Skin cancer in Tunisia: a retrospective study: 1379 cases and risk factors

The aim of this study was to determine the clinical and epidemiological aspects of skin cancer in Tunisia. METHODS: we analysed the clinical files of all cases of skin cancer registrated at the ISA institute between 1975 and 1984. RESULTS: 1379 cases of skin cancer were referred to ISA, representing 9.02% of all cancer cases referred to the institute during the same period. Basal cell carcinoma (CBC) was the most frequent type (57.5%) followed by squamous cell carcinoma (CSC): 32.6% and melanomas: 4%. The sex ratio was 1.7 with a mean age of 61 years in men and 60 years in women. The face was the most frequent involved sites in CBC (92%). This region is usually exposed to the sun. The distribution of CSC in the body was different. The lesions were multiple in 11% of the cases. 13.7% of the CSC were developped on a burn scar. 21 cases were radio-induced and 45 patients had a xeroderma pigmentosum. CONCLUSION: skin cancer is relatively frequent in Tunisia. However, our incidence is inferior to other countries. Sun exposure is the main risk factor.     

再次剖宫产126例临床分析

目的 探讨腹壁纵切口及横切口剖宫产术式对再次剖宫产的影响。方法 选择腹壁纵切口剖宫产术后再次剖宫产产妇68例为A组,腹壁横切口再次剖宫产58例为B组,对两组开腹至胎儿取出时间、手术总时间、腹壁及盆腹腔粘连情况、术中出血量、子宫切口愈合情况进行比较。结果 A组开腹至胎儿取出时间、手术总时间均短于B组,差异有统计学意义(P<0.05);A组腹壁及盆腹腔重度粘连少于B组,差异有统计学意义(P<0.05);两组盆腹腔轻、中度粘连及术中出血量、子宫切口愈合情况差异无统计学意义(P>0.05)。结论 腹壁横切口剖宫产术后粘连较严重,给再次手术增加了难度。对有可能行再次剖宫产的产妇,首次手术选择腹壁纵切口是一种明智的选择。     

新生儿窒息126例临床分析

目的：通过对126例窒息新生儿临床分析,探讨其影响因素及其并发症,为制定新生儿窒息的预防和处理提供科学依据。方法选取2012年1月至2014年12月安康市妇幼保健院产科出生的126例新生儿窒息住院患儿的临床资料进行回顾性分析。结果连续3年新生儿窒息发生率差异均无统计学意义（χ2值分别为0．21、0．23、0．90,均P＞0．05）;新生儿窒息发生围产因素主要为胎儿宫内窘迫、低出生体重儿、羊水污染、早产、胎膜早破,所占比例分别为31．75％、29．36％、22．22％、22．22％、21．43％;新生儿窒息并发症主要包括吸入性肺炎、新生儿缺氧缺血性脑病（ HIE）、黄疸、颅内出血、低钠血症、低钙血症、心肌损害、消化道出血,分别占86．51％、77．77％、68．25％、53．97％、45．24％、31．75％、30．95％、11．11％。结论新生儿窒息关键在于预防,加强产前监测,及时了解有无胎儿宫内窘迫的发生,监测有异常者及时采取有效措施,加强产儿科合作,分娩时实施新法新生儿复苏,在窒息新生儿处理上清理呼吸道是关键,在复苏后处理上早期要维持内环境稳定,减少脑损害及心肌损害。     

Morgagni hernia in elderly patients: a study about two cases

Two cases of retrocostoxiphoid hernia are reported. Both patients were adults. The hernia was strangled in one case and symptomatic in the second case. The diagnosis was confirmed by radiology. Reduction of the visceral hernia and closure of the orifice was carried out after laparotomy. A review of literature and of clinicopathological features are given in the present article. Histogenesis and differential diagnosis are also discussed.     

938例儿童性虐待临床案例的回顾性研究

目的 研究虐待儿童事件的发生条件和发生情况,对被虐待儿童的特征进行临床分析,寻求预防和干预措施.方法 由专业人员运用统一方法、统一数据制表进行研究,并根据判定标准对受虐儿童的一般资料和性虐待状况进行回顾性分析.结果 在938例受性虐待儿童中,女性居多,男女之比为1:311.7;其年龄以6～14岁为主,占受虐待人群的84.2%;性虐待事件常发生于夏季,为发生季节比重的35%;其中,性虐待致死16例,占受虐人数的1.7%.结论 性虐待使小儿身心健康受到严重损害,甚至死亡.应该有针对性的加强健康教育及防范干预措施,以防止儿童性虐待的发生.     

