Therapeutic Characteristics Of Patients Research Articles

Penile Cancer in the Region of Thies: Epidemiological, Diagnostic and Therapeutic Aspects

Aim This study aimed to determine the epidemiological, clinical, histopathological, and therapeutic characteristics of patients with penile cancer in hospitals in the Thiès region. Patients and Methods We conducted a retrospective descriptive study collecting all cases of penile cancer in the different urology departments in the Thies region from January 1st, 2015, to December 31st, 2020. Results We recorded 14 cases of penile cancer during the study period. The average age of the patients was 42.93-years (range: 26 to 82-years). The average consultation time was 18-months. All patients were circumcised during childhood. The circumstances of discovery were penile pain (64.3%), ulceration of the penis (26.6%), and hematuria (14.3%). Squamous cell carcinoma was found in 100% of patients. The cancer was locally advanced or metastatic in 64.3% of cases. Partial amputation of the penis was carried out in 50% of patients, and total amputation of the penis was carried out in 42.85% of patients. One patient refused a total penile amputation. After a 6-month follow-up, 35.7% of patients had died. Conclusion The presentation of penile cancers is often late in the Thiès region. Improving the technical platform will make it possible to better manage these cancers.

Caracterización de pacientes con retinoblastoma en un centro de referencia de la costa norte de Colombia

Purpose: The purpose of the following study was to describe the sociodemographic, clini-cal, and therapeutic characteristics of patients with retinoblastoma (RB), the most common intraocular tumor in children, receiving medical care in an eyecare institution in the Carib-bean region of Colombia.Methods: A case series between 2016 and 2021 was carried out. Eyes of patients with RB, receiving medical care in a single health care institution, and in compliance with the esta-blished follow-up protocol, were included. Descriptive analyzes of relevant variables were performed.99Characterization of Retinoblastoma Patients in a Referral Center on the Colombian North CoastAna María Álvarez Castillo, Cesar Atencia Niño,Diana Cifuentes Zapata, Katia Gutiérrez Brun,Jaime Moreno Chaparro, Javier Antonio Amaya Nieto, Javier Vásquez RamírezVol. 40(1), 2024, 97-108Barranquilla (Col.) Results: In this study, a totalof 21 eyes of 16 patients were examined. The average age at the time of diagnosis was 17.7 months, and 50% of children were male. Using the Interna-tional Classification for Intraocular Retinoblastoma, 42.9% of the total cases were classi-fied as group D. Out of the 21 cases, 71.4% went into total remission without the necessity for enucleation, and the most common treatment was chemotherapy, using Melphalan® via intraarterial or intravitreal administration.Conclusion: Specific findings of patients with RB in the Caribbean Coast of Colombia were identified. These findings imply that, despite the obstacles to healthcare access, an early diagnosis and a treatment plan using intraarterial chemotherapy may provide a satisfac-tory clinical outcome (remission).

Autoimmune Diseases and Low Baseline IgE in Chronic Spontaneous Urticaria: A Clinical and Therapeutic Prospective Analysis in Real-Life Clinical Practice

Autoimmunity contributes to the pathogenesis of chronic spontaneous urticaria (CSU). The subtyping of CSU has revealed an autoimmune form of CSU. Despite autoimmune diseases having been associated with CSU, there are few prospective studies that have evaluated the characteristics and biomarkers of patients with CSU and autoimmune disease in a real-life practice setting. To evaluate the presence of specific biomarkers for the presence of autoimmune disease in CSU and to analyze the clinical and therapeutic features of patients with CSU and autoimmune disease. The clinical, laboratory, and therapeutic features of patients with CSU at a tertiary-level center were prospectively collected. Data obtained were compared in function of the presence/absence of autoimmune disease and typified according to IgE levels. Patients with CSU who had associated autoimmune disease corresponded to middle-aged women with a common pattern of blood test findings: both low baseline IgE and high-affinity receptor of IgE expression, basopenia, eosinopenia, higher baseline erythrocyte sedimentation rate and D-dimer, increased presence of antinuclear antibodies, IgG against thyroid peroxidase, and positive autologous serum skin test result. Total baseline IgE less than or equal to 43.8 IU/mL was both the optimal cutoff to predict autoimmune disease in the CSU cohort and a significant risk factor for the presence of autoimmune disease in the regression analysis. In real-life clinical practice, characteristics of patients with CSU and autoimmune disease share common features with type IIb autoimmune CSU. Total baseline IgE less than or equal to 43.8 IU/mL has been detected as a possible biomarker of autoimmune disease in patients with CSU.

