Is it possible to predict mortality in patients with high-grade blunt liver injury? A single trauma center study

BACKGROUND

Blunt abdominal trauma constitutes a significant portion of trauma cases and is often associated with liver injury. Given that high-grade liver injuries remain life-threatening, identifying patients who will likely require more vigilant attention and care is crucial. This study aims to determine the parameters that increase mortality in patients with high-grade liver trauma.

METHODS

This study enrolled 38 patients with Grade III or higher liver injuries, treated by the general surgery department between 2008 and 2023. Eleven patients who died were categorized into Group 1, and 27 survivors were placed in Group 2. We evaluated their respective mechanisms of injury, imaging results, Glasgow Coma Scale scores, Base Excess, Lactate levels, pH, and Injury Severity Score findings. Receiver Operating Characteristics (ROC) analysis was performed for parameters with significant differences, and certain cutoff values were determined.

RESULTS

The grade of liver injury and additional abdominal organ injuries were significantly higher in Group 1 (p<0.05). The difference in extra-abdominal injury sites was statistically insignificant between the groups (p>0.05). Erythrocyte suspension requirements were significantly higher in Group 1 (p<0.05). Average lactate and base deficit values were also significantly higher in Group 1 (p<0.05), while leukocyte counts were significantly lower in Group 1 (p<0.05).

CONCLUSION

Base deficit, hemoglobin (Hb), lactate levels, injury severity, liver injury grade, accompanying abdominal injuries at admission, and erythrocyte suspension demands were found to be associated with increased mortality rates. Certain cutoff values for the aforementioned parameters could be established. However, further data are required to confirm these findings.

The impact of stigmatization of psoriasis, atopic dermatitis and mastocytosis in different areas of life-A qualitative interview study

BACKGROUND

Stereotypes and false assumptions about chronic and visible skin diseases can determine the behaviour towards affected individuals and result in stigmatization or discrimination.

OBJECTIVE

The aim of this study was to analyze the perceived disease-related stigmatization of individuals with psoriasis, atopic dermatitis (AD) or mastocytosis. The study also aims to broaden people-centred knowledge of the effects of stigmatization in different areas of life, namely in everyday life, at work, in sports and in relationships.

METHODS

Qualitative in-depth semi-structured interviews were conducted among individuals with either psoriasis, AD or mastocytosis. Participants were recruited via self-help networks and were asked to express their experience of stigmatization in different areas of life. All interviews were audio recorded, transcribed verbatim and evaluated based on Mayring's content analysis.

RESULTS

In total, 24 individuals aged 19-79 years and living in Germany were included in the study-eight for each disease. Stigmatization was experienced in all three diseases in all mentioned areas of life as well as in interaction with medical professionals. Self-exclusion, negative self-perception and negative behaviour of others were the most frequent experiences with stigmatization.

CONCLUSION

Stigmatization, both internal and external, is an important factor contributing to the mental burden of people with chronic skin diseases. More research is needed to gain deeper insight into stigmatization and its psychological burden in various contexts to enhance people-centred care in chronic skin diseases.

Determination of serological profiles and avidity of specific antibodies in the sera of patients with potential Epstein-Barr virus (EBV) infection

BACKGROUND

Epstein-Barr Virus, frequently referred to as EBV, is a member of the herpesvirus family and one of the most common human viruses. The virus occurs worldwide, and most people become infected with EBV sometime during their lives.

OBJECTIVES

The purpose of this study was to investigate the serological profiles of specific antibodies among the sera of suspected EBV infection patients along with VCA-IgG avidity.

METHODS

A total of 522 patient's sera were sent to The Clinical Microbiology Laboratory for EBV specific antibody detection and were studied by IFA method during a two year period. The serum samples were tested for EBV specific VCA IgG, VCA IgM, EA, EBNA antibodies and VCA IgG aviditity.

RESULTS

Among 33 patients those who had low avidity for VCA IgG, 27 (81.8 %) of them had a serologic profile as follows; positive VCA IgG, negative VCA IgM, negative EA and negative EBNA.

CONCLUSION

While this profile is considered as a primary infection, the frequency of the coexistence of VCA IgG low avidity with this profile is interpreted that avidity may lead to detect primary infection (Tab. 2, Ref. 25)