颌面部创伤患者临床98例回顾性研究

目的为了进一步研究颌面部创伤患者的临床特点,从而为相关研究提供借鉴和参考。方法选取该院2010年12月—2012年12月期间收治的颌面部创伤患者98例为研究对象,针对患者的性别分布特点、受伤原因分布特点、创伤部位分布特点进行了回顾性的统计分析。结果①98例颌面部创伤患者中,男性患者66例,所占比例为67.35%;女性患者32例,所占比例为32.65%。男性患者与女性患者的比例为2.06:1;②按照受伤原因分析,排名前三的受伤原因分别是交通事故受伤的患者59例;职业性受伤的患者14例;生活意外性受伤的患者11例;③按照创伤部位分析,排名前三的创伤部位分别是下颌骨骨折的患者32例;颧骨颧弓骨折的患者22例;多发性骨折的患者18例。结论男性人群是颌面部创伤的高发人群,交通事故受伤是导致颌面部创伤的主要原因,患者受伤的创伤部位主要是下颌骨骨折。     

Pericarditis in HIV infected patients: retrospective study of 40 cases in Ouagadougou, Burkina Faso

Incidence of pericarditis has increased in sub-Saharan Africa, because of the HIV infection pandemia. We have done a retrospective study in the cardiology unit of the national hospital of Ouagadougou (Burkina Faso), in order to describe epidemiological, clinical, and therapeutic aspects of pericarditis occurring in HIV infected patients. Inclusion criteria were pericarditis proved by echography, and positive HIV serology. We have included forty patients (28 men and 12 women), mean aged of 34.45 years. General signs were fever (87.5%), and weight loss (70%). Thirty-six patients (90%) were in CDC stage C AIDS classification, three (7.5%) in stage B, and one (2.5%) in stage A. The symptoms described by the patients were dyspnea (92.5%), cough 77.5%), chest pain (65%), liver effort pain (27.5%), and palpitations (20%). Heart failure was present in 80% of the patients who had myocarditis. Pericardial effusion was small in 21%, moderate in 31,6%, and large in 47.4% of the patients. Tamponade occurred in for cases (10%). The etiology was tuberculosis in 75% of cases. Pericardial puncture (done in six patients) showed purulent fluid in two cases. Before hospital discharge, eight patients died, giving a mortality rate of 20%. Symptomatic pericardial involvement is frequently associated with stage C of HIV infection. Myocarditis is often associated (37.5%). Mortality rate is high.     

Treatment of ovarian cysts by laparoscopic surgery: a retrospective study of 40 cases

The ovarian cysts treatment has taken advantage of the improvement made on the operating laparoscopy, that gives progressively better results than those of the laparotomy. On the one hand, laparoscopic surgery reduces the traditional surgery constraints by giving an exact histologic diagnosis and a radical cyst treatment. On the other hand, it prevents against inherent recurrence related to a sample puncture, and en the same time diminish adhesion risks. The laparoscopy can treat all kind of histologic benign ovarian cysts. We report the first experience of the Maternité Universitaire des Orangers in treating ovarian cysts by laparoscopic surgery.     

Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

Background  

While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair.     

新疆126例孕产妇死亡评审结果分析

目的 通过孕产妇死亡评审及时发现和掌握各个环节中存在的问题,提出针对性的干预措施,为降低孕产妇死亡率提供决策依据.方法 对自治区2010年10月至2011年9月死亡的上报材料完整的126例孕产妇死亡材料,根据<新疆维吾尔自治区级孕产妇死亡评审管理办法>规定,采用WHO十二格表评审方法进行评审分析.结果 前5位死因依次为产科出血(34.92%)、妊娠期高血压疾病(27.78%)、妊娠合并心脏病(11.11%)、静脉血栓及肺栓塞症(5.56%)、甲型H1N1流感(3.17%);前5位主要死因构成占全部死亡的82.54%.直接产科原因与间接产科原因之比为1.6:1;可以避免的死亡占92.06%,不可避免的死亡占7.94%.结论 地、县、乡三级医疗保健机构缺乏有产科资质的医护人员,现有人员素质偏低;应进一步加强孕产妇急救绿色通道和急救中心建设,保证急危重症孕产妇的有效转诊;乡镇卫生院硬件设施缺乏,孕产妇产前保健质量低下;重视和发挥健康教育的先导作用,提高妇女自我保护意识;计划外生育对孕产妇死亡影响不可忽视.     

Porokeratosis. A study about 6 cases

BACKGROUND: Porokeratoses (PK) represent a less common group of dermatoses that are acquired or hereditary, of unknown pathogenesis, characterized by keratinization disorder. Different clinical forms have been identified and the most frequent are the Mibelli's porokeratosis (MP) and the Disseminated Superficial Actinic Prokeratosis (DSAP). AIM: In this retrospective study, we analysed the observations of PK collected in the Dermatology Department of La Rabta Hospital over a 16-year period. METHODS: Six cases of PK were collected: 4 females and 2 males, with no medical history with a mean-age of 42.7. RESULTS: Only a female patient had (PK) familial history. All our patients had typical clinical aspects with lesions in annular plaques, of atrophic center, surrounded by keratotic border. The histological aspect was consistent with PK, showing the typical cornoid slide. In our series, there are 3 cases of (MP) and 3 cases of (DSAP). PK lesions usually appear during the childhood and the third and fourth decades for the DSAP. In MP, there is one or some large, unilateral, annular plaques. DSAP is characterized by numerous small annular lesions of the photo-exposed regions. Their prognosis is on the whole, favourable but remains conditioned by malignant transformation. Treatment is difficult aiming at reducing that risk of degeneration.     

高血压社区动态综合管理126例分析

目的 提高社区医院老年高血压的管理.方法 运用基线调查、健康教育培训、回访及评估分析高血压社区动态综合管理模式.结果 采用动态综合管理模式进行管理的老年高血压患者降压效果明显(P＜0.05).结论 动态综合管理方法对社区老年高血压治疗和预防有很大的帮助作用.