Development and validation of prognostic nomogram for patients with metastatic gastric adenocarcinoma based on the SEER database.

The aim of this study was to investigate the prognostic factors affecting overall survival in patients with metastatic gastric adenocarcinoma and to establish a nomogram prediction model for comprehensive clinical application. Data from 2370 patients with metastatic gastric adenocarcinoma between 2010 and 2017 were retrieved from the surveillance, epidemiology, and end results database. They were randomly divided into a training set (70%) and a validation set (30%), univariate and multivariate Cox proportional hazards regressions were used to screen important variables that may affect overall survival and to establish the nomogram. The nomogram model was evaluated using a receiver operating characteristic curve, calibration plot, and decision curve analysis. Internal validation was performed to test the accuracy and validity of the nomogram. Univariate and multivariate Cox regression analyses revealed that, age, primary site, grade, and American joint committee on cancer. T, bone metastasis, liver metastasis, lung metastasis, tumor Size, and chemotherapy were identified as independent prognostic factors for overall survival and were included in the prognostic model to construct a nomogram. The prognostic nomogram showed good overall survival risk stratification ability for the area under the curve, calibration plots, and decision curve analysis in both the training and validation sets. Kaplan-Meier curves further showed that patients in the low-risk group had better overall survival. This study synthesizes the clinical, pathological, therapeutic characteristics of patients with metastatic gastric adenocarcinoma, establishes a clinically effective prognostic model, and that can help clinicians to better evaluate the patient's condition and provide accurate treatment.

The length of hospital stays and clinical and therapeutic characteristics of patients with COVID-19 early in the pandemic in Taif City, KSA: A retrospective study

The coronavirus disease-2019 (COVID-19) pandemic is unprecedented in the healthcare sector worldwide. This retrospective study focused on the length of hospital stay and clinical and therapeutic characteristics of patients with COVID-19. Retrospective data of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) positive patients were collected between March 12 and June 30, 2020, and categorized into mild, moderate, and severe disease groups based on symptoms and severity of COVID-19. A total of 843 SARS-COV-2-positive patients were identified in this study (mildly symptomatic, 132; moderately symptomatic, 168; severely symptomatic, 17). The mean lengths (days) of hospital stay of Groups 1 to 8 were 16.38, 13.18, 13.72, 9.30, 6.96, 10.86, 5.77, and 7.37, respectively. Treatment Group 1 had the highest mean. In the treatment group, 7 patients who were not treated had the shortest stay. The patients with heart failure and Group 1 received antiviral, antimalarial, and antibiotic therapy; patients in Group 3 received antimalarial and antibiotic therapy; patients in Group 4 received antiviral and antibiotic therapy were tended to have a longer hospital stay. The length of hospital stay and clinical and therapeutic characteristics are crucial indicators of pandemic management, a shorter hospital stay is a positive outcome of better COVID-19 management.

Caracterización clínica y terapéutica de una cohorte multicéntrica de pacientes con enfermedad inflamatoria intestinal en Colombia

