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A five year analysis of death in accident and emergency room of a semi-urban hospital.

A 5 year retrospective survey of deaths at the Accident and Emergency Unit was carried out to determine the demographic pattern, causes and time spent before demise. There were 475 deaths, annual rate of 95 cases. Males in 279 (58.8%) and 186 females (41.2%), age ranged from 15-90 years, mean 44 SD +/- 21 years. Medical diseases in 354 (74.5%), trauma in 72 (15.2%) and surgical conditions 49 (10.3%) patients There were 135 (38%) cases of cardiovascular diseases and pulmonary diseases 115 (32.6%) patients. Tuberculosis and pneumonia were the most common of pulmonary conditions. Central nervous diseases and gastro-intestinal diseases in 46 (13%) and 40 (11.2) respectively, mainly infectious conditions. Road Traffic Accident caused death in 51 (70.5%), assaults in 8 (11.4%) cases, gunshot and poison 5 (6.8%) each, and snake bites in only 3 (4.5%) cases of trauma. Surgical acute abdomen with peritonitis occurred in 18 (36%) cases, pyomyositis with septicaemia in 7(133%), gastrointestinal bleeding 5 (10%) and burns in only 3 (6.7%) cases In conclusion, over two-thirds of deaths in accident and emergency unit were due to medical problems. The means of the age were in late thirties- mid forties, there was no significant difference in the mean age of those who died of medical, trauma and surgical problems. Trauma victims spent the shortest mean time in accident and emergency before death, the longest staying were the victims of medical diseases.

Adolescent↗

[Therapeutic efficacy of 5-ASA molecules in idiopathic intestinal inflammatory diseases: critical review].

Sulfasalazine has been the most widely prescribed drug for patients with inflammatory bowel disease. Clinical trials have established its usefulness in treating patients with active ulcerative colitis and Crohn colitis and its important role in maintaining remissions in patients with ulcerative colitis. Despite its widespread acceptance, the usefulness of sulfasalazine has been limited by the occurrence of adverse reactions in about 10 to 20% of the patients. Now the aminosalicylates are emerging as a treatment for both ulcerative colitis and Crohn disease. We have critically reviewed the clinical trials assessing the efficacy of 5-ASA molecules. Therapeutic efficacy of 5-ASA appears to be as good as sulfasalazine but causing less adverse effects. In mild to moderate ulcerative colitis relapse, 2g 5-ASA is active while 1 g 5-ASA seems equivalent to 2g sulfasalazine for maintaining remission. 5-ASA enema in the treatment of distal ulcerative colitis is helpful and can replace topical cortisone administration. Administration of 1g 5-ASA enema a day seems to be the best regimen. In case of Crohn's disease, preliminary studies are encouraging but more date are required to define the indications as well as the regimen.

Aminosalicylic Acids↗

[Intestinal inflammatory disease in the province of Soria. Retrospective clinical and epidemiologic study from 1981 to 1990].

The inflammatory bowel disease cases in Soria have been reviewed from 1981 to 1990. Thirty-two cases of ulcerative colitis (UC) and thirteen cases of Crohn's disease (CD) have been found. The mean incidence was 3.2/100.000 inhabitants/year in UC and 1.3/100.000/inhabitants/year in CD. The prevalence was 32 and 13/100.000 inhabitants respectively. We have found a progressive increase in incidence in both UC and CD during the period analyzed. Epidemiologic data (considering the majority come from rural areas), clinical course, endoscopic and radiologic findings, are similar to the results published in the literature. We have found a minor percentage that other authors in extraintestinal signs, complications and need of surgical intervention.

Adolescent↗