19,008 research outputs found
POSSUM scoring system in patients undergoing laparotomy in Mulago Hospital
Background: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction in surgery. The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) was used to score and predict the outcomes of Laparotomy in Mulago Hospital. The main objective of this study was to determine the morbidity and mortality POSSUM scores for patients who underwent Laparotomy in Mulago Hospital, between September 2003 and February 2004.Methodology: Consecutive patients, who underwent a Laparotomy in the three surgical wards in Mulago Hospital, were scored using POSSUM system. For each patient the predicted risk of mortality and morbidity was calculated from POSSUM equation. Multivariate logistic regression analysis was used to determine the relationships between the predicted and observed morbidity and mortality rates. Postoperative complications and mortality within 30days were described.Results: Seventy-six patients were studied. The observed and expected mortality and morbidity rates were 14.5%, 2.6% and 35.4%, 0% respectively. Physiological scores, operative scores, co morbid condition such as Diabetes Mellitus significantly determined the outcomes.Conclusion: POSSUM scoring system can be used to predict the risk of mortality but not morbidity for patients admitted to a surgical ward in Mulago Hospital.Recommendations: The POSSUM scoring system can be used in decision-making process before a Laparotomy is carried out
Cost effective oesophageal intubation
Carcinoma of the oesophagus presents a multitude of challenges of patient care in Africa The majority of patients present with very advanced manifestations of the disease. The treatment options are usually few and limited to palliation. Placement of an endoprosthetic tube is one method which is commonly undertaken and very often provides satisfactory palliation, with restoration of swallowing
Characterising resuscitation promoting factor fluorescent-fusions in mycobacteria
Background Resuscitation promoting factor proteins (Rpfs) are peptidoglycan glycosidases capable of resuscitating dormant mycobacteria, and have been found to play a role in the pathogenesis of tuberculosis. However, the specific roles and localisation of each of the 5 Rpfs in Mycobacterium tuberculosis remain mostly unknown. In this work our aim was to construct fluorescent fusions of M. tuberculosis Rpf proteins as tools to investigate their function. Results We found that Rpf-fusions to the fluorescent protein mCherry are functional and able to promote cell growth under different conditions. However, fusions to Enhanced Green Fluorescent Protein (EGFP) were non-functional in the assays used and none were secreted into the extracellular medium, which suggests Rpfs may be secreted via the Sec pathway. No specific cellular localization was observed for either set of fusions using time-lapse video microscopy. Conclusions We present the validation and testing of five M. tuberculosis Rpfs fused to mCherry, which are functional in resuscitation assays, but do not show any specific cellular localisation under the conditions tested. Our results suggest that Rpfs are likely to be secreted via the Sec pathway. We propose that such mCherry fusions will be useful tools for the further study of Rpf localisation, individual expression, and function. Keywords Rpfs, mycobacteria, tuberculosis, fluorescent fusions, microscopy
Non-extremal Black Hole Microstates: Fuzzballs of Fire or Fuzzballs of Fuzz ?
We construct the first family of microstate geometries of near-extremal black
holes, by placing metastable supertubes inside certain scaling supersymmetric
smooth microstate geometries. These fuzzballs differ from the classical black
hole solution macroscopically at the horizon scale, and for certain probes the
fluctuations between various fuzzballs will be visible as thermal noise far
away from the horizon. We discuss whether these fuzzballs appear to infalling
observers as fuzzballs of fuzz or as fuzzballs of fire. The existence of these
solutions suggests that the singularity of non-extremal black holes is resolved
all the way to the outer horizon and this "backwards in time" singularity
resolution can shed light on the resolution of spacelike cosmological
singularities.Comment: 34 pages, 10 figure
The Nuts and Bolts of Einstein-Maxwell Solutions
We find new non-supersymmetric solutions of five-dimensional ungauged
supergravity coupled to two vector multiplets. The solutions are regular,
horizonless and have the same asymptotic charges as non-extremal charged black
holes. An essential ingredient in our construction is a four-dimensional
Euclidean base which is a solution to Einstein-Maxwell equations. We construct
stationary solutions based on the Euclidean dyonic Reissner-Nordstrom black
hole as well as a six-parameter family with a dyonic Kerr-Newman-NUT base.
These solutions can be viewed as compactifications of eleven-dimensional
supergravity on a six-torus and we discuss their brane interpretation.Comment: 29 pages, 3 figure
The Postoperative Complications Prediction in Mulago Hospital using POSSUM Scoring System
Introduction: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction. The postoperative complications of patients who underwent Laparotomy in Mulago Hospital were studied using POSSUM scoring system. The main objective of this study was to determine the postoperative complications of Laparotomy in Mulago Hospital, between September 2003 and February 2004.Methods: Consecutive patients, who underwent Laparotomy in Mulago, were studied using POSSUM system for development of complications. For each patient operated, they were followed up in wards until discharge. When the postoperative complications were reported, they were reexamined by the surgeons, treated and followed up for 30 days postoperatively. Phone contacts were used for the follow up. Surgical reviews were conducted once a week in Mulago Hospital and the data obtained recorded in the data sheet for the patients.Results: Seventy-six patients were studied. The observed post operative complications were as follows: Respiratory tract infection (28.2%), wound haemmorrhage (18.2%), anaemia (15.5%), hypotension (14.1%), UTI (2.2%), Anastomotic leak (1.4%), Wound sepsis (9.9%), wound dehiscence (4.2%), Thromboembolism (1.4%). The postoperative nursing care significantly determined the outcomes.Conclusion: Postoperative complications can be predicted in the modern management of surgery especially while using a scoring system
A Review on Treatment-Related Brain Changes in Aphasia
Numerous studies have investigated brain changes associated with interventions targeting a range of language problems in patients with aphasia. We strive to integrate the results of these studies to examine (1) whether the focus of the intervention (i.e., phonology, semantics, orthography, syntax, or rhythmic-melodic) determines in which brain regions changes occur; and (2a) whether the most consistent changes occur within the language network or outside, and (2b) whether these are related to individual differences in language outcomes. The results of 32 studies with 204 unique patients were considered. Concerning (1), the location of treatment-related changes does not clearly depend on the type of language processing targeted. However, there is some support that rhythmic-melodic training has more impact on the right hemisphere than linguistic training. Concerning (2), we observed that language recovery is not only associated with changes in traditional language-related structures in the left hemisphere and homolog regions in the right hemisphere, but also with more medial and subcortical changes (e.g., precuneus and basal ganglia). Although it is difficult to draw strong conclusions, because there is a lack of systematic large-scale studies on this topic, this review highlights the need for an integrated approach to investigate how language interventions impact on the brain. Future studies need to focus on larger samples preserving subject-specific information (e.g., lesion effects) to cope with the inherent heterogeneity of stroke-induced aphasia. In addition, recovery-related changes in whole-brain connectivity patterns need more investigation to provide a comprehensive neural account of treatment-related brain plasticity and language recovery
Families of strictly pseudoconvex domains and peak functions
We prove that given a family of strictly pseudoconvex domains varying
in topology on domains, there exists a continuously varying
family of peak functions for all at every $\zeta\in\partial
G_t.
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