IntroductionIn Latin America and Colombia there are few studies about the clinical and therapeutic characteristics of patients with inflammatory bowel disease (IBD). The objective of this study is to obtain an approximation to these data from a sample of patients from different reference centres in Colombia. Patients and methodsCross-sectional study in adult and paediatric patients, with IBD, attended ambulatory in 6 institutions in different cities, between 2017 and 2020 information was collected on different dates, about demographic, clinical, and therapeutic aspects. ResultsSix hundred and five subjects, 565 (93.4%) adults, mean age 43 years (SD 12.78), 64% with ulcerative colitis (UC). The age at diagnosis of UC was 41.9 years, while in Crohn's disease (CD) it was 47.9 years. In UC, there was greater left involvement (47.2%), and in CD, 42.8% ileocolonic (L3). More than 50% were in mild activity or clinical remission. In UC, the biologic requirement was 27.2%, while in CD, 78%. Overall hospitalisation requirement was 39.5%, and the need for surgery was 37.5% in UC and 62.5% in CD. Also, 40 pediatric patients, 90% female, with UC being more frequent (80%). In UC, 83.3% presented extensive colitis, and in CD, all with ileocolonic localization (L3). More than 95% were in mild activity or remission. Biologic therapy was required in 16.6% and 75% for UC and CD, respectively. The frequency of hospitalisations and surgery was 2.7%. ConclusionsThis study shows some unique characteristics of patients with IBD in Colombia. An earlier diagnosis is required, with a better therapeutic approach.

Kaposi's sarcoma in people living with HIV/aids in a public referral hospital in Peru.

Kaposi's sarcoma (KS) is the most frequent cancer in people living with HIV. Research on this condition is scarce in the region, therefore, this article aimed to describe the demographic, clinical and therapeutic characteristics of patients with HIV who developed KS at the Cayetano Heredia Hospital between 2000 and 2018. A total of 129 KS cases were identified, with a median age of 33 years, predominantly males with 92% (119/129), and mostly men who have sex with men (MSM). The median time from HIV diagnosis to KS diagnosis was five months, associated with a CD4 lymphocyte count of 64 cells/μL (IQR: 33-185) at KS diagnosis. Cutaneous involvement was the most common presentation; however, at least half also had the visceral form.

PB2062: EPIDEMIOLOGICAL, CLINICAL AND THERAPEUTIC FEATURES OF REFRACTORY HODGKIN’S LYMPHOMA.

Background: Approximately 10 to 15 percent of patients have refractory Hodgkin’s lymphoma (HL) that either does not respond to initial therapy or progresses after an initial partial response. Refractory HL poses a major problem of care, especially since there is currently no consensus regarding second or third line chemotherapy. Aims: The objective of our study is to report the epidemiological, clinical and therapeutic features of patients with refractory HL to first-line chemotherapy. Methods: This is a retrospective study including 32 patients with refractory HL treated during the period from 2015 to 2020. The patients received the first line chemotherapy according to the national MDH 2015 protocol. Results: The median age of our patients was 33 years old (17-64years) with a sex ratio of 0.88. B symptoms at diagnosis were present in 53% of cases. Localized stage (II) and extented stages (III and IV) were observed in 25% and 75%, respectively. Tumor bulky (≥7cm) was present in 34.5% of cases. The International Prognostic Score (IPS) ≥3 was present in 31% of patients. Frontline treatment was ABVD chemotherapy in 4 patients with PR in 3 cases, progression in 1 case and BEACOPP-R chemotherapy in 28 patients with PR in 15 cases, failure in 8 cases and progression in 5 cases. First line salvage therapy was DHAP chemotherapy in 13 patients with CR in 2 patients, PR in 1 patient, failure in 3 patients, progression in 4 patients and toxic death in 3 patients. For patients refractory to DHAP (8patients), 7 patients received the second line salvage therapy which was IGEV in 2 patients with obtaining a PR in 1 patient and progression in the other patient and Bendamustin-Brentuximab (BB) in 5 patients with obtaining a CR in 3 patients and progression in 2 patients. First line salvage therapy was IGEV chemotherapy in 16 patients with CR in 4 patients, PR in 3 patients and progression in 9 patients. For patients refractory to IGEV (12patients), the second line therapy was DHAP with obtaining a CR in 2 patients, toxic death in 4 patients and failure in 4 patients who received (BB) as third line therapy without response. First line salvage therapy was BB chemotherapy in 3 patients with obtaining a CR in 1 patient and death during chemotherapy in 2 patients. For good responders after salvage therapy (11 /32 patients), autologous stem cell transplant (ASCT) was performed only in 3 patients. The 5 years overall survival and relapse free survival were 49% and 18%, respectively. Summary/Conclusion: Our results are much lower than the literature with a mediocre survival of these refractory forms encouraging the introduction of BB as protocol of salvage therapy and the respect of the ACSP in the good responders.

