss. Community diagnosis is often challenging due to unfamiliarity with current guidelines and a lack of clinical experience, leading to misdiagnosis and treatment delays, which can negatively impact visual recovery and quality of life. Our study examined the time to diagnosis and investigated the barriers to timely diagnosis in adults with newly diagnosed IIH.
View Article and Find Full Text PDFPlast Surg (Oakv)
February 2025
Department of Surgery, Division of Plastics and Reconstructive Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
There is a lack of previous studies investigating oncoplastic practice trends for breast reconstruction in Canada, particularly from the plastic surgeon perspective. Given the rising popularity of oncoplastic techniques, this study aimed to identify current practice trends for breast and plastic surgeons in Canada. A cross-sectional survey study of breast and plastic surgeons performing oncoplastic surgery across Canada was conducted.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
School of postgraduate, Amoud University, Somalia; Faculty of Science, Charles University, Czechia. Electronic address:
Introduction: Giant inguinoscrotal hernias (GIH), defined as hernias extending below the inner thigh midpoint in a standing position, are rare and often seen in resource-limited settings due to delayed medical care. These hernias pose surgical challenges, particularly in low- and middle-income countries (LMICs), where standardized management protocols are lacking, and risks such as cardiorespiratory compromise are significant.
Case Presentation: A 55-year-old male presented with a large, irreducible right inguinoscrotal hernia of 1.
Adv Skin Wound Care
January 2025
Arbie Sofia P. Merilleno, MD, DPDS, is an Inflammatory Disease Fellow, University of Toronto, Ontario, Canada; Clinical Fellow, Women's College Hospital, Ontario; and Research Fellow, Women's College Research Institute, Ontario. Charlene Marie Ang-Tiu, MD, FPDS, is Medical Specialist, Rizal Medical Center, Pasig City, Philippines.
Pyoderma gangrenosum is a rare ulcerative condition that poses diagnostic and therapeutic challenges. Diagnosis and appropriate management are often delayed due to its rarity and the presence of numerous clinical variants. In this case report, the authors present the case of a 36-year-old man who had long-standing and nonhealing ulcers that did not respond to multiple antibiotics and serial wound debridement.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Faculty of Medicine, University of Zurich, Raemistrasse 71, 8006, Zurich, Switzerland.
Introduction: Pelvic ring fractures are known to be associated with complications associated with adjacent organ injuries, such as the urogenital tract (e.g. erectile dysfunction (ED), which are sometimes diagnosed in a delayed fashion.
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