Dissimilar impact of type 2 diabetes on cardiovascular outcomes according to age categories: a nationwide population study from Hungary

BACKGROUND: The excess risks of mortality and cardiovascular morbidity among patients with type 2 diabetes mellitus (T2DM) is well known. In this nationwide study, we assessed risks of mortality and cardiovascular events comparing patients with T2DM and matched controls. METHODS: We identified patients with T2DM in a retrospective cohort study using the database of the National Health Insurance Fund between 1 January 2010 and 31 December, 2013. Controls were randomly included and matched according to age, gender, and zip code of residence. Patients were divided into subgroups according to age decades for outcome analyses. RESULTS: During the mean follow-up period of 2.3 years, 152,678 patients with T2DM and 305,356 matched controls were included. Patients with T2DM showed significantly higher risk for all-cause mortality (HR 1.26, 95% CI 1.22-1.29, p < 0.0001), myocardial infarction (HR 1.81, 95% CI 1.69-1.94, p < 0.0001) and stroke (HR 1.40, 95% CI 1.35-1.46, p < 0.0001) compared to matched controls. The higher risk associated with T2DM for mortality, myocardial infarction and stroke differed significantly between age groups (pinteraction < 0.05 for all outcomes) with significantly higher risk observed in younger patients. CONCLUSIONS: The risk of cardiovascular outcomes and all-cause mortality is significantly higher in patients with T2DM. Notably, the relative hazard increases with decreasing age suggesting that younger patients with T2DM should receive more attention for cardiovascular prevention

A requiem for silicone ?

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Décollement cutané traumatique étendu des membres inférieurs

Four cases of extensive traumatic skin avulsion of the lower limb were treated. The fundamental principle of treatment is the resection of all avulsed skin, even if it appears viable shortly after the accident. Covering of the wound must be assured by thin or thick skin grafts, immediate or delayed, according to the case.SCOPUS: NotDefined.jSCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

LA STENOSE HYPERTROPHIQUE DU PYLORE. UNE REVUE DE 236 CAS (1965-1976)

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SOINS URGENTS AUX ENFANTS BRULES

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TRAITEMENT CHIRURGICAL DES BRULURES PROFONDES CHEZ L'ENFANT

The clinical material is described and the principles of burn wound treatment are indicated: excision and grafting of third degree burns (early whenever possible, delayed if the diagnosis or the limits are difficult to appreciate); local treatment with Silver-Sulfadiazine of second degree burns, and those of undetermined depth. The difficulty of diagnosing the exact depth of the burn as well as the problem of the sequelae are stressed. The treatment of the complications is mentioned, particularly of the large hypertrophic scars. More than ever, prevention seems to be essential, but also possible.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

LES URGENCES DU TRACTUS DIGESTIF DU NOUVEAU-NE ET DU NOURRISSON

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PROPHYLAXIE ANTI-INFECTIEUSE DES BRULURES CHEZ L'ENFANT

Analysis of 300 consecutive hospitalized children with burns. To prevent infection, patients are given a bath with chlorhexidine (0.03%) every day and their burns covered by silver sulfadiazine (1%) and occlusive dressings. In 5.3% of the children positive swabs were obtained during hospitalization and in only 2.3% on several occasions. No case of septicemia could be documented.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

Conservative treatment of 725 burned children hospitalized in 10 years

Seven hundred and twenty-five children were hospitalized in the paediatric burn unit of Brugmann University Hospital during the past 10 years. The majority of the patients were under 5 years of age and presented with scalds on less than 10 per cent of the body surface area. As burn depth was difficult to assess on admission, a conservative form of treatment was performed including a daily bath containing chlorhexidine and silver sulphadiazine dressings. Contamination of the wounds was observed in 80 per cent of the larger than 20 per cent surface burns but only 18 cases (2·4 per cent) of the series needed administration of systemic antibiotics for repeated contamination. No lethal septicaemia was observed. Mean inpatient time ranged between 16 days for ungrafted patients to 69 days for over 20 per cent surface grafted patients. The lower iatrogenic risks (anaesthesia and donor site morbidity) seemed important enough to justify conservative treatment in children despite a slightly longer hospitalization time. © 1986.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Simultaneous laparotomy and intraoperative endoscopy for the treatment of high jejunal membranous stenosis in a 1–year–old boy

A 1-year-old boy with high jejunal membranous stenosis was successfully treated “a minima” by antimesenteric longitudinal enterotomy over the diaphragm, excision of the latter, and transverse closure of the bowel. This was made possible by use of simultaneous peroperative endoscopy, which allowed exact localization of the diaphragm. Peroperative endoscopy is a useful and accurate method for this purpose and should be considered in similar cases. © 1993 Raven Press, Ltd. New York.SCOPUS: ar.jinfo:eu-repo/semantics/publishe