Therapeutic characteristics of patients followed for bipolar disorder with rapid cycles: Study on a Tunisian population

IntroductionBipolar disorder is a frequent and particularly severe psychiatric pathology that causes significant morbidity and mortality. The rapid cycling forms are more severe in terms of their expression, evolutionary course, therapeutic responses and associated comorbidities.ObjectivesThe aim of this study is to conduct a descriptive assessment of therapeutic characteristics in patients with rapid cycling bipolar disorder.MethodsOur work involved a population of 97 patients followed for bipolar disorder diagnosed according to DSM5 criteria, including 37 patients meeting the specification “with rapid cycles”. The patients were divided into two groups: - Group of patients with bipolar disorder with rapid cycles (TBCR) - Group of patients with bipolar disorder without rapid cycling (TBNCR). We compared the therapeutic features among these two groups.ResultsThe dominant polarity was depressive in patients with rapid cycles. They required more mood stabilizers. A greater proportion of them had received treatment with serotonin reuptake inhibitor antidepressants. They were more likely to use hypnotics such as antihistamines and zolpidem.Conclusions Rapid cycling TB is a relatively common clinical modality that should be investigated and identified.The use of antidepressants is associated with this course of the disease. Their utilization in the treatment of bipolar depression must be thoughtful and well studiedDisclosureNo significant relationships.

The clinical, molecular, and therapeutic features of patients with IL10/IL10R deficiency: a systematic review.

Interleukin10 (IL10) and IL10 receptor (IL10R) deficiencies are monogenic inborn errors of immunity (IEI) causing early-onset inflammatory bowel diseases (IBD). In this report, we systematically reviewed articles that included related keywords using PubMed, Web of Science, and Scopus databases. The articles were screened for eligibility criteria before data extraction. We assessed 286 patients (44.5% female) with IL10 and/or IL10R deficiencies who were predominantly from China (40.7%), Italy (13.9%), and South Korea (8.5%). The median age of onset was 1.0 (0.3-4.0) months with a median age of genetic diagnosis at 16.0 (7.4-81.0) months. Consanguinity was reported in all evaluable patients with IL10 deficiency and in 38.2% of patients with IL10R deficiency (22.9% of patients with IL10RA, and 79.4% of patients with IL10RB deficiency). The most prevalent mutations in IL10RA were c.301C>T (p.R101W) and c.537G>A (p.T179T), those in IL10RB were c.139A>G (p.K47E) and c.611G>A (p.W204X). Auto-inflammation and enteropathy were present in all cases. The first presentation of both groups was protracted diarrhea (45.7%), bloody diarrhea (17.8%), and colitis (15.5%). Patients with IL10R deficiency had a high frequency of dermatologic manifestations (50.5%) and failure to thrive (60.5%), while IL10-deficient patients lacked those complications. In the majority of patients, the basic immunologic parameters were in normal ranges. Of the entire publications, 30.7% underwent hemopoietic stem cell transplantation, 57.5% surgery, and 86.6% immunosuppressive treatment. The 10-year survival rate was higher in patients with IL10 deficiency than in patients with IL10R deficiency. In conclusion, IL10/IL10R deficiency predominantly presents with treatment-resistant, early-onset IBD within the first months of life. We detected no clear correlation between the phenotype of patients carrying the same variant. The high prevalence of distinct clinical manifestations reported in IL10RA- and IL10RB-deficient patients might be attributable to the interactions between the target tissue and cytokines other than IL10 capable of binding to IL10RB. These results gain translational significance by contributing to earlier diagnosis, adequate therapy, and avoiding delay in the diagnosis and unfavorable outcomes.

Immunological Evolution of a Cohort of HIV-2 Infected Patients: Peculiarities of an Underestimated Infection.

BackgroundHuman Immunodeficiency Virus type 2 (HIV-2) affects a minority of patients in Italy; nevertheless, the increasing migratory flow from higher prevalence areas led to the spread of this virus into our Country. We evaluate clinical, viro-immunological, and therapeutic characteristics of patients with HIV-2 infection and HIV-1/HIV-2 dual-infection and the early treatment impact on overall survival and incidence of AIDS events.MethodsWe retrospectively analyzed all HIV-2, and HIV-1/HIV-2 positive patients followed in a large Italian clinic from January 1987 to December 2020. We recorded demographic, viro-immunological, clinical, and therapeutic data. We performed a descriptive analysis followed by a longitudinal analysis to explore the factors associated with the CD4+ lymphocyte trend; lastly, we studied the possible predictors of death and AIDS in our cohort in a multivariable model.Results32 subjects were enrolled, 17 (53%) HIV-2 infected and 15 (46.8%) HIV-1/HIV-2 dual-infected; 12 patients were lost to follow up, while 3 died. We found a lack of HIV-2 viremia in 12/32 subjects (37.5%). Most of the patients at baseline had a good viro-immunological profile with HIV-2 RNA <200 copies/ml and CD4+ lymphocyte >200 cell/mcl. We found a CD4+ lymphocyte improvement over time, both in the absolute number (β 472.61, 95%CI 383.05–562.18, p<0.001) and in percentage (β 25.28, 95%CI 21.91 – 28.66, p<0.001). Nevertheless, subjects taking cART had CD4+ lymphocyte percentage increase over time, and this trend appeared significantly better than those who did not receive therapy. Lastly, in the multivariable model CD4+, T-cell count increase was negatively associated with AIDS (HR 0.34 95%CI 0.13–0.91, p=0.032).ConclusionWe found a higher prevalence of HIV-1/2 dual infection than in previous observations. Subjects with HIV-2 infection showed a favorable immunological condition at diagnosis, and the benefits of cART in those who received treatment are undiscussed. Moreover, our data suggest a different disease course based on age at diagnosis, as in HIV-1 infections. We encourage starting cART at diagnosis in HIV-2 patients, regardless of CD4+ lymphocyte, because even in the new cART era, CD4+ lymphocyte decrease remains the strongest predictor of death and AIDS also in this population.

Baseline characteristics of 32 patients with Gaucher disease who were treated with imiglucerase: South African data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry

Background. Gaucher disease (GD) is a rare inherited autosomal recessive metabolic disorder with a prevalence in the general population of ~1 per 100 000. To optimise the recognition, diagnosis and management of patients with GD in South Africa (SA), it is important to have an understanding of local patterns of presentation of the disease. Objectives. To describe the baseline pretreatment characteristics of the SA cohort of patients enrolled into the International Collaborative Gaucher Group (ICGG) Gaucher Registry whowere treated with imiglucerase (Cerezyme; Sanofi Genzyme). Methods. The ICGG Gaucher Registry is an observational, longitudinal, international database that tracks the clinical, demographic, genetic, biochemical and therapeutic characteristics of patients with GD globally, irrespective of disease severity, treatment status or treatment choice. The study population included all SA patients reported in the ICGG Gaucher Registry as of 1 May 2020. Results. The registry included 49 SA GD patients, of whom 32 received imiglucerase as first primary GD therapy. All the patients had GD type 1, 59.4% were female, and mean and median ages at diagnosis were 14.7 and 9.8 years, respectively. The most common genotype was N370S/N370S (37.5%). At treatment initiation, 30.0% of patients had been splenectomised. Among patients for whom data were available, anaemia was present in one-third of non-splenectomised patients and 12.5% of those with splenectomy, and moderate or severe thrombocytopenia was reported in two-thirds of non-splenectomised patients. Bone pain was present in 30.8% and 57.1% of non- splenectomised and splenectomised patients, respectively. No bone crises were reported, and data relating to other bone complications were available for only ≤3 patients. Conclusions. Haematological findings and bone pain in this group are similar to those in the global ICGG Gaucher Registry cohort. Lack of baseline data for other bone complications limits interpretation in that regard. Clinicians who treat patients with GD are encouraged to submit accurate, complete and up-to-date information so that comprehensive data for the subset of SA GD patients can be maintained to improve recognition and diagnosis, and guide appropriate and effective use of treatment for SA patients.

Patient Factors That Influence Reliable Delirium Assessments in a Medical Intensive Care Unit During the Routine Clinical Practice.

This study aimed to determine patient and therapeutic characteristics of patients in the medical intensive care unit (MICU) that contribute to inconsistent results of delirium assessments performed during routine clinical practice. Therefore, electronic health records were reviewed and compared with secondary data collected from the same medical ICU patients who were assessed using the Confusion Assessment Method in the ICU (CAM-ICU). Of 5,241 cases involving 762 patients, 827 (15.78%) cases showed disagreement between assessments. Continuous renal replacement therapy, physical restraint use, and altered mental status were factors that increased the likelihood of inconsistencies between assessments. A significant positive correlation was found between the CAM-ICU disagreement rate and the total number of assessments per month. To maximize the reliability of delirium assessments, individual-targeted approaches considering the patient's level of consciousness and type of treatment implemented are required, along with ensuring a stable, and regulated working environment and customized educational programs.

Profil de consultants dans un service de pédopsychiatrie d’un hôpital général

ObjectivesWe propose to explore the sociodemographic, clinical and therapeutic characteristics of patients who presented to a child and adolescent psychiatric outpatient department. MethodsIt is a retrospective descriptive study focused on patients who consulted at the first time the child and adolescent psychiatric outpatient department of the Mongi Slim Hospital between January and November 2018. We have collected the sociodemographic data of the child and his parents. We specified who accompanied the child the consultation in a child psychiatry consultation, the reason for consultation and the origin of the request for the child psychiatry consultation. The psychiatric diagnoses were retained according to the criteria of the DSM-5. For patients requiring follow-up, the indicated management methods have been specified. After collection, the statistical processing of the data was carried out using SPSS 20.0 software. ResultsWe collected 1013 cases. The children average age was 8 years and 5 months with extremes ranging from 7 months to 19 years. The sex-ratio was estimated at 1.54. In the case of an age of over 11 years, the female sex was predominant with a sex-ratio equal to 0.86; (P < 10−3). The consultants lived in the north of Tunisia in 98.7% of cases, within 94.9% of cases in the north-eastern governorates. The children were the eldest of their siblings in 35% of cases. Children attended primary school in 49.3%. We find that 879 patients were accompanied by one or both parents while five adolescents (four girls and one boy) consulted alone in the service. Among the 1013 patients included in our study, 65.84% (667 patients) were referred to our consultation by doctors. The reasons for consultations were academic difficulties in 23.4%, behavioral problems in 15.1% and language disorders in 11.3% of cases. We did not retain a diagnosis according to DSM-5 criteria for 76 consultants (7.5%), a psychiatric diagnosis was made for 768 patients (75.8%) and a psychiatric diagnosis was suspected, but deferred for 169 consultants (16.7%). Twenty-five of them had an associated organic comorbidity. The psychiatric diagnoses were intellectual disability in 15.69%, depressive disorders in 12.63%, adjustment disorders in 9.47% and autism spectrum disorder in 9.2%. Following the first consultation, we indicated a psychiatric follow-up for 919 consultants (90.7%), among which 635 patients (69.1%) consulted again. Among the 919 patients requiring follow-up, hospitalization in psychiatric hospital was indicated in 11 patients (1.2%). We indicated psychotherapy for 326 patients (35.5%). The psychotherapies indicated were of the type: Listening and support in 280 patients (85.9%), Eye Movement Desensitization And Reprocessing in 23 patients (7.1%), Cognitive and Behavioral Therapy in 21 patients (6.4%) and Narrative Exposure Therapy for Kids in 2 patients (0.6%). One or both parents were referred to an adult psychiatric consultation in 61 cases (6%). An intervention by the child protection representative was requested in 7.6% of cases (70 patients) while an intervention with the school structures attended was necessary for 17.2% of the consultants (158 patients). Medication was necessary in 14.25% of cases. The prescribed therapeutic classes were anxiolytics (23.7%), neuroleptics (16%), psychostimulants (16%) and antidepressants (13%). The most prescribed drugs were Hydroxyzine in 23.7%, Methylphenidate (14.5%), Risperidone (11.4%) and Sertraline (11.4%). ConclusionKnowing the profile of the child psychiatry outpatient will allow us to adapt the training of future doctors and child psychiatrists according to needs and to the specificities of the population.

Age, anamnestic and clinical and therapeutic characteristics of patients with breast malignant neoplasms

Annotation. Results of the analysis of the data of 2173 patients with breast malignant neoplasms treated in the Podillian Regional Oncology Center during 2015-2017 are presented in this article. A detailed analysis of the characteristics of this contingent of patients was carried out with the study of the age structure, classification of breast malignant neoplasms according to ICD-10, the structure of concomitant neoplasms, the stage of the oncological process at the time of detection of the disease, the presence and localization of metastases, the structure of the treatment procedures. The obtained data were processed using the statistical software package SPSS 20.0 for Windows. The age structure of the contingent of patients with breast malignant neoplasms, the structure of localization and stages of the oncological process indicate the extreme urgency of this pathology. Most of the patients of reproductive age (24.67%) require a careful choice of a set of therapeutic procedures and subsequent rehabilitation to preserve reproductive function and working capacity.

P-286 Assessment of the quality of life of patients with colorectal cancer in the Tunisian Center: A report of 142 patients

Colorectal cancer (CRC) is a major health problem in Tunisia. The quality of life (QOL) of patients with CRC is poorly studied in patients with colorectal cancer in Tunisia. We aimed to describe the socio-epidemiological, anatomoclinical and therapeutic characteristics of patients with CRC, to assess the QOL of patients with CRC and to identify the factors that may influence it.

Characterestics of Chronic Heart Failure (CHF) among hypertensive patients

Hypertension is the most common cause for developing chronic heart failure. However, few studies have investigated the consequences of hypertension among patients followed for chronic heart failure. The aim of our study is to investigate the epidemiological, clinical, paraclinical and therapeutic features of patients followed for Chronic Heart Failure and hypertension by comparing them to non-hypertensive patients. Within the sample studied, 358 patients (17.9%) had a balanced hypertension, and 444 patients (22.2%) had an unbalanced hypertension. The mean age was higher in the hypertensive group 84 ± 2 years vs. 53 years with a male predominance in both groups. The etiology of HF (Heart Failure) in the hypentensive and non-hypertensive groups was respectively: ischemic heart disease (51.1% vs. 65.8), valvular disease (29% vs. 19.8%), toxic (2.1% vs. 2.2), idiopathic (6.4% vs. 9.5%) and others (11,4% vs. 2.6%). Clinically, the study has shown that the hypertensive group was less supportive than non-hypertensive. The alteration in diastolic function in echocardiography was more frequent in the hypertension group (25.1%) vs. non- hypertension group (18.4%). The proportion of the AF in the hypertensive and non hypertensive groups was respectively 11.9% and 10%. Blood pressure did not influence the risk of re-hospitalization (16.5% in the hypertensive group vs. 18.2% in the non- hypertensive group). Hypertension is more associated with supraventricular rhythm disorders, renal failure and diastolic LV dysfunction but has no influence on the occurrence of cardiac decompensation and hospitalization in our contexte.

Factors related to the dangerousness of psychiatric inpatients

IntroductionMental illness may explain some acting outs, but it does not necessarily lead to a dangerous attitude.ObjectivesDescribe the socio-demographic, clinical and therapeutic characteristics of patients considered dangerous and to identify the determinants of psychiatric dangerousness.MethodsWe carried out a descriptive and analytical cross-sectional study during six months including patients hospitalized in the psychiatric department at the University Hospital of Mahdia. The data was collected using a 47-item pre-established questionnaire. The assessment of general psychopathology was carried out using the Brief Psychiatric Rating Scale (BPRS) and that of dangerousness using the Historical Clinical Risk-20 scale (HCR-20).ResultsWe have collected 143 patients. The average age was 35 years. The majority of patients were single (70.6%). More than half of the population had addictive behaviors (60.1%). Personal psychiatric and criminal histories were present in 81.1% and 11.9% of cases respectively. More than three-quarters of patients (81.8%) were hospitalized without their consent. Hetero-aggressiveness was the main reason for hospitalization (67.8%). The diagnosis was schizophrenia and bipolar disorder type 2 in 21% of cases for each. The evaluation of psychiatric dangerousness by the HCR-20 scale revealed a mean score of 20.6 with an HCR-20 &gt; 20 in 58.7% of cases indicating a high risk of violence. Factors contributing to violent or criminal behavior in psychiatric inpatients were marital status, presence of personal psychiatric history, presence of criminal history and hospitalization modalities.ConclusionsThe results of our study were generally consistent with the data in the literature.

Acute migraine management in the emergency department: experience from a large Spanish tertiary hospital.

To assess the characteristics of the management of patients with migraine who present to the emergency department (ED) with a migraine attack. Retrospective, observational study analyzing demographic, clinical, diagnostic and therapeutic characteristics of patients with migraine diagnosis presenting to ED for a migraine attack between 2016 and 2019. We reviewed the clinical records of 847 cases. 82.2% were women with mean age of 34.9years. 87.2% had episodic migraine and 12.2% chronic migraine. 62.3% (528/847) had taken analgesics before visiting the ED [non-steroidal-anti-inflammatory drugs (NSAIDs) (300/528; 56.9%) and triptans (261/528; 49.5%)]. 25.4% (215/847) received blood testing and 6.4% (55/847) received cranial CT. Medication was administered in 77.2% cases (654/847). The median time-to-treatment was 70min (IQR 42-120). NSAIDs (81%, 530/654), antiemetics (43.1%, 282/654) and metamizole (39% 255/654) were the most used. Triptans were administered in 7 cases (1.1%) and opioids in 84 (12.8%). At discharge, preventive treatment was prescribed or modified in 8.2% of cases (69/839) and triptans were prescribed in 129 cases (15.3%). 70.5% (592/839) were instructed to follow-up with their primary care provider (PCP), 21.5% (181/839) with a general neurologist and 7.9% (66/839) with a headache specialist. The majority of migraine patients were not receiving the recommended acute migraine-specific medication, both in the outpatient and in the ED setting, being especially remarkable the rare use of triptans in the ED. Furthermore, we found an elevated use of urgent complementary tests, mainly blood tests.

Necrotizing Soft-Tissue Infection and Necrotizing Fasciitis in Adults of a Single Center: Review, Current Concepts and Challenges

Background: The aim of this work is to assess the clinical and therapeutic characteristics of patients treated for necrotizing soft-tissue infection/necrotizing fasciitis (NSTI/NF) and determine their outcomes. Patients and Methods: During the period 1/2012-12/2019 24 adults (18 males, 6 females, aged 33-91 years/mean age 52.4 years) with NSTI/NF were treated. Comorbidities were encountered in 20 (83.3%). Eighteen patients (Group I) presented late, with gangrene and systemic inflammatory response syndrome (9) or septic shock/ organ dysfunction (9). Six patients (Group II) presented early, with local pain, fever, and erythema. Affected areas included perineum-scrotum- external genitalia- abdominal wall or thigh, extremities-trunk, and gluteofemoral area in Group I, and scrotum, extremities, and labium majus in Group II. Results: Intensive resuscitation and antibiotics were started immediately. All patients had a CT scan and underwent surgery within 4 hours from admission. All necrotic soft tissues were aggressively excised. Additionally, patients underwent Hartmann’s colectomy (3) or colostomy (3), thoracostomy (1), opening of compartments of extremities (2), and extrapelvic drainage (1).Wounds were packed open; specimens were sent for Gram stain/cultures and histology. From Group I, 14 remained intubated for 2-10 days, and 15 required 1-5 further limited debridements or incisions (mean 2). Histologically, tissue necrosis was confirmed in all patients, NF in 18. Infection was polymicrobial in 20. Antibiotics were modulated based on culture results. Four Group I diabetics with extended perineal NF died due to uncontrolled sepsis (16.66%). Survivors received antibiosis for 10-18 days (mean, 15), were helped with nutritional support, and they had a planned wound closure or reconstruction. Their mean hospitalization was 28 days (range, 12-46). Conclusion: Improving diagnosis of NSTI/NF requires awareness for early recognition and prompt initiation of aggressive treatment, particularly for lesions extended beside perineum. Unfavourable outcome is affected by the delayed or inadequate surgery and the degree of multiple organ dysfunction on admission.